Moduation Techniques | An Overview

Moduation Techniques | An Overview The evolution of wireless cellular technology from 1G to 4G has a similar aim that is capable to deliver high data rate signal so that it can transmit high bit rate multimedia content in cellular mobile communication. Thus, it has driven many researches into the application of higher order modulations. One of the focuses of this project is to study and compare the different types of Digital Modulation technique that widely being used in the LTE systems. Hence, before being able to design and evaluate this in computer simulation. A study is carried out on digital modulation and drilled down further on QPSK modulation schemes, and followed by the QAM modulation schemes. What is modulation? There are several definitions on modulation taken from several references as follows: Modulation is defined as the process by which a carrier wave is able to carry the message or digital signal (series of ones and zeroes). Modulation is the process of facilitating the transfer of information over a medium. Voice cannot be sent very far by screaming. To extend the range of sound, we need to transmit it through a medium other than air, such as a phone line or radio. The process of converting information (voice in this case) so that it can be successfully sent through a medium (wire or radio waves) is called modulation. Modulation is the process of varying a carrier signal, typically a sinusoidal signal, in order to use that signal to convey information. One of the three key characteristics of a signal is usually modulated: its phase, frequency or amplitude. There are 2 types of modulations: Analog modulation and digital modulation. In analog modulation, an information-bearing analog waveform is impressed on the carrier signal for transmission whereas in digital modulation, an information-bearing discrete-time symbol sequence (digital signal) is converted or impressed onto a continuous-time carrier waveform for transmission. 2G wireless systems are realized using digital modulation schemes. Why Digital Modulation? The move to digital modulation provides more information capacity, compatibility with digital data services, higher data security, better quality communications, and quicker system availability. Developers of communications systems face these constraints: available bandwidth permissible power inherent noise level of the system The RF spectrum must be shared, yet every day there are more users for that spectrum as demand for communications services increases. Digital modulation schemes have greater capacity to convey large amounts of information than analog modulation schemes. Different types of Digital Modulation As mentioned in the previous chapter, there are three major classes of digital modulation techniques used for transmission of digitally represented data: Amplitude Shift Keying (ASK) Frequency Shift Keying (FSK) Phase Shift Keying (PSK) All convey data by changing some aspect of a base signal, the carrier wave (usually a sinusoid) in response to a data signal. For ASK, FSK, and PSK the amplitude, frequency and phase are changed respectively. Bit rate and symbol rate To understand and compare different PSK and QAM modulation format efficiencies, it is important to first understand the difference between bit rate and symbol rate. The signal bandwidth for the communications channel needed depends on the symbol rate, not on the bit rate. Bit rate is the frequency of a system bit stream. Take, for example, a radio with an 8 bit sampler, sampling at 10 kHz for voice. The bit rate, the basic bit stream rate in the radio, would be eight bits multiplied by 10K samples per second or 80 Kbits per second. (For the moment we will ignore the extra bits required for synchronization, error correction, etc.). A Quadrature Phase Shift Keying (QPSK) signal. The states can be mapped to zeros and ones. This is a common mapping, but it is not the only one. Any mapping can be used. The symbol rate is the bit rate divided by the number of bits that can be transmitted with each symbol. If one bit is transmitted per symbol, as with BPSK, then the symbol rate would be the same as the bit rate of 80 Kbits per second. If two bits are transmitted per symbol, as in QPSK, then the symbol rate would be half of the bit rate or 40 Kbits per second. Symbol rate is sometimes called baud rate. Note that baud rate is not the same as bit rate. These terms are often confused. If more bits can be sent with each symbol, then the same amount of data can be sent in a narrower spectrum. This is why modulation formats that are more complex and use a higher number of states can send the same information over a narrower piece of the RF spectrum. Phase Shift Keying (PSK) PSK is a modulation scheme that conveys data by changing, or modulating, the phase of a reference signal (i.e. the phase of the carrier wave is changed to represent the data signal). A finite number of phases are used to represent digital data. Each of these phases is assigned a unique pattern of binary bits; usually each phase encodes an equal number of bits. Each pattern of bits forms the symbol that is represented by the particular phase. There are two fundamental ways of utilizing the phase of a signal in this way: By viewing the phase itself as conveying the information, in which case the demodulator must have a reference signal to compare the received signals phase against; (PSK) or By viewing the change in the phase as conveying information differential schemes, some of which do not need a reference carrier (to a certain extent) (DPSK). A convenient way to represent PSK schemes is on a constellation diagram. This shows the points in the Argand plane where, in this context, the real and imaginary axes are termed the in-phase and quadrature axes respectively due to their 90 ° separation. Such a representation on perpendicular axes lends itself to straightforward implementation. The amplitude of each point along the in-phase axis is used to modulate a cosine (or sine) wave and the amplitude along the quadrature axis to modulate a sine (or cosine) wave. In PSK, the constellation points chosen are usually positioned with uniform angular spacing around a circle. This gives maximum phase-separation between adjacent points and thus the best immunity to corruption. They are positioned on a circle so that they can all be transmitted with the same energy. In this way, the moduli of the complex numbers they represent will be the same and thus so will the amplitudes needed for the cosine and sine waves. Two common examples are binary phase-shift keying (BPSK) which uses two phases, and quadrature phase-shift keying (QPSK) which uses four phases, although any number of phases may be used. Since the data to be conveyed are usually binary, the PSK scheme is usually designed with the number of constellation points being a power of 2. Applications of PSK and QAM Owing to PSKs simplicity, particularly when compared with its competitor quadrature amplitude modulation (QAM), it is widely used in existing technologies. The most popular wireless LAN standard, IEEE 802.11b, uses a variety of different PSKs depending on the data-rate required. At the basic-rate of 1 Mbit/s, it uses DBPSK. To provide the extended-rate of 2 Mbit/s, DQPSK is used. In reaching 5.5 Mbit/s and the full-rate of 11 Mbit/s, QPSK is employed, but has to be coupled with complementary code keying. The higher-speed wireless LAN standard, IEEE 802.11g has eight data rates: 6, 9, 12, 18, 24, 36, 48 and 54 Mbit/s. The 6 and 9 Mbit/s modes use BPSK. The 12 and 18 Mbit/s modes use QPSK. The fastest four modes use forms of quadrature amplitude modulation. The recently-standardised Bluetooth will use p / 4-DQPSK at its lower rate (2 Mbit/s) and 8-DPSK at its higher rate (3 Mbit/s) when the link between the two devices is sufficiently robust. Bluetooth 1 modulates with Gaussian minimum shift keying, a binary scheme, so either modulation choice in version 2 will yield a higher data-rate. A similar technology, ZigBee (also known as IEEE 802.15.4) also relies on PSK. ZigBee operates in two frequency bands: 868-915MHz where it employs BPSK and at 2.4GHz where it uses OQPSK. Notably absent from these various schemes is 8-PSK. This is because its error-rate performance is close to that of 16-QAM it is only about 0.5dB better but its data rate is only three-quarters that of 16-QAM. Thus 8-PSK is often omitted from standards and, as seen above, schemes tend to jump from QPSK to 16-QAM (8-QAM is possible but difficult to implement). QPSK QPSK is a multilevel modulation techniques, it uses 2 bits per symbol to represent each phase. Compared to BPSK, it is more spectrally efficient but requires more complex receiver. Constellation Diagram for QPSK The constellation diagram for QPSK with Gray coding. Each adjacent symbol only differs by one bit. Sometimes known as quaternary or quadriphase PSK or 4-PSK, QPSK uses four points on the constellation diagram, equispaced around a circle. With four phases, QPSK can encode two bits per symbol, shown in the diagram with Gray coding to minimize the BER twice the rate of BPSK. Figure 2.5 depicts the 4 symbols used to represent the four phases in QPSK. Analysis shows that this may be used either to double the data rate compared to a BPSK system while maintaining the bandwidth of the signal or to maintain the data-rate of BPSK but halve the bandwidth needed. Four symbols that represents the four phases in QPSK Although QPSK can be viewed as a quaternary modulation, it is easier to see it as two independently modulated quadrature carriers. With this interpretation, the even (or odd) bits are used to modulate the in-phase component of the carrier, while the odd (or even) bits are used to modulate the quadrature-phase component of the carrier. BPSK is used on both carriers and they can be independently demodulated. As a result, the probability of bit-error for QPSK is the same as for BPSK: However, with two bits per symbol, the symbol error rate is increased: If the signal-to-noise ratio is high (as is necessary for practical QPSK systems) the probability of symbol error may be approximated: As with BPSK, there are phase ambiguity problems at the receiver and differentially encoded QPSK is more normally used in practice. As written above, QPSK, are often used in preference to BPSK when improved spectral efficiency is required. QPSK utilizes four constellation points, each representing two bits of data. Again as with BPSK the use of trajectory shaping (raised cosine, root raised cosine etc) will yield an improved spectral efficiency, although one of the principle disadvantages of QPSK, as with BPSK, is the potential to cross the origin, that will generate 100% AM. QPSK is also known as a method for transmitting digital information across an analog channel. Data bits are grouped into pairs, and each pair is represented by a particular waveform, called a symbol, to be sent across the channel after modulating the carrier. QPSK is also the most commonly used modulation scheme for wireless and cellular systems. Its because it does not suffer from BER degradation while the bandwidth efficiency is increased. The QPSK signals are mathematically defined as: Implementation of QPSK QPSK signal can be implemented by using the equation stated below. The symbols in the constellation diagram in terms of the sine and cosine waves used to transmit them is being written below: This yields the four phases p/4, 3p/4, 5p/4 and 7p/4 as needed. As a result, a two-dimensional signal space with unit basis functions The first basis function is used as the in-phase component of the signal and the second as the quadrature component of the signal. Therefore, the signal constellation consists of the signal-space 4 points The factors of 1/2 show that the total power is divide evenly among the two carriers. QPSK systems can be implemented in a few ways. First, the dual data stream is divided into the in-phase and quadrature-phase components. These are then independently modulated onto two orthogonal basis functions. In this implementation, two sinusoids are used. Next, the two signals are superimposed, and the resulting signal is the QPSK signal. Polar non-return-to-zero encoding is also being used. These encoders can be located before for binary data source, but have been located after to illustrate the theoretical dissimilarity between digital and analog signals concerned with digital modulation. The matched filters can be substituted with correlators. Each detection device uses a reference threshold value to conclude whether a 1 or 0 is detected. Quadrature Amplitude Modulation (QAM) Quadrature amplitude modulation (QAM) is both an analog and a digital modulation scheme. It is a modulation scheme in which two sinusoidal carriers, one exactly 90degrees out of phase with respect to the other, which are used to transmit data over a given physical channel. Because the orthogonal carriers occupy the same frequency band and differ by a 90degree phase shift, each can be modulated independently, transmitted over the same frequency band, and separated by demodulation at the receiver. For a given available bandwidth, QAM enables data transmission at twice the rate of standard pulse amplitude modulation (PAM) without any degradation in the bit error rate (BER). QAM and its derivatives are used in both mobile radio and satellite communication systems. The modulated waves are summed, and the resulting waveform is a combination of both phase-shift keying (PSK) and amplitude-shift keying, or in the analog case of phase modulation (PM) and amplitude modulation. In the digital QAM case, a finite number of at least two phases and at least two amplitudes are used. PSK modulators are often designed using the QAM principle, but are not considered as QAM since the amplitude of the modulated carrier signal is constant. In 16 QAM 4 different phases and 4 different amplitudes are used for a total of 16 different symbols. This means such a coding is able to transmit 4bit per second. 