Tuesday, December 31, 2019
Communication And Interpersonal Skills - Free Essay Example
Sample details Pages: 12 Words: 3695 Downloads: 4 Date added: 2017/06/26 Category Management Essay Type Research paper Did you like this example? 2.0 INTRODUCTION TO MANAGEMENT Present since the dawn of civilization, management can be briefly defined as getting the work done with the least possible errors, through other people with the intention of achieving the targets. Different definitions of management have been given by eminent personalities, which are: Management refers to the process of getting activities completed efficiently, with and through other people. (Stephen Robbins) Management is the art of getting things done through other people. Donââ¬â¢t waste time! Our writers will create an original "Communication And Interpersonal Skills" essay for you Create order (Mary Parker Follett) Although defined by many in numerous ways, management is all about planning, leading, organizing and controlling. In order to properly manage a particular task, it is also important to effectively and efficiently use the available resources. Nevertheless, in the 21st century it has been noticed that the different management skills are also of utmost importance for the success of an organization. The three basic types of skills identified by Robert Katz (1970), which make up effective management, are technical, human and conceptual skills. In addition, with the new types of organizations and the new ways of doing business that are taking place in our current era, new trends, ideas, skills and techniques are equally essential. All of which are the result of Management Competencies, that is the combination of skills, behavior and requirements necessary to accomplish a particular task at its best. 2.1 COMPETENCIES According to Andrew May (1999), Management competencies are used to build a framework for analyzing the resources available to achieve business strategies and forecast areas of control risk, a key factor in business continuity planning. The different management competencies that are very important in todays business environment are interpersonal communication skills, leadership and emotional intelligence. 2.1.1. Communication and Interpersonal skills With the aim of achieving success in a particular business, good communication skills are required, regardless of the size of the organization. Communication and interpersonal skills incorporate the following: Planning and structuring, Communicating in person and writing, Feedback, Presentations, Negotiations, persuasion and influence, and Better understanding others. Communication, defined as the transmission of a message whether verbally or non-verbally from one person to another, occupies an essential position in the work field just as in all other areas of life. Very often, communication is related to interpersonal skills which are the life skills we use daily to interact with other people and in groups. Consequently, known as the Interpersonal Communication Skills, this concept which was firstly introduced in the 1950s has been defined as the ability to work well with people and involve your acceptance of others without any discrimination (Berko et al., 1998/1378: 58). In other words, people exchange thoughts, information and meanings through verbal and non-verbal messages through this method. According to Avkiran (2000), Interpersonal Communication Skills are the ability to act in response to the staffs requirements positively, while developing a non-discriminatory work environment where the staffs are capable of developing their full personal potentials. Interpersonal communication can be applied to: Provide and accumulate information, Manipulate the thoughts and behaviors of others, Build and preserve relationships, Make sense of the world and our experiences in it, Convey personal needs and recognize the requirements of others, Offer and obtain emotional support, Create decisions and resolve problems, Foresee behavior, and Regulate power. It has been noted in many different organizations that though the traditional skills like written and verbal communication, are still important, increasing em phasis is being placed on the capacity to create and nurture partnerships, to develop innovative new programs and to market the products and services that the organization is offering. According to Meyer et al. (1990), the organizational commitment concept which is multidimensional in nature have included three conceptualizations, namely the affective commitment (attachment or recognition), normative commitment (responsibility or obligation to norms) and continuance commitment (sacrifice and investment that increases an individuals cost of leaving). Consequently it can be assumed that organizational commitment is made up of these three components. 2.1.2. Leadership With the purpose of maximizing efficiency and to achieve organizational goals, leadership has always been an important function of management. For Horner (1997), leadership has been defined as the traits, qualities and behaviors of a leader. In short, leadership is mostly concerned with motivation, initiating actions, creating confidence, providing guidance, building morale and work environment as well as co-ordination, in other words a persons skills, abilities and degree of manipulation to get people moving in a direction, making decisions and do things that normally they would not have chosen to do. It is a known fact that the starting point in understanding responsible business behavior and the different competencies of management remains the leadership, especially relating to the personal attitudes and viewpoints. 2.1.2.1 Theories of Leadership In the past, leadership theories focused more the distinguished qualities of the leaders and followers whereas subsequent theories are paying more attention to variables such as skill levels and situational factors. The theories of leadership can be categorized as follows, in spite of the diverse leadership theories that have come into view: TRADITIONAL THEORIES OF LEADERSHIP Great Man Theories which presumes that the capability for leadership is innate (great leaders are born, not made). Great leaders are often represented as valiant and mythic, ordained to ascend to leadership when needed through these assumptions. Trait Theories presume that people receive certain traits and qualities making them better suited to leadership and thus often categorize certain behavioral or personality characteristics shared by leaders. Contingency Theories that might verify which particular approach of leadership is best suitable for the situation focuses on particular variables relate d to the environment and therefore look upon the fact that the leadership style is not same in all situations. Situational Theories recommends that based upon situational variables leaders opt the best course of action that is the most appropriate and effective styles of leadership for decision-making of certain categories. Based upon the idea that great leaders are made, not born, the Behavioral Theories of leadership, which is entrenched in behaviorism, does not focus on the internal states or mental qualities but on the actions of leaders and as such people can be taught through coaching and observation to develop into leaders. Participative Theories suggest that the best leadership style is one that takes the participation of others into account. Participation and contributions from group members are encouraged by these leaders with the aim of helping group members feel more important and committed to the decision-making process. CONTEMPORARY THEORIES OF LEADERSHIP Also known as transactional theories, the Management Theories focus on the function of organization, control and group performance and is based on a system of rewards and punishments. According to Burns (1978), transactional leadership originates from more traditional views of workers and organizations, emphasizing the leaders position of power to use followers for task completion. Relationship Theories also called transformational theories focus upon the associations created among leaders and followers. Transformational leaders inspire and encourage people by helping group members see the significance and superiority of the task. Focused on the performance of group members these leaders in addition wish for each individual to accomplish his or her potential. 2.1.2.2 Management and Leadership Management and Leadership have been used interchangeably, as they are two thinking describing two different perceptions. Managers relate to goals and objectives in an impersonal manner while being primarily concerned with developing plans and budget, organizing direction, co-coordinating and controlling resources whereas leaders have a high sense of active and personal involvement thus capable of influencing others. Quick and Nelson (1997) have stated that Whereas leaders agitate for change and new approaches, managers advocate stability and status quo and have also affirmed that though management and leadership are two different systems, they are also complementary wherein Leadership is a sub-set of good management. Many people believe that leadership is about positioning a new direction for a group to follow while management directs resources or people in a group according to the established values and principles. With the purpose of better understanding leadership and mana gement, one must consider what happens when you have one with or without the other, that is: Leadership without management Ãâ ââ¬â¢Ã sets a vision or direction that others follow, without taking into consideration the method through which the new direction is going to be accomplished. Management without leadership Ãâ ââ¬â¢Ã organizes resources to preserve the status quo or else make sure things take place according to already-established strategies. Combination of leadership and management Ãâ ââ¬â¢Ã does both it both sets a fresh path and handles the resources to achieve it. For example a recently elected prime-minister or president. Consequently, leadership is concerning the setting of a new direction for a group whereas management is about controlling and directing according to the established principles. 2.1.2.3 Qualities, Skills and Styles of Leadership Leadership qualities are normally assumed to be context-dependent since they show a discrepancy in the different companies, teams and situations. The perfect scenario in theory is for a leader to have unlimited flexibility that is being able to adapt the leadership style according to the situation. However, modern leadership theory has begun to realize that the ideal, flexible leader does not exist as everyone has both strengths and weaknesses and consequently there is a need to make an adjustment while trying to meet the needs of the situation 2.1.3. Emotional Intelligence Emotional Intelligence (EI) is described as the ability to recognize and understand ones own feelings and emotions as well as those of others and use that information to manage emotions and relationships. It has been noted that people with high EI are usually successful in most of their tasks especially because of their nature to make others feel good. EI is a unique fundamental element of ones behavior, which can be improved with practice. Used for the first time in 1985 by Wayne Payne, in his doctoral thesis entitled A study of emotion: developing emotional intelligence; self-integration; relating to fear, pain and desire, emotional intelligence is mostly concerned with perceiving, understanding, reasoning with and managing emotions. Back in the 1990s, when EI first acquired noteworthy media attention, for many people it was regarded as the explanation for a remarkable discovery. Many studies have confirmed that this relatively new intelligence was significant to the surviv al of organizations in this new world economy (Bloomsbury, Cherniss Goleman). The US secretary of Labors Commission on Achieving Necessary Skills published a report referring to the important presence of this soft skill at the workplace. In order to achieve a high performance at work, according to this report along with good literacy and computational skills workers should also outshine in personal qualities such as self-esteem, responsibility, sociability or honesty (Secretarys Commission on Achieving Necessary Skills, 1991). The key areas for EI in management competencies are: Reading people Ãâ ââ¬â¢Ã Interacting, presenting, supporting and cooperation Using emotions Ãâ ââ¬â¢Ã Leading, deciding, creating and conceptualizing Understanding emotions Ãâ ââ¬â¢Ã Organizing, executing, analyzing and interpreting Managing emotions Ãâ ââ¬â¢Ã Adapting, coping, enterprising and performing 2.1.3.1 Emotional Intelligence Skills There are four core emotional intelligence skills, grouped under two primary competencies, namely personal competence and social competence. Figure 1: Core emotional skills Self-Awareness Ãâ ââ¬â¢Ã is about how exactly emotions can be identified in the moment and understands the tendencies across time and situation. Self-Management Ãâ ââ¬â¢Ã describes how the awareness of ones emotions is used to create the behavior one wants. Social Awareness Ãâ ââ¬â¢Ã explains the degree to which the emotions of other people are understood. Relationship Management Ãâ ââ¬â¢Ã gives details on how the previously mentioned skills are used to handle the interactions with other people. According to Dr Singh (2003), EI is the capability of a person to properly and effectively respond to a huge variety of emotional stimuli being drawn out from the inner-self and immediate surroundings while comprising three psychological dimensions emotional competency, emotional maturity and emotional sensitivity which motivates an individual to recognize, interpret and handle diplomatically the dynamics of human behavior. For Sterrett (2003), EI refers to a series of personal, managerial and social skills needed so as to help an individual succeed at the workplace and in life on the whole. It encompasses competencies such as character, intuition, integrity and good communication and interpersonal skills. 