Saturday, January 18, 2020
Whay Is There a Lack of Active Teacher Participation in Curriculum Development
Why is there a lack of active teacher participation in curriculum development? ED359 RESEARCH PROJECT Dharmendra . P. Sharma S99007424 Introduction and background In Fiji and in many Pacific Island countries there is a serious lack of active teacher participation in the curriculum development and implementation process. While there are some practicing teachers who write the curriculum in certain subject areas they are merely excluded from the decision making process regarding what is to be taught in schools and how it is taught.Curriculum development is considered a dynamic process and curriculum can be constructed through the work of the main stakeholders who are the teachers. However in most Pacific Island countries this may not be the case as the curriculum is sometimes referred to as a ââ¬Å"Teacher proofâ⬠and ââ¬Å"ready to teachâ⬠curriculum meaning that they do not have the liberty to choose from and modify certain aspects of the material given to better suit the classroom situation.From most of the research conducted in the past three decades it is clearly identified there is a serious concern regarding their involvement in setting the objectives, determining the teaching /learning approaches and the evaluation process . These aspects are largely taken care off by the Curriculum Development Unit. AimWith this is mind the aim of this research project is to investigate the reasons for the lack of active teacher participation in curriculum development and also to investigate strategies that would encourage more participation in every level of the decision making process when it comes to the development and implementation of curriculum in this country. After all teachers play a pivotal role in implementing the curriculum. At present the development and implementation are carried out by two different sets of people.The main research question therefore is why there is a lack of active teacher participation in curriculum development. This research project is justified as curriculum development is a universal issue and is of major importance in the pacific region as we try and adopt a curriculum which is suitable and relevant. The focus and the limitations The focus is mainly on the curriculum practices in Fiji with a few examples from around the region and some developed countries such as Australia and the United States. This provides a basis for comparison with the issues that we are facing.Studies from developed countries are also important in the sense that teachers in these countries have the liberty to choose from a given curriculum to be applied in the classroom. The main limitation of this research project is that curriculum change is a long term process and with the ongoing research in the areas of curriculum development there are many questions that are still unanswered. With the limited time and resources it may be difficult to look into all the areas of curriculum development. Another limitation for this project i s in regards to the Data collection.Getting views from all the Heads Of departments who are currently involved in curriculum development will not be possible as a result of time and financial constraints. Delimitations The study is delimited to Heads of Departments, Teachers with at least 5 years experience, Senior C. D. U officials and Principals of secondary schools. The research question The Main research question for this project is ââ¬Å"Why is there a lack of active teacher Participation in Curriculum Development? â⬠Since this is a sensitive issue in Pacific Education there are some prominent Pacific Academics Who have already looked into this Problem .Some of the issues that are highlighted in most of the available literature can be clearly divided into the following subtopics. Inadequate Training, The lack of Incentives, The role of principals and administrators, the role of the CDU and the school based curriculum development and the ten percent model. Literature revi ew Inadequate training The articles point out that most teachers are not taking part actively in curriculum development because they lack skills in that area. According to (Sharma) Teachers at times lack the necessary skills to take part in the curriculum development process.This is regarded as a major limitation in the area of School Based Curriculum Development which is applicable to Fiji. (Sharma, pp 5-8). In the case of Kiribati the case is more extreme as teachers in the field lack the basic teacher education in the first place. Tearo mentions that many of the teachers who remain in the teaching profession have no formal teacher training at all (Tearo,pp-9-11). This brings us directly to the issue of Teacher training. There is a need for relevant programs in the teacher training courses to deal with the issue of curriculum development and implementation. Thaman 1990) highlights the fact that the teacher education programs have not prepared the teachers for this new role therefo re they lack the necessary skills to actively take part . (Thaman 1990,pp 1-12) In the past teachers did not require teacher training in order to be posted to schools . This has a negative impact on the students educational achievements . Without this basic training in place curriculum development is definitely out of the question for most of the teachers. The lack of financial incentives A major issue while dealing with teacher participation in curriculum development is the issue of the remuneration.Most of the articles highlight the fact that the financial incentives provided are not attractive enough for the teachers. This scenario is directly related to the fact that the CDU lacks financial resources to adequately reward the teachers who at times have to spend the school holidays developing curriculum. In his report to the Fiji Islands Education Panel ( Sharma2001)clearly recommends the need for an increase in funding and resources that is allocated to the CDU in order to allow the Unit to play a more effective role in providing school based assistance to teachers. Sharma2001). (Young 1988) also highlights the plight of teachers In Canada where they felt that they were not adequately compensated for the time they spent in curriculum development activities. (Young 1988,pp109-121). In an invited plenary paper, presented at a regional conference in 1990 Thaman mentions that the teachers lack the professional and material support to be effectively involved in curriculum development process (Thaman 1990, pp1-12). The role of the Principal and administrators Another important reason that affects the degree of teacher participation in urriculum development is the role of the school principals. When the teachers have a favorable environment in school there is the possibility that their participation rates will increase . These includes the introduction of staff development programs. The Principals play an important role as according to (Sharma) they can help the t eachers change their attitude towards curriculum and also their profession in general. This is also a recommendation that was made to the education Panel in 2000(Sharma).There is also a challenge here for the teachers as at times the principals and administrators do not fully realize the important role teachers can play in curriculum development and they seem to adopt a narrow minded approach towards the role of the teachers . They do not allow them to participate in curriculum activities outside the school and also giving little recognition to the work of the teachers. Young 1988 clearly identifies the problem as ion her paper she highlights one of the critical findings.The administrators had a narrow view on the role of the teachers and the teachers received little recognition as well as the principals negative response to the release required by b the teachers to take part in curriculum development activities which at times required a two day release. (Young 1988,pp109-121). The Role of the CDU The Curriculum development Unit also plays an important role in encouraging a higher degree of teacher participation in Curriculum development.Although some teachers are involved in designing the curriculum they have little role to play when it comes to the decision making process on what is to be sent to schools as prescriptions. According to (Sharma 2001) some teachers expressed their concerns on the educational value of many curriculum materials sent to schools. (Sharma 2001). This is one of the reasons teachers do not feel like participating in Curriculum development activities