Tokugawa Period (Edo Period) Essay Example for Free

Tokugawa Period (Edo Period) EssayThe relevance of the Tokugawa Period (Edo Period) to the development of Modern Japan is based on the fact that it marked the restoration of majestic rule and ushered in the beginning of the development of early modern Japan (Bryant 2005). The innovations that were introduced during this period included the increase in commerce finished the encouragement of the transportation system of commodities. This resulted in the economic expansion of Japan on a domestic scale initially and eventually foreign commerce.This also saw the flourishing of braid trades as well as banking facilities and merchant guilds (Bryant 2005). Through these economic developments, Japan quickly saw the urbanization of its society and the rising economic independence through the increase in agricultural production and the spread of rural handicrafts which greatly revitalized the economy and helped convert a population that was comprised of 80 percent (80%) peasants into a more mercantile population. The Qing Dynasty (Manchu Dynasty) was the last ruling imperial dynasty of China. The fall of traditional China was caused by the weakened military power during the 1800s and the circleive rebellions that move China during the same period. By the early 20th century, the death of Ci Xi and the Guangxu emperor had left the imperial family relatively powerless and unstable against the mass civil disorder that had begun (Bartlett 1991).The ultimate humiliation for the Qing dynasty was the loss of imperial power that it had when it relinquished control over the military to Yuan Shi-kai and his Beiyang commanders and the establishment of a republican constitutional reform. This led to installation of Yuan Shi-kai as the president of the Republic pursuant to the negotiations with Sun Yat-Sen. concludingly, in 1912, after 12 rounds of negotiations, Longyu issued the Imperial Edict convey about the abdication of the child emperor Puyi and thus marking the fall of traditional imperial China (Bartlett 1991).ReferencesBeatrice S. Bartlett. Monarchs and Ministers The Grand Council in Mid-Ching China, 17231820. Berkeley, CA University of California Press, 1991.Anthony J. Bryant Sekigahara 1600 The Final Struggle for Power, Praeger Publishers September, 2005

Increasing Cervical Screening for BME Women in the UK

Increasing cervical Screening for BME Women in the UKIt was non until 1988 that the NHS cervical test programme began since then it has proved to be a successful scheme in the detection and prevention of cervical genus Cancer saving 4500 lives per year (NHS cervical Screening Programme 2008, C be Commission 2008). nonwithstanding the core groupiveness of smear tests, evidence shows that only 80% of women with cervical cancer would dedicate had cervical chanceing (Bloomfield 2007 cited in Gannon and Dowling 2008).In 2007 2,828 new cases of cervical cancer were diagnosed in the UK, and worldwide at that rear end ar 493,000 cases annually (Cancer research UK 2010a, Ashford and Collyto a greater extent 2005). With the prevalence of cervical cancer join on thither are concerns with the breathing in of cervical showing in the UK particularly among pagan nonage of women. Evidence by Moser et al (2009) has shown there is a funky white plague of cervical test in pagan gr oups of women British women were 1.35 to 3.42 time more liable(predicate) to have a cervical smear in equality with women from an heathenishalal minority. Although another(prenominal) f recreateors such as age and socioeconomic as demonstrated in Moser et al (2009) have an impact on the using up of cervical binding, culturality seems to be a significant influence. Cervical covering fire is offered to women aged 25-64 years old for women aged 25-49 masking piece is at 3 year intervals and for women aged 50-64 it is any 5 years (DOH 2006). Although uptake of cervical screening is lower overall in heathenishal minority groups, there are differences in the uptake in the midst of ethnic groups (Luke at al 1996, Webb et al 2004).The aim of this belles-lettres review is to discover how the uptake of cervical screening can be increased amongst ethnic minority women in the UK. In doing so the literature review sets out to identify ethnic womens beliefs and attitudes towards cervical screening, identify and evaluate ethnic womens barriers to cervical screening and to evaluate the interventions used to increase the uptake of cervical screening.A literature search was conducted using the search terms cervical smears, ethnic minorities, cancer , screening , barriers, companionship , women , prevention, interventions and UK. As individual search terms did not suffer a fruitful vector sum of papers that were relevant, these search terms were combined as followscervical smears + women attitudes +UKcervical cancer prevention and screening +ethnic groups,cervical screening + interventions UK,cervical cancer + ethnic minorities UK,cervical screening + barriers UKcervical screening knowledge + ethnic minoritiescervical smears + ethnic minoritiesThe combined search terms were used in the search strategies of CINAHL, MEDLINE-via PubMed, BNI, Google Scholar and PsycArticles (see Appendix 1)A total of 11 studies (Appendix 2) were order with the inclusion criteria of primary research and research published after 1990. It was important that the literature reviewed old research as it was only in 1988 that matter cervical screening was introduced and the payoff of cervical screening in ethnic minorities has been on-going. Hence this en suitabled a comparison of how ethnic minority views on cervical screening have changed over time. The exclusion criteria were primary research published outside the UK. This was payable to the unfamiliarity with methods of cervical screening outside the UK. The use of electronic prying did not yield as many research as hoped for, gainmore it was very hard to find research on interventions that were tried on ethnic minority groups of women.Cervical cancer is the second almost common cancer in women under age 35 in the UK (Bedford, 2009). As the name suggests cervical cancer is cancer of the cervix. The cervix (neck of the womb) is part of the fe potent reproductive system and connects the uterus to the vagi na. The cervix has many functions during menstruation it allows the passage of blood flow and during childbearing it dilates for the baby to pass through the uterus and into the vagina (Cancer Research UK 2010b).The cells of the cervix can develop to pre-cancerous changes known as dysplasia. Dysplasia (which is abnormal cells on the cervix) can be agent using cervical intraepithelial neoplasia (CIN) classification (see Appendix 2). For this reason it is important that women have regular smears as early detection of cervical abnormalities can initiate intercession before cancer develops (Patient UK 2010).There are two types of cervical cancers squamous cell carcinoma and adenocarcinoma. Squamous cell carcinoma is the most common form of cervical cancer and accounts for 80- 90% of cervical cancers. Squamous cell carcinoma invades the squamous epithelium of the ectocervix (Dunleavey 2009). The other form of cervical cancer is adenocarcinoma, although less common as it accounts for only 10% in all cases it is considered to be the more severe than squamous cell carcinoma. (Dunleavy 2009, What is cervical cancer? 