Childbirth and Preterm Infants Essay Example for Free

Childbirth and Preterm Infants Essay Discuss disparities related to ethnic and cultural groups relative to low birth weight infants and preterm births. Describe the impact of extremely low birth weight babies on family and society (short and long term, including economic considerations, ongoing care considerations, and co-morbidities associated with prematurity). Discuss whether you feel that support services and systems in your community for preterm infants and their families adequately address their needs or not. Explain your answer. Respond to other learners posts in a manner that initiates or contributes to discussion. Racial and ethnic disparities in health disproportionately affect minority Americans. One of the greatest challenges facing the US healthcare system is the persistence of disparities in infant and maternal health among the different racial and ethnic groups. This disparity in healthcare outcomes does not appear to be limited to the Black community only, but rather it seems to affect all minority groups. In this context, American Indian/Alaska Native infants have higher death rates than White infants because of higher SIDS rates. The exact cause of these persisting racial disparities remains unexplained. The differences in socioeconomic status, maternal risky behaviors, prenatal care, psychosocial stress, and perinatal infection account for more disparities. Hispanics of Puerto Rican origin have higher IMRs than White infants because of higher LBW rates. One major risk factor for preterm birth is maternal genital infection. Others include extremes of maternal age, maternal cigarette smoking and substance abuse, history of PTD and maternal medical conditions such as hypertension and diabetes. There are support services and CHC’s available in our area for minority group women, preterm infants and their families to address their needs.

The Symbolic Use of Light and Dark in James Baldwins Sonnys Blues Ess

The Symbolic Use of Light and Dark in James Baldwin's Sonny's Blues In James Baldwin's "Sonny's Blues" a pair of brothers try to make sense of the urban decay that surrounds and fills them. This quest to puzzle out the truth of the shadows within their hearts and on the streets takes on a great importance. Baldwin meets his audience at a halfway mark: Sonny has already fallen into drug use, and is now trying to return to a clean life with his brother's aid. The narrator must first attempt to understand and make peace with his brother's drug use before he can extend his help and heart to him. Sonny and his brother both struggle for acceptance. Sonny wants desperately to explain himself while also trying to stay afloat and out of drugs. Baldwin amplifies these struggles with a continuous symbolic motif of light and darkness. Throughout "Sonny's Blues" there is a pervasive sense of darkness which represents the reality of life on the streets of Harlem. The darkness is sometimes good but usually sobering and sometimes fearful, just as reality may be scary. Light is not simply a stereotypical good, rather it is a complex consciousness, an awareness of the dark, and somehow, within that knowledge there lies hope. Baldwin's motif of light and darkness in "Sonny's Blues" is about the sometimes painful nature of reality and the power gained from seeing it. Baldwin's use of the symbols light and darkness seem at first stereotypical. Light is the good while dark is the bad, but after several uses it is clear that the author has a more complex idea. The first reference to light occurs while the narrator is thinking over the recently learned news that Sonny has been jailed. "I didn't want to believe that I'd ever see m... ...shes a symbolic motif of light and darkness to illustrate the duality of the brothers' world. Darkness represents reality, often cold, sometimes comforting, while light is the hope that sees them through. Together Sonny and his brother will face the darkness with a light and their hopes, making the black a little less foreboding, creating a reality they can deal with. At the end of the story the narrator sits in the bar watching his brother receive his applause and sends him a drink. He comments, "I saw the girl put a scotch and milk on top of the piano for Sonny . . . as they began to play again, it glowed and shook above my brother's head like the very cup of trembling," (439). Dark and light united in a drink of life, trembling with tenacity. Works Cited Baldwin, James. "Sonny's Blues." The Oxford Book of American Short Stories 1992: 409 - 439.

