Asiatic Cholera essays

Asiatic Cholera essays The disease known as Asiatic cholera first infiltrated Great Britain in 1831, with its arrival in Sunderland1. From there, it broke out in epidemic proportions through 1832. Three more epidemics would follow the 1832 outbreak, 1848, 1854, and 1866. Cholera is defined as an acute infectious disease, originated in India, characterized by profuse vomiting, cramps, etc.2 These epidemics killed numerous Brits and effected many more. Several reasons can be seen for the continued importation and spread during these different epidemics. Amongst the most prominent is dispute within the medical community. Until Robert Koch was credited with isolating Vibrio cholerae in 18833, the community was constantly torn over the cause of disease in general and specifically cholera. Many theories came about, each seemingly disputing the previous. With these new scientific theories came arguments as to the best methods to prevent, control and deal with the cholera. Until Kochs discovery ended the dispute, there was never a general consensus as to the best method of care for cholera victims. This paper will look at the causes and symptoms of cholera, statistics of the four outbreaks, the different effects that cholera had on the lay people, and the differing theories and how they slowed progress towards prevention of cholera. Cholera is a disease caused by the bacteria Vibrio cholerae. Cholera is spread through water or food that has been contaminated by the feces of others infected with cholera4. Symptoms include several characteristics. Initially, the person is anxious, and nauseated as well as dizzy. This is followed by severe vomiting and diarrhea, with feces that are a grayish liquid, often called rice water. This is soon followed by extreme muscle cramps (or even seizures) and a desire for water. This is followed by the sinking stage where the patients pulse and body t...

Free Essays on Turmenistan

TURKMENISTAN†¦ LAGITIMATE? According to 1998’s recoded documentation, Turkmenistan has been under a dictatorship rule since the brake from the former Soviet Union. Under the raining dictator, Saparmurat Niyazov, the citezens are neglectid of every civil and political right. There is no freedom of assembly, no opportunity for public debate and no political opportunities. Not to mention the intimidating authority existence of a Soviet-style, secret police. Turkmenistan is also one of the poorest of the former Soviet republics, due to the bad condition that it’s people are subjected to. Up until the U.S. Government intervened using force, President Niyazov had held many high-profiled polical prisoners. Among these prisoners, there was Khaja-Makhamendov, a leader of the banned Party of Democratic Development of Turkmenistan. Khaja-Makhamendov was held in incarceration since Febuary of 1996 in a psychiatric hospital on medically unjustifable grounds. Six of the eight members of the Party of Democratic Development of Turkmenistan, also known as the â€Å"Ashgabat Eight†, were also released in April. Niyazov’s sole intentions as leader of this nation were to crack down on political and religious dissidents, to restrict freedom of the press, protest, and to eliminate all forms of democracy. In August, the police stopped 200 women from entering the capital where they intended to make their complaints directly to Niyazov. In trukmenistan there are only 2 religions aceptable and legal, Sunni Islam and Russian Orthodoxy however; the police have halted their raids on privately house-held prayer meetings. Niyazov also called for three-generation "background checks" to determine potential university students' "moral character" before they are admitted to study. Abolished his country's World Languages University, ordered that the entire printing of a new Turkmen history textbook be burned, and ordered that foreign languages should no longer... Free Essays on Turmenistan Free Essays on Turmenistan TURKMENISTAN†¦ LAGITIMATE? According to 1998’s recoded documentation, Turkmenistan has been under a dictatorship rule since the brake from the former Soviet Union. Under the raining dictator, Saparmurat Niyazov, the citezens are neglectid of every civil and political right. There is no freedom of assembly, no opportunity for public debate and no political opportunities. Not to mention the intimidating authority existence of a Soviet-style, secret police. Turkmenistan is also one of the poorest of the former Soviet republics, due to the bad condition that it’s people are subjected to. Up until the U.S. Government intervened using force, President Niyazov had held many high-profiled polical prisoners. Among these prisoners, there was Khaja-Makhamendov, a leader of the banned Party of Democratic Development of Turkmenistan. Khaja-Makhamendov was held in incarceration since Febuary of 1996 in a psychiatric hospital on medically unjustifable grounds. Six of the eight members of the Party of Democratic Development of Turkmenistan, also known as the â€Å"Ashgabat Eight†, were also released in April. Niyazov’s sole intentions as leader of this nation were to crack down on political and religious dissidents, to restrict freedom of the press, protest, and to eliminate all forms of democracy. In August, the police stopped 200 women from entering the capital where they intended to make their complaints directly to Niyazov. In trukmenistan there are only 2 religions aceptable and legal, Sunni Islam and Russian Orthodoxy however; the police have halted their raids on privately house-held prayer meetings. Niyazov also called for three-generation "background checks" to determine potential university students' "moral character" before they are admitted to study. Abolished his country's World Languages University, ordered that the entire printing of a new Turkmen history textbook be burned, and ordered that foreign languages should no longer...

