CDC children observation Assignment Example | Topics and Well Written Essays - 750 words

CDC children observation - Assignment Example The second child is Kate, a girl aged 3 years. She is also an active child. Her favorite activity is playing with dolls. As noted the boy is very keen on detail. He plays with his toy car alone at a corner of the playfield. He does not interact with other kids except in situations when they come to him. He seems friendly whenever another child spoke to him. However, he concentrates on the playing with his toy car. At one occasion, he seems to observe something unusual with one of the wheels. He takes up a screwdriver and tries to untighten the screw so that he can remove the wheel. However, he is unable to do it. He seeks help from the caretaker who quickly untightens the screw for him. The boy seems convinced that the wheel has a problem. He looks carefully all around. He notices each detail and observes that the plastic when is cracked. He does not replace the when since there seems to be no replacement. He takes his toy car to the store. I also observed the girl several times. She seemed to enjoy the company of other children. In fact, I did not see her alone at any time. She was always with friends. The girl loves dolls and has several of them. She takes motherly care for them. I observed her trying to feed one of the dolls, soothed it and also lay it to sleep. Along with other girls, she tries to talk to them, assuming that they can hear. She is also quick to cry whenever she is offended by one of her friends. The toys that children use in the center are gender specific. For example, boys are seen to be playing with toy cars. The toy cars are characteristic of male children and are thus male gendered. However, there are also a small number of girls attracted to toy cars. On the other hand, girls are interested in playing mother roles. All of the girls have dolls. Also, I did not see any boy with a doll. Children at the center are always quarreling over toys and playing space. The staff members try to resolve all the

Realism as a Method to Depict Immediacy Unexpectedness and Wonder in Essay

Realism as a Method to Depict Immediacy Unexpectedness and Wonder in Berninis Apollo and Daphne and Poussins Et in Arcadia Ego - Essay Example It’s that disruption of stasis that I felt the night my ex dropped the â€Å"we need to talk† line on me. It’s cliche and immature to dwell on emotional turmoil, yet that night my roommate got an earful of conversations and complaints. Before turning in for the night, he left me with that old as time adage that has passed through nearly every broken heart. â€Å"You can’t understand happiness without feeling pain,† he told me, and as cliche as the phrase is, it is still something I hold to be true. As I studied Apollo and Daphne1 and Et in Arcadia Ego2, I couldn’t help but wonder if Gian Bernini and Nicolas Poussin were attempting to express the same heartache that is so central to this human condition we share. Beyond the longing gaze in Apollo’s eyes and the lamenting stare of the shepherd’s face, what drew me to this question were not the works themselves, but the emotions I felt because of the works. To capture these emotion s, Bernini and Poussin incorporated a novel technique of using realism as a means to achieve the awe-inspiring effect so common to Baroque visual culture. In his 1998 book Italian Baroque Sculpture, Boucher highlights the fact that awe-inspiring effects such as â€Å"immediacy and mimicry, and the unexpected and the surprising were all prized by Baroque artists†3. ... It is for this reason that it became one of the most important aims of Italian Baroque sculpture to represent ‘flesh as flesh’†¦Ã¢â‚¬ 4 . While this quote focuses on sculpture, this emphasis on a realistic style was central to all Baroque visual culture. Combining realistic figures with the shocking imagery of a woman turning into a tree or a forgotten tomb in the middle of a field created these desired effects. Because realism is necessary for the effects of immediacy, unexpectedness, and wonder, realism was essential to Baroque visual culture and was skillfully incorporated into the works Apollo and Daphne and Et in Arcadia Ego. The most obvious effect in Bernini’s sculpture is one that is highly associated with Baroque visual culture: immediacy. In his article â€Å"The Element of Motion in Baroque Art and Music†, William Flemming describes this increased feeling of immediacy in Baroque culture by saying, â€Å"The Baroque period brought about a q uickening of the pulse of human affairs. It was an age of movement, activity, exploration. Time is of utmost importance. The mechanical clock becomes the dominant symbol of this period and performs the unique function of translating the movements of time into spatial dimensions.† If one is to follow this symbolism to Bernini’s sculpture, then Daphne’s extended arm is minutes away from striking twelve: an obvious symbol of the immediacy felt in the scene. This sculpture is not a still life; this is the peak of action in a moment that will define the lives of these two gods forever. To simply depict this scene with a realistic style would completely miss the specter of a woman turning into a tree, yet to completely focus on the tree would be to ignore the metamorphosis. This is where Bernini’s true genius is

Library System Essay Example for Free

