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By I. Gonzales. Saint Rose College.

In addition cheap 15 gm ketoconazole cream with amex, the nurse and client can con- metaphors cheap 15 gm ketoconazole cream otc, thoughts purchase 15gm ketoconazole cream free shipping, insights, intuitions, memo- tinue to explore goals, options, choices, and volun- ries, hopes, apprehensions, feelings, and dreams as- tary mutual patterning strategies as a means to sociated with the health situation. The pattern profile is an expression of the many “interventions” identified in the Nursing person/environment/health situation’s essence. The Intervention Classification (McCloskey & Bule- nurse weaves together the expressions, perceptions, chek, 2004). However, “interventions,” within a and experiences in a way that tells the client’s story. Rather than linking is in a narrative form that describes the essence of voluntary mutual patterning strategies to nursing the properties, features, and qualities of the diagnoses, the strategies emerge in dialogue when- human/environment/health situation. In addition ever possible out of the patterns and themes de- to a narrative form, the pattern profile may also scribed in the pattern profile. Furthermore, Rogers include diagrams, poems, listings, phrases, and/or (1988, 1992, 1994) placed great emphasis on metaphors. Interpretations of any measurement modalities that are traditionally viewed as holistic tools may also be incorporated into the pattern and noninvasive. These and other appreciation and voluntary mutual patterning noninvasive modalities are well described and doc- processes. Barrett’s (1989) Theory of Power as Knowing Evaluation is continuous and is integral both to Participation in Change was derived directly from pattern manifestation knowing and appreciation Rogers’ postulates and principles, and it inter- and to voluntary mutual patterning. The nurse is weaves awareness, choices, freedom to act inten- continuously evaluating changes in patterning tionally, and involvement in creating changes. While the concept of “outcomes” is life experiences and dynamically describes how incompatible with Rogers’ notions of unpre- human beings participate with the environment to dictability, outcomes in the Nursing Outcomes actualize their potential. Barrett (1983) pointed out Classification (Moorhead, Johnson, Maas, 2004) that most theories of power are causal and define can be reconceptualizied as potentialities of change power as the ability to influence, prevent, or cause or “client potentials” (Butcher, 1997, p. At var- aware of what one is choosing to do, feeling free to ious points in the client’s care, the nurse can also do it, doing it intentionally, and being actively in- use the scales derived from Rogers’ science (previ- volved in the change process. Thus, the intensity, frequency, and form in terning strategies and evaluation methods are used, which power manifests vary. Power is neither in- the intention is for clients to actualize their poten- herently good nor evil; however, the form in which tials related to their desire for well-being and bet- power manifests may be viewed as either construc- terment. Barrett (1989) stated that identifies that aspect that is unique to nursing and her theory does not value different forms of power, expands nursing practice beyond the traditional but instead recognizes differences in power mani- biomedical model that dominates much of nursing. Barrett’s Power Theory is useful with clients acausal, pandimensional, rhythmical, irreducible, who are experiencing hopelessness, suicidal and unitary context. Unitary pattern-based practice ideation, hypertension and obesity, drug and alco- brings about a new way of thinking and being in hol dependence, grief and loss, self-esteem issues, nursing that distinguishes nursing from other adolescent turmoil, career conflicts, marital dis- health-care professionals and offers new and inno- cord, cultural relocation trauma, or the desire to vative ways for clients to reach their desired health make a lifestyle change. To prevent biased responses, the nurse ories have been developed that are useful in should refrain from using the word “power. The Kaleidoscoping is a way of engaging in a mutual scores are documented as part of the client’s pat- process with clients who are in the midst of expe- tern profile and shared with the client during vol- riencing a turbulent life event by mutually flow- untary mutual patterning. Scores are considered ing with turbulent manifestations of patterning as a tentative and relative measure of the ever- (Butcher, 1993). Flow is an intense harmonious in- changing nature of one’s field pattern in relation to volvement in