What are the Most Important Aspects of Zaras Essay

What are the Most Important Aspects of Zaras - Essay Example The study reveals that the company remains consistent with its information technology management and also remains focused on its preference for decentralized decision making and speed. Since Zara operates in the retail industry, Information Technology (IT) plays a crucial role in its business activities. Information technology is helping the company to manage queues inside the outlet, control inventory and handle POS-terminals (Point-of-Sale terminal). In addition, IT is playing the all-important role in managing Zara’s online store. The report also uncovered that, with the use of information technology, the company has been able to achieve competitive advantage over its competitors. One of the key findings of the study is that Zara is using outdated software. According to the technical lead of ZARA, the software may be outdated but is highly stable. However, it has been identified that any changes in the system configuration by the hardware vendors may negatively impact the company’s POS terminal operation. Therefore to get rid of this issue the report has provided some recommendations to the company. These recommendations comprise of how the company can update its software without affecting the stability and easy-to-understand interface. The study is about analyzing the most important aspects of Zara’s approach to information technology management. Apart from that, the report will also shed light on whether or not these approaches are applicable and appropriate anywhere in the organization. In order to satisfy these objectives, the study will carry out an in-depth analysis of the external business environment of Zara and a brief internal analysis of the company. However, the focus will be mainly on the information technology management of the company. Based on the findings, the report will draw a conclusion and provide some recommendations regarding how to improve the productivity of the company.

Canadian Politics. Position of women in the work place and Essay

Canadian Politics. Position of women in the work place and globalization - Essay Example However, when the Royal Commission on the Status of Women (RCSW) practically assessed the ground reality of the severity and employment challenges faced by women, the Commission concludes that the â€Å"position of women employees in the Government of Canada deserves close examination, not only because the Government employs a large number of women in a different variety of occupations, but also because the Government’s employment practices should demonstrate its principles†( RCSW, p.108). Since then, Canadian women have started experiencing some forward movement toward equality in the workplace and simultaneously, the public opinion tends to percept that women’s employment issues are by and large â€Å"solved† internationally as well ( UN, 2004,p.25). However, much is still required to be changed as such notions are perhaps overstated. The findings of the International Angus Reid poll surveyed that the employment markets in the developed nations such as A ustralia, Canada, United States and Great Britain found that less than a quarter of total respondents did not disagree that the gender equality in the developed nations have considerably achieved its required level; however, a majority of women in these four countries provided their consent that the governments in their respective nations ought to do more to gain the point of actual gender equality (Angus Reid, 2010). Additionally, in the same findings, Angus Reid (2010) accounts for the Canada’s ranking in the Global Gender Gap Report, which is annually published by the World Economic Forum. Canada’s current position, 31st in 2008, at number 20 is considerably lower than its previous rankings of 7 in 2005, 14 in 2006 and 18 in 2007. Prior to these facts, the Employment Equity Act was enacted into the legislature with its intent to achieve workplace equality so that no person shall be denied employment opportunities or employment benefits for reasons other than ability and, in appropriate achievement of goal, and to correct the situations and conditions of disadvantage in employment faced and experienced by aboriginal persons, women and people with disabilities and members of visible minorities by providing effect to the principle that employment equity means more than treating persons in the same way but also needs special measures and accommodation of differences (Employment Equity Act). Consequently, the original Employment Equity Act was passed in 1986 by the Progressive Conservative Government in response to the findings and recommendations of the Abella Commission. It came into force in 1987 requiring both federally regulated companies and Crown corporations having 100 or more employees are required to determine and develop equity programs and plans to eliminate workplace barriers to the participation of the above mentioned groups. The progress on the equity programs seems to be limited in scope and domain. The most improvement in employmen t tends to be for non-disabled, white women (Agocs, 2002; Leck & Saunders, 1992). In addition, while taking into account women having dual status as women with a disability or women of color, the findings have hinted that the employment equity programs seem to be affiliated with more representative hiring of women with dual status into employment in the clerical positions (Leck & Saunders,1992, p.216). Furthermore, the 2009 Senate Committee on Human Rights highlight the fact that the little data is provided to indicate whether or not recruitment rates, retention rates, representation rates or executive advancement rates offer difference for women and men within these designated groups: Aboriginal, visible minorities, and

