History of the Ancient Olympics

History of the Ancient Olympics The Origins and History of the Ancient Olympics Introduction The first ancient Olympic Games can be traced back to 776 B.C and were celebrated until 393 A.D (Young, 1987). The Games continued for twelve centuries and were dedicated to Olympian gods. Olympia became the site of these historic ancient games that sowed the seeds for the most coveted sporting international event of modern times, the Modern Olympics. The site of the Ancient Olympics is located in the western part of Peloponnese. According to Greek mythology, Peloponnese is the island of Pelops, the Founder of the Olympic Games (Young, 1987). Olympia, in Greece is the sanctuary site for the ancient Greek gods. The central part of Olympia was dominated by the majestic temple of Zeus. The ancient games enjoyed a secular tradition and aimed at securing good relations between the cities of Greece and showing physical qualities and evolution of the performances accomplished by the youth. The Olympic Games were held in four years intervals at the ancient stadium in Olympia that could accommodate more than 40,000 spectators. The surrounding areas around the ancient Olympic stadium were continuously developed until the 4th century BC and were used as training grounds for athletes or to serve as homes for the Olympic judges (Young, 1987). The Ancient Olympics allowed only free men who spoke Greek to participate in the Games. The ancient games had a slight international spirit as they included participants from other parts of Greece. The Greeks that came to the Sanctuary of Zeus at Olympia shared the same religious beliefs and spoke the same language. The athletes were all male citizens of the city-states from every corner of the Greek world, coming from as far away as Iberia (Spain) in the west and the Black Sea (Turkey) in the east (Reeser, 2005) In the ancient Olympics, married women were not allowed to participate in any way. However unmarried women could only spectate. The ancient Olympic Games though did not allow female participants; an exception was made at the Herean Games, staged every four years to honour Hera, wife of Zeus, allowing female athletes to participate in the games. Kyniska, daughter of King Archidamos of Sparta, was the first woman to be listed as an Olympic victor in Antiquity. The events were judged by the Herald, a Hellanodikis (Greek Judge). The Olympic victors in ancient times received their awards immediately after the competition. The Herald, after announcing the name of the victor, placed a palm branch in his hands. Red ribbons were tied on his head and hands to symbolize his victory. The official award ceremony that took place on the last day of the Games was a proud day for the victor. From the elevated vestibule of the temple of Zeus, the Herald announced the name of the winner, his fathers na me and the name of his homeland. The winner was finally honoured with the Herald placing the sacred olive tree wreath or kotinos on the winners head (Reeser, 2005). The Olympic Games, originally created to honour Zeus, was the most important national festival of the ancient Greeks, and a focus of political rivalries between the nation-states. However, all competitions involved individual competitors rather than teams. Winning an Olympic contest was regarded more highly than winning a battle and was proof of an individual athletes personal excellence. The winners were presented with garlands, crowned with olive wreaths, and viewed as national heroes (Young, 1987). Although records of the Olympics date back to 776 BC when the Olympics were reorganized and the official First Olympiad was held, Homers Iliad suggests that they existed as early as the 12th century BC. Emperor Theodosius I of Rome discontinued them in the 4th century AD, and they did not occur again until they were reinstated in Athens in 1896 (Young, 1987). Originally, the Olympics was confined to running, but by the 15th Olympiad, additional sports were added, such as the pentathlon which was made up of five different events, boxing, wrestling, chariot racing, as well as a variety of foot races of varying lengths, including a long-distance race of approximately 2.5 miles. Athletes usually competed without clothes proudly displaying their perfect bodies. Women, foreigners, slaves, and dishonoured persons were forbidden to compete; women, once they were married, were not allowed to spectate any Olympic events, except for chariot races (Reeser, 2005). The actual events taking place have changed significantly since the Ancient Olympics. Evidence shown in pictures, dating from circa 490-480 BC, depicts two men wrestling. Above them hang a discus in its bag and a pair of jumping weights called halteres. Long jumpers used the weights to increase their competition distances by vigorously swinging them forward at the moment of takeoff. The coach or trainer stands to the left of the wrestlers, leaning on his staff and holding a long forked branch. (Rhizopoulou, 2004). The ancient Olympic Games began in the year 776 BC, when Koroibos, a cook from the nearby city of Elis, won the stadium race, a foot race 600 feet long. According to (Wei, 1996), this was the only athletic event of the games for the first 13 Olympic festivals or until 724 BC. From 776 BC, the Games were held in Olympia every four years for almost 12 centuries (Young, 1987). The marathon was not an event of the ancient Olympic Games. The marathon is a modern event that was first introduced in the Modern Olympic Games of 1896 in Athens, a race from the northeast of Athens to the Olympic Stadium and the athlete had to complete over a distance of 40 kilometres. The race commemorates the run of Pheidippides, an ancient day-runner who carried the news of the Persian landing at Marathon of 490 B.C. to Sparta (a distance of 149 miles) in order to enlist help for the battle. According to (finely, 1976) during the fifth century B.C. Ancient Greek historian Herodotus, Pheidippides delivered the news to the Spartans the next day. The distance of the modern marathon was standardized as 26 miles 385 yards or 42.195 km. in 1908 when the Olympic Games were held in London. The distance was the exact measurement between Windsor Castle, the start of the race, and the finish line inside White City Stadium (Wei, 1996). Although the ancient Games were staged in Olympia, Greece, from 776 BC through 393 AD, it took 1503 years for the Olympics to return. The first