Challenging environment Essay Example for Free

Challenging environment Essay Mrs. Dae is a 28 year old Caucasian female. She presents clean and well dressed. She is approximately 5’ 6†, 145 lbs. She appears healthy and in shape. No visible physical deformities. She has normal gate. She is open and cooperative. She has a normal rate of speech and makes appropriate eye contact. Mrs. Dae expresses herself appropriately. In discussing family history, Mrs. Dae has little trouble recalling events. She is unaware of some family history on her father’s side. Mrs. Dae is orientated x 4. She has logical thought process. Mrs. Dae is alert, however, states she has been busy lately and is tired today. She reports getting approximately 6-8 hours of sleep nightly. Mrs. Dae is able to count backward from 100 by 7’s. She displays logical thought processes. No report of hallucinations or delusions. Mrs. Dae appears to have good judgment and insight. She is of high intelligence and is able to appropriately explain the meaning of a common proverb. (â€Å"A rolling stone gathers no moss†) (â€Å"How to†). Mrs. Dae appears happy and confident, with appropriate affect. During the interview Mrs. Dae was relaxed and participated in spontaneous conversation. She denies any suicidal or homicidal ideation. Strengths/ Weaknesses: Mrs. Dae is highly educated. She appears confidant with high self esteem. She reports she enjoys caring for others. She has good insight and appears to have good coping skills. Mrs. Dae has a supportive family. In terms of weaknesses, Mrs. Dae admits to taking on too many activities at once and at times she feels â€Å"burned out†. Family History: Mrs. Dae is the second of three children and grew up in a typical middle class American home. She has an older brother and a younger sister. Mrs. Dae’s parents were divorced when she was 7 years old. Ms. Dae and her siblings lived with their mother. Mrs. Dae reports her father was verbally and physically abusive toward her mother. This was the reason for the divorce. She does not recall being the victim of such abuse herself. However, she reports that her mother tells her that her father was â€Å"mean to all of us† (referring to Ms. Dae, her siblings and mother). Mrs. Dae denies any sexual abuse. Shortly after the divorce, Mrs. Dae reports all three children stopped seeing their father. She currently has no relationship with her father, however she reports speaking to him on the phone occasionally. Aside from these events, Mrs. Dae reports a normal childhood. She reports discipline as a child in the form of â€Å"grounding, which rarely occurred†. Mrs. Dae is currently married. She has been married for the past 8 years. She denies any previous marriages. Ms. Dae describes her marriage as â€Å"good†. She states she and her husband attended marriage counseling for approximately 3 months earlier in their marriage. Mrs. Dae reports that her husband has a well paying job. She denies any current financial hardship. The couple recently bought their first home. She reported some stress during the process. However, she did not think it was â€Å"more then would be expected when buying a home†. Mrs. Dae and her husband have one child, a 5 year old girl. Education and Work: Mrs. Dae graduated high school in the top 10% of her class and went on to college. She majored in psychology and graduated Cum Laude. She continued to earn her Master of Science degree. Mrs. Dae currently works with at risk youth in the prevention and advocacy department of a non-profit company. She has been with her current employer for one year. She reports being satisfied with her job. She states she makes â€Å"good† money and the work she does is rewarding. Mrs. Dae stated she plans on returning to school in the near future for her PhD in Psychology. Her long term goal is to go into private practice serving youth. Mental/ Physical Health: There is no known history of mental illness on her mother’s side of the family. Mrs. Dae reported there may be depression on her father’s side. Mrs. Dae denies any form of depression aside from â€Å"the blues† every now and then. Mrs. Dae reports history of cancer on both sides of her family. Mrs. Dae participates in annual physical examinations. According to her last physical she is in good health. Mrs. Dae denies substance use. She stated she will drink a glass of wine â€Å"once in a while†. Mrs. Dae denies tobacco use. Legal History: Mrs. Dae denies any significant legal history, aside from a few traffic tickets. Social: Mrs. Dae reports she has a group of friends, other married couples, that she and her husband spend time with. She is also a member of