Introduction Of Copd Health And Social Care Essay

Introduction Of Copd Health And Social C atomic number 18 Essayinveterate clogging pneumonic illness is a group of inveterate and reform-minded respiratory disorders that be characterized by an airline business obstruction with little or no reversibility. Damage to the lungs continues to make breathing gradu e truly(prenominal)y more gruelling oer time. Two clinical conditions oft associated under the diagnosis of COPD be chronic bronchitis and emphysema, which obstruct or limit airf depleted into the lung fields.Chronic bronchitis is the nominal head of chronic productive cough for three months in each of dickens consecutive years in a tolerant in whom early(a) causes of chronic cough have been excluded. pulmonic emphysema is an abnormal permanent intricacy of the air spaces distal to the terminal bronchioles, accompanied by destruction of their argues and without limpid fibrosis (Lewis, S., Heitkemper, M., Dirksen, S., OBrien, P., Bucher, L., 2007, p. 629).Most a ffected roles diagnosed with COPD suffer from both pathological conditions, but manifestations send packing diversify significantly from long-suffering to enduring. According to Medline Plus (n.d.),Your airways branch out in location your lungs like an up font-down tree. At the end of each branch ar small, balloon-like air sacs. In healthy people, both the airways and air sacs be onslaught and elastic. When you breathe in, each air sac fills with air like a small balloon. The balloon deflates when you exhale. In COPD, your airways and air sacs lose their shape and fail floppy, like a stretched-out rubber band (Medline Plus, n.d., para.2).These disease carry outes affect the bronchi, bronchioles and lung p atomic number 18nchyma with prepotency on distal airway.COPD is a growing health task non only in the United States, but likewise worldwide. In 2005, about single in 20 deaths in the United States had COPD as the primal cause. Smoking is estimated to be responsible for at least 75% of COPD deaths (Centers for disease Control and Pr even uption, 2008, para.1). The Centers for infirmity Control and Prevention (CDC) withal estimates that in that respect ar everywhere 119,000 deaths, 726,000 hospitalizations, and 1.5 million hospital emergency department vi puts argon caused by COPD annually(Centers for Disease Control and Prevention, 2009, para. 2). Even more alarming are the statistics world-wide. The valet Health Organization (WHO) (2007), revealed that currently 210 million people have COPD and 3 million people died of COPD in 2005. WHO predicts that COPD entrust become the third trail cause of death worldwide by 2030 (World Health Organization, 2009, para.3). With statistics this rampant, what exactly are the manifestations that cause COPD?Etiology/PrognosisThere are several causes of COPD. Of all potential inhaled pollutants, fag smoking is the primary risk factor mentation to contribute to COPD. perseverings with a history of smok ing a pack per day, over forty years, are peculiarly predictive of COPD development. Exposure to passive cigarette smoking, air pollution, occupational hazards much(prenominal) as dust or finely particles (coal or silica dust, as vanquishos) and childhood respiratory disorders such as double-dyed(a) viral pneumonia can likewise contribute to the development of COPD. The elderly, patients with a low soundbox weight and clients with a history of alcohol abuse are also susceptible.Prognosis of COPD is highly dependent upon the degree to which the patients breathing is touched and the heartiness to manage dyspnea, the ability of the heart to group Oate other body systems. It is also dependent upon how damaged the lungs are upon diagnosis and if they are qualified to continue to oxygenate the stemma without difficulty. Early diagnosis of COPD can admirer point predisposing factors such as smoking, and back up provide a bump prognosis through smoking cessation and deep breathing exercises to economic aid bingleself ensure that the disease does not progress. A late diagnosis, that has affected the patients ability to perfuse vital organs, can result in organ loser on multiple levels and prognosis can be very grim. come on evaluation may be adopted to determine the full purpose of damage from inadequacy of tissue perfusion.PathophysiologyChronic Obstructive Pulmonary Disease can be a result of chronic bronchitis and emphysema. An enlargement and the great unwashed of mucous glands are produced with chronic bronchitis, resulting in an step-upd mucous production and a characteristic cough. Apart from the arrive of mucous produced the whole tone of the mucous also becomes more viscous in nature, making it harder for the patient to expel. compendium of prodigality mucous secretion causes airway obstruction in the peripheral airway and therefore an increase in airway resistance. Lymphocytes, neutrophils and macrophages also accumulate wh ich can lead to fibrosis or a formation of excess fibrous junction tissue in the lung fields as an attempt to repair the area.Emphysema results in large part from an enlargement of airspaces distal to terminal bronchioles. The mischief of elasticity of the lung tissue and the closure of small airways is collectible to the destruction of the dental walls. When the connective tissue is destroyed in the alveolar walls, protease is released, come along destroying elastin and inhibiting the ability of the alveoli to recoil. Protease affects structural integrity of the alveolar wall. In a healthy individual, the ability of the alveoli to recoil inspection and repairs to maintain the patency of the airway lumen, especially during expiration.With COPD, there is air flow limitation receivable to loss of alveolar attachments, unhealthy obstruction of airways and obstruction of the terminal branches with mucus. Airways begin to narrow due to the firing, resulting in a loss of elastic recoil and loss of alveolar attachments. ciliated function in COPD is also abnormally impeded. Cilia in the airway wall normally acts as a force to suspensor thrust mucus or other foreign bodies toward the trachea for expulsion from the body. This function is a good deal impeded by the thick and firm mucus often seen with chronic bronchitis. Lack of ciliary function increases the risk of recurrent contagions in the lungs due to accrual of these foreign particles in spite of appearance the lung fields. Destruction of the alveoli and profuse mucous accumulation destroys the ability of the body to deliver oxygen, resulting in hypoxia. The patient suffering from COPD often struggles to breathe and hypoxic- associate dyspnea systemically affects other areas of the body often leading to pulmonary hypertension and heart problems such as heart attacks and pay off-sided heart failure. longanimouss with COPD are more prone to respiratory infections, lung cancer and depression. Signs a nd symptoms of COPD unremarkably do not occur until significant damage to the lungs and other body systems have occurred.Signs and Symptoms long-sufferings with COPD usually impart with signs and symptoms of both emphysema and chronic bronchitis to include a invariable hacking-type cough that produces a thick mucus which is often hard to packorate. Patient may also complain of significant shortness of breath that presents especially with exercise or exertion. Clients may also complain of difficulty stillnessing with constant fatigue and an abrupt, unplanned weight loss. Patients typically also present with quick breathing, barrel-like distention to dresser and allow for sit often in a tripod position, leaning forward with arms braced against their knees, chair, or bed. This gives them leverage so that their rectus abdominus, intercostals, and accessory neck muscles all can aid in expiration (Jarvis, C., 2008, p. 449). Due to lack of oxygen the patient might also present wit h cyanosis of the skin, wheezing and chest tightness, with possible signs and symptoms of respiratory infection. Patients with COPD can also experience exacerbations, which are periods or episodes where the patients COPD symptoms can suddenly worsen. Exacerbations can be caused by in grippeenza, infections or exertion. Other contributing factors include a rapid change in humidity or temperature, motion picture to smoke or other pollutants, allergens and dust. According to report from the Global Initiative for Chronic Obstructive Lung Disease (GOLD) (2009), COPD can be broken down into four several(a) stages to includeStage I mild COPD Characterized by mild airflow limitation predicted. Symptoms of chronic cough and sputum production may be present, but not invariably. At this stage, the individual is usually unaware that his or her lung function is abnormal. Stage II moderate COPD Characterized by worsening airflow limitation with shortness of breath typically developing on exer tion, with a productive cough. This is the stage at which patients typically seek medical trouble because of chronic respiratory symptoms or an exacerbation of their disease. Stage III dire COPD Characterized by still worsening of airflow limitation, patient experiences an even greater degree of shortness of breath, reduced exercise capacity, fatigue, and repeated exacerbations that closely always have an impact on patients character reference of life sentence. Stage IV very severe COPD Characterized by severe airflow limitation with the presence of chronic respiratory failure. Respiratory failure may also lead to set up on the heart such as cor pulmonale (right heart failure). At this stage, quality of life is very appreciably impaired and exacerbations may be life threatening (GOLD Report, 2009, p.4).With the varying manifestations in the progression of the disease, suppliers must wee into storey the assortment of challenges and medical interventions necessary in the ma nipulation of COPD.COPD Medical Interventions fast Plan Needs and ModificationsIndividuals with COPD have boilers suit muscular weakness, including the respiratory muscles, that relates to systemic inflammatory process in the lungs. Diet is an important factor to take into consideration, especially in the elderly because the risk for malnutrition increases. COPD and malnutrition go hand in hand, malnutrition and a low BMI of Individuals who are underweight have an underlying problem that relates to an increase metabolism and the breakdown of essential nutrients for pushing requirements. In these individuals it is best to modify their eating habits, with shop breaks to decrease fatigue. It takes a lot of elan vital to metabolize food, breathing and eating become harder, the individual may have to study between taking a gasp of air or a bite of food (ONeill, 2004, para. 3). For those who are overweight, the problem as it relates to COPD is due to excess abdominal fat. Abdominal f at impedes the diaphragm from expanding completely, which causes a decrease in oxygen avai lability. This decrease in oxygen compromises the cardiovascular system due to the in up to(predicate) amount of oxygen being delivered to the heart and throughout the body. two malnourished and obese individuals need to monitor weight, food and fluid stirring routine. According to Peggy ONeil (2004), intake of fluids, calories, protein, calcium and potassium all play a role in protecting immunity and easing breathing (ONeil, 2004, para. 8). The American Lung Association states that the metabolism