Domestic Violence Against Women In India Sociology Essay

Domestic Violence Against Women In India Sociology Essay Domestic Violence is an act of physical, sexual or psychological abuse against a woman by someone who is intimately connected to her through marriage, family relation or acquaintanceship. It has its roots in the patriarchal set up of the society. Women have always been considered to be the weaker sex. Right from the later Vedic age to the 21st century, Indian women have never experienced the freedom that men have. They have always been subjected to inequality. The subordinate status of women combined with patriarchal ideologies is a major cause of domestic violence. According to United Nation Population Fund Report, around two-third of married Indian women are victims of Domestic Violence attacks. To protect women against Domestic Violence, the Parliament passed The Protection of Women from Domestic Violence Act, 2005 According to this act, any woman who has been subjected to domestic violence can file a complaint to the police officer, protection officer or the magistrate in the for m of Domestic Incident Report, which is similar to an FIR. However, this act is not enough. In light of the increasing instances of domestic violence against women, the government needs to take more stringent measures to reduce the prevalence of domestic violence against women. Objectives The objectives of this project are as follows:- What is the magnitude of domestic violence against women in India? What is the prevalence of physical, sexual and psychological abuse against Indian women? What community and families are associated with domestic violence against women? Whether domestic violence is more prevalent in the higher or in the lower strata of the society. Methodology Hypothesis: The prevalence of Domestic Violence against women is an indication of patriarchal ideologies The survey was conducted in Kolkata, Delhi, Mumbai, Bangalore, Chennai and Ahmadabad in 2012. The survey includes forty women who represent different families culturally as well socially i.e. they belong to different stratus of the society. The study is based mainly on quantitative data. It has tried to get empirically sound and statistically reliable data regarding the physical, sexual and psychological abuse against women. Qualitative methodology has been used to interpret and analyze the data collected. Review of Literature Behind Closed Doors by Rinki Bhattacharya is one of the few books which deal with Domestic Violence against women in India. This book contains narratives by seventeen women who have been the victims of domestic violence. These women have showed immense courage in sharing their stories. These heart- wrenching narratives bring home the fact that domestic violence is still very prevalent and that no amount of privilege can protect women from abuse. A documentary film called Char Diwari was made on this book. The fact that this documentary has been telecasted only twice and that too at midnight shows that such issues are still not brought out open in the public. This book also contains essays by eminent feminists and other sociologists who have tried to analyze the phenomenon of Domestic Violence. What they really try to say is that in a country like India, where people worship the female power of Shakti in the form of goddess, why should women be subjected to domestic violence? Then there are further essays which deal with the loopholes in the domestic violence bill. The book ends with a road map to support the victims of domestic violence. This book should definitely be read by those who wish to bring about a change in d position of the women in the society. There is a case study on domestic violence against women in Nagpur. This Case Study has been conducted by International Clinical Epidemiologists Network (INCLEN). On the basis of the survey conducted, it was found out that nearly sixty- two percent of the women have been subjected to some form of domestic violence. Most of these women have been the victims of psychological abuse (60.2 % as compared to 37.9 % of the women being subjected to physical abuse ). Ten percent of these women left their husbands but most of them had to return since their natal families refused to accept them. There is still a social stigma attached to leaving your husband and the root cause of this is the patriarchal ideologies which are still widespread today. Another Case Study deals with domestic violence in Kerala. This has been conducted by Centre for Womens Studies and Development, Kerala. Around fifty five percent of the women admit being subjected to domestic violence. In Kerala most of the women have been victimized due to issues related to dowry. Like in Nagpur, psychological abuse is very high in Kerala. (54.23% as compared to 32.4% of thee women who are subjected to physical violence). In Kerala the literacy rate is almost 100 percent, yet women are victimized. What does this show? It again goes back to the patriarchal ideologies that have existed since time immemorial. Results and Interpretation of Data Table 1: Socio Demographic Profile: TOTAL 40 HIGHER STRATA OF THE SOCIETY 27 LOWER STRATA OF THE SOCIETY 13 AGE (in years) Woman Respondent Husband 32 36 33 37 31 35 EDUCATION Woman Respondent Illiterate Primary ( 1-5 ) Secondary ( 6-12 ) >12 Husband Illiterate Primary ( 1-5) Secondary ( 6-12 ) >12 4 6 7 23 0 4 8 28 0 0 5 22 0 0 2 25 4 6 2 1 0 4 6 3 EMPLOYMENT Woman Respondent Unemployed Employed Husband Unemployed Employed 27 23 6 34 17 10 0 27 4 9 6 7 This table shows that literacy rate is lower among the woman respondents as compared to their husbands. The overall employment rate is higher among the husbands. However as far as the lower strata of the society is concerned, more women are employed than men. Now we come to the prevalence of domestic violence. First the researcher will deal with the women of the higher strata of the society. 20 out of 27 women have admitted to being subjected to domestic violence by their husbands. Out of these 20 women, 12 have been physically abused, 5 psychologically and 3 sexually. As far as the women of the lower strata are concerned all the 13 of them have been subjected to domestic violence. Out of these women, 8 are physically abused, 3 psychologically and 2 sexually. Graph showing the prevalence of Domestic Violence. Table 2 will show the lifetime physical abuse and Table 3 will show the lifetime psychological abuse. Table 2: Lifetime Physical Abuse :- TOTAL (20) HIGHER STRATA OF THE SOCIETY (12) LOWER STRATA OF THE SOCIETY (8) Slap 11 8 3 Kick 8 3 5 Weapon 1 1 0 Table 3: Lifetime Psychological Abuse:- TOTAL (8) HIGHER STRATA OF THE SOCIETY (5) LOWER STRATA OF THE SOCIETY (3) Insulted 5 3 2 Demeaned 2 2 0 Unfaithful 1 0 1 Now the researcher would like to draw your attention to the reasons as to why these women are subjected to domestic violence. Table 4 shows some of the reasons identified by these women. Table 4: Reasons as to why women are subjected to domestic violence:- TOTAL 33 HIGHER STRATA OF THE SOCIETY 20 LOWER STRATA OF THE SOCIETY 13 Not Cooking Properly 18 13 5 Not Looking after the Household 5 4 1 Harassment due to Dowry 4 3 1 Talking to Other Men 6 0 6 It is evident from the survey