Because I Counld Not Stop for Death

The analysis of the relationship between the life experiences and belief Emily Dickinson held and her poems by analyzing â€Å"Because I Could Not Stop for Death† Emily Elizabeth Dickinson (1830-1886), an American poet, was born in Amherst, Massachusetts. Living in a successful family which had an important status in the community, she lived a very introverted life. After having spent seven years in Amherst Academy, she carried on studying in Mount Holyoke Female Seminary for a short period of time. The locals considered her as an eccentric. Maybe this was the reason why she started to be noted for wearing white clothing, and seldom greeting visitors. One of her closest friend Thomas Wentworth Higginson said:† Emily emerged from her wonted retirement and did her part as gracious hostess; nor would any one have known from her manner, I have been told, that this was not a daily occurrence. † (http://www. gutenberg. org/dirs/etext01/1mlyd10. txt) Dickinson’s introverted world let her develop her unique thought and tone. Having never thought of letting the poems be published–it was called â€Å"the Poetry of the Portfolio,† –her poems were the full display of a writer’s own mind. However, the few works published in her life time were largely altered by the publishers to fit the contemporary poetic rules. Dickinson’s poems were unique in her times. Besides the unconventional writing format of poetry: â€Å"containing short lines, typically lack titles, and often utilize slant rhyme as well as unconventional capitalization and punctuation,† her religious belief and the unconventional utterance were evident to be perceived. â€Å"She loved to speak of a compassionate Savior and the grandeur of the Scriptures, but she disliked the hypocrisy and arbitrariness of institutional church. We can infer that the writer possessed her distinctive way to appreciate God. Moreover, she often mentioned immortality, death, and eternity in her poems. In Because I Could Not Stop for Death (1924), Because I could not stop for Death, He kindly stopped for me; The carriage held but just ourselves And Immortality. In the first stanza she portrayed the approach of death . In Calvinist dogma, â€Å"it is true that death passed upon all men through the First Adam† since he was expelled from the Garden and lost the reliance of immortality from Tree of Life and thus made death certain. http://geocities. com/shsnj_2000/theology/calvinism. html) (http://lifeafterdeath. eu/) The same belief can be inferred in the last stanza: Since then ‘t is centuries; but each Feels shorter than the day I first surmised the horses' heads Were toward eternity. The underlined two lines indicate that Dickinson assumed that with the accompanying of death she was resuming and reentering the immortality. After the sketchy understanding of the religious part of her composing background, then the following is the subconscious part of her composing background. According to William Cullen Bryant and Henry Thoreau, we can apply many of the characteristics of Dickinson’s verse in this poem: â€Å"2. Her style is elliptical — she will say no more than she must –suggesting either a quality of uncertainty or one of finality. † For example, she held the word eternity until the last word of the last stanza to point out the main theme. â€Å"3. Her lyrics are her highly subjective — she knows no other consciousness. † Emily Dickinson altogether used three I and at least ten me and my in this poem. Because the extremely limited life circle and introverted world, it was nothing more easier than applying the protagonism (the first person point of view) in the verse. â€Å"4. Ambiguity of meaning and syntax. Wrote Higginson: ‘She almost always grasped whatever she sought, but with some fracture of grammar and dictionary on the way. ’† For example, in the fifth stanza: We paused before a house that seemed (was) A swelling of the ground; The roof was scarcely visible, (and) The cornice (was not a cornice) but a mound. â€Å"5. Concreteness – it is nearly a theorem of lyric poetry that it is as good as it is concrete. Even when she is talking of the most abstract of subjects, Emily specifies it by elaborating it in the concreteness of simile or metaphor. † Here we go to talk about the figurative language. Dickinson used personification to portray Death as a kind and civil gentleman who accompanies her to pass the life that she is busy with and Death is like a suitor who comes calling for the narrator to escort her to eternity. And she too mentioned that the immortality is another passenger in the