Mechanical Engineering Essay

Mechanical engineering is a discipline of engineering that applies the principles of engineering, physics and materials science for analysis, design, manufacturing, and maintenance of mechanical systems. It is the branch of engineering that involves the production and usage of heat and mechanical power for the design, production, and operation of machines and tools.[1] It is one of the oldest and broadest engineering disciplines. The engineering field requires an understanding of core concepts including mechanics, kinematics, thermodynamics, materials science, structural analysis, and electricity. Mechanical engineers use these core principles along with tools like computer-aided engineering, and product lifecycle management to design and analyze manufacturing plants, industrial equipment and machinery, heating and cooling systems, transport systems, aircraft, watercraft, robotics, medical devices, weapons, and others. Mechanical engineering emerged as a field during the industrial revolution in Europe in the 18th century; however, its development can be traced back several thousand years around the world. Mechanical engineering science emerged in the 19th century as a result of developments in the field of physics. The field has continually evolved to incorporate advancements in technology, and mechanical engineers today are pursuing developments in such fields as composites, mechatronics, and nanotechnology. Mechanical engineering overlaps with aerospace engineering, metallurgical engineering, civil engineering, electrical engineering, petroleum engineering, manufacturing engineering, chemical engineering, and other engineering disciplines to varying amounts. Mechanical engineers may also work in the field of Biomedical engineering, specifically with biomechanics, transport phenomena, biomechatronics, bionanotechnology and modeling of biological systems, like soft tissue mechanics. Mechanical engineering finds its application in the archives of various ancient and medieval societies throughout mankind. In ancient Greece, the works of Archimedes (287 BC–212 BC) deeply influenced mechanics in the Western tradition and Heron of Alexandria (c. 10–70 AD) created the first steam engine.[2] In China, Zhang Heng (78–139 AD) improved a water clock and invented a seismometer, and Ma Jun (200–265 AD) invented a chariot with differential gears. The medieval  Chinese horologist and engineer Su Song (1020–1101 AD) incorporated an escapement mechanism into his astronomical clock tower two centuries before any escapement can be found in clocks of medieval Europe, as well as the world’s first known endless power-transmitting chain drive. During the years from 7th to 15th century, the era called the Islamic Golden Age, there were remarkable contributions from Muslim inventors in the field of mechanical technology. Al-Jazari, who was one of them, wrote his famous Book of Knowledge of Ingenious Mechanical Devices in 1206, and presented many mechanical designs. He is also considered to be the inventor of such mechanical devices which now form the very basic of mechanisms, such as the crankshaft and camshaft. Important breakthroughs in the foundations of mechanical engineering occurred in England during the 17th century when Sir Isaac Newton both formulated the three Newton’s Laws of Motion and developed Calculus, the mathematical basis of physics. Newton was reluctant to publish his methods and laws for years, but he was finally persuaded to do so by his colleagues, such as Sir Edmund Halley, much to the benefit of all mankind. Gottfried Wilhelm Leibniz is also credited with creating Calculus during the same time frame. During the early 19th century in England, Germany and Scotland, the development of machine tools led mechanical engineering to develop as a separate field within engineering, providing manufacturing machines and the engines to power them.[5] The first British professional society of mechanical engineers was formed in 1847 Institution of Mechanical Engineers, thirty years after the civil engineers formed the first such professional society Institution of Civil Engineers.[6] On the European continent, Johann von Zimmermann (1820–1901) founded the first factory for grinding machines in Chemnitz, Germany in 1848. In the United States, the American Society of Mechanical Engineers (ASME) was formed in 1880, becoming the third such professional engineering society, after the American Society of Civil Engineers (1852) and the American Institute of Mining Engineers (1871).[7] The first schools in the United  States to offer an engineering education were the United States Military Academy in 1817, an institution now known as Norwich University in 1819, and Rensselaer Polytechnic Institute in 1825. Education in mechanical engineering has historically been based on a strong foundation in mathematics and science. Education Degrees in mechanical engineering are offered at universities worldwide. In Brazil, Ireland, Philippines, Pakistan, China, Greece, Turkey, North America, South Asia, India, Dominican Republic and the United Kingdom, mechanical engineering programs typically take four to five years of study and result in a Bachelor of Engineering (B.Eng), Bachelor of Science (B.Sc), Bachelor of Science Engineering (B.ScEng), Bachelor of Technology (B.Tech), or Bachelor of Applied Science (B.A.Sc) degree, in or with emphasis in mechanical engineering. In Spain, Portugal and most of South America, where neither BSc nor BTech programs have been adopted, the formal name for the degree is â€Å"Mechanical Engineer†, and the course work is based on five or six years of training. In Italy the course work is based on five years of training, but in order to qualify as an Engineer you have to pass a state exam at the end of the course. In Greece, the coursework is based on a five year curriculum and the requirement of a ‘Diploma’ Thesis, which upon completion a ‘Diploma’ is awarded rather than a B.Sc. In Australia, mechanical engineering degrees are awarded as Bachelor of Engineering (Mechanical) or similar nomenclature[9] although there are an increasing number of specialisations. The degree takes four years of full-time study to achieve. To ensure quality in engineering degrees, Engineers Australia accredits engineering degrees awarded by Australian universities in accordance with the global Washington Accord. Before the degree can be awarded, the student must complete at least 3 months of on the job work experience in an engineering firm. Similar systems are also present in South Africa and are overseen by the Engineering Council of South Africa (ECSA). In the United States, most undergraduate mechanical engineering programs are  accredited by the Accreditation Board for Engineering and Technology (ABET) to ensure similar course requirements and standards among universities. The ABET web site lists 302 accredited mechanical engineering programs as of 11 March 2014.[10] Mechanical engineering programs in Canada are accredited by the Canadian Engineering Accreditation Board (CEAB),[11] and most other countries offering engineering degrees have similar accreditation societies. Some mechanical engineers go on to pursue a postgraduate degree such as a Master of Engineering, Master of Technology, Master of Science, Master of Engineering Management (MEng.Mgt or MEM), a Doctor of Philosophy in engineering (EngD, PhD) or an engineer’s degree. The master’s and engineer’s degrees may or may not include research. The Doctor of Philosophy includes a significant research component and is often viewed as the entry point to academia.[12] The Engineer’s degree exists at a few institutions at an intermediate level between the master’s degree and the doctorate.

