Youth Drug Abuse In Hong Kong Social Work Essay

Youth Drug Abuse In Hong Kong Social Work Essay Drug abuse is nowadays a more and more urgency youth problem all over the world. As an international commercial city, Hong Kong is exposed to this social problem as well, which bring enormous social and economic cost to individuals, families, communities and the whole society there. It is really an issue which requires the public to pay much attention to. In this paper, the author introduced the contemporary situation of teenager psychoactive drug abuse in Hong Kong (including these young peoples population and age, as well as the tendency, the most often use chemicals and arenas), the negative impacts of drug taking on youths in the context of the timing points in human development. Then, the author utilized a bio-psychosocial model, discussed about the original risk elements conducing youth problematic behavior of drug abuse from three aspects: individual, family, and peers. At last, in terms with these relevant reasons, the author brought forward some suggestions for social worker profession, which may serve as useful strategies in coping with youth drug abuse in Hong Kong. Keywords: young, drug abuse, social work Introduction Literature review Definition Drug Is it a concept too simple to define? In fact, drug contains various components. After long-time being influenced by social-cultural context, it becomes more complicated to clarify. For example, is drug therapeutic, or not, or both? The World Health Organization (WHO) described drug in 1981 as any substance or chemical that alters the structure or functioning of a living being. Rassool went further on this phase in his book Alcohol and Drug Abuse (2001) as: A drug, in the broadest sense, is a chemical substance that has an effect on bodily systems and behavior. This includes a wide range of prescribed drugs and illegal and socially accepted substances. Many methods have been used to categorize drugs. For instance, counting in legal and moral, drug is divided into prescription medicine, illegal or illicit drug, and over-the-counter medication. However, they are often intersectional in actual society. Drug abuse Drug abuse, also known as substance abuse, has its public health definitions and medical definitions, all of which express an implication of negative value judgment (Jenkins 1999). In universal meaning, it refers to the taking of drugs without following medical advice or prescription, or the indiscreet use of dangerous drugs for non-treatment purposes. An estimation the UN made tells us there are over 50 million regular drug users all around the world. Though the total number shows a decreasing trend recent years, the age begin to use drug evidently constantly lower. How people take drugs? Existing researches state that Narcotic, Marijuana, Hallucinogen, Cocaine and Amphetamine are all gebraeuchlich drugs, while Cocaine is always reputed as the champagne of drugs and enjoys the greatest appeal for drug users. To further extend oral, smoking, inhalation or sniffing, injecting are the most often routes of drug administration. Drug abuse not only makes impairment on users physical and psychological health, but also brings a host of social and economic problems to the domestic families and the whole community. Furthermore, illicit substance misuse is usually companied with many other deviant behaviors, like alcohol, organized crimes, anti-social activities and so on. It is no surprise at all that drug abuse is a serious social problem now owning to its enormous social and economic cost. Young people Young people, also called young person, youth, shares a communal meaning with teen and teenager, but is different from another purely scientifically-oriented phraseadolescent. In fact, the term youth is ambiguously the time between childhood and adulthood, thus its age boundary line is varied all over the world. In Hong Kong, as a rule, people between 14 to 21 years old are considered as youth. Youth is a predominantly important phrase in human development. Naturally, it is the time that young people: are encountered with dramatic changes in physics, psyche, emotion and social network; commence self-identity forming; urge and begin to seize power on experiencing, adventuring, risk-taking and authority challenging; are particularly possible to be influenced by surroundings on behaviors and lifestyle; are not so close to family and parents as before while attaching importance to peer group membership and peer approval. As far as we can see from below, youths are resourceful, while vulnerable at the same time. Current situation of Youth drug abuse in Hong Kong As stated by the Central Registry of Drug Abuses report in 2008, while the total number of reported drug abusers continually declined, young people below twenty-one years old showed a dramatically-increasing trend: 1002 youths involved in drug abuse in 2002, and then decreased to 2186 in 2004. After that, the number ceaselessly rose to 2894 in 2007. It should be mentioned that the age of lifetime trying of drugs has been dropping apparently (The 2004 Survey of Drug Use among Students, November 2005; Narcotics Division, Security Bureau, HKSAR; Chan, Chu, Wong, Yu, 2005; Chen, et al., 2005; N. W. T. Cheung Cheung, 2005; Ho Liu, 2005; Laidler Pianpiano, 2005; Lam, Weng, Wong, Tse, 2004; Sung, 2001; Youth in Hong Kong Statistical Profile, 2005: report submitted to the Commission On Youth). However, we shouldnt overlook that the real number of youth drug use should be far more. Memo ammonia ketone, which is also called K Tsui, is young peoples most frequently used drug, following is ecstasy and cannabis. Additionally, they often enjoy drugs in their own or friend houses, or public disco/karaoke. All in all, youth drug abuse in Hong Kong is already an alarming matter which should be tackled as soon as possible. It has posed a great threat to the families, the government, and the whole society. Impacts on youths Drug use in teenager group is usually association with physical and psychological morbidity, social disabilities, and presented as a mixture of them. WHOs discovery (2003-04) may offer us a clear angle of view about drug misuse influences on young people: Physical Peri-oral and peri-lesions caused by inhalation or snorting; physical injuries incurred during intoxication; agitation after poly-drug or prolonged use; needle tracks, thrombosis or abscesses owing to intravenous use; withdrawal syndromes; changing in brain structure. Psychological Mood changes (especially depression and anxiety); confusion; personality disorder; depression on withdrawal of simulants; irritability as part of withdrawal syndrome; deliberate self-harm or suicide attempt; psychosis due to drugs effects on neurotransmissions. Social Deteriorating educational performance; family conflict; crime such as petty associated with intoxication, theft to provide funds, dealing as part of more serious association with drug culture. However, many problematic youths preferably evade reporting their drug abusing problem due to two main reasons. Firstly, young people pursue freedom and independence, and resist pressure from legal, family or society on their difficulties with drugs (Milgram Rubin 1992). Moreover, most early drug users do not look themselves as substance reliers so that they do not seek any professional treatments until the problem gets too serious to recover. Latent drug abuse may go further to be a lifelong problem for teenagers. Origin of youth drug abuse In the last half a century, there has been a surge of interest in, and a plethora of studies on substance abuse in youths. Foremost among these are studies on drug abuse. Several theories are in the way to explain the original reasons for youth drug abuse, such as moral theory, disease