COVID Vaccine

1

Introduction

According to Moreira (2020), “Since most, if the COVID-19 vaccines are still in the development stage and thus if they are not successful, people will be left to develop herd immunity which will mean the loss of many lives among the vulnerable population especially the elderly”. Presently, more than 175 COVID19 inoculations are being developed.

B paraphrase

All government strategies worldwide rely on developing a vaccine that will prevent the further spread of the COVID19 virus. However, there are no sure bets that a vaccine would effectively work and prevent the spread of the virus on the downside. Even though tried and tested vaccines give hope to people worldwide, experts are not yet sure if the spread of COVID19 will halt due to a vaccine (Koirala et al., 2020). Despite the doubts and fears, a COVID19 vaccine seems to be the best way of curbing the spread of COVID19.

C Thesis statement

 COVID19 impacts various individuals differently. The majority of the infected people will exhibit minor or restrained symptoms and recuperate without the need for detailed medication. There are three underlying reasons for pursuing a COVI19 vaccine- the vaccine will hinder the virus from spreading further. The vaccine will boost community immunity against the disease. The vaccine will prevent vulnerable people such as the elderly from falling ill.

Reasons for Pursuing COVID19 Vaccine

II First Strong Argument

A

 The vaccine will stop the spread of the virus. The rate at which COVID19 is spreading cannot be stopped by physical means.  A vaccine can be the best way of ensuring that people cannot spread the virus further. With time, the virus mutates into a more complicated organism; some people become asymptomatic while some die in a matter of seconds.

B paraphrase

To save majority of the people, a vaccine would be an ideal way of doing it. A vaccine's role is to ensure that people develop immunity against COVID 19 illness (Udupa et al., 2020). This prevents them from spreading the disease to other uninfected people. Therefore, a vaccine is a mechanism use to construct the body's innate immunity before falling ill. This implies that one cannot fall ill hence the chances of spreading the illness are minimal. Incase an immunized person is exposed to COVID19, the body will successfully build a defense system against the disease; thus the virus will not manifest. Based on professional sentiments, COVID 19 vaccine is more than capable of regulating the spread of the COVID19 disease (Gallagher, 2020). Unparalleled investigative efforts and international harmonization has led to the swift development of possible vaccines and tried and tested steps to preventing the COVID19 spread. Currently, there are numerous vaccine types (Jeyanathan et al., 2020). It is vital to note that COVID19 is a respiratory illness. The first cases were reported in Wuhan China. Primarily, the illness weakens and destroys the respiratory system. More so, a vaccine is made up of antigens which manifest illness. More so, the vaccine is effective enough to boost the body's immunity and prepare it to generate antibodies for fighting off the actual illness.

C Antithesis

 The vaccine will not be effective enough to stop the spread of the virus. Most people claim that a vaccine could be detrimental to the human body, and therefore it will not hinder the spread of the virus (Moreira, 2020). First, the novel virus would vigorously fight off the vaccine, which in turn lead to the emergence of a more superior version of the virus. Therefore, the vaccine would only make the virus stronger than it previously was.

E Counter Argument

 This argument can only hold if the vaccine is made according to specification other than the COVID19 virus. A vaccine is simply a weakened version of the COVID19 virus; hence it is not a foreign form of the virus. Therefore a vaccine helps the body progressively build up a stronger immunity to fight off the virus. Most of the time, a vaccine rarely fails due to the verifications framework and procedural mechanisms that ensure that a vaccine works the way it was intended to before being released for public consumption. Thus, the chances of releasing a vaccine that will be dangerous to the human population are nonexistence hence the safety of the community can be assured all over the entire world. The chance once offers to the people has to be in line with medical and tried and tested mechanisms.

III Second Strong Argument

 The vaccine will provided immunity against the virus . A vaccine would trigger the human immunity to fight off the disease, consequently preventing the disease from spreading further and causing multiple deaths. Currently, most the individuals are susceptible to the illness. The rules and regulations put in place are the only reasons the death toll has decreased since the virus became a global pandemic.

B paraphrase

A vaccine would train the human body to react to the virus by discontinuing it from acquiring and replicating the disease; hence COVID19 cannot spread. Besides, possessing a vaccine forms a pedestal on which other medication forms can be rendered in the long run. Therefore it is necessary to initiate an effective vaccine. According to BioNTech Company, the vaccine is 95% effective and ready for use (Udupa et al., 2020). More so, the UK will administer 40million of the vaccine to its citizens. The vaccine will be administered two doses in a 21 day period. So far, more than 43,000 individuals have already taken the vaccine (Koirala et al., 2020).

C Antithesis

    The body is naturally immune to the virus and therefore no need for the vaccine. This is because the body is naturally immune to viruses in general, and therefore there is no need to come up with another vaccine (Udupa et al., 2020). The vaccine may worsen the virus and quicken its progression stages.  The novel virus has not been fully understood; hence its long terms effect are still not yet known. The uncertainty revolving around the illness has caused negative sentiments to rise against the vaccine (Graham, 2020). Even though the virus has devastated the entire world, a vaccine seems inefficient in preventing the further spread of the disease.  The primary assumption is that the virus might go either way due to quick adaptation of the virus to its host environment.

E Counterargument

 Just like any other virus, COVID19 belongs to a certain group of organisms. Its sequences can be predicted due to the previous studies performed on other Coronavirus classes. Therefore, the vaccine will perform exemplary and help the world gain momentum once again. Also, there is no better alternative than a vaccine that will prevent deaths and spread the vaccine.

IV Strongest Argument

A

 Getting a Covid19 vaccination will prevent people from getting infected. The vaccine is capable of saving the lives of many individuals' especially older adults with an underlying condition. The main aim of developing the vaccine is saving the lives of the many people whose immune system is incapable of fighting off the virus.  COVID19 has been able to take away both young and old. It spread at an alarming rate, and so far more than a 6.1million people have been infected with the disease. More so, social distancing and curfews are not effective enough.

B

 Hence, a vaccine will give all the people a fighting chance. A vaccine cannot harm the body, nor can it hinder the body from performing its natural function. In fact, a vaccine adds to the body's immune system (Graham, 2020). A vaccine is the best way to hinder the spread of the virus while giving vulnerable people the chance to resume their life without fear. The even that one dies from the virus gives people a chance to stay alive and control the outcome.

C Antithesis

 Some people are against vaccination so the vaccine will not be of help to them. Most people are against the production of the vaccine; thus the public will not willingly take the vaccine due to the uncertainty surrounding it (Graham, 2020). The negative attitude toward the vaccine has led to the formation of movement, which hinders the spreading awareness on the importance of the vaccine and how it will fight off the virus. Voicing concerns against the vaccine wake up negative emotion around the vaccine, which in turn discourages the public from using it.

Counterargument

    The intentions of the vaccine will be known when the death toll reduces. In the current day and age, information is all over the internet and other media platforms. No one can be able to stop the production of a vaccine. In the end, people come to the realization that the vaccine is effective due to its capability to save lives.

Strong Argument

 When produced in large quantities, the vaccine help people’s lives get back to normal. With the emergence of the virus, government enacted restrictions and social distancing rules. There is no single aspect of life that COVId19 has to affect. However, with a vaccine, people can interrupt with fear of infecting other people.

Paraphrase

A vaccine is an essential instrument that will enable control the spread of the virus. When joined with mass testing and other preventive intervention, vaccines will bring back normalcy to the society (Udupa et al., 2020). People can go about working without any fear of being infected.

Antithesis

Most people are skeptical about vaccines and their safety so this might hinder them from accepting the vaccine even when it is made available (Udupa et al., 2020).  Negativity surrounding the vaccine will hinder its availability in the community. Also, people have a choice to consume or reject the vaccine. Therefore, its effectiveness depends entirely on public acceptance.

Counter argument

 Governments have a duty to present the right information to the public. No one has a right to misinform the public. Therefore, success delivery of the vaccine depends on how well the government and other medical institutions bring awareness to the communities.

V Conclusion

  COVID19 has disrupted the normal way of human life. People have to work from home and social distance while at social places. Due to the detrimental impact, the disease had on the entire, scientists were forced to develop a vaccine that would prevent the disease from spreading further (Koirala et al., 2020). A vaccine would build up the human immune systems and enable them to fight off the disease. Also, vaccine would protect people who fall under the vulnerable group such as the elderly and people who suffer from underlying medical conditions.

References

Gallagher, J. (2020). Coronavirus vaccine: When will we have one? BBC News. Retrieved from: https://www.bbc.com/news/health-51665497

Graham, B. S. (2020). Rapid COVID-19 vaccine development. Science, 368(6494), 945-946.

Jeyanathan, M., Afkhami, S., Smaill, F., Miller, M.S., Lichty, B.D. and Xing, Z., 2020. Immunological considerations for COVID-19 vaccine strategies. Nature Reviews Immunology, 20(10):615-632. doi: 10.1038/s41577-020-00434-6

Koirala, A., Joo, Y. J., Khatami, A., Chiu, C., & Britton, P. N. (2020). Vaccines for COVID-19: The current state of play. Paediatric respiratory reviews, 35, 43-49. https://doi.org/10.1016/j.prrv.2020.06.010

Moreira, S. (2020). Coronavirus: what will happen if we can't produce a vaccine? Retrieved from: https://theconversation.com/coronavirus-what-will-happen-if-we-cant-produce-a-vaccine-144307

Udupa, N., Seetharam, R. N., & Mukhopadhyay, C. (Eds.). (2020). COVID-19: A Multidimensional Response. Manipal Universal Press.

Introduction

  The aspect of practice selected for this particular study is online counselling clients with mild to moderate depression. There are three pieces of evidence that will be critically analyzed in terms of their value and limitations to online counselling of mild and moderate depression clients. From these analysis, conclusions will be discussed in relation to the online counselling of mild and moderate depression.

 Evidence 1

 According to Egede et al., online counselling of clients with mild and moderate depression is convenient. This is because the counselor and patient have accessibility to each other at various periods. Online counselling eliminates the challenges that comes with setting up and booking appointments within conventional locations. While counselling mild and moderate depressed clients, this piece of evidence indicates that online counselling has the potential to minimize stigma tied to mental illness. Based on this piece of evidence, online counselling mild and moderate patients’ calls for the therapist to address client’s most urgent needs and put in place offer permanent and reliable counselling records so that they can build up from previous counselling sessions.

In the case of treating old patients, who stay far away in rural areas and experience health disparity due to the lack of proper mental medical facilities (Ruwaard et al., 2012). Telepsychology is a unique plan that aims to easily bringing therapy sessions close to the old patients. It is vital to note that old patients lack the means and financial ways of coming up with more than one personal channel of meeting their health needs, also taking into account the basic and immobility associated with old, online therapy session seems to be the best way of accessing these old individuals and solving their condition which in the long run can be helpful in saving lives and initiating a personal changing times with the world (Andrews et al., 2018). Therefore online therapy can address challenges that come with health disparities and in the meantime giving it is cheap to access technology than it is to walk into a mental institution to seek for medical services and advice (De Graaf et al., 2009).

In conclusion, mild and moderate patients’ needs can be met as long as the therapist both the patient and the specialist can reflect on the subject matter under discussion as well as examine the patient’s progress from previous sessions. Also, the therapist has to ensure that accountability standards are set high and recordkeeping is paramount during each session. In addition, good recordkeeping can act as an instrument for management and further discussion.

 The value of these piece of evidence is its application of recent learning material hence makes the evidence actionable and relevant to the topic under discussion. Also, the only limitation tied to this piece of evidence is the failure on unveiling how a therapist can make the online sessions more professional. More so patients with mild and moderate depression, counselling is the first step to the treatment. Therefore, the evidence does not explain how the patient can access other forms of medication if the online counselling session deem it so.

Evidence 2

Gros et al., (2013) highlighted using evidence-based online counselling as a way of reducing expenses and enlarging the psychotherapy framework. Online counselling of mild and moderate depression patients is possible due to the inclusion of more than one technological system such as modern day telecommunication systems. With telecommunication, one is able to store information, take pictures of the patient while at the same time aligning medical objectives to the outcome. Therefore, online counselling is not just two people talking, it is the integration of technology to monitor and manage the progress of the patient. The value of this information brings to light a chance to educate and decrease health disparities found in most of places. During the online sessions, the client can remain anonymous or reveal themselves to the therapist, this types of options give room to the exposition of more interventions for the therapist to explore. One of the primary advantage of incorporating other technological aspects during online counselling is the accurate results retrieved from such counselling. Patients can easily communicate via communication applications hence easing the systematic manner in which the therapist assesses information. On the other side, technology hinders actual follow up due to the physical distance separating the patient from the therapist.