that Domestic Violence is extremely prevalent especially in the lower strata of the society. There is an inverse relationship between socio economic status and domestic violence. Both Education and Employment is also significant for physical and psychological violence. It is seen that women with lower education but better employment than their husbands are subjected to greater domestic violence. This is the case in the lower strata of the society. As far as the higher strata is concerned, it is generally the lesser educated and the unemployed women who are subjected to the wrath of their husbands. Legal Measures for Domestic Violence against women In India In India not much has been done to protect the rights of women. Women have been the victims of domestic violence since time immemorial, but the Domestic Violence Act was passed by the parliament as late as 2005. It was passed in the furtherance of the recommendations of the United Nations committee on the CEDAW. The following abuses are covered by this act:- Physical abuse Sexual abuse Verbal and emotional abuse Economic abuse This act provides women a right to stay in her matrimonial house, even if she does not have ownership rights over the house. Basically a husband cannot throw his wife out of his house. However her rights will extend only to her husbands properties and not to the properties of her in-laws. Under this act, a woman has the right to ask for help and protection. A victim of domestic abuse has the right to seek the help and services of police officers, protection homes, service providers, shelter homes and medical establishments. She also has the right to lodge a complaint under section 498 of the Indian Penal Code for matrimonial cruelty. Under this act, a woman can get the following orders issued in her favour:- Protection Order Residence Orders Monetary Relief Custody Orders Compensation Orders Interim and Ex parte Orders If the respondent is found to be guilty, he can be imprisoned for a term which may extend to one year or can be charged a fine which may extend to Rs 20,000 or both. He may also be asked to provide monetary relief to the victim and her children. In the latter situation, he has to pay compensation damages as well. He has to abide by the arrangements made by the court regarding the custody of the victims children. Drawbacks of the Legal Measures The Act is mainly criticized on the grounds that it is not backed up properly. There is no effort by the government to implement it effectively. Important factors such as the appointment and the training of the protection officers, police officers, service providers, counselors, and judicial officers have been ignored. The authorities lack the initiative to spread awareness. Moreover there is improper budgetary allocation. Most states have still not appointed the Protection Officers. In some states, where Protection Officers have been appointed, they are not aware of their duties and the legal remedies that are available to the victims of domestic violence. Another drawback is that that the act has not been publicized properly. The helpline numbers available to the victims have not been publicized properly. As a result, sometimes domestic violence goes unreported because the victim does not know whom to turn to for help. In some cases, the violence is reported, but no case is filed i n the court. There is a big difference in the number of cases that are reported and the number of cases which are actually heard in the court. These are the drawbacks of the legal measures. Remedial Measures A crucial question in the light of the increasing instances of domestic violence is that what should be done to control and reduce it. As responsible citizens should we just sit and read articles and collect information about domestic violence or should we raise our voices against it?Today Domestic Violence is being viewed as an epidemic disease which needs to be controlled. Many Law agencies, Governmental and Non Governmental Organizations, public and private bodies are working for this cause. We need more stringent laws to curb domestic violence. At present we do not have a single law in the Indian Constitution which effectively deals with the issue of Domestic Violence. Even section 498 A of the Indian Penal Code and The Domestic Violence Act, 2005 have been misused because of the restricted definition of the abuse that women are subjected to. As a result we need more stringent laws to protect the rights of women. There are several NGOs which are actively working in issues relating to women abuse. These NGOs need to spread awareness among women regarding the legal remedies that are available to them. They should encourage more and more women to come forward and report instances of domestic violence so that necessary action can be taken against the culprit. The Police and the Protection Officers need to be sensitized. They need to take Domestic Violence as seriously as other offences. They need to be made aware of their legal duties and the remedies that are available to the victims. Moreover care has to be taken to appoint efficient men as Police and Protection Officers. Gender training should me made mandatory. Steps need to be taken to recognize Domestic Violence as a public health. Training needs to be provided so as to develop the skills of the professionals to provide the basic support to the victims of domestic violence. Documentation on the health consequences of domestic violence should me made so as to spread awareness. Lastly the patriarchal mindset of the people has to be changed. Until and unless women are given due respect in the society, no amount of laws will be helpful. The root cause of domestic violence is patriarchal ideologies and that needs to be changed. Conclusion The study underlines that the situation of Indian women is quite severe in terms of the violence they experience in the marital home. Women are subject to frequent and multiple forms of violence in their lifetime. The main cause of this is the patriarchal mindset of the people. Men have always considered themselves to be the superior sex and have always tried to overpower women. Generally women do not raise their voices against men because they have been taught to believe that they are the inferior sex. In conclusion, it can be said that the hypothesis- The prevalence of Domestic Violence against women is an indication of patriarchal ideologies has been proved and a social reformation needs to be brought about soon. Questionnaire The women were asked the following questions: Name Age Husbands Age Educational Qualification Educational qualification of the husband Employment Husbands occupation Any Physical Violence? Slapped by the husband? Kicked by the husband? Used or threatened to use a weapon? Any Sexual Violence? Any Psychological Violence? Insulted by the husband? Demeaned by the husband? Was the husband unfaithful? Reasons for the violence as identified by the woman. Not cooking properly Not looking after the household Harassment due to dowry Talking to other men The limitation of this study is that in view of the social stigma attached to domestic violence, some women have been reluctant to answer these questions and as a result have not answered them truthfully.