the human/environment mutual field power. The term “kaleidoscoping” was used be- Instead of focusing on issues of control, the cause it evolves directly from Rogers’ writings and nurse helps the client identify the changes and the conveys the unpredictable continuous flow of pat- direction of change the client desires to make. Rogers client mutually explore choices and options and (1970) explained that the “organization of the liv- identify barriers preventing change, strategies, and ing system is maintained amidst kaleidoscopic al- resources to overcome barriers; the nurse facilitates terations in the patterning of system” (p. For example, asking the questions, “What Life Events is used in conjunction with the do you want? A pattern A wide range of voluntary mutual patterning profile describing the essence of the client’s experi- strategies may be used to enhance knowing par- ences, perceptions, and expressions related to the ticipation in change, including meaningful dia- turbulent life event is constructed and shared with logue, dance/movement/motion, sound, light, the client. Cultivating purpose involves assist- ing clients in identifying goals and developing an Theory of Kaleidoscoping action system. The action system is comprised of in Life’s Turbulence patterning strategies designed to promote harmony Butcher’s (1993) Theory of Kaleidoscoping in Life’s amid adversity and facilitate the actualization of Turbulence was derived from Rogers’ Science of the potential for well-being. Unitary Human Beings, chaos theory (Briggs & In moments of turbulence, clients may want to Peat, 1989; Peat, 1991), and Csikszentmihalyi’s increase their awareness of the complexity of the (1990) Theory of Flow. Creative suspension is a technique that well-being and harmony amid turbulent life events. Guided imagery is human/environmental field characterized by a useful strategy for facilitating creative suspension chaotic and unpredictable change. Any crisis may because it potentially enhances the client’s ability to be viewed as a turbulent event in the life process. Forging the uncertainty of a medical diagnosis, marital dis- resolve is assisting the clients in becoming involved cord, or loss of a loved one. Flow experiences • Love themselves, promote harmonious human/environmental field • Identify concerns, patterns. There are a wide range of flow experiences • Give themselves goals, that can be incorporated into the daily activities: • Have confidence and help themselves, and art, music, exercise, reading, gardening, meditation, • Take positive action. The art of kaleidoscoping with turbulence is a mutual creative expression of Research beauty and grace and is a way of enhancing perse- verance through difficult times. As new practice model has been used by the Personalized Nursing theories and health patterning modalities evolve Corporation, an independent, nurse-owned, nurse- from the Science of Unitary Human Beings, there managed company providing outreach nursing remains a need to test the viability and usefulness care to high-risk and active drug users in Detroit, of Rogerian theories and voluntary health pattern- Michigan.

The research: the psychological impact of screening The negative sequelae of screening have been described as ‘the intangible costs’ (Kinlay 1988) but research suggests that they are indeed experienced by the individuals involved ketoconazole cream 15 gm discount. These psychological sequelae can be a result of the various different stages of the screening process: 1 The receipt of a screening invitation order ketoconazole cream 15gm fast delivery. Research indicates that sending out invita- tions to enter into a screening programme may not only influence an individual’s behaviour 15 gm ketoconazole cream otc, but also their psychological state. Their results showed that 55 per cent reported feeling worried although 93 per cent were pleased. However, when asked in retrospect 30 per cent said that they had become anxious after receiving the letter of invitation. It may be assumed that receiving a negative result would only decrease an individual’s anxiety. Most research suggests that this is the case and that a negative result may create a sense of reassurance (Orton et al. Further, Sutton (1999) in his review of the literature on receiving a negative result following breast cancer screening concluded ‘anxiety is not a significant problem among women who receive a negative screening result’. However, some research points towards a relationship between a negative result and an increased level of anxiety (Stoate 1989) or residual levels of anxiety which do not return to baseline (Baillie et al. Further, research indicates that even following negative results