Thursday, January 30, 2020

Circadian Rhythms Essay Example for Free

Circadian Rhythms Essay 1. Describe how circadian rhythms are associated with sleep deprivation. 2. Explain the results of the sleep deprivation assessment. 3. Do you agree, or disagree, with the results. Why, or why not? 4. If you are sleep deprived, what steps could you take to get more or better quality of sleep? Alternatively, if you are not sleep deprived, what techniques allow you to get quality sleep most nights of the week? Circadian rhythms: Their role and dysfunction in affective disorder Press conference on the occasion of the 23rd ECNP Congress 2010, Amsterdam All humans are synchronised to the rhythmic light-dark changes that occur on a daily basis. Rhythms in physiological and biochemical processes and behavioural patterns persist in the absence of all external 24-hour signals from the physical environment, with a period that is close to 24 hours. These rhythms are referred to as  ´circadian ´, from the Latin  ´circa diem ´ ( ´about a day ´), and are attributable to internal biological clocks, driven by a major circadian pacemaker in the brain. The circadian pacemaker is entrained each day to the 24-hour solar cycle, which is the major  ´zeitgeber ´ (literally time-giver). Other zeitgebers are food intake, activity, or social cues, e.g. the alarm clock. Good temporal entrainment allows for optimal performance at the right time of the day, because being able to anticipate future tasks allows the appropriate physiological and psychological preparation. However, our modern society often imposes deviations from the regular work-rest-scheme, as in shift work, which results in problems with entrainment. Failure to adapt to environmental and societal time cues leads to misalignment of internal biological clocks. This  ´dysentrainment ´ comes with enhanced risk of errors and accidents, loss of productivity, and health risks such as increased propensity for cancer, depression, sleep disturbances, gastrointestinal, metabolic and cardiovascular disorders, decreased immune responses and even life span. Hence, people with circadian rhythm disruption caused by shift work often develop glucose intolerance, diabetes and hypertension, and maybe cancer. The recent discovery of the core molecular circadian clock machinery has dramatically increased interest in the impact of circadian dysregulation on mental and physical health. Molecular basis of circadian rhythms Circadian rhythms are directed by a master biological clock in a specific brain structure of the hypothalamus called the suprachiasmatic nuclei (SCN). Apart from the SCN, the body has circadian oscillators in all brain regions and peripheral tissues, for example the liver (Schulz Steimer, 2009, Bechtold et al., 2010). The SCN is synchronised daily by environmental signals – mainly light (Wirz-Justice, 2006). Receiving information on lighting conditions directly from the retina, the SCN drives secretion of the pineal gland hormone melatonin as well as and many peripheral clocks, and their outputs modulate the SCN through feedback or feed-forward effects. Thus, in the body there is a hierarchy of interacting clocks (Schulz, 2007). In all cells, the expression of many genes changes rhythmically over 24 hours. Specific circadian genes such as CLOCK, BMAL1, and PER are responsible for the main SCN clockworking machinery as well as subsidiary clocks in other parts of the body. In m ice with mutations in time-keeping genes, deviant circadian sleep-wake and other rhythms can be observed. In addition, new interest in the role of circadian dysregulation in psychiatric disorders has arisen from the finding that a mutation in a core circadian clock gene induces hyperactivity, decreased sleep, and mania-like behaviour in mice (Turek, 2008). Animal studies were the key development that brought the field to its present exciting position, because their findings suggested that  ´clock genes ´ are directing the circadian rhythms in all physiological processes. Circadian disturbances: clinical impact on affective disorders In healthy individuals, physiological and biochemical variables such as body temperature, cortisol and melatonin, thyroid stimulating hormone (TSH), noradrenaline and serotonin exhibit a circadian rhythm. However, in patients with affective disorders, many of these circadian rhythms are disturbed in phase and amplitude (Schulz Steimer, 2009; McClung, 2007). For instance, women with depression have a greater degree of variability in the timing of physiological and endocrine rhythms. Dysregulation of circadian rhythms and sleep disturbances are also core elements of bipolar