Centered Approach Essay

Family-Centered Approach ECE 313 Collaboration with Parents & Community Kathleen Thomas October 10, 2011 Instructor Cindy Hopper The economy has hit an all time low and has caused two parent households and single parent households into the workforce. As a result of this the parents are looking for childcare centers for their children. The main concern of these parents is will the centers help with the behavior and development of their children. These parents are looking for a place that is going to help with the development of their children’s self-help skills, empowerment, pro-social skills, self-esteem and attachment. These are behaviors that are not easily controlled and because the children spend the majority of their time in the centers the parents are hoping that together they can help develop desired behavior. That is why they are looking for a center that uses the family-centered approach. As the educator you have to develop a relationship with the children and their parents, the parents have to feel that they are going to be involved in everything that goes on in the center and that concerns their child. The educator has to sit down and learn about the child from the parent so that the educator will know what the parent expects from the educator and the center. The educator has to spend time with the child so that they can start to form a relationship. Family-centered has been defined as: Focus on the children within their families. The program includes the family as an integral, inseparable, part of the children’s education and socialization. Families along with their children are the program. (Gonzalez-Mena) p. . It is very important to acknowledge the children within their families because this way, you remember that you can not do anything without involving both of them. It is important that the educators know what the parents expectations are, Teaching children desired behavior may not be easy even when the educator and the parent are using the same methods. Potty training may require the educator and the parent using the same procedure which might be putting the child on the potty several times a day. If either of them changes the procedure this might cause the child to become confused and it may take longer to train her. To encourage desired behavior from children, parents and teachers need to have a strong relationship with the children. A warm affectionate bond and a positive emotional tone in the home and center will convince the children that their teachers and parents are on the same team and promote a spirit of cooperation and understanding. (Neifert, Marianne, MD) Helping a child develop self-esteem takes a lot of work because you can not do it by saying things that are not realistic. You can not say you are the prettiest girl in the world and think that this will help her self-esteem, as a parent you have to promote self assurances, self-help, competence and being â€Å"special. † Self-esteem rises if the individual is proud to perceive herself as being in possession of these traits. (Gonzalez-Mena) p. 205. Self-esteem has four dimensions: significance, competence, power and virtue. Teaching a child about self-esteem would be difficult because hopefully the child would feel loved and cared for by her parents and she would need to feel that you loved and cared for her too. However, if the child did not feel that she was important this is not something that you can make happen. You can try by showing her that you do care about her and that she is important. You could compliment her when she has achieved a goal that was set for her but you should not over praise her. To promote self-esteem you should never have a critical attitude, label a child or use name calling. Use encouragement instead of always praising them. When they have done something better than the last time make a comparison about how much better it was this time. Never compare your child’s performance to another child’s. Children will fail at some of the things that they try to do but this will be an experience for them. Have realistic expectations; be certain that your expectations for the children’s behavior match their age and developmental abilities. You have to be prepared to show them what it is that you want them to do. Practice the skills with them so that they will be able to do them alone. It is not impossible for a two year old to put on their coats but this two year old might not be ready, you will have to practice this over and over until the child is able to do it themselves. Competence, power and virtue are a part of self-esteem and these things might be easier to teach, being competent means that you have skills that you are very good at. If you were doing these skills on a daily basis you would someday be extremely good at that skill. Power is believing that you are in charge of something other than the paper clips and that you have control over the things that happen in your life. Virtue is being a good person and knowing right from wrong. Educators can take these four dimensions and use them to help a child learn how to feel good about themselves. Teaching pro-social skills you can model the children yourself, you have to set limits and tell them why you are setting the limits. The reason is because you don’t want them to get hurt. Have children work and play together so that they will cooperate better. When children are involved in a conflict it is your responsibility to resolve it with a solving approach. Always avoid punishment as a way of discipline. There are other things that you can do when trying to teach pro-social skills; as an educator you should sincerely acknowledge children’s pro-social behavior by recognizing when they are doing things together (ex: two children have started cleaning up the art area) your response could be â€Å"that is real cooperation†. You should explain reasons for rules and help the children understand the effects of their behavior on others. This type of inductive discipline seems to encourage child to be kind and helpful. (Berman, K. L. , M. M. Torres, C. E. Domitrovich, J. A. An educator can encourage good behavior by using a reward system. Choose a behavior you would like to change. There might be a child in your classroom who will not sit still in his seat; you can tell him that if he sits still that you will reward him for staying in his seat. You can tell him that he has to earn five tokens by staying in his seat when you are teaching the class and that five tokens will get him ice cream at lunchtime. It does not have to be tokens; you might have a chart with everyone’s name on it and at the end of the week if they have receive a star for everyday they will receive extra cookies at snack time. Share your reward system with the parents and see if that helps them out with behavior problems at home.

The Public Needs to Know †Revised Version Essay

Our program against domestic violence provides a safe shelter for victims and their families within our community. In order to support a broad range of issues and diverse group of victims, our program has many services available to ensure the safety of everyone involved. Staying at our shelter is usually the first step towards a normal life for a family that has a history of domestic violence. It is our goal to apply all areas of our expertise to ensure the safety and rehabilitation of every family that reaches out to us for help. Shelters have been proven to be a way out for victims who are generally in a more violent situation than victims that would use other services while still staying at their home (Itzhaky & Ben Porat, 2005). Our program is comprised of many services to provide the greatest amount of help to the victim. Though not every victim or family will need a physical shelter to stay, ensuring that we always have a safe place for victims to stay at is always our primary concern. For the duration of their stay, the victim will work closely with our professional staff to assist with fixing or finding the safest way out of the victim’s relationship. Residents of the shelter follow a plan established by our councilors that has been tailored specifically for each victim. We provide basic necessities that would be needed for day-to-day life at no charge. We can also provide a means for the victim to apply for food stamps since in most situations, the aggressor has the only form of income for a family. Our shelter has a state-of-the-art alarm system, which will give the victim a peace of mind that their aggressor will not be able to come after them under our care. Although it is not to be used as a replacement for 9-1-1, we offer a crisis line for individuals that feel the need to speak to a counselor right away. The crisis line is available 24 hours a day, 365 days a year. Our counselors are able to give immediate advice on domestic violence situations, and can assist the victim with leaving the home or residence they are currently staying at to safely make it to our shelter. If a counselor feels that the  victim is still in immediate danger, he or she will contact emergency services for the victim to ensure that no one is harmed. Child abuse, whether direct or indirect, is another area in which we offer our services. Many times, the children affected have witnessed domestic abuse happening between their parents, and may have been victims themselves. We have counselors in our shelter that are educated and trained to help children become social, and ensure that their interaction with other children is safe for everyone. Male children that see domestic violence happen in the household are three times more likely to apply domestic violence in their own household when they are grown up (Straus , Gelles, & Steinmetz, 1980). During their stay at the shelter, we will provide transportation for the children to get to their current schools. We have an on-site clinic for all domestic violence victims to use at any time, but for severe injuries, we will refer victims to the hospital. Many cuts and bruises can be tended to within our shelter, so using our clinic does not create a financial burden for the victim since a hospital will charge for a visit. Counseling services are also offered by our program, and do not require residence within the shelter for a victim to speak with a counselor. Areas of counseling include providing advice to victims that do not want to leave their current residence, help with victim’s friends or families, and serving victims that have previously stayed at the shelter. We offer one-on-one counseling with trained professionals, and group counseling for victims that have experience similar levels of abuse. It is important for victims of domestic violence to understand that they do not necessarily need to stay in our facilities in order to receive help. Sometimes friends or family of victims will suspect that something isn’t right in their relationship, and our counselors can assist acquaintances with reaching out to the victims to ensure that the victim receives the help they need. Public education is the final, and sometimes overlooked service that we offer as a domestic violence shelter. Not all victims wish to initiate the call for help, and spreading our word that we are here to help can give them the drive they need for us to provide our services. In order to ensure we reach the most amount of people in our community, we have brochures in almost every public facility in the area. We strive to reach areas that are geographically separated from major cities, since women who are far away from shelters are more likely to  delay requesting services from domestic violence shelters (Saftlas, Wallis, Schochet, Harland, & Peek-Asa, 2011). Domestic violence shelters are very important for the victim to have, benefits of our shelter immediately affect the victim’s quality of life. After just three weeks, most victims will already feel an improvement in their situation and have a greater outlook on life (McNamara & Fields, 2000). Without our shelter, victims of domestic violence would have nowhere else in the community to turn for a long-term shelter and assistance. As long as a victim is staying at our shelter, that person is no longer in a situation where they can be harmed, emotionally or physically. Our shelter benefits the community by strengthening each victim to become an independent person, and enables each person of the community to turn around and give back to different areas by volunteering to help others. In conclusion, our shelter provides many services that would suit the needs of many victims from domestic violence. We provide housing, crisis support, help for children, basic healthcare, counseling, and public education to help as many victims as possible. The benefits of our shelter are specifically tailored to assist the victim get back on track to have a normal healthy life again. Finally, it is our goal to provide the highest level of service to each person that reaches out to us, since it could be our very own friend, family member, or colleague. References Itzhaky, H., & Ben Porat, A. (2005). Battered women in shelters: Internal resources, well-being and integration. Affilia, 20, 39-51. McNamara, J., & Fields, S. (2000). Psychological Reports. Differential functioning of outpatients and patients of a domestic violence shelter on the abuse disability questionnaire, 56, 893-894. Saftlas, A., Wallis, A., Schochet, T., Harland, K., & Peek-Asa, C. (2011). Prevalence of intimate partner violence among an abortion clinic population. American Journal of Public Health, 100(8), 1412-1415. Straus, M. A., Gelles, R. J., & Steinmetz, S. K. (1980). Behind closed doors: Violence in the American family. Garden City, NY: Anchor Press/Doubleday.