64-QAM yields 64 possible signal combinations, with each symbol representing six bits (2^6 = 64). The yield of this complex modulation scheme is that the transmission rate is six times the signaling rate. This modulation format produces a more spectrally efficient transmission. It is more efficient than BPSK, QPSK or 8PSK while QPSK is the same as 4QAM. Another variation is 32QAM. In this case there are six I values and six Q values resulting in a total of 36 possible states (66=36). This is too many states for a power of two (the closest power of two is 32). So the four corner symbol states, which take the most power to transmit, are omitted. This reduces the amount of peak power the transmitter has to generate. Since 25 = 32, there are five bits per symbol and the symbol rate is one fifth of the bit rate. The current practical limits are approximately 256QAM, though work is underway to extend the limits to 512 or 1024 QAM. A 256QAM system uses 16 I-values and 16 Q-values giving 256 possible states. Since 2^8 = 256, each symbol can represent eight bits. A 256QAM signal that can send eight bits per symbol is very spectrally efficient. However, there is some drawbacks, the symbols are very close together and are thus more subject to errors due to noise and distortion. Such a signal may have to be transmitted with extra power (to effectively spread the symbols out more) and this reduces power efficiency as compared to simpler schemes. BPSK uses 80 K symbols-per-second sending 1 bit per symbol. A system using 256QAM sends eight bits per symbol so the symbol rate would be 10 K symbols per second. A 256QAM system enables the same amount of information to be sent as BPSK using only one eighth of the bandwidth. It is eight times more bandwidth efficient. However, there is a drawback too. The radio becomes more complex and is more susceptible to errors caused by noise and distortion. Error rates of higher-order QAM systems such as this degrade more rapidly than QPSK as noise or interference is introduced. A measure of this degradation would be a higher Bit Error Rate (BER). In any digital modulation system, if the input signal is distorted or severely attenuated the receiver will eventually lose symbol clock completely. If the receiver can no longer recover the symbol clock, it cannot demodulate the signal or recover any information. With less degradation, the symbol clock can be recovered, but it is noisy, and the symbol locations themselves are noisy. In some cases, a symbol will fall far enough away from its intended position that it will cross over to an adjacent position. The I and Q level detectors used in the demodulator would misinterpret such a symbol as being in the wrong location, causing bit errors. In the case of QPSK, it is not as efficient, but the states are much farther apart and the system can tolerate a lot more noise before suffering symbol errors. QPSK has no intermediate states between the four corner-symbol locations so there is less opportunity for the demodulator to misinterpret symbols. As a result, QPSK requires less transmitt er power than QAM to achieve the same bit error rate. Implementation of QAM First, the incoming bits are encoded into complex valued symbols. Then, the sequence of symbols is mapped into a complex baseband waveform. For implementation purposes, each complex multiplication above corresponds to 4 real multiplications. Besides, and will be the real and imaginary parts of = + iand assume that the symbols are generated as real and imaginary parts (as opposed to magnitude and phase, for example). After being derived, we will get and. From (1), x (t) becomes. This can be understand as two parallel PAM systems, followed by double-sideband modulation by quadrature carriers and. This realization of QAM is called double-sideband quadrature-carrier (DSB-QC) modulation. A QAM receiver must first demodulate the received waveform y(t). Assuming the scaling and receiver time reference discussed before, this received waveform is assumed to be simply y(t) = x(t) + n(t). Here, it is being understood that there is no noise, so that y(t) is simply the transmitted waveform x(t). The first task of the receiver is to demodulate x(t) back to baseband. This is done by multiplying the received waveform by both and. The two resulting waveforms are each filtered by a filter with impulse response q(t) and then sampled at T spaced intervals. The multiplication by at the receiver moves the positive frequency part of x(t) both up and down in frequency by, and does the same with the negative frequency part. It is assumed throughout that both the transmit pulse p(t) and the receive pulse q(t) are in fact baseband waveforms relative to the carrier frequency (specifically, that and for). Thus the result of multiplying the modulated waveform x(t) by yields a response at baseband and also yields responses around and. The receive filter q(t) then eliminates the double frequency terms. The effect of the multiplication can be seen by both at transmitter and receiver from the following trigonometric identity: Thus the receive filter q(t) in the upper (cosine) part of the demodulator filters the real part of the original baseband waveform, resulting in the output Assuming that the cascade g(t) of the filters p(t) and q(t) is ideal Nyquist, the sampled output retrieves the real part of the original symbols without intersymbol interference. The filter q(t) also rejects the double frequency terms. The multiplication by similarly moves the received waveform to a baseband component plus double carrier frequency terms. The effect of multiplying by at both transmitter and receiver is given by Again, (assuming that p(t) * q(t) is ideal Nyquist) the filter q(t) in the lower (sine) part of the receiver retrieves the imaginary components of the original symbols without intersymbol interference. Finally, from the identity, there is no crosstalk at baseband between the real and imaginary parts of the original symbols. It is important to go through the above argument to realize that the earlier approach of multiplying u(t) by for modulation and then by for demodulation is just a notationally more convenient way of doing the same thing. Working with sines and cosines is much more concrete, but is messier and makes it harder to see the whole picture. Modulation and transmission of QAM In general, the modulated signal can be represented by Where the carrier cos(wct) is said to be amplitude modulated if its amplitude is adjusted in accordance with the modulating signal, and is said to be phase modulated if (t) is varied in accordance with the modulating signal. In QAM the amplitude of the baseband modulating signal is determined by a(t) and the phase by (t). The in phase component I is then given by This signal is then corrupted by the channel. In this case is the AWGN channel. The received signal is then given by Where n(t) represents the AWGN, which has both the in phase and the quadrature component. It is this received signal which will be attempted to demodulate. Reference Fundamentals of Communication SystemsDescription: http://i.cmpnet.com/dspdesignline/2008/07/image046.gif, by John G. Proakis, Masoud Salehi Description: http://i.cmpnet.com/dspdesignline/2008/07/image046.gif Cross-layer resource allocation in wireless communications: techniques and Models from PHY and MAC Layer Interactionby Ana I. Pà ©rez-Niera, Marc Realp Campalans Digital Communication: Third Edition, by John R. Barry, Edward A. Lee, David G. Messerschmit OFDM for wireless multimedia communications by Richard Van Nee, Ramjee Prasad Modern Quadrature Amplitude Modulation by W.T Webb and L.Hanzo Digital Signal Processing in Communication Systems by Marvin E.Frerking COPD: a Clinical Case Study COPD: a Clinical Case Study Jerry Corners Introduction Chronic Obstructive Pulmonary Disease (COPD) is the fifth leading cause of morbidity and mortality in the UK and fourth in the world (Hurd 2000; Soriano 2000). Though other causes exist, like genetics and environmental pollution, tobacco smoke is by far the leading etiology of this disease (Pride 2002). It may seem axiomatic that if cigarette smoking is the cause of COPD, cessation (or avoidance) of smoking is the prevention. However, despite extensive public education, smoking is still common among men and women in the UK and even when people do quit, relapse within the first year is common (Lancaster et al. 2006). Therefore our attention as caregivers needs to be focused upon methods of cessation that produce lasting results. To illustrate the diagnosis, management, both short- and long-term, and what Mike can expect from treatment as reflected in the medical literature, we present the following case. Pathophysiology of COPD COPD is a chronic disease in which decreased airflow is related to airway smooth muscle hypereactivity due to an abnormal inflammatory reaction. Inhalation of tobacco products causes airway remodeling, resulting ultimately in emphysema and chronic bronchitis (Srivastava, Dastidar, Ray 2007). COPD is a complex inflammatory disease that affects both lung airways and lung parenchyma. The modern focus of the pathophysiology of COPD is centered around this inflammation and it is now recognized that systemic inflammation is responsible for many of the extrapulmonary effects of cigarette smoke inhalation (Heaney, Lindsay, McGarvey 2007). The Clinical Case Study Diagnosis Mike is a 54 year old, self-employed grandfather who smokes 40 cigarettes daily. He was recently diagnosed with COPD based on an FEV1 of 66% of predicted (Halpin 2004). According to Halpin (2004), â€Å"There are still no validated severity assessment tools that encompass the multidimensional nature of the disease, and we therefore continue to recommend using FEV1 as a percentage of the predicted as a marker of the severity of airflow obstruction, but acknowledge that this may not reflect the impact of the disease in that individual. We have changed the FEV1 cut off points and these now match those in the updated GOLD and new ATS/ERS guidelines, although the terminology is slightly different: an FEV1 of 50–80% predicted constitutes mild airflow obstruction, 30–49% moderate airflow obstruction, and According to these criteria, Mike has mild airflow obstruction and will be treated accordingly. But no matter what stage he is at or what pharmacologic interventions are prescribed, we are nevertheless obliged to offer this patient access to an effective nicotine cessation program while in hospital. Treatment Acutely, the mainstays of treatment for Mike’s level of disease are inhalation and possibly oral therapy along with pulmonary rehabilitation (Cote Celli 2005;Paz-Diaz et al. 2007). Of course underlying bronchpulmonary infection is treated with appropriate anitmicrobial therapy. Inhalation and Oral Therapy Bronchodilators Of the three classes of bronchodilator therapy, ÃŽ ²-agonists, anticholinergic drugs and methylxanthines, all appear to work by relaxation of the airway smooth muscles, which allows emptying of the lung and increased tidal volume, with an increase in FEV1 with increase in the total lung volume and dyspnea, subjective air-hunger, significantly improved, especially during exercise (Celli Macnee 2004c). Combining short- and long-acting bronchodilators appears to improve lung function better than either alone, and so Mike will be treated with a combination of salbutamol and (albuterol)/ipratropium. There are many other agents that could be used that have shown to be effective in mild disease, such as Mike’s (Celli Macnee 2004b). Corticosteroids Inflammation is often part of the acute phase of COPD exacerbations and therefore part of Mike’s therapy will be inhaled corticosteroids. Many studies have shown that inhaled corticosteroids produce at least some improvement in FEV1 and ventilatory capacity. It is often necessary for a trial of medication to confirm that a given patient will respond to inhaled corticosteroid treatment (Celli Macnee 2004a). Ries ( 2007) claims that inhaled corticosteroids have become the standard of care for patients with COPD, in all phases of severity (Salman et al. 2003). Mike will be offered inhaled corticosteroids. Pulmonary Rehabilitation According to a statement of the American Thoracic Society, â€Å"[Pulmonary rehabilitation is] a multidisciplinary programme of care for patients with chronic respiratory impairment that is individually tailored and designed to optimise physical and social performance and autonomy†. The Pulmonary Rehabilitation Program Exercise Garrod ( 2007) has shown convincing evidence that exercise significantly modifies systemic inflammation, as measured by CRP and IL-6 levels, that plays such an important role in the pathogenesis of COPD. But rather than target just the pulmonary musculature, Sin et al. ( 2007) have suggested that the skeletal muscle dysfunction and reduced exercise tolerance, which are important extrapulmonary manifestations of COPD, could in fact be due to the systemic inflammation that is important in COPD. Therefore, Mike will be placed on a regimen of weight training designed to improve his over all muscle strength. In addition he will be offered aerobic exercise treadmill sessions to improve his exercise tolerance, similar to cardiac rehabilitation (Leon et al. 2005). Nutritional Support General nutritional status is related to COPD severity (Budweiser et al. 2007;Ischaki et al. 2007) and mortality (Felbinger Suchner 2003). The cachexia