A Health Promotion Program Proposal Health And Social Care Essay

A Health Promotion Program Proposal Health And Social Care Essay There are many substance abuse and mental health organizations throughout the country but minimal effort has been expended in targeting Human Immunodeficiency Virus (HIV) prevention programs toward people with mental illness and chemical dependency. The severely mentally disabled population are at a higher risk for HIV infection than the general population (Perehenets, Mamary, Rose, 2006). HIV prevention programs are at a commodity and rarely within this vulnerable population recognized as a sexually active population let alone at risk of HIV infection. In the health promotion program the proposed program will be a prevention case management approach to reducing the incidence of HIV in people with mental illness or dual diagnosis. The program will include a variety of professional health services, psychiatric care, and individually tailored education on HIV, other sexually transmitted diseases, and safer sex, as well as drug/alcohol treatment as needed. Health promotion being the obj ective of this program there will be active progress to reduce HIV infection among mentally ill and substance abusing population. The process will include working individually with each client to facilitate the identification and modifying risky behaviors, while also treating mental illness and substance abuse issues in an active effort to improve wellness (Aids Alert, 2008). In Cleveland, Ohio, there is a limited effort directed toward addressing the issue of HIV/AIDS among people with mental illness and chemical dependency. At the same time, there is a growing phenomenon of HIV transmission through sexual activity among the severely mentally disabled individuals. Mental illness does not increase risk in and of itself, a person with mental illness can, of course, engage in high risk behaviors for HIV infection. Studies of people with Severe Mental Disabilities show that between 4% and 19.4% are HIV positive. In all cases, the seroprevalence rates among people with mental illness are higher than that of the United States population in general (Courns et. al., 1991; Sucks et.al.,1992; Susser, Valencia, and Conover, 1993). It is critical for the severely mentally disabled clients to be provided with adequate education about HIV/AIDS and prevention strategies. The typical severely mentally disabled client suffers from a severe thought disorder exhibiting periods of active mental illness and remission. Active periods may include symptoms such as hallucinations or paranoia. Negative symptoms, which appear during remission, may include anxiety, depression, or impairment in thought (DSM IV). During periods of active illness, a client is less likely to engage in unsafe sex or other high-risk behaviors. During periods of remission, however, a client may resort to sex and/or drug using behaviors in an attempt to self-medicate (Aids Alert, 2007). Ironically, one of the periods of greatest risk is when a client receives effective case management, including medication and counseling. Researching agencies across the United States it was found that rarely did individuals with severe mental illness have any knowledge of the HIV infection or ways to prevent the spread(Aids Alert 2007). Thus it is critical that severely mentally disabled clients be provided adequate education about HIV/AIDS and preventive strategies. The health promotion project will specifically address three priorities: (1) Promoting Healthy Behaviors and Life Styles, (2) Increasing and improving healthcare, (3) Increasing knowledge. Literature Review A total of six articles reviewed for this project all where consistent in the recommendation to reduce HIV among the severely mentally disabled population. To reduce the transmission of HIV among clients in this population, risk prevention and education are essential (Aids Alert, 2008). A challenge among this population is the continuous need for intensive case management because studies showed following education and risk reduction activities are taught after 6 months at risk behaviors returned (Berkman, Pilowsky, Zybert, Herman, Conover, Lemmelli, Cournos, Koepner, Susser. 2007). In review of the literature one of the weakness is that the reality of sustain prevention behaviors where not demonstrated nor did the articles at hand speak about the need for intensive case management once a person with persistent mental illness present being HIV positive or living with AIDS. Clearly the project being proposed would offer continuous individualized, comprehensive, prevention case management approach, coupled with risk-reduction counseling as well as pre and post counseling for testing for HIV. Prevention Case Management ensures that clients have the necessary infrastructure established in their lives to allow them to focus on treatment and healthy living. The case manager links the client to essential services such as healthcare, housing, entitlements, and training. Assisting in daily living skills, such as budgeting and medication compliance, and acts as a liason between medical doctors and psychiatrists working with the client. Once the client has been linked to resources to meet his or her needs and receives psychiatric care to minimize or control symptoms, then the focus on reducing risky behaviors associated with increased risk of HIV infection. There are many substance abuse and mental health organizations throughout the country but minimal effort has been expended in targeting Human Immunodeficiency Virus (HIV) prevention programs toward people with mental illness and chemical dependency. Conceptual Model The High Risk Prevention Program is based in behavioral science theory. The education and prevention group sessions and prevention case management both use a combination of the AIDS Risk Reduction Model (ARRM) and Harm Reduction theory as a framework to guide interventions. For example, the education portion of the group sessions teaches people what behaviors put them at risk for HIV or other sexually transmitted infection. The participants activiely show the knowledge they are gaining through the High risk, Low risk, No risk game, where a behavior is written on a card and given to each person. Participants are then asked to stand under the sign that shows the level of risk the behavior carries. This is based on the ARRM principle that in order to change behavior, one must first label it as risky. The prevention portion of the group teaches participants how to reduce likelihood of infection through safer sex practices. This is based on both the ARRM principle that a person must make a commitment to change (e.g., use condoms for every sexual encounter) as well as the Harm Reduction principle that people are going to do risky things, so they should be given ways to at least reduce the risk. The ARRM states that the last step to changing behavior is to take action to perform the desired changed (Lanier,M. Gates,S., 1999). The High Risk Prevention Program witnesses this principle in prevention case management clients, since they are seen and intervened upon over a long period of time (sometimes years), whereas group session clients are seen only once. It is essential to provide education about the risk of HIV transmission to practitioner, community members, and clients. All of these groups need to understand what HIV is, how it is transmitted, and