Mental Health Professionals Risk Assessment Health And Social Care Essay

Mental Health Professionals Risk Assessment Health And Social Care Essay This assessment item requires students to compare and contrast traditional risk assessment approaches that offer static predictions of risk versus risk assessment approaches that offer dynamic holistic predictions of risk. Students are expected to research theoretical and empirical literature. This assignment emphasizes academic writing skills. Since the 1980s there has been increased pressure on mental health professionals to improve their ability to predict and better manage the level of risk associated with forensic mental health patients, and offenders being dealt with in the justice system (Holloway, 2004). This increased pressure has also increased interest within a wider spectrum of researchers and forensic clinicians working within the justice system to improve the accuracy and reliability of their analysis of whether recidivism is a high possibility. The overall value of this research is that it enable the improvement in the assessment, supervision, planning and management of offenders, in conjunction with a more reliable base line for follow up evaluations (Beech et al., 2003). However there continues to be an increasing interest and expectation on professionals from the public and the criminal justice system in regards to the potential danger posed by serious offenders being released back into the community and the need for the offenders to be better managed, in order to adequately protect the public from dangerous individuals (Doyle et el, 2002). As the assessment of risk is made at various stages in the management process of the violent offender it is extremely important that mental health professionals have a structured and consistent approach to risk assessment and evaluation of violence. (Doyle et el, 2002). This paper will examine three models of risk assessment that are used currently in an attempt to reduce potential danger to others when integrating violent offenders back into the community. These three approaches are unstructured clinical judgement, structured clinical judgement and actuarial assessment. It is not intended in this paper to explore the various instruments used in the assessment process for the respective actuarial and structured clinical approaches. Unstructured Clinical Judgement Unstructured clinical judgement is a process involving no specific guidelines but relies on the individual clinicians evaluation having regard to the clinicians experience and qualifications (Douglas et al, 2002). Doyle et el(2002, p650) refers to clinical judgement as first generation, and sees clinical judgement as allowing the clinician complete discretion in relation to what information the clinician will or will not take notice of in their final determination of risk level. The unstructured clinical interview has been widely criticised because it is seen as inconsistent and inherently lacks structure and a uniform approach that does not allow for test, retest reliability over time and between clinicians (Lamont et al, 2009). It has been argued that this inconsistency in assessment can lead to incorrect assessment of offenders, as either high or low risk due to the subjective opinion inherent in the unstructured clinical assessment approach (Prentky et al, 2000). Even with these limitations discussed above the unstructured clinical interview is still likely to be the most widely used approach in relation to the offenders violence risk assessment (Kropp, 2008). Kropp (2008) postulates that the continued use of the unstructured clinical interview is that it allows for idiographic analysis of the offenders behaviour (Kropp, 2008, p205). Doyle et al (2002) postulates, that past clinical studies have shown that clinicians using the risk analysis method of unstructured interview, is not as inaccurate as generally believed. Perhaps this is due largely to the level of experience and clinical qualifications of those conducting the assessment. The unstructured clinical assessment method relies heavily on verbal and non verbal cues and this has the potential of influencing individual clinicians assessment of risk, and thus in turn has a high probability of over reliance in the assessment on the exhibited cues (Lamont et al, 2009). A major flaw with the unstructured clinical interview is the apparent lack of structured standardized methodology being used to enable a test retest reliability measure previously mentioned. However the lack of consistency in the assessment approach is a major disadvantage in the use of the unstructured clinical interview. The need for a more structured process allowing for predictable test retest reliability would appear to be a necessary component of any risk assessment in relation to violence. Actuarial Assessment Actuarial assessment was developed as a way to assess various risk factors that would improve on the probability of an offenders recidivism. However Douglas et al (2002, p 625) cautions that the Actuarial approach is not conducive to violence prevention. The Actuarial approach relies heavily on standardized instruments to assist the clinician in predicting violence, and the majority of these instruments have been developed to predict future probability of violence amongst offenders who have a past history of mental illness and or criminal offending behaviours. (Grant et al, 2004) The use of actuarial assessment has increased in recent years as risk assessment due to the fact that more non clinicians are tasked with the responsibility of management of violent offenders such as community corrections, correctional officers and probation officers. Actuarial risk assessment methods enable staff that do not have the experience, background or necessary clinical qualifications to conduct a standardised clinical assessment of offender risk. This actuarial assessment method has been found to be extremely helpful when having to risk assess offenders with mental health, substance abuse and violent offenders. (Byrne et al, 2006). However Actuarial assessments have limitations in the inability of the instruments to provide any information in relation to the management of the offender, and strategies to prevent violence (Lamont et al, 2009). Whilst such instruments may provide transferable test retest reliability there is a