Major assignment Essay Example | Topics and Well Written Essays - 1750 words

Major assignment - Essay Example This paper is aimed towards highlighting the phenomenon of pay secrecy and the changing trends in compensation management that propose pay transparency. In the light of the research, solutions will be presented for the case in question. ‘When salaries aren’t secret’ written by John Case for the Harvard Business Review, presents a rather complicated situation that was being faced by the management of a fashion retailer called RightNow! (Case, 2001). The CEO Hank Anderson was facing the retaliation of an ex-employee who had overheard the management discussing employee payment in a meeting and had probed into the company data to find out blatant discrepancies. Displeased with the inequity, she not only resigned but also gave a departing gift to the company, making the individual employee payment amounts known to all through an e-mail to the whole workforce. This had caused a lot of mayhem as many employees discovered they were being paid only a percentage of what their counterparts were being paid. Many demanded a raise and threatened to leave the organization. The CEO was accompanied by the Vice president of the company, Charlie, and CFO, Harriet, to discuss this situation. The furious employees h ad been seen discussing nothing but the revealing e-mail all day and the management had their share of concerns. They discussed how the situation could be manipulated to give a bad name to the whole organization and its practices, publicly. Their concern was also the height of retaliation that could result from the angry and heartbroken employees who had been exposed to the harsh truth. The vice president gave an instance of three highly paid male employees in an all-female department as possible grounds for a gender discrimination suit. The trusted advisors of the CEO, Hank, present their concerns and possible solutions to the problems namely, sympathizing with the employees, listening to their pleas and demands and promising

Adult Group Learning Essay Example | Topics and Well Written Essays - 1250 words

Adult Group Learning - Essay Example style commonly prevail among the learners are the discussion methods in which they try to discuss the topics with their friends and try grasp as much as possible. Thus learning can take place independently and also it can happen in groups. Adult learning also happens independently and in groups. Adults have more intellectual abilities than the children and can learn the topics independently using some resources like internet, library resources etc. But some adults prefer group learning. They feel that working with a group is more beneficial to their learning than listening in class. This paper briefly explains adult group learning. McKeachie found significant relationships between attitude change and changes in perception of the group norms (Gibb, n. d, p.256). Moreover, Brewer et al (2003) have mentioned that the opportunity to work in small informal groups provides an avenue to interact with peers, fulfilling the needs of some adult learners with a high affiliation motive (Brewer et al, 2003) The attitude of the adults towards group learning is extremely positive. Man is a social animal. It is difficult for a person to live in this society without having the assistance from others. Same way, there are limitations for a person to learn things independently. While learning in groups adults will attain more enthusiasm and positive attitude towards their learning compared to learning independently. Moreover, face to face contact with groups tended to retain beliefs even after these beliefs shown to be without foundation (Gibb, n. d, p.256). It is a fact that all the people like the company of peers for everything. While working, playing, studying, people always like the company of others who are similar in their ages. Same way while learning also adults like the company of adults. It is difficult for an adult to learn in the company of younger people as young people might tease him or harass him. On the other hand he will be more comfortable in the company of

IDiscusson board reply645 Coursework Example | Topics and Well Written Essays - 250 words

IDiscusson board reply645 - Coursework Example Several Christian principles focus on our relationship with others. In his message to the scribes, Jesus speaks of the importance of relationships. He utters that the greatest commandment is, â€Å"Hear, o Israel! The Lord, our God, is the one and only Lord. And, you must love the Lord your God with all your heart, all your soul, your entire mind, and all your strength. The second is also important: Love your neighbor as yourself. No other commandment is greater than these† (KJV Mark 12:29-31). Creation’s account according to Genesis presents an example that provides an account of God’s decision-making, organizing, planning, controlling, and leading. Business commonly accepts the account as management functions that are critical to the success of an organization (Drucker, 2014). God’s principal set of command provides us with a foundation and a sense of our â€Å"mission and purpose.† God further calls us to be â€Å"master over all life, the fish in the sea, birds in the sky, and all the livestock, wild animals, and small animals† (KJV Genesis 1:26). Simply, just like in an organization, God commissions humans to manage the resources provided by

Suffering in Christianity Essay Example for Free