2.1.3.2 Emotional Intelligence Models The creator of the field of EI stimulates huge discussion and due to the fact that EI is a young and ever growing field one has to keep an open mind on this topic while being willing to recognize the qualities of each of the models, and apply what them more effectively. So far, the three EI models that have been proposed are: 2.1.3.2.1 The Ability Model (Mayer and Salovey, 1997) The Ability Model of Mayer and Salovey (1997) defines EI as the intelligence in the traditional sense, that is, a set of mental abilities to do with emotions and also the processing of emotional information which are component of and contribute to reasonable thought and intelligence in general. Such mental abilities are arranged hierarchically from the basic psychological processes to more psychologically integrated and complex practices which can be developed through age and experience. This Ability Model also depicts that the emotionally intelligent individuals are more likely to: Have grown up in bio-socially adaptive households (with more emotionally sensitive parents), Be non-defensive, Be able to reframe emotions effectively, Choose good emotional role models, Be able to communicate and discuss feelings, Develop expert knowledge in particular emotional areas, such as aesthetics and social problem solving. 2.1.3.2.2 The Competency-Based Model (Goleman, 2001) This model of EI by Goleman (2001) has been planned purposely for workplace applications (Gardner Stough, 2002). Based on the theory of performance, it involves twenty competencies which help to distinguish individual differences in workplace performance. Clustered into four different general abilities, these competencies are: Self Awareness Ãâ ââ¬â¢Ã Ability to recognize feelings and precise self-assessment, Self Management Ãâ ââ¬â¢Ã Capability to handle internal states, desires and resources, Social Awareness Ãâ ââ¬â¢Ã Ability to read people and groups emotions accurately, Relationship Management Ãâ ââ¬â¢Ã Ability to induce desirable responses in others. Figure 2: Competency-Based Model 2.1.3.2.3 The Non-Cognitive Model (Bar-On, 1997) In this model, EI is defined as an array of non-cognitive capabilities, skills and competencies that manipulate ones ability to be successful in dealing with environmental demands and pressures. This model consists of fifteen conceptual components that pertain to five specific dimensions which are as follows: Intra-personal skills Ãâ ââ¬â¢Ã capabilities, competencies and expertise pertaining to the inner self, Inter-personal skills, Adaptability Ãâ ââ¬â¢Ã how one can successfully manage environmental demands by successfully evaluating and dealing with challenging situations, Stress management Ãâ ââ¬â¢Ã the ability to cope and manage stress effectively, General mood Ãâ ââ¬â¢Ã the ability to enjoy life and maintain a positive disposition. Figure 3: Bar-on model of Emotional Intelligence 2.1.3.3 Emotional Intelligence importance It has been found that employee behaviors which is focused on the fulfillment of customers needs and desires, by mediating a positive climate for services within the organization, will lead to an increase in customer satisfaction levels and consequently to increases in profitability (Keiningham and Vaura, 2001; Olivier, 1996). 2.2 CHALLENGES Changes in todays organizations environment have been provoked by a variety of driving forces from both internal and external surroundings. These driving forces are elaborated below. 2.2.1. Information challenges The use of information technology is highly important to enhance the whole of any organization and up to now the focus has been largely on the collection, transmission and storage of data. But currently, with the new information revolutions the focus is shifting towards the meaning and purpose of information since it is a known fact that unless organized in meaningful patterns, data is not information. The main task therefore is defining information, creating new ideas and generating latest examples that will help redefine the tasks to be done as well as the different institutions that perform these duties. The challenges are: 2.2.1.1 Exploding digital universe The rate of information growth is increasing rapidly. According to the Digital Universe study (2011), Extracting value from chaos, this expansion of information and big data are changing all characteristics of business and society. In order to make sure that there is a high availability of information and to provide more up-to-date function, there has been duplication of data. This replication has enormously contributed to the expansion of information growth. Every two years the worlds information is doubling and it is assumed that by 2020 the world will make 50 times the amount of information and there will be 1.5 times less IT staff to handle it. New information taming technologies such as de-duplication, compression, and analysis tools are lessening the cost of creating, managing, capturing, and accumulating information to one-sixth the bill in 2011 in contrast to 2005. The International Data Corporation (IDC) is investigating the opportunities and development joined to contr ol and take advantage of this unstable expansion of information (www.emc.com). 2.2.1.2 Varying significance of information Essential to communication, information is a critical resource for performing work in organizations. The importance of information changes regularly. Consequently information that is valuable at present might turn out to be less important tomorrow, according to the needs and requirements of the job. The main reason that information is of such importance to organizations and individuals is that it drives communication, decision making, and reactions to the environment. 2.2.1.3 Increasing dependency on information The strategic use of information plays an important role in determining the success of a business and provides competitive advantages in the marketplace. In this competitive world of ours, there is a must to have the right information at the right time to be able to make decisions. Failure to which might eventually result in making huge loss by the organization. Information helps managers to not only create mission, vision and set goals but also facilitate them in analyzing the environment and viewing different strategic alternatives so as to counteract moves or even providing better products and services than the competitors. 2.2.1.4 Diversity and Globalization Diversity is a very sensitive subject and it can be harmful to an organization if it is not handled properly. It is imperative for any organization to properly implement programmes for diversity management due to globalization of industry and the pursuit of effective competition, since globalization mixes both economics and societies all over the world. In this modern moment, where people have divergent views on globalization, its effect on diversity is very important. 2.2.1.5 Telecommuting Margaret Tan-Solano (2001) defined Telecommuting as the practice of an employee performing his normal office duties from a remote location. With the arrival of telecommuting, several benefits have been achieved, namely more time to focus on work, as location is no more a constraint, flexible work schedules and increased productivity. It also allows closer proximity to and involvement with family, employee freedom, improves productivity as well as promoting safety. 2.2.2. Strategy The new certainties Strategies are very important since these are the set of decision making procedures for the guidance of organizational behavior. According to managers, strategy means their outsized scale, future oriented procedures with the competitive surroundings to optimize accomplishment of organization aims. An influential weapon for surviving with the conditions of change, which surround an organization today, a strategy is quite complex and costly to implement. In accordance with Drucker, strategies must be regarded as the following five new convictions that rather than being economic, are more political and social. 2.2.2.1 Defining Performance Performance can be briefly defined as the production of valid results given over a period of time. Very often it is measured against certain predetermined known standards of completeness, accuracy and speed. 2.2.2.2 Global competitiveness Used to describe the international market, global competitiveness often refers to the struggle of different organizations to prevail over the other on a worldwide basis. In this world of competition, it is a known fact that unless an organization measures up to the standards set by the leaders in its field, it cannot expect to survive for long. 2.2.2.3 The increasing incongruence between economic globalization and political breakage Nowadays, businesses have to define their scope in terms of industries and services worldwide. While the national boundaries are creating certain types of obstructions, the political boundaries are also not moving. It has been noted that the national politics are still ruling against economic rationality within transnational economic organizations. 2.2.3. Managements New Paradigm Todays leaders and managers must deal with continual, rapid change and therefore management techniques must track the business environment continuously, to assess change and adapt. Managing change does not mean controlling it, but rather understanding it, being more sensitive and flexible, and guiding it as much as possible. According to the old paradigms, management was about dominance and control, centralized and hierarchical with rigid budgets, short-term solutions and top-down goal setting. However under the new managements paradigm in most organizations the focus is more on cooperation and trust with continuous adaptation and long range optimization as well as teamwork and jobs selected to fit people rather than people selected to fit jobs. In todays fast changing world, management are forced to apply and adapt to certain new standards of management due to the driving forces in order to be more flexible, responsive and adaptable to the demands and expectations of the stakeh olders demands. Nowadays, managers can no longer refer to an earlier developed plan for direction since they must continuously deal with rapid change. In the 21st century, with the intention of being successful most organization can also strive to move from competition to networking. Competition has been progressive and successful as it literally changed the economic landscape of the world into modern industrial centers with the defining edge of technology. It is important to redefine competition now with the concept of networking and cooperation for the sustainability of business operations worldwide. 2.2.4. The change leader Presently change is the norm and unless perceived as the duty of the organization to guide change, the organization will not exist for long. In a period of rapid structural modification, the only individuals who live on are the change leaders. The four requirements of change leadership according to Drucker (1999) are as follows. Policies to create the future. Organized methods to seek and to foresee change. The precise approach to bring in modification, both inside and outside the organization. Strategies to balance amendments and stability. Change and continuity is seen as two extremities rather than mutually exclusive opposites by Drucker. It is essential to have internal and external continuity so as to be a change leader. 2.3 Conclusion According to Boyatzis (2008), although the understanding of competencies themselves has been extended, perhaps the most important contributions in the last thirty years, has come about primarily in the last fifteen years.