modern Olympics were held in Athens, Greece, in 1896. The man responsible for its rebirth was a Frenchman named Baron Pierre de Coubertin, who presented the idea in 1894. His original thought was to unveil the modern Games in 1900 in his native Paris, but delegates from 34 countries were so enthralled with the concept that they convinced him to move the Games up to 1896 and have Athens serve as the first host (Wei, 1996). The idea of the Olympic torch or Olympic Flame was first inaugurated in the 1928 Olympic Games in Amsterdam. There was no torch relay in the ancient Olympic Games. There were known, however, torch relays in other ancient Greek athletic festivals including those held at Athens. The modern Olympic torch relay was first took place at the 1936 Olympic Games in Berlin. The Modern Olympic flag of five linked rings, each with a primary colour used in the flags of the nations competing in the games, was introduced in 1908. There is no ancient basis for this modern symbol (Rhizopoulou, 2004). THE POLITICS OF THE OLYMPIC GAMES The celebration of the Olympic Games in antiquity was an occasion for citizens of scattered Greek city-states to assemble. At the Games they discussed important political issues, celebrated common military victories and even formed political and military alliances. But the Games were not only a forum in which to discuss political events; they were also the cause of political conflict. Control of the Sanctuary and the Games brought with it prestige, economic advantages and, most importantly, political influence. As early as the 7th century BC we hear of disputes over the control of the Sanctuary of Zeus at Olympia between the city of Elis (30 miles to the north) and the small neighbouring town of Pisa (Wei, 1996). In 668 BC, according to Pausanias (a 2nd century AD Greek traveller), the powerful tyrant of Argos (named Pheidon) was asked by the town of Pisa to capture the Sanctuary of Zeus from the city-state of Elis. Pheidon, with his army of well-trained hoplites (armed soldiers), marched across the Peloponnesos, secured the Sanctuary for the town of Pisa, and personally presided over the conduct of the games. But Pisas control of the Sanctuary was brief: by the next year Elis had regained control (Fineley, 1976). The Olympic Truce was instituted by the city-state of Elis to protect against military incursions which interrupted the Games. Every four years, special heralds from Elis were sent out to all corners of the Greek world to announce the approaching Olympic festival and games. Along with this news, they would announce the Olympic Truce, which protected athletes, visitors, spectators and official embassies who came to the festival from becoming involved in local conflicts. Later, political tyrants of the 7th and 6th centuries BC attempted to achieve influence by more peaceful means. They participated in the athletic and equestrian contests of the Olympic Games and dedicated conspicuously lavish offerings to Olympian Zeus at the site of the games (Finley, 1976). Nowadays there is a strong connection between salesmanship and sports and some would even say that the line between sales pitching and fast pitches has become completely blurred. At Olympic competitions, athletes uniforms and equipment bear the discreet but readily identifiable trademarks of their manufacturers. After the Games, we are presented with images of Olympians endorsing products and appearing on cereal boxes. Later, some Olympic celebrities become commodities themselves, as TV shows and record labels cash in on their fame (Wei, 1996). Even in the Ancient Olympics, the victorious athletes were still celebrated and became famous for their outstanding abilities and achievements. Sculptors were commissioned to create statues of victorious athletes to be set up in the Sanctuary or in the home town of the athlete. According to Pliny, most of the statues set up in the Sanctuary of Zeus at Olympia were idealistic images of athletes. We are told that only if an athlete had won three Olympic victories could a realistic likeness of the athlete appear in the Sanctuary. In the Ancient Olympics, if an athlete was found guilty of cheating or bribing officials, they would be subjected to some form of public humiliation. For example if athletes were found guilty of cheating the they were made to created statues of the eventual champions which were placed in stadium so that people could celebrate them (Rhizopoulou , 2004). THE MODERN OLYMPICS Todays Modern Olympic Games have 32 different categories of competitive events. When you consider that of these many, like track and field, have several events within the category and then break down further to mens and womens and team and individual competition, it is nearly impossible to keep track of the Games as they progress. Things were much simpler in the past. The Ancient Olympics had 13 events which were divided into 6 main categories and only men were allowed to participate in the events (Vassill, 2004). The main categories were boxing, equestrian events, pentathlon, running and jumping. The Equestrian events were broken down into two sub-categories: chariot racing and riding. The Pentathlon was a combination of five events: discus, javelin, jump, running, and wrestling (Crowther, 1996). Boxing in ancient Greece had fewer rules than boxing today. There were no rounds and boxers fought until one of them was knocked out, or admitted he had been beaten. There was no rule that prevented a boxer from hitting an opponent when he was down. There was no weight class in either the mens or boys divisions and the contestants were chosen randomly. The boxers did not wear gloves but wrapped their hands and wrists with leather straps called himantes.and this meant that their fingers were left free (Vassill, 2004). Equestrian events were divided into classes of chariot racing and riding. The chariot races consisted of both the 2-horse chariot and the 4-horse chariot and there were separate races for chariots drawn by foals. There was a race of carts included in this event that consisted of competition between carts drawn by teams of 2 mules. The length of the chariot races was 12 laps around the stadium track which was approximately 9 miles (Vassill, 2004). Riding was the other equestrian event and the course was 6 laps around the stadium track which equaled 4.5 miles. The jockeys rode without stirrups and the races were broken down into competition between foals and