Sunday, January 26, 2020

Health Inequalities In Mental Illness Health And Social Care Essay

Health Inequalities In Mental Illness Health And Social Care Essay In this assignment the author will critically analyse the health inequalities that are evident for people with a diagnosis of a severe mental illness. He will particularly focus on the inequalities that exist in relation to the prevalence, identification and management of the physical health aspects for this set of complex conditions. In the course of the assignment he will critically evaluate these health inequalities from an international, a national United Kingdom and a more local Scottish perspective. In doing so he will critically examine a selection of health promotion approaches which underpin the physical healthcare of people with severe mental illness. He will also systematically evaluate the effectiveness of some of the differing approaches which contribute to the management of these conditions and the enhancement of the health and social wellbeing of mental illness sufferers across the world. Definitions In order to analyse the health inequalities the author will first define some of the key terms that he will refer to throughout the assignment. Health was defined by the World Health Organisation (WHO) (1948) as a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.Though this is a useful and accurate definition, some would consider it idealistic and non-realistic. Using the WHO definition classifies 70-95% of people as unhealthy. However Davis (2009) declared the added importance of the wider definition of health stating There is a biomedical component to health, but it exists in a setting that includes biological, personal, relational, social, and political factors Looking at health in a little more detail the determinants of health are defined by the WHO (2010) as Many factors combine together to affect the health of individuals and communities. Whether people are healthy or not, is determined by their circumstances and environment. To a large extent, factors such as where we live, the state of our environment, genetics, our income and education level, and our relationships with friends and family all have considerable impacts on health, whereas the more commonly considered factors such as access and use of health care services often have less of an impact. The determinants of health include: the social and economic environment, the physical environment, and The persons individual characteristics and behaviours. Alternatively European Union public health information system (2009) define determinants of health as Many, often interacting factors that determine a persons health or disease state. These include Socio-economic factors: education, occupation, employment, poverty and income distribution; Environment: social support, airborne particulate matter and working conditions; Health behaviours: smoking, alcohol use, drug use, food consumption, physical activity and breastfeeding; and Biological and personal factors: overweight and blood pressure. WHO (2010) declared that Health inequalities can be defined as differences in health status or in the distribution of health determinants between different population groups. For example, differences in mobility between elderly people and younger populations or differences in mortality rates between people from different social classes. It is important to distinguish between inequality in health and inequity. Some health inequalities are attributable to biological variations or free choice and others are attributable to the external environment and conditions mainly outside the control of the individuals concerned. Whereas Samuel (2000) describes health inequalities in a more simple fashion as unjust or unfair differences in health determinants or outcomes within or between defined populations. Severe Mental Illness The Rethink operational definition of severe mental illness (2008) is when people: Are diagnosed as suffering primarily from a mental illness, typically schizophrenia or a severe affective (mood) disorder. Suffer substantial disability as a result of their illness, such as inability to care for themselves independently, sustain relationships or work Are currently displaying florid symptoms or are suffering from a chronic enduring condition. Have suffered recurring crises leading to frequent hospital admissions or interventions and/or place a significant burden on their informal carers. Occasion significant risk to their own health or safety or to that of others. The Ottawa charter for health promotion WHO(1986) defines Health promotion as the process of enabling people to increase control over and improve their health They describe it as not just the responsibility of the health sector and that it goes beyond healthy lifestyles to well being. Health promotion has been defined by the World Health Organizations (2005) Bangkok Charter for Health Promotion in a Globalized World as the process of enabling people to increase control over their health and its determinants, and thereby improve their health The United Nations Convention on the Rights of Persons with Disabilities (2006) claim that persons with disabilities have the right to the enjoyment of the highest attainable standard of health without discrimination. States should take all appropriate measures to ensure access to health services with the same range, quality and standard as provided to other persons. A UK based study by the Disability Right Commission (2006) Equal treatment: Closing the gap described an analysis of 8 million health records. It confirmed that people with severe mental illness have rates of cardiovascular and diabetes problems that are 2-3 times more common than would be expected in the general public. Bowel cancer is 90% more common in males with schizophrenia and women are 42% more likely to get breast cancer. The author will now go on to explore the phenomenon where many thousands of people with severe mental illness are at high risk of dying early with physical health problems. He sees this as a significant health inequality across the world and will examine some of the health promotion activities that have been attempted to reduce this inequality. Appendix 1 gives an analysis of the search criteria and the database results that he used in order to critically examine this topic. Evidence of Health Inequalities United States of America Miller et al (2006) in a well conducted and robust clinical study in the USA examined the mortality and medical morbidity of 20,018 patients admitted to psychiatric services with a diagnosis of psychosis in Ohio between 1998 and 2002. It identified that 21 percent of cases died from heart disease and 7 percent from a cancer related disease and 3 percent from diabetes related disorders. They cited the possible