A Teenage Girl Essay

I chose the scenario, A teenage girl is â€Å"in love† with her 17-year-old boyfriend. He is encouraging her to have sex with him saying that he will make sure they only have â€Å"protected† sex. This actually happens often these days with youth; they have the want to experiment a lot. There are five components in which wise judgments could be used. First, there is emotional intelligence which has four components; emotional perception and expression, emotional facilitation of thought, emotional understanding, and emotional management. Emotional perception and expression is the skill to recognize your own emotions and recognizing other emotionstoo. This component involves the ability to both express positive and negative emotions correctly as well. Being a teenage girl is hard;there are so many hard decisions to make. So almost every teen girl thinks she is in love at one point in her teenage life. It is like a must to have a boyfriend when you are a teen and the fact he is 17 years old really makes you seem â€Å"it†. You are not mentally stable when you have â€Å"puppy love† feelings, you do whatever to please this guy you love and when you are young you think that guy is in love with you. Being young you really don’t know how to act on situations like this, you do what you think is right. When I was 14 years old I had a 17 year old boyfriend and wow, the way I acted was insane, I know now I was never in love. I did any and everything for him and now I look back and think, how could I let someone have so much control, but I was just so young, there were a lot of major decisions to make. On top of everything the encouragement from others is hard as well. If Emotional facilitation of thought came about in this teen girl, she could use her emotions to be more able to help with her decision-making. On the other hand, being a teen, she most likely is not emotionally mature. Emotional understanding is to have the ability to recognize emotions with words, to understand the cause and effect of the all different emotions as well have the ability to recognize the relationships between them. Understanding and sometimes have contradictory feelings and how they change over time is an important dimension of emotional intelligence. Personally this is the hardest to overcome when you are young your emotions are everywhere and your changing from a girl into a woman, the feelings and emotions are new to a young teen, I would say they are emotional and impulsive with no understanding. When you are young you think if you’re in love then sex would come next, and so on. But when you’re young you never see the consequences after your actions, they rather just act, and the consequences never come to a young ones mind. Finally, there is emotional management which is self-explanatory which is again hard for teens to achieve because all the emotions combined are overwhelming hard to take on. This makes it much easier for them to act impulsive especially when it comes to sex. The only thing that matters to a teen is what is happening now, not what they would see on the outside looking gin at themselves. The next component would be successful intelligence. Which it is known, successful intelligence you would think fine in three different ways: analytically, creatively, and practically. Creative thinking is more of a personal trait. I think the other two areas, would show one’s maturity level. This scenario is an example of how teens really are; having sex at a young age is very common. Although with the decisions they make they do not think sensible, they think physically more so. Teens have a tendency to think irrational; it is a trait most all of them have. This girl is thinking how to make this guy she thinks she is in love with, happy, so she won’t have boundaries for herself. If she loves him she will do almost anything for him because that is how teen girls think is love. The consequences aren’t ever an issue until after they act upon it. Wearing a condom does not completely protect you what so ever. Last but most definitely not least, there is wisdom itself. When being a â€Å"wise individual† one must be able to balance a variety of self-interests (intrapersonal) with the interests of other people (interpersonal) and of other aspects of the environment in which one lives (extra personal) such as one’s environment. Wisdom is more of the outcome of what decision the girl would make. Dealing with her interpersonal interest would reflect on her interest in having sex or not having sex. Also, she would be dealing with how this decision would affect others around her including her boyfriend’s interest as well; mainly dealing with the consequences could eventually affect the interest of her family and friends. It will affect her environment and/or her extra personal interest counting on what decision the girl makes whether she has sex or not. If she chooses to not have sex it will affect because the guy might not want her and it will hurt her a lot emotionally. Also, she must stay away from the influences that surround her, she will get pulled right back in. If she were to have sex I am not sure she would enjoy the outcome very much, guys tend to get what they want and girls never get what they need, if I said that right it makes really good sense. There are also factors to balance when it comes to wisdom: balancing goals and interests, balancing short- and long-term interests, balancing responses to the environment context, and acquiring and using tactic knowledge. When balancing goals and interests, this teenage girl has to reason with the consequences of every single choice she makes in a situationsuch as this one. Also, looking at how it might affect her future goals, whether it’s long-term or short-term. I would say if she were to have sex possibly the condom breaks she could get an STD or even PREGNANT, which mess everything up mentally and emotionally for the bad. There is balancing short- and long-term interests as well. Teens never think before they act, having sex being the short-term, and the STD’s being the long-term. There are so consequences that are faced with sex, it isn’t even worth it, and really till you 100% understand the concept of it. Balancing a set comeback to the environment goes back to the outcome of her choices and situation. Not having sex with this guy will probably make him not want her in which being in the environment wouldn’t be very healthy for her. Acquiring and using tactic knowledge, say she has good tactic knowledge, she would be able to have her boyfriend understand and explain the possible outcome. In which he will take in consideration, or agree with her. Now if she does not have good tactic knowledge than possibly she doesn’t have much self control, I think personally. A teenage girl is â€Å"in love† with her 17-year-old boyfriend. He is encouraging her to have sex with him saying that he will make sure they only have â€Å"protected† sex. I have personally experienced this situation although today I would have not made that say desision. If I were to step back and look from the outside in, I would of seen what the was a head of me. Being wise is a good trait to have, in which most teens are not. But a wise one analyzes a situation have the knowledge of the bad that could come out of it. Also, seeing that patients are a virtue is also being wise in my eyes personally. Don’t rush into things when you’re young that is the problem with some people today like me, you experience everything, when the real time comes it isn’t as special. Confusing ones emotions with their feelings is rather tough for teens. Don’t risk the consequences; it is so not worth it. You have one but so many major decisions, make the wise decision, and always look at what the outcome could possibly be they are usually never worth it though. Having sex there is too many risks behind it, think before one acts, I would ask for advice if I knew what I knew now a days.

Calyx & Corolla Case Analysis

1. The strength of the Calyx & Corolla formula is that they enhance the delivering speed so that customers get fresher flowers. Also, it lowers the cost of delivery from growers to C & C, from wholesellers to retailers, and from retailers to customers. But there are also problems in the formula. For example, it is hard to control the quality of the products. C & C has to monitor the growers and Fed, and spend extra money to maintain the high quality of the products. . Calyx & Corolla has been successful because they make delivery more efficient, which is to deliver flowers directly from growers to customers so that the plants are fresher. Also, they accurately position themselves and send catalogues to people who are likely to buy flowers. It’s an efficient way to market without a large amount of cost. Third, they developed business partners to promote selling. 3.The large growers like Sunbay Company also distribute and sell flowers themselves. They also buy flowers from other growers. Thus it is hard to control the quality of the flowers they provide. The large growers like Sunbay Company are both partners and competitors because they also sell flowers to customers. 4. They are growing the business by launching an advertising campaign. They will advertise on television emphasizing the longevity and freshness of the lowers.They will insert mini-catalogs into newspaper supplements and magazines. 5. The company is customer-oriented. They directly link consumers with growers in order to reduce the time it took to deliver, thus ensure the freshness and longevity of the consumers. They will not let flowers frozen outside the door in the cold days if they fail to deliver it, because it this will not encourage consumers to buy flowers from them again.They send catalogs regularly and change their banquets seasonally to meet consumers’ needs. All they have done is to keep the â€Å"life-time† customers. They are not only selling flowers, they are se lling good service as well. 6. It’s easy for customers to find what they want through the website, because the company has provided different ways of categorizing the bouquets. Customers can decide what kind of flowers they need according to different situations. It’s very customer-oriented.