Conflict with man and women Essay Example | Topics and Well Written Essays - 500 words

Conflict with man and women - Essay Example How, then, is it possible for men and women to communicate successfully and reach mutual understanding? One key element for the success is the recognition of the differences in the thought process, and to acceptance of those without trying to change the other person or trying to â€Å"shape† them according to what we are comfortable with. Men choose not to talk about unimportant and trivial things. Men need action. They want to go ahead and fix the given situation. If the knee is scraped, just put a bandage on it, and there! - It does not hurt any more. There is nothing more to talk about. It is not the same for women. They not necessary need the bandage, but they do need to have someone who would embrace them and will say it will be alright. Conversation is not only a way to find solution; it is an important process of assessment. Sometime, conversation is a way of relaxing and releasing stress after a full working day. Other times it is a need to stay â€Å"connected† . Both articles give very interesting perspectives on communication differences. The one will be wise to remember those and use it in building connections. As it is shown by the example in the second article, that exact knowledge and understanding helped the couple to improve their marriage of twenty-three years.

How Managers Can Use Motivational Theories to Improve Performance Research Paper

How Managers Can Use Motivational Theories to Improve Performance - Research Paper Example In the case when the production staff is not provided with the motivation to produce end products, to be able to fulfill the demand, the manager would be in serious trouble and it may contribute to majorly drastic consequences. If the efficiency of an organization is to be promoted there has to be provision of motivation. The case can be such that the business division has the very products and resources. However, merely a combination of superior products and resources cannot lead to the best consequences: there is a need for motivation as well if a company aims to be successful (Strategic Direction 22). Simply training the employees and delegating them to work does not ensure loyalty and dedication on their part. Employees have to be motivated in order to attain this. Motivation affects work performance to a great degree, thus it holds a great significance for any organization. As clichà ©d as it may sound employees are an organization’s greatest asset and without motivated workers a company cannot be efficient. A company can only go as far as its workers would lead it, as they are the ones who drive it. An organisation is simply a group of individuals who work together for a general reason. Actua lly they make up the company. No matter how effective the organisation’s technology or devices are, their employees remain as the most valuable asset. Therefore, it is necessary that they are provided with motivation so as to encourage them to perform better and better, which would lead to the company’s increased productivity. Several of the business managers of today do not know how effective motivation can be on the efficiency of their company. Therefore, they are required to learn its importance and to recognize the ways through which they can positively motivate their employees at the workplace. The size of the company is

How Tesco dominates the Supermarket industry in the uk Research Proposal

How Tesco dominates the Supermarket industry in the uk - Research Proposal Example analysis of different studies related to the identified research statement that will facilitate the researcher in taking a stand after the research on the utilization of different approaches in the supermarket industry. Furthermore, the proposed research will endeavor to identify any drawbacks in the supermarket industry and Tesco’s competitors that result in inefficiencies and limit their domination against Tesco. Lastly, the proposed research expects to acquire understanding of possible prospects and future developments in Tesco, as well as the UK’s supermarket industry in a valuable manner. Tesco, established as a private company 90 years ago, is undoubtedly the most prominent and the leading food retailer of the United Kingdom today. Jack Cohen put the foundation of Tesco, by selling grocery surpluses from a booth in East End of London. The first product Jack sold was Tesco Tea, after which the company got its name, TESCO, TE from the initials of TE Stockwell, a tea-supplier from a tea-importing company, and Co from Cohen, Jack’s last name. (Tesco, 2009) Cohen moved on to open stalls in Tooting in 1930, then in Becontree and Edmonton in the year 1931 and went on further to establish Tesco Stores as a private limited company in 1932 with the underlying idea of â€Å"always keep your hand over the money and be ready to run† (Seth & Randall, pp.23-24, 2001). Later led by Ian MacLaurin, it became the second most reputed in the market of United Kingdom during the 1980s. Since onwards, many factors contributed and then there was no stopping and Tesco today has marked itself to be the number one retailer in the UK. Irrespective of the medium customers choose to shop at Tesco, be it online or in-store, they receive an equal treatment. The launch of Clubcard in 1995 with a data-mining partner Dunn Humby, led Tesco handle colossal customer data thus enhancing value to their customer base (Rogers, 2001). The theme of Clubcard for its launch was the world’s

Business Ethics, Invisble Hand Essay Example | Topics and Well Written Essays - 750 words

Business Ethics, Invisble Hand - Essay Example A business's biggest interest is profit maximization. All businesses, be it a small-scale or a large corporation or enterprise, seek to maximize their profitability as much as they can. After and in accordance to this, a firm aims to minimize costs. It is not hidden that when businesses attempt to achieve these aims, they crush many ethical values such as responsibility to the society in the form of, perhaps, pollution control guidelines. They leave, to the society, negative externalities only so that they can earn profits. Under such circumstances, you cannot expect a business to care for the environment or the people around them. True, that firms satisfy our material needs and this does lead to the general good. But in providing us with these services and goods, they will do whatever it takes to get to that level of profit maximization and cost minimization. I do not think that the 'invisible hand' furthers us to greater public welfare because firms forget all about ethics when it comes to power and profits. To support this, let's take the example of California's power market. The electricity industry was freed of regulations so that competition could be promoted and that the invisible hand could work. However, the opposite happened. They failed to provide the service; there were blackouts and prices were also very high. The sellers kept developing new ways of abusing the system until the State intervened (Shaw, W.H., 2004). My second argument is that with globalization taking its toll increasingly and hence, with competition growing immensely, it has become extremely important for firms to maintain and raise their positions in the global market. One would think that competition increases efficiency, along with which, prices are decreased. In any case, the customer, or the society as a whole, benefits. However, this is not usually the case. Globalization emphasizes on competition, true. But as a result it creates awareness in the society, gives customer choices, makes them powerful and hence, demanding. All this put together, puts great pressure on a firm operating in the free global market. Mostly, an average customer is not going to think of buying from a firm who is socially responsible and who has value for ethical guidelines and how it treats its employees or competitors. A customer would want to buy from a firm who provides the good or service, they don't care how, they just want the service. This leads to many businesses sacrificing their ethical values and moving towards the bigger motive of profit earning. Many businesses today in third world countries, especially, adhere to such unethical practices. An example of the water industry in Pakistan can be taken. Such filthy water is provided in the homes of people than many suffer from diseases such as hepatitis, yellow fever etc due to this. Conclusion In the end, it is important to note that not all firms yield to such unethical practices and not all situations demand such practices. Today, 'going green' is also a way of earning profits. However, the arguments presented above do take place and the society is exploited as a result. There are both sides to the pictures. It is only up to the business

Beloved by Toni Morrison Essay Example | Topics and Well Written Essays - 1500 words

Beloved by Toni Morrison - Essay Example It is then left up to them to put the pieces together. The use of the juxtaposition approach of the present and past fulfill that purpose of reinforcing the idea that the past continues to exist in the present. The fact that Morrison is putting the story in fragments, puts the story into one piece that is inseparable . He forces his reader to put the pieces back together. He puts them in a position where they are forced to think of the pieces. The readers are also further forced to think and consider the worth of each piece. When it comes to the style that has been used in the novel, Morrison’s artistry is considered to be nothing but breathe taking. Beloved is a novel that is very complex, and the plot is mainly told by use of flashbacks, which incorporates stories that retold in different perspectives. The novel has a loose structure that was intentionally assigned to it. The plot does not flow in a straight line. The plot meanders, with several flashbacks though forty year since the time when Sethe was born in the year 1835, till when the novel comes to an end in 1875. The plot of the novel revolves around 1873. With the arrival of Paul D in 124 Bluestone , a number of flashbacks come into play. The reason for this is the fact that Paul D and Sethe constantly tend to dwell on a number of issues about their lives. Although the setting of the novel is in 124 Bluestone, the flash backs take the reader to a number of locations, with the inclusion of Kentucky, where Hale, Sethe and Paul D were slaves on a plantation that was known as sweet home plantation. The story goes as far as to the Ohio river, which serves as a line of demarcation between states of slaves, the free states in addition to the place that Denver was born. The flash backs go as far as Delaware, where a weaver woman lived with Paul D for a number of years. Back to the clearing, where the preaching of Baby Suggs was done to the black people, to encourage them to develop a love for themselve s, and finally to the lands that were outside sweet home, which is where Paul D and Sixo were captured, and sadly where Sixo met his end and was burnt. The flashbacks are mainly a means of storytelling, which is also a means for the slaves to be able to cope with some of their repressed memories of the past. As the characters remember their stories, it gives the novel a different twist. At the end of the novel, all the pieces fit together. The structure of the novel is a compound of ever-changing perspectives. All the characters, with the inclusion of the dead ones and those that are half alive, have a section of the story in which they tell. At one instance, Paul D and Sethe share flashbacks that are eventually combined into one, (chapter two). There is also an instance in which the point of view transitions gently between four of the characters who are white. Their conversation is a revelation of how some people may view slaves as nothing other than tamed animals. The variance in the various perspectives creates a tapestry of interesting individuals, who are linked with the present and the past, into forming a community. Another perfect example is the instance in which Paul D and Sethe give their narration of the experience of the corn field. Another instance is made the four men on horses when to Sethe. The use of this mechanism dares to challenge the idea of the singularity, which presents history in an objective manner. Perhaps