Discharge Plan for Older Person

Discharge Plan for Older Person In this assignment the author will discuss a discharge plan with rationale for an older person with a long term condition. Included will be potential and actual problems presenting from the patient profile on discharge from an acute care setting. Reference to the Nursing and Midwifery Councils (NMC) professional code of conduct (2008) shall be made throughout the assignment along with a discussion of legislation in the latter part that is relevant to the plan of care arranged. Moreover any copies of documentation used in the appendix will remain anonymous maintaining confidentiality. The theoretical model used to formulate this plan of care is Roper et al (1990) activities of daily living which concentrates on twelve elements essential for daily living skills and the level of dependence required for them. The elements of the theoretical model chosen will be those applicable to the patients discharge care for example, mobility and breathing. The patient profile referred to is that of an elder gentleman in his late seventies admitted to hospital following weakness on waking to the left side of his body which had mainly affected his mobility. There also appeared to be some facial drooping with dysarthria. For the purpose of this assignment when referring to the patient he will be named as Mr Smith as to personalise the plan of care. Mr Smith has a past medical history of chronic obstructive pulmonary disease (COPD) and asthma for which he receives drug therapy of salbutamol and becotide inhalers. He is also the main carer for his wife whom suffers severe Alzheimers disease. Discharge plan Liaise with the discharge co-ordinator as to the impending discharge of Mr Smith. This will ensure the continuity of his care on discharge. The discharge co-ordinator provides valuable assistance and is able to amplify the experience of a patients venture from hospital to the community Day et al (2009). They are highly skilled nurses in this specialist area and mediate between the multidiscipliness involved in the care needs of Mr Smith. Mobility. Problem 1 Possible changes to Mr Smiths movement, function and orientation. Method/outcome Complete a falls risk assessment using an identified tool and follow advisory notes on completion. With consent liaise with occupational therapy and physiotherapy departments for a discharge assessment and continued rehabilitation within the community. Make certain a home visit with therapy teams has been undertaken before discharge. Rationale A falls risk assessment tool (FRAT) is a way to establish risk and manage falls prevention. Its use is advocated in the National institute for clinical excellence (NICE) guidelines in falls prevention document (2004). Following the use of FRAT (appendix 2) it is decided that Mr Smith is at moderate risk of falling and advices of therapy team input. Mr Smith requires an assessment by the occupational therapy team in his home environment prior to his discharge. This ensures his safety and well being for day to day living and maintains his independence. The visit presents an opportunity for the occupational therapist to evaluate the need for adjustment in the home. For example it is recorded that Mr Smith has some difficulty in rising out of the bath he would therefore need modification in his bathroom to enable him to do this, promoting independence and maintaining his dignity. Mobility doesnt just include the physical aspect of movement it involves fine motor activity, personal assertion, feeling and communicative function also. Having a stroke can cause dysfunction, having a dramatic causatum on the persons life Barnet et al (2009). Making adjustments in the home can be an upsetting experience. An assessment by the physiotherapist will maximise rehabilitation in physical movement and allow instruction on the use of equipment that may be required in doing so, this ascertains safety and accuracy during use. Physiotherapists have superior kinetic knowledge and can introduce advice in falls prevention minimising the occurrence. NMC (2008) requires you as a nurse to refer to another practitioner when it is in the best interests of a persons care. Both therapists will be able to initiate communication with day hospitals for continued rehabilitation therapy sessions within the community. Maintain a safe environment and communication. Problem 2 Mr Smith is to administer daily medication and understand the information provision. Method/outcome Ensure the prescription with 7 days supply is provided and sent to pharmacy in time for discharge. Guarantee Mr Smith and his relatives receive relevant information regarding medication. Explain in an accessible manner. Arrange an out patients appointment. Present written and verbal information regarding the appointment. Inform the GP of Mr Smith discharge. Rationale Mr Smith has been prescribed aspirin 75mg following an ischaemic cerebral vascular accident (CVA). The aspirin is given prophylactically and inhibits platelet aggregation which could otherwise result in a thrombus formation British national formulary (BNF) (2009). Eighty percent of strokes result from ischemia, caused by a thrombus blocking the cerebral circulation therefore, preventative medication such as aspirin reduces the risk of a reoccurrence Greenstein and Gould (2009a). It is important to provide Mr Smith with written and verbal information with regard to instruction on how and when to take his medication, along with the dosage and possible side-effects he may encounter. Educating Mr Smith on the need for medication and possible consequence of non compliance present him with an informed choice and reduces the risk of a drug induced re-admission. Reports suggest that fifty percent of older people may not take medicines prescribed for them as they have not received valued information about the benefits and risks involved Department of health (DOH) (2001). The NMC (2008) says that you must share information about peoples health and regimes in a way they can understand. This facilitates informed choices and compliance. Nurses have a responsibility to continue assessment of their patients suitability for self-administration; the NMCs standards for medicines management (2008) standard 9 require you to acknowledge changes to a patients condition and safety with regard to self-administration. Assessing Mr Smiths understanding and capability of remembering to take his medication is of great importance as if he is likely to encounter difficulty, provision for pre-dispensed medicine or help from a carer can be arranged Wade (2007). Indirect questioning will provide some indication as to how much Mr Smith understands and will not make him feel inadequate, maintaining his dignity and respect. An outpatients appointment with a neurologist will maintain consistent specialist monitoring of Mr Smiths condition even though once discharged the GP is responsible for care in the community and continued prescribing. It is therefore vital that the GP has documentation on this hospital admission and any follow up appointments to be attended. Problem 3 Change to Mr Smiths social and home environmental needs. Method/outcome Inform Mr Smith as to the importance of social services participation and gain his consent. Liaise with social services for an assessment of needs completing the relevant documentation (sections 2 5) in acceptable time ready for Mr Smiths discharge. Rationale Consent must be given by Mr Smith prior to the involvement of social services, even though it is documented that they have had previous input with Mrs Smiths care. It is the individuals right to confidentiality and as a nurse you must respect this NMC (2008). Mr Smith has indicated that he has concerns with regard to coping and caring for his wife whom has severe Alzheimers disease when he is discharged. Social services must assess the need for a care support package and provide financial advice for the services required as Mr Smith is a home owner. With Mr Smiths consent social services may even consider the possibility of Mrs Smith remaining in the nursing home until Mr Smith is more able bodied. The need fulfilment of the dependent can generate emotional stress in