Land Pollution Essay Example for Free

Land Pollution Essay Land pollution, in other words, means degradation or destruction of earth’s surface and soil, directly or indirectly as a result of human activities. Anthropogenic activities are conducted citing development, and the same affects the land drastically, we witness land pollution; by drastic we are referring to any activity that lessens the quality and/or productivity of the land as an ideal place for agriculture, forestation, construction etc. The degradation of land that could be used constructively in other words is land pollution. Land Pollution has led to a series of issues that we have come to realize in recent times, after decades of neglect. The increasing numbers of barren land plots and the decreasing numbers of forest cover is at an alarming ratio. Moreover the extension of cities and towns due to increasing population is leading to further exploitation of the land. Land fills and reclamations are being planned and executed to meet the increased demand of lands. This leads to further deterioration of land, and pollution caused by the land fill contents. Also due to the lack of green cover, the land gets affected in several ways like soil erosion occurs washing away the fertile portions of the land. Or even a landslide can be seen as an example. Causes of Land Pollution Below are the sources of land pollution: 1. Deforestation and soil erosion: Deforestation carried out to create dry lands is one of the major concerns. Land that is once converted into a dry or barren land, can never be made fertile again, whatever the magnitude of measures to redeem it are. Land conversion, meaning the alteration or modification of the original properties of the land to make it use-worthy for a specific purpose is another major cause. This hampers the land immensely. Also there is a constant waste of land. Unused available land over the years turns barren; this land then cannot be used. So in search of more land, potent land is hunted and its indigenous state is compromised with . 2. Agricultural activities: With growing human population, demand for food has increased considerably. Farmers often use highly toxic fertilizers and pesticides to get rid off insects, fungi and bacteria from their crops. However with the overuse of these chemicals, they result in contamination  and poisoning of soil. 3. Mining activities: During extraction and mining activities, several land spaces are created beneath the surface. We constant hear about land caving in; this is nothing but nature’s way of filling the spaces left out after mining or extraction activity. 4. Overcrowded landfills: Each household produces tonnes of garbage each year. Garbage like aluminium, plastic, paper, cloth, wood is collected and sent to the local recycling unit. Items that can not be recycled become a part of the landfills that hampers the beauty of the city and cause land pollution. 5. Industrialization: Due to increase in demand for food, shelter and house, more goods are produced. This resulted in creation of more waste that needs to be disposed of. To meet the demand of the growing population, more industries were developed which led to deforestation. Research and development paved the way for modern fertilizers and chemicals that were highly toxic and led to soil contamination. 6. Construction activities: Due to urbanization, large amount of construction activities are taking place which has resulted in large waste articles like wood, metal, bricks, plastic that can be seen by naked eyes outside any building or office which is under construction. 7. Nuclear waste: Nuclear plants can produce huge amount of energy through nuclear fission and fusion. The left over radioactive material contains harmful and toxic chemicals that can affect human health. They are dumped beneath the earth to avoid any casualty. 8. Sewage treatment: Large amount of solid waste is leftover once the sewage has been treated. The leftover material is sent to landfill site which end up in polluting the environment. Effects of Land Pollution 1. Soil pollution: Soil pollution is another form of land pollution, where the upper layer of the soil is damaged. This is caused by the overuse of chemical fertilizers, soil erosion caused by running water and other pest control measures; this leads to loss of fertile land for agriculture, forest cover, fodder patches for grazing etc. 2. Change in climate patterns: The effects of land pollution are very hazardous and can lead to the loss of ecosystems. When land is polluted, it directly or indirectly affects the climate patterns. 3. Environmental Impact: When deforestation is committed, the tree cover is compromised on. This leads to a steep imbalance in the rain cycle. A disturbed rain cycle affects a lot of factors. To begin with,  the green cover is reduced. Trees and plants help balance the atmosphere, without them we are subjected to various concerns like Global warming, the green house effect, irregular rainfall and flash floods among other imbalances. 4. Effect on human hea lth: The land when contaminated with toxic chemicals and pesticides lead to problem of skin cancer and human respiratory system. The toxic chemicals can reach our body through foods and vegetables that we eat as they are grown in polluted soil. 5. Cause Air pollution: Landfills across the city keep on growing due to increase in waste and are later burned which leads to air pollution. They become home for rodents, mice etc which in turn transmit diseases. 6. Distraction for Tourist: The city looses its attraction as tourist destination as landfills do not look good when you move around the city. It leads to loss of revenue for the state government. 7. Effect on wildlife: The animal kingdom has suffered mostly in the past decades. They face a serious threat with regards to loss of habitat and natural environment. The constant human activity on land, is leaving it polluted; forcing these species to move further away and adapt to new regions or die trying to adjust. Several species are pushed to the verge of extinction, due to no homeland. Other issues that we face include increased temperature, unseasonal weather activity, acid rains etc. The discharge of chemicals on land, makes it dangerous for the ecosystem too. These chemi cals are consumed by the animals and plants and thereby make their way in the ecosystem. This process is called bio magnification and is a serious threat to the ecology. Solutions for Land Pollution 1. Make people aware about the concept of Reduce, Recycle and Reuse. 2. Reduce the use of pesticides and fertilizers in agricultural activities. 3. Avoid buying packages items as they will lead to garbage and end up in landfill site. 4. Ensure that you do not litter on the ground and do proper disposal of garbage. 5. Buy biodegradable products. 6. Do Organic gardening and eat organic food that will be grown without the use of pesticides. 7. Create dumping ground away from residential areas.