Business economics Assignment Example | Topics and Well Written Essays - 3000 words

Business economics - Assignment Example This essay is organized as follows. Section 2 discusses the theoretical views in this regard. Section 3 discusses the property market development mainly housing market development and macro economy in UK in the early 1990s. Section 4 discusses the property market development especially housing market development and the macro economy in UK since 2007 and section 5 concludes the report. 2. Theoretical Views An ideal property cycle according to Ball et al (1998) can be characterized as business upturn and development, business downturn and overbuilding, adjustment, slump and the next cycle. Many economic theories have been put forward to explain these five patterns like the business cycle approach (Barras, 1994; Key et al, 1994), based on accelerator principle. The two major factors affecting property development cycles are exogenous occupier demand for space and pro cyclical exogenous availability of finance according to this approach. However, this approach does not account for the c onstruction completion lags .Further there can be causalities from development cycles to economic activity also. Hence the building lag model developed by Baras(1983,1994) tries to produce an endogenous mechanism to explain development cycles. Here, the lag between demand and supply together with the accelerator principle explains the development cycles. The dynamic model based on historic data for UK property development by Barras and Ferguson (1987a, 1987 b) establishes an endogenous development cycle mechanism. This model identifies the level of user activity and the level of investment activity as the two major economic factors affecting property cycles. This model, however, explicitly includes an endogenous cycle mechanism, which is problematic .Further, the exogeneity assumption for variables like rent, capitalization rates, building costs etc are also questionable. Several explanations based on irrational behaviour of valuers, developers and lenders like slowness of these age nts to respond to clear market signals and failure to learn from experience are also given to property cycles (Baum and Crosby, 1995). However, these models implicitly assume irrational behaviour, which is its limitation. The model of property cycles and option pricing based on owners and developers (Grenadier, 1995) shows that the stickiness of vacancy rates increases with the rise in uncertainty and adjustment costs. Further, the probability of overbuilding rises with the rise in construction period, adjustment costs and uncertainty about future demand. However, this model is based on the assumptions regarding preferences in finance theory, which is unlikely to hold good in property markets. This reduces the predictability of the model (Ball etal.1998).Thus all the models discussed above have some shortcomings. Their predictability cannot be generalized and depends upon the context only. In addition to the above theoretical models, the property markets especially the housing marke ts are obtained to have reverse effects on the macro economy through their impact on the consumption expenditure of households, through the effects on

Providing Rehabilitative Care To People Post Stroke Life Nursing Essay

Providing Rehabilitative Care To People Post Stroke Life Nursing Essay Stroke is a catastrophic event for survivors and their families because significant numbers of stroke survivors experience biophysical and psychosocial limitations after they return to home (Oswald 2008, p.241). Stroke is a common disabling disease that requires the involvement of family caregivers for patients successful rehabilitation (Lui Thompson 2005, p. 2514). After a stroke most people return to their home environment quickly despite suffering from various impairments and disabilities; most often without having received any care and rehabilitation services to reduce or compensate these dysfunctions (Vincent et al 2007, p. 21). Timely access to appropriate rehabilitation services for stroke survivors is needed to optimize recovery and reduce the long-term burden of stroke for patients, families and communities (Dawson et al, 2008, 174). Family caregivers play a key role in the rehabilitative care for stroke survivors, who require prolonged periods of recovery outside structured health care settings. Providing care to stroke survivors in home settings is an increasingly common experience (McCann Christiansen, 1996 ,p.914). However, family caregivers are usually faced with lack of health care education and they need assistance in learning how to manage to help the survivors in activities of daily living (ADL) and other aspects of physical care. Instrumental support, including social support, help with transportation, and financial support or compensation are also commonly requested by caregivers (Grant et al.2006, p.67). In general, care giving responsibilities follow a hierarchical order with spouses being preferred most often, followed by adult children, other relatives, and finally friends and neighbours (Moore et al. 2002, p.291). In Iran the situation is the same, the stroke survivors are usually referred to public or private care centres and to their own homes after discharge from hospital. This may result in many difficulties and long-term problems for stroke survivors and their family caregivers (Dalvandi et al, 2010). In Iran, there seems to be a lack of supportive systems in home care services as well as in knowledge and skills among family caregivers can be assumed to