Explain the causes of the increase in violence and deaths of young Essay

Explain the causes of the increase in violence and deaths of young people due to guns, knives and gangs and discuss the various policing challenges this presents - Essay Example In fact, there have been reports of children as young as 11 being murdered, not out of personal violence, but gang crimes such as the unfortunate murder of 11 year old Rhys Jones. Worse still is the fact that street brawls include more than just fists and kicks now – they include the very real possibility of knives and guns. To get an idea of how widespread the problem is, a 2007 report stated that there are over 600 to 700 young people between the ages of 10 to 19 involved in gang activity, having affected the lives of over 8100 others (Pitts, 2007). In 2009 it was reported that there has been a seventy five percent increase in the number of teenage stab victims over sixteen, and an almost staggering ninety percent increase in the number of stab victims under the age of sixteen (Blair, 2009). The questions is, however, when did this shift arise, and why has it arisen in the first place? What are the reasons that younger children are submerging themselves into this violent culture and finding themselves the dangerous target of an armed child? Where do these children get access to the weapons they use and who is responsible for making it possible? The main problem with gathering data on youth criminals is the fact that it is often a widespread grey area where the question of motivation is concerned. Is it possible for a child or teenage to act of completely independent motivation? If so, one may wonder where motivation arises from and is that source of motivation in any way to blame for the uncultured reaction of an individual not yet considered a mature adult by society. And if not, what are the factors influencing these crimes, and who are these children acting in support with. The obvious answer might be gang activity, but the further confusion arises when one considers that not all criminal youth activity is motivated by gangs, and vice versa. So how is one expected to offer some clarity into this blurred line? Perhaps one

The Role of Employee Identification Essay Example | Topics and Well Written Essays - 1500 words

The Role of Employee Identification - Essay Example I will develop my interpersonal skills by focusing on the subject of organizational communication in my course. This will help to understand different types of personality traits and how they react to different organizational culture. This will allow me to properly communicate with my supervisors as well as my subordinates. The proper communication will help me to monitor the performance level of the firm as well as communicate proper feedback to my supervisors. Improving analytical skills is a relatively long term process, where I will need to focus on problem solving and pattern recognition. I will strengthen my statistical knowledge and gain expertise in tools like excel and SPSS. This will also help me to improve my mathematical skills. Moreover, I will also focus on the financial aspect of management, because a manager needs to be profit oriented. By following the traits of great leaders, I will develop leadership qualities in me that will help me to motivate my employees.Descri bing KSA to a Prospective EmployerBeing an effective and efficient employee requires a combination of both knowledge and expertise. My management studies course has given me enough knowledge to understand the current market scenario and has prepared me to face challenging situations. I have developed analytical skills that will help me make proper decisions and allocate tasks effectively. My good communicational skills will help me to improve my performance efficiency in your organization.

Gay Rights Research Paper Example | Topics and Well Written Essays - 1500 words - 1

Gay Rights - Research Paper Example son of Florida Citrus Commission and also widely known for her best selling pop albums had lent a strong voice against gay activism and protested by stating that the prevalence of this movement was seriously hampering her basic right as a mother and creating impediments in the â€Å"moral atmosphere† that is considered right for the children (Gillian 127). There are enormous reasons for several divisions of opinion among people regarding same sex marriage although they have not been placed with substantiated doctrines or principles that would suffice the purpose of abandoning such marriages. A majority of anti gay activists have not been able to cite any other reason than the principles of the Holy Bible and their perceptions have centered on the fact that same sex marriage challenges the order of God, which is being counter challenged by the gay people who have repeatedly stated that those who have put forth their opinions may not be fit or able-bodied for defying the rights of homosexuals. As a matter of fact, such decisions must be taken by those who are able to envisage gay rights with reason and common sense according to the gay rights activists. On the other hand, the research studies of Regenurus took a different path than the previous studies conducted on same sex marriages. This research was based on a sample of young America n adults and compared with a group that was biologically intact. The parameters that were intended to be measured through this research included crime rates, tendency of sexually transmitted infections and drug addiction. The result of this study was quite disappointing as most of the young adults whose fathers were involved in same sex relationship were more likely to take drugs than others. The girls with lesbian mothers were four times more prone to thrive on public help than the children of normal biological parents or even single mothers (Ponnuru 29). Despite the studies that reveal such thwarting reports, gay activists have

