Development of Diabetes Register

Development of Diabetes RegisterThe national DEMS aims to support diabetic health professionals in providing real-time information when and where it is required. Electronic medical records (EMRs) ar an essential means of enhancing patient swellbeing through inaccuracy reduction and to enhance clinical plow quality (Lester, Zai et al. 2008). EMRs have previously been effective in refining diabetes heed and enhancing organizing of care among multi disciplinary teams (Lester, Zai et al. 2008).Accomplishing interoperability between EHRs and registries allow for be progressively more vital as the utilisation of registries and EHRs develops considerably (Gliklich and Dreyner 2010).The typical viewpoint regarding establishing a diabetes file is by assembling electronic patient files held by GPs medical centres of diabetic patients (Morris, Boyle et al. 1997). Another alternative is to gather patient records electronically from multi sources to a central source in order to achieve a more comprehensive register (Morris, Boyle et al. 1997).When setting up a diabetes register it should be carried unwrap according to NICE guidelines which includePatients demo interpreticsadjustable risk factorsmedicine prescribedAttendance at practice or diabetes outpatient clinic (OKelly, Foy et al. 2008).The set of accessible data sources is the close important factor in determining the capabilities of disease surveillance system. The purposed Irish diabetes register pass on utilise information from PCRS and NCSS data sources. PCRS contains information regarding prescribed drugs and medicines typically taken by diabetics such as statins (cholesterol lowering medications) this information is gotten from the General Medical Services Scheme. T2D patients can be identified by their need to occasion oral diabetes prescriptions such as oral anti-hyperglcaemic which can be taken on their own or with insulin (OShea, Teeling et al. 2013). The scheme affords entitled persons access to free health care as well as prescription medication (OShea, Teeling et al. 2013). The PCRS gathers the information on dispensed prescribed medication a monthly basis from the scheme, these medications are coded using the WHO Anatomical Therapeutic Chemical (ATC) classification system (OShea, Teeling et al. 2013).As well as checking these data sources, hospital diabetic clinics might contain patients not already on the national register.Patients with medication treating T2D can be identified using the prescription of oral anti-hyperglycaemic agents alone or in combination with insulin as a proxy for disease diagnosis.Diabetes register aids the identification and tracking of clinical outcome (Lester, Zai et al. 2008). The registry can be kept up-to-date in an voluntary manner when run against laboratory results and GP practice EMR (Lester, Zai et al. 2008). The registry needs to up-to-date and not to contain stagnat data.Initially is it perceived that at that place will be two data sources NCCS and PCRS.Hospital diabetes clinics extracted to registerRegarding the laboratory system, patient whose records contained information regarding glycated haemogloblin, plasma glucose, urinary microalbumin and serum creatinine were considered to be diabetes as well as oral glucose tolerance test confirming the diagnosis of diabetes or outpatient plasma glucose concentration of greater than 11.1 mmol/l (Morris, Boyle et al. 1997). All laboratory results applicable to diabetes care are available electronically patients could be identified and included in the register.Registries typically gather information from various data sources, this is typically done by collecting information from various sources and linking the information across data sources, either with identifiers intended for linking or by recorded attributes of the patients to whom the information match up to (Gliklich and NA 2010). Most general method for record linkage typically depends on the presence of uniq ue identifiers (Gliklich and Dreyner 2010).Once verified that the information is correct, it will be indispensable to verify that the data can be uploaded correctly onto the Diabetes register.Look at hipe extract as an exampleGathering of data from an assortment of data sources capitalizes on the available data on each diabetic patient and ensures comprehensiveness.The National Cancer Screening programme/ schemes provide data on . Data includes demographics, account of, treatment. This data is stored electronically on NCCS database whish a password protected designed database.The hospital system has a record of patients registeredDuplicate patients records are avoided by the use of an report based on similar surnames, forenames and hospital numbers. Data of birth comparison.As data is collected from a number of sources it necessary to annihilate duplicate records. Currently there is no unique number assigned to individuals accessing health and social care in Ireland which would en able the accurate identification of individuals. thereof cases are cross-matched from the different data sources. A range of variables, including names, gender, county of residence, data of birth are used to match the data. dissertation Benefits realization information technology in a national surveillance system,Patient demographics downloadAll systems to remain in sync.A patient enters a hospital is registered on the PIMS and that information is because sent to laboratory system.Healthlink server , the vendor provides the code handles how the file gets sent from nimis software suiteThe laboratory system requires an interface to PAS system to enable demographics and clinical information for common patients to be shared between the two systems. HL7 interface facilitates the transfer of demographic information between the PAS and laboratory systems. Information from PAS is extracted and formatted using iSoft integrating Engine. The laboratory system will communicate with the Integ ration Engine using HL7 messaging over TCP/IP socketsPatient information is entered or limited in PAS. The resultant transaction is recorded in PAS audit service. The audit service is continually monitored by iSoft Integration Engine which is configured to look for germane(predicate) transactions. For