causes of these problems as medication induced weight gain, poor personal hygiene, reduced physical activity, and increased prevalence of smoking, increased substance misuse and a reduced social support network. In the study they were also able to report that deaths in this client group were three times higher than expected in the general USA population (with Heart disease being the main cause) and the average age of death at 47.7 years was 32 years younger than the general population figures. They acknowledged in their report the need to better integrate the delivery of both me ntal and physical healthcare by collaborating with all stakeholders to improve the quality of life outcomes for this population. They do not however go on to explain how they would take this agenda forward. Australia These international findings are also supported by statements from the Australian National Mental Health consumer and carer forum (2010) who state that the appalling health and early mortality of people with persistent mental illness is unacceptable. These comments from a national user and carer forum are not defined from one particular study but from a body of research and audit from across Australia focussing on outcomes of a series of studies. The national voice and recommendations from a major player in Australian healthcare with a focus on the needs of the patient rather than services is as significant in the authors eyes as a single robust study. They add that these issues are having a significant impact on the persons wellbeing and is also contributing to their social exclusion. They add to the argument by stating that these causes are iatrogenic (occurring as a result of the disorder or its treatment ) They go on to add the other areas that are common in this group and that can add to the impact being poverty, neglect, discrimination, smoking, substance misuse and poor dietary habits. They add that the screening for these conditions occurs less often in patients with mental illness hence they are less likely to be treated. The Australian report adds that the life expectancy of this client group is 25 years less than the general population. An interesting fact that they add though is that their evidence suggests that the client group do not have higher than average rates of disease like cancer and heart disease but they die from the disease 2 to 3 times more often than the general public. They suggest again like the USA repo rt that this is due to patients not receiving appropriate preventative screening and treatment for these illnesses. They go on to state that psychiatrists, GPs and other prescribers of psychotropic medication have a responsibility to monitor the effects of medication on a persons physical state as well as its impact on their mental wellbeing. They go on to recommend a series of actions for the future which include State and territory governments undertake to educate all stakeholders on Physical Health Impacts of Mental Health Problems and Disorders They enable appropriate screening, assessment and physical health checks for all persons with identified mental illness, including attention to dental health The Australian Government takes leadership on these issues by requiring all identified mental health funding to be accountable for physical health maintenance All mental health programs and policy areas report on physical health screening, assessment and monitoring for all mental health consumers in receipt of services Given the nature of mental illness, service providers need to innovate and respond creatively to address the physical health impacts of mental health disorders and their treatment Doctors take responsibility, when prescribing medications for people with mental health issues, to treat them holistically and monitor their physical health changes and needs. United Kingdom Likewise in the United Kingdom Cormac (2009) in a Royal College of Psychiatrists paper cites several papers which indicate a higher incidence of physical health problems in people with severe mental illness. Phelen et al (2001) stated that people with mental disorder have a higher risk of poor health and premature mortality and a meta-analysis of 27 studies almost 10 years ago by Harris and Barraclough (1998) showed a standardised mortality ratio of at least 1.5 for this group of patients however it varied with the severity and type of disorder. Patients with schizophrenia had increased mortality ratios of almost 3-4 times that of the general public with deaths mainly caused by cardiovascular and endocrine type disorders. These findings were reported by Brown et al (2000), Osby et al (2000 and Enger et al (2004). More recent findings in the UK has been the high escalation of the risk of developing metabolic syndrome for schizophrenics which has been found to be 2-4 times higher than the general public, finding borne out in the study by Saari et al(2005) and Thakore (2005). Joukamaa et al (2006) added some additional evidence to suggest that the risk of sudden death in patients with schizophrenia increases with the addition of each different psychotropic medication that is prescribed. Likewise the Department of Health (2010) in the Our health and Wellbeing report suggest that looking beyond neighborhoods and deprivation, certain groups have poorer health and some are uniquely disadvantaged because of a combination of their circumstances. For example: People with schizophrenia: A total of 0.4% of the population experience psychosis each year. A recent UK study found that, of those living with schizophrenia in the community, men experienced 20.5 years lower life expectancy and women 16.4 years lower life expectancy than the general population. The largest single cause of this inequality is an increased rate of smoking, more than three times that of the general population. Scotland Moreover the NHS in Scotland (2008) in their report Improving the physical health and wellbeing of those experiencing mental illness again cite evidence from studies across the world that the physical health of patients with severe mental illness is compromised. They state that research in Europe and the USA has shown that mortality rates from physical illness for those with mental illness is significantly higher than the general population. Schizophrenia is generally acknowledged as a life shortening illness with sufferers dying on average 10 years earlier than the general population. Two thirds of this excess mortality is due to poor physical health. They also identified that this group are developing these illnesses at a younger age and are dying from them earlier with 5 year survival rates reduced by up to 16%. NHS Scotland (2008) also refers to the aspects of stigma and discrimination. They state that Legislation requires that all Agencies dealing with the public remove