of COPD is a common sign of end-stage pulmonary disease. Mike has mild disease and would not be expected to be suffering from malnutrition. However, an evaluation by a nutritionist and possible early correction of any deficits are part of his pulmonary rehabilitation. Psychological Support Depression, anxiety, and somatic symptoms are valid indicators of psychological distress in COPD (Hynninen et al. 2005) and quality of life (Arnold et al. 2006), two very important nursing issues. Much of the psychological distress is related to a sense of personal control because the illness, especially in its late stages, is so often accompanied by a feeling of loss of control in one’s life. Mike is still self-employed and with his mild impairment, he is not likely to be feeling these issues, yet. However caregivers need to be acutely aware that his quality of life may depend upon recognition and early intervention in the future (Gudmundsson et al. 2006;Oga et al. 2007). To that end he will have a psychological evaluation while in hospital to screen for depression or anxiety symptoms. Educational Support There are many areas that are very important to Mike as he goes through his pulmonary rehabilitation. In an initial interview, he needs to know what he can and cannot expect from treatment. He needs a person to explain that the damage done so far is not reversible but that there are many treatments available that will allow him to live a good life, if he stops further cigarette use. Issues of promoting a healthy lifestyle, muscle wasting and psychological adjustment are all treatable with information, when it is presented in a sympathetic, firm, supportive atmosphere. Mike needs to know what to expect in the future, if he is able to quit smoking, and if he does not quit smoking. He may not like to hear the truth, but his quality of life will benefit in the years to come from a clear, honest educational program. In addition Mike needs to understand that he may have exacerbations from time to time and that early intervention by his generalist or pulmonologist are mandatory to avoid more serious consequences. Education that stresses the value of a healthy lifestyle, including regular exercise according to the regimen established in hospital, is very important. Also, education can help considerably in preventing the wasting that, though probably not present now, may become important in the future. Smoking Cessation No subject in the COPD literature is more clear than the need for immediate cessation of exposure to all cigarette smoke; and, no subject is more frustrating to caregiver and patient alike, at least in those instances where there is poor compliance with the cigarette smoke proscription. We will explore with Mike some of the recommended strategies to accomplish this sometimes elusive, if vitally necessary goal. Nicotine Replacement Therapy (NRT) A recent article by West, et al. ( 2007) reported a prospective study of NRT that was large (2009 smokers), multicultural, involving smokers from the US, UK, Canada, France, and Spain, and of sufficient duration to render generalizable (â€Å"real world†) results. They concluded that NRT helps smokers’ cessation attempts and long-term abstinence rates. However, the 6% improvement rate was not large and this form of cessation therapy should be reserved for those who have tried and failed other methods or programmes. There are many forms of NRT, including nasal and oral nicotine sprays, gum, and patches of varying dosages, currently on the market, but whether they have significant one-year success rates over counselling is an arguable point in the literature. Since Mike now smokes 40 cigarettes daily, he will be offered the 15mg nicotine patch to help for the initial 20 weeks of cessation. Bupropion Therapy Buproprion is a dopamine agonist that has antidepressant effects but is also marketed as a smoking cessation agent. In a study comparing the nicotine patch with buproprion and controls (counselling only) by Uyar, et al. (Uyar et al. 2007), reported success of 26 % for the nicotine patch, 26% for buproprion, and 16% for counselling-only at the end of 24 weeks. As an interesting aside, they reported that those who had a Beck depression inventory above 13, i.e. were depressed at the onset of the study, were unsuccessful regardless of treatment or control group. However, because of the small numbers of smokers involved, there was no statistically significant difference between these groups. The authors conclude that counselling is as effective for cessation attempts as these pharmacologic treatments, and there are no known side effects of being in a control group. However, other studies (Tonnesen et al. 2003) have shown a significant effect of bupropion over placebo. Internet-Based Assistance Various groups have tried using an interactive website to help smokers stop smoking. Unfortunately they have yet to show significant positive findings. All that can be said about them is that the more often the smoker logs on to the site, the better his chances are that he will be successful (Japuntich et al. 2006;Mermelstein Turner 2006;Pike et al. 2007). Nurse-Conducted Behavioral Intervention In the UK Tonnesen et al. (Tonnesen, Mikkelsen, Bremann 2006) found that a combination of nurse-based counselling in conjunction with NRT in patients with COPD was more effective than placebo at 6 and 12 months. As one can readily imagine, there are a plethora of cessation strategies available to assist people in smoking cessation. However, there is no â€Å"silver bullet†, i.e. one method that fits everybody. It comes down to proper motivation, which we believe is related to education and perhaps other factors. All we can really be sure of is of that those who try, many will be successful, and try, try, again seems to be the best advice we can offer. But the most important lesson we can learn is to prevent use of this harmful and addictive substance in the first place. Teenage smoking prevalence is around 15% in developing countries and around 26% in the UK and US. Studies have shown that those who make it past 20 years of age are much less likely to succumb to this addiction (Grimshaw Stanton 2006). Conclusion Assuming Mike ceases to smoke cigarettes, and given a regimen of exercise appropriate to his physical functioning, and with a detailed and robust COPD rehabilitation programme, his prognosis is excellent. By far the most challenging days are yet to come as Mike begins to feel better and the educational materiel fades from his mind. Many smokers return to their fatal habit within a year. Many, though perhaps not all, could benefit from periodic follow-up sessions with a motivational nurse-counselor. 1902 words not counting references References Arnold, R., Ranchor, A. V., Koeter, G. H., de Jongste, M. J., Wempe, J. 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M., Aine, T., Hallin, R., Bakke, P. 2006, Depression, anxiety and health status after hospitalisation for COPD: a multicentre study in the Nordic countries, Respir.Med., vol. 100, no. 1, pp. 87-93. Halpin, D. 2004, NICE guidance for COPD, Thorax, vol. 59, no. 3, pp. 181-182. Heaney, L. G., Lindsay, J. T., McGarvey, L. P. 2007, Inflammation in chronic obstructive pulmonary disease: implications for new treatment strategies, Curr.Med.Chem., vol. 14, no. 7, pp. 787-796. Hynninen, K. M., Breitve, M. H., Wiborg, A. B., Pallesen, S., Nordhus, I. H. 2005, Psychological characteristics of patients with chronic obstructive pulmonary disease: a review, J.Psychosom.Res., vol. 59, no. 6, pp. 429-443. Ischaki, E., Papatheodorou, G., Gaki, E., Papa, I., Koulouris, N., Loukides, S. 2007, Body mass and fat free mass indices in COPD: Relation with variables expressing disease severity, Chest. Japuntich, S. J., Zehner, M. E., Smith, S. S., Jorenby, D. E., Valdez, J. A., Fiore, M. C., Baker, T. B., Gustafson, D. H. 2006, Smoking cessation via the internet: a randomized clinical trial of an internet intervention as adjuvant treatment in a smoking cessation intervention, Nicotine.Tob.Res., vol. 8 Suppl 1, p. S59-S67. Lancaster, T., Hajek, P., Stead, L. F., West, R., Jarvis, M. J. 2006, Prevention of relapse after quitting smoking: a systematic review of trials, Arch.Intern.Med., vol. 166, no. 8, pp. 828-835. Leon, A. S., Franklin, B. A., Costa, F., Balady, G. J., Berra, K. A., Stewart, K. J., Thompson, P. D., Williams, M. A., Lauer, M. S. 2005, Cardiac rehabilitation and secondary prevention of coronary heart disease: an American Heart Association scientific statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American association of Cardiovascular and Pulmonary Rehabilitation, Circulation, vol. 111, no. 3, pp. 369-376. Mermelstein, R. Turner, L. 2006, Web-based support as an adjunct to group-based smoking cessation for adolescents, Nicotine.Tob.Res., vol. 8 Suppl 1, p. S69-S76. Oga, T., Nishimura, K., Tsukino, M., Sato, S., Hajiro, T., Mishima, M. 2007, Longitudinal deteriorations in patient reported outcomes in patients with COPD, Respir.Med., vol. 101, no. 1, pp. 146-153. Paz-Diaz, H., Montes de, O. M., Lopez, J. M., Celli, B. R. 2007, Pulmonary rehabilitation improves depression, anxiety, dyspnea and health status in patients with COPD, Am.J.Phys.Med.Rehabil., vol. 86, no. 1, pp. 30-36. Pike, K. J., Rabius, V., McAlister, A., Geiger, A. 2007, American Cancer Societys QuitLink: randomized trial of Internet assistance, Nicotine.Tob.Res., vol. 9, no. 3, pp. 415-420. Ries, A. L., Bauldoff, G. S., Carlin, B. W., Casaburi, R., Emery, C. F., Mahler, D. A., Make, B., Rochester, C. L., Zuwallack, R., Herrerias, C. 2007, Pulmonary Rehabilitation: Joint ACCP/AACVPR Evidence-Based Clinical Practice Guidelines, Chest, vol. 131, no. 5 Suppl, pp. 4S-42S. Salman, G. F., Mosier, M. C., Beasley, B. W., Calkins, D. R. 2003, Rehabilitation for patients with chronic obstructive pulmonary disease: meta-analysis of randomized controlled trials, J.Gen.Intern.Med., vol. 18, no. 3, pp. 213-221. Sin, D. D. Man, S. F. 2007, Systemic inflammation and mortality in chronic obstructive pulmonary disease, Can.J.Physiol Pharmacol., vol. 85, no. 1, pp. 141-147. Srivastava, P. K., Dastidar, S. G., Ray, A. 2007, Chronic obstructive pulmonary disease: role of matrix metalloproteases and future challenges of drug therapy, Expert.Opin.Investig.Drugs, vol. 16, no. 7, pp. 1069-1078. Tonnesen, P., Mikkelsen, K., Bremann, L. 2006, Nurse-conducted smoking cessation in patients with COPD using nicotine sublingual tablets and behavioral support, Chest, vol. 130, no. 2, pp. 334-342. Tonnesen, P., Tonstad, S., Hjalmarson, A., Lebargy, F., Van Spiegel, P. I., Hider, A., Sweet, R., Townsend, J. 2003, A multicentre, randomized, double-blind, placebo-controlled, 1-year study of bupropion SR for smoking cessation, J.Intern.Med., vol. 254, no. 2, pp. 184-192. Uyar, M., Filiz, A., Bayram, N., Elbek, O., Herken, H., Topcu, A., Dikensoy, O., Ekinci, E. 2007, A randomized trial of smoking cessation. Medication versus motivation, Saudi.Med.J., vol. 28, no. 6, pp. 922-926. West, R. Zhou, X. 2007, Is nicotine replacement therapy for smoking cessation effective in the real world? Findings from a prospective multinational cohort study, Thorax. Page 1 of 11 Is Power the Same as Violence? Is Power the Same as Violence? Huang Li Introduction For a long time in history, the coercive side that power involves and the destructive results that power rivalry brings have all along depicted power as horrible and deterrent. It has been viewed as closely related to force and violence, or to a large extent very similar. It is only until the time of modern democratic societies that the meaning of power is gradually enriched with the increasing role of rational recognition in power relations. This essay intends to show that power is not the same as violence; it is more than that because of the most fundamental difference: rational recognition. Power is not only composed of coercive force that resembles violence, more importantly it involves the force of social recognition which violence is short of. Power is a mutually regulated communicative process rather than simply exercised by the powerful over the powerless. After identifying some basic differences between power and violence, this essay will focus on the discussion of power and power relations, to explore the major difference between power and violence rational recognition and why it is so. On one hand, it will show that power can create violence and it consists of coercive elements by demonstrating why power is not a one-way event; on the other hand, this essay will proof why power is more of mutual constraint that rational recognition and willingness of acceptance from others can identify power from violence. Scholars like Weber views power as means than ends, backed by violence, threat or inducement; Mann illustrates power as resources that can be occupied; Parsons and Foucault both intend to reconstruct power but still proceed in the realm of violence theory. This essay mostly follows the ideas of Honneth, Arendt, and Habermas, but attempts to avoid another extreme of equalizing power to purely power of rationality or power of consensus through communicative process. It sees power as a combination shaped by both coercive and rational forces, avoiding placing power in the opposite of violence since in history power has been devastating too and violence could be â€Å"an attempt to achieve justice† (Gilligan, 2000, 11). Basic Differences: Power Dependent on Numbers and Violence on Implements Arendt defines power in the context of groups of individuals, as â€Å"the human ability not just to act but to act in concert† (1972, 143). One individual alone does not generate power; power is the aggregate strength of all the individuals in a group. So the