Case Study Of Downs Syndrome

Case Study Of Downs Syndrome Paul Z is a 30 year old man who has a Learning Disability and Downs syndrome. He lives at home with Mrs Z, his mother who is his main carer and 18 year old sister S who goes to Sixth Form College and hopes to go to University. Mrs Z is devoted to Paul and gave up her part time job when he left school twelve years ago to look after him full time. Mrs Z who was widowed two years ago has recently been prescribed anti-depressants by her GP as she was not sleeping well and finding life difficult to cope with. Paul is able to complete his personal care and dresses himself appropriately, although he does sometimes need prompting or supervising depending on his mood that day. Mrs Z finds it very difficult to leave Paul at home for any length of time even though he is likely to be able to cope on his own for a few hours. She will occasionally leave him with his younger sister S but she has exams and a very full social life of her own. Neither has Mrs Z been willing to allow Paul to access community based activities, other than the Day Centre which he attends two days per week, because she fears for his safety. Paul really enjoys the Day Centre where he has been given his own shelf in the greenhouse and a patch of garden where he grows flowers and vegetables which he takes home to eat. Paul would like to increase his social activities, develop his independent living skills and have access to a bigger garden to grow more vegetables and to possible sell them. Pauls interests include watching films, reading comic books and playing computer games and football. He also enjoys swimming and accompanies Mrs Z when she goes. Paul is very sociable and well liked by all who meet him. Mrs Z does not drive and both she and Paul are dependent on public transport. Paul requires support when in the community as he could be extremely vulnerable if left on his own because of his friendly and trusting nature. Paul has a good understanding of everyday things but due to his learning disability tends to make decisions based on his every day experience and eagerness to please and may not have necessarily understood or taken into account all the information which might affect the decision. He can appear to have a better understanding of things than he has and he needs to be supported when making more complex decisions. Paul is also very difficult to understand verbally and uses his own language with a form of Makaton and picture Symbols. When he becomes anxious or worried he can be aggressive even towards those who he knows well. Also due to his poor communication skills he finds expressing himself very difficult. 3 practice related questions: In the context of Pauls circumstances provide a critical analysis of: Which types of assessments would need to be implemented, how these would be most appropriately conducted and by whom The first assessment that would need to be implemented would be an assessment of Pauls need for community care services. As Paul has a learning disability and Downs syndrome, there will be assessment barriers that need to be taken account for and overcome to enable Paul to participate fully in the assessment process. In addition this will ensure that the relevant and necessary information is gathered to accurately assess Pauls need for community care services. As described Paul has poor verbal communication skills, this could make it difficult for Paul to express himself during the assessment process. Furthermore Paul may need help in making sense of and understanding information, this would need to be addressed to maintain Pauls full involvement and level of understanding in the assessment and for any decision. Pauls challenging behaviour would need to be taken into account so not to cause harm to him or others. Pauls assessment would normally be conducted by a social worker from Pauls local social services department (NHS Choices, 2009). The social worker would need to find ways of dealing with these potential barriers before the assessment takes place. Paul communicates using his own language; with this in mind it may be appropriate to have someone who knows Paul well to be part of the assessment so they are able to interpret the information to the assessor. Pauls mother or sister could do this Alternative communication-picture symbols social worker could use these/interper however Paul is eager to please so may tell interviewer/social worker what they want to hear. May be case if mum/sister is present so an independent advocate may be advisable. As Paul can get aggressive-build the relationship up before assessment. Carers assessment Mothers own s47 assessment The issues relating to risk, proportionate response and capacity Risk assessment, vulnerable adult, MCA, IMCA How you would work to promote Pauls independence and his right to make his own choices, with whom would you cooperate to achieve this and which theoretical perspectives would inform your practice. Person centred planning-Valuing people Social model of disability 3 Legal Questions: What statutory duties, if any, does the local authority have in respect of assessing and providing community care services to Paul and/or Mrs Z? Please identify the relevant legislation. In respect of assessing Paul, the local authority under Section 47(1) of the National Health Service and Community Care Act 1990, has a duty to assess his needs and depending on the result of that assessment, will decide whether Pauls needs call for the provision of community care services. As Brayne and Carr (2010, pp.541) states there are two clear steps that are required by s.47(1)-an information gathering exercise and a decision making process. During the decision making process, the Local Authority will follow the guidance set by the Fair Access to Care Services Guidance for Adult Social Care Needs issued by the Department of Health in the Local Authority Circular 2002 (LAC 2002 13). The eligibility criteria is based on the risk to independence caused by an individuals presenting needs. End with saying about cc