Mark Corson

By U. Mojok. Dakota State University.

The stigma and discrimination associated with mental illness may be di- minishing slowly order 100 ml duphalac with visa, but it is highly visible to those who suffer from its effects buy 100 ml duphalac mastercard. The gap between the number of affordable housing units and the number of people needing them has created a housing crisis for poor people discount 100 ml duphalac free shipping. Between 1970 and 1995, the gap between the number of low-income renters and the amount of affordable housing units sky- rocketed from a nonexistent gap to a shortage of 4. So many individuals currently frequent the shelters of our cities that there is concern that the shelters are becoming mini-institutions for people with serious men- tal illness. For families barely able to scrape together enough money to pay for day-to-day living, a catastrophic illness can create the level of poverty that starts the downward spiral to homelessness. Battered women are Homelessness ● 343 often forced to choose between an abusive relationship and homelessness. For individuals with alcohol or drug ad- dictions, in the absence of appropriate treatment, the chances increase for being forced into life on the street. The following have been cited as obstacles to addiction treatment for home- less persons: lack of health insurance, lack of documentation, waiting lists, scheduling difficulties, daily contact require- ments, lack of transportation, ineffective treatment methods, lack of supportive services, and cultural insensitivity. Mobility and migration (the penchant for frequent move- ment to various geographic locations) 2. Among homeless children (compared with control samples), increased incidence of: a. Psychological problems Common Nursing Diagnoses and Interventions (Interventions are applicable to various health-care settings, such as inpatient and partial hospitalization, community health clinic, “street clinic,” and homeless shelters. Client will assume responsibility for own health-care needs within level of ability. The triage nurse in the emergency department, street clinic, or shelter will begin the biopsychosocial assessment of the homeless client. An adequate assessment is required to en- sure appropriate nursing care is provided. This information is essential to ensure that client achieves an ac- curate understanding of information presented and that the nurse correctly interprets what the client is attempting to convey. Client may need as- sistance in determining the type of care that is required, how to determine the most appropriate time to seek that care, and where to go to receive it. Answers to these questions at admission will initiate dis- charge planning for the client. The client must have this type of knowledge if he or she is to become more self-sufficient. Teach client about safe sex practices in an effort to avoid sexually transmitted diseases. Emergency departments, “storefront” clinics, or shelters may be the homeless client’s only resource in a crisis situation. The client cannot deal with psycho- social issues until physical problems have been addressed. If possible, inquire about pos- sible long-acting medication injections for client. The client may be less likely to discontinue the medication if he or she does not have to take pills every day. If the client is to be discharged to a shelter, a case manager or social worker may be the best link between the client and the health-care system to ensure that he or she obtains appropriate follow-up care. Client verbalizes understanding of information presented regarding optimal health maintenance. Client is able to verbalize signs and symptoms that should be reported to a health-care professional. Client verbalizes knowledge of available resources from which he or she may seek assistance as required. Long-term Goal Client will make decisions that reflect control over present situ- ation and future outcome. Provide opportunities for the client to make choices about his or her present situation. Unrealistic goals set the client up for failure and reinforce feelings of powerlessness. Client’s emotional condition interferes with his or her ability to solve problems. Assistance is required to ac- curately perceive the benefits and consequences of available alternatives. Help client identify areas of life situation that are not within his or her ability to control. Encourage verbalization of feel- ings related to this inability in an effort to deal with unre- solved issues and accept what cannot be changed. Client verbalizes choices made in a plan to maintain control over his or her life situation. Client verbalizes honest feelings about life situations over which he or she has no control. Client is able to verbalize system for problem-solving as re- quired to maintain hope for the future. Home care has become one of the fastest growing areas in the healthcare system and is now recognized by many reimbursement agencies as a preferred method of community-based service. Patients and their families and other caregivers are the focus of home health nursing practice. The goal of care is to maintain or improve the quality of life for patients and the families and other caregivers, or to support patients in their transition to end of life (p. The psychiatric home care nurse must have knowledge and skills to meet both the physical and the psychosocial needs of the homebound client.