exercise of power is preconditioned with numbers. Unlike power, violence does not require numbers or groups in order to be violence. Rather, it depends on implements to â€Å"multiply strength, to a point at which they can replace it† (Arendt, 1972, 145), instead of becoming power. Violence is designed and applied for expanding one’s physical strength that it is totally instrumental and always a means for certain purpose; but power in itself can serve as an end. There is categorical distinction in this sense. Is Power a One-way Event? If violence is not the end, it is a â€Å"blinding rage that speaks through the body† (Gilligan, 2000, 55) and the hope of those who do not possess power. So violence could start from the powerless against the powerful, such as slaves against slave owners, or the ruled against the ruling. Such power relations see those in power as subjects and those under the power objects, to be controlled and manipulated. Power in such a one-way model is pillared by certain condition which is understood as its source. Mann identifies four sources of power: ideology, economy, military and politics (1970, 35) that people who occupy these resources will own power. A society is thus divided into two kinds of people in a one-way power structure. If the will of those in power is not executed, the ruled will be punished, possibly by violence, and they stand up to resist, with violence, for power. It is not difficult to reach the conclusion that in a binary opposition, power and violence can be cause and effect of each other and they are actually two sides of one coin. Derived from the Hobbesian proposition, it should be admitted that power do contain certain aspects of violence, historically or theoretically, when it is understood as something can be possessed like resources. However, what can be relied upon by the ruled class for their struggle if they don’t have any resources at all? In the case of ideology, any interpretation by the powerless will be meaningless and invalid, why would those in power necessitate oppressing and controlling them? Will there be any struggle inside the powerful and the powerless? Power is Mutually Agreed: Rational Recognition of Imbalance Clearly such violence-illustrated power is not the whole picture. Power is more than something can be owned and preserved; it only exists when is â€Å"exercised by some on others† (Foucault, 2003, 126) and will be â€Å"dispersed once the group ceases to exist† (Arendt, 1972, 143). Power is the â€Å"structural feature of human relations† (Elias, 1998, 188). Slaves have power over the slave owner too as long as they are valuable to him; their power depends on the degree to which their owner relies on them; so is the case between parents and children, and teachers and students. In reality, if an individual or group acquires the power to implement self will, such power is not fully discovered if the ruled do not acknowledge it; they do not just accept power, they make certain responses to it based on their own will. So power is not necessarily a unilateral process where one is dominated and controlled by the other; it exists in interdependence and mutual constraint among people with differentiated level of resources; it is both â€Å"pervasive and negotiated† (Gosling, 2007, 3). Not only will power be regulated and negotiated between the ruling and the ruled, but also within themselves. The former power relations are coercive because the power is legitimized by laws, regimes or organizations. The latter may be absent from these elements but power relations and interactions still takes place because some individuals will still tend to persuade and influence others in exchange for recognition of authoritative positions, through knowledge, money and pers onal network, in order to implement one’s own will and better response to such power relations at the â€Å" most micro levels† (michel-foucault.com). In fact, power relations at the micro level are where those power relations between hierarchies originate. At the very micro level, it is to a larger extent the power of rational recognition rather than the power of force that leads to certain power relations. Since interdependence always exists among people regardless of their power positions, power relation is a dynamicequilibrium and mutual power regulation is always there, even in the extreme case of slaves and slave owner. However if the power relations regulated by rational recognition are neglected, those based on them at the macro levels will be shaken. Although power relations are mutually regulated and communicative rational, the degrees of interdependence are different, which lead to unbalanced relationships among the players. In fact, power to some extend is just demonstrated by such imbalance; violence too is demonstrated in kind of imbalance; but power goes further if it is identified different as it means others’ recognition of such imbalance. When the imbalance is maintained in the form of pure coercive force, it is violence; when rational force is included, it starts to turn into power. Under any circumstance, power is the combination of both. Bifacial Nature of Power When examined under Habermas’s context, in the terms of â€Å"facts and norms†, power includes two dimensions as well, described as â€Å"facticity and validity†. The facticity dimension reveals the coercive nature of power that power, in any kind of form, potentially contains coercive forces in realizing goals and excluding all impediments. Such aspect of power is underpinned by violence or the threat of violence which exist as real and concrete facts. The other dimension is validity that refers to power’s tendency of gaining rational recognition from the others. Though the two dimensions coexist in power and so does the tensions between them, they are not always equally demonstrated. In a tyrannic society, power shows more coercive side of its nature whereas the power of rational recognition is more compelling in a democratic society. Violence Does Not Create Power but Destroys It As discussed so far, power involves elements of coercion and it can generate violence. But is it the case the other way around that violence can also produce power? In many scholars’ understanding, violence is viewed as a resource that â€Å"can be mobilized to enforce the compliance of others† (Ray, 2011, 13). Usually exercised by those in power, it creates the ability of an individual or group to achieve their own goals or aims even if others are trying to prevent them from realizing them. Thus violence is naturally seen as a source of power. However, is what one has gained by using violence, or what violence has created, truly power? When a government turns into violence against its own people or a foreign country, or an individual uses violence to acquire what is wanted, it is generally because power in their hand is running out and violence is the last resort. While such a government or individual does not lack means of violence, they are in fact in short of power; to be more accurate, they are lack of recognition of their wills by others. When violence as a resource is utilized against another, it not only consumes the resource itself but also diminishes what little power is left over. Violence is always the choice of the impotent, not the powerful. Viewed in this sense, violence only equals to coercive means regardless of other’s recognitions. It emerges when â€Å"social ensembles are incoherent, fragmented and decadent† (Wieviorka, 2009, 165). Therefore, as violence â€Å"inevitably destroys power, it can never generate power† (Arendt 1972, 152). There is no â€Å"continuity between obedience to command (the enactment of power) and obedience to law (as legitimate authority)† (Ray, 2011, 13). A government that solely relies on violence has no power and â€Å"tyranny is both the least powerful and the most violent form of government† (Arendt, 1972, 140). Reproduction of Power and Violence In the past, power is largely associated with gains of interests, or occupation of social resources like those identified by Michael Mann. In Honneth’s Struggle for Recognition, he reveals the â€Å"force of recognition† behind power. Once this point is taken into consideration, the reproduction of power will no longer be just about violent competition, or rivalry for social resources, rather, the willingness of others to acknowledge and accept. Arendt insists that violence does not give rise to power because she believes that social recognition is missed in violence. When power is taken as a combination of coercive and rational forces, it may be understood as a relationship of mutual recognition among a group of people backed by the potential threats each have for others. Therefore, the reproduction of power naturally includes attempts of occupying as much resources as possible for greater coercive capability; it is indispensible and more important to gain recognition from others. If authoritative coercion is a source of power, it is not the only source. Rational recognition also generates power. So political power is not the potential capability to implement one’s own goals or realize one’s own interests, it relies on those over whom the power is exercised to define what power truly is. The power of a government is conferred through people’s recognition, or in another word, the coercive force of the government is agreed by the people. When applied at the micro level, it can also be stated that the power between individuals does not only arise in the lure of interests or in the constraint of violence, it rests in the one’s recognition of others’ will and authority over oneself. Only when such recognition exists, the will can be implemented without enforcement and power becomes power rather than violence. Right to the contrary, what violence concerned is how one’s own goals are reached through forceful means. Violence is always destructive but never constructive. Terrorist attacks do not increase the power of the terrorists, it grows intimidation and controls; meanwhile it gives the government power to do what it cannot do in the past and to expand its sphere of influence. Violence reinforces state power and makes more violence necessary in order to maintain and reproduce violence. Conclusion When power is perceived under violence theory, man is to be controlled and manipulated, instrumentalized in a subject-object relationship which is all about one trying to dominate the other in struggles for power resources, in order to preserve power and oppress others from grabbing it. Power in that sense equals to violence, which is observed throughout history. While power will fail should it be not supported by forceful and compulsory means, it is not sufficient to have these only. What cannot be overlooked is an â€Å"infinitely complex network of ‘micropowers’, of power relations that permeate every aspect of social life† (Sheridan 1980: 139). Where rational recognition also creates power, power can be compellent but not violent simultaneously. Thus, viewed in a rational context, man becomes a dialogue partner with the coexistence of competition, compromise and cooperation. Mutual regulation and interdependence is the one of the features of such power relationship and mutual understanding and respect is part of the foundation of power reproduction. Recognition of imbalance between people, particularly from those over whom power is exercised, legitimizes power and differentiates it from violence. Power and violence are not the same; the former is more than the latter. Power â€Å"cannot be overthrown and acquired once and for all by the destruction of institutions and the seizure of state apparatuses† (Sheridan 1980: 139). Unlike violence, power is not unitary and its exercise binary; it is interactive; a very important part of power struggle is the rivalry for recognition. In modern democratic societies, the violence aspect of power is decreasing and increasingly giving way to the role of rational recognition in shaping power. The major resources of power is no longer just about military or economy of one’s own capability, it is more about how convincing it is for others to accept, and in the end, how well one’s power is recognized and received by others. Bibliography: Arendt, Hannah, (1972), â€Å"On Violence† inCrises of the Republic, New York: Harcourt Brace Company, pp. 103-184. Elias, Norbert, (1998), â€Å"On Civilization, Power, and Knowledge†, Chicago: University of Chicago Press, chapter 7. Foucault, Michel, (2003), â€Å"The Subject and Power† inThe Essential Foucault, P. Rabinow, ed., New York: The New Press, pp. 126-144. Gilligan, James, (2000), â€Å"Violence: Reflection on Our Deadliest Epidemic†, London: Jessica Kingsley, pp. 1-60. Gosling, David, (2007), â€Å"Micro-Power Relations Between Teachers and Students Using Five Perspectives on Teaching in Higher Education†, available at: http://www.davidgosling.net/userfiles/micro power relations isl 2007.pdf, last accessed on 7 Dec. 2014. Habermas, J., (1996), â€Å"Between Facts and Norms†, Massachusetts: the MIT Press. Honneth, Axel, (1996), â€Å"The Struggle for Recognition: The Moral Grammar of Social Conflicts†, Massachusetts: the MIT Press. Mann, Michael, (1970), â€Å"The Source of Social Power†, Cambridge University Press, chapter 2, pp. 34-72. Michel-foucault.com, (2007), Key concepts, available at: http://www.michel-foucault.com/concepts/index.html, last accessed on 6 Dec. 2014. Ray, Larry, (2011), â€Å"Violence and Society†, London: Sage, pp. 6-23. Shabani, A. Payrow, (2004), â€Å"Habermas’Between Facts and Norms: Legitimizing Power?† available at: https://www.bu.edu/wcp/Papers/Poli/PoliShab.htm, last accessed on 6 Dec. 2014. Wieviorka, Michel, (2009), â€Å"Violence: A New Approach†, London: Sage, pp. 165.