Contex and Principles for Early Year Learning Essay

Question: An explanation of the legal status and principle of the relevant Early Years Framework and why the early year frameworks emphasise a personal and individual approach to learning and development 1. 1 The statutory framework for the EYFS sets out the legal requirements relating to learning and development and the legal requirements relating to welfare. The EYFS framework has statutory force by virtue of Section 44 of the Childcare Act 2006. The EYFS is a central part of the ten year childcare strategy Choice for parents, the best start for children and the landmark Childcare Act 2006. This Act, which regulates the childcare in England, formalise the important strategic role local authorities play, through a set of duties. These duties require authorities to †¢ work with their NHS and Jobcentre Plus partners to improve the outcomes of all children up to five years of age and reduce inequalities between them †¢ secure sufficient childcare for working parents †¢ provide a parental information service †¢ provide information, advice and training for childcare providers. The act also lays out registration and inspection arrangements, providing for an integrated education and care framework for the Early Years and general childcare registers. The sufficiency, information and outcomes duties came into effect on 1 April 2008 and the remaining provisions came into effect from September 2008. The revised, simpler framework for the EYFS was published on 27 March 2012, for implementation from 1 September 2012. This is an integral part of the Government’s wider vision for families in the foundation years. It demonstrates our commitment to freeing professionals from bureaucracy to focus on supporting children. Together with a more flexible, free early education entitlement and new streamlined inspection arrangements, this is a step towards a lighter touch regulatory regime. The Government will continue to seek to reduce burdens and remove unnecessary regulation and paperwork, which undermine professionals’ ability to protect children and promote their development. The new EYFS framework makes a number of improvements: †¢ Reducing bureaucracy for professionals, simplifying the statutory assessment of children’s development at age five. †¢ Simplifying the learning and development requirements by reducing the number of early learning goals from 69 to 17. †¢ Stronger emphasis on the three prime areas which are most essential for children’s healthy development. These three areas are: communication and language; physical; and personal, social and emotional development. †¢ For parents, a new progress check at age two on their child’s development. This links with the Healthy Child review carried out by health visitors, so that children get any additional support they need before they start school. †¢ Strengthening partnerships between professionals and parents, ensuring that the new framework uses clear language. The Early Years Register (EYR) and the General Childcare Register (GCR) provide a regulatory framework for childcare under the act. Ofsted regulates the two registers – the EYR for people caring for children aged from birth to 31 August after their fifth birthday and the GCR for childcare over this age. The GCR has two parts: the compulsory part (for providers of childcare for children aged five to seven) and a voluntary part (for providers of childcare for children aged eight and over or childcare that is exempt from registering on a compulsory basis). The EYFS has replaced three precedent frameworks: Curriculum Guidance for Foundation Stage, the Birth to Three Matters frameworks, and the National Standards for Under 8s Day-care and Childminding. The EYFS is given legal force through an Order and Regulations made under the Act. From September 2008 it will be mandatory for all schools and early years providers in Ofsted registered settings attended by young children – that is children from birth to the end of the academic year in which a child has their fifth birthday. All early years providers are required to meet the EYFS requirements. From September 2008 it is the legal responsibility of these providers to ensure that their provision meets the learning and development requirements, and complies with the welfare regulations. The Early Years Foundation Stage 2012 (EYFS) sets the standards that all early years providers must meet to ensure that children learn and develop well and are kept healthy and safe. It promotes teaching and learning to ensure children’s ‘school readiness’ and gives children the broad range of knowledge and skills that provide the right foundation for good future progress through school and life. Every child deserves the best possible start in life and the support that enables them to fulfil their potential. Children develop quickly in the early years and a child’s experiences between birth and age five have a major impact on their future life chances. A secure, safe and happy childhood is important in its own right. Good parenting and high quality early learning together provide the foundation children need to make the most of their abilities and talents as they grow up. The EYFS seeks to provide: †¢ quality and consistency in all early years settings, so that every child makes good progress and no child gets left behind; †¢ a secure foundation through learning and development opportunities which are planned around the needs and interests of each individual child and are assessed and reviewed regularly; †¢ partnership working between practitioners and with parents and/or carers; †¢ equality of opportunity and anti-discriminatory practice, ensuring that every child is included and supported. The EYFS specifies requirements for learning and development and for safeguarding children and promoting their welfare. The learning and development requirements cover: †¢ the areas of learning and development which must shape activities and experiences (educational programmes) for children in all early years settings; †¢ the early learning goals that providers must help children work towards (the knowledge, skills and understanding children should have at the end of the academic year in which they turn five); and †¢ assessment arrangements for measuring progress (and requirements for reporting to parents and/or carers). The safeguarding and welfare requirements cover the steps that providers must take to keep children safe and promote their welfare. Four guiding principles should shape practice in early years settings. These are: †¢ every child is a unique child, who is constantly learning and can be resilient, capable, confident and self-assured; †¢ children learn to be strong and independent through positive relationships; †¢ children learn and develop well in enabling environments, in which their experiences respond to their individual needs and there is a strong partnership between practitioners and parents and/or carers; and †¢ children develop and learn in different ways and at different rates. The framework covers the education and care of all children in early years provision, including children with special educational needs and disabilities. The aim of the EYFS is to help young children achieve the five Every Child Matters outcomes of staying safe, being healthy, enjoying and achieving, making a positive contribution, and achieving economic well-being by: 1. setting the standards for the learning, development and care, ensuring that every child makes progress and that no child gets left behind. Parents, providers should deliver individualised learning, development and care that enhances the development of the children in their care and gives those children the best possible start in life. Every child should be supported individually to make progress at their own pace and children who need extra support to fulfil their potential should receive special consideration. All providers have an equally important role to play in children’s early years experiences and they have to ensure that the provision they deliver is both appropriate to children’ needs and complementary to the education and care provided in child’s other settings. 2. providing for equality of opportunity and anti-discriminatory practice and ensuring that every child is included and not disadvantaged because of ethnicity, culture or religion, home language, family background, learning difficulties or disabilities, gender or ability. Practitioners should focus on each child’s individual learning, development and care needs by: removing or helping to overcome barriers for children, being alert to the early signs of needs that could lead to later difficulties and responding quickly and appropriately, stretching and challenging children because all of them should have the opportunity to experience an enjoyable programme of learning and development. 3. creating the framework for partnership working between parents and professionals, and between all the settings that the child attends. Working with children means working in partnership with a lot of people, for this reason is important that practitioners ensure continuity and coherence by sharing relevant information with each other and with parents. Parents and families are central to a child’s well-being and learning’s needs. For this reason practitioners should support this important relationship by sharing information and offering support for extending learning in the home. 4. improving quality and consistency in the early years sector through a universal set of standards which apply to all settings and providing the basis for the inspection and regulation regime. 5. laying a secure foundation for future learning through learning and development that is planned around the individual needs and interests of the child, and informed by the use of ongoing observational assessment. It is important to their future success that children’ earliest experience help to build a secure foundation for learning throughout their school years and beyond. Practitioners must sensitive to the individual development of each child to ensure that activities they undertake are suitable for the stage that they have reached. Children need to be stretched, but not pushed beyond their capabilities, so that they can continue enjoy learning. Practitioners must observe assessment planning for each child’s continuing development through play-based activities, and respond quickly to children’s learning and development needs. There are a lot of important aspects on the early years’ provision in the EYFS framework. These principles are: 1. There should be a variety of provision for children under five in any locality. 2. All groups should operate in safe, healthy premises and should register with the local social services department. 3. Groups should be of manageable size and have a high adult to child ratio. 4. Groups should comply with al employment legislation and pay adequate salaries and expenses to volunteers. 5. Staff should be trained and experienced, and with volunteers and parents, should be given the opportunity to further their learning. 6. Groups should have opening times that reflect the needs of parents and children. 7. Groups should have clear policies and procedures for admission and attendance of children 8. Groups should consider children’s dietary needs to ensure that any food or drink provided is appropriate, acceptable and nutritious. In the provision of any refreshment, groups should respect individual, cultural, religious and medical requirements. 9. Groups should have appropriate and adequate insurance cover. 10. Parents are the main educators of their children and should be involved in all aspects of the group including management. 11. Groups should have sound management procedures. 12. Groups should be recognised by, and have contact with, other local providers of education and care for young children. 13. Groups should provide for children and adults with disabilities and learning difficulties including â€Å"children in need† as defined by the Children Act 1989. 14. Groups should be well organised, with carefully planned activities. 15. Groups should provide good quality educational equipment and play activities appropriate ages and stages of development. 16. The quality in any group is ultimately dependent upon the skills, attitudes and commitment of adults, and groups should build upon these. 17. There should be equal opportunities, in all aspects of the group’s work, for adults and children. All children in England between ages 5 and 16 must receive a full-time education. For children under age 5, publicly-funded nurseries and pre-schools are available for a limited number of hours each week. After the age of 16, students can attend sixth form colleges or other further education institutions. There are different types of child settings but all of them should follow The Disability Discrimination Act 1995 that sets out two main duties for childcare providers: †¢ not to treat a disabled child ‘less favourably’ †¢ to make ‘reasonable adjustments’ for disabled children Registered day nurseries Children are normally admitted from age 18 months to 3? years. They usually have fixed opening times and are usually open all day and during the school holidays to meet the needs of working parents. They may also offer before and after school childcare and holiday care for school aged children. Local authority nursery schools and nursery classes They are funded by the local authority. Children can start a nursery school or nursery class attached to a primary school from the age of three. Some nursery places are for a half-day (either a morning or an afternoon), others are for the whole school day. Pre-schools and Playgroups Pre-schools and playgroups provide care, play and learning opportunities for children aged two to five years. They usually offer half day sessions, term time only, although some may offer extended hours. Primary school Primary schools are for children aged from four or five until the age of 11. Secondary school Secondary schools are for children aged 11, until the age of 16 but often also include sixth form centres or colleges which have pupils until the age of 18. Special schools Special schools educate children or young people aged 5 and upwards almost always with statements of special educational need. Childminders Provide care, play and learning opportunities within the childminders own home. They may be able to work flexible hours and periods. Will often take or collect children from playgroup or school. Can care for a maximum of six children under 8 years of age, depending on the play space available, but no more than three under 5 years of age and not normally more than one under 12 months Question: An explanation of how national and local guidance materials are used in setting 1. 