Suffering in Christianity Essay 1. Consider how any single religious tradition copes with the problem of suffering and evil in the world. Nearly every human being on earth has asked this common question. â€Å"Why all the suffering and evil in this world? ’. The presence of evil and suffering has forced adherents of all religious traditions to question their beliefs, their religious identity and their understanding of the ultimate reality. Christians in particular, are faced with these questions and life situations of suffering and evil, confronted to them, on a daily basis. When confronted with life situations they have questioned why an all powerful and an all loving God would allow this to happen. There has been a variety of responses to these questions. Christians have explained suffering and evil as, ultimate judgement of sin, consequences in living in a fallen world, and perhaps the idea of the world not being created in a perfects sense. These are just one of the many responses Christians have thought. However, even though Christians may never know the definite explanation, Christians cope with the idea of evil and suffering by finding ways to respond to it. With the idea of love and compassion taught by Jesus Christ, their goal is to find multiple ways to end suffering and evil through various organizations, actions, deeds and prayers. This illustrates that Christians respond to suffering so the creation of an ideal society in which all suffering and evil can be eliminated. Furthermore, Christians can come to experience the new kingdom of Christ, where love, peace and tranquillity are the centre of all. Suffering which is remotely linked to evil, forces adherents to understand the different kinds of suffering, and how it affects their outlook on life and death. The website â€Å"Suffering and the problem of Evil† states that â€Å"Human suffering, takes on many forms: emotional, natural, and moral. Loneliness, anxiety, and grief are examples of emotional suffering. Fires, tornados, earthquakes, hurricanes, and physical illness are examples of natural suffering. Moral suffering is brought on by the deliver act acts of a fellow human beings to cause suffering, something Christians call a moral evil† (Suffering and the problem of Evil. 2013) This demonstrates the result of moral evil leading to emotional, physical and even at times natural disasters. Suffering therefore brings Christians back to reality, to come into realisation with their mortality, which is very easily ignored. It demonstrates the flaws and hints of Christian’s coming death â€Å"It removes the veil; it plants the flag of truth within the fortess of a rebel† (Lewis, Problem of Pain, pg 83) It creates an atmosphere, ultimately, in which Christian’s thoughts are directed towards God. â€Å"God whispers to us in our pleasure, speaks to us in our conscience, but shouts us in our pains: it is his megaphone to rouse a deaf world† (Lewis, Problem of Pain, pg 84). The painful statement of Lewis states, demonstrate the truth about death. That death is horrific no matter what form it may take. So suffering in a Christian perspective, allows them to gently prod on their consciousnesses and forces them to understand that suffering may indeed lead to their future deaths, if they were to leave suffering without response. However if Christians can cast their doubt and turn to God, it can therefore bring a foundation of a new thinking, attitude, hope and living, not only to themselves, but to their faith. In the book of Corinthians, the apostle Paul states â€Å"We are afflicted in every way, but not crushed; perplexed, but not driven to despair; persecuted, but not forsaken; struck down, but not destroyed; always carrying in the body the death of Jesus, so that the life of Jesus may also be manifested in our bodies†, which demonstrate this tension. Furthermore, the term â€Å"suffering and evil† provides many benefits to the Christian Faith. Suffering provides Christians to give proof of the genuineness of their faith, and to serve to purify, and carry their faith. It provides the opportunity for believers to demonstrate their love for each other as adherents of the body of Christ who â€Å"bear one another’s burdens† (Gal 6:2) D. A Carson a Reformed Evangelical Theologian once stated that â€Å"experiences of suffering. engender compassion and empathy.. and make us better to help others† (Carson, 122). This demonstrates how experiences of a Christian’s own suffering and comfort they receive from the ultimate reality, makes Christians more equipped to help those who are still in suffering and victims of evil. Just as the apostle Paul states in the Book of Corinthians â€Å"Who comforts us in all of our troubles; so that we can comfort those in any trouble with the comfort we ourselves receive from God†. ( 2 Corin 1:4) However most importantly, Christians can cope with suffering and evil as their affliction in God increases them to follow God’s will. In the Book of Hebrews, Jesus â€Å"learned obedience from the things he suffered (Heb 5:8). He learnt the value and significance of submitting the will to God, even at the time it was the most difficult thing in the world o do. Tim Costello, CEO of World Vision, witnessed this kind of teaching and devotion God, when World Vision visited Sri Lanka to provide aid and emergencies to those who were victims of the 2004 Indian Ocean tsunami â€Å" Many people in Sri Lanka though, who were directly affected , were asking a different question. They were asking how they could not believe in God as a result of the tsunami, since God was all they had left† (Bible Study, Where is God in Suffering- World Vision. 013) Suffering and evil also provides Christians to improve on the relationship with other human beings, and to fulfil and follow their faith, in restoring compassion and God again in Christianity. Tim Costello provides an in depth view of how Christians can respond to suffering and evil, in the mindset of fulfilling faith and God’s word. In an interview he proclaims â€Å"Faith is incredibly important for me. In religious terms, I believe salvation is everything that restores the crippled image in God- dirty water, not enough food. Sin I think is everything that cripples the image of God- not having access to education, injustice, inopportunity. For me that faith position that I believe everyone, despite the lottery of latitude, is made in the image of God is really the core of my faith and my life’ (Full Transcript, Tim Costello Enters the zone. 2013) Tim Costello places emphasis that Jesus challenges Christians to test out their faith, by responding to suffering, to encourage salvation and eliminate sin. He believes that every human being is made in the likeness of God, so therefore all human beings should be treated with love and compassion. This can lead to the faith of Christianity and God to be restored, which has been abruptly destroyed by sin. God taught Christians the demonstrating of compassion by entering the world it in the form of Jesus, who suffered and died for all Christians. He demonstrated that God is not a God who rules from above but carries from below. Therefore he taught all Christians, to continue the work of compassion and faith through Jesus Christ by responding to suffering. As what Jesus Christ said in the Book of John â€Å"as the Father sent me, I send you† (John 