discrimination and promote equality, yet a See Me(2006) survey reports that some people with mental health problems still feel stigmatised. The Highland Users Group ( 2008) have found that when it comes to their physical health needs they can be subject to unequal access to services and can feel stigmatised and discriminated against when they try to access general health care services. They feel their physical health concerns are too often put down to their mental health problem, especially if their symptoms are medically unexplained. Frayne et al (2005) suggest that research has confirmed that they do not always receive the same medical treatments as the rest of the public and consequently their health outcomes can be worse. Additionally the Scottish Government (2008) in the equally well report highlights Mental Illness and Mental wellbeing as important factors in the argument. They state that Mental illness and mental wellbeing are specific priorities for the Task Force. People with mental illness are more likely to die earlier from suicide, or illnesses such as cardiovascular disease (CVD) and tend to have generally poorer health through conditions such as diabetes. Mental wellbeing is associated with good mental health, but is not necessarily the same as absence of mental illness. Much of the Task Forces work is based on the importance of factors such as resilience, hopefulness and optimism that create mental wellbeing and quality of life. These allow people to deal effectively with lifes problems and normal stresses, to make the most of their abilities and the opportunities available and to play a positive part in their community. People whose wellbeing is good are more likely to look after their own health. However, depression is closely associated with poor physical health, for example increasing significantly the risks of CVD. The author concludes from the overriding evidence across the world that those suffering from a severe mental illness have much poorer physical health which causes them to have a shorter life expectancy. These conditions are identified as mostly cardiovascular and metabolic type problems. There is evidence that this client group has unequal access to health services and feel stigmatised and discriminated against. Health Promotion Models and Interventions Naidoo and Wills (2000) identify 5 approaches to health promotion. Medical or preventative approaches which target the whole population and are aimed at reducing premature deaths and avoidable diseases. Behavioural Change approaches view health as the property of the individual and encourages them to adopt healthy behaviours that are regarded as key to improving health. Educational approaches are strongly linked to heath education and seek to provide knowledge, information and develop skills so that people can make informed choices about their health behaviour. Empowerment approaches are bottom up approaches which encourage communities to identify their needs, develop skills and make appropriate life changes. Social change approaches is a top down approach which targets specific groups and populations and defined by a belief that socio-economic circumstances determine health status in individuals. Its focus is usually at policy or environmental levels. The author will now explore some of the interventions used across the world within the models/approaches above. In the United Kingdom Phelan et al (2004) introduced a physical health check tool to support the monitoring and management of physical health issues with patients with severe mental illness. This would be seen in the above model as a medical or preventative approach which aims to assess need in a target population and then develop an agreed action plan with the patient on how they are going to address the defined health needs. The assessment is completed on a 12 monthly basis and is designed to supplement normal medical care and review. The results showed that 50% of clients had a diagnosed physical illness with 78.3% saying they had one or more physical symptoms. 65% of patients agreed to one or more of the actions available which included getting advice about smoking cessation, diet and starting regular exercise. The outcomes have seen an increase in the quality of the assessment and recording of the physical needs of the patients as well as a huge jump in the activities being care planned within a structured care programme approach care plan. The study compared the group with a neighbouring community mental health team and demonstrated that the use of the structured assessment and care planning tools significantly improved the quality of information recorded. The failings in the report highlight that although the staff were able to assess and plan care there was as yet no evidence that this approach had improved the health outcomes of patients and the life expectancy of them. When we relate this to the models above we identify that the medical and organisational policy approaches are easier to do and measure compared to the change behaviour that is required by the individuals concerned. The author suggests that further longer term studies are required to evaluate the long term health impact of this approach to the organisation of physical healthcare management. Likewise the Department of health (2006) in their commissioning framework document choosing health give examples of case studies which reflect some of the health promotion interventions across the UK. In one study a selection of clients from across a city were involved in a physical health consultation with a senior nurse. This assessment took place in their own home as there had been a previous reluctance to attend clinics for this purpose. Once the health issues were identified in an assessment patients were selected for inclusion in 2 healthy working groups. One focussed on healthy living and was attended by 15 patients whilst the other had a focus on physical activity, was based in the local sports centre and had an attendance rate of about 20 patients per week. A voluntary walking group was also available. There were very positive outcomes from the study which included the following 57% reduction in alcohol consumption Only a 1% DNA rate at activities 32% reduction in smoking 44%weight loss 50% increase in activity levels 95% improvement in patient self esteem Dietary improvements These significant health improvements for patients can only contribute to improving their life expectancy. The author believes that the above interventions fall into a number of the approaches to health promotion identified by Naidoo and Wills (2000) for the following reasons. Medical and preventative- These interventions are targeted at a particular sector of the population in order to prevent the formation of disease in an identified vulnerable group. The initial