ACA Paper

Therefore, I will give some my personal inspirations, which earn from this course, to illustrate these deficiencies in the AC. Finally, I will present a brief conclusion about evolution of laws, which will influence the future. Five Provisions of the AC The five provisions are related to the humans rights and people daily life. I choose these five provisions, because I think they have good aspects, which can embrace American spirit and value rights of humans, but they have some deficiencies, which need to be innovated. Some of them are the most popular topic in nowadays, and others have great impacts in people future life.Therefore, I want to choose them, and clarify my personal views of them, which I will present following. Provision 1. My first provision is Sec. 1555. â€Å"Freedom not to participate in Federal health insurance programs†( PACE, 201 0 This provision illustrates that â€Å"everyone in America has a right to choice whether if participate in federal insurance c are program, and who opt out federal insurance care program will not be PACE, 2010 According to this provision, I firmly consider that everyone can choose to out of Beamer without penalty.In my personal point of view, really admire this provision. I always considered everyone should join Beamer before, but now, I know it is not mandatory. This provision can absolutely represent the spirit of America. When I originally knew America, I learned that freedom, democracy, and equity are the essential America spirit. Sec. 1 555 completely embodies human rights. Individuals have right to freely decide their own affairs, no one can enforce them to do anything illegally. Provision 2.My second provision is individual mandate provision. † individuals who are not covered by a healthcare insurance will be charged an annual tax penalty f $95, or up to 1% of income over the filing minimum, this provision takes effect on January 2014, but this fee will be more greater, this fee will rise to a minimum of $695 (SO,085 for families), or 2. 5% of income over the filing minimum, on 2016. This fee is prorate, if individuals are not covered by a minimum insurance in half a year, they should pay half of $695 ($2,085 for families).Moreover, exemptions are permitted for religious reasons, or for those for whom the least expensive policy would exceed 8% of their income, and US citizens who qualify as residents of a foreign county under the IRS foreign earned income exclusion rule†( The Individual Shared Responsibility Provision, 2014 In my perspective, I believe that this provision has a reasonable aspect, but some explanations, in individual mandate provision, are inconsiderate. First of all, this provision gives poor people who incomes can not afford the extra taxes. Think it is beneficial to poor people and release their financial burden.It also gives US citizens who live and work in a foreign country this exemption. In addition, exemption for religious reason also can emb race a humankind idea. However, this provision is unreasonable in total. According to Sec. 1 555, people should not get a penalty for opting out of minimum health insurance, but this provision seems to like exchanging the penalty to extra tax. This point is inconsiderate, because it enforces everyone to participate Beamer, otherwise people will be punished. The government should not use such a means to compel citizens participate health insurance program, even though health insurance is good for them.As I have mentioned above, I always consider America is an equal country, but an extra tax breaks my belief. In my personal view, government would take a moderate provision. Government should help people get health insurance through health education. Let people know the importance of health insurance, make people have a long-tern view of their own health. In this way, people will join in insurance consciously. Just like the Florida smoking ban. Florida is the first state which sues toba cco companies, and using compensations to educate people keep away from cigarettes.According to this case, I firmly believe that let people know always more rational than penalties. Provision 3. † Protecting young adults and eliminating burdens on families and genuineness, which is a beneficial provision to all young people who under 26- year-old. These young adults are permitted to remain on their parents health insurance programs, even if they on long live with their parent, are married, are not dependent on parents' tax return, or are not students†( Young Adults and the Affordable Care Act: Protecting Young Adults and Eliminating Burdens on Families and Businesses,201 0). Horology believe this provision is beneficial to all young adults and children. As know, the cheapest bronze level of health care insurance is approximately 5500 per year, and this level insurance, in my opinion, is very limited to utilization. If parents have higher level health insurance, their chi ldren also get higher protection, and families will save more money. Therefore, young people can remain on their parents' insurance not only reduce costs of families, but also will enhance their own health condition.Moreover, I also think, for extending health insurance coverage of young people, some actions can be implemented. Comparing with China, the government gives all school funds to support students buying their health insurances. Young people on school will get a discount for their lath insurances, which means students only need pay few fees to have their own health insurances. Furthermore, companies buying insurance for their employees is also compulsory. Therefore, America government can diversify the way of extending coverage of insurance of young people to lead more of them join in the benefits of insurances. Provision 4. Medicaid Drug Rebate Program also benefits to society, drug manufacturers will get rebates from states, which including, innovator drugs will obtain 23 . 1% of average manufacturer price per unit, blood clotting factor drugs will again 17. % price rebates per unit, non-innovator or multiple source drugs will get 13% average manufacturer price†( Medicaid Drug Rebate Program, 2014 ). According to Medicaid Drug Rebate Program, all people can buy these drugs cheaper, which means people are affordable for some daily drugs and some special diseases' drugs. In my perspective, this provision lets poor people are affordable to their drugs. Ally think it can improve people's health conditions. However, a problem should be defined that not every drug will get a rebate. As a consequence, drug manufacturers in this program will eve a risk to barely manufacture these drugs which can get rebates. Therefore, some useful drugs will not be produced for out of the program. It will cause these non- rebate drugs to merge a market shortage, and people will terribly hard buy these drugs. Therefore, the government should also balance the ratio of re bate drugs and non-rebate drug, and improve drug market condition.Provision 5. † Health Care Education Reconciliation Act of 201 0 has a provision that Chain restaurants and food vendors with 20 or more locations are required to display the caloric content of their foods on menus, drive-through menus, ND vending machines. Additional information, such as saturated fat, carbohydrate, and sodium content, must also be made available upon request†( Federal Health Care Reform, 2010 This provision is available for the customers to distinguish their foods' ingredients, through this way, customers can judge a food whether if good for their health.According to a report, â€Å"more than one-third ( 34. 9% or 78. 6 million ) of U. S adults are obese†( Centers for Disease Control and Prevention, 2014 ). Obesity has been the most popular disease in America and will cause a lot of subsequent diseases, including hypertension, hyperglycemia, and cardiograph. Therefore, the governm ent who regulates chain restaurants and other big food companies to illustrate their foods' calorie and other ingredients, which ingest excessively will result to obesity, is a good way to improve the health situation of individuals.In my personal point of view, although the government's action is reasonable, it is very limited to realistic circumstance. People know the way of calculation necessary caloric for daily life, bur sports and diets are proper means to keep health. Government need to educate their people to recognize lately life and improve their diets. However, this is an extremely difficult way to improve persons' health, because adults have accustomed their foods and their living habits.Therefore, how to initiate a new health education for a new generation and tell them good diets and living habits become significant. In conclusion, good health care is not to treat patient, it is reasonable to prevent ills from humans through improve their behaviors and thoughts. Regula tions of the AC The three regulations are enacted by executive agencies for supplementation of the AC. The three regulations are all related to people's health and their lily life. In my opinion, the first regulation, which will mention, is a good sample for the government instructing humans in a healthy life.The second regulation also protects people who cannot afford their healthcare fees. The third regulation is close to people work and safety. Nevertheless, I believe that the government should modify these three regulation continuously to provider citizens a better situation. Regulation 1. The first regulation is just existing on September 2014, which is â€Å"Guidance for Industry Reporting Drug Sample Information Under Section 6004 of the Affordable Care and Drug Administration, 2014 In my perspective, this regulation has 2 praiseworthy points.Firstly, manufacturers need report information of drugs on the internet. This is very convenient for the ETC supervising quantity and category Of drugs and assessing these drugs demand and supply. In this way, the F-DC can indicate a commercial tendency of these drugs, and accordingly the FDA forecasts what diseases will be happened. This is cheaper than paperwork. Secondly, These drugs reported by manufacturers, which usually have side effects or dangerous ingredients. Therefore, monitoring these drugs is necessary for people's health safety.For example, We know some medications have an ingredient named ephedrine is used for manufacturing methamphetamine, also called ice drug. Some lawbreakers use these medications to extract ephedrine. Therefore, for preventing this case happening, drugs reporting is mandatory. Nevertheless, this regulation need to be consummated. Electronic reporting is a reasonable way to record information, but 2 shortages must be considered. Electronic information leakage has been a serious problem now, although HAIFA has enacted the data breach notification rules. The information safety sys tem should be reinforced.In addition, supervising manufacturers reporting correct information is requisite. Whatever these manufacturers hide information for financial reason or unintentional mistake. These producers need to be audited. Regulation 2. The second pending regulation is † the State Medicaid HIT Plan, Planning Advance Planning Document, and Implementation Advance Planning. In the regulation, SMS wants to invite tenders from the public to design a health information collection software, which can