Benefits of Quitting Smoking

Benefits of Quitting Smoking Group name: Anca Manaf, Asmita Ghale, Comfort Kumi, Hannah Cotton, Ma-Myo Thuzar. Introduction This essay attempts to discuss the health promotion activity on the benefit of quitting smoking. The assessment of health need, epidemiology, demography, current national or local health policies, identification of target group, approaches chosen will be discussed. Ultimately, this essay will evaluate the effectiveness of the health promotion activity. Assessment of health need Health need assessment (HNA) is an essential component of effective health promotion (Carroll, 2004). According to Cavanagh and Chadwick (2005), HNA is a systematic approach of recognising priority health issues, targeting the populations with the most need and taking actions in the most cost-effective and efficient way. MacDowall, Bonell and Davies (2006) stated, HNA is important for health promotion as it provide an opportunity to engage with specific populations and enable them to contribute to targeted service planning and resource allocation. Bradshaw (1972) therefore outlines the four main categories of needs; normative need, comparative need, felt need and expressed need. Hence, normative need was the chosen need for the health promotion activity. Consequently, this need was chosen for the health promotion activity as it is based on the opinion and experience of experts according to the current research and findings (Wills, 2011). They will provide advice, evidence based information, provide individual with range of services, techniques and support them throughout the process of quitting (Will, 2011). Epidemiology and demography, data and trends The number of smokers over the age of 16 in the UK is reducing, from a high of 45% in 1974 to 21% of men and 20% of women in 2010 (Rutter, 2013). Smoking is most common in those aged under 35; 32% in people aged between 20 and 24, and 27% in those aged 25 to 40 (Lader, 2007). It is least common among people aged 60 and over (Public Health England, 2012). Prevalence of smoking among people in the routine and manual socio-economic group (33%) continues to be higher than amongst those in the managerial and professional group (14%) (Public health England, 2013). In England, 2010-2011, 459,900 of NHS hospital admissions were attributable to smoking among adults aged 35 and over (ASH, 2013). Among pregnant women, smoking prevalence is highest for those under aged 35 (Penn and Owen 2002; Sproston and Primatesta, 2004). Smoking is the leading cause of preventable deaths and disease in the UK (Cancer Research UK, 2012). About half of all life-long smokers will die prematurely, losing on average 10years of life. Findings has shown that smoking related deaths are from; lung cancer, respiratory disease and circulatory disease (Huffman, 2003). This attributed to; 36% (22,500) of all respiratory deaths, 28% (37,400) of all cancer death and 14% (18,100) of all circulatory disease (Public health England, 2012). In 2011, there were a total of 442,759 deaths of adults aged 35 and over in England of which 79,100 (18%) were estimated to be attributable to smoking (ASH, 2013). Target group and why health promotion is required The target group for our health promotion activity is focused on smokers. This is because recent statistics has shown that smokers have a significantly increased risk of avoidable mortality and morbidity compared to non-smokers (Heidrich et al, 2007). Thus, Petrosillo and Cicalini (2011) identified that, the major causes of this excess mortality and morbidity among smokers are diseases that are related to smoking such as; cancer and respiratory and circulatory disease. Therefore, health promotion will be required as it is aimed at raising awareness of the health dangers of smoking and tobacco use, and encouraging smokers to try and quit, doing so in the most effective way (DOH, 2013) by providing motivational advice and support. Is smoking a public health issue Smoking is one of the biggest threats to public health, costing more than 120,000 lives per year in the UK (Peto et al, 2004). Behaviour factors affecting health issue Research identified ranges of behavioural factors that influence uptake and pattern of smoking (Nichter, 2003). Some of these behavioural factors include; addiction and attitude to smoking. Being addicted are commonly mentioned reasons for keeping people smoking (Siqueira et al, 2001). People tend to find it difficult to quit smoking because they are addicted to the effects of nicotine addiction. Research reports that smokers who consider themselves to be addicted to nicotine had not expected to become so when they had started smoking (Balch et al, 2004). Furthermore, smokers who have attempted to quit smoking experience withdrawal symptoms including; cravings, difficulty dealing with stressful situations, increased appetite, frustration, irritability and anxiety (Siqueira et al., 2001) Having more positive attitudes towards smoking has been repeatedly related to an increased risk of smoking (Buller et al, 2003). Smokers have more positive attitudes towards the mental effects, appearance features and are less concerned about negative physical and social consequences. Policies: A recent policy that was relevant to the health promotion activity was developed by DOH in 2013, called reducing smoking. Its stresses that high prices put people off smoking, most especially young people and people on lower incomes. Therefore, the government aims to continue to set tax rates high enough to discourage people from smoking, provide updated guidelines to make it easier for local trading standards and HM Revenue Customs officers to work in collaboration to enforce the law against fake and smuggled tobacco. The policy also