2011). more(prenominal)over the cervical smear is not designed to detect adenocarcinoma, however is mainly intended at notice the early changes of squamous cell carcinoma (Poulsen 2005).As cervical cancer progresses slowly it whitethorn be asymptomatic, however as it advances the symptoms such as irregular bleeding, bleeding or vexation after sexual intercourse and increased discharge may be a sign of cervical cancer Smeltzer et al (2009). According to Shiffman et al (1993) there is strong evidence to suggest that Human Papilloma Virus (HPV) causes cervical cancer, with types 16 and 18 deemed to be strongly associated with cervical cancer. Other risk factors include, smoking, subject of sexual partners, age of first intercourse and use of oral contraceptives (Cancer Research UK 2009b).Internal BarriersFrom the literature it is apparent that internal barriers such as , beliefs, attitudes, overplus, and deprivation of knowledge have an influence on the uptake of cervical screening in ethnic minorities (Doyle 1991, Naish et al 1994, Box 1998, doubting Thomas et al 2005, Abdullahi 2009). There seems to be a consensus about beliefs and attitudes of ethnic minority women and cervical screening. Naish et al (1994) investigated factors that deter women from attending there GP for cervical screening. A focus group of women from Turkish, Kurdish, Bengali, Chinese, Vietnamese, Punjabi and Urdu speaking women was conducted. It was found that most of the women shared fatalistic beliefs about cervical cancer. It was noted that if you have it, then that is it and it would be better if were detected early (Naish et al 1994, p.1127). Similarly a more recent playing field by Abdullahi et al (2009) besides found Somalianan women had fatalistic beliefs about cervical cancer however these beliefs stemmed from a religious view rather than a cul tural view as described in Naish et al (1994). Using a purposive take, Abdullahi et al (2009) recruited Somali women from Camden. Somali women commonly believed that cervical cancer was the will of God. This belief is save supported by participants in Box (1998) and Thomas et al (2005) study. Box (1998) aimed to stress the views and experiences of black and minority ethnic (BME) women on smear test screening for cervical cancer. The findings showed attitudes and beliefs about cervical cancer were consociateed with promiscuity and seen as a punishment from God. A woman in Boxs study (1998, p.7 ) say cancer , yes it happens here, not with us we stay with our men. Therefore for some ethnic minority women there is a chance of be culturally and religiously stigmatised as a result of the belief that cervical screening is only appropriate for those who are promiscuous.For most ethnic minorities with strong religious and cultural backgrounds there is a high importance attached to how women should behave when not married. The commitment to religion in ethnic minorities particularly those from a Muslim and Christian background means for most women they have to maintain their virginity until married otherwise may be exposed to genial consequences (Shripinda 2010). For example in Moroccan and Turkish groups women found to have lost their virginity can be killed in what is known as honour killing (Shripinda 2010). This view is still strongly upheld. Young Pakistani, Arabic and Greek orthodox females expressed resilient views on keeping the virginal state when entering marriage (Thomas et al 2005). Thomas et als (2005) study revealed young Pakistani women suggested they would go for a cervical screening only if the screener was not from their cultural background as they feared of universe found out. Likewise in Boxs study (1998), sexually active unmarried women were afraid their doctor or receptionist could not be trusted as to the reason why they attended the GP. The unanimity on beliefs and attitudes towards cervical cancer is not shared across all types of ethnic groups of women. Interestingly the views of African women beliefs about cervical cancer are derived from superstition (Thomas et al, 2005). The African women in Thomas et als study (2005) believed cervical cancer was a taboo and that to mention cancer exponent cause the cancer to manifest. Furthermore cervical cancer was seen as a taboo more than other types of cancers. The evidence above provides a strong get together between ethnic minorities cultural and religious beliefs as a barrier in cervical screening.Another concern over cervical screening was the issue of embarrassment. The cervical smear test is invasive and for most ethnic women the procedure can be physically and psychologically uncomfortable (Box 1998, Abdullahi et al 2009). The issue of embarrassment is particularly important to Somali women. For them the issue of embarrassment arises from female sex mutilation ( FGM). WHO (2010) explains FGM as the total or partial removal of the foreign female genitalia. FGM in most cultures is as result of both cultural, religious and refers to back to the ideology of maintaining premarital virginity. For some Somali women there is the anticipation of embarrassment as result of the reaction from the doctor or nurse taking the samples (Abdullahi et al 2009). Consequently Abdullahi et al (2009) brings an understanding as to how FGM acts as a deterrence for Somali women in cervical screening.These studies (Naish et al 1994, Box 1998, Thomas et al 2005, Abdullahi 2009) have the use of focus groups in common. Though this suggests the appropriate use of focus groups in the study, it has its limitations. Parahoo (2006) states the injury of focus groups is that dominant personalities can keep back the discussions. This was evident in Naish et al (1994), where it was noted that both Turkish and Kurdish women interacted spontaneously and informally compared to t he other ethnic groups of women. This can affect the credibility of the study as the views of ethnic women perhaps only reflected those from Turkish and Kurdish backgrounds and not everyone else. Furthermore focus groups are not effective compared with in-depth interview in dealing with sensitive topics. For example in Abdullahis study (2009) the issue of promiscuity was discussed with discomfort. This presents one of the prime issues within focus groups, where participants may look less inclined to discuss sensitive issues out of fear of scrutiny and criticism from others within the group. This is reinforced by Groups Plus (2003) who states that sensitive topics are easily discussed if participants in the group all share the same problem.The lack of knowledge of cervical screening is often prevalent in ethnic minority groups. Box (1998) identifies that there were misconceptions about the purpose of screening. Similarly Abdullahi et al (2009) found that Somali women failed to rec ognise the importance of cervical screening. This supports a previous study by Doyle (1991) which identified ethnic minorities unawareness of both the importance and existence of cervical screening. Somali women disregarded cervical screening because there was no cervical screening in Somalia the concept