Monday, January 27, 2020

Underage Binge Drinking In UK Health And Social Care Essay

Underage Binge Drinking In UK Health And Social Care Essay The purpose of this study is for the writer to explore the government strategies in combating the rising rates of underage binge drinking in the UK. The writer will approach this topic by briefly examining the prevalence, determinants, and effects of underage binge drinking. The writer will also critically analyse gaps in government strategies in tackling underage drinking and subsequently formulate a policy intervention that would address the gaps highlighted. Ethical consideration of the policy intervention will also be explored, and subsequently reflection and conclusion will close the study. There is no universal definition of binge drinking, but it is often described as a pattern of excessive intake of alcohol over a short period of time (Home Office Findings (HOFs), 2005). Parliamentary Office of Science and Technology (POST) (2005) expands this definition further as such behaviour that leads to a rapid increase in blood alcohol concentration and consequently to drunkenness. However, the writer believes that binge drinking occurs when people have no limit of their alcohol intake within a short period resulting in exposing themselves or/and other people to risk. Underage binge drinking continues to increase in the UK, although the number of young people aged 11 to 15 who drink alcohol has fallen since 2001 (National Institute for Health and Clinical Excellence (NICE), 2007). However, those that drink alcohol continue to drink more and more often (HM Government, 2007 In NICE, 2007). According to HOFs (2006), the nature of offences among aged 10 to 17 during or after drinking was associated with frequency of drinking. Those that drink once a week or more reported getting involved in arguments (48%), fights (19%) and criminal damage offences (12%) during or after drinking compared to those that drink between one and three times a month (16%, 6% and 4% respectively). Another study undertaken by The European School Survey Project on Alcohol and other Drugs (ESPAD) has examined drinking among representative samples of aged 15 and 16 in the UK. In 2003 study, UK was ranked as the third most teenage binge drinkers out of 35 European countries (Hibel l et al., 2004). There are some effects of teenage binge drinking, and one of this is medical effect. Binge drinking causes brain damage that destroys the brain cells and evidence suggests that adolescent binge drinkers are likely to experience impaired memory and reasoning skills (Institute of Alcohol Studies (IAS), 2007). Alcohol poisoning is another common medical condition among young binge drinkers. The risk of cardiovascular, hypertension, strokes, heart diseases, psychological problems, breast and oral cancers are later effects of teenage drinking on adulthood (IAS, 2007). One of the economic implications of binge drinking is the cost to the NHS, it is estimated that the cost of alcohol harm to the NHS in England is  £2.7 billion (2006/07) as compared to  £1.7 billion in 2001/02 prices (The Health and Social Care Information Centre (THSCIC), 2009). Other effects of underage binge drinking result in alcohol related accidents. For example, in 2007, 6,541 deaths in England were directly related to alcohol consumption and this has increased by 19% between 2001 and 2007 (THSCIC, 2009). Also, binge drinking results in unsafe behaviour such as sexual activities and other illicit drug use, which is more prominent with young binge drinkers (IAS, 2007). DETERMINANTS OF UNDERAGE BINGE DRINKING Dahlgren and Whitehead (1991) (see appendix) formulated a useful framework to intensively explore the determinants of health. It is argued that public health is not mainly the absence of diseases (World Health Organisation (WHO), 1948) but to promote ways of prolonging peoples lives (Acheson, 1988) through the complex interactions between social and economic factors, the physical environment and individual behaviour as well as fixed factors such as age, sex and hereditary. The peak of teenage binge drinking age seems to occur around aged 15 and above. HOFs (2006) reported that children aged 16 to 17 reported having had alcoholic drink in the previous 12 months. This report shows the highest alcohol consumption (88%) between the age bracket as compared to children aged 10 to 13 that have the lowest (29%). Conversely, children aged 15 to 16 were used in ESPADs study, which shows high rate of underage binge drinking in the UK among these age bracket (Hibell et al., 2004). HOFs (2005) reported that young males are likely to binge drink (49%) than young females (39%). However, Hibell et al. (2004) argued that UK drinking culture seems to be shifting from young males consuming alcohol far more than young females because figures show that in the UK, Ireland and Isle of Man, teenage girls are more likely than teenage boys to have consumed alcohol in binges (Velleman, 2009). Griffith (2000) suggested that drinking has been reported as being part of British drinking culture for generations. Plant and plant (2006) argued that most people in the UK drink alcoholic beverages and the negative effects of this drinking are clearly a big problem. The drinking patterns are highly influenced by