Why do people respond differently to illness and why is health so hard to define?

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The concepts of health, disease and illness are all very subjective, and thus it is very hard to actually define them. As prospective doctors it is our task to work towards restoring health in patients, so it is essential to understand the idea of health. The problem arises because the concepts of health and illness are very different for each individual; for instance one person might feel a sprained ankle is a major problem because he is a professional rugby player, whilst for someone else it could just be an annoyance. Studies in this area reveal that perceptions of health vary between cultures and communities, due to differences in age, gender, socioeconomic background and ethnicity.

An essential part of discovering why people respond to illness in such different ways was through my placements at a GP's surgery in Barnes and the Hammersmith Hospital. This gave me an excellent chance to gain insight into why people visit their GP. I had a chance to have a quick discussion with patients before they went in for their appointment about why they were there. It was immensely satisfying to be able to combine other aspects of the course with PCC. For example, speaking with the patients allowed me to put into practice my speaking and listening skills that I had learnt in communication skills.

I initially felt quite apprehensive about the reception I would get when I introduced myself as a 1st year medical student and whether people would open up to me. Therefore it was a nice surprise when I found some patients were willing to speak openly about very sensitive topics; one person happily spoke about genito-urinary problems they had been experiencing. As I asked more questions I gained in confidence and the conversations became more natural, creating a more mutual conversation. I also learnt which questions drew out the best responses and I had to be able to adapt to individual patients requiring varying levels of sympathy. I also found that even though I felt I was too inexperienced to talk to patients, it wasn't a problem because I didn't need much medical knowledge since it was mainly my communication skills that I was using.

The GP placement revealed that practically all patients had taken several days, if not a week, to muster enough courage to visit their doctor. Many patients often said this was because they felt that the problem might just go away, or they tried to self-medicate by buying paracetomol from the pharmacy; in particular men were less willing to visit the GPs, because they felt it a weakness to be ill (something we had discussed in our sociology lectures). This was all reinforced by the symptom survey, where we found that in the class 70% of the people surveyed of varying ages chose to self medicate or take no action at all. The theory behind this is described in the symptom iceberg model, which explains that only a small minority of all people with a symptom will see a doctor.

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Zola (17) identified five major 'triggers' that caused individuals to see their doctor (i.e. symptoms were not enough on their on) 1) The occurrence of an interpersonal crisis (e.g. a death in the family); ) Perceived interference with social or personal relations; ) 'Sanctioning' (pressure from others to consult); 4) Perceived interference with vocal or physical activity; and 5) 'Temporalizing of symptoms' (setting a deadline, e.g. "if I feel the same way on Monday"). In the patient interviews I found real life examples of all of these; Patient W was an elderly lady whose husband had just passed away trigger 1, Patient X had bowel trouble which she felt was a social embarrassment trigger , Patient Y had a bad pain in her neck which her family had encouraged her to see the doctor about trigger , and Patient Z had a back problem which he was worried would disrupt his impending water sports holiday trigger 4.

I found that many of the patients who went to their GP were simply there looking for reassurance; one patient had gone to the doctor to make sure her asthma was stable. Another factor was how much prior medical knowledge the patient had especially now with the advent of the Internet. People who had felt pains in their abdomen and had researched them were much quicker to book their appointment than those who had simply suffered from vague troubles. This was highlighted in my patient interviews by the fact that most of those patients who had researched about their problems had almost immediately booked appointments.

Severe illnesses caused quicker responses also; one patient had severe diahorrea and was therefore more inclined to visit her GP immediately. However severe trouble doesn't always mean severe illness, e.g. cancer. Medical knowledge is important for patients in determining the seriousness of their illness, e.g. the media has given a wealth of information about breast cancer, which can sometimes 'scare' people into visiting their GP.

Health has many different definitions. The Oxford Dictionary defines it as "soundness of body" which is quite vague, whilst the World Health Organisation defines it as "a complete sense of physical and mental well being, not just the absence of disease". The Holistic Model of Illness describes how many other factors influence a patient's well-being; Physical, Psychological, Social, Cultural and Environmental factors.