disorder, and might be involved in its pathogenesis (Dallaspezia Benedetti, 2009). Clinicians have learned the enormous importance of synchronising agents ( ´zeitgebers ´) to entrain rhythms in patients with mood disorders, and how useful they are as novel treatments (e.g. light, melatonin). With regard to major depressive disorder, almost all patients present with sleep  disturbances and altered circadian rhythms including hormonal secretion, cardiac function, and body temperature. Sleep disruption is a major symptom in depression, with over 90% of patients showing sleep complaints that affect daytime functioning (Thase, 1999). Insomnia often appears before the onset of mood disorder symptoms and may persist into clinical remission: sleep disturbances are known to be a frequent residual symptom of depression, and the presence of insomnia marks an increased risk of relapse or recurrence. Sleep difficulties often are the key factor that causes depressed patients to seek medical help, and relief of sleep disturbances is important to encourage compliance with antidepressant medication. Associated with chronic depression, sleep disturbance can have as great an impact on health-related quality of life as the mental illness itself (Katz McHorney, 2002). It is well known that changes in clinical state are accompanied by shifts in timing of the sleep-wake cycle. The switch out of depression is often associated with a spontaneous sleep deprivation. Conversely, a prescri bed sleep deprivation can rapidly show antidepressive activity. Even more strikingly, a phase advance of sleep timing can induce longer-lasting antidepressant effects, suggesting an intimate functional relationship between sleep, its timing, and the depressive state. In healthy individuals and in patients with affective disorders, there is a close link between circadian rhythms, the stability of mood, and sleep regulation. How to reset the human biological clock in affective disorders In clinical practice, sleep disturbances in depression generally can be improved with effective antidepressant medication. However, commonly used modern antidepressants may be sleep-disturbing, particularly early in treatment, often to the extent that a sedative or hypnotic compound has to be prescribed concomitantly (Mayers Baldwin, 2005). The search for novel antidepressants has focused primarily on drug development, with the role of psychotherapy and cognitive behavioural therapy to help depressive patients being well accepted. Surprisingly though, clinical application of chronobiological research, so called chronotherapeutics, appears not to fit into any conventional category, and is mostly neglected as putative treatment. Chronotherapeutics Chronotherapeutics is defined as controlled exposure to environmental stimuli  that act on biological rhythms (e.g. light) or direct manipulations of sleep in order to achieve therapeutic effects in the treatment of psychiatric disorders. One major aim of chronotherapeutics is to synchronise impaired circadian rhythms. Today the range of chronotherapeutic indications not only comprises affective disorders such as major depression (seasonal and non-seasonal), bipolar disorder, and premenstrual dysphoric disorder and depression during pregnancy, but also bulimia nervosa, attention-deficit/hyperactivity disorder (ADHD), dementia, Parkinson ´s disease, and shift work and jet-lag disturbances (Wirz-Justice et al., 2009). Chronotherapeutic elements include light therapy, dark therapy or blue-blocking sunglasses, wake therapy (total or partial sleep deprivation in the second half of the night), phase advance of the sleep-wake cycle, and exogenously administered melatonin. Light therapy as a zeitgeber has been used to resynchronise disturbed sleep schedules back to a more normal pattern. Light is also an effective antidepressant, acting on many of the same neurotransmitter systems and brain structures as antidepressant drugs. What is fascinating about light therapy is that it is the first treatment in psychiatry that developed directly out of basic neurobiology research related to seasonal hibernation and reproduction in rodents. Light therapy is effective for all groups of major depression – not only for the seasonal subtype (SAD), for which it is well recognized as the treatment of choice. As an adjuvant to antidepressants in unipolar depressive patients, or lithium in bipolar patients, morning light hastens and potentiates the antidepressant response. Light therapy shows benefit even for patients with chronic depression of 2 years or more, and provides a viable alternative for patients who refuse, resist or cannot