national culture (Velleman, 2009). For example, in Mediterranean culture, young people are most likely to drink and drink more often and never caused public drunkenness (Velleman, 2009) whereas in northern European, drinking is characterised by excessive drinking but less frequent and heavier when it does occur (IAS, 2007). Parental influence was critically explored by Velleman et al. (2005) of which family structure was one of the areas where families can influence their minors substance use behaviour. Hellandsjo Bu et al. (2002) stated that children drinking at a younger age from single-parent families have limited family support. Steinberg et al. (1994) argued that non-separated parents who expect a lot from their children and provide a sense of self-efficacy tend to have children who are less likely to be misusing alcohol. Environmental factor such as advertisement (direct and indirect) is another factor influencing underage binge drinking. Anderson Baumberg (2006) and Hastings (2007) have suggested in their review that alcohol advertising and marketing are significant factors in the rise in alcohol consumption by young people. In contrast, alcohol and advertising industries argued that as the alcoholic drink is a legal product it should be legally possible for it to be advertised (IAS, 2008). Other determinants are the influence of peer pressure (Velleman, 2009) and socio-economic factors (Measham, 1996) as well as individual factors (Ryan, 2005 In IAS, 2007) such as impulsive personality traits, living away from home and to greater affluence, and increase in binge drinking for those who have weak health beliefs. CURRENT GOVERNMENT STRATEGIES AND BINGE DRINKING The four countries that constitute UK responded to ways in which rising rate of binge drinking could be controlled. In England, government published a policy document in 2004 on Alcohol Harm Reduction Strategy for England (Cabinet Office Prime Ministers Strategy Unit, 2004). This strategy sets out to address better education and communication to achieve a long term change in attitudes to irresponsible drinking. It also focuses on better health and treatment systems to improve early identification and treatment of alcohol problems as well as to combat alcohol related crime and working with the alcohol industry to build on the good practice of existing initiatives and develop new ones. Finally, the new licensing law that allows 24 hour access to alcohol was introduced by the government in November 2005 (Department for Culture, Media Sport, 2005). The government measure to tackle binge drinking focuses on harm minimisation but failed to address the availability of alcohol through its 24 hour licensing law and affordability (POST, 2005). The current licensing law according to the government tends to reduce the practice of hoarding alcohol just before the closing hours and also reducing the numbers of people rushing into the street to purchase alcohol. The Royal College of Physician (RCP) strongly disagreed with government policy on its 24 hour licensing law. It was suggested that this will increase the overall consumption of alcohol and will have public health implications (POST, 2005). Government argued that its alcohol licensing law will reduce crime and anti-social behaviour and encourage a change in UK drinking culture (POST, 2005). Following the evidence presented above about the consequence of binge drinking in the UK, it is clear that more reliable and evidence based solutions need to be put in place because the governme nt is hoping to curb alcohol related crime rather than putting strategy that would curb the overall consumption of alcohol in order to safeguard the health of the people in general. The government policy on alcohol seems to contradict the Ottawa Charter for Health Promotion (OCHP) which suggests that all public policies should be examined for its impact on health (WHO, 1986) which seems to have been overlooked by the government. Furthermore, the numbers of people experiencing alcohol related harm continue to increase in the UK. For example, the numbers of people dieing from alcoholic liver diseases are increasing in England and Wales (HM Government, 2007 In NICE, 2007). The writer feels that if the strategy to curb the overall consumption of alcohol could be put in place, it will surely promote what the government is hoping to achieve. People should be entitled to good health and what binge drinking is causing in the UK is contradicting what a good health should be. WHO (1948) defines health as a state of complete physical, mental and social well-being but not necessarily absence of disease. Alma-Ata declaration argued that people should have access to healthcare at a cost that is affordable and people becoming the ownership of their care (WHO, 1978). It also argued that health should be a fundamental human right and not a privilege. The governments strategy on binge drinking seems to lack public health bene fits as it contradicts Alma-Ata declaration of what a good health should be for the people. POLICY INTERVENTION According to Stevenson et al. (2002, p.533) policy is a course of action adopted or proposed by an organization or person. However, the writer argued that a policy is a set of rule or guideline that is specifically drafted for a particular purpose for an