her church and participates in social events at the church. As her child recently started attending elementary school, Mrs. Dae stated she has joined the school’s Parent-Teacher Association. Spiritual: Mrs. Dae reports growing up Catholic but she did not go to church often as a child. She states that she no longer practices Catholicism, however, she does go to a non denominational Christian church. She goes to church on a regular basis. She feels strongly about her beliefs. Mrs. Dae reports that she prays on a daily basis and stated â€Å"this keeps me grounded†. Hobbies/Activities: Mrs. Day states she enjoys reading, yoga, and going to the spa with friends. She admits she has little time to spend on these activities. However, she reports that she and her husband give each other time with their friends, time together, and family time on a regular basis. References How to do a Mental Status Exam. Retrieved on November 9, 2007 from http://www.psychpage.com/learning/library/assess/mse.htm

What is the Future of Social Security? Essay -- essays research papers

What is the future of Social Security?   Ã‚  Ã‚  Ã‚  Ã‚  There is much-heated debate on the issues of Social Security today. The Social Security system is the largest government program of income distribution in the United States. People are concerned that they won't see a dime of what they worked so hard to contribute into the Social Security system for so many years. Social Security provides benefits to about forty-three million Americans. Not only to retired workers, but also to their spouses and dependents of the workers who die prematurely. It also provides benefits to disabled workers and their dependents. Social Security appears to most people like a simple retirement saving’s account. After all, you generally contribute through payroll deductions, then get money back after you retire. Nonetheless, Social Security is a complex and intricate communal program. By design, Social Security involves massive subsidies from the next generation of retirees to the present, from single workers to married couples. Now that the gigantic post World War II baby boomers generation approaches retirement age, there is concern about the consequences it will have on Social Security. There are basically three options, we can do nothing and allow Social Security to run it’s course, revise Social Security, or consider privatization of the system.   Ã‚  Ã‚  Ã‚  Ã‚  Historically, the Democratic and Republican parties have clear and opposing viewpoints. Quite simply, the Democrats whole-heartedly oppose change to a program initiated under Roosevelt's New Deal. The Republicans consider this social program contrary to capitalism. However, over time the Republicans learned that it's popularity with the voters has made this issue untouchable.   Ã‚  Ã‚  Ã‚  Ã‚  According to Congressman Richard Gephardt, the social security was not meant to be the sole source of retirement income but rather as a foundation for retirement to give all working Americans a safety cushion. There will be money in the fund until 2029, so distressing baby boomers don’t have to worry. After that money is depleted the revenue from the payroll tax will be sufficient enough to pay 75% of every social security benefit for the subsequent 75 years. But how many burdens should be put on the young and middle age individuals, whose taxes basically pay for government retirement ... ...s for generations to come, which in essence, needs to start now. Using a conservative economic projection should be one of the steps taken for the growth of future social security. We all know there are no free rides in life; someone is always taking the bill, much less in social security. Any of the changes discussed in this report would impose a real alteration in the level of benefits, taxation and risks. Ultimately, we need to look forward with complete understanding and full acceptance of changes, while keeping faith in a system, which has served us so well.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Richard A. Gephardt, Being Careful with Social Security [article online], Newsweek Inc. Accessed 15 January 1997; Page A19. Social Security Administration. Available from http://www.ssa.gov   Ã‚  Ã‚  Ã‚  Ã‚  Robert J. Samuelson, Justice Among Social Security [article online], Newsweek Inc. Accessed 1 July 1998; Page A23. Social Security Administration. Available from http://www.ssa.gov   Ã‚  Ã‚  Ã‚  Ã‚  

High-Risk Family Assessment and Health Promotion Essay

