Affirmative Action Essay

Martin Luther King, Jr. once stated, â€Å"Injustice anyplace is a danger to equity everywhere.† This announcement will continually sound valid particularly regarding the matter of equivalent open door with regards to work and instruction here in the United States. It’s no mystery that equity has been something America has consistently needed, and yet has consistently been something America represented. Truth be told it very well may be handily deduced that correspondence among the sum total of what men has been something America has stride for since it picked up freedom from the British in 1776. Our establishing fathers were the first to have this underlying idea, that being best depicted in the presentation of freedom, which state’s â€Å"We hold these realities to act naturally clear, that all men are made equivalent, that they are supplied by their Creator with certain unalienable Rights, that among these are Life, Liberty and the quest for Happiness.† (qtd. In statement of freedom) To me this implies our establishing fathers accepted that each man from birth has the inherent right to an existence of freedom and the quest for bliss, however some place during Americas venture as a nation it overlooked it’s genuine belief and became it’s own despot keeping individuals from arriving at their maximum capacity while additionally denying it’s own residents freedom and an interest to joy. Furthermore, in spite of the fact that accomplishing balance in this nation has been downright simple with incalculable set backs and tricky thoughts, fairness among every one of its residents is as yet something America does strides for, and nothing brings you direct uniformity quit like Affirmative Action does. In the event that you consider governmental policy regarding minorities in society for its deliberate purposes than Affirmative Action is extremely simply, its motivation being to level the instruction and monetary hole among minorities and causations. In spite of the fact that it's anything but an ideal strategy to accomplishing equity in this nation, it is basic to acknowledge it for why it’s been instituted and that it is all piece of a procedure. Obviously governmental policy regarding minorities in society is a long way from great and has a reasonable arrangement of issues, such as advancing opposite segregation while backing up negative generalizations. I investigated these perspectives while considering the inquiry â€Å"is governmental policy regarding minorities in society despite everything required in today’s society?† In this paper I will clarify what governmental policy regarding minorities in society is. The History behind governmental policy regard ing minorities in society like how everything unfurled, who made it, and the history with respect to why it is in actuality now. I will likewise show a few advantages and disadvantages of governmental policy regarding minorities in society, how the United States could better governmental policy regarding minorities in society for the future lastly an end, which is my supposition on the subject. Be that as it may, what precisely is Affrimative activity? Conceived of the social liberties development three decades prior, governmental policy regarding minorities in society calls for minorities and ladies to be given extraordinary thought in business and instruction acknowledgment choices. Colleges with governmental policy regarding minorities in society approaches commonly set objectives to expand assorted variety. Governmental policy regarding minorities in society choices shouldn't be founded on standards, nor are they expected to give any inclination to inadequate competitors. Furthermore, in no way, shape or form is governmental policy regarding minorities in society expected to hurt anybody through â€Å"reverse discrimination.† The reason for existing was to make equivalent open door for the individuals who had been unfairly rewarded previously. It was embarked to address this wrong, and make it right. And yet again and again is Affrimative activity is viewed as an answer for a country once sick with, yet now restored of, the abhorrent malady of racial separation. Some would state Affirmative activity is, and ought to be viewed as, a transitory, halfway, and maybe even defective remedy for past and proceeding with segregation. However, all things considered governmental policy regarding minorities in society is characterized as â€Å"The positive advances taken to build the portrayal of ladies and minorities in zones of work, training, and business from which they have been truly prohibited. At the point when those means include particular selectionâ€selection based on race, sexual orientation, or ethnicity† (Fullinwider) obviously governmental policy regarding minorities in society has a profound history to it, and to why it was instituted. Since you comprehend the reason for which it was made, let me clarify who made it and why governmental policy regarding minorities in society was made. The historical backdrop of Affirmative activity, the initial phase in governmental policy regarding minorities in society was its making. President John F. Kennedy originally presented it in 1961. Coming up next is in segments to show the timetable of governmental policy regarding minorities in society in the asking phases of its creation: * March 6, 1961 Executive Order 10925 makes the main reference to â€Å"affirmative action† (Timeline) President John F. Kennedy issues Executive Order 10925, which makes the Committee on Equal Employment Opportunity and commands that tasks financed with government supports â€Å"take confirmed action† to guarantee that recruiting and work rehearses are liberated from racial inclination. * July 2, 1964 Civil Rights Act marked by President Lyndon Johnson The most clearing social liberties enactment since Reconstruction, the Civil Rights Act restricts separation of various types dependent on race, shading, religion, or national starting point. (Course of events) * June 4, 1965 Speech characterizing idea of governmental policy regarding minorities in society In an articulate discourse to the graduating class at Howard University, President Johnson outlines the idea fundamental governmental policy regarding minorities in society, affirming that social equality laws alone are insufficient to cure separation: â€Å"You don't wipe away the scars of hundreds of years by saying: ‘now, you are allowed to go where you need, do as you want, and pick the pioneers you please.’ You don't take a man who for quite a long time has been limped by chains, free him, carry him to the beginning line of a race, saying, ‘you are allowed to contend with all the others,’ and still legitimately trust you have been totally reasonable . . . This is the following and progressively significant phase of the fight for social liberties. We look for opportunity as well as opportunityâ€not simply lawful value however human abilityâ€not only un iformity as a privilege and a hypothesis, yet equity as a reality and as a result.† (Timeline) * Sept. 24,1965 Executive Order 11246 implements governmental policy regarding minorities in society just because (Timeline) Issued by President Johnson, the official request requires government temporary workers to â€Å"take certifiable action† toward forthcoming minority representatives in all parts of recruiting and business. The remainder of the positive activities course of events starting now and into the foreseeable future is essentially simply Supreme Court cases, which can help characterize what precisely it can do and what precisely it can’t do. * In the 1978 Supreme Court case University of California versus Bakke, a white male named Allan Bakke guaranteed turn around separation since he was dismissed twice from clinical school while less-qualified minority understudies were confessed to fill a share that necessary 18 out of each 100 spots be loaded up with minorities. The Supreme Court managed against rigid portion frameworks, however didn't ban governmental policy regarding minorities in society as a whole.(Timeline) The greater part of the claims were against Universities since numerous colleges additionally embraced governmental policy regarding minorities in society programs during the 1970s. These projects were planned for expanding dark enlistment and the quantity of dark personnel. None progressively outstanding then Jenifer Gatz claim again the University of Michigan â€Å"Gratz versus Bollinger and Grutter versus Bollinger.