Equine Assisted Activities Spina Bifida Health And Social Care Essay

Equine Assisted Activities Spina Bifida Health And Social Care Essay Spina Bifida is a neurological disorder whose main attribute is a failure of the spine to close properly before birth. As the fetus develops in the first month of pregnancy, the brain and spinal cord form from a small piece of tissue called the neural tube.   For one in approximately every one thousand babies, this neural tube does not close properly after the spinal cord has developed, resulting in a portion of the spinal cord being exposed at birth. It is not known what exactly causes this malformation, but it has been hypothesized that there may be a genetic link. Another explanation is that Spina Bifida may be caused by this genetic link in combination with a deficiency of folic acid in the mother during pregnancy. Folic acid is a B vitamin that is important for fetal development in the first three months of pregnancy, thus an insufficient amount could lead the spinal cord not forming properly. The brain and spinal cord are some of the first organs to develop in the fetus, and thus a lack of folic acid could interrupt their development (Watson 4-8). In the most severe cases of Spina Bifida, classified as forms of Spina Bifida Cystica, a sac is exposed on the childs back that contains fluid, nerves, protective nerve coverings, and sometimes a portion of the spinal cord (Resources for Working with Youth with Special Needs). This sac is surgically removed within the first few days after birth, while trying to save and replace in the body as many of the viable nerves as possible. The extent of the damage to the spinal cord depends on how far down the spine the opening occurs. This in turn determines the level of paralysis or disability of the individual. The spinal cord and nerves are not always exposed in a sac outside of the body, but can also be just slightly damaged in a form of the condition known as hidden Spina Bifida. Whether or not there is a sac present outside of the body, the deformity of the spinal cord can occur in varying degrees, resulting in three main types of Spina Bifida (National Institutes of Health; Watson, 6). The most common type of Spina Bifida, which results in the most severe disabilities, is called Myelomeningocele Spina Bifida. The characterizing exposed sac protrudes out of an opening in the babys back, and contains a portion of the spinal cord. Because many of the nerves contained in this sac are damaged, this form of Spina Bifida can cause severe disabilities including weakness, loss of feeling in or paralysis of the feet, legs and sometimes waist (Center for Disease Control and Prevention). Meningocele Spina Bifida is less severe than Myelomeningocele, but has similar effects on the individual. The neural sac is still exposed and exists outside of the body, however it does not contain any part of the spinal cord itself, and thus causes less nerve damage. Individuals with this form of Spina Bifida may have some loss of feeling, weakness or paralysis in the feet and lower legs (Center for Disease Control and Prevention). The mildest form is called Spina Bifida Occulta. It is often referred to as hidden Spina Bifida, because it is not apparent at birth and usually does not affect the individual at all. The spinal cord is not damaged in this form of the disease, but there is a small opening between vertebrae in the spine. Because it is so subtle, Spina Bifida Occulta is usually not diagnosed unless the individual has an X-ray or test done for another condition, and it generally is not severe enough to even require treatment (Watson, 6).   Many individuals with Spina Bifida also have a condition known as Hydrocephalus, or water on the brain, which is essentially a build-up of cerebro-spinal fluid around the brain. A widening of the spinal canal called hydromyelia, which creates a cavity where fluid can build up, can cause hydrocephalus. It is a common co-occurrence with Spina Bifida because the deformity of the spinal cord can prevent the fluid from draining as it normally would (Watson, 7). This condition is usually treated with a shunt placed in the individuals skull, which helps to properly drain the excess fluid. In many cases, the hydrocephalus itself is caused by another common co-occurring condition with Spina Bifida, called Chiari II Malformation. This is a malformation of the skull that results in the bottom portion of the skull being smaller than normal. When this happens, part of the cerebellum and brain stem are pushed downward into the neck, blocking the flow of cerebrospinal fluid and causing hydrocephalu s (National Institutes of Neurological Disorders and Stroke). Since the cerebellum is the portion of the brain that controls balance, this can affect the individuals vestibular sense. Many of the problems associated with the two more severe forms of Spina Bifida can be improved with equine assisted activities. Due to the fact that all forms of Spina Bifida affect the spinal cord and nerves of the individual, the most common problems associated with the disease relate to motor coordination as a result of lack of feeling, weakness or paralysis in the lower limbs. Sometimes, difficulties with bilateral integration can also occur depending on the specific individuals disability. Often, individuals with Spina Bifida have increased muscle tone and some spasticity in their legs. Usually they are able to walk with the use of equipment such as leg braces, body braces, crutches and walkers, but have abnormal gaits and have difficulty standing without movement (Bartonek, et. al). They can also have difficulty with trunk control and holding them selves in a sitting position if the nerve damage affected their ability to feel and control their hips and waist. Due to the lack of feeling in some parts of the body, some individuals with Spina Bifida may have problems with sensory integration to some extent. This would be present mainly in terms of the vestibular and proprioceptive senses. Some additional problems such as tendonitis and skin breakdown can co-occur with Spina Bifida, mainly due to the loss of feeling in the lower extremities. In some cases, mental along with physical function is affected and the individual may have some degree of mental retardation, but this is often not the case. Equine Assisted Activities Individuals with Spina Bifida could participate in and benefit from two main Equine Assisted Activities: Hippotherapy and Therapeutic Riding. Because Spina Bifida primarily causes physical problems, hippotherapy would probably be the best option, as it is a true therapy that would provide more medical benefits than a therapeutic riding lesson alone could provide. However, hippotherapy could be used in conjunction with therapeutic riding. Hippotherapy and Therapeutic riding would provide very different benefits, however, they both have the potential to improve an individuals physical motor skills along with their mental and social skills if those areas were affected. Hippotherapy would most likely be the best option for an individual with Spina Bifida, as the conditions primary manifestations affect the physical abilities of the individual, requiring more assistance from a physical therapist to improve motor function. Hippotherapy Hippotherapy would most likely be the main equine assisted activity for riders with Spina Bifida. It would provide the required physical therapy to improve muscle tone and motor function, more so than therapeutic riding alone. The