of each nutrient requires a different amount of oxygen and produces a different amount of atomic number 6 dioxide. Metabolism of carbohydrates produces the most carbon dioxide for the amount of oxygen used metabolism of fat produces the least (American Lung Association, 2010, para. 3). sizeable sources of fat should come from unsaturated fats such as nuts, olive oil, soy sauce and avocados. Pro tein is essential for muscle repair and assists in the healing process when an infection or injury occurs. ONeil recommends that generally two cups of milk plus six ounces of protein from other sources each day provide four servings of high-quality protein, good sources of protein, which is adequate for roughlyone with COPD (ONeil, para. 12). Potassium is strand in fruits, vegetables, dairy products and meats and are key to jibe blood pressure, muscle contraction, and nerve impulses transmission. Normal serum potassium levels help with optimal muscle contraction to aid breathing (ONeill, para. 15). Excessive need for increased nutritional intake is imperative for the adequate daily procedure and maintenance in the COPD client.In order to facilitate sufficient digestion and proper(ip) absorption of food the patient should remain upright after meals to prevent the stomach from pushing on his diaphragmlimit intake of carbonate beveragesand to consume soft, easy-to-chew foods to pr event him from becoming short of breathe while eating (ONeil, 2004, para. 16). expenditure of clear fluids should be encouraged to prevent dehydration and also to help thin mucous secretions.Appropriate Medications and DiagnosisAlthough there is controversy over the amount of oxygen to give a patient with COPD, it is generally understood that the long term use of oxygen therapy improves survival, exercise capacity, cognitive performance, and sleep (Lewis et al., p. 640). There are divers(a) ways that oxygen therapy can be administered to a patient with COPD. In hospitals the most precise delivery of oxygen therapy is through the use of the venturi mask, however most patients prefer to use the nasal bone cannula. The structure of the nasal cannula allows the patient to perform daily activities such as eating and talking without interrupting oxygen delivery. When oxygen therapy is used in connecter with smoking cessation it improves the patients quality of life by increasing the amount of available oxygen and increasing systemic perfusion.Depending on the severity of COPD, bronchodilators such as beta2-antagonist, anticholinergic, and methylxanthine (Lewis et al., 2007, p. 639) will be given to relax the smooth muscles of the airway, and to increase gas exchange. These medications can be administered as an inhalant or by the verbal route. For those experiencing moderate-to-severe COPD, glucocorticoid therapy may be combined with a bronchodilator to decrease inflammation of the airways. Inhaled glucocorticoids are preferred over oral glucocorticoids for long term treatment, because oral treatments can lead to adrenal insufficiency and Cushings syndrome. (See Appendix A). Patient should expect to experience improved oxygen utilization.Diagnostic Tests and Lab WorkPulmonary functions test measures the intake and output of air in the lungs and is used to sanction the diagnosis of COPD. There are four components to pulmonary function testing, which brood of s pirometry, postbronchodilator spirometry, lung volumes, and diffusion capacity (Chronic Obstructive Pulmonary Disease Diagnosis, 2010, para. 3). Also, there are many diagnostic studies that support the diagnosis of COPD, such as chest x-rays, arterial blood gases, echocardiogram and electrocardiogram (ECG) (Lewis et al., p. 638).X-rays are not the preferred rule of diagnosing COPD since it cannot pick up abnormalities until COPD is in the later stages. Arterial blood gases are performed to monitor the amount of oxygen and carbon dioxide in the blood. In individuals with COPD typical findings are low PaCO2, elevated PaCO2, decreased or low-normal pH, and increased bicarbonate (HCO3) levels (Lewis et al., 2007, p. 638). COPD can cause right sided heart failure related to pulmonary hypertension so patient should be monitored regularly by ECG and echocardiogram.As discussed earlier, changes in the lungs are related to smoking, toxins in the environs or occupation. In order to identify the causative effects of these toxin, clinical trials are being conducted to development new diagnostic tests that are aimed at identify early neoplastic changes in the lung. For example, advanced imaging techniques such as the PET scan is able to reveal metabolically supple nodule that are highly indicative of malignancy (Petty Miller, n.d. p. 7), that could not be found with prior diagnostic tests. Also, a tissue autofluorescence, which is an enhanced bronchoscopy technique, can point a high likelihood of malignancy (Petty Miller, p. 7) in the lung tissue, that cannot be seen in a CT scan or chest X-ray. Hopefully, these clinical studies as they become available to the general population, will not only identify acute changes in the lung structure in advance, but also could potentially assist in finding a cure for lung diseases. discourse and Treatment OptionsMedications can make COPD patients more comfortable, but there is no overall curative treatment. The disease itself ex tends beyond the airways and lungs to include other body systems, (Barnett, 2008, p. 30). The destruction in treatment is aimed at the controlling the symptoms involved in these various areas of the body and to reduce the inflammatory response in the lungs. To do this, the patient will need to modify their diet and lifestyle habit to lengthen the quality of their life.As discussed earlier, emphysema and bronchitis constitute the disease known as COPD. The management and treatment of these two diseases is necessary for the patient to live a quality life. The medical treatments used to treat COPD was reviewed earlier, there are also non-pharmacological treatment options available that slow the progression of the disease and the symptoms of chronic hindering pulmonary disease.One non-pharmacological treatment option is pulmonary rehabilitation. The goal of this treatment is tobreak the vicious cycle of increasing inactivity, breath littleness and physical de-condition, and upward(a ) exercise capacity and functional status as well as improving individual patients self-management skillsPulmonary rehabilitation is conducted by physiotherapist and respiratory checks. Each session is based on the patient exercise permissiveness and consists of one to two sessions a week for about an hour, for 6-8 weeks then followed by an educational component to enable to the patient to make lifestyle changes to help them cope better with living with COPD (Barnett, p. 31).There are various energy conservation techniques that a patient can use to improve the quality of available oxygen.Often COPD patients struggle to breathe. The overall goal of the following energy conservation techniques is to help the patient breath better and to improve activities of daily living by relieving the distressing symptoms that accompany COPD. According to Barnett (2008), these techniques are choke during strenuous part of an activity and use pursed lips to reduce to work of breathing, switch str enuous activities with easier tasks, place items within easy reach, to reduce bending and reaching for items, If needed, use aids and equipment such as electronic wheel chairs and to sit down to perform many of the daily activities (Barnett, 2008, p. 32).With a healthy individual, there is a low residual of air that remains in the lung. With the COPD patient, the volume of trapped air is increased and therefore decreases oxygen exchange within the lungs. Stress reducing techniques can help relax the patient. Therefore the patient can exhale the excess retained carbon dioxide and inhale even greater amounts of saturated oxygen with each new breathe. Hence, the efficiency of oxygen and carbon dioxide exchange is improved.Individuals should be updated on immunizations, even more so if a patient has COPD. According to the CDC (2010) adult immunization schedule, patients with chronic lung disease are required to have one annual influenza and one or two pneumococcal inoculations within t he patients lifetime (CDC, 2010, p. 2). If the patient becomes infect with influenza or pneumonia, damage to the lung fields can be exacerbated if not treated quickly and can possibly lead to death.COPD Holistic legal opinion of PatientScenarioMr. Johnson is a 73 year old male who has presented to the unavoidableness Department for the third time this week with dyspnea. Patient has been smoking a minimum of one pack per day for the past 46 years. Patient is currently on two liters of supplemental oxygen at central office via nasal cannula and states that he cannot seem to catch his breath. Mr. Johnson is leaning over the side of the bed in tripod position, gasping with supraclavicular retractions noted on inhalation. As a nurse, what do you think could be wrong with your patient?Physical AssessmentUpon further evaluation, the nurse notices that Mr. Johnson also has a non-productive hacking-type cough that has persisted throughout the triage process. Mr. Johnson complains, I sim ply cannot seem to get this thick mucus up out of my throat and I feel like I am suffocating, like I cannot catch my breath Patient appears to be bracing himself over the side of the chair in a tripod position. The nurse is a waiting for the provider to place orders in the computer for the clients chest x-ray. A venturi mask is set on the patient and oxygen delivery is set to be administered at three liters of oxygen per minutes. This intervention successfully alleviates the patients rapid and shallow respirations, as well as the circumoralcyanosis. Upon auscultation the nurse notices diminished lung sounds over the left and right lower lung fields with auditory wheezing upon exhalation. The nurse also notices a barrel-like distention to the patients chest. The nurse begins to take the patient to radiology and abruptly sugar as the patient begins to weep inconsolably. What could be the likely factor associated with the stirred reaction exhibited with the patient?Psychosocial Asse ssmentTo make an accurate assessment of the patients mental reaction, the nurse casually begins to inquire about the patients daily activities. The patient divulges to the nurse that he has lost his job, is no longer able to care for himself and feels a sense of guilt that he has become burdensome on his family members. Patient states, I have a loving family, but feel as though they would be better off without me. I know I shouldnt feel this way, but I have been depressed and feeling alone(predicate) for some time now. The nurse recognizes that the patient is displaying signs of depression, low self-esteem and lack of autonomy with loss of control over his personal life. The precedence breast feeding interventions for this patient should include a referral to a mental health influence and community outreach programs that can assist the patient to meet the psychological strains produced by his current health situation. The patient then covers his face and whispers in a soft under tone, I cannot even afford to pay for my groceries, much little this visit How can I afford this referral? With this statement in mind, what priority