Evidence 3

 According to Sally Brown’s sentiments, the world is changing at a rapid pace and therefore, online counselling is an inevitability. It would be prudent for prior preparation before online counselling can be made possible for patients suffering from mild and moderate depression. Instead of just embracing technology, therapists need to enroll for a training course that will equip them fully with the necessary BACP competencies (Brown, 2020). In order to meet the needs of mild and moderate depression patients, therapists have to undertake a course that will prepare them on critical mechanisms needed to handle the medical needs of mild and moderate patients. Therefore, these informs on issues that needs to be done before a specialist starts handling mild and moderate depression patients. Online counselling has to be as effective as the conventional form of counselling, training should be a mandatory starting point as it makes the treatment of mild patients sustainable. Training is helpful to the therapist as it helps prevent burnout and enables the therapist coordinate more than one aspect during the therapy session. Even though working online is recommended, one has to transition from in person to online as it makes work easier and the counsellor is able to hand more work while dealing with mild and moderate depression clients. Therefore, the relevance of these piece of evidence to online counselling of mild and moderate patients lies in the suitability. First one has to consider special consideration before assessing the patient during the sessions. In simpler terms, this piece of evidence helps therapist prepare for online counselling by informing on coping mechanisms and other types of preparation a therapist needs to make before commencing online counselling.

Online work or telehealth offers an increased availability to therapy for people with mental illness and even mobility issues (Gros et al., 2013). The advantages that come with supple preparation, accessibility to therapy in any place among other beneficial encounters. Also, the changing times, and the increased need for basic counselling needs makes online working a better option for treating mild depression. Sometimes, one cannot get hold of  the immediate surrounding and change the perspective of the client, it can be an opportunity has to teach the patient how to handle the specified underlying issues causing the illnesses without having to come to contact with him or her personally.

NICE Official Guidelines

Perceiving the future of therapy online platforms might need to be put in good use so as to meet the immediate needs of the patients. Even though the usage of telepsychology is speedily spreading across the world, the specialists need to keep in check all the physical mechanisms that can be used to regulate the practice from unscrupulous business men (Barak et al., 2008). The eventful use of these clinical services in and out of the medical institutions is not yet detailed to warrant a safety pass from most medical bodies hence it is the work of the therapists to ensure that everything is done according to the regulations and framework set in place by medical bodies. In addition, most of the times people with mild depression need more than counselling, some might need complementary services to accompany with the given counselling (Kwok et al., 2014). Therefore, it is up to the therapist to follow up on how the patient will gain access to the other complimentary services that ought to be accompanied with the other additional services.

Conclusion

 Online therapy has helped decrease the rising cases of mild depression. Mild depression patients are not in need of extensive levels of medical care hence online therapy serves as a good tool for opening up the conversation and pursuing further medical conditions. In most of the cases, online therapy has been able to come up with better ways of engaging the patients and making use of constructive conversation coupled with better evidence based intervention to deal with the patients.

Reference

Andrews, G., Basu, A., Cuijpers, P., Craske, M. G., McEvoy, P., English, C. L., & Newby, J. M. (2018). Computer therapy for the anxiety and depression disorders is effective, acceptable and practical health care: an updated meta-analysis. Journal of anxiety disorders, 55, 70-78.

Barak, A., Hen, L., Boniel-Nissim, M., & Shapira, N. A. (2008). A comprehensive review and a meta-analysis of the effectiveness of internet-based psychotherapeutic interventions. Journal of Technology in Human services, 26(2-4), 109-160.

Clarke, J., Proudfoot, J., Birch, M. R., Whitton, A. E., Parker, G., Manicavasagar, V., ... & Hadzi-Pavlovic, D. (2014). Effects of mental health self-efficacy on outcomes of a mobile phone and web intervention for mild-to-moderate depression, anxiety and stress: secondary analysis of a randomised controlled trial. BMC psychiatry, 14(1), 272.

De Graaf, L. E., Gerhards, S. A. H., Arntz, A., Riper, H., Metsemakers, J. F. M., Evers, S. M. A. A., ... & Huibers, M. J. H. (2009). Clinical effectiveness of online computerised cognitive–behavioural therapy without support for depression in primary care: randomised trial. The British Journal of Psychiatry, 195(1), 73-80.

Egede, L. E., Frueh, C. B., Richardson, L. K., Acierno, R., Mauldin, P. D., Knapp, R. G., & Lejuez, C. (2009). Rationale and design: telepsychology service delivery for depressed elderly veterans. Trials, 10(1), 22.

Frazer, C. J., Christensen, H., & Griffiths, K. M. (2015). Effectiveness of treatments for depression in older people. Medical Journal of Australia, 182(12), 627-632.

Gros, D.F., Morland, L.A., Greene, C.J., Acierno, R., Strachan, M., Egede, L.E., Tuerk, P.W., Myrick, H., & Frueh, B.C. Delivery of Evidence-Based Psychotherapy via Video Telehealth. Journal of Psychopathology & Behavioral Assessment. 2013;35(4):506-521. https://doi.org/10.1007/s10862-013-9363-4

Hedman, E., Ljótsson, B., Kaldo, V., Hesser, H., El Alaoui, S., Kraepelien, M., ... & Lindefors, N. (2014). Effectiveness of Internet-based cognitive behaviour therapy for depression in routine psychiatric care. Journal of affective disorders, 155, 49-58.

Kessler, D., Lewis, G., Kaur, S., Wiles, N., King, M., Weich, S., ... & Peters, T. J. (2009). Therapist-delivered internet psychotherapy for depression in primary care: a randomised controlled trial. The Lancet, 374(9690), 628-634.

Kivi, M., Eriksson, M. C., Hange, D., Petersson, E. L., Vernmark, K., Johansson, B., & Björkelund, C. (2014). Internet-based therapy for mild to moderate depression in Swedish primary care: short term results from the PRIM-NET randomized controlled trial. Cognitive behaviour therapy, 43(4), 289-298.

Kwok, T., Au, A., Bel Wong, I. I., Mak, V., & Ho, F. (2014). Effectiveness of online cognitive behavioral therapy on family caregivers of people with dementia. Clinical interventions in aging, 9, 631.

Meyer, B., Berger, T., Caspar, F., Beevers, C., Andersson, G., & Weiss, M. (2009). Effectiveness of a novel integrative online treatment for depression (Deprexis): randomized controlled trial. Journal of medical Internet research, 11(2), e15.

Murillo, L. A., Follo, E., Smith, A., Balestrier, J., & Bevvino, D. L. (2020). Evaluating the Effectiveness of Online Educational Modules and Interactive Workshops in Alleviating Symptoms of Mild to Moderate Depression: A Pilot Trial. Journal of Primary Care & Community Health, 11, 2150132720971158.

Ruwaard, J. J. (2013). The efficacy and effectiveness of online CBT. Universiteit van A van der Vaart, R., Witting, M., Riper, H., Kooistra, L., Bohlmeijer, E. T., & van Gemert-Pijnen, L. J. (2014). Blending online therapy into regular face-to-face therapy for depression: content, ratio and preconditions according to patients and therapists using a Delphi study. BMC psychiatry, 14(1), 355.msterdam [Host].

Ruwaard, J., Lange, A., Schrieken, B., Dolan, C. V., & Emmelkamp, P. (2012). The effectiveness of online cognitive behavioral treatment in routine clinical practice. PLoS one, 7(7), e40089.

Saddichha, S., Al-Desouki, M., Lamia, A., Linden, I. A., & Krausz, M. (2014). Online interventions for depression and anxiety–a systematic review. Health Psychology and Behavioral Medicine: An Open Access Journal, 2(1), 841-881.

Spijkerman, M. P. J., Pots, W. T. M., & Bohlmeijer, E. T. (2016). Effectiveness of online mindfulness-based interventions in improving mental health: A review and meta-analysis of randomised controlled trials. Clinical psychology review, 45, 102-114.

Topooco, N., Riper, H., Araya, R., Berking, M., Brunn, M., Chevreul, K., ... & Kleiboer, A. (2017). Attitudes towards digital treatment for depression: a European stakeholder survey. Internet interventions, 8, 1-9.

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brown, s. (2020). In practice: Working remotely Therapy Today, May 2020 Volume 31 Issue 4. Retrieved 8 December 2020, from.

How does Provider-Patient Communication influence patient outcome?

Communication Question: How communication between healthcare providers and their patients influences patients’ health outcomes?

Introduction

In clinical practice, provider-patient communication is a fundamental part of care delivery. When this communication is done effectively, it provides therapeutic effects for patients leading to improved health outcomes. The way a physician conveys information to patients holds equal importance as the message being communicated. In this context, patients who understand the information being communicated by the health provider have a higher likelihood of acknowledging their health problems, expressing their feelings, understanding available treatment and health management options and in turn, change their behaviors accordingly and adhere to the set medication schedule. According to Vermeir et al., (2015), the findings from recent studies have demonstrated that with effective communication between patients and physicians, patients’ health can improve substantially. Without a doubt, working in the clinical field can be considered as challenging as healthcare providers are required to attend to a diverse patient population with varying communication needs. It has been established that building trust is an integral part of developing effective provider-patient communication. There is a common perception that healthcare professional ought to possess effective communication skills rather than the patients however, in healthcare communication are a two-way process. Thus, healthcare providers should recognize the need for effective communication in achieving an improved patient outcome. The drive for selecting this topic was to explore the extent to which communication between healthcare providers and their patients influence patients’ health outcomes.

Background and Problem Statement

Communication Statement: Providers should build an interpersonal relationship with Patients.

In recent years, the changing trends in contemporary society such as the advancement of medical care and increased accessibility to clinical data have made the relationship between healthcare providers and their patients more challenging. Traditionally, providers were generally considered as a vessel of medical knowledge, competence, and skills, which was used in the provision of care services and health management. However, in today’s healthcare setting, things have changed rather drastically with the dominance of patient-centered care, which required the active participation of patients in their care as well (Ranjan, Kumari & Chakrawarty, 2015). Medical knowledge has therefore become a shared role between providers and patients and therefore care delivery is customised to meet the ever-changing needs of the patients. Most healthcare providers however tend to experience difficulties while trying to build interpersonal relationships with their patients while remaining professional. It is worth noting that in managing patients, the provision of safe and high-quality care requires a healthy relationship between providers and patients (DuPre, 2014). In building healthy relationships, communication and trust are among the necessary factors that are needed. Effective communication is considered as the main ingredient in succeeding in every professional field and clinical practice is not an exception. High-quality interactions between patients have a positive correlation to patient outcomes (Johnson, Quinlan & Marsh, 2018).  To begin with, it encourages patients to work collaboratively with providers in identifying their health needs, treatment options, and adopting behavioral changes for the management of their well-being. With improved health outcomes, this, therefore, allows patients to experience an improved quality of life. As posited by Ward (2018) a great healthcare provider is the one that focuses on the patient while designing an intervention approach rather than solely prioritizing the disease. Focusing on the needs of the patients helps in promoting collaboration, encouraging participation, and building positive interactions, which lead to better patient outcomes. Therefore, this creates the need to investigate the effects of provider-patient communication on the health outcomes of the patients.

Literature Review/Research Evidence

The value of communicating with patients is immeasurable. From sourcing patients’ medical information to sharing the treatment plan, physician-patient relationship with their patients is normally founded on effective communication. Ward (2018) investigated the need for building interpersonal relationships with patients and their impact on trust. The findings of the investigation concluded that interpersonal communication and trust have a positive correlation when it comes it patient satisfaction, health outcomes, and the expected quality of healthcare services about reduced medication errors and policy compliance. Olaisen et al., (2020) supported the notion citing that besides the communication skillfulness that is possessed by the physician, the degree of interpersonal competence and knowledge regarding patients’ communication needs helps in building trust-based relations which lead to improved patient outcomes. In this context, patient-centered communication refers to having a two-way dialogue with the use of open-ended questions to boost the communication process. In this case, building interpersonal relationships with patients requires physicians to focus on adopting collaborative decision making, which leads to improved management, and this, in turn, boosts the chances for complying with the set treatment approaches. The evidence from the scholars therefore demonstrated that patient-centered measure alongside the use of effective communication and trust-building results in better health management and increased patient satisfaction. As a result of collaborative interactions, interpersonal relationships with patients are achieved and this is associated with high quality of healthcare services and improved outcomes.

Healthcare professionals often debate about the best approaches for achieving effective communication and the effectiveness of the strategies in being adopted and assessed objectively. In today’s medical practice, patient-centered care is encouraged given that it leads to improved health outcomes. The objective is to ensure that the health needs of the patients are captured successfully without fail. As noted by Chichirez & Purcărea (2018) without a doubt every physician should develop a unique style of communicating with patients given that there is no one approach that is fit for all healthcare settings. Therefore, in developing interpersonal relationships besides open communication and honesty physicians should also ensure that they retain a positive outlook, provide feedback, listen actively, respect the views and beliefs of the patients and maintain boundaries. Kornhaber, Walsh, Duff & Walker (2016) emphasized that patients are more likely to be expressive of their health needs and feelings only when the physician proves to be welcoming and respective to their rather diverse needs in general. However, Lee & Doran (2017) counters this argument citing that in building interpersonal relationships cultural competence is a necessity given that it allows them to acknowledge the communication needs of each patient while remaining respectful to their differences. The argument hence confirms that interpersonal communication is a complex process that requires physicians to apply a range of skills while mainly focusing on providing patient-centered care.