individual, organisation or country to follow. The writer will therefore focus on strengthening the current government strategy as this strategy appears not to be combating teenage binge drinking in the UK. The writer aims to propose a policy to reduce 24 hours access to alcohol (licensing law) to a restricted time scale and to increase alcohol taxes as ways of managing the availability of alcohol and to reduce early alcohol drinking. These ideas are well supported by RCP, British Medical Association, and Academy of Medical Sciences (POST, 2005). Currently in the UK, the legal drinking age is 18 years (Office of communications, 2004) and the writer is proposing that the age should be increased to 21 in order to reduce teenage drinking at early age and its associated harm. There has been a debate in the Australian media suggesting increasing the legal age of alcohol consumption from 18 to 21 years (Toumbourou, et al. 2008). Several studies conducted in the past suggested that raising the age would reduce adolescents access to alcohol and subsequent associated harms (Grube, 1997; Ludbrook et al., 2002). Lowering the legal drinking age from 20 to 18 in New Zealand is reported to have resulted in a sharp increase in teenage and adults binge drinking (Everitt Jones, 2002). The writer feels that if this approach is embraced, it will restrict access to alcohol among aged 18 to 21 which will partly reduce rate of drinking. However, this action on its own will not resolve the binge drinking and all its associated harm. NICE (2007) produces public health guidelines on sensible alcohol consumption for use in primary and secondary schools in order to tackle the drinking problem among the young people. The policy also sets to provide support for alcohol drinking parents. It appears that government is trying their best to curb the rising rate of underage drinking in the UK. However, the writer feels that sophisticated alcohol awareness programmes should be made available to the parents through their General Practitioners (GPs). There is no routine on alcohol awareness programme for the parents through their GPs and what appears to be available through the GP is to offer support when alcohol is becoming or had become a problem. There is a need for routine based alcohol awareness for the drinking parents in all the GP surgeries. This idea is well supported by OCHP which focuses on helping people develop their skills in order to be in control of their lives and have more power in decisions that affect them (WHO, 1986). In doing this, parents will be able to give advise on alcohol drinking as they will lead by example by not drinking or stocking alcohol beverages in the house. Evidence shows that parents are likely to influence their children through their drinking behaviour (Bandura 1977, In Velleman, 2009). The writer is also proposing that all alcohol related adverts (direct or indirect) should be ban in the UK because a recent review of seven international research studies revealed that there is a correlation between prior alcohol advertising and marketing exposure and subsequent alcohol drinking behaviour in young people (Smith Foxcroft, 2007). Taking actions on alcohol advertisement in order to safeguard the future of minors are well supported by WHOs European Charter on alcohol. It addresses the European countries to take action on alcohol advertisement of which banning was part of the recommendations that were highlighted (IAS, 2008). However, the writer is aware that this approach might not be in favour of the UK economy because alcohol investors may leave or not invest in such country where promotion of their alcohol product can not be advertised. The writer believes that overall health of the people should outweigh such economic problem. Lastly, the writer is proposing that a measure such as introducing a national identity card for its citizens with a view that this card will be used at the point of alcohol purchase in order to keep a record of government recommended (THSCIC, 2009) daily alcohol intake (3-4 and 2-3 units for men and women respectively) for an individual who uses his/her card. This proposal will be monitored in relation to daily alcohol intake should people start to hoard alcohol. This proposal will also limit alcohol access to the minors as evidence suggests they still have access to alcohol despite government policy (HOFs, 2006). ETHICAL CONSIDERATION This study considers the four widely accepted ethical principles (Beauchamp Childress, 1995) which are autonomy, beneficence, non-maleficence and justice. This study will encourage the underage people to make choices based on the information provided. The right information will be passed to them and will be allowed to make their informed decisions. The study is also constructed in a way that is beneficial to underage people, family and society at large. The confidentiality and respect of the people will be maintained. Lastly, the writer will ensure that people are treated fairly and the resources will be shared equally among those that need support. REFLECTION My understanding of public health and application of theory into practice has developed to a considerable level during the course of this study. This study seems to be complex and requiring in-depth knowledge and understanding of public