screening selects those that go forward for health promotion activity. This is a top down expert led approach to target interventions at a vulnerable client group reducing costs in the long term and improving outcomes. Behaviour change- information, support and improvements in access to health, social, lifestyle and sports facilities has encouraged people to make informed choices to adopt more healthy behaviours. The evidence in the outcomes has shown that people have made real improvements in their health by taking responsibility (even though in some cases it was supported initially by staff) and changing their lifestyle significantly. Health education- the specific classes and education provided by staff supported the individuals to make informed choices about their health and the behaviours that they were adopting to support it. Empowerment in this area the nurses were being seen as catalysts of change or facilitators in order to support individuals. The fact that local sports and leisure facilities was involved was evidence of a social inclusion aspect of the service where it was seen to be normal to engage with local facilities and not in specialist hospitals or clinics. Social change approaches- the targeting of this client group in a top down approach by clinicians in many ways is evidence of this approach across the uk. Likewise in the United Kingdom another approach which identifies this social change approach is the mental health component of the general practitioners contract and the quality and outcomes framework that they work to. British Medical Association (2009) states in their advice on interventions to General practitioners that Patients with serious mental health problems are at considerably increased risk of physical ill-health than the general population. It is therefore good practice for a member of the practice team to review each patients physical health on an annual basis. Health promotion and health prevention advice is particularly important for people with serious mental illness however there is good evidence that they are much less likely than other members of the general population to be offered, for example, blood pressure checks and cholesterol checks if they have concurrent coronary heart disease, and cervical screening. They feel the importance of this by identifying a number of targets in mental health two of which relate to physical health and are detailed below. MH 8. The practice can produce a register of people with schizophrenia, bipolar disorder and other psychoses MH 9. The percentage of patients with schizophrenia, bipolar affective disorder and other psychoses with a review recorded in the preceding 15 months. In the review there should be evidence that the patient has been offered routine health promotion and prevention advice appropriate to their age, gender and health status. They also recommend that a review of physical health will therefore normally include: 1. An enquiry about smoking, alcohol and drug use 2. A blood pressure check 3. A cholesterol check where clinically indicated 4. Measurement of body mass index (BMI) 5. A check for the development of diabetes 6. Cervical screening where appropriate 7. An enquiry about cough, sputum, and wheeze. Reports on the two targets have seen achievements in the high 90% range across the country hence showing evidence of improvement in screening. This approach in primary care is commendable but there are a number of patients who still find it difficult to engage and access services. This client group require additional support to access services and NHS Quality Improvement Scotland (2007) felt it was an important enough matter to include it in their Mental Health Integrated Care Pathway standards. The GP targets which only include the offer of health assessment are enhanced further and include a recording of the completion of an assessment and actions relating to the outcome which include health promotion, communication with interested parties and evidence that action has been taken on the findings. The author agrees with NHS QIS that it was necessary to take this top down social change approach in order to bring about change which will enhance the health promotion of this complex client group. Standard 13: A general physical health assessment and management of the findings are recorded. Criteria 13a The care record shows that physical health needs are assessed at least annually using the following features: à ¢Ã¢â€š ¬Ã‚ ¢ the completion of a physical health assessment à ¢Ã¢â€š ¬Ã‚ ¢ the provision of health promotion advice, and à ¢Ã¢â€š ¬Ã‚ ¢ service users receiving medication should have side-effects and physical health assessed and managed according to the appropriate algorithm for that medication. 13b The care record shows information on the management of physical health needs, including: à ¢Ã¢â€š ¬Ã‚ ¢ information on who is responsible for the physical health assessment (primary care or specialist services) à ¢Ã¢â€š ¬Ã‚ ¢ evidence that results have been shared à ¢Ã¢â€š ¬Ã‚ ¢ evidence that results have been acted upon, and à ¢Ã¢â€š ¬Ã‚ ¢ evidence that information and/or advice on promoting a healthy lifestyle has been provided. Marder et al (2004) make a number of recommendations in their paper in the American journal of psychiatry regarding the monitoring and appropriate prescribing of antipsychotic medications. They suggest that the key is to identify the risk factors for each individual patient and tailor the prescribing according to their presentation and the potential adverse side effects of a number of the medications available. They present evidence of side effects of diabetes and cardiovascular issues and suggest that appropriate prescribing will reduce the risks or developing or exacerbating these conditions in patients with schizophrenia. This is borne out also in the NHS QIS (2007) standards above in Scotland where they recommend that service users receiving medication should have side-effects and physical health assessed and managed according to the appropriate algorithm for that medication NHS boards have been asked to develop prescribing algorithms and audit tools that will guide clinicians in assessing the physical health needs and using this information to make informed choices on the best medications for patients which have reduced risks associated with their physical health. These systems are currently under development across Scotland but can in the future only improve the outcomes in the physical health management of patients with schizophrenia. Conclusion The author in this assignment has demonstrated some of the health inequalities that are evident for people who suffer from severe mental illness from across the world. Some of the inequalities are a product of the diagnosis itself where patients often have symptoms that cause