Library System Essay Bulua National High School is a leader high school in legislative District 1, located at Barangay Bulua, Cagayan de Oro City which was governed and funded with the Barangay Officials spearheaded by Pedro P. Legaspi. It was in 1970 when the secondary education, Bulua Barrio High School came to an open with two sections in the First year level and the Second year level was opened on the following year until the 4-year high school level was completed. The school was temporarily located at the compound of Bulua Elementary School campus in which they called as squatters. They did not have their permanent classrooms to be used. Sometimes classes were being held under the shades of the Mango and Butterfly trees. They also conduct night classes just to accommodate working students from the neighboring Barangays. Each enrollee was still entitled to pay 10.00 pesos for the freshmen, 15.00 pesos for the sophomores, 20.00 pesos for the juniors and 25.00 pesos for the seniors every month. The fees were received by the hands of the Barangay treasurer. The school was facilitated with 10 teachers and 1 school in-charge only. It was then in 1985 that BBHS became the PILOT SCHOOL of the 1989 Secondary Education Curriculum headed by its school principal Mrs. Enriqueta C. Pabelic. Year after, BBHS became Bulua National High School (BNHS) which was funded already direct from the National Level under the late President Cory Aquino’s administration. Presently, BNHS is located in its owned 1.4 hectare approximately lot donated by the late Congressman Pedro Oloy Roa through the joint effort of Barangay Chairman Pedro P. Legaspi and the late DECS – Division P.E Supervisor, Mr. Bernabe Pabellic for its lot acquisition. Introduction The Library Hub is a program by the Department of Education aiming to address the lack of public libraries across the countries by setting up the library hubs. Library Hub is a novel and unique structure in the Philippines educational system, whereby an infrastructure and new reading materials made possible through collaborative partnerships with stakeholders are provided to public school students for free. To date, DepEd has set up about 50 Library Hubs in a very short span of time throughout the country. These Hubs will be servicing thousands of public schools. Books were placed in plastics. The Library Hubs are housed in existing buildings with an area of at least 250 to 300 square meters. A Library Hub is run by a librarian, library clerk, and utility staff and functions as a book warehouse for public schools in a given district. Each Hub lends books to its designated schools, which in turn lend the books to their students. The provision of reading books for free in the hub is not only for public schools but ALS, SPED, barangay centers, etc. It also serves as a â€Å"wholesale† library exclusively servicing elementary/secondary schools within a division. The hubs operate warehouse style, compared to the traditional public library setupinstead of books being individually placed on shelves; they are stored in plastic bins for storage. These bins would then be checked out and brought by teachers and administrators of public schools to their respective public schools, to be returned after twenty-five days. While at the school, these books can be borrowedor even brought homeby the students until the books are to be returned to the hub. Launched in 2003 by then undersecretary Juan Miguel Luz, the project has now set up library hubs in 32 school divisions all over the country, for a total of around 145 hubs built since 2004. The hubs are financed by both the public and private sector, with major donors having the option to name the hubs whichever way they like. 1. Background of the study The use of computers and various programs are being developed for that certain desire to be done in a short period of time. Manual System for a Library Hub is quite a difficult task to perform. It takes a long period of time in locating and monitoring the availability of the books and can have the tendencies of missing files. That’s why we created this Computerized Library Hub System in order to solve that problem. Our Computerized Library Hub System is a program that is use to update the information about a certain record of books. It allows adding book information immediately and it only takes minutes to search a specific book. It lessens the possibility of missing files unlike the manual system. This system can be able to monitor automatically where, when or who borrowed a book. It also gives more accuracy in processing any transactions. Besides of that, it can help a librarian to work much easier and faster than a manual system. 2. Statement of the Research Problem * A licensed librarian is one of the major concerned problem of Bulua National High School Library Hub. Since they have a what they called â€Å"Acting Librarian† who was also a full time teacher in the school. It takes a long period of time for her to organized the books especially in putting accession number in it and log it in her module. Another concerned is that the books in the library hub has not been arranged in dewey decimal classification which is the main reason why the personnel in-charge and the students has the difficulty in locating the book and to check its availability. * There’s a possibility that the library hub may encounter following problems such loss of records, repetition of data entry and other important details about the books and the one who borrow the book. * How do they record the books? The students will fill a borrower’s card before they can get the book they want to borrow. Then afterwards the in-charge will log the list of the book that has been used or borrowed in the end of the day in the manual notebook. Unfortunately there are times that the in-charge can’t be able to log or record the borrowed books in the manual notebook. * How do the students know if the books are still available? Knowing that the school don’t have a Dewey Decimal Classification in their books, students have difficulties in searching the specific book and it takes too long for them to wait for the librarian to check unto the logbook whether the book is still available or being borrowed. 3. Statement of Objectives 3.1General Objectives This project aims to propose and develop a well-structured and computerized library hub system to help the library hub’s transactions easier, more effective and efficient. 3.2Specific Objectives * To lessen the burden of the user in handling the day by day transactions. * To lessen the possibility of missing files. * To make the process of updating the books efficient and can be done in a short period of time.

