Identify the key characteristics of the health care services external Essay

Identify the key characteristics of the health care services external environment and discuss their implications for for the pro - Essay Example Whereby, external environment may involve analyzing Strength, Weakness, Opportunities and Threats that may affect provision of health care service (SWOT analysis). On the other hand, internal environment of a health care service may involve determining hospital clients, competitors, stakeholders/collaborators as well as climate which an organization is operating in (Muller, Bezuidenhout and Jooste, 2006). External factor may include; a social, religious believes, occupation and education level may affect provision of health care services (Hitchcock, Schubert and Thomas, 2003). In addition, health campaigns via the social media may influence people behaviours towards health services. For example; health mass media may sensitize and encourage people on the importance of early diagnosis and treatment of diseases. This in turn may have a significant impact on provision of health services (Moseley, 2009). Economic factors may further affect provision of health services. For example, the d iscrepancies in people levels of income may determine the accessibility of health services. Whereby, poor people may not be in a position to afford quality health services unlike the affluent. Additionally, laws and regulations may affect provision of health services because organization must observe established health standards. Hospitals and health organizations must protect the environment and ensure that people take medical insurance cover. On the contrary, internal factors may involves people believes and their core values with respect to the provision of health care services. Connectively, internal factors may further involve the level of knowledge among the people. This may significantly impact provision of health services because people with higher level of knowledge are likely to seek health services than the less knowledgeable members of the society (Muller, Bezuidenhout and Jooste, 2006). Key characteristics of the health care services external and Internal Health Care En vironment External Health Care Environment The United Kingdom health care service contains the following characteristic; population size, mandate, accountability, funding and managing performance. Population characteristic entails actions undertaken by various bodies such as strategic health authority which is responsible for a population of 2.6-7.5 million people. In addition, the primary care trust was responsible for a population of more than ninety thousand people. On the other hand, the public care trust collaborated with local authorities in provision of health. In addition the general practice and foundation trust were also involved in health population (The Change Foundation’s, 2009). Mandate involves the duties and responsibilities that system managers, commissioners and General practice should execute. For instance, system managers should not only make health plans but they should also monitor the progress of both National Health Service and Primary Care Trust. On t he contrary, health care commissioners have a duty of developing local health strategies as well as monitoring and integrating social and health services. In addition, general practice (GP) such as nurses, pharmacist therapist, opticians and dentist they have a both clinical and managerial responsibility (The Change Foundation’s, 2009). In above connection, Secretary of state for health and department of health should be accountable in quality of health and ensure close monitoring of both National

Midterm Assignment Example | Topics and Well Written Essays - 1500 words - 1

Midterm - Assignment Example The fall of this age credited with the Dorian Invasion, which is believed to have happened around 1100 B.C., and which came to be the conclusive deathblow to the Minoan civilization (Lawall & Maynard 24). According to Greek legend, it was in this age that the Oedipus tragedy evolved, and the story later depicted in Aeschylus' Oresteia played out. This was the time of the famous Trojan War, which left the Trojans and Greeks alike bereft of some of their most beloved and courageous men who died as heroes on the incarnadine battle fields (Lawall & Maynard 34). This was the time of the wonderings of Aeneas and Odysseus after the war, and a time where the inhabitants of Mount Olympus interacted with the humans more than ever. Homer did not live during the time, which is named after him. He is believed to have lived three hundred years after the Homeric Age of which he wrote about in his epic poems (35). He is, of course, our most important literary source for knowledge of this period, com bining the history, religion, myth, and lore of many generations (Lawall & Maynard 37). The political institutions of the Homeric Greeks were exceedingly primitive. ... Practically his only functions were military and priestly. He commanded the army in time of war and offered sacrifices to keep the gods on the good side of the community (Lawall & Maynard 48). Although each little group of villages had its council of nobles and assembly of warriors, of these bodies had neither any definite membership nor status as an organ of government. The duties of the former were to advise and assist the king and prevent him from usurping despotic powers. The  functions of the latter were to ratify declarations of war and assent to the conclusion of peace (Lawall & Maynard 50). Almost without exception, custom took the place of law, and the administration of justice was private. Even willful murder was punishable only by the family of the victim. While it is true that the king for settlement, he acted in such cases merely as an arbitrator, not as a judge. As a matter of fact, the political consciousness of   the Greeks of this time was so poorly developed tha t they had no conception of government as an indispensable agency for the preservation of social order. When Odysseus, king of Ithaca , was absent for twenty years , no regent was appointed in his place , and no session of the council or assembly was held. No one seemed to think that the complete suspension of government, even for so long a time, was a matter of any critical importance. Just before the violent Doric invasions, the Achaeans fought the Trojans of Asia Minor. The chronicle of that war, the Iliad, furnishes the first clear picture of the early Greek religion as it evolved from a blending of Achaean, Dorian, Minoan, Egyptian, and Asian elements. This phase of Greek religion called Homeric, after the