Sunday, December 22, 2019
Americaôs Interest in Communist Cuba Essay - 597 Words
When it comes to politics and power, countries tend to side with whatever is at their best interest. As long as someone is scratching their backs and their pockets are filled, politicians turn a blind eye to unjust rulings. For years now, America has gone above and beyond to try to bring Cuba down and in the process Fidel Castro. The American governmentââ¬â¢s determination over the years to hinder the growth of Cubaââ¬â¢s economy is ever so apparent. However Mugabe has been deteriorating Zimbabweââ¬â¢s resources for three decades now and the American government or any other powerful country have yet to step up and put an end to his autocracy. I canââ¬â¢t help but assume that the reason why no one has yet to put an end to Mugabeââ¬â¢s ruling is because thereâ⬠¦show more contentâ⬠¦Everybody knows that unfortunately America is a sore looser, and until theyââ¬â¢ve had the last word the argument is not over. From their end, Cuba has surprised many around the worl d for striving against such barriers. ââ¬Å" The main driver of the Cuban economy is agriculture. The country is a major producer of several crops but sugar and tobacco are the big money products. Despite not being able to export their products to the United States Cuba has become a major exporter of agricultural products. There has been an attempt on the part of the Cuban government to diversify their economy and it looks like natural resources will be one way that they can do this. The country has become a major nickel producer and this has quickly become one of their largest exports. There is also the potential for Cuba to become a major oil producer. There are large reserves of oil in the Caribbean that are in Cubas territorial water. It is very likely that in the near future they will take advantage of these reserves in order to help diversify the economy.â⬠As a way to diversify their economy, the Cuban government has become more lenient with their strict regime. Theyâ⠬â¢ve launched a tourist campaign to attract more revenue through the tourism industry. With the U.S. Embargo still in place it has been difficult, but Cubaââ¬â¢s efforts is showing though the growing numbers of tourist from Canada,Show MoreRelatedCold War Influence in Latin America1616 Words à |à 7 PagesCold War Influence in Latin America The United States and the Soviet Union competed against each other during the Cold War in the second half of the 20th Century like a chess game, with the world as their chessboard and countries as pawns in their game. For the Russians, a critical part of the chessboard was Cuba and Latin America. 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Saturday, December 14, 2019
The Diagnosing Diabetes Mellitus Health And Social Care Essay Free Essays
string(91) " Balasoiu 1997 Meter F 16 32 Very few surveies of this type were carried out in our state\." This was a instance control survey, which was conducted at the Mahatma Gandhi Medical College and Research Institute Hospital, Puducherry, a rural Tertiary attention infirmary with an one-year volume of above 1,00,000 patients over one twelvemonth period. The Institutional Medical Ethics Committee approved this survey. From January 2011 until April 2012 we enrolled patients between the ages of 14 and 86 old ages of age. We will write a custom essay sample on The Diagnosing Diabetes Mellitus Health And Social Care Essay or any similar topic only for you Order Now 100 diabetes mellitus patients and 50 healthy not diabetic controls without any urinary ailments viz dysuria, frequence, urgency, strangury, tenesimus, nocturia, nocturnal urinary incontinence, prostatism, incontinency, urethral hurting, vesica hurting, nephritic gripes, prostate hurting, and who attended Mahatma Gandhi Medical College between August 2010 to July 2012 were enrolled for this survey. These patients did non hold any old vesica catheterisation, instrumentality of urogenital piece of land or old urogenital surgery. WHO criteria was applied to name diabetes mellitus. WHO criteria for naming diabetes mellitus. Methods and standards for naming diabetes mellitus 1. Diabetess symptoms ( ie polyuria, polydipsia and unexplained weight loss ) plus a random venous plasma glucose concentration A ; gt ; 11.1 mmol/l or a fasting plasma glucose concentration A ; gt ; 7.0 mmol/l ( whole blood A ; gt ; 6.1mmol/l ) or two hr plasma glucose concentration A ; gt ; 11.1 mmol/l two hours after 75g anhydrous glucose in an unwritten glucose tolerance trial ( OGTT ) . 2. without symptoms diagnosing of DM should non be based on a individual glucose trial but requires collateral plasma venous finding. At least two glucose trials result on a another twenty-four hours with a value within the diabetic scope is indispensable. It can be either fasting, random sample or the two hr station glucose trial. If the fasting glucose or random glucose values are non diagnostic of DM so the two hr value should be used. Method During initial visit relevant facts were elicited from patients sing history, age, continuance of diabetes, absence of urinary symptoms. H/O old catheterisation, instrumentality and surgery of urogenital piece of land. With respect to female patients, their catamenial history, H/O white discharge. H/O pruritus vulva were elicited. Then elaborate scrutiny of patients carried out peculiarly with respect to complications of diabetes. In male patients, per rectal scrutiny was carried out to govern out prostate expansion routinely. In female patients elaborate gynecological scrutiny carried out to govern out any gynecological jobs, cystocele etc. After these preliminary scrutinies, patients non suiting into choice standards were omitted, and 100 diabetes mellitus patients, and 50 non diabetic control were proceeded to following phase of survey. During subsequent visits, patients and command group random blood sugar degrees, blood carbamide, serum creatinine trials were done. On the same twenty-four hours patients urine samples were collected for civilization and microscopic scrutiny. In female patients urine civilization sample were collected during their non-menstural periods. METHODS OF URINE SPECIMEN COLLECTION Clean gimmick mid watercourse urine aggregation method was adopted. Patients were explained about the methods of roll uping clean gimmick midstream piss and aged female patients were provided with nursing helpers for cleaning the external genital organ. Urine was collected in a unfertile wide-mouthed prison guard cap bottle for civilization intent and microscopic scrutiny. Two back-to-back urine specimens were obtained, and refrigerated instantly, because it was non possible to plate all the samples of urine instantly. One civilization of a clean-voide specimen of midstream piss from an person without symptoms of a UTI with at least 105 cfu/ml of the same individual bacterial species was considered equal to name ASB [ 30 ] . The ground to civilization a 2nd clip is to know apart between true bacteriuria and taint. In most surveies, merely the positive civilizations are repeated to name [ 30 ] . Quantitative CULTURE OF URINE Urine was cultured quantitatively by graduated cringle technique. The civilization home bases were read at the terminal of 24 hours and no. of settlements counted in positive civilizations. If there was no growing the civilization home bases were reincubated for another 24 hours and figure of settlements calculated if growing was noted. ANTIBIOTIC SENSITIVITY TESTS These were done utilizing the standard sums of ( nitrofurantoin, tetracycline, aminoglycosides, co-trimaxazole,3rd coevals Mefoxins, fluroquinolones, ? lactams and nalidixic acid in all civilization positive instances ) and study obtained at the terminal of 48 hours. It was non possible to gauge HbA1C in all the patients in our set-up. Written informed consent was obtained from the patients and controls. We excluded all patients who had factors favoring exclusion standards and included patients who satisfied inclusion standards. Data Collection All information was entered into a Data Collection Proforma Sheet ( Appendix 1 ) and were entered into Excel ( MS Excel 2011 ) . The Sheet had a ocular map for taging and divided into indicants for both genders. Other biographical inside informations were besides collected including day of the month of birth, weight and tallness. Statistical Methods Statistical analysis was carried out utilizing SPSS version 19.0 ( IBM SPSS, US ) package with Regression Modules installed. Statistical methods such as odds ratio and chisquare trials were applied to happen the significance between different variables. ASB Case control Positive 42 [ a ] 3 [ B ] negative 58 [ degree Celsiuss ] 47 [ vitamin D ] Oddss ratio: ad/bc = 42Ãâ"47/58Ãâ"3 = 11.34 Diabetic patients have 11.34 times the hazard to develop symptomless bacteruria than a non diabetic person. Chisquare: X2 = ? ( o-e ) 2 vitamin E df = 1 X2 = 20.564 P = Discussion In this survey an effort was made to find the incidence of symptomless bacteriuria in diabetes mellitus patients with comparing to non diabetic control group, common organisms doing infection and their antibiotic sensitiveness. On reexamining the literature the undermentioned surveies conducted in similar mode to the present survey noted. Writer Year Sexual activity Prevalence Rate % Veljlasgaard 1966 Both 9.3 1986 Both 6.3 Schmitt 1986 F 9.1 Keane 1988 F 3.5 Fold addition Kelestimor 1990 F Meter 31.3 17.4 Zhanel 1955 F Meter 3 fold rise Equal to non diabetic male Zhanel 1955 F 7.9 Kayima 1996 F Meter 28 16 Balasoiu 1997 Meter F 16 32 Very few surveies of this type were carried out in our state. As noted above, most of surveies were conducted merely in female type II diabetes patients. Prevalence of symptomless bacteriuria in female diabetes patients varies from 7.9 % to 32 % . Relatively in the present survey the incidence of asymtomatic bacteriuria in female Type II patients is 35.38 % . Merely few surveies were conducted in male Type II patients. Most of the surveies showed the prevalence of symptomless bacteriuria as equal to non-diabetic work forces. But in the present survey incidence of symptomless bacteriuria in male Type II is 20 % compared to 0 % incidence in non-diabetic control. A survey conducted in Type II patients of both sexes showed the prevalence of symptomless bacteriuria as 9.3 % . In the present survey the incidence of symptomless bacteriuria in Type II patients is 26.66 % ( Male 20 % ; Female 40 % ) . In the present survey incidence of symptomless bacteriuria