PAIN AND ALTERNATIVE THERAPIES Assignment Example | Topics and Well Written Essays - 250 words

PAIN AND ALTERNATIVE THERAPIES - Assignment Example Hence, the nurse should identify information seeking behavior to understand the emotional health, fears and concede that fear and feeling overwhelmed is normal. The nurse might prompt the patient to describe pain accurately by probing into the feelings. For example, asking about breakthrough pain, or if the patient experiences mild or severe pain based on a scale of 0-10 and characterized with impulsive onset or a neuropathic pain. In addition, asking the location of the body that is more painful, quality of the pain whether sharp or dull and duration of the pain is helpful. He nurse might inquire about time of the day in which the patient feels the pain most, interactions that relieve the pain, worsens it, or triggers pain guides the patient to describe experiences (Kantrowitz, 2009). A nurse can also ask about the medications and their effect on the patient to gauge the severity. Mastectomy patients can use mild pain drugs like acetaminophen or ibuprofen for fewer severe pains. Other management plans include infiltration of botulinum toxin to prolong muscle spam or admission under a palliative care program (Layeeque, 2004). Besides, acupuncture, physical therapy, and massage therapy are methods to manage pain (Komen, 2014). Layeeque, R., Hochberg, J., Siegel, E., Kunkel, K., Kepple, J., Henry-Tillman, R., ... Klimberg, V. (2004, October 24). Botulinum Toxin Infiltration for Pain Control After Mastectomy and Expander Reconstruction. Retrieved February 9, 2015, from

STEM CELL DEPATE Essay Example | Topics and Well Written Essays - 1750 words

STEM CELL DEPATE - Essay Example These exceptional cells originate from blastocyst inner cell mass that is a young embryo about five or four years old (Holland et all, 2001). These cells are pluripotent making them unique. Thus, it is easy to characterize these cells differently into any o f the germ layers existing in the body of humans like mesoderm, ectoderm, and endoderm. The endoderm comprises of lungs, intestines, and stomach. The mesoderm is mostly the bone, muscle, and blood. This leaves ectoderm with nervous system and the skin. These cells can repair any human body part, making the embryonic stem cells special. Another element of these cells is that they are able, in any circumstances, to replicate themselves for an indefinite period. The fact these cells can produce themselves in unlimited numbers, and have characteristics of becoming any types of 220 cells, it easy to use in medicine for medical research and regenerative therapy (Holland et all, 2001). Damaged or lost tissues due to injury or disease are easy to for replacement or repair by new tissues developed from administered embryonic cells. Once there is administration of stem cells into the patient body, they move to the damaged place, multiply and engraft, replace the destroyed cells, and restore the functions of the body in the area. Embryonic stem cells can treat diseases such as genetic diseases, juvenile diabetes, blindness, spinal cord injuries and cancer. The technology can also deal with different conditions. The technology can treat major diseases; therefore, it is necessary to use it. What is the ethical challenge about using and harvesting stem cells? The major controversial issue of this research is the state of human embryo. The embryo dies when its inner cell mass is taken. This is because inner mass cell is responsible for formation of the three human body germ layers. Without these cells, the embryo will not develop. People opposing the use of

Administration of medicines is a key element of nursing

Administration of medicines is a key element of nursing Drug administration forms a major part of the clinical nurses role. Medicines are prescribed by the doctor and dispensed by the pharmacist but responsibility for correct administration rests with the registered nurse (OShea 1999). So as a student nurse this became our duty and something that we practiced and become competent in carry out as explained in figure 1, we were also faced with the challenges of administering medication. Each registered nurse is accountable for his/her practice. This practice includes preparing, checking and administering medications, updating knowledge of medications, monitoring the effectiveness of treatment, reporting adverse drug reactions and teaching patients about the drugs that they receive (NMC 2008). Accountability also goes for students, if at any point I felt I wasnt competent enough to dispensing a certain drug it would be in my responsibility to speak up and let the registered nurses know, so that I could shadow them and have the opportunity to learn and then in future be able to practice and administer. The reflective model I have chosen to use is Gibbs model (Gibbs 1988). Gibbs model of reflection incorporates the following: description, feelings, evaluation, and conclusion. (Gibbs 1988). The model will be applied to the essay to facilitate critical thought, relating theory to practice where the model allows. Discussion will include the knowledge underpinning practice and the evidence base for the clinical skill, that I have learnt and supporting this with current literature. The first stage of Gibbs (1988) model of reflection requires a description of events. I was asked to administer a drug to a patient. I had observed this clinical skill on a variety of occasions and had previously administered medication under supervision. On this occasion I was being observed by two qualified nurses, one of which was my mentor. The drug had been dispensed and was ready to be administered and the patient consented to have a student administer the medication. My mentor was talking me through the procedure step by step, and informed me that they have struggled with this patient and her compliance with medication before so I should keep an out and ensure that she swallows her medication and that she not keeping it her mouth. The Medication that this patient is on is Clozapine. Clozapine is indicated for patients with treatment resistant schizophrenia, or those who are unable to benefit from other antipsychotic medicine, as they cannot tolerate the side effects. The decision to use clozapine is not taken lightly because of the potentially life threatening side effect of neutropaenia, which requires regular blood tests to ensure its safe use. In addition, there is the risk of developing paralytic ileus and some cardiac abnormalities. (WLMT). In addition to that statement if a patient on clozapine white blood cells count falls