highlighted that the government will continue to run ‘smokefree’ campaigns to encourage people to change their behaviour. In 2005, the WHO issued a global policy by developing a framework convention on tobacco control, which provides international cooperation to support tobacco control. The initiative of the policy is to protect the present and future generations from the devastating health consequences of tobacco consumption, by providing a framework for tobacco control measures to be implemented worldwide. The tobacco control measures includes; price and tax policies, bans on tobacco advertising, protection from exposure to second-hand smoke, education and public awareness measures, regulation of tobacco product contents and disclosures treatment for tobacco dependence, and measures to combat illicit trade. Approach Health promotion has been applied to wide range of approaches to improve health of people, communities and populations. Naidoo Wills (2009) acknowledged that there are five different approaches to health promotion, which are; medical, behavioural change, educational, empowerment and social change. However, the approach chosen, to this health promotion activity was the educational approach. This approach was chosen to provide knowledge and information to the target group on the benefit of quitting smoking, the support available and develop the necessary skills in order to enable them make well-informed and rationale choices about their lifestyles and behaviour (Gottwald Brown, 2012), through provision of leaflet, visual displays and one-one education. Health belief model (1974) proposed that, people need to have some kind of cue such as; one-one-education, distributing of leaflet, mass media campaign, to take action to change behaviour or make a health-related decision. This informa tion provided will help them explore their values and attitudes and a willingness to change behaviour and lifestyles. An advantage of educational approach is that, it enables individuals to develop their knowledge and change their attitude (Gottwald Brown, 2012). However, Naidoo Wills (2009) expressed that; educational approach can be time consuming and individual may not make healthy choices. Aims and objectives The aim for the health promotion activity is to promote smoking cessation by increasing awareness of the benefits of quitting smoking. The SMART objectives were; by the end of this session, the participants will understand three benefits of quitting smoking, be able to name two diseases caused by smoking and be aware of where to get help. Evaluation Evaluation is an essential element of systematic programme planning (Timmereck, 2003). It is important to assess whether an activity has met its objectives and find out if method used were appropriate and efficient, as it will give a sense of achievement and help work out ways to improve for future (Raingruber, 2014). Therefore, Naidoo wills (2009) identified that, there are three stages of evaluation; process, impact and outcome. Process evaluation involves assessing the activities in the program and quality of the program (Naidoo Wills, 2009). The group used posters, leaflets, NHS free quitting kits, cigarette timeline, AR lung website and one-one communication to address different learning styles, providing information to the target audience that came to the stand. Findings on learning styles Kolb (1984) has shown that people learn differently, so using a range of styles allow for the use of range of learning experiences to help learners develop a wider repertoire than their usually preferred style ( Bunton Macdonald, 2002). The posters were colourful, and clear at first glance, appealing and had catchy slogans to attract the attention of the target group. Koelen, Anne Ban (2004) suggested that, posters should be eye-catching, appealing and stimulate the viewer to think about the content of the message in order to achieve the desired objectives. Leaflets were distributed to the target audience during the one-one communication and education. According to Koelen, Anne and Ban (2004) leaflet may have a meaningful function following interpersonal communication. This leaflet comprises of information of the health benefits of quitting smoking, advice on how to stop smoking, stop smoking service and getting professional support. Therefore, this will enable them to re-read the information given at own pace and at the moment they have a need for this information. The NHS free quitting kit was employed by the group of health promoters to the target audience to help them think about reasons for quitting and recognising the triggers that can make them crave cigarettes, improving their chances of quitting successfully. The NHS free quitting helped the target audience work out how much money they will be saving by quitting. The cigarette timeline contained information of the health benefit of quitting smoking and the healing process, that is, what happens in the body when a person stops smoking. The AR lung website was used as a shock tactic to demonstrate to the participants the damage smoking does to their lungs. In addition, the group communicated effectively with the participant, ensuring that the language used was clear, understandable and Jargon free to convey messages (Lehman Dufrene, 2008). Impact evaluation involves measuring the immediate effects of the program (Naidoo Wills, 2009). In measuring the effect of the activity, questionnaires were handed out to the participants to collect immediate feedback and assessed their level of knowledge at the end of the activity (Powell, 2009). It consisted of few questions that assessed the participant’s on their knowledge and understanding of the benefit of quitting smoking. The data collected showed that, 93.3% of the participants were able to name three benefit of quitting smoking. 