Pervasive Developmental Disorders Essay Example for Free

Pervasive Developmental Disorders Essay The pervasive developmental disorders (PDDs) represent a spectrum of difficulties in socialization, communication, and behavior. Autism is the best recognized and most frequently occurring form of a group of the PDDs. Because most of the research in areas related to communication has been done on autism, we will focus here on this particular PDD. However, we should be aware that autism is probably not the most common disorder on this spectrum. Other types of PDDs include Retts Disorder, Childhood Disintegrative Disorder, Aspergers Disorder, and Pervasive Developmental Disorder Not Otherwise Specified, or PDDNOS (Twachtman-Cullen 1998). This work will also discuss the distinctive features of Aspergers syndrome, which is believed to be genetically related to autism. Much of what can be said about certain features of autism and PDDNOS applies to other forms of non-autistic PDD. The goal of this research is to provide a framework for understanding cognitive development in children with PDDs. The study will cover criteria for early PDDs diagnosis. The best-known type of PDDs is autistic disorder (variously called autism or infantile autism). The symptoms of autistic disorder typically increase gradually through the childs second year, reach a peak between 2 and 4 years of age, and then show some improvement. Young children with greater cognitive ability who receive very early intensive intervention may show dramatic improvement at this age, whereas those who are more impaired will make more modest changes. Persons with autistic disorder exhibit major deficits in their ability to relate to others. The child with autistic disorder often appears content to dwell in a separate world, showing little empathic interest in parents or siblings. Unlike the normally developing baby, the child with autistic disorder may not raise his arms to be picked up or may stiffen in protest when his parents try to cuddle him. The childrens lack of social interest may make some of these babies seem like â€Å"easy babies† because they do not seek parental attention, and appear content to remain in their cribs, watching a mobile or staring at their hands. As they get older, such lack of demandingness is recognized for the relative indifference it actually reflects. The child with autistic disorder may not seek others for comfort when she is hurt or upset, finding little consolation in the gentle words and hugs that are so important to other children. Not only do the children not ask for comfort, they typically are quite indifferent to other peoples distress and do not seem to share their joy. A siblings tears or a parents happiness may elicit no response from the child with autistic disorder. Children with autistic disorder show little interest in the domestic imitation that most children enjoy. For example, unlike the normally developing child, the child with autistic disorder usually does not use his miniature mower to cut the grass like mommy or pretend to shave while he watches daddy. This lack of interest in imitation interferes with one of the primary channels for learning by young children: their ability to model adult behaviors and master them through role play. Social play is one of the primary activities of childhood. A few simple toys can create the backdrop for long hours of companionship. The child with autistic disorder does not know how to join this kind of play, sometimes completely ignoring other children, or perhaps standing on the sidelines, not comprehending how to become part of the group. Not surprisingly, given the range of social deficits they exhibit, children with autistic disorder are very impaired in their ability to make childhood friends. Within the communication domain, impairments are present in a number of linguistic and nonverbal areas, the most fundamental of which are pragmatics and semantics (i. . , the social usage and explicit or implicit meaning of language and gestures). Although linguistic capability varies greatly across the spectrum (from a total absence of speech to highly sophisticated and erudite language), significant impairments in pragmatics and semantics are universal among individuals with PDDs. They communicate primarily to express needs, desires, and preferences, rather than to convey sincere interest in others, or to share exp eriences, excitement, and feelings. Even among those possessing highly sophisticated and complex language, compliments, words of empathy, and expressions of joy in the good fortune of others are very rare. There is little reciprocity, mutuality, or shared purpose in discussions. In addition, speech and gestural forms of communication are poorly integrated, often resulting in awkward and uncomfortable social interactions. Implicit, subtle, and indirect communications are neither used nor perceived. Expressive communication tends to be explicit, direct, and concrete. During discussions, persons with autism often fail to prepare their speaking partners for conversational transitions, new topics, or personal associations. This can result in digressive, circumstantial, and tangential comments and discussions. It would appear as though persons with autism assume that others are implicitly aware of their experiences, viewpoints, attitudes, and thoughts. The fashion in which these deficits are manifest is influenced by age, overall cognitive level, temperament, and the presence of sensory or physical limitations. In toddlers, for example, impaired pragmatics may be manifested by significant limitations in reciprocal eye contact, responsive smiling, joint attention (mutual sharing of interests and excitement), and social imitative play. In addition, socially directed facial expressions, instrumental and emphatic gestures, and modulation of speech prosody (intonation, cadence, and rate) are rarely used to complement speech, communicate feelings and attitudes, or moderate social discourse. Among preschool children, impairments in symbolic functioning (e. g. , language) are accompanied by serious limitations in pretense (e. g. ymbolic, imaginative, creative, and interactive play). Pragmatic impairments among adolescents with Asperger’s syndrome may be manifested by one-sided, pedantic discussions, with no attempt to involve speaking partners by acknowledging and integrating their experiences, ideas, and viewpoints into conversations. Sincere attempts by others to engage in reciprocal conversations may be met with a lack of acknowledgment, annoyance, and disinterest. Comments or questions that are â€Å"snuck in† by the listener may be experienced as rude interruptions, prompting the directive, â€Å"Wait! Im not done talking yet† (Bernabei, Camaioni Levi 1998). The result is a monologue or lecture that often includes abrupt changes of topic and the introduction of unexplained personal associations. This lack of conversational reciprocity suggests that persons with AS and high-functioning autism inherently assume that the listener is implicitly aware of their own experiences, viewpoints, and intent. Because the relaying of factual and concrete information is the primary goal of â€Å"social† dialog among those with ASD, the communication of subtle attitudes, viewpoints, and emotions (particularly secondary emotions, such as embarrassment, guilt, and envy) are largely irrelevant and superfluous. Therefore, emphatic gestures, informative facial expressions, and vocal modulation lack essential meaning for them. The result is that persons with autism generally disregard nonverbal cues and fail to incorporate them into their own discussions. Because this component of social communication often conveys essential information regarding feelings, attitudes, and opinions, an inability to identify, interpret, and produce nonverbal cues can have a highly detrimental effect on social interactions and relationships. Given these impairments, it is not surprising that verbal and nonverbal aspects of communication are poorly integrated, and that subtlety and nuance are rarely conveyed. Figurative and inferential language is another area of communication that is impaired in autism, largely due to a combination of deficits in abstract and conceptual thought, social reciprocity, and appreciation of the subtleties of social communication. Persons with ASD are highly literal and concrete in their language and thought processing, typically failing to understand metaphor, irony, sarcasm, and facetiousness. As a result, comments are often misinterpreted and discussions misunderstood. In addition, in an effort to remain true to the facts, comments and questions are often presented in an overly direct, straightforward, and â€Å"brutally honest† manner, lacking appropriate tact and sensitivity (Szatmari, Jones, Fisman, Tuff, Bartolucci, Mahoney 1995). This can cause embarrassment and distress for the listener and confusion for the speaker with AS. Both may become angry and resentful; the listener, because of emotional distress and perceived mistreatment; the speaker, because of the seemingly unjustifiable overreaction and a negative attitude displayed by the listener. From the perspective of the person with AS, the listener responded in a rude and ungrateful manner to comments that were intended to be informative, useful, and corrective. The emotional distress, embarrassment, and attack on self-esteem experienced by the listener are relatively foreign to the individual with autism. Interestingly, principles, rules, and codes of behavior can be interpreted in a highly concrete and rigid manner. This can result in insensitive and hurtful comments and behavior, because exceptions to the rule, adjustments to unexpected social contingencies, and appreciation for the spirit (not simply the letter) of the law are relatively foreign to those with autism. There is little awareness that rigid adherence to unavoidably flawed rules can result in a situation that is antithetical to the underlying intent of the rule itself. One of the dinning features of autism and Asperger’s syndrome is that of rigidity and inflexibility in response to minor change and transition in the environment and daily routines. This insistence on sameness and invariance can be highly impairing, because the precipitants of these reactions often are of little social significance and do not disturb the smooth functioning of the social world. It is as though persons with autism depend on these inanimate markers of space and time because the social priorities that typically direct schedules and routines have little meaning and significance for them. Aspergers Syndrome has been associated with cognitive strength since Hans Asperger first described the disorder in the 1940s. When he wrote of children who sounded like â€Å"little professors,† Dr. Asperger (1944/1991) was describing not only their pedantic tone but also their cognitive abilities. The assumption of adequate cognitive skill was reiterated when the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) stated that individuals with Aspergers Syndrome show â€Å"no clinically significant delay in cognitive development† (Willey 2001). Aspergers syndrome (AS) was added as a new â€Å"official† diagnosis when DSMIV and ICD-10 were published. In the past, children with AS were sometimes referred to as having schizoid personality, or schizotypal personality, and PDD, NOS. It is now recognized as distinct from autism. AS differs from autism in a number of key ways: first, children with AS may not be detected as early because they may have no delays in language, or only mild delays. In fact, it is usually not until parents notice that their childs use of language is unusual, or their childs play is also unusual, that concern sets in. Unlike autism, where the vast majority of children also experience some degree of mental retardation, children (and adults) with AS are rarely mentally retarded although many have low-average intelligence. Children with AS are sometimes described as â€Å"active, but odd† not avoiding others the way autistic children often do, but relating in a more narrow way, usually centering activity around their own needs and peculiar interests. In fact, having one or more areas of narrow, encompassing interest is highly characteristic of those with AS. Parents often ask whether AS is the same thing as â€Å"high-functioning autism. Research studies have addressed this question, and the answer is â€Å"no† (Fombonne, Simmons, Ford, Meltzer Goodman 2001). One main difference is that children with AS tend to have fairly comparable verbal and nonverbal levels of intelligence, while higher functioning (that is, less cognitively impaired) autistic children tend to have nonverbal IQs that are markedly higher than their verbal IQs. Another key feature of AS is the presence of intense, preoccupying interests that generally are unusual in nature and highly restricted and narrow in scope and breadth. An impressive store of factual knowledge is accrued on relatively esoteric topics; however, this knowledge is rarely utilized for functional, socially meaningful purposes. Rather, factual knowledge is pursued for its own intrinsic value to the AS individual. In addition, children and adults with AS tend to be physically awkward, uncoordinated, and poor in judging visual-spatial perspective (often failing to maintain comfortable interpersonal space during social interactions). With regard to neuropsychological functioning, verbal abilities are generally much better developed than are nonverbal abilities (e. . , perceptualmotor, visual-spatial). In a majority of cases impairments are present in executive functions, including working memory, organization, and cognitive-set flexibility. Although children with AS are thought to show no general cognitive delay, there is actually a great deal of variability in the specific abilities of individuals. In spite of mass media suggestions that individuals with AS grow up to be scientists or software engineers, we do not yet have data to support this connection. For most children, the PDDs last a lifetime. Although early intervention for many young children with autistic disorder, Asperegers disorder, and PDDNOS has produced major developmental changes, the technology has not yet reached the point where the majority of children make the degree of change that allows them to blend imperceptibly into their peer group. As a result, although most children with PDDs benefit in important ways from treatment, many still become adults with PDDs or some significant residuals of PDDs. There are no details of what causes PDDs. There appears to be a genetic contribution to at least some kinds of autistic disorder. For example, Fragile X syndrome is a chromosomal disorder than long has been linked to mental retardation and more recently has been shown to be related to autistic disorder. This disorder gets its name from a narrowing near the end of the long arm of the X chromosome that sometimes makes the tip fragile. Fragile X syndrome shows an X-linked (sex gene-linked) recessive pattern of inheritance. As a result, this disorder typically is transmitted to boys by their mothers. Fragile X syndrome accounts for a small but significant number of boys diagnosed with autistic disorder. General support for the notion that the symptoms of autistic disorder reflect underlying physiological dysfunction comes from research showing that autistic disorder occurs more often than would be predicted by chance among children whose mothers had German measles during pregnancy, that these children experienced a higher than expected rate of problems during pregnancy or birth, and that they are at greater risk for seizures than other children. Findings such as these raise important questions about where in the brain abnormalities may occur and how these neurochemical, biochemical, or neurological factors may be linked specifically to the development of the language, social, affective, and behavioral symptoms that characterize autistic disorder and the other PDDs. The process of accurate diagnosis and classification is an essential endeavor in medicine, because it is key to ensuring validity and reliability, enabling etiological research, and identifying effective methods of treatment. Although ASDs are not medical illnesses in the classical sense, they do result from neurodevelopmental abnormalities that affect social, communicative, and behavioral functioning in fundamental ways. The autism is not a unitary condition with a single etiology, pathogenesis, clinical presentation, and treatment approach; rather, it is a group of related conditions that share many clinical features and underlying social-communicative impairments. The fundamental purpose of arriving at an accurate diagnosis is to promote meaningful research that will eventually lead to effective treatment and an ultimate cure. Accurate diagnosis also enables investigators, clinicians, educators, and parents to communicate clearly, effectively, and efficiently. Ideally, a valid and reliable diagnosis should convey a great deal of information about developmental strengths and weaknesses, short- and long-term prognosis, and treatments that are most likely to be effective. Both basic and applied research endeavors are enhanced by improvements in diagnosis and classification. During recent years, efforts have been made to identify ASD as early in life as possible, in order to begin implementing educational and treatment interventions; providing families with education, support, and community resources; and reducing the stress and anxiety families experience as a result of incorrect or misleading diagnoses. The importance of an early diagnosis is supported by findings of improved linguistic, cognitive, and adaptive functioning as a result of intensive early intervention. Studies have begun to appear in the research literature assessing the reliability and stability of autism diagnoses made during the early preschool years. Experienced clinical investigators have demonstrated that an accurate diagnosis of autism can be made in the second and third years of life. However, accuracy depends on the completion of a comprehensive, interdisciplinary assessment, one that includes the use of standardized diagnostic instruments in conjunction with clinical expertise. Nonetheless, even among experienced clinicians and investigators, false positive and false negative diagnoses are sometimes made. Investigators have begun to examine clinical variables that may be predictive of treatment response and general prognosis. For example, Handleman Harris (2001) found that preschool children with autism who exhibited low baseline levels of social avoidance experienced significantly more social and linguistic progress than did their high-avoidance counterparts following 6 months of intensive incidental teaching and pivotal response training (provided in an inclusive setting). A complementary strategy for assessing the validity of AS is to examine the pattern of associated symptomatology. In this regard, a recent study investigated emotional and behavioral disturbance (psychopathology) in 4 to 18-year-olds with HFA and AS. The Developmental Behavior Checklist (DBC), an informant-based instrument completed by parents and teachers, was used to assess psychopathology. The DBC contains the following six subscales: disruptive, self-absorbed, communication disturbance, anxiety, antisocial, and autistic relating. Children and adolescents with AS exhibited high levels of psychopathology, particularly disruptive behavior, anxiety, and problems with social relationships. The best documented approach to the treatment of people with PDDs is a form of behavior therapy called applied behavior analysis. Since the mid-1960s, when Ivar Lovaas and his colleagues demonstrated that children with autism responded to carefully planned applied behavior analytic techniques, there has been extensive research on the use of these methods to treat the PDDs, especially for autistic disorder, Aspergers disorder, and PDDNOS (Durand 1990). Three decades of research have contributed to the development of a substantial array of specific behavioral treatment techniques and of documentation to support the efficacy of these methods in treatment of PDDs. This research also has demonstrated the essential role that parents can play in the treatment of their children by providing consistency of intervention between home and school, or even in some cases as the childs primary therapist.