some people attend for further tests even though these tests have not been clinically recom- mended (e. They argued that people may not be reassured by a negative result for two reasons. First, they may hold a belief about the cause of the illness that does not directly map onto the cause being tested for. Therefore although the test indicated that they did not have the relevant genes this may not be the case in the future. As expected, the receipt of a positive result can be associated with a variety of negative emotions ranging from worry to anxiety and shock. Moreover, an abnormal cervical smear may generate anxiety, morbidity and even terror (Campion et al. Psychological costs have also been reported after screening for coronary heart disease (Stoate 1989), breast cancer (Fallowfield et al. In addition, levels of depression have been found to be higher in those labelled as hypertensive (Bloom and Monterossa 1981). However, some research suggests that these psychological changes may only be maintained in the short term (Reelick et al. This decay in the psychological consequences has been particularly shown with the termination of pregnancy following the detection of foetal abnormalities (Black 1989). Although screening is aimed at detecting illness at an asymptomatic stage of development and subsequently delaying or averting its development, not all individuals identified as being ‘at risk’ receive treatment. In addition, not all of those identified as being ‘at risk’ will develop the illness. The literature concerning cervical cancer has debated the efficacy of treating those individuals identified by cervical screening as ‘at risk’ and has addressed the possible consequence of this treatment. This suggested that all women with more severe cytological abnormalities should be referred for colposcopy, whilst others with milder abnormalities should be monitored by repeat cervical smears. Shafi (1994) suggests that it is important to consider the psychological impact of referral and treatment and that this impact may be greater than the risk of serious disease. However, Soutter and Fletcher (1994) suggest that there is evidence of a progression from mild abnormalities to invasive cervical cancer and that these women should also be directly referred for a colposcopy. This suggestion has been further supported by the results of a prospective study of 902 women presenting with mild or moderate abnormalities for the first time (Flannelly et al. The results showed that following the diagnosis, the women experienced high levels of intrusive thoughts, avoidance and high levels of anger. However, the authors reported that there was no additional impact of treatment on their psychological state. Perhaps, the diagnosis following screening is the factor that creates distress and the subsequent treatment is regarded as a constructive and useful intervention. Marteau (1993) suggested that the existence of screening programmes may influence social beliefs about what is healthy and may change society’s attitude towards a screened condition. In a study by Marteau and Riordan (1992), health professionals were asked to rate their attitudes towards two hypothetical patients, one of whom had attended a screening pro- gramme and one who had not. The results showed that the health professionals held more negative attitudes towards the patient who had not attended. In a further study, community nurses were given descriptions of either a heart attack patient who had changed their health-related behaviour following a routine health check (healthy behaviour condi- tion) or a patient who had not (unhealthy behaviour condition) (Ogden and Knight 1995). The results indicated that the nurses rated the patient in the unhealthy behaviour condition as less likely to follow advice, more responsible for their condition and rated the heart attack as more preventable. In terms of the wider effects of screen- ing programmes, it is possible that the existence of such programmes encourages society to see illnesses as preventable and the responsibility of the individual, which may lead to victim blaming of those individuals who still develop these illnesses. This may be relevant to illnesses such as coronary heart disease, cervical cancer and breast cancer, which have established screening programmes. In the future, it may also be relevant to genetic disorders, which could have been eradicated by terminations. Screening in the form of secondary prevention involves the professional in both detection and intervention and places the responsibility for change with the doctor. The backlash against screening could, therefore, be analysed as a protest against professional power and paternalistic intervention.