Fuertes, Toporovsky, Reyes & Osborne (2017) argued that with effective communication skills physicians can build interpersonal relationships with their patients and in turn achieve positive patient outcomes and increased satisfaction levels. Unlike before physicians are required to listen and respond respectively to their patients. In that, while enquiring about the health issues they should be allowed to also ask questions without judgment. As also established by Hoff & Collinson (2017)rapport building can be extremely beneficial to physicians as it helps in creating effective interpersonal relationships which can in return help in building trust. Rapport building leads to harmonious and close relationships with patients and also allows physicians to understand the feelings of their patients while communicating efficiently. In this case, interpersonal relationships do not only result from the ability to maintain open communication but also by ensuring that physicians show empathy to patients. It is hard being a patient and therefore empathy helps in ensuring that physicians understand what they are going through. In this context, this allows them to offer more personalized care. An empathetic physician acts and communicates based on the understanding that they acquire for the patients.

Most studies have established that patient satisfaction has a positive correlation with effective communication skills. Carrard et al., (2018) investigated the association between the communication behavior held by the physicians and the satisfaction of patients with the provided care. the findings of the study found that positive communication behaviors usually supports an increase in patient satisfaction, which eventually leads to improved health outcomes. Therefore, the authors concluded that interpersonal based communication is vital in not only ensuring that physicians deliver high-quality care services but also enables patients to trust the physician's clinical judgment. With this, it is, therefore, possible to provide patient-centered care by only focusing on the health needs of the patients through effective communication. Berman & Chutka (2016) supported the findings based on the establishment that patient satisfaction is normally fueled by trust, which is a crucial indicator in understanding the quality of clinical services, and this leads to improved outcomes in general. The scholars similar to most others have demonstrated a robust correlation between care services and satisfaction level. Thus, it is evident that improved patient satisfaction leads to increased rates in adherence to the treatment practices and standards which is associated with improved medical outcomes. In other words, interpersonal relationship leads to quality care and patient safety as physicians can adhere to all the existing protocols and policies. Ranjan, Kumari & Chakrawarty (2015) established that interpersonal relationship has been shown to result in reduced medical error cases in general and this, therefore, contribute to patient safety and improved outcomes. However, this cannot be achieved in the case that the physician is poor in communication since interpersonal relations rely on better communication with patients.

Physicians need to build interpersonal relationships with their patients for better health outcomes and efficiency. Therefore communication requires that physicians should mainly focus on building trust. In a physician-patient relationship, trust has several advantages like avoiding conflict and encouraging patients to relate well with physicians it also helps in discouraging low-quality performance. According to DuPre (2014) patients’ needs to be given something for them to gain trust and this is effective communication. When they are aware that their needs are well recognized and valued they tend to respond more positively. In general, there is a need for physicians to focus on building quality relationships with patients for better outcomes by focusing on delivering quality care and safety (Johnson, Quinlan & Marsh, 2018). Patient-centered care is founded on effective communication and interpersonal relationships.

Communication Recommendations /Conclusions

Communication scholarship hopes to change how physicians interact with patients for better patient outcomes. Physicians play a critical role in determining the safety of patients and the quality of services that they provide. Traditionally, physicians have always retained the role of being the primary decision-makers, while patients act as recipients. However, scholars have proposed that today in building interpersonal physicians are not only required to talk but to also listen to the needs and requests of their patients. It is only through this that they can understand how they feel and therefore make an accurate decision on health management as well as a treatment plan. Therefore, interpersonal based communication generally enables physicians and patients to interact positively while focusing on improving health outcomes. Also, interpersonal communication not only helps in relationships but also eliminates errors leading to treatment effectiveness and success.

Most physicians tend to struggle when it comes to trying to create a balance between the power they possess based on their medical knowledge and the need to pay attention to the communication needs of their patients is critical. In this case, scholars propose that physicians should be willing to design their communication strategies that align with the needs of the population they serve. In this context, they advocate that it is crucial to minimize the overall use of power and control to ensure that patients are treated in an empathetic manner in which their needs are respected and therefore encouraged to actively participate in the care delivery. Patient-centered care urges physicians to ensure that while the health needs of the patients are at the center of guiding their clinical decisions, it should also include collaborative practice. Patients should be treated as primary stakeholders in care delivery given that the decisions made by physicians affect them either directly or indirectly and therefore their contribution is not only crucial but necessary as well. Therefore, they ought to be considered as partners to increase the satisfaction rate while also ensuring that the desired outcomes are achieved.

Scholars additionally hold that it is through building interpersonal relationships that patient safety is improved. Thus, this can best be achieved by ensuring that physicians develop their communication skills constantly. The effectiveness of building interpersonal relationships lies in the ability to retain efficient communication. It normally entails the ability to listen to the needs of the patients and respond appropriately while paying attention to the beliefs, feelings, attitudes, and views of the patient. Communication and cultural competence are a necessity since with diversity the communication needs of each patient tend to differ significantly hence requiring physicians to employ personalized strategies in providing care.

In summing up, based on the evaluation it has been established that physicians need to build interpersonal relationships with patients for improved outcomes and satisfaction. It is only by focusing on the well-being of the patients that trust is built which allows patients to express how they feel thus enabling physicians to make accurate clinical decisions. In other words, care needs to be personalized for patients to benefit fully and ease their role. Patient-centered care is the one that normally emphasizes the collaboration between doctors and patients which equates to interpersonal relationships. In return, this leads to improved care services and patient safety as the mediums for better health outcomes.

References

Berman, A. C., & Chutka, D. S. (2016). Assessing effective physician-patient communication skills:“Are you listening to me, doc?”. Korean journal of medical education, 28(2), 243.

Carrard, V., Schmid Mast, M., Jaunin-Stalder, N., Junod Perron, N., & Sommer, J. (2018). Patient-centeredness as physician behavioral adaptability to patient preferences. Health communication, 33(5), 593-600.

Chichirez, C. M., & Purcărea, V. L. (2018). Interpersonal communication in healthcare. Journal of medicine and life, 11(2), 119–122.

DuPre,A. (2014). Chapter 3: Patient-caregiver communication. In Communicating about health: Current issues and perspectives (4thed.) (pp.50-78). New York, NY: Oxford University Press.

Fuertes, J. N., Toporovsky, A., Reyes, M., & Osborne, J. B. (2017). The physician-patient working alliance: Theory, research, and future possibilities. Patient education and counseling, 100(4), 610-615.

Hoff, T., & Collinson, G. E. (2017). How do we talk about the physician–patient relationship? What the nonempirical literature tells us. Medical Care Research and Review, 74(3), 251-285.

Johnson, B., Quinlan, M. M.,& Marsh, J. S. (2018). Telenursing and nurse-patient communication within Fertility, Inc. Journal of Holistic Nursing,36, 38-53.doi: 10.1177/0898010116685468

Kornhaber, R., Walsh, K., Duff, J., & Walker, K. (2016). Enhancing adult therapeutic interpersonal relationships in the acute health care setting: An integrative review. Journal of multidisciplinary healthcare, 9, 537.

Lee, C. T. S., & Doran, D. M. (2017). The role of interpersonal relations in healthcare team communication and patient safety: a proposed model of interpersonal process in teamwork. Canadian Journal of Nursing Research, 49(2), 75-93.

Olaisen, R. H., Schluchter, M. D., Flocke, S. A., Smyth, K. A., Koroukian, S. M., & Stange, K. C. (2020). Assessing the Longitudinal Impact of Physician-Patient Relationship on Functional Health. The Annals of Family Medicine, 18(5), 422-429.

Ranjan, P., Kumari, A., & Chakrawarty, A. (2015). How can Doctors Improve their Communication Skills?. Journal of clinical and diagnostic research : JCDR, 9(3), JE01–JE4. https://doi.org/10.7860/JCDR/2015/12072.5712

Vermeir, P., Vandijck, D., Degroote, S., Peleman, R., Verhaeghe, R., Mortier, E., Hallaert, G., Van Daele, S., Buylaert, W., & Vogelaers, D. (2015). Communication in healthcare: a narrative review of the literature and practical recommendations. International journal of clinical practice, 69(11), 1257–1267. https://doi.org/10.1111/ijcp.12686

Ward, P. (2018). Trust and communication in a doctor-patient relationship: a literature review. Arch Med, 3(3), 36.

Huntington′s Disease

Introduction

Huntington’s disease is an autosome dominant illness which normally starts during mid-life. It's characteristic of progressive involuntary choreiform motions, mental alterations, and dementia. George Huntington and his lineage were the first to examine the disease in families that lived in Hampton, New York. The diseases' initial cases were traced back to European people and Dutch immigrants who moved into South Africa (Smith‐Dijak et al., 2019). The Huntington’s disease transmutation was recognized in 1993 as an unbalanced extension of CAG. Hence, Huntington's disease is a brain disease transmitted genetically through families, one generation to another. Scientists confirmed that the hereditary disease is a mutated gene that keeps on generating within the DNA. Causes of Huntington’s disease

Symptoms

Huntington’s Diseases lead to the degradation of physical, cognitive, and emotional capabilities, especially during the victim's productive years, and presently, there is no defined cure for the illness (Frank et al., 2016). Most of the victims commence manifesting symptoms in adult years (30-50); however, scientists claim that it can also occur in children and youths. Known as a family illness due to its hereditary capabilities, presently, an estimated 41,000 characteristic Americans and s200, 000 others are at risk of developing the hereditary disease. Most people who experience Huntington's disease have varied symptoms, but some of the most common symptoms are behavior alterations, depression, and mood swings. Also, the rest of the victims are likely to experience amnesia and indecisive behavior. The wobbly pace, involuntary motions combined with indistinct speech usually lead to tremendous weight loss. The majority of people with Huntington’s disease have challenges with their thinking patterns, actions, and motion. Symptoms normally deteriorate after a 10-25 progression period, after which the victim's ability to think, move around, and the converse is damaged. Initially, an individual with Huntington's disease may experience difficulties while organizing, remembering, and persistently carrying out activities. The development of mood swings is in line with the expression of unease, prickliness, and aggression (Benraiss et al., 2016). Hence, this explains the reason why most individuals who have Huntington’s disease are fidgety and shaky. The uncontrolled motions are known as chorea. Huntington’s disease causes a person to lose a lot of weight involuntarily due to the inability to eat properly and focus on tasks at hand. 

Huntington’s disease Gene

 The DNA error responsible for the hereditary illness is normally located in a genetic material known as Huntingtin. All human beings have a Huntingtin gene. However, in the case of a mutation of the huntingtin gene, Huntington's disease occurs and is transmitted from one generation to another.  Genetic material consists of nucleotides, which in turn make up the DNA codes (Claassen et al., 2017). Huntington's disease occurs when C-A-G is overstretched hence straining Huntingtin’s gene. Therefore, the stretching phenomena cause a replication of the mutation in the victim's body, hence leading to Huntington's disease. Within the huntingtin gene, there are more than 20 CAG codes that repeat themselves. Still, individuals with Huntington’s disease have more than 20 replications hence spreading the mutation further and wider into the victim’s body. Thus, a person who contains an expanded CAG within the huntingtin gene will develop the illness, and each gene will be replicated in their children.

 Human genetic material is like an instructional guide for generating protein, which facilitates the operation of everything else within the body. The huntingtin gene encloses guidelines which are replicated onto a biological dispatch that later produces the huntingtin protein. The huntingtin protein is massive and performs more than one operation, especially during a brain's development. Experts have also confirmed that additional CAG is replicated in persons with Huntington's disease because the huntingtin protein is elongated and hard to retain its shape; consequently, its functionality is highly affected (Liu et al., 2020). Over the last four decades, the huntingtin protein mutation produces clusters within the brain tissue, causing a damaging effect on the brain cells. The most susceptible parts of the brain are the striatum, which controls the motion, mood, and remembrance abilities of an individual. The destructive effect on the striatum causes the manifestation of Huntington’s disease.

Impact of Huntington’s disease On Basal Ganglia

 Huntington's disease is known for its neurodegenerative disorder on its victims. The cerebral cortex and basal ganglia are extremely affected by this disease. Currently, experts have no way of medicating the disease's pain despite the expanding information on the disease. Examination of Huntington's disease depended upon the observation of inbreeding. Utilizing the standardized linkage examinations proved that the Huntingtin gene could be isolated and studied to unveil the mutation's underlying causes (Tereshchenko et al., 2019). The brain's basal ganglia region may experience slower activities due to the destruction of the brain cells. Normally, the basal ganglia part of the brain. It is important to note that Huntington's disease undergoes atrophy due to the loss of nerves and gliosis. Imagery mechanism such as CT scans shows that atrophy occurs during as the illness progresses further into the brain. There is plenty of evidence proving that an increased and diminished signal intensity within the striatum leads to extensive damage to the brain cells.

The Impact Huntington’s disease has On Parents

Huntington’s disease negatively affects the entire family unit and system by altering family situations, role functionalities, and tightening some family norms. The illness's impact varies from one family to another because Huntington's disease gradually progresses over the years. The illness constraints a family’s finances as they cater to the needs of the sick family member. Family members might be forced to deal with issues that come with having a Huntington’s disease family member. Families might experience emotional turmoil as they encounter challenges while catering to the needs of the patient (Geva et al., 2016).  The family is obligated to play its parental role to the patient and guide the patient through the day's routines. For instance, children might be forced to take up their parent’s role as the disease progresses further.  Thus, the children have to ignore their needs and give top priority to their parent’s needs. A child taking up the role of the parent helps in coping with the difficult conditions.