Measuring Intelligence: Standardization and the Intelligence Quotient The goal of most intelligence tests is to measure g order duphalac 100 ml online, the general intelligence factor order duphalac 100 ml without prescription. Good intelligence tests are reliable duphalac 100 ml fast delivery, meaning that they are consistent over time, and also Attributed to Charles Stangor Saylor. Because intelligence is such an important individual difference dimension, psychologists have invested substantial effort in creating and improving measures of intelligence, and these tests are now the most accurate of all psychological tests. In fact, the ability to accurately assess intelligence is one of the most important contributions of psychology to everyday public life. A 3-year-old who could accurately multiply 183 by 39 would certainly be intelligent, but a 25-year-old who could not do so would be seen as unintelligent. Thus understanding intelligence requires that we know the norms or standards in a given population of people at a given age. Thestandardization of a test involves giving it to a large number of people at different ages and computing the average score on the test at each age level. It is important that intelligence tests be standardized on a regular basis, because the overall level of intelligence in a population may change over time. The Flynn effect refers to the observation that scores on intelligence tests worldwide have increased substantially over the past [21] decades (Flynn, 1999). There are many explanations for the Flynn effect, including better nutrition, increased access to information, and more familiarity with [22] multiple-choice tests (Neisser, 1998). But whether people are actually getting smarter is [23] debatable (Neisser, 1997). Once the standardization has been accomplished, we have a picture of the average abilities of people at different ages and can calculate a person‘smental age, which is the age at which a person is performing intellectually. Most modern intelligence tests are based the relative position of a person‘s score among people of the same age, rather than on the basis of this formula, but the idea of an intelligence “ratio‖ or “quotient‖ provides a good description of the score‘s meaning. It consists of 15 different tasks, each designed to assess intelligence, including working memory, arithmetic ability, spatial ability, and general knowledge about the world (see Figure 9. It also shows significant correlations with measures of everyday functioning among the mentally retarded. The intelligence tests that you may be most familiar with are aptitude tests, which are designed to measure one‘s ability to perform a given task, for instance, to do well in college or in postgraduate training. These tests are useful for selecting students because they predict success in the programs that they are designed for, particularly in the first year of the [25] program (Kuncel, Hezlett, & Ones, 2010). Intelligence tests are also used by industrial and organizational psychologists in the process of personnel selection. Personnel selection is the use of structured tests to select people who are [27] likely to perform well at given jobs(Schmidt & Hunter, 1998). This is normally accomplished by surveying and/or interviewing current workers and their supervisors. Based on the results of the job analysis, the psychologists choose selection methods that are most likely to be predictive of job performance. The Biology of Intelligence The brain processes underlying intelligence are not completely understood, but current research has focused on four potential factors: brain size, sensory ability, speed and efficience of neural transmission, and working memory capacity. Studies that have measured brain volume using neuroimaging techniques find that larger brain size is correlated [28] with intelligence (McDaniel, 2005), and intelligence has also been found to be correlated with the number of neurons in the brain and with the thickness of the cortex (Haier, 2004; Shaw et al. It is important to remember that these correlational findings do not mean that having more brain volume causes higher intelligence. It is possible that growing up in a stimulating environment that rewards thinking and learning may lead to greater brain growth (Garlick, Attributed to Charles Stangor Saylor. Another possibility is that the brains of more intelligent people operate faster or more efficiently than the brains of the less intelligent. Some evidence supporting this idea comes from data showing that people who are more intelligent frequently show less brain activity (suggesting that they need to use less capacity) than those with lower intelligence when they work on a task [31] (Haier, Siegel, Tang, & Abel, 1992). And the brains of more intelligent people also seem to run faster than the brains of the less intelligent. Research has found that the speed with which people can perform simple tasks—such as determining which of two lines is longer or pressing, as quickly as possible, one of eight buttons that is lighted—is predictive of intelligence (Deary, [32] Der, & Ford, 2001). Although intelligence is not located in a specific part of the brain, it is more prevalent in some [34] brain areas than others. Although different tests created different patterns of activation, as you can see in Figure 9. Intelligence has both genetic and environmental