Analyse How an Adaptation of Your Choice Deals with Gender - Catwoman Essay Example for Free

Analyse How an Adaptation of Your Choice Deals with Gender Catwoman Essay The representation of female super heroes in the media can be said to have had huge institutional, political and social influences that would suggest those in power are favoured at the expense of those without. Female super heroes tend to promote sexualisation and stereotypical gender roles of women, throughout comic books and super hero movies, but why? In this essay I will look at the character of Catwoman, and her representation as a female, particularly in the 2004 adaptation film â€Å"Catwoman†. Originally, she is an iconic character in the batman series. Created in 1940 by Bob Kane (batman creator) and Bill Finger, she has had a strong presence in batman comics and adaptations since then. Her role as a mysterious burglar and jewel thief led her to just miss out on a place in the top ten, ranking 11th in IGN’s ‘Top 100 comic book Villains of all time’ (2009) and 51st in Wizard magazines ‘100 greatest villains of all time’ list (2006). The character has been used in hundreds of comic books, as well as video games, radio stations, TV series, animated series and films. Although she is featured in mostly batman productions and texts, Catwoman was given her first comic book series in 1993, written mostly by Jim Balent. Several years down the line, Catwoman stared as the lead role in the feature film, made in 2004. The movie was an example of post feminism at its best, as in the 1970’s, only 15% of action adventure movies cast female leads. The movie was directed by Pitof and was released on July 23 by Warner Bros. and Village Roadshow Pictures. The cast members include Halle Berry, who plays Catwoman, Benjamin Bratt, Sharon Stone and Frances Conroy. I have chosen to analyse this movie because females are not usually given dominant roles in superhero movies, especially as the lead character. There are many stereotypes that surround women, and I believe this movie challenges those. The film was inspired by the DC comics villain of the same name, however stars a new character, Patience Phillips. There are several similarities to the original character. For example, she has similar office job and is killed by someone she works for. In the 1992 movie staring Michelle Pfeiffer, she uncovers a dark secret in the company and is thrown to her death from a great height. The plot for the more recent movie is very like its predecessor. In both versions she is brought back to life by a group of wild cats. However the most relevant similarity is her appearance and costume. Throughout the film, Catwoman is dressed in a tight black latex costume, black connoting mystery and evil. This material is often associated with sexuality; it clings to her body and shows off her curves. Over the years her costumes have become even more provocative, with this Catwoman being more fetish than ever. These clothes represent Catwoman as a sexual image to be looked at by the opposite sex. Laura Mulvey describes this as the Male Gaze. She explains In their traditional exhibitionist role, women are simultaneously looked at and displayed with their appearance, coded for strong visual and erotic impact so it can be said to connote to-be-looked-at-ness. (1975, p33). It is arguable that woman in the genre of action, drama and super hero are not represented as women, rather an object of sexual desire. The women featured in such genres are slim, pretty, and all wear tight clothing. Lillian Robinson refers to woman super heroes as a pin up girl in a cape, rather than genuine characters (2006). The skimpy outfit has great erotic significance (Richard Reynolds 1994) and could create a negative portrayal of females, as well as being a very bad influence for the young women and girls who watch the movie, or read the comics. Clearly, the media heavily influences teenagers already. They follow the latest fashion trends from celebrities, coolest haircuts, and they diet and loose weight to look like the people they see on TV and in magazines. They look up to the people in the media, and the image of Halle Berry in the cat suit, may encourage young girls to objectify themselves in a similar way. Already, Playboy as a brand has become a fashionable thing, for young girls even at the age of 8. They have the playboy bunny pencil cases, posters and duvet covers. Just like this, cat woman may encourage youthful girls to dress inappropriately with increased sexuality. Even Catwoman’s make-up connotes sexualisation. Her lips are painted scarlet red, which draws your attention straight to her mouth, as well as being the colour of lust to stimulate sexual arousal. This idea is due to the fact men and women have more blood flowing through their lips whilst aroused, turning them a darker shade. Halle Berry was most likely cast because of her beauty. Her eyes, lips, body and sex appeal come before everything else in the movie, (Roger Ebert, 2006). The director of this movie has chosen to portray her as an object of sexual desire for men, rather than a role model for the power and liberation of women. Typical of Hollywood movies, the overtly sexualised view of women is rooted in the darkest chamber of male desire, (Kevin Maher, 2005). She appears powerful and dominant, however, she is in fact the opposite, and inferior to the gaze of men. Laura Mulvey says in her book Visual Pleasure and Narrative Cinema, Women as image, men as bearer of the look, (1975). Personally this idea is predictable and brings nothing new to the genre. Wonder Woman first appeared on screen wearing a gold bra and blue knickers, and in those 36 years gone by, you have to ask yourself, why do superheroes need to be dressed so provocatively? Why can’t the action hero fight crime and ‘kick ass’ in a baggy jumper and a pair of dungarees? Kevin Maher, 2005). I believe the reason behind this is due to the fact that the representation of characters such as Catwoman and Wonder Woman where created by those with power over women. The institution DC comics created both in the 1940’s, which was largely if not entirely controlled by men. Women had no control over their creation and as powerful as Catwoman may be, she is still just an image of the male gaze. Created in a time where females had no authority, they where not able to argue against what could be considered as an unfair representation. Angelia McRobbie has a theory in defence of this sexualised representation, and believes men did not create this image. Women have gained the equality they where fighting for, and now they are using their assets to their advantages. In this case, Catwoman is willingly showing of her body to attract the male gaze, because it gives her power over men. She summarises that post feminism positively draws on and invokes feminism, (1994). However it’s not all negative, Over time things have changed, the presence of female leads in the super hero genre has increased, and to an extent therefore, time has favoured the female lead. Some 50 years ago, males where seen as the hero, there to protect the fragile women. Superman and Lois Lane are a classic example of where the lead role is given to a man, he is strong and courageous, while Lois is inferior to him, she has no special abilities and relies on him completely. However, the number of women in this genre proves a success for the feminist woman and an improvement in today’s society. Iconic actresses such as Angelina Jolie and Uma Thurman have stared as the female lead in modern action movies. Lara Croft, Tomb Raider and Kill Bill are both examples of woman taking active roles, and how accepting it is in this particular genre. Jolie also stared in Mr and Mrs Smith, which showed her as an equal to her husband, just as strong and just as capable of fulfilling the dominant lead. Catwoman has evolved over time, first known as The Cat in DC comics; she then progressed onto TV screens. Her sexual appearance made her an object of desire to the eyes of the male audience, and a role model to girls who wanted to be her, Suzan Colon (2004). In the Halle Berry adaptation, Catwoman is reborn a new woman, sleek, sexy, ambitious and not held back by the restraints of society. She is rebellious and follows her own desires as a feline crime fighter. This representation of Catwoman forces the question that perhaps contemporary women are constrained by the rules of society and are not free. Catwoman