activities and exercises in hippotherapy target neuromuscular function, movement disorders and sensory integration disorders, which are all areas that can be affected in a person with Spina Bifida. Overall, as with other equine assisted activities, the horse would provide perfect three-dimensional motion and warmth, allowing the rider to relax their muscles and let the horse move their legs and hips. This movement would be key, as many individuals with Spina Bifida focus on learning how to walk so they are not confined to a wheelchair. Though many will not be able to walk without crutches or braces, the movement of the horse can teach them both mentally and physically what the patterns of walking look and feel like so that someday they may be able to implem ent the motions off the horse. Since the purposes of hippotherapy revolve around goals related to physical and sensory abilities, the rider would be focused on improving in some of the following areas. Most importantly, the stretches and balancing exercises in hippotherapy could help improve muscle tone and movement, allowing the rider to work on further developing their balance, posture and mobility. Some examples of these exercises could include the rider standing in the stirrups, with assistance if needed, trying to maintain balance, or the rider laying on their back on the horse, using their leg muscles to hold themselves up on the horses neck.   Ultimately, all of the skills and improvements gained from hippotherapy sessions could lead to a final goal of improved gross motor skills such as walking, sitting and standing which are the simple daily tasks that most Spina Bifida patients struggle with throughout their lives. Therapeutic Riding Therapeutic Riding could benefit riders with Spina Bifida, but would most likely be in addition to hippotherapy. Therapeutic riding could provide the added benefit of social interaction and learning riding skills on top of the more intense physical therapy gained from hippotherapy. Therapeutic riding could provide a setting in which the rider could refine the stretches and activities learned in hippotherapy and apply them on a more simplistic level while riding in a therapeutic lesson. Whether in Hippotherapy or Therapeutic Riding, the same fundamental benefits of simply being on the horse would exist. The three-dimensional motion and patterns of the horses gait would encourage walking, and in this setting would be more relaxed than in an intense physical therapy-type lesson. Though hippotherapy would provide most of the necessary therapy components to a rider with Spina Bifida, therapeutic riding does have several aspects that are not present in hippotherapy that could greatly benefit the riders. They would be required to use their bodies a little bit differently in a riding lesson-that is, rather than the horse simply being a prop that moves underneath them while the lay down or stretch, they would have to integrate their movements with those of the horse. The riders would need to use their legs to signal the horse to walk on, and they would need to maintain balance and posture throughout the lesson, requiring them to use their leg, hip, and trunk muscles. In certain activities, such as trotting and two-pointing, they would be required to use their leg muscles even more to keep balanced and remain steady on the horse. This may be very challenging for some individuals, depending on their level of weakness or paralysis in the legs. On top of these benefits, therapeutic riding would provide a setting in which individuals could interact with other riders and their volunteers in a fun and relaxed setting. Hippotherapy, as it is a true therapy, would most likely be very challenging and tiring, and therapeutic riding could provide a setting in which riders could enjoy the company of other people and horses in a less intense session. Contraindications for Spina Bifida and Equine Assisted Activities Though a rider with Spina Bifida can benefit greatly from equine assisted activities, there are several contraindications that should be considered before beginning with either hippotherapy or therapeutic riding. Many of the common contraindications of riding horses are present in individuals with Spina Bifida. However, some can be present but mild enough so as not to limit the rider. Either way, it is important to consider all of the possible contraindications and risks before he rider begins either a hippotherapy or therapeutic riding session. One of the most important things to consider when looking into contraindication for a rider with Spina Bifida is the ability to maintain a sitting position on the horse. If a rider is unable to maintain this position without causing kyphosis or lordosis (inward curving or bowing of the spine), then the Spina Bifida itself could be considered a contraindication (Medline Plus). In most cases, it is only a precaution if a correctly fitted, deep-seated saddle (most likely a western saddle) is available. Another prevalent contraindications for riders with Spina Bifida is hydrocephalus, a common co-occurrence of Spina Bifida. Generally it is a contraindication due to the fact that it is treated with the placement of a shunt. If a properly fitting helmet cannot be placed on the rider without putting pressure on the shunt, it may only be a precaution (North Okanagan Therapeutic Riding Association). Another common contraindication associated with Spina Bifida is the possibility of developing a condition known as Tethered Cord Syndrome-when the base of the spinal cord is held down and unable to move freely in the spinal column. This condition normally occurs as a result of scar tissue forming from the original surgery to remove the myelomeningocele or meningocele. This scar tissue is what ties the spinal cord down. In some cases, the motion of the horse can increase the chances of this condition forming, or aggravate it if the condition has already begin to develop, making it an important contraindication to consider. Tethered cord syndrome can worsen the already existent problems associated with Spina Bifida. It can cause worsening of gait associated with increased pain and spasticity in the legs, and rapid development of scoliosis (Spina Bifida Association). Conclusions   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Spina Bifida is a common neurological disorder that can cause lack of feeling, weakness and paralysis of the lower extremities. In some cases, other conditions such as hydrocephalus, Chiari II malformation, Tethered Cord Syndrome, tendonitis and mental retardation can co-occur with Spina Bifida, ultimately resulting in struggles with physical and sometimes mental function. The problems associated with Spina Bifida and its co-occurrences primarily affect motor function and the tactile, proprioceptive and vestibular senses. For this reason, equine assisted activities such as Hippotherapy and Therapeutic riding can have a very positive impact on riders with Spina Bifida. One or both of these activities can be implemented in the individuals routine to improve their motor function, specifically in terms of their abilities to use the muscles in their feet, legs, hips and trunk. Gross motor skills such as standing and walking are the main challen ges that individuals with Spina Bifida face, and the natural movements of the horse, along with therapy exercises and activities can be very effective in improving these skills in order for individuals to achieve more independence and in turn, better quality of life.