Personal Development Plan for Leadership Skills

Personal Development Plan for Leadership Skills PERSONAL DEVELOPMENT PLAN AND REFLECTIVE RATIONALE WITH REGARD TO LEADERSHIP DEVELOPMENT. BRIEF: 101871 INTRODUCTION In order to understand the reasoning behind the personal development plan and reflective rationale in relation to leadership development in the Nursing field, one will have to define what these two terminologies are. According to the British Medical Association, the personal development plan (PDP), is a tool that can identify areas for further development and encourage life long learning. It acts as a process of planning, monitoring, assessment, and support to help staff develop their capabilities and potential to fulfil their job role and purpose. It is an approach to increase the effectiveness of the organisation’s performance through ongoing, constructive dialogue to ensure that everyone knows what is expected of them; gets feedback on performance; is able to identify and satisfy their development needs. A PDP can identify goals for the forthcoming year and methods for achieving these goals. PDP’s were advocated by the medical royal colleges as a basis for continuing professional development. While the reflective rationale, is stated as one where a practitioner seeks to apply learning and insights of other people in their work, and develop their own insights and share these with colleagues, Gorman (1998). Essentially reflection involves three key stages, awareness of an issue, analysis of knowledge and feelings, and identification and integration of new learning, Atkins and Murphy (1993). Sharing and discussing these insights with their multi-disciplinary team will promote honest open communication and mutual trust. Reflection may be recorded in a diary, journal, or learning log. Now, that we have understand the meaning of these two concepts, we will talk about the personal development plan with regard to nursing from the following the three issues, namely transformational leadership, managing conflict, and motivation. PART 1 TRANSFORMATIONAL LEADERSHIP Due to the emerging importance of clinical leadership, the issue of transformational leadership in the nursing field has become a very important issue. This is partly due to the fact that existing literature covering leadership has found it difficult in characterizing effective clinical leaders. Using five attributes identified by Cook (2004) and other relevant published material, one would explain the issue of transformational leadership. The attributes are Creativity, highlighting, influencing, respecting, and supporting. Creativity This is required to generate new ways of working. As Sadler (1997), puts it, the essence of nursing, can be said to be ‘an individually and socially defined creative process, to meet a recognised need’. Creativity results from engaging actively with the surroundings to seek new possibilities. Using an experience from a mental health nurse, it was explained that the organisation (nursing) was not forward looking, but strictly structured. However, from an experience from a nurse who had just come back from a nursing course, the nurse applied for the course and enrolled, and that over the years they both used their creative experience to develop nursing to what it is now. Highlighting This attribute gives one the ability to point out new ways of care delivery, based on engaging actively with the care environment. According to Cook (2004), the effective clinical nurse leaders were willing to look for new ways of doing things. On a regular basis questions were asked to clarify and enhance understanding. The status quo, were persistent and shared their new knowledge with others. As stated by an experienced sexual health nurse, one of the important issues was the ability to highlight her case her case through others. Influencing Influencing others through provision of meaningful information is the key to this attribute. According to Cook (2004), effective clinical leaders were able to help others to see and understand situations from various perspectives. For example, a community adult nurse explained how she had agreed to take on the care of a person, within her team, in which there was already a burgeoning caseload. She used accurate case notes to keep a log of the happenings, whereby she shared it with her line managers and team. This helped in improving the team’s performance as to how to deal and tackle with situations. Respecting This involves having a regard for the signals that emanate from individuals and the wider organisational area. Respecting these signals enables people to position themselves appropriately to respond to both individual and organisational needs Sergiovanni (1992), West-Burnham (1997), and Jarrold (1998). Hall (1974) uses the term proxemics[1] to explain this phenomenon. In this case effective clinical leaders have well-developed perceptual ability, and therefore, respect signals from individuals with whom they work with. Supporting This attribute refers to the ability to support others through change, whether at an individual level, including changes to self, or involving groups or wider organisational levels. According to Cook (2004), effective clinical nurse leaders in this context recognise that by supporting staff through various situations they enhanced ownership of the problem and promoted effective learning. It is also likely that effective clinical nurse leaders have experienced similar challenges previously, and have acquired the skills to relate their learning to others. With the explanation of an experienced specialist sexual health nurse, Cook (2004) explains that by supporting a person through a problem, the effective clinical leader helped them to see different options and choices. Bennis and Manus (1985), also explains that a transformatic leader has the ability to commit people to action-that is, to covert followers into leaders and to assist new leaders to become viable agents of social or institutional change. This type of leader has vestiges of what the German sociologist Max Weber called pure charisma. Such leaders employ power wisely, and they manage resistance, not autocratically or high-handedly, but by ‘creating visions of the future that evoke confidence in and mastery of new organizational practices’, Bennis and Manus (1985). They also add that ‘leadership is like the Invisible snowman: he or she is never seen but his or her foot prints turn up everywhere’. Riba and Reches (2002), also add that there is a direct correlation between the charge nurse’s charisma and authority and her nurses’ level of commitment, self confidence, sense of belonging and desire to contribute. It is of utmost importance that the char ge nurse be a source of direction and strength, offer answers to professional questions, and provide on-the-spot solutions to on-the-spot problems. They also added that a charge nurse exercises a great influence on the professional development of her subordinates. Her critical role in times of emergency only reinforces that finding and demands a response at the policy-making level. Candidates with leadership potential should be looked for at early stages of professional assessment and given the appropriate leadership training. According to Goldberg (2001), the leadership role of ER charge nurses needs nurturing. MANAGING CONFLICT From the attributes identified by Cook (2004), the issue of influencing others through provision of meaningful information is a way of managing conflict. As described by the community adult nurse; she had to respond to a request to add a person with complex health needs to an already burgeoning caseload. The nurse agreeing to take on this extra person is a method of managing conflict. Also, notes were taken to monitor the impact of this situation, which is a very useful tool to keep a log of the difficulties and problems that arised as a result of this situation. The notes taken would act as a guideline for future recommendations or mishaps that might occur that is similar to what had previously happened. Another attribute mentioned by Cook (2004) which can be deemed as a useful technique to managing conflict is the one of respecting. This attribute which involves having a regard for the signals that emanate from individuals and wider organisational arena. Being able to respect colle agues, and fellow team mates opinions can be regarded as the most important tool for managing conflict. As explained by the surgical nurse, when a previous patient had returned from a theatre that morning, the needs of the patient had made it difficult for care. So, at the time of handover the nurse made sure that a detailed explanation of the patient was made known to the new staff, in which the patient’s partner insisted on participating and helping out with the care. The last attribute which can be described as another good technique to combat conflict is supporting. As Cook (2004), puts it the ability to support others through change, whether at an individual level, including changes to self or involving groups or wider organisational levels. Clinical nurse leaders who are effective recognize that by supporting staff through various situations they enhanced ownership of a problem and promoted effective learning. As the example of the specialist sexual health nurse is expl ained, by supporting a person through a problem, the effective clinical leader helped them to see different options and choices, in order words rather than querying or arguing with a colleague, it is best to support them in their approach thereby avoiding and managing conflict. Harrington-Mackin (1996), also explains that one of the major problems presented in the team work approach is that people are not accustomed to ‘group problem-solving’ in order words working together as a team to avoid conflict and resolve a particular problem. It is a practice that not only hasn’t been learned, but is a difficult one to institute. For example, in school children are taught to rely on their own resources; to develop their individual capabilities. Harrington-Mackin (1996), cites the example of a fourth grader, who wouldn’t be allowed to say, ‘‘Hey, Joe you’re good at word problems and I’m good at multiplication tables, so let’s get to gether for this test’’, yet the adult equivalent of this is seen in the workplace when teams are expected to come up with a group solution to a problem. This is an odd practice for most people, as well as the fact that trying to reach a consensus in a group of adults can frequently result in heated arguments, and no solution. Team decision-making can be frustrating. The team members have to take the time to listen to everyone’s opinions; a time-consuming process where the inclination is frequently to jump on the first answer given rather than go through the lengthy and frequently tedious process of hearing from everyone, Harrington-Mackin (1996). MOTIVATION This is an issue that tends to crop up at every stage of one’s work life. In this context, task variety and participation allows each member in a group or team to perform a number of tasks, motivating members to use different skills, as well as rotating less desirable tasks. According to Hackman and Oldman (1980), interdependence within a team or group also acts as a crucial element in motivation. One form of this is task interdependence, which involves members of the team depending on one another to accomplish goals. Goal interdependence refers not only to a group having a goal, but also to the fact that group member’s goals should be linked. Interdependent feedback and rewards are necessary, as all of the interdependency characteristics, to promote motivation in the team. Another task which helps keep motivation up is workload sharing. Another method to ensure motivation is the use of rewards. It is stressed that rewards should be given in a manner that promotes team cohesiveness. If given in the correct manner, they will likely increase potency, or the belief that the team will perform effectively in the future. Bowen and Lawler (1992), Wall and Martin (1994), also argue that empowering practices such as provision of organisational information to employees, reduction of bureaucratic controls and increased task autonomy helps in increasing employee motivation. French and Raven (1958) also add that motivation is an attribute that makes one want to do or carry-out a task willingly without being instructed. This is related to the latter