health practice. With adequate human and material resources obtained, I was able to uncover difficulties that were initially evident. This study has given credence to the gaps that sometimes occur in government strategy to combat a problem. I am aware that for an issue such as underage binge drinking to be revisited on the public agenda, there may be a need to advocate and mediate between different interests for the pursuit of health of the people in the society. Such way is achieved through media, advertising to raise public awareness, personal appeals by public officials and celebrities and many other approaches (Pencheon et al., 2006). Although this is not a guarantee that such issues will gain public agenda but it is suggested that public opinion has its greatest impact on government decision-making when people feel strongly and clearly about a problem (Pencheon et al., 2006). CONCLUSION This study has attempted to explore the rising rate of underage binge drinking by critically appraising the government measures in tackling the problem, with raised and explored policy interventions in order to address gaps in government strategy. It is hoped that the policy interventions would address the overall alcohol consumption rather than targeting only the alcohol binge drinkers. REFERENCES Acheson, D. (1988). Public Health in England. London: HMSO. Anderson, P. Baumberg, B. (2006) Alcohol in Europe, a public health perspective: A report for the European Commission. London: Institute of Alcohol Studies Bandura, A. (1977). Cited In: Velleman, R. ed. Influence on how children and young people learn about and behave towards alcohol. A review of the literature for the literature for the Joseph Rowntree Foundation (part one). York: Joseph Rowntree Foundation. [Online]. Retrieved on 12th December 2009 from: http://www.drugsandalcohol.ie/12563/1/JRF_children-alcohol-use-partone_2009.pdf Beauchamp, T. L. Childress, J. F. (1995). Principles of biomedical ethics. Oxford: Oxford University Press. Cabinet Office Prime Ministers Strategy (2004). The Alcohol Harm Reduction Strategy for England. London: Cabinet Office. Dahlgren, G Whitehead, M (1991). Policies and strategies to promote social equity in health (mimeo). Stockholm: Institute for Future Studies. Department for Culture, Media Sport (2005) New Licensing Laws Come into Effect at Midnight Tonight. [Online]. Retrieved on 26th January 2010 from: http://www.culture.gov.uk/reference_library/media_releases/3023.aspx Everitt, R. Jones, P. (2002). Changing the minimum legal drinking age.its effect on a central city emergency department. New Zealand Medical Journal 115 (25), pp. 9-11 Grube, J. (1997). Preventing sales of alcohol to minors. Results from a community trial. Addiction 92 (2), pp.251-260. Hastings, G. (2007) Social marketing.why should the devil have all the best tunes? London: Butterworth-Heinemann Hellandsjo Bu, E. T., Watten, R. G., Foxcroft, D. R., Ingebrigtsen, J. E. Relling, G. (2002). Teenage alcohol and intoxication debut: the impact of family socialization factors, living area and participation in organized sports. Alcohol and Alcoholism 37, pp.74-80 Hibell, B., Andersson, B., Bjarnason, T., Ahlstrom, S., Balakireva, O., Kokkevi, A. and Morgan, M. (2004). The ESPAD Report 2003. Alcohol and other Drug use among Students in 35 European Countries. Stockholm: Swidish Council for Information on Alcohol and other Drugs. [Online]. Retrieved on 12th December 2009 from: http://www.sedqa.gov.mt/pdf/information/reports_intl_espad2003.pdf HM Government (2007). Cited In: National Institute for Health and Clinical Excellence. ed. Interventions in schools to prevent and reduce alcohol use among children and young people. [Online]. Retrived on 20th December 2009 from: http://www.nice.org.uk/PH007 Home Office Findings (2005). Findings from the 2003 Offending, Crime and Justice Survey. alcohol-related crime and disorder. [Online]. Retrieved on 15th December 2009 from: http://www.homeoffice.gov.uk/rds/pdfs05/r261.pdf Home Office Findings (2006) Underage drinking: findings from the 2004 Offending, Crime and Justice Survey. [Online]. Retrieved on 15th December 2009 from: http://www.homeoffice.gov.uk/rds/pdfs06/r277.pdf Institute of Alcohol Studies (2007). Binge Drinking. Medical and Social Consequences. [Online]. Retrieved on 10th January 2010 from: http://www.ias.org.uk/resources/factsheets/binge_drinkingmed.pdf Institute of Alcohol Studies (2008). Alcohol Advertising. IAS Factsheet. [Online]. Retrieved on 13th January 2010 from: http://www.ias.org.uk/resources/factsheets/advertising.pdf Ludbrook, A., Godfrey, C., Wyness, L., Parrot, S., Haw, S., Napper, M. Teijlingen, V. (2002). Effective and cost effective measures to reduce alcohol misuse in Scotland. A literature review. Scotland: University of York. [Online]. Retrieved on 20th January 2010 from: http://www.scotland.gov.uk/health/alcoholproblems/docs/lire-00.asp Measham, F. (1996). The big bang approach to sessional drinking. changing patterns of alcohol consumption among young people in North West England. Addiction Research 4(3), pp.283-299 National Institute for Health and Clinical Excellence (2007) Interventions in schools to prevent and reduce alcohol use among children and young people. [Online]. Retrieved on 20th December 2009 from: http://www.nice.org.uk/PH007 Office of Communications (2004). Final revised alcohol advertising rules. London: Ofcom. [Online]. Retrieved on 2nd January 2010 from: http://www.ofcom.org.uk/consult/condocs/AlcAds/decision/rules.pdf Parliamentary Office of Science and Technology (2005) Postnote. Binge Drinking and Public Health. [Online]. Retrieved on 2nd January 2010 from: http://www.parliament.uk/documents/upload/postpn244.pdf Pencheon, D., Guest, C., Melzer, D. Gray, J. A. M. (eds.). (2006). Oxford Handbook of Public Health Practice. 