Domestic Violence Essay

Domestic Violence is one of the many social issues that society is faced with. Research has it that the female group is the one that becomes victimized the most and there are several strategies that have been put into place to culminate this issue of violence at home, more especially against women. One of the strategies that have been introduced in fighting domestic violence in South Africa is the Domestic Violence Act of 1998. Although this Act is one of the good moves by the government, it has many shortcomings. This essay will therefore discuss critically domestic violence and how the Domestic Violence Act is not sufficient to protect women in South Africa from violence at the hands of their abusers To begin with, South African government refers domestic violence to any incident of threatening behaviour, violence or abuse (psychological, physical, sexual, financial or emotional) between adults who are or have been intimate partners or family members, regardless of gender or sexual ity; and in the (South Africa) constitution enacted is an Act which aims â€Å"to provide for the issuing of protection orders with regard to domestic violence; and for matters connected therewith† which is the Domestic Violence Act, 1998 (Act No. 116 of 1998). There are several good points about this Act, and primary to those is that people (especially women and children) to some extent are protected from the deliberate abuse at home. However, many are the shortcomings of this Act. For instance, the exact statistics concerning domestic violence are extremely difficult to obtain hence it becomes difficult to know how much the Act is working. Domestic violence is not a crime as such, and police statistics reflect only reported crimes, such as assault, rape or malicious damage to property, and so forth. In some instances, domestic violence is not reported by the victims because of several reasons. There are many actions that constitute domestic violence that are not defined as crimes, such as forced isolation, verbal abuse, stalking and economic abuse. Domestic violence is often not just a one-off event, but a series of events, or a continuous pattern of abuse. Domestic violence may also exist as a continuum with one serious violent incident at one end, to ongoing and multiple abuses at the other. This pattern of abuse is not recognized in South African criminal law, which tends to isolate individual incidents. In addition, as outlined by Bollen et.al (1999).most crimes of domestic  violence are not reported to the police for fear of intimation, shame, and fear of not being believed, self-blame, or fear of retaliation. Furthermore, it appears from studies and work by organizations offering support to victims that the incidence of domestic violence is very high in South Africa. Community based studies have revealed that in some areas almost a quarter of women report having being abused in their life times by a current or ex-partner, and that up to a half are affected by emotional or financial (Jewkes et.al, 1999). A survey of 269 women who had contacted helping agencies in three major cities found emotional or physical abuse to be the most prevalent form of domestic violence experienced by women, with 90 percent of the sample having experienced this abuse (Bollen et al, 1999). The Domestic Violence Act (Act 116) was introduced in 1998 with the aim of affording women protection from domestic violence by creating obligations on law enforcement bodies to protect women (victims) as far as is possible. The Act sets out a broad range of behaviours that constitute domestic violence; including physical, sexual, verbal, emotional and psychological abuse, stalking, intimidation, harassment, malicious damage to property, unauthorized access to the complainant’s property, as well as other forms of controlling behaviour which may cause harm to the safety, health or wellbeing of the complainant. The Act also extends the notion of ‘domestic relationship’, affording to protection to married couples; same-sex relationships; couples who are (or were) in a dating, engagement or customary relationship, including an actual or perceived relationship; any person in an intimate relationship; parents of a child; and people who do or have recently shared a residence. The Domestic Violence Act allows a complainant to apply to court for a protection order asking for relief or protection. An interim order may be granted, and after an enquiry, a final order may be granted against a respondent. The protection order may prohibit the respondent from committing any act of domestic violence; from entering a specified place; or from committing an act set out in the order. A warrant of arrest is issued simultaneously with the order, and brought into effect if the complainant reports that the respondent has breached any provision of the order. If he or she is found guilty of a contravention, then the court may convict the respondent and sentence him or her to a fine or a term of imprisonment. In terms of the Act, no prosecutor is permitted to refuse to  institute an action, or to withdraw a charge unless authorized by the Director of public prosecution (Dissel & Ngubeni, 2003). Another of the other very serious shortcoming of this Act is that, while the Act criminalizes the breach of an order, it does not create an offence of domestic violence (Dissel & Ngubeni). Where the offender commits an act that is recognized by the criminal law as a criminal offence, a woman can report the case to the police, and it may proceed to a criminal trial but if it is not recognized, then there is nothing to be done. In conclusion, the Act is an indication of the seriousness with which domestic violence is now viewed in South Africa. It offers one form of protection to women who are the victims of domestic violence, but it does not necessarily offer remedies to the problem. The essay has outlined that sometimes the reason why domestic violence is so prevalent is due to the fear of shame and not being believed. The recommendation therefore is that there should be trained personnel who understand clearly the domestic violence issue, persons who understand of such related issue s and that will enable the victims to talk freely so as to reveal everything. References Bollen, S., Artz, L., Vetten, L., Louw, A. (1999). Violence Against Women in Metropolitan South Africa: A study on impact and service delivery. Institute for Security StudiesMonograph Series No 41, September 1999. http://www.iss.co.za/Pubs/Monographs/No41/Contents.html. Retrieved 8 October 2013 Dissel, A & Ngubeni, K. (2003).Giving Women their voice: Domestic Violence and Restorative Justice in South Africa. CSR: Paper presented at the XIth International Symposium on Victimology, Stellenbosch, July 2003. Jewkes, R., Penn-Kekana, L., Levin, J., Ratsaka, M., Schreiber, M. (1999). â€Å"He must giveme money, he mustn’t beat me†: Violence against women in three South African provinces. Pretoria: CERSA (Women’s Health) Medical Research Council