2 UK’s current provision to work with early years children has been influenced by many different theories. FRIEDRICH FROEBEL (1782-1852) Froebel founded his first kindergarten in 1840. He believed in outdoor and indoor play and invented finger play, songs and rhymes. He valued symbolic behaviour through play: this is where children understand that they can make one thing stand for – or symbolise – something else – for example, a yoghurt pot can symbolise a cup of tea. He felt that children were able to learn at their highest level through imaginative play. He was also well known for encouraging block play which he called gift – encouraging children to understand a variety of mathematical concepts and relationship through play with various wooden blocks. His theory start with the concept that humans are creative beings, for this reason true education must help children to understand their true nature as creative beings. Froebel believed that play is the engine that drives true learning. Play is not idle behaviour. It is a biological imperative to discover how things work. It is happy work, but definitely purposeful. Froebel sought to harness this impulse and focus the child’s play energy on specific activities designed to lead them to create meaning from this experience. In his opinion children can only learn what they are ready to learn. Each child is unique and develops according to their own schedule. Nothing can be more wasteful or frustrating than to try to force a child to march to a different beat. Froebel works with each child’s own rhythm but makes it purposeful and guides the child toward the group. Froebel recognized that you cannot control the child so he controlled everything else. A prepared environment provides the teacher with the proper tools and gives children the experiences that the teacher feels are most beneficial, leading the child’s mind to the subject at hand. It feels less structured or forced, but it is actually extremely efficient. After his death the idea of his child-centred kindergarten became popular in both Germany and the rest of Europe. MARIA MONTESSORI (1870-1952) Maria Montessori was a doctor in poor areas of Rome in the early twentieth century. During this time she observed children’s development and saw them as active learners. She did not believe in imaginative play but she felt that children needed to experience concepts such as shape, size and order through structured play. She also felt that, at different stages of their development, children are particularly receptive to certain area of learning and that the adult must guide them through these. Montessori believed that children would become independent learners if they worked on their own. She did not encourage sequence of exercises often using specifically designed didactic (instructional) materials. (Penny Tassoni, 368)These are materials that involve sensory experiences and are self-correcting. Montessori materials are designed to be aesthetically pleasing, yet sturdy and were developed by Maria Montessori to help children develop organization. Montessori believed that the environment should be prepared by matching the child to the corresponding didactic material. The environment should be comfortable for children (e. g. , child-sized chairs that are lightweight). The environment should be homelike, so child can learn practical life issues. For example, there should be a place for children to practice proper self-help skills, such as hand washing. Since Montessori believed beauty helped with concentration, the setting is aesthetically pleasing. The â€Å"Montessori method† consists in a carefully developed set of materials which create the proper environment for children at each stage of their development. In this environment and with the guidance of trained teachers, they can develop their intellects and acquire all the skills and content of human civilization. Over sixty years of experience with children around the world proved Dr. Montessori’s theory that children can learn to read, write and calculate as easily and naturally as they learn to walk and talk. Her methods are still popular in Montessori schools around the world. The High/Scope approach The High/Scope Approach has roots in constructivist theory. Constructivists believe that we learn by mentally and physically interacting with the environment and with others. Although errors may be made during these interactions, they are considered just another part of the learning process. Although both Constructivism and the Montessori Method involve learning by doing, there are significant differences. In Montessori, for instance, the didactic, self-correcting materials are specifically designed to help prevent errors. Children learn by repetition, instead of by trial and error. The role of pretend play is also different in the two methods. In High/Scope, children’s creative exploration is encouraged, and this sometimes leads to pretend play, while in Montessori, â€Å"practical life work† that relates to the real world is stressed. Although Constructivism is a theory of learning, as opposed to a theory of teaching, High/Scope has exemplified an approach of teaching that supports Constructivist beliefs. Thus, children learn through active involvement with people, materials, events, and ideas. What Are High/Scope’s Main Components? Social †¢ One of the fundamental points in the High/Scope approach is that children are encouraged to be active in their learning through supportive adult interactions. †¢ The High/Scope approach includes times for various grouping experiences in the classroom. There are specific periods in each day for small group times, large group times, and for children to play independently in learning centres throughout the classroom. †¢ Children are encouraged to share their thinking with teachers and peers. †¢ Social interactions in the classroom community are encouraged. Teachers facilitate work on problem resolution with children as conflicts arise. †¢ When a child talks, the teachers listen and ask open-ended questions; they seek to ask questions that encourage children to express their thoughts and be creative rather than a â€Å"closed† question that would elicit more of a yes/no or simplistic answer. †¢ Each day the High/Scope teacher observes and records what the children are doing. During the year, teachers complete a High/Scope Child Observation Record from the daily observations they have collected. Curriculum †¢ â€Å"Key experiences† were designed specifically for this approach. The following is a brief summary of key experiences taken from Kostelnik, Soderman, & Whiren (1999, p. 32). The key experiences for preschool children are: -Creative representation -Classification -Language and literacy -Seriation -Initiative and social relation -Number -Movement -Space -Music -Time †¢ â€Å"Plan-do-review† is another major component of the High/Scope framework. Children are encouraged to: 1) plan the area, materials, and methods they are going to work with; 2) do, actually carry out their plan; and 3) review, articulate with the class-room community what they actually did during work time. The review time helps children bring closure to their work and link their actual work to their plan. †¢ Cleanup time is a natural part of plan-do-review. Children are given a sense of control by cleaning up. Representative labels help children return materials to appropriate places (Roopnarine & Johnson, 1993). †¢ The High/Scope classroom has a consistent routine. The purpose of the resulting predictability is to help children understand what will happen next and encourage them to have more control in their classroom. Environmental Set-Up †¢ The High/Scope ® classroom is a materials-rich learning environment. Usually, the locations for classroom materials are labelled to help children learn organizational skills. †¢ Materials are set-up so that they are easily accessible at a child’s level. This helps facilitate children’s active exploration. †¢ Teachers set up the classroom areas purposefully for children to explore and build social relationships, often with well-defined areas for different activities. Reggio Emilia Approach Reggio Emilia is a small town of northern Italy. The approach has become so popular in the early childhood field because it offers many unique curriculum ideas, because of the strong infrastructure for the Reggio schools, and because of the attention to co-construction. What Are the Reggio Emilia Approach’s Main Components? Social †¢ Cooperation and collaboration are terms that stress the value of revisiting social learning. First, children must become members of a community that is working together (cooperation). Once there is a foundation of trust between the children and adults, constructive conflict may be helpful in gaining new insights (collaboration). †¢ Co-construction refers to the fact that the meaning of an experience often is built in a social context. †¢ An atelierista is a teacher who has a special training that supports the curriculum development of the children and other faculty members. There is an atelierista in each of the Reggio Emilia pre-primary schools. †¢ Pedagogistas are built in as part of the carefully planned support system of the Reggio Emilia schools. The word pedagogista is difficult to translate into English. They are educational consultants that strive to implement the philosophy of the system and advocate for seeing children as the competent and capable people they are. They also make critical connections between families, schools, and community. Curriculum †¢ One of the special features of the Reggio Emilia approach is called â€Å"documentation. † Documentation is a sophisticated approach to purposefully using the environment to explain the history of projects and the school community. It does not simply refer to the beautiful classroom artwork commonly found throughout schools following Reggio Emilia Approach. And, even though it often incorporates concrete examples of both the processes and products that are part of a child’s education, it is more than just that. It is a fundamental way of building connections. Documentation is discussed in more detail in the next section that describes the uniqueness of the Reggio Emilia Approach. †¢ Co-construction increases the level of knowledge being developed. This occurs when active learning happens in conjunction with working with others (e. g.having opportunities for work to be discussed, questioned, and explored). Having to explain ideas to someone else clarifies these ideas. In addition, conflicts and questions facilitate more connections and extensions. There is an opportunity to bring in different expertise. Thus, to facilitate co-construction, teachers need to â€Å"aggressively listen† and foster collaboration between all the members of the community whenever possible. Real learning takes place when they check, evaluate, and then possibly add to each other’s work. †¢ Long-term projects are studies that encompass the explorations of teachers and children. †¢ Flowcharts are an organized system of recording curriculum planning and assessment based on ongoing collaboration and careful review. †¢ Portfolios are a collection of a child’s work that demonstrates the child’s efforts, progress, and achievements over time. Environmental Set-Up †¢ In Reggio Emilia, the environment is similar to that found in Montessori schools. However, the environmental set-up as a â€Å"third teacher† has been enhanced and extended in the Reggio Emilia approach. †¢ Like Montessori, it is believed beauty helps with concentration; the setting is aesthetically pleasing. †¢ Reggio Emilia schools create homelike environments. In Reggio, the homelike atmosphere is designed to help make children feel comfortable and learn practical life issues. †¢ Each child is provided a place to keep her own belongings. †¢ Documentation is a major part of the environmental set-up. Documentation illustrates both the process and the product. In documentation, the child is seen as an individual but also in relation to a group, with various possibilities for the individual. Question: An explanation of how different approaches to work with children in early years have affected current provision. 1. 3 Early years frameworks emphasize a personal and individual approach to learning and development because every child is unique and they develop and learn in different ways and at different rates, for this reason all areas of learning and development are equally important and inter-connected. Another reason is that experiences during the early years strongly influence a child’s future development. This means that the care and education that babies and young children receive to support their growth, development and learning must be of high quality and appropriate to their individual needs. Therefore, all practitioners should look carefully at the children in their care, consider their needs, their interests, and their stage of development and use all this information to help plan a challenging and enjoyable experience across all the areas of learning and development. In fact EYFS’s aim is to reflect the rich and personalised experience that many parents give their children at home. Like parents, providers should deliver individualised learning, development and care that enhances the development of the children in their care and gives those children the best possible start in life. Every child should be supported individually to make progress at their own pace and children who need extra support to fulfil their potential should receive special consideration. All providers have an equally important role to play in children’s early years experiences and they have to ensure that the provision they deliver is both appropriate to children’ needs. Question: An explanation of the Partnership model of working with carers 3. 1 Working with children means have a lot of responsibilities and one of the main ones is to have a positive partnership within the child setting’s staff and parents/carers. For this reason every child setting has its own policy to regulate relations between carers and carers and families. Positive partnership calls for: †¢ mutual respect and trust †¢ a recognition of equality between parents and professionals †¢ awareness of cultural and ethnic diversity †¢ partners to share information and skills. This means that good communication is essential to working with children, young people, families and carers. It helps build trust, and encourages them to seek advice and use services. It is key to establishing and maintaining relationships, and is an active process that involves listening, questioning, understanding and responding. †¢ an acknowledgement and sharing of feelings †¢ all parties to play a role in the decision making process. Question: A review of the Potential barriers to participation for carers, and an explanations of how these barriers may be overcome 3. 2 Barriers to partnership working There are many potential barriers to establishing a working partnership with parents, which can apply to both parties. Here are some of them: Time and availability. †¢ Finding a mutually convenient time and venue to meet †¢ Other demands from family and work †¢ Access and transport for some parents Language, culture and religion Cultural and/or religious attitudes towards disability †¢ Language barriers (there are no words for Down’s syndrome in Punjabi or Urdu) †¢ What is culturally acceptable Parents own education †¢ Negative feelings towards school and authority †¢ Feelings of inadequacy †¢ Fear of being judged Communication †¢ Poor communication channels (e. g. through the child only) †¢ Poor information sharing (what does go on in school? ) †¢ Automatic use of jargon. †¢ Shyness †¢ Lack of confidence School and staff †¢ Personal relationships between teacher and parent †¢ Limited facilities for meeting with parents †¢ Lack of empathy with the role of parent †¢ Lack of staff skills and confidence †¢ Access to relevant information †¢ An unwelcoming environment Parent and school †¢ Who to talk to? †¢ Lack of acceptance or awareness of child’s difficulties †¢ The value placed on education †¢ Young people not wanting parents involved †¢ Lack of information around transition periods (from one school to the next) †¢ Disinterest/lack of clear responsibility. †¢ Lack of consensus between parents Previous experience †¢ Negative previous experience †¢ Feelings of being judged †¢ Lack of action or follow up †¢ Being patronised Some ideas for overcoming barriers Communication †¢ Use regular newsletters to improve information flow †¢ Have a central information point e. g. regularly updated notice board †¢ Have a central contact point †¢ Exploit technology – web sites, email, blogs, text messaging †¢ Provide up to date information and a jargon buster †¢ Create regular meeting slots †¢ Create opportunities for informal as well as formal contact e.g. parents assemblies, social events. †¢ Collect parents views e. g. suggestion box, parent forum, parents’ spokesperson †¢ Involve parents in school activities †¢ Use home/school books and diaries †¢ Use email or phone if there is sensitivity about keeping a written record School and staff †¢ Develop staff skills in communication and listening †¢ Increase availability of staff and head teacher e. g. regular meeting slots, surgery times for 1-1 meetings †¢ Improve the range of activities in which parents can participate †¢ Make direct personal contact with parents †¢ Provide creche.