Corporate social responsibility Essay Example for Free

Corporate social responsibility Essay 1) Corporate Ethics The broad area dealing with the way in which a company behaves towards, and conducts business with, its internal and external STAKEHOLDERS, including employees, investors, creditors, customers, and regulators. In certain national systems minimum standards are required or recommended in order to eliminate potential conflicts of interest or client/employee mistreatment. 2) Board of Directors (BOD) An appointed or elected body or committee that has overall responsibility for the management of a nonprofit or nonstock organization, such as a foundation, university or mutual fund. 3) Executive Officer is generally a person responsible for running an organization, although the exact nature of the role varies depending on the organization. 4) Corporate Compliance means having internal policies and procedures designed to prevent and detect violations of applicable law, regulations, rules and ethical standards by employees, agents and others. It involves legal risk management and internal controls. 5) Corporate Governance refers to the set of systems, principles and processes by which a company is governed. They provide the guidelines as to how the company can be directed or controlled such that it can fulfil its goals and objectives in a manner that adds to the value of the company and is also beneficial for all stakeholders in the long term. 6) Corporate Responsibility includes being consistent with ethical principles and conduct such as honesty, integrity and respect for others. By voluntarily accepting responsibility for its actions corporations earn their licence to operate in society. 7) Corporate Social Responsibility is a form of corporate self-regulation integrated into a business model. CSR policy functions as a built-in, self-regulating mechanism whereby a business monitors and ensures its active compliance with the spirit of the law, ethical standards, and international norms. 8) Corporate Sustainability is a business approach that creates long-term consumer and employee value by not only creating a green strategy aimed towards the natural environment, but taking into consideration every dimension of how a business operates in the social, cultural, and economic environment. Also formulating strategies to build a company that fosters longevity through transparency and proper employee development.

Examples of Unethical Experiments

Examples of Unethical Experiments Section 1 HISTORICAL CASES Nazi Experimentations –Testing the effectiveness of sulfanilamide and other drugs in curbing infections. ETHICAL PRINCIPLES NOT MET: Respect for Human dignity Informed Consent Privacy Respect for Vulnerable persons Minimizing harm and maximizing benefit The persons involved in these experiments, were Human beings. Their privacy was invaded by these Nazi doctors. There was coercion – they did not have a say in terms of what was being done to them. Having battlefield wounds being inflicted, was not a voluntary decision by these people. Since the doctors in Nazi Germany were guided by utilitarian moral principles, they did not need to consider informed consent. Experiments were conducted with no considerations for the wellbeing of the subject from the possibilities of injury, disability, or death. In these experiments the subjects experienced extreme pain, resulting in permanent injury, mutilation, or death. Respect for these subjects in the eyes of the Nazis was not a priority, as they were seen to be â€Å"Less-Human.† These people were vulnerable to the Nazis, and to whatever was being done to them. Minimizing harm was not a consideration that was taken by the nazi medics. However, even though it was for the Germans be nefit, it was torture for the Jewish and Non-German people. There is no way in which this experiment can be reconstructed to become an ethical process. However, since it was geared towards finding cures for those wounded in battle, what can be a possible suggestion is that, instead of using those innocent people and inflicting battle wounds, the wounded casualties should have been used instead, with consent ofcourse, to find those possible remedies for infections. Another senario, would have been to take blood samples of infected persons, again with consent, and test with appropriate apparatus/equipments to find cures. Tuskegee Syphilis Study- Learning more about syphillis and its treatment, especially for blacks in the U.S. This study had good intentions. However, it shifted from helping persons with the disease to becoming a study about the effects of untreated Syphilis on live patients. At the time, the â€Å"couloureds† had no access to medical care. This study was more or less based on Deception. ETHICAL PRINCIPLES NOT MET: Respect for Human Dignity Informed Consent Respect for vulnerable persons minimizing harm and maximizing benefit Independence of research and conflicts of interest or partiality must be explicit. The participants in this study were not informed that they were more or less test subjects, and the doctors were more interested in the results of their autopsies. It is more accurate to say however that they were informed, but rather misinformed, and not notified that the disease they were being treated for was indeed serious and possibly fatal. â€Å"The duration of the experiment was so long that the study violated two laws that were passed since its beginning. The Henderson Act of 1943, which requires the testing and treatment of sexually transmitted diseases, and the World Health Organizations (W.H.O.) Declaration of Helsinki of 1964, which requires professionals to provide informed consent on all medical experiments that researched effects on people (Brunner, 2009). Despite the passing of these laws the doctors involved in the study not only withheld information from these men, but also deliberately misinformed them and prevented them from seeking alternative methods of effective treatment.