† It decided that governmental policy regarding minorities in society satisfies â€Å"a convincing enthusiasm for acquiring the instructive advantages that stream from a differing understudy body.† The reason for governmental policy regarding minorities in society strategy moved from changing treachery to advancing estimations of decent variety. Be that as it may, significantly after all these choosing cases on governmental policy regarding minorities in society it’s still a warmed matter of debate. After much enactment and numerous Supreme Court choices, governmental policy regarding minorities in society keeps on being disputable (Legal History, Ongoing Debates area, para. 1). These debates lead to questions, which must be replied by understanding why governmental policy regarding minorities in society was placed into impact in any case. It is essential to recollect governmental policy regarding minorities in society is as yet a work in progress to accomplish something a lot greater than any one person. Individuals will in general overlook that and the history to why governmental policy regarding minorities in society was instituted. It can't be denied that America’s history is loaded with abuse of minority people. Ladies didn't get an opportunity to decide in favor of about a century and half after the introduction of the nation. African Americans were caught and constrained into subjection, Although the Thirteenth Amendment finished organized subjugation in the United States in 1865, African Americans were not offered equivalent whites according to the law for about one more century, they were viewed as just a single third of resident. So with the 200 years of bondage reaching a sudden conclusion another system or preferences was to become effective. Obviously much after the finish of subjection African Americans were reliably denied business, lodging, and training. In the south segregation was a day by day schedule upheld by â€Å"Jim Crow laws.†(Affirmative activity) Unjust social sculptures and standards were passed during the 1800s that build up discrete, mediocre, open offices, schools, lounge areas, railroads vehicles, and bathrooms for African Americans all through the nation. This has caused a domino impact on our general public that despite everything seen today. Those unbelievable normal practices were drilled in America until late in the social equality development when president JFK at long last recognized the battle for balance and the possibility of Affirmative Action was conceived. After President Kennedy’s rendezvous, President Lyndon B. Johnson passed the Civil Rights Act of 1964. It restricted separation based on race, national starting point, and sex in the regions of work, open offices, and government programs. The possibility of e

The Advantages And Disadvantages Of Using Esearch English Language Essay

The Advantages And Disadvantages Of Using Esearch English Language Essay Dynamic The reason for this examination will assess the benefits of utilizing eSearch exceed the weaknesses for NTIC understudies. The examination depends on arrangements of writing survey that allude to the scholastic web index or internet learning assets securing. The essential research directs by a poll. The example for the most part originates from understudies who learn at Nottingham Trent International College and attempt to discover a sensible outcome. The example size is twenty-eight understudy of NTIC. The discoveries uncover that the upsides of utilizing eSearch motor exceed the disservices for the NTIC understudies. There were absolute 96% respondents have thought eSearch style is significant for scholarly data getting. There were twenty-six respondents think the benefits of utilizing eSearch motor exceed the drawbacks. This finding may help understudies who learn at NTIC to know and utilize the eSearch on the NTU site. Presentation This is an exploration venture report. It endeavors to discover some hugeness about utilizing scholastic web search tool such eSearch on the NTU site. Most likely, some NTIC understudies don't have a clue what precisely capacity and activity does eSearch has. Ideally, the forthcoming finding might be an advantageous and accommodating direction for NTIC understudies. Foundation The advancement of data and correspondence innovation began from 1970s. In the previous two decades, the applications dependent on data and correspondence innovation has gained incredible ground in real applications. These days, data and correspondence innovation is growing quickly. There are assortments of electronic applications dependent on the Internet and PC. For instance, the internet searcher, for example, Google, that assumes an indispensable job in present work, study, entertainment and wherever throughout everyday life. Be that as it may, for some scholastic research region, general web index isn't excellent for scholarly reason (Golian, 2000). In like manner, a scholarly web search tool, for example, eSearch use of Nottingham Trent University (NTU) site come out. Understudies can acquire bottomless scholastic assets and do the examination by this sort of electronic programming. Such scholarly web indexes have turned out to be increasingly more well known among various learning establishments. Theory and Research Problem As far as understudies of Nottingham Trent International College (NTIC), searching for a substantial and dependable scholarly data asset is a significant thing for the individuals who is doing an examination venture or only for an exposition reason. My theory is that to utilize eSearch presumably is a superior path for understudies who might want to acquire scholarly data assets. In this way, my exploration question is that whether the upsides of utilizing eSearch exceed the weaknesses for NTIC understudies or not. Point and Objectives This examination will direct by a poll. The general point of this examination is proposed to assess the benefits of utilizing eSearch exceed the hindrances for NTIC understudies. The result of this examination will be a guide of utilizing the eSearch, particularly for the individuals who despite everything don't have the foggiest idea what the eSearch application is. Concerning unequivocal targets of this work, it will concentrate on: To discover what advantages of utilization of eSearch has of an incentive to NTIC understudies. To research why NTIC understudies use eSearch motor on NTU site. To show to what expand the benefits of utilizing eSearch exceed the impediments for NTIC understudies. Writing Review In purpose of reality, the eSearch is an electronic and scholarly web index. The fundamental motivation behind this writing audit will give a diagram that investigates some proof of essential research or book into the utilization of scholastic web crawlers, which will identify with the eSearch and chose inquire about inquiry territory. The writing audit is going to separate into two segments. At the principal area, it will see what focal points and impediments of utilization of scholarly web crawler have been alluded to and what is still not referenced. At the subsequent segment, it will take a gander at some real utilize and relative explanation that understudies utilize scholastic internet searcher. The points of interest and drawbacks of the eSearch The eSearch application can be utilized in the field of data assembling and subject research. There are many research finding indicated that the utilization of scholarly web index has points of interest and impediments. Kruse (2004) contends that eSearch gives a quick and advantageous way that students get helpful data assets. Mama (2006) concurs with him and he additionally demonstrates that the learning by eSearch can be lifetime learning with the ease. Truth be told, the substance of eSearch has a place with the extent of e-learning framework. Holmes and Gardner (2006) contend that e-learning style dependent on web or other data and correspondence innovation, the students can realize what they need to realize by web. In the mean time, some finding likewise demonstrated the detriments of