Ways of quitting smoking Essay Example | Topics and Well Written Essays - 500 words

Ways of quitting smoking - Essay Example year because of smoking related illnesses and cigarettes contain at least 43 cancer-causing chemicals in addition to the poisonous carbon monoxide that’s also inhaled. Every year approximately 46% of regular smokers attempt to quit, with only about 10% being successful in the short term1Research has shown that only 3-5% of smokers are successful using will power alone (Hughes et al, 2004) Smokers have an extremely difficult time to quit cigarettes because of the nicotine contained in the tobacco cigarettes. Nicotine is one of the most addictive substances known to man, and it acts directly on the pleasure centers of the brain by releasing dopamine which causes the individual to feel good, while also reducing anxiety, tension and appetite5.Regular use affects the brains reward system, so that when there is no nicotine, the dopamine levels will fall and withdrawal starts. The main withdrawal symptoms associated with smoking cessation are: These nicotine withdrawal symptoms and not will power are the main reason smokers find it so difficult to quit. Although most symptoms subside within a few days to two weeks, the most troublesome one, the Cravings sometimes can last for years, and that’s is the biggest hurdle. There are many alternatives available to help the smoker quit. The alternatives range from prescription drugs like Zyban (also an antidepressant) and Chantix which is supposed to target the nerve receptors from the effects of nicotine, to â€Å"nicotine replacement therapy† products such as gum, patches or inhalers. Unfortunately these products have had little success in achieving permanent smoking cessation from its users. The other main reason for its lack of success lies directly in the fact that these products provide a very low dose of nicotine administered over a longer period of time ,which is totally opposite to the instant rush of nicotine a smoker feels within 7-10 seconds after inhaling a puff from a tobacco cigarette. So in simple terms,