High-Risk Families A high-risk family is a family unit that is at an increased risk for emotional, intellectual, or developmental problem because of the type of environment or circumstances that is occurring within the family unit. Adults and children that are involved in these high-risk family units are at a higher risk to develop problems, both physically and emotionally. There are many indicators for early detection of risk factors: neighborhood environment, poverty, poor kept homes, characteristics of adults present in the home, marital problems, and child neglect. There are many programs and interventions that can be implemented to try to change the negative effects and ensure a positive outcome within the family unit. History of Teen Pregnancy According to Furstenberg, Brooks-Gunn & Chase-Lansdale (1989), in an article titled Teenaged Pregnancy and Childbearing, teen pregnancy did not become prevalent until the 1960s. Two changes occurred contributing to the increase in teenage pregnancies: 1.) an increase in sexual activity of young girls and 2.) a decrease in the number of teenage marriages. By the 1980s over half of white females and three-fourths of black females were sexually active by the age of 18 (Furstenberg, Brooks-Gunn & Chase-Lansdale, 1989). Contraception was not regularly used when having sexual relations, and many of these females became pregnant during their teen years. Furstenberg, Brooks-Gunn & Chase-Lansdale (1989), also continue to say that compared to the number of unmarried teenage females in 1950 the females of 1980s were two-thirds white and almost 97% black single females. Also, 40% of these teenage pregnancies would end with abortion, and that the younger teenagers would have more abortions. A pre gnant teenager has many decisions to make regarding her future: 1.) future schooling 2.) relationship with the  baby’s father 3.) family’s support 4.) peer’s support. Summary of the Health Profile of a Pregnant Teen The risk of some teenagers getting pregnant is high in some circumstances. There are many life situations that place teenage girls at a risk of becoming pregnant. These may include poor school performance, sexual abuse, poverty, being raised by a single parent household, having a mother who was an teenager mother, or having a sister who has become pregnant at a young age. According to Saewyc, Magee & Pettingell, (2004) the risk of a teenager getting pregnant is increased if that teenager has been sexually abused. The pregnancy is because they have been sexually abused they have a feeling of powerlessness which can lead to impairment when it comes to using a contraceptive (Saewyc, Magee & Pettingell, 2004). Also, if the teenager has been sexually abused then they may have a higher chance of substance abuse and running away from home (Saewyc, Magee & Pettingell, 2004). Substance abuse can lead the risk for multiple partners, unprotected sex, and turning to sex work in order to support their habit. Many teenagers feel that they are under pressure to have sexual relations. Peer pressure, bullying, and teasing by friends can lead to sexual intercourse at a much earlier age. Also, being allowed to date at an early age can lead to pregnancy, especially if the individual they are sleeping with refuses to use contraception. There are many social and cultural changes that have occurred regarding dating. Getting to know a person over a long period, or courting, is no longer part of dating. Couples now move onto physical relationships much quicker, and sex is part of the relationship. Poor education and low achievement levels in school can lead to unwanted pregnancies. Teenagers who drop out of school are more likely to become pregnant and not complete their education. Teens that get pregnant tend to come from more disadvantaged families than those who do not become pregnant. Being of lower income contributes to a low hope of possible financial success which usually leads to choices of short-term contentment, having a  baby while they are young and unmarried. Orem’s Self-Care Model Dorothea Orem published the Concepts of Nursing in 1971 and the sixth publication in 2001. According to Sitzman & Eichelberger, (2011), â€Å"Orem’s Self-Care Model describes a structure where the nurse assists the client, as needed, to maintain an adequate level of self-care. The degree of nursing care and interventions depend on the degree to which the client is able (or unable) to meet self-care needs† (p. 96). Orem’s general theory is in three parts: 1.) theory of self-care 2.) theory of self-care deficit 3.) theory of nursing system (Chitty, 2005, p. 283). The theory of self-care focuses on patient’s self-care capacities. The theory of self-care deficits specifies when nursing care is needed. Orem identifies