below accepted lower limit are classified as Red alerts medication must be withdrawn, and any other prescriber in the future wishing to restart medication are aware of the patients haemotological history. Adverse drug reactions are the main limiting factor on using anti-psychotics, for this reason prescribers should keep dosages to a minimum required for efficacy starting at a low dose with gradual upward titration. An awareness of side effects is important to primary care practitioners because they have most contact with the patients, patients with long term monitoring falls within their remit. Clozapine is an atypical antipsychotic, and atypical anti-psychotics are considered of choice both accurately and for maintenance in schizophrenia. Clozapine holds a unique position among the atypical due to its ability to improve negative as well as positive symptoms (delusions, hallucinations). (Morris, D) . During the process of administering anti-psychotics I learnt that using anti-psychotics is just a component of a holistic approach to the patient with psychotic illness and that care should also include psychological treatments and social care. The patient at such does not have any issue with the drug it self but with the staff, as she is in a very psychotic state she is very paranoid and non compliant with medication this is closely monitored by staff and as stated in figure 1 I have to prompt her to ensure that medication is complied with. Service users have requested strategies from services providers to manage the risk of using psychiatric medication to inform their choice about which psychiatric medication to use. (DOH 1999). However evidence suggests that, there is choice, but generally by practitioner experience. (Hamann et al. 2005). In non compliance of medication I had to encourage the patient to make their choice to take the medications and that it was in their care plan a nd apart of their treatment. A nurse who has built a good relationship with a patient by informing and empowering them will be in a strong position to have a non judgmental conversation with them about the importance of adherence. (Mc Lellan. A 2009). I am now going to enter into the second stage of Gibbs (1988) model of reflection, which is a discussion about my thoughts and feelings. I was aware of being under the supervision of two qualified nurses and this made me feel very nervous and self conscious and I had to ensure that I was doing everything correctly and that I made no errors. Once my mentor questioned my practice, concerning if I knew the side effects of the drug I was about to administer, I became even more aware of feeling nervous and under pressure. The patient was present and I did not want the patient to feel that I did not know what I was doing. So I had to ensure before administering that I was giving the medication to the right patient and at the correct dose that it was at the right time and route. All of these had to be done to guarantee that I am competent in my ability to administer medication under the supervision of a registered nurse. This also gave me the opportunity to carry out this task in order to a chieve this so I could get it signed off by my mentor in my essentials skills cluster. The nurse patient relationship is by many considered the core of nursing; this can be done to build a good relationship and rapport with patients. (Framer.J.Kramer.S, 2001). When I was first orientated to the ward, I took it upon myself to read the patients notes so that I had little insight to the patients and their illness and index offences if any. After this I went and introduced myself to the patients because its vital that the patients are aware of who I am and my status if I am to provide nursing care for them. (Berlo 1960) puts great emphasis on dyadic communication, therefore stressing the role of the relationship between the source and the receiver as an important variable in the communication process. So to provide patients with adequate care its important that there is effective communication, that the patients is aware of everything, and that the nurse provides care and compassion in the delivery of care. There is evidence that our ability to use language actually affect s the thoughts themselves, the words we can command, and the way that we put them together affects: what we think how we think whether we are thinking So as a student nurse I was made aware that words can have an impact on care provided and the way in which these words are delivered can have an even greater impact. As explained in figure 1, when I was admitting a patient on to the ward I had to make certain that I was communicating effectively, making certain that I was delivering information in ways that were easy to understand refraining from uses of jargon, and that I was showing compassion to the patient as this could be a time of high anxiety for them, reassuring them that they are in great hands and offering them tea were among the things I did to exercise my care and compassion skill. so my main aim was to make the care of people your first concern, treating them as individuals and respecting their dignity, and working with others to protect and promote the health and well being of those in my care, their families and careers, and the wider community. (NMC 2008). However I tried to use different forms of communication to con vey information from my patients, for instance as stated in figure 1, when I had my 1-1 personal time with my patient I would use (Bein and Miller 1992) the use of open and ended questions and active listening, so that I could comprehend everything I was being told so that when I came round to me providing comprehensive and accurate written report based they would reflect everything that was being. Studies show that during interpersonal communication only 7% of the message is verbally communicated by the words used. Â  Of the 93% non-verbal communication: As a result I learnt to pick up non verbal signals Even if someone decides to say nothing they are still communicating (effective communication skills). All of which skills I can adopt to engage with patients and to help with my development in nursing. Evaluation is the third stage of Gibbs (1988 ), here I will the explain the importance of administering medication and how this combined with care, compassion and communication forms the bases of a holistic approach to care, and with the knowledge I got from supporting literature formed the foundation of my learning and practice. Burnard (2002) suggests that a learner is a passive recipient of received knowledge, and that learning through activity engages all of our senses.