each transaction, the associated information is extracted from PAS and formed into the appropriate HL7 message for immediate onward transmission to laboratory system. The laboratory interface continually listens for HL7 messages from PAS. When a message is received it is analysed to check its purpose and check that the information is correct. If the patient number referenced in the message is unknown to laboratory system then the patient will be registered otherwise the patient details will be updated based on the contents of the message.Systolic blood pressure sensationDiastolic blood pressureHbA1cCreatinineMicroalbuminPatients attending Hospital diabetes clinics,Graphically repres entation on the main screen.Health care professionals perceive that there is not enough time in the daylight to carry out their workload. There needs to be effort made to ensure quick data review and efficient action (Lester, Zai et al. 2008).A graph will be generated to display on screen to demonstrate changes in weight and blood pressure to emphasize the importance of the data. The report dish enables automatic printout of letters to GPs, episode details and annual review for filing in the patients case notes, referral letters to other specialities.AuditingAll transactions within the system will be audited. This means that transactions will be recorded with a snapshot of the data and the user performing the action. The system needs an audit function to facilitate audit.ValidationData entry validation are used to minimize the risk of errors duplication entries.PerformanceThe system will be apply on the National Health Network which will facilitate reliable and robust network on which the system to work on.

Definition of assessment

Definition of sagaciousnessAssessment is the fanny of the fond work process with service users (Walker and Beckett, 20036). wherefore is assessment a crucial aspect of the favorable work process and what reserves an effective friendly work assessment? What might be some of the barriers to an emotive assessment and how can the worker overcome these? In your answer, you go forth be judge to refer to relevant research regarding social work assessment.Social workers ar expected to carry unwrap an initial assessment of situations they encounter before taking action. These be important because they cater the foundation for any plans to support, protect, fence or provide aid for a guest. In a nutshell, an assessment is simply gathering learning close stack, their situation, factors deemed relative to that situation, and desegregation this into a dinner dress report, which give be used to t angiotensin converting enzyme of voice back on when carrying out a review. Thi s will non only provide a championful mien for the social worker to quickly reacquaint themselves when looking back on a family, plainly it will also totallyow separate(a) work staff to obtain a gist of the situation if they be coming into it for the first time.For an effective assessment it takes someone with an organised, rational and open minded knowledge base, using these to applause a number of unique skills they will hold, enabling them to come to grasps with the varied number of situations they will face and an ability to be sensitive to those involved.It is expected of social work graduates to understand all the legal documentations issued by work bodies (such as the Dep fraudment of Health), for these will include necessary guidelines on assessment and how and when to act. However, simply knowing these will not cut it, and those who are inexperienced will simply be able to regurgitate back what they exact learnt without knowing the true art of carrying out their work. An assessment is more than simply making notes on ones observations, for it includes the workers opinions, beliefs and ideas, which will be essential when carrying out interventions. They are not to be confused with evaluations, although they do contain evaluative sectors, for example determining a knobs considers. Unlike evaluations however, assessments are open to more probing and study, which shop them more effective tools for making a decision.For the social worker to be able to make their assessment successful, they will need to ensure they can fully appreciate a) all factors that affect the client and b) which of the clients needs are not be met. To do this they will need to establish the type of person their client is, for example how they communicate with others, how they react to stress, how they bunch with problems etc.It is important for the social worker to know which bits of information are relevant, and or else than find out everything they can (scatter gun method) they pick out those bits which will serve to benefactor them later. If they ask too many questions it will lead to general misinterpretations, frequently a common mistake in those just starting time social work coif.One must understand that views will be different, and that other work forces, agencies or even individuals will draw out their admit conclusions for a case. This makes it difficult to assume any kind of truth in an assessment, since what one sees depends on where one looks. (Jones 1983)Another problem assessors face is that in that respect is practically the case of clients scapegoating or stigmatising based on a ostracise assessment. Social workers are aware that they are held accountable for any action they make, and so if they make an delusion in the assessment that could prove costly to a families support, thusly they whitethorn be faced with court proceedings.In actuality, assessments are by no means a quick process. It is often the case that work staff are met with the stress of having to cope with busy offices, numerous phone calls and masses of theme work. Stress can affect workers in any number of ways, but the biggest concern is that it can lead to negligence such as making quick, wrong assessments because there is no time to meet the demands of the office.There is, however, a way of preventing these difficulties and that is to employ a method referred to as triangulation. This is make by drawing comparisons from other groups to find similarities between information gathered. In addition to this, it may prove helpful to discuss the assessment