lead suffering from complications and probably even from less effective recovery processes for both patients and their families (Alaei, 2008,p. 7). Therefore, we need to explore the experiences of Iranian stroke survivors family caregivers about the providing rehabilitative care in order to identify aspects that should be con sidered in developing delivery rehabilitation care for both patients and their families.. Aim and research questions The aim of this study was to explore the experiences of family caregivers about the providing rehabilitative care for stroke survivors at home. The following questions were raised: How do Iranian family caregivers experience the provision of rehabilitative care at home after stroke? How should the rehabilitative care for stroke survivors assistance be provided and organized? Method The constant comparative method (CCM) was used in this study. The constant comparative method of analyzing qualitative data combines inductive category, coding with a simultaneous composition of all units of meaning obtained (Glaser Strauss,1967). According to Boeije (2002) the constant comparative method together with theoretical sampling constitute the core of qualitative analysis in the grounded theory approach developed by Glaser and Strauss, 1967; Strauss, 1987; Glaser 1992.(p.391-394) .The constant comparative method, which can be seen as the core category of grounded theory, includes that every part of data, i.e. emerging codes, categories, properties, and dimensions as well as different parts of the data, are constantly compared with all other parts of the data to explore variations, similarities and differences in data. The constant comparative method of grounded theory is strict enough to be helpful to the researcher in exploring the content and meaning in the data, but no t saddled with so many strict rules to be too rigid for a grounded theory researcher (Hallberg, 2006, P.141-145). According to Strauss and Corbin (1998) the art of comparison has to do with creative processes and with the interplay between data and researcher when gathering and analysing data. The cycle of comparison and reflection on old and new material can be repeated several times, it is only when new cases do not bring any new information to light that categories can described as saturated (Boeije ,2002,p. 391-394). Participants Twelve family caregivers participated in the study .The characteristics are shown in Table 1: Insert Table 1. The inclusion criteria for selecting family caregivers was: those family members who had the main responsibility to take care for stroke survivors in stroke survivors homes, such as offspring, spouses or other relatives, willingness to participate in this study, being able to communicate in Farsi and reside in an urban area in Tehran. The first author (AD) referred to hospitals and rehabilitation clinics formally and asked for permission to undertake the study. After the permission, he read more than 400 stroke survivors documents and then selected 35 case documents based on inclusion criteria. Then researcher contacted participants by telephone with the permission of universitys authorities. They were informed about the aims of the study and their rights as participants, and were asked to participate in the study. Finally twelve family caregivers agreed to participate in the study. Data-collections Techniques Data were collected through open-ended interviews and observational field notes. The open-ended interviews started with a general question: As a family caregiver, how do you experience providing rehabilitation care of a survivor after stroke at home? Then, step by step the interview continued to more specific and directed questions. Probing was performed according to the reflections offered by each respondent but sought to cover themes such as their experiences of the post-stroke life and the role of family caregivers in this situation. Interviews lasted between 45 to 60 minutes. The venues of the interviews were chosen by the participants at the survivors homes and it took from February 2007 to June 2007. In two cases, a second interview was conducted after some ambiguities had aroused during the first. During interview main researcher have been observed and considered all situations regarding the participants and focus on what participants said about doing one thing but in reality they are doing something else. Data Analysis All interviews were tape-recorded, transcribed verbatim, and analyzed word by word and then approved by some participants, together with the observational field notes. Following Corbin Strauss (2008, p.160-167) instructions, data collection and data analysis took place simultaneously by using the process of constant comparative analysis method. Every interview was analyzed directly after the interview in order to identify ideas, which guided the next interview. During the phase of open coding, the researchers thoroughly read all interviews several times word by word and selected incidents, facts, key words or phrases in the text as in vivo codes (codes which directly came from interview with participants, not from other sources). In this phase, 482 primary codes were extracted. Open coding requires a brainstorming approach to analysis because, in the beginning, analyst wants to open up the data to all potentialities and possibilities contained within them (Corbin Strauss, 2008, p.160). Whereas open coding fractures the data into concepts and categories, axial coding puts those data back together in new ways by making connections between categories and subcategories. Thus axial coding refers to the process of developing main categories and their sub-categories. Then, the codes were compared to