causes, and these have been systematically studied through a large number of twin and adoption studies (Neisser et al. These studies have found that between 40% and 80% of Attributed to Charles Stangor Saylor. But there is also evidence for the role of nurture, indicating that individuals are not born with fixed, unchangeable levels of intelligence. The fact that intelligence becomes more stable as we get older provides evidence that early environmental experiences matter more than later ones. Environmental factors also explain a greater proportion of the variance in intelligence for children from lower-class households than they do for children from upper-class households (Turkheimer, Haley, Waldron, D‘Onofrio, & [38] Gottesman, 2003). This is because most upper-class households tend to provide a safe, nutritious, and supporting environment for children, whereas these factors are more variable in lower-class households. Poverty may lead to diets that are undernourishing or lacking in appropriate vitamins, and poor children may also be more likely to be exposed to toxins such as lead in drinking water, Attributed to Charles Stangor Saylor. If impoverished environments can harm intelligence, we might wonder whether enriched environments can improve it. Government-funded after-school programs such as Head Start are designed to help children learn. Research has found that attending such programs may increase intelligence for a short time, but these increases rarely last after the programs end (McLoyd, [41] 1998; Perkins & Grotzer, 1997). But other studies suggest that Head Start and similar programs may improve emotional intelligence and reduce the likelihood that children will drop [42] out of school or be held back a grade (Reynolds, Temple, Robertson, & Mann 2001).

Dialogue 100 ml duphalac for sale, descrip- the nursed must be in the circle cheap 100 ml duphalac with mastercard, and the focus of tion purchase duphalac 100 ml without a prescription, and innovations in interpretative approaches study must be the nursing situation, the shared lived characterize research methods. Development of experience of caring between nurse and nursed and systems and structures (e. The community created is that of persons living imbursement) to support nursing necessitates caring in the moment and growing in personhood, sustained efforts in reframing and refocusing famil- each person valued as special and unique. In teaching nursing as caring, faculty assist stu- Nurses in research and development roles carry dents to come to know, appreciate, and celebrate out their work facing environmental pressures both self and other as caring persons. Students, as similar to those experienced by the practitioner, well as faculty, are in a continual search to discover the administrator, and the educator. Research greater meaning of caring as uniquely expressed in and development in nursing require disciplinary- nursing. Examples of a nursing education program congruent values and perspectives, free-ranging based on values similar to those of nursing as car- thought, openness, and creativity. Institutional sys- ing are illustrated in the book Living a Caring-based tems and structures often seem to favor values and Program (Boykin, 1994). Researchers and accepting responsibility for summative evaluation developers guided by the assumptions and themes calls for the integrated foundation provided by the of nursing as caring are empowered to create novel guiding intention to know and nurture persons as methods in the search for understanding and mean- caring. This intention helps the nurse to transcend ing and to articulate effectively the value, purpose, limiting historical practices while creatively invent- and relevance of their work (Schoenhofer, 2002). Does this mean that the nurse must like Theory of Nursing as Caring everything about the person, including personal life choices? Perhaps not; however, the nurse as nurse is The following presents several common ques- not called upon to judge the other, only to care for tions—and responses—that nurses ask about nurs- the other. Related to the previous dilemma, this question Mayeroff’s (1971) caring ingredients offer a useful presents the crucible within which one’s commit- starting point for the nurse committed to knowing ment to the assumptions and themes of nursing as self and other as caring persons. The underlying ques- include knowing, alternating rhythm, honesty, tion is, “Does the person to be nursed deserve or courage, trust, patience, humility, and hope. All persons are caring, even when not all cho- dence, conscience, competence, and compassion— sen actions of the person live up to the ideal to offer another conceptual framework that is helpful which we are all called by virtue of our humanness. Coming to know In discussions of hypothetical situations involving self as caring is facilitated by: child molesters, serial killers, and even political fig- • Trusting in self; freeing self up to become what ures who have attempted mass destruction and one can truly become, and valuing self. However, problems, difficulties, in order to remember the when such a person presents to the nurse for care, interconnectedness that enables us to know self the nursing ethic of caring supersedes all other val- and other as living caring, even in suffering and ues. The theory of nursing as caring asserts that it