services to link to next paragraph. Community Care services are a range of services that are generally provided by social services to enable the people who are receiving them to remain living within the community rather than moving, for example into residential care (Clements and Thompson, 2007). The main statue that directs community based services is Section 29 of the National Assistance Act 1948. This gives local authorities the power and duty to provide domiciliary care services to disabled people who fall within the definition as defined by the act and who are in need of such services. Services can be provided within the service users home or elsewhere, such as a day centre. As Paul has a learning disability and Downs syndrome, he would be eligible for these services. Under s.29 of the NAA 1948, Paul could receive arrangements to support him with gaining independent living skills, services for recreational and social activities and assistance with setting up his own business so he could sell his vegetables. Paul, under s.29 of the NAA 1948, is defined as being disabled and therefore Local Authorities have further power and duties to provide services under Section 2 of the Chronically Sick and Disabled Persons Act 1970. This section offers a wide range of services that could be available to Paul. He could benefit from outings outside of his home, assistance with travel arrangements for such outings, practical assistance within his home and holidays. Mrs Z is Pauls main full time carer and so would be entitled to an assessment under Section 1 of the Carers and Disabled Children Act 2000, of her own needs in terms of her ability to provide and to continue to provide care for Paul. A carer, as described in the legislation, is an individual who provides or intends to provide a substantial amount of care on a regular basis for another individual aged 18 or over. Within s.1 of the CDCA 2000, Mrs Z, would still be eligible for an carers assessment even if Paul was to refuse a community care assessment himself. The local authority involved in this case, has a statutory duty, under the Carers (Equal Opportunities) Act 2004, to inform Mrs Z of her right to an assessment and must take in to consideration whether Mrs Z works or wishes to work or would like to undertake any education, training or leisure activities. The results of Mrs Zs assessment would be considered during the decision making process of Pauls need for the provision of community care services. If Paul was going to be placed in residential care what statutory duties or powers does the local authority have to place him in residential care, and what statutory duties does the local authority have in respect of the choice of accommodation. Would your answer differ if Paul lacked mental capacity to decide where he should live? If Paul was going to be place in residential care, the local authority has a duty to provide this under Section 21 of the National Assistance Act 1948. Within this act it states that residential accommodation must be provided for persons aged eighteen or over who by reasons of age, illness, disability or any other circumstances are in need of care and attention which is not available. Once Paul has been assessed as eligible for accommodation As Clements and Thompson (2007, pp.222-223) states the NAA 1948 (Choice of Accommodation) Directions 1992 constitute one of the few examples of genuine choice that individuals have in relation to their community care services. The NAA 1948 (Choice of Accommodation) Directions 1992- gives individuals genuine choice that individuals have in relation to their community care services. When they are engaged, the directions give service users a legal right to choose setting of their residential care. Once a social services authority has assessed a person as eligible for accommodation under NAA 1948, S21, it is then obliged to make arrangements to accommodate that person in a care home of his or her choice provided that the conditions in direction 3 of the NAA 1948 (Choice of Accommodation) Directions 1992 (as amended) are satisfied. S1(2) MCA 2005 -presumption of capacity S2 MCA 2005 Decision must be time and issue specific. S4 MCA 2005 if lacks mental capacity then a best interest decision is required c)In the context of the case study please identify any vulnerable adults and say why and in what circumstances you consider them to be vulnerable. What assessments if any would you carry out and what measures if any would you put in place to protect them? Critically analyse which other individuals and/or agencies, if any, you would involve in the safeguarding process. Assessment There are a number of statutes that deal with the matter of assessment. The overarching duty on local authorities is set out in the NHS and Community Care Act 1990. NHS and Community Care Act 1990 Section 47(1). This imposes a duty on local authorities to carry out an assessment of need for community care services with people who appear to them to need such services and then, having regard to that assessment, decide whether those needs call for the provision by them of services. An assessment is triggered where : The person appears to be someone for whom community care services could be provided and The persons circumstances may need the provision of some community care services There are a number of other Acts which deal with the matter of assessment: The NHS and Community Care Act 1990 Section 47(2). If, during the Section 47(1) assessment the person is identified as being disabled *, that person has additional rights as set out in Section 47(2). This requires local authorities to make a decision as to the services required under Section 4 of the Disabled Persons (Services and Consultation and Representation) Act 1986. Note: * see Section 29, National Assistance Act 1948 below Disabled Persons (Services and Consultation and Representation) Act 1986 Section 4. This imposes a duty on local authorities to decide whether the needs of a disabled person call for the provision by the Local Authority of any services in