† (Amaris Joy, 2011) How can this process be revised, so as to become more ethical? Participants need to be informed and not mislead about the study. Researchers should not maximize harm to obtain maximum benefit The rights of Human beings/dignity should be of a high priority Research should be made explicit Blood samples should have been taken, with consent and with the person being throughly informed, and then be analysed for a cure, thereby not using the individual and having him/her prone to any harm. Since penicilin was used to counter the disease, it should have been enforced. The government should have been aware that the study was going on after they found the penicilin cure and should have shut down the study. They should have been more aware of what was going on. The Willowbrook Study ETHICAL PRINCIPLES NOT MET: Respect for Vulnerable persons Respect for Human dignity Witholding information about risks Coercion or undue pressure on parents to volunteer their children. Willowbrook State School, located in Staten Island, is a school for retarded children, which in 1956, agreed to participate in a research experiment to determine the course of the hepatitis virus and whether or not gamma globulin (a protein complex which contains antigens to provoke the body to produce antibodies) could be used to inoculate children against the virus. How can this process be revised, so as to become more ethical? A series of Blood samples of those infected or who have now enrolled to the school, could have been taken with parents informed consent at different phases, and analysed with the various methods to find the cure. Children should not be taken for experimentation without their consent or parents consent children should not have been used as test subjects at all. Laud Humphrey, 1960s, Washington University (PhD diss) Tearoom Sex Study The study planned first to obtain information about homosexual practices in public restrooms and then to conduct further investigation on the men who took part in the acts. The researcher went undercover and gained the confidence of the men by acting as a look out. The researcher identified 100 active subjects by tracing their car license numbers. A year after he completed the initial study of direct observation of homosexual acts the researcher distributed a social health survey throughout the communities where he knew the subjects lived. ETHICAL PRINCIPLES NOT MET: Respect for privacy and confidentiality Respect for vulnerable persons Ensuring research was conducted in the best interest of society Respect for free and informed consent How can this process be revised, so as to become more ethical? What Laud Humphrey should have done, was not to pry on peoples privacy, but interview those who were willing to go along with his study, who found themselves in that category. Questionaires/Surveys done with confidentiality could have been done instead, being distributed to various communities. Section 2-Report THE UNIVERSITY OF RED BRICKS WARRENVILLE CAMPUS Research Ethics Board March 11, 2014 Dr. Researcha, University of Red Bricks, Warrenville Campus. Re: Approval report on the research proposal requested by Dr. Geographia. Dear Dr. Researcha, As an external reviewer of Dr. Geographias study of community vulnerability to natural disasters, I have approved the complete protocol, â€Å"Strategies of the richest and most famous: Minimizing vulnerability to Earthquakes and other Natural Disasters in Trinidad and Tobago.† The Project is scheduled to last twenty-four months, which includes the areas of Warrenville and surroundings, commencing on May 5, 2014. Dr. Geographia, is very experienced in this area of study, has published in peer reviewed journals, and has many books published in the subject area of natural hazards and risk perceptions. The protocol involves no special populations in particular, thereby reducing the ethical principle of subject vulnerability. The pupose of the proposed research is limited only to the social elite, being approximately five percent and not to socio-economically disadvantaged groups. According to the proposal read, this study seeks to disclose the resources, networks, and strategies of the countrys wealthiest and apply the results gained to formulate a â€Å"trickle-down† mobilization stategy. In emulating societys elite, this can strengthen the socially disadvantaged in coping with natural hazards. The study incorporates views and community perceptions.Quantitative methods such as blood sampling, laboratory usage, and other sampling experiments and analysis will not be performed. The study is a Qualitative study. Research material will be obtained through semi-structured interview via researchers within the residents homes, taped and transcibed, completed in the participants homes for their comfort, in keeping with ensuring research is conducted in the best interest of the society as a whole. The ethical principle of Privacy and confidentiality will therefore not be compromised as the study demands the highest discretions due to the wealth status of the individuals participating. Respect for free and informed consent, will be adhered, since once the participant decides to take part, their verbal consent will be recorded, and therefore a consent form will not be necessary. Data will be collated and analyzed in order to formulate applications to prevent loss and vulnerability among the poorest in the Region. Her study in no way violates any other ethical principles such as respect for human dignity, confidentiality, justice, and respect for minimizing harm and maximising benefit. No harm is done to the participants in the study. It has minimal to no risks involved. Benefits are obtained, when results are obtained and analyzed accordingly. The proposal is a more or less cost effective study. Whatever expences are required, are thereby funded by Right Hand Left Hand Insurance Group. A suggestion that I would recommend, is that Dr. Geographia should incorporate in her study, the views and opinions of the Poor. The study should be revised to incorporate the poor, although the main focus is on the social elite. The perspectives of the socio-economically disadvantage will add leverage to her study, and a deeper understanding of their own responces to natural hazards can be contrasted and compared to that of the social elite. Sincerly, _________________________ TARA TRISHA MANNIE. EXTERNAL REVIEWER

Supporting Pupils On Autistic Spectrum In Mainstream Classroom Education Essay