theory, genetic theory, psychological theories and socio-cultural theories. Integrating all of their conclusions related to the origin of youth drug abuse, it is not a single factor but a combined effect of several risk factors predisposing young people to use illicit drugs, which can be divided into five levels in accordance with bio-psychosocial perspectives: biological determinations, youth psychological development characteristics, interpersonal elements (include family functioning elements and peer influencing elements), community variables, and societal factors. Weiner (1992) made a splendid contribution on clarifying causes of youth drug abuse. He referred to the achievements of Brook with his collaborators (Brook, Nomura, Cohen, 1989; Brook, Whiteman, Gordon, 1983), pointing out that personality, family, and peer determinants are the most closely related factors for teenager substance abuse. On the word of Weiner (1992), one factor exerting a particularly strong influence can be sufficient enough for a young person to become drug-involved, even though the other two factors are minimal. The triad of primary elements-teenagers personal variables, family functioning, and peer relationships-serves as the center of bio-psychosocial model related to young peoples involvement into substance abuse. Thus, we will focus point on these three and go over community and society as well. Personal factors When negative psychological characteristics, personality and personal experiences work together, young individuals will inevitably have ability of resiliency weaken. In other words, they will lack coping skills in case of environmental challenges, and lean to drugs either voluntarily or passively. Psychological characteristics of developing phase As what has been discussed above, youth is such a time people urge to grasp any chance to take adventure, challenge authority and enjoy the pleasure of independence. So, it is understandable that young people consider taking drug as an approach to show recreation, to alleviate boredom, to feel confident, and to be hard (Home Office, 2007). personality It has been demonstrated that lower teenagers self-efficacy, self-esteem and sense of competence are, more stress-vulnerable they are (Cowen et al., 1990). When internal or external difficulties happen, the ones will have more risk to take drugs, get buzz so as to escape from their problems, which winds them into a bigger possibility of indulging psychoactive substance. personal experience Young people who have miserable personal experiences now or in the past are especially vulnerable to problematic drug use. These groups include: truants, those excluded from school, the homeless, those look after by local authorities or in foster care, young offenders, those involved in prostitution, children from families with substance-abusing parents or siblings and young people with conduct or depressive disorders (Lloyd 1998). Family functioning As the primary environment for individuals growth, family shares a powerful and intimate connection to youngsters involvement, exacerbation, and relapse of drug problems. Family calls attention here because it shares a codependent relationship with youth drug problem, which means while addiction affects abusers family, the family are making effect on individuals substance taking at the same time. According to Muisener (1994), four categories of factors related to familys function in teenager drug misuse are: Major family life: changes in family structure, family composition, geography, ethnicity, socioeconomic status Family dynamics: leadership, boundaries, affectivity, communication, and task/goal performance Family dysfunction especially substance-abusing parent(s) Family relationship especially relationships between parents and youths In considering these four, relationship factors are most consisted with the childrens drug using problems (Brook, Arencibia-Mireles, Richter Whiteman, 2001). Parenting practices including low or excessive monitoring, ineffective discipline, and poor communication with children are all imperative variables in youths initiation and maintenance of drug abuse problems (Liddle, Rowe, Dakof Lyke, 1998; McGillicuddy, Rychtarik, Duquette Morsheimer, 2001). Peer relationship In the phase of youth, peer group is able to be as important as youngsters second family, and makes heavy impacts on their values, beliefs, and behaviors through interpersonal relationships with each other. As like family environment, peer relationships also serve as a perpetuating environment for teenagers involvement into substance abuse, mainly by two categories: Peer crisis It is also called as peer shock by Elkind (1984), and can be broken down into three types: the shock of exclusion, the shock of betrayal, and the shock of disillusionment. Substance-abusing peers This peer cluster can be a strong influence in youngsters initial and ongoing usage of chemicals (Oetting Beauvais, 1986). Friends reinforce others drug habit through driving them into this group activity, encouraging them to carry on drug using, and fostering their denial of drug problem (Shilts, 1991). In most cases, peer crisis and abusing peers are interacting with each other. For example, a young man who has been excluded from other friends enjoying psychoactive drugs together will have to pay the price of participation into the shared group activity, so as to maintain the membership in this peer group. Later on, he will suddenly find that he is eliminated by other groups. In order to have sense of belonging, he has no other choices but to stay there and develop into a drug abuser. Additionally, peer influence may become more powerful in situations where a young person lacks support, understanding or affection from parental figures. Community and society As part of youngsters surroundings, communitywhich is composed of schools, community organizations, police departments and criminal justice systems, other local government institutions and servicescan also act as risk factors increasing their likelihood of using psychoactive substances. In a larger scope of the whole society, youth culture and music, social acceptability and the media, may also lead to teenagers initiation and continuation of drug misuse. More direct and special, illicit chemicals are accessibility for youths in Hong Kong society. It is worth mentioning there are extra elements in continued substance use. Rather than by rational decisions, the reasons why people dont cut out taking drugs may be more related to combined factors, such as individuals physiological dependence on psychoactive chemicals, chaotic use, psychological fear of withdrawal symptoms, social exclusions, mental health problems and other environmental elements. Such situation is very common for most drug misusers: they actually have tried to stop taking drugs, but are only able to rationally do this for short periods of time rather than everlasting withdrawal from illegal substances. Strategies for social work on youth drug abuse Basing on information from the Narcotics Division, Security Bureau, HKSAR, the Hong Kong government has taken a number of measures related to youths drug abuse into action. These include law requirement, policy reinforcement, and promotion activities. On the other side, the jointed work of social worker and doctors is another universal type in running drug treatment and rehabilitation programmes in Hong Kong, such as compulsory placement programme, counseling programme and substance abuse clinic. Nevertheless, as new drugs are endlessly brought in, or old drugs are experienced again by a new generation, all the efforts only have a short-term effect on substance abuse among young people, and continued progress in eliminating drug abuse has gradually slowed down as