carriage. http://www. cummingsstudyguides. net/Guides2/Dickinson. html#Characters)Therefore, from the interaction between the personified Death and the speaker we can perceive that the speaker is a woman who is sound in her decision to leave. She is too naive concerning Death’s intension for her. â€Å"Frank Bernard states that ‘at [the] poem's opening the speaker is, to say the least, na ive . . . . She does not have the foresight to dress warmly. . . and there is no luggage. ’† (http://www. associatedcontent. com/article/657821/emily_dickinsons_because_i_could_not. html? cat=38) The metaphor in the poem is multiple: first, in the forth stanza, the speaker is only wearing gossamer, tippet, and tulle and feels cold. It means she had come to the late night of her life, and human race has nothing to armor themselves against the cold of death. Second, in the forth stanza, the writer chose the word gown to indicate that she went with death not with sadness but with the attitude to be a bride. Third, in the fifth stanza, the line â€Å"the tomb [is like] a house† points out that there is a place for her to dwell in the long time after passing away because death is not the end but â€Å"eternity. Forth, â€Å"The setting sun passed us† means that human race is a tiny existence that can only be dominated by the power of time. (http://www. cummingsstudyguides. net/Guides2/Dickinson. html#Top) The use of simile and irony are also significant: In the fifth stanza the writer used the simile:† a house that seemed a swelling of the ground. † It i ndicates that the tomb is a swelling of the ground. The use of the irony is in the third stanza: We passed the school, where children strove At recess, in the ring; We passed the fields of gazing grain, We passed the setting sun. The speaker illustrated the three images of the stage of life. Each of them is portrayed vividly, however, the speaker is getting away from them and soon entering the next stage, the final stage right after the sunset. â€Å"However, it is understood that when looking back on the experience, she realizes the significance of those seemingly mundane occurrences. † (http://www. associatedcontent. com/article/657821/emily_dickinsons_because_i_could_not. html? cat=38) Analyzing this poem by new criticism, the theme is clear. Though Dickinson's insights are profound, they are limited in topic. Because I could not stop for death† echoes the reoccurring theme of the inevitability of death. In this poem, Dickinson skillfully conveys that theme through a personification of Death as a courtly lover. Death is not the end but the eternity. (http://www. associatedcontent. com/article/657821/emily_dickinsons_because_i_could_not. html? cat=38) The Symbols in the poem are carriage, schoo l, fields, and the setting sun. The carriage symbolizes the procedure of death. As the carriage moves, human beings experience their lives in each stage get and more and more closer to the final destination of life (death). The school, fields, and the setting sun symbolize the early, middle, and late stage of life. The last one of the characteristics of Dickinson’s verse is obscurity and the space for another answer. Higginson said’ †¦ she was obscure, and sometimes inscrutable; and though obscurity is sometimes, in Coleridge's phrase, a compliment to the reader, yet it is never safe to press this compliment too hard. ’ â€Å" †¢ Is Death a kind, polite suitor? The speaker refers to his â€Å"kindness† and â€Å"civility. † He drives her slowly; is this an expression of tact and consideration for her? If he is the courteous suitor, then Immortality,who is also in the carriage (or hearse) would be their chaperon, a silent one. †¢ Is Death actually a betrayer, and is his courtly manner an illusion to seduce her? Because of his kindness in stopping for her, she agrees to go with him (â€Å"put away / My labor and my leisure too†). Is Death really cruel? She is not properly dressed for their journey; she is wearing only a gossamer gown and tulle tippet (gossamer: very light, thin cloth; tulle: a thin, fine netting used for veils, scarfs, etc. tippet: covering for the shoulders). Is Immortality really an accomplice to Death's deception? (http://academic. brooklyn. cuny. edu/english/melani/cs6/stop. html) From the above analysis it is not hard anymore for us to infer that Emily Dickinson who is a talented writer who conceived the vivid imagination in mind. Her life experiences and religious belief have influenced her verse a lot. From this poem Because I Could Not Stop for D eath the another indicated her interpretation of death: Death is not the end but the eternity.