80% of the participant answered the questions correctly in regards to diseases caused by smoking. 40% of the participant knew the three available services of helping people to quit smoking. 100% thought the activity was very useful; however, this may not be accurate as participants may find it difficult to give negative feedbacks due to the presence of the group. 60% of the participant did not suggest any further improvement for the activity; nevertheless, 40% requested for free freebies. The second and third questions were misinterpreted by the participant which may have been the reason why 80% incorrectly answered the question. Therefore, in future when writing the questionnaire, the health promoters will ensure the questionnaires are re-framed in a much easier format, to aid easy understanding. The table was not big enough to contain all our leaflet, therefore In future, a bigger table will be deemed necessary for any future health promotion activity. Also, the group will have more interactive game and free freebies to attract more participants to the campaign. Outcome evaluation involves measuring the long-term effect of the program (Naidoo wills, 2008). The outcome will be unrealistic to measure as it will be difficult to gather participants together again due to the small scale of the activity, lack of resources necessary for undertaking the survey and time to assess participants in the future. Boltz (2012) suggested, outcome evaluation is more complex, difficult, costly and time consuming to implement. Therefore, HP activity on the benefit of quitting smoking can be carried out in the hospital and community, as supported by Youndan (2005), nurses are in frequent contact with smokers in the community and hospital, therefore, the role of nurse as a health promoter is important. WHO (2014) suggested that, smoking is one of the biggest threats to public health; hence, nurses are in a major position to help people quit by offering encouragement, providing information and refer them to smoking cessation services. In addition to Christensen ( 2006), nurses have a wealth of skills and knowledge and must be able to use this knowledge to empower people to make lifestyle changes and choices. These skills include; excellent communication and negotiation skills, caring and empathetic, non-judgemental and counselling skills (priest, 2013). Conclusion Health promotion is carried out in order to enable individual increase their control and improve their state of health. Undertaking this health promotion activity has broadened student’s understanding on the important of health promotion in nursing. WORD COUNT: 2, 197 References: Ash. (2013). Smoking statistics: Illness and death. Retrieved April 25, 2014 from http://www.ash.org.uk/files/documents/ASH_93.pdf Balch, G. I., Tworek, C., Barker, D. C., Sasso, B., Mermelstein, R. J., Giovino, G. A. (2004). Opportunities for youth smoking cessation: Findings from a national focus group study. Nicotine Tobacco Research, 6 (23), 9-17. Boltz, M. (2012). Evidence based geriatric nursing protocols for best practice. (4th ed.). New York: Springer publishing company. Bradshaw, J. (1972).Ââ€Å"A taxonomy of social need, Problems and progress in medical care. † (7th ed.). Oxford: Oxford University Press Buller, D.B., Borland, R., Woodall, W.G., Hall, J.R., Woodall, P. Voeks, J.H. (2003). Understanding factors that influence smoking uptake. Tobacco Control, 12 (16), 25. Bunton, R. Macdonald, G. (2002). 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Harley-Davidson’s Motivational Programs Essay

History of Harley-Davidson:Today it is hard to imagine Harley-Davidson (Harley) as a low-quality motorcycle manufacturer in severe financial trouble. But that’s exactly what Harley was in the beginning of the 1980’s. Harley motorcycles were of such poor quality that over half of all the cycles produced were effectively inoperable because of missing parts or poor assembly. When Japanese motorcycle manufacturers entered the US market th reliable and well-built bikes, past and potential Harley customers switched over to the foreign brand. The only customers that remained with Harley were its most loyal, technologically savvy ones who were committed to the Harley brand name. As a result, between 1973 and the early 1980’s, Harley’s market share dropped from over 75% to under 25%. By 1984, sales had dropped to $294 million and profit was merely $2.9 million. The future of Harley was nothing but bleak. In order to change the company’s performance and improve the quality of the bikes produced, Harley implemented a series of programs and reorganization efforts to motivate its employees to help Harley turn around. Since Harley was financially squeezed, the bulk of the incentive programs were based on intrinsic motivation, including employee empowerment and increased challenge and excitement in the job. Harley also began offering financial incentives that were tied to specific performance factors. Due to the extraordinarily positive results from these programs, they are still in effect today. Intrinsic Motivational StrategiesEmployee EmpowermentIn order to motivate its employees to improve the manufacturing process, Harley implemented a program that empowered its employees at all levels to take more control of the operations and decision-making in the company. In order to get the best that each employee has to offer, Harley encourages every employee to suggest ideas, involves all employees in major company decisions, and allows its hourly workers to make more decisions than most companies. This not only improves employee morale by instilling a sense of worth in each employee, it also creates a sense of attachment to the company. In turn, this