well (Johnston et al., 2008). Social work is such a profession best prepared to deal with social problems and assist disadvantaged groups. In terms with the original reasons of youth drug abuse, social worker may also initially handle this problem from three aspects: individual, family, and peers. Individual Prevention and health education This method is widely conducted by doctors, government, mass-media and community. It is mainly used in drug preventive process and emphasis publicizing knowledge of drugs, consequences of use and promoting antidrug use attitudes to public at large. Social workers bring professional features in this process. For instance, social work may host discussion, experiential activities, and group problem-solving exercises in school, communities, and other public places. Further causes probing Since variety of negative factors are able to bring young people risk for contacting illicit drugs, social workers should try them best to find hidden and real causations, and prevent or healing problematic individual through coping with latent issues first. Individual counseling can be conducted this part. Self-potency enhancing According to Shamai (1994), some personality traits can typify youth in distress, such as impaired self-control, low self-esteem, self-confidence and self-satisfactory, sense of coherence, low level of aspirations and little hope for the future. Empowerment is one of the major measures social work profession utilizes. Setting in substance addicted teenagers, what social workers can do includes to bring youths a positive attitude towards their drug dependence, to help them develop skills against peer influence and pressure, improve self-efficacy and self-control capacity. Cognitive-behavior therapy is considered useful in self-potency enhancing for youth involved in substance abuse, which processes of instruction, demonstration, practice, feedback and reinforcement. Personal and social skills training Individual resources are qualities that enable youth to contend with negative life events and stressful situations (Ben-Sira 1993; Lazarus and Folkman 1984). Social worker may work with organization such as youth centers, communities here. To assist young people, either who have already taken psychoactive chemicals or who have the danger for touching drugs, to gain personal anti-drug skills, social work will teach them how to reduce their anxiety, how to apply generic skills to resist substance-use influences, to establish non-substance-use norms, and so forth. Useful methods include recreational activities, behavioral rehearsal, resistance-skills training, and practice via behavioral homework. In terms with social skills training, communication, use of same age or older peer leaders, vocational training, social and assertive skills, participation in community service projects are all possible methods social workers can make use of. Family According to a recent view of environments role in addiction (Nader and Czoty 2005), owning a less stressful and more privileged environment may help individuals enlarge the protection from addiction or relapse during recovery process. In this way, teenagers original family should be considered as a recovery environment and a focus of treatment. While family recovery and family therapy are widely used in recent years, social workers roles there are mainly releasing risk elements associated to youth drug abuse, and assist families to offer continuum of care and support for problematic young people in drug recovery. Family recovery skills can be categorized into family addiction awareness, family development awareness and strengthening family dynamics, in which social workers can serve as assistances and organizers. Peers In or before the process of giving up drugs, most of these problematic teenagers are usually faced with exclusion from young persons who do not take illicit chemicals. However, to get out of drug abuse, they should complete dual challenges or missions: giving up former young companions, and making new friends with others who do not abuse chemicals. Rather than force youths to get out of old friends, social workers should assist youths to make new friends for his support and social needs. Group work is an effective method here. One is group treatment, which includes chemical awareness group and abstinence support group. Teenagers in recovery get together, share their experiences, thoughts, feelings, and skills to avoid drugs. They can also claim to give up taking chemicals, which is demonstrated an impactful way. About another kind of group work, several addicted young people will be planned to stay with others who dont take drugs. By sharing their experiences and decision to avoid chemicals, the disadvantaged ones will enjoy the chance to make new friends, as well as get support from them, which is extremely important in preventing their doom to relapse in recovery.

Intravenous therapy is an infusion of medicine and fluids into vein

Intravenous therapy is an infusion of medicine and fluids into vein BACKGROUND OF THE STUDY Intravenous therapy is an infusion of medicine and fluids into a vein. IV therapy is essential part of clinical use. There are also complications which included in IV infusion are local and systemic, local include thrombophlebitis, infiltration, extravasations, nerve injury and systemic include bacteremia, septicemia, emboli, thrombus, circulatory overload etc . Thrombophlebitis,Thrombo means clot Phlebo means vein and itis means inflammation. Thrombophlebitis refers to the presence of a clot plus inflammation in the vein. Phlebitis is defined as the acute inflammation of internal lining of the vein Infusion Nursing Standards of Practice (2000). According to international association of pain (IASP) (1994), pain is an unpleasant sensory experience associated with actual and potential tissue damage. The pain is classified as nociceptive, neuropathic, acute and chronic pain. The nociceptive pain is caused due to damage to somatic or visceral tissue damage which pain from surgical incision ,a broken bone, or arthritis ,the neuropathic pain is caused by damage to peripheral nerves or CNS which include trauma, inflammation ,metabolic diseases like diabetes mellitus, tumors, toxins, and neurologic diseases such as multiple sclerosis and acute pain is dure to post operative pain ,labour pain, and pain from trauma and the chronic pain is for longer periods due to cancer. Pain is a highly unpleasant and professional sensation that cannot be shared with others. It can occupy all a personal thinking, direct all activities and change a person. Yet pain is a difficult concept for a client to communicate. Pain is universal experience its exact nature becomes mystery. Unrelieved pain presents both physiological and psychological hazards to health and recovery. Care givers should include assessment of pain as a fifth vital sign to emphasize its significance and to increase the awareness among the health care professional of the importance of effective pain management. There are many non pharmacological measures which is provided including massage, exercise, transcutaneous electrical nerve stimulation, percutaneous electrical nerve stimulation, accupunture heat therapy, cold therapies, and cognitive therapies including distraction ,hypnosis and relaxation strategies. Edema which is the accumulation of fluid in subcutaneous tissue due to extracellular volume expansion. There is swelling of tissues which can be demonstrated by pressing lightly with the thumb over a bony prominence especially on dorsum of feet and around the ankles. The types of edema include hydrostatic edema, oncotic edema, inflammatory and traumatic edema and lymphatic edema. Phlebitis can be classified into 3 three categories which include mechanical, chemical