need for caution when the instruments are used wit hin differing samples of the test population that were used as the validation sample in developing the test (Lamont et al, 2009). Inexperienced and untrained staff may not be aware of the limitations of the test instruments they are using. The majority of actuarial tools were validated in North America (Maden, 2003). This has significant implications when actuarial instruments are used in the Australian context, especially when indigenous cultural complexities are not taken into account. Doyle et al (2002) postulates that the actuarial approach is focused on prediction and that risk assessment in mental health has a much broader function and has to be link closely with management and prevention (Doyle et al, 2002, p 652). Actuarial instruments rely on measures of static risk factors e.g. history of violence, gender, psychopathy and recorded social variables. Therefore static risk factors are taken as remaining constant. Hanson et al (2000) argues that where the results of unstructur ed clinical opinion are open to questions, the empirically based risk assessment method can significantly predict the risk of re offending. To rely totally on static factors that are measured in Actuarial instruments and not incorporate dynamic risk factors has lead to what Doyle et al (2002) has referred to as Third Generation, or as more commonly acknowledged as structured professional judgement. Structured Professional Judgment Progression toward a structured professional model would appear to have followed a process of evolution since the 1990s. This progression has developed through acceptance of the complexity of what risk assessment entails, and the pressures of the courts and public in developing an expectation of increased predictive accuracy (Borum, 1996). Structured professional judgement therefore brings together empirically validated risk factors, professional experience and contemporary knowledge of the patient (Lamont et al, 2009, p27). Structured professional judgement approach requires a broad assessment criteria covering both static and dynamic factors and attempts to bridge the gap between the other approaches of unstructured clinical judgement and actuarial approach (Kropp, 2008). The incorporation of dynamic risk factors that is to say taking account of variable factors such as current emotional level (anger, depression, stress), social supports or lack of and willingness to participate in the treatment rehabilitation process. The structured professional approach incorporates dynamic factors which have been found to be also significant in analysing risk of violence (Mandeville-Nordon, 2006). Campbell et al (2009) postulates that instruments that examine dynamic risk factors are more sensitive to recent changes that may influence an increase or decrease in risk potential. Kropp (2008) reports that research has found that Structured Professional Judgement measures also correlate substantially with actuarial measures. Conclusion Kroop (2008) postulates that either a structured professional judgement approach or an actuarial approach presents the most viable options for risk assessment of violence. The unstructured clinical approach has been widely criticised by researchers for lacking reliability, validity and accountability (Douglas et al, 2002). Kroop (2008) also cautions that risk assessment requires the assessor to have an appropriate level of specialized knowledge and experience. This experience should be not only of offenders but also with victims. There would appear to be a valid argument that unless there is consistency in training of those conducting risk assessments the validity and reliability of any measure either actuarial or structured professional judgement will fail to give the level of predictability of violence that is sought. Risk analysis of violence will always be burdened by the limitation which lies in the fact that exact analyses are not possible, and risk will never be completely era dicated (Lamont et al, 2009, p 31.). Doyle et al (2002) postulates that a combination of structured clinical and actuarial approaches is warranted to assist in risk assessment of violence. Further research appears to be warranted to improve the methodology of risk management and increase the effectiveness of risk management. References Beech, A.R., Fisher D., Thornton D, 2003. Risk Assessment of sex offender. Professional Psychology, Research and Practice 34: 339-352. Borum, R. (1996). Improving the clinical practice of violence risk assessment. American Psychologist, Vol 51, No 9, 945-956. Byrne, J.M., Pattaviana, A. 2006. Assessing the role of Clinical and Actuarial Risk Assessment in an Evidence-Based Community Corrections System: Issues to Consider. Journal of Federal Probation, Vol 70, No 2 p64-66. Douglas, K.S., Kropp, P.R., 2002, A prevention-based paradigm for violence risk assessment: Clinical and Research Applications. Criminal Justice and Behaviour, Vol. 29, 5, 617-658. Doyle, M., Dolan, M. 2002. Violence risk assessment: combining actuarial and clinical information to structure clinical judgements for the formulating and management of risk. Journal of Psychiatric and Mental Health Nursing. 9: 649-657. Grant, T.H., Rice, M.E., Camilleri, J.A., 2004. Applying a Forensic Actuarial Assessment (the Violence Risk Appraisal Guide) to Nonforensic Patients. Journal of Interpersonal Violence, Vol 19, p 1063-1064. Hanson, R. Karl, Thornton, David, 2000. Improving Risk Assessments for Sex Offenders: A Comparison of Three Actuarial Scales. Law and Human Behaviour, Vol 24, No 1. Holloway, F. 2004. Risk: More questions than answers. Invited comment on Psychodynamic methods in risk assessment and management. Advances in Psychiatric Treatment, 10: 273-274. Kropp, P.R., 2008, Intimate Partner Violence Risk Assessment and Management. Violence and Victims, Vol 23, No 2. Lamont, S., Brunero, S.,2009. Risk analysis: An integrated approach to the assessment management of aggression violence in mental health. Journal of Psychiatric Intensive Care, Vol.5, 25-32. Maden, A., 2003. Standardised risk assessment: Why all the fuss? Psychiatric Bulletin, Vol 27: 201-204. Mandeville-Norden, R., 2006. Risk Assessment of Sex Offenders: The Current Position in the UK. Child Abuse Review, Vol 15, 257-272. Prentky, R.A., Burgess, A.W., 2000. Forensic Management of Sexual Offenders. Kluwer Academic/Plenum Press: London. Introduction Since the 1980s there  has been increased  pressure on mental health professionals to improve their ability to  predict  and better manage the level of risk associated with forensic mental health patients, and offenders  being dealt  with in the justice system (Holloway, 2004).  