1984 Essays (376 words) - Nineteen Eighty-Four, Free Essays

In the appendix of Nineteen Eighty-Four George Orwell warns against the enormous power a regime can hold once it has control of the language. Winston, on the other hand, believes he is free as long as he can hold on the mathematical axiom, 2+2=4. Unfortunately, Winston grossly underestimates the sheer power held be Oceania?s totalitarian regime. With the Inner Party at the helm, Oceanian society has been deliberately drawn down to a deep, inescapable socioeconomic morass, with Party exercising its conscious aim of nurturing a state of ?unfreedom and inequality?. Having learnt a great deal from totalitarian regimes that had failed in the past, the Inner Party became a small ruling group that was determined to create a societal structure that would ensure the Party maintained a permanent stronghold over Oceania and its people. Unlike their predecessors, the Inner Party was comprised of people who were ?less avaricious, less tempted by luxury, hungrier for pure power, and above all, mor e conscious of what they were doing and more intent on crushing opposition. From this steely resolve of the Inner Party to be the eternal guardians of power in Oceania stems the wide and varied sources of truth and power held be the totalitarian regime. Collectively, these sources present a frightening combination that, fundamentally, serves to destroy the essence of the human spirit and to ensure the ruling group an endless reign of power. As Orwell details in the appendix of the novel, control over language is one of the major sources of truth and power held by Oceania?s totalitarian regime. The introduction and steady implementation of Newspeak as the language of choice for Party members, meant that the Party effectively assumed control of the boundaries of human expression and thought. The elimination of words and phrases considered unfavourable to the Party and its ideals made it extremely difficult to express conflicting or derogatory views towards the Party. And, with this su ppression of free thought through language, the Party is also able to eliminate unwanted ideas, emotions, and ideals associated with those words. The embodiment of the slogan ?Ignorance is Strength? is another source of power for the totalitarian regime in Oceania. The Party exploits the basic idea that ignorant people are content people.

Detailed research on the history of Jesus Christ and Christianity Essay

Detailed research on the history of Jesus Christ and Christianity - Essay Example Josephus mentions Jesus the Messiah in the book. Furthermore Eusebius, an early Christian Bishop, recorded the words of Josephus in 324 A.D. Josephus said that Jesus was an extraordinary and wise man (if he can be called a man). Many of the Jews and Greeks trusted him. He was condemned to the cross, but his disciples followed him and believed in his message. Due to his hardships, his tribe of Christians is present to this day. (Argubright, 2007) The religion started about 2000 years ago in present day Israel previously known as Judea. Jesus Christ and his group of disciples began preaching amid much controversy and hostility. The ruler at that time was a Roman and Judea was cross cultural centre of bustling cities and farms. Majority of the locals who were Jewish found the polytheistic beliefs of Rome intrusive and pagan. (All About Religion, 2008) According to Gospel accounts Jesus was born to a virgin Jewess Mary who conceived him by the miracle of the Holy Spirit. Luke the evangelist says that Mary and her husband Joseph were traveling from Nazareth to Bethlehem to avoid registering (the Roman emperor had ordered a census of the population) the birth of Jesus in Jerusalem. The birth took place in a stable due to unavailability of vacancy in the inn and after the birth, an angel informed three local shepherds about it. Mathew however takes a much more troubled story. According to him, three Magi of the East follow a star to Bethlehem and on their way, inform Herod (the King of Palestine) that they are on their way to see the newly born king of the Jews. Herod orders the massacre of all the male children under the age of two for fear of rivalry. Fortunately an angel informs Joseph who escapes with Mary to Egypt. After the death of Herod, another angel tells Joseph that it's safe to return. The census was held in 6 BC. and Her od died in 4BC. Thus it is concluded that Jesus was born around 6BC. (Gascoigne, 2008) Early Life: Regarding the early life of Christ the gospels are virtually silent. However, facts gathered from various source indicate that Jesus was from a small town called Nazareth where he trained as a carpenter. He spoke Aramaic but he also knew Greek since he used it to talk with the Roman Officials during his time of having the government. Jesus was a Jew and he practiced the Jewish faith. He was also well aware of Jewish laws. The only other fact reported in the Gospel after the birth of Christ is that one day, the 12 year old Jesus wanders away from his parents to a religious temple. Upon return, when Mary scolds him, he asks, 'Didn't you know I would be in my Father's house' (Religion Facts, 2007) The Ministry of Jesus: Jesus is mentioned again in the gospel at the age of 30. It begins by the Baptism of Christ by John the Baptist. This event marks the beginning of Jesus's ministry. Several of John's followers left to follow Jesus after the Baptism. He then proceeded to select several other disciples establishing a group of 12. (Religion Facts, 2007) To all those who listened, Jesus taught to learn their enemies, not to judge others, not to be anxious about the future, trust in God. Jesus Christ often taught with parables, a short story with a spiritual meaning. Some were easy while others hard to understand. Mathew chapter 13 has several parables. One