empowerment results in increased dedication to the company, hard work and improved employee performance because each employee is given the power to initiate change and make decisions that affect the company. Furthermore, Harley’s culture supports its strategy of employee empowerment. Harley is a flat organization with only two layers of management that fosters a friendly and collaborative environment. The atmosphere is casual and all employees interact with each other-there are no rigid lines between the management and the hourly workers. This generates a sense of camaraderie and feelings of mutual respect, which in turn facilitates open lines of communication and comfort with speaking up to identify problem areas and possible solutions. In addition, the company does not punish failed ideas or criticize out-of-the-box suggestions. Instead, the company always evaluates the new ideas and rewards employees for creative solutions that work. In fact, in 2001, more than 20% of Harley’s IT staff was internally promoted for creative thinking that resulted in better or faster production. Finally, Harley doesn’t force the added responsibility and power onto the employees and leave them to fend for themselves, adopting a survival of the fittest attitude. Rather, it provides them the tools and skills necessary to succeed in the more challenging and complex environment. Believing that all employees that are expected to take on the responsibility of increased employee power should be equipped with certain necessary competencies, Harley provides training in communication, conflict resolution, team skills, planning, problem solving, decision making, and performance management. For example, Harley-Davidson University, a training program required for all employees, â€Å"teaches employees how to do business stimulation and how to plan for ownership succession since they deal with a lot of goods and services† (How Companies are Managed). Harley even provides hourly workers the skills necessary to be able to market their new ideas to management and their peers. It trains employees on computers and teaches them how to give presentations on PowerPoint and how to use spreadsheets to manage the implemented changes. This commitment to training and education demonstrates Harley’s loyalty to and confidence in its employees and gives them the skills and abilities necessary to make employee empowerment a success for the company and a non-threatening, welcomed aspect of the job to the employees. An example of how employee empowerment motivated an employee to generate change in the production process and therefore financially benefit Harley is when an hourly worker suggested putting two tanks in the pain chamber where he worked. The suggestion was quickly implemented and ended up doubling the productivity in the paint shop! If not for the combination of employee empowerment, the necessary training, and a supportive culture, it is unlikely that this hourly worker would have even discovered the potential improvement in the painting process. Yet, even if he did, he probably would not have cared enough to felt comfortable enough to suggest his idea to his manager. Consequently, Harley would have missed out on the full potential of its employee and would have been less productive in the manufacturing process. Challenging & Enjoyable WorkHarley also motivates its employees by matching its employees with projects that are personally interesting and challenging to each employee. First, management makes the projects more meaningful to the employees by explaining the overall business objectives of the projects and helping them understand the business value of successfully achieving those objectives. For example, Harley doesn’t just promote new technology for technology’s sake, but rather markets the technology’s tangible importance to the customer and the bottom line. This gets the employees interested in the project and excited about achieving the stated goals. Harley also tries to motivate employees by making their work sufficiently challenging. While giving the employees the ability to and pressuring them to step up and initiate positive change in the organization is one strategy to make the workplace more exciting, Harley doesn’t stop there. It also offers all of its employees the chance to work on new technologies, innovative processes and highly-visible projects. Employees are assigned to these activities by â€Å"showing initiative, keeping up with current technologies [or process improvements] and learning soft skills such as how to work effectively on a team and how to talk with business customers† (Hamblen). This not only keeps employees interested in their work, it motivates them to improve their portfolio of skills so that they can participate in these challenging and exciting projects. Finally, Harley makes a concerted effort to match employees with projects and jobs in which they have specific interest. Managers are urged to stay in tune with the interests of their workers in order to best match them with the available job opportunities. For example, managers have quarterly review meetings with their subordinates to discuss upcoming projects in the company and determine which projects are of interest to the employee. Harley’s commitment to maintaining the employee’s interest in their work is paying off. In 2001, the IT department, which has over 200 employees, had a turnover rate of less than 3%. Such a low rate clearly illustrates the employees’ satisfaction with their jobs and commitment to Harley. Intrinsic Motivation: An exampleA prime example of Harley’s use of intrinsic motivation programs is its use of councils. Councils are groups of employees, with ten approximately members, who work to address specific issues that affect