tolerate medication, or for whom drugs may be contraindicated, as in antepartum depression (Wirz-Justice et al., 2005). In addition, light therapy has been successfully used in other psychiatric or neurological illnesses, including bulimia nervosa and Alzheimer ´s disease. Dark therapy has yielded positive results to control symptoms in acute mania and to calm `rapid-cycling ´ bipolar patients in the manic phase – a group with one of the highest suicide rates among the mentally ill. By keeping patients in the dark and extending rest-sleep for periods of 10 to 14 hours, the mania episode could be ended. Dark therapy is theoretically interesting for its rapid effects, but is not very  practical. One alternative at present being investigated is the use of blue-blocking sunglasses. Blue is the wavelength to which the circadian system is particularly sensitive, thus by blocking this range in the light spectrum we can induce circadian darkness while not impairing the patients vision. Melatonin is a hormone secreted by the pineal gland only at night, and is suppressed by light. Cued by darkness, melatonin is especially important for the onset of sleep, but is also involved in many other systems cardiovascular, immune, endocrine, and metabolic. If rhythms are out of sync, as in depression, then melatonin rhythms also occur at the wrong time thus accentuating the sleep disturbance. Exogenously administered, melatonin acts as a zeitgeber to synchronise circadian rhythms. In addition, its thermoregulatory action is important to induce a rapid onset of sleep, though it is not a sedative age nt per se. Wake therapy (a single nights sleep deprivation) is the most rapid antidepressant available today: approximately 60% of patients, independent of diagnostic subtype, respond with marked improvement within hours. A single nights sleep deprivation induces similar brain changes as many weeks of antidepressant drugs (Benedetti and Smeraldi, 2009). Relapse after recovery sleep can be prevented by daily light therapy, concomitant administration of antidepressants (SSRIs), lithium (for bipolar patients), or a short phase advance of sleep over 3 days. Combinations of these interventions show great promise (Wirz-Justice et al., 2005, 2009). Despite the growing evidence for the efficacy of the available chronotherapeutic methods, it is surprising how limited the use of these treatments still is. Given the rapid action of chronotherapeutics, lack of side effects, and easy combination possibilities, how can sleep physicians and psychiatrists be educated about their use? Perhaps it is the patients that need to be educated, who are much more interested in non-pharmaceutic approaches? Obviously, treatments that are not patentable do not make profits for industry, thus denying the commercial marketing model used for drugs. Because they do not go through official clinical trial registration at federal regulatory agencies, chronotherapeutic treatments are not on the list for insurance reimbursement. On account of their simplicity, chronotherapeutics contrast with high-tech medicine, and for this reason are often not taken seriously. Clinical implications In clinical practice there is still rather widespread ignorance about circadian sleep disturbances and chronotherapeutics in spite of the significant evidence base. How can wider dissemination of chronotherapeutics be achieved? First, enterprising doctors should try them out. Only with first-hand experience does the reality of efficacy and response emerge. Second, the techniques should be taught in medical school and during residency – since it is the younger generation that is most open to change and use of cogent alternatives to medication. The nonprofit, multilingual patients website www.cet.org and clinicians website www.chronotherapeutics.org of the Center for Environmental Therapeutics (CET) illustrate some first attempts to meet this Phase 3 educational challenge. Third, through its societies, the field of chronotherapeutics needs to advocate recognition for reimbursement. In the treatment of affective disorders, chronotherapeutics offer a new synthesis of non-pharmacol ogic interventions designed to accelerate remission in patients with depression and bipolar disorder. Combining chronotherapeutics with concomitant or follow-up medication shows great promise. Given the urgent need for new strategies to treat patients with residual depressive symptoms, clinical trials of wake therapy and/or adjuvant light therapy, coupled with follow-up studies of long-term recurrence, are of high priority. Conclusion Circadian dysfunction can have drastic consequences on brain functions. Increasing