Evidence Based Healthcare Research Social Work Essay

Evidence Based Healthcare Research Social Work Essay Evidenced Based Healthcare and Research: Appraisal. In the United Kingdom the concept of Independent Living and Self-directed Support has become an established approach for the delivery of health and social care services, that it is currently the preferred residential alternative for people with learning disabilities (Binnie Titchen 1999). Independent living can be defined as enabling independence by receiving the right support how and when it is required (Morris 2004). It has now become a key principle in various government policy documents such as the Valuing People Now Strategy (UK Department of Health, 2009) and the Personalisation through Person-Centred Planning initiative (UK Department of Health, 2010). This assignment aims to present a detailed critique of a qualitative study entitled How adults with learning disabilities view independent living (Bond Hurst 2010). A critique can defined as a balanced evaluation of the strengths and limitations of a research article, in order to determine its credibility and/or applicability to practice (Gamgee 2006). This study is a welcome contribution to the current health and social care research domain because whilst independent living is the preferred residential option, it is not at all clear whether it is suitable for all people with learning disabilities, moreover if there is in fact sufficient empirical evidence to support this notion. It is therefore imperative to establish a sound evidence base that draws upon the lived personal experiences of those with learning disabilities. Using an acknowledged framework A Step by Step guide to critiquing a quantitative study (Coughan et al., 2007) the relative worth of the evidence in support of i ndependent living will be judged systematically. As well as exploring the significance of independent living as an essential nursing intervention and its application to modern clinical practice. Ryan-Wenger (2003) suggests that in analysing published articles it is important to ascertain two fundamental aspects of a critique which can be subdivided into elements that influence the robustness of the research methodology also known as integrity variables and elements which influence the believability of the research such as writing style, author(s), report title and abstract otherwise known as credibility variables. The latter seems to be the most logical place to commence. Evaluation of the Journal Article Polit and Beck (2006) state that writing style should be such that it attracts the reader to read on; this paper is well written, comprehensive and concise. The structure and layout of the paper is well organised with a logical consistency and free from jargon in comparison to some papers where the author(s) can be opaque in their approach. However slight reservation is reserved concerning the level of proof reading as there seems to be some grammatical and typographical errors which can be found on pages 288 and 289. Both authors appear to have a sound background in learning disability from both a social context and educational settings. As indicated in the acknowledgements the authors qualifications indicate that they have a degree of knowledge in this field and this piece of research seems to be a part of a taught component of their masters programme. The report tile seems to be descriptive and succinct, although it lacks specificity of the research methodology used in the study. This can be very useful for others who are searching for this type of paper. Although the term qualitative research is mentioned under keywords the title itself could be more specific. As a result the report title is ambiguous and merely eight words in length. Meehan (1999) states that a title should be between ten to fifteen words long in order to clearly identify the purpose of the study for the reader. This paper presents both an accessible and detailed version of the abstract, but are both helpful? The accessible form includes information on the subject and the number of participants, whereas the detailed form provides an outline of the methodology used, ethical framework, findings and recommendations. On balance the summaries present a clear overview of the study, however it does beg the question in what sense is the accessible form accessible? and to whom? It seems that the authors are trying to be politically correct rather than logical because how many service users actually read the British Journal of Learning Disabilities?. It seems that this is a knee jerk reaction which has been applied incorrectly; it would be more suitable if the document was aimed at informing an audience with learning disabilities such as Valuing People (UK Department of Health, 2001) which caters to a wide range of readers. The easy -read version is aimed at service users whilst the denser version is aimed at professionals and service providers. Having identified and analysed variables that affect the credibility of the research presented, how believable the work appears, the authors qualifications and their ability to undertake and accurately present the study. The robustness of the research methodology and the integrity of the findings will be appraised in order to determine the trustworthiness of the study and its applicability to nursing practice. The authors state the aim of the study is to explore the views of nine people with learning disabilities who have already achieved independence and wish to contribute to the debate of independent living. The authors suggest that this style of living is now viewed as desirable, but what is the reality for people who live with learning disabilities? This concept of desirability is held as problematic by the authors who choose to study and present the reality of living independently as opposed to the notion of general and conventional wisdom. A study conducted by Barlow Kirby (1991) concluded that people in receipt of self-directed support had more life satisfaction than those in residential care. This finding is further supported by the publication of Independent Living (HM Office for Disability Issues, 2007). The decision to suspend judgement about independent living is justifiable and is supported by other researchers in the field of learning disabilities; as there are several impli cations for service users, professionals and service providers. This is for a number of reasons for instance promoting choice and control (OBrien, 2002), health issues (Priest Gibbs, 2004), vulnerability (Cooper, 2002) and the ability for those with learning disabilities to access services (Jansen et al., 2006). The literature review conducted by the authors demonstrates an appropriate depth and breadth of reading around independent living. The majority of studies included are of recent origin being less than five years old; the few historical studies included put the concept of living independently into context. The authors successfully identified conflicts between the literature by comparing and contrasting findings (Burns and Grove., 1997), because although evidence exists to show people who have moved from larger institutions prefer smaller group homes (Forrester-Jones et al., 2002) there is still no accurate data detailing the number of people with learning disabilities living independently (Beadle Brown et al., 2004). However the authors failed to mention how they conducted their search and information on the databases used to gather papers in their review. The authors did however, use primary sources of information as opposed to secondary sources and anecdotal information, which attes ts to the integrity and value of the study presented. Bond Hurst (2010) ascertained the narratives of nine people with learning disabilities via the use of semi-constructed interviews within their methodology. The authors are to be commended for their attention to detail in terms of their ability to design and structure interviews so as to accommodate the needs of the participants. As well as conducting interviews at times and venues convenient to them. The interview structure included open-ended questions to assist understanding as communication emerged to be a key barrier for some people with learning disabilities. The authors report on a number of theoretical issues that have been adapted for the participants in order that they might fully participate in the research process. The structure of the interviews was devised using the Canadian Model of Occupational Performance (Canadian Association of Occupational Therapists, 1997), but is this model applicable to the United Kingdom population and to which care setting? Bond Hurst (2010) adopted thematic analysis within their methodology in assessing the narratives. The data collected was audio taped and later transcribed into coded themes, which is acknowledged