how to change risky behaviors in order to prevent infection. Without this knowledge, the disease will continue to be misunderstood and it will continue to spread through people with mental illness and/or substance dependence. Group sessions will be provided at local community organizations that provide mental health and substance abuse treatment, thus reaching a larger community. Experience shows that many people with mental illness are reluctant to go to an unfamiliar place and/or are likely to isolate themselves at home. Staff will provide outreach to homeless drop in centers and group homes to assist in reaching marginalized populations. Providing prevention education materials and the tools necessary for clients to practice prevention and risk reduction techniques nurses and other supportive staff will offer clients a variety of safer-sex products, including condoms, female condoms, dental dams, lubricants, and pamphlets about specific sexually transmitted disease or HIV. Free anonymous or confidential OraSure testing will be provided to participants following each session. In addition to education and prevention seminars, it is important to assist clients through learning, understanding, and implementing a risk-reduction life style. Prevention case management is critical in ensuring that clients have the necessary infrastructure established in their lives to allow them to focus on treatment and healthy living. The case manager will link the client to essential services such as healthcare, housing, entitlements and/or job training. The case manager will assist with daily living skills, such as budgeting and medication compliance, and act as the constant between medical do ctors and psychiatrists working with client. Project Goals and Objectives The first goal will be to increase knowledge and awareness around HIV and other sexually transmitted disease and prevention models, such as safer sex practices to clinical staff. The objective will be to provide education session about HIV and other sexually transmitted disease to employees and interns to ensure internal agency staff members are informed with accurate knowledge about high-risk behaviors associated with HIV and STDs. A secondary objective for this goal will be for staff members comfort and capability to talk with clients about sexual behaviors and HIV/STD prevention. The second goal will be to decrease behaviors that put people with mental illness and substance abuse problems at risk for HIV infection through comprehensive case management while supporting clients physical, emotional, social and mental health. The first objective will be to provide prevention case management services to 45 unduplicated clients. The intervention will be providing case management services to 30 clients each month, with overlap from month to month ( the average number of case management encounters will be two per client, per month). The second objective for the goal number two is to provide prevention and education sessions to One hundred and Eighty clients. With mental illness and/or substance use to increase knowledge about high risk behaviors associated with HIV/AIDS, other sexually transmitted disease, and safer sex. The intervention will be for multidisciplinary staff to provide prevention education sessions. Seminars will rotate through the community and will be held throughout the year, with an average of one seminar per month. Free, anonymous HIV testing will be provided through collaboration with an established testing provider. The outcome will be that clients achieve an increase in knowledge and awareness of issues around HIV, other sexually transmitted disease and safer sex, as evidenced in pre post test result analysis. Evaluation Component Evaluation of the projects success has two components. The first component is a pre/post test to assess clients knowledge of HIV, safer sex, and sexually transmitted disease. This evaluates the Education and Prevention component of the Project. Post-test scores that are higher than pre-test scores will show that the Education and Prevention session improved the participants knowledge of HIV, and other sexually transmitted diseases and safer sex. The second evaluation component is a documented review of client goals. This evaluates the Prevention Case Management component of the project. After establishing rapport with the client, the Prevention Case Manager will collaborate with the client to formulate a personal goal about HIV or other sexually transmitted disease risk reduction or safer sex. Typically, the Prevention Case Manager checks in with the client about this goal at each session to evaluate one or more of the following: the clients knowledge about HIV and prevention, his or her attitudes about changing risky behaviors, and skills available to implement a change. There is a formal written review of the clients goals that takes place every ninety days and is kept in the clients record. Progress is determined by both the clients personal assessment of his or her achievements and the Prevention Case Managers clinical opinion. Optimal outcomes in Prevention Case Management evaluation will demonstrate increase in condom use, cessation of injection drug use, or decreased number of sexual partners. Barriers and Challenges The adoption of Evidence Based Interventions can be best implemented under real-world conditions. The agency implementing the change must also have the ability to offer capacity building activities for the adopters of the intervention. Just adding responsibility to staffs all ready full scheduled can be a barrier to the motivation and successful implementation of the interventions. The level of care also needs to be assessed when offering Prevention Case Management when in fact the client is aligned in needed intensive case management simply to manage basic needs and this intervention would not have any significant change in behavior. The severly mentally ill client will present with challenges of psychiatric stability and that does need prioritizing. Successful behavioral change is not a one-time event. Change occurs over time, and with small steps which accumulate to make large differences. Change must be maintained over time and interwined into the culture of the person and their support system. The clinicians must remain flexible and meet their clients where they are moving them to risk free behaviors in their time line, pulling on their strengths. Nurses must expand their efforts to design and implement interventions which support promotion of health and prevention of disease and disability. Preventing and staying healthy is complex, focus is not only on the client but their family, their support system and their beliefs. The nurses approach needs to be comprehensive looking at primary, secondary and teritarty levels of prevention and involve the client and community in the planning. The Aids Risk Reduction Model allows the nurse to understand and predict clients behavior including how they use and adhere to recommended therapy. Health promotion being the objective of this program there will be active progress to reduce HIV infection among mentally ill and substance abusing population. The process will include working individually with each client to facilitate the identification and modifying risky behaviors, while also treating mental illness and substance abuse issues in an active effort to improve wellness (Aids Alert, 2008). .