Vital Pieces of Essay Samples for Gmat

Vital Pieces of Essay Samples for Gmat The Essay Samples for Gmat Game Practicing will assist you in quite a few ways. First, it will help you master your timing. When you haven't exercised your writing muscles for some time, it's recommended to put in some practice. Among the greatest GMAT essay advice is to practice, practice, practice before you finish the GMAT AWA section on test day. If you currently have an earlier GMAT OG, trust the one that you have. Practicing can help you get accustomed to the structure of GMAT AWA prompts and help you become accustomed to the forms of questions that you'll see on test day. Another one of the important GMAT writing suggestions is to select the opportunity to establish your essay in a transparent way. Want to Know More About Essay Samples for Gmat? Most books on essay writing will provide you with quite a few model essayscollect a few of these as they are fantastic teachers! PaperCoach will be able to help you with all your pap ers, so take a look at the moment! Essays are the center of fellowship applications. Writing quality essays is the principal purpose of our services. International differences are going to be taken into consideration more strongly. Students lead busy lives and frequently forget about an approaching deadline. Students which are undertaking such courses should never need to be concerned about having the ability to find the help they need for the papers since there is so much at their disposal, so much they can look forward to. The Fight Against Essay Samples for Gmat The test taker must select the very best method of rendering the underlined part. Creating an AWA template is a fantastic method. Order a top-notch custom GMAT essay and become ready for the test! You may also become different discounts on our site which will help you to save some more money for future orders or anything you want to spend them on. 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Inside this introduction, every thing that should be said has been said. Start by stating your position and make propositions that you're going to be presenting on the subject available. Do not present your own perspectives on the argument accessible. The D eath of Essay Samples for Gmat You don't need to speak about the argument generally. To begin with, you should underline the flaw itself. Without regard to the prompt, you need to always produce the case that the given argument is flawednot whether you agree with this. No matter the prompt, you always need to produce the case that the given argument is flawednot whether you agree. Getting the Best Essay Samples for Gmat You may elect for 4-6 paragraphs, yet this template described. Although there are a few basic measures to writing an assignment, essay writing isn't a linear procedure. You should attack the essay with a particular template which you've already perfected beforehand. 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How to Pronounce Thank You in Chinese

Being able to thank someone is one of the first things we learn to say in another language, and the word è ° ¢Ã¨ ° ¢ (è ¬ Ã¨ ¬ ) †xià ¨xie† therefore appears in the first chapter of almost all beginner textbooks in Chinese. This word is very versatile and can be used in most situations where you want to thank someone, so treating it as a direct equivalent of the English †thank you† works well most of the time. But how do you pronounce it? How to Pronounce è ° ¢Ã¨ ° ¢ (è ¬ Ã¨ ¬ ) †xià ¨xie† Even if the word è ° ¢Ã¨ ° ¢ (è ¬ Ã¨ ¬ ) †xià ¨xie† often appears in the first chapter of most textbooks, it certainly isnt easy to pronounce, especially if you havent had time to internalize Hanyu Pinyin yet, which is the most common way of writing the sounds of Mandarin with the Latin alphabet. Using Pinyin to learn is good, but you should be aware of some of the problems involved. There are two things you need to pay attention to: the initial †x† and the tones. How to Pronounce the †x† Sound in è ° ¢Ã¨ ° ¢ (è ¬ Ã¨ ¬ ) †xià ¨xie† The †x† sound in Pinyin can be tricky to pronounce for beginners, and together with †q† and †j† they are probably the hardest initials to get right for native speakers of English. These sounds might sound similar to the English †sh† and in †sheep† (in the case of †x†) or to the English †ch† in †cheap† (in the case of †q†), but that will not give you the right pronunciation. To pronounce †x† correctly, do like this: Lightly press the tip of your tongue against the teeth ridge just behind your lower teeth. This is a very natural position and this is probably what you do when you breathe normally through your mouth.Now try to say †s† while still keeping your tongue tip in the same position. To produce the sound, the tongue needs to be raised, but since you cant raise the tip (it shouldnt move), you have to raise the body of the tongue (i.e. farther back than when you say s).If you can produce a hissing sound with this tongue position, congratulations, youre now pronouncing †x† correctly! Try playing around a bit and listen to the sounds you produce. You should be able to hear a difference between this †x† sound and the †sh† in †sheep† as well as a normal s. The next part of the syllable, â€Å"ie†, usually doesnt cause much trouble for beginners and simply trying to mimic a native speaker as well as you can is likely to be enough. The tones, however, are a different matter, so lets look at how to say â€Å"thank you† without sounding like a tourist. How to Pronounce the Tones in è ° ¢Ã¨ ° ¢ (è ¬ Ã¨ ¬ ) †xià ¨xie† Tones are tricky because they arent used to create different words in English. Of course, we do vary the tone height when we speak English too, but it doesnt change the basic meaning