Herzlich (17) observed how people felt that illness and disease were both seen as more external, whilst health is more of an internal problem; this is described by Hellman as "Disease is something an organ has; illness is something a man has." This reinforces the point that health is a very personal and subjective thing; it is entirely dependent on the individual's feelings. Another problem arises with health since a person suffering from breast cancer may feel fine in their day to day life, whilst an elderly person suffering form the common cold might feel they are seriously ill; which one is the more healthy? We would probably say the person with the cold, but the lady with the breast cancer will probably feel better. This is the major concept in medicine; that you are treating not just a patient, but an individual human being with similar worries, aspirations, and perceptions as yourself. Therefore they are people who need the same care and attention that you would expect.

The first module of the PCC course has definitely opened my eyes to the realities of medicine; it is all too easy during lectures to believe that medicine is just about learning to diagnose diseases. There are many more issues involved in establishing a co-operative relationship with your patient. The whole crux of this essay comes down to the fact that everyone is an individual and therefore they feel differently, and that is why they have different perceptions of health and illness.

BIBLIOGRAPHY

Scambler, Graham, Sociology as applied to medicine. 1. Balliere Tindall. London

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The principles of biological classification and the diversity of organisms.

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Put things into groups makes it easier for us to understand them. It also helps us to identify a new object by deciding in which group it fits into. If you find an animal that you have never met before, you can decide, whether it is an insect or a mammal, even if you do not know precisely what is it.

The first person who classificate living organisms was Carl Linnaeus.

Living things evolved over thousand of millions of years. First, single- celled organism appeared. Some of them evolved into more complex organisms.

The things are classified according to how closely are related. E.g. mammals and birds evolved from reptiles so this three, are put into the same group.

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Mammals, birds, reptiles, and insects all have a backbone and five-fingered or pentadactyl limbs. Therefore, it looks as they all evolved from the same group of ancestors, and are quite closely related.

Features like backbone and pentadactyl limbs are called HOMOLOGOUS STRUCUTURES. These are the ones which are built to the same design, but with variations because of differences in the way they are used.

These groups are called KINGDOM. There are five kingdoms bacteria, protoctista, fungi, plants and animals. These groups contains thousands and thousands of different organisms.

Each kingdom is divided into PHYLA that are divided into CLASSES, then ORDERS, then FAMILIES, then GENERA, and then SPECIES.

Species

This is the smallest natural group of organisms. Apart from small variations, members of a specie are almost identical in their anatomy, physiology and behavior. Members of a species also are very closed in appearance to another specie.

One of the main features that determinates whether organisms belong to the same species is whether they can successfully breed together. Closely related species are grouped into a GENUS. Like, for example, stoats, weasels and polecats are grouped into the genus mustela.

Binominal nomenclature

Species must be named in a way that, that name is recognized around the world. For this we use the binominal, that means 'two names', the first name give the genus and the second the specie. For example, the stoat and weasel are both in the genus mustela but they are different species; the stoat is Mustela erminea and the weasel is Mustela nivalis. The name of the genus is always in capital letter and the names of the species always start with a small letter. This last is frequently descriptive.

Arthropods;

This class includes crustacean, insects, centipedes and spiders. It means joined limbs, and this is a feature common to them all. They have a hard external skeleton, called a cuticle. Their bodies are segmented and flexible. In most arthropods the segments are grouped together to form different regions.

-Crustacean they have an exoskeleton and jointed legs. Also two pairs of antennae which are sensitive to touch and to chemicals, and they have compound eyes; this eyes are made up of ten or hundreds of separated lenses with light-sensitive cells beneath. They typically have a pair of jointed limbs on each segment of the body. Example crabs, prawns, lobsters, shrimps and barnacles.

-Insects they form a very large class of arthropods. They have segments bodies with a firm exoskeleton, three pairs of jointed legs, compound eyes and, sometimes, two pairs of wings. The segments are grouped into head, thorax and abdomen regions. Insects difference about all the crustaceans because they have a pair of wings, one pair of antennae and only three pairs of legs. They have very successfully colonized the land. One of the reasons of this is that they have very permeable cuticles, which prevents desiccation even in very hot, dry climates. Example butterfly, bees.