How Slps Treat Huntington’s disease

 Huntington’s disease varies from one patient to another.  Hence, speech-language specialists tailor their therapies to suit the needs of the patients. The SLP might begin the therapy by asking a few questions about the symptoms. For example, what the patient feels and responds to swallowing difficulties. One of the best pieces of advice is keeping a journal on the patient's challenges (Tereshchenko et al., 2019).  SLP assists the patient to learn how to eat slowly. Patients are advised to consume soft food staff. In terms of speech challenges, specialists assist the patient in performing breathing activities. They might illustrate how to carry out specific mouth motions for the sake of making communication easier.  Also, the caregivers are usually guided on minimizing distractions whenever interacting with Huntington's patients. Talking sluggishly and requesting yes and no answers help the patients nod their heads or even seek help when stuck. In terms of devices, the specialists might insist on employing assistive devices to assist the patient in communicating better and at their own pace. Examples of assistive devices are smartphones, computers, and other technological devices that can interpret facial expressions and then transmit the information onto the screen for interpretation (Claassen et al., 2017). Also, the speech-language specialist analyzes how the patient can improve on his or her own swallowing mechanisms, which in turn gives the specialist an accurate gauge of the severity of the symptoms. To take care of the patient without hindering the entire medication procedure, most specialists have to focus on attaining the most credible results and ensure that the patients are more accessible from their homes. The dietary supplement helps the patient feed and give them a chance to meet his needs. In summary, the specialists assist the patient gain the upper hand and improve feeding and oral habits.

Early Interventions

 Setting up the patient's goals helps improve the physical well-being due to the skilled mechanisms used to counter the disease's progression. The disease is known to cause impairment of the joints and speech. An early intervention equips the patient with the skills needed to retain a quality lifestyle that enables them to sustain themselves. If a speech-language specialist is to achieve success, they have to commence the treatment at the early stages of Huntington's disease. This gives room for the patient and the specialist to generate an active bond and prepare themselves for each phase (Dickey, & La Spada, 2018). One of the most effective strategies used is the compensatory strategy, where the specialist combines more than treatment is used throughout the disease's progression. Categories of interventions applied vary from one phase to another. The therapies may vary from assistive to supportive, depending on the needs of the patient. During the initial stages, the therapy has to integrate breathing workouts, formulate a routine, make changes to the diet, and ensure that the patient does not choke on the food. The specialist is teaching the patient how to adjust to Huntington's disease as it worsens the patient's physical situation.

Conclusion

 Huntington’s disease affects both the patient and the family.  The autosomal dominant disease is inherited from one generation to the next due to the mutation of huntingtin genes by expanding the CAG codes. The brain's nervous tissues deteriorate with time, leading to the loss of speech and unsteady motions. The patient develops slurred speech, and the patient easily loses functional capabilities. Early intervention is teaching the patient speech techniques that can be used to express a need. Therefore, the patient has to adapt to eating soft foods, swallowing food at a slower pace, and talking steadily but certainly. The disease does not have any medication; hence the specialists have to help the patient develop coping mechanisms. Children are forced to play the parental role to cope with the challenges that arises from dealing with Huntington’s disease. Most of the times, it takes a 10-25 period before the disease develops fully in the patient’s body. George Huntington’s family is credited for discovering the disease hereditary characteristics in certain families in New York.

References

Benraiss, A., Wang, S., Herrlinger, S., Li, X., Chandler-Militello, D., Mauceri, J., ... & Ding, F. (2016). Human glia can both induce and rescue aspects of disease phenotype in Huntington disease. Nature communications, 7(1), 1-13.

Claassen, D. O., Carroll, B., De Boer, L. M., Wu, E., Ayyagari, R., Gandhi, S., & Stamler, D. (2017). Indirect tolerability comparison of Deutetrabenazine and Tetrabenazine for Huntington disease. Journal of clinical movement disorders, 4(1), 3.

Dickey, A. S., & La Spada, A. R. (2018). Therapy development in Huntington disease: from current strategies to emerging opportunities. American Journal of Medical Genetics Part A, 176(4), 842-861.

Frank, S., Testa, C. M., Stamler, D., Kayson, E., Davis, C., Edmondson, M. C., ... & Vaughan, C. (2016). Effect of deutetrabenazine on chorea among patients with Huntington disease: a randomized clinical trial. Jama, 316(1), 40-50.

Geva, M., Kusko, R., Soares, H., Fowler, K. D., Birnberg, T., Barash, S., ... & Cha, Y. (2016). Pridopidine activates neuroprotective pathways impaired in Huntington Disease. Human molecular genetics, 25(18), 3975-3987.

Liu, Q., Cheng, S., Yang, H., Zhu, L., Pan, Y., Jing, L., ... & Li, X. J. (2020). Loss of Hap1 selectively promotes striatal degeneration in Huntington disease mice. Proceedings of the National Academy of Sciences, 117(33), 20265-20273.

Smith‐Dijak, A. I., Sepers, M. D., & Raymond, L. A. (2019). Alterations in synaptic function and plasticity in Huntington disease. Journal of neurochemistry, 150(4), 346-365.

Tereshchenko, A., Magnotta, V., Epping, E., Mathews, K., Espe-Pfeifer, P., Martin, E., ... & Nopoulos, P. (2019). Brain structure in juvenile-onset Huntington disease. Neurology, 92(17), e1939-e1947.

Introduction

Mental wellbeing dictates the state of the human mind and body. It affects thinking patterns, feelings, and even actions. Additionally, mental health helps individuals manage stress, socialize, and arrive at conclusive choices (Prince et al., 2007). Mental health is key throughout the life of an individual- childhood, infancy, and adulthood. As one goes through life, experiences affect mental health status due to challenges encountered, moods, and occupational routines. For instance, life experiences such as sexual abuse, family background, and biological aspects such as genes may affect an individual's mental health. Mental health challenges are common but medics have solutions. One can easily get better and slowly resume a normal life. Furthermore, research shows that social ties play a critical role in the sustenance of good mental health. Social contexts set the pace for actions, behavior, and attitude. Hence, it is normally advisable to change the environment whenever one wants to improve his or her mental health.

Summary of the Service User

Tristan, a 22 to year old male, 6-foot-tall, and an average build, living in a flat attached to his parents’ house and is currently unemployed, due to being sacked from his job due to bizarre behavior, is spending a lot of time isolating himself. Tristan has no main interests and spends a lot of time on his own. His mum and dad do not interact with him very much. His dad has expressed frustration but is not too concerned. Although Tristan did okay in school and college, he deteriorated towards the end of the college course. Tristan doesn't have many friends or much of social life, however, he does have his mum who does the majority of his cooking and cleaning. Tristan has been referred to as the primary health care team for assessment due to his mother’s concerns. Upon mental state examination, Tristan was casually dressed although reluctant to maintain eye contact, with limit facial expressions and closed body language. He also appeared anxious and agitated with a very limited vocabulary. Taking this is into consideration, there was no evidence of thought disorder. When challenged about the bizarre behavior that led to him being fired, Tristan became quite excitable and animated with his speech and body language. He explained the event leading up to him being fired, which seemed quite unrealistic and showed signs of paranoia, as well as appearing to respond to unseen stimuli. Tristan expressed he was not concerned about being fired from his job. After Tristan explained what had occurred, he reverted to closed body language with limited speech, he appeared very unconcerned about what had happened, denying and lack of sleep, loss of appetite, or stress as a result of the incident. Tristan's mum had further concerns, regarding his behavior, as he was displaying signs of being very paranoid, staring or watching neighbors, shouting, and responding when he is alone, particularly in the evenings.

LO1 – therapeutic relationships

The therapeutic relationship refers to the relationship between a healthcare professional and a patient. It is the basis upon which a nurse and patient hope to engage and communicate with each other in order to effect beneficial change in the patient (Abuse, 2013). As with all relationships, it is essential that the therapeutic relationship is mutually respectful, professional, caring, and has clear boundaries. In this particular case scenario, the therapist should help Tristan feel more welcomed. For instance, Tristan can choose the date and place where him and the therapist can meet and discuss issues concerning his health. Tristan is withdrawn from the society, therefore, the therapist can make a point of ensuring that they meet a private place even if it means meeting in the confines of his room. Also, the therapist should note that forming relationships take time, especially relationships that need trust and closeness. The therapist needs to focus on small talks which interest Tristan such as video games and looking for hidden prizes in snowflake boxes. In no single situation should the therapist judge Tristan situation. It is only through genuine a genuine use of polite language that can make Tristan open up to the therapist.

A therapeutic relationship shapes the thoughts, actions, routines, and elevates the mood of the patient. First, the therapist has to be genuinely engaged in the conversation and positively regards Tristan. As seen from this case scenario, Tristan uses monosyllabic words to express himself, without generating enough interest, the therapist will not be able to develop a genuine relationship with him. Therefore, the best way to about it is having unconditional positive affection toward him so that he cannot feel out of place during the conversation.

. In simpler terms, therapeutic relationships map out recommendations and present the patient with immediate solutions to his current predicament. Before the commencement of any psychotherapy, a patient must connect with the medic or therapist. Numerous factors impact the end outcome of fruitful treatment (Patel et al., 2007). The patient has to believe that counseling will lift off his or her challenges. An effective therapeutic relationship forms the basis upon which the therapist communicates the patient’s challenges hence an effective therapeutic relationship should be able to establish mutual trust between the service user and the therapist, lead to a common perspective on the viewpoints of the outcomes of the therapy, mutual and informed decision making.

 A therapeutic relationship is tailored according to the needs of the service user and the patient or service user must perceive it as thoughtful, reassuring non-judgemental behavior integrated within a secure surroundings during which one can feel at ease while conversing about personal challenges (Davydov et .al, 2010). These relationships are to last for short instances or can extend based on the service user's needs. Normally, a therapeutic relationship demonstrates openness, sincerity interest, responsiveness, and the desire to facilitate and support the service user. Consequently, therapeutic relationships foster a sociable atmosphere that enables the effective exchange of information between the service user and the therapist (Keyes, & Lopez, 2009). Therapeutic relationships between the service user and the expert may lead to improved patient fulfillment, sticking to medication regulations, improved quality of life, decreased nervousness and depression levels, and decreased medical expenses. Conversely, if the patient’s condition worsens, then the therapeutic relationship is not effective. Therapeutic relationships have the ability to cultivate and strengthen the association between the medic and the service user. Subsequently, giving supportive surroundings enhances communication between the service user and the therapist. It is vital to note that therapeutic relationships influence service experience (Maroda, 2009). Thus communication between the patient and therapist underpins service user’s perceptions and helps on the development of trust and engagement.

 Effective communication skills assist in the attainment of usable information from the service user (Kieling et al., 2011). Secondly, effective communication skills can gauge the status of the patient and identify a suitable remedy for the patient’s condition and emotions. Communication can be either verbal or nonverbal. In this case, Tristan can be told to nod his head if he does not feel like talking. Also, the therapist can use images to make the therapy sessions livelier. Nonverbal forms of communication are effective because they force Tristan to communicate things he found uncomfortable speaking about. Both forms of communications assist the therapist to spend more time while assessing the patient and getting rid of misunderstandings that might have occurred during the entire therapy session. The service user needs to feel safe and relaxed and return articulate his thoughts and perspectives without regardless of the therapist’s values on issues (Walsh, 2011). The therapist should not treat the patient like a contract but as a person who is in dire need of help. The exchange of decent conversation and the flow of reliable conversation between two the service user and the therapist brings about a solution at the end of the day.

LO3 Health Assessment Strategies and Tools

 In this particular case study, one of the assessment strategies used is observation. As evidenced by the case study, Tristan is unemployed due to a mishap that occurred at work. Through observations, his parents noticed that he is withdrawing from social life and staying within the confines of his quarters day after day (World Health Organization, 2013). Observation is one of the most reliable assessment tools as Tristan's parents can tell whenever their son deviates from normal behaviour (Saraceno et al., 2007). Tristan locked himself away in the confines of his flat and no one from outside could see his activities as the curtains were always drawn. It is hard to tell the state of his mind while he is locked away in his flat. Observation is the first step in obtaining first-hand information from a patient. No one is as close to the patient as his parents are. The only way the parents can retrieve their son's activities is by accurately understanding his behavior and underlying factors influencing those behaviors. Figuring out vital issues helps in the development strategy needed to address these subject matters. Observation is a collective effort in which Tristan’s parents have ensured that the therapist interprets. From the factual information emerging from observation assessment, Tristan needs the help of a therapist so that he can improve his life and resume a normal life. In this specific context, observation gave Tristan’s parents the chance to monitor and evaluate his condition and later document evidence of facts grasped and gotten (Slade, 2009). Sighted activities and happenings in Tristan’s residence created the context needed to evaluate his mental status and defined his challenges based on the observations. This way, the therapist was able to get detailed insights and comprehension of the underlying issues driving him toward depression (Slade et al., 2009). The key is applying observational information to Tristan’s situation and then trying to find a suitable solution to his mental situation. For instance, Tristan lost interest on a day to day activities such as watching television, lost friendships over time, and spent most of his time indoors playing video games. The observation was the only assessment tool that was able to gather these facts over a period of time hence was reliable and effective in the long run.