and bacterial where mechanical is due to the size of cannula is too big for the selected vein causing unnecessary friction on the internal lining leading to inflammation, chemical phlebitis is due to peripheral IV devices when the medication or solution irritate the endothelial lining of the small peripheral vessel wall and bacterial phlebitis is usually precursor to an infection at the infection site. Thrombophlebitis is evident by localized pain,redness, warmth, and swelling around the insertion site or along the path of the vein,immobility of the extremity because of discomfort and swelling. Non pharmacological treatment includes discontinuing the IV, applying a warm compress, elevating of the extremity, and restraining the line in the opposite extremity .In the presence of signs and symptoms of thrombophlebitis, one should not attempt to irrigate the line. Pharmacological and non pharmacological agents are available for relief of pain, edema and inflammation. The cost and side effects are comparatively high in modern medicine. The number of client seeking unconventional treatment has risen considerably. Nonpharmocological therapies, natural therapies, cryotherapies, and aromatherapies are available with less expensive and fewer side effects. Likewise in combact aloveragel is also very much used in reducing pain, edema and severity of inflammation. For local treatment in order to relieve pain, edema and severity of inflammation alovera gel can be used. Since in the era of Ancient Egypt humans having using aloe. They used one of the ingredients of embalming fluid. In the tenth century, the Europeans were introduced, where it became an important ingredient in many herbal medicines. By the sixteenth century, aloe arrived in the West Indies, where still today it is harvested. Alovera is one of the therapeutic herbs as a healing plant. The uses of aloe of popularized in 1950s itself.There are over 300 different types of aloe, but only a few were used traditionally as an herbal medicine. In the middle ages the yellowish liquid found inside the leaves was a favored as purgative. Aloevera gel is the mucilaginious gel produced from the centre (the parenchyma) of the plant leaf. It contains 400 species.The gel portion of the plant is prepared by peeling the outer portion of the skin and the pericap away. It is preparation which is called pure aloevera gel in commerce. Aloevera is thick, tapered with spiny leaves grow from a short stalk near ground level. It is not a cactus, but a member of the tree Lilly family known as Aloe Barbandesis. Some species , in particular Aloevera are used in alternative medicine and in home first aid .Both the translucent inner pulp and the resinous yellow exudates from wounding the Aloe plant are used externally to relive skin disc omforts. The gel found in the leaves is used for soothing minor burns, wounds and various skin conditions like eczema and ringworm. Aloevera gel has both antimicrobial and anti-inflammatory effects. The constituents include gibberlin,lectins,lignins,glucose ,mannose, glucuronic acid other polysaccharides including galctogalacturans and galactoglucoarabinomannas.The most abundant constituents is water(99%).The aloevera gel contain anti-inflammatory agent gibberlin and polysaccharides which effectively decrease inflammation and promote healing.Aloevera effectively relieves pain because it contain salicylic acid .Aloevera contain ligin which helps to penetrate deeply into skin to deliver its therapeutic effects. Most of the nursing interventions fit comfortably within the real of the natural therapys the illness healing paradigm shift and converge, and role of nurses shifts can gives to the healer. Therefore aloevera gel could be a suitable intervention which helps the nurse to reduce pain, edema and phlebitis. NEED FOR THE STUDY IV therapy has become a pervasive world wide as a routine therapy. Nurses yearly still insert, use and monitor millions of peripheral venous catheters (PVC).To diagnose and assess phlebitis severity is essential as a way to prevent a host of severe complications such as septic phlebitis, bacteremia, septicemia, arthritis, osteomyleitis eventually leading to death. However it is still prone to associated complications, of which phlebitis is most common, with prevalence varying between 20% to 80% Workman (2000). Villicampa (2008)Spanish review a national multicentric epidemiological study having the institutional participation of 10 centres. In this study 381 complications appears in the 2701 peripheral catheters studied which represents an incidence level of 14.11%.They reviewed 8700 treatment records this study proved that implementation of strategies to improve the quality of care reduces non instrumental complication persistent pain at the entrance point ,extravasations of edema, second or third degree phlebitis and infection associated with catheters. Nassaji Zaveareh (2007) conducted a prospective study on peripheral interventions catheter related factor .In this study 300 patients admitted to medical and surgical wards from April 2003 to Feb2004 were participated. Variables evaluated were age ,gender, site and size of catheter ,type of insertion and underlying condition were observed for 3 days continuously. Out of that 26 % occurred phlebitis . There were no significant relationship between age catheter bore size trauma and phlebitis. Related risk factors were gender,ie.,female site and type of insertion of catheter, diabetes mellitus and burns. Important role of nurse is to control pain that of thrombophlebitis. The quality of care received in the hospital was often reflected in client care. Among paramedical profession, nursing personals were inserting intravenous line, monitoring, administering intravenous fluids and administering medicines. Maintenance of peripheral intravenous cannulae and removal of peripheral cannulae was an integral component of nursing care. Nordell, et al.,(2002)in a study of 52 patients, found 5 diagnosed cases of thrombophlebitis (10% ) .Out of fifty two patients twenty six hand or wrist venipunctures, he found 3 with thrombophlebitis.Also he had done Fifteen forearm punctures produced the other 2 cases of phlebitis while of the eleven patients undergoing antecubital fossa venipuncture, none were found to have developed thrombophlebitis. The reported incidences of thrombophlebitis vary from a low of 2% 21 up to 15%.33.One well-controlled Swedish study of over 1000 cases reported venous complications of many types at 31% is having thrombophlebitis. Singh , Bhandary ( 2007) , Dhulikhel Hospital Kathmandu University Teaching Hospital, Nepal carried out a prospective observational study to determine the occurrence of peripheral intravenous catheter related phlebitis and to the possible factors associated to its development.A total 230 patients under intravenous catheter were selected peripheral infusion site was examined for signs of phlebitis once a day using jackson Standard visual phlebitis scale and the result obtained was 136(59.1%)patients developed thrombophlebitis. Related risk factors as found in the present study were insertion site (forearm), size of catheter (20G) and dwell time (>=36 hours). There were higher incident of phlebitis among the client with Intra venous drug administration and especially between ages 21 40 years. Therefore more attention and care are needed in these areas by the care provider. In another study the overall phlebitis rate was 39%. Phlebitis developed in 53% of patients with short lines, in 41% of patients with midsized lines, and in 10% of patients with long lines, and these catheters remained in place an average (Â ± SD) of 3.0 Â ± 2.4 days, 4.6 Â ± 3.4 days, and 7.8 Â ± 6.6 days, respectively. The variables that influenced the development of phlebitis, as determined