as the prescriptions given by the CDU are making the teachers more passive and de-skilled.This leads to a more laid back approach and decreases the teachers desire to participate in curriculum development programs. School Based Curriculum development and The Ten percent model School, based curriculum development is also an initiative which will widely increase the rate of teacher participa tion. This is a move away from the more centralized models of development such as system and school based models. The teachers role in the curriculum development process cannot be overemphasized .The teachers can tasked with 10% of the over curriculum enabling them to work in areas of curriculum development in which they have most interest in. With this the teachers should be given more responsibility to develop curriculum at the school level. The curriculum can then be developed by the teachers themselves or in partnership with the parents and the communities. (Garret R. M 1990). Sharma also emphasizes the importance of school based curriculum development as teachers can be given the task of preparing curriculum for non-examination based subjects such as music and art& craft. Sharma) The school based approach and the 10% model are effective tools as they can boost the morale of the teachers and encourage them to be involved actively in the curriculum development process. These are the factors that are responsible for the low degree of teacher participation in curriculum development. Improvements in these areas are required in achieving an education system which will include teachers more actively in the curriculum development. Methodology Project Design The research method for this project is that of a Qualitative nature.The design is that of a case study . This research method and design are most suitable for this particular research project as there are multiple possibilities or outcomes possible for the research question. An Inductive nature of reasoning is synonymous with qualitative studies Samples are taken from populations to draw conclusions for the whole population. (Leedy&Omrod 2010). In this project interviews with teachers will provide a basis for drawing conclusions for teachers in general in regards to their response to the research question.Case studies are useful in evaluating any educational approach which in this case is Curriculum Developme nt. Sample & Population This study is aimed at the teachers who play the most important role in curriculum development and design as they are the implementers of curriculum themselves. CDU officials and Principals of Secondary Schools will also be aimed in this study as the secondary targets to clarify some of the issues raised in this research project. Data Collection and Analysis Data will be collected mainly in the form of interviews.For this purpose a recording device will be utilized as well as notes taken alongside. For the interviews prior arrangements will be made with the respectable institutions. Consent forms will be utilized for this exercise . The interviews will include open ended questions. The data collected from these interviews will then be organized thematically. Some of procedures utilized in organizing and analyzing data will be followed. This will include open coding, Axial coding, Selective coding, finding patterns and determining categories Results (Research findings)/DiscussionsThe teacherââ¬â¢s perspective on curriculum development From the several teachers who were interviewed and from the general talanoa sessions the data collected were assigned descriptive codes and the relationship s were used to determine common themes. This was an essential step to be used in presenting the research findings. From the interview with the several teachers from schools around the Suva area, the following categories were present after analyzing the data. * Experience/Inadequate training * Workload * Financial incentives * Teacher proof curriculum * External factors Experience/Inadequate trainingMajority of the teachers who were interviewed mentioned that they felt that more experience was required to take part in curriculum development activities . The normal selection criteria as mentioned by a senior education official in the C. D. U requires a teacher to have at least five years experience as well as to be the Head Of Department in that subjec t of interest to be considered by the C. D. U. The teachers also mentioned that being involved in Curriculum development was a task too difficult for them as they had taught that particular subject for only a certain number of years.A teacher who had 17 years of work experience admitted that she felt at ease while working as a curriculum developer and was never under any real pressure. Another interesting point mentioned was that most of the teachers did not undergo proper training in order to fully understand the importance of curriculum work in their teacher education programs. This as mentioned by some of the teachers was one of the major reasons for them lacking the general interest to take part on the curriculum development process. This goes well in line with the Research findings of Akhilanand Sharma.Where he mentions that Teachers may lack the necessary skills to take part in the curriculum development process. This is regarded as a major limitation in the area of School Bas ed Curriculum Development which is applicable to Fiji. (Sharma, pp 5-8). This clearly shows that if the teachers do not acquire the necessary skills, this becomes a limiting factor in their participation in curriculum development activities Workload Another area of concern for the teachers was the immense workload that they had as compared to the yesteryears . ith the introduction of the classroom based assessment and internal assessment there was more work for the teachers. Upon invitation by the C. D. U the teachers sometimes had to think twice as participation in curriculum workshops meant playing catch up later which can be a daunting task . This was one of the reasons given for not being actively involved in curriculum work. Young 1988 mentions that her study of teachers involved in curriculum work the teachers found little point in taking part when the materials produced were not necessarily used and on top of that it added to an n already heavy teaching load. Young 1988, pp11 9) Although this particular research was carried out in Canada from the informal conversations with the teachers there was a always a mention of the extra workload. ââ¬â Financial incentives Although the teachers knew that it was important to contribute towards curriculum development majority felt that there was a general lack in financial incentives. Although amounts were not disclosed some teachers felt that that were not receiving the correct financial compensation for their time spent in developing curriculum.An interesting comment was made by one of the teachers as she mentioned that if curriculum review work was being funded by AID Organizations such as Aus Aid then the financial rewards were way better off than compared to being involved in curriculum activities with the local government. Thaman 1988 highlighted the plight for teachers as she mentioned that financial assistance to teachers in the form of allowances was merely enough to compensate the teachers for their ti me and effort and was minimal when compared to the huge amounts spent on overseas consultants. (Thaman 1988, pp4). This is certainly an area that needs to be looked into.However this depend on the current political and economic climate of the country concerned and also the policies that are in place in regards to financing curriculum development work. Teacher proof curriculum Most teachers believed that the C. D. U was providing prescriptions with largely ready to teach material and therefore the teaching becomes passive and the teachers are not challenged enough. Majority of the participants believed tha5t they were comfortable with this particular approach while come voiced their concerned as ready to teach materials were undermining the professional capabilities of the teachers.This seriously highlights the need to adopt the school based curriculum development model as mentioned by Sharma, where teachers select from whatever curriculum material is available and develop them for f urther use in the classrooms (Sharma). External factors There were other factors which were mentioned by the Heads of Departments . These included factors such as family commitment, the attitude of the principals towards their participation in curriculum activities. Some teachers mentioned that