Briefly Outline the Key Features of a Cognitive-Behavioural Approach to Counselling - Free Essay Example

Sample details Pages: 5 Words: 1445 Downloads: 8 Date added: 2017/09/15 Category Advertising Essay Did you like this example? Briefly outline the key features of a cognitive-behavioural approach to counselling and discuss some of the ways in which this approach differs from one of the other main approaches to counselling. In part two reflect on and write about which of the two approaches discussed in your essay you prefer and why. This essay will explain key aspects of a cognitive-behavioural approach to counselling. Revealing how this method of counselling differs from the psychodynamic approach, and demonstrating my preferred method. The first of these approaches ‘Cognitive-behavioural’ is an umbrella term for a method of counselling comprising several approaches. It evolved from behavioural psychology founded by J. B Watson; an American psychology professor whose 1919 publication entitled Psychology from the standpoint of a Behaviourist largely influenced this approach. (McLeod (2008) p. 132) The first basic premise to cognitive-behavioural counselling involves client and counsellor collaborating, breaking problems down into individual parts, examining, modifying and changing them for a successful outcome. Don’t waste time! Our writers will create an original "Briefly Outline the Key Features of a Cognitive-Behavioural Approach to Counselling" essay for you Create order The second is the value of a scientific approach. Just as scientists employ hypotheses, experimentation and evaluation in their work; the cognitive-behavioural counsellor does the same. This is demonstrated in the counsellors’ constant observation and evaluation of change in clients. The third is closely monitoring the cognitive process through which people observe and control their behaviour. (McLeod 2008 p132) The aim of Cognitive-behavioural counselling is to empower clients to recognise irrational thoughts, modify feelings and behaviour by changing thought processes. The Client aims to focus on specific goals but thinks in an illogical fashion, producing detrimental emotions. The connection between thought and behaviour are the epicentre of this approach; the founder of Cognitive therapy; Beck, concluded; observing how patients viewed themselves was more important than traditional psychoanalytic tactics he’d previously practised. Beck explains â€Å"I was struck by the fact a patient’s cognitions had an enormous impact on his feelings and behaviour† (McLeod 2008 p143) Beck believes a client’s emotional and behavioural problems aren’t shaped by certain events, instead; ersonal interpretation of events are key to feelings and behaviour. Albert Ellis created RET- rational emotive therapy. Focusing on the resolution of emotional-behavioural difficulties not only affecting the client but also impinging upon others and empowering people to experience lives that are more positive. To illustrate; the A-B-C method used i n RET states: A stands for the activating event leading the client to feel C, which represents the emotional or behavioural consequence of the event. Yet; Ellis believes A is not responsible for C instead, it is the individuals’ B or beliefs about the event that could include past or present or future internal or external events. The role of the cognitive-behavioural counsellor is akin to a coach encouraging clients to improve, stating confidence in clients’ abilities to succeed, motivating, praising alongside clients. There is homework, writing and role-play that must be adhered to in cognitive-behavioural therapy and failure to do so results in the counsellor assuming the client is unwilling to change their behaviour for the better. (Word count 440) The psychodynamic approach to counselling has its roots in Sigmund Freud’s psychoanalytical theories in which Freud’s analysis of clients link these premises: One-Emotional difficulties lie in a person’s childhood events. Two-We are not consciously aware of childhood experiences due to repressed memories that we cannot recognise as they live in the ‘unconscious’ part of our brain (Freud categorized the unconscious as a ‘part’ of the brain). Three-unconscious matter presents itself surreptitiously during therapy, in our fantasies and dreams and as an emotional response of transference (redirection of feelings) towards the counsellor. McLeod 2008 p130) Anna Freud; the youngest of Freud’s children; and psychoanalyst, updated her father’s theory on ‘defence mechanisms’- seven stages of forces determining behaviour manifesting themselves through defence mechanisms. Within the psychodynamic approach are various consi derations and decisions regarding how to best to help the client when the counsellor is aware of a client displaying the mechanisms of defence and the conflict it causes a client. (McLeod 2008 p 96-97) The psychodynamic counsellor will use various strategies to assist clients. One such method is ‘Transference’, the counsellor’s