Sunday, January 26, 2020

Transdisciplinary Play Based Assessment Observation Children And Young People Essay

Transdisciplinary Play Based Assessment Observation Children And Young People Essay Transdisciplinary Play-Based Assessment Observation Transdisciplinary Play-Based Assessment [TPBA] is a practical approach to assess children at risk for developmental delays or disabilities, and involves the child, his or her parents, and other educational or diagnostic professionals in an ordinary environment of assessment and intervention. A TPBA framework is planned around the play screening session, and the play conference is based on information obtained from the childs parents in relation to their childs developmental status. During the conference session, guiding principles can provided for observing the thinking, social-emotional development, communication and language abilities, and sensorimotor development of the child. The behavioral validity of TPBA methods, materials, and techniques are Vital to this assessment. Mainly, because the assessment requires planning that include the family, as well as from others who are familiar with the child. This aids the baseline for the assessment, which is now similar to the familys environment and experiences. TPBA provides numerous opportunities for children to intermingle with new and familiar materials. In addition, to capture as many perspectives as possible, a variety of observers is included in the assessment. Furthermore, pre-assessment questions answered by the parents aid the educators and other professionals preparing the setting that will stimulate the childs optimal abilities. The implementation of the assessment usually involves the examiner to use informal assistance, and follows and expands upon the childs lead. In a formal setting, the examiner assists the child as he or she elicits behaviors that were not natural in the earlier phase. Then, the child is then, observed after being introduced to a peer in order to observe the interaction among them. Formal and informal play among the parents and the child, motor play, and snack time, allows for a screening of oral-motor difficulties as well as social and adaptive development. Throughout the observation period, an educator or the diagnostic professional discusses with the parent the observations of the childs behaviors, the professional analysis of behaviors, and the parents view of the childs behavior. The observers also guided their observations by questions that address both measurable and qualitative characteristics of the childs behavior. When the assessment is completed, and the childs observed behavior, accomplishments, transdisciplinary recommendations are developed, and a program-planning meeting is arranged to provide added suggestions for the childs parents. These experiences respected the child, his or her family, and the culture in which the child lives. Emphasis focused on the collected data from the areas of development of the child. As for mentioned, TPBA uses observation to evaluate the development status of a child in systematized play settings. According to Stuhlman et.al (2010), the summary of the benefits for observations of play are as follows: Providing opportunities to assess the behavior of child tha is unable or refuses to perform in a formal testing setting. Reveal characteristics of the parent child relationship that help explain the behavior of the child. Provide explanations of developmental domains, and give diagnostic professionals numerous opportunities to learn effective play strategies from a childs parent. Recommend ways to support parents play strategies that are not effective. Identify coping skills and risk factors that affect the childs diagnosis and hinder their planning program. Then increase the parents and professionals relationships (p.2). These play observations correlate to the normal developmental information acquired in the setting, and provide the opportunity to create a parent to professional partnership. Spur of the moment play behaviors of the parent and child, can add critically important information to an assessment. The setting and procedures of the setting allows the child and his or her parents to establish their weaknesses and strengths as well as their areas of difficulty. In general, the principles for observing and assessing is summarized as the need for practitioners to be clear on the need for and purpose of assessing, ensure the appropriateness for the child. In addition, ensure the process is meaningful, consider the ethical issues, validity the outcomes, use appropriate observational methods for the child and the setting, consider the timing of the observation, ensure there is adequate staffing to free the observer from additional responsibilities if necessary, and be clear on how the outcomes will be disseminated, and to whom. The major disadvantage of this approach is that the assessment cannot easily be dynamic, that is, the team members cannot interact with the child in order to see how quickly the child learns or how the child responds if activities were in different ways and by different persons. This research paper has reviewed the literature on transdisciplinary play based assessment, outlining its basic premises and observation features. The implementation of TPBA observation highlighted the importance of increasing the success of this practice of distinguished roles, independent and team responsibility for professional development, and a learning based and supportive team environment.