evidence suggests that disrupted temporal organisation impairs behaviour, cognition, and affect (Benca et al., 2009). Disruption of circadian clock genes impairs sleep-wake cycle and behavioural rhythms, which may be implicated in mental disorders. Several different psychiatric disorders, including depression, bipolar disorder, seasonal affective disorder (SAD), schizophrenia, and borderline-related disorders are commonly associated with abnormalities in circadian rhythms. In particular, biological clocks play a major role in the pathophysiology of affective disorders. Synchronising impaired circadian rhythms, improving sleep, or paradoxically staying awake most of the night can be extremely helpful to treat patients with depression and bipolar disorder. Chronotherapeutic combinations of light and wake therapy achieve fast results and, by reducing  residual symptoms, also minimise relapse over many months. In addition, chronotherapeutics seem to be a major facilitator of drug response, and, in combination with antidepressants, a promising method to stabilise patients over the long term. Researchers are working on extending our knowledge concerning pharmaceutical and non-pharmaceutical ways to alter circadian rhythms. Recent discoveries of molecular clocks responsible for the generation of circadian rhythms provide novel insights into temporal disruption, offering new therapeutic avenues for the treatment of affective disorders. Sleep Drive and Your Body Clock * Sleep Topics Most people notice that they naturally experience different levels of sleepiness and alertness throughout the day, but what causes these patterns? Sleep is regulated by two body systems: sleep/wake homeostasis and the circadian biological clock. When we have been awake for a long period of time, sleep/wake homeostasis tells us that a need for sleep is accumulating and that it is time to sleep. It also helps us maintain enough sleep throughout the night to make up for the hours of being awake. If this restorative process existed alone, it would mean that we would be most alert as our day was starting out, and that the longer we were awake, the more we would feel like sleeping. In this way, sleep/wake homeostasis creates a drive that balances sleep and wakefulness. Our internal circadian biological clocks, on the other hand, regulate the timing of periods of sleepiness and wakefulness throughout the day. The circadian rhythm dips and rises at different times of the day, so adults stron gest sleep drive generally occurs between 2:00-4:00 am and in the afternoon between 1:00-3:00 pm, although there is some variation depending on whether you are a â€Å"morning person† or â€Å"evening person.† The sleepiness we experience during these circadian dips will be less intense if we have had sufficient sleep, and more intense when we are sleep deprived. The circadian rhythm also causes us to feel more alert at certain points of the day, even if we have been awake for hours and our sleep/wake restorative process would otherwise make us feel more sleepy. Changes to this circadian rhythm occur during adolescence, when most teens experience a sleep phase delay. This shift in teens circadian rhythm causes them to naturally feel alert later at night, making  it difficult for them to fall asleep before 11:00 pm. Since most teens wake up early for school and other commitments, this sleep phase delay can make it difficult to get the sleep teens need an average of 9 1/4 hours, but at least 8 1/2 hours. This sleep deprivation can influence the circadian rhythm; for teens the strongest circadian â€Å"dips† tend to occur between 3:00-7:00 am and 2:00-5:00 pm, but the morning dip (3 :00-7:00 am) can be even longer if teens haven’t had enough sleep, and can even last until 9:00 or 10:00 am. The circadian biological clock is controlled by a part of the brain called the Suprachiasmatic Nucleus (SCN), a group of cells in the hypothalamus that respond to light and dark signals. From the optic nerve of the eye, light travels to the SCN, signaling the internal clock that it is time to be awake. The SCN signals to other parts of the brain that control hormones, body temperature and other functions that play a role in making us feel sleepy or awake. In the mornings, with exposure to light, the SCN sends signals to raise body temperature and produce hormones like cortisol. The SCN also responds to light by delaying the release of other hormones like melatonin, which is associated with sleep onset and is produced when the eyes signal to the SCN that it is dark. Melatonin levels rise in the evening and stay elevated throughout the night, promoting sleep. In