accordance with Section 2(1) of the Chronically Sick and Disabled Persons Act 1970. National Assistance Act 1948 Section 29 (1). To qualify for services under this Section persons must be:   Ã‚  Ã‚  aged 18 or over who are blind, deaf, or dumb, or who suffer from mental disorder of any description, and other persons aged 18 or over who are substantially and permanently handicapped by illness, injury, congenital deformity or such other disabilities as may be prescribed by the Minister. The definition of disabled person should be interpreted in this context to mean people over 18 years who have a permanent and substantial disability such as learning disability, physical disability, sensory impairment, mental health difficulties, chronic illness or any combination of these. LAC(93) 10 Appendix 4 asks councils to give a wide interpretation to the term substantial to take full account of individual circumstances and a flexible interpretation to the term permanent in cases where they are uncertain of the duration of the condition. Examples include episodic or recurring illness, intermittent disability / conditions. People who are disabled within the terms of this definition are not obliged to register with the Department, nor is access to assessment and services dependent on registration. Chronically Sick and Disabled Persons (CSDP) Act 1970 Section 2. This places a duty on local Authorities to assess the individual needs of everyone who falls within Section 29 of the National Assistance Act 1948 above. back to top Assessment of Carers The Carers and Disabled Children Act 2000 Section 1. This section gives carers, aged 16 or over, the right to an assessment of their ability to provide care or continue to provide care: Where they provide or intend to provide a substantial amount of care on a regular basis for another individual 18 or over And the local council is satisfied that the person cared for is someone for whom it may provide or arrange for the provision of community care services. This right exists even where the person cared for has refused an assessment by the local council social services department or has refused the delivery of community care services following an assessment. Note: The Carers and Disabled Children Act 2000 will only rarely be used by councils looking at the needs of 16 and 17 year old carers. Where it is used in these circumstances the assessment must be child centred and follow the guidance set out in the Framework for the Assessment of Children in Need and their Families (paragraphs 3.61 to 3.63.) (Ref The Carers and Disabled Children Act 2000 policy and practice guidance). The Carers and Disabled Children Act 2000 Section 6 . This section provides that a person with parental responsibility for a disabled child has the right to an assessment from the local authority of their ability to provide (and to continue to provide) care for the child. The local authority must take that assessment into account when deciding what services, if any, to provide under section 17 of the Children Act 1989. (Ref The Carers and Disabled Children Act 2000 policy and practice guidance). Disabled Persons (Services Consultation and Representation) Act 1986 Section 8. Carers also have rights under this section which requires local councils to have regard to the ability of the carer to provide or continue to provide care when deciding what services to provide to the disabled person. In these circumstances the assessment of the cared for person must take account of the carer situation and record this as part of the assessment of the cared for person. This requirement exists even where the caring role is not of a regular or substantial nature. back to top Mental Health Act 1983, section 117 requires a local authority jointly with the Health Authority to provide aftercare services for people leaving hospital after being compulsorily detained. It is implicit in such a duty that a process of assessment must be undertaken prior to discharge to identify needs and how they will be met. The delivery of all mental health services is framed within the Care Programme Approach (CPA) which provides the framework for all patients, both in hospital and in the community. Among the key elements of the CPA are: Systematic arrangements for assessing peoples health and social care needs The formulation of a care plan which addresses those needs The appointment of a Care Co-ordinator Regular review of the care plan. Other specific assessment requirements within Mental Health are determined by Sections 2, 3, 4 and 7 of the 1983 Mental Health Act. These sections require an Approved Social Worker to undertake an assessment of an individuals mental health along with key health colleagues. back to top Provision of Services Fair Access to Care Services and the Duty To Provide Once a community care assessment is carried out, councils need to make decisions about whether to provide support or not to individuals. Fair Access to Care Services (FACS) provides councils with an eligibility framework for adult social care to identify whether or not the duty to provide services under the following legislation is triggered. (Ref. Fair Access to Care Services policy and practice guidance). The duty on social services to provide or arrange services is triggered only for those people with eligible needs that is needs above the threshold for services line. The national FACS policy LAC (2002)13 states that councils may take account of the resources available to them in deciding which needs to meet. Needs that are identified as eligible needs and which sit within the laws relating to a duty on Social Services to provide services must be met. How those needs are met is a separate issue. Provision of services takes place primarily under: The National Assistance Act 1948, Section 21 and Section 29 The Chronically Sick and Disabled Persons Act 1970, Section 2 The Health Services and Public Health Act 1968, Section 45 The NHS Act 1977, Section 21 Mental Health Act 1983, Section 117 Carers and Disabled Children Act 2000 Community Care (Direct