Recent developments in health and social care policy Essay Example for Free

Recent developments in health and social care policy Essay This essay will evaluate recent developments within Health and Social care policy. It will focus on the development of charges within the NHS, the ideology behind it and its impact on women, different ethnicities and those living in poverty. It will then go on to analyse the differences in formation and adaption of this policy from devolved governments in Wales and Scotland. Before the start of the ‘welfare state’ in 1948, the majority of Health and Social care services were subsidised by benevolent donations to voluntary hospitals, or through service users paying for their own care. This is due to the ideology of the time being that of the government not being responsible for the nation and that people were to stand on their own two feet and support themselves. However, following the massive devastation to the country, both physically and mentally, following WWII, the government’s ideology changed. The labour government in power at the time felt that the nation’s welfare was their responsibility and so the ‘welfare state’ was born. Everyone was entitled to free NHS health care and there was no criteria or eligibility attached. In 1952 the first charges had been introduced in an effort to fund the rapid growth of costs incurred by the NHS, people now had to pay for prescriptions, dentures and spectacles. This move was due to the government’s ideology slowly changing to one of paying for yourself if you can afford to do so, and eligibility and criteria was attached to certain services. If you did not meet the requirements you had to pay. During the 1980s, under the Conservative governance of Margaret Thatcher, the ideology had gone full circle and was back to that of non-dependence of the ‘Welfare State’ and the responsibility of the nation lay with the individual, not the government. It was a time of taking away universalism with a residual attitude. As a result of this shift in attitude present charges were increased and new charges were introduced as a means to reduce public spending (Thornes, 2000:97). Eligibility, criteria and targeting meant that only those most vulnerable were able to access Health and Social care services for free. In 2013 the present ideology is similar to that of 1952. The Conservative, Liberal Democrat coalition government maintain the ideology of taking away universalism and standing on your own two feet. They feel that in having charges for NHS services the stigma attached to welfare will be reduced and individuals will feel that they deserve the service they are accessing (Thorne, 2000:97). The government also feel that it will prevent the abuse of free services by discouraging people from using Health and social care services which they are not in need of. This is evident with the proposal for those that visit AE to be charged ? 10 as a means to prevent unnecessary use of the service. AE specialist believe that 30% 40% of visits are unnecessary and that in having a ? 10 charge upon arrival, which is fully refunded should the condition warrant AE attention, will significantly reduce the amount of people taking up vital resources (Campbel, 2014). This charge is set to reduce unnecessary visits and waiting times to those who are in actual need of emergency care, however experts feel that they will ‘penalise poorer patients’. Dr Helen Stokes-Lampard, a spokeswoman for the Royal College of GPs has said that Charging patients for the use of emergency departments would put us on the slippery slope towards the Americanisation of healthcare, where only those who can afford to get it get the care and attention they need, (Campbel, 2014). Dr Mark Porter, chairman of the BMA, said: The majority of GPs and hospital doctors are committed to an NHS that delivers care on the basis of need and not the ability to pay. In this survey, two thirds of GPs state they are against [charges] for using AE services †¦ it runs the risk of deterring vulnerable patients who genuinely need help from seeking treatment at a time when many people, from all backgrounds, are struggling financially. (Campbel, 2014). This shows that the government is not promoting equality and that services will only be available to those that can afford them. Another charge which is proving to be detrimental is that of the 2011 charge for care during pregnancy and childbirth to migrant women. This policy has had a negative impact on both those giving and receiving care. Migrant women are not attending appointments or are running away from hospitals as a result of being unable to pay thousands of pounds for treatment, this puts both mother and baby at risk of complications which are not detected in early pregnancy, which is evident in a newspaper article from December 2013 highlighting the negative impact of the policy in which midwives are warning us that the fees are endangering migrant women (Taylor, 2013). Susan Bewley, a professor of complex obstetrics at Kings College London agrees that charging migrant  women for NHS antenatal care is putting pregnant women in danger (Taylor, 2013). The policy is written in very complicated language which means that eligibility and criteria is very hard for migrant women and professionals to understand and is resulting in some pregnant women being declined treatment and care due to misinterpretation. This goes against the core values of midwifery. In an article in the Nursing Times, David Foster wrote about the 6 Cs of Health and Social care and how they are essential for the NHS to deliver fair, consistent care to those who require it ( Foster, 2012:12). In declining care to migrant women, midwives are