2nd edition. New York: Oxford University Press. Plant, M. Plant, M. (2006). Binge Britain. Alcohol and the National Response. New York: Oxford University Press. Ryan, F. (2005). Cited In: Institute of Alcohol Studies. ed. Binge Drinking Nature, Prevalence and Causes. [Online]. Retrieved on 10th January 2010 from: http://www.ias.org.uk/resources/factsheets/binge_drinking.pdf Smith, L. A Foxcroft, D. R. (2007). The effect of alcohol advertising and marketing on drinking behaviour in young people. A systematic review. London: Alcohol Education and Research Council. [Online]. Retrieved on 10th January 2010 from: http://www.aerc.org.uk/documents/pdfs/finalReports/AERC_FinalReport_0040.pdf Steinberg, L., Fletcher, A. Darling, N. (1994). Parental monitoring and peer influences on adolescent substance use. Pediatrics 93(6 pt 2), 1060-1064 Stevenson, A. (ed.), Elliott, J. (ed.), Jones, R. (ed.). (2002). 2nd ed. Colour Oxford English Dictionary. New York: Oxford University Press. The Health and Social Care Information Centre. (2009). NHS. The Information Centre. [Online]. Retrieved on 30th November 2009 from: http://www.ic.nhs.uk/webfiles/publications/alcoholeng2009/Final%20Format%20draft%202009%20v7.pdf Toumbourou, J., Moodie, R., Eyre, J. Harper, T. (2008). Set boundaries, set an example. Australia: Fairfax. Velleman, R. (2009). Influence on how children and young people learn about and behave towards alcohol. A review of the literature for the literature for the Joseph Rowntree Foundation (part one). York: Joseph Rowntree Foundation. [Online]. Retrieved on 12th December 2009 from: http://www.drugsandalcohol.ie/12563/1/JRF_children-alcohol-use-partone_2009.pdf Velleman, R., Templeton, L. Copello, A. (2005). The role of the family in preventing and intervening with substance use and misuse. A comprehensive review of family interventions with a focus on young people. Drug Alcohol Review 24, pp.93-109 World Health Organisation (1948). WHO definition for health. [Online]. Retrieved on 10th January 2010. http://www.who.int/about/definition/en/print.html World Health Organisation (1978). Alma-Ata declaration. [Online]. Retrieved on 11th November 2009 from: http://www.who.int/hpr/NPH/docs/declaration_almaata.pdf World Health Organisation (1986). The Ottawa Charter for Health Promotion. [Online]. Retrieved on 11th November 2009 from: http://www.who.int/hpr/NPH/docs/ottawa_charter_hp.pdf

Saturday, January 18, 2020

American Literature: Pursuit of Happiness

Caitlyn Parker February 21, 2013 American Literature Essay #1 Pursuit of Happiness Comes in Many Ways In Ron Carlson’s â€Å"The Ordinary Son. † Reed discovers that what he might want in life is different than how his family lives. Reed’s family isn’t your typical scenario. His family is a â€Å"famous family,† a group of geniuses not known by their family’s last name but by each individual. The children even called their parents by their first names. They all had their own names, they were known by who they are not by the traditional way of saying, â€Å"Oh they are the Landers family. Geniuses lived not in a typical way of life. They were so focused on making the next big thing, that they never even spent family time together. Their house wasn’t full of fancy decorations, but actually quiet empty. They didn’t even have a dinner table. Geniuses weren’t social lights either, they never had people come over; they didnâ₠¬â„¢t keep up with all the tech savvy stuff either. They had no television or telephone. It was a genius household and it wasn’t to be diminished by electronic gismos. Reed accepted the way of life as a genius family.He realized that living without a telephone or refrigerator was natural for him. Didn’t even have a car. He was used to not living like society. He accepted this way of life, so simplistic and empty. He noticed that how they lived was very different than other people’s lives. He learned that society mostly was settled around two things: television and soft foods with tons of sugar. Living this way meant you didn’t sweat the small stuff, but to live for the work they do, not for things. They don’t need anything in life, just their brains full of ideas.Being in a household of geniuses is hard for Reed because he wasn’t like the rest of his family; he’s the odd one out. He didn’t spend his life trying to show off his talents or be an overachiever like his siblings. He would congratulate them and their successes but lived his life in the shadows, behind the fame. At the age of seventeen Reed discovered that the genius gene had skipped him and that at least he was smart but not going to be a genius. He was free. He felt more alive than ever. He figured that now he could do whatever he wanted, he had no obligations.These were the days for big change, to start his life the way he wanted