the carer and burden their physical well-being with the high level of physical exertion needed to provide endowed care Mackenzie and Lee (2006). When Mr Smith returns home it is the expectation that he will be allowing himself time to recover and not put his self under duress which could result in a relapse in his health. Anecdotally, caring for his wife at this stage would not be beneficial to his rehabilitation. Problem 4 Transportation home on discharge from hospital. Method/outcome Liaise with relatives regarding transport home and if necessary arrange hospital transportation. Verify Mr Smith has keys to his property, that someone will be there to receive him or that the key safe number is available. Rationale It is of upmost importance that Mr Smith and his relatives are fully aware of the date of discharge and the preparations for his arrival. Where possible, Mr Smith and his relatives should contribute to the discharge plan. The expectation of you as a nurse is that you uphold peoples rights to be involved in decisions about their care NMC (2008). Working and playing. Problem 5 Possible isolation and lack of social contact. Method/outcome With consent refer Mr Smith to the community stroke liaison services and complete the relevant referral documentation. Provide the services contact details. Rationale The community stroke liaison nurse is there to provide support with initial changes to Mr Smiths life. She is a specialist in stroke rehabilitation and can present him with coping strategies. These will help Mr Smith focus on problem solving approaches and heighten his sense of control Carpenito-Moyet (2008a). The nurse specialist may also be able to provide Mr Smith with mini health checks and details of support groups, clubs and give advice regarding enrolling on an expert patient programme if it is available within the local authority. The expert patient programme is a self management course for people with long term conditions. It was launched in 2002 as a pilot programme but is now national. The course is delivered over a six week period by a trained tutor who is either a volunteer or a previous programme attendee and is vastly beneficial. The service reduces isolation, promotes confidence and empowers those living with deficits or complex needs DOH (2001). Eating and drinking. Problem 6 Nutritional support and secondary prevention Method/outcome With consent refer Mr Smith to a community dietician completing the documentation. Highlight the importance of lifestyle and dietary changes with regard to his condition. Outline the need to attend to any future difficulty in swallowing or further dysarthria. Rationale Following his stroke Mr Smith may have a reduced appetite. Carpentino-Moyet (2008b) suggests this may be due to fatigue, being less mobile or even because of some pain from limb limitation. Carpentino-Moyet (2008c) also discuss that during Illness or convalesce a good nutritional consumption can reduce the risk of further complications and aid faster recovery. Referring to the community dietician ensures that a diet plan optimal in calories and nutrition is received. Making certain that Mr Smith has some understanding about his condition will endeavour compliance with diet and life style changes. The reoccurrence of a CVA is much higher during the first year of rehabilitation, therefore regular checks and life style conversions need to be initiated DOH (2001). Mr Smiths awareness and detection of further difficulties with speech and swallowing is a desired outcome as this could most definitely interfere with his nutritional intake in the future and would incorporate further change to his diet and lifestyle they would also warrant a referral to a speech and language therapist for a swallow assessment. Breathing Problem 7 Mr Smith has COPD and asthma and requires respiratory maintenance and secondary prevention advice. Method/outcome Ensure Mr Smith is aware of how to use his inhalers with the correct technique. Inform him of the importance to have regular visits to the GP or respiratory nurse in order to maintain adequate respiration. Provide cessation of smoking advice. Rationale Belamy and Booker (2000) suggest that the recommended maintenance appointment for patients with mild to moderate COPD should be annually within the primary care setting, they also indicate the monitoring session should involve a full assessment of the patients smoking status, symptom control, and medication efficiency with inhaler technique. Furthermore it allows the health care professional to perform spirometry. It appears that Mr Smiths therapeutic intervention of becotide and salbutamol inhalers have symptomatic control of his COPD at present however, he is now also prescribed aspirin which could contraindicate his condition. Occasionally aspirin causes bronchospasm Greenstein and Gould (2009b) therefore close monitoring is essential. In practice we can promote smoking cessation and provide advice to Mr Smith with regard to the health risks involved following his stroke and COPD. It is his individual choice as to whether he will participate. Many people given smoking cessation advice will continue smoking disregarding concern for their health. The NMC (2008) stipulates that as a nurse you must not discriminate against those in your care, treating people as individuals regardless of whether their choice exacerbates their illnesses. Key issues in older adults and long term conditions care provision: Extensive change has been underway with regard to the care standards and expectations of health and social care services for older people. The force for change has happened due to demographic analysis, which indicates that people are living much longer with an increase in those above the age of eighty. According to the DOH (2001) this figure is expected to have doubled between 1995 and 2025. Such longevity influences the amount of people living with long term conditions. Research and reports from extensive consultation with older people, their carers, healthcare professionals and from media coverage, discuss services declining to meet the needs of older people with age discrimination and depletion of dignity and respect being a major domination as clinical areas lacked evidence based practice DOH (2001). The introduction of clinical governance has helped develop effectiveness of evidence based practice assuring the quality of care is of a high standard. Zwanenberg and Edwards (2004) describe clinical governance as a system to advance the quality of care in which healthcare managers are responsible for policy compliance. They explain that primary care trusts are accountable for providing evidence of their effectiveness and quality of clinical practice and further acknowledge the level of need for accountability since public interest in cases of malpractice. Care plans are aspects of clinical governance policies Lugon and Secker-Walker (1999) as is the essence of care document developed by the DOH in 2001. The essence of care document is a guidance tool specific in enabling healthcare professionals to deliver a structured and patient focused practice within eight areas of care. Some of the areas include food and nutrition, self-care and privacy and dignity. The document also enables professionals to distinguish areas of poor practice allowing for remediation DOH (2001). The national institute of clinical excellence formulated guidelines for practice in assessment and prevention of falls, declaring that falls are a major cause of disability or mortality in the elder population and impact on their quality of health and life NICE (2004). NICE (2004) also report that falling can have a devastating repercussion to an individual causing psychological distress, lack of confidence and poor self esteem, dependency and even pressure injury. The guidelines provide strategies for assessment (FRAT appendix 2) of those at risk of falling, including individuals following a stroke and suggest setting provision for interventions such as physical therapy, home adjustment and the revisal of visual deficit NICE (2004). The development of the national service framework (NSF) for older people by the DOH (2001) delivers policies as to the standard of healthcare that older