-Arachnids Their bodies are divided into two regions, the cephalothoraxes and abdomen. They have four pairs of limbs on the cephalothoraxes but no antennae. In place of that, there are chelicerae, which are used to hold prey. There usually several pairs of simple eyes. Example spiders, scorpions.

Vertebrates they have a vertebral column. It is sometimes called spinal column or spine, and consists of a chain of cylindrical bones joined end to end. The five classes of vertebrates are fish, amphibians, reptiles, birds and mammals.

-Fish they are poikilothermic vertebrates. Many of them have a smooth, which offers minimal resistance to the water through which they move. Their bodies are covered with overlapping scales and they have fins, which play a part in movement. They breathe by means of filamentous gills, which are protected by a bony plate, called operculum. Fish reproduce sexually but fertilization usually takes place externally, the females lays eggs and the male sheds sperms on them after they are laid. Example sharks, rays.

-Amphibian they are poikilothermic with four limbs and no scales. This name means double life and refers to the fact that the organisms spend part of its life in water and part on the land. They have moist skins with a goods supply of capillaries, which can exachange oxygen, and carbon dioxide with the air or water. They do not have a diaphragma. When females lay eggs, the male simultaneously releases sperms over them. Fertilization, is external even through the frogs are in close contact for the event. Examples frogs, tads and newts.

-Reptiles they are land-living vertebrates. Their skins are dry and the outer layer of epidermis forms a pattern of scales. This skin resists water loss. Also, the eggs of many species have a tough, parchment-like shell. Reptiles, not live in damp habitats, they do not need water to breath. There are poikilothermics but they can regulate their temperature to some extern. Male and female reptiles mate, and sperms are passed into the female's body. The eggs are, fertilized internally before being laid. In some species, the female retain the eggs in the body until they are ready to hatch.

-Birds they are homoeothermic vertebrates. The vertebral column in the neck is flexible but the rest is a rigid structure. The epidermis over most of the body, produces a covering of feathers but, on the legs and toes the epidermis form scales. They have four limbs, but they are modified to form wings. The feet have four toes that help the bird to perch, scratch for seeds or capture prey. The upper and lower jaws are extended to form a beak which is used for feeding in various ways. the fertilization is internal an the female laid hard eggs in a nest were she incubates. The contour feathers cover the body and give the birds its shape and coloration; the large quill feathers on the wing are essential for flight.

-Mammals there are homoeothermic, with four limbs. They have a diaphragm which plays part in breathing. They have mammary glands that produce milk. Humans are mammals. Mammals give birth to fully formed young instead of laying eggs. The eggs are fertilized internally. The youngest's foos is the milk, and when they get older they eat what their parents, like meat or another animals, or plants.

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THE PROS & CONS FOR THE NEED OF CRITICAL & PRAGMATIC APPROACHES IN ANALYSING MEDIA

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The forthcoming analysis starts off with several definitions and confines the main emphasis of this essay to the importance of studying media and the role that media text and messages play in our everyday life. The differences between the 'critical' and 'pragmatic' approaches discussed by Sinclair will also be exemplified in this essay. My analysis will rest heavily on definitions, opinions and several substantiating examples, which will support my arguments.

According to Shibata (00), 'critical analysis' is defined as multiple abilities whereby people receive and interpret information critically through the media. It can also be defined as the ability with which people can read information critically through the media, such as Television, radio, newspapers, the Internet, and to express their opinions creatively. One other alternative way of examining 'critical analysis' is to critically read the "reality" created by the media. An example drawn by Shibata (00) states that the critical use of media is expected to strengthen the democratic structure in society without making the audiences passive and isolated by believing any and all information provided by the media.

Knowing about how and whether we are informed about the world, about power and politics, about art and entertainment is a basic reason for an in depth study of media. Sinclair (00), in his article argues that the media is capable of inducing 'false consciousness' through diversion and misinformation to its consumers. Media as understood is a very influential and widely used medium, it forms so much a part of the social and cultural fabric of any society. In less developed nations, the media forms a part of nation building by way of reaching out to the masses. The production and consumption of cultural representations affects the construction of our identity hence the need for nation-states to regulate content is vital in order to preserve national identity.