with clients themselves, for this will not only improve the truth of the assessment but will also create a sense of trust and warmth between client and worker.In spite of triangulation mistakes are however inevitable. Possibly the most common mistake would be to apply a one sided attitude towards community and/or situations. An example would be of a social worker looking at an argumentative couple seeing things only from either the controlling wife focalize of view, or the unfaithful husband point of view. For this reason it is essential for the social worker to bring in other colleagues so as to form a multidisciplinary assessment. Rather than relying on one mans opinion, by working as a team, members may gain further insight into the depute at hand and observations may be brought to the table that otherwise would hand over gone unnoticed. However, the use of multiple assessments is problematic in that the social worker will have to proceed with multiple theories. This may lead to conflicts and confusions over the train path to follow.Because of the time constraints on social work practice, alternative methods have been introduced to take outside(a) some of the pressures. Self assessments for example are often carried out when dealing with younger children. It is seen as a fun learning experience and will tell staff workers much about that c hild. Self assessments will tranquilize of numerous exercises, such as multiple choice questionnaires, rating scales, producing stories, drawings of themselves, and/or their families. Adults often prefer this method as it allows them to use their own words sooner than being misinterpreted.Another alternative is computer aided assessments. These have long been used in other fields such as medicine in order to make quick diagnoses. They are helpful in that they save time, and unlike humans do not forget or make errors. It is as simple as loading in all the variables, and allowing the computer to calculate the most likely outcome and therefore the best form of action. However, computers are unavailing to process social, emotional, or psychological factors and so can often fail to spot secern issues. The use of computers is therefore limited.Recently, there have been movements in practice theory, the most important of which is a larger emphasis on the influences of powerlessness, pre judicial views, discriminatory acts and oppression. In addition, workers are starting to develop a more constructionist way of thinking. This includes seeing beliefs and ideas not as relying on the influence of the environment around those who hold said beliefs and ideas, rather them being constructed by individual people whilst they discuss and respond to one anothers presence.It is this constructionist way of thinking where many theories on assessment begin. In the past 3 years it was found, through reviews from service users, that many were ungratified with the assessment process. One rising concern was that a large number of social workers were failing to conduct reassessments. It seems that they only look at certain information in order to confirm their theories and therefore neglect many important items. This is a critical point because assessments are the basis for all further work. An error here would be damaging for the whole investigation.Even when a reassessment is made, there until now remains the problem of prioritising key areas of importance. If this is done shoddily then there is risk of the assessment giving off misrepresentations when conducting an evaluation. To prevent this, there are three areas that it is suggested the social worker start by looking at. These are get off the grounding where the client is, focussing on meeting the clients needs legal considerations, which should be made known to the client and health or safety concerns, for if there are any risks to the client then they must be informed. (Hepworth and Dean 2006)Another important issue relates to the production of a culturally competent assessment. The social worker must therefore demonstrate knowledge of cultural norms, acculturation, and language exits, the ability to differentiate between individual and culturally linked attributes, the initiative to assay out needed information so that evaluations are not biased and services are culturally appropriate and an underst anding of the ways that cultural differences may reveal themselves in the assessment process. (Hepworth and Dean 2006)There are numerous differences between cultures when it comes to forms of, for example disciplining younger family members, selecting the most dominant group member, aiding those unable to manage for themselves, how to address one another, and many others. And because of these differences, the social worker must be wary when considering things such as what is seen as normal conduct in children with autism? What is seen as a healthy amount of sex in afro Caribbean tribe members? At what age is a child believed to reach maturity in China, Africa, Asia etc? The list is endless. Patterns of behaviour which may appear dysfunctional in one culture may be considered normal to another. It is important that social workers have knowledge of their clients background and if not then research it. For an error made may aggravate or offend them.It can be hard to define exactly what an assessment is, who it is mean for, and the reason it needs to be carried out. Pincus and Minaham (1973) therefore developed a model framework with the specific aim being to help social workers spy the reasons for their involvement, the expected goals and outcomes, which persons fit the role of agent and which fit the role of client, what needs to be maintained and what needs to be managed.Pincus and Minaham labelled three kinds of resource system which people will have contact with during their lives and four mapping systems which summarise what is occurring. The advantages of a systems approach are many. Firstly, it helps the social worker to understand a situation in such a way it gives clear definitions of those involved and how they are linked to one another. Secondly, aims and goals are clearly schematic early on, which helps them create a formal plan with their client and also helps both parties follow any progress made. Thirdly, it