Payments) Act 1996 back to top Duty to arrange/provide services for people with Eligible Needs National Assistance Act 1948 Section 21(1). Concerns the provision of residential accommodation to certain groups of people over 18 years who through age, illness, disability or any other circumstances are in need of care and attention which would otherwise be unavailable to them. The duty is owed to people ordinarily resident in the Local Authoritys area. National Assistance Act 1948 Section 29. The local council has a duty to exercise its powers for people ordinarily resident in its area and must provide: A social work advice and support service Facilities for rehabilitation and adjustment to disability Facilities for occupational, social, cultural and recreational activities Chronically Sick and Disabled Persons Act 1970 Section 1. This section imposes a duty on local authorities to provide information about relevant services. Chronically Sick and Disabled Persons Act 1970 Section 2 (1). This section sets out the types and range of services that local councils should have available to meet the needs of disabled people *. These include: provision of practical assistance in the home; provision of recreational facilities outside the home or assistance to take advantage of educational facilities; provision of assistance with works for adaptation in the home; provision of meals. Note: * See Section 29(1) of the National Assistance Act 1948 above. National Health Services Act 1977 Section 21. This section identifies that services can be provided in relation to expectant mothers, prevention and after care and that home help and laundry facilities are functions exercisable by social service authorities. Schedule 8 identifies the power to provide and maintain day centres or similar facilities and power to arrange services specifically for people with alcohol and drug problems. Also to provide laundry services as part of the input of home help services. Mental Health Act 1983 Section 117(2) This section creates a joint duty on the local Health and Social services Authorities to provide after care services to various categories of people who have been detained in hospital for as long as the person needs them. Aftercare services are not defined in the Act but will include social work support in helping the ex-patient with problems of accommodation or family relationships, the provision of domiciliary services and the use of day centre and residential facilities. Community Care (Direct Payments) 1996 Act This sets out the circumstances when direct payments should be considered. It gives local authorities the power to offer people cash payments as an alternative to arranging social care services to meet their assessed, eligible needs. (Ref Direct Payment policy) Carers may also have access to Direct Payments. See Carers and Disabled Children Act 2000 Section 5 powers set out below. Health Services Act 1968 Section 45. The Local Authority has a power to make arrangements to promote the welfare of older people. The Carers and Disabled Children Act 2000 Section 2. Under this section the Local Authority has powers to provide services for carers following a carers assessment (whether joint or separate) under Section 1 of this Act. Services to carers are not defined by the Act. The local authority may provide any services they see fit to provide and which in their view help the carer care for the person cared for. These services may take the form of physical help or other forms of support such as training or counselling for the carer. (Ref The Carers and Disabled Children Act 2000 policy and practice guidance). The Carers and Disabled Children Act 2000 Section 5. This section extends the option of Direct Payments to carers aged 16 years or over who care for a person aged 18 or over. (Ref The Carers and Disabled Children Act 2000 policy and practice guidance).

Cruise Tourism Industry

Cruise tourism industry is has become the most important icon of modern tourism in the 21st century. This has mainly been prompted by the changing human utilitarian demands and globalization which makes it much easier to move and interact with environment and other people. Besides, it has been boosted by vast advancement in technology that makes it easy for the people to move out within the highest considerations of safety, comfort, and precise predetermination of the expected destination.Cruise tourism industry has given the tourism total revolution making the industry to be one of the most important sectors in the world economy (Kingston, 2006). However the development and future of the industry is highly dependent on the emergent issues that directly affect the world economy as the main source of consumers for the industry, the international peace & stability especially of the destination regions, the environmental considerations for the industry, and the regions of destination. O f greater importance however, is the consumers desire to explore and experience new aspects and phenomenon different from their home settings.Besides, it forms a direct platform for effective research in different aspects of psychology, natural sciences, social interactions and technological applications (Wood, 2000). Therefore, it depicts a coterminous entity upon where vast applications can be simultaneously applied and studied with ease. Overview of the cruise industry Historical background and development of the industry The current Cruise tourism industry has a long history dating back to the late 19th century when Prinzessin Victoria Luise was finished and commissioned by Hamburg-American Line Company for Transatlantic expeditions.However, historians argue that cruise voyages have existed since the famous travel of Christopher Columbus. Though scholars have sharply been divided over the issue, a common ground appears to have been reached with re-definition of tourism and chara cterisation of its different aspects. Most of the ancient voyages were driven by desire to search for new lands and exploit them for economic gains and less concerned with need for