full-grown horses. Because it was so expensive to train, feed and equip the participants the owners were awarded the olive wreath of victory instead of the riders (Wei, 1996). The most physical event of the Ancient Olympic Games was the pankration. This grueling event consisted of both boxing and wrestling. The hands were not wrapped in the leather himantes. The only limitations on physical brutality were the rules against biting and gouging the opponents eyes, nose, or mouth with fingernails. Kicking in any part of the body was allowed. There were separate divisions for men and boys, but like in boxing there was no weight division and the opponents were chosen at random (Vassill, 2004). The pentathlon, like the modern event, consisted of a 5-event combination. The 5 events of the Ancient Olympic Games were discus, javelin, jumping, running and wrestling. The Greeks considered this the most beautiful of the contests as it combined the endurance of the race course and the bodily strength necessary for the other physical events. The discus was made out of either of iron, stone, bronze, or leads and was shaped to resemble the discus of today. The sizes varied and the boys competed with a lighter weight than the men. The ancient Greeks thought the precision and rhythm of an athlete throwing the discus as important as his strength (Wei, 1996). The javelin was a throwing event as in the modern games and like the discus the competition was based on the distance the object was thrown and in the case of the javelin the precision. The javelin was made of wood, with either a sharpened end or an attached metal point. The javelin had a thong for the throwersfingers that was attached close to the center of gravity of the instrument that increased the precision and distance of the throw (Wei, 1996). The jump event was similar to the modern long jump but with a major exception. The jumpers carried stone or lead weights called halteres. These weights, shaped like telephone receivers, were carried out in front of the jumper when they jumped the weights were thrust backward and dropped during the descent to increase the distance of the jump (Fineley , 1976). Running was broken down into 4 types of races in the Ancient Olympic Games. The stadion was the oldest of the events and consisted of a sprint covering one stade (192 meters) which was the length of the stadium. Other races were the 2-stade race and the long distance runranged from 7 to 24 stades. The most grueling of the races was the warrior race designed to build and test the speed and stamina Greek men needed for military service. The race was 2 to 4-stades in distance and was run by an athlete wearing armor. The standard armor of that time weighed approximately 50-60 pounds and of course included a helmet and shield (Fineley, 1976). Wrestling was similar to the modern sport in that the athlete was required to throw his opponent to the ground landing on a hip, shoulder, or back for a fair fall. To win a match required 3 fair falls or throws. Genital holds and biting were not allowed and breaking your opponents fingers was also not permitted (Vassill, 2004). The art and sculpture of ancient Greece is alive with the depictions of the Olympics and the events described in this article. One can feel the excitement and spirit of the Ancient Olympic Games in that art. In modern games the spirit of the Olympism of old is recreated in the ceremonies and competitiveness of the event (Fineley, 1976) In conclusion the Ancient Olympics were held to honour Zeus. There were 13 events in the Ancient Olympics compared to the 32 events in the modern Olympics. Most of the events that were held at the Ancient Olympics are still part of the modern day Olympics. In the ancient Olympics only men were allowed to compete whereas nowadays men and women are allowed to compete in all of the events. The athlete who won gold medals at the Ancient Olympics had sculptures with their picture on them so that people could celebrate their victory. Nowadays, there are some traditions that are still valued and for many athletes, winning an Olympic gold medal is still the main highlight of their career. Reference Page Crowther, N, (1996), athlete and state: qualifying for the Olympics games in ancient Greece, journal of sport history, 41 800-688 Finley, I, (1976), Olympic Games the first thousand years, London, Chatto Windus. Reese, J, C, (2005) Gender identity and sport: is the playing field level, Journal of Sports Medline, 39 695-699 Rhizopoulou, S, (2004), Symbolic plant (s) of the Olympic Games Journal of Experimental Botany, 46, 620-588 Vassill, G, (2004).The Olympic Games explained a student guide to the evolution of the modern Olympic Games, London, Routledge. Wei, Y, (1996), The Olympic image the first 100 years, Edmonton, Alberta, QuonEditions. Young, D, (1987), The origins of the modern Olympics a new version, International Journal of the History of Sport, 39 695-699

Teaching Preschool Children Reading

Phonological awareness is an important aspect in the fundamentals of reading. It is the first step in literacy. Children can learn phonological awareness in a variety of ways. Rhyming, sentence and word recognition, sound knowledge, phonemes, letter identification, spelling, and games which require active listening are a few of the techniques used by teachers in the classroom. All of these methods help in a child’s reading and speech fluency.All children need to learn how to read and write in order to survive in today’s society. There have been many different methods used in order to teach phonemic awareness to preschool children. Phonemic awareness is the capability of an individual to differentiate, identify and manipulate specific sounds. An example would be a child combining and blending the sounds in the word cat. Many people believe that phonics and phonemic awareness are the same thing. However, phonic awareness is recognizing that words come from sounds with in turn make up a language. Phonics is knowing that sounds are composed of letters which compose a writing style.In order to teach a child phonic awareness and to read, a teacher must comprehend the procedure that the brain formulates in order to understand the printed data. The brain undergoes three functions which facilitate understanding. First, there is information retention which has to deal with spurs of the environment. Second, language articulation is where a child uses prior knowledge in order to associate its