20:21) Suffering and evil have sometimes encouraged Christians to devote their lives entirely to helping those with evil and suffering. Not only do they devote their lives to this, but they also provide other Christians encouragement to contribute in the smallest way, in ending suffering. They have taught not only to the Christian faith, but to all religious traditions, how to incorporate Jesus teachings, but more specifically, love and hope. Mother Teresa is one of the many influential Christians who have taken upon this life. Throughout her life, she went out and lived her faith by seeing her God in every human being in front of her, especially the sick, the aged, and the abandoned. She served God by serving God in them, demonstrating that she lived the Gospel with every breath in her body. She established hospitals for the sick and dying, and started the religious new order, the Missionaries of Charity, in Calcutta which is now practiced and spread throughout the world. She was devoted in caring for the poorest of the poor, the sick and the dying. She clean them, feed them, pray with them, and serve them as their spent their last hours in dignity. She demonstrated compassion for those who were less fortunate then she is, as she once said to a man who she was picking muggets off his face â€Å"You pray to your God, and I will pray to Jesus for your healing† With the many attitudes and teachings that Jesus Christ and the Father have provided to their adherents, Christians have also devised many organizations and appeals in contributing to help those who are suffering and victims of evil. In example, many Christians have responded to those who are suffering in extreme poverty. There are many Christian organizations that deal with this. These are World Vision, Compassion International, Salvation Army, Christian Aid and many more. All of these organizations also â€Å"have principles of the Christian religion in their charters† (What are the type of Different Christian NGOS? 2013) In example, the Salvation Army vision is â€Å"a growing, loving, community of people dynamically living God’s mission in a broken world† (The vision, mission and values of the Salvation Army. 2013) Compassion International places emphasis on â€Å"recognizing the suffering of others, then take action to help† (Meaning of Compassion. 013) While all may have different mechanisms in responding to the issue of poverty, they all place emphasis on ending suffering and taking action. As the Book of Timothy says â€Å"They are to do good, to be rich in good works, to be generous and ready to share, thus storing up treasure for themselves as a good foundation for the future, so that they may take hold of that which is truly life† (1 Timothy 6:18) Conclusively, Christianity provides adherents to respond to suffering and evil, in order to cope with it. Christians are challenged and called by Jesus Christ, to realise the destruction of suffering and evil to all people of the world, and to act on it. Christians are called to act with love and compassion as they serve their faith and Lord, by providing essential needs, love and faith to all those who are still encountering suffering. However furthermore they are called to act as a collective and restore the image of faith and Christianity, and to provide hope, so a world of suffering and evil can soon be eliminated.

Old Age An Incurable Disease Health And Social Care Essay

Old Age An Incurable Disease Health And Social Care Essay Health is a central issue and fundamental human right associated with increase in longevity of population ageing. The maintenance of health status and functioning with age is a critical factor impacting upon many other aspects of the lives of aged, their family and communities. Ageing is a natural process which is inevitable and thus being the end of the human life cycle. Perceiving ageing with fear is recent phenomenon, it seems to be increasing each day, as world become more complex and moreover ageing is associated with decline in functional ability which affects all aged peoples. Aged have limited regenerative abilities and more prone to disease, syndrome and sickness than adults. Old age is an incurable disease, You do not heal old age but You protect, promote and extend it. James Sterling Ross The number of persons above the age of 60 years is fastly growing, especially in India. India is the second most popular country in the world has 76.6 million people at over the age of 60, constituting above 7.7% of total population. The most obvious manifestations of old age are changes in physical appearance such as wrinkles appearing on the face, graying of hair, restriction of movements and more prone to chronic illness. Too frequently, older adults suffer from the emotional side effects of ageing such as feeling of distress and anxiety regarding their future, loneliness and social isolation. The major area of concern is the health of the aged with multiple medical and psychosocial problems which have an impact on functional ability of aged. Functional disability in the aged is defined as an acquired difficulty in performing basic everyday tasks or more complex tasks needed for independent living Davidson. (2011). The most common problem confronting aged people is functional disability that leads to dependency and institutionalization. The functional disability in the aged includes three dimensions: physical, emotional, and mental performance. The population of functionally disabled aged is growing rapidly. The number of aged who suffered with functional disability due to arthritis, stroke, cognitive impairment, anxiety and emotional distress is expected to increase at least 80 percent by 2049. Functional disability limits the autonomy of older people, introduces dependence, and reduces the quality of life and increase the risk of nursing home admission. Studies have shown that the proportion of aged persons who cannot move and are confined to their bed or home ranges from 77 per 1000 in urban area and 84 per 1000 in rural areas. The family and community play a vital role in the care of a functionally disabled aged. The supportive care for aged with functional disability is the major concern which includes early rehabilitation with adequate nutrition, fluids, range of motion exercise, second hourly position changing; skin care and reviewing medical follow up. This will enable to prevent the development of