is in seeking relief from suffering. It is only with sustained intentionality, com- for one can only truly understand in another mitment, study, and reflection that the nurse is what one can understand in self. In order ment, and engaging in study and reflection, indi- to know the other as caring, the nurse must find vidually and in concert with caring others. The key point here is the “caring between” that is Process, as it is understood in the term “nursing the nursing creation: When nursing a person who is process,” connotes a systematic and sequential se- unconscious, the nurse lives the commitment to ries of steps resulting in a predetermined, specifi- know the other as caring person. It requires that all ways of knowing nursing by Orlando (1961), is a linear stepwise be brought into action. The nurse must make self as decision-making tool based on rational analysis of caring person available to the one nursed. The full- empirical data (known in other disciplines as the ness of the nurse as caring person is called forth. Proponents of the theory of nursing as and knowing the other directly through authentic caring view nursing not as a process with an presence and attunement; the hope and courage to endpoint, but as an ongoing process; that is, as risk opening self to one who cannot communicate dynamic and unfolding, guided by intentionality verbally; patiently trusting in self to understand the although not directed by a preenvisioned outcome other’s mode of living caring in the moment; hon- or product. Nursing responses of care arise in est humility as one brings all that one knows and aesthetic knowing, in the creative and evolving remains open to learning from the other. The nurse patterns of appreciation and understanding, and in attuned to the other as person might, for example, the context of a shared lived experience of caring. In that vulnerability, the nurse recognizes that which is experienced as valuable arising in and that the one nursed is living caring in humility, evolving through the “caring between” of the nurs- hope, and trust. Much of that value is neither measur- nerability, merely “taking care of” the other, the able nor empirically verifiable. That which is nurse practicing nursing as caring might respond measurable and empirically verifiable is relevant in by honoring the other’s humility, by participating the situation, however, and may be called upon at in the other’s hopefulness, and by steadfast trust- any time to contribute to and through the nurse’s worthiness. Information that the nurse has situation might come from the nurse resonating available becomes knowledge within the nursing with past and present experiences of vulnerability. Knowing the person directly is what Connected to this form of personal knowing might guides the selection and patterning of relevant be an ethical knowing that power as a reciprocal of points of factual information in a nursing situa- vulnerability has the potential to develop undesir- tion. That is, any fact or set of facts from nursing able status differential in the nurse-patient role re- research or related bodies of information can be lationship. As the nurse sifts through a myriad of considered for relevance and drawn into the sup- empirical data, the most significant information porting knowledge base. This knowledge base re- emerges—this is a person with whom I am called to mains open and evolving as the nurse employs an care. Ethical knowing again merges with other alternating rhythm of scanning and considering pathways as the nurse forms the decision to go be- facts for relevance while remaining grounded in the yond vulnerability and engage the other as caring nursing situation (Schoenhofer & Boykin, 1993, person, rather than as helpless object of another’s pp. Aesthetic knowing comes in the praxis of In addition to empirical knowing, knowing for caring, in living chosen ways of honoring humility, nursing purposes also requires personal knowing, joining in hope, and demonstrating trustworthi- including intuition and ethical knowing, all con- ness in the moment (Schoenhofer & Boykin, 1993, verging in aesthetic knowing within each unique pp. Professional nurses will continue to find meaning in Nurses are frequently heard to say they have no their technological caring competencies, expressed time for caring, given the demands of the role. At the beginning of of machine technology and caring technology the the twenty-first century, the environment for prac- practice of nursing is transformed into an experience tice, administration, education, and research is of caring. Nursing practice models have been developed that can promote routinization and depersonal- in acute and long-term care settings. In 2002, a two- ization on the part of the caregiver as well as the year demonstration project was completed that fo- one seeking care; cused on designing, implementing, and evaluating • demands for immediate and measurable out- a theory-based practice model using nursing as car- comes that favor a focus on the simplistic and ing. This project demonstrated that when nursing the superficial; practice is intentionally focused on coming to • organizational and occupational configurations know a person as caring and on nurturing and sup- that tend to promote fragmentation and alien- porting those nursed as they live their caring, trans- ation; and formation of care occurs.