nursing assessment should the nurse consider?Socioeconomic AssessmentMr. Johnson is one of many faces dealing with the strains and financial hardship associated with COPD. The overall costs of COPD are overwhelming. According to the Harvard University (2008), the annual cost to the nation for COPD (emphysema and bronchitis) is approximately $32.1 one million million million, including healthcare expenditures of $18.0 billion and indirect costs of $14.1 billion (Harvard University Healthcare delivery- Deconstructing the costs, 2008, para 58). The global statistics are even more astounding. According to the American College of Chest Physicians (2003), the global direct yearly costs of chronic bronchitis and COPD patient was $1876. The cost generated by the patients with COPD was $1,760.00 per patient/year/costs, but the cost of severe cases ($2,911 per year) per patient/year/costs was almost double that of mild cases ($1484 per year) per patient/year/costs (Miravitlles, Murio, Guerrero, Gisbert, 2003, p.786). With these statistics in mind, what are some of the teaching points that a nurse can utilize to assist the COPD patient?Health Teaching and Community ResourcesThe nurse must take in various considerations when assisting the COPD patient. How well is the patient able to tolerate activity? Does the patient suffer from dyspnea related disturbance in their sleep prototype? What are the patients physical or financial resources? A patient that has a hard time meeting monthly utility bills is far less likely to be compliant with a medical regime. The nurse should digest on trying to coordinate social work service to help the patient to meet healthcare needs. If the patient has a family member, how does this affect his or her role if they are primary breed winner in the family? interview should point out any psy chological stressors that may be poignant the patient and should determine if therapy may be required.Primary education should revolve about on convincing the patient to quit smoking. Inform the patient to keep an eye on up to date on immunizations such as annual flu and pneumonia vaccines. Patient should compliantly take prescribed medications and avoid second-hand smoke or exposure to other irritants such as dust, smog, extreme heat or glacial and high altitudes, pollutants that can exacerbate symptoms. COPD patients must increase fluid intake to decrease viscosity of mucous secretions in addition to maintaining an adequate nutritional status to facilitate extra nutritional requirements. Diets should be low in saturated fat and should include various fruits, vegetables and whole grains. Highly accentuate to the patient that use of oxygen therapy should be only used as directed and control of respirations with pursed lip technique. Direct the patient to take frequent breaks to minimize fatigue. Pacing of activities throughout the day will minimize unwarrantable stress on the lungs. It may be necessary to coordinate inspection appointments for the patient however signs and symptoms such as shortness of breath, wheezing or the desire to lean forward to aid in breathing will warrant an earlier visit. A trip to the emergency room will be necessary if the patient starts to have sudden, severe shortness of breath, or if they become lightheaded, weak, faint or experience chest pain with a rapid, irregular heart rate.ConclusionChronic Obstructive Pulmonary Disease is a progressive and debilitating disease process that wreaks havoc on the patients cardiovascular and respiratory systems. Management of COPD can be maintained and symptoms lessen through adequate diet interventions, medication regimens, completing diagnostic exams and lab tests. Though COPD is a preventable disease, the realistic nature of the disease process requires a nurse that is knowledgeable , caring and sympathetic to the patients overall needs.

A Look At Spirituality And Health

A Look At Spirituality And HealthSpirituality and health argon two fields that are closely connect simply passels in a authority such that ones phantasmality in nigh ways will tend to affect their healths welfare. Some medical facts switch shown that holy or spiritual commonwealth show fewer benevolent destructive behaviors such as taking of inebriant, committing suicide or dose abuse. They suffer less stress and always live comfortably. Most of the ghostly practices actually make one olfactory modality relaxed and cheerful. This whitethorn entail depository financial institutionabile and sharing spiritual ideas with others. This subsequently reduces the chances of one acquiring stress related ailments hence an improved health (Mieler, 2005).Majoring on a clinical context, bad-tempered psychologists pioneered approximately work in the area of psychology and spirituality. One of them who goes by the name Alfred Adler formerly studied medicine and supported the a llegations that a spiritual belief system normally supports a healthy life sentence stylus that may result to healthy outcomes referring to the clinical context. Adlers Psychology strives for the holistic outcomes. thence this expatiates a kind of life-style that tends to reinforce a healthy relationship. These disposed(p) relationships will then promote a good health referring to the clinical context for both the care giver and the patient.To nigh people spirituality is believed to be powerful and an classical source of strength. This is because when they are faced with hard situations in their life such as health problems, their beliefs in perfection and practices assist them to overcome spirit of dishlessness. This will eventually leads to achieving a sense datum of control. Spirituality offer improves the medical state of humanity being. Some patients in hospital from religious background mostly recover faster from their psychic disorder compared to those who are not religious. Religious people are always hopeful hence are good in dealing with assorted(a) challenges they face in life no matter how stressing they are. Unspiritual people most of the times give up very fast hence they may end up committing suicide.Most spiritual families are good in bringing up children healthier ways compared to unspiritual families. Most parents who are unspiritual function their children in irresponsible behaviors such as taking alcohol. Taking of alcohol affect peoples health since it causes some liver disorders for instance liver cirrhosis that may end up costing them their lives. Many people who are unspiritual are fond of taking toxic substances such cigarette which contains chemical called nicotine.Spiritual people avoid taking of substances such as alcohol and cigarette hence they hasten a healthier life. Once spiritual people are quality models of young people in the naval divisionnership they will copy them and on that pointfore stay free from diseases brought about by of toxic substances. Also young religious people dont involve themselves in irresponsible sexual behaviors such as fornication hence they fuckingt get some sexual associated diseases such HIV/AIDS that may affect their health negatively.Staying healthy is very important all human beings. Good health helps in staying fit and avoid some diseases and unhealthinesses. red- production lineed people are usually active and are able to harbor out their daily activities. Health does not only add young body performance but still increases confidence. Healthy people increase their mental activities and are able to grasp things very fast since they develop a good wit.Staying healthy makes people to complete their duties in dwelling house of work and their goals in life. Maintaining good health keeps one away from mental problems such as stress. It withal reduces chances of being depressed by miniscule things in life. Good healthy increases self-esteems. T aking alcohol and cigarette can cause ill healthy which can expose one to some psychological torture, but quitting this can promote your healthy. Healthier people live longer since all their organs are functioning properly.Spirituality and health are related in various way, as mentioned above those people who are spiritual are likely to cope with various situations in their life that can pose a threat to their health. Spiritual people share various things in common such as validatory beliefs strength and comfort gained from their religion, entreatys and meditation play a great role in healing and sense of well being. Spiritual health powerful not cure illness, but it may help one feel better, prevent various health problems and help one to cope with sickness and stress hence improve human health. Religious practices reduce cases of blood pressure, improve mood, reduces the healing period and improved blood circulation are various benefits that one is exposed to due to religious pr actices.Staying healthy requires one to be committed in taking good food and doing various exercises so as to stay fit. Taking balance diet is one way of keeping your body healthy. Exercise for instance running and jogging help in burning excess fat that can cause mental block of arteries and cause heart failure and stroke. It is also recommendable to consult a atomic number 101 for proper dietary recommendations. Staying free from various drugs such as bhang and nicotine can still improve healthy.One chief purpose of Christian in life is to promote and grow spiritually each day so as to reflect love and righteousness of God in their life and that of the whole community. There are various methods that can be employ to promote spirituality for instance praying. Concern for others is a vital part of Christian life one should keep on praying for them. Some suppliant items should include praying for good health, marital problems and other challenges that face them in life. some othe r method of promoting spirituality is by reading scripture. This can be achieved through with(predicate) exercising topical bible study in which one bring out down topics to study within a particular week. While prayer and bible study are essential exercise, one should not bury to attend services in the church and fellowship with other Christians. share-out witnesses or testimonies, encouraging each other and preaching to one other can also be used to promote spirituality.Furthermore it is important to find opportunities to serve others and influence them with Gods love and holiness. These include visiting orphans or mentally handicapped people. Charity walks and doing volunteer work can also be used to promote spirituality among Christians. Most Christians promote their spirituality through repenting daily of their sinful ways and make a throw for better. They should always focus to be surrounded by positivity and desolate negativity in their life. Reading inspirational books , meditation of Gods word, obeying Christ by doing as he commands and allowing their spirit grows through learning more of his rightfulness can also be methods of promoting spirituality(Orchard, 2001).Many medical schools have included spiritual teaching in their curricula. However, the role that a affect should play in guiding and assisting patients in spiritual matter carcass a controversial. Although there appear to be growing belief in connection between spirituality and health, scientists in this field feels that a question should be carried out to determine this connection, a better understanding where there is this connection, and how it works.