five methods of helping: 1.) acting for and doing for others 2.) guiding others 3.) supporting others 4.) providing an environment promoting personal development in relations to meeting future demands 5.) teaching another (Orem, 2001 as cited in M asters, 2011, p. 183). The theory of nursing system describes the responsibilities and roles of the nurse and patient, the reason for the nurse-patient relationship, and the types of interventions needed to be provided to meet the patient’s needs. The theoretical framework of Orem’s theory as it relates to the metaparadigm for nursing is based on the person, a nurse, environment, and health. Nursing is the ability to assist patients to provide and manage self-care to improve and maintain human function at some level. Health is not only taking care of the body but is also how a person performs with daily activities of living and progressing toward higher levels of functioning. Environment includes four features: 1.) physical 2.) chemical 3.) biological 4.) social (Orem, 2001 as cited in Masters, 2011, p. 183). The environment has an impact on the individual’s health and well-being. Finally, persons are human beings who are different from other living beings. Human beings can reflect, symbolize, and use symbols. The person is a patient whom the nurse cares for. Orem’s theory can be applied to all three levels of prevention: primary, secondary, and tertiary. Every person needing nursing care has requirements at the primary level of prevention. Secondary prevention is required after the onset of illness and is directed toward reducing complications and disability. Tertiary care is appropriate when functioning is limited. Dorothea Orem’s  theory provides a widespread foundation to the nursing practice and is specific to when nursing care is needed. Orem’s theory can be applied can be applied to various age groups including teenage mothers of newborns. The self-care deficit theory of nursing is useful with teenage mothers of newborns. The theory will focus on the strengths and/or weaknesses of the individual. Methods of help and interventions include teaching, guiding, and providing for and/or maintaining direction in an environment that supports personal development. Healthy People 2020 Objectives According to Healthy People 2020 goals are to improve pregnancy planning and spacing, and prevent unintended pregnancy. Reducing pregnancies among adolescent females aged 15 to 17 years, reducing the number of pregnancies conceived within 18 months of a previous birth, increasing the number of both males and females who have never had sexual intercourse, increasing the number of sexually active persons who use condoms to both effectively prevent pregnancy and provide barrier protection against disease, and increase the number of adolescents who received formal instruction on reproductive health topics before they are 18 years old are all applicable objectives related to teenage pregnancy (â€Å"Family planning,†). There are many nursing interventions that are applicable for prevention of teen pregnancies. Nursing education that includes teaching about contraception, abstinence, and having schools administer condoms through the health office. Interventions can also include designing and presenting programs that includes parent-teen communication with their parent(s), while promoting abstinence and the proper use of contraception. According to Furstenberg, Brooks-Gunn & Chase-Lansdale (1989) there have been efforts made to prevent teen pregnancies. According to the Panel on Adolescent Pregnancy and Childbearing primary prevention, delaying sexual activity, and using contraception is where all efforts should be focused on for prevention (Furstenberg, Brooks-Gunn & Chase-Lansdale, 1989). Primary prevention programs include: 1.) educating teens about sexuality and contraception 2.) changing attitudes about early sexual involvement and 3) providing contraceptives and family planning (Furstenberg, Brooks-Gunn & Chase-Lansdale, 1989). Role of the Advanced Practice Nurse as a Case Manager Advanced Practice Nurses have the education, training, and skills to perform many of the primary-care duties performed by physicians. Advanced Practice Nurse Case Manager carries out advanced practice functions and develops functions that help to achieve the best results for the client through valuable interactions with clients. The Advanced Practice Nurse will manage and coordinate care for the pregnant teenagers and their families, provide health education, teach self-care behaviors, and offer psychosocial counseling and support, assess the efficacy of the health care