challenges the female stereotype and adopts the masculine lead role in this superhero movie. She is a protagonist, independent and capable of standing alone. A crucial scene in the movie shows Catwoman arguing with a large masculine looking man. She demands he turn down his music, which results in her physically attacking him. The argument ends with him lying on the floor with her foot on top of him. This scene portrays her as superior to the man, and the physical pose makes him vulnerable to her. This scene is important, because when she was her human self, known as Patience, the man would not listen to her. As Catwoman, her voice is heard. Simone de Beauvior Invokes ‘the independent women’ who wants to be active, wants to take things for themselves and refuses the passivity men try and want to impose on her. The modern woman accepts masculine values; she prides herself on thinking, getting a job and working to pay her own way, existing on the same terms as man, (1949). Catwoman does exactly that. She completely demolishes feminine stereotypes at the end of the movie when she rejects the love interest and chooses to be a free independent woman. She is not reliant on anyone, especially a man and because of that, I believe this movie demonstrates a victory for women. â€Å"Freedom is power† (Catwoman, 2004). Motivated by revenge, no man stands in her way. However another scene tells a very different story and shows off Catwoman as purely a vision of sexual desire. As she is transformed from patience Phillips, into Catwoman, supposedly now free and independent, we are reminded of her physical qualities. ‘Reminded’ is an understatement actually; it’s thrown in our faces. As she walks across a rooftop the camera angle starts from her feet, moves up her legs and to the top of her body. Paying particular attention to her bum, first impressions are everything! This scene completely confirms Mulvey’s theory, and as Liz Wells suggests, certain films objectify the female star, (2004). However Catwoman is not the only dominant female in this movie. Hedare Beauty is the company Patience works for, and is run by a man named George, or so you are made to believe. Yet in fact, the one calling all the shots is his wife, Laurel. She is controlling the strings of her puppet husband and forces him to her way of thinking. She is an evil, sinister character, full of greed, and in the end she kills her husband in cold blood. She is the villain in this movie, but also a woman in power and free from the constraints of society. In the early 1970’s, after the second wave of feminism, more women were gaining better professions and breaking out of the stereotypical roles. The post modern figure of a female became more appealing to both genders, and resulted in women wanting to achieve higher status in the world of work. An example of such acceptance was seen in the recently released song by male pop artist Ne-Yo, called ‘Miss Independent’. This continues the suggestion of the need for change in the way female super heroes where represented in order to capture the post-modern audience. Catwoman and Laurel Hedare are both great examples of female presence in superhero movies and the result of female empowerment. Judith Butler brings an interesting theory to the table. She believes gender is free floating, rather than fixed, that males and females aren’t simply masculine and feminine. She says that gender is a performance, rather than an aspect of our identity and we behave differently on different occasions. This theory suggests Catwoman isn’t necessarily challenging gender roles by taking on the masculine super hero, but rather an act she’s choosing to play. Women can be masculine because the individual chooses their gender identity. â€Å"When the constructed status of gender is theorized as radically independent of sex, gender itself becomes a free floating artifice, with the consequence that man and masculine might just as easily signify a female body as a male one, and woman and feminine a male body as easily as a female one† (Judith Butler, 1990, p6). Interestingly she suggests that if there where no longer conventional roles for either gender it would be considered the norm for a woman to be in a position of power at work or for a man to stay at home looking after the children. After looking into the history of Catwoman, her creation, and other adaptations in the past, I believe her image is over sexualised. The film is centralised around a beautiful woman, wearing the sexy, tight black costume to do none other than attract male attention. They do however promote that she is a powerful woman and has the freedom to do as she pleases. The fact that a female is the lead role in a movie of this genre is a positive thing. Although the message left behind is that to have freedom and power, you have to entail being objectified. In the end, this movie has done the same as its predecessors, portray woman in a sexualised, unrealistic and in a possibly insulting way.

Mental Health Illness and Stigma Literature Review

Mental Health Illness and Stigma Literature Review 1. Introduction 1.1 Mental illness and stigma Inequalities in health services delivery and utilization for people with mental illness has been widely documented.1 Subsequently this results in poorer outcomes for this population in regard to general health, such as circulatory diseases, mortality from natural causes, and access to interventions .2-4 Several issues have been identified as contributing to these disparities in health service access and delivery, including stigma.5-6Stigma associated with mental illness has been defined as negative attitudes formed on the basis of prejudice or misinformation that are triggered by markers of illness.1-5Illness markers include atypical behaviours, the types of medication prescribed and noticeable medication related adverse effects.5-7These markers allow for the continuation of stigma concerning people with mental illness, but they also allow community pharmacists to identify patients with a broad range of what are often unaddressed health related needs.1 Behavioural and mental disorder s are estimated to account for 12% of the global burden of diseases. Mental health related medications account for >10% of all medications prescribed by general medical practitioners8, therefore, it is an inescapable fact that community pharmacists must interact with patients suffering from mental health problems.9 Mental illness is relevant to practising pharmacists who can play vital roles in the treatment of patients with mental illness.10 Throughout the latter half of the previous century, the diagnosis and pharmacological treatment of mental illness improved radically.9 1990-2000 was proclaimed the Decade of the Brain. to promote the study of disorders of the brain, including mental illnesses.11 Despite these advances, the stigma associated with mental illness remains a compelling negative feature in society.10 Unfortunately health care professionals, including pharmacists are not invulnerable to such harmful attitudes.9 Pharmacists attitudes toward mental illness and the menta lly ill are extremely important because they can affect their professional interactions and clinical decisions.12-13 In addition, they could ultimately affect the delivery of pharmaceutical care which has been defined as the pharmacist assuming the responsibility for positive patient outcomes.14 Activities like medication counselling and monitoring of therapy have been documented to improve both satisfaction and adherence to drug therapy in patients with mental illness.15 It has been pointed out that pharmacists must become more involved in such activities for patients with mental illness.9 1.2 Optimising the use of medications for mental illness Community care offers many advantages over institutional care; however, it can place extra demands on family, friends and primary health care practitioners.16 Health professionals have identified people with mental illness as the most challenging patients to manage.8 The quality and accessibility of community care for people with mental illness needs to be improved.17 The appropriate use of medicines plays an imperative role in the effective management of mental illness, nonetheless, there is evidence that psychotropic medicines are often used inappropriately.18-19 Elderly people are especially susceptible to the effects of psychotropic medicines, and may experience adverse effects such as cardio toxicity, confusion