previously mentioned. Bass and Avolio (1990), also argue that a generally accepted approach that motivates followers to perform their full potential overtime is by influencing a change in perceptions and providing a sense of direction. The kind of knowledge required to motivate others is transformational knowledge. This is soft knowledge that is difficult to define and involves intuition, wisdom and mystery in contr ast to technical control. PART 2 REFLECTIVE RATIONALE According to Plato ‘the un-reflected life is not worth living’, Taylor (2000). These are very meaningful words that imply that individuals need to reflect on every aspect of their lives. This is more so whilst leading a professional life as practice in a profession has implications for more than just an individual. Taylor (2000) insists that the ability to reflect is a valuable part of human life. It is this ability that separates humans from other species. As Taylor (2000) argues, it is the throwing back of oneself to thoughts and memories using thinking, contemplation, meditation and any other forms of cognitive strategies to make changes if they are required. It requires a rational and intuitive process which allows change to occur. These aspects of thinking are integral to reflection, and for making sense of personal and work events and can depend on the demands of the situation and the enormity of the task, Taylor (2000). Schon (1983) thought similarly but was able to categorise reflective practice into reflection on action which can be viewed as a retrospective activity, looking back and evaluating ones professional practice. According to Schon (1983), reflection in action is a more dynamic process of thinking about and coming to an internal knowledge of current professional practice at the time. In practice these distinctions may seem quite blurred at times and the NHS Trust encourages nurses to focus on the process of reflective activity other than individual reflective strategies NHS Trust (2003). Literature suggests that professionals can use strategies that will minimise the shortcomings of reflection and make it relevant to the present. The attribute of influencing others through provision of meaningful information, is one that correlates with the previous mentioned. Gray (1998) asserts that to be able to reflect, one needs to step outside the experience to make the observation comprehensive. With the use of creativity, one would be abl e to be as spontaneous as possible in recording thoughts and feelings for the best outcome of reflection. This tallies with Imel (1992), whereby reiterating that important insights will come from a frank and honest self, a view that is supported by Wilkinson (1996). Taylor (2002), states that ‘if you try to sanitise these valuable parts of yourself, you will not be able to get to the ‘heart’ of the matter as effectively’. This means that in addition to the courage you need to face other people, one will need the courage to face oneself. Highlighting a particular issue as an attribute from a transformatic leadership point of view enables one to share issues they have identified while on the job, promotes and enhances a reflective rationale which team members or management would all gain from, because it becomes knowledge or reflective rationale shared rather than tacit knowledge (knowledge that is not shared but held by one person). According to Cox, Hickson , and Taylor (1998), comments from nurses include not being able to be honest in case they are not able to handle what they find, and the fear of wrecking the illusion that keeps them sane. They argue that writing honestly ensures that the dialogue with ourselves is authentic, not softened by any other thing. They also argue that this is not an easy task, because it is almost impossible to scrutinise our own writing without justifying and rationalising our actions, and resorting to feelings of guilt, blame or victimisation. As a result, scrutiny with regard to reflective rationale, from a personal development plan perspective, one might find inconsistencies between what the PDP is required for and what has actually happened in reality. For example, the issue of team work from a transformatic leadership view is one that is very objective. I.e. although one might reflect back on issues or conflicts that were encountered and resolved, there is no readily made solution to this. The dyna mics of being part of a team makes it difficult to identify the best way to resolve possible conflicts of interests and opinions, which is the responsibility of the leader. According to Boud et al (1985), a mere description of events does not do justice to the practitioner. They suggest that reflection has two aspects of utilising positive feelings and removing obstructive bias feelings. Critical thinking can be described as an attitude and a reasoning process involving many intellectual skills and places rationality at the head of the list of characteristics. Wilkinson (1996) states that, reflection is made up of a strong emotional subjective side whilst acknowledging that rationality is central to reflection. The attitudes suggested for critical thinking include independent thought, intellectual humility, courage, empathy, integrity and perseverance. He adds that other attitudes required are fair mindedness and the need to explore thoughts and feelings. This correlates with the at tribute of respecting other people’s thoughts with regard to transformational leadership. It acts as a means to develop a certain type of character which is enhanced by using a personal development plan. Although, the purpose of reflection is action if needed, it is done with a view to action. Practically speaking, the time consuming nature of reflective activities has often been cited as significant inhibitor to the consistent implementation of reflective practice. This assertion is that the rhetoric surrounding reflective practice has been strong, but implementing reflective strategies in a sustained, focused manner is increasingly becoming a common norm. For practising nurses, reflection can be viewed as a link between theory and practice Emden (1998). Leadership is facilitative, aiming to mobilize all the skills, good will and know-how at the disposal of the practice. These qualities of the leader are inextricably linked with the empowerment of practice staff. If all part icipants (all staff, clinical and non-clinical, practice employed and attached) are involved in the planning stage, where the team decides if it wants to take part, then success is much more likely later on Jowett and Wellens (2000). Staff members find it easier to buy-into the ideas if they can see the relevancy and benefits of the changes to their practice. Three points are important here: An approach that begins by consulting all practice staff, listens to their ideas and respects their differing professional perspectives is an important indicator to those staff that things will be made better by these moves. A learning practice which is primarily the reason for writing a reflective rationale or practice is unlikely to work unless it is owned by those involved in it; they want it to happen, shape the outcomes Cohen and Austin (1997) and feel they have some control over the inputs and process. Therefore, clearly learning practice strategies for change and development must emanate from within the practice and not be imposed. In Primary care, this might mean taking sometime and care to allow staff to learn about the ideas, discuss them and warm to them, before the whole practice signs up to the changes. Time-out or time taken to examine the effectiveness of a particular approach or response to a situation can lead to more effective performance next time. Becoming a reflective practitioner can be the first step towards recognizing the hidden skills that exist within primary care or rather nursing. This type of experience routinely goes unnoticed. However, skills, gained through experience, can be passed on to new learners to enhance and speed their learning, or assist job-shadowing and critical questioning. Reflective practice is likely to be useful both in administrative roles in health care settings and in clinical leadership. Now when writing out a reflective rationale it should include three sections: An introductory section On going journal writing for a period of at least 10 weeks A closing synthesis section INTRODUCTORY SECTION The most difficult part of journaling is finding a place to begin. Literature relating to journal writing, suggests that one of the best ways to get started is to begin with yourself. One can do this by writing a short autobiographical section. This will help to locate yourself in the context of growth, to get a sense of where you have come from. Some of the following questions may help provide useful guidelines: Why did I decide to become involved in Nursing? When and how did I decide? What and who influenced me? In what ways? As I look back to this time what feelings and images remain? If I could make the decision again to become involved in this profession, would I? Why or why not? What do I see as my greatest professional strengths? What would I like to change or work on to improve my practice as a nurse? What are a few of the frustrations I experience in my work place? What are a few of the hopes I have for health and safety practice in the organisation I work in or work for? Why did I decide to pursue a management course to become a charge nurse? When and how did I decide? If one has not been involved in reflective practice writing before it may seem like a daunting task at first. It does become much easier with practice. ON-GOING JOURNAL WRITING FOR A PERIOD OF AT LEAST 10 WEEKS Allocating time to writing a reflective professional preference and work situations vary but as guidelines writing your reflective journal may require three writing sessions of 10 – 15 minutes spread throughout the week, and one slightly longer session to facilitate greater reflection and theorising. Writing journal entries it is helpful to think of it as an activity which can take place at three different but overlapping levels: Describing Reflecting Theorising Writing at each of these levels can be facilitated by asking a series of questions about aspects of what you do. Describing is about questions such as: What happened? What did I do? Where was I? Who was I interacting with? Who else was in the range of interaction Reflecting is about looking beyond the surface and asking questions such as: Why did I do that? What was I thinking and feeling at the time? Where did these thoughts and feelings come from? What assumptions was I making at the time? What values and beliefs underline my decisions to act in this particular way? How did relationships with other people influence what happened? Theorising goes beyond reflection in that it takes the writer beyond the context of their personal experience and links them with the broader theoretical underpinnings of their profession. Theorising builds on reflection as described above but is also itself the subject of reflection. It is about questions such as: How well does my experience fit in with contemporary approaches to nursing practices? Are there ways in which my experiences suggest ways of revising or developing these approaches and the theoretical perspectives which underpin them? What do my experiences suggest about ways in which the health and safety management needs to develop as a profession? CLOSING SYNTHESIS SECTION If reflective writing is to realise its full potential with regard to transformational leadership as a means of learning professional development, it is important to bring together and synthesise in some way what your journal has revealed to you ‘reworking, rethinking and re-interpreting the diary entries, further powerful insights can be gained. To bring what your journal reveals to you to consciousness it is necessary to re-read it. Sometimes it is appropriate to return to your writing shortly after you have written it. Sometimes a longer time lapse will be more appropriate. In either case it is important not to be judgemental about what you have written and put yourself down, rather experience and appreciate the story you have written so far. SUMMARY AND CONCLUSION This paper looks at the use of personal development plan in the field of nursing, from the perspective of transformational leadership, using five attributes mentioned by Cook (2004) namely, Creativity, Highlighting, Influencing, Respecting, and Supporting; managing conflict; and motivation. It also talks about the use of a reflective rationale incorporating the above mentioned. Additionally, a critical analysis as to the above mentioned is used with regard to the validity of the use of a reflective rationale to improve ones personal development for leadership in the field of nursing. It will be conclusive to state that the issue of leadership within the nursing field is one that has come about in the past decade. However, due to a lack of preparation and hindsight over the years and decades with regard to the growing importance of care nursing, there has not been a formal leadership programme in the field of nursing. The use of the personal development plan and a reflective rationale are tools that are useful to addressing this issue. With constant refinement and identifying particular individuals who are suited for this role, with time, real leaders in the field of nursing will come to be a thing of the past. REFERENCES AND BIBLIOGRAPHY Atkins, S., and Murphy, K., (1993), ‘Reflection; a review of the literature’. Journal of Advanced Nursing, 18: 118 – 119. Bass, B., and Avolio, B., (1990), Transformational leading ability development: Manual for the multifactor leading ability questionnaire. Consulting California Press, CA, USA. Bennis, W.G., and Nanus, B., (1985), Strategies for taking charge. Harper Collins, New York. Bowen, D., and Lawler, E., (1992), The empowerment of service workers: What, Why, how, and when. Sloan Management Review, Spring: 31 – 39. Boud, D., Keogh, R., and Walker, D., (1985), Reflection: Turning experiences into learning. London: Kogan page. Cook, M.J., (2004), Learning for Clinical Leadership, Journal of Nursing Management, 12, 436 – 444. Cox, H., Hickson, P., and Taylor, B., (1998), Exploring reflection: Knowing and constructing practice. In G. Gray and R. Pratt (Eds.), Towards a discipline of nursing (pp. 373 – 389). NSW: Churchill Livingston. Cohen, B.J., and Austin, M.J., (1997), Transforming human services organisations through empowerment of staff. Journal of community practice 4 (2), 35 – 50. Emden, C., (1998), Becoming a reflective practitioner. In G. Gray and R. Pratt (Eds.), Towards a discipline of nursing (pp. 335 – 354), NSW: Churchill Livingston. French, J. and Raven, B., (1958), The bases of social power. In studies in social power (ed. D. Cartwright), pp. 150 – 167. Institute for social Research, Ann Arbor, MI. Gray, C., (1998), Reflection and reflective practice: The reflective technique. In G. Gray and R. Pratt (eds.), towards a discipline of nursing, pp. 355 – 372. NSW: Churchill Livingstone. Goldberg, S., (2001), Nursing leadership in an era of reform in the health care system: Evaluation of the head nurse leadership style in relation to the effectiveness of the department. Ben-Gurion University of the Negev, Israel. Gorman, P., (1998), Managing multidisciplinary teams in the NHS, Kogan page Ltd, London. Hall, E.T., (1974), Handbook for Proxemic Research, AAA Publications, CA, USA. Hackman, J., and Oldman, G., (1980), Work Redesign, Reading MA: Addison – Wesley. Harrington – Mackin, D., (1996), Keeping the Team going. Imel, S., (1992), Reflective practice in adult education. ERIC Digest No. 122, www.ericdigests.org/1992-3/adult.html. Jarrold, K., (1998), A view from here ‘servants and leaders’. In the York symposium on health, 30th July (S. Martin ed.), Dept. of Health Studies, University of York, York. Jowett, R., and Wellens, B., (2000), Developing Occupational Standards, a learning disabilities project. Journal of clinical nursing, 9 (3), 436 – 444. NHS Trust (2003), Portfolio management and reflective practice: Introductory guidelines. www.northbristol.nhs.uk/nursing/reflective.asp. Riba, S., and Reches, H., (2002), When terror is routine: How Israeli nurses cope with multi – casualty terror. Journal of Issues in Nursing. Sadler, J., (1997), Defining professional nurse caring; a triangulation study. International Journal for human caring 1 (3), 12 – 21. Sergiovanni, T.J., (1992), Moral leading ability; getting to the heart of school improvement. Jossey – Bass, San Francisco. Schon, D., (1983), The reflective practitioner: How professions think in action. London: Basic Books. Taylor, B., (2000), Reflective practice: A guide for nurses and midwives. St. Leonard’s: Allen and unwin. Wall, T., and Martin, R., (1994), Job and work design. In C. Cooper and I. Robertson (Eds.), Key reviews in managerial psychology. Chichester: Wiley and Sons: 158 – 988. Chichester: Wiley and Sons. West – Burnham, J., (1997), Leadership for learning re-engineering ‘mind sets’. School leading ability and management 17 (2), 231 – 244. Wilkinson, J., (1996), Nursing process: A critical thinking approach. Menlo park, California: Addison-Wesley. 1 Footnotes [1] Social anthropologists explain this as the closeness of relationships between people and spaces

The Creator Speaking Through His Creation :: essays research papers

Prospero’s epilogue at the conclusion of The Tempest provides interesting parallels to its author’s life. Written near the end of his career, numerous scholars suggest that it is Shakespeare’s written farewell. Just as Shakespeare sculpts a world from nothing, Prospero authors the events on the island. Prospero’s monologue flows naturally with they story and provides a natural ending to the work. He describes the loss of his magical power at the beginning of his monologue when he says, â€Å"My charms are all o’erthrown, and what strength I have’s mine own, which is most faint.† He remains â€Å"confined† on the Island because he has already â€Å"pardoned the deceiver† and does not wish to return as the Duke of Naples. He follows this with a peculiar request of those listening to â€Å"release me from my bands with the help of your good hands.† This could be seen literally as a request of the audience to clap so that the sails of the boats will be filled, for his friends’ return trip home. <?xml:namespace prefix="o" ns="urn:schemas-microsoft-com:office:office" /> Contrast this to what Shakespeare is voicing through Prospero. "Now that my charms are all o'erthrown, and what strength I have's mine own,† takes on a new meaning. Now his plays have ended, and anything more he yearns to say can only come directly from him, not through his characters. Furthermore, the "Island" or stage Shakespeare is on is now "bare† and it is time for the audience to release him and his from the play with the "help of [y]our good hands.† Not only was he requesting release from the performance, but from his career as a playwright. In addition, the audience’s pleasure fills his sails, or makes him happy. If no one finds pleasure in his works then what he sent out to accomplish has not been achieved. Finally, after separating the perspectives, one can see how

Understanding Indigenism: Building A Different Future for Us All :: Essays Papers

Understanding Indigenism: Building A Different Future for Us All â€Å"Defining one’s ‘culture’ is a life long process,† according to Indian rights activist Norman DesCampe of the Grand Portage Chippewa Tribe. â€Å"You have to live it.† Today, the life long process of understanding indigenous cultures is limited by terms of â€Å"cultural survival.† The ability of future generations to define themselves as Inuit or Kayapo is threatened as their natural environments and social integrity is hurt by government negligence: indigenous cultures must be protected under a political structure that allows the people to live as they choose to live, outside of the transformative power of established nation-states, and the assumptions of these powers. Thus, international organizations must actively ensure the rights of impoverished indigenous â€Å"states within states†: The right to â€Å"exchange equitably† (Rose 234) as autonomous states with nation states is the basis for the new politically explosive global phenomenon (Neisen 1) of indigenous sovereignty and cultural autonomy. However, in Western government, â€Å"native peoples are in the way because they are thought to undermine the state- whichever state they find themselves in- because of their struggle to maintain their own ways of life† (Wolfe, â€Å"Tribes†). Because they present economic challenges to land use and resource exploitation, indigenous peoples share sufferings under political oppression, deracination and racism and are, as in the case of Australian Aborigines, the â€Å"poorest of the poor.† Destroyed by a â€Å"rhetoric of hate,† genocide and mass murder are the tools of nation states to control the unwanted obstacles in economic development (Niezen 55). Colonialism transformed the indigenous life of the Yanomami, the Maasai, the Hawai’ians, the Aborigines and hundreds of other indigenous peoples. Industrialization moved humanity beyond the â€Å"world in which people mattered to a world in which they are expendable† (Wolfe). Today, still entrenched in the imperialistic ideology of colonialism by modern forms of globalization, nation states noisily quarrel over the rights to exploit both land and people for economic power without regard to indigenous existence. Non-Hawaiian haoles crudely render false historical interpretations of their â€Å"settler society† as a blessed yoke of â€Å"civilization† to the pitiful â€Å"feudal† Hawaiians (Trask). Some indigenous people attempt to assimilate, as â€Å"for years [one Aboriginal man] had ‘sweetened’ himself up just like tea, trying to make himself and others understood [to invading Western cultures]’† but â€Å"‘nothin g been come back. Just nothing’† (Rose 195). Without political muscle, indigenous people are forced to promote ecologically harmful projects, such as hydroelectric dam proposals, to survive within the paradigm of the Western world.

Cancer Genesis and Cancer Treatments: an Overview Essay -- Health, Dis

The human body is made up of trillions of living cells all working together. Normally, these cells grow, divide, and die. However, sometimes the process is mismanaged; and during this time, uncontrolled cellular growth and division occurs. The uncontrolled growth and division lead to tumors, which usually leads to cancer. However, not all tumors lead to cancer. In addition, the word cancer is a general name given to over 100 diseases, which begin with uncontrolled cellular growth. If these growths are left untreated, they can cause severe illness and even death. In the United States, half of all men and one-third of all women will develop cancer sometime during their lifetimes. The threat of developing cancer can be reduced by changing one’s lifestyle. A better diet (Ames, 2001; Bergstrà ¶m et al., 2001), daily physical activity( Kampert et al., 1996), limiting sun exposure (Elwood et al., 1997), quitting smoking (Peto et al., 2000), and reducing excessive alcohol consumption (Tsugane et al., 1999); all add up to a reduced the probability of developing cancer. In addition, the earlier a cancer is diagnosed and treated, the less likely that that individual will die of it. Therefore, the combination of early diagnosis, therapies and lifestyle changes can beat the occurrence of cancer. Cancer Genesis Cancer begins when a cell starts to grow out of control. All cancers begin with out-of-control growth due to damaged DNA. DNA is the genetic material found in every cell, it contains instruction and blue prints for cellular growth, division, and death. Normally, when DNA damage occurs the cell has mechanism to either repair the damage or initiate its own death. However in cancer cells, the DNA damage is not repaired nor does the cell com... ...l activity involving regulatory, metabolic and healing processes. Electrical currents that occur at the site of injuries such as bone fractures are considered a sign of healing energy. In salamanders this contributes to the processes involved in limb regeneration† (O’Clock, 1999). Another type of energy medicine is Ayurveda, which is an ancient Indian medicine system .The therapy re-establishes harmony between the body, mind, and forces of nature to cure cancers and other illness. The therapy requires exercise, herbal remedies, lifestyle changes, and meditation. Practitioners of Ayurveda strengthen and purify their bodies and mind and increase their spiritual awareness. A recent clinical study, by the National Institutes of Health, showed that in 79% of cases, patients with chronic disease had significant improvements after Ayurvedic treatment (Treatments, 2011).