their day-to-day work. Fellow workers choose the members, and it is considered an honor to be selected to serve. The work done on the council is typically exciting and challenging, and produces tangible and noticeable results throughout the organization. Due to the prestige associated with being on the council, along with the skills developed by serving on one, â€Å"participating in a council is widely recognized as a career growth opportunity† (Vitiello). While these councils do increase decision-making time, the benefits are worth the lost time. First, they motivate employees to perform well in order to get on one of the councils and to get recognized while serving on one. Second, they create wider acceptance of the decisions by the employees because they were partly responsible for and involved in making the decisions rather than them being mandated by management. Financial MotivationHarley understands that while intrinsic rewards are important, employees are also significantly motivated by financial incentives. Therefore, Harley implemented three kinds of variable financial incentives, all of which that are linked to valued behavior. First, at least a portion of every employee’s compensation package depends on the achievement of the company’s annual goals; when the company meets or exceeds  its objectives, the employees meet or exceed their target salary. Second, Harley utilizes a stock program whereby a portion of the employees’ compensation is in stock options. This motivates employees to continually improve the overall performance of Harley because the better the company does, the higher the stock price a nd potential financial benefit to the employees. Finally, employee performance bonuses are given to individuals that provide exemplary work or suggest improvements that result in increased productivity or lower costs. All three of these programs motivate the employees to improve the productivity, efficiency, and financial performance of Harley. Harley-Davidson Today: The Results of Harley’s Motivational ProgramsThe programs implemented by Harley back in the middle of the 1980’s are still being used today. And for good reason-Harley’s performance has done nothing short of skyrocket since their implementation. In the first quarter of 2003, Harley reported net sales of $1.1 billion and a net income of $186.2 million. This is over 3.7 times the sales generated throughout the entire 1984 fiscal year. The Vice-President of the Kansas City office believes these motivation programs are the reason why Harley has had such a complete and long-lasting turn around:†[W]e’ve created an environment where all employees are valued and expected to make good decisions to benefit the enterprise, and people who feel they are making a contribution to the business are happier people, and they are committed to helping the company succeed. With 8,000 people showing up each day, determined to find ways to improve our business, I’m confident we will be able to continue our successful growth† (How Companies are Managed). Web Sites Used: 1.Why you can still buy a Harley; by Derek Parker; week of January 15, 2001: http://portland.bizjournals.com/portland/stories/2001/01/15/editorial1.html2.Harley profit roars past estimates on slower U.S. sales; week of April 14, 2003: http://www.bizjournals.com/milwaukee/stories/2003/04/14/daily26.html?jst=s_cn_hl3.How Companies are Managed; by Brandon McNeal: http://academic.emporia.edu/smithwil/001fmg444pa/eja/mcneal.html4.Harley-Davi

Reflection for “I Know Why the Caged Bird Sings”

Reflection for â€Å"I Know Why the Caged Bird Sings† Abstract This essay consists of three sections. The first section, a brief synopsis of the book â€Å"I know why caged bird sings† is presented. At the second part, three insights after reading the book are introduced. That is, metaphor of caged bird, power of literacy, and power of silence. At the last section, discipline-specific knowledge that relevant to the main character of book is stated. Synopsis of the Text This autobiography is Maya Angelou’s coming of age story, and follows Marguerite’s (called â€Å"My’ or â€Å"Maya† by her brother) life from the age of three to seventeen.In this story, Angelou as the storyteller, tells the audience about her experiences as an African American girl living in the Southern United States and her struggles with racism and being raped at eight years old. The book reveals the process of how she overcomes these difficulties and transforms into a sel f-possessed, dignified young woman, capable of responding to prejudice. Her maturity is mainly gained by her grandmother, Momma, the power of literacy, and the love around her. The book starts with Marguerite at three years old.At three, she was sent to Stamps, Arkansas, with her older brother Bailey to live with her grandmother and crippled uncle. Momma owns a merchandise store in the Stamps, and her store is a center of the African American community. Church, school, and the store are main places that little Maya and her brother live around. They are acquainted with African American life in Stamps which is hopeful in the morning before they go to cut the cotton, then turns dissatisfied and disappointed in the evening when they return from the cotton field.  