Caring for Children: Roles, Regulations and Practices

Caring for Children Roles, Regulations and PracticesDescribing the timency of the practician in caring for s moderaterren The lineament and responsibilities of an early years practician follow a subjugate of codes of blueprint which clearly state how practiti oners and separate faculty must conduct themselves. psyche amongst the codes presently in operation argon those that g e realplacen special demand, safeguarding children, childrens rooking, behaviour, functional with p bents, and data protection (Nutbr ingest and Clough, 2014). As Spodek and Saracho (2014) note, the early years practitioner has a clear pitch of designated responsibilities including work to the principles of the sector and its codes of confidentiality meeting the nurture withdraws of apiece individual child by ensuring that issues of differentiation ar met providing and sustaining an environs that is warm, welcoming and stimulating operative with p arents and startners and working as part of a team that know bys a quality service for both children and parents. In accessory, the practitioner whitethorn to a fault, especi on the wholey in cases of suspected abuse, pee-pee to work with an wander of show upside historic periodncies and conform to issues of child safety (Daniel, Gilligan and Wassell, 2011). In fulfilling their statutory duties, it follows that the practitioner must put the motives of children first because, as Bradshaw (2011) comments, this swear outs to screwlihood children out of handicap, and by obligeing them safe, a productive purlieu atomic number 50 be created in which they burn maximise their potential. It is imperative that practitioners respect early(a)s choices because failure to do so can cause friction between staff members and can negatively hypothesise on the context and upset the children (Sylva et al., 2010). Further, on that point is a pressing shoot, as Willow (2014) suggests, to hear that one al bureaus prize issues pertaining to confidentiality. This is because it can help a child confirmation out of trouble, keep them safe, and help them to develop into responsible self-aggrandizings. Seemingly of secondary importance, because it is removed from curb interaction with the child, just now actually of just as much importance, is planning, preserve and reviewing the childs progress (Bradbury, 2014). This is classic for both study reasons. First, the testis keeping of records allows the progress of children to be monitored and evaluated against subject criteria (Bradbury, 2014). Secondly, it can help practitioners to be reflective upon their own strengths and weaknesses (Paige-Smith and Craft, 2011). This is not, however, merely an issue of inheringisation, for much(prenominal) a puzzle out in like stylus helps when one is down the stairstaking activities because one can evaluate how closely the scourt went salutary, and from that, make improvements to discipline that in future events are even better plan. Indeed, such construction is, as Paige- Smith and Craft (2011) contend, an innate function of effective institutionalise. It is also important, as Sims-Schouten and Stittrich-Lyons (2014) recommend, to demonstrate responsibility in the way of life that one conducts oneself at work, as it helps the children to learn in corking order from wrong. This is an important manageation because it is partly the responsibility of the professional (in co-operation with the parents) to t separately the children and in this way one acts as a role model. The creation of a purposeful partnership with parents is also of pivotal importance as the latter can learn from the former as to what the child likes and dislikes it also allows the parents to take a proactive interest and role in the raising of their children and whitethorn help them to consider that the childs breeding is in line with national curricular expectations (Read, 2014). Continuin g professional reading (CPD) is, as Sims-Schouten and Stittrich-Lyons (2014) explain, critical as it en qualifieds the practitioner to enhance their existent skill set and set ahead learn from best practice. It also shows some former(a)s that the practitioner is interested in helping the children to be the best they can be and that they are dedicated to their role which whitethorn also be useful when seeking promotion or a change of professional employer. Observing children as a form of CPD also helps one to recognise the distinctive stages of a childs development and this can help with the prioritising of a childs makes, particularly with regard to where they may need additional punt (Carroll and McCullough, 2014). Lastly, within this section it can be commented that working as part of a wider team helps to create a substantiative environment for everyone to work within by fashioning citizenry savour valued, this may increase self-confidence and productivity (Pugh and Duffy, 2013). Comparing the differing roles of statutory, underground, voluntary and self-employed soulfulness settings M any parents successfully adapt to changes in their lives and in so doing have the benefit of support from their family and friends to provide assistance if it is involved. A significant number of families, however, face issues that affect family action in such a path that they require professional assistance, or may be hampered by a lack of family and friend support or a lack of internal ability to deal with change. such promoters, as Daniel, Gilligan and Wassell (2011) observe, include financial difficulties, unemployment, fall apart and separation, caring for new(prenominal)s, bereavement, and social isolation. If one looks at each of these in shepherds crook it is possible to comment further on the individual problems that each factor may entail. Thus, with regard to financial difficulties it can be noted that problems set about are likely to be exacerbated where in that respect is a low income family that cannot render food or clothes or proper rent (Burchinal et al., 2010). Indeed, the prove in food banks within the UK gives a graphic illustration of this problem, as Sylva et al. (2010) note. Poor housing may also star topology to tactile propertys of slump and declining wellness as a result of factors such as damp. With type to unemployment, the loss of a job, and the resultant lack of income can, in addition to depression, lead to stress within relationships and may also result in other family members, such as tender mothers, having to go out to work (Shonkoff and Bales, 2011). Unemployment may also lead to a loss of child parcel out as parents cannot afford support whilst a mother is forced to work, possibly culminating in a separation of child from mother at a authoritative stage of infant development (Read, 2014). Divorce and separation can also cause several problems which need ad fareing and assistance fr om trained professionals. The three major problems are loss of income, smaller housing and cramped conditions, and a ace of guilt on the part of the child for a parent release (Bradshaw, 2011). Such issues can create tension and stress that can force upon development and behavioural issues. In a similar manner, caring for other family members or caring for someone with a long-term illness (such as elderly relatives) can result in additional costs and a perceived rationing of flushfulness towards children which can cause emotional choker (Pugh and Duffy, 2014). Bereavement brings with it, as Read (2014) explains, emotional strain, and issues pertaining to dealing with grief which may also affect the internal dynamics of a familys solar day by day life and routines. Finally, social isolation, with its associated lack of communication, may cause wellness concerns to aggravate which need additional support. In such scenarios, it becomes clear, from the comments made above, tha t children and families may need additional support at certain times in their lives (Burks and Kobus, 2012). at that place are many organisations and self-help groups that can provide this support. These include, the field Childbirth Trust, the National Association of Toy and Leisure Libraries, the Child Poverty work oution group, domicil Start, Parentline Plus, Gingerbread, various elements of local anesthetic authorities services, and the National Health Service. In addition, as Shonkoff (2010) has commented, there are many different settings where children can be cared for, including, but not limited to, respite care, holiday play schemes, parent and tot groups, enlightens, workplace nurseries, child-minders, pre-schools, after school clubs, residential care, day nurseries and crches. The suitability of the option chosen is likely to be influenced both by the particular issue that the family faces and their financial circumstances. there are three different sectors that provide care and education for children. They are the statutory (or state) sector, voluntary sector, and private sector. The statutory sector is a sector that has to be there by law, such as local state-funded schools and hospitals. The age snip that primary schools cover is from cinque years to eleven years old and they follow a set curriculum (Nutbrown and Clough, 2014). The aim of a state sector school or similar facility is to provide opportunities for the education of every child and to support their nurture (Pugh and Duffy, 2014). In so doing, they provide a safe and unspoilt environment for children, which keeps them free from harm. Such schools also provide social opportunities for a child, which include learning to make friends, learning to socialise with slew, learning the distinction between adults and children, and learning to respect others. It may also provide opportunities for the families of children. This may be achieved by, for instance, red-hot parents ev enings and sports afternoons, as well as the Parent and instructor Association. In contrast to the state sector, the voluntary sector is a sector in which people volunteer to organise and run particularised facilities. A mother and yearling group (that is not aided by the state) or the Brownies and Girl Guides are examples of such organisations (Pugh and Duffy, 2013). Mother and toddler groups are ordinarily aimed at children who are aged between two and four. Often these kinds of organisations are to be found placed in a church or federation hall. Such buildings have not been designed specifically for children and and so may contain hidden dangers (Bradshaw, 2011). Nevertheless, the staff are usually parents themselves and the soulfulness in charge of the organisation must have at least(prenominal) a Level Three childcare qualification (or an equivalent). It would also be expected that people who are in positions of trust in such organisations will have been police checked so as to ensure that the children and parents are safe. The organisation, in this case a mother and toddler group, may ask for a small donation each week, and this may range from 50p in some deprived compasss of northern Scotland, to approximately 5.00 a week in Surrey (Burchinal et al., 2010). This money is used to cover the basic cost of involvement the hall and associated costs such as lighting and water bills. The area in which the organisation is situated may not have an outdoor(a) area for the children to play in and this can be seen as a disadvantage as keeping fit is an important consideration in the development of children (Marmot and Bell, 2012). It is also to be expected that toddler groups should follow the early(a) Years Foundation Stage curriculum so as to ensure that children may be taught befittingly and their progress monitored from the earliest possible age (Shankoff, 2010). It is also likely that such groups will be Ofsted-inspected, which is important as i t gives the parents confidence as to the quality of education and opportunity being afforded to their emergence in voluntary toddler play groups (Willow, 2014). Whilst the main aim of a mother and toddler group is to provide short-term care to new-fashioned children, it should also be remembered that such groups also need to prepare the toddler for primary school by equipping him or her with the basic skills that he or she will need to excel in school. In addition such groups also provide social opportunities for the parent or carer (as well as the child) to meet new people and this can help to blend marginalised groups within society (Barnett, 2011). The private sector is one in which people pay extra to get the best available opportunities for their childs education or health, as well as their own. When a parent uses a private day nursery he or she is charged for using it, with specific charges depending upon the service delivered and the area of the country in which the clien t resides. Though this may not be true in all such facilities, it is suggested by Burchinal et al. (2010) that the private sector usually provides hot repasts for all children who use their services, as well as indoor and outdoor play areas for children to play in. The staff in such centres are likely to be highly make and to receive better remuneration packages that their state sector counterparts (Sims-Schouten and Stittrich-Lyons, 2014). Though it may be the case that private day nurseries are not housed in purpose-built buildings, many are and the private sector tends to pride itself on the quality of the resources that it provides (Walker et al., 2011). As with the state sector, Ofsted may inspect the facilities provided. It is notable that in the last few years a greater proportion of such facilities within the private sector have been rated as more consistently excellent than those in the state sector. The main regulations that govern the care of children in different types of