The reigns of Justinian as the emperor of Byzantium during

The reigns of Justinian as the emperor of Byzantium during 527 to 565 BC and Romanus IV in 1068 to 1071 AD were two most important events in Byzantine. The former marked the stability and economic growth of the land and the former was known to start the end of the empire. Byzantine (Istanbul today), which was called as an extension of Roman Empire in eastern part, after it was captured and made it a province. Justinian known as ‘Justinian the Great’ according to Alexander A.Vasiliev â€Å"is the central figure of this entire period† (1954, 132) for invading Italy, pacifying Africa and controlling Persia from invading the land through his faithful and able generals named Belisarius and Mundo (Treadgold, 1997, 207). Romanus IV on the other hand had a strategy that did not work for him. Romanus IV gathered large army in troops enough to defeat the enemy, yet he lost the battle for he lost control of them due to disloyalty of his men.Justinian seldom joined the army, while Romanus was at the center of the battle. Justinian delivered direction and instruction to his trusted men, and Romanus IV if not misunderstood, was left alone by his warriors to seek refuge (Bradbury, 2004, 176). The challenges in the reign of Justinian were the uprising of the people and uncontrollable circumstances that weakened his control – the plagues and earthquakes that befell the land.Romanus IV’s challenges were much severe since he reigned at the time when Byzantine never had any recur but to drive away the Seljuk Turks to contain the territory at the midst of unfaithful generals and warriors. Justinian was just fortunate to have a wife and Belisarius who advised and obeyed his command. Romanus IV had a different case instead because he was caught unprepared despite a well-organized plan he made to win the battle.His greatest challenge was not the number of enemy but the sphere of his influence as a leader to execute commands. Romanus had no lawful men and he was unaware of that; besides, the empire was surrounded by men with greedy ambition. Bibliography Bradbury, J. 2004. The Routledge Companion to Medieval Warfare. USA: Routledge. Treadgold, W. 1997. A History of the Byzantine State and Society. USA: Stanford University Press. Vasiliev, A. 1954. History of the Byzantine Empire, 324-1453. USA: University of Wisconsin Press.