complications such as infection, bed sore, constipation, movement incapability, urinary tract infection, deep vein thrombosis, muscle atrophy and contractures with resultant deformity in the aged. Studies shown that majority (70%) of the aged over 60 years with functional disability are expecting the need of care by the caregivers to perform their daily activities. Caregivers are the one who is always present with the aged client, satisfying their needs and solving their problems. The caregivers of the aged may be their spouse, childrens or some other paid caregivers. The involvement of caregivers in caring the aged ones has been a help to create a great confidence in the aged to perform some kind of activities of daily living and also it has profound effect on aged reaction to medical treatment, emotional adaptation and rehabilitation. To implement the care for aged it is necessary that caregivers must be aware of functional disability in the aged to provide supportive care. BACKGROUD OF THE STUDY: By reviewing the bureau report 2009, globally aged population will increase from 595 million to 2 billion, a four fold rise by 2050, in terms of proportion 10% in 2000, 15% by 2025 and rise to 21.6 % by 2050. Ageing population is an end product of demographic transition, the number of older adults aged above 60 years is increasing and they are becoming larger percentage of over all population. In India, it is estimated that the elderly population has grown from 12.6 million in 1901 to 80.93 million in 2010 and India is the second largest country comprising aged in the whole world and is likely to touch 300 million within next half century. Data available from India suggest that almost 50 per cent of the elderly suffer from chronic diseases with the prevalence of diseases increasing with rising age from 39 per cent in 60-64 years to 55 per cent in those older than 70 years. Research by the National institute of ageing reports that 80% of the aged are living with chronic conditions. Most of them are able to meet their own needs but only 25% of them require a special type of care. More than two third of the aged (22 %) live independently in a family setting. It is estimated that 10% of the aged need some form of long term care in the home. Prevalence of various functional disabilities gradually increases with advancing age, starts at the age of 60 years and cause a growing need for help especially after the age of 65 years. Ageing process and changes in life style pattern such as chronic alcoholism, smoking, use of tobacco, sedentary life style, obesity, lack of exercise and improper nutrition during the young age has led a risk of chronic disease conditions among elderly population which results in 70% of disability making elderly more dependent on family and caregivers. Eden. (2000) stated that old age is still perceived as a casual agent for seeking dependence in performing daily activities and the factors frequently causing dependency are age, gender, falls, illness etc. A large population of todays ageing is dependent on the family members for their health maintenance. Approximately 54% of the aged above 60 years are dependent, 24% of them are partially dependent and 22% of them are independent in performing their daily activities. The dependence on others for meeting the various needs will generate a felling of physiological and psychological dependence among the aged. The prevalence of unmet needs for functional disability in the aged due to vision problems is about 4.3%, 22.6% due to hearing problem, 32.5% due to immobility, 50% due to cognitive impairment, 62% due to difficulties in activities of daily living, 35% due to chronic illness, 25% due to psychological and social problems among those aged 60 and older. The involvement of caregivers in caring the aged will help to create a great confidence in aged to perform some kind of activities of daily living. Approximately 4.1 million caregivers are involved in intense care giving. Hence the care giving is not only the responsibility of health professionals but also the family members, relatives, friends and even non- professionals who cares for the aged in home. NEED FOR THE STUDY: Advances in technology and the combination of high fertility and declining mortality in twentieth century have resulted in rapid and large number of aged people worldwide especially in developing countries. In every country, the proportion of people aged over 60 years is growing faster than any other age group. Ageing causes numerous changes in the physiology of human beings which decreases functional ability. This in turn makes them dependent on caregiver. Inadequate care results in falls and depression among older adults. Among the aged, the focus is not only on reducing disease related morbidity and mortality, but also on promoting optimal health and ensuring disability-free years. The literature states that the effect of functional disability will have an effect on quality of life among aged, as the aged become dependent where the caregivers should play a major role in taking care of such aged person. Caregivers are the one who is always present with the aged client, satisfying their needs and solving their problems. It is necessary that caregivers must be aware of functional disability in the aged to provide supportive care. Investigator, during her clinical posting and community postings came across many aged with functional disability such as loss of control in body movements, functional immobility and associated coexisting illness who were dependent on their caregivers for their daily activities. While interacting with their caregivers the investigator came to know that they are not having adequate knowledge regarding the effects of functional disability and the care needed for the aged. Investigator felt that, aged with functional disability need some form of long term care in the home. If the caregivers had the knowledge they would help the aged in taking care of their health to prevent further complications. So the investigator felt the need to assess the knowledge regarding functional disability in the aged and its supportive care among caregivers to develop insight on the needs of older adults. STATEMENT OF THE PROBLEM: A study to assess the knowledge on functional disability in the aged and its supportive care among caregivers at selected settings in Chennai OBJECTIVES: To assess the knowledge on functional