This increased  pressure  has also increased interest within a wider range of researchers and forensic clinicians,  working in the justice system to improve the accuracy and reliability of their analysis of whether recidivism is a strong possibility.  The overall value of this research is that it allows the improvement in the assessment, supervision, planning and management of offenders, in conjunction with a more reliable base line for follow up evaluations (Beech et al., 2003). However, there continues to be an increasing  interest  and  expectation  on professionals from the public and the criminal justice system in regards to the potential  danger  posed by  serious  offenders  being released  back into the community and the need for the offenders to be better managed, in order  to adequately protect  the public from dangerous individuals (Doyle et el, 2002). As the assessment of risk  is made  at various stages in the management process of the violent offender,  it is  extremely  crucial that mental health professionals have a structured and consistent approach to risk assessment and evaluation of violence. (Doyle et el, 2002). This paper will examine three models of risk assessment that  are used  currentlyto  reduce  potential danger to others when integrating violent offenders back into the community.  These three approaches are unstructured clinical judgement, structured clinical  judgement  and actuarial  assessment. It is not intended, in this paper, to explore the various instruments used in the assessment process for the  respective  actuarial and structured clinical approaches. Unstructured Clinical Judgement Unstructured clinical judgement is a process involving no specific guidelines,  but relies on the individual clinicians  evaluation  having regard to the clinicians experience and qualifications (Douglas et al, 2002).  Doyle et el(2002, p650) refers to  clinical  judgement as first generation, and sees clinical judgement as allowing the clinician  complete  discretion in relation to what information the clinician will or will not take notice of in their final determination of risk level. The unstructured clinical  interview  has been widely criticised because it  is seen  as inconsistent and inherently lacks structure and a  uniform  approach  that does not allow for  test, retest reliability over time and between clinicians (Lamont et al, 2009). It  has been argued  that this inconsistency in  assessment  can lead to  incorrect  assessment of offenders, as either high or low risk due to the subjective opinion inherent in the unstructured c linical assessment  approach  (Prentky et al, 2000). Even with these limitations discussed above the unstructured clinical  interview  is still likely to be the most widely used  approach  in relation to the offenders violence risk assessment (Kropp, 2008). Kropp (2008), postulates that the continued use of the unstructured clinical  interview  allows for idiographic analysis of the offenders  behaviour (Kropp, 2008, p205).  Doyle et al (2002) postulates, that  clinical studies have shown,  that clinicians using the risk analysis  method  of unstructured interview, is not as  inaccurate  as  generally  believed.  Perhaps this is due, largely to the level of experience and  clinical  qualifications of those conducting the assessment. The unstructured clinical  assessment  method  relies heavily on verbal and non verbal cues and this has the potential of influencing individual clinicians assessment of risk, and thus in turn has a high probability of over reliance in the assessment on the exhibited cues (Lamont et al, 2009).  A major flaw with the unstructured clinical  interview,  is the apparent lack of structured standardized methodology  being used  to  enable  a  test  retest relia bility  measure  previously mentioned.  However, the lack of consistency in the assessment approach is a  substantial  disadvantage in the use of the unstructured clinical interview.   The need for a more structured  process  allowing for  predictable  test retest reliability would  appear  to be a  necessary  component of any risk assessment in relation to violence. Actuarial Assessment Actuarial  assessment  was developed  to  assess  various risk factors that would improve on the probability of an offenders recidivism. However, Douglas et al (2002, p 625) cautions that the Actuarial  approach  is not conducive to violence prevention. The Actuarial approach relies heavily on standardized instruments to assist the clinician in predicting violence, and the majority of these instruments  has  been developed  to predict future  probability  of violence amongst offenders who have a history of mental illness and or criminal offending behaviours. (Grant et al, 2004) The use of actuarial  assessment  has increased in recent years as risk assessment due to the fact that more non clinicians  are tasked  with the responsibility of management of violent offenders such as community corrections, correctional officers and probation officers.  Actuarial risk assessment methods enable staff that do not have the experience,  background  or necessary  clinical  qualifications to  conduct  a standardised clinical  assessment  of offender risk. This actuarial  assessment  method  has been found  to be extremely  helpful  when having risk assessing offenders with mental health, substance abuse and violent offenders. (Byrne et al, 2006). However, Actuarial assessments have limitations in the inability of the instruments to provide any information in relation to the management of the offender, and strategies to prevent violence (Lamont et al, 2009).  Whilst such instruments may provide transferable  test  retest reliab ility, there is a need for caution when the instruments  are used  within differing samples of the  test  population that  were used  as the validation  sample  in developing the  test  (Lamont et al, 2009).  