in both female and male diabetic patients are high when compared with non diabetic control group ( 36 % and 20 % and 0 % ) Both Type II ( insulin ) and Type II ( OHA ) patients are every bit affected ( 26.66 % and 28.33 % ) . Percentage of male patients with diabetes mellitus on insulin with positive civilization ââ¬â 20.00 % Percentage of male patients with diabetes mellitus on OHA with positive civilization ââ¬â 20.00 % Percentage of female patients with diabetes mellitus on insulin with positive civilization ââ¬â 40.00 % Percentage of male patients with diabetes mellitus on OHA with positive civilization ââ¬â 35.00 % Percentage of patients with diabetes mellitus on insulin with positive civilization ââ¬â 26.66 % . Percentage of patients with diabetes mellitus on OHA with positive civilization ââ¬â 28.00 % Percentage of male patients with positive civilization ââ¬â 20.00 % Percentage of female patients with positive civilization ââ¬â 36.00 % In control group no. of male patient with positive civilization ââ¬â 0 In control group no. of female patient with positive civilization ââ¬â 3 Percentage ââ¬â 12.00 % Many surveies have found that the commonest being doing symptomless bacteriuria is E. coli 40 % , and gram negative B made up 66.7 % of the isolates. Relatively in the present survey, the common being is E.coli ( 57.14 % ) . Other beings isolated include Klebsiella ( 33.33 % ) Enterococci ( 4.76 % ) , Proteus ( 2.38 % ) , acinetobacter ( 2.38 % ) . Bacteriuria appears to hold no relation to increasing age. In the present survey symptomless bacteriuria occurred in all age groups. About 55 % of civilization positive causes are in the age group of 41-60 old ages. Bacteruria is common among aged life in non- instituitional community scenes, particularly among adult females, although non every bit common as among the aged in institutional scenes [ 16 ] . The feeling that true bacteruria in the diabetic is chiefly confined to aged diabetic adult females. Furthermore, the prevalence of bacteriuria among them was significantly greater than that of aged non diabetic females [ 22 ] . Contaminated piss is defined as the presence of at least 3 different micro-organisms in 1 urine specimen. [ 4 ] The prevalence of ASB is increased in adult females with diabetes [ 26 % vs 6 % ] and might be added to the list of diabetic complications in adult females [ 4 ] . Longer the continuance of diabetes with the presence of complications apparently increases the hazard of ASB in type 1 diabetic adult females [ 4 ] . The rate of ASB is non influenced by quality of diabetic control [ glycosylated hemoglobin, fasting glucose degree ] or nephritic map [ 40 ] . Longer continuance of diabetes, but non glucose control, is associated with bacteriuria prevalence. A statistically important longer diabetes continuance was found for diabetic topics with bacteriuria than without. Prevalence of bacteriuria additions 1.9 ââ¬â crease times in every 10 old ages continuance of diabetes. However, there was no association between long ââ¬â term glucose control, as reflected by glycosylated hemoglobin degree, and bacteriuria prevalence [ 34 ] . Asymptomatic bacteriuria is common, particularly in functionally impaired aged patients with multiple medical morbidities. If symptoms or marks of infections are absent testing with everyday dipstick and subsequent antimicrobic intervention is neither recommended. Early acknowledgment and direction of assorted hazard factors of ASB is really of import to potentially cut down its happening [ 6 ] . Sing all results there is no benefit of testing for and intervention of bacteriuria [ 7 ] . It is hard to turn out that ASB is more frequent among adult females with diabetes than among those without diabetes [ 8,12 ] . Prevalence of ASB is about three times higher in patients with diabetes when compared with the control subjects [ 11 ] . Prevalence of bacteriuria was 4.4 times higher among diabetic than non diabetic topics [ 23 ] . The prevalence of ASB among patients with diabetes is higher than in an seemingly healthy group [ 24 ] . The prevalence of bacteriuria in diabetic adult females is 7 % to 13 % , approximately three times higher than not diabetic adult females [ 28 ] . ASB is improbable to be a effect of hapless control of diabetes [ 11 ] . Damage of metabolic control of diabetes as revealed by an addition in HbA1c degree increases the hazard of developing ASB [ 8 ] . Duration of diabetes, high HbA1c degree, glucosuria and pyuria are risk factors for ASB in patients with type 2 diabetes. E.coli and K.pneumoniae are the most often stray bacteriums in diabetes patients with ASB. Routine urine civilization might be recommended in diabetic patients who show no urinary symptoms but who have one or more of the hazard factors mentioned [ 42 ] . The prevalence of ASB and leukocyturia ( A ; gt ; 5 cells / high power field ) was higher in kids and immature grownups with diabetes than those of control topics and the spectrum of bacteriums in ASB was different from the usual spectrum of UTI. There was a inclination in the diminution in nephritic map in type 1 diabetic adult females who had ASB [ 44 ] . Asymptomatic urinary infection can non with certainty be correlated with increasing continuance of diabetes. The prevalence rate of symptomless bacteriuria increased with longer continuance of diabetes. In the present survey 30 % of positive civilization instances had diabetes for 1-3yrs continuance. Another 24 % instances had diabetes for 5 to 10 year. continuance. Even 33.33 % of freshly detected diabetes patients had positive urine civilization. Any patient with diabetes can hold symptomless bacteriuria irrespective of their continuance of disease. The prevalence of symptomless bacteriuria is non affected by steps of glucose control. In the present survey 40 % civilization positive instances had random blood sugar value in the scope of 201 to 250 milligram % . Another 24 % had in the scope of 151 to 200 % . 15 % patients had in the scope of 251 to 300 % . The determination that quality of diabetic control does non impact the prevalence of symptomless bacteriuria is confirmed. The prevalence of symptomless bacteriuria additions as diabetic retinopathy becomes more terrible [ 33 ] , 2 instances of diabetic retinopathy are civilization positive in the present survey. Of the 6 patients with diabetic nephropathy 4 instances are civilization positive. A instances of diabetic pes in present survey non had any urinary piece of land infection. Of the 4 instances with ischaemic bosom disease, 2 instances are civilization positive. Certain surveies found that isolates were ill sensitive to on a regular basis available antibiotics ââ¬â Achromycins ( 33 % sensitive ) , cotrimaxazole ( 33 % sensitive ) . Other disinfectants with over 80 % sensitiveness degree included aminoglycosides, nitrofurantoin, 3rd coevals cepholosporins and fluroquinolones. All the beings that are grown in civilization in the present survey are immune to normally used antibiotics like Achromycins, cotrimaxazole, and nalidixic acid. Almost all isolates are sensitive to quinolone group of drugs. Some are sensitive to aminoglycosides. Most of them were sensitive to nitrofurantoin. Some of them were even immune to nitrofurantoin and 3rd coevals Mefoxins. Some of them were merely sensitive to drawn-out spectrum ?-lactam antibiotic. No benefit was idenitified in continued showing and intervention of symptomless bacteriuria. Antimicrobial therapy cleared bacteriuria in the short term, but did non diminish the Numberss of diagnostic episodes and hospitalizations during long term follow up, and the high rate of recurrent bacteriuria led to markedly increased usage of antimicrobic agents. Increasing antimicrobic opposition is a major concern [ 13 ] . Antimicrobial direction of urinary piece of land infection in diabetic adult females should concentrate on the prompt designation and effectual intervention of diagnostic episodes [ 13 ] . Isolated E.coli strains were immune at similar rates to ampicillin, cotrimoxozole, Cipro and Macrodantin in both diabetic and non-diabetic patients. Hence diabetes mellitus could non considered per se a hazard factor for the outgrowth of a non E.coli being and for antibiotic opposition [ 43 ] . Diabetes has a considerable public wellness impact on the hazard for and forecast of enterobacterial bacteriemia acquired in the community [ 45 ] . Screening for or intervention for ASB is non indicated in adult females with diabetes and intervention with antibiotics did non detain nor diminish the frequence of diagnostic UTI untill 3years of follow up [ 10 ] . The clinical significance and direction of ASB differs harmonizing to different groups of patients as listed below [ 36 ] Indications for the intervention of patients with symptomless bacteriuria Definitive Possible Not indicated Pregnancy Diabetess mellitus elderly Before an invasive GU process Short- term Indwelling catheterisation Intermittent catheterisation School misss and premenopausal adult females Children with reflux Renal graft Long term indwelling catheter Patients with unnatural urinary piece of land In most of the old surveies E.coli was the most prevailing micro-organism and klebsiella the 2nd most common [ 12 ] . Analyzing the diabetic adult females with ASB showed that diverse E.coli strains are capable to be colonized in piss. Perennial infections were common chiefly after handling ASB most often with a new E.coli strain [ 14 ] . In patients who had frequent E.coli causation ASB, repeated intervention did non decide the vesica infection [ 14 ] . When compared to non diabetics ASB is more prevailing among females with type 2 diabetics in Sagamu, Nigeria [ 35 ] . Womans with ASB had a significantly higher opportunity of developing a diagnostic UTI than not bacteriuric adult females [ 41 ] There is an increased susceptibleness to urinary piece of land infections in female diabetics above the age of 50, and diabetes likely in association with ripening, accentuates factors which allow the constitution of infection in non diabetic individuals instead than specially predisposing the kidney to infection [ 37 ] . Guidelines published by the IDSA in 2005 province that there is no mensurable benefit in testing or handling ASB in the undermentioned patients: diabetic patients, premenopausal adult females who are non pregnant, older patients populating in the community and in the long term attention installations, and with spinal cord hurt patients or patients with indwelling vesica catheters [ 31 ] . Screening and