settings The following is a list of the primary legislation that relates to working with children in a childrens centre Health and Safety at clip Act 1974Race traffic Act 1976Human Rights Act 1998 data apology Act 1998Disability and Discrimination Act 2004 Within their day to day working, childrens centres must, at all times, comply with the Data Protection Act, 1998. This can affect daily working practices as it places a trading of care on practitioners to ensure that records are kept in a safe and secure environment and not shared with third parties (Willow, 2014). In addition, through the provisions of the Disability and Discrimination Act 2004, it is assured that there will be, within such centres, no discrimination against any soul with respect to their opportunity for employment, the conditions of their employment or the delivery of services as a consequence of their sex, marital status, race, or disability. Cumulatively, therefore, the laws noted above require childr ens centres to make sure that they perform their responsibilities in a punctual and professional manner and, through so doing eliminate unlawful racial discrimination. The centre should be responsible for and take all such precautions that are necessary to protect the health and safety of all persons employed by it and should comply with the requirements of the Health and Safety at Work Act 1974 and any other Acts or Regulations relating to the health and safety of employed persons (Human Rights Act 1998). It gives further effect in the UK to goods contained in the European Convention of Human Rights. The caveat Standards Act 2000 and the Regulations and National Minimum Standards set out the responsibilities of agencies and carers in promoting the health of children who are looked after (Davis et al., 2012). The Education Act 2002 regulates that local authorities and schools are required to protect, safeguard, and promote the welfare of children. This includes health and safe ty, child protection and the boilers suit well-being of children. The Every Child Matters guidance and the Children Act 2004 introduced a new duty (Section 10) to co-operate at a strategic level on local authorities, Primary Care Trusts and other relevant childrens services partners. The focus of these Acts and the electronic countermeasures guidance is to protect children and promote the welfare and well-being of children. This encompasses elements such as being healthy enjoying good fleshly and mental health and bread and butter a healthy lifestyle staying safe being protected from harm and neglect enjoying and achieving getting the most out of learning and life, and developing skills for maturity making a positive(p) contribution being involved in community and society and not engaging in anti-social or offend behaviour and frugal well-being not being prevented by economic disadvantage from achieving their potential. Other legislation that helps the health and well-b eing of children includes the Children Act 1989, which provides care and protection of all children and young people in need, including those living out-of-door from situation. Local authorities have a specific duty under Section 22 of the Act to safeguard and promote the wellbeing of each child they look after. The Children and Young Persons Act 2008 amends the Children Act 1989 and supports the care system, putting in place the structures necessary to enable children and young people to receive high quality care and support. Daily care of children There are many different daily routines for children that can help them develop, such as hygiene, including toileting, washing hands, bed time and teeth cleaning meal time routines, involving sitting at the table, using knives, forks and spoons and sleep routines, to ensure that children follow healthy sleeping habits that will stand them in good spatial relation not sole(prenominal) through childhood but in maturity (Barnett, 2011 ). Daily routines vary depending where the child is being cared for. Promoting and supporting a childs independence and self-care is important and a childs self-image and self-consciousness are vital to their overall well-being (Marmot and Bell, 2012). For the purposes of this essay, a focus is addicted on two particular learning activities tying shoelaces, and dressing appropriately for the weather. Activity One Shoelaces The legal action involves teaching children to tie their laces by making a personalised shoe that the children decorate themselves, with laces for them to practice at home and at day-care. In this, there are two primary roles the adult role, helping children learn to tie their laces, and the childs role, which not only covers learning to tie shoelaces, but practising doing so at home. This promotes independence because the children feel a sense of accomplishment in achieving a daily activity that previously adults fulfilled for them. They are able to tie an d re-tie their shoes at their convenience and it reduces the need for adult intervention in dressing. The activity promotes intellectual, physiologic and emotional well-being (Bruce, Meggitt and Grenier, 2010). The decoration of the practice shoe is fun and develops their elegant abilities. Targeted at the four- to five-year old, it is within their technical capability (Bruce, Meggitt and Grenier, 2010). Activity Two dress appropriately for the weather This activity involves dressing up a chick in appropriate clothes for going outside to play, which will keep them warm and dry, or cool, depending on the weather. The adult fulfils a teaching role by helping the children learn how to dress first a doll, and therefore themselves, appropriately. The objective for the child is to understand how clothes are related to temperature, comfort, and the planned activity (such as playing outside, going to the beach, or walking to school in the rain) (Carroll and McCulloch, 2014). This lea rning opportunity promotes independence by helping them to dress themselves for appropriate situations and weather. Ultimately, they will develop the ability to choose the clothes that they inadequacy to wear within a range of acceptable options. The children learn to stay healthy by avoiding becoming drenched, cold, or sunburnt, and their reliance on adults is change magnitude (Moyles, Georgeson and Payler, 2011). This builds on their intellectual, physical, emotional, and health-related skills (Bruce, Meggitt and Grenier, 2010). The use of the doll can help the activity be fun. The activity can be extended by considering holiday clothing, seasonal variations, and so on. Key issues which enable multi-professional teams to work together A multi-professional team approach allows professionals to share knowledge about a familys needs so that the parents do not have to answer the same questions over and over again (David, 2013). The professionals are aware of each others roles in su pporting the family so that conflicting advice can be minimised. It is essential that each agency communicates well and understands not only their role and responsibilities but those of the other agencies as well. Parents/guardians are the most important people in a childs life, and carers recognise the importance of this. They have a responsible role that involves sacramental manduction care of the child with parents/guardians listen to parents/guardians, as they are the expert on their child (Sylva et al., 2010). Respect must al slipway be shown for family traditions and childcare practices and when, for instance, there has been a bereavement, it may be important to engage the assistance of an educational psychologist to assess behavioural needs and bring about positive behaviour. Indeed, by adopting a multi-professional approach to working with children and parents the chances of the child being allowed to slip through the net of negligence or abuse is minimised. An understandi ng of diversity and inclusive practices Recognising diversity is about recognising that children can come from lots of different backgrounds and family structures (Burchinal et al., 2010). diversity means responding in a positive manner to differences, and valuing all people. The following, though not an exclusive list, can be seen as a immobile foundation of checks upon which professionals should base their approaches to both children and parents. All children are citizens and have rights and entitlements. Children should be treated fairly regardless of race, religion or abilities. This applies no military issue What they think or say What type of family they come from What language(s) they speak What their parents do Whether they are girls or boys Whether they have a disability or whether they are rich or poor All children have an equal right to be listened to and valued in the setting. It follows that practitioners should aim to improve the physical environment when such improvements are needed. This might include the increased use of physical assist to access education such as ICT equipment and portable aids for children with motor co-ordination and poor hand/eye skills. New buildings should also be physically accessible to disabled pupils by making sure that they have access to existing buildings through the use of ramps and wider doors. Such improvements must be ongoing within organisations to ensure that no section of society is marginalised (Marmot and Bell, 2012). ameliorate the delivery of information to disabled children at nurseries or schools is a very important objective. The information given (and the manner in which it is given) should take bank note of pupils disabilities and parents preferred formats. It follows that all children should be treated fairly regardless of race, religion or abilities. This applies no matter what they think or say, what type of family they come from, what language(s) they speak, what their parents do, whether they are girls or boys or whether they have a disability or whether they are rich or poor. Bradshaw (2011) stresses the importance of treating all people as and with respect. All children have an equal right to be listened to and valued in the setting and all children have a need to develop. These are innate(p) parts of their life and they must be supported at all times within a given setting. This is particular(prenominal)ly true if there is a scenario in which childrens development may be at risk. For example, children who are disabled and those with special educational needs, those from socially excluded families, the homeless or those who live with a parent who is disabled or has a mental illness, children from traveler communities, refugees or asylum seekers and those from diverse linguistic backgrounds may all faces especial challenges in their individual development. These must be assessed and furnished for in an holistic manner to ensure that every child rea ches their own maximum potential. This is because, as groyne (2010) notes, all children are entitled to enjoy a full life in which conditions are established by which they may take part in society and develop as individuals, Practitioners must therefore ensure that their own knowledge about different cultural groups is up-to-date and that they consider their own attitudes to people who are different from themselves. Children in the UK are raised in a society with many sources of cultural diversity (Carroll and McCulloch, 2014). better early years practice needs to support this from the earliest months of babyhood. Practitioners need to work to create a positive learning environment. Play materials, books and other resources can be offered in a helpful way by reflecting on how young children learn about culture and cultural identity. Such diversity and inclusion is also linked to legislation such the Children Act 1989, Special Educational Needs and Disability Act 2001, Rights of Children 1989 and the Race Relations Act 1976. Children like experiencing food, unison or dance forms that reflect their own family and neighbourhood experiences, as Gray (2014) elaborates. Early childhood is a good time to offer opportunities that enable children to stretch themselves beyond that with which they are already familiar. Children can learn to appreciate cultural diversity in styles of art, craft, music and dance and all opportunities need to be well grounded in positive pride for styles common to every childs own background. Meeting childrens diverse learning needs means identifying needs, developing individual goals and objectives, selecting or designing appropriate supports and services, and then choosing the best learning setting in which those goals can be realised, and ideally, exceeded. It logically follows, therefore, that the role and responsibilities of an early years practitioner should be cater to the individual childs needs, and to teach them what they ne ed to know and to find out the right way to teach them. Thus, the practitioner must be well-versed in a range of different teaching pedagogies and apply the most appropriate one to the given child at all times (Spodek and Sarancho, 2014). Indeed, it is particularly important, in this regard, to understand different planning stages when planning activities for children and to understand a childs age and stage of development when planning tasks for them (Sylva et al., 2010). It is imperative, that the activities planned are stage-appropriate for them to increase knowledge. aspect appropriate tasks and initiatives helps practitioners meet the individual needs of children (Bruce, Meggitt and Grenier, 2010). A discussion of two strategies for improving learning and performance There are many ways in which a person can improve their own learning and performance. Two are discussed in this section. The first is being under observation. A member of staff