meaning; and the third process is modeling and making connections with former information . Reading comprehension occurs in the frontal lobe of the brain. When this process takes place, it leads to an understanding and knowledge of what a person has seen and read.Phonological processing is a person’s ability to listen and  comprehend dialect as well as printed terms. Hence, it is to say that the child recognizes the sound each letter makes. Mechanically our brai n unconsciously processes verbal communication. Instantly a child gathers phonemes in order to pronounce the word and decomposes it to grasp the oral language. In contrast to speech, reading involves a child’s knowledge in the process of associating written words with the alphabet and in turn producing spoken words. Therefore, a child has to be of conscious mind in order to learn reading. A teacher must instruct a child in the phonological sequences of letters in order for the child to acquire phonological processing.There are many different techniques a teacher can utilize in order to build phonological awareness. One technique would be merging words and sounds collectively in order to construct new words. The words composed can be silly or factual. This technique facilitates the child’s use of phonemes, which was a study conducted by McCandlies, Cohen, and Dehaene in 2003 . Having a child combine letters and then separating them is another form of building phonologic al awareness. It will also help them in recognizing the letters of the alphabet. Examples of the activities mentioned above are having a child say the first sound in the word â€Å"rat† and then saying each letter sound individually. Blending would consist of telling a child say ‘at’ and then stating to them to put an ‘r’ in front and say the new word.These activities can been done with a variety of materials such as chalk, boards and markers. Remember preschool children are very visual. The more movement they utilize, the better they retain the information. Image is a phonic awareness 3 letter word game.Many people do not see imaginative play as a means of learning. However, it is during play that children are at their most influential developmental stage according to Vygotsky, a Russian psychologist. Since the children are imaging different situations, they are associating everyday activities and assigning meaning to them. During this time, individ uals and items can transform themselves into different things. For example, a child can become a cat, or a baby and a piece of construction paper can be converted into a notepad for taking orders in a restaurant. Through the children’s interactions and language, they gather and exchange knowledge, experiences,  and vocabulary which enhance their verbal communication through mutual exchange (Genishi and Dyson, 2009).Collaborative songs and games can also be a means to teach phonological awareness. Nursery rhymes can be utilized as a tool for phonological awareness. Rhyming activities such as asking a child which words rhyme or which ones do not rhyme will enhance their awareness. A teacher may also say a word and ask a child which word rhymes with it (Phillips, Clancy-Menchetti, Lonigan, 2008). Some examples would be: this old man, head shoulder knees and toes, one two buckle my shoe and Humpty Dumpty. Games that constitute phonological awareness do not have to come from a b ook. They can be invented from one’s everyday activities. Examples of these activities would be a trip to the grocery store or beauty salon.Children can be asked which items in the store begin with the same letter sound or which nail polishes have the same letters in them. If a child does not respond or say the correct answer, be sure to mirror the correct response and not state that they were wrong. The teacher should support the child through the learning process. The following illustration explains the steps of phonological awareness.Activities which implement pattern recognition are also efficient at phonological awareness. This is an excellent tool to utilize in the classroom due to the fact that children learn how to read by identifying patterns. When a child associates words from letter patterns and connects the sounds, this is called patterning. A teacher should replicate, rehearses, and observe the children when teaching pattern recognition in order to determine the child’s advancements in this area. Assessments should cover word subdivision, sound combinations, and sorting new data into patterns. Repetition is the key in the learning process.Preschool children have a short attention span; therefore, keep activities fun and exciting in order to facilitate the best learning environment. Not all children have the same literacy background and predisposition; they come from a variety of environments and cultural upbringings. Consequently, teachers must adapt to each individual child’s style of learning and pace. There will always be  variations in the learning process.Technology is a part of our everyday lives. Children have computers, iPhones, iPod’s, and tablets. Since technology surrounds children twenty -four hours of the day, seven days a week, parents need to take advantage of the situation and use the time wisely. There are many games online which can help children build their phonological awareness. Websites which par ents can utilize are: starfall.com, PBSkids.com, ABCmouse.com, learninggamesforkids.com, sheppardsoftware.com, and ezschools.com.All these websites provide educational games for preschool children. They have a variety of subjects such as math, reading, and science. Also they cover the fundamentals of the alphabet, phonics, sounds, and blending. These games are especially interesting for those children who are visual and auditory learners.Percentage of children who are going online daily for educational purposes As stated above, there are many different techniques that a teacher can employ in order to educate a child. Other methods such as repeated reading, modeling fluency, and leap frog are also useful tools in phonological awareness. Children imitate and mimic adult behavior. Therefore, it is vital that a teacher speaks to a child in the appropriate grammatical matter. They will store the information and use it later in other situations that arise. Although a preschool child does not know how to read, they do make associations with words. Hence, reading every day for thirty minutes will build a child’s vocabulary.Books which have