reduce paperwork and collect arsenal health information efficiently.In this regulation, SMS has defined some detail requirements of this software, which includes information of fingerprints Of people, suspension Of Medicaid Payments and re-screening Of Medicaid and chip providers every five years†( Centers for Medicare Medicaid Services, 2014 These details are reasonable, also deem that an electronic tool is not only convenient for government using and collecting basi c data, but is also useful to people recognize their health information. Person just need a cellophane to manage their own physical condition data.However, mom important rules do not cover in this regulation, and this regulation also has its own deficiencies. Think two managements are required in this regulation. The first of all, there is a possible issue that some information cannot be matched from different software, when they are sent to each other. SMS should make a identical standard in order to all collecting data in diversified health data software can be commonly handled. Finally, for information abusing and breach, SMS should through HIPPO to monitor data of health of software providers and improve the system for safety of data ace ritzy Regulation 3.The third regulation has been exiting, which is† people applies healthcare insurance, and the insurance needs to take effect in ninety days. All insurance companies cannot delay applicants' insurances beyond ninety days with any excuse. However, this period can only be amended by the government. This is the Ninety-Day Waiting period Department of Health an Human Services, 2014 I firmly believe that the regulation will be admired by all people. This regulation gives people a safeguard, because people may have some accidents when they wait their insurances taking effect.Therefore, the sis of accidents will be reduce by this regulation, whatever people on working or daily life. However, I think the waiting period can be shorter. On the one hand, ninety-day means three months that people will be out of insurance. If the government can cut the waiting time, the risk can be smaller. On the other hand, some insurance companies, for financial concern, will delay people insurance until the deadline. Therefore, if the limitation can be shorter than three months, it also can spur the work efficiency of insurance companies, and let people obtain their insurances as soon as they can. TheConstitutionality of the AC These two cases including the National Federation of Business v. Sublime and Barbell v. Hobby Lobby ,which greatly impact the constitutionality of AC. According to these cases, I clearly realize the main deficiencies of AC and it constitutional process. National Federation of Business v. Sublime In this case,† Twenty-six States, several individuals, and the National Federation of Independent Business brought suit in Federal District Court,challenging the constitutionality of the individual mandate and Medicaid expansion, the U. S. Supreme court judge this case with following mints.Firstly, the U. S. Supreme court considers that the individual mandate takes a penalty to people, who dose not have health insurance, is unreasonable, but penalty can be regarded as a tax which imposes on people who dose not buy health National Federation of Business v. Sublime, 201 0 ). In my personal point of view, I agree with the statement that people should not be taken a penalty fee for out of health insurance. However, I think that changing this penalty as a tax, which is somewhat far- fetched, because, it just changes an explanation to enforce people join in health insurance programs.No matter this tax influences peoples' action to buy insurance or not, the government has no right to compel its persons to purchase a product, which they do not like it. Moreover, † U. S. Supreme court decides that states will lose their Medicaid funds, which compels Medicaid expansion, and this is unconstitutional ( National Federation of Business v. Sublime, 201 0 † I firmly agree this decision. I learned that America is the federal state, every state of U. S. Has right to administer itself. Furthermore, every state also has right to depart from U. S. , if its people agree. Rule insider the state government has equal status with the federal government. Therefore, the federal government can not exploit their right or threatens them to agree Medicaid expansion. As the case mentioned that † When a court confronts an unconstitutional statute, its endeavor must be to conserve, not destroy, the legislation†( National Federation of Business v. Sublime, 201 0 ). For some rational reason, it is right to preserve AC and tear out Medicaid expansion. However, I quite sure the constitutionality need to be cautious and considerate. In AC it still has some unconstitutional acts and rules.Although conserving AC is better than destruction, AC passes too fast to inspect by congress. Therefore, constitutionality is a long-term process, AC still need to be carefully checked by congress and society. Barbell v. Hobby Lobby In this case, the Supreme Court holds three main points. † At the first, the Supreme Court considers that the government has failed to satisfy the least- restrictive-means standard of the Religious Freedom Restoration Act. HAS has not shown that it lacks other means of achieving its desired goal without imposing a substantial burden o n the exercise of religion.This decision follows the Religious Freedom Restoration Act in 1993. Secondly, the Supreme Court deems that, according to the Religious Freedom Restoration Act, no conceivable definition of a person includes natural persons and non-profit corporations, but not for-profit corporations, which is different from He's defined action. Finally, the Supreme Court declares that only the contraceptive insurance can be picked out of the insurance mandate, and only closely held companies are suitable for this decision†( Barbell, Secretary of Health and Human Services V.Hobby Lobby Stores, 2014 Without a doubt, firmly Greer the first and second decisions of Supreme Court. Religions, beliefs, and religious actions should be respected. Moreover, for-profit companies also is including the scope of the person. Think HAS cannot support more evidences to demonstrate Hobby Lobby and others violate the RAFF and for- profit companies also need to be regarded as non-profit companies in this case for religious reason. Therefore, these two decision can embrace justice and equity for treating religion and religious companies.However, I concern that the third decision is partial. I have three points to illustrate my perspective. Firstly, it is partial to women who work in religious companies, because these women have no right to obtain contraceptive insurance comparing with other women who work in non-religious companies. Firmly consider that this partiality can be regarded as discrimination of women. Managers cannot deprive a right from employees, which should be reasonably procured, even for a religious reason. Secondly, the exemption only for closely held corporations and its religious reason, which is not rational.I firmly believe some companies will intentionally change their status to closely held corporations for avoiding contraceptive insurance. The last but not least, the Supreme Court has exempted religious reason for the declination of contrac eptive insurance currently, in the future, have reason to believe that some companies will utilize religious reason to avoid more mandate insurances. All in all, in this case, the Supreme Court fails to predict potential imparts, which will make more difficult for congress to enforce the laws.Actually, this decision makes harder to force employers to provide health insurance. Therefore, it really influences both implementation and constitutionality of AC badly. The conclusion I believe that, in total, AC is enacted for innovating the health environment of people. It covers all aspects of human daily life and wants to affect quickly. Indisputably, related agencies and congress are best effort for consummating and renewing AC. I can see that they want to regulate all behavior and rule all possible situation. This is an extremely huge work.

Human life development Essay

Introduction Growth refers to an increase in size, such as changes in an individual’s body for example size, weight, height and shape. Development usually comes in stages, as in the changes in the complexity of an individual and a rise in skills or knowledge, such as learning how to walk. Conception to birth (0-9 months) P1) The internal development is the development of the embryo in the mothers body which is needed to absorb oxygen and food from the blood for the baby. At this stage all of the developments are physical changes. M1) Physically about two weeks after a woman’s menstrual period the ovary releases an egg, which then travels down the fallopian tube. Sperm travels through the cervix and swims into the fallopian tube – one single egg penetrates the egg cell and the resulting cell is called a zygote, then the fertilised egg travels down the fallopian tube. While doing this the fertilized egg divides once it has travelled through the fallopian tube, the embryo implants into the womb lining. From four weeks the embryo now relaxes in the womb lining, the outer cell reach out like roots to come together to the mothers blood supply. The inner layer of cells form into two then later on shape into three, each one of these layers will grow to be different parts of the baby’s body. One of the layers becomes the brain and nervous system, the eyes, skin and ears. Another layer will form into the lungs, gut and stomach; finally the third layer will grow into the blood, muscles, heart and bones. The fifth week is the time of the first missed period when many women are only just beginning to think they may be pregnant. Nevertheless already the baby’s nervous system is starting to develop. A groove forms into the top layer of cells. The cells fold up around to make a hollow tube called the neural tube. This will form into the baby’s brain and spinal cord. At the same time the baby’s heart is coming together and already has some of its own blood vessels. A string of these will link baby and mother and will become the umbilical cord. From week six to seven there is now an outsized bulge where the heart is and a bump for the head because the brain is developing. The heart begins to beat and can be seen beating on an ultrasound scan. Dimples will appear on the side of the head which  will become the ears and there are thickenin gs where the eyes will form. On the baby’s body there will become bumps where the muscles and bones will be forming. At seven weeks the embryo has grown to 10mm long from head to bottom, this measurement is called â€Å"crown- rump length†. By week eight a face is gradually forming, the eyes are more recognizable and have some colour in them. Also there is a mouth in which the tongue has formed. There are now the beginnings of hands and feet, with ridges where the fingers and toes will be. The major internal organs are all developing which are the, brain, heart, kidneys, lungs, gut and the liver. On week nine the baby has grown to about 22mm long from head to bottom. Week ten to fourteen, just 12 weeks after conception the fetus is fully formed. Its development all their