 An alternative assessment strategy applicable to the Tristan case is interviewing schedules. Observation helps in the collection of information for evaluation purposes. On the other hand, interviewing schedules’ aim is collecting data and then placing them in a relevant context. An interview helps level the playing field for both the patient and the therapist. This is a two-way conversation between the patient and the therapist (Seedat et al., 2009). It is a useful procedure for both Tristan and the therapist. In this scenario, the specialist had to examine Tristan’s situation from his point of view and then dissect each detail. The specialist recounts the facts of the case in order to help the patient put everything in his perspective. Normally at this point, the specialist is trying to observe his patient's behavior and tailor the treatment to fit his personality (Eisenberg et al., 2007). For example, during the interview, Tristan’s clothes were untidy, and his baseball cap hid his facial features throughout the entire interview. The specialist designed his questions to fit observable evidence. During the interview, Tristan was nervous and gave out short monosyllabic answers. However, the specialist never observed any symptoms of a thought disorder.  The interview provided a face to face interaction between the patient and specialist thus establishing a certain objective for both of them (Zivin et al., 2009). Moreover, the interview relied on pre-structured questions based on his parent’s sentiments and the interviewer’s observations and analysis. The interview helped in cementing the familiarity between the Tristan and the specialist which in turn facilitated the development of familiarity. The direct contact Tristan had with the specialist was enough to take not of his animated conversation tone and his excitement. The specialist can detect and isolate the challenges he is undergoing. The professional could observe the physical traits of the service user and then check for extra details that might assist in solving the mental issues the patient is undergoing daily (Kessler et al., 2008). Furthermore, during an interview, the specialist ensured that Tristan’s experience was natural and the conversations revealed the challenges he faced. Occasionally, if the service user needs the interviewer to question him on other issues that are outside the subject matter scope, the specialist can always oblige with the hope that it will still solve the main predicament (Corrigan et al., 2014). A successful interview should be in line with the assessment schedule hence permitting the conversation to flow easily, motivating the service user to disclose more about the situation while at the same time directing him what needs to be done. This way, the specialist ensures that all aspects of the patient are covered and nothing is left unattended to. In simple terms, the specialist has to make the exchange between Tristan and him as natural as possible.

LO4 Principles of Risk Assessment, Risk Management, and Positive Risk-Taking

Principles of risk management entail professional obligation towards the service user. The medical needs are aligned with personal issues and public safety (Reiss, 2013). Medics are supposed to balance the service user's decision making and independence with personal demands, proficiency, and public responsibility. Managing risks must concentrate on decreasing risk while at the same time ensuring that possible benefits are recognized and increased. Each day the mental health medics are supposed to adhere to specified duties stipulated under medical and safety regulations such as protecting his safety as well as that of others (Keyes, 2012). For the sake of proper risk management, the service user and the professional must all play their roles effectively. The family is not left out of the equation as they have a role to play in minimizing risks associated with service users.

 In this case scenario, Tristan’s mental condition is to be handled in the same manner as other medical conditions. The reason for treating Tristan’s mental condition like any other medical condition is to avoid arousing any suspicion from him. This will make him less defensive and obliged to accept any medical evaluation that may be required in the future (Rickwood et al., 2007). The professional is supposed to make his situation sound as normal as possible. Portraying him as crazy will paint the situation as abnormal and hinder the medics from finding a suitable solution. Therefore, just like any medical condition, the specialist is to identify the underlying factors, evaluate the risks, examine the situation, and then present a lasting solution based on Tristan's needs. Supplementing professional efforts to stabilize the condition and bring about an accepted methodology, Tristan and his parents are to be involved in the decision making process (Greenberg, 2014). The risk management mechanisms are to provide both parties with the best solutions which will in turn increases the chances of a positive outcome and create a good rapport between the Tristan and the professional.

 Tristan's case worsens each day and the medic must draw out a risk management plan based on his condition. For illustration, Tristan's mother claimed that his son withdrew from her hence raising her concern. Tristan would avoid meeting his mother whenever he came into his room. Entertainment facilities such television were moved into his bedroom (Lamers et al., 2011). The professional has to address all these issues in his treatment plan in order to minimize the risks. Thus, the mental health specialist has to increasingly give education and therapy based on the facts tabled. There is sufficient information on Tristan's perceptions and the specialist needs to direct his patient on critical matters. Exploring family vulnerabilities will help in unveiling Tristan's perceived control hence enable in the development of coping mechanisms and setting the pace for counseling.

 In Tristan’s situation, the objective is to handle risks in a manner that improves the quality of his social life, to revive family relations he once had with his family members and at the end of it, all stop the condition from worsening. Not all risks are to be effectively managed or moderated effectively, however, some of the risks are predictable (Gilbert, 2007). For instance, the service spends most of his time isolated from the entire world. From this point, the specialist can formulate a plan to make Tristan socialize with the outside world. Positive risk-taking will allow Tristan's family members to critically isolate potential risk factors and benefits to attain the desired result (Milliken et al., 2007). The role of the professional will comprise motivating and supporting all of them in positive risk-taking. As long as Tristan's situation gradually improves, all risks will be minimized and the feedback from both parties will be satisfactorily examined. Hence risks taking should be considered a priority during the entire treatment plan.

LO5 Consider Relevant Legal and Ethical Issues When Delivering and Evaluating Care

 Since patient care is multifaceted and established on ethics and lawful requirements, ethical and legitimate obstacles ought to be considered (McManus et al., 2016). Perceptively, Tristan's deteriorating mental condition should be analyzed from both an ethical and legal angle. According to mental health ethical norms, patient safety, and averting or mitigating any additional damage is a primary priority among the medics. Hence, the ethics and safety of the patient are one of the most emphasized aspects of delivering quality mental health care all over the world. Correspondingly, Tristan is supposed to be handled within a health system that assures him of his safety, prevents any mishaps from occurring, and approaches his condition with systematic efficiency it requires (Lorenc et al., 2012). Thus, Tristan will attend a medical institution with a certified mental health program and reputable clinical governance hence providing a framework that will facilitate the delivery of quality of mental health care according to ethics and legal legislations.

From Tristan’s case, one can tell that he went to a mental facility willingly. In other words, he was a voluntary patient. According to the Mental health Act, if need be a patient can be forcefully detained and medicated without any agreement. However, in this particular case, Tristan's condition can be contained and observed (Pierson, & Hayes, 2007). The specialist examines, diagnoses, and medicates based on first-hand information received from the patient’s parents. However, in this individual circumstance, Tristan's condition has already been gauged and his mother confirms that her son might be hallucinating. Most of the time, the patient wants no one near his personal space. Thus, from evidence, Tristan’s mental condition is not urgent and he is not a danger to the other people hence there is no reason to forcefully treat his condition.

 Under the Mental Health Act, families and friends are advised to critically collaborate with the mental health care medics unless otherwise. In this context, Tristan is still in contact due to the proximity of his quarters (Liotti, 2007). The parents visit him from time to time and are genuinely concerned about his conditions. Lately, he only uses his bedroom and bathroom thus making it hard for his parents to monitor his whereabouts. These actions prompted them to seek the help of a mental institution.  Sometimes, Tristan's parents can spot him peering through his bedroom curtains. His bedroom window looks across the neighbor's' compound and the neighbors complained of Tristan’s stares. This evidence details a containable situation as he does not pose a danger to himself and the community. The isolation graduated to hallucination and at this actual point his parents sort professional help. Isolation from the outside world, Tristan began creating an imaginary situation and then responding to imaginary people. Thus, his parents intervened so that they could seek out help for me.

 After establishing that Tristan's situation falls under a non-emergency category, the law requires a family member or guardian to voice their concerns just as Tristan's mother did. Discussing the situation with a specialist assists the patient to get the much-awaited help that he needs (Abraham et al., 2010). The only solution is bringing about a solution and ensuring that everything returns to normalcy. Tristan can truly change if only the specialist treats his case confidentially and preserve his dignity according to the law availed to protect him.

 Professional mental health specialist practices with sympathy and esteem for the characteristic self-respect, value, and exceptional characteristics of all the patients. A specialist should handle his or her patients respectfully and use dignified language while communicating with the patient (Gu et al., 2015). It is vital to note that a patient’s family members should also be treated with care and respect in order to foster an effective relationship and allow the unbiased flow of information from one person to the next. As stated earlier, mental health is a result of a combined effort between the family members and the patient himself. It would be prudent for the specialist to commit to both the service user and his parents or community for the sake of catering to each and every need that might arise during the treatment. Besides, the specialist principal obligation is dedicated to the service user and other people's concerns should come second (Fonagy & Allison, 2014). The specialist has to look at all the aspects of the situation and then deal with immediate issues first. For example, Tristan might be hiding an important underlying factor from his parents. It is the specialist duty to unveil such issues because it is not normal for one to neglect social life and live in isolation. Therefore the inclusion of the service user's thought into the treatment plan is the best way of letting the patient feel appreciated and catered.

 In the process of trying to find a solution for Tristan, the specialist ends up promoting, advocating and protecting the rights, well-being, and safety. This is in line with mental health regulations (Freedland, 2011). The specialist should have all the privacy guidelines on his or her fingertips so that the patient is assured of a treatment plan which considers and meets all his medical needs both ethically and legally.

LO2 Evidence Base Required To Care for and Support People with Acute Mental Health Conditions

 As earlier stated, the specialist tailors the medical treatment according to the patient's symptoms and wants (Hasson, & Joffe, 2007). The meeting place between a patient and the specialist sets forth the mood for everything. Speaking, language and the kind of the atmosphere surrounding the conversation depends on the meeting location. This is the underlying reason experts consider the meeting location before anything else can happen. Individual personality and the ability to interpret the questions might the first signal of recovery. In an effectual planning process, the patient and the specialist have to be on the same page for the sake of uniformity and engagement (Pope et al., 2011).  More so, in the care planning process, the specialist is to remain objective in terms of assessing the service user’s support plan and then evaluating personal data such as screening and evaluating the information received. Motivating the service user to invite their family members for support purposes and decision making makes the planning process more open and objective oriented tasks. Secondly, holding a conversation with the service user or his relatives builds on the relevant information already availed during the entire medical session. This way, the specialist concentrates on how his or her expertise can bring about a lasting solution to the impending situation. Thirdly, the utilization of a support plan as a fundamental point for the discussion aligns the service user's personal goals with the family's interests and keeps on track all the collaboration effects of the entire plan (Wahlbeck et al., 2010). Lastly, collecting reactions from everyone participated may help in the implementation of a useful implementation plan. For instance, Tristan's parents are to be involved all the way and if the neighbors feel that they can be of value, then they can also be updated on his progress throughout the entire medical treatment plan.

Tristan's recovery plan is inclusive of his daily routines and the manner in which he responds to social settings. Despite adhering to his daily routine, Tristan is in a sensitive situation, that is, he has to ensure that he abandons his usual routine if the recovery plan is to work. The formation of new routines will motivate him to acquire new habits which will then need the direction and application of the specialist concepts and ideas (Almlöv et al., 2011). At this particular point, the role of the specialist has to rely on past notes in order to assess and then evaluate how the patient is feeling.  Habitual change can be enforced by inviting his elder sister and her family to the parental flat (Roche et al., 2014). This way, numerous people create more socializing opportunities for Tristan. Even if he is reluctant, he will be forced to adjust his attitude towards other people. This might be effective in two ways- eliminating loneliness, altering the dynamics of the situation, increases human contact, and decreases Tristan's loneliness. Consequently, increasing contact may lead to a boosted self-esteem and conversational induced atmosphere (Benson et al., 2016). On the other hand, the ability to regulate the outcome. Each therapy session should be about solving Tristan’s challenges. The current situation is already well known and documented by both the parents and the specialist. The perspectives of both parties are accessible and the specialist has settled on a solid plan that would help his patient achieve the desired result (Blow et al., 2007). At the very least, the specialist can begin taking notes of the patient’s progress and the steps he is making in realizing a social life and reduced anxiety. Also, the specialist should ensure that Tristan has access to basic mental health facilities. The need for a group-based approach during the implementation of the treatment plan delivers care based on prior recommendation and it can then be facilitated through the mental healthcare of the specialist who takes notes of everything and approves only suitable recommendations. Assessment of each session is supposed to unveil a new problem and let the specialist deal with it as soon as it arises. The trick is getting rid of each and every underlying problem that might be fuelling the surface symptoms. Anti-social behaviour does not emerge suddenly hence the need to treat the patient

 In summary, mental health is pivotal in the management of emotions, actions, and even lifestyles. Normally, humans are social beings and any deviation from a social aspect should be a deviation from normal behavior. Tristan's antisocial behavior and withdrawal from public spaces seem to be driven by unemployment. He is not remorseful for his mistakes and is not accountable for his actions. Therapeutic relationships establish the foundation for trust, effective communication, and bonding for both the patient and the specialist. The service user has to be assured of the specialist's commitment and confidentiality so that he can feel free to open up and reveal everything to the specialist. The exchange between the specialist and the patient has to be mutual and respectful in order to detail the extent and severity of the patient's situation. Observation and interviewing are some of the data collection methods applied to this particular case study. 