Humanism :: essays research papers

Humanism The word â€Å"humanism† has a number of meanings, and because there are so many different meanings it can be quite confusing if you don't know what kind of humanism someone is talking about. Literary Humanism is a devotion to the humanities or literary culture. Renaissance Humanism is the spirit of learning that developed at the end of the middle ages with the revival of classical letters and a renewed confidence in the ability of human beings to determine for themselves truth and falsehood. Cultural Humanism is the rational and empirical tradition that originated largely in ancient Greece and Rome, evolved through out European history, and now constitutes a basic part of the Western approach to science, political theory, ethics, and law. Philosophical Humanism is any outlook or way of life centered on human need and interest. Sub categories of this type include the two following. Christian Humanism is defined by Webster's Third New International Dictionary as â€Å"a philosophy advocating the self fulfillment of man within the framework of Christian principles.† This more human oriented faith is largely a product of the Renaissance and is a part of what made up Renaissance humanism. Modern Humanism, also called Naturalistic Humanism, Scien- tific Humanism, Ethical Humanism and Democratic Humanism is defined by one of its leading proponents, Corollas Lamont, as â€Å"a naturalistic philosophy that rejects all supernaturalism and relies primarily upon reason and science, democracy and human compassion.† Modern Humanism has a dual origin, both secular and religious, and these constitute its sub categories. Secular Humanism is an outgrowth of 18th century enlightenment rationalism and 19th century freethought. Many secular groups, such as the Council for Democratic and Secular Humanism and the American Rationalist Federation, and many otherwise unaffiliated academic philosophers and scientists advocate this philosophy. Religious Humanism emerged out of Ethical Culture, Unitarianism, and Universalism. Today, many Unitarian- Universalist congregations and all Ethical Culture societies describe themselves as humanist in the modern sense. The most critical irony in dealing with Modern Humanism is the inability of its supporters to agree on whether or not this world veiw is religious. The Secular Humanists believe it is a philosophy, where the Religious Humanists obviously believe it is a religion. This has been going on since the early years of the century where the Secular and Religious traditions combined and made Modern Humanism. Secular and Religious Humanists both share the same world views as shown by the signing of the Humanist Manifestos I and II. The signers of the Manifestos were both Secular and Religious Humanists. To serve personal needs, Religious Humanism offers a basis for moral values, an inspiring set of ideals , methods for dealing with life's harsher realities, a

Early Childhood Intervention Services on Social Performance Essay

Based on many researches, surveys, and studies conducted recently, the early intensive intervention method showed a significant outcome for children having autism. The behavioral approach as intervention on preschoolers with the said disorder showed an affirmative short- and long-term effect (Anderson, Avery, DiPietro, Edwards, & Christian, 1987; Fenske, Zalenski, Krantz, & McClannahan, 1985; McEachin, Smith, & OI, 1993). It was said that results showed a partial to nearly complete recovery from symptoms of autism where the most hopeful and positive result suggests a nearly 50% recovery through intensive early intervention (Handleman, Harris, Celiberti, Lilleheht, & Tomchek, 1991; Hoyson, 1984; Lord & Schopler, 1989; Lovaas, 1987; Sheinkopf & Siegel, 1998). The reported improvement was based on the outcomes from â€Å"standardized pre-post test scores† and at times, was based on behavioral outcomes (Handleman, Harris, Celiberti, Lilleheht, & Tomchek, 1991; Hoyson, 1984; Lord & Schopler, 1989; Lovaas, 1987; Sheinkopf & Siegel, 1998). Also, in contrast to the previous approximations that implied only 50% of all children have a chance to learn to use â€Å"functional speech†, more recent approximations as based from participating children under early intervention showed at least 85% to 90% of these children can utilize the functional speech if intervention begins in the preschool stage (Koegel, 2000). The intricacy in terms of mutual social interactions involved in autism disorders paved way to the need of early identification of this disorder to children because of the significant advantages that resulted if early intervention is performed. It is also this same complex nature on the social feature of autism that led to formulation of early intervention programs. But to date, there are few intervention programs that focus on the enhancement of social interactions to peer groups and siblings since most programs formulated were on â€Å"child-adult† interactions (Koegel, Koegel, & Frea, 2001). There is also the inadequate outcome of these programs on the child’s â€Å"true† functioning in his or her natural environment such as social and behavioral improvements because most outcomes are based on the alterations of the child’s IQ scores and post-intervention assignments (Koegel, Koegel, & Smith, 1997). It was also noted that few assessment studies were conducted on the consequences or results of early intervention programs on autistic children less than three years of age since the knowledge of possibility for practitioners to diagnose autism prior to age three was only recent. CHAPTER 1 The Historical Viewpoint behind Early Childhood Intervention Programs The concept that brain development can be manipulated during the early childhood period necessitates the need for early treatment or intervention of autism since this imposes a greater chance of success and the possibility of a long-term treatment being prevented and reduced (Ornitz, 1973). The trainings in communication, social learning, and self-help skills from the family, school, community, peers, and group can further help autistic children on their social and emotional development. In an early intervention program, the factors being evaluated that become indicator if improvement occurred are age and IQ. There are studies showing that the incidence of a higher IQ and an earlier age at the start of intervention is a positive predictor of better chances of recovery and better outcomes (Gabriel, Hill, Pierce, Rogers, & Wehner, 2001; Handleman, Harris, Celiberti, Lilleheht, & Tomchek, 1991). Recently, the recognized predictor of intervention outcome in the language and peer aspect is the stage of the child with autism on peer social avoidance after under intervention program for six months (Ingersoll, Schreibman, & Stahmer, 2001). Peer social avoidance is described as the frequency of the child’s avoidance near peers. Some studies showed a noteworthy connection of the child’s use of joint attention behaviors and later communicative language improvement (Mundy, Sigman, & Kasari, 1990). These joint attention behaviors include eye gaze alternation and pointing. There is also a study demonstrating that child initiations anticipate very high favorable treatment outcomes (Koegel, Koegel, Shoshan, & McNerney, 1999). Child initiations are defined as the start of a new interaction or changing where the interaction is headed for. These three characteristics namely peer avoidance, joint attention, and initiations are described in nature as