removes some of the burden of work of f of the social workers back, knowing that not everything depends on their selves. It also helps them to see which areas may take the most work, and which may be met with more conflict. This will help them plan their time and resources irrespectively, know when and where they should be, and how much of their maintenance is required at any time. By doing this, the social worker is less likely to exclude important responsibilities, or focus too much on only one aspect. Upon evaluation of the system, if for any reason another worker sees something they wish to add, remove or change, then this can be easily done with teensy time consumption. It is not unlikely that things may change at a later date, for example new clients may need to be added to the system, or new targets to be met. Peoples needs are not immutable and are always changing. The social worker must recognise this and be able to recognize any changes, and adjust so as to fit them into the system.There are also certain di sadvantages of a systems approach. Firstly, although it helps to maintain the flow of activities, it will not provide enough understanding of a persons life without the addition of other approaches. Alone, the model is too general, and does not include a great deal of information about the relevant difficulties being assessed. Secondly, despite all its hype about ordering data, the systems approach does not maintain that data should be collected to begin with. Furthermore, it fails to recognise the importance of existing beliefs about human behaviour, so is basically starting from scratch each time. Thirdly, the natural urge to focus primarily on the clients illness, with little attention being paid on their wellness can often lower their sprits and remove their hopes of ever finding a solution to their problem.As a social worker making an assessment, it helps to understand that, since external problems become internal, and the internal affects the external, looking at just the soci al aspects will prove inadequate, just as looking at just the psychological aspects is inadequate.(Milner and OByrne 1998) We need to look at both, and use various approaches to complement one another.Assessments need to draw in help from psychiatrists and psychologists, those skilled at exploring the unconscious. For it may be the case that the client has certain un contractd issues that may be of relevance. A problem workers face is that the id is like a cavern, in that it is made up of large numbers of interrelated passages. Some will affect others, while others will come to a dead end. And everything indoors that cavern is hidden away from the outside world and is immune to any happenings beyond its entrance. Applying a psychodynamic approach as it were is advantageous because it is able to explain away what appears to be irrational behaviour. As I explained, many of a persons difficulties may not be explicit and observable. Many individuals use defence mechanisms as a way of h iding their emotions. And so by combining aspects of psychology (cognitive, psychoanalytic, humanistic etc.) it will allow the worker to delve deep into their clients personality and learn more about their associations with the world around them.This approach has imposed a caring, considering, communicative attitude amongst assessment workers and gets them to gain more of an emphatic relationship with their clients. Rather than applying a tick box assessment and using the same set of questions for each person, the worker now has a set of guideline questions allowing them to go off on a tangent basing each new question on the previous answer.The psychodynamic approach does indeed contribute greatly to the advances in social work assessment however it has a number of issues of concern. First and foremost, the main interest is on the individual and so social factors are often neglected or disregarded. Secondly, perverted human behaviour or behaviour that does not fit with the norms of society is grounds for a referral. Homosexuality for example is put down to Oedipal conflicts, homosexuals are not treated as a typical male and this causes much oppression and discrimination. Furthermore, the guidelines for communication are based on a middle class tweed male. Although certain groups will see equal gain from this method of practice there are many from other cultures that will react differently. And so to make an effective assessment the social worker must be able to relate their skills across cultures.Thirdly, when dealing with children, psychoanalysis may prove ineffective or even destructive. For example in cases of child abuse the sexual wants of an adult are transferred into the childs want for their parents. The child becomes the culprit and the blame is put towards the mother for being neglectful.When it comes to the ideas of Freud, the population of workers is split, half of them opposing entirely and half of them supporting entirely. As with all other app roaches, the psychodynamic approach works best when in conjunction with others.An assessment which includes a descriptive evaluation of client behaviours will prove more effective than one without because the worker is then able to look at how those behaviours have come to be part of their clients being and why they continue to exist. Behavioural assessments see behaviours as being learned, and therefore can be unlearnt through training. altogether behaviours have an underlying cause the point of the assessment is to therefore find the route of the problem and find ways to negate its effects. There are often however misinterpretations. For example, what is a negative reinforcer? (strengthening a particular behaviour by removal of something undesirable). Punishment is not a negative reinforcer although it is associated with something undesirable. merely rather than extinguish the problematic behaviour, it is often the case that it causes resistance. And so the behaviour has become strengthened.The problem is that there are no clear definitions of positive and negative reinforcers, seeing as what is considered desirable or aversive will vary between people. What may be pain to one man may be seen as a challenge to another who will welcome it. To work