disability in the aged and its supportive care among caregivers at selected settings in Chennai. To associate the knowledge regarding functional disability in the aged and its supportive care with selected demographic variables among caregivers at selected settings in Chennai. OPERATIONAL DEFINITIONS: ASSESS: In this study assess refers to the process of gathering information as expressed by the caregivers in response to the semi-structured interview schedule and analyzing it with the statistical method. KNOWLEDGE: In this study knowledge refers to the awareness about functional disability and its supportive care as expressed by caregivers as response to the semi-structured interview schedule and analyzing to the statistical method. AGED: In this study the aged refers to the people above 60 years who are available in the hospital and community. CAREGIVERS: In this study the caregivers refers to the family members, relatives and paid non professional persons in the age group from 21 years to 65 years who are taking care of the aged. FUNCTIONAL DISABILITY: In this study the functional disability refers to deviations from the normal or customary function of an individual within any of the three dimensions i.e, physical, emotional or social skills necessary for an independent life. SUPPORTIVE CARE: In this study the supportive care refers to the care which is provided to support the functionally disabled aged in meeting their daily needs. SETTINGS: In this study setting refers to the place or type of surroundings from where the sample is collected i.e, community and hospital setting. ASSUMPTIONS: The knowledge on the functional disability in the aged and the supportive care among the caregivers will vary from adequate to inadequate. The knowledge on functional disability in the aged and the supportive care among caregivers will be influenced by the selected demographic variables. DELIMITATION: The samples are the caregivers of the aged available in the community setting i.e, Thoraipakkam, Navalur and those admitted to the two hospitals i.e, V.H.S multi speciality and Dr.Kamakshi memorial hospital. Period of data collection is limited to one month. PROJECTED OUTCOME: The results of the study will project the knowledge levels of whom regarding various functional disabilities in the aged and the supportive care needed. The knowledge levels will highlight the need for educating the caregivers on various problems of functional disability By assessing this need, we can formulate the various methods of educating the caregivers on common problems of functional disability and it supportive care in the aged. CONCEPTUAL FRAMEWORK A concept is an image or symbolic representation of an abstract idea. Conceptual frameworks are interrelated concepts or abstractions that are assembled by virtue of their relevance to a common theme Polit and Beck (2001). It is a device that helps to stimulate research and the extension of knowledge by providing both direction and impetus. A framework serves as a spring board for scientific advancement. A conceptual framework serves as a guide, to identify systematically and precisely defined relationship among the variables. It gives an idea to the main view and common theme of the research that is a visual diagram by which the researcher explains the area of interest. MODEL: The conceptual framework adopted for the study is based on PENDERS HEALTH PROMOTION MODEL (1987). Health promotion is, directed towards increasing the level of well being and self actualization in a given individual or group. This model focuses on the three aspects, Modifying factors. Cognitive perceptual factors. Participating in health promoting activities. MODIFYING FACTORS: It refers to the situational, maturational, socio cultural, personal and biological factors. In this study, it refers to the demographic variables like age, gender, marital status, educational status, occupational status, family income, type of family, any previous experience of taking care of the aged, relationship with the client, history of any present diseases in aged person, degree of physical dependency, hours spent in the care of the aged person, any previous information on functional disability in the aged and its supportive care. COGNITIVE PERCEPTUAL FACTORS: In this model, cognitive perceptual factors have important motivational significance. These variables can be modified through nursing actions. In this study it refers to the knowledge of caregivers regarding functional disability in the aged and its supportive care in the aspects of disability in the aged, vision problems, hearing problems, loss of control in body movements, memory impairment , functional immobility, activities of daily living, importance of exercises, coexisting illness, psychological problems and family support. PARTICIPATING IN HEALTH PROMOTING ACTIVITIES: Participation of caregivers in this study is considered as one of the health promoting behavior as this will help the caregivers to be aware of their existing knowledge on functional disability in the aged and its supportive care, which enhance through the advices given. CUES FOR ACTION: The responses of the caregivers regarding their knowledge on functional disability in the aged and its supportive care provide cues for nursing action like reinforcement and also creating awareness in terms of early rehabilitation of functionally disabled aged with adequate nutrition, fluids, range of motion exercise, second hourly position changing; skin care, reviewing medical follow up, providing assistive devices, assisting in daily activities, emotional support, engaging in social activities, promoting comfort and psychological support. MODIFYING COGNITIVE PERCEPTUAL PARTICIPATING IN HEALTH FACTORS FACTORS PROMOTING BEHAVIOUR KNOWLEDGE OF CAREGIVERS REGARDING FUNCTIONAL DISABILITY IN THE AGED AND ITS SUPPORTIVE CARE: Information regarding health promoting behavior includes, Disability in the aged Vision problems Hearing problems Loss of control in body movements Memory impairment Functional immobility Activities of daily living Importance of exercises Coexisting illness Psychological problems Family support Participation of caregivers in the study and sharing information regarding functional disability in the aged and its supportive care DEMOGRAPHIC VARIABLES: Age Gender Marital status Educational status Occupation Family income Type of family Relationship