by multivariate analysis, type of catheter, blood hemoglobin levels, and IV therapy with either corticosteroids or erythromycin Lutter et al.,conducted a retrospective survey to identify the complication of venous catheterization in the left lower limb and right lower limb for 1,143 patients. Patients occurred phlebitis in 56% in left lower limb 51% in right lower limb. Aloevera has salicylic acid which include in analgesic effects, it contains ligin which helps to penetrate deeply into skin to deliver the therapeutic effects, it contain anti-inflammatory agent gibberlin and polysaccharides which decrease inflammation and promote healing. Netherlands, conducted a prospective study on treatment of superficial thrombophlebitis with aloevera gel in relieving the local pain, swelling and redness. In this 116 patients were selected with thrombophlebitis and applied for a period of 3 days. The efficacy of aloevera was recorded. There is a drastic improvement in patient received aloevera gel as treatment than the control group Winchers IM (2005). The investigator selected this study because during her clinical experience has observed the many patients who had admitted in the hospital with cannula, developed the catheter related complications such as blockage, pain, redness and thrombophlebitis. This incidence insists the investigator to do some intervention to overcome this problem. Nurses need to be equipped with current interventional skills in relieving the pain, edema severity of inflammation and to prevent and treat complications.Hence the investigator interested in assessing the effectiveness of aloveragel in thrombophlebitis patients in reducing pain, edema, and severity of inflammation. STATEMENT OF THE PROBLEM: A study to assess the effectiveness of aloveragel in reducing pain, edema and severity of inflammation among thrombophlebitis patients in selected hospitals at Kanyakumari District May 2010. OBJECTIVES To assess the pretest level of pain, edema and severity of inflammation for the experimental and control group. To assess the post test level of pain, edema and severity of inflammation in experimental and control group. To compare the pre test level of thrombophlebitis between experimental and control group. To compare the posttest level of thrombophlebitis between the experimental and control group. To compare the pre and post test level of thrombophlebitis for both the experimental group. To compare the pre and post test level of thrombophlebitis for both the control group. To associate the post test level of thrombophlebitis of the experimental and ontrol group with their selected demographic variables. OPERATIONAL DEFINITION Assess Systematically and collecting, validating and communicating the patient data. Effectiveness: In this study effectiveness means reduction of pain and edema and severity of inflammation of thrombophlebitis patients after the administration of aloveragel. Pain Refers the discomfort and irritability felt by the patient intravenous infusion site due to inflammation of vein and it is assessed by numerical pain scale. Edema Refers to the swelling in the infusion site and assessed by edema scale. Phlebitis: Refers to the redness which is occurred due to the intravenous infusion and is assessed by phlebitis scale. Aloeveagel: Refers to green leaves when it is teared which contain semi solid liquid and is applied in affected site. ASSUMPTION Pain,edema and severity of inflammation among thrombophlebitis can be reduced in adults by applying Aloveragel. Patient with thrombophlebitis at intravenous infusion site have pain , edema and inflammation . HYPOTHESIS RH1 There is a significant difference in pre test level of pain, edema and severity of inflammation between experimental and control group. RH2 There is a significant difference in post test level of pain, edema and severity of inflammation between experimental and control group. RH3 There is a significant difference in pre and post test level of pain, edema and severity inflammation among thrombophlebitis patients in experimental group. RH4 There is a significant difference in pre and post test level of pain, edema and severity of inflammation among thrombophlebitis patients for control group. RH5 There is a significant association of post test level of pain, edema and severity of inflammation among thrombophlebitis patients with their selected demographic variables (age, sex, site,duration etc). DELIMITATION The study is delimited for 4 weeks of data collection. The study is limited to a sample of 60 adults. CONCEPTUAL FRAME WORK Conceptual model presents certain views of phenomena in the world that have profound influences on our perception of that world. A model is a simplification of reality or representation of reality. Concepts in the model builds consider relevant and as aids to understanding. The study is mainly focused to find out the effectiveness of aloeveragel in reducing pain,edema and severity of inflammation among thrombophlebitis patients. In order to reduce pain,edema and severity of inflammation aloveragel was applied. The investigator adopted the Kings Goal Attainment theory (1980) as a base for developing the conceptual framework. Imogene Kings Goal attainment theory is based on the personnel and interpersonal systems, including interaction, perception, communication, transaction, role, stress, growth and development, time and action. PERCEPTION: Refers to person representation of reality. It is universal yet highly subjective and unique to each person. Hence the investigator perception was peoples may have pain,edema and severity of inflammation JUDGEMENT: The investigator judged that application of aloeveragel reduces pain,edemaand severity of inflammation thrombophlebitis patients. The investigator to judge the need to reduce the level of pain,edema and severity of inflammation. ACTION: The investigator applied aloeveragel. The thrombophlebitis patient willingness to accept aloeveaagel and participate in the study. REACTION: The investigator and to asset mutual goal setting. INTERACTION: Refers to verbal and non verbal behavior of individual and the environment or two or more individual with a purpose to achieve goal. It includes the goal directed perception and communication. Here the investigator interacts with the thrombophlebitis patient by giving aloeveragel applied 3 times per day. TRANSACTION: Refers to an observable, purposeful behavior of individual interaction with their environment to achieve the desired goal. At this stage the investigator analysis the pain,edema and severity of inflammation among thrombophlebitis patients in order to administer aloeveragel application.The positive outcome in post test is the reduction of pain,edema and severity of inflammation which indicate the aloeveragel application. OUT LINE OF THE REPORT The report is divided into 6 Chapters: Chapter I dealt with background of the study, need for the study, statement of the problem, objectives, operational definitions, research hypotheses, assumptions, delimitations of the study, conceptual framework and outline of the report. Chapter II relates with review of related literature pertaining to various areas of study. Chapter III contains with the research design, variables, setting of the study, population, sample, sample size, sampling technique, criteria for sample selection, development and description of the tool, content validity, reliability of the tool, pilot study, procedure for data collection and analysis of the study. Chapter IV presents the data analysis and interpretation of data Chapter V relates with discussion based on the findings of the study. Chapter VI includes summary, conclusions, nursing implications, limitations and recommendations of the study. The report ends with bibliography and appendices.