Supporting Pupils On Autistic Spectrum In Mainstream Classroom Education Essay Introduction The National Autistic Society (NAS) describes Autism as: A lifelong developmental disability that affects how a person communicates with, and relates to, other people and the world around them. It  is a spectrum condition, which means that, while all people with autism share certain areas of difficulty, their condition will affect them in different ways.  Asperger syndrome is a form of autism. (NAS, website) Autistic Spectrum Disorders (ASD) can have an effect on the ability of a child to learn and participate in the classroom, however, there are ways to ensure autistic children learn and participate within the mainstream environment. As a teacher of Support for Learning, I am working in both the Primary and Secondary sectors. My role involves supporting children with additional needs within a mainstream school, either in the classroom, one-to-one or in small groups. The pupils I support display an array of additional needs including those exhibiting autistic tendencies. Looking at a case study of a child within a mainstream primary school exhibiting autistic tendencies, this assignment discusses the topic of ASD; the historical aspects, characteristics, theories and diagnosis, policy and legislation, and support provided. The Case Study Child Pupil N is 10 years old, and in primary 5. When the family moved from England to Scotland he was held back for a year in nursery due to delayed development. He had communication and language difficulties which were amplified when he started nursery in a Scottish school, not only did he have difficulties understanding spoken language, but he now had to contend with the Scottish accent as well. To gain some background information, I designed a questionnaire for parents to complete. The questionnaire was carried out verbally during a telephone conversation with Ns mother. During the conversation, she also clarified some of the questions in more detail. (See appendix 1) As shown in the questionnaire, and from my own observations, some of the characteristics displayed by pupil N, which are identified in the triad of impairments, include: lack of eye contact, poor social skills, difficulty in forming friendships with peers, delayed speech although he now speaks fluently, however he does have difficulty in understanding language; liking for sameness, a special interest in tractors, does not initiate and sustain conversation, has had frequent diarrhoea and issues with going to the toilet, which seems to have improved as he has grown older; he can also occasionally, swear and display aggressive behaviour towards others, and gets in trouble for this at school. The Historical aspects of Autism Research in Autism dates back to 1938, though Wing (1993) suggests there were accounts in literature prior to this, but states there is no information as to the occurrence of autism before the second half of the twentieth century, however Volkmar, et al (2005) suggests that in 1867 Henry Maudsley possibly made the first step toward a classification by grouping children with peculiar, unhinged behavior under the label insane. He suggested a number of subgroups, one of which he called instinctive insanity, which could indicate that some of the children he discussed had ASD. Studies carried out by Kanner in 1943 involved children identified as having conditions which were different and unique from anything recognized so far. Around the same time, but independently, Asperger also carried out work in the same field. All of the children in Kanners study were different but displayed very similar characteristics; the common elements found in these children included a lack of emotion, repetitive actions, speech formation problems, ability to manipulate various objects, learning difficulties, and their levels of intelligence. Kanner noted the symptoms were very similar to those of schizophrenia however, they appeared to manifest at a much earlier age. He assumed that à ¢Ã¢â€š ¬Ã‚ ¦.. these children had come into the world with an innate inability to form the usual, biologically provided affective contact with people. (Kanner, 1943 p250) Asperger discovered many individuals had similar problems with social skills and repetitive actions but did not have trouble with learning or their cognitive abilities. Some showed exceptional talents or abilities that were considered outstanding. Both Kanners 1943 study Autistic Disturbances in Affective Contact and Aspergers 1944 study Autistic Psychopathy in Childhood are important in early autism research, though Aspergers study was not translated into English until 1991 by Dr. Uta Frith. (Long, B. 2007, website) Both Kanner and Asperger described autism as a distinctive developmental disorder that had not been clinically described before; people suffering from it were unduly considered to be mentally handicapped. (Bogdashina. 2005) Defining Autism There has been much research, and varying theories in the field of autism since the studies of Kanner and Asperger, however there does not appear to be a single core deficit, nor is there a cure. Authors such as Happe (1994), Powell and Jordan (1997), Sicile-Kira (2003), Bogdashina (2005), and Lathe (2006), discuss the most universally used criteria for defining and diagnosing autism which is known as Wings Triad of Impairments. The Triad of Impairments is based on certain behavioural characteristics, described by Schreibman (2005) as deficits, which are exhibited in three main areas: impairments of social interaction, impairments in social communication and impairments in imagination. Impairments of Social Interaction Wing (2003) suggests this can be shown in different ways, and groups them into four categories: The aloof group Probably the most common social impairment in young children; behaving as if other people do not exist, and not responding when spoken to; appearing to have empty expressionless faces unless displaying extreme anger, distress or joy. They tend not to want to be touched, and do not make eye contact; rather they look past or straight through you. They show no sympathy if you are in pain or upset, and seem to be in a world of their own. For some it may change as they grow older, but for others it may continue throughout life. The passive group Children and adults are not completely cut off and accept approaches from others; however they do not instigate social interaction; also having difficulties with eye contact but can often make contact when reminded. Passive children are happy to join in games but can often be left out when games change. Generally, their behaviour is less problematic although some can display disturbed behaviour during adolescence. The active but odd group People in this category can initiate contact with others but this can appear odd and inappropriate, and tends to be with those in charge rather than their peers. They appear to be concerned with their own needs rather than those of others. When not getting the attention they want, they can behave aggressively towards others, due to the lack of understanding of social interaction. The over-formal, stilted group This type of behaviour usually manifests in later adolescence, in those who are more able, with a good level of language. They tend to be over polite and formal, and try very hard to be well behaved. However, they do not fully understand the rules of social interaction and have difficulty adapting their behaviour to different situations. Impairments of social communication