presenting themselves as neutral; encouraging clients’ to project feelings or behaviour onto the counsellor, brought about by experiences or relationships. The reason for neutrality is for the counsellor’s assurance that whatever feelings are projected towards them, it’s not anything the therapist has caused due to remaining detached, the client ‘transfers’ an image of a family member or someone who influenced them onto the counsellor. Transference enables the counsellor to make clients aware of such projections so the client can recognise this and prevent it happening in future relationships. Transference is a feature of psychodynamic methodology, useful in determining clients’ histories that aid counsellors in seeing why clients repeat unhelpful patterns behaviourally. Just as a client can project transference, the therapist can experience ‘counter-transference’ whereby a client evokes feelings from the therapist akin to those of others in contact with the client. It is useful to the counsellor because counter-transference provides an insight into relationship commonalities and lifestyle of a client. There will be focus on specific issues or life events that their client has sought counselling to resolve. A client’s problems can be interpreted as developmental, childhood issues that need resolving. The person will repeat patterns of problematic behaviour and thoughts until gaining enlightenment on how to resolve recurrent difficulties. (Word count 389) As this essay has demonstrated, the two approaches outlined lead to conflicting interpretations by counsellors regarding clients. In psychodynamic counselling, a reasonable, connection between counsellor and client is regarded as an ending achievement. By contrast, cognitive-behavioural counsellors assume clients’ can be ‘taught’ practical strategies as opposed to psychodynamic methods, which use an enriching, therapeutic approach by analysing clients’ early lives. Within Cognitive-behavioural, there is little focus on (past) problems unlike psychodynamic theory, instead; ‘solution-focused’ (current) techniques help clients manage their moods quickly with new thought patterns aiming to replace irrational thoughts for rational. Psychodynamic rationale sees the counsellor as a ‘specialist’ with the knowledge to analyse people and treat accordingly consequently there’s no overt collaboration of client with counsellor as in cognitive-behavioural. Transference is a feature of psychodynamic methodology, useful in determining clients’ histories that aid counsellors in seeing why clients repeat unhelpful patterns behaviourally whereas cognitive-behavioural doesn’t recognise childhood and the unconscious and turns to the here and now. (Word count 160) I prefer the cognitive-behavioural approach because I’ve spent too much time focussing on my past that’s often hazy in memory, especially early childhood memories which are therefore difficult to recount and analyse. Although the past is relevant to who I am, I need to learn coping strategies presently. I was diagnosed with depression and anxiety 12 years ago and manage it with mild medication. To me, it is logical to change one’s cognitions in order to achieve happiness. I can’t envisage any resolution without changing something. Once learned, I could employ new techniques of CBT when needed. It would be convenient, practical and immediate which gives me hope and confidence in its potential success. I haven’t experienced a useful outcome from previous counselling that I’ve undergone for depression. I believe the reason for this is because I’m only eligible for up to a maximum of 12 sessions on the NHS and can’t afford to self fund further counselling. Although CBT is not perfect, as I‘ve demonstrated in this essay, I respect its value of the scientific approach. I like that; if a technique isn’t serving its purpose, I could re-evaluate or try another with the guidance of a CBT counsellor. The idea of positive praise, encouragement and the aforementioned immediacy, greatly appeals to me. I have a wealth of life experience, empathy and a yen to help people overcome psychological distress, or cope better with mental illness. This is what has motivated me to study a psychology degree with a view to becoming a psychologist. (Word count 255) References McLeod, J. (2008) Introduction to counselling [Ed. D. Langridge], Maidenhead/Milton Keynes, Open University Press/The Open University. Introduction to counselling, ibid, p. 132 Introduction to counselling, ibid, p. 143 Introduction to counselling, ibid, p. 130 Introduction to counselling, ibid, pp. 96 to 97 Self-evaluation The parts of the material I feel I have gotten to grips with best are the summaries and appraisals at the end of the chapters of the course book, as they are a good reminder and great clarification for anything that I might not have understood at a first read. I have found the book very deep and overly detailed in places which can sometimes confuse me. I may need help on TMA 2. I would have preferred one or two tutorials too.