tape recordings and CDs are also good sources for vocabulary buildings, rhyme, and word segmentation. In these days, parents are not concerned about their children’s education. They spend fifty or more dollars on video games instead of providing educational support. It is ignorant for them to believe that programs like VPK and Head Start are providing a child to play and interact socially. Although social interaction is vital to a preschool child, education stimulation is also crucial. Teachers go through countless training sessions in order to provide their students with high standards. There are a variety of sources that parents and teachers can use. Computer games, internet sites, books, rhymes, music and movement, and activities created by the teacher or parent are all ways to provide phonological awareness.Parents and teachers alike have to remember that every child is  different and each child has his or her way of thinking and processing information. Thus, educators and parents have to learn their child’s learning style whether it is audio, visual, or kinesthetic in order to provide a grade a learning environment. Reading, writing, and spelling are the principles of fluency. If children are provided with the proper tools now, they will be better equipped for the future. Remember, the children of today will be the leaders of tomorrow!

Nursing and nutrition

IntroductionIn different healthcare institutions the question of feeding patients, particularly those who are seriously sick and expected to die soon, raises questions of moral and ethical nature thus making a decision making process very difficult for the caring staff. Such questions may include:–  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   How can decisions of giving or withholding feeding and hydration be made?–  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   What values and assumptions underlie these decisions?–  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Which courses of action are in the patient's ‘best interest', and how is this ‘interest' determined?–  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   How and when, if ever, should a decision not to feed or hydrate be made?–  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Can so basic a provision as food and water ever be considered as optional care?In most of the healthcare institutions whether they are hospitals or senior homes, the decision making lies within the practice of the nurses who are usually faced with dilemmas. While doctors are more advanced in professional knowledge they rarely find themselves in the difficult situation of making the decision of withholding nutrition or giving it. However, there is sometimes a differentiation between nutrition as part of the care given to the patient and nutrition as a biological life sustaining process:â€Å"In modern practice there is often an underlying tension between two different understandings of ‘nourishing' the patient. First, nourishing as an intrinsic part of giving care, which falls within the realm of nursing. Second, nourishing as a biological and technical process, a life-sustaining treatment under the control of the medical or nutrition team (from which the nurse may be excluded).† (Hunt, 1994)Yet the daily practice and the roles of nurses and doctors indicate that the nurses find themselves in the dilemma of making the decision more than other medical staff. In many cases where the withholding of nutrition is legally right and in the interest of the patient, the nurse still finds herself in the ethical and professional dilemma. She is not given the opportunity to discuss her opinion or given any information. As a result whatever decision she makes may be taken as wrong regardless of the fact that she was partially ignorant.The dilemma is even more difficult when considering nutrition as a basic need or a medical treatment. For a seriously sick person one may accept withholding medication or a technological device that prolongs life unnecessarily, but it is not easy to withhold nutrition which is the basic need for healthy and unhealthy persons.  Ã¢â‚¬Å"Dresser asks, ‘Ought we to regard tube and intravenous feeding as forms of medical treatment, or should we classify them with more basic sorts of care?'† (Dresser, 1985)The decision of withholding nutrition or hydration is a difficult ethical questi on that poses emotional stress on the nurses. Withholding medication or technological devices is justifiable and there is enough professional and legal guidance for healthcare staff to follow. Indeed, â€Å"Food and water are so central to an array of human emotions that it is almost impossible to consider them with the same emotional detachment that one might feel toward a respirator or a dialysis machine† (Lynn & Childress, 1983)In this research I am going to study this issue in order to confirm or rule out the possibility of establishing a professional guidance that assists the nurses in decision making. This is expected to relief them from a lot of stress and confusion that are imposed as a result of dealing with the issue on personal terms rather dealing with it objectively according to professional guidance and standards.The proposal for this research will be studied under the following headings:1.    Description of a case study2.    Literature review3.      Pro posal4.      Summary and ConclusionsDescription of a Case StudyA case study either from literature or from the records of healthcare institution is expected to illustrate the extent of the problem and its importance. In addition this will emphasise the roles of nurses, relatives and patients in the decision making process. It would also highlight the difficulties facing nurses at different stages of care giving for seriously sick persons.  