Deforestation Essay -- Environment Pollution

Deforestation in China Deforestation has been a big problem in China to this day. Throughout its long history, China has gone through several cycles, from mild recovery to severe deforestation. When the Communists took over China in 1949, they introduced many new policies and programs to bring about economic and political changes; however, shifts in policies have led to program shifts in every field of China’s economy, including deforestation. Deforestation exercises a significant influence on the ecosystem, stimulating natural disasters, introducing negative environmental and climatic changes, and threatening biodiversity. Floods are among the most common consequences of deforestation. During the Qing Dynasty (1644-1911), deforestation caused floods to occur every decade, and once every six years between 1921 and 1949, but once every two years in the 1980s. The situation has dramatically worsened since 1994, with the Yangtze flooding every year. Growing silting of rivers and lakes from the def orested lands in the Yangtze basin and encroachment on river beds by Chinese farmers resulted in record levels of floods in the summer of 1998. The building of The Three Gorges Dam is said to stop flooding greatly. As early as the 1950s deforestation in China attracted attention, but it was not until the 1960s that it assumed alarming proportions. The Land Reform of 1950 authorized state ownership of large forests and other types of land. The Cultural Revolution, which turned China upside down, also unfavorably affected its forests. The Ministry of Forestry, like most Chinese institutions and organizations almost ceased to exist during the Cultural Revolution. Decades of neglect resulted in excessive deforestation, impacti... ...is decreasing. In Tibet is has fallen from 9-5 percent, between the years 1950-1985; Yunnan 55-30 percent, 1950-1975; and in Sichuan, 30-65 percent, 1950-1998. Despite all the afforestation measures, heavy deforestation continues to plague China due to mismanagement, unclear policies, bureaucratic corruption, and ineffectiveness. Although recently, China has afforested a total area of 1.4 million hectares over the past two years, with another 13 million hectares of land reclaimed from desertification. The achievements come from a large afforestation project covering northern, northeastern and northwestern China. The project aims to form a shelter forest covering ten provinces, municipalities and self-governing regions. Finally, China plans to invest another 400 million Yuan, or more than 48 million US dollars in afforestation in these areas this year.

Model of Leadership Essay -- Leadership, philosophy

A large amount of work has gone into studying, researching, and developing models of leadership. There have been numerous models put forth, examined, applied, and either used or discarded. However, after all this work, there is still not one 'perfect' model or method of leading. Every situation and group is different, therefore a good leader must be flexible. A good model of leadership is one that incorporates different models into one that understands that the only constant is change. Therefore, my model of leadership will be based primarily upon flexibility. I feel that a leader must first understand the basic styles of leadership and how to apply them. Then he/she can know what style is the most appropriate given the task and group composition. Second, he/she must be able to observe his/her group in order to decide when the aforementioned styles are to be applied, and when problems begin threatening the group or its task. Then, that leader must be able to effectively communicate and influence his/her followers in order to fix problems, provide feedback, and inspire a group to be more than the sum of its parts. That is what effective leadership is about. â€Å"Whatever is flexible and flowing will tend to grow. Whatever is rigid and blocked will atrophy and die.† -John Heider, The Tao of Leadership A flexible leader realizes the advantages and disadvantages inherent in each of the three styles of Authoritarian, Democratic, and Laissez-faire leadership. While it seems that most of the researchers agree that democratic style is the most effective, there are certain situations that call for different styles. Effective leadership demands that a leader be able to adjust his/her style according to the circumstances. Autho... ...th honey than with vinegar.’ It is my hope that I have developed a competent model of leadership arising out of flexibility. I hope that I can apply this model in my own practices of leadership, to help me build the confidence I need to grow out of my leadership apprehension. I feel that an understanding of the group process, and of the styles of leadership, working together, can provide one with a very powerful method of effective, flexible leadership that can be applied to multiple groups and situations. First, by learning the styles of leadership, he makes harmony between himself and the group. When understands how the group acts and reacts, he can make harmony between the members of the group. And when this leader understands how to influence and conduct his followers, they can both begin to play beautiful music that no one would have been able to play alone.