contents in order to find points of similarities and differences as base for those categories and sub-categories that were developed. These codes outlined properties and dimensions of each category and subcategory. This process resulted in eight conceptual categories. After axial coding at the end of the process, in selective coding phase, the core variable was identified. lack of continuity in rehabilitative care, which was clearly observed in all data, was identified as a core variable. Selective coding involves the integration of the categories that have been developed to form the initial theoretical framework (Corbin Strauss 2008, 163). Trustworthiness The conformability and credibility of the data were established in 3 main ways: First, the participants were contacted after the analysis and were given a full transcript of their coded interviews with a summary of the emergent themes to determine whether the codes and themes were true to their point of view (member check). Four participants chose to validate their transcripts and a few minor comments regarding spelling were made. As a further validity check, faculty members checked about half of all transcripts (peer check) when researcher presented the aim process and summary of data gathering. Finally, all the authors checked an English version of the coding and the coherence of the categories .The researcher documented the steps followed in the research and the decisions made to save the audit ability for other researchers to perform the steps of the research in future studies. Ethical considerations This study has been approved by Iranian National ethical committee in the Ministry of Health Medical Education (P/361-31/JUL/2005). All participants have received information about the aim of the study and what is expected from them as study participants. They also were informed that the participation is voluntary and they have the right to terminate their participation any time they want, without giving a reason, and their right to confidentiality. They also were informed that their continued care or rehabilitation was not dependent by their decision to participate or not. The researcher used all his attempts to make the participants comfortable to tell about their experiences and needs freely, and tried to note any non verbal signs of wishes for going out from the study, all participants signed the written informed consent paper after reading it carfully. When participants needed to have counselling in their homes, researcher coordinated by experts rehabilitation and some time researcher referred them to Neuro-rehabilitation clinic and also with hospitals to follow his/her problems clinically or in-patiently. Findings The participants ranged in age from 20 to 68 years. Seven main categories were identified within the analysis process: family integrity, modifying homes environment, managing co-morbidities, accessibility of rehabilitative services, expanding nurses roles, utilizing social insurance, and acquiring knowledge and skills. Family integrity conceptualized the way the participants continued their attempts to maintain family structure and function despite of the complications caused by the stroke. Modifying homes environment experienced as to facilitate the stroke survivors to live at home conveniently, and managing co- morbidities perceived as essential to prevent recurrent of strokes by controlling other symptom and diseases. Accessibility to rehabilitative services experienced as inappropriate and misdistribution of these services. Expanding nurses roles means that nurses roles should be developed as coordinator in rehabilitation teams to decrease biophysical and psychosocial limitations. Utilizing social insurance wished for as the main rehabilitation supportive service, acquiring knowledge and skills perceived as the basic needs for facing with the stroke event and help caregivers to accept the reality of their own situation. Conceptual relationship statements Researcher inferred that the lack continuity of rehabilitation care at survivors homes is the main variable concepts on the advancement of the providing of survivors rehabilitation because family caregivers experience accessing to services and covering rehabilitation services by social insurances could provide continually for leading, helping and supporting survivors to be independent sooner. In this way they perceived that special educational programs and skills are needed to be well-adapted with new situations. It causes the pressure on family members would be made less. As the part of Iranian cultural values, Islamic religious believes, preserving, unity ,maintain family structure and emotional feeling during event are the essential strategies which families adapt with .In this case family caregivers have been involved to continue providing rehabilitation care and changing home environment to facilitate better situation for survivors in their homes. Lack of continuity of rehabilitation care services cause overload working by family care givers such as survivors; lifting, transferring, feeding and caring because fatigue, frustrations and loss of energy. Therefore assisting by lay care givers could help them a lot especially during the first few months in this process. Lack of knowledge and skills regarding survivors care made them to be agitated and later on disappointed. They believed that the nurses roles are as important as the family care givers on the recovery of these patients regarding education and skills, introducing recourse, emotional support and medicine recommendations, timely teaching of patients and caregivers, and assessment and information exchange regarding patient progress and care needs. Lack of access to