in general research literature to be good practice. On balance, the authors adhered to the steps in the research process and it is conveyed between the fluidity of phases. The critique subsequently moves onto considering the ethical framework. This research paper was supported by the local ethics committee and all participants in the study gave informed consent. Although it is not clear whether or not it was an National Health Service (NHS) ethics committee. However, the authors sought to ensure their working methods complied with the Data Protection Act (1998) but not with all government legislation applicable to the study such as the Mental Health Act (1983). Although there is mention about accessibility, the authors failed to ensure the participants had the capacity to make informed decisions as defined in the Mental Health Act (1983). In relation to the number of participants, the sample size is small and therefore may not be reflective or wholly representative for all people with learning difficulties. Small samples are more likely to be at risk of being overly representative of small subgroups within a target population (Coughan et al., 2007). Th erefore slight reservation is held as the authors did not mention whether they sought to remove overall bias by generating a sample that is likely to be representative and generalisable to the target population. Parahoo (2006) states that for a sample to truly reflect of the population it represents the authors must generate a probability sample. The participants in this study were recruited via convenience sampling using a third party (Melton 1998); however several variables could have an affect on the sample which can lead to it being distorted such as the vast age range. The authors are to be commended however, in their efforts to maintain the confidentiality of their participants by offering them the choice to provide their own pseudonyms. In the discussion the authors identified seven themes from their data analysis which reflected the views of all the participants and in turn addressed the aims of the study. Their findings supported the four key principles as stated in the Valuing People policy document, and ways in which people can be supported to achieve this includes increasing social inclusion, increasing autonomy and choice for people and raising awareness of the vulnerability of those with learning disabilities. However the study also highlighted that the majority of participants struggled with the more complex aspect of living independently, such as money management and budgeting. The government has recently introduced Direct Payments as part of a nationwide transformation in social care services, which involves paying money directly to an individual in need to take control of their own support and care services. This initiative will aid finance management as it enables service users to have control over the c are they receive and how they receive it. The majority of participants maintained that when comparing their current lifestyle of independent living to that of their previous lifestyle it was clear that they wanted to remain living independently. Application to Clinical Practice This section will explore the significance of independent living as an essential nursing intervention and its application to modern clinical practice. Gates Atherton (2001) state that there is a need for evidence of effectiveness in health and social care. The most important aspect of being a practitioner regardless of ones vocation, is that collectively we as professionals seek the best evidence available on which to base our practice (Coughan et al., 2007). The evidence in support of independent living is limited and not entirely accurate, therefore when evidence is presented it should not be taken on face value. As Cullum Droogan (1999) put it not all research is of the same quality or high standard therefore as a learning disability nurse and social worker it is important being a care provider that although a paper has been published it can be critically appraised. This paper is of central relevance to our practice in ensuring that the lifestyles of people with learning disabil ities are informed by valid and reliable evidence. This research paper adds value to the current literature available in support of independent living however caution must be expressed as it is not solely about living independently. The concept of independently living cannot be advocated for everyone; each person is different and therefore require different levels of support which will meet their needs. The publication of Valuing People (UK Department of Health, 2001) the key document that prompted a change in the way health and social care services operate. The paper made Person-Centred Planning a central component of service reform, and outlined four key principles namely: Human Rights, Independence, Choice and Social Inclusion (Mansell and Beadle-Brown, 2004). This means that people with learning disabilities should be valued members of society, treated with dignity and respect whilst having the same rights and choices as everybody else (OBrien, 2002). Furthermore, people with le arning disabilities should feel empowered to take control over the care that they receive in order to plan and live their lives independently. Previously, people with learning disabilities were shunned away from the community and susceptible to abuse. The Community Care Act (1990) was introduced as a result of both political and social changes in attitudes towards the treatment of people with mental illnesses. In line with Mental Health Act (1983) the aim was to remove the stigma associated with mentally ill people away from isolation towards social inclusion (Social Role Valorisation, Wolfensberger, 1983). But does independently living mean that you get social inclusion? Currently we are seeing a culture of people who require support being effectively excluded from society, waiting for the next support worker to cook their meals, help with personal hygiene and general cleaning. This is a downward spiral in our society which is putting a demand on our system. As a care provider in line with the General Social Care Council and the Nursing and Midwifery Codes of Conduct (2008), it is our duty to advocate in the best interest of the client at all times but who is actually making the decisions? Bond Hurst (2010) highlighted how closely health was linked to independent living and that many of the participants suffered from chronic conditions such as asthma, diabetes and arthritis. Is it a case of compromising funding for services at the expense of overlooking health issues? It seems that the authors make a plausible case that people with learning disabilities are being seen as not a priority as they carry a disproportionate burden of health inequalities among our population. The reality for people with learning disabilities is far from the projected lifestyle of independence (Emerson UK Literature). It is a challenge to support people with learning disabilities, several factors need to be considered to prevent potential disregard. Jansen et al., (2006) points out the need to adopt integrated care approaches in treating those with learning disabilities. This will involve working with different agencies (interagency team working) and different types of professionals (multidis ciplinary team working) in order to provide an holistic service to meet their needs. Current research shows that a disabled person is likely to be in contact with at least ten different care professionals in their lifetime (UK Department of Education, 2003). Issues can arise through out this time which may lead to lack of continuity and communication. Therefore, a sufficient amount of training and awareness is needed to ensure that all staff are qualified and skilled to ensure equity of service provision. When caring for patients it is essential as a practitioner to adopt the current best practice. To determine what this is one must be able to critically appraise evidence that is presented to them (Basset and Basset., 2003). This paper focused on the lived experiences of nine people with learning disabilities about the reality of living independently. In critiquing this paper, the authors successfully highlighted the importance of independent living as an essential nursing intervention however there were also some limitations, the most important being limited verification of the data. Furthermore the narratives of the participants were highly subjective and findings non-generalisable, thus the notion of independent living is not to be applied to all that have a learning disability, or vulnerable adults with complex needs. As recommended by the authors, further accurate, reliable and valid research is needed that will add value to the evidence-base domain. Total Word Count: 2,452 Excluding Headings and References