and unwanted sedation .8 Contributing factors to the high rates of non-compliance to psychotropic medicines include, psychosocial problems, the emergence of side effects, and the delayed onset of action of anti-depressant medication.20-21 Medical co-morbidity is also comm on, and polypharmacy increases the risk of medication misuse and drug-drug interactions.22 The World Health Organisation (WHO) has indicated that the inclusion of pharmacists as active members of the health care team can improve psychotropic medication use.23 The benefits of dynamically engaging mental health service users in their own management is supported by both clinical experience and research evidence.24 A systemic review of the role of pharmacists in mental health care, published in 2003, concluded that pharmacists can bring about improvements in the safe and effective use of psychiatric medicines.23 The wide range of pharmaceutical services provided by community pharmacists are potentially well suited to assisting patients and prescribers optimise the use of medications for mental illness.8 2. Method 2.1 Literature search strategy Pubmed (1965-March 2010), International Pharmaceutical Abstracts (1970-March 2010), Embase (1974-March 2010), Cinahl (1981-March 2010) and Psychinfo (1972-March 2010) were searched using text words and MeSH headings including: community pharmacist.s, pharmacist.s, pharmaceutical care, pharmaceutical services, mental illness, mental disorders, stigma and mental illness, mentally ill persons, depression, schizophrenia, bipolar disorder, psychotic disorders, psychotropic drugs, antidepressive agents, benzodiazepines, anxiety agents and antipsychotic agents. ~550 abstracts were read. Reference lists of retrieved articles were checked for any additional relevant published material. Exclusion criteria included articles not published in English, no service provided by pharmacists, not relevant to mental illness, and studies and surveys that were carried out to evaluate pharmacist.s services in hospital inpatient or acute care settings. The literature search identified 88 papers that reporte d or discussed community pharmacist.s involvement in the care of patients with mental illness. 2.2 Inclusion criteria and review procedure For section 3.1 of the discussion, studies and surveys conducted into the attitudes of community pharmacists toward mental illness and the impact of stigma were considered. The literature review procedure for section 3.2 of the discussion, which deals with optimising the use of medication for mental illness, differed from that of 3.1, as studies without control groups, results of postal surveys and qualitative interviews were excluded. Studies with a parallel control group that reported the provision of services by community pharmacists in community and residential aged care facilities were considered. This included trials specifically conducted for individuals with a mental illness, and studies of medication reviews and education initiatives to optimise the use of medication for mental illness. Papers that reported pharmacist.s interventions in nursing homes were included, because community pharmacists frequently provide services to nursing homes. Studies of pharmacist.s activities as part of multi-disciplinary teams were also included. The literature search identified 57 papers that reported or discussed community pharmacy services to optimise the use of medications for mental illness. 3. Discussion 3.1 Mental illness and stigma While the views of the public9 and of certain health care professionals25 and health care students26-28 toward mental illness have been well documented over the years, there are limited numbers of investigations accessing community pharmacists and pharmacy student.s attitudes. Crimson et al.12 examined the attitudes of 250 baccalaureate pharmacy students toward mental illness, Phokeo et al.29 studied the outlook of 283 community pharmacists toward users of psychiatric medication, Cates et al.9 detailed the attitudes of community pharmacists toward both mental illness and the provision of pharmaceutical care to patients with mental illness, and Black et al.1 studied the satisfaction that patients with mental illness have with services provided by community pharmacists. 3.1.1 Community pharmacist.s attitudes toward patients with mental illness In general, pharmacists express positive, unprejudiced attitudes toward mental illness,1, 9, 29, 30 and overall they show encouraging attitudes toward the provision of pharmaceutical care.9 Phokeo et al.29 reported that pharmacists feel uncomfortable inquiring about a patient.s use of psychiatric medication and discussing symptoms of mental illness compared to the medication and symptoms associated with cardiovascular problems. Pharmacists also monitor patients with mental disorders for compliance and adverse effects less frequently than patients with cardiovascular problems. Crimson et al.12 found an association between a personal or family history of mental illness and attitudes of pharmacists toward mental illness. Age and years in practice are also connected with attitudes toward providing pharmaceutical care to patients with mental illness. The older and more experienced pharmacists have more encouraging responses than their counterparts.9Pharmacists are of the opinion, however, that patients with mental illness do not receive adequate information about their medication from their physicians. These patients may also receive less attention from pharmacists compared to medically ill patients, which raises concerns that their drug-related needs are not being met.29 3.1.2 Patient.s attitudes toward community pharmacists Consumers of mental health services generally have a positive perception of community pharmacists and their services, however, expectations are limited to standard pharmacy services, like providing patients with information about their medication and resolving prescription issues when dispensing medications.29 The majority of patients feel at ease while discussing their psychotropic medication and related illnesses with pharmacists.31 Clinically orientated services like working collaboratively with other health care providers, making dosing or treatment recommendations, monitoring response to treatment, and addressing the individuals physical and mental health needs have been found to be unavailable to patients.32 Patients with mental health problems, expectations of community pharmacists are low, and do not match the services that they can provide.33 Although stigma has been perceived to be similar with other health care professional, Black et al.1 revealed that 25% of patients with mental illness have experienced stigma at community pharmacies. 3.1.3 Substance misuse The prevalence of coexisting substance misuse and mental illness (dual diagnosis) has increased over the past decade, and the indications are that it will continue to do so.15 A patient with both a mental illness and a substance misuse problem can face prejudice and stigma from health care professionals, who might question the capacity of dually diagnosed individuals to respond to care.34 A Canadian survey into the attitudes of community pharmacist.s toward mental illness showed that only 55% of respondents agreed that substance misuse is a mental health problem. This finding reflects the perception that addiction represents poor self control or is a self inflicted problem.29 Over recent years, the capacity to intervene pharmacologically in substance misuse has increased greatly, pharmacotherapy is now available for opiate, alcohol and nicotine misuse.19 Some psychiatric patients with comorbid substance abuse achieve stabilisation rapidly, furthermore, severe mental illness does not necessarily predict worse outcomes.35 Socio-economic and emotional aspects are the main challenges to recovery, and case management in the context of integrated community and residential services has been shown to increase medication compliance over time.36 The contribution that community pharmacists have in the management of substance abuse has been well documented.37 Most general psychiatrists are only in the position to give patients 5-10 minutes of brief advise or intervention regarding a substance misuse problem,38 whereas community pharmacist.s are easily accessible to the public and are in a central position to provide specific advice about substance misuse.37 Community pharmacists currently provide dispensing services