people should receive. The NSF endeavoured to set strategies over a 10 year programme looking for improvements within specific areas of health promoting independence and providing treatment with respect and dignity. The document lists the quality of care that is required on the best available evidence and provides one standard for all, achieving consistency within healthcare DOH (2001). The focus of the NSF for older people was to abolish age discrimination and provide a patient centred approach to care DOH (2001). The document defines stroke and falls prevention, promotion of health and introduces standards of care for hospital and intermediate settings and for mental health illness in older people. The DOH in connection with the NSF for older people also developed the NSF for long term conditions in 2005. The document expresses the need for the promotion of quality of life with autonomy based around the individuals specific need for their condition. Implementation of this policy includes provision of support for housing, benefits, education and pension schemes helping those suffering with long term conditions to live as independently as possible with access to services as required DOH (2005). A stroke (CVA) is classified as a long term condition and the DOH (2007) stroke strategy document identifies the need for health promotion and management of risk. The plan of action firstly focuses on awareness and prevention, treatment and services available for those whose lives have been affected by stroke. Secondly, it identifies that all needs, health and social of the individual, should be contemplated in a plan of care not just medical ones DOH (2007). The stroke strategy guidelines allow for individuals following a minor event to be given an MRI scan within 24 hours, as evidence suggest eighty percent will follow on to have a severe stroke DOH (2007). Clinical areas can therefore reduce deaths in practice if they adhere to this policy. Promotion of healthy weight, physical exercise and smoking cessation along with regular blood pressure checks and advice on alcohol consumption further reduce risks DOH (2007). The stroke strategy also expresses the need for a multidisciplinary approach, all health and social care workers collaborating together cultivating a stroke care community that will provide the best possible service for those affected returning home DOH (2007). Continued assessment by the multidisciplines following a hospital admission is essential to ensure an individuals suitability for discharge. The DOH (2004) suggests that consideration be made for the individuals physiological, functional and psycho-social wellbeing during the assessments. Being fit for discharge means that receiving care in an acute setting is no longer needed and continued care can be provided between the GP, community services and outpatients appointments DOH (2004). One professional included in the multidiscipline approach within the community is a pharmacist with initiatives developed to increase their involvement in care, such as repeat dispensing, medication reviews and independent prescribing especially for those with long term illness DOH (2005). The pharmacists involvement within the multidisciplinary team is very beneficial to patient care as it decreases medication errors, discovering discrepancies and many contra-indications before the medication reaches the patient. All legislation and government policies have influence on the way healthcare professionals practice. They provide guidelines as to accommodate continuity of healthcare in general. They set standards for quality of care that service users can expect when accessing healthcare provision and project how they will receive this provision. Legislation is an important aspect of healthcare and individuals have the right to life without discrimination, being treated equally with dignity and respect regardless of their condition, disability or age. The writer concludes that Mr Smith is awaiting discharge from hospital following a stroke. Evident from the patient profile he has achieved a satisfactory level of independence and he appears to be making good progress. The discharge plan documented for Mr Smith incorporates many of the NHS and social care policy initiatives to deliver continuity of care from hospital to home using elements from the Roper et al (1990) theoretical nursing model. The discharge plan supports the inclusion of multidisciplines, health promotion, prevention strategies and patient participation. It also up holds the NMC code of professional conduct (2008) whilst focusing on independence and maintenance of ones dignity, providing community support and rehabilitation. References: Barret, D. Wilson, B. Woollands, A. (2009) Care planning a guide for nurses, Essex: Pearson Education Limited. Belamy, D. Booker, R. (2000) Chronic obstructive pulmonary disease in primary care, all you need to know to manage COPD in your practice 3rd ed. London: Class Publishing. BNF 57 (2009) British national formulary. London: BMJ Group/RPS publishing. Carpenito-Moyet, L.J. (2008) Nursing care plans documentation, nursing diagnoses and collaborative problems 5th ed. Hong Kong: Lippincott Williams Wilkins. Day, M.R. McCarthy,G. Coffey, A. (2009) Discharge planning: the role of the discharge co-ordinator, Nursing Older People, 21, (1), pp. 26-31. Department of Health (2001) Medicines and older people: implementing medicine-related aspects of the NSF for older people, The Department of Health. [online]. Available from: http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4008020 [accessed 18/03/2010]. Department of Health (2001) The essence of care: patient-focused benchmarking for healthcare practitioners, The Department of Health. [online]. Available from: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4127915.pdf [accessed 12/02/10]. Department of Health (2001) The national service framework for older people, The Department of Health. [online]. Available from: http://www.dh.gov.uk/dr_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4071283.pdf [accessed 14/02/2010]. Department of Health (2002) The expert patient program, a new approach to chronic disease management for the 21st century, The Department of Health. [online]. Available from: http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4018578.pdf [accessed 30/03/2010]. Department of Health (2004) Achieving timely simple discharge from hospital, a toolkit for the multi-disciplinary team, The Department of Health. [online]. Available from: http://www.dh.gov.uk/dr_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4088367.pdf [Accessed 26/03/2010]. Department of Health (2005) The national service framework for long-term conditions, London: The Stationary Office. Department of Health (2007) National stroke strategy, Department of Health. [online]. Available from: http://www.dh.gov.uk/dr_consum_dh/groups/dh_digitalassets/documents/digitalasset/dh_081059.pdf [accessed 25/03/2010]. Greenstein, B. Gould, D. (2009) Trounces clinical pharmacology for nurses 18th ed. London: Churchill Livingstone Elsevier. Lugon, M. Secker-Walker, J. (1999) Clinical governance, making it happen. London: Royal Society of Medicine Press. Mackenzie, A. Lee, D.T.F. (2006) Carers and lay caring, In: Nursing older people: Redfern, S.J. Ross, F.M. (eds.) Nursing older people. 4th ed. London: Elsevier. National Institute of Clinical Excellence (2004) Clinical practice guidelines for assessment and prevention of falls in older people. CG21. London: Royal College of Nursing. Nursing and Midwifery Council (2008) Professional code of conduct, London. Nursing and Midwifery Council (2008) Standards for medicine management, London. Roper, N. Logan, W. Tierney, A.J. (1990) The elements of nursing, based on activities of daily living. New York: Churchill Livingstone. Wade, S. (2007) Refusing discharge or transfer of care, in: Nurse facilitated hospital discharge: Lees, L. (ed.) Nurse facilitated hospital discharge. Keswick: MK Publishing. Zwannenberg, T.V. Edwards, C. (2004) Clinical governance in primary care, in: Clinical governance in primary care: Zwannenberg, T.V. Harrison, J. (eds.) Clinical governance in primary care. 2nd ed. Oxon: Radcliffe Medical Press Ltd.