utilization of scholastic web search tool. Kruse (2004) thinks about that occasionally there are some specialized issues that the chance of acquiring incorrectly data when utilizing eSearch application access to the assets, which will sit around. In addition, Allen (2003) makes reference to that the e-learning framework is defectiveness, which absence of viable and community learning thus much research inquire about by e-realizing way that outcomes a pool execution. Disregarding these writing referenced are the two points of interest and drawbacks of utilizing eSearch style, all finding are surface and general, which appears to be just about the way that obtains data by online application like eSearch is fortunate or unfortunate. The extent of information assortment is extremely expansive. They didn't concentrate on a unique gathering and notice any favorable circumstances or drawbacks of utilizing eSearch application that identify with understudies who need to get scholarly data assets, particularly for the individuals who need to realize whether focal points of utilizing eSearch to do an examination venture exceed weaknesses among the NTIC. This appears as though that more work need to do in this particular territory. The viable utilization of eSearch At present, the scholastic internet searcher as a typical practice is likely assuming indispensable job in a greater part of learning organizations. From one viewpoint, Allen (2003) focuses that numerous understudies acquire data by utilizing eSearch style since it is progressively adaptable and intriguing for their learning. Then again, Allen likewise makes reference to that a few understudies imagine that eSearch applicatons are exhausting, futile, a powerless looking through capacity that can't get to helpful assets after they attempted eSearch applications. Regardless of that, the eSearch application is as yet assume a functioning job on learning of research. In down to earth case, inspirational mentalities are more than negative perspectives (Burgess, 2007). It appears as though that the improvement of data and correspondence innovation lead to an inescapable result. Nonetheless, their finding didn't make reference to that how significant or helpful when utilizing an eSearch application to do a scholarly research. Moreover, due to eSearch style can get scholarly data assets truly and dependably, numerous libraries of learning organizations create electronic library as a scholastic data inquire about apparatus. Gibbons (2007) contends that the scholarly library depends on Web 2.0 with bottomless scholastic data assets, which can just inquiry a book or other scholarly data. In the interim, Gibbons features that eSearch style gives magnificent opportunity to understudies who live in the web age. By the by, every single past outcome simply show getting scholastic data assets by eSearch style is suggested, yet for NTIC understudies, there is no exploration finding to show that the benefits of utilizing eSearch on NTU site exceed detriments. Most likely, this hole will be filled by this examination. System This segment is going to state what look into strategy was decide for the information assortment of this exploration and how to regulate it. Research philosophy isn't just about what techniques the investigation use, the rationale behind the strategy is very significant too and it additionally need to clarify why the specific technique was chosen and for what reason didn't pick others (Kumar, 2008). Strategy for Data Collecting A survey that dependent on picked theme zone has been utilized for information assortment. This is fundamental and one of a kind strategy for information assortment this exploration utilized. Others like meeting or perception have been thought of, nonetheless, because of absence of times, those are perplexing strategy for this exploration. To utilize those way, which are more enthusiastically to direct and most likely will cost additional time. Along these lines, so as to gather appropriate data quickly and productively. The poll was picked. To perceive how great the poll done, which is a generally proper path for the reason that gathering helpful data among understudies who learn at NTIC. Survey Administering The survey of this exploration was directed through both email and vis-à-vis way. These two different ways are both function admirably. To convey surveys by means of vis-à-vis way, it appears as though an ideal way to deal with recover the data of the exploration. Truth be told, once in a while to pose inquiries and find solutions from others particularly the individuals who are more bizarre and don't have the foggiest idea where do their answers going. They not just stress over the security of some protection yet in addition withdrawn when face to an outsider. Because there is somewhat troublesome through vis-à-vis way, so as to flexibly an insufficiency, a few polls sent by means of email. The respondents arbitrarily originated from the email rundown of NTIC understudies. Portrayal of Questionnaire There are thirteen inquiries in the survey (reference section 1) and incorporate two inquiry types. The vast majority of inquiries are list question. There were nine inquiries are list, which gave a few or more decisions for respondents. Other four inquiries are scale question, which give various phases of scaling to re

History of Ngo Essay Example

History of Ngo Essay Example History of Ngo Essay History of Ngo Essay The changing substance of chipping in India 26 September 2006 by Patralekha Chatterjee Stepping cautiously around the pits and hills, four men moved toward the main wellspring of light to be seen a little lamp fuel lamp consuming inside a mud and grass cabin. There were four occupants inside a couple and their two youngsters, 10 and eight. They burrowed the pits, cut the stone and pulled it to the trucks, all without compensation. They were fortified workers, reinforced forever and for ages to the proprietor of the pit since some precursor at some point had obtained cash and had been not able to take care of it. Two of the four men who visited the cottage that night in 1985 were from a nongovernmental association called Bandhua Mukti Morcha (Bonded Labor Liberation Front). The other two were writers brought by the NGO to demonstrate that fortified work a type of subjugation existed directly in the countries capital. After the visit, the men from the NGO went to the police headquarters to hold up an objection, in light of the fact that reinforced work is illicit in India, as is kid work in a calling as perilous as this. The objections, and the articles composed by the columnists after the visit, were a piece of the NGO crusade to make the administration execute the law. Consistently, various NGOs all over India are doing things like this. At some point it might be taking an example of water from a well that has been contaminated by a close by plant, getting the water dissected and afterward documenting an open intrigue request in a court to compel the production line to observe against contamination laws. Some other time, it might be a warmed discussion with an official on why all residents ought to reserve the privilege to be educated pretty much all administration choices that influence their lives. In spite of the fact that the term NGO got famous in India just during the 1980s, the intentional part has a more established custom. Since freedom from the British in 1947, the intentional segment had a great deal of regard in the psyches of individuals first, in light of the fact that the dad of the country Mahatma Gandhi was a functioning member; and second since India has consistently had the convention of respecting the individuals who have made some penance to help other people. In autonomous India, the underlying pretended by the deliberate associations began by Gandhi and his supporters was to fill in the holes left by the administration in the advancement procedure. The volunteers sorted out handloom weavers in towns to frame ooperatives through which they could advertise their items straightforwardly in the urban areas, and therefore show signs of improvement cost. Comparable cooperatives were later set up in regions like advertising of dairy items and fish. In practically every one of these cases, the volunteers helped