the principals at times had a negative attitude towards them participating in curriculum development activities.The curriculum development Unit From the interviews carried out at the curriculum development the data gathered can be categorized in the following areas * The actual process * The attitude of teachers * Financial benefits * The credibility of the C. D. U officers The actual process A senior education officer explained that the actual process in curriculum development. The Heads of departments who are selected for curriculum activities were done through recommendation from the C. D. U officials who conducted curriculum workshops in various schools.Upon selection the participants wer e trained in their respective areas. An interesting point to note here is that there are different groups assigned to the different tasks involved in the curriculum development process. While one group wrote the curriculum another group carried out the vetting and editing . This was required to make improvements to the curriculum produced. It verified the context, avoided repetition of concepts from another subject area and generally raised the standard of the curriculum material produced. At the point where decisions are made by the C.D. U on what is to be taught in schools the representatives of the teachers are informed of the implementation. The senior education officer also mentioned that some teachers may not be aware of the curriculum changes if the representatives fail to pass on the message to their colleagues. It is argued by Stenhouse 1975that prescriptions should be curriculum proposals that inform the teachers planning of the teaching and learning process rather than to determine the teacherââ¬â¢s plan of action. (Stenhouse 1975) The attitude of teachersAnother important point to mention that the C. D. U officials highlighted was that there were rare cases when the teachers rejected the offer to participate in curriculum work. This was mainly because of the fear of participating in curriculum development activities which was considered to be a higher level playing field as compared to teaching in the classrooms. As a result of this certain teachers had declined the offer to contribute towards curriculum development in their subject areas. Financial benefits Upon questioning the senior education officer agreed that financial ompensation may be a factor affecting certain teachers from participating in curriculum work. The Ministry Of Education has set aside a certain portion of their budget for curriculum development activities. The Officer mentioned that in certain cases the teachers who travelled from the rural areas had to file for claims on t he expenses incurred and it would take some time before they received their claims. There were some cases where the claims filed were not received on time and these may be the teachers who felt that they were not being compensated properly.The teachers generally had become money ââ¬âminded and were not concerned about the important role they played in developing or reforming curriculum at the national level. The credibility of the C. D. U officers One of the major concerns that have been raised in many research papers is the creditability of the C. D. U officers in being part of the curriculum process. Upon questioning a senior education official mentioned that the selection criteria for the officials were very strict and personnel selected for positions within the department were highly qualified and carried the necessary experience.For example in senior positions most officials had more than a decade of experience. This is directly in line with the comments made regarding the department where Sharma 2001 mentioned that some C. D. U staff were not suitably qualified to develop and implement curriculum (Sharma p281) The Principals role in curriculum development. The principal plays an important role in facilitating active teacher participation in curriculum development. From the interviews conducted one very important theme can be derived. This includes Principalââ¬â¢s involvement in Curriculum developmentIt can be clearly identified that the principals are mostly willing to allow their teachers to participate in curriculum work. There was an exception however if the C. D. U requested the help of the teachers at a busy time in the annual calendar. If the Principal felt that the teachers performance in school would be affected he or she would not allow the teacher to engage in curriculum work. All the principals interviewed shared the same opinion. Development programs were also in place in collaboration with the C. D.U to facilitate the training of teac hers in the field of curriculum development . When posed with the question of their involvement in curriculum development, the principals mentioned that their first priority was the administrative affairs of the school simply meaning that curriculum development was not really a priority. As mentioned in a paper entitled ââ¬Å"Principal a s a curriculum facilitatorâ⬠Dr Sharma mentions that a contemporary secondary school principal is more involved in the administrative affairs of the school and as a result curriculum work is assigned top department heads .This has a major effect on the leadership and the supervisory role as a whole. (Sharma 1992, pp 18). One of the principals disagree with this notion stating that he was able to perform his duties as a leader by maintaining a balance between issues within the school and national issues such as curriculum work. Conclusion The research project makes an attempt to understand the reasons behind the lack of active teacher participa tion in curriculum development in the context of the Fiji Islands.The Research Question is to investigate the reasons for the lack of active teacher participation in curriculum development and also to investigate strategies that would encourage more participation in every level of the decision making process when it comes to the development and implementation of curriculum in Fiji. As a result of this the main target audience in the research includes the Heads of Departments who are actually involved in curriculum work at the ground level; the secondary target audiences are the Curriculum Development unit staff and Principals from selected schools from the Greater Suva Area.The Method use for this research is the Qualitative approach as there are multiple possibilities and outcomes for the study. From the small scale research conducted it can be clearly identified that there may be several reasons why teachers may not be actively participating in curriculum development. From the Tea chers perspective the reasons include the lack of training and inexperience, financial intensives and some external factors such as the role of the school, principals as they are the facilitators in encouraging active participation of teachers in curriculum development work.However from the information gathered at the C. D. U it can be stated that there may be some changes in the role that teachers play in the developing and implementing curriculum at the national level. Their role has become more active as they are being thoroughly consulted in all levels of the decision making process except the policy making of the Curriculum development Unit. As The research project was inspired by a paper written in the year 2000 it can be seen that there have been major reforms when it comes to the teacherââ¬â¢s role in curriculum development.It must be noted that the Principals also play an important role in encouraging teachers to be part of the curriculum process . It can be clearly iden tified from the data collected that there are programs in place which are focused at the professional development of the teachers. The principals therefore are facilitating and providing an encouraging environment for the teachers so that they can become active participants in the curriculum, development process It can be stated that in the coming years there will be a greater participation from the teachers in the curriculum development process.This is mainly due to the changes that are visible at present. With teacher education programs emphasizing curriculum development and the changing roles of the school principals it can be said that the future is looking bright as far as curriculum development is concerned in Fiji. References 1. Garret. R. M. 1990. The introduction of a school based curriculum development in a centralized education system ;A possible Systemâ⬠. In international Journal of educational Development,109(4)303-309. 