them to have reduced motivation to help themselves in many situations. Often this patient group also comes with a lower socio economic deprivation with a poor employment and education history which again provides barriers to their self management in respect to their physical health. Recent advances in the treatments available for psychoses which have physical health related side effects and the introduction of the disability human rights legislation which stipulates the requirement of equal access for all has further highlighted some of the health inequalities that exist for this complex patient group. The needs identification and health promotion interventions that the author has looked at separate themselves into key areas. This client group requires support to access to services and all of the interventions identified this need and had both support to access, structured recall systems and the facilitation of services close to patients home as their key themes. Assessment of physical health needs and the prescribing of the most appropriate psychotropic medication for their mental illness requires to be structured and coordinated in an improved fashion. Structured physical health assessments frameworks and prescribing guidelines associated with physical health symptoms appeared to be the best way of coordinating this process for this patient group. A mixture of a social change and educational approach is a model that appears to mix well with the review of mental health nursing in Scotland and across the world with mental health services now promoting a more patient inclusive and community involvement role. This allows nurses in particular to facilitate ownership of these health problems and use their teaching skills to teach patients how to change their lifestyles and effectively manage the physical health difficulties that they have. Nurses will engage with local leisure and sports facilities to make support available in a more normal rather than institutional fashion. Reflection The author in completing this assignment has been able to explore different aspects of this problem that exists in Scotland and compare the Scottish approaches with what is happening in other areas. He has found a very similar pattern of difficulties and also some similar solutions although they seem to be at different levels of implementation. He noticed the American studies focussed a lot on the prescribing issues and getting appropriate prescribing correct. He felt this was probably due to the costs and charging policies associated with the American system and possible litigation if there are side effects of prescribed medications which go on to cause disease where risks are known and identified. He felt this is becoming more apparent in the UK now but the study in America was several years ago. The approaches used were similar but there seemed to be a more coordinated approach to the assessment and monitoring of patients in the UK. The author felt that this was due to the NHS role in the coordination of care across the country where the USA has many different health economies and is focussed on a charging and insurance type policy. Recommendations Mental health nurses should continue work in a patient focussed way encouraging patients to take individual ownership of their needs and promote healthy living. The services in Scotland should coordinate themselves to ensure a physical health check is commissioned; takes place and the appropriate actions are followed through. Patients should be supported to access primary care services to enable this screening to take place. Medication algorithms should be developed and audited to ensure that prescribed medications are appropriate to the health profiles of patients and that medication for psychiatric reasons does no harm in relation to the patients physical health.

Saturday, January 18, 2020

I Heard a Fly Buzz When I Died and After the Apple PIcking: An Analysis Essay

A poet uses the elements of poetry to express his/her theme. This is particularly true in the poems I Heard a Fly Buzz When I Died by Emily Dickinson and After the Apple Picking by Robert Frost. Both poets use metaphor and rhyme scheme to accentuate the themes of these two famous poems by two of America’s most beloved poets. Metaphors, comparing two unlike or unrelated things, are essential to poetry and the purpose of poetry is to evoke an emotional response. Therefore, there must be a theme, or main point, to a poem and that point is what will awaken emotion in the reader. I Heard a Fly Buzz When I Died is a work that when the title or first line is read, sets a tone of uneasiness because it deals with death and flies. Most people do not want to dwell on their own mortality and no one can find tolerance for a fly. However, Dickinson portrays death in a way that it is only thought of as part of the natural process of life and she does this through the use of metaphors. The most obvious metaphor is where death is compared to a fly. The fly is seen as an annoying insect that is drawn to putrid decaying things that were once alive. The fly is insignificant where humans like to think that the whole world will be affected by their deaths, in reality, it will be as common as a house fly. The next metaphor is tied to the first in that the deathbed watchers are waiting for the King to make his presence known in the room. The King is obviously a metaphor for a royal personification of death. While they are anticipating some type of pageantry, death shows himself as a fly which heightens the theme of the commonality of death. After the Apple Picking is also rich with metaphors. The most obvious metaphor is the comparison of death with sleep. The narrator has finished a hard day’s work picking apples and he is extremely tired. In fact, he has fought sleepiness all day. The setting is late fall to early winter which also points to the end of life. This sleep is something that the narrator can not fight just as a person can not fight death. When the time comes, there is nothing a person can do but give into it. Rhyme scheme is another way that Dickinson and Frost accentuate the theme. In After the Apple Picking, the rhyme scheme is varied and subtle just as death can be. Death is certain like the rhyme scheme, but it is different for each person and it is not always earth shattering. Dickinson’s rhyme scheme in I Heard a Fly Buzz When I Died does follow a pattern, but it is also subtle. Her use of subtly takes the form of slant rhyme so that there is not a harshness that would detract from the theme of the commonness of death. Theme is the major element of poetry and through the use of other poetic elements, it can be conveyed effectively. Emily Dickinson and Robert Frost knew this and made use of rhyme scheme and metaphors to enhance the meanings of their poems.

