Saturday, January 25, 2020

Prevalence of Inappropriate Behavior With Schizophrenia

Prevalence of Inappropriate Behavior With Schizophrenia Sexuality is basic human need. This need is present at every developmental stage and as age increases, it become more dominant. According to Freud if person fixated at one stage or its needs repressed then in later life it comes in his behavior (Townsend, 2006). According to Muslim Public Affairs Council (1996) sex and sexuality are consider taboo subjects in Pakistan. Our culture also doesn’t allow talking about these issues openly before marriage and consider legal to satisfy sexual desire only after marriage. Religion also doesn’t support to discuss these matters openly. It is important to discuss on this topic in mental health because if we don’t discuss on sexuality, the patient may start expressing his thoughts in unacceptable manner which is against our norms of society and it is called as â€Å"sexual disinhibition†. The study uncovered that 26.7% of persistent schizophrenic patients had huge obsessive enthusiastic indications, with a high prevalence in the age set underneath 35 years. Obsessive habitual side effects were more serious in patients with term of sickness more than 5 years. The obsessive impulsive indications were more common around paranoid schizophrenics (Hemrom et al, 2009). A 33 yr. old female admitted in Karwan-e-Hayat with complain of schizophrenia. On assessment I found her depressed and prepared to give teaching on coping mechanism. While giving teaching to her on coping strategies she suddenly started telling her sexual thoughts, desire and feelings to have a sexual intercourse. Even she was ready to have an intercourse with his divorced husband and wanted to get married. When she was telling this I was quiet, anxious, uncomfortable, and not confident to discuss. Once I thought that I was not able to assess her problem for which she needed help. In schizophrenia obsessive compulsive symptoms that of being contamination, sexual, and aggressive thoughts is the positive sign. In a research it has been found that 10% of schizophrenic patient had these obsession symptoms (Hemrom et al, 2009). Sexual obsession is common in schizophrenic patients and relates the DSM-IV criteria of schizophrenia and OC (Bancroft, 2008). Who encounter such a sort of unadulterated fixations (i.e., fixations that are regularly portrayed by the absence of unmistakable impulses) assess unpleasant considerations as unsafe and excessively significant and, hence, fight to control their beliefs (Dell’Osso et al, 2012). The patient was suffering from schizophrenia so having sexual obsession could be the part of her disease process as Turkcan et al. (2007) reported that 16% of patient had obsessive compulsive symptoms with schizophrenia. According to Freud (1961), psychoanalytic theory describes formation of personality through five stages of psychosexual development. Fixation of libido (sexual drive or instinct) at any stage of development certainly results in psychopathology (Townsend, 2006) and fixation at any stage will also influence the behavior of person in later life (McLeod, 2008). As in case of my patient, she was divorced due to which her sexual desires were repressed and unable to fulfill them. It results in fixation of sexual needs due to which her sexual needs are at extreme level that, she have intense feeling to have intercourse and have sexual thoughts, which may change into behavior at any time. On the other hand, literature shows that some antipsychotic drugs induce sexual disinhibition which includes risperidone and quntipien (Lam et al, 2007). Risperidone side effect is that it increases sex drive and also decreases sexual function in some cases. Some cases have been reported which shows the effect of risperidone in increasing the sexual obsession compulsive thoughts (Basil et al, 2002). So, my patient was also taking risperidone it may be one of the factor for having compulsive thought. Whereas, there is also literature support for medication that decreases sexual desires such as one of the late study evaluate that second generation antipsychotic i.e. risperidone, olanzapine, quntipien, and haloperidol is the biggest study to date to assess sexual dysfunction and reproductive side effects (Kelly Conley, 2004). Therefore, it is important to take alternative medications to treat these symptoms. Whereas various late medicine studies and narrative case reports have indicated an adjunctive particular serotonin reuptake inhibitor (SSRI) may be a convincing medications to treat OC in schizophrenia. Patients getting clozapine and other atypical antipsychotics as their support medicine ought to be thoroughly screened for new onset or compounding of prior OC indications (Hwang et al, 2006). Although my patient had intense thoughts and desires to have intercourse, so with the pharmacological management it is important to do cognitive therapy because patient only have thoughts, but her thoughts can be change into behavior. It is important to change her thoughts through cognitive therapy. There are different strategies through which inappropriate behavior of patient can be change and these are discussing below. Cognitive therapy helps dependent upon perception, and all the more particularly, the particular judgment evaluation by a single person of an occasion, and the feelings or practices that come about because of that examination. Cognitive techniques include identifying and modifying repeated thoughts (thinking errors) and schemas interior values (Townsend, 2006). The goal of cognitive therapy is to change irrelevant beliefs, faulty way of thinking, and negative self- statements that cause behavioral problems (Stuart, 2013). Cognitive therapy focuses on controlling and reducing obsessive compulsive behaviors by behavioral strategies for managing symptoms, thoughts, beliefs and feelings are perused and examine for relevance and validity. Behavior modification system is dependent upon the precise examination and requisition of fortification. Support is the procedure by which new reactions are obtained and existing ones are fortified (Jessor, 2013). Moreover, motivational interventions can be done to develop patient’s motivation to change. By asking open-ended question can help to identify patient agenda. Affirming, reinforcing positive statements, and hopeful can emphasize that change is possible and it will also increase the self esteem of patient which will help him and motivate to change (Stuart, 2013). Role modeling can be done to teach the behavior. Lifestyle change to help an individual identify high-risk situations, change cognitive distortions or faulty thinking, and cope with stressful or high-risk situations that may trigger relapse (Townsend, 2006) Furthermore, nurse role is important in recognizing these issues in mental health. As, in my patient scenario it was my lacking that I was unable to recognize patient needs correctly so as nurse it is important to asses patient needs rightly and to do interventions accordingly. For this nurse should be competent in communication skills, confident to talk on this sensitive topic. She should have complete knowledge about the topic, positive approach and effective communication style can greatly improve the interaction. An approach that rises strengthening and self-governance ought to be utilized and the suitable health-advancement messages through consultation for individual client (Gott et al, 2004). All in all, prevalence of inappropriate behavior with schizophrenia is high; therefore as nurse it is important to asses patient needs and play the role of counselor, advocator, and as a care giver in giving awareness to families about patient disease process. Family and health care support also helps patient to cope his situation. In mental health it is important to modify the behavior of client according to needs through required techniques.