2. Leedy. Paul D &Ormrod Jeanne E, 2010 Pract ical research, planning and design and design. Interenational Edition. New Jersey .Pearson educational Inc. 3. Sharma, Akhilanand. ââ¬Å"Teacher Participation in curriculum Development-The Fiji context. â⬠directions. . page. Web. 12 Aug. 2012. http://directions. usp. ac. fj/collect/direct/index/assoc/D1175398. dir/doc. pdf 4. Sharma, A. 2001. The National curriculum . In Learning together: Directions for education in the Fiji Islands (Ministry of Education Report of the Fiji Islands Education Commission/Panel 2000 pp278-89). Suva, Fiji: Government Printer. 5. Sharma, Akhilanand. ââ¬Å"The Principal as a curriculum facilitator. ââ¬Å"Directions. n. page. Web. 17 Aug. 2012. . 6. Stenhouse, L. 1975. An introduction to curriculum research and development, London: Heinemann 7. The National curriculum . In learning together: Directions for education in the Fiji Islands, Tewaeariki. ââ¬Å"Strategies for optimizing the input of Teachers to Curriculum Development in Kiribati. â⬠Å"Directions. n. page. Web. 17 Aug. 2012. . 8. Thaman, K. Helu. ââ¬Å"Towards a Culture Sensitive Model of Curriculum Development for Pacific Island Countries. ââ¬Å"Directions. n. page. Web. 16 Aug. 2012. . 9. Young, Jean. H. ââ¬Å"Teacher Participation on Curriculum Development: What status does it have? â⬠3. 2 (1988): 109-121. Web. 17 Aug. 2012 Appendices For this project both structured and unstructured questions were utilized to gather the data required. For the teachers the questions mainly involved * Their involvement in the curriculum development process. * The quality of the materials produced at the C. D. U. * Whether the materials were teacher proof or not. * Their views on the reasons why they may not be actively participating in curriculum process if that is the case.For the C. D. U officers the questions involved * Explanations on the curriculum process. * Their views whether teachers were actively participating in The curriculum development process. * The sel ection criteria for the C. D. U officers For the principals the questions mainly involved * Their willingness to allow teachers to participate in curriculum activities. * Their involvement in Curriculum development. * The programs in the school that encourage professional development of the teachers. * Their views on the current state of affairs in regards to
Friday, January 10, 2020
Career Goals Scholarship Essay Samples Explained
Career Goals Scholarship Essay Samples Explained Career Goals Scholarship Essay Samples - What Is It? Paragraph i state a synopsis of what you're going to speak about in the essay. The action of writing down the definition can help you remember this, and you may incorporate an illustration of the way the word is utilized to boost your opportunity of memorising it for use in essays. Both examples manage the very same theme sick parent but utilize various approaches. If you prefer excellent paper essay examples, reach out to us here today and we'll do our very best to give you the most suitable aid. They may need to keep up a superior grade average to guarantee they get in the school of their selection. Therefore, among the most important things you need to do when getting prepared to compose your college scholarship essays is to devote some time reflecting on precisely how wonderful you truly are. If you're asking for a scholarship, odds are you're likely to should compose an essay. But before someone is granted a complete scholarship an individual must first submit an application for college application. To be able to convince the judges you should obtain the scholarship rather than the other applicants, you've got to tell the judges what makes you a better candidate. Nowadays it's very difficult to go into the university without having deep pockets. Choosing Good Career Goals Scholarship Essay Samples In fact, the majority of career goals essay questions contain several questions in one, so be certain to deal with every one of them. As a way to do this career goals you are going to want to create essays. Thus, to put it short, this essay on career goals really can determine your future once since if you don't persuade the possible employer they should hire you or the admissions board to offer you an opportunity to study at their college, you're losing an excellent chance. Composing an appropriate career goals essay can be hard should you not actually ha ve any ambitions. When these essays can appear to be a little step toward your future, they're a step nonetheless. Freelance essay writer You may look for freelance essay writers on the internet too. Here are some suggestions to remember when writing a scholarship essay. When you proceed through this bit of writing, it is possible to almost see or hear the author speak with their special tone and in a sense that is particular to his personality. The Fight Against Career Goals Scholarship Essay Samples Your future is dependent on it. What's the aim of attending. We did all this voluntarily, but with suitable expertise, I am going to be able not just to resume doing this but also do it on a bigger scale and with a larger impact. Like your organization i hope to assist animals for the remainder of my life. Scholarship essays are a critical matter. You can achieve this with several freelance essay writers to come across different superior sample essays. While scholarship essay format won't provide you any credentials, they ought to be able to steer you properly on the best way to compose the suitable essay. Get familiar with common essay questions. Top Career Goals Scholarship Essay Samples Choices You may also get several discounts on our site which will help you to save some more money for future orders or anything you want to spend them on. Read my essay writing service reviews and my guide to selecting the very best service for everything you will need to understand about how to select the best writing businesses. Our customer support will gladly tell you whether there are any special offers at the present time, along with make sure you are getting the very best service our business can deliver. As soon as you locate a service you want, don't neglect to look at my review of it. The Argument About Career Goals Scholarship Essay Samples A seasoned professional will make an error-free assignment right away and can help you boost your grades. Contrary to other companies, we're safe and skillful group of writers that are deeply concerned in regards to the academic writing tasks. It's critical that the service you decide on knows for sure they're only selecting the ideal essay writers. I saw my parents on the job, and I helped them with a number of those tasks.
Wednesday, January 1, 2020
The Effects Of Prozac And Its Effects On The Brain
When we talk about medication and the different side effects, it makes you wonder why someone would risk their own health just for a medication. Although the drug I will be researching shows limited side effects and is something that many physician would recommend to their own patients. My reasons for choosing Prozac, is to learn more about the drug and how it helps individuals whom have depression. Another reasons for this, is to learn more about the side effects and how it can be a positive outlook for someone who have mental illness. Lastly, for the last few years I have been dealing with depression and I want to learn more about the different drugs option to help individuals control their depression Prozac is a selective serotonin reuptake inhibitors antidepressant. In other words this drug is used to help with individuals whom have depression, anxiety etc. Prozac affects the chemicals in the brain that is associated with the following mental illness, depression, anxiety and obsessivesââ¬â¢ compulsive disorder. Therefore, the drugs affect the chemical in the brain that causes unbalance and is the main cause for the mental illness mention above. The drugs main affect towards the mind and the body, is to provide there to be some form of balance and allow the individual who is taking the drug to calm down. According to Parker, ââ¬Å"By altering the action of a specific set of neurotransmitters, chemicals involved in the transfer of signals from cell to cell in the central nervousShow MoreRelatedEssay on Prozac -- the Toxic Miracle Drug1698 Words à |à 7 PagesProzac -- the Toxic Miracle Drug Americas society has turned to an aggressive means to treat the overwhelming numbers of people who suffer from depression -- antidepressant medication. 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Tuesday, December 24, 2019
Euthanasia as One of Todays Most Prevalent Ethics Issues...