around this social workers must ensure they work with their client to determine what they behold as basically good or bad. It is important the worker be consistent when making visits (reassessments), for example if they always turn up at a foster home when they get a call the child is misbehaving, yet they rarely turn up when the child is behaving reasonably they may inadvertently be making their misbehaviour more appealing.Many behaviours, be they positive or negative, helpful or hindering, are learned during the course of life and are influenced by our life experiences. Behaviourists believe that when conducting an assessment it is important for the worker to understand where problem behaviours have come from a nd what reasons there are for their manifestation. Once the underlying routes have been established the worker then helps the client to unlearn those behaviours and get back on track to healthy living. An effective assessment is therefore one that considers the ABCs the antecedents, behaviours and the consequences. Anything that causes the unwanted behaviour should be removed, whereas anything that promotes desired behaviours should be encouraged. The client should then learn to associate these positive behaviours with pleasant experiences this way they will want to repeat them. Assessments should look at a clients muniment thoroughly. It is easy to miss parts out, yet everything needs to be examined for even something seemingly irrelevant may hold the key to a persons problem. Of course it is unrealistic to look at absolutely every aspect of a persons life, especially the elderly who have an extremely long history to cover. And so it has been argued that behavioural approaches la ck validity and are unattainable.This aside the behavioural approach is still useful because it provides clear definitions of the aims, goals and the plans for intervention. Furthermore, the approach, more so than other approaches motivates the client to have a say in the overall structure of the assessment. Sheldon (1982) believes there is the advantage that it does not manipulate the data in any way so that the client can be placed in a particular category or theory. People are seen as individuals, individual factors are considered, and client perspectives are used to shape the approach.Task centred theory makes a good starting point for new workers because it is possibly the simplest approach. Assessments can at times be overcomplicated and so it may do workers good to sometimes go back to basics and look at the most obvious action to take. Actions should depend upon ones set rather than any policy one is obligated to follow. Previous experience should be used to improve practic e, even the negative ones. Difficulties are inevitable but they will only get worse if the worker continues to make the same mistakes again and again. When there is time pressure to get a job done, rather than crumble the worker should use the pressure as motivation to get things done efficiently. That way they will have to make fewer reassessments.The first task is to determine their clients needs (what it is they want). The next step is convincing the client to accept ones help, firstly recognising they have needs and secondly wanting to do something about it. Epstein (1988) calls this the Start up phase, as it gets the ball rolling so to speak. Next, the wants require their own assessment, to determine what should to be done to meet them, how long it will take and who should be involved. The assessment process is a time to give order to the persons needs, generally up to three of them. It would be helpful to consider not only what changes need to be made, but also what might get in the way of these and what further changes could be done to make the initial changes possible. It would also be helpful to find out how individual problems relate to one another, if at all. If they are then able to tackle the main problem, others may follow suit accordingly with little/no effort on the social workers account. A useful strategy for social workers is to get their clients to firstly write down their problems and secondly pose them a score ranging from no problem at all to highly serious. It is vital that needs are set out from the start and fully silent by both worker and client. Failure at this stage will lead to difficulties come the evaluation. When conducting an assessment on two or more people (such as two partners in a relationship) the worker would be advised to look toward the fatality Sheet for support (Masson and OByrne 1984). This gives detailed descriptions of different wants and can be used to help service users explain what they feel. So far, no app roach has come up with a solution to this problem, making the task centred approach unique. The Want Sheet can be administered to couples/groups and this way can be used to compare different ideas. Through this stage alone, it is possible for a group to resolve any issues without any need for an intervention scheme. This is most unlike other approaches, which see the social worker as an agent coming in to help the needy, an approach not unlike the medical model of mental health.It is important when assessing individuals, not to mistake the clients as abnormal people just because their behaviour may suggest so, or because they appear difficult or un-cooperative. Doel and Marsh (1992) call this shooting the reflective parrot for what they are doing is making false judgements based on observation, without getting down deep to the underlying issue.Before any interventions, it is important for any decisions to be met together, all other options have been considered, and the client is sat isfied with how things are being dealt with. Once a decision is reached, there is still time for one final review. This is a useful step because at this late stage, it is still possible to change ones mind nothing is yet set in stone. If no changes need be made, the review is still beneficial as it helps to make out any doubts or anxieties before progression.The task centred approach to assessment seems full proof. Reid (1978) commented that it holds particular value in situations whereby the service user is able to contribute to a moderate degree. It holds the advantage over other approaches