pleasure and site seeing of the current tourism (Kingston, 2006).However, it is very clear that the modern system has directly been shaped by the historical connotations and vastly modified by advancement in technology to reflect its present situation. During the mid 20th century, intercontinental travellers largely used ships for their movement due to the resultant comfort and good experience attached to it (Abraham & Yoel, 1999). However, most of them were directly travel oriented and had less to do with tourism demands. It was due to these experiences that the current systems of massive cruise ships largely establish its basement and progress.More cruise ships specifically meant for holiday were established with greater emphasis for comfort and satisfaction being given much higher priorities (Charles & Brent, 2006). However, most of the cruise considerations were thought to be reservations for the upper class while the lower classes had no position in the same type of expeditions. The current cruise ships are fully inclusive and entirely meant for all the people as the cost adjusts downwards with the rising suppliers of the services. Organization and management Due to the high returns from the industry, massive investments have been mobilized by the different cruise industries.Unlike the previous travelling where much smaller and simpler systems operated with greater focus of transferring people from one destination to another only, the current cruise ships are organised much like float hotels with complete hospitality staff. In the Royal Caribbean International, the staffs in the ship are equal or slightly less than the number of tourists on-board. Effective coordination and management with technicians, engineers, security, and astrologists form the technical bench in the MS Libe rty of the Seas.Besides, they are well manned from the land by constant coordination with the base surveillance monitoring unit via satellite. In the Minors of the Sea, several thousand meals are several thousand meals are served at any particular sitting. The system has been equated to an ecological unit with all the systems highly interdependent and fully self sustaining with minimal external monitoring. Demand for the cruise tourism Since late 1980s, the demand for cruise tourism has strongly risen globally as different generations change the approach to tourism to become part of their lifestyle demands which sets a strong mark of achievement.Compared to the demand during the ‘rebirth' of the industry in 1980s', the demand had doubled by the year 2005. An average of 500,000 people in North America took cruises by the onset of 1980s (Zeneth, 2008). However, the industry was marred by uncertainty due to poor development of technology and lack of enough information for the ind ustry. Besides, cruising was mostly undertaken in US and Eastern Europe only with other countries being at the tender ages of developing their systems. Since then, the demand has been rising at an average rate of 8% annually and is expected to reach a total of 10 million cruises by the year 2007.This number has been projected to continue rising as more players have ventured into the market shifting the previously upper class venture consideration to an all people exercises for faster expansion of the business. By 2015, it is predicted that the number of people cruising the oceans will reach 17 million a 70% increase on the 2000 total number. According to the cruise lines international (CLIA), the demand from the people is double the current number of the cruisers but strongly restricted by location which hinders accessibility (Chris et al, 2008).The most visited region is the Caribbean with over 80% of the tourists it every year. Europe regions are also greatly visited especially al ong the Mediterranean Sea routes. However, fast demand is shifting to the Baltic land along Copenhagen, Tallinn, Stockholm, Helsinki and St. Petersburg ports. Supply of cruise tourism Arguably, the supply of Cruise Tourism has been rising very fast over the last three decades. However, the pace is considered to be a slow one compared to the level of demand by the people for the same services.As indicated earlier cruise tourism is one of the most expensive ventures in the world. Though most travellers view is as a system of get-enjoy-achievement, the underlying harmonization entails vast demands in terms of engineering, coordination and human labour management, security connotation, and international considerations of environment and related protocols. As a result, only few industries have been wiling to venture into the complicated business (Charles &Brent, 2006). This has left the field to smaller ships with much lower holding capacities to operate the lucrative business.The modern carriers are generally much bigger with massive and advanced facilities to hold and secure more consumers with higher levels of comfort during the voyage. Currently, Carnival Corporations is one of the largest cruise companies owning Princess Cruise ship, Swan Hellenic, P& O Cruises and Costa Cruises among others operating US and Europe. By 2010, the company aims at having over 100 cruise ships added to the current 200 operating in the sea. Other major operators and suppliers of the services include Royal Caribbean which is highly established in the North American region.It serves the tourists even to further destinations like Bermuda regions and the polar areas. Norwegian Cruise Lines serves most of the Europe especially along the Mediterranean sea with extension to the polar regions and the Baltic lands. Currently, cruise tourism is becoming a mass market with other major players like India, China, Japan, and Singapore establishing their cruising tourism systems to tap the fast r ising demand. In US, 1/3 of the cruise sails from the port of Miami with others sailing from Port Everglades, Port Canaveral, New York, Tampa, Galveston, and San Juan.Many of the UK cruise lines operate from Barbados (Zeneth, 2008). Economic aspects of cruise tourism Due to the high demands for the cruise services in the world, most of the countries have greatly reaped from the establishment. With the currently demand being expected to rise to 11. 