not only ignoring the core values of midwifery, they are putting lives at risk and failing to fulfil basic Human rights and are not promoting equality. In March 2011 the department of health published the NHS constitution, which sets out the core principles of the NHS. One principle which is in contradiction to the charges placed on pregnant women is that â€Å"We have a responsibility to maximise the benefits we obtain from NHS resources, ensuring they are distributed fairly to those most in need. Nobody should be discriminated or disadvantaged and everyone should be treated with equal respect and importance† (NHS choices, 2013). Care, compassion, courage, communication, commitment and competency are values which should be predominant within midwifery, however in adhering to the 2011 policy midwives are failing to maintain the 6Cs. Communication is a big issue as the policy is open to misinterpretation and so compassion and care are also lacking within the sector as midwives are refusing care to women (Taylor, 2013). The commitment to provide the best possible care to all pregnant women is being compromised as some midwives have been quoted as feeling like ‘Immigration officers’ and so their roles are under question (Taylor, 2013). In another article in the Nursing Times by Maria Flynn, she explains that organisational culture, policy and politics can exert a damaging influence on caring values (Flynn, 2013:12) which supports the negative impact the charges are having within the midwifery profession. After the Francis report was published, following the incidents within the Mid Staffordshire hospital, it was found that nurses and midwives felt frustrated at not being able to fulfil their role correctly as a result of the restrictions put in place by policies and that the compassion deficit is more likely to be down to political ideology driving health policies then shortcomings in caring values . After extensive research I have been unable  to find any positive impacts on both service users and providers with regard to the implementation of charges within the NHS. According to an article from the BBC news Scotland the department of health claim that charges were introduced to ‘plug gaps in funding’ and that the fees raised around ? 450 million a year, which is the salaries of 18,000 nurses or 3,500 hospital consultants (BBC news Scotland, 2011). However it is apparent that the fees are not being spent on employing more staff as Laura Donnelly, health correspondent for the Telegraph reports. There is currently a shortage of 20,000 nurses within the NHS and an investigation into 14 hospitals with unusually high death rates highlights the common factor as inadequate staffing levels (Donnelly, 2014). On 1 April 2011 prescription charges were abolished in Scotland. BBC news Scotland reports that â€Å"The Scottish Greens said it believed there should be equal access to the NHS and that meant free access to everyone at the point of use, including free prescription. (BBC news Scotland, 2011). Daniel Martin, of the Mail online, described it as â€Å"the latest example of ‘medical apartheid’, where the devolved nations enjoy better health services despite paying far less tax per head† (martin, 2011). The ideology of the devolved Scottish government is one of universalism and in helping the majority of the population of Scotland who are living in deprived conditions. The English government still fund Scotland using the Barnett formula: (Martin, 2011). Policies are developed in Scotland by the Scottish parliament, which is made up of 129 public servants who are politically impartial, and the Scottish government. The Scottish parliament debate matters of importance (which are devolved), such as health care, then vote on legislation holding the Scottish government to account. The Scottish government decide how the country is run and implement laws passed by parliament. This is very different to the English way of developing policies as that involves all parties agreeing to what is proposed and is a fair way of ensuring the policy is fit for purpose. With the abolishment of  prescription charges the Scottish parliament looked at the savings it would make to families living in poverty and the health benefits to those who could not afford to pay for drugs (Explanatory notes, 2005). However it did not recognise the cost it would have on the health of people suffering with cancer. Due to drug companies charging large amounts for certain cancer drugs, as a result of eradicating prescription charges, the SNHS cannot afford to purchase these drugs and so cancer sufferers are having to either go without or move to England, where the drugs are available. Maureen fleming, 63, faces the dilemma of raising the ? 10,000 needed for a 3 month supply of the cancer drug she needs or to move to England. Scottish labour leader Johan Lamont said the Scottish NHSs ? 7. 2 million bill for paracetamol prescriptions would pay for 200 patients to get cetuximab for a year. She said: In the First Ministers Scotland, if you have a headache your prescription is free. If you have cancer, your prescription can cost ? 3000 a month. (Gardham, 2013). In conclusion it is evident when looking at fees in the English and Scottish NHS that there are positives and negatives to both countries. England may have a lot of criteria and eligibility in order for prescriptions to be free to those who need it, however in having fees in place the NHS in England is able to purchase expensive drugs which are not available to people living in Scotland where prescriptions are free to all. It is apparent that there should be some compromise between both policies in order for those in genuine need to access the care they require.