Euthanasia as One of Todays Most Prevalent Ethics Issues Euthanasia can be considered one of the most prevalent problems when dealing with the ethics of patient treatment. Should people have the right to end their own lives when prolonging it will only cause them more pain? Should families who love someone so much, that they donââ¬â¢t want to lose them, cause them more pain by keeping them alive. What makes that more ethically correct then letting them die? The more you look into this issue the more you see how contradictory people are when it comes to making these decisions. This paper shows the issue in a more detailed manner, gives some background, shows the effects on modern society and explains briefly my standpoint on theâ⬠¦show more contentâ⬠¦He considered it merciful to assist patients with ââ¬Å"terminalâ⬠illnesses. His definition of terminal, ââ¬Å"any disease that curtails life even for a dayâ⬠(3), didnââ¬â¢t convince the courts of his legal innocence. While people who have terminal illnesses sometime s wish to die, society punishes the people who assist them. In my opinion, punishing physicians in relation to this form of medical treatment is a moral contradiction. The indirect killing of a person, referred to as ââ¬Å"passive euthanasiaâ⬠, is thought to be the lesser of the two evils. Despite the fact that it is more legal than ââ¬Å"active euthanasiaâ⬠it is still the termination of a human life. Through the removal of life extending treatments, the physicians are still causing the patients death. Many life-sustaining treatments and examinations may actually cause the individual more pain and suffering, without a worthy return. A good medical example of this, are burn victims in which their survival is improbable, sometimes debridement treatments are used, which can provide the patient no gain what so ever and are extremely painful. When dealing with patients who will die with or without treatment, most people consider euthanasia the most appealing procedure. Legally euthanasia is broken down into those two categories, Active being illegal everywhere but Oregon and the Netherlands. In 1994 Oregon passed itsShow MoreRelatedApplication Of The Code Of Ethics For Nurses With Interpretative Statements1699 Words à |à 7 PagesApplication of the Code of Ethics for Nurses with Interpretative Statements As one of the cornerstone documents, the Code of Ethics for Nurses with Interpretative Statements helps to guide the ethical decisions of young and old nurses today (Finkelman Kenner, 2014, p. 22). Nurses will encounter many different ethical dilemmas in the healthcare field and must be prepared. A few dilemmas include active euthanasia, influenza vaccinations, maintaining an ethical environment, keeping patients healthcareRead MoreThe Morality Of Suicide Throughout The Ages1697 Words à |à 7 Pagescertain situations, but society generally doesnââ¬â¢t define this type of act as suicide because of the stigma associated with the word itself. Suicide can be more than just killing oneself over emotional distress; it can include honorable suicide, and euthanasia, which all have further reaching implications especially when analyzed throughout history. Origin and Development According to Online Etymology, the word suicide comes from ââ¬Å"the Latin root sui, which means oneself, and cidium meaning to killâ⬠(Harper)Read MoreMoral Perspectives On Physician Assisted Suicide2738 Words à |à 11 PagesMoral Perspectives on Physician-Assisted Suicide When your conscience says law is immoral, don t follow it - Jack Kevorkian Introduction Physician-assisted suicide, also known as voluntary active euthanasia, is easily one of the most prominent and controversial issues in media circulation today. Definitively, physician assisted suicide is as a physicianââ¬â¢s knowingly providing the means to commit suicide to a competent patient who voluntarily makes this request and uses those means independentlyRead MoreThe British House Of Lords Select Committee On Medical Ethics2506 Words à |à 11 PagesThere are different euthanasia laws in each country. 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Most of these dilemmas we face are due toRead MoreThe Social And Political Aspects Of Physician Assisted Suicide Essay2172 Words à |à 9 PagesPhysician-assisted suicide is not a new concept or phenomenon even though medical professional codes and ethics have long prohibited physician involvement in assisting an individual in carrying out such an act. However, over the years due to many high profile cases and various media outlets, calls for the repeal of this ban have increased. A total of four states (Oregon, Washington, Vermont, and California) and one being legal with court decision (Montana) have all passed the Death with Dignity law, and 21 moreRead MoreThe Ethical Principles Of Assisted Suicide2430 Words à |à 10 Pageswell-being? These are only a few of the many reasons why someone might want to die today or tomorrow. Whether this is right or wrong is very controversial. Assisted suicide is very prevalent in todayââ¬â¢s society, with five states deeming it legal and the remaining states considering it illegal. There are several major conflicting values and ethical principles within assisted suicide that may be in opposition to the code of ethics. However, the ethical principle of autonomy allows the patient to have controlRead MoreHsm 542 Week 12 Discussion Essay45410 Words à |à 182 Pagesgenetics, genetic research, or the human genome project, develop a set of legal and ethical guidelines, which can be applied to genetic issues for the conduct of medical practice and/or research. | B | Given the contentious debate surrounding issues of procreation, develop an institutional policy, which can be applied to the range of treatment and research issues related to procreation. | C | Given the mandate for advance directives, informed consent, and the legal obligation to report, illustrateRead MoreThe Controversy Over The Ethics Of Stem Cell Research Essay2367 Words à |à 10 PagesThe Controversy of Embryonic Stem Cell Research THE 210/04December 2, 2012 There is a debate over the ethics of stem cell research and many people on opposing sides of the issue are not aware of all aspects. In order to intelligently debate the legal and ethical issues regarding stem cell research, one must understand what stem cells are, the applications currently available, and the impact of the research. It is also important to understand the distinction between adult and embryonic stem cellsRead MoreOverpopulation in the Philippines4001 Words à |à 17 PagesREPRODUCTIVE HEALTH IN THE PHILIPPINES INTRODUCTION It has been a politically perceived issue that there is over population in the Philippines. This issue has been constantly blamed for the aggravating poverty situation. One side is claiming that unbridled population increase is putting so much strain on the financial and food resources of the country that more and more Filipinos are no longer eating three square meals a day. Economic rating system is also stating a poor Filipino family
Monday, December 16, 2019
Climate Change and Food Security Free Essays