organs, muscles, bones, limbs, and its sex organs, from now on it has grown and matured. The baby is now able to move about; however, the movement’s cannot yet be felt. By fourteen weeks the heart beat is well-built and can be heard through using an ultrasound detector. The baby’s heart beat is extremely fast, about twice as fast as a normal adult’s heartbeat. At fourteen weeks the baby is about 85mm long from head to bottom. From week fifteen the baby has now growth swiftly, the body grows bigger so that the head and body are more in proportion and the baby doesn’t look so top heavy. The face looks much more human and the hair is beginning to grow as well as eyebrows and eyelashes. However the eye lids stay closed over the eyes. The lids of the skin of the fingers are now made, so now the baby has its own individual fingerprint. Toenails and fingers are growing and the baby has a firm hand grip. At twenty-two weeks the baby is covered in a very fine, soft hair called â€Å"lanugo†. At about sixteen to twenty-two weeks you will be able to feel the mothers baby move for the first time. The baby is now moving about vigorously and responds to touch and to sound. You may be able to feel the baby hiccup which will make the baby jerk. The baby may also begin to follow a pattern for waking and sleeping. From this stage you are now capable of hearing the heart beat through a stethoscope, also your partner may even be able to hear it by putting an ear to your abdomen, but it may be difficult to find. The baby is now enclosed in a white, greasy substance called †Å"vernix†. It is thought that it is maybe to protect the baby’s skin as it floats in the amniotic fluid. The vernix mostly goes before birth. By twenty-four weeks the baby is called â€Å"viable† this means that the baby is  now thought to have a chance of survival if born. Around about twenty-six weeks the baby’s eye lids are exposed for the first time. The eyes are almost always blue or dark blue. It is not until some weeks after birth that the eyes become the colour they will stay, although some babies do have brown eyes at birth. The head to bottom length at thirty weeks is about 33cm. By the time the baby is thirty-one to forty- weeks is it growing chubbier, so the skin which was quite wrinkled before, is now smoother. Both the vernix and the lanugo begin to disappear. By about thirty-two weeks the baby is typically lying downwards braising for birth. Sometime beforehand the baby’s head may move down into the pelvis and is said to be â€Å"engaged† but sometimes the baby’s head does not engage until labour has begun. Birth to infancy (0-3 years) Physical development P1) When a child is new born they are powerless – this means that it is a parent or caregivers responsibility to ensure it survives however, all children are born with natural physical developments, such as rooting, sucking, swallowing, grasping, stepping and startle reflexes although new born babies have very low muscular co-ordination they are able to focus their eyes and follow sounds from side to side. They are also able to cry and make gurgling sounds which helps indicate the child’s needs. (M1) Humans are fairly helpless and dependent then they are born. To ensure the new-borns survival they need to be looked after. Babies are born with several reflexes which are sucking, rooting, grasping, swallowing, stepping and the startle reflex. New-borns are mostly immobile when they are born and have very little muscular co-coordination. Soon the muscles start to strengthen and babies get going, their movements allow them to begin to explore their environment and learn how their world operates. Physical control progresses downwards, beginning with the head and moving through the arms, neck, trunk and finally their legs. From two months the baby is able to raise its head when lying on its stomach, at four months they can grasp objects using their whole hand, at six months they will be able to sit up without support, at eight months they can start to crawl, at twelve months  they can walk without help, at eighteen months they can climb stairs and run but often fall, at two years they can control muscles which allow for toilet training and they can climb on furniture and kick a ball but not yet catch one, and by three years they will be able to jump and ride a tricycle. Emotional development P1) Our emotional development starts from a very young age that way a child and their main caregiver bond together this will result in the attachment they gain towards one another the emotional development of infancy is all about the intellect of having security around you and the development of trust and self-worth for yourself and others. M1)Emotional development is the way we are able to form effective relationships. Young babies cry if they are parted from their carer for a long time. One-year old babies are about to learn about the effects their behaviour has on their caregiver and they can express emotions through laughter, tears and facial expressions. Two-year old children are known for their temper tantrums as they find it hard to express their emotions. They are able to show a certain degree of empathy, which is often stated through play such as punishing or praising a doll. By the time they get to three, children are most sensitive to other individual’s feelings and are eager to share toys and take turns when playing. They are interested in having friends and this is often when children start nursery or playgroup. Intellectual development P1) At this stage children begin to develop the mind, which allows them to recognise, remember, reason, know and understand things that are around us. This all helps towards developing communication skills which help us to be understood and the start of developing relationships when children start to interact with the environment they develop their own thoughts and responses to the world. Language is also part of intellectual development. M1) intellectual development refers to the development of the mind and lets  us recognise reason, remember, know and understand things around us. As a child co-operates with the environment, they progressively organise their thoughts and develop an appropriate set of responses for dealing with the world. Children should know at least six words by the time the child is eighteen months. Most one-year olds should be able to name straightforward objects and by the age of two most are able to put two or three words together into a trouble-free sentence. By the age of three most speech should be understandable and children should be able to speak in complete sentences. Children at this age love to have stories read to them, often the same ones over and over again. Social development P1) Social development starts a few days after your child is born. New babies will respond to sounds of humans who are around them and will focus on the humans faces social development is linked very closely with emotional development as the first social relationships that are built are with those who are the main care provider for the child. M1) Our need to be sociable seems to be something we are born with, yet babies of a few days old will react to the sound of human speech, touch and smell, however social development starts in the womb. The baby will be able to hear music, a care giver reading a story and how the mother’s mood is. If you watch and listen you will observe that older babies and toddlers make social moves towards each other and are pleased to see each other. At first the most important relationship will be the baby’s caregiver and other family members, whereas relationships with peers become more important as children start to grow up. Young children form relationships and have a habit of showing preferences for particular people. Language skills are vital in the developing of these relationships and, as children develop, they are more able to express their feelings verbally. Children benefit from spending time with younger and older individuals. One way in which children develop social rel ationships outside their families is through play. Childhood 3-11 years (M1) Childhood is such an exciting stage of development with physical skills forming as well as children learning about society in which they live. Children become much more independent and in many cultures already start to take on many responsibilities. Physical Development (P1 When a child leads into their childhood stages they become more independent and take on their own responsibility and choices. The growth at this period is still very fast as they start to develop their body proportions during childhood. These stage children start to develop their growth motor skills which help to co-ordinate and muscle their large muscles, this helps with the skills for an example: walk, run, sit and other physical activities. They also start to develop their fine motor skills which help to co-ordinate and control the small muscles in the body. M1) Growth carry’s on developing rapidly during this phase, however not as fast as in the first few years, and body proportions and beginning to be more becoming more advanced. Children begin to be more aware of things and are cable of tying their on shoes laces, making and decorating a cake, play sport such as football, building a brick tower, play a musical instrument, throwing a ball and gymnastics. Children learn any skills through doing these activities such as co- ordination. Intellectual development For the period of stage children begin to be able to do more logical activities, they also start to understand different concepts whilst you explain things to them however, the individual needs to see them in order to completely understand. As children start to grow up and start to develop intellectual skills their language becomes more fluent and extremely clear. Likewise through this stage children start to develops the sense of the past, present and the future. M1)we can only guess what children are thinking by their gestures and by what they say. During this stage of development numerous things start to change and take place in many different countries this is the time where when  children often start formal schooling, some ideas about what we should be teaching children at this stage are based on Piaget’s theories about what children are capable of understanding. Stage 1- Sensorimotor (0-2 years) the infant learns about the word through their senses such as their mouth and tasting. Born with reflexes- the infant learns to control their muscles and movements. The child needs to develop object permanence- Piaget said s/he doesn’t remember and know that something still exists if it is â€Å"out of sight†. Stage 2 pre-operational (2-7) Children can now use language but Piaget said they can’t think in a logical way. They need to develop â€Å"conservation† i.e. understand that a tall slim glass of water doesn’t contain more water than a short wide glass (children look at the physical size instead of using logic). Stage 3 Concrete operational (7-11 years) the child can use logic but tends to focus on practicable/observable solutions. Stage 4 Formal operational (11+) the individual can now think about problems in their head and come up with different possible solutions. For an example if I turned on the light in a classroom which didn’t work, why do you think this might be. As