of preventative health was also unfamiliar. The concept of preventative health is unaccustomed in some cultures. Doyle (1991) suggests in the Asiatic communities the reliance on folk medicines meant screening was outside the traditional views of healing. The disregard towards preventative health is perhaps underpinned by religious beliefs. Thomas et al (2005) found that many ethnic groups felt it was important to turn to religion as a form of coping emotionally. There was a consensus amongst the groups that if things are left with God he resolves the problem.Despite the lack of knowledge of cervical screening amongst ethnic groups, other groups are more knowledgeable. Guajarati wo men in Boxs study (1998) were the only ones aware that cervical screening is able to detect pre-cancerous cells. Thomas et al (2005) found African groups were more able to identify cervical cancer as a commonly occurring cancer within their community. However age has an influential role on the amount knowledge that is embedded. Younger African-Caribbean participants had the least knowledge about cancer as there was a perception cancer affected older people (Thomas et al 2005).It appears that Thomas et als study (2005) has a methodological weakness. In their study they aimed to describe factors that act as barriers to effective uptake of breast and cervical screening. However the sample may not be representative of the target population as the sample consisted of men. Since men do not partake in breast and cervical screening, their inclusion may have distorted the findings, therefore reduces the transferability and credibility of the study. Regardless of this, Thomas et als (2005) st udy shows the significance in the link between age and lack of knowledge in cervical cancer.The lack of knowledge amongst ethnic minorities perhaps was as a result of language difficulties. If they were able to communicate and comprehend information they received then this could enhance their understanding and knowledge of cervical screening. The majority of ethnic women declared that translated information in their languages was often inadequate and difficult to make sense of (Naish et al 1994, Abdullahi 2009, Thomas et al 2005, Box 1998). The translated information was not only seen as a problem, but for some ethnic minority women who were illiterate translated information was still perplexing. As a result there was a preference for macrocosm told about the cervical test in their own languages rather than reading a translated script (Box 1998).External BarriersOne major external barrier that was very frequently much expressed was the gender of the GP or screener. There were conc eptions that if it was male practitioners that did the screening then women are less likely to uptake cervical screening. Some women in Boxs study (1998) felt that their bodies should only be seen by their husbands and it were adamant that the smear taker should be a female. Similarly Somali women, felt that as Muslim, women having a male practitioner taking the smears is inappropriate. Abdullahi et als (2009) study is significant in identifying and providing solutions to the barriers that discourages Somali women from up taking up cervical screening. This study is commended well on its originality as mentioned by Abdullahi (2009), and this was the only study investigating barriers to cervical screening that was found that focused on the views of Somali women. Conducting a study on Somali women brings new knowledge to this theater of operations of research as the Somali community do not lend themselves to research because they are seen to be invisible compared to other Muslim ethn ic minorities (Information centre about Asylum and Refugees ( ICAR) 2004).However, Naish et al (1994) found that both Kurdish and Turkish women did not sense male practitioners, as they are used to male doctors in their home countries. Nonetheless it appeared that a female practitioner still had more favour compared to that of a male practitioner.From the evidence the preference for a female doctor is not only due to cultural or religious views but also due to the lack of understanding and insensitivity that male doctors display towards ethnic women having cervical smears. This is particularly demonstrated in Box et als study (1998, p.7) where a women stated the doctor was cross with me when I asked for the forceps (speculum) to be warmed, how would he feel if it was him? However Thomas et al (2005) suggests that this poor relationship between practitioners and patients was due to poor conversation skills. In Thomas et als (2005) study BME women identified that the attitudes portr ayed by their GP was very discouraging and at times it felt as if their GPs did not want them to be there. Moreover the issue of racism is problematic for ethnic minority women. For example in Box (1998) some of the Asian women were cited as being treated coldly by the smear taker because of their race. Health advocates noticed BME women were treated less favourably than white women and when smears were taken they were provided with less comfort (Box 1998).Childcare issues also play an influential part in preventing ethnic women in up taking cervical smears. Naish et al (1994) found with many women, having children in the same way of life was very distracting. This view was also supported by Somali women who indicated the lack of childcare facilities was a barrier in attending cervical screening (Abdullahi et al 2009).There is a link between the perceived lack of sterility of equipment and the uptake of cervical screening. The views expressed by some ethnic women were that the spec ulum was not hale and that this could be a cause of cervical cancer instead of the association with HPV (Box 1998). One woman expressed the following concern the cancer might be there in the clinic you never know they need to cover it with water, wash it all away Ive never seen them do that (Box 1998 , p.g 9). The view is also reiterated in Naish et als (1994) study, where Chinese women were adamant that the use of unsterile equipment could induce infections. This demonstrates how important the lack of knowledge amongst ethnic minorities can affect the uptake of cervical smears.Interventions that increase cervical screeningInterventions that increase cervical screening such as health promotion, education, invitations, psychological interventions and media interventions are examined below.Kernohan (1996) investigated the effectiveness of community-based intervention to improve knowledge on the uptake of breast and cervical screening. The sample consisting of 1000 women from differen t ethnic backgrounds were involved in a health promotion intervention. The study focused on Bradfords main minority ethnic women (South Asian) and was concerned with the impact of health education programmes on the knowledge of cervical screening in South Asian women. Compared to the other ethnic groups South Asian women had the lowest level of knowledge on cervical smears, however their knowledge had considerably improved from 35.8% to 68.7% after the intervention. Kernohan (1996) study is noteworthy for depicting a positive(p) correlation between health promotion and knowledge of cervical screening. However as this