Emma by Jane Austen :: essays research papers

Emma by Jane Austen Setting Emma took place in small town called Highbury in 18th century England. During the time period set in the novel, there was a definite social rank, or hierarchy. Almost all of the scenes in the book take place in or around the estates of the characters. Their property mostly determined their social status. This setting has significance to the storyline, because of the social rank. Emma, who is constantly trying to play matchmaker, tries to convince her friend Harriet to marry someone of a higher class than her current love, a farmer. The characters are very aware of their status, and can be discriminating towards people of a lower class, such as the farmer. The book was most likely set in this place and time in order to include the conflicts of a hierarchal society. Character Analysis Emma Woodhouse: Emma is the main character of the novel. She is a beautiful, smart, and wealthy 21-year-old woman. Because of her admired qualities, Emma is a little conceited. She is the daughter of Henry Woodhouse. Since her mother has died, Emma has taken the role of taking care of her father, who is old and often sick. Because she feels she is obligated to stay by his side, Emma decides not to marry. Emma believes that she is a good matchmaker, and tries to put together several couples throughout the novel. Emma believes that social classes are very important and refuses to see anyone cross over to marry someone lesser than themselves In chapter 8-page 52, Emma is talking about Harriet’s situation with the farmer with Mr. Knightley. She says, â€Å"Mr. Martin is a very respectable young man, but I cannot admit him to be Harriet’s equal. As the novel progresses, Emma becomes more mature, and realizes how silly she had been in the past. In the end, she finally stops matchmaking others and marries Mr. Knightley, who was perfect for her all along. Mr. Knightley: Mr. Knightley is another main character of the novel. He is quite a bit older than Emma, at 38. He is also Emma’s brother in law. He often visits the Hartfield estate to play cards. He is a little protective of Emma, and often gives her advice to change her prying ways. Mr. Knightley, although high in status, does not fully believe in the hierarchal customs of Highbury. He thinks that people’s actions and feelings are better judges of themselves than their title or property. Emma by Jane Austen :: essays research papers Emma by Jane Austen Setting Emma took place in small town called Highbury in 18th century England. During the time period set in the novel, there was a definite social rank, or hierarchy. Almost all of the scenes in the book take place in or around the estates of the characters. Their property mostly determined their social status. This setting has significance to the storyline, because of the social rank. Emma, who is constantly trying to play matchmaker, tries to convince her friend Harriet to marry someone of a higher class than her current love, a farmer. The characters are very aware of their status, and can be discriminating towards people of a lower class, such as the farmer. The book was most likely set in this place and time in order to include the conflicts of a hierarchal society. Character Analysis Emma Woodhouse: Emma is the main character of the novel. She is a beautiful, smart, and wealthy 21-year-old woman. Because of her admired qualities, Emma is a little conceited. She is the daughter of Henry Woodhouse. Since her mother has died, Emma has taken the role of taking care of her father, who is old and often sick. Because she feels she is obligated to stay by his side, Emma decides not to marry. Emma believes that she is a good matchmaker, and tries to put together several couples throughout the novel. Emma believes that social classes are very important and refuses to see anyone cross over to marry someone lesser than themselves In chapter 8-page 52, Emma is talking about Harriet’s situation with the farmer with Mr. Knightley. She says, â€Å"Mr. Martin is a very respectable young man, but I cannot admit him to be Harriet’s equal. As the novel progresses, Emma becomes more mature, and realizes how silly she had been in the past. In the end, she finally stops matchmaking others and marries Mr. Knightley, who was perfect for her all along. Mr. Knightley: Mr. Knightley is another main character of the novel. He is quite a bit older than Emma, at 38. He is also Emma’s brother in law. He often visits the Hartfield estate to play cards. He is a little protective of Emma, and often gives her advice to change her prying ways. Mr. Knightley, although high in status, does not fully believe in the hierarchal customs of Highbury. He thinks that people’s actions and feelings are better judges of themselves than their title or property.

The Secret of Ella and Micha Chapter 24

Ella â€Å"Are you sure you want to do this?† I ask Lila for the thousandth time. She piles the last box into her trunk and slides her glasses over her eyes. â€Å"Hmmm†¦ let me think. Go back to a home where I'm nothing but a burden? Or go back to the campus with you and have some fun?† I pick some dirt out from underneath my fingernail. â€Å"I'm just making sure, before you get too committed.† She takes my hands and gives them a swing. â€Å"I want to go with you, okay, so go say good-bye to your dad so we can hit the road.† â€Å"Okay, I'll be right back.† I head across the front lawn for the door when Ethan's truck pulls up in my driveway. I walk up to his window and rest my arms on it. â€Å"So you got my message I take it?† He looks like he just came from work, grease on his face and clothes, and his dark hair has some shavings of rust in it. â€Å"Yeah, I figured I'd come and say good-bye to both of you.† I slant my head to the side and pierce him with an accusing gaze. â€Å"Don't try and pretend that you're here for me.† He places his hand over his heart, faking hurt. â€Å"My heart is breaking and you're making jokes. Wow, you really are evil.† â€Å"Yeah, yeah,† I back up so he can open the door and climb out. â€Å"I'll give you two a minute.† â€Å"I think you've overestimating what's going on between the two of us.† â€Å"Well, I wouldn't have to if one of you would tell me what's going on.† He shrugs and then rounds the back of the truck. Rolling my eyes, I walk into the house to tell my dad I'm leaving and that I plan on coming back in a couple weeks to meet up with Dean. After a long talk on the phone with him – and I'm sure a lot of persuading from Caroline – we decided to meet up here, when Dean can take off work, and give my dad an ultimatum. It's probably one of the hardest things I'll have to do, because I know there will be things said during the conversation that will hurt me. I'm going to push through it, though, because now I understand what I can handle. I find him on the couch, eating a microwave dinner, with a six-pack on the table in front of him. He's watching the television, with a cigarette in his hand, and he barely notices me enter the room. â€Å"Hey Dad,† I say from the doorway. â€Å"I'm getting ready to leave.† He rips his eyes from the television, startled, and I wonder if he was even watching it or if he was dwelling in his thoughts. â€Å"Oh, okay, well drive safely.† I rub my sweaty palms together and walk into the room. â€Å"Dean and I are going to be coming back in a few weeks.† He sets his tray down and grabs a beer. â€Å"What for?† I pat my hands on the sides of my legs uneasily. â€Å"We want to talk to you about something.† He sets the beer down. â€Å"I thought Dean was still here.† I shake my head, feeling guiltier about leaving. â€Å"He went home a week or two ago†¦ but Dad, can you try and take care of yourself a little bit better?† I take a deep breath and throw a hint out into the open. â€Å"And maybe stop drinking so much?† He glances at the row of beers in front of him like he just realized they were there. â€Å"Oh, I don't drink that much, do I?† I sigh and sit down on the couch beside him. â€Å"You didn't used to, but now it's kinda all you do.† He bobs his head up and down. â€Å"Alright, I'll try to cut back.† I know he won't, but hopefully Dean and I will be able to convince him to go to rehab where he can get the help and counseling that he needs. I give him a hug, even though he winces. Then I walk away, hoping he'll be okay, but knowing that until he makes the decision to change all I can do is try to help him.