The Importance of Clothing in Macbeth Essay -- Macbeth essays

The Importance of Clothing in Macbeth In Shakespeare's Macbeth, clothing imagery represents the titles that Macbeth wears. Macbeth receives two new titles throughout the play; one is earned and the other stolen. The first, Thane of Cawdor, is rightfully his because he earned it. The second, King of Scotland, is a stolen title that does not fit him honestly. Macbeth's clothing in the play symbolizes both of the titles that he acquires. In the beginning of the play, Macbeth already bears the title Thane of Glamis. After a Norwegian invasion and local rebellion in which Macbeth captures the Thane of Cawdor, Macbeth receives his title. When Macbeth is first hailed Thane of Cawdor by Ross he responds with, "Why do you dress me in borrowed robes?" (Act I, Scene III, Line 116). The "borrowed robes" are that of the previous Thane of Cawdor. Macbeth says this not knowing that Duncan, the King of Scotland, has sentenced the treacherous Thane of Cawdor to death and named Macbeth with his title. Banquo, Macbeth's friend at the time compliments Macbeth on his new title, but at the same time says they do not quite fit him yet. New honors come upon him, Like our strange garments, cleave not to their mold But with the aid of use (Act I, Scene III, Line 161). He is saying that Macbeth is not used to wearing the Thane of Cawdor title because it is such a new feeling. Macbeth does not feel comfortable with the title although he earned it by catching a traitor to the king and to Scotland. &n... ...someone else. This is because they do belong to someone else. They were stolen from Duncan, the "giant" (V, II, 24), by "a dwarfish thief" (V, II, 25), Macbeth. The previous quote gives an image of a small, wicked man taking the rightful position of a large, strong man through treachery and betrayal. Macbeth's robes "hang loose" (V, II, 24) because he is not big enough to fill them up. Throughout the play, Macbeth is seen as a small dishonorable man always wearing clothing that does not belong to him. Whether the clothes are too small or too big, the main point is that they do not fit Macbeth because they do not rightfully belong to him. Shakespeare fills his play with clothing imagery in order to easily show Macbeth's different titles.

Essay on The Yellow Wallpaper, A Rose for Emily and Babylon :: Yellow Wallpaper essays

The Yellow Wallpaper, A Rose for Emily and Babylon It is amazing how differently people see the world. People from different walks of life interpret everyday experiences in different ways. This is ever so apparent when discussing the gaps that occur in stories by great authors. In The Yellow Wallpaper, a woman is being "treated" by a doctor (her husband) for a condition he refers to as anxiety. She is placed in a room, apparently one that was previously inhabited by a mental patient, and told to rest. Over the course of a few weeks the woman begins to exhibit signs of paranoia and regularly has hallucinations. Through the course of the story, the woman continuously makes reference to the yellow wallpaper. The first, and possibly the greatest, gap in the story comes when interpreting the meaning(s) behind the wallpaper. Does the color yellow infer something about insanity? The woman repeatedly refers to the patterns that the peeling wallpaper makes. Do the patterns suggest order from chaos? It is apparent, from the number of times that it is mentioned, that the wallpaper plays a role in the mental changes the woman experiences (and details her changes) throughout the story. Part way through the story, she begins seeing a woman moving behind the wallpaper, as if trying to escape it. Is she actually seeing herself in the wallpaper, as suggested by Chris Tildon, or is the hallucination what she fears she is becoming? At the end of the story, she takes on the role of the "creeping" woman and follows a smudge around the room and over her fainted husband. This supports the idea that she is the woman that has been trapped in the paper. Maybe she feels trapped and tormented by John's lack of sympathy for her condition. Another story that benefits from gaps is Babylon Revisited by F. Scott Fitzgerald. The gaps in this story are numerous, but the most important gaps involve Charlie's previous bout with Alcoholism, and his struggle to retrieve his daughter Honoria. Charlie claims to be a reformed man. However, after reading deep into the story, it is apparent that Charlie plays a role in his own downfall. Does Charlie actually try to rid himself of his past, or is he actually perpetuating it? In the story, Charlie visits his old "haunts", maintains a "one drink a day" attitude, and inadvertently brushes elbows with a couple of old drinking buddies.

A Term Paper on Qubee Wimax Essay

Acknowledgement By the cordial mercy of Allah, now we will be able to submit our report to our honorable teacher Tahsina Khan Nimmi we strongly believe that it would not be possible preparing such a report without her help. Now we would like to thank our honorable teacher Mrs. Tahsina khan Nimmi for her keen efforts and invaluable guidance, helped us to understand, what the modern concept of marketing mix, Bostorn Consulting Group (BCG) matrix and SWOT analysis which help us to complete this successful completion of the report. This acknowledgment will remain incomplete if we don’t thanks to this person who helped and being corporate with us specially Fayyad Ahmedul hye(Senior product manager-Qubee) for helping me to find necessary information regarding the report. We would also like to express gratitude to our class members. They should be remembered because they produced the platform of our knowledge. Finally we are really grateful to the other employees and officers of Qubee for their help and valuable advice. Again, I like to thank our honorable teacher for giving us such a chance in completion of the report Finally, we like to say that, we have prepared this report from our own experience. We are ready to accept our unwilling errors and omission which belong to us. Executive Summery The report is prepared to determine the marketing mix, BCG matrix, SWOT analysis of Qubee. Qubee has strong and effective compensation policy which works for raising the morale, efficiency and cooperation among the employees and also adopting new operation process, marketing strategy. Through this report, a clear idea is generated about what actually marketing mix, BCG matrix, SWOT analysis is and its impact in Qubee, the importance of these, the methods and policy used to set for these, what type role these plays to encourage the employees to perform better and achieve the standards fixed and the Qubee’s view toward its necessity and success plus how they measure the results. So I can draw a sharp line of the issue toward its impact of the total human resource management department and overall the total operation and efficiency of Qubee especially in the Foreign Exchange (Bangladesh & Pakistan branch). Here I tried my level best to show the compensation system in online sector and integrate the total process with the functions of the Human Resource Management Department, after that I focused on the issue towards the contribution to other department and at last its contribution towards the efficiency and competitiveness of Qubee. Introduction [pic]Qubee is part of the Augere group. Qubee is a new and exciting company from Augere providing fast and reliable broadband internet services to residential and business customers across Bangladesh. qubee believes that everyone should be able to enjoy trouble-free access to the internet and the world of opportunities that it brings. Their aim is to make a magical internet experience available to everyone, everyday, without exception. Qubee is the creation of a group of global telecoms professionals who saw that a new technology called WiMAX could really change the internet experience for millions of people worldwide. WiMAX means that people don’t  need telephone lines or cable to get connected: all people’s need is to live close enough to a transmitter to receive the internet wirelessly. Qubee is busy building a network of base stations to offer their brand