Inexperienced and  untrained  staff  may not be aware of the limitations of the  test  instruments they are using. The majority of actuarial tools  were validated  in North America (Maden, 2003). This has  significant  implications when actuarial instruments  are used  in the Australian context, especially when indigenous cultural complexities are not taken into account. Doyle et al (2002) postulates that the actuarial  approach  are  focused  on prediction and that risk assessment in mental health has a much broader  function  and has to be  link  closely with management and prevention (Doyle et al, 2002, p 652). Actuarial instruments rely on measures of static risk factors e.g. history of violence, gender, psychopath y and recorded social variables.  Therefore, static risk factors  are taken  as remaining constant.  Hanson et al (2000) argues that where the results of unstructured  clinical  opinion  are  open  to questions, the empirically based risk assessment  method  can significantly predict the risk of re offending. To rely  totally  on  static  factors that  are measured  in Actuarial instruments,  and not incorporate dynamic risk factors has  lead  to what Doyle et al (2002) has referred to as, Third Generation, or as more commonly acknowledged as structured professional judgement. Structured Professional Judgment Progression toward a structured professional  model  would  appear  to have followed a process of evolution since the 1990s.  This  progression  has developed through  acceptance  of the complexity of what risk assessment entails, and the pressures of the courts and  public  in developing an expectation of increased predictive accuracy (Borum, 1996).  Structured professional judgement  Ã‚  brings together empirically validated risk factors, professional experience and contemporary knowledge of the patient (Lamont et al, 2009, p27).  Structured professional judgement approach requires a  broad  assessment  criteria covering both static and dynamic factors, and attempts to bridge the gap between the other approaches of unstructured clinical judgement and actuarial  approach  (Kropp, 2008).  The incorporation of dynamic risk factors that are  taking account of variable factors such as current emotional  level  (anger, depression, stress), so cial supports or lack of and willingness to participate in the treatment rehabilitation process.  The structured professional approach incorporates  dynamic  factors, which  have been found, to be also crucial in analysing  risk  of violence (Mandeville-Nordon, 2006).  Campbell et al (2009) postulates that instruments that  examine  dynamic risk factors are more  sensitive  to  recent  changes that may  influence  an increase or decrease in risk potential. Kropp (2008) reports that research has found that Structured Professional Judgement measures also  correlate  substantially  with actuarial measures. Conclusion Kroop (2008) postulates that either a structured professional judgement approach, or an actuarial approach presents the most viable options for risk assessment of violence.  The unstructured  clinical  approach  has been widely criticised by researchers for lacking reliability, validity and accountability (Douglas et al, 2002). Kroop (2008) also cautions that risk assessment requires the assessor to have an appropriate level of specialized knowledge and experience. This experience should be not only of offenders but also with victims.  There would  appear  to be a valid argument that unless there is consistency in  training  of those conducting risk assessments the validity and reliability of any  measure  either actuarial or structured professional judgement will fail to  give  the  level  of predictability of violence that  is sought.  Risk analysis of violence will always be burdened by the  limitation  which lies in the fact that  exact   analyses are not  possible, and  risk  will never be totally eradicated (Lamont et al, 2009, p 31.). Doyle et al (2002) postulates that a combination of structured clinical and actuarial approaches  is warranted  to assist in risk assessment of violence. Further research appears to be warranted to improve the methodology of risk management and increase the effectiveness of risk management.

The Good Earth :: essays research papers

In The Good Earth, Pearl Buck describes the lifestyle and customs of the Chinese through the character of Wang Lung. She also shows the rise of a simple peasant to the enviable position of a wealthy landowner. At the beginning of the novel, Wang Lung, a poor farmer, is ready to marry O-Lan, a slave who is purchased from the great house of Hwang. She is a sturdy, silent woman who has immense resourcefulness. She is Wang Lung's helpmate throughout the book. Wang Lung and O-Lan, in the span of a few years, have five children. Wang Lung has always believed that the earth is a wonderful provider. When he manages to save some silver from his farming efforts, he decides to invest it in the good earth. He buys a parcel of land belonging to the House of Hwang. Wang's Uncle, who is lazy and evil, knows of his nephew's success and repeatedly comes to Wang to beg for help and food. It is the Chinese custom to help relatives, so Wang reluctantly aids him. Unfortunately, a famine strikes, and everyone, including the Wang family, suffers. The Uncle spreads the rumor that Wang is hoarding food and money, which causes the famished villages to plunder Wang's house; but they find nothing, for Wang is also starving and unable to provide for the basic needs of his family. As a result, Wang takes his family and flees to the South, where they eke out a living. Wang pulls a rickshaw through the streets to earn money. During Wang's stay in the South, the first rumbles of the revolution are heard. One day in Kiangsu, the angry peasants break down the gates of a huge mansion and enter it to plunder and pillage its riches. At first, Wang Lung is unable to steal anything; but when he sees the fat Lord clobbering the peasants, he picks up as much gold as he can and leaves. Wang returns to his homeland with his family. He keeps buying more and more land from the House of Hwang, which has now fallen into decay. As his children grow up, his life begins to prosper. Wang educates his first two sons. The eldest, Nun En, marries a girl from a well-bred family. The second son, Nun Wen, becomes a grain merchant. The third child, a daughter born during the famine, is retarded; Wang loves her dearly and affectionately calls her "poor fool.