too. He started by getting a job doing landscaping and general cleanup maintenance at a motel. He even bought a car. He began to alienate they ways of how he was raised. Reed began to live like society. He felt he was indifferent and wanted to learn from his peers. He had a friend, named Jeff who educated him on the larger things in life, like the sex department. He finally felt something to live for. He wanted to experience something so foreign to him and understand it. Reed was satisfied working a job and not takin g the high road in life.He worked hard and was making money. He didn’t weigh the little things; he just went with the flow. He didn’t need to live in the fast lane he was happy with a sweaty back and a pocketful of cash. He felt as if he was a genius in his own way. Working at the motel allowed him to start having a little life. He learned new skills and liked being able to stand up on his two feet without his family’s lights shining down on him. Reed was immersing himself in the real world. In Lorrie Moore’s â€Å"Community Life. † Olena wanted to be an English teacher and teach literature but she failed to graduate the study of it.She then transferred to library school where she was taught how to take care of books. She learned to read at a young age and loved to read. Olena learned to speak English and was taught to blend into the community at a young age. Every Saturday she would go to the library to read. She loved to go to the library, she fe lt as if she could do whatever she wanted. She became very fond of the librarian. Olena valued her mother and thanked her for teaching her English. Her parent’s wanted to give her an American life but Olena was left all alone due to a car accident when her parents died.Olena wished to start over, to be someone living in the world, hiding behind books and carefully learning voice. She missed her mother the most. The only thing to cope her pain was to work in a library surrounded by books, she loved to read and being around something you love helps her stay sane. Olena struggles with being social and brave. She likes to hide and not associate herself to the outside world. She likes libraries because there’s no who’s or whys just where is it. It’s an easy solution to escape the world around her. Olena seems very to herself, and doesn’t want to live her life like an American.She’s very stubborn when it comes to going out and living her life, she rather stay home and be isolated from the world. This makes her relationship suffer. Her partner, Nick tries to push her to connect to the community and go to events but she just argues and thinks these people are too glad-handing people who never really spoke to you but at you about their life stories. She could care less and didn’t want to associate with them. Olena lived differently than the society she began to be afraid of going out. She knew that she was a foreigner and a fool and she didn’t want to be part of it.Everything about the community was her enemy. She had become a rapist and strived to think something was wrong with her. This was a huge obstacle for her to overcome. She went through hysteria and spent her life in crisis. She hated America and tried to find herself throughout the entire process. â€Å"She was alone as a book, alone as a desk, alone as a library, alone as a pencil, alone as a catalog, alone as a number, alone as a notepad. † She had to lift herself from her loneliness to find her happiness. To be one with her parents again, searching to find herself.What is your definition of happiness? That is a good question, happiness comes in so many ways from small little gestures or an old friend saying, â€Å"You’re beautiful today. † Happiness is a word that associates with your surroundings. You would probably be happier if you just bought at new car rather than being hit by one. Your emotions play a lot into how you are feeling. You can feel happier when you see someone else smile because it makes you smile. For me, my happiness comes mostly from my family. With out my family I wouldn’t be who I am today.I’ve been through a lot of struggles while growing up and having to face problems at a young age made me become more independent on my own and stronger to face life’s hardships. When I was ten I had to live without a mother, this was very hard since she was my rock and I leaned u pon her for my every need. It was an adjustment to have to move on with my life and stay close to my older sister for guidance. Without my sister I don’t know how I would have been able to cope and succeed in my journey into adulthood. Ever since I was three years old I have loved to ice skate, skating is my escape from society it lets me free my mind.Whenever I’m down, I just think of skating and it makes me feel better. I love to skate and how it makes me feel free from anything, like I can do anything. Free as a bird. I value the little things in life, even though I never came from a rich family I have always never been forgotten. It’s great to have a few people love you tremendously rather than having no one there to support you. My dad has been a huge influence in my life because he has always been there for me, he would do anything for me and it’s great to know you have someone to count on.He has taught me so much and gave me his artist talents as w