string(64) " be what the range and principle of this research will warrant\." Changing Agricultural Practices: Shift of Agricultural Crops Subject to Market or Climate Change- A Study of Meghnath Gorahanna and Aurahi VDC in Mahottari District Climate Change and Food Security Introduction Nepal is an agro-dominated of course rich state. From physiographic facet, Nepal is divided into three distinguishable ecological zones- the Mountain, Hills and Tarai. Each part has its ain biophysical, socioeconomic and cultural differences. We will write a custom essay sample on Climate Change and Food Security or any similar topic only for you Order Now Agribusiness is the common business of bulk of population in the state. Almost to a big bulk of 65 per centum of Nepali population are dependent on agribusiness for their supports ( GoN, 2012 ) . The lowland Tarai, is the nutrient basket of Nepal. It is the exclusive part in agricultural excess, providing nutrient grains to the less productive hill and mountain countries. More than 70 per centum of families in Nepal have less than 1 hectare of land and many depend on agricultural lands that are excessively little to run into their subsistence demands ( GoN, 2011 ) . Although agricultural retentions per family are the smallest in the state, this sector dominates the economic system supplying about 35 per centum of the GDP ( CIA, 2011 ) . At present, Climate Change is a large challenge to the planetary environment and the economic system. Nepal has besides identified clime alteration as a cut acrossing issue by virtuousness of its nature and impacts. Despite nominal nursery gas emanation of about 0.025 per centum ( GoN, 2010 ) , Nepal is listed as a state at utmost hazard to the impacts of clime alteration ( CCVI, 2014 ) .According to the regional appraisal of International Panel of Climate Change the most profound impacts of clime alteration in Nepal will be in the sectors of agribusiness / nutrient security, H2O resources and biodiversity. The heavy trust on rain Federal agriculture, limited irrigation installations, and deficiency of H2O preservation and harvest home patterns makes Nepali agribusiness vulnerable to the impacts of clime alteration. The high dependance of husbandmans on monsoon have increased their exposure to rainfall fluctuation. Furthermore, the variableness in temperature have besides challenged the agriculture patterns. At many topographic points the fickle rainfall has resulted into diminution in harvest production. The state of affairs of deficient rain and increasing temperature have accounted for drouth, whereas the happening of intense rain in short period have reduced the land H2O recharge by speed uping overflow and triping inundations. These fortunes have induced negative effects in the agribusiness impacting harvest production and endangering nutrient security. Market whether physical or practical is a topographic point where the dealing of goods and services is carried out. Market is governed by demand and supply state of affairs and determines monetary value of goods and services. In instance of unfastened market topographic point, market is a large initiation factor for merchandises, it determines the monetary value and creates the win-win state of affairs of the purchaser and marketer. Tarai is the part of Nepal with the unfastened boundary lines with India and it implies that the market for the merchandises get wide-opened if proved competitory. Evidence from other parts of Africa shows that procedures of agricultural intensification and productiveness growing are frequently driven by hard currency harvests having the development of interlocked recognition, input, and end product markets ( von Braun and Kennedy 1994 ; Dorward, Kydd, and Poulton 1998 ; Shepard 1999 ) . Owing to the higher return from hard currency harvests husbandmans t hese yearss are more inclined towards hard currency harvest agriculture. At many instances, the local strains of harvest have been replaced by the improved or intercrossed 1s. These intercrossed harvests have higher outputs but at the same clip, they incur immense cost on environment and human wellness. Hybrid harvests fuel the usage of fertilisers and pesticides which causes dirt debasement and increases agricultural disbursals every bit good. Using analytical penetrations from the New Institutional Economics literature, Dorward, Kydd, and Poulton ( 1998 ) have shown that export-oriented hard currency harvests may function to excite smallholder harvest productiveness and income growing, provided that omnipresent recognition market failures can be overcome through institutional inventions in farmer/marketing agent relationships. The intent of this research is to place the factor which is responsible for the alteration in agricultural patterns in the tarai part. This survey aims to analyze the instance of cultivation displacement from staple harvest to hard currency harvest is whether due to climate alteration or market forces. Rationale of the Study Nepal is home to preponderantly rural population. Agribusiness is the pillar of Nepalese economic system which non merely employs two-third of the countryââ¬â¢s labour force but besides contributes over tierce in the national GDP. The alteration in agricultural pattern can be due impacts of either clime alteration or market forces. Associating with climate alteration issues, the addition in temperature is likely to do more harm on agricultural sectors in Tarai part compared to the hills and mountains. Tarai part lying at low countries are susceptible to downpours. Monsoon rains, snow thaw, and glacial thaw run downstream from upland parts doing the Tarai the most ataÃâ ?risk country for deluging. Besides this, the happening of brassy inundations in the fields have besides caused siltation of farm lands and decreased its birthrate. The heavy H2O tabular array and the depletion of groundwater is the another critical job witnessed in Tarai these yearss. This state of affairs has af fected the twelvemonth unit of ammunition irrigation. Owing to fickle monsoon and deficiency of irrigation, rice organ transplant is delayed and therefore the production has decreased. There are besides groundss of switching agricultural form. Thus the impact of clime alteration in tarai can endanger the nutrient security of the full state. There is a famine of literature on the factor- based harvest displacements in assorted parts of the universe. In instance of Nepal excessively this sector of research has been out of involvement. Therefore, to carry through the spread that has of course been built between the topographical disparities based on the harvest displacement will be what the range and principle of this research will warrant. You read "Climate Change and Food Security" in category "Essay examples" Study Area The survey country will be chiefly based in the Mahottari territory of Nepal which is one of the premier territories among the six territories of Janakpur zone. Though the territory is a premier manufacturer for harvests, it suffers from drouth and it is besides shattered by the inundation during showery seasons. This territory covers 0.68 % of the entire country of Nepal and the population in the territory is about 2.39 % of the entire population of the state ( Mahottari District Profile, CBS 2065 B.S. ) . Though the territory has chances like fertile cultivable land, entree to electricity, forest, rivers and unfastened boundary line to India, the territory has non been able to come on which besides supports the ââ¬Å"Resource Curse Hypothesisâ⬠. As sample for the survey, two VDCs of the territory viz. Meghnath Gorahanna and Aurahi will be purposively selected. The VDC Meghnath Gorahanna is located on the cardinal Tarai part of Nepal whereas Aurahi VDC is really nigh to the main road traveling south from the territory. The entire population of the Meghnath Gorahanna VDC is 6077 in 1048 families, with 3135 female and 2942 as male population. And, the entire population of the Aurahi VDC is 8575 in 1638 families, with 4225 male and 4350 as female population. In footings of exposure ranking of the National Adaptation Plan of Action ( NAPA ) of Nepal, Mahottari falls in high vulnerable territory in the exposure index to climate alteration. The intent for choosing these two wards is that in both of these wards husbandmans have shifted the cultivation from cereal harvests to hard currency harvests. Aims of the Research: The overall aim of the survey is to place whether the cultivation displacement from staple harvests to hard currency harvests is climate induced or market driven. To accomplish the above mentioned general aim, the following specific aims will be fulfilled. To place the challenges in the agriculture patterns originating out of clime alteration induced environmental debasement in Meghnath Gorahanna and Aurahi VDCs of Mahottari territory. To transport out cost-benefit analysis of the basic harvests versus