Market strategy, Market positioning and Marketing-Mix Assignment

Market strategy, Market positioning and Marketing-Mix - Assignment Example Furthermore, Metrao faces increasing competition from other calorie calculators being sold in the market. Generally, this means that Metrao is obliged to differentiate its products from others in the market by being innovative and unique. In addition to, the calorie calculator market is growing showing that there are likely to be diverse consumer needs and expectations. Consequently, Metrao should utilize strategic marketing tools to get an actual picture of the level of competition in the market and the customers’ needs. A marketing strategy is a process that enables a company to focus its limited resources on the strategic opportunities to attain a sustainable competitive advantage and increase their sales volumes (West, Ford, and Ibrahim 57). A marketing strategy should be based on consumer satisfaction. A marketing strategy is made up of different aspects such as pricing, product development, promotion, distribution and relationship management. Further, it establishes the choice of marketing mix, positioning, target market segments and relationship management. Some of the strategies adopted by the company include the PESTLE and the SWOT analysis. Marketing Mix This primary marketing strategy adopted in the promotion of Metrao. Generally, four aspects in the 4Ps strategy include product, place, price and promotion. The first element of the marketing strategy is product (Schroeder 11). Product refers to the product or service being offered in the market. Metrao is a calorie calculator that enables people keep track of the calorie intake on their daily basis for healthy purposes. This device includes a database approximates the protein, calorie, fat and carbohydrate intake. In addition to, the device offers a recommendation of the appropriate diet for different users. The device is also used o approximate how many calories an individual can cut down on a daily basis. Consumers buy products based on their perceived value of it. For this reason, Metrao en sures product value for its consumers by ensuring consumer satisfaction. Price is the second aspect that greatly influences customers’ decision to buy give product or service. Furthermore, it the only aspect in the Marketing Mix that generates profits. However, the company resolved not to put a selling price on Metrao but opted to get profits from the product’s promotion. In other words, the company is undertakes promotional pricing to generate profits and compete with other players in the market (Robinson 78). However, the company intends to set a reasonable price once the consumers are fully aware of the existence of the product in the market. Promotion is the way in which information about a product is brought to the attention of the consumers. The company has a brand name and intends to raise its awareness using a wide range of advertising campaigns staged on offline and online marketing channels. The company also promotes its products on its website that was recen tly established to target the online market segment. The final aspect of the marketing mix is place and it relates to where a certain product can be purchases and how the buyers can easily access it. The product will be available in the company’s stores, the company’s website and other shops that sell health related products. The product will be sold in the UK and if it performs well, it will be introduced in other parts of the world. SWOT analysis The company

Comparing Short Stories Essay Example | Topics and Well Written Essays - 500 words

Comparing Short Stories - Essay Example Through the use of plot, tone, and irony, the authors were able to convey that during the realism era of France people were separated by the concepts of wealth and destitution, eventually succumbing to the fact that money never equated to happiness. Though the plots of both stories do differ from each other in the events that lead to their conclusions, they still share the same general idea: each male protagonist starts off with a comfortable life, perhaps not entirely rich, but with money enough to make them pleased with their lives. Due to circumstances, they each find themselves in a position that compromises this wealth and comfort. This is where the similarity ends. Monsieur Lantin sells off his late wife’s jewelry, making him incredibly rich. He dwells in this feeling, though eventually marries another woman who is angry and appalling. Rich he may be, but Lantin had lost his comfort of life. The banker, convinced that the young man would not see out his part of the bet, lives happily, spending money and losing it frivolously. When it becomes apparent that the banker will have to pay the young man, he realizes that he no longer has the money, and the only solution he can come upon is to kill the young man before the time is up. When he goes to perform this horrific deed, he comes upon a note from the young man stating that he despises what money does to people and says that he will not follow though with his part of the debt. The banker is relieved, though upset that he would even consider committing such a crime for money. These plot ideas show that, despite what these men were able to do with their money, they still ended up being morose. The tone of â€Å"The Jewels of M. Lantin†, at the beginning of the story, was cheerful and exuberant, as Monsieur Lantin proposed and lived happily married to one of the prettier girls of the the town. As the story went on, the tone changed to exasperation, then despair as his wife

How global warming affects animals Essay Example | Topics and Well Written Essays - 3000 words

How global warming affects animals - Essay Example The current literature blames the inability of policy makers and politicians to design measures that can help curb further destructions on climate. In fact, most nations lack political will to mitigate the impacts global warming poses on animals. The current literal works of researchers underscore on the need for the world to focus its activities towards protection of the environment but does not say about the future and uncertainty surrounding animals as global warming gets to its extreme. This paper takes the assumption that the situation of global warming is typical fight between cases of survival for the fittest against the selection of the fittest by Global Warming. This means that with time, every animal species in the globe will adapt to global warming in varying ways. For example some animals will undergo genetic regeneration whereas others will simply die. I plan to organize my paper by discussing the main points as earlier stated while giving a detailed analysis concerning the impact of global warming on animals on such matters as habitat displacement, breeding, hibernation and migration behaviours. in this regard, the points will be arranged chronologically. Melting ice in the polar region has caused flow of water disturbing natural habitats of polar bears in the arctic regions. In addition, the breeding environments for waterfowl in the prairie pothole region of north Iowa and central Alberta has been adversely affected due to rising temperatures in the springs. Animals often move into new habitats whenever their current habitats become elusive to their survival. However, the current human population limits this movement since land that would otherwise have been suitable in accommodation Global warming raises temperatures within the arctic regions of the world which is the main habitat of polar bears. In addition, raised temperatures in the springs destroy breeding conditions of waterfowl

Peer response Article Example | Topics and Well Written Essays - 250 words - 11

Peer response - Article Example re that manager or leaders of nursing homes have comprehensively evaluated techniques and strategies that would ensure continued existence of these nursing homes. Factors that are within management’s control are costs, which they deemed, should be kept at a minimum, to generate profits, as needed. Another comment is that team learning and shared mental models are internal factors that management could tap to increase job satisfaction and productivity (Bossche, Gijselaers, Segers, Woltjer, & Kirschner, 2011). But these alone, could not ensure increased profits, if and when not enough revenues are generated by nursing homes. I share the same contention, however, that ‘in times of economic scarcity, cutting back on teamwork is a mistake, as teamwork is needed then more than ever’. Actually, in diverse settings, regardless of economic condition, organizations should harness the power of teamwork as a means of improving performance and productivity. Teamwork should go beyond teams in respective departments of the organizations; but more so, the collaborative departments that comprise the entire organization. As such, shared decision models would be useful in soliciting responsible inputs from different departments to facilitate achievement of the organization’s

The Impact of Direct Digital Manufacturing on Supply Chains Essay

The Impact of Direct Digital Manufacturing on Supply Chains - Essay Example Eyebrows are getting raised over the potential of DDM in cutting the demand for logistics services, as products would be manufactured at the place of demand or use. Effect of DDM would be felt in all industry sectors for meeting urgent product needs, providing customized products and parts of products, which were earlier supplied in bulk through the logistics industry. The crucial question before the logistics businesses worldwide is whether DDM would affect the business of logistics industry for transporting goods from one location to another. Naturally future repercussions of the innovation in technology cannot be denied. When customized parts could be accessed from the local DDM in a cost-effective and faster way, who would like to order it through a logistics process? Possibility of getting parts supplied locally becomes more evident for implementing changes in the designs of products. Actually, the risk to logistics business is genuine because no company would like to pay airfre ight for getting a part from abroad when it can be produced locally but the business of DDM depends on innovation in concepts; only genius is not enough. If an idea is good enough, it will take time in proto-typing. 3D printing also requires time to process a concept into a product. It would start a war-like environment for safeguarding intellectual property. Imitators and innovators, both would make attempts to present their products fast to the market (â€Å"3D Printing† par. 27). For getting competitive edge from the given scenario, only those companies would get the leverage that would plan a long-term marketing strategy without considering the profit factor. Delivery of products would demand accuracy of timing in taking the products to the customer locations (â€Å"3D Printing† par. 30). A look at the business growth of DDM can help in evaluating the potential of new technology sweeping the stakes of supply chains. Seeing the latest market trends on manufacturing solid products by 3Dprinters, business in additive manufacturing reached $1.2 billion in 2008 and the possibility is that it could double in size by 2015. For understanding the impact of DDM business on logistics, some crucial data analysis is mandatory such as 75% of the sale of 3D printers has been registered for producing common sort of products while the balanced sale of the 3D printers has been made for producing industrial products. With the approaching time, there would be increase in the sale of cheap 3D printers, which can be to the tune of 90% market as price depreciates and functionality improves of 3D printers. Demand of the DDM machine is increasing not only for model-making and rapid prototyping, but for all types of machines for producing finished products as well (â€Å"A factory on your desk† par. 4). The only difference between the industrial revolution of the 1800s and the seeming-revolution of the future is that the manufacturing industry won’t be a ble to get the benefit of economies of scale that comes with bulk production. Another difference would be seen in the distribution of capital, employment, and intellectual property, thus, indirectly affecting the logistics business as any impact on various industries would get reflected in logistics, affecting its business potential (â€Å"Print me a Stradavarius† par. 9). Have a look at the success story of a U.S. company. Seeing the current status of rapid manufacturing (RM) in the business of making invisible dental braces, U.S. based Invisalign

Pre-writting Essay Example | Topics and Well Written Essays - 500 words

Pre-writting - Essay Example For instance, if you say that Joy is 90 years old, it automatically means that Joy is over 20 years even without mentioning that in the premise. This is because 20 is less than 90 and that it can validated by that, on the same not if Joy is 20 years, then you could not say that she is 90 years because it cannot be validated by the conclusion. The chapter then emphasizes on the arguments that are sound, effective, and cogent. The conclusion of a statement should be carved from the premise of the same sentence, this is what the book tries to put forth in terms of developing a research paper. The chapters have given a legion ways of ensuring that your writing is carefully argued with precaution of not falling into the trap of vagueness. For the authors to make the audience understand the points that they wants taken, they fondly use rhetorical strategies, this means that the author has to consider several factors before choosing on which rhetorical strategy to be used as it determines how the information will be consumed by the intended person. In the case of this book, the author has in forms those rhetorical analyses are important for communicating your purpose of writing and that one has to choose carefully which one to use when developing a research paper (Faigley and Selzer 244). The author has also informed that writing different research papers calls for different use of rhetorical analyses, for instance the way one would report a science paper based on a laboratory research is different with the way a paper that in forms on how something comes into existence or the working mechanism of a process. This book forms the basis of good writing especially for those who want to give a concise paper on their writings. Logical and sound writing is important for the conveyance of intended information, otherwise, the intended meaning of the whole process will no longer hold