to drug addicts,38 and they are also the first point of contact for people misusing substances who are not in touch with the substance misuse services.39 3.1.4 Overcoming the barriers created by stigma Studies have indicated that patients prefer to go to the same pharmacy for their medication and other pharmacy needs and a significant number of patients favour to interact with the same pharmacist, which suggests that the relationship they have with their pharmacist plays an imperative role in their health and well being.1 A lack of privacy from failure to use an available private counselling room in the pharmacy contributes to patients feelings of discomfort regarding talking about their medication and their illness.31 Pharmacists are trained to educate and support patients regarding psychotropic medications, including how a drug works, monitoring for treatment response and adverse effects, and guiding patients through the process of stopping treatment, however, there are inconsistencies in the provision of these services.29 The potential for discrimination and stigma in community pharmacies has been well documented and initiatives to improve exposure of pharmacists to persons with mental illnesses in practice and in training has been suggested.23, 29 Pharmacists experience an increased level of discomfort in this therapeutic area as they receive inadequate undergraduate training in mental health.9 Adequate training in mental health is needed to improve the professional interactions of community pharmacists toward users of psychiatric medication.1 3.2 Optimising the use of medications for mental illness Community pharmacists are one of the primary health care providers in the community and have the opportunity to influence patient.s perception of their mental illness. Patients are far less likely to adhere to medications for mental health problems outside the hospital setting. Community pharmacists can significantly contribute to optimising medication use in mental illness through counselling, 40-42 patient education and treatment monitoring, 43-36 medication review services, 30, 47-49 pharmacotherapy meetings with general medical practitioners, 50-54 delivering services to community mental health centres and outpatient clinics,55-57 improving the transfer of information between health care settings,58-60 and being active members of community mental health teams.61-63 3.2.1 Counselling services In the Netherlands, three studies were carried out to highlight the impact of community pharmacist.s medication counselling sessions for people commencing non-tricyclic antidepressant therapy.40, 42 Intervention patients participated in three consecutive counselling sessions which lasted between 10 and 20 minutes each. They also received a take-home video that reiterated the importance of adherence. Throughout the counselling session, pharmacists informed patients about the appropriate use of their medications, which included, providing information about the benefits of taking the medication, informing patients about potential side effects, informing patients about the onset of action for antidepressant medication and explaining the crucial importance of taking their medication on a daily basis. Medication compliance was measured using an electronic pill container that recorded the time and frequency that the cover was opened.41 At the three month follow up the intervention patients had significantly more positive attitudes compared to the controls.40 At six months greater medication compliance was observed with the intervention patients that remained in the study25 55, also apparent improvements in symptoms were noted.41 Research on adherence shows that the patient.s knowledge and beliefs about the benefits of adhering to their medication regime plays a critical role in compliance.64 Non-adherence is not an irrational act but rather a product of poor communication.65 Patient compliance to health care recommendations is more likely when communication is optimal.66 The results of these studies indicated improvements in depressive symptoms,41 more positive attitudes,40 and better compliance to their medication.42 A limitation of this method was that the same pharmacist provided counselling services to both the intervention and the control group. As the intervention studied was multifactorial, it is inconclusive whether the three face-to-face counselling sessions or the take home video were primarily responsible for changes in drug attitude, adherence and the symptom scores.40-42 3.2.2 Patient education and treatment monitoring Four studies have reported results from pharmacist conducted patient education and treatment monitoring services for people prescribed antidepressant medications in the United States.43-46 These services involved the pharmacist taking a medication history, providing information about the prescribed antidepressant medications, and conducting telephone and face-to-face follow-ups. In two of the investigations, one of which was controled43 and the other randomised controlled, 62 medication adherence was calculated by reviewing prescription dispensing data, and reported using an intention-to-treat analysis. Both studies also demonstrated that involvement of the pharmacist was associated with a decrease in the number of visits to other primary health care providers; however, statistical significance was only achieved in one of the studies. Improved adherence to antidepressant medication was reported in both studies, 43-44 although patient satisfaction was only evident in one.44 The other two studies were randomised controlled.45-46 One of the studies was conducted using a self administered health survey,45 while in the other study antidepressant adherence was measured by asking patients how many times a day they took their medication in the past month. The results obtained from these investigations45-46 showed that patients who were taking their medication at the six month follow-up exhibited better antidepressant compliance and improved symptoms. However, antidepressant adherence and depression symptoms scores were similar for both the intervention and control group.46 Given the high rates of antidepressant discontinuation during the first three months of treatment, pharmacists have a potentially crucial role in providing medicines information and conducting treatment monitoring for those patients at high risk of non-compliance. Studies need to be conducted to compare outcomes of pharmacist.s treatment monitoring of people commencing antidepressant medication and o ther health professionals monitoring.8 An investigation into the impact of nurses treatment monitoring, also demonstrated improved medication adherence.67 3.2.3 Medication management reviews Pharmacist conducted medication management reviews are crucial in identifying potential medication related problems among people taking medications for mental illness.8 Medication review services provided by pharmacists comprise of comprehensive medication history taking, patient home interviews, medication regimen reviews, and patient education.68 A randomised controlled study of pharmacist conducted domiciliary medication reviews was carried out in the United States. The patients involved in the study were individuals living independently in the community that were identified to be at high risk of medication misadventure. The results showed a significant decline in the in the overall numbers and monthly costs of medication, however, there was no major difference in cognitive or affective functioning between the intervention and control group. The majority of patients were unwilling to follow the pharmacist.s recommendations to discontinue benzodiazepines and narcotic analgesics.47 The great potential of pharmacist conducted medication reviews for people with mental illness may not be limited to optimising the use of mental health medication.8 Physical health care for people with mental illness is generally less than adequate. This is caused by the tendency among health professionals to focus solely on the management of the mental illness among people with both mental and physical illnesses. Pharmacist conducted medication reviews may be a comprehensive strategy to improve medication use for both mental and physical illness.68 3.2.4 Medication management reviews in nursing homes Older people who are cared for in nursing homes are arguably the most vulnerable patient group, and the useful contribution that pharmacists can