hard currency harvests in Meghnath Gorahanna and Aurahi VDCs. To measure the production form of the harvests in the several wards and its impact on the nutrient security position of the part. To warrant the above aims, the undermentioned hypotheses will be used: The cultivation displacement from staple harvest to hard currency harvest is climate induced. The cultivation displacement from staple harvest to hard currency harvest is market driven. Research Questions What is peopleââ¬â¢s apprehension of environmental debasement due to climate alteration? What are the challenges in the agriculture patterns originating from clime alteration in the VDCs? What is the production form of the harvests and the value generated by them in the several wards? What is the province of the cost-benefit analysis of the basic and hard currency harvests produced in the several wards? What is the position of nutrient handiness, nutrient use, nutrient handiness and nutrient stableness in the survey country? Methodology The Research Design As clime alteration impacts have multiple dimensions, research on understanding these dimensions requires a methodological analysis uniting the macro and micro range of question, primary and secondary informations, qualitative and quantitative methods and a cross-disciplinary attack. To acquire the holistic image and in-depth apprehension of the research issues and concerns, assorted method attack will be applied for research survey, where triangulation of quantitative and qualitative informations will besides be used for this survey. Primary Data Collection: The primary nature of the research design of the proposed survey is explorative and descriptive. Quantitative and qualitative primary informations from multi-stakeholders in two different VDCs will be collected utilizing study, in-depth interviews, focused group treatment and PRA techniques such as societal function and transect walk ( for physical confirmation ) . To forestall any biasness in the research, approximately 10 % of the entire population, 100 people will be considered as the sample including both VDCs. Besides that, to keep the quality of research, after the questionnaire studies, Key Informantsââ¬â¢ Interview will be carried out with School schoolmasters and Agriculture Officer of the part. If necessary, Water tabular array analysis utilizing GIS tools and techniques will besides be carried in order to find the depletion of land H2O. Secondary Data Collection: Temperature and Precipitation informations of Mahottari territory obtained from Department of Hydrology and Meteorology ( DHM ) will be used to find the tendency analysis. District and small town profiles will be referred from Central Bureau of Statistics as per the demand. Datas Analysis: Both qualitative and quantitative analysis tools and techniques will be used for the information analysis. The cryptography and decryption of informations will be done as per the demand. MS- Word. MS- Excel will be used for the written and graphical presentation of the information. Statistical Package for Social Scientists ( SPSS 20.0 ) will be used for the correlativity analysis, arrested development analysis and histogram analysis as per the research demand. Restrictions Lack of temperature and precipitation informations of the specific wards. This research will be carried out in specific wards of Meghnath Gorahanna VDC and Aurahi VDC of Mahottari territory, therefore the research end products can non be generalized. This research will be a sample based research within a limited timeframe, so the research end product might hold diverting consequences for a portion of population. Expected end products The research will lend to the concluding study to be developed by Women in Environment ( WE ) on the undertaking Populating with Climate Change: Function Experiences and Adaptation Strategies in the Global South and North ( LCC ) This research study will be the foundation papers for the policy preparation sing the factor based cultivation displacement in the tarai part of Nepal. Mentions Climate Change Vulnerability Index ( CCVI ) , ( 2014 ) , Maple croftââ¬â¢s Climate Change and Environmental Risk Atlas, Available at: hypertext transfer protocol: //maplecroft.com/themes/cc/ ( accessed 04/04/2014 ) . CIA ( Central Intelligence Agency ) . 2011. The World Fact book. Dorward. A ; J. Kydd and C. Poulton.eds, ( 1998 ) , ââ¬Å"Smallholder Cash Crop Production Under Market Liberalization.â⬠Oxon ; New York, NY: CAB International c1998. Government of Nepal ( GoN ) , ( 2010 ) , ââ¬Å"National Adaptation Programme of Action ( NAPA ) to Climate Change, Ministry of Environment, Kathmandu. Government of Nepal ( GoN ) , ( 2012 ) , ââ¬Å"Economic Survey 2011/12â⬠, Ministry of Finance, Kathmandu. Government of Nepal ( GoN ) , ( 2011 ) , ââ¬Å"Nepal Living Standard Survey ( NLSS ) 2011â⬠, Central Bureau of Statistics, Kathmandu. Hem R. Regmi. ââ¬Å"Effect of Unusual Weather on Cereal Crop Production and Household Food Securityâ⬠,The Journal of Agriculture and Environment. ( 2007 ) : 24. Von Braun and E. Kennedy ( explosive detection systems ) , ( 1994 ) ,Agricultural Commercialization, Economic Development, and Nutrition, The Johns Hopkins Press Ltd. Maryland, 1994. How to cite Climate Change and Food Security, Essay examples
Sunday, December 8, 2019
Health e-Record for Quality and Safety Implications-myassignmenthelp
Question: Discuss about theHealth e-Record for Quality and Safety Implications. Answer: Introduction Health e-record refers encompasses a nationwide system integrating data from healthcare facilities all over to generate a common record all patients can access online (Par et al., 2014). This paper reflects on the hustles of Elise with regards to her daughters medication focusing on the usefulness of health e-record. While Elise was able to have a successful medical procedure for Violet, the presence of e-record would have handy. Description Elise receives an emergency call from her paediatrician regarding the prick test of her baby, but could not visit the facility as she was out of town travelling to another city, Brisbane. In this event, one notes two key themes of nursing care; Information focus and patient focus. Information focus relates to how information is used and made accessible to the patient while patient focus relates to how the care services is based on the patients needs. Feelings As a nurse, I feel remorseful that it took Elise through a lot of hustle before she could get her daughter, Violet through her medical procedures. All these glitches were caused by the information focus of nursing care. Elise could not get information regarding the past medical history of her daughter from her former healthcare facility in time when she moved between cities. Values/Beliefs As a nurse, I have beliefs that patients are entitled to access good quality care with less hustles. The quality of service a patient receives depends upon the timeliness and the relevance of care to the needs of the patients. In this case, Elise could not access the information about the medical history of her daughter from her past healthcare facility in timely hence interfering with quality of care to her daughter. Analysis The events in the case of Elise and her daughter were not pleasant. Elise had previously taken her daughter to a health facility in Toowoomba city for prick heal test, but had not gotten the results until when she was on her way out of the city to Brisbane. Elise decides to take her daughter to another healthcare facility in Brisbane. While at the facility, she needs to provide information about her daughter which she did not have. Also, the fact that the former facility did maintain any electronic record of patients information makes Elises retrieval of the information even harder. She has to wait for the pedestrian to check in before she can call to be provided with the information from the paper filing. At this point, health e-records turn out to be an invaluable tool in healthcare (King, Patel, Jamoom, Furukawa, 2013). Had the healthcare