Friday, January 10, 2020

Managing Workplace Stress

While there are existing businesses and constantly changing competitive business environments, the skills required to not only run a business but to sustain its performance and, more importantly, to rise above the rest are deemed of utmost significance. Although the employees in a specific company’s workforce are separate individuals in one way or another, it cannot be doubted that the overall performance of the workforce poses a great amount of influence in the total functioning of every company. While achieving this particular objective, this also causes stress in the workforce which may led to a decrease in productivity levels of employees. This is one of the reasons why stress management procedures are crucial to every business venture. More importantly, a great deal of the creation and management of teams to make them more effective rests at the heart of business undertakings if they feel like they are not working at all.  Read also Post-Traumatic Stress Disorder. Similar to a well-oiled machine composed of individual but interrelated parts, it can be said that business management teams, in order to accomplish and even surpass their goals, are expected to work together fluently and effectively with the indispensable addition of satisfaction and low stress levels. The smooth interaction and constant dealings of these people in the business organization will most likely lead to favorable consequences in the operations of the business from a larger scheme. On the other hand, the weight of the team manager in assembling a team that is composed of individuals that are not stressed fit well the positions they are to handle is of paramount importance as well. This is because a team that is created with members occupying specific positions strictly in accordance to their capabilities and related experiences is a team whose identifiable roles are devoid of apparent complications and performance-related problems related to stress (Foxman, 2006). Individual and team conflicts may never be far behind inn such a scenario in a stressful working environment. One way in order to preempt such an unwanted instance is to practice techniques that will ensure a high team performance. The Relationship of Stress and Alterations in Health In man’s day to day activities, there are certain factors that hinder him from functioning normally in the office. It may be physical, mental, emotional, or a combination of any of these three. As long as it incapacitates him or debilitates him from doing things normally, then it is a problem that needs to be taken care of. These factors are what are commonly known as stress. According to Peurifov, stress is defined as the â€Å"forces from the outside world impinging on the individual. † Putting it on the medical language, stress is considered as disruption of the balance in our bodies or homeostasis by means stimulus which is physical or psychological in nature (Peurifoy, 2005). These stress stimuli can be of different natures like mental, physiological, anatomical or physical involuntary reactions of our body. There are several processes of our body which we don’t really has a direct control over it. It can be an involuntary habit or reaction that usually arises when something familiar or unfamiliar happens or shows up. If the occurrence of stress made a greater impact to the person, it could be the cause of several serious changes in the person. These changes are alterations in the human health, as it is caused by stress. Once a person is exposed to a certain traumatic stress, he could be facing various changes in the limbic system, hypothalamic-pituitary-adrenal axis, and some important neurotransmitters. Some manifestations of these alterations can be classified into hyper arousal, dissociation, numbing, and the reoccurrence of certain trauma. Stress and traumatic experiences may trigger several parts of the human brain, most especially the limbic system, which is responsible for maintaining the chemical balance of the body or homeostasis depending on the outside factors. Several networks of the neural regions can be greatly affected in the occurrence of stress and traumatic experiences (Colbert, 2005). When this occurs, the brain could have involuntary abnormal reactions to similar, non-traumatic situations. The messages being sent by the brain to the different parts of the body is affected or hampered at times. There are also several researches that points out the effects of stress on the human’s immune system, as it was examined with different kinds of psychological stressors. Some highlights on the research showed that psychological stress can possibly be able to alter or change a person’s response to a vaccine, thus increasing the risk of infection (Glaser, 1996). It is relevant because we are able to see how the body actually reacts to the occurrence of these live viruses, and how our bodies respond to it. Stress alterations are also being tested on its effect on the body’s ability to repair the wound, since it was found that those undergoing psychological stress heals a lot slower than those who are in a normal living condition (Harding, 2006). The impending problem regarding this matter is about the lingering signs of stress after a stressful experience has occurred. An accident may have caused a post-traumatic stress disorder on a certain person, yet he is unable to notice this. Because of this, he suffers from continued impairment and incapacity as a normal human being. This could be caused by undetected injuries that could have resulted from an assault, several alterations in health behaviors, compromised immune system functioning and several stress-induced health issues (Brealey, 2006). If these concerns are not taken care of, this could lead to permanence in the alteration that he is suffering which would impair the patient for a very long period of time instead of recovering from the stress. The Case of Telstra. One case which can be used as an example is that of Telstra. Aimed at competing with major telecommunications players, the company resorted to create a business team that will seek the most desirable designs for telecommunications services as well as the innovations obtainable through benchmarking as well as an in-depth research of the industry (Siebel, 2001). In order to find the most suitable individuals that will fill-up the various positions in the team, it is an imperative for the prospective team members with varied expertise to be derived from various departments in Telstra. This