of a word like it does in Chinese. Therefore, its common for beginners to not be able to hear tones properly, but this is just a matter of practice. The more you expose yourself to tones and the more you practice, the better you will become. Practice makes perfect! Tones are normally indicated by a mark above the main vowel, but as you can see in the case of è ° ¢Ã¨ ° ¢ (è ¬ Ã¨ ¬ ) †xià ¨xie†, there is no mark above the second syllable, which means that its a neutral tone. The downward mark on the first syllable indicates a fourth tone. Just like the tone mark indicates, the pitch should fall when you pronounce this. The neutral tone should be pronounced more lightly and should also be shorter. You can treat the word è ° ¢Ã¨ ° ¢ ( è ¬ Ã¨ ¬ ) †xià ¨xie† as a word in English with stress on the first syllable, like â€Å"sissy† (I mean for stress purposes, the other sounds are different). There is an obvious emphasis on the first syllable and the second one is quite reduced. Practice Makes Perfect Simply knowing how è ° ¢Ã¨ ° ¢ (è ¬ Ã¨ ¬ ) †xià ¨xie† is supposed to be pronounced doesnt mean that you can pronounce it, so you need to practice yourself as well. Good luck!

Analysis Of Running Head Voices War - 1161 Words

Running head: VOICES IN WAR What Is a Voice in War? Name Date What Is a Voice in War? How do you give someone a voice? In this culture today, many people are relegated to the file similar to out of sight out of mind. Unfortunately, this reality is what faces many veterans from the US military and have returned from war only to be marginalized and embroiled in a more obscure conflict from within. Using art can bring a change to a veteran’s health and well-being in addition to traditional treatment from a medical perspective of using medications. Having a voice expresses intelligence, emotion and conveys the identity and uniqueness of an individual. Each person has a unique perspective from the life experiences and brings†¦show more content†¦These photographs are emotionally charged and show varying degrees of emotional conflict by the facial and bodily postures. â€Å"On August 8th, 2014, student and photographer Devin Mitchell began backpacking/traveling the west coast in search of veteran stories in hopes of illustrating these individuals through the art of pictures. The Veteran Vision Project is a photo documentary, featuring authentic military service members and their lives† (Mitchell, 2015). The Veteran s Vision Project uses photography and the mirror to illustrate the many reanges of problems veterans are facing after service in the United States military. There is a wide range of emotions, relations and in some cases the mental dilemma that stands in front of the veteran. By not using any words the artist is trying to show by body posture and facial expressions that can readily show how a person is changed by war. Now most images are serious and show some level of struggle to try to live in a culture where the idea of war is ignored or almost non-existent. Most all reflections have a military image on one side or the other, but in a couple of cases have uniforms on both sides of the mirror. Standing at attention in uniform is the usual stance of military bearing and the almost steely eyed focus of a determined effort to fight a war is a standard of conduct. Now after the time is served, some come from service to find that

Abigail Adams Chapter Guide Free Essays

Haley Young Dearest Friend: A Life of Abigail Adams Reading Journal Chapter 1: A Minister’s Daughter * Abigail was born to Reverend William Smith and his wife Elizabeth in Weymouth parsonage in Massachusetts. * She has two sisters, Mary and Betsey. The main point of this chapter was to showcase the religious, family-oriented background that Abigail was raised in. We will write a custom essay sample on Abigail Adams Chapter Guide or any similar topic only for you Order Now It explains why she is so focused on her family and John later in her life. It also explains her penname â€Å"Diana† and her love for literature and being involved in politics, after being taught to read at a young age. Chapter 2: John * Abigail and John were married on October 25, 1764. The maim point of this chapter is to show the love developing between John and Abigail. The way they were not attracted to each other at first explains why they work together so well. They have different views on things so they balance each other out. Their love for each other also sets up their depression during their separation later in their lives. Chapter 3: Wife and Mother * Abigail and John had six children: Abigail, John Quincy, Susanna, Charles, Thomas, and Elizabeth (stillborn). The main point of this chapter is to show the Adams family growing. Abigail’s deep connection to her kids at such a young age explains her sadness later on in her life when they are no longer with her, especially when her sons begin to leave home with their father to help with his politics and see the world. It also explains her connection to Nabby, since after Susanna and Elizabeth died young; Nabby was the only Adams daughter. Chapter 4: Politics * John elected representative to Massachusetts legislature, then later chosen as a delegate to the Continental Congress. Chapter 5: War Abigail had to raise her kids and deal with the family farm buy herself while John was away in Philadelphia. Chapter 6: Independence * Abigail used her influence over John to fight for women’s’ rights and representation during the drafting of the Constitution. * John was elected commissioner to France. Chapter 7: A Woman’s Sacrifice * While John was away in Europe, Abigail once again had to run her household on her own, which put her into a depression. Chapter 8: The Long Separation * After his commission to France, John was elected minister plenipotentiary which extended his stay in Europe. Chapter 9: Years of Decision * While John was in Europe, Abigail couldn’t decide whether or not to join him, but when he was commissioned to negotiate a treaty of commerce with Great Britain, she and Nabby decided to go and join him in Europe. * Nabby fell in love with Royall Tyler so the trip was also to see if their love would last. Chapter 10: Europe * Abigail liked London because of the class but disliked Paris because she thought it was dirty and the people were rude. * The servants did less in Europe, so it was more expensive to