handling is appropriate for adult females during gestation and for patients who have a positive urine civilization consequence prior to surgical use of the urinary piece of land to avoid precipitating sepsis [ 31 ] . In the past diabetes mellitus was regarded as a status in which ASB predisposed to renal papillose mortification and nephritic inadequacy but recent retrospective and prospective surveies indicate that does non transport a nephritic hazard. Therefore the possible benefit from antibacterial intervention of ASB is dubious. However we emphasize that one time diagnostic urinary piece of land infection is present, it tends to run a more aggressive clinical class in the diabetic patient [ 40 ] . From all the surveies, past attacks to direction differed between U.S and European doctors. In the U.S. , intervention of bacteriuria was recommended whereas in Europe, bacteriuria is non treated. Even if diabetic adult females with symptomless bacteriuria are at hazard for diagnostic urinary infection, the overall cost benefit of testing and handling big Numberss of symptomless diabetic adult females at frequent intervals was in the demand to be evaluated. The inquiries were complex and broad -ranging. There was a demand to construct the current clinical observations and prevalence studies to make a foundation of cognition that is sufficient for developing rational and appropriate attack for caring for diabetic patient who has a urinary infection [ 3 ] . Long term follow up surveies will demo whether ASB becomes diagnostic and affects nephritic map in diabetic patients and whether intervention of ASB is warranted [ 4 ] . Recently [ IDSA ] Infectitious Disease Society of America came out with a guidelines in the twelvemonth 2005 for diabetic adult females follows as Diabetic Womans Many prospective and cohort surveies done in diabetic adult females for ASB which was followed up for 18 months to 14years of showed no differences in rates of occurence diagnostic urinary infection, patterned advance to diabetic complications.There was no hold, lessening in urinary infections nor the no of hospitalizations in persons with bacteriuria after 3 old ages of follow up was clearly proved by a randomized, controlled test for bacteriuria reported after a upper limit of 3 old ages of follow-up. There was no acceleration or patterned advance of diabetic complications like nephropathy etc. , in bacteriuric patients who did non have antimicrobic therapy. However, diabetic adult females who received antimicrobic therapy had significantly more inauspicious antimicrobic effects. Thus continued testing and handling symptomless bacteriuria in diabetic adult females neââ¬â¢er showed any benefits and there was even grounds of some injury due antibiotic use. Recommendatio: Screening and intervention of symptomless bacteriuria in diabetic adult females is non indicated ( A-I ) . The guidelines besides mention that antimicrobic therapy is frequently unsuccessful in eliminating the micro-organisms and may, in fact, consequence in occurence of immune micro-organisms, such as drawn-out spectrum ?-lactamase immune bacteriums, vancomycin ââ¬â immune enterococci, and other multidrug-resistant bacteriums. In add-on, intervention of patients will subject them to the hazard of an allergic reaction, diarrhea, and other inauspicious reactions ensuing from usage of the antimicrobic drug. Finally, clostridia difficile infection may develop, because the intestine vegetation is altered when handling ASB [ 31 ] . Endothelial disfunction, oxidative emphasis, and the increased formation of advanced terminal merchandises, lower urinary cytokine concentration and hence decreased urinary leucocyte Numberss compared with nondiabetic adult females may play a function in the development of diabetic complications [ 4 ] . Defective polymorphonuclear leucocyte maps [ opsonization, chemotaxis, phagocytosis and killing ] are possible conducive factors. Changes of bacterial adhesion to uroepithelial cells, partially explained by alterations of the chemical science and concentration of Tamm-Horsfall protein besides promote urinary ââ¬â piece of land infection [ 24 ] . The vesica disfunction due to diabetic neuropathy taking to impaired vesica elimination could play a function in the prevalence of ASB among adult females with diabetes and in the natural history of UTI [ 8,28 ] . Clinical tests covering with the intervention of symptomless bacteriuria in diabetes are limited. The undermentioned decisions can be made from these tests. Frequent reinfections occur instead than backslidings. Long term suppressive therapy is effectual, nevertheless when discontinued, perennial infections occur comparatively quickly. Few patients sustain a permanent remittal from bacteriuria. Trying obliteration of bacteriuria in patients with anatomic abnormalcies may be ineffectual. Therefore, there are no benefits in continued showing and handling diabetic persons with symptomless bacteriuria and as there is possibility of some injury with antibiotic overusage. Restrictions: In this survey we couldââ¬â¢nt step HbA1c for all the patients as it was non executable and so couldââ¬â¢nt assess the relationship between glucose degrees and symptomless bacteriuria. We besides have no thought whether there would be any opportunity of development of complications in the persons diagnosed with symptomless bacteriuria as this is non a follow up survey. Hence measuring of HbA1c degrees and a follow up of these civilization positive patients would give a better apprehension in the relationship between glucose degrees and asmptomatic bacteriuria and the presence or absence of complications in civilization positive patients. Summary There is a high incidence of symptomless bacteruria in diabetes patients, chiefly in females than males in this survey. Therefore, there are 2 subjects to inquiry, whether symptomless bacteriuria is associated with inauspicious results. ? , whether the intercessions of showing and antimicrobic intervention better these results? The inquiries whether they develop complications or non and whether antibiotic therapy is needed or non necessitate to be assessed by farther follow up surveies. However latest guidelines suggest that antimicrobic therapy did non detain nor diminish the frequence of diagnostic urinary infection, nor did it diminish the figure of hospitalizations due to urinary infections nor it prevented the acceleration of patterned advance of diabetic complications, therefore periodic proving for symptomless bacteriuria is non recommended for individuals with diabetes mellitus. Decision Based on the consequences and the methodological analysis employed, we have concluded that: High incidence of symptomless bacteriuria has been observed in both diabetic males and females. High incidence of symptomless bacteriuria occur in both diabetes mellitus on insulin and unwritten hypoglycaemic agents. Causative beings in diabetic and non diabetic symptomless bacteriuria are similar. E.coli is the commonest being. Most of the symptomless bacteriuria instances occurred in the age group of 41 to 60 old ages. Asymptomatic bacteriuria occur inspite of good glycemic control. . Preventive steps for diabetic patients include increased surveillance and turning away of well-known hazard factors for urinary piece of land infections. Asymptomatic bacteriuria can be present even in freshly diagnosed diabetic patients. Most of the being are sensitive to nitrofurantoin. Some are sensitive to aminoglycosides, fluroquinolones. Some beings are merely sensitive to drawn-out spectrum ?-lactam antibiotics. Periodic proving for symptomless bacteriuria is non recommended for individuals with diabetes mellitus as per latest guidelines. Abstraction Aim: To analyze the incidence of symptomless bacteruria between diabetics and non diabetics, the common beings and their antibiotic sensitiveness Methods: A sum of 100 diabetic patients and 50 non diabetic controls without any history of urinary piece of land infection and catheterization was enrolled in this survey Consequences: The incidence of ASB was 39 in diabetic and 3 in control with the significance of P A ; lt ; 0.001. Diabetic patients have 11.34 times higher hazard in developing symptomless bacteriuria than non diabetics. Decision: The incidence of ASB is significantly increased in diabetic patients as compared to non diabetic controls.A larger survey with a longer follow-up is needed to turn to the issue of handling such patients who are symptomless How to cite The Diagnosing Diabetes Mellitus Health And Social Care Essay, Essay examples
Friday, December 6, 2019
Rabbit Proof Fence free essay sample
Fence tells the true story of three Aboriginal girls who are forcibly removed from their families. Set in 1931, their removal was part of an official Australian government policy which removed ââ¬Ëhalf casteââ¬â¢ children from their parents and placed them within institutions that trained these children to become domestic servants. The story centres on the three girls escape from the Moore River Settlement (the institution in which they are placed) and their incredible 1,500 mile journey home following the rabbit-proof fence. We can also consider how the generic structure of the Rabbit-Proof Fence affects the meaning. The use of Mollyââ¬â¢s voice-over at the beginning of a film is a recurrent pattern in film making and occurs because of audience preference and the success of particular patterns of story telling. These patterns also reflect an audienceââ¬â¢s cultural background. Many Australian feature films have for example adopted a documentary style narration or include a family member who supports the telling of the story. We will write a custom essay sample on Rabbit Proof Fence or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page The inclusion of a voice over also reflects the fact that story telling is traditionally an oral activity in Aboriginal culture. * Rabbit-Proof Fence is quite comprehensible without a knowledge of Australian life and culture. Factors such as gender, ethnic background and economic status cut across the various levels and forms of education. A cultural and ideological approach to a film text however exposes assumptions about the way we live our lives. This film can therefore be read on one level as an exciting adventure story in which three innocent children make a daring escape from their captors. On a second level, a social and cultural study of the film will draw the viewer to consider what is meant by the Stolen Generation and consider the thinking