exceedingly analogous. They are also called as intervention target behaviors. Before early intervention or treatment services are done, a proper and thorough evaluation of the child with autism should be conducted to identify the appropriate approach to conduct (Shackelford, 2002). First, this assessment should be performed by a trained staff to work on a suitable methods and procedures to be followed. Secondly, it should be based on â€Å"informed clinical opinion† from skilled medical professional for the said specialization. And lastly, there should be a review of the relevant records that would be applicable in evaluating the child’s current health and medical history and child’s level of functioning on the critical development areas such as cognitive, physical (including vision and hearing, communication, social or emotional, and adaptive aspects (Shackelford, 2002). As defined, the term â€Å"early intervention† generally refers to program options for the child with autism at six years of age and below (â€Å"Early Intervention†, 2007). There are many described and formulated different early intervention options specifically center-based programs for children with an array of developmental delays, conventional and expert preschool programs, center-based programs specializing in Autism Spectrum Disorder (ASD), home-based programs on a certain therapy approach, specific therapies from particular clinics, agencies that organize the early intervention personnel to visit the child’s home on a regular or semi-regular basis or outreach service, and programs that are investigated and organized with parents (â€Å"Early Intervention†, 2007). There are many different types of services offered under the early intervention program. These are family support services, funded specialist programs, non-funded specialist programs, specific therapies, alternative therapies, and behavioral assistance services. Many family support services are available (â€Å"Early Intervention†, 2007). Example is the â€Å"Early Childhood Intervention Services† from the Department of Human Services that funds support programs like â€Å"Early Choices† and â€Å"Making a Difference† for a successful implementation of these programs. The local councils can also render this support service as they are funded too to provide such (â€Å"Early Intervention†, 2007). The support and information service under family support services can help families through immediate guidance, sensible and emotional support, and provision of necessary information regarding autism through library, information packages and tip sheets, and published magazines (â€Å"Early Intervention†, 2007). The funded specialist programs are funded under the Department of Human Services purposely for children with Autism Spectrum Disorder (ASD) (â€Å"Early Intervention†, 2007). These are center-based programs and outreach programs (â€Å"Early Intervention†, 2007). But still, funding is greatly limited and these funded programs are only available to offer services just a not so many hours per week. Outreach programs are where trained personnel visit the patient in his or her home, or are community based services such as child care or preschool for autistic children. The non-funded specialist programs are programs that do not receive funding from the federal government (â€Å"Early Intervention†, 2007). Example of this is the Applied Behavior Analysis (ABA). The ABA is a home-based therapy that is structured in pattern to the work of Dr. Ivar Lovaas (â€Å"Early Intervention†, 2007). The format of this program is one-to-one instruction, and support and strengthening. But an ABA trained teacher or psychologist is the only one certified to develop and supervise the program. On the other hand, only the parent and/or trained ABA therapists can carry out the teaching conferences. It is known that ABA program outcomes are positive but still, as usual, the outcomes vary from child to child. The only possible disadvantages being seen are on the financial and time viewpoints, that is, it is expensive and not all families can afford it (â€Å"Early Intervention†, 2007). Another type of service for early intervention is the conduction of specific therapies. These trained therapists are those already skilled in executing therapies in relation to autism (â€Å"Early Intervention†, 2007). These are the psychologists, speech therapists, occupational therapists, early intervention teachers, physiotherapists, music therapists, and dance and movement therapists. Most of these therapists are in private practice and have explicit professional fees. Some families are able to secure funding from support programs while others have to pay it on their own. In year 2006, the federal government tried to include mental health conditions in Medicare insurances to help families to lessen expenditures if therapy is the proper approach to the autism condition of the child (â€Å"Early Intervention†, 2007). The identified alternative therapies are those treatments or approaches that showed constant positive outcomes (â€Å"Early Intervention†, 2007). These are usually the educationally and/or behaviorally based programs (â€Å"Early Intervention†, 2007). These programs are intensive, planned, ordered, and long-standing. There is no instant approach. The behavioral assistance programs are more often than not where parents ask for help (â€Å"Early Intervention†, 2007). In view thereof, Gateways Support Services developed an interactive website with a large data bank as guidance for these parents (â€Å"Early Intervention†, 2007). Researchers and educators have debated the question of how communication goals and objectives for children with autism and related disabilities should be derived. The perspective espoused by traditional behavioral programs has been to establish goals and objectives a priori (Lovaas, 1987). Behavioral discrete-trial programs begin with general compliance training to get a child to sit in a chair, look at the clinician, and imitate nonverbal behavior in response to verbal commands. Speech is taught as a verbal behavior, and objectives are targeted beginning with verbal imitation, following one-step commands, receptive discrimination of body parts, objects, person names and pictures, and expressive labeling in response to questions. Later, language objectives include prepositions, pronouns, same or different and yes or no. More contemporary behavioral approaches have developed goals for outcomes from a functional assessment. Goals and objectives are individualized, based on a child’s repertoire of communicative behaviors, teaching functional equivalents of challenging behavior, and addressing the child’s individual needs. The functional emphasis focuses on goals that affect a child’s access to choices of activities in which to participate, opportunities for social interaction, and community settings (Brown, 2006). Contemporary behavioral programs emphasize teaching communication skills so that greater access is provided to a variety of people, places and events, thereby enhancing the quality of life of children with autistic spectrum disorders. The perspective espoused by developmentally oriented approaches has been to focus on the communicative meaning of behaviors and to target goals and objectives that enhance a child’s communicative competence by moving the child along a developmental progression (Ornitz, 1973). Contemporary developmentalists begin with social-communicative goals, including gaze to regulate interaction, sharing positive affect, communicative functions, and