run a household ,which frustrated Abigail. John was then appointed minister to London by congress. Chapter 11: â€Å"The Ambassadress† * Abigail was overwhelmed by the wealth of the royal court in London. * She and John were not used to the expenses of clothing, servants, and hosting dinners for other dignitaries. This was made even worse by the low salary John was being paid by Congress. Chapter 12: A Homesick American * In London, Abigai l continued to miss American and her easy-going life in the countryside because she felt confined in the city in London. Chapter 13: The Vice President’s Lady * After Europe, Abigail was sure that she wanted her husband to continue his political career. * In March of 1779, John was elected Vice President, so the whole Adams family moved to New York to serve with George and Martha Washington, the new president and first lady. * Once again, like London, Abigail had many social obligations to fulfill as the second lady of the United States. * Congress then moved the capital city to Philadelphia, so once again the Adams family had to move. Chapter 14: An Interlude at Quincy * For John’s second term as Vice President, Abigail spent most of her time back in Braintree running the farm. * After her health scare while moving to Philadelphia, The Adams family didn’t want to risk her getting even more sick. * In 1796, George Washington announced he would not serve a third term as president, which made people speculate that John would succeed him. John would have to run against Thomas Jefferson in order to do so. Chapter 15: Mrs. President * John’s election made Abigail nervous. John was not as widely supported as Washington. * Abigail played a huge role in John’s presidency by expressing her opinions in politics, which was uncommon for a woman of the time. * While living in Philadelphia for John’s presidency, Abigail grew to enjoy the city. Chapter 16: â€Å"The Federal City†: * When John’s political career ended, Abigail returned to Quincy to a busy home full of her family. * Abigail soon set out for Washington, the new capital city, but when John was not reelected, they both returned. Chapter 17: The Matriarch of Peacefield * With both John and Abigail back in Quincy, Abigail took right back to being the matriarch of the house and taking care of her numerous grandchildren. * Abigail enjoyed having her husband always with her, and helping to raise her small grandchildren while in retirement. Chapter 18: The Curtain Falls * On October 28, 1817, Abigail died after falling ill with typhoid fever, at age 73. * Abigail was able to die peacefully with most of her family around her. How to cite Abigail Adams Chapter Guide, Essay examples

Cognitive Behavioural Therapy in Health Care-Samples for Students

Question: Discuss about the Cognitive behavioural therapy in health care. Answer: Introduction: The aftermath of an accident is often much harder to deal with that the actual incident. There are many repercussions that haunt the victims even after years of the accidents they have encountered. The trauma of an accidents is a major cause of mental health adversities in many of the accident victims and there are instances where the victims have to seek out professional mental health care for the post traumatic stress disorders, furthermore, the burden of the accident is even higher for the unfortunate victims that have had to go through a disability due to the accident, it has to be understood that any accident acquired disability is associated with not just physical repercussions but there are many psychological restrictions that facilitate extreme burden on the psychological health and well being of the victims (O'Donnell et al. 2013). This assignment will make use of the theories and principles of the cognitive behavioural therapy are order to design supportive care taking the assistance of a case study. Brief description of the case study: The case study represents the case similar of the patient who had to go through a severe spinal injury due to an accident. Andrew, the patient under focus in the case study had become disabled due to the accident. It has to be mentioned here that Andrews had been a passionate young man with a job and life ahead of him, where an accident changed his life forever and put him in a wheelchair. There are many restrictions that he struggles with in his daily life; on a more elaborative note, Andrew present is paralyzed from the waist down and needs assistance in mundane everyday works like moving around the house in his wheel chair, bathing, and most important going outside the house on his own is completely impossible for the patient under consideration. Along with that, it has to be mentioned that his parents are also very worried about the wellbeing of their disabled son due to the fact the he could not survive without a full time assistance. The financial constraint on the family is al so rising with the retirement of Andrews father nearing, the patient and his parents are worried if they are going to be able to afford the car needs that a disabled individual needs. Along with that, another very significant objective data about the patients is the complete powerlessness and dependence that the patient feels. On a more elaborative note, he had been unable to voice his needs and grievances to his parents in the fear of offending them and his helplessness. And his helplessness and powerlessness has facilitated feelings of agitation, irritation and anger, which is being reflected oh his actions and his response to his mothers attention to him. The patients is going through extreme mood swings and he is constantly worried about his future. He is worried about becoming too flabby for sitting idle in his wheelchair all day. Even when he meets his older friends, he feels inadequate and inferior to them, his past relationships have ended because of his accident as well and these incidents have increased the psychological burden on the patient. Hence, in this condition the patient is in desperate need for supportive care from the professionals and supportive assistance from the community disability aid and mental health services (O'Donnell et al. 2015). Interpersonal skills needed: It has to be understood that the patient under focus for this case has a variety of different care priorities and a care design for Andrew will have to take into consideration an interdisciplinary