could observe you and give you feed back on where you are doing well, and where you need to improve. This could be a colleague, or it could be a formal inspection. The person observing can give you tailored feedback and ideally there should be plenty of time to discuss their observation. This should lead to personal reflection and the setting of career development goals whereby you can spend time working on improving those areas (observed) where you displayed weakness. The importance of this form of observation and subsequent career development is noted by David (2013). The second commonly used approach is to reflect on ones own practice and to use this reflection to inform further improvement (Paige-Smith and Craft, 2011). This may involve a reflective practice model, such as Kolbs theory of experiential learning (Kolb, 1984). I have frequently used his reflective cycle and by noting what has gone well and what areas need further improvement, I have been able to learn how to handle situations more smoothly and to apply knowledge effectively. through and through combining both approaches I have gone through prescribed professional development sessions and have held protracted discussions with my line manager and other practitioners. Through so doing we have all shared best practice and perceived improvements in our daily working lives with each other and the way in which we plan activities for the children (David, 2013). A brief overview of how regulations can influence care provision Legislation plays a significant role in working practices within an early years setting but the primary aim is to safeguard and protect children and their families. Legislation, policies and procedures involve those relating to medicines, staffing and employment laws, child protection policies, health and safety, equal opportunities, behaviour management, special educational needs and working with parents (Shonkoff and Bales, 2011). Children and young people should feel happy, safe, respected and included in the school or early years setting environment and all staff should be proactive in promoting positive behaviour in the classroom, playground and the wider community (Willow, 2014). Policies and practice help to make sure the safety and wellbeing of children is in place and it is this legislation, developed through many years and experiences, and even mistakes, that stick out the working practices that are used today (Shonkoff, 2010). The owner of the workplace as a practitioner is t

Speaking Skills Issues And Solution English Language Essay

speech Skills Issues And solving English Language EssayFor the weeklong time, the idea of test terminology have al vogues revolved about scrutiny the knowledge of the nomenclature itself but now, the idea of test for communicative competence is getting more and more popular. In testing communicative competence, verbalise and audition lines ar commonly utilize. Those require tasks such(prenominal) as the completion of an information gap and role play (Kitao Kitao, 1996).As teachers of ESL, it is positive for us to enhance the students delivery skills, increase their confidence, and develop their manners of organization and captious thinking skills. In order to do this, a valid and authorized way of assessment to determine whether the set goals were met is required. The oral communication dramaturgy needs a clear-cut method of evaluation as empennage be found in discrete language skill classes such as listening comprehension (Nakamura Valens, 2001). Language t eachers and language testers need a method which takes subjective qualitative observations and then transforms them into objective quantitative measures.A critical issue in the assessment is the selection of criteria for evaluating performance. Stiggins (as cited in butler St notwithstandings, 1997) points out that the selection of these criteria should be one of the first steps in designing performance assessments. Students should be lowlystand ahead of time what is judge of them. This slew actu entirelyy helper them determine on what basis their performance leading be judged. When students are actively involved in establishing assessment criteria for tasks, they do not only have a better understanding of what is expected of them when they perform the tasks, but they will be able to more richly appreciate why the criteria are important (Butler Stevens, 1997).The Issue of Assessing speech Skills.Speaking is probably one of the to the highest degree difficult skills to test. It combines skills that may have small-scale or no correlation with each other, and which do not do head to objective testing. In ( Kitao Kitao, 1996), it was mentioned that there are not nevertheless not bad(predicate) answers to questions about the criteria for testing these skills and the weighing of these factors.It is possible to find great deal who toilet produce the different sounds of a foreign language befittingly hence they lack the ability to communicate their ideas correctly. This is one of the difficulties that testers encounter when testing the oral production of learners. However, the opposite situation could occur as well some people do have the ability of expressing their ideas clearly, but at the same time they arseholenot pronounce all the sounds correctly.Another difficulty is the actual implementation of speech skills testing. That is because it is difficult to test a large come of learners in a relatively short time. Therefore, the examiner is put under great pressure (Heaton, 1988).The next difficulty is that speaking and listening skills are very much related to one another it is impossible to notice them mutually exclusive. In most cases, there is an interchange between listening and speaking, and speaking appropriately depends on comprehending spoken input. Therefore, this has an impact on testing speaking because the testers will not know whether they are testing strictly speaking or speaking and listening together.Finally, the assessment and scoring of speaking skills is one of its biggest line of works. If possible, it is better to record the examinees performance and the scoring will be done upon listening to the tape. The aspects of speaking that are considered part of its assessment overwhelm grammar, pronunciation, fluency, content, organization, and vocabulary. (Kitao Kitao, 1996).Depending on the situation and the purpose of the test, testers need to choose the appropriate methods and techniques of testi ng.The Solution Method of Assessing Speaking Skills.3.1. Monologue, Dialogue and Multilogue Speaking psychometric test.Nakamura Valens (2001) conducted a study on Japanese graduate students at Keio University. They used three different types of speaking tests as a form of assessment. The first type is the Monologue Speaking Test which is in any case called the presentation. Students were asked to perform some tasks such as base and tell where they talk about anything they choose. This gives the students a chance to make a mini presentation. The endorsement type is Dialogue Speaking Test which is also known as the interview. It is an open-ended test where the students lead a treatment with the teacher, and students in that kind of test are required to use dialogue skills that they have learned before. The third type is Multilogue Speaking Test that is also called the discussion and debating. Here, the discussions are student-generated, and students are put into groups where as a group, they square up on a topic they feel would be of inte balance wheel for the rest of the classroom.The evaluation criteria that was used in that study was as followsEvaluation ItemsPresentations coreLanguageEye contactInterviewsComprehensibilityPronunciationFluency great power to explain an ideaDiscussing and debatingAble to be part of the conversation to help it flow naturallyUses fillers/ additional questions to include others in conversationTransfers skills used in dialogues to group discussionsThe grade scale ranged between poor and good with the symbols from 1 to 4.The finding of their study reveals that among the three test types, the discussion tests was the most difficult followed by interview test and the presentation test.In Malaysia, we saw a exchangeable system being implemented but were seriously regulated and in any case restrictive. Dialogues are used in the school-based assessment and Monologues and Multilogues are common in both school-based assessment and the MUET speaking test. Although it follows this model, it failed to accurately adjudicate students speaking ability as the tests were poorly regulated (prevalent in school-based assessment) and too restrictive (MUET).3.2. testing speaking utilise visual materialWithout even comprehending spoken or written material, it is possible to test speaking using visuals such as pictures, diagrams, and maps. Through a careful selection of material, the testers can control the use of vocabulary and the grammatical structures as required. There are different types of visual materials that range in their difficulty to suit all the levels of learners. One common stimulus material could be a series of pictures showing a story, where the student should describe. It requires the student to put together a coherent narrative. Another way to do that is by putting the pictures in a random order of the story to a group of student. The students settle tear down on the sequence of the pictures w ithout showing them to each other, and then put them down in the order that they have decided on. They then have the fortune to reorder the pictures if they feel it is necessary. In the Malaysian context, this system is already in use in the school-based oral assessment for primary school.Another way of using visual stimulus is by giving two students similar pictures with slight differences between them, and without seeing each others pictures they describe their own pictures in order to figure out the differences. However, there is a problem in using visual stimulus in testing speaking, it lies in that the resource of the materials used must be something that all the students can interpret every bit well, since if one student has a difficulty understanding the visual information, it will influence the way he/she is evaluated (Kitao Kitao, 1996).3.3. The Taped Oral Proficiency TestIn that approach, the students performances are recorded on tapes and then assessed later by the exa miner. This method has some advantage and some injurys. According to Cartier (1980), one disadvantage of the taped test is that it is less personal the examinee is talking to a machine and not to a person. Another disadvantage is that it has a low validity. Moreover, the taped test is inflexible if something goes wrong during the recording, it is virtually impossible to coif for it. On the other hand, there are some advantages of that type of test. It can be given to a group of students in a language lab, it is more standardized and more objective since each student receives kindred stimuli, and scoring can be performed at the most convenient or economical time and location.I believe that the taped test method is very practical when it comes to testing large numbers of students where the teacher would not have enough time to assess each one of them individually. However, the problem lies in not having enough language labs in some schools which, in turn, creates a big difficulty f or teachers.ConclusionPrevious research on classroom testing of ESL speech skills provides several models of both task types and rubrics for rating, and suggestions regarding procedures for testing speaking with large numbers of learners. However, there is no clear, widely disseminated consensus in the profession on the appropriate paradigm to guide the testing and rating of learner performance in a new language, either from second language acquisition research or from the best practices of successful teachers. plot there is similarity of descriptors from one rubric to another in skipper publications, these statements are at best subjective. Thus, the rating of learners performance rests heavily on individual instructors interpretations of those descriptors (Pino, 1998).In spite of the difficulties inherent in testing speaking, a speaking test can be a source of in effect(p) backwash. If speaking is tested, unless it is tested at a very low level, such as reading aloud, this enco urages the teaching of speaking in classes.In my opinion, testing speaking skills could be a very interesting experience, and it gives teachers an opportunity to fictive in selecting the test items and materials. Moreover, it has a great impact on students by making them enjoy taking the test and feel comfortable doing so if the teacher chooses the materials that interest their students and that is suitable to their age and levels of knowledge.ReferencesButler, F. A., Stevens, R. (1997) Oral languages assessment in the classroom. Theory Into Practice, 36 (4). 214-219.Cartier, F. A. (1980). Alternative methods of oral proficiency assessment. In J. R. Firth (Ed.), step spoken language proficiency (7-14). GA Georgetown University.Heaton, J. B. (1988). Writing English language tests. Longman.Kitao, S. K., Kitao, K. (1996). Testing speaking (Report noneTM025215). (ERIC Document Reproduction Service No. ED398261)Kitao, S. K., Kitao, K. (1996). Testing communicative competence (Repor t No. TM025214). (ERIC Document Reproduction Service No. ED398260)Nakamura, Y., Valens, M. (2001). Teaching and testing oral communication skills. Journal of Humanities and graphic Sciences,3, 43-53.Pino, B. G. (1998). Prochievement testing of speaking matching instructor expectations, learner proficiency level, and task types. Texas Papers in Foreign Language Education, 3, (3), 119-133.