these services could delay survivors recovery. Continuity of care specifically relates to the nurses continued presence with the patients and involved coordination of the multi professional teams diverse efforts. Nurses, interacting with patients and relatives frequently throughout the day in many diverse situations, are in a unique position to facilitate the interpretive work that stroke survivors and their families go through and which is a prerequisite for moving ahead in the adjustment and rehabilitation processes following a stroke. Family integrity Family caregivers experienced that maintaining integrity, morale and durability were important to maintain family structure and their roles despite of the complications caused by the stroke. Family caregivers were also forced to look for new ways to compromise with this real event, as the part of their Iranian cultural values, Islamic religious believes, unity and emotional feeling that were the essential strategies which families had adapted. Whereas in Iran, family structure is so important for its members, therefore religious and emotional behaviors help us to stand, It should be continue by culture and empowered (Family caregiver 2), Modifying home environment Participants perceived that after the unpredictable event of stroke, their home environment needed to be changed, depending on survivors condition. The changes aimed at helping both the survivors and the family caregivers to play their roles better and live an active life by participating in the family life, whatever is available at home. We have to change the home environment to help survivors by using devices such as grab bars in bathroom, a raised toilet seat and a long-handled brush, and also electric toothbrush and an electric razor. (Family caregiver 9). Managing co- morbidities Participant perceived that managing other symptoms like body pain, and diseases such as diabetes and cardiovascular disorders, as well as hypercholesterolemia and obesity were important to prevent recurrent period and prevent progressive diseases. I have tried to manage other disease such blood pressure, diabetes and cardiovascular disorders with helping Doctors and nurses as well the control of dietaries and drugs management ,besides of stroke and its complications (family caregiver 6). Accessibility to rehabilitative services There are only a few special rehabilitation centres for stroke survivors in Iran and usually the stroke patients are referred to public or private caring centres and  to their own homes, because these clinics are very far from their homes. These services were regarded to be expensive and not easy to access from home and community, therefore stroke survivors and their family caregivers suffered of not receiving rehabilitation services. My family has lost their energy and in times, we are so tired and agitated If somebody comes to our home for caring and helping us it would be fantastic (Family caregiver5). I really need to get some facilities in my place, close to my home, suitable for our incomes; going far from my home is very expensive to access and so difficult for me and my family as well to bring services in our home (Family caregiver 11) . Expanding nurses roles Most participants experienced that nurses have a multidimensional role in rehabilitative care and they can act as team coordinators and educators for patients and their families. They were also regarded to be able to promote healthy lifestyle, advocate available recourses, nutrition, and medication, rehabilitative care recommendations to survivors and family caregivers, as well as prevention of stroke relapse. Nurses have a sense of advocacy and morale besides the care delivering, this is a fact, and I do emphasis that the role of nurses for patients is vital and important.(Family caregiver 3) Utilizing social insurance Participants regarded their friends or family members as the source of encouragement to seek social support. They experienced that social support from relatives, community and close personal relationship each has a beneficial effect in stroke patients life. The social support from them gave a sense of self-confidence and self-sufficiency in stroke survivors. Family caregivers expressed also that lack of assistant to care and insufficient social insurances for covering and receiving services from therapists caused the families a burden. The provision of social support was regarded to help the survivors to be enforced regarding the sense of belonging to others and also to friendship. During these times my family network visited and encouraged us to be happy and satisfied, I am so grateful to them because they come at my home to give a lift again.(Family caregiver 4). The cost of care and treatment that are extra in our life , if we had more support in advance, it would be more helpful and could be more effective.(Family caregiver 10). Acquiring knowledge and skills Family caregivers experienced lack of knowledge and skills to provide care for the survivors and deal with new situation; they perceived the need for information and education at their homes regarding transferring, lifting, feeding, drug taking and how to care I faced with lack of information and skills related to the event, the provision of supportive education is necessary for stroke survivors and their family caregivers from hospital to home , I dont know what to do (Family caregiver 12) Discussion The first author (AD) faced with some limitations in this study, such as cultural barriers to be accepted into the participants houses. The study shows that the need of continuity of care and rehabilitation services is pivotal for promotion of ADL and the health situation of stroke survivors and their