Read also Post-Traumatic Stress Disorder  (PTSD).Stamps is a place where the black world and white world is clearly distinctive. Segregation makes them feel fear and hatred towards the white people in Stamps. Maya and her b rother’s relatively peaceful lives are disturbed by their father’s appearance at Stamps. He takes them to St. Louis, Missouri, to live with their mother. Later, Maya was raped by her mother’s boyfriend. After her mother’s boyfriend’s death, Maya misconceives that her words lead him to his death, and then she refuses to speak.This make her mother feel helplessness, therefore she decides to send her children to Stamps again. In Stamps, Maya meets Mrs. Bertha Flowers, who supplies her with books to encourage her love of reading and helps her to break through her shell. Later, Momma decides to send her grandchildren to their mother in San Francisco, California, to protect them from the dangers of racism in Stamps. Before Maya graduates, she becomes first African American female streetcar conductor in San Francisco.During her final year of high school, she worries that she might be a lesbian and initiates sexual intercourse with a teenage boy. Later, sh e finds out that she is pregnant. Maya gives birth at the end of the book and begins her journey to adulthood by accepting her role as a mother. Insights You Obtained from Reading this Text Metaphor of Caged Bird In this text, the cage is used to imply many things. In young Maya’s eyes, being black is like living in a cage; she always imagines she could escape from her black skin.In addition, her uncle’s handicapped body is his own cage. African American laborers in the Stamps cotton field are also being caged, because they are repeatedly doing the same labor work day after day, but their life does not seem to change. It is still very tough; they are like the caged bird cannot go anywhere. When the â€Å"powhitetrash† girls ridicule Momma, Maya looks through the window and watches the whole process of Momma being ridiculed by these girls. She was angry and wanted to yell at them but she could not, like the caged bird.From reading this text, I could know the seve rer victimization from racism and the impacts of segregation on African American person’s life at that time. When Maya firstly comes across the white community in Stamps, she feels fear and perceives the white people there are un-human. Segregation produces misunderstanding between the two groups and escalates the conflict. Power of Literacy Maya is scared about the power of words after the death of Mr. Freeman, and refuses to speak. After she goes back to Stamps, Maya met Mrs. Flower, who encourages her reading of books.Books become a refuge in her bewildering childhood. Maya finds characters of a book to make sense of her bewildering world. She even uses books as a way of coping with her rape. From the literacy, Maya gets comfort; literacy expands her thought and enables her to think independently without considering the unwritten rules of society at that time. Literacy also enhances Maya’s ability of thinking; it lets her have better understanding of herself, elabor ates her thought, and makes her become a stronger person. In addition, literacy inspires her to think what true human dignity is.It is very lucky for Maya to find a way to coping, as McPherson says, â€Å"if there is one stable element in Angelou’s youth it is a dependence upon books. † (McPherson, 1990, pp. 215). I wonder what the most dignified characteristic of a human being is. The answer I found from this book is not the color of skin, socioeconomic status, or power; it is the self-determined ability to not allows others to decide the value of themselves, because everyone is equally dignified. Power of Silence Maya’s grandmother is a quite successful African American woman in the African American community in Stamps.However, Momma and Momma’s family frequently suffered from racist attacks. On one occasion, Momma is taunted by â€Å"powhithetrash† girls. Maya sees Momma through the window coping with ignorance while being dignified. When these girls go to leave, Momma says to them â€Å"Bye, Miz†. After seeing how Momma fights with racism, Maya realizes racism can be fought without impudence, but instead with dignity. On the another occasion, Momma hides Uncle Willies in a vegetable bin to protect him from Ku Klux Klan raiders, because at that time, it was hard for a black man get protection from the police.Momma chooses very realistic ways to protect her family and shows to little Maya what truth dignity is. Discipline-Specific Knowledge that You Think is Relevant to this Main Character If Maya is a client, what should a practitioner do with Maya? At first, the counselor needs to decide the time that Maya come to see him or her. Maya has come to see the counselor after she has been raped. As described in the book, after this incident, Maya refused to speak and closed herself to the outside world. Therefore, it can be assumed that this period is the first crisis in Maya’s life.At the beginning of the counsel ing session, establishing a good relationship is very important. Sexual abuse involves betrayal of the child’s trust. The effect of such behavior makes a child who survives sexual abuse feel that it is difficult for them to trust others. Therefore, the counselor needs to make a tremendous effort to build a good rapport with Maya. We can utilize the things that Maya likes in the beginning of the session. As known from the text, Mrs. Bertha Flowers introduces books to Maya and encourage her love of reading books.Therefore, we can talk about characters or authors of books, or whatever can bring her interest. After establishing a good relationship with Maya and making sure that she is ready to talk, the counselor will do assessment. Through talking with Maya, the counselor can comprehend Maya’s feelings, her coping behaviors, her perceptions about the incident, her developmental tasks, and her ecosystem. At the end of the assessment, two main issues might emerge. That is, trauma from sexual abuse and racism-related issues, including obsession with race and an identity issue.It is said that counselors are ethically and legally mandated to report suspicions of child sexual abuse to authorities (Miller, Dove, & Miller, 2007). Therefore, documenting and