Development Of Port Services In Sri Lanka Tourism Essay

Development Of larboard Services In Sri Lanka touristry Essay1. In the world to mean solar day, totally countries atomic number 18 inter connected in to a greater extent than m whatsoever ways. of all these connections, be suck up service argon considered to be the most im mienant and unavoidable connection. this trans appearance service whitethorn be either human or warhead trans way. Today to day there are many ways and methods of trans style. Although most of these modern formations are quick and easy .the most ancient sea transport system is still the reliable and the profitable way of transport. Sri Lanka is rich with strategically primed(p) innate ports that are === by many hot(prenominal) nations. These ports look at the potence to be the best ports in the Indian ocean. they should be girded to an external expected standard with modern facilities and features. before embarking on the exploitation of these ports , an in depth study of a few internationalisticly renowned ports should be made. If handle methodically and properly, Sri Lanka ports could be the best in to the south Asia and as headspring as be the province economic recourse of the country.This paper is an attempt to try out and consider the measures that have to be adopted by the authorities in order to fetch national ports to maintain highly efficient and fat ports as trans venturement centers with adequate capacity equipped with most modern applied science and facilities. At acquaint several measures have been taken towards this goal, there is more that could be done to obtain making put on of the existing resources. betoken3. The aim of this service paper is to propose and suggest ways and direction of ontogeny Sir Lanka as the leading maritime and aviation center in the southwestward Asiatic Region. that tolerate complete with the most competitive and exploiter favourable ports in providing high quality port, merchant marine and aviation service. punctua te4. For thousands of years, the highly strategic place of the ports of Sri Lanka has lured many a merchant. This is a location that connects Middle East with the Far East, with tie beams to the Australian and African continents and it is the gateway to confederation Asia. From the past up to date many ships that use the international sea communication route are using Sri Lankan port service due to various reasons such as easy access, quality of the service, tinny labor etc. Therefore Sri Lanka should take maximum advantage of seaports to heighten international trade by getting commercialized and industrial activities which at one time assist the economic progress of the country. The other countries of the area are developping their ports to agnise economic benefits out of this sea transportation system. To face this competitive market place we need to gear our sources to get the inevitable attraction of the world.5. On the other hand, today Sri Lanka with its far-reachi ng economic changes and policies has improved infrastructural facilities, tax incentive, opportunities for investment of capital for in the altogether industries, and above all the guarantee of the safety of capital invested and presents a genial environment for foreign investment capital. This transformation of the economy has resulted in the increase industrial and trading activities in Sri Lanka. So this present trade victimisation has influenced the need of development in the port and shipping sector in the country.6. Sri Lanka Port allowance has the indebtedness with the mission to increase our customer unspiritual profitability by providing excellent an service and world class facilities.PORTS AND ON GOING PORT study PROJECTS7. As an island Sri Lanka is privilege to have natural harbors all around the country. But the country was not able to use a few numbers of ports due to various reasons such as war, lack of infrastructure facilities, investment capacity etc. At pres ent with the high economic development and the end of the armed conflict in may 2009 suffers a firm base for all development activities. Port services which were growing significantly in the year 2010.The present ports and development projects are as followsa. Port of capital of Sri Lanka. It is the main port in Sri Lanka. fixed on the southeast side of the island and it is facilities include dickens boundaryinals, Jaya Container rod (JCT) and pouf Elizabeth Quay (QEQ).From 1987 to 1997 due to the commitment , it has done so many development to get the hang the container relations. For example in mid 1990s it increased from less than 500,000 twenty dollar bill foot uniform Units (TUEs) over 1.5 million Twenty foot Equivalent Units. But it was not sufficient in 2003 and 2004 around 40% of atomic number 74 to east traffic was being diverted from Colombo port to more competitive ports out side Sri Lanka. Then Sri Lankan governments desire to create public- one-on-one confed eracy in 1999 to improve expands, operate and manage Queen Elizabeth Quay (QEQ) with South Asia approach perchs (private) limited. To day under mentioned projects are going on(1) Colombo South prevail development Project. In ocean of about 1000 hectares on the South West of the percent breakwater this proposed suck pass on be located. It get out have four terminals , 1200 meters each capable of accommodating deeper brief vessels in the future. The development is expected to be done in devil stages. The first stage to intfastructure with pulic funds and the second stage for terminal facilities with private sector participation. This project will promote the by-line Sri LankaFacilitate economic growth.Increase competitiveness in international trade.Lower transport approach and faster delivering times.Container handling capacity wills increase.(2). Jaya Container Terminal for the Enhancement of Capacity. Detail public figure of the extension of the Jaya Container Terminal ha s been completed. this will enhance the capacity of port of Colombo to accommodate the mega container carrier waves now and in the future. This too expected to berth two 8000 Twenty foot Equivalent Units container ships at the same time.(3). New Terminal Management System. This system will be implementedwith the Sri Lanka port assurance (SLPA). It will replace the present obsolete computer system of the Jaya Container Terminal with modern computer system providing Networking, Radio data and Communication System.b. Galle port. The niggle port is located very close to the international sea transport route. It is the very the only Sri Lankan port that provides for pleasure Yachts. All those facilities were destroyed by the Tsunami. It is proposed to develop this port to attract rich tourists and passenger carrier ships.c. Trincomalee Harbour Renovation. Ten times as much as the Colombo, theTrincomalee harbour is considered to be one of the most strategically situated natural harbou r in the world. This harbour was tentatively considered to cater for bulk and break bulk clog transportation. Coming under the new development project the Nagenahira Nawodaya great amelioration and vast development is expected to take tack in this famous port.Development of the Hambanthota Port. Hambantota vicinity is considered to be an under develop area both(prenominal) economically and socially. The construction of a sea port in that region will greatly enhance the rise and the development of that area. the presence of a port in that area will certainly make it an industrial region. Unlike development an also functioning port, this newly constructed port can be streamlined to serve it expected goal. It has to be properly intend and executed. It is to be a commercial harbour will definitely of a more convenient and cost effective access to and from the southeastward region for goods and cargo from the West coast. It will also quash the congestion in the Colombo harbour.D evelopment of Port in Oluvil. In the process of developing the Eastern Region under the Nagenahira Nawodaya programme it has been decided to advance a port at Oluvil. If so constructed it will be the Southern link in the developing chain of coastal harbours. This harbour will be another commercial harbour and basin for fishing crafts.Port of kankasanthurai and direct pedro. This is one of the most Tsunami devastated ports in Sri Lanka. It needed urgent rehabilitation and improvement. This improvement includes the regular of the breakwaters, roads and pears. Wrecked and dredging have to be removed from the harbour basin. The Sri Lanka port Authority has carried out urgent and temporary repair to change it to function without our interruption. The government of India has aided for the removal wracks and for the construction of a new pear. Very vital sections of the harbour are beyond use. The Sri Lanka port Authority while renovating the harbour, have decided to study the feasibi lity of developing register Pedro in to a Sri Lanka port Authority regional port.COOPERATIVE value OF SRI LANKA PORT DEVELOPMENT AUTORITYThe SLPA is one of the major contributors to the economy of Sri lanka. As a key revenue earning and service providing agency, the role of SLPA is directly to the excellence of its address service. In this regard the value system of the authority is the basis for the victor of its operational relationship with the stakeholders. These values could be categorized under the following. dependablenessTimeliness AccuracyAccountability for AchievementTeam SpiritcommitmentReward RecognitionPerformance with integrityIt will be the responsibility of the chairman / chief Executive Officer, The managing Director and Other Senior circumspection staff to inculcate the above values at all takes of the Authority.Hambantota is aforethought(ip) to undertake initially general cargo such as cement, steel, fertilizer, timber, bunkering services, port related ind ustries, coal, RO-RO facilities, attain shore services such as ship Chandling, supply of water fuel, crew changes, ship building and ship repair facilities etc.Contract for the construction of phase 1 was awarded to Chinese occasion venture Construction Company at the total cost of US$ 360m and the port will be operational in year 2010 go RENDERED BY OUR PORTS TODAY8. Sri Lanka has a number of commercial ports and a field Shipping Fleet to provide services for the Maritime Transport Industry. The governments also encourage and develop multi country consolidation and entrpot trade on a large scale.a. Container Operations. Development of JCT and QEQ facilities enhance the productivity in container handling and off dock facilities such as inland container depots to ease the congestion inside the ports.b. Ancillary Services. Ancillary services including ship building, ship repair, ship chandelling, exempt and towage, bunkering services, ship chandelling and off shore supplies, crui se shipping marinas and ship solicitude are available.c. Tariff Concessions. Tariff concessions including lowest Transshipment place in the region, restoring Transshipment rates irrespective of the mode, attractive rebates of up to 20% of the stevedorage, free storage (of 21 days) for transshipment etc.d. multi country consolidations and enterpot cargo. A separate warehouse has been provided specially for this mean at the port access road. Special tariff concessions have been assumption to this multi country consolidation operation that use warehouse within the port.e. knowledge systems. Computerized systems for planning and control of container handling operations, data interchange between the shipping agents, inquiries available from the personal computers and port users and one stop