At this stage of building the skeleton of this research paper very little can be said about the case study until one has been adopted.Literature ReviewThe literature generally confirms the importance of the problem and has been addressing the issues related to the problem of nutrition for sometime now. While it is suggested in the literature that in some cases of chronically ill persons the provision of nutrition is burdensome rather than beneficial, it is agreed that the interpersonal and inter-professional tensions of nurses are ignored. ( Hunt, 1994) It is also pointed out that the stressful environment in which nurses provide their professional care sometimes result in burnouts.The burnout case â€Å"evolves by a process involving three stages: (a) an imbalance between resources and demands, (b) the immediate short-term emotional response to the imbalance, and (c) changes in attitude and behavior such as negativism and emotional detachment† (Riordan & Saltzer, 1992). However, it is also indicated that there are personal differences here: while one may react to stressors by becoming a burnout another with personal hardiness may find the stressors only minor irritants. Riordan and Saltzer (1992) assert:  Ã¢â‚¬Å"Current literature points unanimously to a proactive approach in preventing burnout. This preserves organizational integrity by maintaining human resources and supplying cost-effective care while maintaining quality† (Riordan & Saltzer, 1992).There are a number of suggestions for reducing stress and assisting nurses to cope with the environmental difficulties, though no specific guidelines or procedures are given for dealing with the problem of nutrition and hydration.  It is also indicated in the literature that nutrition and hydration in some terminal cases may only prolong the biological life which is thought to be burdensome for some patients and their families. As Hunt (1994) asserts: â€Å"Feeding may in some circumstances prolong the process of dying and may cause avoidable suffering to the dying patient.†While generally the decision of using nutrition support for the terminally ill people is discussed as a problem facing nurses, some scholars relate the decision to dietitians.  Ã¢â‚¬Å"Clinical guidelines for nutrition support indicate that dietitians should be members of institutional ethics committees and should have an integral role in institutional policy development concerning nutrition support at the end of lifeâ€Å" (Langdon et al, 2002)To put it in a nutshell the literature review confirms the dilemma facing healthcare professionals, particularly nurses, and families in dealing with the decision of providing nutrition and hydration or withholding it for chronically ill people whose illness is diagnosed as terminal. It is also confirmed that the decision making involves personal feelings, ethics, and sometimes legal consideration. Yet there are no clear professional guidelines that streamline the decision making in this issue in the professional practice. Rather there are observations of some acceptable practices.Sometimes the distinction between ordinary and extraordinary is used as a means of reaching decision.  Ã¢â‚¬Å"However, there appears to be an increasing opinion that artificial feeding can be viewed as a'heroic' method of treatment and is morally optional (Meyers and Grodin 1991, Hoefler and Kamoie 1994, Singer 1995, Gillick 2000).This optional treatment is referred to as ‘extraordinary' and is more likely t o be invasive, artificial or complex. Nevertheless, the Hastings Centre guidelines, cited in Meyers and Grodin (1991), stated that decisions over whether to provide artificial nutrition and hydration cannot be made solely on the distinction between ordinary and extraordinary methods of treatment. Despite this, Solomon et al (1993) demonstrated that 74 per cent of health professionals continued to use this distinction in termination of treatment decisions. It would also seem that the decision was significantly influenced by whether it was a decision to withdraw treatment or simply not initiate it in the first place. The Hastings Centre guidelines stipulate that this distinction should not be a consideration (Meyers and Grodin 1991)† (Young et al, 2002).The problem of decision making in providing or withholding nutrition and hydration in the case terminally ill people is a dilemma for nurses until some professional steps are identified to make the decision an objective one made on the basis of professional judgement   rather than being a personal one affected by personal feelings, ethics, beliefs etc.ProposalSince the aim of the study is to justify a professional basis for decision making, in this study we will attempt to investigate the possibility of establishing professional guidelines that may relief the burden on nurses. This will involve identifying criteria that make withholding nutrition more beneficial to the patient than prolonging his biological life. It should also be essential to identify professional means that enable healthcare staff to decide that a patient is not making any sense of life and advise families accordingly to participate in decision making. This should be important especially when the patient is suffering pain or given morphine regularly.In order to be able to design a professional tool or procedure that assists nurses in decision making through this study or alternatively recommend further research on this issue, the study will be a non-experimental one designed to elicit the RN’s attitudes towards nutrition of chronically ill patients using survey instrumentation.The sample will be full time RNs employed by a healthcare region in hospitals and nursing homes of the region. It is advisable to include also a sample of dietitians working in the same healthcare institutions. The RNs involved need to be well informed about the study and its aims and should be positively motivated to participate in the study.It is also important for the study to be approved by a professional body that confirms the study question and methods are ethical.  The instruments of the study should be designed in a way that they measure the attitude of the study sample towards giving or withholding nutrition and hydration for a variety of terminally ill patients. It is also important to determine the internal consistency reliability for the questionnaires and structured interviews.Summary and ConclusionsThese will follow na turally from the analysis of data and discussions and will eventually constitute a recommendation: either a draft of a guideline for assisting nurses in decision making or alternatively suggestions for further research in order to identify a suitable professional tool for relieving the burden on nurses.ReferencesI am not going to list the references now since this is just a skeleton to discuss with your supervisor; unless you deem it necessary.  