make to the care of these patients has been documented.30 Older people are particularly sensitive to the effects of medication,69 regular use of psychotropic medication is associated with an increased risk of recurrent falls,70 and also long term usage is linked with tardive dyskinesia.71 Psychotropic medication use may also be connected with an increased rate of cognitive decline in dementia.72 The beneficial effects of psychotropic medication must be balanced against extrapyramidal and other side effects.73 In 1995 it was reported that psychotropic drug use in Australian nursing homes was 59%, although this figure has fallen in recent years.74 In Ireland, 19% of older people in nursing homes were reported to be taking phenothiazines,75 however, this figure is lower now following a tightening of the licensing indications of thiordazine. In the England, a study showed that 30% of residents in nursing homes were taking antipsychotics.76 Two studies have looked at the appropriateness of psychotropic medication prescribing in the United Kingdom. In Scotland antipsychotic medication use in nursing homes is 24%, it was found that 88% of these prescriptions were inappropriate if the United States criteria for use were applied. In England, 54% of prescriptions were found to be inappropriate according to the United States criteria.77 A study conducted in Denmark suggested that behavioural problems were a determinant for the use of antipsychotics and benzodiazepines, irrespective of the psychiatri c diagnosis of the resident.78 A randomised controlled study of pharmacist-led multidisciplinary initiative to optimise prescribing in 15 Swedish nursing homes was carried out. The study involved pharmacists participating in multidisciplinary team meetings with nurses and physicians at regular intervals within a 12 month period. A significant decline in the use of antipsychotics, benzodiazepines and antidepressants by 19%, 37% and 59%, respectively was observed in the intervention facilities.79 A follow-up investigation of the same intervention and control facilities three years later indicated that the intervention facilities maintained a significantly higher quality of drug use, with far fewer residents being prescribed more than three drugs that could lead to confusion, not-recommended hypnotics and combinations of interacting drugs.48 An additional randomised controlled study showed that pharmacist.s medication reviews in residential care facilities demonstrated significant reductions in the number and cost of medications prescribed. 10.2% fewer residents were administered psychoactive medications and 21.3% fewer hypnotic medications. The impact of medication reviews on mortality was also measured and a noteworthy reduction was observed.49 One study indicated that one hour per week of a pharmacist.s time can make a significant contribution to patient care in nursing homes. It was found that this input was well received by nursing staff and prescribers and that general medical practitioners accepted the pharmacist.s advice in 78% of cases.30 Physician.s recognition was 91% in south Manchester, where 55% of interventions resulted in treatment modifications. Community pharmacist.s in Northamptonshire analysed prescriptions of nursing home residents and provided prescribing advice to general medical practitioners. The advice was accepted in 73% of cases and it was estimated that pharmacist involvement could give a 14% reduction in the cost of prescribing.69 A randomised controlled trial in 1 4 nursing homes in England showed that a brief medication review reduced the quantity of medication overall with no detriment to the mental and physical functioning of the patients.58 A reduction in the use of primary and secondary care resources by pharmacist medication review services has also been shown.80 The recommendations provided by pharmacists included stopping and starting medicines, generic substitution, switching to another medicine, dose modification, changes in administration frequency, formulation change and requests for laboratory tests or nurse monitoring.30 Almost 50% of the recommendations were to stop medication and 66% of these were due to the fact that there was no indication for the drug prescribed. This suggested that medication regimes were not reviewed. Conversely, initiation of a new drug made up 8% of recommendations, which implied that indications were present but not always treated76. Pharmacists have an important part to play in multi-disciplinary heal th teams and they must be integrated into any proposed models of care. Nursing home residents are a vulnerable group of patients who deserve the same high-quality clinical care as people of any age living at home.30 3.2.4 Pharmacotherapy interventions to optimise prescribing Pharmacist.s educational visits to general medical practitioners have been shown to modify prescribing behaviour.54 Four studies have evaluated the impact of pharmacists educational visits to general medical practitioners to optimise the prescribing of benzodiazepines and other psychotropic medications prescribed for mental illness,50-53 two of which showed positive results.52-53 A cluster randomised controlled study carried out in the United States found that pharmacists educational visits to general medical practitioners were associated with a significant decline in the prescribing of potentially inappropriate psychotropic medications in intervention facilities.53 An Australian study of educational visits to general medical practitioners, conducted by three physicians and one pharmacist resulted in a noteworthy decline in the prescribing of benzodiazepines.52 In the Netherlands, groups of local pharmacists and general medical practitioners conduct inter-professional meetings to optimise prescribing. These pharmacotherapy meetings are undertaken as part of routine clinical practice. A cluster randomised study of pharmacotherapy meetings to discuss prescribing of antidepressant medications resulted in a 40% reduction in the prescribing of highly anticholinergic antidepressants, compared to a control group of practitioners that did not partake in these meetings39. The possible awareness of prescribing related issues generated by asking general medical practitioners to conduct a self-audit of their prescribing caused this overall reduction.52-53 Additionally, pharmacist.s initiatives to improve prescribing are most effective when both pharmacists and general medical practitioners have an opportunity to build rapport.39 3.2.5 Community mental health centres and outpatients clinics Two studies were carried out to investigate the effect of pharmacist delivered services to community mental health centres and outpatient.s clinics.56-57 In a controlled trial, pharmacists managed patient cases in a community mental health centre in the United States. Significantly better personal adjustment scores were observed from patients receiving case management from a pharmacist in comparison to those receiving it from a nurse, social worker or psychologist.56The patients also rated themselves as healthier and were considerably less likely to seek help from other health care providers. The medication service provided allowed the pharmacist to adjust medication doses and dose timing, and prescribe or discontinue medications under supervision. The cost effectiveness of incorporating a pharmacist as part of the health care team was also measured. It was estimated that a 60% cost reduction can be achieved when medication monitoring is conducted by a pharmacists instead of a clinic psychiatrist. The pharmacist also performed more medication monitoring of patients per month than the clinic psychiatrist and had more contact with each individual patient .56 In Malaysia, a study of patients discharged from hospital after admission for relapse of schizophrenia, who were identified as having poor medication adherence were allocated to receive pharmacist medication counselling or standard care.57 The importance of compliance to medication was also reinforced by the patient.s psychiatrists at follow up visits. At the 12 month follow-up, patients receiving counselling from a pharmacist and who were exposed to daily or twice daily medication treatments, had significantly fewer relapses that required hospitalisation than patients receiving standard care.57 3.2.6 Integrated mental health services The needs of people with recurrent, severe mental illness fluctuate over time and services must be