Baron-Cohen (2008) claims that if children do not produce single words by the age of two, or phrased speech by the age of three; they are identified as having language delay. Pupil N did not speak until nursery age, even then, he could not form the words properly and was referred for Speech and Language Therapy (SALT). Wing (2003), suggests that all children and adults with ASD have communication problems; however Baron-Cohen (2008) suggests there is no speech and language delay with Asperger Syndrome. Wing (2003) states that speech and language delays are common, some may never speak at all. Those who do speak often start by repeating words echolalia, spoken by others. Echolalia can be immediate or delayed. With delayed echolalia, they can often repeat something randomly that they have heard previously, which could be some time ago. The level of understanding varies; most have some understanding although this can be limited. They also have difficulties in understanding non-verbal communication such as nodding ones head, and facial expressions. A major characteristic is that they take things literally, for example, if they were told it is raining cats and dogs, they would expect to see cats and dogs falling from the sky, therefore care is needed when speaking to a person with an ASD; figures of speech can be taken at face value, leading to stress and terror. The majority of people with ASD have an odd monotonous tone when speaking, which can be inappropriate, they can occasionally speak too loud or too quiet; some often use their special voice which is different from their own. Impairments of Imagination Children with ASD are unable to develop imaginative play. Some do show evidence of imaginative play; however it tends to be very repetitive, doing the same thing over and over again. Some may even copy a character they have seen on television or in a book, or a non-living object, but also in a repetitive manor. Other repetitive activities include tapping, tasting, smelling, feeling and scratching different surfaces, and some can inflict self-injury in the form of scratching, biting and head-banging. (Wing, 2003) Other features suggested by Sicile-Kira, (2003) include: Not liking change in routine or environment Not reaching developmental milestones Only eating certain foods Eating or chewing unusual things Lacking of common sense Not understanding simple requests Frequent diarrhoea, upset stomach or constipation. Theories in Autism Theoretical approaches to research in Autism include neuropathological and neuropsychological. Neuropathological Neuropathology relates to the central nervous system and brain. Discussed by Frith (2003) and Feinstein (2010), Kemper and Bauman carried out a study which led to autism being treated as a biological disorder. They found that cells in the hippocampus, subiculum and amygdala; parts of the brain associated with emotions, space, behaviour and memory (OMara et al, 2009), were decreased in size and closely packed, and suggested the irregularity occurred in the cells during early development. Anthony Bailey noted that four out of six people with autism had unusually large heavy brains, and Dr. Eric Courchesne reported that he found evidence of rapid brain overgrowth in the first year, in infants who develop autism. Dr Manuel Casanova investigated mini-columns of neurons; the smallest unit of cells capable of processing information, and suggested they are smaller and more abundant in autistic people. Gillberg, Kemper and Bauman were interested in both sides of the brain as the left side deals with linguistic performance, while the right side deals with non-verbal communications such as, gestures and emotional expression, which are impaired in autism. (Feinstein, 2010) Neuropsychological Theories The non-social features that have been explained by researchers include: theory of mind, weak central coherence, executive dysfunction and joint attention. Theory of Mind Theory of mind is the ability to impute mental states to self and others. (Doherty 2008) Baron-Cohen, Leslie and Frith (1985) suggested that autistic children do not develop theory of mind (ToM). Research was carried out by using the Sally Anne test (See appendix 2) which suggested that they suffer from mind blindness and cannot envisage what others might think. ToM attracted criticism due to the fact that dolls were used instead of real people. Baron-Cohen cited by Feinstein (2010), stated that the test produced similar results after being carried out again with real people. Weak central coherence Normally developing people process information by looking at and understanding the whole picture. Frith and Happà © cited by Rajendran and Mitchell (2007), suggest people with autism process the component parts individually rather than the whole; indicating that they have weak global coherence. Shah and Frith tested central coherence using the Wechsler block design (See appendix 3), which requires children to use separate blocks to construct an entire design. They found that autistic children produced a higher score than others in the test, and were also faster in constructing the design. (Frith 1985, Shah and Frith, 1993) Frith, cited by Rajendran and Mitchell (2007), argues that autistic people perform better on these tasks because they lack the understanding of global form. Executive Dysfunction Executive function (EF) is defined as the ability to sustain problem-solving activities for achieving future goals. EF is used for activities such as planning, organizing, strategizing and paying attention to and remembering details. Researchers have noted that symptoms that are not explained by ToM can resemble specific brain injury symptoms, which has led to Ozonoff theorizing that autism could be explained as a deficit in EF. However, different researchers have produced differing results, which suggests that not all autistic individuals exhibit EF problems, also, these difficulties are seen in other disorders and not exclusive to autism. (Rajendran and Mitchell 2007) Joint attention Joint attention is the way in which one draws somebodys attention to a stimulus by gazing or pointing. This developmental milestone emerges around six months of age. Charman (2003) suggests impairments in joint attention are among the earliest signs of the disorder. There has been other hypothesis suggested as causing autism such as the triple MMR (measles, mumps, rubella) vaccine, implicated by Dr Andrew Wakefield, which is administered to children at eighteen months, around the same time that autism is most commonly detected. Rutter, cited by Feinstein (2010), stated that although research has pointed out that there is no link between