in different regions of improvement running education classes for grown-ups around eve ning time, for instance. During the 1980s, in any case, the gatherings who were presently known as NGOs turned out to be increasingly particular, and the intentional development was, as it were, divided into three significant gatherings. There were those viewed as the conventional advancement NGOs, who went into a town or a gathering of towns and ran proficiency programs, crEches for youngsters and centers, urged ranchers to explore different avenues regarding new harvests and animals breeds that would bring more cash, helped the weavers and other town craftsmans advertise their items, etc in short turned out to be just about a piece of the network in their picked territory (as a rule in provincial India) and attempted to fill all the holes left in the improvement procedure by the legislature. There are numerous instances of deliberate associations of this sort running effectively in India throughout the previous five decades. Maybe the most praised model would be the treatment community for uncleanliness patients run by Baba Amte in focal India. The second gathering of NGOs were the individuals who inquired about a specific subject inside and out, and afterward campaigned with the legislature or with industry or requested of the courts for upgrades in the lives of the residents, undoubtedly. A notable case of a NGO of this sort is the Center for Science and Environment. It was a CSE who got that example of well water and afterward presented the aftereffects of the substance examination to a court in light of the fact that the association had not had the option to get the plant to change its dirtying rehearses in some other manner. In the third gathering were those volunteers who considered themselves to be as activists than different NGOs. Obviously, all NGOs embraced a specific measure of activism to express what is on their mind they appealed to the civil servants, they cautioned the media at whatever point they discovered something incorrectly, etc. Be that as it may, this third gathering of NGOs considered activism to be their essential methods for arriving at their objectives, since they didn't accept they could get the specialists to move in some other manner. Maybe the most popular case of a NGO in this class is the Narmada Bachao Andolan (Save Narmada Campaign), an association that restricted the development of a progression of enormous dams in a huge stream valley of focal India. The individuals from this NGO accept that huge dams decline water shortage for most of the individuals over the long haul instead of take care of the issue, and they restrict the dislodging it involves upstream of the dam. At the point when the NBA found that it couldn't convince the organizers in India to consent to its perspective, the NBA individuals set up pickets, held exhibitions and attempted each other way they could consider to contradict the development of the first of the large dams. A large portion of the NBA part went to prison various occasions thus. At the present time, some of them including commended writer Arundhati Roy face the possibility of being imprisoned once more, since they censured the Supreme Court of India when the courts choice on dam development didn't go in support of them. There is no exacting limit between these three gatherings of NGOs truth be told, Baba Amte is currently a significant individual from the Narmada Bachao Andolan. What's more, whatever be the classification a specific NGO falls into, every one of them assume a significant job in present day India they consider the government officials responsible to the individuals. India is a delegate as opposed to a participatory vote based system. When the races are finished, the legislators who run the administrative and state governments don't generally need to return to the electorate for each significant choice there is no convention of choices in India, as there is in Switzerland or Denmark. Thus, in the five years between on political race and another, the NGOs and parts of the media, somewhat are regularly the main methods accessible to the residents to voice their feelings on any choice taken by an administration. In an enormous creating nation like India, there are various holes left by the administration in the advancement procedure now and again by expectation, now and then because of absence of assets, in some cases because of absence of mindfulness. These are the holes that numerous NGOs attempt to fill in present day India. Some of them may work in territories that the administration wouldn't like to get into like battling separation based on station. Most Indian lawmakers would prefer truly not to agitate the current station chain of importance in their voting public, on the grounds that the government official is reliant for votes on the prevailing standings of that specific voting demographic. All the while, laws restricting segregation based on position are regularly overlooked except if there is a NGO working in the region that is happy to take up the reason for those being victimized.

Improving Medication Concordance in Mental Health - Free Essay Example

Improving Medication Concordance in Mental Health- A Review of the Literature Where a man is against his will, that to him is a prison. Epictetus Abstract There has been much discussion on why concordance with antipsychotic medication and treatment appears to differ from other fields of medicine. Does the literature support this contention? This review aims to seek out best practice and apply the principle of informed choice in assessing concordance and using appropriate interventions to educate individuals with psychosis. Contents Abstract Introduction Compliance or concordance? Client centered therapy Administration of medicines and patient capacity Competent or non-competent? Schizophrenia in comparison with asthma and epilepsy Negotiating medication Antipsychotics- Hobson’s choice? Education the patient’s view Psychosocial treatment interventions Compliance therapy Conclusion and Recommendations References Introduction The aim of this literature revie w is to identify if possible, what simple, easily introduced refinement may be useful on an acute mental health ward, with the aim of better understanding the factors affecting concordance with both medication and treatment provisions. The review of the evidence was necessarily broad, for two reasons. Firstly, the premise that concordance is poorer with mentally ill patients (Hughes, et al. 997, Marland and Cash, 2005), compared with those suffering from physical illnesses (although acknowledging the considerable over-lap). This premise has been personally encountered whilst on practice placements. Secondly, whether any advantage might be gained from other areas of practice and applied to the chosen patient group. The literature search strategy was carried out by initially accessing the â€Å"Pub med† and â€Å"Ovid† databases, using the terms â€Å"concordance†, â€Å"compliance† and â€Å"adherence†. Attention was focused on research papers that dealt with both physical and mental conditions. Priority was given to any evaluation of techniques potentially useful in improving concordance, and research papers frequently referred to by other authors, or otherwise indicated as seminal. The review was limited to studies carried out in the UK, Ireland, and the USA. It was of course, necessary to limit the final discussion to a representative number, which aim to reflect some changing views, with emphasis on recent research. Gray, et al. (2002) note that non-compliance with antipsychotic medication is a major preventable cause of relapse in psychotic patients. The causes of non-compliance are seldom immediately clear, and the literature suggests a large number of factors interplay, and individual reasons for stopping medication can be arbitrary. Evidence-based medication management aimed at enhancing treatment concordance should include a collaborative, educational approach to working with patients, tailoring medication regim es to the patient. Gray, et al. advocate using therapeutic techniques such as compliance therapy, discussed in this review, in order to empower individuals, and preserve their right to choice. Compliance or concordance? Repper