Friday, January 17, 2020

My intercultural communication at school Essay

My ESL classes at Heald College took six months and these were necessary requirements so that I could pursue major courses in Architecture. There were other students like me from other countries and it felt good to belong to a group that was being taught the American way of life and culture. It felt good because it gave me the feeling that I was not alone in my hardships. It did not feel so bad and odd being with a group struggling with nuances of the English language and pronunciation and the idiosyncrasies of American culture. While I considered myself an out-group when I was with natural-born Americans, I felt like a member of an in-group when I was with the foreign students. Probably, this feeling springs from the fact that one naturally feels out of place when all others behave and talk in a different way. There is some comfort gained from knowing that one is just like the others. My struggle to fit in was at times frustrating, as I could not be properly understood by the teacher on account of misplaced accents or outright mispronunciations. At first I really felt stupid when the teacher would rephrase my statement and ask if it was what I meant. When I would say it was not what I meant, another classmate would butt in with a genuine intention to help me out but I would end up all the more confused and misunderstood. Realizing the setbacks of my lack of facility with the language, I resolved more than ever to master the English language. My Intercultural Communication at Work Working as a busboy and later, as a waiter in a restaurant gave me the chance to encounter more people and gain more facility with the English language. Finding work was quite an exhilarating experience for me. I felt that I could already communicate my ideas clearly and so I gained more confidence. Of course, there were still some instances when some patrons would fail to understand how I pronounce my words but whenever such a thing happened, I would remember the word and practice saying it correctly when I got home. I had discarded my Dari-English dictionary and I could already carry on a conversation with a native speaker of American English without fumbling for the right word or halting. I once attempted to be friendly with other waiters hoping to generate deeper camaraderie while we were up and about with our tasks. To my horror, I found that Americans seem to be single-minded and so focused when they go about their work that banter is misconstrued as not being serious about work. From then on, I learned to be very business-like while doing my work, bearing in mind that I was not working in an Afghan setting Conclusion This profound reflection on my sojourn in America has made me realize a lot of things that I once took for granted. First, I realized that I possess the resilience and tenacity that is a hallmark of a true Afghan. I used to take for granted the lore and history that due to the Afghan experience of a succession of foreign invasions, Afghans are by nature strong in spirit and character. Indeed, it is no easy task for an 18-year-old boy to force himself to become an adult almost overnight due to peculiar personal circumstances. I realized too that exposure to another culture widens ones horizons and makes one more tolerant of other people. Assimilation into another culture truly begins and is facilitated by an earnest desire to learn the language to a level that one speaks it like one born into the language itself. Together with this is a keen sense of awareness of the seemingly insignificant cultural differences between one’s culture of origin and the host culture. Cultural sensitivity, if I may use the term, enables one to steer clear of problematic situations. Indeed, it is not always wise to act and behave according to one’s cultural orientation when one is in another cultural setting. My intercultural communication with the Peterson family was at first regulated by cues from the reactions of Mr. Peterson. I came to know what he disliked by observing how he reacted. Yet, the sincere sharing of cultural traditions was the factor that truly made our relationship rise up to a higher level. Mutual respect and understanding resulted from the open sharing and this could not have happened by merely observing each other’s reactions. Truly, if one wants to have a meaningful intercultural communication, it must begin with an honest sharing of culture and traditions. It makes it possible to view the other person from their own cultural perspective. The moment I stopped my automatic comparison of Afghan and American values whenever I encountered an unfamiliar cultural practice, I became more accepting of American culture. As Holliday, Hyde and Kullman advise, â€Å"Put aside simplistic notions about what is real and unreal in your perception of another culture, and appreciate that every society is as complex and culturally varied as your own†. (10) The moment I began to have this attitude in my attempt to fully integrate myself into American society, I may have taken the first step towards â€Å"intercultural competence†. Alred and Byram (2002) define intercultural competence as â€Å"the ability to behave appropriately in intercultural situations†¦. the ability to stabilize one’s self-identity while mediating between cultures† (340). I may have taken the first step but I still have a long way to go. All people regardless of culture have the innate need to feel a sense of belongingness. I am sure this is the reason why I felt at ease with my fellow Afghans as I did with other foreign students who were struggling to deal with language difficulties. Yet, once a genuine intercultural communication is initiated, it leads one to learn and marvel at the diversity and richness of all cultures around the world. Works Cited Alred, Geof and Mike Byram. â€Å"Becoming an Intercultural Mediator: A Longitudinal Study of Residence Abroad. † Journal of Multilingual and Multicultural Development 23. 5 (2002). Retrieved from http://www. multilingual-matters. net/jmmd/023/jmmd0230339.htm on April 25, 2007. Holliday, Adrian, Martin Hyde, and John Kullman. Intercultural Communication: An Advanced Resource Book. New York: Routledge, 2004. Questia. 25 Apr. 2007 . Robson, Barbara, Juliene Lipson with Farid Younos and Mariam Mehdi. â€Å"Afghans Their History and Culture, Cross-Cultural and Adjustment Challenges, published by the Center of Applied Linguistics, The Cultural Orientation Resource Center last updated 6/30/02. Retrieved from http://www. cal. org/co/afghan/acult. html on April 25, 2007.