Social Model Of Health Health And Social Care Essay

Social Model Of Health Health And Social Care Essay This essay will define the social model of health and health definitions, taking into account social health factors and influences on the social model of health. A summary will present the key findings of this analysis challenging the current effectiveness of the social model of health. The social model of health aims to improve personal and community well-being and health by evaluating the conditions of social and environmental health causes in conjunction with biological and medical considerations (Quipps, 2011) both at local and national level working to eradicate health inequalities. Causes can be understood as social, personal, economic and environmental issues (Ottewill and Wall, 2004, p. 14) present in class, ethnicity, gender, social disability and mental health. The World Health Organisation determines health as a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity (Blackburn with Darwen PCT, 2012). The social model of healths focus on well-being relates to a sense of happiness or being healthy (Cambridge Dictionaries Online, 2011). To obtain this all aspects of a persons life, social conditions, housing, education should be fulfilled; health is therefore multidimensional (Yurkovich and Lattergrass, 2008, pp. 439; Hilleboe, 1972, pp.139). The impact of the social model of health and causes of social conditions are factors that can determine the perception of health conditions and the management of health needs. For example childhood health attitudes and upbringing can determine future adult health perceptions and outcomes (Toivanen and Modin, 2011). As an instance a child may not have been encouraged to exercise and in adulthood develop related health conditions; intervention in community fitness knowledge could have reduced any further health risks. The impact from food manufactures can also influence social attitudes affecting a healthy diet such as overeating. Advertising, food labeling and the concept of convenience foods (Naidoo Wills, 2008, pp. 177) has encouraged an inactive lifestyle, creating chronic conditions (Kirby et al., 2012, pp. 1572). This may cause heart problems, diabetes and place pressure on health services. Under the social model of health, health policy should pressure food industries to provide healthier options, alert people of unhealthy eating and encourage healthier eating as a positive state of well-being, especially in poor communities where there is a lack of available healthy food and food education (The Fat Nutritionist, 2012). Social class inequalities determine social indifference of class status, responses and management of health perceptions (Naidoo Wills, 2008, pp. 111) and could affect available health distribution amongst social classes such as postcode lottery (WHO, 2012), possibly leading to the exclusion of health benefits for the lower classes (McDougall, 2007, pp. 339). The social model of health aims to promote well-being and reduce social class inequalities making health available for all social classes and ensuring the access of health information, hospitals, clinics, health websites and community centres eventually leading an individual and/or community to better health choices and lifestyles (local.gov.uk, 2012). For instance should inadequate disabled legislation challenge a persons ability to actively become a productive member of society, their condition could become institutionalising. Silva et al., (2012); Kizito, et al., (2012) suggest that free access to health services can reduce b arriers to poor health of the population and increase the effectiveness of social well-being, allowing individual potential to be fulfilled. Larson (1991, p. 2) further exemplifies this concept in social health disability by suggesting social well-being can be the capacity of a person to perform usual tasks in their everyday life despite their illness. In cases of ethnic and social inequalities access of health support and information can influence good health. The UK is culturally diverse consisting of different ethnic groups, and language barriers can impact on the understanding of these groups, which may lead to some social exclusion. Health information may not be fully understood and from a Health Survey for England found the black and minority groups are most likely to become ill (Postnote, 2007, p.1) because of a lack of understanding in social health matters. The social model of health would prescribe that health facilities and information should be formatted and made accessible in a way that can be received and understood by different ethnic groups to reduce health risks and improve social well-being. Minority mental health inequality has been previously under represented, however the social model of health would understand that minority cultural and social background issues, should be addressed by social health services to deliver appropriate health care and enable a sense of well-being (Aisenberg, 2008, pp. 297). In environmental conditions Seedhouse (1988) as cited in Ottewill and Wall (2004) suggested that ensuring appropriate food, shelter and warmth (p 4) can also support a sense of well-being and improvement of health creating a sense of security. Seedhouse further supports this concept when identifying an individuals condition of health as equal to the circumstances surrounding them, which may affect their ability to achieve goals based on the state of their biological and mental capacity. Thomas McKeown explores living conditions further as being a critic of medical explanations as to the improvements of mortality rates between 1850 and 1970, determined health improvements were a result of better living conditions and nutrition (Department for Health and Aging, 2008), a basis for social well-being. The Black Report of 1980 also determined health inequalities in lower social classes were a result of poor housing and sanitary conditions leading to unhealthy life styles (Maguire, N. D.). Socio-economic factors can also affect health, as incomes become divided lower income may encourage poor living conditions (Kawachi, 1997), and with persistent economic conditions can affect health (Watts, 2000). In gender the socio-economic status of women and mens health can be affected through economic opportunity and prosperity (Ballantyne, 1999). The social model of health would focus on reducing economic disparities in salary to offer equal health. To conclude, social health determinants can significantly influence the physical, mental health and well-being of a person and society to fulfil their lifes potential. The social model of health is a factor in attaining good health by recognising the benefits of improved living conditions, lifestyle choices, food and access to care. Specifically social well-being draws attention to improving social inequalities and encourages a healthy society whilst challenging government and businesses to adapt to different service users, ensuring they are not impinged by their illness. In evaluation, the social model of health is not diverse enough and could benefit from broadening itself in conjunction with medical concepts, and push harder for inequalities to be recognised in society where poverty is commonplace, and health care practices are being ignored in hospitals and other care environments.