The Occupational Safety and Health Act Essay -- Workforce Safety Regul

The Occupational Safety and Health Act Just imagine working in an environment where there are very few safety regulations, and little safety equipment. Think of how it was for employees of a steel manufacturing plant to work where there are almost no safety regulations and safety hazards all around you. This is how the work environment was before 1970; there were only few laws or regulations that required employers to maintain certain safety standards or working conditions for employees. However in 1970 President Richard Nixon sought to change all of this by signing into law the Occupational Safety and Health Act (OSHA). The Occupational Safety and Health Act’s mission is to assure the safety and health of America's workers by setting and enforcing standards; providing training, and education; and encouraging continual improvement in workplace safety and health (OSHA.org). OSHA covers an extremely wide array of workers, from construction workers to office workers. However when the act was first passed it was not heavily enforced and lacked inspectors. In 1970 because there were three times as many fish and game wardens than there were OSHA inspectors, people said that the trout and quail were more protected than Americas working men and women (Bennett, Alexander, & Hartman, 2003). Though today OSHA has approximately 2100 inspectors, plus complaint discrimination investigators, engineers, physicians, educators, standards writers, and other technical and support pers...

The Rise of Hitler

The Nazi party first started after WWI when a group of unemployed German men. They were known as â€Å"The German Workers Party (GWP). † Adolf Hitler joined the group in 1919 and quick rose to a high ranking leader. His rise to the top of the GWP was due to his powerful speeches. Despite the ability of his speaking he often used it to promote national pride, militarism, and a racially â€Å"pure† Germany. After Hitler’s rise to leadership he changed the name to â€Å"The National Socialist German Workers’ which was referred to as â€Å"The Nazi Party†.Hitler tried to overthrow the government with the Nazi Party, but had no success. This leads up to his election as chancellor of Germany. While incarcerated, Hitler wrote a book called Mein Kampf, which established a foundation for the beliefs of the Nazi party. After its publication, Hitler could truly grow an army of supporters. According to the narrator’s of â€Å"World at War† After Hitler’s release he quickly pursued a political campaign for chancellor.This provided him with a chance to persuade more of the German public that they needed to condemn all Jews. He brought food and water to the poor, which help with the growth of The Nazi party and his supporters. According the text in â€Å"A Teachers Guide to The Holocaust† Hitler also began create subgroups for specific Germans such as, children, women, doctor’s, etc. Hitler’s attempt was also short lived because they lost the election.Years later after gaining more supports the Nazi Party prevailed and took over Germany due to Hindenburg’s new Government. This allowed Hitler to carry out his plan to rid the world of all Jewish people. In 1938 Germany started to ban Jews from most places. In 1942 the Germans decided it was time to take action start with their plan called â€Å"the final solution† which leads to the founding of concentration camps and the holocaust. The Germans quickly formed alliances with Italy, USSR, and Japan.Despite the alliance Japan created more problems for the Nazi party by attacking America without a declaration of war. After the attacks on Pearl Harbor America had officially joined the war against the Germans in WW2. America’s involvement created the Unfortunately Hitler’s ambition drove him to commit treason against Russia, which was Germany’s biggest ally at the time. Despite the Germany advantage of surprise they could not defeat the Soviets. America capitalized on Germany’s mistake by forming a brief alliance with Russia.