study was a pilot study this area of research would film further work in order to provide robust evidence. Furthermore kernohan (1996) did not look at the impact of increased knowledge on the afterward(prenominal) rate of uptake.Evidence from Abdullahi et al (2009) and Naish et al (1994) suggest that addressing barriers which deter women from having cervical smears can be used as interventions to increase cervical smear rates. The lack of knowledge of cervical screening is an apparent barrier in most ethnic women and a proposed solution would be to increase the levels of knowledge of cervical screening. Abdullahi et al (2009) suggests that education about the purpose of cervical screening is key to support Somali women to attend for cervical screening. However, suggesting such solutions to overcome barriers to cervical screening without effort may be futile, since without some testing the solutions there remains a gap in understanding the impact of the intervention suggested by Abdullahi et al (2009).More importantly Sabates and Feinstein (2006) investigated the role of education on the uptake of preventative health care, in this case cervical screening. Sabates and Feinstein (2006) suggest that educational effects on the uptake of preventative health results in raising the awareness of and the importance of having a regular health check and therefore the inclination to uptake preventative health checks. The study found that women enrolled in courses or training leading to qualifications had a positive impact on the probability of the uptake of cervical smears. Sabates and Feinsteins (2006) study provides further support to the socio-economic determinants of the uptake of screening. However, the effectiveness of this particular intervention is limited as women within ethnic minorities tend to not achieve the accolades of adult learning as a result of cultural demands. According to YWCA (2011) some black minority ethnic women are missing from the nurture register and are pulled out of school as a result of family duties to marital commitment.A doctrinal review conducted by Forbes et al (2009) reviewed interventions targeted at women to encourage the uptake of cervical screening. It concluded that invitation garner and educational materials were the most effective types of interventions. However evidence from Stein et al (2002) suggests that invitation letters were not effective. Stein et al (2006) investigated the effectiveness of three methods of inviting women with a massive history of non - attention to undergo cervical screening. The methods of invitation were a telephone call from a nurse, a letter from a well-known celebrity and letter from the local NHS Cervical Screening Commissioner. A telephone call and a letter from a celebrity were ineffective. A letter from the commissioner resulted in a small increase in the uptake of cervical screening this was not statistically significant. Although Stein et al (2006) findings contradict that of Forbes et al (2009), this does not nullify the results of Forbes et als (2009) study. The findings from Stein et al (2005) highlighting one of the limitations of doing a single study. Egger et al (2001) argues a single study often fails to detect a statistically significance between interventions when in fact such difference may exists, therefore are m ore likely to produce false negative results. Moreover, in the hierarchy of evidence for interventions, systematic reviews are at the top as they are more likely to produce a strong and less-biased synthesis of findings that to show whether the intervention has an effective exit (Melnyk and Fineout-Overholt 2010) . For this reason Forbes et al (2009) has a more valuable contribution towards knowledge on the interventions that increase the uptake of cervical screening.The NHS cervical screening programme (2011) highlights that encouraging women through reminders such as invitation letters is exceptionally important this may not be as effective in motivating ethnic minority women to attend cervical screening. Some ethnic minority women are more likely to ignore invitation letters if translation is unavailable ( Naish et al 1994). On the other hand, there is a link between planning when, where and how of making an appointment and the success rate in uptake of cervical screening. This is referred to as implementation intentions the installing of behaviour is determined if the conditions when, where and how are planned (Bartholomew et al 2011).This was demonstrated by Sheeran and Orbell (2000) who tested the concept of implementation intentions as a method to increase non-attendance in cervical screening. It was found that the participants who produced implementation intentions were much more likely to attend for a cervical smear test compared to the control group. This demonstrates how empowering women to have more control on the choices in arranging their appointments can significantly encourage the uptake of cervical screening. This supports Abdullahi et al s (2009) study where it was identified that inconvenient appointment times were also considered to be a barrier. Consequently the use of implementation intention as an intervention is noteworthy of encouraging ethnic women to uptake cervical screening. Furthermore, an area of research that would increase e xisting knowledge is to investigate implementation intentions on ethnic minority women and subsequent uptake of cervical smears, in order to provide strong evidence for such intervention.The media has potentially an important role on the uptake of cervical screening. Howe et al (2002) investigated the impact of a television soap opera on the NHS cervical screening programme. Using a retrospective analysis on information of the NHS cervical screening databases, during the 6 month of the storyline, the number of smears performed in women whose previous smears were compared to women who had smears taken previously that year. The storyline involved a character that missed her regular screening appointments later she was diagnosed with cervical cancer and 6 weeks later she died. Howe et al (2002) found that there were substantial increases in the number of cervical smears- from 65 714 in 2001, to 79,712 in 2002, 19 weeks after the storyline. This demonstrates a significant link between t he effects of media in motivating women to take up cervical screening. In support is the impact of a celebrity profile on uptake of cervical screening. The media coverage of Jade Goody from diagnosis of cervical cancer till death has been an influential motive for some women to uptake cervical screening. Parkers (2010) reports that, since the media coverage of Jade Goodys case, figures from NHS Rotherham showed an 80% improvement rate in the uptake of cervical screening.DiscussionFrom reviewing the literature it is apparent that increasing the uptake of cervical screening amongst ethnic minority women poses a challenging problem. Ethnic minority women are faced with internal and external barriers that play an important role on their non- attendance for cervical screening. It appears the internal and external barriers are interrelated. For instance the issue of embarrassment may arise as a result of being screened by a male practitioner, as