Agent of the Disease Essay

The term â€Å"awareness† has become a popular expression for the past decade. It is now so extensive that its meaning can span from being physically to socially aware. Societal consciousness is kept in a lot of ways because of the vast number of researches in different fields and constant media exposure. People have learned millions of facts about the human body unknown to our ancient ancestors. Yet Dr. Bob Moorehead (1995) has once put that we have â€Å"more medicine, but less wellness†. For instance, cancer is known to be a potent killer of human beings yet until now we have no cure for it. In this sense, let’s take cervical cancer differently. This type of cancer occurring in women is the only one known to be caused by a certain type of human papillomavirus (HPV) (â€Å"Genital HPV Infection,† 2004). Viruses can be destroyed by antiviral agents such as chemicals, ionizing radiation and vaccines (Tortora, 1995). This is the reason why there are a large number of groups around the world promoting awareness about this disease believing that it could be the easiest cancer to fight. The World Health Organization (2007) has categorized human cervical cancer as one of the leading types of cancer in women affecting over 510,000 cases annually. It is often asymptomatic which means that the person infected may not immediately know that she is infected. Tests should be done to detect the presence of this disease. Agent of the Disease A group of DNA viruses from the family Papovaviridae cause cervical cancer. This family also includes viruses that cause warts. Human Papillomavirus is the causative agent of cervical cancer. Certain strains are responsible for the simple warts but a few â€Å"high-risk types† of strains lead to cervical cancer (Parkin, 2006). Although viruses can lead to this disease, the American Cancer Society also lists smoking, secondary infection and genetic predisposition as risky factors (â€Å"Cervical,† 2007). HPV strains 16 and 18 are especially risky to women as it causes a certain change in the cervical cells detected through a Pap test. Thus, a woman can be diagnosed of cervical cancer if there is an HPV infection but not all women with HPV can lead to cervical cancer. Vulnerability to the Disease In 2005, lung cancer is the leading cause of death of American citizens and cervical cancer statistics are low (WHO, 2007). Pregnant women can also be affected by this virus but cases of vertical transmission to the offspring are rare. Basically, men and women are prone to infection and transmission of the virus. Women who get infected by HPV are usually sexually active or may have been exposed to the virus previously. They may have multiple sex partners or a single infected partner (â€Å"Genital HPV Infection,† 2004). Again, the HPV strain that causes warts is different from the one causing cervical cancer which means that having warts is not directly linked to having cervical cancer. Environmental Factors As far as infection is concerned, sexual contact is enough to elicit a possibility especially if the partner is infected by the virus. WHO considers poor diet, primary HIV infection, taking oral contraceptives and multiple pregnancies as environmental risks too. Dietary factors such as having foods that are carcinogenic and unhealthy eating habits can lead not only to cervical cancer but to other diseases too. HIV infection, which impairs the human’s immune system against diseases, may bring about cervical cancer making HPV an opportunistic pathogen. There is no clear basis of the link of oral contraceptives and having multiple pregnancies to cancer but hormonal drugs may induce cellular changes in lining of the cervix. There have been recent reports that the use of condoms reduces the risk of HPV infection and cervical cancer in women (â€Å"Condoms help†¦. ,† 2006). Further studies are conducted about this claim and is still a topic of debate in the scientific community. Modes for Disease Transmission Since cervical cancer is primarily caused by a virus, transmission of the disease is through direct contact, in this case, genital contact. An infected genitalia may have sores or ruptures that may come into contact with an uninfected genitalia. Oral sex can also transmit the virus. HPV infection from mothers to newborns is rare or may lead to respiratory papillomatosis. A recent study has reported that a person that may have been infected earlier by a milder strain of the HPV may lead to cervical cancer. Persistent strains may remain dormant in the body and in later years alter its physiology and cause cervical cancer (Cason, Rice & Best, 1998). Thus, the early claim that only â€Å"high-risk types† of strains can cause cervical cancer needs to be re-assessed. Controlling the Spread of the Disease With the increased awareness of the benefits of early detection and prevention of cervical cancer, there are a lot of ways to avoid contracting and preventing the spread of the disease. Cellular analysis, vaccination, use of condoms and the use of microbicides are few suggestions (â€Å"Human Papillomavirus,† 2007). Cytological analysis of the lining of the cervix, commonly called a Pap smear test is effective in distinguishing cellular growth abnormalities. If the Pap smear test results are abnormal, an HPV test that detects the presence of the DNA of the virus can be subsequently done. There are also latest additions of tetravalent vaccines developed by multinational pharmaceutical companies that are now commercially available for women only. The vaccines are still not fool-proof as there are reports of minor side-effects like having fever and redness of the skin (â€Å"HPV,† 2006). Avoiding sexual contact is the most effortless and cheapest way of prevention. Another simple and convenient technique of preventing spread is through the use of condoms. Although condoms are believed to be preventive of sexually transmitted diseases, the effectivity of this practice is still under deliberation. Still there is no harm in using condoms because prevention is always better than cure. Lastly, latest idea in disease control is the production of topical microbicides that can kill the virus before sexual contact. Social and Cultural Influences It is a stigma in this society being labeled as someone having a sexually transmitted disease. Having the disease is already tough, plus the collective prejudice one is subjected to. In the context of social relevance, people have become liberal about having sexual contact where there is no issue about unmarried couples having sex. Teens under legal age also commit this act. It is therefore incontestable that the chances of contracting the disease are really high in this modern age. Awareness of the cause, prevention, detection and treatment of cervical cancer is indubitably crucial. Social beliefs can sometimes prevent the treatment of the disease. The use of condoms is an issue to the Catholic persuasion. Contraceptives are not an option for Catholics, as instructed by the Vatican. Another issue about the treatment of cervical cancer is the use of vaccines that are not yet suitable for use of everyone and may cause side-effects. From the past decades, there have been significant steps in promoting awareness of sexually transmitted diseases. Princess Diana of Wales guilelessly reduced the stigma put by the society to HIV infected patients all over the world. Other famous figures followed her lead to not only erase prejudice but also to let everyone know what these diseases are and find ways to cure them. In the modern world, certain groups educate people worldwide and create ways to reach out to people such as the Digene Corporation. Conclusion Cervical cancer in women is primarily caused by an infection of the human papillomavirus (HPV). There are certain strains that are â€Å"high-risk† for cervical cancer. It is believed that the virus causes an alteration in the cells of the cervix that can lead to cancer. Transmission of the disease is through direct sexual contact or through oral sex where the uninfected skin comes into contact with an infected sore or lesion. Since the cancer is caused by a virus, it is believed to be treated easily and preventable in some ways. Vaccination, the use of condom and topical microbicides, and undergoing the Pap test are some suggested ways to avoid and control the spread of the disease. Due to its curable nature, steps are now done to promote awareness about the disease so that people can avoid contracting and find ways to cure it. References Cason, J. , Rice, P. , & Best, J. (1998). Transmission of cervical cancer-associated human papillomaviruses from mother to child. Intervirology, 41:213-218. Retrieved July 6, 2007, from http://content. karger. com/ProdukteDB/produkte. asp? Doi=24939 â€Å"Cervical Cancer†. 2007, Wikipedia: The Free Encyclopedia (2007).. Retrieved July 5, 2007, from http://en. wikipedia. org/wiki/Cervical_cancer Condoms help protect against cervical cancer 2006. Associated Press. Retrieved July 6, 2007, from http://www. msnbc. msn. com/id/13461194/ â€Å"Genital HPV Infection – CDC Fact Sheet† 2004. U. S. Department of Health and Human Services. Retrieved July 5, 2007, from http://www. cdc. gov/std/HPV/STDFact-HPV. htm â€Å"HPV (Human Papillomavirus)†. 2006. U. S. Food and Drug Administration. Retrieved July 5, 2007, from http://www. fda. gov/WOMENS/getthefacts/hpv. html â€Å"Human Papillomavirus† . 2007. Wikipedia: The Free Encyclopedia (2007).. Retrieved July 5, 2007, from http://en. wikipedia. org/wiki/Human_papillomavirus â€Å"Human papillomavirus infection and cervical cancer†. 2007. World Health Organization. Retrieved July 5, 2007, from http://www. who. int/vaccine_research/diseases/hpv/en/ Moorehead, B. (1995). â€Å"The Paradox of our age. † Retrieved July 6, 2007, from http://www. trans4mind. com/counterpoint/moorehead. shtml Parkin DM (2006). â€Å"The global health burden of infection-associated cancers in the year 2002†. Int. J. Cancer 118 (12): 3030-44. PMID 16404738. Tortora,G. J. et. al. 1995. Microbiology: An Introduction. 5th ed. USA: The Benjamin/Cummings Publishing Company. â€Å"The Impact of Cancer† 2007. World Health Organization. Retrieved July 5, 2007, from http://www. who. int/ncd_surveillance/infobase/web/InfoBasePolicyMaker/reports/ReporterFullView. aspx? id=5

Mind Games Essay

The goal of argumentative writing is to persuade the audience that their ideas are valid or more valid then other authors. Greek philosopher and writer, Aristotle, divided persuasion into three sections: Ethos, Pathos, and Logos. These persuasion guidelines give readers a sense of credibility, emotion, and reasoning. Ethos is associated with credibility or ethical appeal (Ch. 3, Ethos). Does the author portray the characters as people who are worthy of respect? One problem with argumentation is the ability to impress the reader. By making the character someone that is respected and therefore likable the reader is more interested in the work. An example of this would be a doctor, lawyer, or veteran. Even though all of these jobs serve our community in different ways, they are all respected by society. Another example of logos that the book noted was â€Å"If a company is well known, liked, and respected, that reputation will contribute to it’s persuasive power (Ruszkiewicz, 56).† If its character is problematic in any respect, it may have to use argument to reshape an audience’s perception (Ruszkiewicz, 56). Authors will also use ethos from personal experience. Writer and activist Terry Williams attacks those who poisoned the Utah deserts with nuclear radiation (Williams, 58) Terry Williams is a women worth listening to because she has lived with the nuclear peril. These are just some of the ways authors can show authority. Pathos is emotional and persuades by appealing to the reader’s emotions (Ch. 2, Pathos). Language choice affects the audience’s response, and emotional appeal can enhance an argument. The book gives an example of a teacher telling her students that she is legally blind (Kleege, 45). While reading this example, you are probably envisioning yourself sitting in the classroom in shock from what you just heard. When someone gives you information about them or reveals a truth, as the listener, you are taking in everything the speaker is saying; while relating that to every circumstance you can recall. As a student sitting in her classroom, you are thinking about your personal experience with another blind person and forming your own opinion on this person. This example plays in on your emotional side because from the very first day you are aware of your teacher’s disability. Pathos does not always have to be sad; it can also be humorous. Writers can use humor to lighten up the mood and make the reader more comfortable with an argument. The example from Dave Barry (Barry, 49) touches on the idea that men do not need to read the manual but often times make mistakes. This particular example is saying men think they know all, but in reality, they still need help. Logos persuades by the use of reasoning (Ch. 4, Logos). The heart of the argument is presenting the reader with reasons. Effective persuasion can help you back up your claims as well as give proof to your argument. Aristotle divided argumentative writing into facts and reason (Ruszkiewicz, 69). He used what we call hard evidence and reason or common sense (Ruszkiewicz, 69). The book gave an example of U.S. ambassador to the UN asking ambassador Zorin if he had â€Å"placed or is placing medium and intermediate range missiles and sites in Cuba (Ruszkiewicz, 70)?† Representatives allowed him to ask this question because he had hard evidence of spy photographs to prove his claim (Ruszkiewicz). Logos can be shown through text also. By reprinting a single page from a document, you have proof from years past. The example in the book stated the connection between statements and proofs was credible. The article talked about gun ownership (Lindgren, 75). Logos is important in argumentative writing because readers like to have more then one credible source. As a college student, I would write an article on local colleges and universities providing more activities to 18-20 year old students. This article would show ethos because I am a nineteen-year-old local college student. This topic would show pathos because I am appealing to local people that might be affected by drunken college students driving on the roads. I would use the local police records to provide logos to persuade my readers. Another college student might write an essay to persuade local governments to allow 18-21 year old students into the bars. It would be important for the writer to be a responsible college student to establish ethos. The student could argue that this policy would allow underage students to be designated drivers for the legalized students. This would demonstrate pathos. The writer could use local traffic records and news stories to create logos. When an author writes a good rhetorical essay it is similar to a sales representative selling a product. The writer is selling their idea to the public just like the sales rep is selling their product. It will be important for both of them to establish ethos with their audience to make credible representations. They will both use pathos to interest a person in their product or idea. It is also important for both of them to use logos to back up the claims they are making. A sales rep will be rewarded with a commission, and a successful write will be rewarded with future writing assignments. Works cited Ruszkiewicz, Andrea A. Lunsford John J. Everything’s an argument. Vol. 56. Boston: Bedford/St. Martins, 2009.