Importance of Community Health Workers

Importance of Community Health Workers DEFINING THE PROBLEM Community Health Workers have been used in several countries dating back about 60 years ago, to address the gap experienced by the underserved members of these communities, with issues of access to health care. More importantly in Low and middle-income countries, Community Health Workers have particularly been helpful in reducing the impact of the shortage of skilled health workers. Community Health Workers can make valuable contributions to healthcare especially in the delivery of basic health care; however, across countries and individual programs there are varying and inconsistently established approaches on how they are recruited, trained, monitored, incentivized, as well as the roles and activities they perform. The lack of a standard structure globally and in CMMB countries creates several divisions of Community Health Workers, which may lead to poor monitoring, increased attrition, poor planning, budgeting and sustainable financing. The Effect on Women and Children Several programs have reported a high attrition rate which has led to the breakdown of the programs and is mostly due to problems with how these Programmes are structured or maintained. The initial purpose for which the CHW was set up was to link the communities with the formal health system, if the system fails, the underserved especially the vulnerable populations (women and children), in absence of quality health care are at risk of poorer health outcomes. BACKGROUND. Community health workers are adjunct health workers with a myriad of appellations across countries. According to WHO, they should be members of the community, selected by the community, trained and work within the community, answerable to the community, they should be supported by the health system but not necessary being a part of it, and have a shorter course of training than other professional workers. Although they function more at the peripheral of the health system, and their duties widely vary across countries and programs, their roles in the delivery of basic health care can not be overemphasized. In some countries, they also perform the role of record keeping. Over the years, the use of CHWs has gained prominence, with several countries adopting the trend to mitigate the growing proportion of infectious diseases and a shortage of health workers, migrating for green pasture, however, not all CHW programs follow the WHOs definition of CHW. In CMMB countries, the approach is also different across the in the individual countries. RECRUITMENT, TRAINING, AND INCENTIVES In Peru, the Ministry of health has specific regulations on how the CHWs program should be structured. CHWs in Peru are usually volunteers, they could receive incentives but they do not have contracts or salaries. They are appointed by the community organization at the general assembly or the social grassroots organization to which the community health agent belongs. There is variation in the duration of training the CHWs to receive in Peru. In South Sudan, there are no specific regulations in terms of services, CHW could receive incentives and could also be employed. They are trained in Basic health care service for 6 months whereas, in Zambia, the Implementing partners have different policies for training, recruitment, remuneration, and incentives for CHWs. Programs funded and managed by implementing partners are typically on contracts of two-to-five year but their remuneration and incentives vary across programs. The training also varies between 2-11 weeks depending on if it is af filiated with government health facility or an NGO and the Ministry of healths CHW handbook, 2005 is used as a guideline. ROLES AND ACTIVITIES Several kinds of literature have grouped the CHWs as being either generalist or specialist in the way they are trained or work. Generalist perform a wide range of functions while the specialist has a program specific focus. In the CMMB countries, the CHWs are more generalist than they are a specialist or obscured in between. They are generally involved in implementing promotive and preventive health activities especially in providing family planning and immunization. In south Sudan, CHWs perform addition roles of supporting primary health care units as health staff to clerk patients and also work in the pharmacy. They follow up pregnant women receiving ART while in Zambia, CHWS, also provide basic curative services and refer cases if complicated, they performfollow-up care including home visits for patients with TB, AIDS, pregnant and postnatal mothers, tracing for malnourished children. Most literature about CHWs and what they do, agree that they are important in improving access to care especially in areas where they are most needed. However, it is important to consider the local context where the CHW program will operate(culture, language, social norms, and values etc.) for the program to excel. The mode of selection of the CHWs, duration of training as well as the roles the CHWs would be performing should also be considered and possibly be unified across programs. In order to extrinsically motivate CHWs, it is important to also Incentivize them and a mechanism for monitoring and evaluating their activities would help assess problems in the program and health care delivery. APPROACHES AND METHODOLOGIES In order to encourage behavioral change and improve the quality of health care using CHWs, CMMB will be focusing on theses 3 approaches which have been applied in public health and have improved health outcomes: Positive deviance approach, Integrated community case management approach and make me a change agent approach. Positive Deviance: This is an approach based on the belief that unusual behavioral practices in communities among few members of the community who are called the positive deviants, help them find a better solution to problems and improve their outcomes compared other members of the same community that share similar exposures and resources, but poorer outcomes. The positive deviance is based on the principles that: (Pascale, Sternin, Sternin ,2010) Communities possess the solutions and expertise to solve their own problems. Communities are self-organizing and possess the human resources with necessary assets to solve community problems. communities have a Collective intelligence which is evenly distributed and is not dependent