well as FGM particularly in the case of So mali women as stated earlier. Moreover the culturally sensitive issues such as the expiration of virginity still pays a price tag in many cultures and the stigmatisation attached towards it means some young ethnic minority women might feel reluctant to take up cervical smears.Needless to say the extent to which a barrier act as a deterrent to the uptake of cervical screening is very much culturally dependent. Women from African cultures see cervical cancer as a taboo, where as in Asian cultures cervical cancer is perceived as a disease for those who are promiscuous. Additionally, the cultural attitudes and beliefs may be a stronger barrier than child care issues for some ethnic minority women, whilst the sterility of equipment may have a stronger influence than the issue of embarrassment.The lack of knowledge was the most common barrier that was revealed and it appears this has not changed over the years amongst ethnic minority groups ( Box 1998, Thomas et al 2005 , Abdullahi et al 2009). From evaluating the interventions, it remains substantial that socioeconomic factors (lack of knowledge and education) are predictors in determining ethnic minority women attendance for cervical screening. For this reason, it would be beneficial for communities where ethnic minorities are prevalent to have health promotion projects that produce the awareness of cervical screening (kernohan 1996).There was fitted evidence to suggest language difficulties as an important factor in deterring ethnic minority women from the uptake of cervical screening. Though research has not tested the effect of bilingualist services as an intervention to increase cervical screening, an area in practice that needs room for improvement is the use bilingual services and bilingual interpreters in the cervical screening recall system. Forbes et al (2009) research supports the use of invitation letters as an intervention to improve the uptake of cervical screening and currently still remains the m ost popular intervention used. Therefore a recommendation for practice would be for invitation letters to be printed in the languages of ethnic minorities.What was interesting and surprising, was the issue of racism as a barrier to the uptake of cervical screening. The ethnic minority often experience health inequalities as a result of racism, karlsen (2007) reports racism can lead to differences in treatment and access to health promoting resources for the ethnic minority. This was reflected in Box (1998) where Asian women expressed their concerns of being treated coldly and treated indecently as a result of their race. This area highlights the need for a change within the health services offered to ethnicity minorities in the UK. More importantly a contribution to research would be to tackle racism as an intervention to encourage ethnic minority women in the uptake of cervical screening (Szczepura 2005).Furthermore training needs to be put in place for health professionals to unde rstand and embrace the forms of cultural and religious beliefs amongst ethnic minorities in order to reduce prejudice and discriminatory practices. This would be particularly important to women from ethnic minorities where FGM is seen as a custom practice. Denniston et al (2001) states FGM continues to take place in many cultures around the world health practitioners and screeners need to be taught to take a sensitive and a considerable approach when screening women with FGM.Sheeran and Orbells study (2000) makes a positive contribution towards the issue of improving the uptake of cervical screening in women from ethnic minority groups. The use of implementation intentions seemed to have an effect on women in their attendance for cervical screening. Implementation intentions would be advantageous for some ethnic minority women. Planning when, where and how an appointment would address some of the barriers identified, including the gender of the screener, ensuring that a bilingual in terpreter was present, so if needed information given could be clarified. Thomas et al (2005) implies that the planning of an appointment for ethnic minority groups, especially for those with religious festivals is important. Ethnic women given the chance to decide when their appointment should take place would eradicate inconveniences such as being invited for screening during Ramadan. However further research would be necessary to establish the effectiveness as well as the cost-effectiveness of using implementation intentions amongst ethnic minority women and the uptake of cervical screening.To conclude, this literature review examined how to increase the uptake of cervical screening amongst ethnic minority women in the UK. The evidence discussed in this review has explored the internal barriers and external barriers that deter ethnic women in the uptake of cervical screening.It is hard to change peoples behaviour because of what we believe in and how this has shaped our social no rms and values. Therefore to increase the uptake of cervical screening amongst ethnic minority groups remains complex and inconclusive. With the evidence examined in this review, the interventions (health promotion, education, implementation intentions, invitation letters and the media) to improve the attendance and uptake of cervical screening noticeably have an influential impact in encourag

Professional Relationships with Children and Young People

Professional Relationships with Children and Young PeopleUnit 01 Communication and Professional Relationships with Children and Young People (2.1) (2.5).This task is all about communication with children, five-year-old people and big(a)s. Please explain what you get learnt/know using the headings provided (2.1), (2.2)Explain the skills needed to communicate with children and infantile people. (2.1)To communicate effectively with children and young people, you moldiness be fitting to demonstrate the following skillsShowing effective communication. This is the main bureau to build relationships with children and young people. Communicating effectively includes using body manner of speaking, nervus facialis expressions, facing the child, using open handed gestures, and smiling.It is all important(p) to be courteous and respectful when communicating, listening to the childs point of view. Being considerate of the childs position and needs, and remembering issues that argon pe rsonal to them, and taking the time to actively listen to the child. Breakdowns in communication and relationships often stem from not being able to listen attentively.It is important, when communicating with children and young people, to be clear and concise, using age appropriate language in a way that the child understands, taking into consideration any surplus cultivation needs that they may have. Being relaxed, confident and articulate helpers the child or young person to follow the conversation and gives them say-so when communicating with you as a teaching assistant. It is important to overturn sarcasm and shouting as this can cause the child to become frightened and confused.It is important to provide questions, prompts and cues to encourage and animation the childs language skills and to assist