Tap Dance in America Essay Example for Free

Tap Dance in America Essay According to Funk Wagnalls New World Encyclopedia, â€Å" tap dance [is a] style of American theatrical dance, distinguished by percussive footwork, [which] marks out precise rhythmic patterns on the floor.† Also, â€Å"Tap is an exciting form of dance in which dancers wear special shoes equipped with metal taps. Tap dancers use their feet like drums to create rhythmic patterns and timely beats,† Treva Bedinghaus, graduated from Holli Barrons School of Performing Arts and The Ballet Academy, writes in Tap for beginner, â€Å"The term tap dancing is derived from the tapping sound produced when the small metal plates on the dancers shoes touch a hard floor or surface. † In 125 Years of Tap, Jane Goldberg, a dancer-writer who is considered as one of the most prolific voices in the filed of tap dancing, writes: â€Å"What distinguishes tap [dancing] from most other dance forms is that it is two arts in one: music and dance. The dancers are ‘playing their feet’ and moving at the same time.† In another article The Art of Tap Dancing, Amy Brinkman-Sustache, artistic director of Dance-works on Tap (DOT), describes, â€Å"A step is a word. You put steps together to make a sentence. Questions are raised and answered through rhythm. It’s like listening to a conversation.† Literally, tap is America’s unique contribution to dance. â€Å"Tap history is mostly an oral tradition,† Kikelly, performer/scholars from Virginia Tech, says, â€Å"and a single definitive history has not yet been written.† Still, Kikelly and many other people like her are working hard to reveal the truth about how this art form developed. Tap is believed the double of diversity. â€Å"The history of tap has been a story of survival, revival, renaissance and innovation,† Jane Goldberg indicates in her 125 Years of Tap article, â€Å"the controversial roots of which arc still being debated, though the primary sources are usually considered to be Irish and African-American.† According to Constance Valis Hill, Ph.D. in Performance Studies from New York University, â€Å"tap dance is an indigenous American d ance genre that evolved over a period of some three hundred years. Initially a fusion of British and West African musical and step-dance traditions in America, tap emerged in the southern United States in the 1700s. The Irish jig (a musical and dance form) and West African gioube (sacred and secular stepping dances) mutated into the American jig and juba. These in turn became juxtaposed and fused into a form of dancing called â€Å"jigging† which, in the 1800s, was taken up by white and black minstrel-show dancers who developed tap into a popular nineteenth-century stage entertainment.† Furthermore, â€Å"early styles of tapping utilized hard-soled shoes, clogs, or hobnailed boots. It was not until the early decades of the twentieth century that metal plates (or taps) appeared on shoes of dancers on the Broadway musical stage,† Hill summarizes, â€Å"in the late twentieth century, tap dance evolved into a concertized performance on the musical and concert hall stage. Its absorption of Latin American and Afro- Caribbean rhythms in the forties has furthered its rhythmic complexity. In the eighties and nineties, tap’s absorption of hip-hop rhythms has attracted a fierce and multi-ethnic new breed of male and female dancers who continue to challenge and evolve the dance form, making tap the most cutting-edge dance expression in America today.† Yet, according to theatredance.com, â€Å"no one really knows when the phrase ‘tap dance’ was first used – perhaps as early as 1900 – but it didn’t appeared in print until around 1928.† â€Å"Unlike ballet with its codification of formal technique, tap dance developed from people listening to and watching each other dance in the street, dance hall, or social club where steps were shared, stolen and reinvented. ‘Technique’ is transmitted visually, aurally, and corporeally, in a rhythmic exchange between dancers and musicians. Mimicry is necessary for the mastery of form,† Hill points out. Moreover, she continues indicating, â€Å"The dynamic and synergistic process of copying the other to invent something new is most important to tap’s development and has perpetuated its key features, such as the tap challenge. [†¦] The oral and written histories of tap dance are replete with challenge dances, from jigging compe titions on the plantation that were staged by white masters for their slaves, and challenge dances in the walk-around finale of the minstrel show, to showdowns in the street, displays of one-upsmanship in the social club, and juried buck-and wing-contests on the vaudeville stage.† Indeed, Jane Goldberg also writes, â€Å"one documented fact is that many tap legends began performing any place they could — especially street corners — before the discipline Invaded vaudeville shows and, eventually, the silver screen. In a contest by the performers to outdo one another, tap kept evolving, transforming into an art form of self-expression as well as highly stylized production numbers.† For such a long time, tap was considered â€Å"a man’s game† or even â€Å"a largely black, male-dominated form.† People easily notice various famous male tap dancers in history like Bill Bojangles Robinson (1878-1949), John W. Bubbles (1902-1986), or Sammy Davis Jr. (1925-1990). Female dancers, in contrast, were not very honored in history books. Yet, Jane Golden presents, â€Å"a number of young white women got into the act starting in the mid-1970s. These women studied and often performed with their male mentors,† even though the fact Stacie Strong has noted in History, Herstory, OUR STORY article: â€Å"While male tap dancers acted as headliners, women tappers filled out the chorus lines. Though many of their names have been lost, these women were incredibly versatile and talented. Headliners often did the same act week after week (or even year after year), but the chorus had to learn a new routine every few weeks, often working with props and in outlandish costumes, performing as many as four shows a day.† Professor Constance Valis Hill’s inclusive history is the first to also highlight the outstanding female dancers, she wrote in Tap Dance in America: A Very Short History, â€Å"In 1986, La Mama presented Sole Sisters an all woman, multi-generational tap dance show directed by Constance Valis Hill that brought together high-heeled steppers and low-heeled hoofers, the veteran grande dames of tap and younger prima taperinas.† Next, she indicates, â€Å"Soul Sisters was not the only production to open the door for the recognition of female jazz tap dancers. On the West Coast Lynn Dally, who founded the Jazz Tap Ensemble in 1979, combined her extens ive experience in modern dance with jazz tap to organize a group of dancers that insisted on performing and interacting with a live jazz ensemble. On the East Coast, singer, jazz and tap dancer Brenda Bufalino, formerly a partner of Honi Coles, founded the American Tap Orchestra, and set about experimenting with how to layer and orchestrate rhythmic groups of dancers on the concert stage.† â€Å"Today the type of tap that mostly closely resembles the style current during Robinsons era is jazz or rhythm tap. These dancers concentrate on improvisation and choreography that incorporate the complicated rhythms of classic jazz music. Often they look crouched over, listening to their feet — and thats exactly what theyre doing. While some rhythm tappers have begun choreographing for their upper bodies, the emphasis is still on the dancers hearing themselves. The mentors of todays leading rhythm tappers have often been called ‘hoofers’,† writes Jane Goldberg. In addition, The Basic Characteristics of Tap Dancing shows, â€Å"Tap dancers make frequent use of syncopation. Choreography typically starts on the eighth or first beatcount. Another aspect of tap dancing is improvisation. This can either be done with music and follow the beats provided or without musical accompaniment, otherwise known as acappella dancing.† This article also points out another major variations on tap dance, besides rhythm tap: â€Å"Early tappers like Fred Astaire provided a more ballroom look to tap dancing, while Gene Kelly used his extensive ballet training to make tap dancing incorporate all the parts of the ballet. This style of tap led to what is today known as Broadway style, which is more mainstream in American culture.† Specially, the article give some examples of common tap steps and how professional tap dancers make their new steps: Common tap steps include the shuffle, shuffle ball change, flap, flap heel, cramp roll, buffalo, Maxi Ford, single and double pullbacks, wings, Cincinnati, the shim sham shimmy (also called the Lindy), Irish, Waltz Clog, the paddle and roll, the paradiddle, stomp, brushes, scuffs, and single and double toe punches, hot steps, heel clicks, single, double and triple time steps, riffs, over-the-tops, military time step, New Yorkers, and chugs. In advanced tap dancing, basic steps are often combined together to create new steps. Timesteps are widely used in tap and can vary in different areas. These consist of a rhythm that is changed to make new timesteps by adding or removing steps. The images of tap dancer and their shoes has also changed, especially for female dancers: â€Å"Boundaries have shifted dramatically since the 1970s, when high-heeled tap shoes were reserved for Broadway-style tap and flat oxford-style shoes were associated with rhythm tap,† according to Darrah Carr MFA from New York Universitys Tisch School of the Arts. Additionally, Carr notes that â€Å"Introductory high-heeled taps range from 1†³ to 1 ½Ã¢â‚¬ ³ high, while more advanced heels can be up to 3†³ high. [†¦] Dancing in heels also forces you to hold your body more upright, which can change your stage presence. [†¦] ‘Heels encourage you to incorporate your hips and your shoulders into your dancing and wearing heels makes you think about extending the line of your leg’. In contrast,  "many tap dancers find that nothing beats the comfort of flats,† Carr reveals, â€Å"Flat tap shoes are made in the same oxford style for women and men, and many dancers feel that the shoe looks best when paired with pants or jeans. And flats have larger metal taps than heels, so the sound produced is a deeper, heavier bass tone. (The smaller metal taps on high-heeled shoes create sounds that are higher in tone.)† Another ideas showed by Carr are: â€Å"A dancers body placement in flat tap shoes is centered between the toes and heels. [And] certain steps, such as side shuffles and toe stands, are easier to execute in flats because your weight is more evenly distributed.† Still, â€Å"Whether youre a heels lover or forever committed to flats, its important that you become comfortable with both shoe styles,† she advises. Indeed, according to Elena North-Kelly, â€Å"High heeled, low heeled, soft leather, hard leather, split soled, and full soledall tap shoes are not created equal. Different styles of tap shoes facilitate different styles of tap dancing. When shopping for a shoe, you need to consider comfort, flexibility, aesthetic, shape, and, of course, sound.† Also, North-Kelly quotes a statement from Lynn Schwab, who teaches tap at New York Citys Steps on Broadway, to help people with choosing tap shoes: While part of a tap dancers sound is a product of technique, it also relates to the material of the shoe. For rhythm tapping, the best sound comes from a harder shoe with a wider heel. Finally, North-Kelly says, â€Å"Dancers hoping for a career on Broadway, however, have a little more leeway, partly because most Broadway dancers use different tap shoes for performance, classes, and auditions.† Briefly, with a relatively brief but rich history, the tap tradition is growing bigger, better and broader every year. In fact, holding an enormous respect for the past, Jason Samuels Smith, the first tapper to win an Emmy award for choreography since Hermes Pan in 1958, used to say: â€Å"Tap culture is all about celebrating the past and accumulating its vocabulary over time. If we don’t maintain our history, we lose what’s valuable about tap.† He is not the only person who thinks that way, Donna-Marie Peters – professor at Temple University, also express her ideas in Passing On: The Old Head/Younger Dancer Mentoring Relationship in the Cultural Shpere of Rhythm Tap: Respect for the artistic tradition of tap is the value that humbles even the most seasoned performers. This value demands subservience to the art that is seen as bigger than the individual and takes a lifetime to master. By honoring the art over the individual, the tap dancers become servants to the art, working to the best of their ability to execute it well. The long-term survival of this struggling art form is dependent on a cot munity of individuals with a sense of purpose, dedicated to keeping the art form alive and moving forward. Works Cited TAP DANCE. (n.d.): Funk Wagnalls New World Encyclopedia. EBSCO. Web. 26 Oct. 2011. Bedinghaus, Treva. Tap for Beginners. About.com n. pag. Web. 26 Oct 2011. http://dance.about.com/bio/Treva-Bedinghaus-32821.htm Carr, Darrah. Heels vs. Flats. Dance Spirit 14.8 (2010): 98. MAS Ultra School Edition. EBSCO. Web. 26 Oct. 2011. Hill, Constance. â€Å"Tap Dance in America: A Very Short History.† (2002): n. pag. Web 26 Oct 2011. http://www.nypl.org/locations/tid/55/node/70581 Holmes, Vance. All ABout Tap Dance. TheatreDance.com n. pag. Web. 26 Oct 2011. http://www.theatredance.com/tap/. Goldberg, Jane. â€Å"125 Years of tap.† Dance Spirit 7.5 (2003): 34. Academic Search Premier. EBSCO. Web. 26 Oct. 2011. North-Kelly, Elena. Tap Shoes Meet These Dancing Feet. Dance Magazine 79.3 (2005): 68. MAS Ultra School Edition. EBSCO. Web. 26 Oct. 2011. Peters, Donna-Marie. â€Å"Passing On: The Old Head/Younger Dancer Mentoring Relationship in the Cultural Shpere of Rhythm Tap.† Western Journal of Black Studies 34.4 (2010): 438-436. Academic Search Premier. EBSCO. Web. 26.Oct.2011. Schneider, John. â€Å"The Art of Tap Dancing.† n. pag. Web. 26 Oct 2011. http://www.expressmilwaukee.com/article-11832-the-art-of-tap-dancing.html Strong, Stacie. â€Å"History, Herstory, OUR STORY,† Dance Spirit 11.10 (2007): 62. MAS Ultra – School Edition. EBSCO. Web. 26 Oct 2011. The basic characteristics of tap dancing. Ballet Shoes n. pag. Web. 26 Oct 2011. http://shoes-collection.net/2011/10/05/tap-shoes-capezio/.