Neural Markers of Categorization

In 2006, University of Delaware’s Paul C. Quinn and Harvard Medical School’s Alissa Westerlund, and Charles A. Nelson study titled â€Å"Neural Markers of Categorization in 6-Month-Old Infants† was published in Psychological Science. The study was motivated by the lack of existing literature on neural markers in infants. These neural markers have been seen as critical in developing an underpinning concept-formation in infants which in turn influences perception and cognitive development. Despite the importance of the neural markers of categorization to various fields of study, there is limited existing literature about it. Furthermore, existing literatures have not yet determined the neural markers and conditional determinants that can be associated with category formation. Most studies on infants have focused on the use of novel stimuli or the use of behavioral indicators to indicate categorization or concept formation. Study Objectives The main objective of the study was to identify neural activity involved in concept-formation in infants. By analyzing learning a category during familiarization, behavioral performance preference for a novel category global-level category learning, neural determinants will be identified. This will then enhance existing methodologies and research regarding concept formation, in particular, category-learning processes in infants. In doing so, the study will be able to not only further knowledge in neural markers and development but also serve as a means to verify conclusions regarding the topic determined outside of neural indicators (Quinn et al 58). Furthermore, the study is to serve as a foundation for further studies focusing on infant development and learning. Methodology Ten infants were included in the study that was selected from an original group of twenty one. Criteria for inclusion included were the child’s ability to stay focused on the stimuli and behavior. The mean age of participants was 198.8 days and 70% of the selected participant were female (60). The stimuli used for testing were colored photos featuring various breeds of cats and dogs assuming different postures. Luminosity of the photographs was based from analysis of the pictures using Adobe Photoshop: luminosity of the pictures ranged from 225.54 to 248.42 for pictures depicting dogs, for cats 226.05 to 249.57. Shape values ranged from 20.03 to 56.88 for cats and 24.28 to 61.65 for dogs. While the area and perimeter of the pictures was based on LASICO 1281 Area/Line Meter. Testing procedures included event-related potential (ERP) Testing, ERP Waveform Analysis and Behavioral Testing. ERP Testing was conducted in an acoustically shielded and light-controlled room. The infants sat with a respective parent in front of a monitor measuring 48 centimeters across and 31 centimeters tall. The infants viewed the pictures randomly from a distance of 60 centimeters with each picture being flashed for 500 ms. Adjustments were made based on observations on the child through video monitors. The results were then recorded and amplified onto a vertex reference at 0.1- to 100-Hz band-pass filtering and digitized at 250-Hz. Electroencephalographic data was handled through NetStation 4.0.1. Adjustments were made as baseline correction to 100-ms prestimulus recording interval. Final phase of testing was done to determine behavioral evidences for category learning. Two 5-s test trials during which a novel cat was paired with a novel dog in a left-right arrangement with two independent observers, both blind to the lateral position of the animals shown to the infant. Results The study concluded that infants, in the processes of learning a category, exhibited higher negative amplitude on left occipital-parietal scalp in response indicating initial experience with category exemplars with the first cat pictures 1 to 18 and novel dogs. Furthermore, comparisons of average amplitude of ERP signals between 1,000 and 1,500 ms after each picture was shown did not vary in cats 1 to 18. this indicates that neural instantiation of are key behavioral indicants of categorization implying that the infants respond to the novel as something familiar. With regards to novel categories, the results indicated the infants’ preference for such (61). This was indicated by the infants’ response to the novel dogs: negative amplitude over left-central became more pronounced. The implications is that Nc component or negative central component of the ERP  waveform can be e a neural marker of infants’ novel-category preference. Behavioral Performance tests from the looking-time data recorded when paired-preference was conducted indicated the infants’ preference for the novel dog versus the novel cat. The infants also showed novel-category preference by 62.52%. Since this value exceeds probability thresholds which in the study are divided equally between cats and dogs, the researchers are confident in concluding that the infants learned category representation for cats that included novel cats without the exclusion of the dogs. The results also yielded conclusions regarding global-level category learning. The researches believe that global-coding nodes are quickly learned as a means to represent or map large differences when there are a limited number of attributes that distinguished the global level Significance and Implications The discrimination of entities categorically is believed to have its roots during development. Therefore, determining the mechanism of category representations develop together with knowledge structures, vocabulary development and expressions that influence cognition, thus, the importance of measuring infants’ visual timing and recognition when presented with both realistic and abstract figures. This will allow for insights to not only in visual and cognitive development but also provide critical information in the overall development mapping of an individual (59). However, since there are no previous studies existing to evaluate the conclusions of the study to, the determination made by the paper will need further research, a constraint that the researchers themselves recognized (61). Despite this constraint, the study was able to provided significant evidence using neural markers using ERP and brain wave mapping that infants learning a category through the process of familiarization have a preference for novel category and respond to category exemplars at multiple levels of inclusiveness. Therefore, neural architecture required for object categorization processes is present in infants aged six months and below which in turn is giving greater insight to the neurological developments critical to learning and development. Work Cited Quinn, Paul C., Westerlund, Alissa and Nelson, Charles A. Neural Markers of Categorization in  6-Month-Old Infants. Psychological Science 17 (1) (2006), 59–66.