system, and assist and monitor improvement ideas of the health care system. Conclusion Teenage pregnancy has been a major problem facing our children since the 1950s. Teen parents are less likely to finish school, more likely to live in poverty, more likely to have babies with low-birth weights and more likely to have children who become teenage mothers themselves. The goals of the health educator should include changing the behavior, providing counseling services, primary and preventative health care, and family educations. For the future, all teens should be aware of the risks involved of sexual intercourse and be educated on the ways to prevent pregnancies. Reference Chitty, K. K. (2005). Professional nursing, concepts & challenges. W B Saunders Co. Family planning. (n.d.). Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicId=13 Furstenberg, F. F., Jr., Brooks-Gunn, J., & Chase-Lansdale, L. (1989). Teenaged pregnancy and childbearing. American Psychologist, 44(2), 313-320. doi:http://dx.doi.org/10.1037/0003-066X.44.2.313 Masters, K. (2011). Nursing theories, a framework for professional practice. Sudbury, MA: Jones & Bartlett Publishers. Saewyc, E. M., Magee, L. L., & Pettingell, S. E. (2004). Teenage pregnancy and associated risk behaviors among sexually abused adolescents. Perspectives on Sexual and Reproductive Health, 36(3), Retrieved from https://www.guttmacher.org/pubs/journals/3609804.html Sitzman, K., & Eichelberger, L. W. (2011). Understanding the work of nurse theorists, a creative beginning (2nd ed.). Sudbury, MA: Jones & Bartlett Learning.

Italianate Homes, Romantic and Picturesque

Of all the homes built in the United States during the Victorian era, the romantic Italianate style became the most popular for a short period of time. With their nearly-flat roofs, wide eaves, and massive brackets, these homes suggested the romantic villas of Renaissance Italy. The Italianate style is also known as Tuscan, Lombard, or bracketed. Italianate and the Picturesque Movement The historical roots of Italianate styles are in Italian Renaissance architecture. Some of the first Italian villas were designed by Renaissance architect Andrea Palladio in the 16th century. Palladio reinvented Classical architecture, melding the designs of a Roman temple into residential architecture. By the 19th century, English-speaking architects were reinventing Roman designs yet again, capturing the flavor of what they imagined to be the Italian villa look. The Italianate style began in England with the picturesque movement. For centuries English homes tended to be formal and classical in style. Neoclassical architecture was orderly and proportioned.  With the picturesque movement, however, the landscape gained importance. Architecture not only became integral to its surroundings, but also became a vehicle for experiencing the natural world and surrounding gardens. The pattern books of British-born landscape architect Calvert Vaux (1824-1895) and the American Andrew Jackson Downing (1815-1852) brought this concept to an American audience. Especially popular was A. J. Downings 1842 book Rural Cottages and Cottage-Villas and their Gardens and Grounds Adapted to North America. American architects and builders such as  Henry Austin (1804-1891) and Alexander Jackson Davis (1803-1892) began to design fanciful recreations of Italian Renaissance villas. Architects copied and reinterpreted the style for buildings in the United States, making Italianate architecture in the U.S. uniquely American in style. One of the finest examples of late Victorian Italianate architecture is owned by the National Park Service. The John Muir National Historic Site in Martinez, California lays claim to the 17-room John Muir Mansion, built in 1882, and inherited by the famous American naturalist. Queen Victoria ruled England for a long, long time — from 1837 until her death in 1901 — so Victorian architecture is more a time frame than a specific style. During the Victorian era, emerging styles captured a large audience by the widely-published house pattern books packed with building plans and home building advice. Prominent designers and illustrators published many plans for Italianate and Gothic Revival style homes. By the late 1860s, the fashion had swept through North America. Why Builders Loved the Italianate Style Italianate architecture knew no class boundaries. The high square towers made the style a natural choice for upscale homes of the newly rich. However the brackets and other architecture details, made affordable by new methods for machine production, were easily applied to simple cottages. Historians say that