The Impact of the World Trade Center Attacks on New York Citys Economy :: Economics

The Impact of the World Trade Center Attacks on New York City's Economy A study by the New York City Partnership and the Chamber of Commerce estimates that New York City's economy will sustain a gross loss of about $83 billion and lose 57,000 jobs over three years as a result of the World Trade Center attacks. The study, which was released Nov. 15, said even after payment of insurance claims and federal reimbursement for rescue, cleanup and infrastructure repair costs, the net damage to the economy is likely to be at least $16 billion in lost economic output. "If third-party reimbursement is delayed or inadequate, or if New York lags behind the nation in recovery from the national recession, the loss could be far greater." The report estimates that 125,000 jobs would be lost in the fourth quarter of this year as a direct result of the attack. "While many of these jobs will return, New York City will still have a net loss of approximately 57,000 jobs attributable to the attack at the end of 2003," the partnership said in the report. The NYCP brought together a group of consultants and economists to help tally and evaluate how the attacks of Sept. 11 would impact the main drivers of the city's economy, especially the financial services industry. Consultancies including A.T. Kearney, Bain & Company, Booz Allen Hamilton, KPMG, McKinsey & Company, Boston Consulting Group and PwC Consulting worked on the report. The group in turn worked with state agencies as well as the Federal Reserve Bank to cull economic data and provide assesssments of 14 separate private industry sectors. Not surprisingly, the study showed that lower Manhattan absorbed the greatest damage. In addition to the thousands of lives that were lost in the destruction of the World Trade Center, the downtown region lost 100,000 jobs along with close to 30 percent of office space in the wake of the attack. "This puts at risk many of the 270,000 jobs that are still located in the area south of Chambers Street." The financial services industry, which generates 24 percent of the city's $440 billion annual economic output and 14 percent of the city's tax revenue, was by the far the most impacted in the short term.

Science and My Daily Life

Science and My Daily life Brenda Durbin Kaplan University Science and I Science has and always will play a constant important role in my daily life, maybe more so than others. Science for me has not always been my strong subject in school and I very easily tend to get intimidated. But when I look at my daily life and realize how much science plays a role in it, I cannot help but smile. Science is not at all bad, it has allowed me to do many things every day, even if I do not take the time to stop and think about it, it is there.From the way the microwave heats up the water for my coffee every morning or the way my body digests the food I eat every meal and makes it into energy or even a trip to the doctor’s office with my son, science is a constant companion and without it, my life would have turned out very different indeed. If I arrived home late one night and after unlocking the front door, I tried to turn on a light and it did not respond I would begin a process of elimina tion, or in other words, using the scientific method to find out the problem.First I would check the light bulb, to see if it had blown, once replacing the bulb if I still did not have light I would then go to my back porch and to the fuse box. I would then check the fuses to see if maybe a breaker was tripped or I had a blown fuse. If even after doing this I still have no power I would then call my electric company, asking them if someone had hit a power pole, or if they were conducting some kind of random test(s) or even making repair(s) to the line. Once finding out some information from the company I would then know whether to light some candles and to be patient or if I would have to call an electrician.For scenario number two I will use the situation of my car not starting. First I would check the level of gas in my vehicle, if that was found to be not the problem I would then check the battery and the terminals making sure they are all clean and connected. I would then check the spark plugs to see if they were misfiring, dirty or corroded. If after checking these items I still would be finding no solution, I would do my best to get a jump start from a passing motorist. If the jumps start did not elp to start my car I would then have to call a tow truck to bring my car to a garage where a mechanic would be able to research the problem better with his/her equipment and tools. While waiting for the answer and the problem to be fixed from the mechanic I would have to plan to either take a cab or find a ride with my friend(s) and/or co-workers to work, appointments and any place I need to go for my routine errands. Every day I get up at 5:30am. Without science (to tell the time of day) and the technology that goes into my alarm clock chances are 5:30am would not be the time I would be getting up.I then go upstairs and wake up my sons Warren and Ryely to get ready for school. When Warren comes down stairs I help him get his morning treatment machines ready. W arren was born with Cystic Fibrosis and relies on science and the continuing scientific advances of treatments, medicines and therapies to continue living. Warren’s first treatment is called a nebulizer, this lasts about 15 minutes. The nebulizer loosens the thick mucus on the walls of Warren’s lungs. Then his next treatment is done with what is called â€Å"the vest airway clearance system† (Hill-Rom Services, 2011).This vest gently compresses and releases the chest wall up to 25 times per second (Hill-Rom Services, 2011). In other words it basically pounds the loosened mucus (from his first treatment, â€Å"the neb† as we call it) off and out of Warren’s lungs so that he may cough it up. This vest treatment last for thirty minutes. After his treatments are finished, I