children are developing and getting older they are able to carry out more logical activities. They start to begin to understand different concepts but often need to actually see concrete objects in order to understand them. For example if the child is learning about fractions they will be able to understand it but only if they can use a concrete example like dividing up a pie so that a number of people can each have a piece. As children retreat through this stage they become more or less fluent in language and may mature a good vocabulary. They start to be able to contrast sentences and use grammar fairly well, it is also during this stage that children begin to see things from other points of views not just their own, Also they have a sense of past, present and future. Moral development is something which also forms during this stage of development this is the process by which children adopt the rules and expectations of the society in which they are brought up and develop of wisdom of right and wrong. This would be learnt from the people around him such as their mother and father. Emotional development P1) During childhood the is the stage where children start to show pleasure towards their families and individuals who the children may be close to. They will create close attachments with these individuals, through this stage children start to develop and show may different emotions which for some changes for the wrong reason. Children will tend to act frustrated, sad and angry. This shows then they start to feel tired or need help with something. M1) as children headway through this stage they start to loosen their attachments with their main carers although they still need their support. They arise to be more individual and start to develop a sense of â€Å"self†. Most of our emotional responses are learned from our primary caregivers. Most children learn to be in control of their emotions responses and to resolve conflict and carers should praise the child when this occurs while trying to understand the temper tantrums of frustration that do occur. At this development the children start to show signs of compassion and empathy and again, carers need to encourage this. During this stage they also start to form the ability to talk about their feelings, even at a young age children will say things such as â€Å"I feel sad† or â€Å"that makes me happy†. Social development P1) childhood is when socialisation occurs to children, this is the development of bonds and friendships between individuals. And this is the stage where friendships outside the family become more significant as they start to move from the stage into adolescence where that begins vital to them. M1) As children form into social begins they go through what is termed â€Å"socialisation†. Primary socialisation takes place within the family although there are many different types of family’s. relationships with people outside of the family become more important as children move through this stage and into teenage years. One way in which these relationships develop is through play. Solitary is where young children like to explore and play with a wide range of toys by themselves. They will also like games  of imagination and make-believe. The approximate age would be 0-2 years, parallel is where toddlers will play alongside others and will even watch what they do but will not play another the approximate age would be 2-3 years. Simple co- operative is where children join in many different activities with others and learn to share and take turns this would be aimed at 3-5 years and complex co- operative is children making up complex games with others, organising themselves and making their own rules. Approximate age would be 5 years and onwards. Adolescence (Teenage ages (11-18 years) Physical development P1) During adolescence the physical change to an individual’s bodies is going through puberty, which is a rapid growth of our bodies an when we become physically able to reproduce. Puberty occurs in both boys and girls usually at the average age of 12. Both female and males go through physically changes such as weight gain and growth spurts. (M1) At puberty, chemicals in your body called hormones set off many physical changes, including growth spurts and weight increases, and boys and girls begin to change and look different as they grow into a young men and women. Similar changes to women and men are under arm hair grows, pubic hair, body smell gets stronger, emotional changes and growth rate increases. Changes which only happen for men are: voice breaks, testes, penis increases, testes start to produce sperm cells, shoulders get wider and hair grows on face and chest. Changes which would happen for women: breasts develop, ovaries start to release egg cells ( period starts) and hips get wider getting ready for pregnancy and birth. Intellectual development P1) At this stage of adolescence the mind develops broader and you start to learn the ability to work with abstract concepts. You also start to develop their long term memory which enables the individual to remember more  information and store it in their brain for a later date such as studying for a upcoming exams, this will be awfully key to in your life stage. M1) Stage 4 Formal operational (11+) the individual can now think about problems in their head and come up with different possible solutions. For an example if I turned on the light in a classroom which didn’t work, why do you think this might be. Teenagers also begin to see the difference between fact and opinion, learns that current actions many have an effect on the future and in late teens they will start to think about what they would like to do in the future for a career. Emotional development P1) At this stage you start to develop your own identify as an individual and your emotional intelligence. Also through this stage their emotional develop is all over the place, it has been portrayed as one of â€Å"storm and stress† in this period it is very common for an individual to feel misunderstood at times and they may start to challenge parental values. M1) At this stage the most important period in development of adult personality. Through this period teenagers may feel overwhelmed; often teenagers alternate from behaving like children and then behaving as adults. They also frequently feel misunderstood and may challenge parental values, deliberately pushing against boundaries by this stage teenagers become less dependent on family for emotional support and turn to their friends for advice. This is called the influence of the peer group. Young people want to be accepted by their friends and this can be sometimes lead to difficult situations, affecting both self- esteem and self- concept which may lead to depression, anxiety, being stressed and confused. Social development P1) this is the most difficult stage for social development because as you come be independent on your peers you may start to find it a fight to fit in with different crowds of individuals. For example the clothing you wear, or the type of personality they have. The main issue for social development  throughout adolescence is peer pressure. M1) Social and emotional development is interlinked and as teenagers gain independent, they spend more times with their friends. This allows them to practise social skills, sometimes called social intelligence. For some adolescents factors such as living in poverty, living in a dysfunction family and/or living somewhere in a are which as high crime make this period of life much more difficult. Peer pressure can also be difficult if in the wrong crowd; this is often a period during which issues such as experimenting with alcohol, sexual orientation and attitudes towards education are examined. However sexual relationships vary on your social group the avenge age is 17 years old. Adulthood ( grown-up 18-65 years) Physical development P1) Individuals which are in their twenties and thirties which would be early adulthood are usually at the peak of their physical development. They are completely mature and it is at this stage that a lot of people have children, Individuals who are in their thirties or older start to see and feel the beginning of physical aging process. M1) Most elite perform at their bet in their twenties and even have to think about their retirement. Good exercise regimes and a healthy lifestyle can help to expand this ad many individuals decide to start to develop their fitness after this age. From around about the age of 30 the physical ageing process begins and individuals begin to note certain changes about their appearance such as wrinkling of the skin, hearing and sight decline, bones lose calcium, greying and thinning hair, flexibility reduces, circulatory system not as efficient and the menopause for women over 50. Intellectual development P1) Early adulthood is the stage where most individuals continue or further their education to get to their desired career, their intellectual health is very important because it helps creativity, general knowledge and common  sense. There is also evidence that memory decreases with age and, just as physical self needs exercise to keep flexible, so an individual’s mind will also need to be kept active. M1) Intellectual development surely does not stop after the age of 18. Some individuals in our society either continue with their education or start work at this stage of development. A lot of young adults continue their education at a collage or university even this stage the individuals intellectual development does not stop. Once at work, many new skills are required and individuals may well also follow a number of more formal training courses. Young adults continue to develop problem solving and decision-making skills. Emotional development P1) Emotional development is very strong at this stage in life as individual aged between their twenties and thirties they will be thinking about life partners and developing close emotional bonds with one another. This is also the time where some people decide to have a family, which means new responsibilities. Most young adults have the emotional maturity to manage these, although there are sometimes too many pressures and they need to access outside help. Middle adulthood from the forties onwards is also a time of change and for some these changes can cause â€Å"Mid-life crisis†. Individuals will start to become aware of their physical ageing, women will go through the menopause, there are a fewer job options, some children are thinking of moving away from their parents, and middle aged adults may be helping looking after their own ageing parents, who are themselves experiencing difficulties. However for many people it is a positive time their experience is valued, they have been productive, there is more freedom as children leave home and people are usually established in their communities. Individuals can look at the contribution they have made to society which gives them a sense of belonging and well-being. Social Development P1) Social changes are significant throughout this stage. In an individual’s twenties they usually do not have too many responsibilities and most people are able to spend quite a bit of free time socializing with other people because friendships becomes vital and they begin to find it exciting being with other individuals