Italianate became the favored style for two reasons: (1) Italianate homes could be constructed with many different building materials, and the style could be adapted to modest budgets; and (2) new technologies of the Victorian era made it possible to quickly and affordably produce cast-iron and press-metal decorations. Many 19th century commercial buildings, including urban rooming houses, were constructed with this practical yet elegant design. Italianate remained the preferred house style in the U.S. until the 1870s, when the Civil War curbed the progress of construction. Italianate was also a common style for modest structures like barns and for larger public buildings such as town halls, libraries, and train stations. You will find Italianate buildings in nearly every part of the United States except for the deep South. There are fewer Italianate buildings in the southern states because the style reached its peak during the Civil War, a time when the south was economically devastated. Italianate was an early form of Victorian architecture. After the 1870s, architectural fashion turned toward late Victorian styles such as Queen Anne. Italianate Features Italianate homes can be wood-sided or brick, with commercial and public properties often being masonry. The most common Italianate styles will often have many of these characteristics: a low-pitched or flat roof; a balanced, symmetrical rectangular shape; a tall appearance, with two, three, or four stories; wide, overhanging eaves with large brackets and cornices; a square cupola; a porch topped with balustraded balconies; tall, narrow, paired windows, often arched with hood moldings projecting above the windows; a side bay window, often two stories tall; heavily molded double doors; Roman or segmented arches above windows and doors; and rusticated quoins on masonry buildings. Italianate house styles in America can seem like a mix of characteristics from different eras, and sometimes they are. The Italian-inspired Renaissance Revival homes are more palatial but still often confused with the Victorian Italianate style. The French-inspired Second Empire, like houses in the Italianate style, often feature a high, square tower. Beaux Arts buildings are grand and elaborate, often embracing Italianate ideas along with Classical. Even Neo-Mediterranean builders of the 20th century re-visited Italianate themes. Victorian architecture encompasses a variety of popular styles, but ask yourself how picturesque each is. Examples of Italianate Houses Italiante houses can be found across the United States. often tucked away in unexpected places. The Lewis House built in 1871, is on a side road outside Ballston Spa, New York. Not named for the original owner, the Lewis family converted historic home near Saratoga Springs into a Bed Breakfast business. Italianate Lewis House, 1871, Ballston Spa, New York. Jackie Craven In Bloomington, Illinois you can visit Clover Lawn, built in 1872. Also known as the David Davis Mansion, the architecture combines Italianate and Second Empire stylings. David Davis Mansion, 1872, Illinois. Teemu08 via Wikimedia Commons, own work, Creative Commons Attribution-Share Alike 3.0 Unported license (CC BY-SA 3.0) cropped The Andrew Low House in Savannah, Georgia was built in 1849. This historic house by New York architect John Norris has been described as Italianate, most notably because of its urban garden landscaping. To get the full sense of Italiante details, especially the roof, the observer must step back both physically and in time. Andrew Low House, 1849, Savannah, Georgia. Carol M. Highsmith/Getty Images (cropped) Sources Italianate Architecture and History, Old-House Journal, August 10, 2011, https://www.oldhouseonline.com/articles/all-about-italianates [accessed August 28, 2017]Italianate Villa/Italianate Style 1840 - 1885, Pennsylvania Historical and Museum Commission, http://www.phmc.state.pa.us/portal/communities/architecture/styles/italianate.html  [accessed August 28, 2017]A Field Guide to American Houses by Virginia and Lee McAlester, Knopf, 1984, 2013American Shelter: An Illustrated Encyclopedia of the American Home by Lester Walker, Overlook, 1998American House Styles: A Concise Guide by John Milnes Baker, AIA, Norton, 2002Photo Credits: Clover Lawn, Teemu08 via Wikimedia Commons (CC BY-SA 3.0) cropped; Andrew Low House, Carol M. Highsmith/Getty Images (cropped); Lewis House, Jackie CravenCOPYRIGHT: The articles you see on the pages of this website are copyrighted. You may link to them or print them for your own use, but do not copy them into a blog, web page, or print publication without permission.