Saturday, January 18, 2020

To Examine Pressure Ulcers Health And Social Care Essay

Pressure ulcers as stated by the European Pressure Ulcers Advisory Panel ( EPUAP, 2007 ) : â€Å" A force per unit area ulcer is localised hurt to the tegument and/or underlying tissue normally over a cadaverous prominence, as a consequence of force per unit area, or force per unit area in combination with shear and/or clash. A figure of lending or confusing factors are besides associated with force per unit area ulcers ; the significance of these factors is yet to be elucidated. † In add-on, National Institute for Clinical Excellence ( NICE, 2008 ) defines a force per unit area ulcers as â€Å" A force per unit area ulcer is harm that occurs on the tegument and implicit in tissue. Pressure ulcers are caused by three chief things: Pressure – the weight of the organic structure pressing down on the tegument. Shear – the beds of the tegument are forced to skid over one another or over deeper tissues, for illustration when you slide down, or are pulled up, a bed or chair or when you are reassigning to and from your wheelchair. Friction – rubbing the tegument † . Some of the force per unit area ulcers intrinsic causes ( built-in to single ) include decrease mobility, incontinency ( Horn, 2004 ) , old age, malnutrition, hapless hygiene, dry tegument, diabetes mellitus and surgery ( ex. hip break ) and anemia ( Gunningberg, 2000 ) . Some extrinsic causes include clash, shearing forces, hypothermia ( Scott, 2001 ) and length of surgery ( Houwing, 2004 ) . Pressure ulcers are a common complication of lessening mobility due to hip break with reported incidence of between 8.8 % and 55 % ( Baumgarten, 2003 ) . Harmonizing to Versluysen ( 1985 ) , 17 % of patients that is admitted to hospital for surgery had force per unit area ulcers upon admittance and that 34 % developed lesions during the first hebdomad of stay in infirmary. Versluysen ( 1986 ) conducted another survey that 66 % of the patients with hep break developed force per unit area ulcer, bulk of these force per unit area ulcers appeared during the first 48 hours of admittance. Incontinenc e increases the hazard of holding a force per unit area ulcer because of the inordinate wet on the tegument, moist tegument adhere to the mattress therefore consequences to increased shearing forces ( Defloor and Grypdonck, 1999 ) . Dry tegument besides increases the hazard of holding force per unit area ulcers because of the reduced snap of the tegument ( Gunnigberg, 2000 ) . Surgery itself ( Lindgren, 2005 ) and length of surgery of 4 hours or more ( Schoonhoven, 2002 ) have been reported to increase the hazard of developing a force per unit area ulcer. In 2005, the National Institute for Clinical Excellence has issued clinical guidelines to the National Health Service ( NHS ) about force per unit area ulcers. The guidelines are about bar and intervention of force per unit area ulcers, which are recommended for the usage of physicians, nurses and other health care professionals working in the National Health Service in England and Wales. The guidelines were prepared by health care professionals, scientist, and people stand foring the position of those who have or attention for person with the status. The groups make a recommendation based on the grounds available at the clip the recommendation is made on the best manner of handling or pull offing the status, and these clinical guidelines are recommended for good pattern. Under these NICE guidelines ( 2005 ) , it recommends that healthcare professional work together with the patients in order for the patients to hold an active function in doing determination sing their program of att ention with the pick to affect their carer if they wished to. It besides mentioned that health care squad should esteem and take into consideration the patient ‘s cognition, experience, and demands, particularly if the patient has have been at hazard of developing force per unit area ulcers for a long clip. Furthermore, it besides mentioned that patients and carer should be given developing and information as to the grounds why the patient is at hazard of developing force per unit area ulcer, parts of the organic structure most at hazard to hold force per unit area ulcer, how to inspect the tegument and acknowledge the alterations in the tegument, how to alleviate force per unit area, and supply information to the patient and carer where to happen aid, advice, and support. Pressure on the tegument over cadaverous prominence such as sacrum, hips, cubituss, mortise joints, heels and shoulder causes decreased blood flow to the tissue, therefore cut downing tissue oxygenation. If this force per unit area is non relieved, the affected country starts to alter coloring material, inflammation to patients with just skin tone and bluish for patients with darker tegument tone and deemed to be ‘at hazard ‘ ( EPUAP, 2009 ) and may turn out to be difficult to observe, which so advancement to a more intensive tissue hurt if no attention is given. Members of the European Pressure Ulcers Advisory Panel and National Pressure Ulcer Advisory Panel ( 2009 ) have had on-going treatment about many similarities the two organisation ‘s force per unit area ulcer grading/staging systems. They developed a common international categorization system and definition for force per unit area ulcers. EPUAP and NPUAP attempted to happen a common word to depict the class and phase but to no help. The word class was recommended as a impersonal term against phase and class and has the advantage of being non-hierarchical. They recognize that there is a similarity to the words – phase and class, and hence, they suggested to utilize whatever is most clear and understood. The most important addition from this partnership is that the degrees of skin-tissue harm and definition of force per unit area ulcer are the same, even though they may be labelled otherwise. Pressure ulcers are classified into four ( 4 ) stages/categories based on the EPUAP ( 2009 ) categorization system. Non-blanching erythema is labelled as grade/category I, the tegument is integral with inflammation that is non-blanching of a localised country over a bony prominence when light force per unit area is applied. The affected country may be painful, house, soft, and heater or ice chest compared to the environing tissue. As mentioned earlier, patients with dark skin tone may be hard to measure and hold ‘at hazard ‘ . Partial thickness skin loss of both or either one of the first or 2nd bed of the tegument called cuticle and corium is classed as stage/category II, this stage/category of force per unit area ulcer presents itself in many ways, it can be a ruddy or glistening shallow ulcer without gangrene ( bed of dead tissue separated from the environing ) , may besides show itself as an integral or ruptured sero-sanginous filled or serum-filled blister, or merely bruising. Stage/category III is characterized with full thickness skin loss ; it involves harm to or the loss of hypodermic fat but non musculus, sinew, or bone. Pressure ulcer in this stage/category varies harmonizing to the site affected. Stage/category IV portraits as force per unit area ulcer with full thickness skin loss with extended harm of tissue which may include musculuss, facia, and other supporting construction and may set the patient at hazard of developing osteomyelitis or osteitis. NMC Code of Conduct ( 2008 ) EPUAP definition ( 2007 ) hypertext transfer protocol: //www.npuap.org/pr2.htm Nice definition hypertext transfer protocol: //www.nice.org.uk/nicemedia/pdf/CG029publicinfo.pdf Versluysen M. Pressure sores in aged patients. The epidemiology related to hip operations. J Bone Joint Surg Br 1985 ; 67: 10-3. Versluysen M. How aged patients with femoral break develop force per unit area sores in infirmary. BMJ 1986 ; 292: 1311-3. Defloor T, Grypdonck MH. Siting position and bar of force per unit area ulcers. Appl Nurs Res 1999 ; 12: 136-42. Gunningberg L, Lindholm C, Carlsson M, Sjoden PO. The development of force per unit area ulcers in patients with hep breaks: unequal nursing certification is still a job. J Adv Nurs2000 ; 31:1155-64. Lindgren M, Unosson M, Krantz AM, Ek AC. Pressure ulcer hazard factors in patients undergoing surgery. J Adv Nurs 2005 ; 50: 605-12. Schoonhoven L, Defloor T, new wave der Tweel I, BuskensE, Grypdonck MH. Hazard indexs for force per unit area ulcers during surgery. Appl Nurs Res 2002 ; 15: 163-73. EPUAP hypertext transfer protocol: //www.epuap.org/guidelines/Final_Quick_Prevention.pdf ( 2009 ) Lindholm C, Sterner E, Romanelli M, Pina E, Torra y Bou J, Hietanen H, Iivanainen A, Gunningberg L, Hommel A, Klang B, Dealey C. Hip break and force per unit area ulcers – the Pan-European Pressure Ulcer Study – intrinsic and extrinsic hazard factors. Int Wound J 2008 ; 5:315-328. Scott EM, Leaper DJ, Clark M, Kelly PJ. Effectss ofwarming therapy on force per unit area ulcers – a randomised test. AORN J 2001 ; 73:921-7,929-33, 936-28. Houwing R, Rozendaal M, Wouters-Wesseling W, Buskens E, Keller P, Haalboom J. Pressure ulcerrisk in hep break patients. Acta Orthop 2004 ; 75:390-3. Gunningberg L, Lindholm C, Carlsson M, Sjoden PO. Effect of visco-elastic froth mattresses on the development of force per unit area ulcers in patients with hep breaks. J Wound Care 2000 ; 9:455-60. Baumgarten M, Margolis D, Berlin JA, Strom BL, Garino J, Kagan SH, Kavesh W, Carson JL. Riskfactors for force per unit area ulcers among aged hip break patients. Wound Repair Regen 2003 ; 11:96-103. Horn SD, Bender SA, Ferguson ML, Smout RJ, Bergstrom N, Taler G, Cook AS, Sharkey SS, Voss AC. The National Pressure Ulcer Long-Term Care Study: force per unit area ulcer development in long-run attention occupants. J Am Geriatr Soc 2004 ; 52:359-67.