and meeting new people. M1) Friendships are vital, both same sex and opposite sex, and meting new individuals is often an exciting activity. Throughout this stage there are many different types of relationships that develop both public and personal. The personal ones will be extended families, long-term friends and, possibly, a life partner. Public relationships are those which take place in the wider world. Such as the world of work, social networks are developed and maintained through a number of different ways. Old age (65+ years) Physical Development P1) This can be a very important stage as physical appears starts to change, the skin starts to become lose and wrinkle in all places, most commonly the face and hands. The hair starts to thin and become grey, in most cases fall out easier. The skeletal bones and the joints become weak and fragile and start to give way. An individual may also develop sight and hearing impairments which is blindness and deafness and the brain stops development if the person is not kept active and this results in memory loss for most individuals. M1) Once an individual hits the age around about their sixties their ageing process progresses more quickly. At some point almost all older people will have to deal with some sort of disability as they are no longer able to the things which they were able to do at a younger stage. Different physical effects of ageing can be their eye sight may find it difficult reading and the brain may cause some memory loss. Intellectual development P1) During this stage keeping mentally active you will still be able to learn  different skills and hobbies, you can keep you intellectual development increasing through lifestyle factors, if you are an active individual this could just be through walking then you are more than likely going to keep your brain mentally more active than those who do not do any physical activity such as exercise. M1) Many individuals do not retire until much later and often act as advisors due to long life experience and wisdom. Older individuals can still learn different skills and hobbies, which has been shown to help people in a positive way. They can learn foreign language, bridge, learn to play a musical instrument, join a painting or pottery glass and play scrabble. Many of these activates also involve others, which in itself provides mental stimulation. Social factors can also be significant. Older individuals who live with their family members and who have a lot of human interactions tend to a lot better both in terms of physical and intellectual health than those who more isolated in old age. Emotional Development P1) Emotional development in old age can be equally positive and negative. When an individual gets to the stage of old age it is known that they have a sense of pride. This is because many young individuals will look up to the older generation and want to listen to the things they have to say. From that it will make them feel like they have made a good contribution to their community. Likewise some older individuals look forward to having their own free time to be able to spend with their family and friends or people who they are with during hobbies. M1)Many old individuals are satisfied to be able to have more free time and are able to spend their retirement visiting family and friends or pursing their hobbies. In some societies the wisdom of old age is valued so those individuals feel they are making a contribution to their communities. But if this is not the cause it can make people feel that they are just a drain. Social Development P1) During old age individuals start to consider retirement, this means that most of the elderly become less social in the community, however it gives them more social time with individuals who care about them such as friends and family. If the individual had strong connections with family and friends this would be the stage where an individual can feel they are losing bonds. This is because people around your own age or older will start to lose their lives which will end up leaving you with a loss of a close friend or a family member is can lead to heavy depression and upset. M1) Many individuals prepare for retirement by developing interests that can followed later and other may do voluntary work. These kinds of social interactions have been shown to be vital for a healthy older age. If families do not live nearby, when partners and friends die or health problems make it difficult to get out, it is easy to become isolated and depressed. But there are now many services designed to help avoid this situation. Bibliography Class notes Text book health and social care Level 2 Btec first : Elizabeth Haworth: Unit 8 published by Pearson Education Limited 2010

Comparison Of Post Stroke Rehabilitation Health And Social Care Essay

Stroke is considered to be the 3rd cause of decease and disablement for 1000000s of people in both developed states ( 1 ) . Stroke is the clinical manifestation of a broad scope of pathologies, with different etiologies and forecasts, and many hazard factors. Stroke is defined as a syndrome characterized by quickly developing clinical symptoms and/or marks of focal loss of intellectual map, in which symptoms last more than 24 hours or take to decease, with no evident cause other than that it is a vascular beginning. Stroke victims who survive the first onslaught may hold prevailing damages such as cognitive damages, upper and lower limb damages and address disablements. The United land ‘s prevalence of shot in the population is estimated to be 47 per 10000 doing stroke the most common cause of big physical disablement ( 1 ; 2 ; 3 ) . Stroke rehabilitation is a chief factor in assisting shot subsisters to recover their functional ability when medical and surgical intercessions are limited ( 4 ) . Physical therapy plays a major function in shot rehabilitation. Physical healers choose the continuance and type of therapy given and supply instruction for shot patients. Stroke rehabilitation purposes at giving the patients the ability to recover maximal and full potency in functional activities and Restoration of motor control ( 5 ; 6 ; 7 ; 4 ) . Three chief factors in rehabilitation contribute to the velocity and quality of recovery. These factors are: intervention session continuance and frequence, type of intervention attack used for rehabilitation, and supplying instruction about the status for patients during and after therapy ( 2 ; 3 ; 6 ; 8 ; 7 ) . Physical therapy rehabilitation for shot patients is designed to impact the disablements and damages associated with station shot conditions. Rehabilitation is chiefly aimed at restricting any impairment of damages and maximising the functional degree for patients enduring from shot. To be able to present this, physical healers should follow a certain set of guidelines which will see better results and avoid unneeded patterns that could protract and detain optimal addition of map ( 5 ; 6 ) . It is ill-defined whether physical healers in Kuwait follow any specific guidelines in shot rehabilitation. Therefore, it would be plausible to larn more about current local rehabilitation processs. This may assist in the farther development of local rehabilitation processs and pattern guidelines, optimisation of intervention and rehabilitation direction, betterment in shot patient ‘s wellness and quality of life, and minimisation of conflicted rehabilitation patterns that prolong therapy which in bend affect and burthen the wellness system with increased figure of patients ( 5 ; 9 ; 7 ; 10 ) . We hypothesize that shot rehabilitation in Kuwait follows general guidelines and scientific discipline based patterns in shot rehabilitation. Therefore the purposes of this survey are to: Explore if stroke rehabilitation in Kuwait follow general guidelines of shot rehabilitation sing frequence of intervention Sessionss and continuance of each session. Investigate if physical healers specialising in the field of neuroscience in Kuwait follow general guidelines of shot rehabilitation sing their intervention attacks. Identify if instruction is being provided for shot patients about their status during and after rehabilitation.Literature Reappraisal:Stroke is defined as a syndrome in which clinical symptoms and/or marks of intellectual map loss develop quickly, and last for more than 24 hours or consequence in decease. Stroke can be classified harmonizing to the cause, which is either ischaemic or haemorrhagic. Ischemic strokes history for 85 % of all shots, while 15 % history for haemorrhagic shots. Over 10 % of patients who had a first shot will hold a 2nd one within a twelvemonth, and the hazard of return within 5 old ages is 15-42 % ( 1 ) . There are a broad scope of conditions that lead to stroke, such as high blood pressure and diabetes. Each twelvemonth, 5.45 million deceases are attributed to stroke, and over 9 million survive. Survivors frequently experience a broad scope of prevailing damages. Common damages include Physical disablement, cognitive damage, Lower limb damages, and address troubles. ( 1 ) Rehabilitation is an of import portion after endurance from a shot. Rehabilitation was defined in the New Zealand guideline for direction of shot as ‘a problem-solving and educational procedure aimed at cut downing the disablement and disability experienced by person as a consequence of disease, ever within the restrictions imposed by both available resources and the implicit in disease ‘ ( 12 ) . It ‘s of extreme importance that the shot patient understands, and receives instruction refering his/her status and what restrictions may prevail, even after rehabilitation ( 12 ) . Reker D. M. et Al, researched whether attachment to post shot guidelines was associated with greater patient satisfaction. They used a prospective origin cohort survey design for new shot admittances, including post-acute attention, and they made follow-up interviews at 6 months after the shot hurt. Two hundred and 80 eight patients were included in the survey, from 11 Veterans Affairs medical Centres ( VAMCs ) . The chief result steps used in this survey were: 1 ) conformity with the Agency for Healthcare Research and Quality ( AHRQ ) , 2 ) patient satisfaction with attention provided, and 3 ) stroke-specific instruments. Consequences have shown that, for every 10 % percent addition in guidelines conformity, the mean value of patient satisfaction additions by 1.5 points for the average overall satisfaction mark, which ranges from 4 to 39, and includes points for hospital satisfaction, place satisfaction, and overall satisfaction. The survey concluded that conformity to AHRQ guidelin es is significantly associated with patient satisfaction. ( 6 ) Several comparings between Stroke Rehabilitation Protocols/ guidelines have been performed. This is good in set uping the best intervention, with respects to dosing, strength, continuance, every bit good as efficiency and efficaciousness of intercessions. A survey by McNaughton H, et al 3 examined the pattern and results of shot rehabilitation between New Zealand and the United States installations. This survey used a Prospective experimental cohort design and included 1161 participants from six United States ( U.S. ) Rehabilitation installations and 130 participants from one New Zealand rehabilitation installation, all