ell. Since I was little I have loved to draw, being creative is my section nature. I can do it in my sleep. I’m very passionate about being artistic; through generations my whole family has some kind of artistic ability. My grandfather was a painter, photographer, my grandmother knitted and sewed like a seamstress, my dad was an illustrator, drawer, my mom was a watercolor artist, and my aunt was a graphic designer, printmaker. It’s in my blood to be talented in the arts.I have always been passionate when it comes to making something beautiful and done from the hand. Life seems so much easier when you can make something from your heart. You can never buy something so eternally special. Being surrounded by loving people is a huge inspiration because they are your support group and when you feel down you just look to these people and they will always motivate you and push you in the direction you want to go in. In the future I hope to see myself becoming a designer.I lov e the thought of me opening up my own brand and starting a clothing line. I have always thought of myself becoming famous someday. My goals for myself is to finish school with honors and graduating with a degree in Graphic Design then continuing to complete my associates in Interior Design. Then after college start to work for a magazine or firm to get some experience and do logos, websites, etc. I think to maintain my happiness I just need to keep skating and don’t settle for a day job.I want to schedule my own hours and do work that will be something I enjoy rather than sitting at a desk all day being miserable. I also have always wanted to travel the world to get inspiration and if I follow my dreams, happiness will stay with me till I past. My purpose of life is to have fun and fulfill my wishes, if I don’t I will regret my life choices and be miserable for the rest of my life. If I keep up the hard work, my life will be complete and I will feel satisfied. Happines s is the way of life if your not happy then your not making your life have a purpose.Being able to use my imagination helps me cope with society, now a days everything is digitalized and electronic that my mind wants to explode. For me, I always have to step away from the computer and relax my mind. I love to do yoga and mediate it helps me become one with my body and it’s a reliever of stress. I also keep a journal to jot down notes or ideas that I might come across at random times. It helps me stay true to myself and when I’m having a bad day I just look in it and re-read silly things I wrote and it makes me feel better. I always feel happy when I’m being silly and just being myself.

Friday, January 10, 2020

Health information exchange Essay

The Health information exchange or also known as HIE is the sending of healthcare-related data electronically to facilities, health information organizations and government agencies according to national standards. The goal is to be able to access and retrieve data more efficient, safer, and to improve the quality of care and patient safety and reduce healthcare costs. The Health Information Exchange has existed for over two decades. In the 1990s there were attempts to organize networks. It began in 2006 by Governor Sonny Perdue. The U.S. Department of Health & Human Services is responsible for setting the standards for national health information exchange. The Health information exchange was created so that health care providers could use it to improve health care. Health care professionals are able to access your information, such as in an emergency situation, this way they can make informed decisions about your emergency faster. Also, your files are stored safely just in case your area is hit by national disaster. There are several benefits of the system. It helps to assist patients from receiving prescription medications to which they may be allergic. The HIE helps reduce medical errors. Health care providers are able to give you the care you need and it won’t interact with your other treatments. Because health care providers can see what tests you have had and the results, they don’t always have to repeat them. When your health information is shared electronically, information about access to your record is stored electronically. This helps to know who accesses your information, when, what and why. This helps the medical staff to check your records faster. Having faster access to your records helps healthcare providers find the information needed to diagnose health problems earlier, which gives them a more complete picture of your overall health. This leaves less room for error, more time with the patient. Not only are there the good benefits of the HIE, but there are the risks that come with it. Let’s start one a well-known problem, Identity theft. More people are also able to break into records and steal information, for example hackers. There are more known errors to occur. If your health care  provider does not enter the correct information, the information remains in the health record until it is corrected. Then there are also the concerns of privacy issues. This is when HIPPA comes into effect. The Health Insurance Portability and Accountability Act of 1996 (HIPAA) regulates the privacy of health information exchange. The HIPPA reduces health care fraud and abuse. It