For one cheap ketoconazole cream 15 gm, although the color purple does appear to us as a mixing of red and blue ketoconazole cream 15 gm low cost, yellow does not appear to be a mix of red and green cheap ketoconazole cream 15 gm amex. And people with color blindness, who cannot see either green or red, nevertheless can still see yellow. An alternative approach to the Young-Helmholtz theory, known as the opponent-process color theory, proposes that we analyze sensory information not in terms of three colors but rather in three sets of “opponent colors‖: red-green, yellow-blue, and white- black. Evidence for the opponent-process theory comes from the fact that some neurons in the retina and in the visual cortex are excited by one color (e. Flag" for about 30 seconds (the longer you look, the better the effect), and then move your eyes to the blank area to the right of it, you will see the afterimage. When we stare at the green stripes, our green receptors habituate and begin to process less strongly, whereas the red receptors remain at full strength. Stare at the flag for a few seconds, and then move your gaze to the blank space next to it. The tricolor and the opponent-process mechanisms work together to produce color vision. When light rays enter the eye, the red, blue, and green cones on the retina respond in different degrees, and send different strength signals of red, blue, and green through the optic nerve. The color signals are then processed both by the ganglion cells and by the neurons in the visual cortex [7] (Gegenfurtner & Kiper, 2003). Perceiving Form One of the important processes required in vision is the perception of form. German psychologists in the 1930s and 1940s, including Max Wertheimer (1880–1943), Kurt Koffka (1886–1941), and Wolfgang Köhler (1887–1967), argued that we create forms out of their component sensations based on the idea of the gestalt, a meaningfully organized whole. We tend to group Do you see four or eight Proximity nearby figures images at right? The rather than in principle of continuity leads more us to see most lines as discontinuous following the smoothest Continuity ways. We tend to fill in Closure leads us to see a Closure gaps in an single spherical object at Figure 4. Perceiving Depth Depth perception is the ability to perceive three-dimensional space and to accurately judge distance. Without depth perception, we would be unable to drive a car, thread a needle, or simply [8] navigate our way around the supermarket (Howard & Rogers, 2001). Research has found that depth perception is in part based on innate capacities and in part learned through experience [9] (Witherington, 2005). The infants were placed on one side of the “cliff,‖ while their Attributed to Charles Stangor Saylor. Gibson and Walk found that most infants either crawled away from the cliff or remained on the board and cried because they wanted to go to their mothers, but the infants perceived a chasm that they instinctively could not cross. Further research has found that even very young children who cannot yet crawl are fearful of heights [11] (Campos, Langer, & Krowitz, 1970). On the other hand, studies have also found that infants improve their hand-eye coordination as they learn to better grasp objects and as they gain more [12] experience in crawling, indicating that depth perception is also learned (Adolph, 2000). Depth perception is the result of our use of depth cues, messages from our bodies and the external environment that supply us with information about space and distance. Binocular depth cues are depth cues that are created by retinal image disparity—that is, the space between our eyes, and thus which require the coordination of both eyes. One outcome of retinal disparity is that the images projected on each eye are slightly different from each other. The visual cortex automatically merges the two images into one, enabling us to perceive depth. Three-dimensional movies make use of retinal disparity by using 3-D glasses that the viewer wears to create a different image on each eye. The perceptual system quickly, easily, and unconsciously turns the disparity into 3-D. An important binocular depth cue is convergence, the inward turning of our eyes that is required to focus on objects that are less than about 50 feet away from us. The visual cortex uses the size of the convergence angle between the eyes to judge the object’s distance. You will be able to feel your eyes converging if you slowly bring a finger closer to your nose while continuing to focus on it. When you close one eye, you no longer feel the tension—convergence is a binocular depth cue that requires both eyes to work. As the lens changes its curvature to focus on distant or close objects, information relayed from the muscles attached to the lens helps us determine an object’s distance. Accommodation is only effective at short viewing distances, however, so while it comes in handy when threading a needle or tying shoelaces, it is far less effective when driving or playing sports. Monocular depth cues are depth cues that help us perceive depth using [13] only one eye (Sekuler & Blake, 2006). Assuming that the objects in a scene are At right, the cars in the same size, smaller the distance appear objects are perceived smaller than those Relative size as farther away. When they appear closer together, we Linear Parallel lines appear to determine they are perspective converge at a distance. At right, because the When one object blue star covers the overlaps another pink bar, it is seen as object, we view it as closer than the Interposition closer. Perceiving Motion Many animals, including human beings, have very sophisticated perceptual skills that allow them to coordinate their own motion with the motion of moving objects in order to create a collision with that object. Bats and birds use this mechanism to catch up with prey, dogs use it to catch a Frisbee, and humans use it to catch a moving football.