9 and 5. 3 million in America and Europe respectively, World Trade Organization indicates that the sector will form a strong economic support for the individual countries by the year 2015. International Council of Cruise Lines indicates that the industry is riding a strong line of consumer demand improving the economic conditions in North America.According to Zeneth (2008), an average economic impact of the cruise industry spending is estimated at US $ 1, 523 million annually including the total consumption of the ship and passengers. Owin g to the current growth rate of the industry, the amount is expected to double as the industry becomes more vibrant and more players venture into the business. Most of the seaports where the cruise ships take off have highly developed from the business. Scholars argue that the â€Å"flavour and taste† of port cities like Miami, St.Peters burg and Barbados have fully changed to reflect the new ideals of superiority and expensive derivation. The efficiency of the services and facilities offered in these towns have greatly increased with modern aspects relating to cruise tourism improving with speed to cater for the fast growing business (Chris et al, 2008). In Australia, the Cruise industry is expected to contribute immensely to the country's economy in the next decade. Most of the industries specializing in human services provision have found special niches where they can get fast market for their products and services.Environmental aspects of cruise tourism Though this indust ry is fast growing and offering vast promises to the investors and the economy, major concerns have been cited in its application and which requires strong consideration necessary for reducing possible negative effects. Over the years, environment has become a major concern for the cruise tourism industry. Taking into consideration that most of the cruise ships are very large and hold vast numbers of people, the system is also expected to generate vast wastes and emissions into the environment as it tries to sustain them and itself (Sarah & Claudia, 2008).Most of the cruise ships are petroleum driven and consume vast quantities of fuel. This is mainly used in production of electricity used in cooking, propelling the ship and maintaining its on-board supportive systems. As a result, it releases vast emissions into the atmosphere contributing to global warming. With the current rise in production and use of large cruise ship in the world, their total contribution into the atmosphere h as been projected to surpass vehicles production by 2015.A large Cruise ship like Royal Caribbean International has been indicated to have higher capacity to produce envisions equal to to production of 1200 cars (Zeneth, 2008). Owing to the large numbers of the people involved, vast quantities of food prepared and served, supportive services like cleaning and maintenance of these ships during the voyages, they release a lot of effluents and solid wastes into the sea. Most of the petroleum effluents have high sulphur contents that easily change the properties the immediate water threatening the vast biodiversity in the cruise ship travelling lines.Cleaning and maintenance of the cruise ship involves use of chemicals that too end up in the waste stream coming from the ship. The argument that ocean water forms strong and effective dilution mediums that have high capacity to assimilate most of their wastes is totally wrong. The International Convention for the Prevention of Ship Polluti on denotes the essence of respecting the ecological integrity and sanctity necessary for harmonious coexistence of all the ecosystems. During the year 2002, the massive death of Penguins in the southern polar region was attributed to ship pollution (Sarah & Claudia, 2008).Solid wastes management has also posed massive threats to the wildlife in the sea. Most of the lines along the cruise ship path ways highly littered with plastic bags and metallic cans for refreshments. Conclusion and recommendation Cruise ship industry has been growing at a tremendous rate since mid 20th century. This has been caused by the fast rising demand and opening up of the industry to all the people as opposed to the prior social classes consideration. As a result more players and investors have entered into the industry opening its lager contribution to the world economy.Arguably, the last two decades have seen US and Europe dominate the world cruise market with large percentage. However, other players fr om developing countries have effectively come up to participate in fast growing sector. Cruise tourism holds the key to the future of tourism industry as people change their consumerism patterns for different services (David & Richard, 2008). However, the industry should address issues relating to its negative impacts especially to the environment.Most importantly, the company owners should establish better ships that have higher fuel combustion efficiency in order to reduce the overall emissions to the atmosphere. Besides, liquid and solid waste treatment systems should also be installed to reduce their poisonous nature to the marine environment along the routes that these cruise ships follow. Reference list Abraham, P. & Yoel, M. (1999). Consumer behaviour in travel and tourism. Bonn: Haworth Press. Chris, C. , John, F. , Stephen, W. & David, G. (2008). Tourism: Principles and Practice. Geneva: Pearson Education. Charles, R. &Brent, R. (2006).Tourism: Principles, Practices, Philos ophies. New York: John Wiley and Sons. Kingston, R. (2006). Cruise Ship Tourism. New York: CABI. David, J. & Richard, S. (2008). Tourism and Development in the Developing World. London: R outledge publishing press. Sarah, V. & Claudia, C. (2008). Water Pollution Issues and Developments. Brussels: Nova Publishers. Wood, R. (2000) ‘Caribbean cruise tourism: globalization at sea', Annals of Tourism Research, 27(2), 345-70 Zeneth, P. (2008). Tourism development: Analytical consideration of Cruise tourism industry, Journal of tourism management, 29(41): 401-469