teenagers, research has shown that melatonin levels in the blood naturally rise later at night than in most children and adul ts. Since teens may have difficulty going to bed early to get enough sleep, it can help to keep the lights dim at night as bedtime approaches. It can also help to get into bright light as soon as possible in the morning. Circadian disruptions such as jet lag put us in conflict with our natural sleep patterns, since the shift in time and light cues on the brain forces the body to alter its normal pattern to adjust. This is why jet lag can leave travelers feeling poorly and having more difficulty thinking and performing well. But these symptoms can also occur in everyday life, when the circadian rhythm is disrupted by keeping long and irregular hours. Because of this, it is important to keep a regular sleep schedule and allow plenty of time for quality sleep, allowing these two vital biological components the sleep/wake restorative process and the circadian rhythm to help us perform at our best. References Circadian rhythms: Their role and dysfunction in affective disorder. (10, April 30). Retrieved from http://www.eurekalert.org/pub_releases/2010-08/econ-crt082610.php# Sleep Drive and Your Body Clock | National Sleep Foundation Information on Sleep Health and Safety. (n.d.). Retrieved from http://www.sleepfoundation.org/article/sleep-topics/sleep-drive-and-your-body-clock Good sleeping habits begin with a regular bedtime routine. If you thought that was just for kids, its time to reconsider the importance of pre-sleep rituals in your life. A relaxing bedtime routine helps to prepare your brain and body for bed and promotes restful sleep. | If you try to jump straight from the swirling thoughts and frantic activity of your everyday life into a deep sleep, chances are youll be unsuccessful. Thats because your mind and body arent controlled by flipping a switch to the off position in that way. However, establishing a soothing bedtime routine as an integral part of your sleeping habits sets the stage for a good nights sleep. Humans are creatures of habit and our natural body rhythms crave consistency. So, when youre planning your bedtime routine, keep things simply and easy because your ritual needs to be something you can do every single night. If you make it too lengthy or intricate youre setting yourself up for failure. Your pre-sleep behaviors should be soothing and relaxing. The aim is to give yourself the time and space to wind down from the stresses of the day and reach a calming state of relaxation to make it easier to fall asleep. If your sleeping habits include some of the following, youll be well on your way to establishing an effective bedtime routine. Take a warm bath A drop in body temperature helps to trigger the need for sleep so a warm bath (or a soak in the hot-tub) may help you fall asleep faster. You can enhance this effect by using aromatherapy products (bath oils, scented candles and so on) with calming properties. Practice Relaxation Techniques Todays fast-paced world tends to make us tense and irritable, which can really interfere with your ability to sleep well. Spending some time on relaxing activities (breathing exercises, yoga, massage, meditation, or entle stretches) before bed can lower anxiety levels and calm your body and mind. | Have a Bedtime Snack A bowl of nachos or that last slice of pizza definitely shouldnt have a place in your bedtime routine. But, certain foods and drinks can have a positive effect on your sleep. Some foods contain an amino-acid called tryptophan that can make you feel sleepy. Remember that glass of warm milk your mom used to urge you to drink? She knew what she was doing because milk contains tryptophan. In addition to milk, many dairy products such cheese and yogurt contain this chemical, as do soy products, poultry, whole-grains and many seeds/nuts. So, a glass of milk and a handful of wholewheat crackers could be a good addition to your sleeping habits. Many herbal teas can have a relaxing and calming effect, as well. Avoid Sleep-Destroying Activities Foods Any activity that stimulates your brain or body (with the noticeable exception of love-making) can sabotage your bedtime routine. Stay away from horror movies, work e-mail, strenuous exercise, caffeine, alcohol, tobacco, and spicy foods. Also, watch out for unexpected side effects of prescription drugs, over-the-counter medications and natural remedies that you may take for other conditions. Changing your sleeping habits and establishing a bedtime routine that encourages deep, restful sleep takes time and determination but the rewards are well worth the effort.