gestural communication. Language goals are mapped onto social communication skills and are guided by a developmental framework (Koegel, Koegel, & Frea, 2001). Developmental perspective usually guides the goal-setting in an augmentative and alternative communication (AAC) intervention. Beukelman and Mirenda (1998) state that the goals of an AAC intervention are to assist individuals with severe communication disorders to become communicatively competent in the present, with the view toward meeting their future communication needs (Lovaas, 1987). One major purpose of communication assessment is to document change as an outcome measure of treatment. However, most formal or standardized language assessment measures focus primarily on language form and rely on elicited responses. Because language impairments associated with autism are most apparent in social-communicative or pragmatic aspects of language, formal assessment instruments can provide information about only a limited number of aspects of communication for children with autism (Shackelford, 2002). Formal language measures are especially imprecise in measuring nonverbal aspects of communication and therefore are not sufficient, particularly for low-functioning children with autism. In many situations, the tests used for pre- and post-assessment are different, due to the child’s increasing age, making interpretation of results difficult. Another major purpose of assessment is to provide information for educational planning that can be directly translated into goals, strategies, and outcome measures for communication enhancement. Several communication abilities have been identified as important to assess for children with autism like use of eye gaze and facial expression for social referencing and to regulate interaction, range of communicative functions expressed, rate of communicating, use of gestures and vocal/verbalizations, use of repair strategies, understanding of conventional meanings, and ability to engage in conversation (Shackelford, 2002). It is pointed out that communicative abilities of children with autism should be documented in natural communicative exchanges, with a child’s symbolic abilities serving as a developmental frame of reference (Mundy, Sigman, & Kasari, 1990). To supplement formal measures, the systematic use of informal procedures to assess language and communication is needed. In order to gather an accurate picture of the communication and symbolic abilities of children with autism, a combination of assessment strategies has been recommended that includes interviewing significant others (i. e. , parents, teachers) and observing in everyday situations to find out how a child communicates in the home, classroom, and other daily settings (Mundy, Sigman, & Kasari, 1990). Although there is consensus on the importance of enhancing communication abilities for children with autism, intervention approaches vary greatly, and some even appear to be diametrically opposed (Koegel, 2000). The methodological rigor in communication intervention studies in terms of internal and external validity and measures of generalization has been stronger than in many other areas of autism intervention studies. Nevertheless, there have been relatively few prospective studies with controls for maturation, expectancy, or experimenter artifacts. The strongest studies in terms of internal validity have been multiple baseline, ABAB, or similar designs that have included controls for blindness of evaluations (Koegel, 2000). There have been almost no studies with random assignment, although about 70 percent of the studies included well-defined cohorts of adequate sample size or replication across three or more subjects in single subject designs. A substantial proportion of communication interventions have also included some assessment of generalization, though most often not in a natural setting (Koegel, 2000). In order to examine the critical elements of treatment programs that affect the speech, language, and communication skills of children with autism. It is then useful to characterize the active ingredients of treatment approaches along a continuum—from traditional, discrete trial approaches to more contemporary behavioral approaches that used naturalistic language teaching techniques to developmentally oriented approaches (Koegel, 2000). The earliest research efforts at teaching speech and language to children with autism used massed discrete trial methods to teach verbal behavior by building labeling vocabulary and simple sentences. Lovaas (1987) provided the most detailed account of the procedures for language training using discrete trial approaches. Outcomes of discrete trial approaches have included improvements in IQ scores, which are correlated with language skills, and improvements in communication domains of broader measures, such as the Vineland Adaptive Behavior Scales (McEachin, Smith, & OI, 1993). A limitation of a discrete trial approach in language acquisition is the lack of spontaneity and generalization. Lovaas (1987) stated that â€Å"the training regime†¦its use of ‘unnatural’ reinforcers, and the like may have been responsible for producing the very situation-specific, restricted verbal output which we observed in many of our children†. In a review of research on discrete trial approaches, Koegel (2000) noted that â€Å"not only did language fail to be exhibited or generalize to other environments, but most behaviors taught in this highly controlled environment also failed to generalize†. There is now a large body of empirical support for more contemporary behavioral approaches using naturalistic teaching methods that demonstrate efficacy for teaching not only speech and language, but also communication. According to Koegel 2000, there are many approaches that could be considered that include natural language paradigms (Koegel et al. , 1987), incidental teaching (Hart, 1985; McGee et al. , 1985; McGee et al. , 1999), time delay and milieu intervention (Charlop et al. , 1985; Charlop and Trasowech, 1991; Hwang and Hughes, 2000; Kaiser, 1993; Kaiser et al. , 1992), and pivotal response training (Koegel, 1995; Koegel et al. , 1998). These approaches use systematic teaching trials that have several common active ingredients: they are initiated by the child and focus on the child’s interest; they are interspersed and embedded in the natural environment; and they use natural reinforcers that follow what the child is trying to communicate. Only a few studies, all using single-subject designs, have compared traditional discrete trial with naturalistic behavioral approaches. These studies have reported that naturalistic approaches are more effective at leading to generalization of language gains to natural contexts (Koegel 2000). There are numerous intervention approaches based on a developmental framework. While there are many different developmental programs, a common feature of developmental approaches is that they are child-directed. The environment is arranged to provide opportunities for communication, the child initiates the interaction or teaching episode, and the teacher or communicative partner follows the child’s lead by being responsive to the child’s communicative intentions, and imitating or expanding the child’s behavior. Although the empirical support for developmental approaches is more limited than for behavioral approaches, there are several treatment studies that provide empirical support for language outcomes using specific strategies built on a developmental approach