with the client Any previous experience of taking care of the aged Hours spent in the care of the aged person Any previous information on functional disability in the aged and its supportive care History of any present diseases in aged person Degree of physical dependency Reinforcement Adequate knowledge Eliciting the knowledge of caregivers regarding functional disability and its supportive care through semi-structured interview schedule Moderate knowledge Inadequate knowledge Cues for nursing action FIG.1 CONCEPTUAL FRAMEWORK BASED ON PENDERS HEALTH PROMOTION MODEL (1987) CHAPTER II REVIEW OF LITERATURE Review of literature aids the researcher to understand what already known in relation to problem of interest and what remains to be known. It helps to plan and conduct the study in a systematic manner. It is defined as reviewing and analyzing the work of literature in relation to the specified topic in research Simai Haji Mati. This chapter deals with selected studies and articles which are related to the objectives of the proposed study. For the present study an extensive review of literature relevant to study was undertaken and is presented under the following headings. Part I: General information about ageing, functional disability in and its supportive care. Part II: Studies related to functional disability and its supportive care in the aged. Part III: Studies related to knowledge of caregivers of aged on functional problems and its supportive care. Part I: General information about ageing, functional disability and its supportive care. Ageing is the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age. It applies to both individuals and population groups. Ageing allows people to realize their potential for physical, social, and mental well-being throughout the life course. According to Stephan John. (2009) Ageing is denoted as, Young old 65-74 yrs. Middle old 75-84 yrs. Older old 85 and older Darnton. (1995),emphasized that quality of old age people depends mainly on psychological well being, perceived health status with independency in meeting self care needs. Normal Ageing process: The ageing process creates profound changes that there will be 1-2% decline in functional ability per year. Normal Ageing brings about the changes in physiological, Social and Psychological well being Judith A. McCann. (2003) Physiological aging process: Changes in body composition, reduction in bone mass and strength, reduction in blood volume, reduced motility of the large bowel, changes in autonomic function, reduced elasticity of eye lens, high tone hearing impairment and reduced motor and sensory function. Social and psychological aging process: Feeling of distress, anxiety regarding their future, loneliness, depression, grief, sadness, and social isolation. However, some of the above effects of ageing can be slowed by engaging in interventions that improves outcome in the health events. Functional disability in the aged is defined as an acquired difficulty in performing basic everyday tasks or more complex tasks needed for independent living. It is an important health indicator in the aged, jeopardizing quality of life and causing heavy social impact with long-term institutionalization and increased use of medical care. Reducing functional disability in the aged is a major challenge for public health- Frazil.(2005), performance in functional disability includes three dimensions: physical, emotional, and mental performance. Physical performance relates to the bodys sensory and motor function. Emotional performance is measured through the individuals adaptation to various events in their lives. Mental performance is evaluated through tests that measure the individuals intellectual and rational capacity. The causative factors for functional disability are as follows: Vision problems, hearing problems, loss of control in body movements, memory impairment, functional immobility, difficulties in performing daily activities, lack of physical exercises, coexisting illness, psychological problems and family support. The effects of fundamental disability include walking, lifting objects, climbing stairs, reading standard-size print and hearing disturbances, short-term memory loss, disturbance in daily activities, disorientation to time and place, reducing mobility and social activities. The care necessary for the effects of functional disability are early rehabilitation with adequate nutrition, fluids, range of motion exercise, second hourly position changing; skin care, reviewing medical follow up, providing assistive devices, assisting in daily activities, emotional support, engaging in social activities, promoting comfort and psychological support. By over viewing the various informations regarding functional disability in the aged will thereby helps the caregivers to prevent further complications and also provide supportive care for the aged. Part III: Studies related to functional disability and its supportive care in the aged. Felix. (2001) stated that disability is systemic; no body system is immune to its effect. From his statement it is evidenced that meeting the self care activities and physical maintenance are essential for managing the effects of disability. Nandi Manju. (2002) stated that as ageing increases there will be decline in functional ability, which is compromised with good nutrition, assistive support, with psychosocial concerns and with medical care. Steffen Been. (2005) proposed a statement that there will de decline in cognitive and functional abilities of old age due to continuous degeneration of numerous brain cells which aid them to obtain a fully dependable care from caretakers. Frey. (2006) stated that decreased level of physical activity and growing number of chronic illness that often increase with age, frequently create vicious circle of illness, and related functional disabilities that has adverse effect on activities of daily living. In this statement, he highlighted that decrease in functional ability makes the individual to become more dependent and need constant support and supervision. McDougall.(2006) conducted a cohort study to identify the prevalence of memory impairment among 265 older adults by means of survey method and the results showed that 29.4% (78 individuals) of them had memory impairment in the later adult period .He also concluded that those with declining memory are less aware of their deficits in meeting activities of daily living. Human research center for ageing.