Meningitis Vaccine Policy in Saudi Arabia

Meningitis Vaccine Policy in Saudi Arabia Meningitis Vaccine Policy During Hajj Overview of the Essay This essay looks at the meningitis vaccine policy during Hajj in Saudi Arabia, first looking at the healthcare system in Saudi Arabia, in terms of how the health care system is structured and what the policies towards vaccination against meningitis are. The essay then moves on to discuss more general policies towards meningitis vaccination, from the World Health Organisation (WHO), for example, and how the Saudi model of vaccination fits in to this more general framework. The essay then moves on to looking at social theories that have been suggested to explain how organisations work, in terms of understanding how meningitis can be spread through the hajjis attending the Hajj pilgrimage. The essay then moves on to look at what evidence has been gained from research in to meningitis outbreaks during Hajj, and meningitis control through vaccination. This is presented in the form of a literature review of the current, relevant, literature regarding meningitis outbreaks during Hajj, and meningitis control through vaccination. Literature that is specific to Saudi Arabia is focused on, although vaccination programmes that have been successfully attempted further afield will also be discussed. The essay then moves on to looking at how and when the current Saudi Arabian vaccination policy and how this policy differs from previous policies, in terms of why the new policy was introduced and what the positive and negative effects of this policy have been. This section incorporates research reviewed in the previous section, through the literature review of the relevant research, and also looks at how historical trends and international trends in healthcare have contributed to this policy. The impact of globalisation on health care is also discussed. The essay then moves on to discuss any gaps that are present between the stated policy and the implementation of this policy, in terms of the organisational constraints that are present that directly affect policy implementation. The next section of the essay looks at the implications of the policy for nursing practice, in terms of the direct involvement of nurses, the need for counselling and educating parents, in terms of the historical development of nursing and the international trends in nursing. Introduction The Saudi Healthcare System This section looks at how the health care system is structured in Saudi Arabia, and what the policies towards vaccination against meningitis are within the Kingdom of Saudi Arabia. The essay then moves on to discuss more general policies towards meningitis vaccination, from the World Health Organisation (WHO), for example, and how the Saudi model of vaccination fits in to this more general framework. The essay then moves on to looking at social theories that have been suggested to explain how organisations work, in terms of understanding how meningitis can be spread through the hajjis attending the Hajj pilgrimage. The healthcare system in Saudi Arabia is essentially a national health care system, provided by the Government, which is overseen by the Ministry of Health (MOH), which provides primary healthcare services through a series of health care centres scattered throughout the Kingdom. These primary care centres refer applicable cases to advanced specialist curative services based in hospitals. In addition, secondary and tertiary care is provided by a variety of Ministries, and through a variety of private and public organisations: for example, Saudi Arabian universities provide specialist care, through their research hospitals and Saudi Arabian airlines provide health care to it’s employees. Emergency care is provided by the Saudi Red Crescent Society, and is also responsible for providing medical care during the Hajj and Umra pilgrimages. Health care is free, at the point of delivery, to all Saudi citizens and expatriates working in Saudi Arabia, and the Saudi Government spends an estimated ten per cent of its annual budget on health care: this seems to be a good investment as the Saudi’s have one of the highest life expectancy in the region, although obesity is becoming a concern in Saudi Arabia, due to the introduction of the ‘Western’ diet to the region. Whilst a more than adequate health care system is provided by the Saudi Government, as has been seen, there is also a thriving private healthcare system which provides all levels of care, from primary to tertiary and including emergency medical services. The Saudi Government is also interested in reforming the health care system, with a desire to achieve coordination amongst the various sectors and to increase the number of Saudi medical and nursing graduates so that Saudi employees can work in this sector, rather than employing many hundreds of thousands of expatriate nursing and medical staff, as is currently the case. The Saudi Government is also attempting to introduce a cooperative health insurance scheme, which would cover all non-Saudi residents living and working in the country. Infection Control for the Hajj In order to attend the Hajj, vaccination against the A and C meningitis strains was made mandatory, following on from the worldwide outbreak of meningitis A which occurred following the 1987 Hajj (Fonkoua et al., 2002) and a 1992 outbreak of meningitis A which occurred amongst Umra pilgrims (Wilder-Smith et al., 2003). In addition to this requirement for travellers entering Saudi Arabia for the Hajj, all hajjis coming from countries belonging to the African meningitis belt, and those arriving from areas that had recently experienced a meningitis outbreak, were required to take a single dose of ciprofloxacin upon arrival to Saudi Arabia (WHO, 2001). This policy was in place in Saudi Arabia until the recent outbreak of the W-135 serogroup. The current concern of health professionals and health organisations is, however, the W-135 serogroup, due to the recorded outbreak of meningitis amongst Singaporean pilgrims returning from the Hajj in 2001, many of whom had been vaccinated with the quadrivalent vaccine (Wilder-Smith et al., 2003). As stated in Wilder-Smith et al. (2003), there was a massive outbreak of serogroup W-135 meningitis in the 2000 and 2001 pilgrimages, through pharyngeal carriage of the serotype in pilgrims returning from the Hajj. Wilder-Smith et al. (2003) looked at meningitis carriage during the minor pilgrimage (Umra) and found that, whilst the W-135 serotype was carried, it was at a much lower rate of incidence, at 1.3% versus the 17% found in Hajj pilgrims, leading to their conclusion that in order to reduce the potential introduction of N.meningiditis W-135 in to the countries of origin of the pilgrims, then a ttentions would be better focused on those pilgrims attending the Hajj rather than the Umra. Following on from the Hajj-associated outbreak of W-135 serogroup, the Saudi Arabian Ministry of Health changed their policy with regards to meningitis and made it mandatory for hajjis to receive the quadrivalent vaccine (against A, C, Y and W-135) as a visa requirement from 2002 for people entering Saudi Arabia for the purposes of the Hajj (Wilder-Smith et al., 2003). In addition, the Saudi Arabian Ministry of Health administers antibiotics to all local Saudi hajjis in order to eradicate the carriage of the W-135 serogroup and to reduce transmission to local contacts and to the larger community (Wilder-Smith et al., 2003). In terms of more general policies with regards to vaccination programmes against meningitis, the World Health Organisation (WHO) recommended control practices for meningitis involve vaccination with the A/C vaccine in response to epidemics, which requires that epidemics are detected early and that stocks of vaccines be set up in at-risk regions, so that vaccination can be rapid (Fonkoua et al., 2002). Whilst other outbreaks of the W-135 strain of meningitis are becoming increasingly common, such as the outbreaks in Yaounde in Cameroon (Fonkoua et al., 2002) and in Burkina Faso (which killed 1500 people of the 13000 known to have been infected), the WHO is recommends preventative vaccination to protect those individuals at risk (for example, travellers, people in the military and pilgrims) (WHO, 2003) and vaccination for those who have been in close contact with known meningitis cases. In terms of vaccination for epidemic control, the WHO recommends that in the African meningitis belt , the known hotspot for meningitis, stretching from Senegal to Ethopia, epidemics be controlled with enhanced surveillance and the use of oily chloramphenicol, with mass vaccinations for those areas in the epidemic phase and those contiguous areas that are in alert phase: such mass vaccination, promptly administered is estimated to prevent seventy per cent of cases (WHO, 2003). As shown in a 2001 WHO report (WHO, 2001) on the emergence of the W-135 strain of meningitis, infection with this strain can lead to outbreaks of considerable size and because the epidemiology of this strain is not well understood, there is a serious need for travellers to the Hajj to be protected. The 2001 outbreak of W-135 strain of meningitis at the Hajj spread worldwide with a total of 304 cases reported and this outbreak raised serious questions as to whether the W-135 strain of meningitis will become a major public health problem at national and international levels (WHO, 2001). As shown in the NHS leaflet specially designed for UK citizens and residents planning on attending the Hajj, the W-135 strain of meningitis is deadly and vaccination against the A and C strains of meningitis does not protect an individual against this more deadly strain: only the quadrivalent vaccine will protect individuals against the W-135 strain of meningitis (NHS, 2007). In terms of the WHO policy on the W-135 strain of meningitis, the WHO has stated that the currently available vaccine is too expensive to be applicable for mass vaccination programmes that are known to be effective in the prevention of the epidemic outbreak of other meningitis strains, and so the WHO is pressing for an affordable vaccine against the W-135 strain, i.e., a vaccine at a price that would be affordable in an African situation, given that the majority of outbreaks of meningitis occurring worldwide occur in the African meningitis belt (WHO, 2003). Thus, there is no widespread vaccination programme with the quadrivalent vaccine, which protects against the W-135 strain of meningitis, unlike the routine vaccination programmes with the vaccines that are effective against the A and C strains. As the WHO, the Saudi government and various Governments who deal with their citizens who attend the Hajj (for example, the UK) are recommending, it is, at the moment, sufficient that the quadrivalent vaccine is given only to those who are at risk, i.e., those who are planning on entering a region that is known to have the W-135 strain. Widespread vaccination against the W-135 strain of meningitis is not being practiced anywhere in the world, mainly, it seems, due to the high cost of the vaccine but also due to the fact that there is no scientific evidence as to the global direction of the W-135 strain of meningitis i.e., the fact that there is no evidence, as yet, to suggest that the W-135 strain of meningitis will become a global scourge (WH O, 2001) and, as such, that it is not certain, as yet, as to whether a mass vaccination against this strain is necessary. Due to this information, the Saudi Arabian government implemented a mass vaccination with the tetravalent vaccine, active against the A, C and W strains of meningitis (WHO, 2001) and put in place the controls for hajjis as previously outlined: i) making it mandatory for hajjis to receive the quadrivalent vaccine (against A, C, Y and W-135) as a visa requirement from 2002 for people entering Saudi Arabia for the purposes of the Hajj (Wilder-Smith et al., 2003); ii) administering antibiotics to all local Saudi hajjis in order to eradicate the carriage of the W-135 serogroup and to reduce transmission to local contacts and to the larger community (Wilder-Smith et al., 2003); and iii) requiring all hajjis coming from countries belonging to the African meningitis belt, and those arriving from areas that had recently experienced a meningitis outbreak, to take a single dose of ciprofloxacin upon arrival to Saudi Arabia (WHO, 2001). Social theories to explain how organisations work This section looks at some of the social theories that have been suggested to explain how organisations work, in terms of understanding how meningitis can be spread through the hajjis attending the Hajj pilgrimage. In terms of the social theories that have been suggested to explain how organisations work, in terms of understanding how meningitis can be spread through the hajjis attending the Hajj pilgrimage Bourdieu, writing in Hillier and Rooksby (2005) talks about the concept of ‘habitus’ in terms of describing both geographical and social spaces or dispositions, which Bourdieu (2005) describes as permanent manners of being, seeing, acting and thinking, a permanent structure of perception, conception and action. Bourdieu’s (2005) thinking on habitus and dispositions can be applied to participation in the Hajj, as Bourdieu (2005) widens his definition of habitus to include unity of human behaviour, or what he terms lifestyle: that is, a set of acquired characteristics which are the product of prevailing social conditions. Bourdieu (2005) argues that this habitus, this disposition, can lead to entrenched behaviours and responses, especially in religious beliefs, for example, which leads, for example, to people wishing to attend the Hajj pilgrimage as part of their religious beliefs. Other social theories that have been put forward to explain organisational behaviour include social network theory (Barnes, 1954) which explains how social networks are formed, through the formation of nodes (i.e,, individuals) which are bound together through interdependency such as values or visions or disease transmission. The use of this theory can help epidemiologists explain how, for example, meningitis is spread amongst and beyond hajjis, leading to the development of plans and policies to contain the spread of meningitis. This will be looked at in more detail later in the essay. The Evidence from the Research This section looks at what evidence has been gained from research in to meningitis outbreaks during Hajj, and meningitis control through vaccination. This is presented in the form of a literature review of the current, relevant, literature regarding meningitis outbreaks during Hajj, and meningitis control through vaccination. Literature that is specific to Saudi Arabia is focused on, although outbreaks and vaccination programmes that have been successfully attempted further afield will also be discussed. There was a massive outbreak of serogroup W-135 meningitis in the 2000 and 2001 Hajj pilgrimages, through pharyngeal carriage of the serotype in pilgrims returning from the Hajj (Wilder-Smith et al., 2003). Wilder-Smith et al. (2003) looked at meningitis carriage during the minor pilgrimage (Umra) and found that, whilst the W-135 serotype was carried, it was at a much lower rate of incidence, at 1.3% versus the 17% found in Hajj pilgrims, leading to their conclusion that in order to reduce the potential introduction of N.meningiditis W-135 in to the countries of origin of the pilgrims, then attentions would be better focused on those pilgrims attending the Hajj rather than the Umra. Outbreaks of the W-135 strain of meningitis are becoming increasingly common further afield, such as the outbreaks in Yaounde in Cameroon (reported in Fonkoua et al., 2002) and in Burkina Faso (which killed 1500 people of the 13000 known to have been infected) (reported in WHO, 2001). To this