coordinated, and be able to anticipate, prevent and respond to crisis. Integrated mental health services across primary and specialist services should promote early interaction and allow the provision of continuous care to meet patients needs.58 Prescribed medication is an important component in the successful management of mental illness. Accurate information should be transferred seamlessly between primary and secondary sectors to ensure the optimum care of these patients.59 The simple delivery of information to community pharmacists regarding drugs prescribed at discharge enables comparison with general medical practitioners prescriptions and any discrepancies can be followed up and resolved.82 Discrepancies that may occur can be described as any changes observed between supplies of prescribed drugs, including a wide spectrum of observed events.83 These can range from simple changes between supplies of prescribed drugs to more complex errors that might result in adverse reactions.60 This information transfer enables a cost-effective reduction in all unintentional discrepancies, including those judged to have significant adverse effects on patient care.58 An investigation that evaluated the impact of providing mental health patients with a pharmacist generated medication care plan at the time of discharge found that patients with care plans were less likely to be readmitted to hospital than those without. Information contained in the care plan included l ists of discharge medications, a summary of the patient education that was provided, and the potential adverse effects that need to be assessed. Community pharmacists who received copies of the care plan were also more likely to identify medication related problems for the discharged mental health patients than those pharmacists who were not provided with copies of the care plan, however, the results from this study are not significantly significant.57Other methods of transferring information such as electronic transfer have the potential to be of value in this patient population.84 People with mental illness have complex needs which are not recognised by organised boundaries.58When discussing discharge and after-care in the community, medication management must be prioritised.85Mentally ill patients are vulnerable and medication is a vital part of their well being. It is therefore essential that an accurate transfer of information between care settings minimises the potentially har mful discrepancies that can occur. Community pharmacist.s interaction in this area could prevent such incidents.58 3.2.7 Community mental health teams Most people with bipolar mood disorders and psychotic illnesses in the United Kingdom and Australia are managed by interdisciplinary community mental health teams (CMHTs).86 The potential benefits of greater involvement by pharmacists in CMHTs have been documented and debated for over 30 years.87-90 The majority of clinical team meetings conducted by CMHTs do not involve a pharmacist. A review of CMHTs in New South Wales found that just 1 in 5 had a designated pharmacist.91 Pharmaceutical care programs provided by phar

The Pressures of War in Journeys End :: R.C. Sherriff Journeys End War Essays

The Pressures of War in Journey's End The First World War provoked many different reactions in the people affected by it, particularly the soldiers, which Sherriff seeks to explore in "Journey's End". He uses Hibbert to show the way in which some soldiers reacted, but which was frowned upon by all others, and then presents the opposite view of Stanhope, who, despite being the stereotypical 'perfect' soldier, still has his moments of fear and self-doubt. Clearly, both the officers and the men involved in World War I lived in conditions of extraordinary hardship. The men refer to the poor food, the rough sleeping conditions and the rats, of which there are "about two million", according to Hardy. There is also a torturous routine of inspections, patrols, raids and duty in early hours of the morning. The men also have to cope with the ever-present shadow of death. In the background, there is a constant rumble of guns and heavy artillery, although it is the silence which affects the men more, as they do not know what is happening - it is more of a threat than the guns. Most of the men, although Hibbert is the significant exception, are brave and dutiful, but their methods of coping with the challenge of warfare vary according to their temperaments. The play opens with a conversation between Hardy and Osborne, in which they seek to block out the atrocities occurring all around them by concentrating on seemingly mundane, irrelevant things, such as earwig racing. The extraordinary type of morbid humour which situations such as the First World War seem to provoke shows through whilst they are discussing the relatively serious matter of the bombing which they are under. OSBORNE: Do much damage? HARDY: Awful. A dug-out got blown up and came down in the men's tea. They were frightfully annoyed. OSBORNE: I know. There's nothing worse than dirt in your tea. Clearly, there are many things worse than 'dirt in your tea', and one would expect an adjective that was rather stronger than 'annoyed' to describe the men's reaction to the fact that they were being bombed. Osborne tries to put things in perspective and see the beauty in situations to cope with the pressure he is under. He tells Raleigh to "always think of it like that, if you can. Think of it all as - as romantic. It helps." Osborne epitomises a certain type of cultivated middle-class reticence and self-possession. Like Stanhope and Raleigh, he attended private school, which taught him the traditional and typical English values, which can be summed up in the phrase "stiff-upper-lip". He maintains an apparent steady clam in the face of

Military Service Should be Mandatory Essay -- Papers

Military Service Should be Mandatory Americans, especially baby boomers, should be ashamed of themselves. How can the world's richest population let its military go begging for recruits? Each year, the military services -- Air Force, Army, Marines, Navy -- establish recruiting goals to maintain adequate numbers of personnel. The numbers change annually depending on, among other factors, service needs, recruitment figures the year before and retention of current troops. Most informed folks are familiar with the sorry statistics, but let me repeat them for the record: The Air Force has a goal of 33,800 for this year; it expects to fall short by 1,700. The Army needs 74,500 but will miss the mark by 6,300. Currently short of its goal of 53,200, the Navy expects to have enough recruits by week's end. Because of its unique tradition, the Marine Corps is the only branch that consistently fills its quota. In all, according to the Associated Press, the services need 197,115 recruits to maintain a force of 1.4-million. Why are the services having such a hard time recruiting? One obvious reason, according to the New York Times, is that the number of people between ages 18 and 22, the prime age for recruits, has dropped to approximately 21-million, 5-million fewer than in 1980. Another major reason, of course, is that the economy has opened job opportunities to those who otherwise might see the military as an option. These two are real reasons for the shrinking recruiting pool, but I see another reason, one that is perhaps at the heart of the problem: As a group, those between 18 and 22 are not patriotic. And perhaps even worse, too many baby-boomer parents and other "influencers" -- teachers and coaches -- bad-mouth the milita... ...y" if we expect to recruit effectively. Where I am from, we call such thinking bass ackward. No, we need to scrap the all-volunteer army concept and draft everyone -- including the children of the rich and the powerful in gated enclaves -- who does not volunteer. I leave the logistics to the experts. Unfortunately, money drives everything these days. When parents advise their children on career choices, fewer of them ever mention the military. It is not an option. The New York Times quotes a 17-year-old senior in the class of 2000 about the attitudes of his peers toward the military. His response? "It's not even in their vocabularies." As a nation, we should be ashamed. President Clinton is not to blame for this one, folks. All of us -- especially parents, teachers and coaches -- are blameworthy. Everyone who enjoys the freedom of living in America should serve.