practice. First and foremost, it has to be mentioned that the most important concern with a disabled patient is the adequate verbal and nonverbal communication skills. It has to be understood that a disabled individual goes through a myriad of different restrictions and hence the dependence on the care provider often leaves the patient with discomfort, agitation and he tendency to get offended very easily (Beck 2011). In order to provide optimal care to such a patient, it is crucial for the care provider to develop a therapeutic relationship with the patient and build a mutual respect where the patient feels comfortable with the care provider and can feel free to share any grievances with the care provider. The communication approach in this case has to be very compassionate and understandi ng, so that the patient can interpret the genuine concern and insight and then respond to it (Craske 2010). The next interpersonal skills with utmost importance for the care scenario is the nonverbal communication, it has to be understood that the response of the care seeker to the approaches of the care provider is often dependent on the nonverbal gestures of the care provider. For instance the body language and eye contact often play a huge role in gaining the trust of the care seeker. In this case the care provider has to be very friendly and warm in his approach so that Andrew feels engagement and companionship rather than being crowded (Hofmann et al. 2012). The tone of voice and communication style also has a profound effect on the relationship between a care provider and seeker. In this case, the tone of voice and style has to be respectful and empathetic so that the patient feels empowered and is not offended by any manner. Other than that, the insightful behaviour and open communication are two interpersonal skills that will help the care provider gain the confidence of the patien t and help him regain control in his life. Lastly, it has to be understood that the sensitivity and respectful approach to the opinions, believes and perspectives of the patients and his family members (Tolin 2010). Cognitive behavioural approach and its link to the case study: Cognitive behavioural theory is one of the greatest approaches that can help the care providers take up the best approach to improve the health and wellbeing of the patients. The cognitive behavioural approach is primarily utilized to treat any mental health disorders, however the underpinning theories and principles can be very effective in determining and categorizing the care needs of a disability victim and can design better care plan for the same. The main ideology of the cognitive behavioural theory is based on three core areas of human behaviour, cognition, emotion and finally the response or behaviour (Wetherell et al. 2011). On a more elaborative note, cognitive behavioural therapy identifies the negative interpretation and thinking in an individual and thereby the equally negative reactions. For instance, it has to be understood that the general assumption of the cognitive behavioural therapy dictates that any anomaly or abnormality in the behaviour is generated from a flaw ed cognition and interpretation about the world and ownself. These faulty cognitions facilitate distortions in the thinking procedure and the distorted mental representation distorts the behaviour or reaction. There are two particular theories that can be easily correlated with the cognitive behavioural therapy, such as the learning theory and the emotional processing theory. The learning theory states that the behavioural modifications in an individual is dependent on the environmental cues, where as the emotional processing theory provides a framework to understand the onset of behavioural issues and post traumatic stress disorder (Arch et al. 2012). In case of Andrew, it has to be mentioned that the onset of behavioural issues and depression the patient had been due to the faulty perception of the restrictions and troubles he had been encountering in life due to his disability and the confinements that it has introduced in his life. According to the cognitive behavioural approach, the faulty and contorted perception of any activity or incidence is the main contributing factor behind the abnormal behaviours in the individuals and in order to effectively and successfully addresses the behavioural issues and the resultant stress and withdrawal; it is imperative t address the contorted perception (Deblinger et al. 2011). As per the cognitive behavioural therapy, for every negative interpretation of life, there can be a positive alternative interpretation, and the patients have to be encouraged to opt for the positive interpretation instead of the negative one and gradually the behaviour of the patient under therapy will also change positively (Carroll 2011). Possible solution: The possible recommendation to follow for the patient under consideration will need to begin with the patient indentifying the distorted cognitions with the help of a evaluative process. In this case, the patient has distorted conception of his disabilities and the restrictions that these disabilities have posed on him. Along with that, Andrew has a basic idea that due to his dependence and powerlessness, he cannot express his own choices and preferences to his parents. Along with that his perspective guides him to believe that his mothers concern for him is out of pity and his friends disinterest is due to him being crippled. Lastly, it has to be mentioned that Andrew believes he has no future and his life has no meaning anymore that he is dependent on the care providers and he is beginning to feel like a burden (Mitchell et al. 2012). The cognitive therapists will have to help him identify the root to these contorted perceptions and will help him learn to discriminate between his p erception and the reality. The second step of the solution will be encourage the patient to document his change in feelings, if Andrew can document every time the contorted thoughts he can document how he could change it with a positive interpretation and what effect did it impart on his response. This documentation will not only be exceptionally beneficial for him to evaluate his irrational thoughts and how he can convert it to rational thoughts, it will provide a sense of control and power over his own progress. According to