family caregivers, after discharge from hospital. Depending on survivors situation, communication between family caregivers and rehabilitative care providers could be coordinated to improving rehabilitative care issue in order to achieve self-care and self-management. Even the social support from relatives was a strategy which was used and recommended by the family caregivers of stroke survivors. Thus, the delivery of continuous support and rehabilitative care is needed to reduce burden of care giving. Lack of continuity of rehabilitation was extracted as core concepts among data and concepts and related categories because family care givers have been following the process of receiving rehabilitation services for reducing physical disturbances; socio psychological limitation and help survivors to be self -independence ,they believed social insurance could involve these services at the survivors homes ,provide the transportations to rehabilitation centers and support nursing care and lay care givers for preventing of family burden. They experience that lack of these kinds of supports resulting in: cause less integrity and enduring among family members despite of their efforts and to incomplete rehabilitation services for stroke survivors. Family caregivers need many skills and have many difficulties associated with the involvement and tasks of care giving (Bakas et al 2004,p.243). Establishing comprehensive intervention programs in order to address the unique needs of individual family caregivers is emerging as a critical focus for research, as well as an important topic for policymakers, both in Iran and other countries. Han Haley (1999,p. 1479) also mean that stroke survivors have, besides of stroke and its complications, other diseases, such as diabetes, blood pressure, cardiovascular disorders, and even these needs to be taken into consideration in dietaries and drugs management. Our study participants expressed the need of education programs. Bakas et als study (2004,p.245) show that family caregivers have concerns about managing the symptoms and deficits of the stroke survivor. Lui Thompson 2005,p. 2515) indicate that teaching family caregivers to cope with these problems and to relieve their stress is essential. There is also some evidence that caregivers well-being affects even the health and recovery of stroke patients (ibid.). Our study findings show the same in Iranian context. Our study shows also that the home environments need to be modified, as the modifications can help the family caregiver to play their roles better and to have active daily lives. Vanhook (2009) found that that the quality and quantity modification in home environments depends on survivors condition although there is minimal consideration of the psychological, social, environmental needs during and after rehabilitation: when the survivor returns home, the environment is a foreign one (Vanhook, 2009 ,p.7). The participants in our study considered that there is need to expand the roles of nurses in rehabilitative care. As Steiner (2007) claims, nurses have a holistic approach through coordinating and integrating with other team members to deliver rehabilitation services for survivors and help caregivers to manage the situation. Besides, nurses are often the first to interact with the stroke patient in both acute care and intensive rehabilitation. Using evidence-based knowledge, the nurse has the responsibility to expand the nursing history to include such factors as previous cognitive state, previous perceptions of health status, present role within the family dynamic, previous self-concept, cultural influences, and relationships both personal and social. In our multicultural society, it is also imperative that we recognize and develop an understanding of the power of ethnicity as it relates to individuals health perception, thus affecting the recovery process. Steiner (2007,p.48-54) The participants in our study experienced that providing informations and appropriate education in responding to their needs, were the most important and valuable things which improve efficacy of these services. Family caregivers perceived that covering of rehabilitative services by social insurances agencies can help survivors and their family caregivers to get better rehabilitation facilities and improve functional performances. The social insurances can also reduce stress in the survivors situation by providing lay caregivers for helping family members.. Previous studies have examined the effect of different types of social support on functional recovery after stroke (Friedland McColl 1992, p.575), similarly to our study showed that social support from family, community and from close personal relationships each has a beneficial effect in stroke patients. As Shah (2006,p. 472) and Weimar et al. (2002,p. 2055) claim, the post stroke family support, financial status, and community resources should be evaluated to optimize successful return to the community. This study confirms the results of Oswald et al (2008,p.245) who found that stroke is expected to continue to be a major concern for survivors, their families and health and social care providers because stroke continues to affect the survivors and their family members life situation a long time. Besides, most stroke survivors live in the community and are assisted by family caregivers, especially by spouses. Stroke-related impairments and post stroke depression interfere with recovery and result in impaired relationships and reduced life satisfaction for the survivors and their spouses.By increasing the patients participation in rehabilitation, their ability to solve problems in ADL and to transfer knowledge to new situations we hope that