behind official government policy of the period. * The first frame is a close up shot of Molly with her mother Maude. They are both looking upwards (watching the Spirit Bird which is out of shot). Early in the film the viewer is therefore positioned to see the spiritual nature of Aboriginal culture. The Spirit Bird later in the film becomes central to the girlsââ¬â¢ ability to cross the desert. It acts as a spiritual guide, providing strength to endure, survive and succeed. * Archive footage is used to create authenticity in the construction of the setting (the city of Perth in Western Australia). The original black and white film has been coloured in a laboratory to add to the realism of the scene. Written codes are also applied to this frame. Frame two is a close up shot of a pen nib writing the word ââ¬Å"Mollyâ⬠on a card. Frame three juxtaposed with frame two is a low angle medium close up as Neville looks up from the card. The angle gives him power and authority. * The film ends (as it began) with the use of a documentary style narration. After witnessing the intense emotional impact of the girls return to Jigalong we hear directly from the real Molly and Daisy (as they are today : two old ladies reflecting back on their painful true story). The montage of shots all include sub-titles as Molly speaks in dialect. The montage begins in Mr. Nevilleââ¬â¢s office and moves from a silhouette shot of Molly, Daisy, Frinda and Maude from the film to a series of aerial landscape shots reflecting the immensity of their journey along the rabbit-proof fence. The montage concludes and the film ends with final frames of the real Molly and Daisy walking in mid-shot and concluding that they will never return to ââ¬Å"that place. â⬠Rabbit Proof Fence free essay sample Alabamaâ⬠uses literary techniques such as symbolism, repetition and rhyme to express the journey being undertaken by Skynard. Each of these texts explore the notion that it is the journey, not the desitination that is important. The use of symbolism in Rabbit Proof Fence is used to explore the concept that the journey not the distination matters. Symbolism is the use of one object to represent a notion or other object. The inclusion of the spirit bird in the story explores the importance of religion to the girls and the importance of the journey. As mentiioined in an aearlier scene, the spirit bird appears (over the exhausted Molly and Gracie) and awakens them from their sleep. This is used to refer to hope and provides in indication that they will make it home, and will have spiritually benefited from their journey. The use of symbolism lends to the notion that it is indeed the journey, not the destination that matters. We will write a custom essay sample on Rabbit Proof Fence or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Different lighting techniques enable the notion of the journey being the thing that matters to be convery to the viewer. Lighting specific to the mood is used to infer location, time and the changing nature of the journey. The harsh brightness throughout the journey is a portrayal of the unforgiving locale and conditions needing to be overcome in order to reach the destination. The most relevant and important example of this being the pitch black used when the girls are reunited with Maud. This sued of darkness is used to imply the solemn nature of the arrival, and is accompanied by Mollyââ¬â¢s statement ââ¬Å"I lost oneâ⬠which is indicativbe of the importance of the journey, rather than the final destination. Camera angles are used by Noyce to explore the idea that it is the journey, not the destination that matters. The panning long shot of the horizon (used at the commencement of the journey, when the three girls escape Moore River) is used to express the long difficult task at hand, and that in order to arrive home, they must over come a harsh terrain and long journey. The use of such varying camera angles sis indicative that it is the actual journey that matters, as oppose to the final destination. The ââ¬Å"Rabbit Proof Fenceâ⬠plays two vital roles throughout the journey of Molly, Daisy and Gracie, and is reflective of the importance of the journey. The fence is a representation of a map, as it is a symbol of home for the girls and provides a way in order for them to get home (following the fence). What is later revealed is that the fence has actually proven to be an obstacle, and that they have followed the wrong fence, and must change direction to get home. The ability of the girls to overcome this hurdle, and arrive home is again indicative of the notion that it is the journey ââ¬â not the destination ââ¬â that matters when undertaking a physical journey. The growth of Molly throughout the film reflects on the importance of the journey rather than the final outcome achieved. Molly is established from the beginning of the film as a key character, but her growth throughout the journey serves to reaffirm and strengthen this notion. We see her growth into a hunter, a supplier of food and water, and most importantly a maternal figure for her sister and cousin. This is most prominent in the arrival home, with her regretful statement, ââ¬Å"I lost oneâ⬠The physical journey undertaken enabled Molly to become more empowered, and provided a chance to hone the traditional skills of Aborigines, such as hunting, tracking and finding of water, and for this reason, the journey ââ¬â not the destination ââ¬â is what matters from a physical journey.
Friday, November 29, 2019
The Case of Sally with Adlerian Therapy free essay sample
The Case of Sally and Mid-Life Transition: An Adlerian Perspective in Therapy Title: The Case of Sally: An Adlerian Perspective in Therapy Author: Document Type:Article Subject Terms:Psychology; Adler; Adlerian Abstract: Examines the counseling case of Sally in perspective of an Adlerian view. Sallyââ¬â¢s somatic complaints and mistaken beliefs allows Adlerian technique to help her to experience a full life including career and social connections. Adlerian assumptions: Interpreting Sallyââ¬â¢s record; Effect of Sallyââ¬â¢s Birth order; Tasks for the counselor. Full Text Word Count: Sallyââ¬â¢s predominant reason for coming to counseling is to alleviate a number of somatic complaints such as panic, anxiety, and possibly depression. Her physical symptoms have included: hot flashes, cold sweats, shortness of breath, tremors, fainting, heart racing, fears dying of heart attack, shakes, hot flashes, and cold sweats. Although there was no stated medical causes, hot flashes could be the beginnings of peri-menopause due to her age being 39 years old and although early, hormonal changes could be contributing to her distress. We will write a custom essay sample on The Case of Sally with Adlerian Therapy or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page I chose an Adlerian approach because Sally needs immediate help as panic can be debilitating and frightening and an Adlerian therapist can get to the core issues quicker than could a psychoanalytic approach. I would be concerned that an existential approach could exacerbate her problems and cause her to look elsewhere for therapy. An Adlerian therapist would look beyond Sallyââ¬â¢s symptoms to the causes which could include the following: transitioning to mid-life and her role of parenting coming to a close, dissatisfaction with her marriage, feeling stuck about actually getting a job as a teacher, and feeling overweight. Although she takes pride in her role of homemaker, mother and wife, she is aware that she has lived for others and wants to become more motivated and assertive about her own life goals. That is, Adlerian therapy never places the counselor in a superior position with respect to truth, or express disrespect, condescension or lack of empathy. Sally is feeling very inferior and and needs to know that the therapist will provide the support to find encouragement and hope again. An Adlerian therapist would work to build respect, confidence, equality, and cooperation with Sally. Sally reports a number of fear based thoughts that the therapist should take note of such as: her husband will leave her if she makes any changes in herself, she might go to hell for not believing the same dogmatic beliefs as her parents, and she is afraid of taking the initiative to work outside the home. Her reasons for most of these issues are losing the approval of her family, husband, and children. She does not report that she has friendships or social contacts other than attending a church. Since childhood she has always felt socially awkward, constantly being worried about what others have thought of her. Finally, she has concerns about death and dying and evidence supports that panic attacks can certainly perpetuate that notion in a client with high anxiety. It seems appropriate that Sally is questioning life right now and she does show some insight into her issues already as she previously questioned the dogmatic beliefs she was raised with enough to attend a different church than her parents. And yet this too has caused consternation as well because of her fear of going to hell and losing parental love and approval. Even though her life is consistent and stable, she considers it boring and stale and wants help from therapy to push her out of this and yet fears that therapy could make her even worse. According to Adler, all behavior is purposeful and for Sally to be this anxious and panicky has hidden goals. The therapist would work with Sally to help her assume responsibility for finding her life beyond her role of only a mother and wife. An Adlerian therapist would say that Sally is unconsciously avoiding meeting life tasks. Although her problems are manifesting somatically, her issues would best be solved if viewed through a social context and life tasks: building friendships (social task), establishing intimacy (love-marriage task), and contributing to society (occupational task). Sally has not worked through friendships, she has contributed to society by raising her children but that role is coming to a close and she has not fulfilled her task to become a teacher, and she is in a marriage but sheââ¬â¢s not experiencing intimacy. So all three universal tasks are not developed and an Adlerian would be concerned with all three areas. According to Corey (2009) there are four processes in Adlerian psychotherapy: a) forming a relationship (b) investigating the clientââ¬â¢s life style through assessment and interviews both subjective and objective, (c) interpreting the data to the client and (d) helping the client to reorient towards a more prosocial stance by modifying certain convictions held by the client that arenââ¬â¢t helpful and promoting courage, optimism and finding meaning in life. Another area of focus would be Sallyââ¬â¢s early recollections and especially her being the oldest child and how she feels affected by that. First born children tend to be rule bound, dependable, hard-working and take on a pseudo-parenting role. Because of her birth order, Sally is most likely resistant to new ideas and has a habit of being right thing oriented. Sally could talk about her feelings about being an oldest and the pressure involved. Sally could explore how that early role of taking care of others is not necessarily the only way she has to define herself. How can taking care of yourself help your marriage and your relationship with your children? What kind of role model does this give to your children? Is the goal of creating dependency in others really the healthiest aim? The following are some possible issues a therapist could go over in terms of Sallyââ¬â¢s ââ¬Å"private logicâ⬠or mistaken beliefs: 1. I should adhere to my parentsââ¬â¢ morals and rules and not my own. 2. If I find out who I really am, Iââ¬â¢ll not only find nothing or I could be worse off than before. 