Effects of Behavioral Interventions on Disruptive Behavior and Affect in Demented Nursing Home Residents Essay Example for Free

Effects of Behavioral Interventions on Disruptive Behavior and Affect in Demented Nursing Home Residents Essay Behavioral interventions might ameliorate them and have a positive effect on residents’ mood (affect). Objectives: This study tested two interventions—an activities of daily living and a psychosocial activity intervention—and a combination of the two to determine their efficacy in reducing disruptive behaviors and improving affect in nursing home residents with dementia. Methods: The study had three treatment groups (activities of daily living, psychosocial activity, and a combination) and two control groups (placebo and no intervention). Nursing assistants hired specifically for this study enacted the interventions under the direction of a master’s prepared gerontological clinical nurse specialist. Nursing assistants employed at the nursing homes recorded the occurrence of disruptive behaviors. Raters analyzed videotapes filmed during the study to determine the interventions’ influence on affect. Results: Findings indicated significantly more positive affect but not reduced disruptive behaviors in treatment groups compared to control groups. Conclusions: The treatments did not specifically address the factors that may have been triggering disruptive behaviors. Interventions much more precisely designed than those employed in this study require development to quell disruptive behaviors. Nontargeted interventions might increase positive affect. Treatments that produce even a brief improvement in affect indicate improved quality of mental health as mandated by federal law. Key Words: affect †¢ Alzheimer’s disease †¢ behavior therapy †¢ dementia †¢ nursing homes Nursing Research July/August 2002 Vol 51, No 4 proximately 1. 3 million older Americans live in nursing homes today (Magaziner et al. , 2000). By 2030, with the aging of the population, the estimated demand for long-term care is expected to more than double (Feder, Komisar, Niefeld, 2000). Thus, nursing home expenditures could grow from $69 billion in 2000 to $330 billion in 2030 (Shactman Altman, 2000). About half of new nursing home res idents have dementia (Magaziner et al. , 2000). The disease has an impact on four major categories of functioning in persons with dementia. These are disruptive behavior (DB), affect, functional status, and cognition (Cohen-Mansfield, 2000). This article will focus on the first two categories. Disruptive behavior has received much more attention than affect has (Lawton, 1997), perhaps for three reasons. First, more than half (53. 7%) of nursing home residents display DB with aggression (34. 3%) occurring the most often (Jackson, Spector, Rabins, 1997). Second, DB threatens the wellbeing of the resident and others in the environment. Consequences include: (a) stress experienced by other resiCornelia K. Beck, PhD, RN, is Professor, Colleges of Medicine and Nursing, University of Arkansas for Medical Sciences. Theresa S. Vogelpohl, MNSc, RN, is President, ElderCare Decisions. Joyce H. Rasin, PhD, RN, is Associate Professor, School of Nursing, University of North Carolina. Johannah Topps Uriri, PhD(c), RN, is Clinical Assistant Professor, College of Nursing, University of Arkansas for Medical Sciences. Patricia O’Sullivan, EdD, is Associate Professor, Office of Educational Development, University of Arkansas for Medical Sciences. Robert Walls, PhD, is Professor Emeritus, University of Arkansas for Medical Sciences. Regina Phillips, PhD(c), RN, is Assistant Professor, Nursing Villa Julie College. Beverly Baldwin, PhD, RN, deceased, was Sonya Ziporkin Gershowitz Professor of Gerontological Nursing, University of Maryland. A Note to Readers: This article employs a number of acronyms. Refer to Table 1 to facilitate reading. 219 220 Effects of Behavioral Interventions Nursing Research July/August 2002 Vol 51, No 4 TABLE 1. Acronyms Term Activities of daily living Analysis of variance Apparent affect rating scale Arkansas Combined Disruptive behavior(s) Disruptive behavior scale Licensed practical nurse(s) Maryland Mini mental status exam Negative visual analogue scale Nursing home nursing assistant(s) Observable displays of affect scale Positive visual analogue scale Project nursing assistant(s) Psychosocial activity Research assistant(s) Acronym ADL ANOVA AARS AR CB DB DBS LPN MD MMSE NVAS NHNA ODAS PVAS PNA PSA RA decreases in targeted behaviors (Gerdner, 2000; Matteson, Linton, Cleary, Barnes, Lichtenstein, 1997). However, others reported nonsignificant reductions (Teri et al. , 2000), no change (Churchill, Safaoui, McCabe, Baun, 1999), or increased behavioral symptoms (Mather, Nemecek, Oliver, 1997). These studies used nursing home staffs to collect data, had sample sizes below 100, and measured an array of DB with different assessments. Only in the last decade have researchers investigated affect. Compared to studies to reduce DB, far fewer studies have measured interventions using affect as an outcome measure. Studies reported positive outcomes on affect from such interventions as simulated presence therapy (Camberg et al. , 1999), Montessori-based activities (Orsulic-Jeras, Judge, Camp, 2000), advanced practice nursing (Ryden et al. , 2000), music (Ragneskog, Brane, Karlsson, Kihlgren, 1996), rocking chair therapy (Watson, Wells, Cox, 1998), and pet therapy (Churchill et al. , 1999). The studies on affect used global measures that relied on observer interpretation, which could have compromised objectivity. Theoretical Bases A number of conceptual frameworks have guided intervention research on persons with cognitive impairment (Garand et al. , 2000). The theoretical basis for this study was that individuals have basic psychosocial needs, which, when met, reduce DB (Algase et al. , 1996) (Table 2). The interventions, one focusing on activities of daily living (ADL) and the other focusing on psychosocial activity (PSA), and a combination (CB) of the two, were developed to meet most of the basic psychosocial needs that Boettcher (1983) identified. These included territoriality, privacy and freedom from unwanted physical intrusion; communication, opportunity to talk openly with others; self-esteem, respect from others and freedom from insult or shaming; safety and security, protection from harm; autonomy, control over one’s life; personal identity, access to personal items and identifying material, and cognitive understanding, awareness of surroundings and mental clarity. The section on study groups specifies which interventions were designed to meet which needs. Positive affect usually accompanies interventions that meet basic psychosocial needs (Lawton, Van Haitsma, Klapper, 1996). Several researchers and clinicians have suggested that displays of affect may offer a window for revealing demented residents’ needs, preferences, aversions (Lawton, 1994), and responses to daily events (Hurley, Volicer, Mahoney, Volicer, 1993). The study reported here dents and staff; (b) increased falls and injury; (c) economic costs, such as property damage and staff burn-out, absenteeism, and turnover; (d) emotional deprivation such as social isolation of the resident; and (e) use of physical or pharmacologic restraints (Beck, Heithoff, et al. 1997). Third, before the Nursing Home Reform Act (Omnibus Budget Reconciliation Act, 1987), nursing homes routinely applied physical and chemical restraints to control DB with only moderate results (Garand, Buckwalter, Hall, 2000). However, the Act mandated that residents have the right to be free from restraints imposed for discipline or convenience and not required to treat the residents’ medical symptoms. Thus, researcher s have tested a wide range of behavioral interventions to reduce DB and replace restraints. The Act (1987) also stipulated that all residents are entitled to an environment that improves or maintains the quality of mental health. Interventions that promote positive mood or affect fulfill this entitlement. Therefore, this article will report the effects of an intervention to increase functional status in activities of daily living (Beck, Heacock, et al. , 1997), a psychosocial intervention, and a combination of both on reducing DB and improving affect of nursing home residents with dementia. TABLE 2. Basic Psychosocial Needs Relevant Literature Literature suggests that behavioral interventions offer promise in managing DB. A wide range of modalities and approaches have been tested: (a) sensory stimulation (e. g. , music); (b) physical environment changes (e. g. , walled garden); (c) psychosocial measures (e. g. , pet therapy); and (d) multimodal strategies. Many studies found significant Territoriality Communication Self-esteem Safety and security Autonomy Personal identity Cognitive understanding Nursing Research July/August 2002 Vol 51, No 4 Effects of Behavioral Interventions 221 adopted the inference by Lawton et al. (1996) that frequent displays of positive affect when basic psychosocial needs are met might indicate improved emotional wellbeing. is leg continually and without apparent reason needs redirection. This intervention lasted 45–60 minutes a day during various ADL. PSA Intervention. A PNA also conducted the PSA intervention, which involved 25 standardized modules designed to meet the psychosocial needs for communication, selfesteem, safety and security, personal identity, and cogni tive understanding through engagement in meaningful activity while respecting the individual’s unique cognitive and physical abilities (Baldwin, Magsamen, Griggs, Kent, 1992). The intervention was chosen because it: (a) provided a systematic plan for the PNA to address some of the participant’s basic psychosocial needs; and (b) represented clinical interventions that many long-term care facilities routinely used, but had not been formalized into a research protocol or systematically tested. Each module contained five psychosocial areas of content (expression of feelings, expression of thoughts, memory/recall, recreation, and education) and stimulated five sensory modalities (verbal, visual, auditory, tactile, and gustatory/olfactory). For instance, Activity Module I involved life review, communicating ideas visually (identifying and making drawings), clapping to different rhythms, massaging one’s face, and eating a snack. Initially, many participants tolerated less than 15 minutes of the activity but eventually habituated and participated 30 minutes. CB Intervention. This treatment consisted of both the ADL and PSA interventions and lasted 90 minutes daily. Placebo Control. This involved a one-to-one interaction between the participant and PNA. It controlled for the effect of the personal attention that the PNA provided to the three treatment groups. The PNA asked the participant to choose the activity, such as holding a conversation or manicuring nails. It lasted 30 minutes a day. No Intervention Control. This condition consisted of routine care from a NHNA with no scheduled contact between participants and the PNA. Instruments: Disruptive Behavior Scale. The 45-item disruptive behavior scale (DBS), designed to construct scores based on the occurrence and severity of behaviors, assessed the effect of the interventions on DB (Beck, Heithoff et al. 1997). Gerontological experts (n 29) established content validity, and interrater reliability tests yielded an interclass correlation coefficient of . 80 (p . 001). Geropsychiatricnursing experts weighted the behaviors using a Q-sort to improve the scale’s capacity to predict perceived patient disruptiveness. Factor analysis identified four factors (Beck et al. , 1998). Two corresponded to two—physically aggressive and physically nonaggressive—of the three categories from the factor analysis of the Cohen-Mansfield Agitation Inventory (Cohen-Mansfield, Marx, Rosenthal, 1989). The third category of the Inventory was verbally agitated; in contrast, the factor analysis of the DBS produced a third and fourth category—vocally agitated and vocally aggressive. To obtain a score for the DBS, a trained individual completed a DBS form for every hour of a shift by check- Methods The primary aim was to conduct a randomized trial of the ADL and PSA interventions individually and in combination (CB) for their effect on DB and affect on a large sample of nursing home residents. The experimental design consisted of three treatment groups (ADL, PSA, and Combined) and two control groups (placebo and no intervention). Individual residents were assigned to one of the five groups at each of seven sites in Arkansas and Maryland, which controlled for site differences. To demonstrate the practicability of the interventions and assure adherence to the treatment protocols, certified nursing assistants were hired and trained as project nursing assistants (PNA). They implemented the interventions Monday–Friday for 12 weeks. Afterward, one-month and two-month follow-up periods occurred. Nursing assistants employed by the nursing homes (NHNA) recorded DB. To measure affect, raters were hired for the study to analyze videotapes filmed during intervention. Research Subjects: The sample initially consisted of 179 participants. The study design allowed for the detection of an improvement in DB scores on the Disruptive Behavior Scale (DBS) (Beck, Heithoff et al. , 1997) across time of at least 1. 6 units with a power of 80%. This power calculation assumed that the repeated measures would be correlated with one another at 0. 60. Inclusion criteria were age 65; a dementia diagnosis; a Mini Mental Status Exam (MMSE) (Folstein, Folstein, McHugh, 1975) score of 20; and a report of DB in the previous two weeks. To form a more homogeneous group for generalizing findings, exclusion criteria were a physical disability that severely limited ADL; a psychiatric diagnosis; and a progressive or recurring medical, metabolic, or neurological condition that might interfere with cognition or behavior. Study Groups: ADL Intervention. A PNA used the ADL intervention during bathing, grooming, dressing, and the noon meal based on successful protocols that improved functional status in dressing (Beck, Heacock et al. , 1997). It attempted to meet residents’ psychosocial needs for territoriality, communication, autonomy, and self-esteem to promote their sense of safety and security. The intervention also tried to respect participants’ cognitive and physical abilities by prescribing three types of strategies specific to the individual participant. First, strategies to complete an ADL address specific cognitive deficits. For example, the person with ideomotor apraxia needs touch or physical guidance to start movements. Second, standard strategies are behaviors and communication techniques that work for almost everyone with dementia. For example, the caregiver gives a series of one-step commands to guide the resident to put on her shoe. Third, problem-oriented strategies address particular disabilities such as fine motor impairment, physical limitations, or perseveration. For example, a subject who rubs his hand back and forth on 222 Effects of Behavioral Interventions ing the behaviors that occurred. The score for a behavior was the frequency (0–8) times the weight. The item scores were summed to obtain each of the four subscale scores. Mini Mental Status Exam. The Mini Mental Status Exam (MMSE) (Folstein et al. 1975) provided a global evaluation of participants’ cognitive statuses for screening subjects for the study. Test-retest reliability of the MMSE is . 82 or better (Folstein et al. ). Cognition is assessed in seven areas, and scores lower than 24 out of 30 indicate dementia. Nursing Research July/August 2002 Vol 51, No 4 Observable Displays of Affect Scale. The Observable Displays of Affect Scale (ODAS) (Vogelpohl Beck, 1997), designed to rate videotaped data, contains 41 behaviors categorized into six subscales of positive and negative facial displays, vocalizations, and body movement/posture. Raters indicate presence/absence of each behavior during five 2-minute intervals from a 10minute videotape. Scores range from 0–5 for each item. The range of scores for each scale is: facial positive (0–20), Aggression during bathing facial negative (0–20), vocal positive (0–45), vocal negative (0–50), body could stem from physical positive (0–30), and body negative discomfort or rough (0–40). Interrater reliabilities (Kappa handling coefficients) for the ODAS range from . 68–1. 00, and intrarater reliability is . 97–1. 