on the leadership of a community alone or in external experts.This collective intelligence is what the approach aim to draw out and capitalize on to solve community problems. The bedrock of the approach is sustainability. The community is encouraged to observe and develop sustainable solutions based on observed positive deviants within the community. Practicing encourages behavior change. This approach has been used successfully in communities in the management of malnutrition and has contributed immensely to reducing the burden of malnutrition in communities where it is being practiced. The community health and families after an observation made by a positive deviant inquiry, practice better ways to cook their food with a particular interest in quality, feeding, and hygiene when managing malnourished children using local resources and technologies. It is a proactive measure; harnessing the strength, knowledge, human resources locally available within the community to solve their community health problems. This approach ensures fast, sustainable, affordable, culturally acceptable solutions to solve community health problems and it also encourages local participation. Integrated community case management: This approach was adopted by WHO and UNICEF. The ICCM has been piloted in many underserved countries, where there is a major gap in access to care. The aim is to bring health care closer to the doorstep of these population and strategically increasing coverage of treatment using Community health workers who are appropriately trained, supervised and monitored. The CHWs are adequately supported with medical supplies. They are trained to identify, promptly and correctly manage or refer cases of common community diseases like malaria, pneumonia, diarrhea and malnutrition in children under 5 years. ICCM uses interventions that are evidence based and it focuses on diagnosis, the community health workers are trained to make a quick diagnosis using portable diagnostic tools and appropriate treatment. common interventions used are antibiotics for dysentery and pneumonia, ORT for diarrheal diseases, antimalaria for malaria, nutritional rehabilitation for malnutrition. The approach employs the use of CHWs who are members of the community and perform their duties either from their homes or selected community building, which is easily accessible to members of the community. Using CHWs from the community encourages trust and sustainability. Make me a change agent: To effectively improve the quality of health by encouraging behavior change, this approach which is used multi-sectorally will help the CHWs to become an effective change agent by developing their skills of effective communication, showing empathy, individual counseling. It also teaches the approach of using their individual testimonies and storytelling ability to encourage health behavioral change. CHWs after acquiring skills from health training, have to effectively communicate their training to the community which is critically important in encouraging the patient to adhere to treatment and adopt preventive health behaviors. The CHWs are engaged in several activities that include role playing to help them understand the importance of respecting patient, good communication, active listening during conversations. There are several barriers that mitigate against behavioral change, the ability to circumvent these barriers would help the CHWs reach their target population and help them make them make the right behavior change. In order to effectively do this, the CHWs needs to be able to put themselves in the perspective of their audience, sharing their experiences which help foster a personal relationship and makes the change easier to communicate. The approach also emphasizes the importance of storytelling and the use of individual testimonies to promote a particular health behavior by changing preformed misperceptions about the particular health behavior. The testimonials offer the audience the chance to appreciate changes made by someone else who is not different from them, who has had a positive result. These approach as a skill for encouraging behavioral change is easily remembered, the audience can relate to the story and have a pictural understanding of what the change is about. Moreso, it can be a source of external motivation to encourage change. INTERVENTIONS: The growing adoption of community health workers as part of the health system as a means to reach the underserved communities is met with the need to understand how to implement a sustainable CHW program in different countries across different programs. As field workers in underserved communities, we would also be employing the services of the CHWs in executing our goals. An effective process for managing (recruitment, training, supervision and support, Incentives) community health workers will help sustain the program. RECRUITMENT: Recruiting community health workers is dependent on the proposed health need they are supposed to meet. Some ministries of health have an established protocol for recruiting health workers. It is important to note that to sustain the program, several papers as well as WHO has suggested that community health workers should be selected by and from the community they are to work in. However, the primary criteria in selecting CHWs is that they should be members of the community they serve. This to harness the establish connections within the individual members of the community and the individual interest of the health worker towards the community. The recruitment process may require the use of different social structures or organization within the communities like the clinics, community-based organizations e.g market women association, religious organizations, the ruling council, other CHWs etc. as sources of referral for the appointment of community members into several CHWs position. Recruitment should be formal, individuals should follow a process of recommendation, interview, and screening. General characteristics of CHWs vary across countries and programs. Literacy is an important criterion for recruiting a CHW. Although not all programs require their CHWs to have any form of education, most programs require a primary level of education while some require a higher level of education. The least literacy level should be required; however, the higher the level of education the more preferable the CHW. The gender of the CHW