above the age of 18 old ages. In this survey, New Zealand patients were older than the United States patients. However, the badness of initial shot was higher for the U.S. patients. Despite that fact, patients in the U.S. were discharged earlier. They besides had more intensive therapy, represented in higher continuances spent with physical therapy and occupational th erapy professionals. Besides, U.S therapists tended to pass less clip on appraisal and non-functional activities, while concentrating more on active direction of patients. Consequences showed that, U.S. participants had better outcomes represented by alterations in Functional Independence Measure FIM tonss and fewer discharges to institutional attention ( 13.2 % vs. 21.5 % ) . This survey illustrates that continuance and strength of therapy can be adjusted to derive a better result. Besides, it is of import to cognize which activities are being done in the intervention session, and happen out if they contribute to a better result of rehabilitation. ( 9 ) Horn et Al. investigated the consequence of specific rehabilitation therapies in shot rehabilitation on results, taking into history the differences between patients. In this survey, they wanted to analyze the associations between patient features, rehabilitation therapies, neurotropic medicine, nutritionary support, and clip of get downing therapy with functional results and discharge finish for shot inmates. Discharge entire, motor, and cognitive FIM ( functional independency step ) tonss and discharge finishs were registered for 830 patients with moderate or terrible shots from five U.S. inmate rehabilitation installations. Consequences showed that earlier induction of rehabilitation, clip spent in higher-level rehabilitation activities, such as upper-extremity control, pace and job resolution, use of newer psychiatric medicines, and stomachic eating, were all associated with better results. The survey besides illustrated that a assortment of Physical Therapy, Occupational Therapy , and Speech Language Pathology activities were correlated with higher or lower FIM tonss. On one manus, more proceedingss spent per twenty-four hours on PT pace activities, OT upper-extremity control activities and place direction, and SLP job work outing activities were associated significantly with higher FIM tonss. On the other manus, more proceedingss spent per twenty-four hours on PT bed mobility and posing, OT bed mobility, and SLP audile comprehension and orientation were systematically associated with lower FIM tonss. ( 10 ) One survey described Physical Therapy intercession for shot patients in inmate installations within the U.S. ( 12 ) . Six rehabilitation installations in the U.S. included 972 topics with stroke hurt. Variables studied were clip spent in therapy, and content and activities that were used in rehabilitation. The average continuance of stay in the inmate installations was 18.7 yearss, and received PT was on an norm of 13.6 yearss. Patient spent 57.15 proceedingss on norm for Physical therapy intervention mundane. Activities of pace, transferring, and pre-functional activities, which include beef uping exercisings, balance preparation, and motor acquisition, were the most performed intercessions. Besides, healers included activities that incorporated different maps into one functional activity. This survey implicated that a focal point of physical healer when supplying intervention is optimising functional activities, as they were the most frequent activities performed. However, activiti es to rectify damages and to counterbalance for lost maps were besides included in the intervention Sessionss. ( 12 ) Brocklehurst, et Al. investigated the usage of physical therapy, occupational therapy, and address therapy for patients enduring from shot, as they mentioned that those intercessions formed the footing of shot rehabilitation. The survey included 135 shot patients from five general and one geriatric infirmary, in South Manchester. Of the 135 topics, 107 received PT, 35 received OT, and 19 received speech therapy. Consequences were obtained after mensurating the rate of alteration in map over a one twelvemonth period. Patients who had more terrible disablements, and the worst forecast, were more likely to acquire physical therapy intervention. Factors that determine type and specificity of physical therapy to stroke rehabilitation were besides examined. Some of the factors were extent of disablement, and disability-associated morbidities, such as faecal incontinency, spasticity, centripetal loss and dysphasia. Even though the most handicapped received the most physical therapy interven tion, they showed the least betterment in map even after six months of therapy. This survey besides concluded that patients whose advancement was poorest, received more physical therapy. ( 4 ) Hsiu-Chen Huang et Al, investigated the impact of timing and dosage of rehabilitation bringing on the functional recovery of patients enduring from shot. In this survey, a retrospective reappraisal of medical charts was done for 76 patients who were admitted to a regional infirmary for a first-ever shot. Patients had multidisciplinary rehabilitation plans, including PT, OT, and a uninterrupted rehabilitation for at least three months. The chief result step for this survey was the Barthel index, taken at initial appraisal, one month, three months, six months and one twelvemonth after shot. Consequences of this survey showed that there is a dose-dependent consequence of rehabilitation on functional result betterments of shot patients. Besides, earlier bringing of rehabilitation is associated with permanent effects on functional recovery up to one twelvemonth post-stroke. ( 13 ) It is ill-defined whether physical healers follow grounds based pattern many states of the universe including Kuwait. There is no uncertainty the epoch of grounds based pattern is upon us for many grounds including better intervention results, patient satisfaction, reimbursement amongst others. In one study survey, conducted by Iles and Davidson, scrutiny of physical healers ‘ current pattern in Australia was undertaken. This survey found that there are several barriers in the manner of evidence-based pattern. Those barriers included clip to remain up to day of the month, entree to diaries, entree to sum-ups of grounds that are easy to understand, and deficiency of personal accomplishments in looking for and measuring research grounds. ( 14 ) Salbach et Al, examined the determiners of research usage in clinical determination devising among physical healers handling post-stroke patients. Two hundred and sixty three physical healers from the province of Ontario, Canada, responded to a study questionnaire, incorporating points for measuring practician and organisational features and perceptual experience of research believed to be act uponing evidence-based pattern. The study besides contained the frequence of utilizing research grounds in clinical determination devising in a typical month. Consequences showed that, merely a little per centum of healers ( 13.33 % ) reported utilizing research in clinical determination devising six times a month or more. However, most healers ( 52.9 % ) reported utilizing research 2-5 times a month, while 33.8 % used research 0-1 clip per month. In this survey, research usage was associated with the academic readying in the rules of Evidence-Based Practice ( EBP ) , research engagement, servi ce as a clinical teacher, being self-effective in implementing EBP, attitude towards research, perceived organisational support of research usage, and entree to bibliographic databases at work. This survey concluded that a 3rd of healers seldom apply research grounds in clinical determination devising. Suggested intercessions to advance research usage included instruction in the rules of EBP, EBP self-efficacy, holding a postitive attitude towards research, and engagement in research. ( 7 ) A survey by Ogiwara, made a comparing between the bases of intervention between Nipponese physical healers, and Swedish healers. They investigated the grounds why the Japanese choose certain attacks of intervention when managing shot patients, and so compared the consequences with those of Swedish healers. Swedish healers attributed their pick of intervention to hands-on experience and engagement in practical classs, in which assorted techniques are taught. Bobath ‘s attack was the lone method that was normally continued to be used after graduation in both states. Consequences have illustrated that Swedish healers were more interested in new methods of intervention ( 91 % ) , whereas merely 77 % of Nipponese healers had an involvement. Implication of their consequences might intend that Nipponese healers are interested in their intervention attack, and besides show that presenting new attacks of interventions takes a longer clip in comparing to Sweden. Additionally, Swedish hea lers tend to do a combination of intervention attacks, while Nipponese physical healers tend to follow merely one peculiar attack. Several grounds were speculated for turn toing the differences in intervention protocols, some of which were: 1 ) diverseness of civilizations, 2 ) diverseness of wellness the attention system, 3 ) handiness of equipment and infinite needed to follow a certain new attack, 4 ) belief of efficaciousness of a certain attack and 5 ) the linguistic communication barrier imposed on Nipponese healer, and handiness of translated literature. This survey showed that there are several barriers and differences encountered when the demand of application of new attacks is desired. ( 8 ) Wachters-Kaufmann et Al, conducted a survey sing the conferring of information for shot patients and health professionals. Their survey investigated how information was provided to patients and health professionals and how they really preferred to be informed. The existent and coveted information correspond in footings of content, frequence, and method of presentations good as the existent and coveted information. The survey was done in the North of the Netherlands and the shot unit of University infirmary Groningen. The General practicians ( GP ) distributed a usher from a community-based survey of cognitive upsets and quality of life ( CognitiVA ) after a shot. The usher was given three months after the shot. For the concluding measuring of the survey, which was 12 months subsequently, the patients and health professionals participated in a telephone study, which asked about three things: 1 ) professional stroke-care suppliers, 2 ) other beginnings of information, 3 ) the usher. Fi fty one patients and 38 health professionals were contacted, of which 18 patients and 11 health professionals declined to be interviewed for assorted grounds. The consequences showed that the GP ‘s, brain doctor, and physical healers were both the existent and coveted information suppliers. As for the content, the existent content was the usher, whereas the desired was largely medical information refering the class of the disease, its cause, effects, and intervention. Sing the frequence, the existent and desired was within 24 hours of the shot, and one twenty-four hours to two hebdomads subsequently, and after two hebdomads. As for the method of presentation of information, the patients and health