way, the time to adapt to the company culture may be lessened and at the same time decrease stress in the workplace. Thus, this particular move could inhibit higher productivity. In general, the consequent results to the objective of managing stress in the team and will be reported to higher management for future stress management procedures. With several hefty expectations pending, the composition of the team should indeed be one which is devoid of or at least with very minimal complications so as to accomplish the objective of minimizing stress in the workplace completely. Primarily, the type of team being assembled is a cross-functional task force since the aim is to create a team for Telstra composed of employees coming from different departments that can be dissolved after the completion of the task with minimum stress. Conversely, the team is temporary by nature and, hence, there is a strong desire to compound the best employees of varying expertise. In the same way, this could provide an avenue for the discovery of new environments which lessens stress and competition within the company (Bruzzese, 2007). Further, there are several essential measures that must be taken in order to achieve the ends. One of these is to place the finest employee in a position in accordance to his or her expertise. Another essential measure is to highlight the common purpose of the team as well as to ensure trust among the team members and the team manager. Granting incentives and sharing motivations will aid the team surpass challenges along the way thereby also reducing stress and motivating workers at the same time. Although conflicts in the performance of each of the team members may tend to arise, the key is to be able to work with the stress in the office and still pursue the tasks at hand. Stress Management Skill of Managers Enhances Productivity Levels On the other hand, a figure of an effective manager does not only circle around the vicinity of technical and intellectual capabilities. It also requires a huge heart with sentiments not for personal advantage alone, but for the creation a harmonious relationship with the group and at the same time reducing work related stress. It does not mean that the leader, having been vested with the power to rule or govern over the organization, will be inconsiderate of his constituents’ feelings. Managers must bear in mind that the position under his control requires much in conceptual and emotional skills, rather than technicalities. Internal and External Demands According to Miller, Several organizational changes which are blatantly occurring in the 21st Century pressures conventional managers to be more agile and resilient so as to meet the standard constraints in the extremities on complex and interdependent organizations, which on a state of realization is quite hard to comply (Miller, 2008). As a result, some organizations find themselves hooked a maze of mistakenly trying to be all things to be all people in an attempt to meet proficient external and internal demands and creating stress among employees along the way. The form of leadership required for organizations must align with visualization, resources, and dedication to sustain a frontward impetus in the midst of modifications in twists of challenges faced by the organization (O'Connor, 2005). This helps a lot in reducing work-related stress in the office as employees are faced with an outlook driven goal like in the case of Telstra. Leadership, as defined, is an element of interaction armed with the power to supervise, command, lead and influence members under his leadership in achieving the specified organizational goals willingly, which then implies that effective stress management is collaborative (Miller, 2008). However, the precise definition of the term seemingly confuses many for the reason that application of the word along with its function varies on the nature of the organization, its type, the contingency of the environment, and the leadership style which is to be applied. The complexity of the word is vast and puzzling which then requires conceptualization and analysis, or else a slight mistake on its utilization may shatter the organization as a whole. Human Resource Issues and Challenges to Consider – Including Suggested Solutions. The challenge to have a trained and skilled workforce is the ultimate competitive advantage for any organization. This is also an implied reason why stress should effectively be managed in the workplace (Wheeler, 2007). The rapidly expanding base of new information and technologies affects every one of us, from factory floor to business office and this causes stress. No matter how capable or successful an organization is, like Telstra, if staff training and continuing education is overlooked, there will be problems in the organization. The challenge is to get the best value for the training dollars spent by choosing training that suits the needs of the company and least impacts the bottom line. In order to meet the challenge of reducing stress in the workplace, comprehensive approach to employee development can be adopted like what Telstra does. Set goals and reach them, identifying the needs, developing the right intervention, and delivering a practical, results-oriented solution. Interactive training is designed for the adult learner, requiring involvement in the learning process (Luskin and Pelletier, 2006). Handle specialized workplace challenges with customized group training. Handle challenges specific to the organization (Siebel, 2001). A good approach is to maximize training dollars spent by tailoring content to the organization’s explicit situation to produce the results needed. For instance, Telstra employs top-notch trainers who can combine their experiences with the latest in learning techniques in stress management for interactive sessions that emphasize skill development and application. Analysis on Stress Management. Stress Management in Telstra fragility caters two factors, the dependent and independent variables which simultaneously changes depending on the type of manager, the type of stress reducing procedure being imposed which adheres with the level of knowledge and skills required for the certain designation as well as the height of control which is to be employed (O'Connor, 2005). Stress management patterns of today’s generation are carefully crafted and studied for the benefit of the certain organizations seeking for clarity in the intricacy of some theories, otherwise, a clashing of actions will most likely float up.