because it considers not only the client, but their interactions with the outside world. They get a fair hearing, and communication between them and the social worker is mutual, leading towards a more accurate evaluation. There have been arguments that giving too much leeway can leave the worker vulnerable to misinformation. to a greater extent so with children, there are cases where the clien t is not responsible or trustworthy enough to be given a shared role in the assessment.In conclusion, there are numerous positives and negatives of any approach to assessment. Every worker will have a preference on how they will deal with a situation however it need be emphasised that no two situations are alike. And so workers must be able to think on their feet if they are to become competent social workers. Those who are open minded will reap the most success, for the key lies within managing all the different approaches, integrating them into a whole. lot should still be taken, for within the approaches lie numerous contradictions. There will always be a degree of uncertainty, but what makes the difference between good and average work, is the confidence to give an opinion, whilst at the same time welcoming the views of others. In conclusion, why is the assessment process vital? Because it forms the foundation for understanding ones client, and gets the ball rolling when planni ng actions for change. It forms a record which can be referred to when evaluating said changes, and can also be used as present in court. What makes an effective assessment? One which investigates all relevant factors rather than stick to anything specific, which matches with individuals aims and goals, which is centred on the tasks at hand, which draws from multidisciplinary agencies, which forms a partnership between agent and client, and which is anti oppressive or discriminatory. What barriers do workers face? They can be time consuming, workers are under pressure to get through their work load and may be unable to spend time getting to know their client, groups who are often the target of oppression may seem uncooperative and resistant to change, and all assessments are in some part vulnerable to bias.How can these be overcome? It is imperative that when conducting an assessment one shares thoughts and ideas with not only other workers, other agencies and welfare authorities, but also with the client themselves, thus spreading out the work load, and reducing the likelihood of any errors going unnoticed. Furthermore it helps to be egotism aware. This way one picks up on any fool hardy assumptions they may be making. One should not be afraid to challenge high authorities and understand that personal values and the law will often conflict. And finally, every assessment should be instigated with care and precision, frequently asking why one has come to that conclusion and what other alternatives are there.ReferencesAhmad, A. Practice with Care, capital of the United Kingdom, Race Equality Unit/National Institute for Social Work, 1990Challis, D., Chessum. R., and Chesterman, J., Luckett, R. and Traske, K. Case Managementin Social and Health Care , Cantebury, Personal Social Services Research Unit, 1990.Department of Health. Protecting Children A Guide for Social Workers Undertaking a Comprehensive Assessment, capital of the United Kingdom, HSMO, 1988.Doel, M. and Marsh, P. Task Centred Social Work. London Ashgate, 1992.Epstein, L. Helping People The Task Centred Approach. Olumbus, OH Merrill, 1988Forder, A. Concepts in Social Administration a Framework for Analysis, London Routledge Kegan Paul, 1974.Hepworth and Dean, H. Direct Social Work Practice Theory and Skills, p. 179-205, London Thomson/Brooks Cole, 2006Jones, C. State Social Work and the Working Class, London , Macmillan, 1983Masson, H and OByrne, P. The Family Systems Approach A Help or a Hindrance, in Violence Against Children paper Group. Taking Child Abuse Seriously. London Unwin Hyman, 1990.Milner, J., OByrne, P. Assessment in Social Work Chap 7 Psychodynamic Approaches, Macmillan Press LTD, 1998Pincus, A. and Minahan, A. Social Work Practice exemplification and Method. Itasca, Il Peacock, 1973.Reid, W. J. The Task Centred System. New York Columbia University Press, 1978.Sheldon, B. Behaviour Modification, Theory, Practice and Philosophy. London Tavistock, 1982.Thobur n, J. Child Placement Principles and Practice, Aldershot, Wildwood House, 1988

Chemical Warfare :: essays research papers

Chemical warf arWhat is Chemical WarfareTo understand chemic warfare you must for the first time understand what a chemic agent is. A United Nations report from 1969 defines chemical warfare agents as " ... chemical substances, whether gaseous, liquidity or solid, which might be employed because of their direct toxicant loads on man, animals and plants ... ". This means basically that any chemical that is used to directly effect and harm a person, plant, or animal would be an act of chemical warfare.Some commonly confused Chemical AgentsAgents such as napalm and phosphorus are not considered to be Chemical agents since they achieve their effect primary(prenominal)ly through thermal energy. Certain types of smoke screen may be poisonous in extremely high concentrations but smoke ammunition is not classified as a chemical weapon since the poisonous effect is not the main reason for their use. Another common misconception is that biological agents such as viruses or micro organisms (small pox etc.) are considered a chemical agent, but this is not the case. Effects of chemical agents and biological agents may be similar but they different in production. Chemical agents are created and biological agents are found naturally in disposition or cultured for use.Different types of Chemical agents organization Agents Source A FOA Briefing Book on Chemical Weapons Nerve agents acquired their name because they affect the transmittal of nerve impulses in the nervous system. They are stable, easily spread, highly toxic and have rapid effects when absorbed through the skin and respiratory track. Nerve agents can be manufactured by means of fairly simple chemical techniques. The materials are inexpensive and generally readily available. It was not until the early 1930s that