then help Warren break down the machines, clean them and put them away until they are needed again in the evening. Warren does both of these treatments twice a day. Without science I would not have had Warren in my life for so long.He is nineteen and each day he does these treatments is another day I get to have my son in my life. Next, I prepare breakfast for both Warren and Ryely. We have a gas stove in our kitchen so the use of science plays a big role in the cooking of the food for all our meals. After dinner I then lay out all of Warren’s many medications they he needs to take. The absolute most important of all the medication is what is called Creon. Creon â€Å"contains pancrelipase – a combination of three enzymes: lipase, protease, and amylase† (Drugs. com, 2011).These enzymes are produced in the pancreas of people without CF. In people who do have CF however, the thick sticky mucus plugs the ducts in the pancreas so that the enzymes cannot reach the food to help break down and digest what food is eaten. So every time Warren eats he needs to take these, five capsules for snacks and seven with meals. Without science, everything War ren eats would pass right through his system and no nutrition would be absorbed by his body. After breakfast it is usually time for the boys to leave so that they can go to their bus stops.When they leave I will usually either start getting ready for any appointments that are scheduled or start cleaning the house. I must also admit there are some days that I do in fact go back to bed to catch an hour or two of more sleep. Science plays a huge role in the cleaning of my house also. From the hot water I use to mop the floors to the cleaners I use to disinfect and make my home smell clean science is there. Science has improved the quality of my life so very much. In explaining how I will get very emotional and I hope you understand.Without science Warren would not have lived, therefore I would not have become a mother. Without the scientific understanding of genetics and genetic diseases not only would I have lost Warren but I could have very well ended up in jail for child abuse. Befo re a doctor thought of giving Warren a sweat test (a test which measures the amount of salt in sweat) I was being investigated by the state of Maine for suspicion of child abuse. Warren was only 3 months old at the time and got down to 2 pounds 1. 3 ounces.The doctors and nurses immediately thought where I was a young mother I must have not been feeding him. This hung over my head the whole time Warren was being tested and in the neonatal critical care unit. Only when a CF specialist visiting Mid Maine Medical Center from the Children’s Hospital of Boston, after examining my son decided that a sweat test was needed, and done did this allegation clear up. Removing all doubt from the doctors and nurses of my mothering skills and love toward my son. The sweat test came back positive that Warren had CF. It was right then my life changed.Not only did my life change due to the treatments, medications and care Warren needed daily but also I was taught a most valuable lesson, never t ake anyone (who is in your life), no matter how small they are for granted. Every smile, laugh and memory with and from both my children have become even more precious to me now knowing that without the help of science Warren would not be a part of the family. Warren fought so hard to live (and continues to fight) so that I could be a mother, his mother. That in itself changes a person. To be perfectly honest, there has been only one negative impact that science has had on my life.I have always wanted to have at least two children. I underwent genetic testing soon after Warren was diagnosed with CF and the results that came in were scary. Warren’s father was found to have passed a gene unto him that is very common in about 80% of CF cases, while I had passed on to him a much rarer gene that was only evident in 2% of CF cases. The guilt was unbelievable and very painful to work through. And if that was not enough we were also told that with every child I would have with Warren ’s father the chances it would be born with CF were 1 in 4.I do not believe that I could live without science and I sincerely do not think anyone else could either. As people, we get sick, have headaches, toothaches and need surgeries for a multitude of reasons and without science we simply could not and would not be here. From a small aspirin someone takes for pain, to the food we eat or the healthcare we need and receive science is all around us every day! Science has made it possible for people such as me to live longer, be cared for, and to eat a variety of foods no matter if it is in a box or can and to live.To be honest I have always been too busy with my daily life that I have never stopped to think about how much science was in my life and the ways it presents itself. But through this course I have found a definite respect for science. I will look at things differently now and probably always will since taking this course. Science has been around me long before Warren was born but it was when he came into my life that I began to appreciate science and all the possibilities it holds for the future.One of the biggest possibilities that my family and I are hoping for is one day when CF will stand for cure found. Through the length of this course I have shared many of my own opinions and life experiences. Reflecting on them all I cannot help but smile, I should never be intimidated by science, because it is through science I have the life I live now. References Drugs. com, (2011). Creon, Retrieved on November 12, 2011 from http://www. drugs. com/creon. html Hill-Rom Services, (2011). The Vest Airway Clearance System, Retrieved on November 12, 2011 from http://www. thevest. com/products/

Madonna and the Child with Saint Peter and Saint John