3. I am socially awkward and weird and noone will want to be my friend. 4. My purpose in life is to take care of others. 5. I believe I should share my parents religious beliefs or I might go to hell or lose their approval. 6. My husband will leave me if I make changes in myself, such as work outside the home. 7. Life is boring and should not be fun, not even sexually fun. 8. I am afraid of confrontation and not doing the right thing. 9. The world is a scary place. The goal of the second phase with Sally would be to utilize her autobiography, and the Life Style Assessment and interview which includes information regarding family constellation, early recollections, and birth order. By utilizing a Life Style Assessment, the therapist works on modifying Sallyââ¬â¢s mistaken attitudes, and not just eliminating symptoms. At this point the therapist can make use of what Dreikurs (1997) calls ââ¬Å"The Question. â⬠The therapist would ask Sally, ââ¬Å"If I could wave a magic wand and your symptoms would go away, how would your life be different and what would you be doing differently? â⬠After a relationship is established and the client has a comfort level, the counselor would discuss client goals for therapy. Although not required in Adlerian therapy, a contract or plan would promote better focus. Sally and her therapist should begin to formulate a plan or contract detailing what she wants, how she plans to get it and what is preventing her from successfully attaining her goal, how can she change nonproductive behavior into constructive behavior, and how can she make full use of her assets in achieving her purpose. In Sallyââ¬â¢s case there was no information offered about her dreams but an Adlerian therapist could use this as another way to interpret her issues. Adlerians view dreams as rehearsals for possible future courses of action. There are so many different techniques that an Adlerian therapist can apply. The therapist could remind Sally and celebrate the reality that she already done the hard work of going back to school and getting a teaching degree. An Adlerian could help Sally explore her fears about stepping into the workplace and what the worst case would be. Is the fear of failure holding her back from making any attempts at all? We already know that Sallyââ¬â¢s birth order contributed to her fear of change and fear of failure. The therapist could also help Sally with the technique of ââ¬Å"as ifâ⬠. Sally is already acting ââ¬Å"as ifâ⬠she might not get hired or ââ¬Å"as ifâ⬠there are no new roles for her. Would her family really fall apart? Can she teach her children to be less dependent on her so they become healthy as well? It would be helpful for Sally to see that her own lack of activity is causing her more stress. She knows she wants to find herself and take some risks and what would be the worst case if she failed in her job? What would the best case look like? Because of Sallyââ¬â¢s case and my choice for Adlerian therapy, I researched Adlerââ¬â¢s beliefs about women in the workplace and found he was a man ahead of his time. In Chandlerââ¬â¢s article, she states ââ¬Å"it is not easy in our culture for a girl to have self-confidence and courage. From an early age girls are told through various social modalities that they are incapable and are suitable for only subordinate work. Obviously a girl who is unable to examine such judgment s for their correctness will regard female inability as womanââ¬â¢s inevitable fate, and will ultimately herself believe in her own inability. Sally shared with the therapist at the start that she likes to be ââ¬Å"in control. â⬠Sally could be helped to see that the only people who have difficulties with fears are those that have to be in control. We can choose to be afraid of a lot of things because so many things can go wrong. But is living in fear and paralysis really good living? According to Adler, Sally is lacking courage, the courage to take a risk which would be to interview and get a job. Sallyââ¬â¢s symptoms could indicate her faulty belief that she has to be perfect, have love and approval and that she cannot make mistakes and fail. Her anxiety and panic keep her immobilized from finding out that she can succeed or even that maybe she would fail but is that worse than sitting home with panic? Life changed for her because her children grew up and she canââ¬â¢t control that. Life is never a constant and we are better off if we change with it and find new purpose. If Sally disagrees with the client that she is in control by manifesting panic and anxiety and being immobilized then the Adlerian that would refute her rationalizations that she is ââ¬Å"out of controlâ⬠is called ââ¬Å"spitting in the soup. â⬠She may still feel out of control about her anxiety but it wonââ¬â¢t taste good. The therapist would want to find out if Sally is afraid of getting a job because she wonââ¬â¢t ââ¬Å"needâ⬠her husband anymore and work with her on her new job bringing a source of joy to her that will help her marriage. It seems that Sallyââ¬â¢s courage was undermined by her fatherââ¬â¢s harshness and rigidity and also by her husbandââ¬â¢s lack of promoting her efforts to work outside the home. The therapist would teach Sally that she canââ¬â¢t change her mind about working if she doesnââ¬â¢t know her own mind. It makes sense that she is not working because her mom didnââ¬â¢t work and because she has never wanted to challenge her father and now husband. Is Sally also holding back because she still continues to feel awkward in the presence of others like she did as a child? Also, if Sally sought her children to be her friends and now that they are growing up and leaving, this could be causing anxiety. It sounds like Sally was never really allowed to have a teenage life with a boyfriend as well as girlfriends so she missed important years for developing this aspect of her life. If she finds that she does not get support and make friends at her job, she can always look for another job. Or she can stay in that job and work through her friendship skills with the help of a counselor. And not everyone always has a friend at their job. Sometimes we benefit from just the work experience itself but either way, working helps us to learn more about ourselves, especially socially where Sally is lacking confidence. Another technique to be used is the paradoxical intention which would involve having Sally exaggerate her stuck thoughts and behaviors, go with their resistance, rather than against it and become aware of her behavior and her responsibility for its consequences. A therapist would use disclosure and well-timed interpretations such as ââ¬Å"It seems to me thatâ⬠¦Ã¢â¬ ¦or Could it be thatâ⬠¦Ã¢â¬ ¦. Or this is how it appears to me. â⬠Sally would never be led to defend herself and she would be free to discuss and even argue with the counselor any hunches and impressions. According to Hilary Silver in her article Reflections on Alfred Adler, she states that ââ¬Å"In turn, dignity bestows well-being: job satisfaction, a livable pace of work, creativity, meaning, and fulfillment. Dignity may be inherent in being human, but people also earn dignity through their actions. Work is not only a way to earn a living it is also a way of being useful. â⬠In the reorientation phase of therapy, Sally and her therapist could consider alternative attitudes, beliefs and actions. Hopefully, Sally will no longer be locked into the past pattern of avoiding and she feels more encourage and powerful enough to make the changes she needs. Sally will have learned that its not enough to gain insight but that we have to become action-oriented. Sally could be given some tasks and homework such as calling some school districts, and putting in some applications. The therapist could role play the interview process with Sally to give her a comfort level. Also Sally could role-play talking with her husband and working through her perceived resistance about her working outside the home. The therapist could switch roles and be Sally and Sally could be her husband. To sum up, Adler believed that our answers can be found by looking at life through a social context. We find our highest ideals by by incorporating such traits as caring for others, the courage to be imperfect, and contribution to the common welfare. If Sally goes on to get a job she will see and recognize her importance in society and not just to her family. This will increase her confidence in herself and allow for more intimacy in the family, not a one down position to her husband. By learning more assertiveness in herself, she can take more risks, become more active and courageous, and less in control. When this occurs she will lose the panic feelings and anxiety, and feel confident and positive about her new life as a teacher, as a lover and spouse, and friend to those in the community. References: Dumont, F. and Corsine, R. (2000). Six Therapists and One Client. New York: Springer Publishing Company. Wedding, D. and Corsini, R. (1995). Case Studies in Psychotherapy. Illinois: Peacock Publishers. Chandler, C. (December 1, 2009). Individual Psychology: The Journal of Adlerian Theory, Research Practice, University of Texas Press. Corey, Gerald (2009). Theory and Practice of Counseling and Psychotherapy, 8th Edition; California: Thompson Publishing.