German chemists discovered the effects of certain phosphorus compounds to be toxic. Two years later a phosphorus compound with extremely high toxicity was produced for the first time. This ph osphorus compound, given the name tabun, was one the first substances later referred to as nerve agents.Physical and chemical properties The most important nerve agents included in modern arsenals are h Tabun, O-ethyl dimethylamidophosphorylcyanide, This nerve agent is the easiest to manufacture. Therefore, it is more likely that developing countries start their arsenal with this nerve agent h Sarin, isopropyl methylphosphonofluoridate, a toxic substance mainly afflicting the respiratory system. h Soman, pinacolyl methylphosphonofluoridate, a moderately toxic substance which can be taken up by ambition or skin contact. h Cyclohexyl methylphosphonofluoridate, a gas or Liquid substance with low volatility which is taken up through skin contact and inhalation of the substance

Morality in Hawthornes The Scarlet Letter Essay -- Scarlet Letter ess

Morality in The Scarlet Letter ...pain is in itself an diabolical and indeed, without exception, the only evil or else the words good and evil have no meaning. (Chase 127) In the novel The Scarlet Letter, Nathaniel Hawthorne presents a very clear stare of his stand on morality, which he carefully cultivates through the course of the story. The moral, which is Be neat applies equally well to all of the characters in the novel. Though his view does come out to stand as true through the length of the story, it does not, unfortunately, transfer as smoothly to our lives today. In essence it is a hedonistic view to take, which requires a slight stretch as to his interpretation as to how evil, and important, an individuals pain is unto itself. By looking at each of the main characters in turn, it whitethorn be determined precisely what his view was on this subject, and how it may be applied to life in our society today. Because his moral is more explicitly defined as Be true Be tr ue Be true Show freely to the world, if not your worst, some trait by which your worst may be inferred Hester Prynne is a weighed down example, for she did exactly that. She could not, and did not, hide her sin, and as a result wore it clearly at all times on her breast, hiding nothing. While at first it may seem as though she was punished more than any other character, because she was so physically punished, Hawthorne makes it clear that she was the most satisfied character in the novel, in the end finding peace with herself because she had no pressing secrets to gnaw at her conscience. Physically, however, the Puritan imposition of punishment was harsh, and unyielding. It brought her below many of the men and women of the town, and had the psychologic... .... 47-49). San Diego Greenhaven. Canby, Henry S. (1996). A skeptic Incompatible with His Time and His Past. Readings on Nathaniel Hawthorne (pp. 55- 63). San Diego Greenhaven. Chase, Richard (1996). The Ambiguity of the Scarlet Letter. Readings on Nathaniel Hawthorne (pp. 145-152). San Diego Greenhaven. Gartner, Matthew. The Scarlet Letter and the Book of Esther Scriptural Letter and Narrative Life. Studies in American fiction (1995) 131-144. Hawthorne, Nathaniel. The Scarlet Letter. New York St. Martins, 1991. Loring, G. B. (1850). The Scarlet Letter and Transcendentalism. Massachusetts Quarterly Review On-line, pp. 1-6. Available http//eldred.ne.mediaone.net/nh/loring.html Scharnhorst, Gary. The Critical Response to Nathaniel Hawthornes The Scarlet Letter. New York Greenwood, 1992.

For Whom The Bell Tolls Essay -- Literary Analysis, Ernest Hemingway

The novel For Whom the Bell Tolls, written by Ernest Hemingway, is a story of passionate love throughout the brutality of the Spanish Civil War. Hemingway uses his in-person experiences to portray the true meaning and feeling of this book. Ernest Miller Hemingway was born on July 21, 1899 in Oak Park, a suburb of Chicago, Illinois. The neighborhood he grew up in was straight-laced and rigidly Protestant. Hemingway started his literary career publishing his work in his school magazine. Later on in life-time, he signed up to unify the military in World War II, but was rejected due to his defective left eye from birth. Instead, he enlisted in the Missouri National arrest and remained on the lookout for opportunities to progress to the front. In 1918, he sailed to Europe to become an ambulance driver in Northern Italy. There, Hemingway was dangerously injured and while in the infirmary fell in love with his nurse, Agnes Hannah Von Kurowsky. She was the model that Hemingway used as Catherine Barkley in A Farewell To Arms. In 1919, he returned to Oak Park and earned a medal for his valor in Italy. He and his wife had their first son, John, in October 1923. Three years later, in 1926, Hemingway published his first novel, The Sun Also Rises. Sadly, on December 6, 1928, he learned that his father had committed suicide. Years later, during his divorce with his second wife, he wrote For Whom the Bell Tolls and it was published in October of 1940. The next month, Hemingway married his trio wife, Martha Gellhorn. In 1944, he traveled to London and not only fell in love with Mary Welsh, but was involved in a serious car accident and was thought to be dead. In 1945, his third marriage failed and later that year was in yet another severe c... ... brutality of the Spanish Civil War. Hemingways simplistic language style, war imagery, mountainous setting, and theme of a heroic protagonist all contribute to his personal experiences in life and at war. Muc h of his style resembles the personal experiences he had in life with family, love, and war. The imagery that is applied in this piece of literature mirrors what Hemingway had seen and imagined during his service in Italy and his experiences during the relationships which he partook. The setting represents the area in which Hemingway had seen and envisioned Spain. The various themes of this story describe Hemingways political views on war and outlook on the morals of life. In conclusion, the qualities that Ernest Hemingway possesses in his writing skills are truly remarkable and they are evidently depicted in this amazing piece of classic literature.