The National Gallery of Art in Washington D. C. holds a wide selection of works of art from ancient times. Among these are Madonna and the Child (expressed in tempera on panel) and Madonna and the Child with Saint Peter and Saint John the Evangelist (also expressed in tempera on panel). The themes of both works are similar in that both contain an interpretation of the Virgin Mary (Madonna) and her interaction with the Christ Child. However, the differing contexts in which these are placed add further levels of meaning to each individual piece as depicted by each artist. Despite this, similarities also exist between the two paintings, and these similarities range from the use of color and lighting, to the sizes and perspectives used by the artists. Therefore, superimposed upon the differences in style, context and (to an extent) subject matter; similarities of color, lighting and perspective are to be found in these two works of art. The work Madonna and the Child was most likely painted some time between 1320 and 1330 AD. This was done in the late Byzantine Period in Italy by the artist Giotto, whose style is considered to be anticipatory of naturalism. The panel that holds this particular work represents Giotto in the later stages of his career and demonstrates the sobriety and restraint of an artist that had already spent his enthusiastic flare. Nardo (who died in his twenties), on the other hand, displays his 1360 painting in much brighter and vibrant colors that are typical of his youth and enthusiasm. While in Giotto’s work one detects the deliberate strokes of a talented artist that seeks to display the natural portrait of a woman and her baby caught in motion, in Nardo one also sees the talent, but with a less naturalistic tint. Nardo represents a return to the more traditional portrait-like paintings where subjects appeared poised specifically to be captured in the medium. Therefore, whereas in Giotto’s painting, the hands of the mother and child are caught in the act of brushing by her chest, Nardo’s painting depicts mother and child in absence of motion. Furthermore, Nardo’s painting includes the apostles on the side in adoration of these persons as saints, while Giotto represents them more on the side of human persons spontaneously experiencing life in solitude. The colors and lighting techniques used by these two artists offer themselves up for scrutiny. Contrast and conceptualization are used to a large extent in both the Giotto and the Nardo paintings. Giotto uses a method of alternating between gold and black to emphasize the importance of the Madonna. A conceptual interpretation of the colors might also demonstrate that the Madonna is herself covered by a black shroud of humanity, though her gold-tinted skin demonstrates the worth of the person within the shroud. The colors used for the Christ child corroborate this and elevate Him in relation to his mother, as he is given no dark-colored garment to attenuate the golden nature represented in the color of his body. In a similar fashion, the Nardo depiction of the Madonna, Peter and John features a stark black background that has the effect of focusing the eyes of the viewer upon the portraits within. Yet, the pictures of Peter and John on either side of the Virgin take on less significance because of a reduction in their sizes and of the contrast between their color and that of the wall in front of which they stand. This has conceptual value in that is denotes that the Madonna and the Christ Child take more precedence than the apostles. The mother and child’s position at the center also highlights this idea. One gets several feelings when one views these two paintings in the gallery. The immensity of the subject and the beauty of the golden and reddish colors give the idea that one is in the presence of highly exalted persons. Yet, one also gets the idea that the persons being viewed (especially in the Giotto painting) are also natural and in the middle of living their lives. With Giotto, the viewer has the sense that he/she witnesses â€Å"a quite drama† in which occurs â€Å"the human interaction between a mother and a child† (National Gallery). In contrast with this, the Nardo portrait gives a more contrived picture which resembles the posing of the two for a portrait. According to interpretation by the Gallery’s art historians, â€Å"Nardo’s Virgin, despite her soft expression, appears removed from human concerns.† The Virgin is, in this picture, aware of being under the scrutiny of others: the Saints Peter and John that flank her on each side, and the artist himself for whom she poses. Works Cited Giotto. Madonna and the Child. (Tempera on Panel). Samuel H. Cress Collection. National   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Gallery of Art. Washington D. C., 1320/1330. Nardo di Cione. Madonna and the Child with Saint Peter and Saint John the Evangelist. Samuel   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   H. Cress Collection. National Gallery of Art. Washington D. C., 1360. National Gallery of Art. â€Å"Byzantine Art and Painting in Italy during the 1200s and 1300s.†   Ã‚  Ã‚  Ã‚  Ã‚   Madonna and the Child. (Giotto.) Samuel H. Cress Collection. National Gallery of Art. Washington D. C., 1320/1330.      

Pestle Analysis for Education

Political| * Schools being privatised (like the NHS) * A government initiative creates the risk that the school may fail to deliver the policy or be diverted away from local priorities etc. * Changes to the skills required to be a teacher/ tutor * Changes to curriculum with short lead times * Requirement to be self managing * Requirement to be self financing| Economic| * Central or local government funding decisions may affect school/ establishment finances * Closure of a local industry may affect fund raising plans etc. Ability of parents to raise funds for optional activities * The need to run breakfast/ after schools clubs * Ability to invest ‘savings/ surpluses’ * Cost of providing resources: * Staff – teaching & support * Basics – books/ paper * Technology solutions laptops etc * Interest rates * Shortages of materials on national/ international markets * Over provision of school places in the area resulting in competition