protects the privacy of all individual’s health information. The HIE has privacy and security concerns. There is a privacy rule that all employees and health care providers should abide by. If you see a medical record in view where patients or others can see it, cover the file, or turn it over. When speaking about patients, try to prevent others from overhearing the conversation. Conversations about patients should be held in a private area. Do not discuss patients while you are in public areas. When medical records are not in use, they should be put away. Never remove the patient’s official medical record from your office. You should not leave records out where your family members or others may see it. If an y copies are made and not used they should be shredded. Privacy policies can be particularly hard for an HIE to deal with .There are efforts such as the government’s Connect project that provide guidelines for securing HIEs. Privacy laws vary from state to state giving complications for cross-state HIEs. The HITECH Act, part of the American Recovery and Reinvestment Act of 2009, has increased the penalties healthcare providers face if their systems are breached. There is a HIPAA privacy rule that provides federal floor of protection. One of the main challenges that HIE face is getting data to doctors and other clinicians. It is normally delivered directly to a providers’ EMR system, however with limited EMR use across the country, HIEs have had to provide alternative delivery methods. If an EMR isn’t compatible or if doctors don’t have systems, they can use a Web portal to see data. The problem with portals is that they force doctors to take an extra step to view data. Due to this doctors often end up using the HIE less as a result, and some provider groups decide the exchange isn’t worth the investment if their clinicians aren’t using it. With all the concerns about HIE, there are still more pros then cons. It benefits healthcare providers by reducing their operational costs. The system supports the retrieval of and access to clinical data. HIEs can improve payers’ ability to manage outcomes and reduce medical costs and increases accuracy of the information. www.himss.org/hieforums/ www.health.ny.gov/†¦health_information†¦/health_information_exch www.informationweek.com/healthcare/†¦/health-information-exchan www.myphr.com/healthliteracy/health_information_exchange.aspx www.himss.org/Asp/topics_News_item.asp?cid=67543&tid=33

Thursday, January 2, 2020

The Recounting Of Kristallnacht, By Susan Warsinger

propaganda to see individuals like this as lazy or as a problem to Aryan society, especially since they are depicted as rather frightening with their demands. This leads into stage number six, where social division becomes even more solidified. Stage number six is Polarization. According to Stanton, this is where â€Å"Extremists drive the groups apart. Hate groups broadcast polarizing propaganda. Laws may forbid intermarriage or social interaction. Extremist terrorism targets moderates, intimidating and silencing the center.† In this stage segregation can really be seen taking place. Signs such as â€Å"Jews not Welcome here† were placed in shop windows and outside businesses. Another clear example of this is the event of Kristallnacht,†¦show more content†¦And according to Susan, the Rabi’s family had the exact same impression, as they found them up there already when they arrived. The people that live on the third floor will shortly become relevant as Susan recalls their pacifism towards the onslaught of violence against her family, and other Jewish residents that were living in her same building. She continues, And our apartment was, not ransacked too badly, but a lot of our furniture was broken and a lot of things were missing. But it... you could still live in it. However the rabbi s apartment, when they people had rushed up there during my mother... the eve of my mother’s birthday, they burned all of his books. He had this beautiful library and they got torn and burned and his furniture was really destroyed. And the people who were on the third floor, they pretended they didn t know anything was happening. After the Night of the Broken Glass everybody in Germany wanted to leave. I mean I think maybe that was the objective of the Nazis, to try and get everybody out. This is a clear example of the growing pacifism of those who were not Jewish and how they chose to react, or not, to such acts. While it may come off as a cold shoulder, the important realization of this situation was fear. Those on the third floor, as many others did, pretended that nothing was awry during the ransacking of their Jewish neighbor’s apartments and homes. Propaganda, up to thisShow MoreRelatedTranslated Into English Means : The Poisonous Mushroom1893 Words   |  8 PagesIn this stage segregation can really be seen taking place. Signs such as â€Å"Jews not Welcome here† were placed in shop windows and outside businesses. Another clear example of this is the event of Kristallnacht, translated as â€Å"Night of Broken Glass.† In the recounting of Kristallnacht by Susan Warsinger, she tells her account of what happened to her and her family that night in November of 1938. In an interview conducted by the United States Holocaust Memorial Museum, she recounts, What s happening