facilities maintained e-records, it would have been easier for information about Violet to be accessed. Conclusions Drawn From the above scenario, it is evident that implementation of health e-records would have a number of positive indicators to this patient care experience. These would include improvements in the quality of care reduced medical errors and improved appropriateness of care (Hoover, 2016; Middleton et al., 2013). On the other implementation of the same e-records would have a range of negative indicators on the patient experience in this scenario including security and privacy concerns of the patients (Bowman, 2013). Action Plan In this event, the elements of care for the individual include Holistic, patient-centered approach, management of time, clinical atmosphere. Partnering plays a critical role in the transformation health care. Partnering can be achieved through interprofessional collaboration between hospitals and adopting health electronic record system. Interprofessional collaboration enhances communication and coordination between different hospitals, thus improving safety and quality of patient care. The integrated electronic healthcare system enhances access to quick access to patient data thus appropriateness of care (Krist et al., 2014). Conclusion The essay has explored health care experience of Elise as regards her daughter. From the exploration, it is evident that Elise has had a tough experiencing getting her daughter Violet through medications. The reason for this is attributed to information focus where e-records are not availed to enhance quick access to patient information. Implementing health e-records would sort out this stalemate. References BowmanS. (2013). Impact of Electronic Health Record Systems on Information Integrity: Quality and Safety Implications.Perspectives in Health Information Management,10(Fall), 1c Hoover,R. (2016). Benefits of using an electronic health record.Nursing,46(7), 21-22. doi:10.1097/01.nurse.0000484036.85939.06 King,J., Patel,V., Jamoom,E.W., Furukawa,M.F. (2013). Clinical Benefits of Electronic Health Record Use: National Findings.Health Services Research,49(1pt2), 392-404. doi:10.1111/1475-6773.12135 Krist,A.H., Beasley,J.W., Crosson,J.C., Kibbe,D.C., Klinkman,M.S., Lehmann,C.U., Waldren,S.E. (2014). Electronic health record functionality needed to better support primary care.Journal of the American Medical Informatics Association,21(5), 764-771. doi:10.1136/amiajnl-2013-002229 Middleton,B., Bloomrosen,M., Dente,M.A., Hashmat,B., Koppel,R., Overhage,J.M., Zhang,J. (2013). Enhancing patient safety and quality of care by improving the usability of electronic health record systems: recommendations from AMIA.Journal of the American Medical Informatics Association,20(e1), e2-e8. doi:10.1136/amiajnl-2012-001458 Par,G., Raymond,L., Guinea,A.O., Poba-Nzaou,P., Trudel,M., Marsan,J., Micheneau,T. (2014). Electronic health record usage behaviors in primary care medical practices: A survey of family physicians in Canada.International Journal of Medical Informatics,84(10), 857-867. doi:10.1016/j.ijmedinf.2015.07.005
Sunday, December 1, 2019
The Phenomenon Of Bipolar Affective Disorder Has Been A Mystery Since
The phenomenon of bipolar affective disorder has been a mystery since the 16th century. History has shown that this affliction can appear in almost anyone. Even the great painter Vincent Van Gogh is believed to have had bipolar disorder. It is clear that in our society many people live with bipolar disorder; however, despite the abundance of people suffering from it, we are still waiting for definite explanations for the causes and cure. The one fact of which we are painfully aware is that bipolar disorder severely undermines its' victims ability to obtain and maintain social and occupational success. Because bipolar disorder has such debilitating symptoms, it is imperative that we remain vigilant in the quest for explanations of its causes and treatment. Affective disorders are characterized by a smorgasbord of symptoms that can be broken into manic and depressive episodes. The depressive episodes are characterized by intense feelings of sadness and despair that can become feelings of hopelessness and helplessness. Some of the symptoms of a depressive episode include anhedonia, disturbances in sleep and appetite, psychomotor retardation, loss of energy, feelings of worthlessness, guilt, difficulty thinking, indecision, and recurrent thoughts of death and suicide (Hollandsworth, Jr. 1990 ). The manic episodes are characterized by elevated or irritable mood, increased energy, decreased need for sleep, poor judgment and insight, and often reckless or irresponsible behavior (Hollandsworth, Jr. 1990). Bipolar affective disorder affects approximately one percent of the population (approximately three million people) in the United States. It is presented by both males and females. Bipolar disorder involves episodes of mania and depression. These episodes may alternate with profound depressions characterized by a pervasive sadness, almost inability to move, hopelessness, and disturbances in appetite, sleep, in concentrations and driving. Bipolar disorder is diagnosed if an episode of mania occurs whether depression has been diagnosed or not (Leiby,1988). Most commonly, individuals with manic episodes experience a period of depression. Symptoms include elated, expansive, or irritable mood, hyperactivity, pressure of speech, flight of ideas, inflated self esteem, decreased need for sleep, distractibility, and excessive involvement in reckless activities (Hollandsworth, Jr. 1990). Rarest symptoms were periods of loss of all interest and retardation or agitation (Gurman, 1991). As the National Depressive and Manic Depressive Association (MDMDA) has demonstrated, bipolar disorder can create substantial developmental delays, marital and family disruptions, occupational setbacks, and financial disasters. This devastating disease causes disruptions of families, loss of jobs and millions of dollars in cost to society. Many times bipolar patients report that the depressions are longer and increase in frequency as the individual ages. Many times bipolar states and psychotic states are misdiagnosed as schizophrenia. Speech patterns help distinguish between the two disorders (Turner,1989). The onset of Bipolar disorder usually occurs between the ages of 20 and 30 years of age, with a second peak in the mid-forties for women. A typical bipolar patient may experience eight to ten episodes in their lifetime. However, those who have rapid cycling may experience more episodes of mania and depression that succeed each other without a period of remission (DSM III-R). The three stages of mania begin with hypomania, in which patients report that they are energetic, extroverted and assertive (Hirschfeld, 1995). The hypomania state has led observers to feel that bipolar patients are addicted to their mania. Hypomania progresses into mania and the transition is marked by loss of judgment (Hirschfeld, 1995). Often, euphoric grandiose characteristics are displayed, and paranoid or irritable characteristics begin to manifest. The third stage of mania is evident when the patient experiences delusions with often-paranoid themes. Speech is generally rapid and hyperactive behavior manifests sometimes associated with violence (Hirschfeld, 1995). When both manic and depressive symptoms occur at the same time it is called a mixed episode. Those afflicted are a special risk because there is a combination of hopelessness, agitation, and anxiety that makes them feel like they could jump out of their skin(Hirschfeld, 1995). Up to 50% of all patients with mania have a variety of depressed moods. Patients report feeling dysphoric, depressed, and unhappy; yet, they exhibit the energy associated with mania. Rapid cycling mania is another presentation of bipolar disorder. Mania may be present with four or more distinct episodes within a 12-month period. There is now evidence to
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