The Undeniable Truth About Social Commentary Topics That No One Is Sharing With You

The Undeniable Truth About Social Commentary Topics That No One Is Sharing With You The Death of Social Commentary Topics Five absences will lead to a failing grade. Additional absences will lead to a decrease grade. Students may usually accurately inform you what score they ought to receive. They are encouraged to do this three weeks before the start of the semester. They need rubrics and multiple assessments in order to get the correct feedback for this. Students and their parents want to understand where the student started at a particular point of time and the knowledge they gained over the time period that's being reported. What is Actually Going on with Social Commentary Topics Finally, the usual idea remains that individuals might not have the drive to fix society until it's been utterly demolished and they don't have any other choice. Most people have their very first appointment throughout that time period, meaning it's not possible to understand anyway. Most folks think that they do not have anything to say. Another thing that they don't research with this is how you get diagnosed. Not one of those cops survive the evening. The important point to remember here is you do not comment your memories you retell them. There's a whole lot of great stuff and lots of bad in rap. Long story short, it's about commenting something. The Secret to Social Commentary Topics You will have to finish a group of projects that will allow you to acquire intermediate sculpture making skills. Adjusting your report cards to standards based instruments will be a rough road. For a fine artist like an oil painter, but the procedure will be a great deal more protracted and detail-oriented. It's possible to also talk about the issues that arrive with having a football program. There's no cure, you simply get to the point at which you're able to handle it better. Mental illnesses don't have a cure. If you're not actually having anxiety over the scenario, it isn't anxiety. Offering ways to cut back childhood obesity. The procedure will vary widely based on what it is that you are doing. The goal of Sculpture II is to extend someone's research and exposure to the numerous mediums, methodologies and genres in the area of sculpture. Emphasis on three-dimensional expression in a selection of materials. This may include cultural, political, or religious features of society. Prior exposure or knowledge about a specific subject provides better hindsight that may bring much better arguments on the issue. Their behaviour can be extremely negative and they'll have a tough time building healthy relationships. Discussing the essence of euthanasia. Details of Social Commentary Topics It is essential to experience the author guidelines carefully and make sure that all these requirements are met before submission. Discover which of the topics, you presently have a fairly good background on which will make it possible for you to have a relative edge. If you have sufficient understanding about your field, it ought not be tough for you to compose a commentary. You should make sure to produce your argument just like you would in any other essay too. At the conclusion of assignments we are going to have group critique (discussion). It is crucial to take part in the discussion in the event the critique is to be prosperous. This will alter the paradigm of instruction. A Startling Fact about Social Commentary Topics Uncovered To begin with, the ideas ought to be fresh and relevant. It was just then, that I was able to commence writing my story. The book's appeal goes beyond the domain of constitutional doctrine. Brainstorm with your friends to produce the list of superior topic ideas. The Debate Over Social Commentary Topics More women ought to take interest in politics, and seek out political power in any way levels. Successful women ought to be ready to support different women. There are a few women who can squirt quite frequently, however, they're in the huge minority, and so it shouldn't be included in every. Communication dif ferences between women and men.

Mental Health And Health Care - 3541 Words

Mental illness affects one in four people at some stage in their life. It is estimated that at any one time, there are 450 million people experiencing a mental illness, most of whom live in developing countries. About 25% of patients using primary health care services in developing countries suffer from a mental illness. â€Å"Despite the substantial burden of disease and the availability of effective and affordable treatments, mental health care remains a neglected issue, especially in developing countries† (Kermode, Herrman, Arole, White, Premkumar Patel 2007, pp. 2). The relationship between women’s mental health and reproductive health has come to be recognized as having a considerable burden on women’s health and lives. The World†¦show more content†¦Women are led to believe that the birth of a baby will bring them joy and happiness and that the period after childbirth will be the most satisfying and fulfilling time of their life. However it is per ceived as being one of the most stressful and anxiety-producing times for a woman and her family (Daniel 2008). The nature, prevalence and determinants of mental health problems in women during pregnancy and in the period following childbirth have been thoroughly investigated in high-income, developed countries. The mental health of women living in low-income, developing countries has only recently become an interest for research, due to a greater priority of preventing pregnancy-related deaths (Fisher, Cabral de Mello, Patel, Rahman, Tran, Holton Holmes 2012). According to the WHO (2009, pp. 15), â€Å"the available evidence on reproductive mental health conditions comes overwhelmingly from middle- and high-income countries, conveying the false impression that such conditions do not affect