In such a context, 'regulation' refers to the attempts of governments to assert control over the content and/or distribution of the media, whether through the screen media, radio or print. An example would be rules set on what content could be brought in from overseas. With reference to this point, it can also be said that "nationalism" can be used to avoid the influence of Western culture in Asia. It is considered from this, that "nationalism" is regarded as a defensive cultural wall for Asians. Therefore, in Asia, the "critical" aspects of media can play the same role as "nationalism". Critical use in media in Asia exhibits a unique character - preserving Asian culture by criticising American or Western culture.

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According to McKee (001), when one performs textual analysis on a text, an educated guess of some of the most likely interpretations of that particular text is made. 'Text' as mentioned by McKee (001) actually refers to television programmes, films, newspapers, magazines and radio programmes. Understanding the role that media plays in our lives and precisely how its messages participate in the cultural construction of our view of the world is a vital point in analysing media.

The aim of analysing media might be to reveal how audiences are manipulated and deluded by stereotypical or intransigent material. Take for example the ongoing war between the United States and Iraq. On one hand the Iraqi media is portraying numerous civilians severely injured as a result of the US bombings on Baghdad, however the United States are insisting that their bombings are only on strategic military targets.

As mentioned by Bazalgette (000), the politics of media affect our lives as much as the politics of Parliament or Congress. It not only wakes us up to the influences we previously knew about but were not fully aware of, it also challenges us to take new and alternative perspectives on any text. As expanded by Bazalgette (000), one of the strengths of media studies is precisely that it queries us to consider texts from different and often sharply contrasting perspectives. Bazalgette (000) also moves on to explain that what media studies really does is to open up our understanding of how things work, how people become informed or misinformed, and how the ideologies that govern our lives are created and sustained.

In Sinclair's article (00), pragmatic approaches depicted examples of positivism and American empiricism in media. Propaganda was cited to be use as a positive force for building popular sentiment and public opinion to invoke other concepts. Sinclair moves on to specify that similarly to positivism, such sciences were based on forming knowledge through direct observation and laboratory experiments. 'Content analysis' in such context was devised more as a systematic and quantifiable method for the description and analysis of the meaning of media messages. This was primarily to determine what content messages contained, and the effects it had on its consumers.

One point proposed by Thompson (15) supports the pragmatic conception of ideology. This focuses attention on ways in which symbolic forms serve to establish and sustain relations of domination. If ideology were conceptualised in this manner, the development of media would greatly increase the capacity to transmit potentially ideological messages across extended stretches of time and space as suggested by Thompson (15). He also moves on to discuss that as much as it is vital to emphasize on the contextual character of ideology, whether mediated messages are ideological will depend on the ways in which they are taken in by individual recipients and incorporated in their own lives. McKee also acknowledges that there could be many feasible interpretations of the same text.

In conclusion, the denotation of studying media not only aids in developing critical thinking skills, but likewise has helps us understand at first hand how media works are designed to influence and reflect on new perspectives. As pointed out in this essay, media can easily manipulate and delude its audiences and readers with stereotypical material. Even as content providers continue to push their content on users rather than users determining what they want to read and view, an analysis of the critical use of media has been expounded on in detail. We studied here, how the critical use of media is an enabling tool for audiences and readers to cope with media industries potential to "control" the recipients of their products. We were also aquatinted with other vital factors such as being aware of whether we, as consumers are being fully informed of the world's happenings. In short, media plays a crucial part in moulding the cultural structure of any nation. Regulation in less developed nations is thus stringent as a precautionary action to preserve the national culture. Hence highlighting the importance of studying media has helped us scrutinise the role that media text and messages plays in our everyday lives.

Please note that this sample paper on THE PROS & CONS FOR THE NEED OF CRITICAL & PRAGMATIC APPROACHES IN ANALYSING MEDIA is for your review only. In order to eliminate any of the plagiarism issues, it is highly recommended that you do not use it for you own writing purposes. In case you experience difficulties with writing a well structured and accurately composed paper on THE PROS & CONS FOR THE NEED OF CRITICAL & PRAGMATIC APPROACHES IN ANALYSING MEDIA, we are here to assist you. Your cheap research papers on THE PROS & CONS FOR THE NEED OF CRITICAL & PRAGMATIC APPROACHES IN ANALYSING MEDIA will be written from scratch, so you do not have to worry about its originality.