providing the largest case review. Developmental approaches share many common active ingredients with contemporary naturalistic behavioral approaches and are compatible along most dimensions. Many researches had been done on the effectiveness of â€Å"early intervention† because a proper selection of goal when dealing the autistic spectrum disorder should be done since the disorder is characterized of many complexities that treating it also involves critical selection of approach. In general, it was shown that researches on these intervention programs had focused on the effectiveness of the programs and not the appropriateness of different goals. For example is knowing a certain intervention program to be effective but the parent and child had to travel across town once a week for the said program or the child is taken out from class in order to be treated by his therapist. Educational objectives must be based on specific behaviors targeted for planned interventions. However, one of the questions that arises repeatedly, both on a theoretical and on a clinical basis, is how specific a link has to be between a long-term goal and a behavior targeted for intervention. Some targeted behaviors, such as toilet training or acquisition of functional spoken language, provide immediately discernible practical benefits for a child and his or her family. However, in many other cases, both in regular education and specialized early intervention, the links between the objectives used to structure what a child is taught and the child’s eventual independent, socially responsible functioning are much less obvious. This is particularly the case for preschool children, for whom play and manipulation of toys (e. g. , matching, stacking of blocks) are primary methods of learning and relating to other children. Often, behaviors targeted in education or therapy are not of immediate practical value but are addressed because of presumed links to overall educational goals. The structuring of activities in which a child can succeed and feel successful is an inherent part of special education. Sometimes the behavior is one component of a series of actions that comprise an important achievement. Breaking down a series of actions into components can facilitate learning. Thus, a preschool child may be taught to hold a piece of paper down with one hand while scribbling with another. This action is a first step in a series of tasks designed to help the child draw and eventually write. Other behaviors, or often classes of behaviors, have been described as â€Å"pivotal behaviors† in the sense that their acquisition allows a child to learn many other skills more efficiently (Koegel, Koegel, Shoshan, & McNerney, 1999). Schreibman and the Koegels and their colleagues have proposed a specific treatment program for children with autism: pivotal response treatment. It includes teaching children to respond to natural reinforcers and multiple cues, as well as other â€Å"pivotal† responses. These are key skills that allow better access to social information. The idea of â€Å"pivotal skills† to be targeted as goals may also hold for a broad range of behaviors such as imitation (Stone, 1997; Rogers and Pennington, 1991), maintaining proximity to peers (Hanson and Odom, 1999), and learning to delay gratification (understanding â€Å"first do this, then you get to do that†). Longitudinal research has found that early joint attention, symbolic play, and receptive language are predictors of long-term outcome (Siller and Sigman, 2002). Although the research to date has been primarily correlational, one inference has been that if interventions succeed in modifying these key behaviors, more general improvements will occur as well (Kasari, 2000). Another explanation is that these behaviors are early indicators of the child’s potential developmental trajectory. Sometimes goals for treatment and education involve attempting to limit and treat the effects of one aspect of autism, with the assumption that such a treatment will allow a child to function more competently in a range of activities. For example, a number of different treatment programs emphasize treating the sensory abnormalities of autism, with the implication that this will facilitate a child’s acquisition of communication or social skills (e. g. , auditory integration; sensory integration). For many interventions, supporting these links through research has been difficult. There is little evidence to support identifiable links between general treatment of a class of behaviors (e. g. , sensory dysfunction) and improvements in another class of behaviors (e. g. , social skills), especially when the treatment is carried out in a different context from that in which the targeted behaviors are expected to appear. However, there are somewhat different examples in other areas of education and medicine in which interventions have broad effects on behavior. One example is the effect of vigorous exercise on general behavior in autism (Koegel, Koegel, Shoshan, & McNerney, 1999). In addition, both desensitization and targeted exercise in sports medicine and physical therapy often involve working from interventions carried out in one context to generalization to more natural circumstances. Yet, in both of these cases, the shift from therapeutic to real-life contexts is planned explicitly to occur within a relatively brief period of time. At this time, there is no scientific evidence of this kind of link between specifically-targeted therapies and general improvements in autism outside the targeted areas. Until information about such links becomes available, this lack of findings is relevant to goals, because it suggests that educational objectives should be tied to specific, real-life contexts and behaviors with immediate meaning to the child. Because the range of outcomes for children with autistic spectrum disorders is so broad, the possibility of relatively normal functioning in later childhood and adulthood offers hope to many parents of young children. Although recent literature has conveyed more modest claims, the possibility of permanent â€Å"recovery† from autism, in the sense of eventual attainment of language, social and cognitive skills at, or close to, age level, has been raised in association with a number of educational and treatment programs (Ingersoll, Schreibman, & Stahmer, 2001). Natural history studies have revealed that there are a small number of children who have symptoms of autism in early preschool years who do not have these symptoms in any obvious form in later years. Whether these improvements reflect developmental trajectories of very mildly affected children or changes in these trajectories (or more rapid movement along a trajectory) in response to treatment (Lovaas, 1987) is not known. However, as with other developmental disabilities, the core deficits in autism have generally been found to persist in some degree in most persons with autistic spectrum diagnoses. There is no research base explaining how â€Å"recovery† might come about or which behaviors might mediate general change in diagnosis or cognitive level (Ingersoll, Schreibman, & Stahmer, 2001). Although there is evidence that interventions lead to improvements and that some children shift specific diagnoses within the spectrum and change in severity of cognitive delay in the preschool years, there is not a simple, direct relationship between any particular current intervention and â€Å"recovery† from autism. Because there is always room for hope, recovery will often be a