reporting the suspected sexual abuse of Maya is the counselor’s first job. In the specific counseling session, the counselor needs to consider that treatment issues for child victims of rape typically includes many symptoms. Some of these symptoms include anger, trust issues, social withdrawal, self-blame, emotional dysregulation, dissociation, eating disorders, self-injury, and Post-Traumatic Stress Disorder (Budrionis & Jongsma, 2003).Previous research suggests cognitive-behavioral approaches â€Å"reduce the impact† of (child) sexual abuse (Berliner & Elliot, 2002), and are more effective than supportive therapy in promoting improvements in children’s knowledge about body safety sk ills (Deblinger, Stauffer, & Steer, 2001). The counselor could apply cognitive behavioral therapy (CBT) to identify distorted thinking, like how Maya thought being raped and Mr. Freeman’s death were caused by her; modify beliefs; facilitate relating to others in different ways; and changes Maya’s behaviors associated with her trauma.Next, the counselor needs to deal with the racism-related issues that Maya is experiencing. Cross model of psychological nigrescense (the process of becoming Black)(Cross, 1971, 1991, 1995;Hall & Cross, & Freedle, 1972) indicated that the evolution from the pre-encounter to the internalization stage reflects a movement form psychological dysfunction to psychological health. Evidence from the book supports an assumption that Maya is in her pre-encounter stage, where individuals consciously or unconsciously devalue their own Blackness and concurrently value White values and ways.This can be seen when Maya often imagines that one day she will escapes from her black skin and become a blond and blue-eyed white girl. African Americans at pre-encounter stage evidence self-hate, low self-esteem, and poor mental health (Vandiver. 2001), whereas African Americans with the greatest internalization of racial identity report the highest self –esteem (Pierre & Mahalik, 2005). It seems that accepting who you are and being proud of yourself are fundamental for African American to maintain mental health. However, long journey needs to be gone through in order to make changes.For changing the perception of herself and her perceptions towards African Americans, the counselor could introduce Maya with some movies or books of outstanding African Americans. Facing racism, Neal-Barnette and Crowther (2000) found that parents who focusing on human values and ignoring the role of race more likely generate children’s higher levels of social anxiety, particularly with African American peers. It means, for African Americans, it is crucial for parents actively prevent racism by admitting existence of racism, putting this issue on the table, and guiding their children to confront racism.In Maya’s case, the counselor could refer to Sue and Sue (2007)’s recommendation. That is, the counselor can employ family and community support systems. Specifically, members of the family and other important individuals (brother, Momma, uncle, teacher, etc. ) in Maya’s life could be asked to meet together in Momma’s home, and then all the members could share information about their struggles and search for identity. Sue and Sue (2007) indicated that, use of these techniques, derived from African American experience, can lead to personal empowerment. Reference Angelou, M. (1971).I know why the caged bird sings. New York, United States: Bantam Books. Berliner, L. , & Elliot, D. M. (2002). Sexual abuse of children. In J. E. B. Myers, L. Berliner, J. Briere, & Ct. T. Hendrix (Eds. ), The APSAC handbook on child maltreatment (2nd ed). (pp. 55-78). Thousand Oaks, CA: Sage Publications, Inc. Budrionis, R. , & Jongsma, A. E. (2003). The Sexual abuse Victim and Sexual Offender Treatment Planner. Hoboken, NJ: John Wiley. Cross, W. E. (1971). The Negro-to-Black conversion experience: Towards a psychology of Black liberation. Black World. 20, 13-27 Cross, W. E. (1991).Shades of Black: Diversity in African American identity. Philadelphia: temple University Press. Cross, W. E. (1995). The psychology of Nigrescence: Revising the Cross model. In J. G. Ponterotto, J. M. Casas, L. A. Suzuki, & C. M. Alexander(Eds. ), Handbook of multicultural counseling (PP. 93-122). Thousand Oaks, CA: Sage. Deblinger, E. , Stauffer, L. B. , & Steer, R. A. (2001). Comparative efficacies of supportive and cognitive behavioral group therapies for young children who have been sexually abused and their nonoffending mothers. Child Maltreatment, 6 (4), 332-343. Hall, W. S. , Cross, W. E. & Freedle, R. (1972). Stages in the development of Black awareness: An exploratory investigation. In R. L. Jones (Ed. ), Black psychology (pp. 156-165). New Yourk: Harper & Row. Neal-Barnett, A. M. , & Crowther, J. H. (2000). To be female, middle class, anxious, and Black. Psychology of Women Quarterly, 24, 129-136 McPherson, Dolly A. (1990). Order out of Chaos: The autobiographical Works of Maya Angelou. New York: Peter Lang Publishing. Miller, K. L. , Dove, M. K. , & Miller, S. M. (2007, October). A counselor’s guide to child sexual abuse: Prevention, reporting and treatment strategies.Paper based on a program presented at the Association for Counselor Education and Supervision Conference, Columbus, OH. Pierre, M. R. , & Mahalik, J. R. (2005). Examining African self-consciousness and Black racial identity as predictors of Black men’s psychological well-being. Cultural Diversity and Ethnic Minority Psychology, 11, 28-40. Sue, D. W. , & Sue, D. (2007). Counseling the Culturally Diverse : Theory an d Practice. (5th Ed). Hoboken, NJ: John Wiley & Sons. Vandiver, B. J. (2001). Psychological nigrescence revisited: introduction and overview. Journal of Multicultural counseling and Development, 29, 165-173.