Wednesday, January 22, 2020

Sin, Guilt and Shame in The Pardoners Tale Essay -- The Canterbury Ta

   Geoffrey Chaucer's "The Pardoner's Tale," a relatively straightforward satirical and anti-capitalist view of the church, contrasts motifs of sin with the salvational properties of religion to draw out the complex self-loathing of the emasculated Pardoner. In particular, Chaucer concentrates on the Pardoner's references to the evils of alcohol, gambling, blasphemy, and money, which aim not only to condemn his listeners and unbuckle their purses, but to elicit their wrath and expose his eunuchism. Chaucer's depiction of the Pardoner in "The General Prologue" is unsparing in its effeteness; he has "heer as yelow as wax/ But smoothe it heeng as dooth a strike of flex/ By ounces heenge his lokkes that he hadde...But thinne it lay, by colpons, oon by oon" (677-681). The pale, lanky qualities of his hair relate to his androgynous makeup, and the repetition of "heeng" ironically foreshadows his castration. Further hints of the Pardoner's being a eunuch, such as "A vois he hadde as smal as hath a goot/ No beerd hadde he, ne never shold have," are interspersed between description of his "feined flaterye and japes" that accompany his selling of false relics (707). The assumption can be drawn that the Pardoner's status as a man is also one of "feined flaterye and japes," that he relies on words to compensate for what he considers a body as fraudulent as his relics. In this sense, the relics become a substitute for the Pardoner's loss of masculinity, yet also a symbol of his incompleteness. The Pardoner's need to flaunt them corresponds with his desire to boast of his hypocrisy, a preemptive, self-deprecating strike that ensures future resentment from his audience: "Thus can I preche again that same vice/ Which th... ... I wol thee helpe hem carye./ They shal be shrined in an hogges tord" (664-7). The Pardoner is speechless, and his repressed motive to expose the direct connection between his relics and his testicles is finally made by someone else. After the knight restores tranquillity, it leads one to wonder whether the Pardoner's underlying intent may have been to expiate his guilt and face his shame.    Works Cited and Consulted Chaucer, Geoffrey. The Canterbury Tales in The Riverside Chaucer. General Ed. Benson, Larry D. Boston: Houghton Mifflin, 1987.   Pichaske, David R.  Ã‚  Ã‚   "Pardoner's Tale." The Movement of the Canterbury Tales: Chaucer's Literary Pilgrimage.   New York:   Norwood Editions, 1977   Rossignol, Rosalyn.  Ã‚   "The Pardoner's Tale."   Chaucer A to Z: The Essential Reference to His Life and Works.  Ã‚   New York:   Facts On File, Inc., 1999   

Tuesday, January 14, 2020

Principles of Health Care Practice Code of Conduct Essay

1.1 Introduction I am writing this report as a requirement for my HNC Health Care course which will be submitted to Christine Hughes. In this report I will be comparing and contrasting two health care professions, the two health care professions I have chosen to compare is nursing and social work. The report will be highlighting the principles of healthcare, such as Education and Registration, (still to finish) 1.2 Nursing Education & Registration To train to be a qualified nurse you undertake either a pre-registration diploma or degree at university this is normally a three year programme. Degrees and diploma programmes comprise of 50% theory and 50% practice, with time split between the higher education institute. Nursing is organised into four branches – Adult, Children, Mental Health and Learning Disabilities. During the first year of nurse training you are introduced to all of the key areas as part of the Common Foundation Programme. In the second and third year you focus on a specific branch, which runs the course. Registered nurses and midwives are responsible for assessing the needs of individuals, planning and implementing their care, and evaluating the effectiveness. The Nursing and Midwifery Council (NMC) is the statutory regulatory body for nursing, midwifery and health visiting in the United Kingdom. All nurses working in the UK, including those trained abroad, need to be registered with the NMC in order to practice as a nurse in the UK, of that care. All qualified nurses, midwives and health visitors are required to be members of the NMC in order to practice. If nurses, midwives or health visitors are found guilty of misconduct, the NMC has the authority to strike them off the register. www.nhscareers.nhs.uk, www.planitplus.net/careerzone/ www.nursingnetuk 1.3 Social Work Education & Registration Social work requires a professional qualification, currently a three year undergraduate honours degree or a two year Masters degree in social work that has been approved by the General Social Care Council (GSCC)). The course involves a combination of course work and a minimum of 200 days spent in practice settings providing the opportunity for lots of practical experience before you actually qualify. The social work qualification is suitable for social workers in all settings and sectors. As a student and once qualified you will need to register with the General Social Care Council (GSCC) which is responsible for regulating the workforce. Previous qualifications in social work including the diploma will continue to be recognised as valid social work qualifications. There are a variety of ways to enter the social work profession, according to age and previous experience. www.socialworkcareers.co.uk, www.planitplus.net/careerzone 2.1 The Nursing & Midwifery Council The NMC is the regulatory body for nursing and midwifery; there purpose is to improve the