with their independent learning. Asking open questions encourages children and young people to talk.As well as asking questions, it is important to be able to come the childs q uestion and responding incontrovertiblely to what is being said and encourage them to ask questions.Explain how to align communication with children and young people for. (2.2)The age of the child or young personIt is important to squander into consideration the age of the child or young person you are communicating with, as this affects how you lodge your communication style, and the childs direct of apprehensiveness and ability to communicate effectively.When communicating with a younger child it is important to make sure that you are at their level and able to take for good eye contact with them. Using simple and clear language helps young children to understand and follow what is being said. It is important to ask simple, open questions for in truth young children to encouragethem to talk. Younger children may need much assurance and help in expressing themselves than an older child would.For older children, it is important to provide opportunities for important conver sation to take place. As a teaching assistant, you should be receptive to new ideas, respond positively and actively listen to the young person. This then gives them the confidence to express their views and opinions.The context of the communicationCommunication should be adapted according to the situation we are in. As a teaching assistant, we would be adapting our communication with children or young people according to the academic setting of the classroom environment or individual or group learning activity, or a more social setting such as the playground or dining hall.In the classroom, it would be obligatory to take a more baronial access code to communicating with children and young people, so as to maintain their focus and attention on the task at hand. In more social settings you would be able to take a less formal approach to communication, keeping conversation light and fun.Communication differencesEffective communication with children and young people must take into a ccount any difficulties the child might have when communicating. Kamen (2010), states that everyone has individual language needs, but some people may have additional or spare needs that affect their ability to communicate effectively with others.Factors affecting a childs communication abilities include English as a second language. Autistic spectrum disorders, behavioral/emotional difficulties, cognitive difficulties, and hearing impairments.As a teaching assistant, it is important to be aware of each childs communication needs and to be able to adapt our communication skills to support them. It is vital that we keep information clear and concise, ensuring that it is kept short and avoiding complex words and instructions. We must ensure that we are patient and understanding with the child or young person so that they do not feel rushed or pressured. Sometimes, it may be necessary to use additional aids to assist with communication. Additional aids may include pictures, signs, or symbols, sign language, or even an interpreter for a child whose beginning language is not English.Explain the main differences between communicating with adults and children/young people (2.3)As a teaching assistant, we must be aware of how we communicate, not but with children and young people, but also with adults. We must look at the situation which we are in, for example, in a classroom with children, or in the playground, or in a meeting with other professionals or parents evening. If speaking to a child in the classroom, communication can be more playful and less formal than in the classroom environment, all the while maintaining a level of professionalism. Communication with adults (professionals and parents) would be more formal. It is important to maintain a high level of professionalism when communicating with bothadults and children. It is vital that you maintain a high level of respect when communicating with adults and children as this helps to build trust and foster positive relationships.When communicating with adults it is attainable to use more complex language, discussion, and negotiation. With younger children, there is a much bigger emphasis placed on body language, facial expressions, pitch, and the use of more simple language.Explain how to adapt communication to meet the different communication needs of adults (2.4)It is important to also be aware of the communication needs of adults and to adapt our communication skills accordingly. Often, we change the way we communicate with others depending on the way they respond to us and we often adapt the way we communicate without realising it, (Burnham Baker, 2010).If you are speaking with an adult with a hearing impairment, it is important to ensure that you are facing them and qualification eye contact so that they can lip read. It may be necessary to adapt your communication to include written communication as an aid. Much of the time you would ensure that you are facing the person you are communicating with and making eye contact as this reassures them that you are engaged in the conversation and actively listening to them.Where appropriate it may be necessary to use the help of someone else when communicating with others. For example, if someone is deaf it could be useful to have the help of someone who knows sign language or if English is not their first language then a translator would be helpful,It is also important to make sure you are using the correct form of address, using positive body language and being friendly and approachable.Explain how to manage disagreements between TAs and children/young people and adults (2.5)Breakdown in communication can lead to misunderstandings and disagreements. Therefore, it is important to clarify any misunderstanding by adapting the way that we communicate. Disagreements with adult can be resolved by discussing and negotiating any issues quickly and sensitively.Sometimes adults may have differing ideas about how to deal with things. Schools may suggest that children do things in a particular way, whereas the parents may not agree with this. It is important to discuss this with the parents, clarifying wherefore things happen differently in the school environment and working alongside the parent/caregiver to ensure the best outcome for the child.A good way to manage disagreements and misunderstandings is to clarify what someone has said to be sure that we have fully understood them.Tassoni (2010) uses the following example of checking understanding with a child to avoid miscommunicationChild Want that. Me want thatPractitioner So you want the ball, do you?Child (Nods).With adults, we would simply ask to clarify what is being said, and discuss any misunderstandings. preparation Submission DeclarationCandidate Print NameKatie RolinsonCandidate SignatureReferencesTassoni, P. (2010) Children and Young People Workforce Early Learning and Childcare. Essex, Heinemann.Burnham, L Baker, B. (2010) Supportin g belief and Learning in Schools (Primary) Essex, Heinemann.Kamen, T. (2010) Childrens Care, Learning and Development 0-16 Years. London, Hodder Education.