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Sleep Inertia Journal Evaluation

The title of the article is “Sleep Inertia Varies with Circadian Phase and Sleep Stage in Older Adults” written by Edward J. Silva and Jeanne F. Duffy. The purpose of the study was to examine if much older adults display the impacts of sleep inertia on performance at the planned wake up time. The study also determines if these impacts are subject to circadian stage or sleep period wakening.

Summary of Prior Research

Previous research on sleep inertia shows that transitioning from sleeping to waking up cannot be regarded as an instant adjustment from one state to a different one but rather is a course that takes a while to complete. Several experimental models have been used to research sleep inertia and one of the methodologies that have been used is the use of sudden wakening by audible provocations. Such studies have been used to examine sleep inertia after wakening at night time and dozes during the day (Silva & Duffy 2008). Results for such a study showed that as sleeplessness before taking a nap became greater, the impacts of sleep inertia also became greater. This increased the awakening performance impairment by lengthening the wake periods before the nap. Research also shows that the deeper the phase of sleep before awakening from the doze off, the lesser the wake performance. A study conducted on young subjects showed that the impacts of sleep inertia on routine on wakening from stage two non-rem sleep were extra evident compared to the ones after awakening from REM sleep. These studies showed that the importance of having a nap to counter routine deficiencies because of sleep loss has to be evaluated against routine deficiencies because of sleep inertia after waking up from the nap.

Despite these methodologies being applied practically, they might not be pertinent in comprehending the impacts of sleep inertia from performance wakening. Research from a group of young subjects about the impacts of sleep inertia indicated that performance straightway after awakening from an eight hour sleep at night at the usual time for bed was poorer than routine after a twenty-six hour of sleep deficiency. Much of the prior research has been conducted on young subjects and there is no clarity on if there are sleep inertia impacts on routine on older subjects (Silva & Duffy 2008). Also not clear is if the sleep inertia affects performance exists, what aspects affect the magnitude of performance deficiencies because of sleep inertia. Aging is connected to fluctuations in sleep quality and that the pervasiveness of reported sleep complaints such as not being able to maintain sleep, waking up early, and being sleepy during the day all increase with age. Compared to young subjects, subjective evaluations of early morning wakening and objective measures of sleep periods and consolidation show that older subjects find it more difficult to maintain sleep when it is planned at different circadian stages.

Participants

The participants included ten healthy older adults ranging from the ages of fifty-five to seventy-two whereby five were men and the other five were women. All the participants volunteered for the study. They were all evaluated medically and psychologically through a screening assessment before the study (Silva & Duffy 2008). Participants had to have a sleep duration between seven and ten hours and were not supposed to have any serious sleep grievances. They were all assessed for sleep conditions before being admitted. For three weeks before the study, the participants were not to take caffeine, nicotine, alcohol, and any medication. Those who complied with these criteria were verified by a urine analysis upon admission. Each subject had to provide written consent before the start of the study. The study was conducted in private study rooms where each subject had their own which were protected from external time and signals.

Procedure, Instruments, and Techniques

Every single study started with three, day-and-night standard days that consisted of sixteen hours of sleeplessness and eight-hour sleep opportunity. This was planned following the typical sleeping and waking time for each participant beginning from the week before the study. The three standard days were accompanied by a desynchrony section that consisted of eighteen, twenty-hour days corresponding to fifteen days of the calendar. There were 13.33 hours of sleeplessness and a 6.67 hour sleep moment each day and the sleep episodes were planned to start four hours earlier. The outcome of this was sleeping and waking incidents taking place at all circadian stages (Silva & Duffy 2008). The light intensity of the surrounding was planned during wake episodes and the staff was not to discuss the time of day with the subjects. During the planned sleep episodes, the lights were turned off. A rectal temperature sensor was used to record body temperature whereby it was worn all through the study to aid in the evaluation of circadian stages. For all the planned sleep occurrences, the polysomnogram was documented using the standard montage. A vita port digital sleep recorder was used to acquire the polysomnogram data. A computer was used to automatically switch off the lights.

Results of the study

Results from the study show that the impacts of sleep inertia are existent in healthy older adults when they sleep at their usual intervals and performance improves as wake time escalates. The majority of the subjects were not able to remain asleep for the whole eight-hour sleep opportunity which is usual for persons in this age set (Silva & Duffy 2008). There was a substantial impact of the circadian stage on performance resulting from wakening, with the first performance when awakening in the early afternoon. When the waking period befell in the late evening and during the night, the performance was poor. In the circadian stage where there exists the most sleep inertia impact, there are significant implications for older adults. Elder adults wake at an earlier circadian stage compared to younger adults. There was also a substantial impact of the sleep stage on awakening performance, whereby the early stages of performance are greater when subjects woke up from REM sleep compared to the time they woke up from NREM phases one or two sleep. The findings showed that elder adults go through more stages of sleep inertia at their normal wake up intervals because they usually wake up at an earlier natural interval, nearer to the essential body temperature when the impacts of sleep inertia are extreme and therefore the study turned out as anticipated.

Strengths and Weaknesses

The study used an effective procedure and equipment that gave detailed data throughout the study (Silva & Duffy 2008). The participants were well assessed before the study and therefore relative results.  Each subject had its study room hence the capability for the study to provide effective results. However, in some of the cases, planned tests were delayed due to technical issues. The study used a few subjects and only concentrated on healthy ones. The findings from the study maintain that older adults are more open to sleep inertia compared to younger adults.

References

Silva, E. J., & Duffy, J. F. (2008). Sleep inertia varies with circadian phase and sleep stage in

older adults. Behavioral neuroscience, 122(4), 928.

Critical Reflection in Prescribing

Subject Area-Professional: for example, you have undertaken the prescribing course that will change your practice, the delivery of your service, or impact on patients.

Topic- Prescribing in the acute medical unit

Introduction

 Nurse prescribing is the practice of ordering treatment for a patient. In the past, prescribing was done by medical professionals only. Today, nurses are authorized to prescribe treatment or in other words, they have entered into advanced practice roles where they perform different advanced nursing roles. Common drivers to nurses performing advanced practice roles are physician's shortages, an increase in chronic conditions, and the need for an inter-professional team. The purpose of this reflection is to focus on how the prescribing course will bring about change in acute medical unit. I will use the analysis model from the Gibbs' reflective cycle to explore how nurses prescribing will help meet the needs of patients with acute medical illness. Today, patients' needs are changing and hence nursing roles. Chronic diseases and healthcare costs are on the rise and this means that chronic disease management and cost-effectiveness are needed. Having undertaken the prescribing course, I will now have the prescribing authority to prescribe medications to patients with acute medical illnesses.

 According to Jones (2009, p.14), there is a development in the nursing health system since many countries have adopted nurse prescribing to meet the health services of patients.   Factors for extending the nursing roles include access problems, disparities, fragmentation, and more (Salmond & Echevarria, 2017, p. 12). I count myself as an agent of the transformation since I will contribute to the change by providing patient-centered care. According to Jones & While, A (2011, p. 120) the United Kingdom has extended nursing roles in all settings. This means that independent prescribers no longer have a sole responsibility of prescribing. What happens is that there is a shared responsibility where the supplementary prescriber is helping patients’ access medicines (Pittman, P., 2019, p. 22). Thus, prescribing is a multi-professional practice where non-medical healthcare professionals are performing the role.

De Oliveira Toso et al (2016, p. 171) puts it clearly that functions carried out by doctors have been transferred to nurses. For example, nurses are now prescribing or offering treatment to patients with acute illness such as heart diseases. Asthma, and more. In general, a group of doctors are working together to combat the high prevalence of acute disease (Alharthi et al 2019, p. 50). As healthcare providers in the acute medical care unit, I need knowledge about clinical management. The latter means that I must effectively and efficiently meet the complex health care needs. Thus, my prescribing course will enable me gain skills in case management that will enable me in caring for patients with asthma, hypertension, diabetes, and other illnesses. Note that in the prescribing course, I will receive special training not only to perform consultations but also to prescribe medicines. For example, suppose I have a diabetic patient in the acute medical unit, I will prescribe insulin. If a patient is a smoker and wants to quit, I will prescribe tablets to stop smoking.  In short, I will not be restricted from prescribing but professionally, I will practice with competence

According to Jones et al (2007, p. 488), since 2006, the United Kingdom has developed the health care system and now nurses are providing service effectively through prescribing. However, The British Medical Association is against nurse prescribing and argues that nurses should not prescribe drugs and the practice is 'absolute idiocy' (Jones et al., 2007, p. 488). Despite these arguments, the USA established the Physical Assistance Programs in 1965 after realizing there was a shortage of medical providers and hence patient dissatisfaction (Zaman et al. 2018, p. 2015). I highly support the physician assistant programs not only in the USA but also in other countries like the UK.  My interest as a healthcare provider in the medical unit is promoting patients' satisfaction through providing a 'time investment' service.

 Sabin et al. (2016, p. 330) says that patient safety is critical in the acute medical unit. Hospital staffing is an important concept in that for healthcare providers to manage acute hospital care, they must work as a multi-disciplinary team.  Note that in the past, a junior doctor performed roles such as taking patient history, taking blood samples, among other simple roles.  However, today, once a patient is admitted, seniors' doctors provide diagnosis and management immediately and this means that there is a great transformation. My prescribing course is a path to progress and I will have the ability to work in medical admission where I will perform supporting tasks like prescribing. The Robert Wood Johnson Foundation (2011, p. 163) found that nurses should be allowed to gain education and training for them to improve quality, access, and value. The need for advanced practice is to manage acute illnesses. Olayiwola (2015, p. 4) says that health care providers meet inevitable changes while working in primary care settings. Patients’ present different diagnoses yet some healthcare providers lack the experience to handle the medical problems. My prescribing course is a path to advanced practice nursing and where I will gain knowledge and skills needed in the acute care unit.

Conclusion

 There are sound reasons why my prescribing course will change my practice, service delivery, and make a difference in patients' life. The prescribing course will provide prescribing competence where I will develop knowledge and skills about the assignment and diagnosis. An extended formality is a significant development that will enable me to address community acute illnesses. Nurses need competency in nursing practice. Likewise, competence is important in prescribing as it allows nurses to make a diagnosis and prescribe treatment. I feel that with my prescribing course, I will be competent to make assessment, diagnosis, and provide the appropriate treatment.  

References

Alharthi, N.R., Kenawy, G. and Eldalo, A.S., 2019. Antibiotics' prescribing pattern in intensive

care unit in Taif, Saudi Arabia. Saudi Journal for Health Sciences, 8(1), p.47.

COMMITTEE ON THE ROBERT WOOD JOHNSON FOUNDATION INITIATIVE ON THE

FUTURE OF NURSING, AT THE INSTITUTE OF MEDICINE. (2011). The future of

nursing: leading change, advancing health. Washington, D.C., National

Academies Press.

De Oliveira Toso, B.R.G., Filippon, J. and Giovanella, L., 2016. Nurses’ performance on

primary care in the National Health Service in England. Revista Brasileira de

Enfermagem, 69(1), pp.169-177.

Jones, K., Edwards, M. and While, A., 2011. Nurse prescribing roles in acute care: an evaluative

case study. Journal of advanced nursing, 67(1), pp.117-126.

Jones, M., Bennett, J., Lucas, B., Miller, D. and Gray, R., 2007. Mental health nurse

Supplementary prescribing: experiences of mental health nurses, psychiatrists and

Patients. Journal of Advanced Nursing, 59(5), pp.488-496.

Olayiwola, J.N., 2015. RN role reimagined: How empowering registered nurses can improve

primary care. California HealthCare Foundation.

Pittman, P., 2019. Activating nursing to address unmet needs in the 21st century. Robert Wood

Johnson Foundation. Princeton NJ.

Sabin, J., Khan, W., Subbe, C.P., Franklin, M., Abulela, I., Khan, A. and Mohammed, H., 2016.

‘The time it takes…’How doctors spend their time admitting a patient during the acute

medical take. Clinical Medicine, 16(4), p.320.

Salmond, S.W. and Echevarria, M., 2017. Healthcare transformation and changing roles for

nursing. Orthopedic nursing, 36(1), p.12.

Zaman, Q., Yogamoorthy, S., Zaman, M. and Fouda, R.M.F.R., 2018. Patients' perspective of

physician associates in an acute medical unit within an English district general teaching

hospital–a pilot survey study. Future Healthcare Journal, 5(3), p.213.

Successful Aging

Successful aging is defined as biological, psychological, and social functioning without major diseases. Successful aging is described as evading ailment and disability, having a high cognitive, psychological, and physical function, active engagements in life, and adapting well mentally in later life. According to Urtamo, Jyväkorpi & Strandberg (2019), in psychological functioning, you know you have aged successfully when you do not have a disability or a disease and have lived a long and healthy life. However, even people with diseases can have successful aging. For cognitive functioning, aging successfully includes maintaining cognitive capabilities and preventing memory disorders. This should be a central component of successful aging and comprises insight, attention, memory, and higher functions. Maintaining physical function is a very significant component of successful aging. You know you are aging successfully when you engage in regular physical activities because it maintains your health and reduces the chances of some diseases. Having an active social life is an important aspect of aging successfully. It reduces loneliness, offers emotional and instrumental support to you and other people.