(2006) stated that immobilization, loss of control in body movements and falls need not to be the consequence of living to advanced age all this may be prevented through muscle strengthening and range of motion exercise which has reported benefits of spontaneous activity by the old age people. Stark.et.al.(2007) conducted a correlational study to assess the health status of functionally disabled aged under the supervision of institution and family by means of health indicator assessment scale and the results showed that the older adults who receiving the care such as adequate nutrition, fluids, range of motion exercise, second hourly position changing, skin care, reviewing medical follow up and participating in family activities are in the family are having moderate health status than the older adults in the institutionalized care. Zbylut j. (2007) conducted a national survey to evaluate the health status of older persons and prevalence of common health problems among elderly above 60 years. The survey results shows that a large number of older persons were suffering from one of more age-associated chronic diseases like osteoporosis, osteoarthritis, dental problems, visual problems, cognitive impairment and depression which may impair their functional ability and quality of life. Kart berg. et.al (2010) conducted a descriptive study to assess the functional ability among the aged by means of questionnaire in the aspects of physical, mental and social abilities and the study concluded that low functional ability lead to dependency and stressful environment for the aged which again increase the risk of complications. Lawton and Brody.(2010) described that assessment of functional ability often includes evaluation of individuals ability to carry out activities of daily living which is an early sensitive indicator to promote quality of life of old age people. From the above studies the investigator identifies the prevalence, impact of functional disability in the aged and the important aspects of supportive care for the aged. It helped to formulate the need for the study and also helped to identify the major areas which should be included while formulating the objectives. Part IV: Studies related to knowledge of caregivers of aged on selected functional problems and its supportive care. Skalska.et.al. (2007) conducted a cohort study with the aim to evaluate the knowledge on various areas of functional problems among 62 caregivers of aged at risk by means of questionnaire and the samples are (78% family members and 22% non related) results revealed that only 41% caregivers had knowledge on functional problems such as (vision, hearing, and memory problems in the aged) and 59% were not aware of functional problems mainly in cognitive and social problems. Chelma.et.al. (2009) conducted a explorative study to identify the measures on management of functional problems of elderly among 629 caregivers by means of check list, the result revealed that 47% of them were aware on the common measures and 53% were unaware on common measures on management of functional problems among elderly. Through these studies the investigator understands the importance of caregivers awareness on functional disability in the aged and its supportive care which helped me to formulate the tool. CHAPTER III METHODOLOGY This study was undertaken to assess the knowledge on functional disability in the aged and its supportive care among caregivers at selected settings in Chennai. This chapter on methodology includes research approach, research design, setting, population, criteria for selection of sample, sample size, sampling technique, data collection tool, development and description of the tool, validity of the tool, pilot study, data collection procedure and plan for data analysis. RESEARCH DESIGN A non experimental descriptive design was chosen for this study. RESEARCH APPROACH Research approach was descriptive in nature. SETTING OF THE STUDY The setting of the study was chosen on the basis of feasibility, in terms of availability of adequate samples from hospitals and community. Voluntary Health Services Hospital, Adyar, Chennai. Dr.Kamakshi Memorial Hospital, Pallikaranai, Chennai. Community- Thoraipakkam and Navalur. POPULATION FOR THE STUDY The population of the study consists of the caregivers of the aged in selected hospitals and in the community. SAMPLE OF THE STUDY The caregivers of the aged within the selected hospital and in the community who have fulfilled the inclusion criteria. CRITERIA FOR THE SELECTION OF SAMPLES Inclusion criteria: The caregivers who are taking care of the aged with functional disability. The caregivers in the age group of above 20 yrs. Both male and female caregivers of aged people. Caregivers who are willing to participate. Exclusion criteria: The caregivers who are included in the pilot study. The caregivers of the aged who are independent in doing their daily activities. Care givers who do not understand and communicate in Tamil or English. SAMPLE SIZE The sample size of this study is 60 caregivers of the aged people at selected settings, Chennai. SAMPLING TECHNIQUE Purposive sampling technique is used in this study. DATA COLLECTION TOOL The data was collected from the caregivers using semi-structured interview schedule. DESCRIPTION OF THE TOOL The tool prepared in this study was based on the information gathered from the review of literature; objectives of the study and the personal and professional experience of the investigator. It consists of two parts Part I: It consists of demographic variables like age, gender, marital status, educational status, occupation, family income, type of family, any previous experience of taking care of the aged, relationship with the client, hours spent in the care of the aged person, any previous information on functional disability and supportive care, history of any present disease in aged person and degree of physical dependency of the aged. Part II: It consists of 11 questions which have three parts to assess the knowledge on functional disability in the aged and its supportive care among caregivers using semi-structured interview schedule. SCORING PROCEDURE: In part II: In first question, part (A) the correct option carries one mark; the incorrected option carries zero mark. In part (B) each option carries one mark. For all other question