Faith in Young Goodman Brown Essay -- Young Goodman Brown YGB Nathanie

Faith in Young Goodman BrownIn Nathaniel Hawthornes Young Goodman Brown, Hawthorne introduces Goodman Brown, who doubts himself and reiterates his false confidence to himself repeatedly. His assay between the unrighteous temptations, the devil, and the proper church abiding life, is a struggle he does not think he can handle. This story is about a man who challenges his faith in himself and in the community in which he resides. Goodman Brown must venture on a journey into the local woodwind, balk the temptations of the devil, and return to the village before the sunrise.The story is set in the forest of Salem, Massachusetts, around the time of the witch trials. Goodman Brown is a prude, and Salem is a Puritan village appears to be a good Christian community in the beginning of the story. Hawthorne once again criticizes a Puritan community or the sacred community of his time through this short story. In this short story, Hawthorne criticizes the Puritans who take the words of Bib le without interpretation, and who believe they are pure but inside the evil resides just as in the people they persecute.The story begins with Goodman Brown passing the house at sunset while his wife, Faith, trying to persuade Goodman to depart at sunrise. Brown starts his journey to the darkness that awaits for him in the forest where Puritans believe the devil lives. Hawthorne seems to be using many symbolisms in the story such as Goodmans wife Faith which symbolizes his real faith in God. Goodman leaves his faith behind him and set forth into his journey with his own strength and power. Although he felt guilty leaving his Faith back home in their early stage of marriage, he justifies this guilt by swearing that after this night he will rive to her skirt and follow her to heaven. However, will there be another day for Goodman Brown to share his life with Faith? Although his faith, described with pink ribbon, is sincere, pure, and innocent, is his will stong replete to walk th ough a dreary road, darkened by all the gloomiest trees of the forest? Goodman believes nothing can tempt his faith, not even a devil. Upon entering the forest he is suspicious of every rock and tree, thinking something evil will jump out at him. A man waits for Goodman in the forest and then walks by Goodmans side. Although the narrator does not say this man is the ... ...en he reaches the final destination where whole community is there to participate in sinful acts, a little faith he has to the community and himself are completely destroyed. The devil has apparently infested all of the Puritans souls with sin at least to the eyes of Goodman Brown. age he tries to help his wife Faith from the devil, he wakes up from imagination or dream in the forest wondering what has happened in the previous night. Whether the scenes he witnessed were real or his imagination, Goodman believes what he remembers and trusts no one in the village when he returns, not even his wife. Goodman seems to live the rest of his life with misery and distrust.In the beginning of the story, Goodman is a faithful man who is able to pass any temptation the devil gives him. He is happy with the community and his faith until his trip. Upon his discovery of satanic acts of the community, he becomes an evil himself. When Goodman comes back he thinks he is better than the rest and judges everyone instantly. Young Goodman Brown fails the test of the devil completely not still because he loses his faith in living life, but also he has no hope after life since he became an evil.

Free Raisin in the Sun Essays: Bad Dreams :: Raisin Sun essays

Bad Dreams in A Raisin in the Sun The issue of racism is one of the most significant themes in Lorraine Hansberrys A Raisin in the Sun. Many black men have to deal with inherent racism. The frustrations that they deal with does not only affect them, but it also affects their families as well. When Walter downwind has a bad day he cant yell at his boss for fear of loosing his job Instead he takes it out on his family, mainly his wife ruth. Walter is thirty-five years old and drives a limousine for a living. This job provides just enough for his family without there being extra bullion left oer to spend. It is so bad that when Travis asked his mother Ruth for fifty cents she said she couldnt give it to him because they couldnt afford it. Walter hears this and gets a little upset with Ruth and gives Travis a dollar instead. Walter tells Ruth that she shouldnt tell Travis that they cant give him fifty cents because they dont have it. I believe Walter is upset because he realizes that he isnt able to provide his son with pocket change without decorous broke himself. What kind of man would he be? What kind of role model would he be for Travis if he cant bring home enough money to support his family? How would he be a strong black man for his family? Its obvious that Walter is not able to provide his family with what is considered the American Dream. Walter complains to Mama to the highest degree the way he feels about his job. I open and close car doors all day long. I drive a man around in his limousine and I say, Yes sir no sir very good sir shall I take the drive, sir? Walter wants to be the one sitting in the back of that limousine while someone else is doing the driving. Walter wants financial freedom, he doesnt want just enough money to provide for his family but rather he tells his mother I want so galore(postnominal) things. Walter is materialistic and greedy, he has been corrupted by a superficial American dream. Walter has no desire to find out ab out himself through his African American Heritage. He believes he can define himself through money, money is everything to this man. Money is status, money is wealth, money is happiness, money is almost God to him.