end, as will be seen, whilst there is a vaccine against the W-135 strain of meningitis, this vaccine is extremely expensive and, as such, is not suitable for mass vaccination programmes. The vaccine is currently only in usage for travellers who are expecting to travel in to high risk regions, i.e., hajjis travelling to the Hajj which happens in a known outbreak area. It is hoped, however, that the WHO lobbying of the pharmaceutical companies will produce a more affordable version of the vaccine that would then be utilised in mass vaccination programmes, particularly across the African meningitis region, in order to minimise the spread of the deadly W-135 strain of meningitis. The Saudi Arabian Vaccination Policy This section looks at the current Saudi Arabian vaccination policy and how this policy differs from previous policies, in terms of why the new policy was introduced and what the positive and negative effects of this policy have been. This section incorporates research reviewed in the previous section, through the literature review of the relevant research, and also looks at how historical trends and international trends in healthcare have contributed to this policy. The impact of globalisation on health care is also discussed. Prior to the W-135 meningitis outbreak amongst those who had attended the 2001 Hajj, and following on from the worldwide outbreak of meningitis A which occurred following the 1987 Hajj (Fonkoua et al., 2002) and a 1992 outbreak of meningitis A which occurred amongst Umra pilgrims (Wilder-Smith et al., 2003), the Saudi Arabia vaccine policy was for mandatory vaccination against the A and C meningitis strains for all hajjis, with the necessity to present a certificate of vaccination upon application for a visa to travel to Saudi Arabia for the Hajj. In 2003, similarly to many other countries, such as the UK, who also undertake such a mass vaccination scheme, the Saudi Arabian government implemented a mass vaccination with the tetravalent vaccine, which is active against the A, C and W strains of meningitis (WHO, 2001). Following the 2001 W-135 outbreak, the Saudi Arabian Government put in place several controls for hajjis: i) it became mandatory for hajjis to receive the quadrivalent vaccine (against A, C, Y and W-135) as a visa requirement from 2002 for people entering Saudi Arabia for the purposes of the Hajj (Wilder-Smith et al., 2003); ii) the Saudi Arabian Government administered antibiotics to all local Saudi hajjis in order to eradicate the carriage of the W-135 serogroup and to reduce transmission to local contacts and to the larger community (Wilder-Smith et al., 2003); and iii) it became a requirement for entry to the country that all hajjis coming from countries belonging to the African meningitis belt, and those arriving from areas that had recently experienced a meningitis outbreak, were to take a single dose of ciprofloxacin upon arrival to Saudi Arabia (WHO, 2001). In terms of how international trends in healthcare and globalisation have contributed to these changes in the policy of the Saudi Arabian Government towards controlling meningitis, whilst the Hajj has always attracted pilgrims from all over the world, only recently has the deadly W-135 strain of meningitis reared its head, presenting a potentially disastrous scenario if this disease became epidemic as a consequence of the ideal conditions for disease replication that the Hajj presents. Thus, the Saudi Arabian Government has had to work fast to draw up a policy that minimises, as far as possible, the chances of a W-135 epidemic. The Saudi Arabian response to this threat has been impressive, in terms of drawing up practical, preventative measures so quickly and putting these in to practice so quickly. Globalisation has speeded up international travel and, through globalisation, the world has become, in a very real sense, smaller. One can literally travel wherever one desires, faster than ever before. The fact that there was an outbreak of W-135 in Singapore, amongst Singaporean hajjis, shows that what could once, historically, have been an isolated outbreak of such a deadly disease now has the potential to affect many thousands of individuals, as those infected could, potentially, travel on many different modes of transport, across many thousands of miles, coming in to contact with many different individuals, who could then become carriers of the disease, spreading the disease far afield and leading to different outbreaks of the same disease in places where the disease has never been reported previously. Problems Facing the Policies in Place to Prevent Meningitis Outbreaks During the Hajj This section discusses the gaps that are present between the stated policy and the implementation of this policy, in terms of the organisational constraints that are present that directly affect policy implementation. The actual situation of meningitis control amongst hajjis requires attention, as it is known that many hajjis enter Saudi Arabia illegally and thus are not reached by formal checks or health services whilst entering Saudi Arabia (WHO, 2001). This leads to the situation where diseases could be spread through an individual slipping through the many and varied controls that have been put in place by the Saudi Arabian Government, as it is known that many of these illegal immigrants come from countries that do not have vaccination programmes in place and who, therefore, are highly unlikely to have been vaccined prior to travelling to Saudi Arabia for the Hajj. For this reason, aside from the formal border controls on entry of hajjis, vaccination posts have been established in the last few years around the Holy Mosque (WHO, 2001). In addition, risks are presented by the arrival, at Saudi Arabian border entry ports, of individuals bearing false vaccination certificates. This presents a particular problem as these individuals put at risk the Saudi Arabian control policies that are in place, through the fact that these individuals may be carriers of disease, and may pass disease to the hajjis, but also because the need to vaccinate these individuals, often numbering in to the thousands, costs the Saudi Arabian Government time and money, paying for and administering the vaccine, a vaccine that is in short global supply and which is expensive (WHO, 2001). In terms of minimising the chances of such problems occurring, the Saudi Arabian Government has been in close talks with the Governments of countries of the African meningitis belt to offer direct, on the spot, help with vaccination programmes, donating vaccines to those countries who cannot afford them and opening temporary health centres in those countries that do not have the necessary infrastructure for the administration of said vaccines (WHO, 2001). The Saudi Arabian Government is also involved in research looking at, for example, carriage prevelance of meningitis strains in Mecca and the impact of mass chemoprophylaxis with ciprofloxacin (Who, 2001). Thus, whilst there are gaps that are present between the stated policy and the implementation of this policy, in terms of the organisational constraints that are present that directly affect policy implementation, the Saudi Arabian Government seems, really, as shown through this in-depth study, to be doing literally all it can to attempt to control, as far as possible, the outbreak of various strains of meningitis amongst hajjis during Hajj. Implications of the Saudi Arabian Policy for Nursing Practice The next section of the essay looks at the implications of the policy for nursing practice, in terms of the direct involvement of nurses, the need for counselling and educating parents, in terms of the historical development of nursing and the international trends in nursing. There are many and varied problems presented to UK nurses by the Saudi Arabian policy on vaccination against meningitis, in terms of the fact that UK nursing staff need training to understand the cultural significance of the Hajj to their muslim patients, in order to understand any potential requests for vaccination and to diagnose any potential diseases on their return from the Hajj. Nurses dealing directly with hajjis also require further training in the current vaccination requirements for hajjis, as determined by the Saudi Arabian Government’s vaccination policy, as shown through their visa requirements, in order to administer the correct, required, vaccines. The nursing staff in contact with hajjis should also be fully versed in the symptoms of all types of meningitis (including the deadly W-135) and other diseases that could be contracted whilst undertaking the Hajj, in order for timely diagnoses to be made, and timely treatment to be delivered to the patient. The fact that there was an outbreak of W-135 in Singapore, amongst Singaporean hajjis, shows that what could once, historically, have been an isolated outbreak of such a deadly disease now has the potential to affect many thousands of individuals, as those infected could, potentially, travel on many different modes of transport, across many thousands of miles, coming in to contact with many different individuals, who could then become carriers of the disease, spreading the disease far afield and leading to different outbreaks of the same disease in places where the disease has never been reported previously. Thus, globalisation has led to the situation where nursing staff need to be attuned to the possibility of ‘local’ patients presenting with ‘tropical’ or ‘foreign’ diseases. Whilst there is a system of reporting set up for such diseases, the early diagnosis of such diseases is often mistaken for common ailments, such as flu, for example, and diagnosis and treatment delayed, often leading to the spreading of the disease whilst the patient is ‘at large’ and not contained. This was the case in the 2001 outbreak of W-135 meningitis in the UK, with only 8 of the 51 total cases being actual pilgrims and 22 cases being contacts of the pilgrims, with 21 cases not having any apparent contact with the pilgrims: transmission was maintained for several months prior to diagnosis which is suspected to have led to many of the additional cases (WHO, 2001). Thus, nursing staff in countries that host Hajj attendees, such as the UK, need to be aware not only of current policies which affect the vaccination requirements of hajjis, but also of diseases that could be contracted whilst at the Hajj, in terms of knowing what symptoms to look for in patients returning from the Hajj. Saudi Arabian policies that are aimed at controlling the spread of meningitis during the Hajj thus not only have an effect on Saudi Arabian nursing staff, in terms of requiring them to administer any necessary vaccines and/or other medication, but also have a direct impact on nursing staff in those countries that host hajjis, for example, the UK, requiring special training for nursing staff. Conclusion This essay has looked at the meningitis vaccine policy during Hajj in Saudi Arabia, first looking at the healthcare system in Saudi Arabia, in terms of how the health care system is structured and what the policies towards vaccination against meningitis are. It was seen that the Saudi Arabian policies to vaccination against meningitis have changed somewhat in light of the 2001 outbreak of the W-135 strain of meningitis, which led to a tightening of requirements for entry to the country for the purposes of the Hajj and to a widespread vaccination programme across Saudi Arabia, and a local vaccination and medication programme in the immediate vicinity of the Hajj sites. The essay then moved on to discuss more general policies towards meningitis vaccination, from the World Health Organisation (WHO), for example, and how the Saudi model of vaccination fits in to this more general framework. As seen, the WHO is concerned that a major outbreak of the W-135 strain of meningitis could not be controlled, due to the high cost of the vaccine; the Saudi mondel fits in to this general framework in terms of aiming to prevent an outbreak not through mass vaccination with the quadrivalent vaccine but through the careful control of individuals entering the Hajj zone. The essay then moved on to looking at social theories that have been suggested to explain how organisations work, in terms of understanding how meningitis can be spread through the hajjis attending the Hajj pilgrimage, showing that many social theories are applicable to explain how diseases are transmitted across the Hajj period. The evidence that has been gained from research in to meningitis outbreaks during Hajj was then discussed, as was the historical treatment of meningitis control through vaccination. This was presented in the form of a literature review of the current, relevant, literature regarding meningitis outbreaks during Hajj, and meningitis control through vaccination. Literature that is specific to Saudi Arabia was focused on, although vaccination programmes that have been successfully attempted further afield were also discussed. The essay then moved on to look at how and when the current Saudi Arabian vaccination policy has changed, and how this policy differs from previous policies, in terms of why the new policy was introduced and what the positive and negative effects of this policy have been. It was shown that, prior to the W-135 meningitis outbreak amongst those who had attended the 2001 Hajj, and following on from the worldwide outbreak of meningitis A which occurred following the 1987 Hajj (Fonkoua et al., 2002) and a 1992 outbreak of meningitis A which occurred amongst Umra pilgrims (Wilder-Smith et al., 2003), the Saudi Arabia vaccine policy was for mandatory vaccination against the A and C meningitis strains for all hajjis, with the necessity to present a certificate of vaccination upon application for a visa to travel to Saudi Arabia for the Hajj. In 2003, similarly to many other countries, such as the UK, who also undertake such a mass vaccination scheme, the Saudi Arabian government implemented a mass vaccination with the tetravalent vaccine, which is active against the A, C and W strains of meningitis (WHO, 2001). Following the 2001 W-135 outbreak, the Saudi Arabian Government put in place several controls for hajjis: i) it became mandatory for hajjis to receive the quadrivalent vaccine (against A, C, Y and W-135) as a visa requirement from 2002 for people entering Saudi Arabia for the purposes of the Hajj (Wilder-Smith et al., 2003); ii) the Saudi Arabian Government administered antibiotics to all local Saudi hajjis in order to eradicate the carriage of the W-135 serogroup and to reduce transmission to local contacts and to the larger community (Wilder-Smith et al., 2003); and iii) it became a requirement for entry to the country that all hajjis coming from countries belonging to the African meningitis belt, and those arriving from areas that had recently experienced a meningitis outbreak, were to take a single dose of ciprofloxacin upon arrival to Saudi Arabia (WHO, 2001). In terms of how historical trends and international trends in healthcare have contributed to this policy, and the impact of globalisation on health care, it was shown that globalisation has meant that diseases can spread far more rapidly and widely than ever before, and that this has grave consequences in terms of deadly diseases such as the W-135 strain of meningitis. Various problems for the Saudi Arabian vaccination policy were then discussed, and the relevant solutions were given, and then the essay moved on to discussing the role of nurses involved in the care potential hajjis and of returning, infected, hajjis, in terms of the implications of the Saudi Arabian vaccination policy for nursing practice, in terms of the direct involvement of nurses, the need for counselling and educating parents, and in terms of the historical development of nursing and the international trends in n