professionals largely desired merely verbal ( 73 % patients, 89 % health professionals ) . ( 15 )MethodsThis comparative design research undertaking will compare the shot rehabilitation plan implemented in Kuwait with the established guidelines for shot rehabilitation in the United S tates of America. The rehabilitation plan shot patients are having in Kuwait ‘s Ministry of Health infirmaries, specifically, Al-Jahra, Mubarak, Farwanya, Physical Medicine and Rehabilitation, and Al-Sabah infirmaries will be investigated. Subjects of the survey will be physical healers practising in the shot rehabilitation field. We will supply physical healers experienced in shot rehabilitation with self-administered questionnaires, which will be collected after one hebdomad. We will besides analyze patient records over a three hebdomad period. To entree the records, we will acquire permission from the caput of the physical therapy section of each infirmary every bit good as each infirmaries manager. Institutional Review Board ( IRB ) blessing will be obtained prior to any informations aggregation. Blessing from the Ministry of Health ‘s IRB will be obtained every bit good as blessing from Kuwait University. Data will so be compared with the established American Stroke Guidelines. All informations gathered during the survey will be kept under lock and cardinal. Any identifiable information obtained from patient files and records will merely be accessible to the primary research worker. No identifiable information will be used for publication intents. Confidentiality will be insured throughout the survey continuance. Subjects: The topics of this survey will be physical healers working in Kuwait ‘s Ministry of Health infirmaries ‘ neurology section and with experience in out-patient shot rehabilitation. Tools: To look into the frequence and continuance of intervention, we will look into the records, which are the patients ‘ files. There is besides a subdivision in the questionnaire that will inquire about the frequence and continuance of Sessionss. As for happening out the intervention attack patients are having, a self-administered questionnaire will be distributed at selected MOH infirmaries, specifically at Al-Jahra, Mubarak, Farwanya, Physical Medicine and Rehabilitation, and Al-Sabah infirmaries. Therapists will be given the questionnaire to make full out. In order to measure the type of instruction given to patients, educational ushers, or booklets, about the patient ‘s status available at the infirmary and distributed to patients will be looked at. The questionnaire will besides inquire about different patient instruction techniques used by the participants. For comparing of informations, we will compare the information we obtain with the American Stroke Association guidelines. Questionnaire: The questionnaire will dwell of several inquiries used in the Ogiwara ( 8 ) questionnaire every bit good as others pertinent to our survey population. The questionnaire will dwell of four parts: demographic information inquiries refering the healer ‘s professional history and experience inquiries refering the rehabilitation plan: intervention attack, and frequence and continuance of Sessionss. inquiries refering the types of instruction techniques Each questionnaire will hold a cover missive explicating the intent of the survey, and a consent signifier. Datas Analysis The information will be analyzed utilizing SPSS ( Statistical Package for Social Sciences ) ( v. 15.0 ) to depict agencies, standard divergences, frequences, and per centums. Once the information is analyzed, we will compare the information we collected with the general guidelines and intervention attacks in the literature.Expected Results and RecommendationsOur outlook for this survey is that physical healers in the province of Kuwait will be following the American shot rehabilitation guidelines. Due to cultural differences between the two states, set uping new guidelines for the shot rehabilitation in Kuwait might be necessary, turn toing the nature of referral to physical therapy in Kuwait, and doing recommendations for increasing intervention continuance if needed. Besides, it should be mentioned what type of particular equipment might be used in the procedure of rehabilitation. Mentions Rudd A, Olfe C.W. ( 2002, Feb ) . Aetiology and pathology of shot. Vol. 9, pg 32-36. Hafsteinsdottir T.B, Vergunst M, Lindeman E, Schuurmans M. ( 2010, 29 July ) . Educational demands of patients with a shot and their health professionals: A systematic reappraisal of the literature. www.elsevier.com/locate/pateducou Hoffman T, McKenna K, Herd C, Wearing S. Written stroke stuffs for shot patients and their carers: positions and patterns of wellness professionals. Top Stroke Rehabil 2007 ; 14 ( 1 ) :88-97 Brocklehurst J.C, Andrews K, Richards B, Laycock P. J. ( 1978, 20 MAY ) . How much physical therapy for patients with shot? Vol. 1, 1307- 1310. British Medical diary. Kollen, B, Kwakkel G, Lindeman E. ( 2006, 11 July ) . Functional Recovery After Stroke: A Review of Current Developments in Stroke Rehabilitation Research. Vol.1, No.1, 75-80. Reker D.M, & A ; Duncan P. W, Horner R.D, Hoenig H, Samsa G.P, Hamilton B, Dudley T.K. ( 2002, June ) Postacute Stroke Guideline Compliance Is Associated With Greater Patient Satisfaction. Arch Phys Med Rehabil Vol. 83, pg 750-756. Salbach, M.N, Guilcher JT.S, Jaglal B.S, Davis D.A. ( 2010 ) Determinants of research usage in clinical determination devising among physical healers supplying services post-stroke: a cross-sectional survey. hypertext transfer protocol: //www.implementationscience.com/content/5/1/77 Ogiwara S. ( 1997 ) Physical therapy in shot rehabilitation: A comparing of bases for intervention between Japan and Sweden.vol.9 Pg. 63-69, Journal of physical therapy scientific disciplines. McNaughton H, DeJong G, Smout R.J, Melvin J.L, Brandstater M. ( 2005, Dec ) A Comparison of Stroke Rehabilitation Practice and Outcomes Between New Zealand and United States Facilities. Vol. 86, suppl.2, Arch Phys Med Rehabil. Horn, S.D, DeJong G. Smout R.J, Gassaway J, James R, Conroy B. ( 2005, Dec ) Stroke Rehabilitation Patients, Practice, and Results: Is Earlier and More Aggressive Therapy Better? Vol. 86, pg. 101-114, suppl. 2, Arch Phys Med Rehabil. Life after shot: New Zealand guideline for direction of shot ( November 2003 ) . Jette, D.U, Latham N.K, Smout R.J, Gassaway J, Slavin M.D, Horn S.D ( 2005, March ) Physical Therapy Interventions for Patients With Stroke in Inpatient Rehabilitation Facilities. Vol. 85, num. 3, pg. 238-248, physical therapy. Huang H, Chung K, Lai D, Sung S. The Impact of Timing and Dose of Rehabilitation Delivery on Functional Recovery of Stroke Patients ( J Chin Med Assoc: May 2009, Vol 72, No 5 ) Iles R, Davidson M. Evidence based pattern: a study of physical therapists ‘ current pattern. Physiother. Res. Int. 11 ( 2 ) 93-103 ( 2006 ) Watchers-Kaufmann C, Schuling J, The H, Jong B. Actual and desired information proviso after a shot. Patient Education and Reding 56 ( 2005 ) 211-217AppendixsAppendix 1E. Patient and Family/Caregiver EducationBackgroundThe patient and family/caregivers should be given information and provided with an chance to larn about the causes and effects of shot, possible complications, and the ends, procedure, and forecast of rehabilitation.RecommendationsRecommend that patient and family/caregiver instruction be provided in an synergistic and written format. Recommend that clinicians consider placing a specific squad member to be responsible for supplying information to the patient and family/caregiver about the nature of the shot, stroke direction rehabilitation and outcome outlooks, and their functions in the rehabilitation procedure. Acknowledge that the household conference is a utile agencies of information airing. Recommend that patient and household instruction be documented in the patient ‘s medical record to forestall the happening of extra or conflicting information from different subjects.N. Educate Patient/Family, Reach Shared Decision About Rehabilitation Program, and Determine Treatment PlanAimEnsure the apprehension of common ends among staff, household, and health professionals in the shot rehabilitation procedure and, hence, optimise the patient ‘s functional recovery and community reintegration.RecommendationsRecommend that the clinical squad and family/caregiver reach a shared determination about the rehabilitation plan. A A A The clinical squad should suggest the preferable environment for rehabilitation and interventions on the footing of outlooks for recovery. A A A Describe to the patient and household the intervention options, including the rehabilitation and recovery procedure, forecast, estimated length of stay, frequence of therapy, and discharge standards. A A A The patient, household, health professional, and rehabilitation squad should find the optimum environment for rehabilitation and preferable intervention. Recommend that the rehabilitation plan be guided by specific ends developed in consensus with the patient, household, and rehabilitation squad. Recommend that the patient ‘s family/caregiver participate in the rehabilitation Sessionss and be trained to help patient with functional activities, when needed. Recommend that patient and health professional instruction be provided in an synergistic and written format. Supply the patient and household with an information package that may include printed stuff on topics such as the recommencement of drive, patient rights/responsibilities, support group information, and audiovisual plans on shot. Recommend that the elaborate intervention program be documented in the patient ‘s record to supply incorporate rehabilitation attention. Intensity of Therapy The heterogeneousness of the surveies in all aspects-patients, designs, interventions, comparings, result steps, and results-combined with the boundary line consequences in many of the tests limits the specificity and strength of any decisions that can be drawn from them. Overall, the tests support the general construct that rehabilitation can better functional results, peculiarly in patients with lesser grades of damage. Weak grounds exists for a dose-response relationship between the strength of the rehabilitation intercession and the functional results. However, the deficiency of definition of lower thresholds, below which the intercession is useless, and upper thresholds, above which the fringy betterment is minimum, for any intervention, makes it impossible to bring forth specific guidelines. Partridge et al did non happen any differences in functional and psychological tonss at 6 hebdomads in 104 patients randomized between a criterion of 30 and 60 proceedingss of physical therapy. Kwakkel et al randomized 101 middle-cerebral-artery shot patients with arm and leg damage to extra arm preparation accent, leg preparation accent, or arm and leg immobilisation, each intervention enduring 30 proceedingss, 5 yearss a hebdomad, for 20 hebdomads. At 20 hebdomads the leg preparation group scored better for ADLs, walking, and sleight than the control group, whereas the arm preparation group scored better merely for sleight. The clinical tests provide weak grounds for a dose response relationship of strength to functional results.

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