The word count may not be exactly 3500, but I think what has been written here is enough for your purposes. As soon as you give feedback on this I will start work on the proposal. Nursing and nutrition IntroductionIn different healthcare institutions the question of feeding patients, particularly those who are seriously sick and expected to die soon, raises questions of moral and ethical nature thus making a decision making process very difficult for the caring staff. Such questions may include:How can decisions of giving or withholding feeding and hydration be made?What values and assumptions underlie these decisions?Which courses of action are in the patient's ‘best interest', and how is this ‘interest' determined?How and when, if ever, should a decision not to feed or hydrate be made?Can so basic a provision as food and water ever be considered as optional care?In most of the healthcare institutions whether they are hospitals or senior homes, the decision making lies within the practice of the nurses who are usually faced with dilemmas. While doctors are more advanced in professional knowledge they rarely find themselves in the difficult situation of making the decis ion of withholding nutrition or giving it. However, there is sometimes a differentiation between nutrition as part of the care given to the patient and nutrition as a biological life sustaining process:â€Å"In modern practice there is often an underlying tension between two different understandings of ‘nourishing' the patient. First, nourishing as an intrinsic part of giving care, which falls within the realm of nursing. Second, nourishing as a biological and technical process, a life-sustaining treatment under the control of the medical or nutrition team (from which the nurse may be excluded).† (Hunt, 1994)Yet the daily practice and the roles of nurses and doctors indicate that the nurses find themselves in the dilemma of making the decision more than other medical staff. In many cases where the withholding of nutrition is legally right and in the interest of the patient, the nurse still finds herself in the ethical and professional dilemma. She is not given the oppor tunity to discuss her opinion or given any information. As a result whatever decision she makes may be taken as wrong regardless of the fact that she was partially ignorant.The dilemma is even more difficult when considering nutrition as a basic need or a medical treatment. For a seriously sick person one may accept withholding medication or a technological device that prolongs life unnecessarily, but it is not easy to withhold nutrition which is the basic need for healthy and unhealthy persons.â€Å"Dresser asks, ‘Ought we to regard tube and intravenous feeding as forms of medical treatment, or should we classify them with more basic sorts of care?'† (Dresser, 1985)The decision of withholding nutrition or hydration is a difficult ethical question that poses emotional stress on the nurses. Withholding medication or technological devices is justifiable and there is enough professional and legal guidance for healthcare staff to follow. Indeed, â€Å"Food and water are so central to an array of human emotions that it is almost impossible to consider them with the same emotional detachment that one might feel toward a respirator or a dialysis machine† (Lynn & Childress, 1983)In this research I am going to study this issue in order to confirm or rule out the possibility of establishing a professional guidance that assists the nurses in decision making. This is expected to relief them from a lot of stress and confusion that are imposed as a result of dealing with the issue on personal terms rather dealing with it objectively according to professional guidance and standards.The proposal for this research will be studied under the following headings:1. Description of a case study2.   Literature review3.   Proposal4.   Summary and ConclusionsDescription of a Case StudyA case study either from literature or from the records of healthcare institution is expected to illustrate the extent of the problem and its importance. In addition this will em phasise the roles of nurses, relatives and patients in the decision making process. It would also highlight the difficulties facing nurses at different stages of care giving for seriously sick persons.At this stage of building the skeleton of this research paper very little can be said about the case study until one has been adopted.Literature ReviewThe literature generally confirms the importance of the problem and has been addressing the issues related to the problem of nutrition for sometime now. While it is suggested in the literature that in some cases of chronically ill persons the provision of nutrition is burdensome rather than beneficial, it is agreed that the interpersonal and inter-professional tensions of nurses are ignored. (Hunt, 1994)It is also pointed out that the stressful environment in which nurses provide their professional care sometimes result in burnouts. The burnout case â€Å"evolves by a process involving three stages: (a) an imbalance between resources an d demands, (b) the immediate short-term emotional response to the imbalance, and (c) changes in attitude and behavior such as negativism and emotional detachment† (Riordan & Saltzer, 1992). However, it is also indicated that there are personal differences here: while one may react to stressors by becoming a burnout another with personal hardiness may find the stressors only minor irritants. Riordan and Saltzer (1992) assert:â€Å"Current literature points unanimously to a proactive approach in preventing burnout. This preserves organizational integrity by maintaining human resources and supplying cost-effective care while maintaining quality† (Riordan & Saltzer, 1992).There are a number of suggestions for reducing stress and assisting nurses to cope with the environmental difficulties, though no specific guidelines or procedures are given for dealing with the problem of nutrition and hydration.It is also indicated in the literature that nutrition and hydration in some t erminal cases may only prolong the biological life which is thought to be burdensome for some patients and their families. As Hunt (1994) asserts: â€Å"Feeding may in some circumstances prolong the process of dying and may cause avoidable suffering to the dying patient.†While generally the decision of using nutrition support for the terminally ill people is discussed as a problem facing nurses, some scholars relate the decision to dietitians.