and Perkins (1998) highlighted the importance of terminology in mental health, and suggest that the use of words like compliance infer patients should be passive recipients of health-care, and should obey professionals. It has recently been proposed that â€Å"concordance† should replace the words â€Å"compliance† and â€Å"adherence†. Concordance emphasizes patient rights, and the importance of two-way decision making. More controversially, it also suggests patients have the right to make choices such as stopping medication, even if clinicians do not agree with the decision. This principle conflicts with traditional psychiatric practice, and potentially with the provision of treatment under the Mental Health Act 1983. Since this re view reflects the source literature, the three terms are retained, and may be read as synonyms, unless the context dictates otherwise. Client centered therapy Rogers (1975) Client centered therapy, described five factors affecting health behaviour; severity, susceptibility, response, self-efficacy and fear. Focusing on the latter two factors, self-efficacy has been defined as a person’s belief in his ability to accomplish a given task (Bandura, 1977, quoted by Hughes, 2004). How a person thinks an illness will affect him is determined by previous knowledge or experience, as well as fear, or threat appraisal. Belief that a change would improve coping strategies, and the person is empowered to undertake such a change, can improve considerably the ability of the patient to be more independent, and concordant with medication strategies. Administration of medicines and patient capacity The law imposes a duty of care on those that administer medication to others (Griffith, et al . 2003). Administration of medication is not without its complications. Minor prescribing errors, adverse drug reactions, interactions with food, or herbal products, overdoses (intentional or otherwise), and even possible genetic problems or death. These potential problems are reflected in the strict legal framework that regulates the prescribing and distribution of medication. There is however, still widespread concern in the UK over the administration of non-prescribed medicine and the practice of covert administration in the non-compliant (Wright, 2002). The law is clear that covert administration is only justifiable in cases of incapacity. Incapacity occurs where the patient is unable to comprehend and retain information material to the decision, or the patient is unable to weigh up the information as part of the process of an informed decision (Nys, et al. 2004). In the case of covert administration to an adult there would be a need to demonstrate that the patient is inca pable. The nurse should be able to justify the techniques of administration were in the patients best interests, and the crushing of tablets, for example, was safe. In practice this should be a multi-disciplinary team decision. The covert administration of medication observed on placement was one reason I have chosen to explore the literature, and examine any methods used that may be applied to adults who are non-concordant with anti-psychotic medication. Competent or non-competent? Levenson (2003), interviewed patients with Parkinson’s disease, and their views are quoted here for two reasons. Firstly health care professionals may tend to view patients with Parkinson’s disease in a similar manner to those with a mental illness, i. e. not competent to self-administer medication. Secondly the benefits of helping patients maximize control over their own medication are so apparent, and might well be applied to patients with other illnesses. The issue of balancing the benefits of medication against very significant unwanted effects was a major concern to interviewees. The patients had in common an understanding of the symptoms of the disease, and how their medication, particularly the timing, affected their symptoms. It was clear in one case; the doctor really listened to the needs of the patient, adjusting dosages and times accordingly. Another patient was able to use a dosset box with electronic timer as a memory aid. Some patients experienced difficulties retaining control of their medication when admitted to hospital. They found the timing of the drug rounds did not suit them. This undermined their efforts to comply with the medication. This aspect of medication administration appears to lend weight to the instrumental passivity hypothesis (Baltes and Skinner 1983, quoted in Faulkner, 2002) The argument is that hospitals and nursing homes reinforce dependent behaviour by supporting and encouraging them. The primary ethical strategy Fau lkner advocates is for staff to focus on reinforcing independent behaviour. Forms of self-medication come into this category. Melanie Baker (2003) described a scenario involving a 47 year old man suffering from bipolar affective disorder. His case typifies the interplay between physical and psychiatric health, and the patient poorly concordant with medication. Among his numerous significant medical conditions were angina, and a myocardial infarction. He also had diabetes mellitus and developed diabetic neuropathy, which was treated with carbamazepine. His mental state was coincidentally improved with the introduction of carbamazepine, but after 18 months of stability, he took an overdose, resulting in the prescription withdrawn. Prior to the 18 month period stability, the patient had a long history of decline. Psychotropic medication and his unstable angina may relate to poor adherence with cardiac medications. He was more amenable to cardiac treatment when mentally well. The consultant and Multi-disciplinary team felt that when he was mentally stable, his physical health improved in parallel, possibly due to improved compliance with both medication and lifestyle advice. He appeared to view psychiatric care as stigmatizing, contributing to poor compliance. Treatment for diabetic neuropathy was perceived as less stigmatizing. The importance of tailoring medication to each individual is highlighted in this case, as the accidental overdose of Carbamazepine led to a serious long-term deterioration. Schizophrenia in comparison with asthma and epilepsy Marland and Cash (2005) have found that the belief that non-compliance is a direct result of disease processes in schizophrenia dominates the clinical perception of non-compliance for these patients. One explanation given, was likened to a negative feedback, where a patient who stays off medication, perhaps out of a delusional feeling (â€Å"my doctor is poisoning me†), for a time feels well, which ma y have the effect of strengthening the delusion. They also demonstrated that although patient attitudes to medication change over time, the process of change is rarely well documented on an individual basis. The study objective was to compare the medicine taking decisions in people with schizophrenia to those of people with asthma and epilepsy, also both enduring, episodic illnesses. They concluded that for people taking antipsychotics, relapse was socially disadvantaging and unwelcome, particularly if it resulted in readmission to hospital. They confirm that the association between stopping medication and hospital readmission is learned eventually by many people on anti-psychotics. Interestingly people from all three diagnostic groups seemed prepared to experiment with timing and amounts of medication when well presumably as the fear of illness subsides. Patients for whom the consequences of altering medicine regimes were delayed or relatively mild were more likely to experim ent than those who experimented with medication leading to rapid or severe symptoms. Hence there was a learned ability to balance symptoms and medication side effects to achieve an optimum quality of life, whilst living with a fear of relapse. Fear of dependence was also a strong motivator for some, and exceptionally leads to complete cessation of medicine taking for long periods, even leading to frequent or severe symptoms. They conclude by confirming interventions useful in promoting therapeutic interactions with medicine in physical illness should also be appropriate in schizophrenia. They found it important to ascertain the individual’s level of understanding and insight, of the illness, medication and side