00. Ten gerontological nursing experts established content validity (Vogelpohl Beck). Apparent Affect Rating Scale. The Apparent Affect Rating Scale (AARS) (Lawton et al. , 1996) is designed for direct observation of persons with dementia and contains six affective states: pleasure, anger, anxiety/fear, sadness, interest, and contentment. (In later work, Lawton, Van Haitsma, Perkinson, Ruckdeschel [1999] deleted contentment). Each item has a noninclusive list of behaviors that might signal the presence of the affect from which observers infer the affect. The observer assigns a score of 1 to 5 to measure the duration of the behavior. Visual Analogue Scales. The Positive Visual Analogue Scale (PVAS) and Negative Visual Analogue Scale (NVAS) (Lee Kieckhefer, 1989; Wewers Lowe, 1990) are two 10centimeter lines on separate pages for rating positive and negative affect. The PVAS has end anchors of â€Å"no positive affect† and â€Å"a great deal of positive affect. † The NVAS has end anchors of â€Å"no negative affect† and â€Å"a great deal of negative affect. † Scores range from 0 to 100. Procedure: The study consisted of six phases: (a) preliminary activities, (b) a three-week normalization/desensitization period, (c) a 12-week intervention period, (d) a onemonth follow-up period, (e) a two-month follow-up period, and f) a videotape analysis. Preliminary Activities. The institutional review boards at the University of Arkansas for Medical Sciences and the Univer- sity of Maryland approved the research. Each nursing home identified residents with dementia and sent letters informing persons responsible for the residents that researchers would be contacting them. Responsible persons could return a signed form if they did not want to participate. Willing responsible persons received a telephone call explaining the study followed by a mailed written description along with two consent forms. Those willing kept one consent form for their records and signed and mailed back the other. Screening involved a review of the residents’ charts, recording their diagnoses, and interviews with the staff to find evidence of DB during the previous two weeks. Each resident took the MMSE to meet inclusion criteria. Within each home, female residents who passed these screens were randomized to one of the five groups by a drawing, but males were assigned to the five groups to ensure even distribution of their small number. Simultaneously, research staff members were hired and trained. Normalization/Desensitization. For the next three weeks, each PNA accompanied a NHNA to learn the routines of the facility but did not help care for potential study participants. A videotape technician placed a camera that was not running in the dining and shower rooms to desensitize residents and staff to its presence. In addition, nursing home staffs participated in two-hour training sessions on the DBS. Throughout the study, a gerontological clinical nurse specialist trained any new NHNA and retrained if behaviors reported on the DBS differed from those she observed during randomized checks. Intervention. During the 12-week intervention period, the first three weeks were considered baseline and the last two weeks postintervention. The PNA administered the treatment/s or placebo five days a week. Every day, they asked participants to give their assent and espected any dissents. During weeks 11–12 (postintervention), the PNA prepared the participants for their departure by telling them that they were leaving soon. To facilitate data collection, a separate form of the DBS for each of the three eight-hour daily shifts was developed. Eight one-hour blocks accompanied each item of the scale. The NHNA placed a check mark in the block that corresponded to the hour when the NHNA observed the behavi or. The NHNA completed the DBS on all participants during or at the end of a shift. In addition, a technician videotaped participants in the treatment and placebo groups every other week during an interaction with the PNA and no intervention group monthly during an ADL. The technician monitored positioning and operation of the camera from outside the room or behind a curtain to respect the participants’ privacy. One-Month and Two-Month Follow-up. One month and two months after the research team left the nursing home, Nursing Research July/August 2002 Vol 51, No 4 Effects of Behavioral Interventions 223 esearch assistants (RA) retrained nursing home staffs on the DBS. The NHNA then collected DB data on their shifts Monday–Friday for one week. tervention, week 16 as one-month follow-up, and week 20 as two-month follow-up. Participants with fewer than six observations at any time period were omitted. For each period, a total DBS score represented an averVideotape Analysis. The videotapes ranged in length from age of the participant’s data for the t hree shifts of each day less than five minutes to 40 minutes, depending on the across the five days of the observation week. Therefore, activity and the participant’s willingness to cooperate with total DBS scores were obtained for baseline (M of weeks the treatment (baseline and control participants’ tapes 1–3), intervention (M of weeks 4–10), postintervention (M tended to be shorter). To standardize the opportunity for of weeks 11–12), first follow-up (M of week 16), and secbehaviors to occur, an editor took 10-minute segments ond follow-up (M of week 20). The same procedure from the middle of baseline and final treatment eek tapes yielded subscale scores for physically aggressive, physically and randomized them onto videotapes for rating. Because nonaggressive, vocally aggressive, and vocally agitated videotaping occurred to ensure appropriate implementabehaviors for each of the five time periods. tion of interventions, the treatment groups had more A repeated measures analysis of variance (ANOVA) usable videotapes than the control groups did. consisted of two between- subjects and one within-subjects A master’s prepared gerontological factors. The between-subjects factors nurse specialist intensively trained six were intervention group and state (AR raters on the Observer III Software or MD) to account for regional differSystem (Noldus Information Technolences in scoring DB, and the withinogy, 1993) for direct data entry and subjects factor represented DBS scores the affect rating scales. The raters for the five different time periods. Each reached . 80 agreement with the speanalysis allowed for testing by intervencialist on practice tapes before they tion group, time period, and state. The Screaming may started rating the study videotapes. nalysis of the interaction effect of She monitored reliability for each tape intervention group by time period express pain or monthly, retrained as needed, and rantested the hypothesis that the intervenself-stimulation domized the sequence of rating the tions would decrease DB across time in scales. The raters entered the ODAS treatment conditions as compared to and AARS data directly into a comcontrol conditions. The analysis was puter using the Observer. The system repeated five times, once for each suballowed raters to watch videos repeatscale of the DBS and once for the total edly in actual time and slow action to score. Level of significance was set at document behaviors objectively and 0. 05. The researchers believed that the precisely. The raters indicated their small group sizes justified the liberal perception of the participants’ positive and negative level of significance. For the videotape analysis, analyses of affect by placing a vertical mark at some point between covariance occurred for the 14 variables observed from the the two end anchors of the PVAS and NVAS. They videotapes during intervention. The baseline score served marked neutral affect as negative. s a covariate for the final score. While a multivariate analysis would have been desirable, it would have had Intervention Integrity: The PNA and video camera techniinsufficient power with this number of variables and subcian underwent two weeks of intensive training on general jects. The 14 univariate analyses do inflate the Type I error aging topics, stress management, information on dementia, rate. and confidentiality/privacy issues. Training also involved instruction on the study interventions, DBS, and research Results protocols. Of the 179 initial participants, 36 did not finish; the greatA gerontological clinical nurse specialist viewed treatest attrition occurred in the no intervention control group. ment and placebo videotapes biweekly in a private office to Attrition resulted from death (39%), withdrawal of fammonitor PNA compliance with research protocols, provide ily’s consent or at nursing home staff’s request (26%), discorrective feedback to PNA, and help PNA recognize and charge (18%), and change in health status/medications meet participants’ needs as they changed during treatment. hat did not meet inclusion criteria (17%). This left 143 The possibility for contamination appeared to be low participants: 29 in the ADL, 30 in PSA, 30 in CB, 30 in the because NHNA were unlikely to change their care practices placebo, and 24 in the no intervention, but 16 with incomand had little opportunity to observe PNA. Further, NHNA plete data were dropped. Table 3 gives the demographic were b linded to the hypothesis of the study, the nature of the statistics for the 127 participants with complete data. No interventions, and the participants’ group assignments, statistically significant demographic differences emerged although they probably could identify the no intervention among the five groups. In short, this sample primarily conparticipants. sisted of elderly, white females with severe cognitive impairment. Analysis: Reviewers checked for completeness of all data. For the videotape analysis, the final number was 84 The researchers designated intervention weeks 1–3 as baseparticipants with 168 videotape segments. Most were line, weeks 4–10 as intervention, weeks 11–12 as postin- 224 Effects of Behavioral Interventions Nursing Research July/August 2002 Vol 51, No 4 TABLE 3. Description of the Sample by Intervention Group No Intervention 19 89. 5 78. 9 84. 2 86. 47 (6. 37) 11. 47 (6. 43) ADL Number in group Percent female Percent white Percent widowed Mean age (SD) M MMSE (SD) 28 78. 6 82. 1 64. 3 82. 29 (8. 40) 11. 44 (7. 69) PSA 29 82. 1 85. 7 66. 7 82. 18 (7. 64) 10. 65 (6. 76) CB 22 81. 8 77. 3 77. 3 82. 82 (9. 81) 7. 91 (5. 41) Placebo 29 75. 9 86. 2 75. 9 86. 45 (6. 92) 11. 11 (6. 39) Total 127 81. 0 82. 5 72. 8 83. 64 (7. 97) 10. 55 (6. 64) Note. ADL = activities of daily living; PSA = psychosocial activity; CB = combination. emale (79%) and widowed (69%) with a mean age of 83 (SD 7. 44). Participants had a mean score of 10 (SD 6. 34) on the MMSE, indicating moderate to severe cognitive impairment. Table 4 displays the means and standard deviations for the DBS overall and the four subscales across the five time periods for the five groups. No significant differences emerged for the interventi on-by-time interaction for any of the dependent variables. Thus, the results failed to support the hypothesis that the interventions would decrease DB across time in treatment groups as compared to control groups (statistical analysis tables on Website at: http://sonweb. nc. edu/nursing-research-editor). However, the main effect of state was significant in three analyses. Arkansas recorded significantly more behaviors than Maryland did for the dependent variables of physically nonaggressive (p . 001), vocally agitated (p . 001), and overall DBS (p . 002). Further, the main effect of time was significant for overall DBS (p . 002) and the four subscales of physically aggressive (p . 001), physically nonaggressive (p . 027), vocally aggressive (p . 021), and vocally agitated behaviors (p . 008). The significance resulted from increased DB after the PNA had left the home (generally from intervention or postintervention to first follow-up). For the videotape analysis, the hypothesis stated that treatment groups, compared with control groups, would display more indicators of positive affect and fewer indicators of negative affect following behavioral interventions. In general, neither the positive nor the negative affect scores were particularly high, indicating that this sample had relatively flat affect. Results from the analysis of covariance tests supported increased positive affect but not decreased negative affect. Compared to the control groups, the treatment groups had significantly more positive facial expressions (p . 001) and positive body posture/movements (p . 001), but not more positive verbal displays on the ODAS. The treatment groups displayed significantly more contentment (p . 037) and interest (p . 028) than the control groups did on the AARS. For the negative affects on the AARS, the treatment groups had a shorter duration of sad behaviors (p . 007) than the control groups did. Comparison of VAS scales likewise showed that the treatment groups displayed more positive affect (p . 012). Discussion In contrast to other studies (e. . , Hoeffer et al. , 1997; Kim Buschmann. , 1999; Whall et al. , 1997), this study found no treatment effect on DB. The interventions were a synthesis of approaches believed to globally address â€Å"triggers† of DB and meet psychosocial needs (Boettcher, 1983). They did not address the specific factors that might have been triggering the particular behavior (Algase et al. , 1996). Such triggers include under/over stimulation, unfamiliar or impersonal caregivers, and particular individual unmet psychosocial needs. For example, aggression during bathing could stem from physical discomfort or rough handling (Whall et al. 1997). Interventions much more individually designed require development. Increasing DB across all groups was reflected in the DBS scores at 1-month follow-up. Two factors may explain this increase. First, the PNA had warned participants that they would be leaving. Second, the ADL and CB participants no longer received care from the familiar PNA, and PSA, CB, and placebo participants no longer had a daily activity or visit. The increased stress and time constraints for NHNA as they resumed caregiving of the ADL and CB participants may explain the heightened DB in the control groups. Such changes may trigger increased behavioral symptoms in persons with dementia (Hall, Gerdner, Zwygart-Stauffacher, Buckwalter, 1995). Two measurement issues may have affected outcomes. First, observers view behaviors differently (Whall et al. , 1997) and come to expect particular behaviors from certain residents (Hillman, Skoloda, Zander, Stricker, 1999). If the NHNA were accustomed to a participant’s DB pattern, such as persistent screaming, they may have overlooked decreases in that behavior. Initial training and retraining of raters occurred as needed; however, some Nursing Research July/August 2002 Vol 51, No 4 Effects of Behavioral Interventions 225 TABLE 4. Weighted Scores for Disruptive Behavior by Intervention Group and Time Period No Intervention (n = 19) Mean (SD) 408. 71 (427. 24) 303. 69 (408. 44) 281. 97 (410. 85) 418. 31 (630. 58) 292. 85 (405. 15) 114. 66 (202. 89) 90. 85 (182. 70) 77. 98 (173. 15) 130. 92 (257. 12) 128. 20 (195. 67) 191. 97 (157. 75) 117. 11 (112. 30) 118. 23 (137. 08) 154. 46 (225. 05) 100. 45 (153. 30) 55. 16 (74. 70) 42. 89 (54. 54) 33. 26 (47. 06) 64. 72 (77. 89) 28. 09 (37. 02) (continues) DB Category Time Period DBS total Baseline ADL (n = 28) Mean (SD) 172. 51 (191. 47) 182. 45 (181. 3) 164. 56 (154. 95) 207. 22 (205. 58) 190. 70 (291. 06) 20. 67 (30. 52) 32. 59 (51. 29) 15. 02 (26. 10) 44. 18 (100. 62) 21. 45 (36. 47) 95. 50 (105. 28) 87. 58 (87. 58) 85. 04 (89. 60) 88. 81 (85. 69) 148. 75 (187. 28) 22. 85 (32. 10) 28. 37 (32. 50) 21. 15 (26. 54) 30. 72 (48. 95) 18. 28 (24. 55) PSA (n = 29) Mean (SD) 348. 02 (467. 50) 306. 81 (393. 03) 303. 24 (367. 54) 373. 17 (533. 05) 300. 20 (366. 42) 85. 87 (199. 01) 83. 94 (167. 53) 82. 82 (166. 93) 113. 49 (235. 71) 81. 30 (151. 85) 162. 41 (206. 65) 130. 82 (142. 72) 133. 92 (145. 97) 141. 47 (188. 99) 164. 92 (223. 63) 49. 64 (93. 15) 43. 80 (64. 6) 37. 90 (53. 43) 54. 47 (90. 33) 40. 26 (45. 26) CB (n = 22) Mean (SD) 287. 66 (373. 73) 300. 84 (379. 33) 286. 21 (365. 78) 374. 10 (510. 10) 312. 83 (433. 18) 68. 84 (126. 18) 67. 14 (137. 79) 61. 04 (127. 78) 92. 68 (205. 52) 60. 40 (131. 54) 136. 67 (189. 03) 124. 64 (164. 49) 125. 99 (157. 78) 159. 97 (202. 75) 146. 53 (201. 83) 34. 49 (55. 91) 40. 73 (52. 60) 31. 18 (33. 85) 36. 95 (42. 70) 32. 82 (51. 32) Placebo (n = 29) Mean (SD) 325. 96 (337. 14) 337. 60 (328. 94) 336. 80 (366. 55) 389. 92 (434. 43) 319. 15 (384. 59) 49. 26 (90. 24) 62. 10 (112. 71) 59. 67 (106. 37) 76. 79 (165. 45) 48. 25 (101. 4) 167. 01 (177. 80) 164. 62 (161. 48) 175. 36 (189. 80) 201. 68 (212. 06) 87. 67 (127. 38) 47. 20 (79. 70) 39. 55 (57. 74) 32. 69 (55. 77) 29 . 30 (47. 60) 30. 18 (52. 85) Intervention Postintervention 1 month follow-up 2 month follow-up Physically aggressive Baseline Intervention Postintervention 1 month follow-up 2 month follow-up Physically nonaggressive Baseline Intervention Postintervention 1 month follow-up 2 month follow-up Vocally aggressive Baseline Intervention Postintervention 1 month follow-up 2 month follow-up 226 Effects of Behavioral Interventions Nursing Research July/August 2002 Vol 51, No 4 TABLE 4. Weighted Scores for Disruptive Behavior by Intervention Group and Time Period (Continued) NoIntervention (n = 19) Mean (SD) 47. 65 (97. 22) 68. 32 (103. 13) 68. 01 (116. 62) 84. 50 (112. 48) 73. 07 (117. 12) DB Category Time Period Vocally agitated Baseline ADL (n = 28) Mean (SD) 33. 49 (84. 39) 33. 91 (62. 52) 43. 17 (72. 10) 43. 48 (64. 39) 50. 53 (117. 95) PSA (n = 29) Mean (SD) 46. 92 (98. 70) 52. 84 (96. 03) 52. 50 (90. 78) 68. 22 (98. 89) 48. 89 (92. 33) CB (n = 22) Mean (SD) 62. 49 (98. 97) 70. 43 (110. 85) 69. 08 (107. 29) 82. 14 (118. 97) 75. 80 (129. 67) Placebo (n = 29) Mean (SD) 50. 0 (92. 05) 48. 25 (81. 63) 48. 59 (72. 20) 63. 74 (95. 30) 54. 11 (80. 61) Intervention Postintervention 1 month follow-up 2 month follow-up Note. Scores were created by assigning each behavior with a severity weight prior to summing and then averaging across day and then week(s). DBS = disruptive behaviors; ADL = activities of daily living intervention; PSA = psychocial activity inte rvention; CB = combination of the two interventions. NHNA appeared to continue to consider participants’ behaviors, such as repetitive questioning, to be personality characteristics or attention-seeking efforts rather than DB. Thus, they may have under-reported behaviors. Further, staff may prefer withdrawn behaviors, such as isolating self and muteness (Camberg et al. , 1999), and view them as nonproblematic. Second, categorizing a behavior as disruptive without understanding its meaning to the person with dementia may be conceptually flawed. For example, screaming may express pain or self-stimulation. Two design features may explain differences between the findings of this study and others. First, this study had both placebo and no intervention control conditions. Just a few other studies randomized subjects to treatment or control groups or included two control groups (e. g. , Camberg et al. , 1999). In most studies, control conditions preceded or followed treatment conditions (e. g. , Clark, Lipe, Bilbrey, 1998). In both designs, subjects served as their own controls, which limits examination of simultaneous intra- and extra-personal events that might affect DB frequency. Second, many control groups came from separate units or different nursing homes (e. g. , Matteson et al. , 1997), which makes it difficult to control for differences in environment, staff relationships, and personalities. This study occurred at seven sites in two different geographical areas, but at each site, the randomization of female participants distributed the groups across all nursing units to control for environmental and staff characteristics. Acknowledged limitations include the following. First, in spite of the large overall sample, the group sizes were small (range 19–30) with the greatest loss in the no inter- vention group. Larger groups might have provided more definitive findings on the relationship between behavioral interventions and DB frequency as Rovner et al. (1996) did (treatment group 42; control group 39). Second, NHNA served as data collectors because using independent observers would have been cost-prohibitive. These results suggest that future intervention research should consider the individual characteristics of the person with dementia (Maslow, 1996) and the triggers of the behavior (Algase et al. , 1996). Studies that have individualized interventions have demonstrated decreased DB (Gerdner, 2000; Hoeffer et al. , 1997). Researchers need to continue to refine methods for identifying what works for whom (Forbes, 1998) to minimize the prevalent trial-anderror approach to DB management.