autism and the MMR, there are still some parents who choose to have individual vaccinations for their children. Although many theories have been connected with the origins of autism, the core deficits of the disorder are still unknown. Kemper, cited by Feinstein (2010), stated: there is not going to be one cause or treatment. Diagnosis Sicile-Kira, (2003) states that there is no medical test to diagnose ASD, and any diagnosis is based on observation of behavioural characteristics. Medical practitioners base the diagnosis on guidelines set out in the World Health Organizations International Classification of Diseases (ICD-10), which requires that all three of the triad of impairments are present at 36 months of age; or the American Psychiatric Associations system the Diagnostic and Statistical Manual (DSM-IV) and (DSM-IV-TR), which also requires that the age of onset should be recorded. (AWARES.org, website) The ICD-10 specifies that at least 8 of the 16 specified items must be fulfilled, which should include 3 from Impairments of reciprocal social interaction, 2 from Qualitative abnormalities in communication, and 2 from Restricted, repetitive, and stereotyped patterns of behaviour, interests and activities. The diagnosis for Asperger Syndrome is similar to Autism however; the diagnosis requires that single words should have developed by two years of age or earlier. (World Health Organization, 1993) The Criteria from DSM-IV specifies there should be a total of six or more items which includes 2 from Qualitative impairments in social interaction, 1 from each of the other areas. For Asperger Syndrome, the DSM-IV also states there should be no significant impairments in language communication. (American Psychiatric Association, Internet source) The guidelines for diagnosing autism differ from each other in that the ICD-10 requires a minimum of 8 manifestations for a diagnosis, whereas, the DSM-IV only requires 6. It appears that a person may or may not be diagnosed with autism, depending on which criteria are used. After many conversations with researchers, Feinstein (2010) suggests that there has been an increase in the prevalence of Autism, possibly due to the expansion of the spectrum and improvements in diagnostic tools. Dorothy Bishop re-tested adults diagnosed with speech and language disorder as children, but not autism, which resulted in a quarter of them being re-diagnosed with autism. (Feinstein, 2010) Criticisms of diagnostic criteria Cited by Feinstein (2010), researchers such as Lorna Wing, Dr Patricia Howlin, Christopher Gillberg, and Dr Fred Volkmar who was on the DSM-IV classification drafting committee, have criticized the ICD-10 and DSM-IV, especially as far as Asperger syndrome is concerned. They suggest it is very feigned; both criteria state that spoken language must be normal for an Asperger syndrome diagnosis, when in fact; Asperger originally stated that peculiarities of speech and language were a key feature. Fombonne (1999) suggests that there are more boys than girls diagnosed with autism; on the other hand, Dr Judith Gould cited by Hill (2009) argues that doctors are failing to diagnose thousands of girls who have Aspergers syndrome, and suggests that girls are not being noticed in the first place, or if they ask for help, they are being turned away and are often rejected when referred for diagnosis. Pupil N appears to display many signs of autism but does not have a medical diagnosis; however he has been diagnosed with speech and language delay, and health issues such as toileting. HMIE (2006), state that for best practice, education authorities should not limit support only to those with a formal ASD medical diagnosis. There are many reasons why N may not have an official diagnosis. Autism is very complex; therefore it is possible that the behaviours he displays fit into more than one category, or none at all, depending on any criteria used, which can make it difficult to ascertain. Also, diagnosis can be time consuming and perhaps stressful for the child and the parents. A survey carried out by Osborne and Reed (2008) examined how communication between parents and professionals concerning ASD and its diagnosis, could be facilitated; most parents wanted a quicker and easier process, and would prefer the procedure to be more consistent in content and structure. They also called for better professional training and awareness about ASD, especially regarding the information that professionals possess, and the interpersonal skills of some professionals. Sicile-Kira, (2003) suggests if parents have concerns about their child, it is important to seek advice from a medical professional who is experienced in ASD, and acquire a diagnosis as early as possible to gain access to services. Another reason which may prevent a parent from requesting a medical diagnosis is the stigma of labeling a child. Labeling can suggest a low overall attainment compared with their peers, have an effect on the attitude and behaviour of teachers towards children, and affect the children themselves. (Hart, et al, 2004) Authors such as Sicile-Kira, (2003) and Ho, (2004) comment that labels ascertain the eligibility for people to access benefits and services, however, Ho (2004) also argues that it provides an excuse for school officials to assume a medical model of learning disabilities, and ignore other problems in our educational and social systems that give rise to a range of students learning difficulties. Policy and Legislation In 2001, Scottish Ministers commissioned the Public Health Institute of Scotland (PHIS, now NHS) to carry out a needs assessment of services for people with ASD in Scotland. The aim was to look at current service provision, and provide advice on how the services could better meet the needs of both children and adults with ASD. The report suggested a lack of understanding amongst service providers of the nature of ASD and made 32 recommendations, resulting in the National ASD Reference Group being set up by The Scottish Executive in June 2002, to identify priorities to support the development of good practice across a range of services. (PHIS, 2001) The Scottish Executive (2006) suggested an audit of training in each NHS board with a view to addressing training needs and gaps, this corroborates the earlier discussion that parents suggested there is a need for more professional training and awareness about ASD, however, the Scottish Executive (2006) only discussed training for health practitioners and not education. In the past, pupils with additional needs would have been educated within a special school; recent legislation and policy such as The Standards in Scotlands