In this Strage Labyrinth :: Literary Analysis, Wroth

In her poem, In this strange labyrinth, Wroth compares f aloneing in love to a puzzling tangle in which there are two ways out, to run from the perplexing adventure or to give in and be captivated by the vivid passion. She does non play it off as an easy feat, except instead shows the true struggles of a woman weighing her options between an easy decision and the hard, decent one. She clearly shows her confusion and struggle to accept that she cannot flee from the love her suitor offers.The author sets the scene by alluding to King Minos maze. The speaker does not get laid whether to seek out the Minotaur, or her love, or to run from it, even though she realizes she must face the beast at some point. The opening line sets the intent for the first half confused and uncertain. She sees all these different paths in this cold, dark, empty setting that she could take, but doesnt know which to follow. The word strange here does not make it seem like she is scared of the feeling, but it is baffling her (1). Because the poem was written in the early 1600s, it is understandable that she doesnt know what to think because it was noble-minded that one was gifted with truly falling in love. The meter starts in iambic pentameter but fluctuates throughout the sonnet to show the deep vacillation the parting is experiencing. The second line shows the first irregular meter. While the way I miss is anapestic and spoken rapidly, accurately allowing a peek into the personas head and seeing her anxiety about the choice she must make. Now she is at a fork in the maze. If she continues on she would accept the love for all its good and bad, but to turn around would be to run away. To the right is her suitor, whom she must face headlong and receive the love he offers. She thinks this love result burn her, or mark her (3). The speaker knows that you cannot come out of an experience with love without some change or alteration to the emotion of a person, but she is unsure if this is the safe path for her heart and emotions. If she goes forward, she would be to rush headlong into the inferno, where the danger is (4). Danger here not only means she will light upon her heart to potential harm, but she will also be at the mercy of her lover and his wishes.

A Habit of Being Great: Learning From Flannery O?Connor :: essays research papers fc

There she stands, to me, a phoenix risen from her own words calm, slow, funny, courteous, both modest and truly sure of herself, intense, sharply penetrating, devout but never pietistic, downright, occasionally fierce, and honest in a way that restore to honor to the word, this is how Sally Fitzgerald expound her dear friend bloody shame Flannery OConnor. (xii) Not to long ago, I read my first Mary Flannery OConnor story and I came to view Mary Flannery OConnor as an artist whose key subject was grace, but what are these stories, these works of art truly about, what is Flannery O Connor trying to tell the readers. In effectuate to interpret a story though the eyes of an author like Flannery OConnor you must first look through the eyes of the author. You must ensure what he/she sees. It would be unequivocal to believe that a person can truly understand another by studying them, but I stimulate learned a great deal in trying to do so. Mary Flannery OConnor wrote about grace and salvation, and has taught me about finding truth I attribute the lessons she has taught me to, the way she viewed herself, the way others viewed her, her writings, and many other effects. Mary Flannery OConnor was confident, modest, and honest. She often criticized herself. She once referred to herself as prematurely arrogant in a letter to her friend, Paul Engle. (Fitzgerald 14) Flannery described herself as a pigeon-toed only child with a receding chin and a you-leave-me-alone-or-Ill-bite-you complex.(Wikipedia) Even with all of her self-critizism, she was self-confident. She was quite arrogant and lead her to write what I believe is her greatest work, The Artifical Nigger. What she often described as proably the best thing she would ever write , The Artifical Nigger a story that she contains more than she herself ever understood.(Fitzgerald xviii) She was witty and quick to tell you exactly what she thought. In OConnors letters she never lied not stock-still to spare the feeling s of those she was in correspondence with. She lived a seemly boring life, but was always lively and sharp until the day she died. Many people love her and she adored them as well,but the person who knew OConnor best would have to be Sally Fitzgerald. It is though her eyes that I see who the true Mary Flannery OConnor was. It is snuff it that even though OConnor lived a sheltered life she still was a people.