Thursday, January 2, 2020

The Dictionary States That Fracking Is A Method Used For

The dictionary states that fracking is a method used for getting oil and gas from underground rocks by injecting liquid into the rocks so that they can break apart (Merriam-Webster). Fracking can be a controversial topic in numerous people’s eyes due to the side effects that coincide with this procedure. Fracking has evolved over the years and made a comeback around 2010. Lately, the United States has heard tremendous news regarding this procedure and the drawbacks from fracking natural gases and oil. Fracking can be beneficial; sadly, the side effects greatly outweigh the benefits. The environmental risks, pollution, and the overall risk factors prove to not worth the risk of fracking. Fracking is a†¦show more content†¦The environmental risks that accompany fracking are potentially hazardous. In order to frack, thousands of acres of forests need destroyed to allow roadways the space they need to exist (Lampe 38). However, these roadways allow erosion to occur due to the lack of vegetation (Lampe 38). Along with erosion, siltation occurs and sand, soil, and mud sink to the bottom of rivers, and ponds (Lampe 38). Therefore, the animals living in these habitats may migrate, or simply just die. Trees situated on the acres of land for hundreds of years would have to be chopped down to make way for roadways. In some cases, depending on where the oil reservoir is located, the state declares eminent domain on houses and pays the landowners. Consequently, the houses will be destroyed and the oil reservoirs will be fracked. The greatest common concern on the subject today is water contamination. Individuals grew worried that the chemicals used to gather these natural resources will seep into the water and contaminate the United States. The water necessary to frack is gathered from rivers, lakes, ponds, and even aquifers. This is then combined with chemicals and pumped into the ground. Fracking was exempted from the Federal Safe Drinking Water Act and the chemicals used to frack are not tested frequently in our water (Lampe 34). Bordering on 20 to 40 percent of the water used to frack rises back up to the surface and is stored on site (Lampe 34). AnShow MoreRelatedThe Effects Of Climate Change On Fossil Fuels1431 Words   |  6 Pagesâ€Å"a change in global or regional climate patterns, in particular a change apparent from the mid to late 20th century onwards and attributed largely to the increased levels of atmospheric carbon dioxide produced by the use of fossil fuels.† (Google Dictionary ). Due to our dependence on fossil fuels as our main source for energy and our carbon dioxide emissions over decades, climate change has rapidly emerged on Earth. Yet, we still have those who deny any scientific evidence of the effect of the dependenceRead MoreHydraulic Fracking Essay15746 Words   |  63 PagesHydraulic Fracturing (â€Å"Fracking†) LAS 432 – Technology, Society, and Culture Team B Michael Griffin Mark Hartwick Alena Hutson Kansas Gentry Kevin Gracia Professor Douglas McCoy 8/24/12 Contents Thesis†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Page 3 Abstract†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.Page 3 Hydraulic Fracturing Description†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦.Page 4 History of Fracking.....................†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦..Page 5 Cultural Context†¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦PageRead MoreRenewable Resources And Natural Resources2610 Words   |  11 Pagesimproving the American economy. Wind also has enormous potential. It could possible generate 20 times more than what the human population needs at full capacity. Because turbines must be spread apart, the spaces of land in-between the turbines can be used for other things, unlike the bulky, close together rows of solar panels needed to harness solar energy. Due to better technology and advances in the field prices of turbines have significantly decreased (80% since 1980). While wind energy has many