Woodstock Music Festival :: essays research papers

WoodStock music festival, took place near Woodstock New York, on August 15, 16, and17, 1969, and became a symbol of the 1960s American counterculture and amilestone in the were lots referred to as hippies and who characteristically rejectedhartred and authority, protested against the Vietnam War, supported the civil rightsmovement, dressed differently, and experimented with depend upon and illegal use of drugs.Woodstock began by four partners Michael Lang, the manager of a inclination band,Artie Kronfeld, an executive at Capitol Records, and two capitalists, John Roberts andJoel Rosenman. Their original plan had been to build a recording studio in Woodstock, asmall town in the Catskill Mountains that had become a careen center when musician BobDylan and a rock group called the Band settled there. To scrambleout the word the fourpartners decided to necessitate a concert, which they called WoodStock Music and Art Fair.The festival was expected to attract 50,000 to 100,000 people . After a long search fora large enough space, the partners eventually rented a plain from a local dairy farmer,Max Yasgur, who owned land about 48miles from Woodstock, in the town of Bethel.Early in the week before the festival, it became edify that the event as going todraw a much larger audience than expected. By the day before the official opening, trafficjams miles long bar most roads leading to the area. On Friday, August 15, when thefestival began, its management was ineffective to watch the estimated 400,000 or morepeople coming into and out of the field and decided to end admission fees. Sweetwater, theband scheduled to open the festival, could not get to the site because of the traffic, sofolksinger Richie Havens, who was already there, began the festival instead. As a payoffof the audience size, volunteers from inside and out helped with any possible problemsWoodstock Music Festival essays inquiry papers WoodStock music festival, took place near Woodstock New Y ork, on August 15, 16, and17, 1969, and became a symbol of the 1960s American counterculture and amilestone in the were often referred to as hippies and who characteristically rejectedhartred and authority, protested against the Vietnam War, supported the civil rightsmovement, dressed differently, and experimented with sex and illegal use of drugs.Woodstock began by four partners Michael Lang, the manager of a rock band,Artie Kronfeld, an executive at Capitol Records, and two capitalists, John Roberts andJoel Rosenman. Their original plan had been to build a recording studio in Woodstock, asmall town in the Catskill Mountains that had become a rock center when musician BobDylan and a rock group called the Band settled there. To getout the word the fourpartners decided to have a concert, which they called WoodStock Music and Art Fair.The festival was expected to attract 50,000 to 100,000 people. After a long search fora large enough space, the partners eventually rented a field from a local dairy farmer,Max Yasgur, who owned land about 48miles from Woodstock, in the town of Bethel.Early in the week before the festival, it became clear that the event as going todraw a much larger audience than expected. By the day before the official opening, trafficjams miles long blocked most roads leading to the area. On Friday, August 15, when thefestival began, its management was unable to watch the estimated 400,000 or morepeople coming into and out of the field and decided to end admission fees. Sweetwater, theband scheduled to open the festival, could not get to the site because of the traffic, sofolksinger Richie Havens, who was already there, began the festival instead. As a resultof the audience size, volunteers from inside and out helped with any possible problems

Origins And History Of The Dulcimer :: essays research papers

Origins and History of The DulcimerThe dulcimer is a member of the string family. It is further categorized intothe Psaltrey family, a group of instruments that are comprised of stringsstretched across a frame and play by plucking or drumming. The onlydifference, in fact, between the dulcimer and the psaltrey is the fact that oneis plucked and the other is drummed. The dulcimer family is divided into twosections. The dulcimers with keys and dulcimers without keys. A dulcimer withkeys would be played by depressing a key which would move a mechanism that wouldcause a hammer to strike the string. The most improved instrument in the identifydulcimer section is the piano. Dulcimers that are played without the aid of akey are usually in the unusual shape of a trapezoid. Early descriptions of thisinstrument, dating stomach to the Middle Ages, describe the instrument as arectangular box with strings stretched over two bridges. Both the single and thedouble bridged dulcimers are usual in t raditional Irish music. It is played bystriking the strings with padded wooden hammer.It is commonly believed that the dulcimer came to Europe from the East sometimein the fifteenth century. This cannot be true. The dulcimer is closely relatedto the yang chin from China. However, the yang chin was introduced to theChinese around 1800. A similar traditional dulcimer found its way to Korea inabout 1725. The dulcimer originated as the santir in what is right away Iraq from aGreek instrument, the psalterion. The santir was a trapeziodal box covered withstrings. It was played by striking the strings with light sticks. From therethe Arabs carried the santir through North Africa where it was integrated intothe Judaic culture. From North Africa it was taken to Spain, for a carving wasdiscovered in the cathedral Santiago de Compostela, dated 1184. It is unknownwhy the Irish make mention of the timpan, a generic term for any member of thepsaltrey family, being used by St. Patrick in the 6th century, six hundred historic periodearlier than the dulcimers first initiation into Spain from North Africa.Dulcimers gained popularity from the churches and cathedrals throughout the 14thcentury. But in the 16th century, as the violin and wind instruments becameincreasingly fashionable, the dulcimer virtually disappeared. For the next twohundred years it went unnoticed. In 1705 Pantaleon Hebenstreit presented theFrench King Louis XIV with a slightly revised dulcimer.