from (2 to 11), The first part of each question carries one mark for each YES option and no mark for NO options. And the second and third part of each question carries one mark for each option. Thus a total of 101=10 for first part of question 461=46 for second part question 381=38 for third part question Total of 94 marks will be awarded under the knowledge regarding functional disability in aged and its supportive care among caregivers. It is interpreted in percentage as: Adequate knowledge : Greater than 75% Moderate knowledge : 50-75% Inadequate knowledge : Less than 50% VALIDITY OF THE TOOL The tool used in this study was validated by the experts in the field of general medicine and Medical surgical nursing. PILOT STUDY The pilot study was conducted in Voluntary health service hospital, Dr.Kamakshi memorial hospital, Thoraipakkam and Navalur community area, Chennai from 20.7.12 to 25.7.12 after obtaining the permission from the respective heads of the organization. Totally 6 caregivers (2 from each of the hospitals and community area) who fulfilled the inclusion criteria were selected purposively, to generalize the study. A

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Moraru Teodora-Bianca IIIrd year, German-English gr. I. The Psychological Origins and the Effects of the Hobbyhorse in Laurence Sterne’s â€Å"Tristram Shandy† Defying Dr. Samuel Johnson’s statement that â€Å"Nothing odd will do long†, Laurence Sterne’s eccentric masterpiece, â€Å"The Life and Opinions of Tristram Shandy, Gentleman†, an extended act of meditation upon story-telling based on John Locke’s philosophical theory of the association of ideas, became a notable forerunner of the modern English novel, celebrating the infinite possibilities of the art of fiction. Undoubtedly, one of the most crucial philosophical literary works of the 18th century was John Locke’s â€Å"Essay Concerning Human Understanding†, which had a tremendous influence on the writers of his time and also on the worldwide approach to terms such as â€Å"the nature of thought† and â€Å"human consciousness†. In his â€Å"Essay†, Locke stated important theories about the sequence of ideas and their interrelation, which profoundly influenced Sterne and became the basis of much of the seemingly arbitrary structure of his comic metanovel, â€Å"Tristram Shandy†. Sterne adopted in particular two of Locke’s concepts. First, the association of ideas, by which certain ideas, either by accident or because they have some particular significance, become so closely linked in a man’s mind that he cannot think of any of them without inevitably calling up all the others as well, in the same order in which he had prieviously experienced them. Secondly, the train of ideas, which is a more general concept of the mind as being constantly in motion, with the result that one idea automatically suggests another in some way similar to it, which in turn leads on to something else. Sterne uses this latter concept as an explanation for much of the seemingly eccentric behaviour of his characters and as a basis for many of the dazzling transitions of time and space which take place in the novel. John Locke considered the ideas as being the fundamental building blocks of all human thought, also stating the fact that â€Å"all our knowledge and ideas arise from experience† and that there are no innate ideas. He viewed the human mind as a â€Å"tabula rasa†, a â€Å"white paper, void of all characters, without any Ideas†. This empty room of the mind is gradually furnished with ideas of two sorts: first we obtain ideas of things we suppose to exist outside us in the physical world by sensation, and secondly we come to ideas of our own mental operations by reflection.

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Over het opeten van twee boterhammen doe je langer dan over à ©Ãƒ ©n. Je huiswerk maak je sneller als je niet tegelijkertijd tv kijkt. Een reclame die je dagelijks ziet, onthoud je beter dan een die je minder vaak ziet. Kijk nu naar 2 kinderen, waarvan de à ©Ãƒ ©n tweetalig opgroeit en de ander à ©Ãƒ ©ntalig. Het tweetalige kind heeft het dubbel zo druk, ook is het taalaanbod verdeeld over twee talen. Betekent dit ook dat meertaligen daardoor langzamer zijn in hun taalverwerving? Wat is het effect op de spraak- en taal ontwikkeling? Welke factoren hebben invloed op taalproblemen bij meertalige kinderen? Op al deze vragen zullen we proberen antwoord te geven in deze deelvraag. Wat is tweetaligheid? Tweetaligheid betekent het kunnen gebruiken van twee verschillende talen in diverse communicatievormen. Het komt niet vaak voor dat beide talen even goed beheerst worden, oftewel een gebalanceerde tweetaligheid. Meestal is er sprake van een dominante taal, deze wordt makkelijker gebruikt dan de tweede taal. Er bestaan twee verschillende soorten tweetaligheid: simultane en successieve tweetaligheid. Simultane tweetaligheid Er is sprake van simultane tweetaligheid als een kind twee (soms drie) talen gelijktijdig aanleert. Vanaf jongs af aan worden de talen aangeboden. Van beide talen moeten de woordstructuur, woordvorming en zinsleer worden verworven. In allebei de talen gaan kinderen door dezelfde taalontwikkeling als kinderen die à ©Ãƒ ©ntalig worden opgevoed. Simultane opvoeding vergt een bepaalde structuur van de ouders. In bepaalde situaties moet een bepaalde taal worden gesproken. Thuis bijvoorbeeld Engels en op school Nederlands. Successieve tweetaligheid Als een kind tot op een latere leeftijd à ©Ãƒ ©ntalig wordt opgevoed en dan pas in aanraking komt met ... ... in het onderwijs voorkomt. Vaak draait het in zulke gevallen om groepen die minderwaardig worden gezien in een samenleving, zoals Marokkanen in Nederland. Dit wordt ook wel subtractieve tweetaligheid genoemd. Dit houdt in dat een kind 2 talen kan spreken en gebruiken maar beide talen zijn van (te) lage kwaliteit. De andere vorm is additieve tweetaligheid, de eerste taal/moedertaal wordt op een voldoende manier gebruikt en daarom kan er een tweede taal aan worden toegevoegd. Op deze manier van het gebruiken van twee talen ontstaan positieve effecten. Doordat meertalige kinderen al vanaf jongs af aan zich veel bezighouden met taal en verschillen in talen, zijn zij zich er snel bewust van wanneer er bepaalde taalverschijnselen voorkomen. Zij kunnen dit verbinden aan verschijnselen die zij in verschillende talen kennen en daardoor leren ze de nieuwe fenomenen snel aan.