â€Å"Clinical guidelines for nutrition support indicate that dietitians should be members of institutional ethics committees and should have an integral role in institutional policy development concerning nutrition support at the end of lifeâ€Å" (Langdon et al, 2002)To put it in a nutshell the literature review confirms the dilemma facing healthcare professionals, particularly nurses, and families in dealing with the decision of providing nutrition and hydration or withholding it for chronically ill people whose illness is diagnosed as terminal. It is also confirmed that the decision making involves personal feelings, ethics, and sometimes legal consideration. Yet there are no clear professional guidelines that streamline the decision making in this issue in the professional practice. Rather there are observations of some acceptable practices.Sometimes the distinction between ordinary and extraordinary is used as a means of reaching decision.â€Å"However, there appears to be an increasing opinion that artificial feeding can be viewed as a'heroic' method of treatment and is morally optional (Meyers and Grodin 1991, Hoefler and Kamoie 1994, Singer 1995, Gillick 2000). This optional treatment is referred to as ‘extraordinary' and is more likely to be invasive, artificial or complex. Nevertheless, the Hastings Centre guidelines, cited in Meyers and Grodin (1991), stated that decisions over whether to provide artificial nutrition and hydration cannot be made solely on the distinction between ordinary and ex traordinary methods of treatment. Despite this, Solomon et al (1993) demonstrated that 74 per cent of health professionals continued to use this distinction in termination of treatment decisions. It would also seem that the decision was significantly influenced by whether it was a decision to withdraw treatment or simply not initiate it in the first place. The Hastings Centre guidelines stipulate that this distinction should not be a consideration (Meyers and Grodin 1991)† (Young et al, 2002).The problem of decision making in providing or withholding nutrition and hydration in the case terminally ill people is a dilemma for nurses until some professional steps are identified to make the decision an objective one made on the basis of professional judgement   rather than being a personal one affected by personal feelings, ethics, beliefs etc.ProposalSince the aim of the study is to justify a professional basis for decision making, in this study we will attempt to investigate t he possibility of establishing professional guidelines that may relief the burden on nurses. This will involve identifying criteria that make withholding nutrition more beneficial to the patient than prolonging his biological life. It should also be essential to identify professional means that enable healthcare staff to decide that a patient is not making any sense of life and advise families accordingly to participate in decision making. This should be important especially when the patient is suffering pain or given morphine regularly.In order to be able to design a professional tool or procedure that assists nurses in decision making through this study or alternatively recommend further research on this issue, the study will be a non-experimental one designed to elicit the RN’s attitudes towards nutrition of chronically ill patients using survey instrumentation.The sample will be full time RNs employed by a healthcare region in hospitals and nursing homes of the region. It is advisable to include also a sample of dietitians working in the same healthcare institutions. The RNs involved need to be well informed about the study and its aims and should be positively motivated to participate in the study.It is also important for the study to be approved by a professional body that confirms the study question and methods are ethical.The instruments of the study should be designed in a way that they measure the attitude of the study sample towards giving or withholding nutrition and hydration for a variety of terminally ill patients. It is also important to determine the internal consistency reliability for the questionnaires and structured interviews.Summary and ConclusionsThese will follow naturally from the analysis of data and discussions and will eventually constitute a recommendation: either a draft of a guideline for assisting nurses in decision making or alternatively suggestions for further research in order to identify a suitable professional tool for relieving the burden on nurses.ReferencesI am not going to list the references now since this is just a skeleton to discuss with your supervisor; unless you deem it necessary.The word count may not be exactly 3500, but I think what has been written here is enough for your purposes. As soon as you give feedback on this I will start work on the proposal.

Counselor´s Record Keeping System Essay - 815 Words

A clear, well-organized record-keeping system is essential for counselor who provides treatment, nutritional assessment and consultation services. But setting up such systems can be challenging. For one, a counselor need to attack the fine balance between the need to maintain client privacy and confidentiality and the need to communicate with insurers, other treating professionals and larger health systems. Counselor’s records must also follow the state and federal laws (King Klawitter, 2007). . In addition, a counselor needs to plan for retirement and the eventual disposal of records. In order for counselor to have these records, information needs to be documented. Some of the things that need to be documented include counseling†¦show more content†¦No information can be given without Josephine’s information can be released without her written consent but there are exceptions to this rule. All hospitals and clinics have something call the privacy statement w hich describes how medical and psychological information can be used and disclosed which is needed to be reviewed before signing. For counseling to continue, insurance information needs to be on file making sure that co-payments are made before counseling starts. So to continue with follow up, Josephine has to make sure that all information with payments is correct. If she has changed any information in regards to insurance, she will have to provide the correct information and any payments that are not made yet. The focus of motivational therapy is to encourage Josephine to develop a bad view of what is going on so that she will want to and have the desire and willpower to change her behavior. What I have to do is to develop and express empathy, rolls with resistance, and supports self-efficacy. 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