of internet access right across Bangladesh. They’re starting in Dhaka, but quickly plan to do the same in cities nationwide. Qubee has gathered a highly talented team right here in Bangladesh to build a company that’s determined to improve the internet experience for millions of people – not just here, but ultimately all over the world. History Augere Wireless Broadband Bangladesh Ltd, one of the licensees to whom BTRC gave license last year to run business providing Wimax [pic] facility in Bangladesh, has inaugurated Wimax internet service in some selected areas of the capital. The inauguration ceremony was held on 21st October in a hotel in Dhaka. Augere named much-waited Wimax internet service â€Å"Qubee†. On its inauguration ceremony, Russel T Ahmed, head of marketing, Augere, said that the service is initially being given in Gulshan, Banani, Mirpur, Bashundhara Residential Area, and Uttara Residential & Commercial Area. Anyone living in these areas can become a subscriber of the country’s first Wimax service provider, Qubee. Augere said that the service will be available in each part of the country in near future. WiMax is a technology that provides wireless transmission of data using a variety of transmission modes from point-to-multipoint links to portable and fully mobile internet access. Bangladeshi internet users have been dying for this technology since past few years. Last year Bangladesh Telecommunication Regulatory Commission (BTRC) arranged an auction for starting Wimax business in Bangladesh. Augere, who has already started Wimax Internet service in Bangladesh under the brand name â€Å"Qubee†, is one of the four winners of the auction. After the launch of Wimax in Bangladesh with the hand of Augure wireless  Broadband Bangladesh Ltd, mixed reaction is seen among general people of the country. Most of them are not satisfied due to the â€Å"Extreme Monthly Charge† applicable for Wimax customers. However, on the inauguration ceremony of Qubee, it was said that the monthly charge will be reduced by making some offers in future. What’s qubee: Qubee is the real internet experience from Augere. They believe that everyone should be able to enjoy trouble-free access to the internet and the opportunities that it brings. They also believe that in the internet world, speed is happiness so they offer fast and reliable download backed up by customer service that never sleeps. They aren’t just making the internet work; they’re making it work beautifully. Where’s Qubee: Qubee is a new company providing fast, reliable and competitively priced broadband internet services to emerging markets around the world. They believe that everyone should be able to enjoy trouble-free access to the internet and the world of opportunities that it brings. Their aim is to make a magical internet experience available to everyone, everyday, without exception. [pic]

Common Errors in English Language Learning and Use – the Philippine Context

For half a decade, I have spent significant time working with and studying English as Second Language (ESL) learners in several contexts – online, corporate, and academic. In the course of interfacing with these different types of students, several interesting features arise in the study of the learners’ language, most especially errors in writing. In this article, I will give a brief background of the errors of the learners. I will also try to encapsulate some of my observations and experiences in dealing with language errors and probably suggest ways on how to appropriately address them. Hopefully, this will be an eye opener to a lot of English language teachers and practitioners that errors are important in both learning and teaching ESL. The Context The influence of mass media, which use English as a medium for communication has greatly contributed in the development of the English language in the Philippines. Several broadsheets and magazines, FM radio shows and late night newscasts in English are just a few manifestations that the language is indeed alive in the local media scene. Furthermore, the prevalence of business process outsourcing (BPO) industries is also a validation that the country is home to thousands of bilingual customer service representatives who deliver quality customer service to English-speaking clients. Philippine education, however, does not have the same story. Through the years, teachers and school administrators have tried different strategies to improve the English language proficiency of their students. But based on observation and research, there is incongruence between the strategies and the language practices in Philippine schools ; for instance, â€Å"most colleges and universities claim that their medium of instruction (MOI) is English but there is often no explicit school policy articulating this (Bernardo and Gaerlan, 2006:21). † This, in return, results in the decline of English proficiency, leaving educators and teachers with unresolved problems regarding standard policies and procedures in using the English language in the academe. On Errors and the Learners’ Language (Interlanguage) Errors are considered significant features in acquiring, learning, and teaching a second language. It has been customary for students and teachers to talk about errors in the language classroom, most especially in writing classes. Teaching professionals often feel frustrated with the quality of the language of their students’ essays. , For some, errors are signs of failure while others believe that they are indications of and opportunities to understand the very complex process of learning to communicate in a second language. One methodology in studying the learner’s error is by doing Error Analysis (EA) or â€Å"the process of determining the incidence, nature, causes and consequences of unsuccessful language† (James, 1998:1). Brown (2000:218) states that errors may result from several sources, two of which are: â€Å"interlingual errors of interference from the native language and intralingual errors within the target language, context of learning and communication strategies. To simply put it, the first kind refers to the second language errors that reflect native language structure while the second one, results in faulty structures that do not follow the standards of the target language. It is also a must to acknowledge the kind of language that learners produce in order to come up with a holistic study of the learners’ errors. Larry Selinker labels this as interlanguage or â€Å"the separateness of a second language learners’ system, a system that has a structurally inte rmediate status between the native and target languages† (1972 in Richards, 1974:31). With this, it will be easier for teachers to understand where learners are coming from and also for them to come up with possible solutions to address these errors. The Classroom Experience In the English classroom, where formal learning takes place, I have encountered several â€Å"unique experiences† in dealing with errors in academic writing. Filipino college students are very innovative in constructing English sentences that often result in several interlingual and intralingual errors. Take for instance the following excerpt from a student’s composition: Me in my friend was stranded at the gate 3 of fort Bonifacio because the jeepney cannot pass over because of the heavy flood that if we measure is in a waistline and in some place in a neckline. Me and my friend was just stay in the jeepney hoping and waiting that the rain would stop for us to go home. † It is quite obvious that the student has committed several intralingual errors such as: a. Misused pronoun (Me and my friend – My friend and I) b. Faulty capitalization (fort Bonifacio – Fort Bonifacio) c. Wrong conjunction (Me in my friend – â€Å"and†) . Incorrect verb tense (was just stay – stayed) e. Lack of punctuation (Me and my friend was just stay in the jeepney (,) hoping and waiting that the rain would stop(,) for us to go home. f. Inventing new vocabulary and usage (pass over which means â€Å"to pass through†; waistline which should be â€Å"waist deep†) The student also used her knowledge of the first language (in this case Tagalog) to write in English. For example, the compound subject â€Å"Me and my friend† is a direct translation of the Filipino phrase â€Å"Ako at ang kaibigan ko†. This is a concrete example of an interlingual error. It is really tedious to mark essays that contain numerous errors but these things must be pointed out in order to improve the language abilities of students. Moreover, by studying these kinds of errors, it will be easier to diagnose certain areas that need reinforcement. Some Possible Solutions As a teacher and researcher, I have realized that it is imperative to put utmost importance to the errors that ESL students commit in academic writing. Studying these errors may mean finding probable solutions to address them. The following are some suggestions that other teachers can do in their own classrooms: 1. Analyze and rectify the errors found in the learners’ compositions by following specific â€Å"linguistic criteria or the formal features of a language† (James, 1998:206). With this on hand, a basis for assessing and correcting the errors of students will be available. 