from neighbouring schools * T he risk of highly valued, key staff moving on to more ‘up and coming’ schools/ academies| Social| * Decline in birth rate, reflecting national trends * Local population changes (increasing/ decreasing numbers) * Demographic changes may affect likely pupil rolls or the nature of pupils needs e. g. pupils with English as a second language etc. Closure of local firms providing employment * Inability to attract staff * Social networking – blogs, facebook, twitter * Changes to qualifications expected * Integration with local community * Integration of students with special needs * parental preference – an increase in ‘parent power’ has allowed parents more freedom of choice over their child’s school * the risk of highly valued, key staff moving on to more up-and-coming establishments * Information is accessible to staff anywhere in the world via the Internet * Staff were not given enough training or access to effectively change their habits and how they expected information to be made available| Technological| * Changes to standards/ equipment required * Risk of selecting the wrong technology at times of change (i. e. windows -v- open source) * New computer viruses may affect school/ college operations, * Disturbing/ illegal images on the internet may affect ICT security measures etc. * Move from paper based books to e-book readers * Computer hardware being out of date * Computer software being out of date * Time to anage IT systems  | Legislative| * new legislation may create risks of non-compliance with the law, create new administrative burdens etc * Changes to child protection legislation * Raise the age of school leaving age * Raise/ lower the age of starting school. Nursery/ kindergarten * Change to school opening hours * Changes to funding of charity based organisations * Health & safety legislation| Environmental| * A new highway layout near the school may create new dangers for pupils etc * Waste disposal * Reduction of green space available for activities * Changes to local bus routes * Using a significant amounts of paper and photocopier toner to produce printed information. |

Accomplishment Report

Republic of the Philippines DepED-REGION III Division of City Schools District III Daan Sarile Elementary School Cabanatuan City Accomplishment Report C. Y. 2011 * * School is said to be the place where learning takes place, thus pupils learning is a great accomplishments to every school. However accomplishments of school as a basic institution within the community have different dimensions and components to improve and address. In order for this to realize shared efforts are required. For these, the following are the endeavors of Daan Sarile Elementary School for CY 2011. * * A.School Leadership/School Head * *Updating EMIS/SIS * *Trainings/conferences attended- * 1. Public Accountability and Values Enhancement Seminar- March 23-25. * 2. t2t Orientation Training Program for Teachers and School Officials-Oct 11-14,2011. * B. Pupils Development * *Registered 55 GSP and 44 BSP * *Organized Pupil Government, Earth Savers Club, Future Homemakers Club. * * Participated and won on differen t contest. * 1. District Read-a-Thon Contest winners: * * Jellie I. Pascual- Oral Reading Interpretation, 2nd place (English) * * Jazz Chant – 4th Place * *Micol Joy D.Pagayanan- Oral reading Interpretation, 3rd place (Filipino) * 2. 2011 District Press Conference * *Revelyn L. Reselva- Feature Writing-Filipino 3rd Place * *April L. Reselva- Copyreading Filipino 3rd Place, * Feature Writing Filipino 3rd Place * *Von Ivan F. Flores-News Writing- English 2nd Place News Writing- Filipino 1st Place * *Joanna Grace T. Oteyza -Feature Writing Filipino 5th Place * *Marco G. Soriano-Feature Writing Filipino 4th Place * * *Scriptwriting & Radiobroadcasting 4th Place * *2011 Science Fair *Sayawit sa Kalikasan-Champion * * *Conduct Search for Mr. & Ms. Earth Savers * *Celebrate Nutrition Month * *Celebrate Buwan ng Wika * *Conduct School Press Conference ,School Science Fair * *Participated in GSP Encampment- 15 No. of delegates * *Participated in BSP Encampment- 17 No. of Delegates * * Participated in Regional BSP Encampment – No. of delegates * * C. Staff Development * *Trainings Attended: * 1. Gerleeh Q. Sacdal-Regional Seminar Workshop on Campus Journalism-Oct. 21-24,2011-RELC * 2. Marlon M. Imperio-Regional Training in Elem.Math-Sept. 29-Oct. 2,2011, RELC * 3. Marlon R. Imperio, Evangeline F. adrineda, Jonathan D. Diaz, Victoria D. Arahan- * T2t orientation & Training Program for Teachers and School Officials-Oct. 11-14,2011, T Hall * 4. Ma. Luisa F. Pacolor, Jonathan D. Diaz-Division Seminar Workshop on On-Line Publication * 5. Jonathan D. Diaz, Loida O. Cruz- Division Jamborette * 6. Mary Ann Tatlonmaria Corazon J. Bautista, Gerleeh Q. Sacdal-Division Encampment * 7. SLAC in Mathematics by Mr. Marlon M. Imperio * * D. Curriculum Development * *t2t Program recipient *Produce ICT aided instructional materials in Science III, HKS III, Math IV-VI, EPP V &VI, Music, English V & VI, Filipino V. * * E. Physical Development * *Construction of Drainage * *Cons truction of Plant Boxes and Landscaping * *Putting-up of the following HPTA projects: bookshelf-Grade III-Santan, wallfan-Grade IV-Dahlia,repainting of Grade V-Daisy classroom and mural paintings, Deskfan-Grade III-Rosal. * * F. Community Development * *Participated and support the Waste Management Program implemented by the City Government thru CAECO. * * * * Prepared by: * * VICTORIA D. ARAHAN * Principal I * * PICTORIALS * * * Classroom Structuring * * * Delegates to Regional BSP Jamborette * * * * * * * * * School Supplies from a stakeholder (Coun. Orlando Tumibay) * * * Stand fans donated by a pupil * * * * * * * * Regular Meeting with the stakeholders * * * Regular meeting with the teachers * * * * * * * * Buwan ng Nutrisyon Celebration * * * * * * * * * * * School Feeding Program * * * Plentiful harvest from gulayan sa paaralan * * * * * * * * Tree planting * * * Maintaining the cleanliness of school premises