effects. Negotiating medication Carder, et al. (2003) were concerned with how adults with illnesses characterized by repeated flare-ups, or instability, resulting in temporary inability to manage tasks of daily living, negotiated their medication needs. They incl uded sufferers of multiple sclerosis, rheumatoid arthritis, and systemic lupus erythematosis, along with those with schizophrenia and bipolar disorder. They described how these individuals with chronic illnesses made on-going negotiations with health-care practitioners, balancing health and illness with a preservation of self-identity. Many of those interviewed described on-going efforts to find the right medication or combination of medications. In addition, a third of participants described the use of alternative medications, such as vitamins, Chinese herbal tablets, and naturopathic remedies. It was found the necessity of taking daily medication did not always square with the individuals self-identity (â€Å"I am not ill†), so adaptation was stressed. The psychotic individual can often be fixed in their thinking, however, or for some, their illness appeared to have ended. Others described an aversion to feeling dependent on drugs, or perceived themselves subject to t heir prescriber’s ‘experimentation’. Some researchers describe resistance to medication as an initial stage (Gray, et al. 2002), but these participants described an on-going and periodic resistance to taking medication. Some described withholding accurate accounts of their symptoms, fearing an increase in dosage or a change in medication. One woman, at first appeared concordant, but described the emotion as one of â€Å"surrender†, a process of â€Å"going with the flow†, rather than fighting the illness and feeling resigned to whatever medication was prescribed. In the conclusion (Carder, et al. 2003), it was acknowledged medication remains the paramount way to manage chronic illness. For those who are asymptomatic while on medication, the medication is the only indicator of illness, and non- concordant individuals are sometimes led to question the need for medication, the diagnosis, or the reliability of the health-care team. The emphasis of this study was how healthcare practitioners must guide people through negotiations, identifying different choices, how best to self-regulate, and the effect that symptoms, side effects, and medication have on the body and on self-identity. A useful exploratory study confirming the findings of Carder, et al. was carried out by Hostick and Newell, (2004). They wished to determine the reasons service users discontinue community mental health-care. Although the presenting problems of respondents could not generally be classified as serious mental illness, the findings were significant. The study began on the premise that users would stop attending for two main reasons, either they had improved, or they were dissatisfied with the service. Few users cited improvement as the reason for non-completion. Many users expressed dissatisfaction about the lack of service flexibility, but could also be linked to practical difficulties or accessibility. The theme therefore continues for the need for a flexible, patient centered approach. Antipsychotics- Hobson’s choice? Hughes, et al. 1997) begins by describing what has become the standard medication regime for schizophrenia sufferers in the community, that is, the depot injection, administered intramuscularly on a regular basis at home, or at a community mental health centre. Depot injections are a dosage form of the anti-psychotic, allowing the drug to be released slowly into the bloodstream over a period of 1-5 weeks. For patients treated in the community, where good compliance with oral treatment cannot be guaranteed, depot anti-psychotics potentially provide a practical solution. However while having a monthly or fortnightly injection may be for some, less problematic than following an oral medication regime, good compliance is not guaranteed. Healy (2002) noted that far from blaming the medication, there was a tendency among mental health personnel to see the compliance issue in terms of patient unreliabili ty or lack of insight. In effect however, the depot removes control from the user, and even the administering nurses, since it is immediately obvious to service managers when someone stops receiving their depot injection. In addition to the unwanted side effects of anti-psychotic medication, there are the potential problems of intra-muscular injections to consider, and whilst good practice should minimize these, subcutaneous fat in adults in the dorso-gluteal area (site of choice for many UK nurses) varies from 1cm to 9cm. If injected into this layer, absorption of the drug will be adversely affected, and the tissue may become irritated. This occurs in up to 15% of patients (Greenway, 2004), and the threat of injury also remains significant to the sciatic nerve, and superior gluteal artery, which lie only a few centimeters from the optimum site. The suggestion was made by Hughes, et al. (1997) that it may not be the presence of unwanted side effects themselves, but rather how these side effects are regarded by the patient, that is in determining compliance. The physical discomfort of side effects may be less important in influencing compliance than the meaning patients attach to these side effects, for example, a movement side effect (tremor) is taken as the beginning of multiple sclerosis, or Parkinson’s disease. In this way, compliance may be improved simply by allowing patients to voice fears and concerns about side ffects. Hughes, et al. (1997) draws attention to another explanation for poor compliance in the hypo-manic or psychotic individual. Some sufferers enjoy the sense of euphoria that can characterize hypo-manic episodes. Similar problems have been experienced with patients with a history of recreational drug use. One likened his psychotic experiences to â€Å"tripping†. Education the patient’s view Carder, et al. (2003) found that even without structured efforts on the part of clinicians to inform patients about medicati on, education played an important role in their decision making. Of note in the context of this review, was the response of persons diagnosed with depression, who, in common with those suffering psychoses, are poorly motivated. They found these persons go through an extensive interpretive process that includes understanding the condition and its causes, the reality of medication side effects, and negotiating with healthcare practitioners. The view of one perplexed woman with bipolar disorder reflected the experience of many. â€Å"Some of the psychiatrists would hand you five or six different medications at once. I mean, how do you know which one’s working, or what’s not working. It took a while before I found a psychiatrist who sat and listened â€Å". The suggestion is made of using motivational interviewing techniques to weigh up identified positive and negative aspects of psychotic symptoms. For this reason, some clinicians have concentrated on schizophreni cs with relatively higher levels of negative symptoms. Hughes, (2004) describes how recent self-management approaches have produced better outcomes in these patient groups. Self-management programmes aim to encourage, or coach, patients, by supporting and influencing health behaviour and increasing knowledge of specific aspects of care, for example, pain and symptom control, or medication side effects. Nurses are well placed to offer holistic support to patients becoming more independent, but issues surrounding power and control in the nurse-patient relationship must be acknowledged in this process. The health belief model has been used to help patients perceive the benefits of following the recommended treatment regimen. Four factors identified as influencing patients were; the benefits of the treatment, susceptibility to relapse, the severity of the symptoms, and the cost in effort and pain from side effects. It was recommended health care practitioners not neglect the †˜secondary’ benefits of the medication, i. e. feeling calmer, sleeping better, easier socializing, and improved concentration, when seeking the views of patients , it was correctly predicted the secondary benefits of the medication would be valued as often as the main benefit of improving positive and negative symptoms. 