should meet the cultural norm especially in places where there are limited interactions between males and females. The age of CHWs differ across programs but ranges from 20 45years. Finally, marriage status is an encouraging criterion for selection. CHWs with a married status are more likely to remain in the society for a longer period of time than those that are single. TRAINING The Success and quality of a CHWs program also depend on the process of training and continuous assessment of training. Training program varies across programs which depend on the length, depth, element, approach and authority. In some countries, a manual for training of CHWs have been developed; where necessary, it should be employed. The length of training varies across programs and it is based on the services the community health worker would be rendering. It could be from days to weeks to years; however, it is important to space the training so that the CHW can have time in between training to have an in-depth review of the material. A process of a continuous training after the initial training can help improve the performance of CHWs through supervision and adding additional knowledge to the CHW. The use of an interactive, skilled based setting that encourages participation should be employed as a style for training considering the varying educational background among the CHWs. The training material could be categorized into three major topics: skilled- based knowledge, relevant health knowledge, and research implementation knowledge. Training authority may vary, although WHO prefers the government of the countries to be involved in the training but more experienced CHWs, nurses and doctors can be part of the training team. SUPERVISION AND SUPPORT Long term sustainability of health programs involves active supervision and mentorship of the CHWs.The supervisors also provide support to CHWs. In most cases, the supervisor will be provided by the programs main authority. They are usually of different professional backgrounds but have an understanding of the program, the roles of the CHWs and the aim of the program. They evaluate the performance of the CHWs, define their roles and expectations and also answer questions raised by the CHWs. The frequency of supervision which is variable across programs depends on the target goal of the program, the available funds e.tc. Supervision as a general term could be practice in different styles and approaches. Group supervision involves a group of CHWs with a supervisor and has been implemented in many programs. Community supervision is another approach for CHWs. The innovative approach involves communitys participation by providing feedback and guidance to CHWs and their supervisors. Other methods that can be used are the peer supervision, clinical mentoring and mobile electronic devices. It is also important to note that the supervisors also needs to be actively supported by the programs main authority by providing material support e.g medical supplies, transportation etc. supporting the supervisors will help them perform their functions regularly. INCENTIVES The incentives for CHWs is one of the most controversial topics but it plays a significant role as it has been shown to be associated with CHWs performance, motivation and retention. many studies have debated on how compensations should be structured for the most effective way to incentivize CHWs. There are two categories of CHWs: the Volunteers and Full-time employees. Some countries have a process for how the community health workers should be paid based on the type of appointment and who employs them. CHWs employed by the government on a full-time basis are on paid salaries while most, especially the volunteers are given either monetary or non-monetary incentive; however, it is important to recognize that an opportunity for career advancement in this field can be an incentive. Full-time CHWS are comparatively rare to the part-time CHWs because of the financial implication on programs. A small amount of incentive is more commonly implemented in community-based programs. common monetary incentives are small monetary compensation for their time and transportation subsidies. How much monetary incentive is enough is unknown but it is important to give the CHWs some monetary incentives. The non-monetary incentive is also common. CHWs could get meals during training, bicycles for transportation, umbrellas etc. like the monetary incentive, there are no rules on how the authorities should incentivize their CHWs, or what item will effectively attract CHWs and motivate them. ROLES AND ACTIVITIES IN MATERNAL AND CHILD HEALTH The CHWs globally have been very effective in improving maternal and child health as well as reducing mortality especially in low-income countries. Their function varies across countries and programs; while in some countries, it is just preventive, in others it also involves diagnosis and treatment. The table below highlights how and areas where CHWs can work effectively to promote maternal and child health. PREVENTION DIAGNOSIS TREATMENT OBSTETRIC CARE Anemia *Nutrition Supplement, *Routine Haematinics Nutrition Supplement HIV *HIV Counseling *Distribution of condom Routine Followup on PMTCT Malaria *Distribution of Insecticide-treated net *Prevent therapy with sulfadoxine-pyrimethamine Rapid Diagnostic kit Antimalaria Obstetric Care Routine Tetanus toxiod Routine ANC Visit Post partum care PPH *Breast feeding counselling *Distribution of misoprostol at home births. GYNAECOLOGICAL CARE Family planning *Use of contraceptive PEDIATRIC CARE Diarrhea *Health education on handwashing, food preparation and packaging ORS Zinc supplement Malaria *Distribution of Insecticide-treated net Rapid Diagnostic kit Anitmalaria Antipyretics Pneumonia Antibiotics Malnutrition *Breast feeding Education *Growth monitoring Nutrition supplement Routine Immunization of Children INFECTIOUS DISEASES Tuberculosis Direct observation of tuberculosis treatment CHWs roles and activites are not limited to the above, there are also actively involved in diseases surveillance, home visits, record keeping, community health education, monitoring people with chronic diseases e.g hypertension , diabeties. INTEGRATION INTO CMMB PROJECTS AND PROGRAMS References: Pascale, Sternin, Sternin. (2010) The Power of Positive Deviance: How Unlikely Innovators Solve the Worlds Toughest Problems. Harvard Business Press. Print.