The goals of cognitive functioning and maintaining physical function are important and connect to integrity vs. despair’s Erikson’s life stage. This is because in this stage, individuals view life differently and if they did not maintain a healthy life or maintained their cognitive abilities, they feel like they would have lived differently and felt like failures. People who maintain cognitive and physical functions are satisfied with how they lived. An active social life is also an important goal and connects to generativity vs. stagnation (Martin et al. 2014). This is because generativity involves successful mastering of one’s work, and contributing to the development of other people. It also includes engaging in productive work which contributes positively to society. The people who fail to master this task may experience stagnation and may have no connection to other people in society.

References

Martin, P., Kelly, N., Kahana, B., Kahana, E., Willcox, B. J., Willcox, D. C., & Poon, L. W.

(2015). Defining successful aging: a tangible or elusive concept?. The Gerontologist, 55(1), 14–25. https://doi.org/10.1093/geront/gnu044

Urtamo, A., Jyväkorpi, S. K., & Strandberg, T. E. (2019). Definitions of successful ageing: a

brief review of a multidimensional concept. Acta bio-medica: Atenei Parmensis, 90(2), 359–363. https://doi.org/10.23750/abm.v90i2.83768

 Use of Psychosocial Theories in Nursing

From the case, a 65-year old woman is experiencing social distress. Another point to note is that the level of distress differs within an individual. This means that a 65-year old women and 25 years old or 45 years old have a different level of distress. In general, all women experience distress and all need effective strategies for screening adherence (Ahmadian & Samah, 2013). The concept that could be used in planning for the old women's care is health belief-model. The health behavior researchers has found that the health belief-model allows healthcare providers to employ a cultural perspective. This is because there are factors that might prevent the patient from seeking cancer assessment and treatment. Note that some patients lack knowledge, fear, lack of self-efficacy, and other factors (Ahmadian & Samah, 2013). However, the health belief model will help in gathering information, and evaluate the health issue and its consequences. In general, the health belief-model will help the health care provider   understand the severity of the disease, the susceptibility of the lines, the preventive action, and barriers to implementing the actions (Ahmadian & Samah, 2013). The health belief model will help the patient understand the perceived benefits. This means that the clinician will encourage the patient to go for screening.  The patient is experiencing external and psychological barriers but the health belief model will understand the benefits of screening.

 If the women were 25 years old or 45 years old, the social-cognitive theory could work best. The social cognitive theory improves self-efficacy and in the end, the patient will gain the confidence to perform cancer assessment. The difference between a 65-year-old woman and 25 old year women is that the former may lack knowledge while the latter may have the knowledge but have low self-efficacy. Therefore, the social cognitive theory will influence the patient's experience and the health care provider will activate behavioral change (Ahmadian & Samah, 2013). The goal of social cognitive there is to increase independence and help the patient develop healthy behaviors.

  Health care providers have been using social psychology theories such as the protective motivation theory to encourage women to attend cancer screening. The protective motivation theory ensures that women have better knowledge (Darvishpour et al. 2018). This is also a strategy to enhance adherence by informing women and ensuring that they gain a high level of health literacy. It is believed that women fear breast cancer screening due to illiteracy

 In my clinical practice area, social psychological theories have been used to treat psychopathology. The research in the field of health care has found that social and situational factors play a role in the development of clinical problems. Thus, social psychological problems could help understand the emotional problems, maladaptive behaviors, and improve therapeutic effectiveness (Darvishpour et al. 2018). For example, cognitive-behavioral therapy is used to treat psychological problems such as anxiety and depression. Social psychological theories help health care providers in understanding human behavior and employ the best cognitive approach.    Some of the social psychological theories that have been used in clinical practice are self-affirmation theory. The theory helps individuals gain self-worth and self-affirmation. Another theory of self-categorization theory which states that individuals have self-concepts or they use different perception in understanding the problem (Darvishpour et al. 2018). They help individuals improve personality self-ratings and develop self-concept. In general, the integration of social psychological theories has been associated with effectiveness through helping the care providers in making clinical decisions. Another point is that the theories have been associated with positive health behavior change.

Reference

Ahmadian, M., & Samah, A. A. (2013). Application of health behavior theories to breast cancer

screening among Asian women. Asian Pac J Cancer Prev, 14(7), 4005-13.

Darvishpour, A., Vajari, S. M., & Noroozi, S. (2018). Can health belief model predict breast

cancer screening behaviors?. Open access Macedonian journal of medical sciences, 6(5),

949.

Infection and immunity

Part 1: Report

• Describe the contribution of Semmelweiss and Koch to the Germ Theory of disease and the early development of epidemiology by Snow.

Koch experimentation with anthrax led him to the discovery that specific germs were responsible for certain diseases and this contributed to the great revolution in the field of medicine referred to as the germ theory. His experiment involved examining blood from cows that had died from anthrax. He later conducted an experiment where he exposed mice to the blood obtained from cows stricken by anthrax (Thiel, 2017). The presence of similar rod shaped bacteria in the dead cows’ blood and the mice infected helped Koch to draw the conclusion that specific germs were responsible for the occurrence of diseases and that the diseases could be spread.

Semmelweis contribution to the germ theory of diseases resulted from his studies to explain the occurrence and spread of cholera. From his observations, Semmelweis discovered that maternity wards attended to by students had higher infection rates than those attended to by midwives (NRC, 2004). The realization that infections and death rates were relatively low in summer led to the discovery that the medical students directly contributed to the number of infections. Semmelweis’ research revealed that infections could be spread by human contact as the high infection rates were attributed to poor hand washing hygiene from the medical students (Thiel, 2017).  The high rate of infections was attributed to the students’ failure to wash their hands before attending to patients in the wards especially because they also worked in the autopsy department. Semmelweis’ contribution helped to identify how diseases are spread and also preventive measures that can be taken to reduce the spread of infections. 

Snow’s contribution spearheaded epidemiology as his research involved analyzing data of infected people to determine the cause and origin of the infection. When Snow was conducting research, people believed that cholera was spread through human contact or by Miasmas (Johnston, 2008). After examining the bodies of the victims however, Snow noted that the symptoms displayed affected the gastrointestinal tract and this disapproved the notion that the disease was spread by air since patients did not display any pulmonary symptoms. This led to the discovery that cholera may have been caused by ingesting contaminated water and Snow identified a tap that acted as the source for contamination (Johnston, 2008). Statistics on the number of people infected in specific locations enabled Snow to focus his research to the first boy who had been infected and how his excrements had been disposed off in a cesspool adjacent to the water pump discovered to have been the cause of the infection.

• Explain the history of the development of vaccination, including the contributions of Jenner (smallpox) and Pasteur (attenuated vaccines).

The history of vaccines can be traced back to hundreds of years when Buddhist monks drake snake venom to raise their immunity to snake bites and Variolation, a Chinese practice that made them immune to small pox. The greatest contribution was however made by Edward Jenner in 1796 when he inoculated a boy with cowpox disease, making him immune to smallpox (Feemster, 2017). Jenner used pus obtained from lesions on a milkmaid’s hand resulting from cowpox. Six weeks after the boy had been inoculated with the pus; Jenner exposed the boy to smallpox and proved is experiment had worked and the same results were recorded from the rest of the tests conducted on other people. The discovery led to the development of a smallpox vaccine, spearheading the start of immunization.

            Louis Pasteur’s contribution encouraged the use of vaccines on other diseases as vaccines were interpreted to mean the use of cowpox to immunize against smallpox. Pasteur was responsible for developing a rabies vaccine that operated as a post-infection antidote due to the long incubation period for germs that cause rabies (Plotkin, 2011). His research motivated research that sought to create vaccines for other diseases other than smallpox and is greatly responsible for how people define vaccines today.

Part 2: Structured questions

A.C 2.1
Q1.      (a) Describe the range of non-specific responses to infection, including fever.

Animals rely on specific and non specific responses for protection against foreign invaders. Specific immune responses are able to differentiate types of invaders and act accordingly but are not present in all animals. Non-specific defences are present in all animals and offer the same type of protection regardless of the nature of invasion. Some of the non-specific responses include barriers and Fever.

            Barriers offer protection by establishing boundaries that separate the organism from elements in the environment that could cause harm (Baron & Dianzami, 2016). Barriers like mucous membranes and the skin control what enters the body and therefore reduces the number of pathogens that enter the body. The barriers also release secretions like saliva and mucus that are acidic and prevent bacterial growth.

            A fever is another form of non-specific protection that triggers the hypothalamus to raise the body temperature once an invader or pathogen is discovered (Baron & Dianzami, 2016). Fevers also speed up the repair process, increase body metabolism and can also slow down bacterial reproduction to allow other cells enough time to get rid of the pathogen.

1. b) If a person suffers an injury such as cut or graze, the area often becomes inflamed for a few days afterwards. Describe how the inflammatory process protects the person from infection

The inflammatory response occurs whenever tissues are damaged by pathogens, trauma, toxins and other causes. The swelling occurs as a result of chemicals like histamine, prostaglandins and bradykinin released by the damaged cells which in turn cause blood vessels to lea fluids into the tissue causing the swelling (Chen et al, 2017).  The process prevents infection as it stops the foreign entity from coming into contact with more body tissue while the toxins attract white blood cells referred to as phagocytes which consume the foreign substance and any dead or damaged cells. The phagocytes eventually die out and the remaining dead tissue and bacteria collects to form pus.

            The ability for antibodies and phagocytic cells to fight pathogens and eradicate them from the body is made possible by the complement system. It comprises of a number of tiny proteins that are located in the blood and synthesized by the liver (Chen et al, 2017). The process is part of the acute phase reaction that occurs during systemic inflammation. When the complement system is stimulated by a trigger it initiates a process where proteases that are in the system start cutting specific proteins in order to release cytokines responsible for activating the cell killing membranes that get rid of the pathogens.

A.C 2.2

Q2.      (a) Describe how bacteria are destroyed by phagocytes.

Phagocytes destroy bacteria through the process of phagocytosis which is initiated when the white blood cells known as phagocytes identify some form of pathogen invading the body. The phagocyte moves closer t the bacterium and uses its cell membrane to fuse with the bacterium and engulf it with a cellular compartment known as the phagosome (Iwasa, 2020). The phagosome in turn fuses with a lysosome containing toxic chemicals and acidic enzymes that create a phagolysosome. The phagolysosome uses the chemicals to break down the bacterium before digesting it and in so doing, destroys the bacteria.

Q3       Complete the table: 

Q4. ( AC2.3)

Use the diagram provided to explain why a person infected with chicken pox normally only gets the disease once. You must specifically refer to the importance of memory cells in this process.

People who have already been sick with chickenpox only get the disease once because human beings posses circulating memory cells that are programmed to identify the virus destroy it before the individual gets sick. The memory cells remain in the body after the patient recovers from chicken pox to identify and destroy any pathogens that could cause chickenpox before it develops (Baxter et al, 2016). Once a pathogen is identified, the memory cells facilitate the commencement of secondary adaptive immune responses, producing B cells and T cells that attack and destroy the chickenpox pathogens.

            The secondary adaptive immune response offers protection that prevents the body from developing symptoms associated with chickenpox and the individual may not even be aware that the chickenpox causing pathogens entered the body (Baxter et al, 2016). The memory cells however become more efficient in preventing the reoccurrence of chicken pox as the number of cells that can identify chicken pox are left circulating in the body making the patient more immune.

References

BARON, S. (2016). Medical microbiology. Menlo Park, Calif, Addison-Wesley, Health   Sciences Division.

Chen, L., Deng, H., Cui, H., Fang, J., Zuo, Z., Deng, J., Li, Y., Wang, X., & Zhao, L. (2017).             Inflammatory responses and inflammation-associated diseases in   organs. Oncotarget, 9(6), 7204–7218.  https://doi.org/10.18632/oncotarget.23208

Feemster, K. A. (2017). Vaccines: what everyone needs to know.  New York, NY : Oxford           University Press

Ghebrehewet, S., Stewart, A. G., Baxter, D., In Shears, P., Conrad, D., & Kliner, M.         (2016). Health protection: Principles and practice. Oxford, United Kingdom : Oxford      University Press,

IWASA, J. (2020). Karp's Cell and Molecular Biology: concepts and experiments. John   Wiley

Johnson, S. (2008). The ghost map: The story of London's most terrifying epidemic--and how       it changed science, cities, and the modern world. London: Penguin,

National Research Council, (2004) “A theory of germs” Washington DC: National Academies     Press, retrieved from, vhttps://www.ncbi.nlm.nih.gov/books/NBK24649/

Plotkin, S. A. (2011). History of Vaccine Development. New York, NY, Springer Science+Business Media, LLC. https://doi.org/10.1007/978-1-4419-1339-5.