or concern women in low-income countries†. Oftentimes the health of people in resource-poor settings is overlooked and underestimated. Research indicates that approximately 70% of women who give birth each year experience some negative changes in their mental health and moods. Women suffering from postpartum depression have described the period after childbirth as a nightmare as they experience sleeplessness, confusion, memory loss, and anxiety during anShow MoreRelatedMental Health And Health Care974 Words   |  4 PagesSummary Mental health illnesses are just as serious to address as any other disease, and with this Amid Crisis, Senate Bill Seeks Boost Access to Mental Health Care outlines the recent legislation that is being drafted in order to improve Mental Health Care services. Through The Mental Health Reform Act, various measures would be in place to address the growing Mental Health Care concern. The bill would, â€Å"update state funding, improve mental health practices, and increase access to mental healthRead MoreMental Health And Health Care1213 Words   |  5 Pages1) Mental health treatment has seen substantial improvements within the developed world. However, mental health patients continue to experience difficulties receiving mental health care as opposed to physical health care. There are many barriers to receiving mental health services in the developed world even with the advances in technology and treatment seen in medical treatment. When compared with physical health care services , mental health services delivery continue to face issues (Andrade etRead MoreMental Health And Health Care3259 Words   |  14 PagesMental Health Services in Rural Canada When looking at the rural areas of Canada, there is one particular area of health care that appears to be lacking – mental health care services. This can have many serious implications on the communities in which are being underserved, as well for the nurses and health care professionals providing the care for those with mental illness. Approximately 99.8 percent of Canada is considered to be a rural area (World Health Organization, 2009). Within this, thereRead MoreMental Health And Health Care842 Words   |  4 PagesMental health providers utilizes many forms of research from the interventions that they use to provide care to their clients all the way to the assessment’s that they use to gauge the level of satisfaction of their clients with their services and how effective their services are in regards to their overall mental health wellness. Pennsylvania Mentor’s Lehigh Valley location provides Intensive Case Management (ICM) / Resource Coordination (RC) service, Family Based Mental Health Services and CertifiedRead MoreEssay On Mental Health Care1221 Words   |  5 PagesSoumerai, S. B., Mclaughlin, T. J., Ross-Degnan, D., Casteris, C. S., Bollini, P. (1994). Effects of Limiting Medicaid Drug-Reimbursement Benefits on the Use of Psychotropic Agents and Acute Mental Health Services by Patients with Schizophrenia. New England Journal of Medicine,331(10), 650-655. doi:10.1056/nejm199409083311006 This study provides information on two Medicaid claims the first one was at psychiatric hospital in New Hampshire where Medicaid had a three-prescription limit over the 11-monthRead MoreA Brief Note On Mental Health And Health Care762 Words   |  4 Pages 4. Reasons for Treatment Gap Barriers to mental health care, which increase the treatment gap, are originated both at the governmental and the individual level (Kohn 2013). Barriers to care at the individual level result from the individual’s attitudes, false beliefs about mental illness, stigmatization, and lack of compliance with medicines. Andrade et al., (2014), using data are from the WHO World Mental Health (WMH) Surveys found that for among those with a DSM-IV disorder in the past twelveRead MoreMental Health Care Of Indonesia1383 Words   |  6 PagesNations Project: Rough Draft Katie Metro February 9, 2015 Mental Health Care in Indonesia It ruined my dignity or whatever shred of humanity I had left, says Anto Sg, of his experience with Indonesian mental health care. He was repeatedly chained while undergoing medical treatment in East Java at various medical centers. Anto notes that what he really needed was a psychiatrist and counseling, but instead he was shackled for months. He also says that his family believed he was insane and onlyRead MoreMental Health Care Analysis1485 Words   |  6 PagesFirstly, the analysis will address the standard of mental health care across each category of prison individually, discussing good examples of mental health support, but also, where there are failures. With this, there is a visual map of how the data was categorised. The analysis will then thematically explore the range of recommendations from every prison category to create an overarching conclusion of standards in reference to general failures across the prison system, the impact this has on currentRead MoreThe Issue O f Mental Health Care1211 Words   |  5 Pages2016, Presidential candidate Hillary Clinton released an ambitious plan for addressing the issue of mental health care in the United States1. This plan echoes numerous bipartisan bills that have been produced in Congress over the past several years and seems to be one of the few issues that both sides of the aisle can agree on.2 Earlier this year, a bill providing additional support to mental health care was passed in the House with a 422-22 vote3, so it is now up to the Senate to pass its own reformRead MoreVeterans and mental health care965 Words   |  4 Pages Take care of Veterans I believe that it is the best interest of veterans, whom have served the military in any capacity to be afforded not just medication, but also some form of counseling. Being a veteran myself I have experienced: over medicating by the government, not receiving any form of counseling, and when I was given an appointment it was six months from the day that it was scheduled. When I was Honorably Discharged from the military I was not afforded any form of mental counseling