2. After analysis, provide supplementary materials that will help reinforce language proficiency. This can be done by addressing specific areas of concern like grammar, lexis, usage, and mechanics. This will be helpful most especially to struggling students that are having difficulties in understanding the complex rules of the target language. 3. It is also a must to recognize individual differences inside and outside the classroom. Finding time to connect with students will also help in understanding the nuances of the languages that they use. Knowing how they interact and being able to cope with their interests will give the teachers several insights as regards the learners’ language. . Finally, continuous research and error analysis can lead to a development of a standard material based on empirical data. This will help address the most frequent errors that learners commit in specific linguistic areas. References: Bernardo, A. & Gaerlan, M. J. (2006). Teaching in English in Philippine higher education: The case of De La Salle University-Manila. Hong Kong University. Brown, H. (2000). Principles of language learning and teaching. England: Longman. James, C. (1998). Errors in language learning and use. London: Addison Wesley Longman Limited. Selinker, L. (1972). Interlanguage in error analysis: Perspectives in second language acquisition. Jack C. Richards, (Ed. ). London: Longman Group Limited. Author’s Profile Mark Arthur Payumo Abalos teaches college English, writing (expository, research and technical), oral communication, and literature at the Far Eastern University – East Asia College and De La Salle – College of St. Benilde in Manila, Philippines. He also works as an English language program facilitator at John Robert Powers International and an IELTS consultant at the PALMS Australian Immigration Services. He used to be a full-time Educational Consultant for the Language and Literacy Programs of Scholastic Publishing. He obtained his bachelor’s degree in English Studies: Language from the University of the Philippines – Diliman. His master’s research focuses on the significance of interlanguage grammar and error analysis in developing ELT materials. You can reach him at [email  protected] com.

Psycho Shower Scene Symbolic Analysis Essay

Psycho has many memorable scenes and objects, from the skeleton in the basement, the dark and creepy house to the first horrific murder in fictional movie history which takes place in the infamous shower scene. The shower scene of Psycho was one of the most controversial scenes in the movie, the era and possibly of all time. The point of the scene begins as the protagonist, Marion Crane, decides to return the money the has stolen and mulling the thoughts over, has a shower. But at closer scrutiny it is revealed that the shower is washing away the darkness and guilt of her crime and seems that she is becoming her innocent self again. The shower is almost unanimously all white, except the bright silver tap, now the white symbolises Marion’s innocence and goodness and that the guilt and evil of her crimes are being washed away, Until half way through the scene, the audience feels that this scene will be a bright and happy scene, until a dark blemish appears on the shower curtain. If light represents goodness, than logically darkness symbolises evil, the audience feels this as a dark spot is revealed on the curtain, which slowly grows larger and larger, showing that the danger is increasing as does the size of the darkness, this is what builds the suspense as consciously the audience is seeing a dark figure approach while their subconscious minds register the symbolism causing twice the tension as would be caused without the rest of the scene. The bathroom light is also visible from this angle and causes the shadow to appear that it is approaching the light. Soon the darkness is large enough to make out the figure of a person. A dark figure trying to destroy the light, it stands there, just long enough to give the audience time to try and work out who did it but their attention is then wrenched back to the movie by the loud piercing sound of screeching violins with only half formed suspicions racing through their minds as they watch in horror as the protagonist is horrifically murdered before their eyes, and a feeling of uselessness as the protagonist squeals her agonized cries and the audience can do nothing but sit and watch. In her last moments, Marion seems to be reaching for something, perhaps she feels herself slipping from this world and needs to feel a material object to maintain her grip on this world, either that, or she also could be reaching for the audience as if she is trying to say â€Å"why didn’t you help me? † She then proceeds to slowly sink to the floor as low pitch, sombre music starts to play. Her hand finally manages to find the shower curtain and wrenches it from the rail as she topples over the edge of the bath. The scene than shows that the one part of the shower that wasn’t white, the tap, the symbol of cleanliness puts on a darker purpose, washing away Marion’s blood, this shows that the symbolism of cleanliness can be used to both purge darkness but also to scrub one clean of it’s life. (petty morbid when you think about it) The final part of this scene begins with an extreme close up of Marion’s un-moving, unseeing, unblinking eye. The fact that the audience realise that their staring into death is quite unnerving, along with the fact that there appears to be a single tear on her face, which shows the immense sadness of the scene, one of the main reasons of the sadness was because the audience had bonded with her and that she had died leaving so much left to complete. After all that was the first time that a movie had killed off the main character as of yet. At the end of the scene, the camera pans around to reveal the money, left unnoticed, never to be revealed to anyone or reveal the truth of Marion’s true intentions. This reveals a sense of loneliness and unfulfilled purpose. If you really scrutinise the scene, it almost appears like the symbology has a story of its own†¦ A grey woman, torn between light and darkness, she had once been white but was lured by temptation and grew darker, now here she sits, realising all she had done and decides to rid herself of the darkness. The lets the darkness drop off her body and begins to cleanse herself till she sparkles once more, she surrounds herself with light and silver and feels the darkness ebbing away. A shadow appears behind her, approaching the her, it pulls back the light and ends her life, the woman reaches for something to hold, an anchor to the material world, to feel for one last time before she departs but ultimately just drags it with her. Then darkness, at the time too weak to change the light manipulates the silver, darkening it and using it to leech away whatever life the white woman had remaining, and leave nothing but a husk, an empty shell that once contained the woman in grey. The body of the woman sheds a tear in the memory of what it had once been, as the tempter gloats, covered in light on the outside yet shady and dark underneath.