Bangor Family Physicians Case Study Essays - 4600 Words

Bangor Family Physicians Case Study Executive Summary amp; Stakeholders Bangor Family Physicians is a partner based medical group practice located in Maine. The practice consists of four family practice physicians, and a medical support staff. The medical support staff is made up of a practice manager, two receptionists, four nurses, two medical assistants, two billing clerks, and a laboratory technician. Additionally, Bangor Family Physicians employs a CPA to assist with taxes and financial advising. The key stakeholders are the four family physician partners, in which each physician holds an equal stake in the practice. Bangor Family Physicians Reimbursement There are two determinants to reimbursement for Bangor Family†¦show more content†¦Compensation Systems Compensation systems can take on many forms, all of which have positives and negatives related to it. However, certain components are noted to be determinants of solid compensation plans. One agreement of a solid compensation system is the use of incentives. â€Å"Clearly a successful companies set objectives that will provide incentives to increase profitability† (Needles amp; Powers, 2011). Incentive bonuses should be measures that the company finds important to long-term growth. According to Needles amp; Powers (2011) the most successful companies long term focused on profitability measures. For large for-profit firms, compensation programs should offer stock options. The interweaving between the market value of a company’s stock and company’s performance both motivate and increase compensation to employees As the market value of the stock goes up, the difference between the option price and the market price grows, which increases the amount of compensation† (Needles amp; Powers, 2011). Conclusively, a compensation plan should serve all stakeholders, be simple, group employees properly, reflect company culture and values, and be flexible (Davis amp; Hardy, 1999; The Basics of a Compensation Program). Four compensation models are laid out by the Bangor Family Physician case study. These models include: (1) revenue model; (2) net income model; (3) base salary plusShow MoreRelatedThe Tudor Temper : An Analysis On The Royal Mind2344 Words   |  10 PagesAn insight into the mental wellbeing of the Tudor Royal Family Daniella Smithers BA Hons Bangor University (History/Archaeology/ Heritage) The mind of a Royal can be the decimation or the making of a nation. Whether at the fore front or behind the curtains, it was a fierce time for both young and old alike, so being strong minded was vital. I intend this essay to set out to decipher documents to better comprehend how the Royal family thought during the 15th to the 16th century. Historians haveRead MoreThe Problem Of Elderly People2891 Words   |  12 Pages There are a number of population groups vulnerable to loneliness. However, elderly people are often more so targeted by loneliness which is owed to ‘loss of friends and family, loss of mobility or loss of income’.(Saito) Because of this, there has been an increased public concern on the issue of loneliness in senior populations. The statistics on population aging in developed countries are well known. Those aged 60 and above currently account for approximately 20 percent of the population in developedRead MoreMarketing Mistakes and Successes175322 Words   |  702 Pages1-800-CALL WILEY (225-5945). Library of Congress Cataloging in Publication Data Hartley, Robert F., 1927Marketing mistakes and successes/Robert F. Hartley. —11th ed. p. cm. Includes index. ISBN 978-0-470-16981-0 (pbk.) 1. Marketing—United States—Case studies. I. Title. HF5415.1.H37 2009 658.800973—dc22 2008040282 ISBN-13 978-0-470-16981-0 Printed in the United States of America 10 9 8 7 6 5 4 3 2 1 PREFACE Welcome to the 30th anniversary of Marketing Mistakes