patients and relatives satisfaction in daily life will increase. Conclusion The study illustrates that the family caregivers are stricken of the stroke because the providing care for stroke survivor in order to rehabilitate the survivor major engagement is needed from the family caregivers. Enhanced discharge planning and nurses follow-up with collaboration of stroke survivors families should be considered as essential in maintaining the well-being of the family caregivers and bridging the gap between the hospital and the community , reducing family burden ,receiving high quality of rehabilitative care and make decisions regarding their own life and care. Relevance to clinical practice There is a need to develop family caregivers abilities to provide care that is more suitable to survivors needs. Both educational practice and financial support should be provided to the stroke survivors and their family caregivers in order to enhance better coping in the difficult life situation. Social and emotional support should also be provided to minimize the family members burden and help them managing the consequences of stroke. Therefore, the Iranian Government should improve the social and financial support and order a social insurance for stroke survivors and their family caregivers both by public and private social insurance agencies. There is also a need for organizing and extending rehabilitation services in health programs for reducing physical dysfunction, thus helping the patients and their family caregivers to apply better role performances and encourage independency in activities of daily living. Further, a rehabilitation team should plan and focus on functional disturbance and social support. There is also a need to write a stroke rehabilitation protocol that coordinates team work. In this work, nurses experiences are highly needed. Funding: This study is funded by deputy of research at University of Social Welfare and Rehabilitation Sciences. Conflicts of Interest: The first researchers have no conflicts of interest regarding financial support and official affairs in this study.

Frederick Douglass Influence on the Anti-Slavery Movement Essay

Frederick Douglass' Influence on the Anti-Slavery Movement Frederick Douglass was one of the most influential men of the anti-slavery movement. He stood up for what he believed in, fought hard to get where he got and never let someone tell him he could not do something. Frederick Douglass made a change in this country that will always be remembered. Born Frederick Baily, Frederick Douglass was a slave, his birthday is not pin pointed but known to be in February of 1818. He was born on Holmes Hill Farm, near the town of Easton, Maryland. Harriet Baily was Frederick's mother. She worked the cornfields surrounding Holmes Hill. As a boy, he knew little of his father except that the man was white. As a child, he had heard rumors that the master, Aaron Anthony was his father. Frederick's mother was required to work long hours in the fields, so he lived with his grandmother, Betsey Baily. Betsy Baily lived in a cabin a short distance from Holmes Hill Farm. Her job was to look after Harriet's children until they were old enough to work. "Frederick's mother visited him when she could, but he had only a hazy memory of her." He did not think he was a slave during the years with his grandmother. When Frederick was six he was put to work on the Lloyd Plantation. This was the last he saw of his grandmother as he realized that he was now a slave. He learned that the master, Aaron Anthony, would beat his slaves if they did not obey order. Luckily for Frederick he was picked to be Daniel Lloyd's friend, the youngest son of the plantation's owner. Frederick also found a friend in Lucretia Auld, the master's daughter. One day in 1826 Lucretia told Frederick that he was being sent to live with her brother-in-law, Hugh Auld, who managed a ship building company in Baltimore. When Frederick got to the Auld home his only duties were to run errands and care for the Auld's infant son, Tommy. Frederick liked the work and grew to love the child. Sophia Auld was the master's wife, she often read the bible to her son and Frederick. She started to teach Frederick to read and write but soon after the master learned of this and forbid it. Frederick only learned the abhalbit and some words. So he learned the rest by himself. Soon Frederick bought a local paper and learned about abolitionist. This changed his views on many things but was soon sent back to work on a plan... ...ass was given the ceremonial position of marshal for Washington, DC. He enjoyed this post that had a large staff responsible for the overseeing the criminal justice system in Washington D.C. As he got older Douglass settled down doing fewer speeches each year and concentrated on being Marshall. This was until he was appointed to the post of recorder of deeds for Washington, D.C., after the election of 1880. He held the job for 5 years over seeing the department that made records of property sales for the capital. This job left him time to write. He was with his wife until she died in August of 1882. He married again in 1884 to Helen Pitts who was 20 years younger than him. They remained together for 9 years, that was until his sudden death of a heart attack on February 20, 1895. He was 77. Frederick Douglass was laid to rest in Rochester, New York. All of the black public schools closed for the day that he died. Frederick Douglass was a man that touched the hearts of millions and spoke out when no one else would. He fought for the freedom of the black man and stride for the basic human rights they deserved. Frederick Douglass was truly a great man who cried out for freedom.