Schools etc Act 2000, and The Education (Additional Support for Learning) (Scotland) Act, 2004, places a duty on education authorities to meet the needs of all pupils in a mainstream environment, where possible, alongside their peers, including those with additional support needs. Children are described as having additional support needs if they require additional support to enable them to make progress in their learning. My local authority provides guidance to schools for supporting children with autism, with a staged intervention procedure to meet the needs of children and young people on the autistic spectrum, which  acknowledges the role of multi-agencies in developing consistency in both school and home. HMIE (2006) implies that some education staff feel they do not have enough knowledge and understanding of ASD therefore, training for all staff involved in the education of pupils with ASD is an important area to develop. They also argue that parents are not always kept fully informed about the range of provision available for their children, implying there is a greater need for collaboration between parents, teachers and other professionals. The HMIE report highlights a conversation with Ns class teacher (appendix 4), in which she commented that he is a bit strange, and gave the impression that she is unaware of Ns difficulties, therefore, there is a need for more collaboration to develop a good working relationship with the class teacher, pupil and parents, in order to meet his learning needs. Collaboration can mean different things to different people, at different times; on a professional level, through sharing good practice, it can improve effectiveness, self-reflection and teacher learning; on a personal level, it can enhance moral support and confidence. Effective schools need effective communication and collaboration amongst staff, other agents, parents and pupils. (Head 2003) Classroom Practice Powell and Jordan (1997) state that a great deal of what needs to be taught to pupils with autism is out-with the curriculum, such as interaction and communication skills, therefore the needs of the child should determine the curriculum. Most children require some one-to-one teaching, not just to address their difficulties, but also develop their skills and strengths. Pupil N was known to the Speech and Language Services in England prior to moving to Scotland (See appendix 5), and received some one-to-one support in the form of SALT, which continued until 2007. He then received an Individualised Educational Programme (IEP) and support at school level to address his literacy skills. When I started this post a teacher of SFL in January 2010 pupil N was being removed from class along with five other pupils, to work on the literacy program Read and Write Inc (RWI) (See appendix 6), which provides a structured approach to the teaching of phonics and literacy. (Miskin, R, website updated 2010) As I did not know anything about the pupils at the start, I decided to re-assess their reading ability in the RWI programme, and found that although pupil N could read the words, he did not fully understand. I have recently been involved in auditing pupils needs within the school, to identify that require high, medium and low priority support, along with colleagues, with a view to making changes in the way support is offered, and produce an IEP for those who need one. Up until now, all the pupils have been coming out of class for support rather than receiving in-class support. The changes would allow more targeted support to meet the individual needs of the children, within the class, individually, and in small groups. Children have the right to say what they think should happen and have their opinions taken into account when adults are making decisions that affect them (UNICEF, 1991), therefore, the audit included a questionnaire to find out what support and help the pupils felt they needed. When asked, it appeared that pupil N did not fully understand the questions; however, he did say that he liked to come out of class, preferably on his own. (See appendix 7) During the audit, I discovered that the last IEP for pupil N was in 2008, and had not been reviewed. Through collaboration with pupil N, his class teacher and parents, a new IEP has been developed. (See appendix 8) During a conversation with Ns mother at parents evening, she felt his needs were not all being appropriately met, she had not been fully informed of his progress except through yearly class-teacher reports, and was unaware that N had previously received an IEP. A copy of the new IEP has been sent home to parents to allow them to become more involved in Ns learning and development, which should have been done with his previous IEP. The class teacher, parents and I will now take steps in working towards developing strategies to enable N to meet his IEP targets and enhance his learning to make further progress. Conclusion Very little was known about autism during the early part of the twentieth century; however, since the reports by Kanner and Asperger, much research has been carried out. Many hypotheses have been identified and researched, such as Theory of Mind, Weak Central Coherence, Executive Dysfunction and Joint Attention and impairments in the function of various parts of the brain. The MMR vaccine has also been implicated in the cause of autism; though this was dismissed through further research. Although there has been much research into possible causes, and the various theories look as if they may all be related, there does not appear to be one single cause, but rather, many; those with autism seem to display traits from all of the theories in varying degrees. For a diagnosis, there needs to be a display of the characteristics from the Triad of Impairments, however the criteria for diagnosis differs, in that, a person may or may not be diagnosed with autism, depending on whether the ICD-10 or the DSM-IV is used. Although Pupil N does not have a formal ASD diagnosis, he does display many characteristics, and according to HMIE (2006), for best practice, he should receive the support as he would if he was diagnosed. After carrying out the audit of needs for all the pupils with additional needs in the school, it appeared that although pupil N had made much progress in terms of speech and reading, there are other difficulties and strengths, which have not yet been addressed. The new IEP which has been developed in collaboration with the pupil, parents, class teacher and I is the start of working towards meeting those needs. There will be a review in three months time to assess progress, and a continued support and review cycle thereafter.