Thiel, K. (2017). The Germ Theory of Disease. New York, NY, Cavendish Square

Quality Improvement in Nursing

Introduction

           Quality improvement in nursing refers to the systematic process that healthcare organizations use to monitor and assess the delivery of medical care to improve the quality of care provided. Medical professionals rely on a cyclic chain of activities that assist in the delivery of care and continuous improvement creates an ideal working environment. Organizations can therefore rely on quality improvement when trying to replace inefficient traditional concepts with more innovative approaches to improve the quality of care in healthcare organizations. This paper will therefore discuss the topic of quality improvement in the nursing unit; the role it plays in defining teamwork in respect to the health care system; and how accountability, advocacy, and collaboration of care augment the management of care.

Quality Improvement in the Nursing Unit

           In nursing, quality improvement is essential as nurses have a direct effect on the quality of care offered, efficiency of care, and the attitude that patients have towards the type of treatment they receive and the overall quality of care offered. 

Healthcare organizations must therefore use efficient programs in the delivery of care to help improve the quality of care offered and customer satisfaction with the type of care offered and healthcare organizations in general (Izumi, 2012). Shifting trends in the healthcare industry have however created an environment where the quality of care is determined by different factors. Other than the quality of treatment, patients rely on other experiences such as the level of professionalism demonstrated by caregivers, time spent waiting for lobbies, and attitudes from nurses when attending to patients (Weston & Roberts, 2013). Healthcare organizations must therefore seek out different avenues to improve all aspects of care delivery within the organization to create an ideal environment for both caregivers and their patients. 

           One approach that can be used to enhance quality in nursing units is developing a culture where work is performed through systems and processes. Instead of viewing the nursing unit as separate entities that perform specific tasks in the healthcare organization, the units should be considered as parts of the key processes in the delivery system that assists the entire organization to accomplish its objectives (Izumi, 2012). Any activity carried out by nurses should therefore be included in the overall process that determines the overall quality of care. The quality of care is likely to improve if nurses are treated with the same importance as other caregivers (Izumi, 2012). Enhancing all processes involved when attending to patients improves the quality of care offered as well as the attitude that patients have after visiting a medical institution.  

           Quality improvement should also guide nurses on how to focus the quality of care to suit the patient’s needs. When determining the quality of care offered, patients rely on their experiences when seeking treatment as well as the actual treatment. In most organizations, nurses take on the responsibility of attending to patients before they see a doctor and afterward during follow-ups or when seeking clarification about the type of treatment (Weston & Roberts, 2013). Although treatment involves different caregivers, the time a patient spends interaction with nurses makes up the majority of the time patients engage with their caregivers. Training nurses how to make the services they offer patient-centered is therefore likely to have a positive impact on the quality of care provided. A patient-centered approach ensures that caregivers are more committed to offering services that are in line with the patient’s preferences.  

Accountability, Advocacy, and Collaboration and how they augment the management of care

• Accountability           

Healthcare organizations should strive to ensure that nurses and other caregivers practice accountability, advocacy, and collaboration when performing duties. Accountability in nursing is important as it trains nurses on how to be responsible. As caregivers, nurses should be held accountable for their actions because mistakes or omissions made in any stage of the treatment process could affect the effectiveness of the treatments offered and the quality of service (Illiadi, 2020). Nurses should ensure that they follow the correct procedures and that any deviations or challenges experienced are communicated to the relevant departments. Accountability can also help to identify where mistakes were made and in so doing, facilitate faster conflict resolution. 

• Advocacy

           Enhancing accountability could also promote advocacy in nursing units. Although nurses greatly contribute to the overall quality of care that patients receive, individual contribution is just as important in maintaining the levels of quality established (Aveling et al, 2016). Nurses must therefore engage in routines that make their work easier and equips them with the skills and knowledge to accomplish their objectives. Through advocacy, nurses can create a culture where support is provided for individuals who have difficulty performing specific tasks (Aveling et al, 2016). Proper channels of communication can be used to discuss areas that individual nurses or units have difficulty in. other caregivers and more experienced nurses should also utilize the channels created to guide new nurses on how to go about performing their duties. 

• Collaboration 

           Collaboration on the other hand strengthens the relationships that exist within nursing units and also among nurses and other caregivers. When attending to patients, treatment often involves contributions from different departments in the health facility (Dickerson, 2013). Patients pass through different departments such as the reception area, laboratories, x-ray rooms, and other departments depending on the type of medical care needed. The different departments work together to identify the medical condition the patient is suffering from before the doctor can recommend the correct treatment for the patient (Aveling et al, 2016). Collaboration is therefore important as it enhances the flow of information between departments and in so doing, offers better care to patients. It also enhances accountability by prompting each department to play their part and observe quality when attending to patients. 

Teamwork with Respect to the Health Care Team

           Accountability, advocacy, and collaboration in nursing can be enhanced through teamwork. With advancements in technology and patients’ desire for quality medical care, clinical care has become more complex and caregivers have to work in a team to offer the highest quality of care (Benishek et al, 2018). Through teamwork, caregivers can analyze current trends in the medical field; what forms of technology have been incorporated in the field of medicine; and what strategies can be used to adapt to these changes and maintain high standards of quality (Benishek et al, 2018). Teamwork is essential in that it helps to develop a clear guideline on how to implement certain procedures and what protocols to follow to enhance coordination between teams and other departments. 

           Nurses can form teams that are designed to handle different responsibilities and generate innovative ideas that can help to improve the quality of care. Nurses with specialized training and unique skills can be elected as team leaders and guided on how to train new nurses on how to excel at performing duties (Benishek et al, 2018). The teams can also help individuals to identify areas where they are weak in and develop routines to help caregivers gain new skills and knowledge that will go a long way towards enhancing the quality of care provided. 

Conclusion

           Quality management has become an integral part of how an organization goes about accomplishing their objectives. In the medical field, healthcare organizations are expected to uphold high standards of care and ensure that the processes involved when attending to patients are just as efficient as the treatment offered. Caregivers must therefore maintain high standards of care and be held accountable for the decisions they make when attending to patients. Organizations must therefore promote quality management as a way to ensure that patients get access to the best quality of care available. 

References

Aveling, E. L., Parker, M., & Dixon-Woods, M. (2016). What is the role of individual      accountability in patient safety? A multi-site ethnographic study. Sociology of health &        illness, 38(2), 216–232. https://doi.org/10.1111/1467-9566.12370

Dickerson S, (2013) “Whose job is it, anyway? The nurse’s role in advocacy and accountability”             Ohio Nurse Foundation, retrieved from,             https://d3ms3kxrsap50t.cloudfront.net/uploads/publication/pdf/883/OH9_13.pdf

Illiadi P, (2020) “Accountability and collaborative care: How inter-professional education            promotes them” Health Science Journal, Iretrieved from,        https://www.hsj.gr/medicine/accountability-and-collaborative-care-how-          interprofessional-education-promotes-them.php?aid=3600

Izumi S. (2012). Quality improvement in nursing: administrative mandate or professional             responsibility?. Nursing forum, 47(4), 260–267. https://doi.org/10.1111/j.1744-      6198.2012.00283.x

Roberts W and Weston M, (2013) “The influence of quality improvement efforts on patient          outcomes and nursing work: A perspective from chief nursing officers at three large health systems” The Online Journal of Issues in Nursing, retrieved from,             https://ojin.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/O            JIN/TableofContents/Vol-18-2013/No3-Sept-2013/Quality-Improvement-on-Patient-            Outcomes.html

Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J.,   & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-           quality care. The American psychologist, 73(4), 433–450.            https://doi.org/10.1037/amp0000298

 Project 1: Video Reaction Paper

Video 1

Introduction:

In her ted talk, “Enough with the fear of fat”, Kelli Jean Drinkwater talks who live with the constant fear of becoming fat which causes anxiety.  She narrates about her personal experience as a fat person and describes the challenges that she faces on a day to day basis. In this context she confronts the perception held by the public against bigger bodies. Throughout the presentation, she asserts that such beliefs are indicators of fat phobia, which is a prejudiced mentality. The speaker rationalizes how people, media, and doctors tend to visualize at fat people as bad people, although slim people are fundamentally good. This paper provides a detailed descriptions of my reactions to Kelli Jean’s and Meaghan Ramsey’s video on body image and its effects on individuals’ well-being. The paper provides relevant solutions for changing the cultural norms which entails judging people based on their looks to help all individuals achieve their goals. The paper talks about how most people are affected by their appearances and what they can do to develop self-confidence and become successful in life.

Drinkwater narrates about her personal experience of being overweight and the storms she has encountered as people judge her based on her appearance. She states that most people spend most of their life trying to maintain a lean body because it was what the society has always supported as attracted (Drinkwater, 2020). However, she insists that people should be allowed to be happy regardless of their body size because everyone is human and there is no need of limiting the definition of attractive.

My reaction to the Drinkwater’s video positive because she is brave, straightforward, and has high self-esteem. The speaker evokes positive energy based on her confidence while challenging people’s negative perception about big bodies. The speaker has made me feel happy and proud of her because unlike many people, she has accepted her big body, and she is unremorseful for being herself. The speaker is narrating her story while smiling, and this proves that she is happy and satisfied by her physical appearance. At a first, glance I would not help but recognize that the speaker was overweight which in turn created a negative attitude about her lifestyle and choices. However, based on her presentation this notion changed rather fast because of her confidence as she raised relevant arguments about how the perception affects individuals who are considered to be fat.

The initial thoughts that went through my head when I first I saw the speaker is that she needs to lose some weight to fit in society and avoid developing chronic illnesses which are associated with being overweight. In summary, the speaker talked about fat phobia because in our modern culture, being fat is considered as being as a result of irresponsibility, greediness, and laziness. However, we often forget that factors such as genetics play a role as well in determining our body size.

Fat people are often discriminated, abused, and excluded in some activities like a catwalk, club shows, prominent dance stages, and public swimming pools (Drinkwater, 2020). The speaker started engaging in activities that are regularly prohibitive to bigger bodies to show the world that fat people are also real human beings. She emphasizes that it is by accepting self that one is likely to protect his or her mental well-being.  

         The things that the speaker said and made me surprised include fat bodies that can blow an individual’s minds and there are fat activisms that encourage people to reject fat fear. The speaker said that fat phobia prevents people from making peace with their bodies. I can relate to that statement because most overweight people hate their bodies and all people have a fear of being obese, so they try dieting in every possible way to the extent of overdosing themselves with pills which causes further harm to their bodies.  Sometimes they even think they are obese, so they get anorexia or bulimia. These factors contribute to the development of illnesses particularly mental conditions such as anxiety.

The speaker’s statement that challenged my perceptions of fat people is that they should be valued and respected in society. Fat people should not be underestimated because they are normal human beings and productive (Drinkwater, 2020). By the end of the video, I have learned that a person should make peace with his body to overcome fat phobia and live happily.

By the end of the talk, my impression of the speaker is that she is a role model because she has managed to change positively many lives of obese individuals. She is also a hero because she managed to overcome the fear of fat at six years. Before the video, my perception of fat people was that they were irresponsible, inactive, and greedy. After the video, my perception changed because some people were born fat, and despite being active, they are still overweight and therefore, fat people should not be condemned and abused. I agree with EP's comment that bullying people who are obese is horrible thus, people should stop the habit (Drinkwater, 2020). I also support Abe Felisa's comment that no one in the world wants to be obese, and this makes some individuals define obesity as an illness.

Video 2

Introduction:

In the video “Why thinking you're ugly is bad for you,’’ the speaker, Meaghan Ramsey argues that people should avoid media pressure. The video talks about the effects of people thinking they are ugly. Thousands of individuals wonder and try to search for answers on Google to confirm whether they are beautiful or ugly because they think that their appearance is not good enough. One in three teenagers does not participate in class discussions to avoid drawing attraction. Teenagers with low body confidence underperform compared to those with high body confidence. The keyways to overcome image-related pressure include educating teenagers about body confidence, respecting, and looking for themselves.

My reactions to this video are sad because I have learned that most teenagers are affected by what they think they look (Ramsey, 2014). People are loved by the way they look and therefore, those that are considered as unattractive are subjected to bullying and abuse especially on social media platforms.

What I have learned from the video is that today, the online environment is training children to value themselves by the likes and comments they get because there is no separation between online and offline life. What has surprised me is that there is a girl who posted her picture on social media and asked people whether she was ugly and beautiful because her mother used to tell her she was beautiful while her friends used to tell her she was ugly. The confusion made her ask a public opinion on her look, but unfortunately, she received absurd comments (Ramsey, 2014).  Parents should show their kids that what they look is just one part of their identity, and they love them for who they are and what they make them feel.

Analysis Section

           I was asked to watch the two videos back-to-back because they talk about body appearances. In both videos, fat people are considered ugly, while slim people are viewed as attractive. The videos are similar and relevant because they address an important issue that is affecting society today.  The videos asserts that people should not be judged based on their appearances because fat and slim people are all human beings and useful. The videos relate to other reaction papers because the speakers are reacting to body weight and image confidence. The videos relate to mind-body connection because people who find themselves attractive succeed in life while those who find the unattractive become losers.

What I have learned through this project is that the habit of bullying others based on their weight and attraction is harming teenagers and people in general. Mental health is the most essential because it gives people clear thinking, inner peace, and increases their self-esteem. For example, in the ‘’ enough with the fear of fat’’ video, I have learned that people should start accepting themselves at an early age to become strong and overcome fat and appearance phobia.