5% of patient identified the main benefit, but 70% noted the secondary benefits (for example; â€Å"it allows me to make friends†) and these were found to be more strongly associated with medication compliance than the primary benefits. Zygmunt, et al. (2002) was not so favorable to the health belief model. They felt the rational assumptions and broad generalizations implicit in it were not helpful in predicting concordance. This may reflect a more recent shift towards motivational interviewing and its development into compliance therapy. Psychosocial treatment interventions Zygmunt, et al. (2002) carried out a study of psychosocial interventions ta ilored for psychoses. Adherence to medication and outpatient appointments has become crucial for positive outcome during maintenance treatment. No one specific intervention demonstrated significant advantages in improving adherence; however, the small sample size may have been a factor. It was felt that both patients and their families need a more active role and greater self-responsibility. They found the greatest benefit of the six interventions studied, most evident during the first six months of treatment. The most prominent conclusion reached however, was that psycho-education alone had no effect on patient compliance, but felt this finding did not negate the need for further education and implementation of structured treatment programmes Psycho-educational interventions focused primarily on dissemination of information about the illness, medication and treatment, group therapy was based on the evidence of peer support and shared problems. Family interventions derived from a belief in the family as a critical influence on the course of a member’s illness. Community programs typically . involved a complex variety of supportive and rehabilitation services delivered without a choice. Cognitive treatment targets patient’s attitudes and belief toward medication. An assumption is made that adherence is a coping behaviour, heavily determined by each person’s own interpretation of his illness and medication regime. Behavioural modification techniques assumed that behaviours are acquired through learning and conditioning, and can be modified through rewards and punishment, reinforcement, and the promotion of self-management. Behavioural strategies worthy of note include providing selected patients with detailed medication instructions, reminders, self-monitoring tools, cues and reinforcements. In another instance, the therapist used assertiveness training techniques to teach patients to negotiate with their prescribers more effectivel y. An important conclusion about this study was that of the many interventions in practice, most were viewed as too complex, and multifaceted, and hence difficult to identify exactly what contributed to individual successes or failures. Interventions addressing medication non-adherence specifically, were found to work better than those covering a wider range of problem areas. One recommendation noted from this study, was the monitoring of patients with a history of non-adherence involving any medication prescribed for physical, not simply psychotic illness, and the authors opted for a definition of non-adherence as a complete cessation of medication for at least one week, as opposed to dosage deviations. Compliance therapy Kemp, et al. 1996), sought to determine if compliance therapy could improve compliance with treatment and hence social adjustment, and if the effects persisted six months later. 25 patients received compliance therapy and showed significant improvement in their attitude to drug treatment in comparison to a similar control group. Individuals were assigned to the two groups on a random basis. The 4 -6 counseling sessions lasted between 10 and 60 minutes. The following issues were addressed, eliciting the patient’s stance towards treatment, exploring ambivalence to treatment, and a treatment maintenance plan. The patient is first encouraged to review their recent past, identify likely barriers to treatment adherence, and describe any negative outcomes experienced. Secondly, the patient is encouraged to systematically choose possible alternative strategies to their antipsychotic medication. There is an emphasis on â€Å"normalizing† the experiences, for example, â€Å"in extreme situations hallucinations can occur to anyone†, and if requested, provide more information about treatment options. Thirdly, the patient’s freedom to choose whether to maintain treatment is emphasized, and parallels drawn with conditi ons such as diabetes, where regular insulin injections may be required. The object is to lessen any perceived stigma. The patient is encouraged to look ahead, set goals, examine what they find personally important, and the emphasis is on how not taking medication could affect the outcome of their goals. Finally, the therapist acknowledges, and empathizes, with the costs associated with any course of action, including the desired outcome of concordance with treatment. The control group received a similar number of timed sessions, but the sessions had no discussion of treatment, and were less structured. By rating compliance using a scale of 1 to 7, with 1 being fully compliant, and with an added interest in the medication, the authors were able to demonstrate a 23% improvement over six months. There are problems associated with measuring patient compliance, common techniques such as urine tests may overestimate compliance when drugs have a long half-life. Blood serum tests, when a vailable, are invasive, and of limited value in assessing partial compliance. Pill counts are widely considered a useful indicator, but potential exists for inaccuracy or deception, with no guarantee the patient ingested the tablets. A similar problem exists for electronically tagged dosset boxes. The study noted the high human and social costs of relapse, or persisting symptoms, and felt any proved means of counteracting non-compliance had important managerial implications. Kemp, et al. (1998) carried out a further investigation of the original trial, extending the number of participants, and including an 18 month follow-up. An effort was made to measure not only compliance, but also insight, attitudes, and a functional assessment. There were comparatively few participants dropping out, 11 over 18 months, or less than 10%. Results indicated a definite advantage for those who received compliance therapy. Relatively poor results with first admission patients could have been rel ated to acuteness of illness onset, lack of previous experience with antipsychotic effectiveness, or perhaps denial. Overall, the work supported the premise that poor compliance was associated with more severe drug side-effects. A recent study in Dublin (O Donnell, et al. 003), using the same basic techniques, failed to replicate the previous findings, and found no advantage over non-specific therapy in terms of patient adherence. Then again, in common with the earlier studies, there were fewer than 100 participants; therefore the possibility of false negatives remained. They did confirm that patient attitudes change over time, and were a useful predictor of future compliance. Despite the name, compliance therapy fits with a concordance model, involving patients in each decision making phase, with no coercion, implied or explicit, to obey professional opinion. Conclusion and Recommendations All of the papers reviewed agreed that ignorance about medication was common. Frequently, antipsychotic treatment had not been fully explained to patients or their families, where appropriate. The individual needs to be fully informed about the effects of the prescribed medication, there is no justification for withholding knowledge about adverse effects or poor prognosis, this would be paternalistic and unethical. The aim of the treatment should be made as clear as humanly possible, and alternatives clearly presented. Such patient empowerment enables genuine participation, reduces fear, facilitates informed consent, and gives the closest opportunity for concordance. Although by definition, the primary responsibility lies with the consultant, as part of a multi-disciplinary team, nurses on ward level, in primary care, or in the community, are