On Racist Speech

Adetayo Adedoyin Dickson Lam ENGL 1304 February 16, 2013 On racist Speech The voice of writers and authors are the key components to their inner thoughts. It is a way of actually portraying what a person is trying to say. However the case is that their words silenced and put in period of exile away from the eyes of the public. Author Charles Lawrence goes on to state that racist speech is wrong simply because of the drastic agony it puts on a victim’s perspective.In the article â€Å"On Racist Speech,† the author, Charles R Lawrence III, effectively establishes creditability, logics and emotional themes to supports his argument which infers that the use of harmful language should not be protected by the First Amendment Law in order to stop racism. Lawrence sheds light upon the very turbulent issue of the First Amendment right to the Freedom of speech in contrast to the inequality caused by its misuse through racially bias speech.The author states that the University off icials should endorse some sort policy that will protect the rights of those who are victimized by this â€Å"racial nuisance,† while at the same time not censoring our constitutional right of free speech, â€Å"I am troubled by the way the debates has been framed in response to the recent surge of racist incidents on college and university campuses and in response universities attempts to regulate harassing speech† (51). Continually, Lawrence defines the set of ideals that the First Amendment was based on, particularly; equality.He goes on to show the audience that this very balance is in danger if the speech in question is stated in a deliberately hurtful manner. Lawrence brings up factual evidence from the Brown vs. Board of education that supports his claim that prejudice can also be viewed as a form of racist speech. Lawrence argues just as Brown did, that segregation in schools causes disparity and unfair conditions to the victims of racist speech. Brown deemed t he idea of segregation as a symbolic message that affected the hearts and minds of young black students.Lawrence correspondingly deems free speech that allows â€Å"Hate Mongering Speech† as unfair and segregating â€Å"Brown held that segregated schools were inherently unequal because of the message of the message that segregation conveyed-that black children were an untouchable caste, unfit to go school with white children† (52). The author hence, proposes that the racist speech can hurt so much so that it can create an unfair educational environment for those who are victimized by it. The author used this notable example because he is trying to convey an important point to the lawyers, attorneys and the University regarding the on racist speech.Lawrence suggests that speech should be regulated in a way that does not limit it. First, the speech should not invade the general privacy of any student. This meant that speech would not be tolerated in personal spaces such as dorms, restrooms, or any living space â€Å"Minority students should not be required to remain in their rooms in order to avoid racial assaults† (52). Another regulation was the idea that speech that was intentionally hurtful or unruly would not be tolerated. However, any public demonstrations would have to give fair warning so that others may produce a counter-argumentation or avoid it entirely.The author takes a different approach to the problem. He suggests that on an individual basis lawyers could bend the rules to distort the will of their client so that the victim would be amended. This solution on an individual basis would help to cool the flames of racism without opening the floodgates. Lawrence also supports his claims by making visible repetition in the article. This shows how the author constantly makes the audience feel like they should be responsible and they should be able to do something about the racist speech issue in the society.The author Charles Lawrenc e is able to establish creditability in his article he relates his childhood experiences with human rights â€Å"I have spent the better part of my life as a dissenter† (51). This is to show that he has been an active member of the First Amendment right even as a child. Lawrence also appeals to the audience emotions by stating how hurt the victims are in the society â€Å"Above all I am troubled that we have not listened to the real victims ,that we have shown so little understanding of their injury and we have abandoned those whose race, gender, or sexual preference continues to make them second-class citizens†(52) .Persistently, the author defines the set ideals that the First Amendment was based on particularly equality it seems to him a very sad sarcasm that the first instinct of civil libertarians has been to challenge the exertions the university makes to provide minority students the protection the constitution guarantees them. Lawrence tries to make his argumen t justifiable by not defining a subjective issue in his argument he sticks to the main purpose of writing the article which is to talk about the â€Å"On racist speech† and he is able to give strategic examples like the First Amendment and the Brown versus Board of Education case.He thereby avoids subjective issues which makes him deviate from the actual facts regarding the on racist speech which is supposed to be conveyed to the audience. Lawrence creatively draws out many ideas that would help with the problem of racist speech by stating that we could regulate racist speech without violating the First Amendment law and he fears that if the government refuses to look into this there would be an upbringing of racial ferocity he also explains that racist speech should be diminished by the society as a unit because racism does not just affect the individual but the society at large .The author Charles Lawrence claims that it is unfair to place the burden of racism on anyone bec ause it forces them to live and work in an environment where at any moment they may be subjected to condescending verbal harassment and assault.

Age of Imperialism Japan China Essay examples - 1170 Words

The nineteenth century was a turbulent time of western imperialism and a major Asian power shift. European powers and the United States had a destabilizing effect on the region and the choices Japan and China made in response their imposing expansion was a major contributor to the trajectory of their respective futures. Social factors, such as the differences in national and religious unity, also played a role in the how the two nations emerged from the Age of Imperialism. European trade with China was historically restricted. In 1793, emperor Qianlong denied King George IIIs request for fewer trade restrictions by declaring, â€Å"Our Celestial Empire possesses all things in prolific abundance... There was therefore no need to import†¦show more content†¦Finally, deeply rooted tensions between Britain and China began to come to the surface as the Chinese attempted to crack down on opium use and trade within its borders. The appointment of Lin Tse-hsu as Imperial Commi ssioner at Canton was the catalyst that changed the trajectory of Chinese-British relations. Tse-hsu immediately began to shut down the opium trade at its source by exposing and punishing corrupt officials and seizing opium supplies without compensation. He wrote a letter to Queen Victoria requesting Britain forego further opium imports to China, citing Britains banning of its use and trade within its own borders (Hooker). The Queens refusal enraged Tse-hsu and he threatened to end trade with Britain altogether. Britain responded by using their superior military might to compel them to keep trade channels open and to remove the many trade restrictions currently in place, thus beginning the first opium war. It is important to note that the opium trade was merely the final straw amongst a heap of British-Chinese tensions. 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