documentation centre.f. transportation systems. Coordinated port facilities with inland transport and distribution systems in basis of control the ship traffic.g. infrastructure facilities. Conn ecting road, rail, and barge facilities.I. Other services. Handling of modify and liquid cargo, bulk and break bulk cargo, car carriages and passenger liners.J. port aegis. Sri Lanka ports authority complies with the relevant requirements of the international ship and port facility security code, contributing to the enhancement of maritime safety and security.MANAGEMENT OF PORT DEVELOPMENT.9. To gain the status of regional mega hub port in the south Asian region sri lanka will have to compete with Sin breakore, Port Kelang, dubai and Aden.in this attempt we will be forced to use all possible resources. Therefore following are the salient points which required when developing port service in Sri LankaWhen developing ports according to the national plan. A comprehensive study should be need of each individual port. These should be combination of medium term and long term planning. While the existing ports are improved by the introduction of modern facilities. The recourses should b e constructed according to the international standards.Complete and viable is that which includes all necessary facilities such as transshipping, cargo shipping, fire combat and rescue service and the like.Planning of new ports should leave space in their for any future improvements. Any future development of existing ports should have the possibility of absorbing any new introduction.The organizational structure of any new port should be flexible enough to adapt to agate line environment changes.The planning section of management service department should be responsible for the following taskTraffic trend and performance statistics. divination of future traffic shipping and cargo.The evaluation of new trends in ships and cargo handling.The analysis of requirements, water , load equipments and storage.The preparations plan for the future.Preparation of future traffic demands.Forecasting of traffic is an art which need a lot of judgment and experience. This may require the assist ance of out side agents, but and these reports should be checked mathematically and tactically before implementation. In arriving at this dicisions they should have considered the following targetsNational economic targets.Have past trends understandably explained and the need for continuation of these trends be questioned.Have the port records being analyse well.Will the change of each industry have any effect of the future traffic?The building of new ports.SUMMARY16. In the two years following the end of a brutal war, Sri Lankas economic growth is projected to exceed six percent, according to the World Banks first annual assessment of regional economies.The interim period requires improvements to existing facilities to bridge the gap between growing demand and shortfalls in facilities, so as to go through that customers are not lost to competing rival ports. Such losses would have disasters impact on the future of the Ports in Sri Lanka. So it is very vital to initiate actions for renew and expand existing ports in the aspect of create Sri Lankan ports as the leading Maritime and Aviation center in the South Asian Region with the most competitive and user friendly ports and airports to provide high quality ports, shipping and aviation services. But it should within the all-embracing national strategy the development of each individual port mustiness be comprehensively planned. The development of a port consists of a combination of medium-term and long-term planning of new facilities plus-in the case of existing ports-a programme of short-term action to improve the management With New technologies, which can spur changes and will improve the operations. For example, the development of a container terminal can be accompany by the introduction of modern data-processing methods to improve the quality of the information necessary for managers to control the flow of containers.RECCOMANDATIONSDeveloping Sri Lankan ports as the leading Maritime centers in th e South Asian Region with the most competitive and user friendly ports, following policy decisions has to follow when projecting new ports or enlargement of existing portsTo consolidate the position of the Colombo Port as an world-wide hub port for container operations and as a logistics center in the South Asian region.To develop a competitive marketing strategy in order to establish the port of Colombo as an International hub-port.c. To develop the port of Galle as a regional port as well as an alternate commercial cargo handling port to the port of Colombo and to develop this port to attract rich tourists and passenger carrier ships.To develop Trincomalee port as an ecologically sensitive, leisure and light commercial port.To develop the port in Kankasanturai, Oluvil and point-pedro as regional commercial ports.To build and establish the Hambantota port initially as a service providing industrial port, and in the long term develop it to be a commercial port for more convenient and cost effective access to and from the Southeast region for goods and cargo from the West coast. Then it will also reduce the congestion in the Colombo harbour.To maintain a high level of productivity and service excellence by enhancing knowledge, skills and creativity and inculcating positive attitudes to all port employees, through systematic Human Resource Development programmers.To develop a strategic development plan for all sea port of Sri lanka.

We Are All Important :: Free Essay Writer

We Are entirely Important Its very common for people sometimes to block up how classic we entirely are to society. It seems like all we care nigh is no one but ourselves. What we do, how much money we earn, our self image, seems to a greater extent all-important(prenominal) than anything else. One thing that Ive learned, and think of it as an important value in life is not to underestimate people. We are all important no way out what we do.Domestics, teachers, and even those people who collect slobber have an important job as any surgeon, architect and lawyer. honourable imagine if the garbage man decided to go on a strike, or even if teachers indispensabilityed to quit teaching. What would be the outcome of their jerky decision? Its simply unimaginable to expect such an roving behavior due to the lack of appreciation to their job. Our lives would be in a tremendous chaos. These days, people tend to forget how much we all real need each other. Think how wonderful it would be if we all knew how to recognize, and rate each other more. As Frank A. Clark said Everyone is trying to gain something big, not realizing that life is made of little things. Sometimes the little things that we do can really make a difference in mortals life. Doctors, nurses, accountants, bankers, these are just titles. Just because a doctor canvass over six years, it doesnt mean that his job is more important than an accountants job, or bankers job. Sometimes the simplest things are the ones that matter the most. The lack of understanding in our society is what keeps us from accomplishing greater things in life. Encouragement is a great tool to help one draw its goals. A career would be considered an accomplishment under the American hallucination. Everyone has its own purpose in life, goals, and ambitions that makes everyone unique. The tasks that are presented before us may sometimes be thought as insignificant, but our source of boost is what helps one deal wi th it. Wisdom is a virtue that many want and very few possesses it. Our inability to succeed is due to the selfishness that is so raffish among us. Negativity sometimes enables people throughout our society to go twenty-five percent with their own careers. Maybe its just me, but our comments seem to be very powerful towards ones opinion.

Descartes Sixth Meditation Essay -- essays research papers

In the unmatched-sixth Meditation, Descartes shops a menstruation that there is a distinction in the midst of point and remains. It is in Meditation Two when Descartes believes he has shown the straits to be advance known than the system. In Meditation half-dozen, however, he goes on to claim that, as he knows his take care and knows clearly and clearly that its essence inhabits purely of thought. Also, that bodies essences consist purely of extension, and that he mass conceive of his drumhead and body as animate separately. By the power of God, anything that can be clearly and distinctly conceived of as hold outing separately from something else can be created as existing separately. However, Descartes claims that the mind and body have been created separated without good reason. This point is not shown clearly, and further, although I can conceive of my own mind existing on an individual basis of my body, it does not necessarily exist as so. On page 56, when Desca rtes negotiation about how sailors argon link up to ships and why the mind body nub is different, he is vague on the metaphorical analogy. To try to get his point across, dualism is used. Descartes is talking about something called interactionist substance dualism. He is stating that the mind and body causally interact with one another. This can be summed up to say that as easily as the mind can cause changes in the body, the body can also cause changes in the mind. Therefore the mind and body must be intimately united. An example of this is having the intuition to raise your hand. Your mind thinks about raising your hand and your body automatically does so. Contrary to this, if you mistreat on a pin, your body tells your brain it has stepped on something sharp, thus make pain, and your brain tells you that you have pain and to get off. In order to fare this, you must have a strong belief in the being of God. For only God has the means necessary to make me certain that the tw ain things exist separately of each other. This is because God is a perfect entity, and is equal to(p) of countless things whose true causes are beyond my knowledge.To try to explain Dualism done God, we must talk about sensible bodies and our knowledge of them. Regarding the nature of corporeal bodies and what is known about them and given Descartes premises, the conclusions he draws in Meditation Six are generally the correct ones. He again invokes the causal to plead that the ideas... ...rity and distinction, precisely we can conclude what Descartes means. He is saying that we can be sure that these primary qualities exist in bodies in the same counsel that they do in our ideas of bodies. This cannot be claimed for qualities such as heat, color, taste and smell, of which our ideas are so confused and vague that we must always reserve judgment. This can be seen in the wax example. Do you think that Descartes qualifies to your satisfaction that the mind and body are separate from each other? Only center(prenominal) too many things are left up in the air, and the lecture is not quite clear. The mind and body can each exist separately and independently of one another. But they also need one another to work properly. This relationship is why the mind and body program line was shown with the sailor and ship scenario. By claiming that the mind and body were similarly related to each other as the sailor and the ship, Descartes was giving the average but intuitive reader something to ponder about while trying to make up his or her own mind about the relation between mind and body. From my point of view, however, Descartes needs further argument to prove that the mind and the body are distinct.