goal for many children, but in terms of planning services and programs, educational objectives must describe specific behaviors to be acquired or changed. Research on outcomes (or whether goals of independence and responsibility have been attained) can be characterized by whether the goal of an intervention is broadly defined (e. g. , â€Å"best outcome†) or more narrowly defined (e. g. , increasing vocabulary, increasing peer-directed social behavior); whether the study design involves reporting results in terms of individual or group changes; and whether goals are short term (i. e. , to be achieved in a few weeks or months) or long term (i. e. , often several years). A large body of single-subject research has demonstrated that many children make substantial progress in response to specific intervention techniques in relatively short time periods (e. g. , several months). These gains occur in many specific areas, including social skills, language acquisition, nonverbal communication, and reductions of challenging behaviors. Often the most rapid gains involve increasing the frequency of a behavior already in the child’s repertoire, but not used as broadly as possible (e. g. , increasing use of words) (Mundy, Sigman, & Kasari, 1990). In single-subject reports, changes in some form are almost always documented within weeks, if not days, after the intervention has begun. Studies over longer periods of time have documented that joint attention, early language skills, and imitation are core deficits that are the hallmarks of the disorder, and are predictive of longer-term outcome in language, adaptive behaviors, and academic skills. However, a causal relationship between improvements in these behaviors as a result of treatment and outcomes in other areas has not yet been demonstrated. Many treatment studies report post intervention placement as an outcome measure (Mundy, Sigman, & Kasari, 1990). Successful participation in regular education classrooms is an important goal for some children with autism. However, its usefulness as an outcome measure is limited because placement may be related to many variables other than the characteristics of a child (such as prevailing trends in inclusion, availability of other services, and parents’ preferences). The most commonly reported outcome measure in group treatment studies of children with autism has been IQ scores (Lord & Schopler, 1989). Studies have reported substantial changes in IQ scores in a surprisingly large number of children in intervention studies and in longitudinal studies in which children received nonspecific interventions. However, even in the treatment studies that have shown the largest gains, children’s outcomes have been variable, with some children making great progress and others showing very small gains. Overall, while much evidence exists that education and treatment can help children attain short-term goals in targeted areas, gaps remain in addressing larger questions of the relationship between particular techniques and both general and specific changes (Lord & Schopler, 1989). The child with autism is also protected in the federal state law. These are the Public Law 108-77 also called Individuals with Disabilities Education Improvement Act of 2004 and Public Law 105-17 also called Individuals with Disabilities Act or IDEA of 1997. This mandates the major care provider to refer the child with autism and the family to an early intervention service. It was stated that every state has an early intervention program and must make it available to children from birth to three years of age, thus, autistic children are covered under this law. Examples of these program are behavioral methods, early developmental education, communication skills, occupational and physical therapy, and structured social play.

Research about National Museum Essay

The National Museum of the Philippine is the official repository established in 1901 as a natural history and ethnography museum of the Philippines. Some of the historical artifacts, instruments, and other things came from Philippine ancestors. One of the things that are restored here was the Spolarium 1884 a National Cultural Treasure by Juan Luna. National Museum has a very important role in our country to preserve the things we have from the past. National Museum gives the people information about the things we learned from the school especially for the students. National Museum of the Philippines must improve the location, the areas inside the museum and other information inside it. It is because this museum is one of the major attractions in Manila and also in the Philippines. Improving or developing the surrounding and some areas of National Museum will help the country to gain more tourists because of the curiosity of the tourist to know more about the history hidden from the past in the Philippines. This museum will help the tourist to give importance in the culture of the Philippines have. This chapter represents the background of the study about the developing plan of National Museum of the Philippines. BACKGROUND OF THE STUDY National Museum of the Philippines is one of the major attractions here in Manila. Its image inside and outside of the museum must attract more international and local tourists. Also, this attraction will benefit the students from their studies in histories and other subjects like sciences. Nowadays, the community of Manila was starting to develop its image to improve its service for the tourists and attract more people to visit this  place. Some people suddenly had forgotten its treasure inside the museum. Only few people visit this place and some of this is students. People nowadays don’t appreciate its beauty and think it was a boring attraction for them. People usually seek some adventurous place to visit and make them satisfied in their vacation. But the National Museum of the Philippines make some events and exhibit to expose the things inside the museum. They also welcome new inventions and new things came from the people in this era. The planners gather some data about the things that should be develop inside and outside the museum. Planners think of some ideas how to prevent its decline opportunity to cater the Philippines to be a one of the treasure attraction in Manila. Some of the recommendation and plans will help the people who handled the museum to implement and develop the museum. This paper focuses on the developing plan inside and outside of the Philippine National Museum. It deals in the idea to preserve and attract more people or tourist to know more about the historic and treasured place in Manila and all over the Philippines. OTHER INFORMATION FOR NATIONAL MUSEUM This is the current picture of The National Museum of the Philippines. National Museum is the repository and guardian of the Philippines’ natural and cultural heritage. As one of the lead government cultural agencies, it is tasked to achieve the goals of instilling cultural consciousness and a sense of pride and nationalism among Filipino citizens through its activities covering the sciences, education and culture. Established in 1901 as an ethnography and natural history museum, and subsequently housed in its present building which was designed in 1918 by the American Architect, Daniel Burnham, the National Museum has since then broadened its concerns in the arts and sciences. Today, it occupies the main building (former Old Congress Building) where the arts, natural sciences and other support divisions are housed and the adjacent former Finance building in the Agrifina Circle of Rizal Park now called The National Museum of the Filipino People where the Anthropology and Archa eology Divisions. The Vision Statement of the National Museum is â€Å"A Filipino nation, unified by a deep sense of pride in their common identity, cultural heritage and natural patrimony and imbibed with the spirit of nationalism and strong commitment to the protection and preservation of their legacy.