The Metamorphosis :: essays papers

The Metamorphosis The introduction gets the readers attention because of its plot movement and extreme details. This particular introduction, unlike most other works contains the climax to the story. This paper will show the importance of these introductory lines. â€Å"When Gregor Samsa woke up one morning from unsettling dreams, he found himself changed into a monstrous vermin.† This line greatly moves the plot, more so than any other line. It is the climax of the novel, and everything following it helps build the conclusion of the story. The juxtaposition of â€Å"unsettling† and â€Å"dreams† is ironic, as dreams are peaceful and never unsettling, only nightmares are unsettling. Gregor has transformed into a â€Å"monstrous vermin.† The remainder of the first paragraph gives details of exactly what the monstrous vermin is. His back is as â€Å"hard as an armor plate†. This metaphor shows the rigidity of his body. Gregor’s body has â€Å"arch shaped, a vaulted brown belly, and many legs.† As a result of this, he does not even know who or what he is. â€Å"What’s happened to me?† He knew it was not a dream. Kafka blends a short sentence about the realization that it is no longer a dream into a paragraph of long sentences to show how the idea of being a dream is chimerical. His room is still a â€Å"regular human room.† In his room are lines of fabric samples, because he is a traveling salesman. Gregor had a picture hanging on his desk. It â€Å"showed a lady done up in a fur hat and a fur boa.† This picture, and the mention of him being a traveling salesman, show the extravagance of his family, while he is a common worker. The weather is overcast, a symbol of Gregor’s despair. He looks out the window, in search of answers to his unanswered questions. He could hear the raindrops and was completely depressed. His depression portrays his feeling that he has no control over the future. He even has no control over himself. â€Å"In his present state, he could not get into that position. No matter how hard he threw himself onto his right side, he always rocked onto his back again.† Kafka beautifully incorporates the climax into the introduction of his story in order to deeply involve the reader in the story.

The Limits of Narrative in in Joseph Conrads Heart of Darkness Essay

The Limits of Narrative in Heart of Darkness    Early English novelists depicted a very general reality; that is, what many observed to be "real" is what found its way into the narratives. For example, several novels of the eighteenth and nineteenth centuries emphasize, or entirely revolve around, the idea of social status. Samuel Richardson's Pamela addresses a servant's dilemma between her morals and low social position; the hero of Henry Fielding's Tom Jones must also confront his "low birth." Jane Austen famously portrayed class struggles in nearly every one of her novels. These texts all represented the world at its face; the actions of the characters spoke for their "reality," and the narrator was simply the descriptor of these events. The novels conformed to a very narrow world-view, limited by popular thought. True, there was much to explore within this confinement, as shown by the range of commentary in the texts. Still, as stories they could only offer what society observed: a kind of reality by consensus. As Joseph Conrad's Heart of Darkness demonstrates, modernism rejected the aims and methods of realism, and claimed the inner self represented the real more closely than the public world. Furthermore, realism appeared to represent the world wholly and concisely. Conrad's novel rejects this, and instead exposes the failure of language to describe a complete reality. In Heart of Darkness, Marlow himself is incomplete, and so is his narrative. He is forced into imprecise language, resigned to using negative modifiers and repeating inexact words. He struggles to tell his story satisfactorily, and by his own admission, his telling is deficient. The limitation of language, then, becomes the focus of t... ...e rejection of nineteenth century realism. Since Marlow the storyteller is flawed, his story falters as a result. The novel effectively reduces each to their flaws, but does not attempt to hide its limitations behind a manufactured authority. It is this absence, or seeming absence, of controlled writing that brings Heart of Darkness closer to "the real" than any authoritative work of realism.    Works Cited Conrad, Joseph. Heart of Darkness. 1902. New York: Dover, 1990. Erdinast-Vulcan, Daphna. The Strange Short Fiction of Joseph Conrad. Oxford: Oxford University Press, 1999. 78-108. Greaney, Michael. Conrad, Language, and Narrative. Cambridge: Cambridge University Press, 2002. 57-76. Hawthorn, Jeremy. Studying the Novel. 4th ed. London: Arnold, 2001. 60-61 Leavis, F.R. The Great Tradition. New York: Stewart, 1950. 173-82.   Ã‚  Ã‚  Ã‚  Ã‚        

Of Gods And Romans Essay -- essays research papers

Of Gods and Romans The Romans during the time of their Republic relied on their advanced technology, social structure, leadership and politics to achieve as much as they did. To these people, their gods affected all of these factors and the relationships mankind had with them. The contractual relationship between mankind and the gods involved each party in giving, and in return receiving services. The Romans believed that spirits residing in natural and physical objects had the power to control the processes of nature, and that man could influence these processes by symbolic action. The first is a primitive form of religious creed; the second a type of magic. The services by which the Romans hoped to influence the forces that guided their lives were firmly established in ritual - the ritual of prayer and the ritual of offering. In either case, the exact performance of the rite was essential. One slip, and you had to go back to the beginning and start again. The very multiplicity of deities caused problems, as did the gender of some of them: 'wether you be god or goddess' was a common formula in Roman prayers. The motivations of the sacrifices are what of interest. Most of the time, sacrifices took place for purification, supplication, or celebration. The purification ritual was one that was performed before battle (285). Asking for a deed to be done was very popular as well. One usually asked for victory and good fortune in battle (20). Celebration is the event that seems to be the most spectacular of all. Whether it is in joy of an enemies’ death, such as Mithridates (201), the end of illness of a leader like Pompey (218), or simply the merriment that comes after large victory, we see this in Caesar’s winnings in Gaul (264). Some sacrificial events took place in order to ask forgiveness and appeasement for defeat of a religious enemy (90 – 91). Any sacrificial routine was elaborate and messy. The head of the victim was sprinkled with wine and bits of sacred cake made from flour and salt. Then its throat was cut and it was disemboweled to ensure there was nothing untoward about its entrails. If there was, it was not only a bad omen, but the whole process had to be repeated with a fresh animal until it came out right. The vital organs were burnt upon the altar and the carcass cut into pieces and eaten on the spot, or else laid aside. Then the priest, we... ...als to changes in social conditions and attitudes. To the Romans, the observance of religious rites was a public duty rather than a private impulse. Their beliefs were founded on a variety of unconnected and often inconsistent mythological traditions, many of them derived from the Greek rather than Italian models (90 – 91). Without any basic creed to counter them, foreign religions easily made inroads into a society whose class-structure was being blurred and whose constitution was being changed by social change. The brilliance of some of the major foreign cults had considerable attraction for those brought up on homespun deities of the hearth and fields. Compare to modern society, the Romans seem extremely superstitious. But then today's major religions have all throughout their past discouraged, even combated, superstitions. Also present-day sciences and technological world allow little room for superstition. The Romans lived in an era previous to this. Their world was full of unexplained phenomena, darkness and fear. These characteristics affected every aspect of Roman life. To Romans, these superstitions were a perfectly natural part in the relationship between gods and men.