well placed to facilitate evidence-based treatment regimens. The most promising recent development has been â€Å"compliance therapy†. Three of the papers discussed sought to quantify its potential. O’ Donnell et al (2003) gave a conflicting view, but most authors mention it as promising. It is recommended here that further application of its principles, in a local setting, be attempted. As an aid to an admitting nurse, or during a care plan review, a simple evaluation tool be devised, a questionnaire, to address past concordance issues, an area we noted was often overlooked, with the principle of future self-management the goal. If possible, such a tool could be applied on a rehabilitation ward or acute setting. Other considerations that should be studied are: ethical issues, staff education, and through multidisciplinary evaluation. Finally, although in this review evidence has been highlighted from a patient perspective, of the considerable debilitating side effects of antipsychotic medication, it is not the aim to argue here that it has no role in helping to relieve the suffering of patients with psychotic symptoms. There does remain considerable scope for discussion of implementing informed choice for the mentally ill individual, and multidisciplinary cooperation in how to best inform them. References Baker, M. (2003) The coincidental treatment of a major mood disorder Progress in Neurology and Psychiatry, accessed from www. rogressnp. com Carder, P. C. Vuckovic, N. and Green, C. A. (2003) Negotiating Medications: Patient perceptions of long term medication use Journal of Clinical Pharmacy and Therapeutics 28, 409- 417 Faulkner, M. (2002) Instrumental passivity: A behavioural theory of dependence Nursing Older People 14(2) 20- 22 Gray, R. Wykes, T. and Gournay, K. (2002) From compliance to concordance: a review of the literature on interventions to enhance compliance with anti-psychotic medication Journal of Psychiatric and Mental Health 9, 277- 284 Greenway, K. 2004) Using the ventrogluteal site for intramuscular injections Nursing Standard 18 (25) 39- 42 Griffith, R. Griffiths, H. and Jordan, S. (2003) Administration of medicines part one: the law and nursin g Nursing Standard 18 (2) 47- 53 Healy, D. (2002) Psychiatric Drugs Explained (3rd Edition) London, Churchill Livingstone Hostick, T. and Newell, R. (2004) Concordance with community health appointments: service users’ reasons for discontinuation Journal of Clinical Nursing 13 (7) 895- 910 Hughes, I. Hill, B. and Budd, R. 1997) Compliance with anti-psychotic medication: from theory to practice Journal of Mental Health 6 (5) 473- 489 Hughes, S. A. (2004) Promoting self-management and patient independence Nursing Standard 19 (10) 47- 52 Kemp, R. Hayward, P. Applewhaite, G. Everitt, B. and David, A. (1996) Compliance therapy in psychotic patients: randomized controlled trial British Medical Journal 312, 345-349 Kemp, R. Kirov, G. Everitt, B. Hayward, P. and David, A. (1998) Randomised controlled trial of compliance therapy: 18 month follow-up British Journal of Psychiatry 172, 413- 419 Levenson, R. 2003) Compliance in medicine taking- seeking the views of patients London, Depart ment of Health, Medicines Partnership Marland, G. R. Cash, K. (2005) Medicine taking decisions: schizophrenia in comparison to asthma and epilepsy Journal of Psychiatric and Mental Health Nursing 12, 163- 172 Nys, H. Welie, S. Garanis-Papadatos, T. and Ploumpidis, D. (2004) Patient capacity in mental healthcare: legal overview Health Care Analysis 12 (4) 329- 337 O’Donnell, C. Donohoe, G. Sharkey, L. Owens, N. Migone, M. Harries, R. Kinsella, A. Larkin, C. and O’Callaghan, E. 2003) Compliance therapy: a randomized controlled trial in schizophrenia British Medical Journal 327, 834- 842 Repper, J. and Perkins, R. (1998) Different but normal: language, labels, and professional mental health practice Mental Health Care 2 90- 93 Rogers, R. (1975) A protection motivation theory of fear appeals and change Journal of Psychology 91, 93 Wright, D. (2002) Medication administration in nursing homes Nursing Standard 16 (42) 33- 38 Zygmunt, A. Olfson, M. Boye, R. C. and Mechanic, D . (2002) Interventions to improve medication adherence in schizophrenia American Journal of Psychiatry 159 (10) 1653- 1664

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However, their different directorial visions and styles make it so that Hitchcock and Tarantino films are nothing alike. This is because Hitchcocks objective was to make the audience feel afraid, tense, and anxious for the protagonist, whereas Tarantinos objective is to illustrate the absurdity of violence by elevating

Proud Aunt free essay sample

Just got out of volleyball practice when my cell phone rang. I knew it was my mom calling to tell me sister had the baby because yesterday my sister was having real bad stomachaches. Nervously I answered the phone and sure enough, it was my mom saying my sister, Jamie, had the baby. She was coming to pick me up from practice and we would go straight to the hospital. I couldnt decide whether to be happy or scared for meeting my niece for the first time. But for curtain, I was going to love that baby no matter what. I still remember when my sister announced that she was pregnant.She brought the whole family out to dinner, and wrote things on our napkins like Proud Aunt or Proud Grandpa. Out of Joy, my eyes watered and I hugged my sister and congratulated her. I counted down the months and days until her due date. We will write a custom essay sample on Proud Aunt or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Finally, the day has come and my first baby niece has arrived. She was one week early. The drive to the hospital seemed like It took a life-time. Of course, there was tons of traffic, and we even got caught by a train. I had a lot of road rage and I wasnt even driving. My legs couldnt stop bouncing and my nails were about gone.My mom asked if I was hungry and wanted to stop to get something to eat. Even though I was starving after practice, I told her no because I didnt want to waste any more time. After the longest 20 minutes of my life, we finally arrived at Christ Hospital In Oak Lawn. We walked In the hospital and asked the receptionist what room my sister was In. She told us the floor and the room number, and told us the elevators are down the hall to the right. We made It up the 5th floor and started looking for the room. Then, there It was; Room 553. My mom walked In and I followed right after her. Finally, there she was, In my sisters arms.My sister asked me If I wanted to hold my new baby niece, Rarely Merle for the first time. I went over to my sister and she placed baby Rarely In my arms. As soon as she let go, I fell In love with her right away. Her body was so delicate, and she had the most perfect tiny nose. She was the perfect niece In my eyes. As I was rocking her back and forth, she decides to open her eyes. Her big ocean blue eyes stared at me for one second and closed again. Looking Into her eyes for that short of a second felt Like a life-time to me, and was the perfect ending because I had to give her back to y sister for her feeding. At that moment, I was a proud aunt of that baby but I still am of that young lady that Is eight years old now. Proud Aunt By penuriousness The drive to the hospital seemed like it took a life-time. Of course, there was tons After the longest 20 minutes of my life, we finally arrived at Christ Hospital in Oak We walked in the hospital and asked the receptionist what room my sister was in. Hall to the right. We made it up the 5th floor and started looking for the room. Then, there it was; Room 553. My mom walked in and I followed right after her. Finally, here she was, in my sisters arms.My sister asked me if I wanted to hold my new baby niece, Reilly Marie for the first time. I went over to my sister and she placed baby Reilly in my arms. As soon as she let go, I fell in love with her right away. Her body was so delicate, and she had the most perfect tiny nose. She was the perfect niece in my eyes. As I was rocking her for one second and closed again. Looking into her eyes for that short of a second felt like a life-time to me, and was the perfect ending because I had to give her back to am of that young lady that is eight years old now.