† The National Museum has a tri-dimensional goal covering diverse fields of knowledge through various educational, scientific and cultural activities. As an educational institution, the National Museum disseminates scientific and technical knowledge in more understandable and practical forms through lectures, exhibitions, interviews, and publications for students and the general public. As scientific institution, the National Museum conducts basic research programs combining integrated laboratory and field work in anthropology and archaeology, geology and paleontology, botany and zoology. It maintains reference collections on these disciplines and promotes scientific development in the Philippines. As a cultural center, the National Museum has taken the lead in the study and preservation of the nation’s rich artistic, historic and cultural heritage in the reconstruction and rebuilding of our nation’s past and venerating the great individuals who helped in the building hou sed. One of the artifacts that National Museum features is the â€Å"Spolarium† which is in a Latin word referring to the basement of the Roman Colosseum where the fallen and dying gladiators are dumped and devoid of their worldly possessions. It is the most valuable oil-on-canvas painting by Juan Luna, a Filipino educated at the Academia de Dibujo y Pintura (Philippines) and at the Academia de San Fernando in Madrid, Spain. With a size of 4.22 meters x 7.675 meters, it is the largest painting in the Philippines. A historical painting, it was made by Luna in 1884 as an entry to the prestigious Exposicion de Bellas Artes (Madrid Art Exposition, May 1884) and eventually won for him the First Gold Medal. In 1886, it was sold to the Diputacià ³n Provincial de Barcelona for 20,000 pesetas. It currently hangs in the main gallery at the ground floor of the National Museum of the Philippines, and is the first work of art that  greets visitors upon entry into the museum. STATEMENT OF THE PROBLEM 1. What is the promotional strategy of Philippine National Museum as one of the tourist attraction in Manila? 2. How does the host community will help the Philippine National Museum in sustaining their tourist arrival? 3. How does a foreign tourist will help the Philippine National Museum in preserving and improving the Museum? 4. Is the existing situation of Philippine National Museum is enough to increase tourists? 5. What are the other tourism development opportunities in Philippine National Museum? OBJECTIVE OF THE STUDY 1. To know the promotional strategy of Philippine National Museum as one of the tourist attraction in Manila. 2. To know how the host community will help the Philippine National Museum in sustaining their tourist arrival. 3. To know how local tourists will help the Philippine National Museum in preserving and improving the Museum. 4. To know if the existing situation of Philippine National Museum is enough to increase tourists. 5. To know what are the other tourism development opportunities in Philippine National Museum. CHAPTER 2 INFORMATION ANALYSIS I. Tourism Issues and Development Opportunities Resources Feature Issues Tourism Development Opportunities Tourism Development Constraints Quality Disseminating more information about what the Philippine National Museum can give some benefits to our country. The promotion of this attraction can give the museum to attract more tourists to go here and to maintain the nature of the museum. It will also help the museum to maintain the quality they give to all visitor coming to them In current situation of the museum, there is ongoing renovation. So the media can’t easily provide any information about the plans of the museum. Only if the museum already done in renovating the can promote the museum easily. Uniqueness The museum will help to tell the history of the Philippines. It includes the culture, arts and historical materials inside the museum. It will give more information to all tourists coming in the museum about the history and other special things and events from the past of the Philippines. Some of the tourist, visitor and other traveler want an adventure kind of tour. Some of the tourists did not satisfy what a museum give to them. Appeal The maintenance of the structure, other facilities inside the Philippine National Museum and other attraction around the museum. Beautiful attraction can attract more visitors especially if the structure of the building inside and outside is good enough to satisfy what the tourist needs to know about the museum. The Philippine National Museum is ongoing renovation and construction in some area. But it will help the museum to attract more tourists after the renovation. II. SWOC ANALYSIS STRENGTHS WEAKNESSES OPPORTUNITIES CHALLENGES Philippine National Museum is in Manila only. It will benefit the student for their tours or field trip. It will help for the researches and other things that are needed in collecting the data about the Philippines. There is always a traffic or congestion within the area. Only few people know about the information about the museum. Some of the travelers do not like to visits museums Some traveler was not interested about what the Philippine National Museum have Some city tour can include the Philippine National Museum. Job opportunities for all the workers of tourism management. Increase number of tourist coming in the Philippines. Increase number of visitor n Manila. Worsening the traffic problems in Manila. Competition in other nearby tourist attraction. Unpredictable weather condition. Quality of the new maintenance of the building. TOURISM ACTIONS PLAN GOAL: To help the Philippine National Museum in having a unique tactic in promoting their Museum. OBJECTIVES: To know the promotional strategy of Philippine National Museum as one of the tourist attraction in Manila. GOAL: To inform local community about the possible effect in their lifestyle. OBJECTIVES: To know how the host community will help the Philippine National Museum in sustaining their tourist arrival. GOAL: To ascertain that local tourists can give sufficient funds or support to preserve and to improve the museum. OBJECTIVES: To know how local tourists will help the Philippine National Museum in preserving and improving the Museum. ACTIONS STEP BY KEY PLAYER 1. A fare in each people who are arriving in the museum. Government 2. Provide a learning trip for all students in awareness about museums. Government and Host GOAL: To encourage government in improving the Philippine National Museum. OBJECTIVES: To know if the existing situation of Philippine National Museum is enough to increase tourists. ACTIONS STEP BY KEY PLAYER 1. To renovate the museum. Government 2. Provide a sufficient fund in upgrading the facilities of the museum. Government GOAL: Provide Job opportunities. OBJECTIVES: To know what are the other tourism development opportunities in Philippine National Museum. ACTIONS STEP BY KEY PLAYER 1. Allow the museum to have tour guides, more security companion. Government 2. To promote as one of the best museum and attract more tourist here in the Philippines. Government