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"Huckleberry Finn"

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The main theme of The Adventures of Huckleberry Finn is adventure. The adventures of Huck show different emotions and the different roads of life. Mark Twain, the author, uses setting, theme, imagery, satire, characterization, and other elements.

Satire is used of human nature when Huck sees Sherburn shoot Boggs, who everyone knows is harmless. When the angry mob goes to lynch Sherburn, he takes a stand on his porch. Sherburn then himself makes his speech. He accuses the men of being cowards. He says that no one really wants to be there and everyone is afraid. He goes on to say that they failed to bring a true man, someone to follow who is brave and has a purpose. After the end of the speech, the crowd disperses. The speech was so powerful that it made Huck think, I could a staid, if Id wanted to, but I didnt want to. Twain uses Sherburns speech to satirize the average man. Huck learns from this experience about the average man and his limitations. This is a constant theme throughout the book as Huck is always learning and playing on the nature of humans. Through the killing, the speech, and Huck's emotion, Twain used satire to portray all the details to create an astonishing way for Huck to show his thinking.

Characterization is an element that Twain used strongly to show what type of person Huck really was. In the beginning of the story, Huck had no aversion to slavery. In the middle he meets a slave and helps him escape to freedom. In the end, Huck has a totally different view of blacks. The slave's name is Jim. Huck's characterization is showed when Huck's teacher talks to both Huck and Jim and therefore creates the difference in the way Huck and Jim talk. This gives Huck character. In the book it is from pages two to five. Huck grows and matures while learning things through Jim. Huck discovers the evils of society, but also discovers his own moral values. Twain shows Huck's characterization through the story by Huck's changes. Huck becomes more mature while taking the steps into manhood.

The setting is a very important element used in this story. The novel is set it St. Petersburg, Missouri, a town on the Mississippi River. The setting is natural meaning it's in a real town, not a fictional spot made up just for the story. Twain uses setting to bring out the bittersweet reality of the town. During this time racism is still strong and present, however it isn't as bad as it was in the previous history. Twain makes the town create the strong feeling of voice through the way people talk and their actions done. The setting of when and where the story takes place makes all the other aspects of the story come true. Help with essay on "Huckleberry Finn"Mark Twain used basic element to create a masterpiece. Twain used characterization, satires, and setting very strongly throughout the whole book. The elements made the story what it really is. I would recommend this book to anyone who likes reading about people's life and their adventures. It was a great book and made me feel like I needed to go out and learn more through others.

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Human relation

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¡°Maria Simmons is Director of Human Resources in a large metropolitan bank. Shi is 54 years of age and has achieved her position, after years with firm, through hard work starting at the very bottom level in the bank as a service clerk. Maria has a Bachelor of Commerce degree, majoring in economics and accounting.¡± (Peter, 00)

As we know, Maria is a very nice lady; she has enough experience in her career. She loves her job; she works very long hours and weekends. Maria likes to work with her colleagues and her subordinates. She also has a strong personality such as smart, conscientiousness, hardworking, optimistic and good communication skills. She has a good relationship with her bosses colleagues and subordinates. However, she is not a perfect people; Maria still has some disadvantages in her job and personality. She is too subjective and bigotry sometimes, she has too many stresses when the bank became more hierarchical and bureaucratic and she has lots of bifurcations with the new CEO of this bank. Because of these bifurcations, she has become negative, stressful. Furthermore, she wants to change another job which she never used to do. Therefore, Maria still needs to improve her behavior and personality in her job.