Thursday, January 9, 2020

The EPA and Anti-tobacco Zealots Essay - 1293 Words

The EPA and Anti-tobacco Zealots Tobacco smoking has been one of the hot controversies of our time. Many people find tobacco smoke annoying, smelly and just plain dirty and unpleasant. Some smokers themselves agree with that sentiment. Todays smoking restrictions, not to mention the attack on smokers and extortion of tobacco companies, could not have been engineered simply on the grounds that tobacco smoke is unpleasant. We needed another reason. So the Environmental Protection Agency (EPA) literally manufactured, using bogus science, the finding that second-hand smoke is a class A carcinogen causing death and illness for tens of thousands of people who are simply around tobacco smoke. The major news media, along with anti-tobacco†¦show more content†¦This impossibility of making interpersonal utility comparisons is applicable to most well-being type comparisons. For example, suppose there is a beautiful lady that both Jim and Bob are pursuing. If Jim wins her hand, Bob is harmed and if Bob wins her hand, J im is harmed. There is no scientific way anyone can determine whose harm is more important and should take precedence over the other. In a socialistic society, conflicting harms are resolved through government intimidation and coercion. In a free society, conflicting harms are settled through the institution of private property rights. Private property rights has to do with rights, belonging to the person deemed owner of property and protected by the state, to keep, acquire, use and dispose of property as he deems fit so long as he does not violate the property rights of another. Therefore, in a free society, whether smoking harms others or not is irrelevant. The relevant issue is who owns the air? It is clear that if you own the air, it is your right to decide how it is used. If you do not want tobacco smoke in your air, that is your right that government should protect. By the same token, if I own the air, I have rights just as you do to decide how it is used. If I want to have tobacco smoke in my air, I have every right to do so and theShow MoreRelated Using Nazi Tactics Against Smokers936 Words   |  4 PagesI, Jewish-American publications were investigated and prosecuted by the U.S. Government for writing favorably about Germany, a nation at war with the U.S. Much of German history has been one of racial toleration. This is partially seen by their anti-slavery positions in Brazil and the United States. In the United States, Germans had a large hand in assisting runaway slaves by way of the underground railroad. Germans also had an established reputation of getting along very well with American

Wednesday, January 1, 2020

A Devilish Predator in Where Are You Going, Where Have You...

A door to the beginning of her outcome is all that divides Connie in, â€Å"Where Are You Going, Where Have You Been?† from Arnold Friend, the devilish predator. Symbolism takes a big part in this story that gives a deeper meaning to Connie’s choices that ultimately extent to giving herself to Arnold. The author, Joyce Carol Oates in the short story, â€Å"Where Are You Going, Where Have You Been?† represents Arnold Friend as the real world by being challenging and malicious, and Connie as the innocent world by being defenseless and naive. One of the symbols in the story are the sunglasses Arnold wears. He wears them to hide himself from the real world and to hide what his intentions are to do with Connie once she gets in the car to go for a ride with him. Arnold Friend himself also plays a symbol in the story. When you see the name, â€Å"Arnold Friend† and take the R out you will get â€Å"An old friend† or if you take both R’s out you will get â€Å"An Old Fiend† that is referring to the devil. He keeps talking to Connie trying to lure her into the vehicle stating everything will be ok and her family will not be home anytime soon because he knows exactly what they are doing at the exact moment. The text also says Arnold stands up in his boots and wobbles as if his boots were stuffed to make him taller and not all the way in. Arnold’s car is another symbol. His car is one of the first clues that gives Connie a reason that Arnold could be there for the wrong intentions and something could goShow MoreRelatedWhere are you Going? Where Have you Been? by Joyce Carol Oates1100 Words   |  5 PagesWhere Are You Going, Where have you been? is a short story written by Joyce Carol Oates. The 75 year old American author and professor at Princeton University, introduce the story of 15 year old Connie who is rebelling against her mother’s whishes. A very arrogant and selfish girl that in her world the only thing that matters is how many heads she can turn when walking into a room. Through the story life gives her a test, to confront Arnold Friend, the antagonist of the story; who possesses a nefariousRead MoreArnold Friend In Where Are You Going, Where Hare You Been? Essay1161 Words   |  5 Pagesown menacing qualities and depraved actions. None, however, have struck such a devastatingly creepy chord as Arnold Friend of Joyce Carol Oates Where Are You Going, Where Have You Been? Seducer of young girls and embodiment of Lucifer, Arnold Friend is anything but a friend. Arnold Friend is presented through both actions and appearances, and these combine to diminish his likeability, while adding to his devilish persona. Although Arnold Friends traits are never stated outright, they are presentedRead MoreCharacter Analysis of Arnold Friend in Oates ´ Where Are You Going, Where Have You Been605 Words   |  2 PagesMost of us have heard of the famous story by Oates called ‘Where Are You Going, Where Have You been’, featuring the infamous Arnold Friend and plenty of adult themes. So many possible theories stem from just one character from a short story whether he could perhaps be death, or the devil in disguise coming to take Connie away; or perhaps just a mental creepy man coming to kidnap and rape Connie. So many things that Arnold Friend tells little vain Connie can be interpreted in either direction, itRead Moretheme of alienation n no where man by kamala markandeya23279 Words   |  94 Pagesshe is taken to a cave, her place of entombment. On Thebes: Thebes was the most important city of Boeotia, on mainland Greece. It was one of the chief city-states of ancient Greece, after Athens and Sparta. Sophocles described it as â€Å"the only city where mortal women are the mothers of gods.† According to Greek legends, the city was founded by Cadmus and was destroyed by the Epigonoi in the time before the Trojan War. In the sixth century B.C., Thebes recovered its glory to some extent, and in Sophocles’