Micheal Dransfield :: essays research papers

Michael Dransfield: A poet you can feel, but never truly understand.   Ã‚  Ã‚  Ã‚  Ã‚  During a time of great change, both ideally and physically, in Australian history, a young man by the name of Michael Dransfield made his presence known in the highly evolving scene of poetry. Dransfield was an eccentric character, to say the least, and was recognized for his masterful ability of truly capturing the essence of many of life’s situations. Regardless of the â€Å"heaviness† or the difficulties of the subject matter being portrayed throughout his poetry, Dransfield was mentally equipped to fully encompass any life experience and dawn light on some of its â€Å"eternal truths† in the world. Although he tragically died of a heroin overdose in 1973 (he was 24 years old), Dransfield made a lasting impression on Australian poetry; never to be forgotten and to be forever considered â€Å"one of the foremost poets of the ’68 generation of counter-cultural dreamers† (Chan, 2002).   Ã‚  Ã‚  Ã‚  Ã‚  Throughout his brief existence on this earth, Dransfield was able to produce an extensive body of work that ranged from the human act of â€Å"loving† to the dreadful experience of having a drug overdose. His work is â€Å"framed within the literary construct of the ‘Generation of ’68’† because it undeniably challenged the â€Å"literary status quo† during that period of time, and he â€Å"overwhelmed it with sheer talent† (Kinsella, 2002). Dransfield was innovative, unique, and was seen as somewhat a â€Å"global poet, and something of a prophet† (Kinsella, 2002). He existed during a time where poets were more inclined to avoid any mention of what they really did ( in the drug using sense), taking refuge in the socially accepted subject of football, rather than confronting the challenges associated with drug use. Dransfield had no such inhibitions, he was the â€Å"quintessential drug poet† in Australi an literary history, and it was through his drug usage—both the beauty and the destruction of it—that Dransfield was able to fully let his talent and generosity shine for all to see. He blazed the new trails for all those that were to follow him, and successfully created a place for the â€Å"authentic experience† in the realm of poetry.   Ã‚  Ã‚  Ã‚  Ã‚  It is a shame that it took such a personal tragedy â€Å"for [Dransfield] to engage so definitively with the experience of addiction†¦in such an astonishingly short time† (Armand, 1997). His work can only be marveled at and admired for its â€Å"richly cosmopolitan tone, its urgent sense of possibility, its sheer ‘cannibal energy’, and its persistent attempt to resolve difficult emotional problems† (Armand, 1997).

Freedom and Slavery

The United States promotes that freedom is a right deserved by all humanity. Throughout the history of America the government has found ways to deprive selected people this right by race, gender, class and in other ways as well for its own benefit. This is a boundary of freedom. Boundaries of freedom outline who is able to enjoy their freedom and who isn’t. These people alter with time and as history unfolds. Slavery and the journey of their freedom was a big part of the foundation of the United States. At the beginning of the Civil War, Lincoln’s goal was to restore the Union and planned on keeping slavery present in the states.African American’s journey to freedom and what freedom means was a long and turbulent one. With the British colonies being established in the New World, a source of cheap labor was needed. The Slave Trade was introduced into the colonies from Africa. Slaves were an important part of the success of this new economy being built. 7. 7 millio n African Americans were estimated to be transported to the New World between 1492 to 1820. They were treated like other goods and were sold through the triangular trade route across the Atlantic. Slavery had its advantages to Englishmen.They couldn’t claim the protections the English law offered, their time of work never ended and their children were born into slavery and owned by the master as well. They also had encountered many diseases known to Europe and were less likely to capitulate to diseases. Slavery began to replace indentured servants on the Chesapeake plantations. To the normal plantation owner, it became more economical to buy labor for life, or a slave that you owned until they died. Slaves could be sold, passed on to family members, and leased. No black could own arms or put their hands on a white or else they were faced with extreme consequences.Also, if off the plantation, a white person could ask a black to provide their freedom certificate or a note of pe rmission to be off the plantation from the master they also faced extreme consequences. Slaves were like children to whites. They could not rebel without repercussions and could not betray or leave their owner. They had free labor that could not go anywhere; slavery was a huge benefit and was like a dream for a plantation owner. They were essential to production and cultivation of crops and plantations. By 1700, slavery was existent in all of the colonies.The House of Burgesses realized that slaves were an extremely important part of the labor force and therefore, to the economy. A new slave code was enacted in 1705 stating that slaves were property of their owners and to the white community. Slaves were the legal responsibility of the master and if they started to rebel it was the master’s obligation to keep them in line. Slavery also brought a new division of people to the New World. The slaves that were transported to the colonies for labor were not all from the same cultu re, race or society.They spoke different languages, had diverse customs and had many various religions. Many of these people would have never come in contact with each other if not for this slave trade. An overall stereotype of African’s was what they now where known as. There cultures and ideologies emerged into a single background and ancestry for people born into this lifestyle and they no longer came from different tribes or kinships. There new culture was based on African traditions, English fundamentals and American standards. This could almost be considered as the first installment of America becoming known as a ‘melting pot’.Slavery was a huge part of the development of the New World and to the rise of its commercial supremacy. In Britain the profits from the slave trade encouraged the growth of ports, banking, ship building and helped to finance the industrial revolution. It also boosted the colonies wealth and set the foundation for the strong economica l society it would later become. As a historian would later transcribe: â€Å"The growth and prosperity of the emerging society of free colonial British America †¦ were achieved as a result of slave labor†.