Essay --

Introduction Romance, cuisine, the attractions, the history†¦these are all aspects of France that are appealing to the common tourist. It is even more exciting to get paid to travel to a foreign country as part of a job. But amidst a cloud of clichà ©s many Americans do not really know how to make business with the French, the differences of body language, etiquette, expressions, and even the values of the French people. That is why it is essential to know about all aspects of the country before traveling to do business. Since comportment is key to likability the purpose of this report is to inform the reader of the customs, traditions, and manners in order to avoid awkward instances of cultural ignorance. It includes tips on dining etiquette, greetings, body language, French culture including food cuisine, art, fashion, major attractions, currency, time difference and other smaller aspects such as correspondence, business relationships, and even idioms. The ultimate intention is not only a s to inform travelers, but perhaps even shed light on some of the less unknown parts of the French experience and make the trip to the illustrious country all the more enjoyable. Bon voyage! Language and Greetings In order to be able to negotiate and persuade effectively, a person needs to have some knowledge of the French language. Below is a list of essential and commonly used greetings in France. French English Salut Hi Bienvenue Welcome Bonjour Good day Bonsoir Good night Bonne Journà ©e Good day or Goodbye Bonne Soirà ©e Good evening or Goodbye Bonne Nuit Good night Au revoir Goodbye. Salut Goodbye à  tout de suite See you in a minute à  plus tard See you later à  la prochaine Until next time. à  demain. See you tomorrow à  la semaine pr... ...ich may give off the impression as unfriendly - just another common misconception of the French. In fact, they offer much closer hugs and a few kisses too. Of course they may not want to talk about personal affairs at the dinner table such as salaries, religion, and politics, but they do it just to avoid trouble. In this way they are not stiff upper-lipped people, but calm and relaxed and wanting to enjoy life to the fullest (even if it requires a few love affairs here and there). Some of France’s laws may be a little questionable, and their business cards may not be able to fit into your average wallet, however, doing business here is not only exciting, but possibly life changing. Seeing aspects of regular life from a different perspective which may not only affect the way a person does business, but also looks at their own life - family, government, and culture. Essay -- Introduction Romance, cuisine, the attractions, the history†¦these are all aspects of France that are appealing to the common tourist. It is even more exciting to get paid to travel to a foreign country as part of a job. But amidst a cloud of clichà ©s many Americans do not really know how to make business with the French, the differences of body language, etiquette, expressions, and even the values of the French people. That is why it is essential to know about all aspects of the country before traveling to do business. Since comportment is key to likability the purpose of this report is to inform the reader of the customs, traditions, and manners in order to avoid awkward instances of cultural ignorance. It includes tips on dining etiquette, greetings, body language, French culture including food cuisine, art, fashion, major attractions, currency, time difference and other smaller aspects such as correspondence, business relationships, and even idioms. The ultimate intention is not only a s to inform travelers, but perhaps even shed light on some of the less unknown parts of the French experience and make the trip to the illustrious country all the more enjoyable. Bon voyage! Language and Greetings In order to be able to negotiate and persuade effectively, a person needs to have some knowledge of the French language. Below is a list of essential and commonly used greetings in France. French English Salut Hi Bienvenue Welcome Bonjour Good day Bonsoir Good night Bonne Journà ©e Good day or Goodbye Bonne Soirà ©e Good evening or Goodbye Bonne Nuit Good night Au revoir Goodbye. Salut Goodbye à  tout de suite See you in a minute à  plus tard See you later à  la prochaine Until next time. à  demain. See you tomorrow à  la semaine pr... ...ich may give off the impression as unfriendly - just another common misconception of the French. In fact, they offer much closer hugs and a few kisses too. Of course they may not want to talk about personal affairs at the dinner table such as salaries, religion, and politics, but they do it just to avoid trouble. In this way they are not stiff upper-lipped people, but calm and relaxed and wanting to enjoy life to the fullest (even if it requires a few love affairs here and there). Some of France’s laws may be a little questionable, and their business cards may not be able to fit into your average wallet, however, doing business here is not only exciting, but possibly life changing. Seeing aspects of regular life from a different perspective which may not only affect the way a person does business, but also looks at their own life - family, government, and culture.

Good and Evil in Quinns Ishmael Essay -- Daniel Quinn essays research

Human beings are destroying the world. It's a fact we all know. Pollution is abundant, we chop down rain forests, we kill our own kind, we steal, lie, and cheat, and the list could go on and on. Daniel Quinn believes that this destruction comes from something more extreme than just the notion to survive. In his novel, Ishmael, Quinn believes that the problems facing humanity are do to man's knowledge of good and evil.   Ã‚  Ã‚  Ã‚  Ã‚  Man's knowledge of good and evil gives us the power to rule the world any way we please. A God or Gods no longer have control. Once Adam, who represents the life of the human race, took a bite from the fruit of the tree of knowledge man's fate was sealed. This knowledge insured, "Man was born to rule the world" (165). To man this knowledge is the greatest of all. Becau...