Monday, November 25, 2019
How To Get Insanely Loyal Followers On Social Media - CoSchedule Blog
How To Get Insanely Loyal Followers On Social Media Blog How many social media followersà do you need to make your business succeed? Since everyone cant be Beyoncà ©, how many people do you need in your corner to make things happen for you? While we all wish we could live the life of a major celebrity for a day, the fact of the matter is that you donââ¬â¢t need to have a superstar-level following to turn your social media engagement into something more than a couple of likes and a retweet. Aiming for sustainability and setting your sights on an achievable goal can lead to big rewards. Be interested in other people and theyââ¬â¢ll be interested in you. #SocialMediaBuild Your Fanbase With A Social Media Followers Kit Dont miss out on this awesome social media followers kit. Its made up of: A social media engagement checklist to help youà explore new tactics that will work for your business An editable slide deck to present your social media persona to your team A loyal social media followers worksheet that will help you get to know more about your audience and goals You Want To Build A Group Of 1,000 True Fans In Kevin Kellyââ¬â¢s seminal 2008 post, ââ¬Å"1,000 True Fans,â⬠he starts off describing ââ¬Å"the long tail,â⬠which is his name for what the internet did to markets as it grew in popularity. Because it removes barriers and makes things easier to find, it has led to a lengthening of the market. For example, if you like classical trombone concertos, it used to be that youââ¬â¢d have to scour the record store and probably buy an entire album, even though it was just one or two tracks you really wanted to listen to. Thanks to the internet, you can find as many of those as you want on SoundCloud, Bandcamp, Spotify, or even YouTube. There are an increasingly infinite array of products available in a particular sector, meaning customers are split up into smaller and smaller groups. Obviously, there will be superstars- a ubiquitous product that blows up, or someone with the right combination of talent and luck that comes along at just the right time and captures a big following. Kevinââ¬â¢s point is that you canââ¬â¢t reasonably aim to replicate superstar success. What you can do, however, is figure out what level of support will work to make your success sustainable. What you want to do is work on building a group of 1,000 True Fans. Or 500. Or 3,000. Recommended Reading:à How To Get More Followers With 21 Unique Ways That Will Boost Your Social Media Traffic How To Get More Followers On Pinterest With 21+ Tactics That Will Grow Your Following How To Schedule Your Social Media Content Curation For Massive Growth Different business models will need different numbers. The key is that itââ¬â¢s hard, but itââ¬â¢s achievable. As Kevin puts it, ââ¬Å"You can count to 1,000.â⬠So what is a True Fan? A True Fan is defined as someone who will purchase anything and everything you produce. They will drive 200 miles to see you sing. They will buy the super deluxe re-issued hi-res box set of your stuff even though they have the low-res version. They have a Google Alert set for your name. - Mike Masnick Itââ¬â¢s this level of loyalty and passion that we can build with our social media following. Pro Tip:à Figure out how many True Fans you need to be sustainable. A good go-to way to think about this is to assume each will spend $100 on you per year. Start counting. 1. Change The Way You Think About Social Media The social media ground game has evolved. Back in the wild west days of social media, the only numbers that mattered were followers, likes, and shares. It didnââ¬â¢t matter how you got the followers, as long as that number was big. The same how-to was floating around in everyoneââ¬â¢s heads: Build followers Get likes Profit The world has become so number-obsessed. You even saw people like Klout trying to develop an algorithm to score influence. What was lost in all the frenzy was a basic understanding of what has made social media a part of our everyday lives. Social media is valuable because it helps you learn, communicate, and engage with other people. You use social media to have conversations. Recommended Reading: How To Get Your Content In Front Of The Right Audience At The Right Time How To Delight Your Marketing Target Audience To Boost Conversions Iââ¬â¢m a huge baseball fan, and social media gives me access to up-to-the-minute information in a way that Iââ¬â¢d never get in a newspaper. When I think about what I like the most, itââ¬â¢s being able to see a variety of perspectives about a particular play or trade, from players, scouts, superfans, and reporters, and being able to talk to them about it. Itââ¬â¢s the insider experience that is valuable to me. Pro Tip: Take the time to think about what you use social media to do, and why you use it the way you do. Does that insight change the way you could communicate with your customers? 2. Engage With Your Followers To Make Them Loyal Fans The biggest mistake most marketers make is thinking of social media as a broadcast channel. They think itââ¬â¢s about sending out your message, about repetition and variationà as if itââ¬â¢s just another form of TV. What they donââ¬â¢t do enough is listen. Instead, use these tips to better engage with your followers: Get smaller.à Instead of trying to broadcast to a large, general audience, narrow your focus to interacting with a small, specific audience. Who do you want to talk to? Focus on your customers social streams. Begin by listening. Have a conversation. Tell stories.à Stories are what get people engaged and emotionally connected. A story is something unique, personal, and engaging. Stories let us see the people, idea, or values that you represent. Social Media Examiner has a great guide to using stories in your social media marketing. Show your face.à Use visual content to get attention. Study after study shows that a post attached to a strong visual is more likely to get shared. More importantly, it lets us see behind the curtain. We will connect better with you as aà person than a brand, so donââ¬â¢t be afraid to show your face. As Kevin put it very clearly: "Understand this isnââ¬â¢t ââ¬Ëlook at me, look how cool I amââ¬â¢ content, this is perhaps just the opposite if it is to connect. This is 'look at me, look how much I care, look how regular I am, look at why I might be the perfect person to guide you to the result you are seeking.'" Have conversations.à Talk to people, ask questions, and find ways to get engaged. Show that you are interested in what others have to say, and not just obsessed with selling something. Shutterstock has a great guide for creatives on how to have more authentic conversationsà on social media. Pro Tip: Donââ¬â¢t broadcast, blindly flailing into the social media abyss. Be specific about who you want to talk to, lead with listening, and start having a conversation. Recommended Reading:à 8 Social Media Best Practices That Will Save You 25.5 Hours In A 2-Week Sprint 3. A Loyal Following Comes From Being A Real Person In her useful guide to building a loyal following on social media, Mei Pak offers this incredibly wise piece of insight: Building a successful creative business means polarizing the people that find you. They are either your target customer or theyââ¬â¢re not. - Mei Pak Itââ¬â¢s natural to be cautious about putting yourself out there because it can seem pretty risky. You might come off wrong, or miscommunicate, or make a fool of yourself. But while thatââ¬â¢s off-putting to some people, it will make others fall in love with you. As long as you show vulnerability and admit mistakes when you make them, you have nothing to lose. Achieving this successfully requires making sure youââ¬â¢re clear about your values. Decide whatââ¬â¢s important early on, and it becomes easier to know what to post about. If an event is happening nearby, you could post a shout-out, or even share a photo or video from it. Shared values are going to attract your most loyal customers. Finally, make sure that you keep upbeat. As Mei says: Present and focus on the positive points so you donââ¬â¢t sound like a whiner. - Mei Pak That doesnââ¬â¢t mean you canââ¬â¢t post about something youââ¬â¢re struggling with, but try to stay constructive and positive to get people to root for you. Pro Tip:à Find ways to make your posts more personal. Talk about whatââ¬â¢s going on in your neighborhood, talk about what you love, keep positive, and have a conversation. Recommended Reading:à 20 Ways To Be Creative When You Donââ¬â¢t Feel Inspired Get Engaged All of this advice really boils down to a simple revelation:à Social media is about having a conversation, not about who can yell the loudest. The same way that you approach meeting people at a party is the way you should approach your social media game. As Dale Carnegie advises, be interested in other people and theyââ¬â¢ll be interested in you.
Thursday, November 21, 2019
How different people understand the issues of civil rights and racism Term Paper
How different people understand the issues of civil rights and racism in America today - Term Paper Example The movement stood up for reason, rationality, and above all, liberty. This is important in understanding the underpinnings of modern civil rights movements surrounding fundamental human liberties. Joseph (2014) revisits the Freedom Summer in his article titled, When Civil-Rights Unity Fractured, stating that racial divisions that emerged during the 1960s are still present today and in order to understand the present efforts to build interracial coalitions, the present must be considered in context with its historical legacy and context. The Freedom Summer is an important period in history where began a lasting movement of black activism and involvement. Black revolution intensified during the period as many students became increasingly active and engaged themselves with various movements. Looking back at the Enlightenment Movement of the 18th century, a viable connection can be made with Freedom Summer which ignited activism based on recognition of civil and human rights to fundamental liberties. The main purpose of black activism was not merely to obtain voting rights but their aim went beyond this. With their activism, blacks were looking out for greater political transformation and greater rights for the blacks. To confront racism on a country wide scale was another prominent goal of the activists. The Mississippi Freedom Democratic Party played an important role for the blacks as it provided a useful tool for independently organizing their projects. Activists like Fannie Lou Hamer led the party being used as a vehicle to voice their demands. As a great number of black African Americans acquired the right to vote, the Mississippi Freedom Democratic Party used the voter base in order to challenge the dominant White American Democratic state delegation at the convention. Another aim of the effort was to pressurize the national party and Lyndon B.
Wednesday, November 20, 2019
Product development Essay Example | Topics and Well Written Essays - 750 words
Product development - Essay Example 1) He may look for large and growing markets with real buyer needs. For example, the artist specialization is contemporary drawing that is very popular nowadays. The artist can make an accent on the fact that contemporary art market is growing and having even a small market share he would have a lot of customers because the market itself is big enough and flourishing. Insignificant point of difference is a vital factor of new-product failures. Moreover, superior characteristics of the product must be valuable for the customer to switch from another one. In general, the major sources of product differentiation are: quality (often related to price), usability and design, promotion methods, differences in availability (e.g. timing and location). According to these factors the products of art can differ from competitors on a basis of price: more expensive paintings would be perceived as more unique; due to aesthetic considerations; positioning: for example, ââ¬Å"perfect present for the grand-fatherâ⬠or ââ¬Å" do you want to be a modern person ââ¬â buy only contemporary pieces of art workâ⬠and so on; place where the art is sold: underground den or luxurious gallery. Brand has a direct connection with a business growth. There are two ways how a brand can impact growth: negative and positive. For example, if the artist has a well-known and respectful brand of his ââ¬Å"product lineâ⬠his new pictures would be wiped off the shelves despite the fact that there may be not the best bets on the market. On the other hand, the artist may create something incredible but his brand would not be recognizable and his painting would gather dust on shelves. The more important thing is how exactly to measure the brand impact on the business. Sam Miller (Par. 8) offers: During the marketing of the art competitor-oriented, cost-oriented and demand-oriented pricing approaches might be utilized. If the artist is recently graduated and up and coming the
Monday, November 18, 2019
Why Abu Dhabi government band shisha from Coffee shops Research Paper
Why Abu Dhabi government band shisha from Coffee shops - Research Paper Example This was posing a great threat particularly to children who could openly see the awful act done publicly (Frank & Sloan 112). The condition made government, which form part of the stakeholders, to push for a ban of shisha business. In their opinion, they argued that the business would merely increase the immorality despite of earnings it receives in form of revenue from the same (Richard, & Thomas 79). This came out despite an acclamation from one the stakeholders ââ¬ËI expect that we will make no more than Dh 100 a day, our business greatly depends on shisha.ââ¬â¢ Government had justification in their opinion and stand on the ban of the business in Abu Dhabi. This was in the fight against various severe implications associated with conducting the business legally. Cases of children who could see people smoke publicly and try to enumerate the same declined (Sue Pryce 94). Therefore, banning the business particularly from areas with high populations and different forms of human activities became a step in achieving habitable environment for the entire community (George Fisher & Elmer Berry 134). In the economy sector, there is improvement. This is from the fact of decline in the number of people reporting having shisha related complications. There is low expenditure of finances and other recourses used to curbing the menace. These resources go to profitably profitable and critical sectors that develop the economy. Additionally, human skills that were otherwise lost from deaths resulting from smoking shisha are no more there. In my opinion in support for the ban, it is very evident that currently death rate resulting from smoking is becoming alarming. This is from the actual statistics and data from countries and regions that are facing this menace of shisha smoking. The deaths results from several chronic illnesses arising smoking even other substances like tobacco (Michael & Lyman 68). Research
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