Maria likes to talk with her colleagues and subordinates, she has very good human relations with people, this is an effective human relations and it consists of nine guidelines ¡°be optimistic, be positive, be genuinely interested in other people, smile and develop a sense of humor, call people by name, listen to people, help others, think before you act and create win-win situations.¡±(Robert, 001) Through these nine guidelines, she can know her colleagues and subordinates' thinking, their ideas, their job satisfaction and also she can help them to solve their work problems. Therefore, Maria could create a win-win situation for the relationship between her and her subordinates. In addition, Maria likes to communicate especially face to face with her subordinates about their suggestions for possible ways to improve work procedures. This is very necessary to make mutual understanding between bosses and employees. Through this kind of communication, Maria can know the disadvantages of the work process, the positive or negative performance of the employees. After the talking, Maria can find solutions to motive, to improve the work process or employees' behavior to achieve a new level. Even there are some problems in the workplace; Maria tries to look at it from a variety of perspective with a view toward meeting the needs of other people (Peter, 00). She will not have the simplex view to look at the problems, she will have a group work to discuss and analyze the problems. Through these kinds of group focus, it could be more united and the problems can be solved easily. Maria has a Type A personality, which is characterized ¡°as fast moving, hard driving, time conscious, competitive, impatient, and preoccupied with work.¡± (Robert, 001).She signed the work contract, which only covers 40hours per-week. However, she works very long hours and weekends voluntarily, and she told her friends that the most important thing is being a well-respected and professional Director. Why does she work a long time and think the most important thing she could do is her job? The family problems maybe are the most direct causes in her life. She has no close family ties now and she had been divorced. Consequently, the job is the only thing she could do. For instance, lots of women could give up the very good jobs because of their family, their children. However, Maria is unmarried and has no children; she could not compare the import between family and career. That is just the possible reason why she works long hours without salary. Maria is very forthright director, she told her a colleague that she was a lot happier now as a manager of other people than she was as a service clerk (Peter, 00). That looks she is very pretension. Nevertheless in my opinion, she is a forthright lady; her speech may motivate other people's behavior. When you have a good, step by step work performance, everyone can get a good career; Maria is the good example.

However, Maria still has some problems in her personality such as bigotry, subjective, pretension; she is not a perfect people. ¡°When she hires new service clerks, she tends to prefer hiring younger people who have a Bachelor of Commerce degree with a major in accounting.¡±(Peter, 00).She has got the same degree of accounting, thus Maria want to employ people who have got the same degree because she is a successful example. She is too subjective. Different people have different personality, different attitude and different intention. Nowadays, a lot of young people have absolutely different thinking, and also we suspect their professional knowledge. Furthermore, when some problems were found, she would like to find solutions but not accepted others' methods because she takes a long time to produce them (Peter, 00). Another problem of Maria is pretension. She had been nominated for professional award as a quality mentor for women in human resource management roles by a women's leadership group (Peter, 00). However, Maria said she don't want to get the nomination and award because it is her responsibility. It will have a negative effect for other women. Another problem of her pretension was the inadvertent mistake which she hired a dishonest employee. Someone suggested that she should redesign the selection processes, but her response was pretension. Though she has a very effective human relation with her colleagues, but it still will cause some relation problems in the workplace. Nowadays, as the bank becomes larger and larger, a new CEO came into this bank, and he requires that managers and directors should direct and stick to the process of the work (Peter, 00). This sudden changing causes lots of problems, especially Maria's work environment. As mentioned above, Maria likes to work with her colleagues and subordinates. However, this work method is absolutely different with the new CEO's. She has spoken and explained to the CEO about the group works' effect for the bank, but it does not work. ¡°After three months later, Maria has been losing weight, looks constantly tired, is short-tempered and emotionally fragile and is taking more and more about looking for another job; things she never used to do.¡±(Peter, 00).In addition, Maria has avoided meeting the CEO on some meetings. She has too much negative stress about the work environment. ¡°Too much stress affects personal health, morale, productivity, organizational efficiency, absenteeism, medical costs, and profitability.¡±(Robert, 001).we can see Maria has all the characteristics of the stress; loses weight, looks tired, low morale and absenteeism. Why this could be happened? Because the organizational climate has been changed, the management behavior has been replaced, the degree of job satisfaction has been weakened. Maria has lost interest in and motivation to do her work because of the work environment stress. Her work behavior is very dangerous. She should adjust her behavior, and there are some advices for Maria to decrease stress. She can do some exercises and relaxations such as watch a movie, take a walk, have some fun and laugh. She has to have some nutrition like breakfast. The most important things Maria should do are positive thinking and talking to her friends. She need to think about the CEO said and try it, maybe it will more effective or not, maybe after two or three months later, the CEO will change his mind. Do not always think his require is useless, Maria should learn how to change her work environment.