standards of nursing and midwifery care in order to protect the public through professional standards. NMC register all nurses and midwives to ensure that they are properly qualified and competent to work in the UK. They set the standard of education; training and conduct that nurses and midwives will deliver high quality healthcare consistently throughout their careers. NMC also makes sure that nurses and midwives keep all their skills and knowledge up to date and to uphold the standards of their professional code. They also investigate allegations made against nurses and midwives who may not have followed the code. Every registered nurse, midwife or health visitor must renew their registration every three years. Post-registration education and practice (Prep) is set by the NMC which is designed to help nurses and midwifes provide a high standard of practice and care. There are legal requirements set which must be met in order for there registration to be renewed. 2.2 General Social Care Council The General Social Care Council (GSCC) sets standards of conduct for social care employers and workers, this regulates the social care workforce including regulating social work their training and education. The GSCC is responsible for codes of practice for employers and employees in the care sector. Social Care Register is a register of qualified social workers, the registration will ensure that those working in social care meet rigorous registration requirements and will hold them to account for their conduct by codes of practice. Registered social workers are also required to complete post-registration training and learning activities before renewing their registration every three years. Post-registration training and learning requirements that all registered social workers must meet are every social worker registered with the GSCC shall, within the period of registration, complete either 90 hours or 15 days of study, training, courses, seminars, reading, teaching or other activities which could reasonably be expected to advance the social worker’s professional development. To keep a record of post-registration training and learning undertaken, and failure to meet these conditions may be considered misconduct. Continuing Professional Development in Nursing All registered nurses and midwives are required to take part in continuing professional development (CPD) in order to maintain their professional registration. This is part of the post-registration education and practice (PREP) requirements, set by the Nursing and Midwifery Council NMC. There are two types of PREP, 1. Practice standards and Continuing professional development standards. CPD is fundamental to the development of all health care practitioners, as it is important that nurses keep there knowledge and skills up-to date, to improve standards in the practice and to gain more qualifications. To meet the CPD standards nurses must undertake at least 35 hours of learning activity relevant to their practice every three years, to maintain a personal professional profile of their learning activity and to comply with any requests to audit how they have met these requirements. Nurses and midwives who do not comply with the Prep requirements will cause their registration to lapse and can no longer work as a registered nurse or midwife. These requirements must be met every three years, and are declared at the point that registration is renewed. 3.1 Clinical Governance Clinical governance is the framework through which the NHS is accountable for the continuing improvement of quality of professional standards whilst still safeguarding high standards of care, thereby creating an environment which aims for clinical excellence. It is to ensure that high quality and professional standards are being maintained, and that health professionals are competent to deliver care safely with the right training and skills. This protects the patients from risks and mistakes allowing them to have confidence and faith in their care providers. Clinical governance also ensures that practitioners are accountable for the quality of patient care they provide meaning that they are more likely to question their practice and seek to make it of more benefit to the patient’s health. If it is found that those standards are not being met or they have got complaints from individuals about there delivery of care, there will be someone answerable for the failures to maintain standards. Nurses are responsible for their own competence and if they carry out treatments or procedures then they will be deeming themselves to do so.

Sunday, January 5, 2020

The Juvenile Justice System And Juvenile Offenders

There have been many studies conducted that examine ways in which the juvenile justice system responds to female offenders. Historically juvenile female offenders have been treated under status offense jurisdiction (Zahn et al., 2010, p. 10). United States Courts would exercise the principle of â€Å"parens patriae† to place the female in detention as a form of punishment for misbehavior (Sherman, 2012, pp. 1589-1590). This principle also remains prevalent as it pertains to how the juvenile justice system currently responds to juvenile female offenders. Studies suggest that there is a divide between the government and public response to juvenile incarceration. Bullis Yovas (2005) state that support is given to correctional facilities to house juvenile offenders as a form of punishment (as cited in Shannon, 2013, p. 17). Individuals who support this perspective are often more likely to support the construction of more prisons and stern penalties on crime based upon the presumptions that youthful offenders are aware of the consequences of their actions (Drakeford, 2002 as cited in Shannon, 2013, p. 17). On the other hand, opponents of this perspective believe that incarceration creates an opportunity to rehabilitate the offenders (Huffine, 2006 as cited in Shannon, 2013, p. 18). This perspective supports the purpose of juvenile detention centers as â€Å"preparatory in nature – that is, offering services focused on the development of skills needed to return successfully to mainstreamShow MoreRelatedJuvenile Offenders And The Juvenile Justice System950 Words   |  4 Pages Since 1899 when the juvenile justice system was first created it has undergone quite a series of changes relative to how they go about the overall handling of juvenile offenders in the criminal justice system. 