the most of the authors, the empowerments and being included in the care planning and implementation procedure enhances the involvement and interest of the patient in their own care plans. And hence, the journals will be a great outlet for Andrew to express his feelings and discover where his thoughts are being distorted and with what kind of positive thoughts he would like to replace them with (Addington et al. 2011). On a more elaborative note, it has to be mentioned that the use of rational emotive behavioural therapy can be excellent for the patient to learn how to convert the irrational believes to rational and optimistic believes. Along with that, the use of ASC model of irrational beliefs provide a step by step framework for the patients and his therapist to follow, by the means of three basic steps, activating event, beliefs, and consequence. The cognitive triad is another set of exponential therapeutic intervention for the patient that suffers through spontaneity of negative thoughts. This triad is based on three basic steps, the negative view of the self, the negative view of the world and resultant negative view of the future (Leichsenring et al. 2013). In this case, due to his paralysis, Andrew had very negative view of himself due to his incompetence and a very negative view of his surroundings as well, be it his parents or the rest due to his dependence and hence as a result of both h e had pessimistic perception of his future. Targeting all thereof these elements can be beneficial for him to overcome the behavioural issues. Ethical considerations: It has to be understood that like any the psychotherapy, the utilization of the cognitive behavioural therapy is no exception to ethical constraints. Ethical practice is a major practice priority among the cognitive behavioural therapists, and in cases where the patients are relatively powerless while receiving the treatment, the ethical constraints are even more imperative. First and foremost, the confidentiality and privacy of the patient has to be maintained and along with that, the importance of informed consent is even more crucial for CBT (Brabban et al. 2017). Along with that, the application of different models of cognitive behavioural therapy often is unconsciously or consciously forceful while changing the cognitions of the patients, which needs to be avoided at all costs. Along with that, even though the fact that cognitive behavioural therapy deals with the concept of transference only marginally, care has to be taken that the transference is not favouring the therapist a nd offending the patient (Sookman 2015). Usefulness of the approach: It has to be mentioned in this context, that the cognitive behavioural therapy is a exceptionally important tool in understanding the behavioural issues of the clients seeking therapy and root cause behind. The therapy is extremely suitable for understanding human behaviour because it focuses on the human thought process and the impact of the thoughts. According to the authors, human behaviour is complex, and the path of the thought process is responsible for both accomplishments and challenges. This therapy hypothesizes on the fact that the behavioural issues are focused on the maladaptive and negative assumptions and perceptions of human mind in any adverse situation and hence their responses or actions are correlated with the degree or nature of the negativity of the assumptions. Hence, the cognitive behavioural therapy provides a useful cause and effect framework to follow and discover the human behavioural issues successfully. Personal reflection: This case study has given me an incredible opportunity to utilize and reflect on my psychological knowledge and expertise in a real world and practical social care providing scenario. This case study required me to read and understand thecognitive behavioural therapy in detail and apply the theoretical principles and assumptions to the case of Andrew. However, I would also like to mention that the process of researching the cognitive behavioural therapy helped me discover key points of human behaviour. I have understood that our perception of any situation is the driving factor behind our actions and in turn our future. Hence we can control the path our future can take if we can control the perception and thoughts about anyone and anything in a particular scenario. This has been a tremendous life lesson for me and I will ensure to implement positive interpretation even in adverse scenarios so that in the social care setting as well, my positive outlook can benefit and inspire my care seekers and can help them find their way back to better living. The case study of Andrew has given me an insight on the practical real life challenges and scenarios that I, as a social care provider can encounter in the future. Along with that, it has to be mentioned that this case study has given me opportunity to understand the behavioural issues Andrew was facing and discover the root cause of the issue with te help of cognitive behavioural therapy. Along with that, I had also the opportunity to recommend care solutions for Andrew and outline the ethical considerations applicable to the case. Hence, I can proudly state that this has been a perfect opportunity to test my skills and expertise and I can state that I am ready for my career in the social care setting. Conclusion: On a concluding note, it can be stated that the stress and the trauma for the accident acquired injuries and resultant disabilities can be huge on the victim and can even lead to many mental health co-morbidities. Hence, in order to avoid such serious consequences, the aid of community social care support can be extremely effective. Although there are many approaches that can help the victims overcome the mental and physical stress that these victims go through, the most important and most frequently used therapy is the cognitive behavioural therapy. This case study utilized the use of different models of cognitive behavioural therapy and the use of this therapy helped in designing a useful and suitable care plan for the patient. Hence, cognitive behavioural therapy is a potent tool in deciphering human behaviour and any anomaly associated with it, with more research emphasis, this therapy can be integrated to many mental and behavioural health issues. 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