Why are Geographers interested in Marston Vale?

Marston Vale lies upon the Oxford clay, between Bedford and Milton Keynes in UK. The soils in this area are very fertile. Because the majority of English houses are built in bricks, and the location of Marston Vale is also near London, many brickwork industries were set in this area over last hundred years. Most of the clay extracted here is sent to London to build houses. Today, the extraction of clay and the brick making is still busy, and the Stewartby brickwork industry is one of the biggest industries formed in Marston Vale. Millions of tonnes of clay are extracted from the clay pit everyday, then the clays are transported by conveyor belt to the brickwork, where the clays are drained, moulded and then fired in kilns to make the red bricks that are used to build houses. After all the clay that is valuable to mine has been extracted, huge holes are left on the ground. The topsoil has been removed from the ground during clay extraction, and so no plants will be able to grow in such areas. The area turn to worse if there is rain, the whole area will turn muddy and dirty. A chain of pits stretches along the A421 from Bedford to the M1 near Milton Keynes. This was one of the worst areas of rural derelict land and damaged Ecosystem. The noise, pollution, traffic and bad view that has been produced by the extraction pit and brick making factory affect local residents badly. What can be done to improve the situation? In 1989, 12 National Community Forest project were launched. These Forest will cover 470,000 hectares , which take over 3.6% of all land area in England and Wales, nearly equal to half the total land area used by the National Parks. The Community Forests is a national programme of improving the environment, which affects half of the people in England. Improving the countryside around towns and cities by planting woodland is the main aim of the Community Forests, especially in the areas of the derelict land. This will improve the environment and benefits the local people. In theory, the land must be made to contribute the local communities, e.g.: Creating jobs, Creating farmlands, Creating an attractive environment, Creating a variety of different landscapes, Creating sports facilities, Creating settlements. The Marston Vale Community Forests. Marston Community forests is one of12 National community forests projects which introduced in 1989. The Marston vale community forests cover a total area which more than 150kmà ¯Ã‚ ¿Ã‚ ½. About 25,000 people are living inside the forest area, about 145,000 people are living on the edge of the area, most of them are in Bedford and Kempston, about 500,000 people are living within 20 minutes' drive. (These figures are from GeoActive) In order to succeed in this project, local people should put efforts in planning, planting and looking after the woods that are planted. The past experience has shown us that most environmental management, which involved local people, are more likely to succeed. Local people are encouraged by the Forest team to grow their own seeds in Marston Vale Community Forest project. The results of that are small woodland have begun to grow in their villages. Forest team also need to encourage landowners to allow their land to be planted with trees and organise seed collection and planting days. (This information is from GeoActive.) From this act, we know that the Marston Vale Community Forest project does not just involve the restoration of the clay extraction pits, but also allows local people to get in. It encourages people to plant trees, to protect the woodland created, to take a part in the development of the forest. The most important thing is people will love what they have planted, in order to love the whole nature. The restoration of the clay extraction pits in Maston Vale community Forest. There are three possible ways to restore the clay extraction pit: 1) The main restoration for the clay extraction pits is by changing them to an artificial forest. The way of doing so is to spread 3-4 metres of topsoil over the top. Then trees may be able to be planted in. The local people are involved in the development of the Marston Vale community forest. The plan is for local people to plant 100 ha of woodland each year and 5 Km of hedgerow each year. Farmers can apply for grants from the Forestry Commission for planting woodland. 2) The huge hole left on the ground can also be turned into an artificial lake by pouring water into the pit, or just leave them until the rain season comes. Separate clay extraction holes may be joined together by digging out the soil between them. The Stewarby Lake is an example of this restoration. 3) There's also another restoration, which is making it into a landfill site. I personally think this is a fantastic restoration, because this is also a waste solution. Million tonnes of waste can be buried in the clay extraction every day. This solved the crisis of waste in London. After the waste is filled in, plants can also be planted on top. After a long time, a chemical reaction will be happen when the waste decays and the methane gas is produced in this process. We went to an L-field landfill site, which is run by Shanks company; more information on landfill site will be in the back. *Questions On my coursework. 1) How brickwork, clay extraction and landfill sites effects local people ‘s life 2) What's local people's knowledge on Marston Vale Community Forest Project? 3) How successful is the Marston Vale community forest project? Both in attempting to solve the problems of pits left on ground after the clay extraction, and to create the better environment for local people. These are three questions that I set through my coursework. The answers for these questions will be in the end of my coursework in details. For first data collecting, the school organised a day fieldtrip to the Marston Vale area. On the day of the fieldtrip, we visited the following places: *Community forest centre, the artificial forest that has been restored from pits. *Stewartby lake, an artificial lake in the forest, also a different landscape created from clay extraction pit. *The Quest pit, one of the present clay extractions pits run by Hanson Company. *Wootton village for the questionnaire, to ask a few questions on how the brickwork and the landfill site affects local residents. *Randalls Farm, to do some water tests on the Elstow Brook River located there. *Landfill, to see what is the landfill site is like. Issues in the Maston Vale to look at. A Geographer will particularly look at the environmental issues in this area, such as how clay extraction damages the area's Ecosystem, how this affects local people, and what can be done to solve the problems, and finally are these attempts successful or not, and what can be improved? To answer all these doubts, I will first introduce the area to the readers, give them the exact location of the Marston Vale area and what transportation is available to get there. To let readers understand more about my coursework, especially on the day we went to the Marston Vale. I'll explain clearly what we've done on the fieldtrip; where we did them; why we did them; and what are the data can tell us.