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So once juven ile is making face to face contact with the police officers, his life is in the hands of that officer who can make very important and sometimeRead MoreJuvenile Offenders And The Criminal Justice System1307 Words   |  6 Pagesâ€Å"The behavior of a repeat or habitual criminal.† Juvenile offenders are studied on the re-offense that will occur and it is said that from 70% to 90% of offenders will re-offend. In the light of the criminal justice system and recidivism there is not actual consensus on what a criminal recidivism counts as, for example whether it counts as a repeat probation violation. National data that exist proves that 6 out of 10 juveniles return to juvenile court before their 18th birthday. You have to wonderRead MoreAn Increase Of Teenage Female Offender s Joining The Juvenile Justice System1258 Words   |  6 Pagesdecade there has been an increase of teenage female offender’s joining the juvenile justice system. The number continues to the rise t hroughout both violent and non-violent offenses. This is a huge change from the population only a decade ago, the change in gender roles through society is partly the reason for this change however, there are several other reasons that contribute the growing population. In female juvenile offenders there tends to be high occurrence of emotional and mental illness thatRead MoreShould Juvenile Offenders Be Punished?1423 Words   |  6 PagesAmericans, justice is important. When harm is done to most Americans, often victims of harm say they want the juvenile offender to pay for what he/she has done. Making someone pay for the harm they have caused is an easy concept when it comes to adult offenders; however, what about juvenile offenders? Should juvenile offenders be punished for what he/she has done? When victims want the juvenile offender to be punished for the harm they have caused, this is called retributive justice. Often AmericansRead MoreStatus Offenders, Dependent and Neglected Youths, and Juvenile Victimizations1872 Words   |  7 PagesStatus Offenders, Dependent and Neglected Youths, and Juvenile Victimizations: As they come into contact with the juvenile justice system different, delinquent youths are treated differently in this system. Notably, the jurisdiction of this system and its courts also extends to non-delinquent youths like dependent and neglected youths, and status offenders. However, non-delinquents are not only viewed differently but they are also treated separately from delinquents. In most cases, non-delinquentsRead MoreThe Juvenile Justice System Is A System Modeled To Provide1066 Words   |  5 PagesThe Juvenile Justice System is a system modeled to provide a legal setting where youths account for their wrongs or are offered official protection. A distinct juveniles justice system commenced in the United States over 100 years ago. The first juvenile court was established in 1899. The system is founded under a range of core principles. First, juveniles are different from adults and hence need to be handled differently by the Justice System. Second, it is argued that juven iles differ from oneRead MoreThe Abolition Of The Juvenile Justice System1748 Words   |  7 PagesIn Canada, the juvenile court was established as a tribunal having the sole jurisdiction to hear, process as well as pass judgments for illegal behaviour that are committed by youths. This is a court system that fully distinguishes youths from adults as far as crime is concerned where their misconduct is labeled as delinquent acts rather than crime (Barry, 1987, p. 476). Youth are presumed to have less understanding of social norms and they are less aware of the long-term consequences of their behaviourRead MoreThe United States Juvenile Justice Court Was Based On The1325 Words   |  6 PagesThe United States juvenile justice court was based on the English parens patriae adopted in the United States as part of the legal tradition of England. But the efforts of the state to rehabilitate juvenile offenders with institutional treatment with the houses of refuge and reformatories failed . Today, the United States has 51 different juvenile court systems; the laws and statutes vary from jurisdiction to jurisdiction. Thus, each state’s approach to handle the youth offenders is responsible forRead MoreThe Juvenile Justice System1313 Words   |  6 Pages Today s concept of the juvenile justice system is relatively new due to significant modifications in policy overtime. The justice system has been trying to figure out effective ways to treat juvenile criminal offenders successfully for years. The justice system did not always have a special category for juveniles and their crime. Juveniles was once treated as adults when they committed crimes and were subjected to harsh punishments. The juvenile court was the culmination of efforts of the positivist