Thursday, January 9, 2020

Alices Adventures in Wonder Land, James and the Giant Peach

Alices Adventures in Wonder Land, James and the Giant Peach Alices Adventures in Wonderland was written by Lewis Carroll in 1865. It was written for children and is a story of a twelve year old girl who falls down a rabbit hole. On her adventures, the protagonist, Alice, comes across many weird and wonderful scenes, sites and characters. She comes across many creatures and animals with anthropomorphic behaviour. The entire story is set in a strange world of continuous change. James and the Giant Peach, written by Roald Dahl in 1965, is also a book written for children. It is about a boy called James, who is also the protagonist and is also a similar age as Alice, and he comes across a huge peach. This peach contains†¦show more content†¦Happiness is exactly what James is searching for in his story as well. Seeking happiness being the main reason why he came aboard the giant peach in the first place, to escape his evil aunts. His main guidance and a large influence on the story is a wise old grasshopper, who, unlike Alices Cheshire cat, doesnt try to confuse or mislead James with word riddles as the cat does. Which way I ought to go from here? That depends a good deal on where you want to go, said the cat. I dont much care where-. Said Alice. Then it doesnt matter which way you go, said the cat. -so long as I get somewhere, Alice added as an explanation. Oh youre sure to do that, said the cat, if you only walk long enough. The cat as a character has great authority over Alices decisions and therefore over the stories development. However much Alice asks for his guidance and help, he cant help but try to confuse her or procrastinate in giving her the answer she wants. In James and the Giant Peach, Jamess stories and adventures are influenced by the insects he stays with on the peach. Unlike the cat in Alice, they are his friends and the advice, assistance and aid they provide him with is helpful, friendly and upfront. Would you like me to take you under my wing so that you wont fall over? asked the Ladybird. I dont know

Wednesday, January 1, 2020

The Benefits of Multilingualism in a Globalized Society Essay

With the Internet now ubiquitous, making it as easy to talk to someone on another continent as if they were your neighbor, coupled with the accessibility of global travel, it is now more beneficial than ever to know more than one language. However, United States citizens are mainly monolingual English speakers. In today’s globalized society, multilingualism is essential in keeping the pace on the world stage, and the United States should seriously consider taking action to encourage it. There are many benefits that a multilingual individual enjoys. According to Michael B. Paradowski, from the Institute of Applied Linguistics at the University of Warsaw, â€Å"Multilinguals can expand their personal horizons and—being simultaneously insiders†¦show more content†¦Instead, the American citizens should view immigrants as an asset rather than a problem (Brown). These other languages and the cultures that accompany them have helped shape America in the past and wil l do so again if the multiple viewpoints of multilinguals are respected. Immigrants who come to America are usually put into an ESL, or English as a Second Language, program, if their local school offers it. This means that they are mostly segregated from their peers until they have learned enough of the language to enter the inner circle of the English speaking world. Recently, though, other methods of teaching English to immigrants have become more popular, such as Two-Way or Dual Immersion programs. In this program, half of the students in the classroom are native English speakers and half are native speakers of a foreign language. This not only helps the non-native English speakers learn the language better and faster but gives the native English speaking students an understanding of the other language and culture (Brown). In the school districts of Hillsborough County, Florida, more than 150 foreign languages are represented, making this an extremely diverse community. This also makes it a reflection of national trend (Brown). In Hillsborough alone, â€Å"nearly 31,000 students spoke Spanish at home; six of the most commonlyShow MoreRelatedEffects Of Globalisation On English Lingua Franca Essay1743 Words   |  7 PagesIn a globalizing world, where language governs our society extensively the dominance of English has effects on linguistic and communicative inequality between native and non-native speakers (Tsuda, 1999). Research on globalisation argues strong evidence that English is the lingua franca or international language and communication of today. But to what extent has globalisation progressed through language? 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