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Comparing the Effects of Pain Coping Interventions on Functioning and Quality of Life: A Quasi-Experiment

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Comparing the Effects of Pain Coping Interventions on Functioning and Quality of Life

A Quasi-Experiment

Abstract

Objective To determine the extent to which an intervention aimed at increasing client participation in their own care (?) improves outcomes in the treatment of recalcitrant chronic pain.

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Participants Participants have experienced a variety of other treatments without success. They are referred by physicians to the "experimental" arm (Arm I), which is funded by public insurers; or to the "control arm (Arm II), which is not. Treatment is cognitive-behavioural therapy (?) in both arms; but Arm I also involves ….. (?)

Methodology Quasi-experimental design, pre-and-post study. Referrers are blinded as to differences in intervention style. Data collection is at enrolment, at discharge, and 6 months post-discharge. Data are entered into SPSS and compared using Student=s t-test or repeated measures ANOVA as appropriate. Variables include demographics, health status (SF-1), depression level (CES-D), a variety of pain management scales, employment status.

Outcome Measures Changes in health status, in limitations and level of activity, as indicated by the short for of the Medical Outcomes Survey (SF-1). Changes in use of pain relief techniques, as indicated by the Pain Relief Log (PRL). Degree of disability, as indicated by the Pain Disability Index b(PDI). Health services utilization. All data are collected at enrolment, discharge, and 6 months post-discharge

Results N=6; 58% male; mean age 46.1. By follow-up, there was a trend toward decreased use of emergency rooms for pain management (NS) in both arms. PDI declined from 4.7 to 6. in Arm I, and from 45.8 to 44.1 in Arm II. PRL declined from 16 to 11 in Arm I, and increased from 1 to 16 in Arm II; similarly, mental component scale scores from the SF-1 improved from 0.1 to 6.4 in Arm I and declined from 8.4 to .5 in Arm II. The Sf-1's physical component scale scores improved from 8.5 to 5.0 in Arm I and from 8.5 to 1.4 in Arm II.

Conclusion These results indicate that, even though clients= pain levels do not change, their abilities to function improve more substantially in the "experimental" arm. Thus, the intervention appears to produce the desired outcomes, and may merit further study.

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Unnecessary Ob-Gyn Procedures

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Reprint of Article seen on

HealthNewsDigest.com

NEW BOOK EXPOSES PROBLEM OF UNNECESSARY

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OB-GYN PROCEDURES

When a physician discovers pre-cancerous or dysplastic cells in a female

patient, the immediate recommendation is often invasive and sometimes

aggressive; the better-safe-than-sorry philosophy usually secures patient

agreement. But, according to the author of the new book Dysplasia, women

would be wise to think twice before conceding to the wisdom of their

OB-GYN.

The discovery of gynecological, pre-cancerous conditions in women prompts

understandable fear, says Brad Lewis, author of Dysplasia. The result can

be costly, unnecessary procedures completed by overly-aggressive

physicians.

Lewis claims a financial incentive drives doctors to recommend procedures

to resolve conditions which often pose no immediate health threat, and

which may be mitigated naturally or via less intrusive means. OB-GYN

physicians, faced with extensive overhead and investments in costly medical

equipment, hastily recommend procedures which appease the emotions of the

patient, but which can be medically unnecessary.

Dysplasia, a medical thriller, provides an in-depth look at the

inner-workings of a renowned OB-GYN practice, and probes sensitive medical

issues including the unethical and unsavory practices of some physicians.

Lewis, who relied on his own medical training and extensive research for

Dysplasia, hopes his entertaining novel will also serve as a real-life

wake-up call to women.

Dysplasia is reality-based fiction, he notes. Important information can

sometimes best be relayed and accepted when it is presented in a

non-threatening manner.

The bottom line Women need to be aware of aggressive male doctors whose

recommendations should not be taken as gospel, adds Lewis.

There are various types of pre-cancerous conditions; patient education and

second opinions can prevent the stress, discomfort and danger of

unnecessary procedures. The best and simplest approach between patient and

doctor is for the patient to be advised of exactly what the doctor knows,

and then let the patient decide whats next. There are tremendous

variations in what is considered normal vs. atypical. Dont jump to surgery

until you and your doctor are sure.

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