Robert Aldrich :: essays papers

Robert Aldrich Robert Aldrich Robert Aldrich was born into an extremely wealthy family. He became an assistant director in Hollywood, working in the 1945 - 1952 period with many directors. A notably high percentage of these were in the extreme left: Jean Renoir, Lewis Milestone, Robert Rossen, Joseph Losey, Charles Chaplin. Kiss Me Deadly Kiss Me Deadly (1955) is Aldrich's most remarkable film. Aldrich began directing in 1953, and by then, the film noir cycle had run its course as a Hollywood phenomenon, peaking in the years 1942 - 1951. However, film noirs were still being made steadily through the 1950's, and many of these works were classics of the cycle. There is a remarkably detailed visual analysis of the film in "Kiss Me Deadly: Evidence of a Style" by Alain Silver, in Film Noir Reader (1996), edited by Alain Silver and James Ursini. The remarks below are simply intended to point out a few more things about this film, one of the most complex and creative of all film noirs. 3D Camera Tec hnique The staging in Kiss Me Deadly shows a three dimensional quality. Partly this is due to depth of field. Many scenes keep in focus far into the rear of the scene. This is a technique associated in Hollywood with Orson Welles. Aldrich is often considered to be a Welles disciple. There are other techniques that aid in the film's 3D quality: 1) The showing of an irregular wall along one side of the shot. When Mike Hammer's car pulls up to a gas station near the beginning of the film, we see the entire front of the gas station along the right side of the shot. The gas station facade is by no means smooth; it contains many projections. All of these are fully lit up. The gas station is shot as if it were an elaborate piece of sculpture, like one of Louise Nevelson's friezes. As the camera moves past it, it emphasizes the station's complex 3D qualities. The projections on the station all are "rectilinear": they are "box" like, with flat, perpendicular walls. A shot with even greater depth of field shows Mike Hammer knocking on a door in the Angel's Flight neighborhood. Behind him we see first a long narrow alleyway, then a huge depth of field showing a Los Angeles city scape.

A Comparison of Hamlet’s Gertrude and Ophelia Essay -- William Shakes

A Comparison of Hamlet’s Gertrude and Ophelia      Ã‚  Ã‚   Queen Gertrude and Ophelia, the main female characters in Shakespeare’s dramatic tragedy Hamlet, have a variety of personal qualities and experiences in common. This essay, with the help of literary critics, will explore this commonality. In the Introduction to Twentieth Century Interpretations of Hamlet, David Bevington enlightens the reader regarding the similarities between Gertrude and Ophelia as the hero sees them: Yet to Hamlet, Ophelia is no better than another Gertrude: both are tender of heart but submissive to the will of importunate men, and so are forced into uncharacteristic vices. Both would be other than what they are, and both receive Hamlet’s exhortations to begin repentance by abstaining from pleasure. â€Å"Get thee to a nunnery†; â€Å"Assume a virtue if you have it not.† (9) As Bevington says, both Gertrude and Ophelia are â€Å"tender of heart,† motivated by love and a desire for quiet familial harmony among the members of their courtly society in Elsinore. At the first social function in the play, Gertrude is motivated out of love for her son to advise: Dear Hamlet, cast thy nighted color off, And let thine eye look like a friend on Denmark. Do not for ever with thy vailed lids Seek for thy noble father in the dust. (1.2) Likewise does she ask that the prince remain with the family: â€Å"Let not thy mother lose her prayers, Hamlet, / I pray thee stay with us, go not to Wittenberg.† Later, when the hero’s supposed â€Å"madness† is the big concern, Gertrude lovingly sides with her husband in the analysis of her son’s condition: â€Å"I doubt it is no other but the main, / His father’s death and our o’erhasty marriage.† Later she confides her family... ...NJ: Hayden Book Co., Inc., 1973. Jorgensen, Paul A. â€Å"Hamlet.† William Shakespeare: the Tragedies. Boston: Twayne Publ., 1985. N. pag. http://www.freehomepages.com/hamlet/other/jorg-hamlet.html Kermode, Frank. â€Å"Hamlet.† The Riverside Shakespeare. Ed. G. Blakemore Evans. Boston: Houghton Mifflin Co., 1974. Pennington, Michael. â€Å"Ophelia: Madness Her Only Safe Haven.† Readings on Hamlet. Ed. Don Nardo. San Diego: Greenhaven Press, 1999. Rpt. from â€Å"Hamlet†: A User’s Guide. New York: Limelight Editions, 1996. Pitt, Angela. â€Å"Women in Shakespeare’s Tragedies.† Readings on The Tragedies. Ed. Clarice Swisher. San Diego: Greenhaven Press, 1996. Rpt. from Shakespeare’s Women. N.p.: n.p., 1981. Shakespeare, William. The Tragedy of Hamlet, Prince of Denmark. Massachusetts Institute of Technology. 1995. http://www.chemicool.com/Shakespeare/hamlet/full.html