Definition of quality of life

Definition of quality of life CHAPTER 2 THEORETICAL STUDY 2.1 Introduction Chapter two discusses the theoretical aspect in quality of life. In addition, the description of the Orang Asli community will also be given to providing a better understanding of this community. This is because quality of life has become one of government main agenda in developing the countries. This chapter will explain relation with quality of life and Orang Asli community. The reasons are quality of life always related with the studies at urban areas meanwhile studies about quality of life at rural area is rarely done. That is the reason on choosing a Orang Asli community as a subject of study because Orang Asli community are usually located at the rural area and remote area. Other than that, Orang Asli community always said to live in a backward and lagging behind compare to other races in Malaysia. Therefore, the understanding of quality of life and Orang Asli should be suppressed in chapter two. 2.2 Definition 2.2.1 Definition of Quality Of Life Quality of life is a subjective matter that difficult to be measured. So it is important to known the actual meaning of quality of life. The best ways of understanding is by separate the word of ‘quality of life. According to oxford dictionaries, ‘quality is standard of something as measured against other things of a similar kind which is the degree of excellence of something meanwhile ‘life bring stand for the period between the birth and death of a living thing , especially a human being. So quality of life actual meaning is degree of excellence of human being. According Lim Lan Yuan, Belinda Yuen and Christine Low (1999) in a book entitle ‘Quality Of Life in the Cities, quality of life is a multifaceted concept. Meaning of multifaceted is something that is wide. In this case it is because quality of life covers not only a material aspect such as level of living but also aspect of life such as a good health and level of education. In other words, Lim Lan Yuan, Belinda Yuen and Christine Low (1999) try to tell us that the quality of life cannot stand by itself. Types of result that may come from the research is depends on what respondents have experienced in their life. These three writers agreed that quality of life for respondent is according to location they live and work. This is the reason why quality of life for every person is different from one and another. Ramkrishna Mukherjee (1989) says that quality of life is concern about the living condition of the people. Ramkrishna (1989) use several approach to measure quality of life such as the standard and style of living. The standard of living for example is constructed from quantitative variation in the object of inquiry which is given by list of information items such as consumption of food, clothes, use of various kinds of durable goods like furniture and fitting, possession of item like radio, television and other housing amenities. Mark Rapley (2003) believes that the quality of life has been constructing from being a social scientific index of the relative well being of the whole population to being a measurable aspect of individual subjective experience. American sociologist James Q. Wilson (www.wordiq.com) mention the ‘Broken Window Theory, which asserts that relatively minor problems left unattended send a subliminal message that disorder in general is being tolerated, and as a result, more serious crimes as well end up being committed (the analogy being that a broken window left unrepaired show an image of generalized collapse). This theory tries to show that the condition of the environment gives the direct massage to people that that space or place is unsafe. These unsafe senses show that people are live in danger in that place and it directly show that their quality of life is in low level. One indicator that has been used to measure quality of life is level of happiness and when their fell that their life is in danger, they cannot reach the quality of life. This American sociologist tries to tell that physical environment can contribute to level of quality of life. Mark Rapley (2003) refers to Noll (2000) says the great society is concerned not with how much but with how good. It means that it is not with the quantity of goods but with the quality of their lives. Rapley (2003) also added that quality of life research is same as the welfare measurement. He defines that welfare is the subjective well being and the most important is the measure of the satisfaction and happiness. 2.2.2 Definition of Orang Asli Who is the Orang Asli? That is question that we must answers before we get to know this unique group. Orang Asli is a generic name given to the indigenous people living on Malay Peninsular. Other ethnic in Sabah and Sarawak is not taking into account of this Orang Asli group because these two states use the term â€Å"Sabah indigenous† and â€Å"Sarawak indigenous†. Eighteen ethnic group subgroups is fall in this category, which can be classified into three groups. These three groups are the Negrito, the Senoi and the Malayu Asli. This group is determined based on their language, livelihood and administrative purpose. The term Orang Asli is a Malay translation of the English word â€Å"aborigine† with ‘orangmeaning â€Å"human† and ‘asli meaning â€Å"original† or â€Å"traditional†. Orang Aslirefers to the indigenous peoples ofPeninsular Malaysia that not MalayMuslims, Malaysias main ethnic group. There were about 2.93 million orang asli in Malaysia in year 2006 (Malaysia Bulletin of Statistics issued on June 2006). They are the minority group because they make up just 11.8% of the national population. Nabuto Toshiro (2009) refers to Mohd. Tap (1990), pointed that the Malaysia government began using the Orang Asli term in 1996. Before that, the Orang Asli was variously described as the Biduanda, Jakun, Sakai, aborigines and other term. A. Baer (1999) in book entitle â€Å"Health, disease and survival: a biomedical and genetic analysis of the Orang Asli of Malaysia† tell early development activity that has been carry out by the government in developing the country is not considering the Orang Asli community. The development has taken Orang Asli formers and current land. This cause destruction to their natural resources and create a miserable life for Orang Asli community. There are attempt take by the government to fix this problem by give a small agricultures scheme. The main intention is to allow the Orang Asli community to do cash crop farming as the sources of economic and foods. Other than that, government also gives a minimal aids and land and expected that is enough to support their lives. This led Orang Asli community to lagged behind compare to other community in Malaysia. That is reasons on Orang Asli ethnic become the poorest of the poor. This shows that Orang Asli quality of life is at a low level due to they are economically poor. 2.2.3 Definition of rural area There are various definitions on rural area. According to Department of Statistic (2000), rural area is area that populated not more than 10,000 people. This population amount must according to the census of population and housing. Other than that, Malaysia Urban and Regional Planning Department also described rural area as area that located far from the urban area. Types of land use at rural area also characterise by the agricultural and natural resources such as forest. Next, rural area should consist with a settlement that cover all types of village and small settlement that not more than 10,000 people. Rural area can be categories into several factors which are: I. Population size II. Population density III. Urbanization levels IV. Level quality of life and public facilities (paved roads, electricity supply, water supply) Types of settlements that exist in rural area consist of traditional village, FELDA and FELCRA, Orang Asli village and other areas that cover under Regional Development Authority. 2.3 Conceptual and Philosophical issues of Quality of Life Concept on quality of life nowadays simply defined as a standard of living that has been received by individual or a community group. This standard of living concludes a sense of happiness, lifestyle, satisfaction and wealth. People who received all these criteria can be said has achieved a good quality of life. The issue is whether standard of living only criteria that can be determine quality of life. Mark Rapley (2003) stated that quality of life is a driving force in service design, delivery and outcome evaluation across medicine and social care. The quality of life of ‘patients/ ‘service user is now usually advocates as a measure of the ‘quality and ‘values of money of service. Mark Replay (2003) also adds that there are two conceptual ideas that use of the idea of quality of life which is an objectivity and subjectivity. Concept objectivity in quality of life can be defined as an attainment of various basic life needs such as a food and shelter which is considered common to all culture. Other than that, objectivity concept is representing external life condition such as economical factors. Subjectivity in quality of life is concern about the feeling that individual get in their life. It is more on appraisal of the thing that they get in their life. Figure 2.1 show the differences between the external condition (the material life arena) and the internal, personal element of people (the personal life arena). This figure tries to show that what exactly an objectives matter about and the subjective matter are about. Robert J.Rogerson (1999) described a material life arena can be viewed either as a geographical space within which place is people live. So the material life arena is the objective concept in defines a quality of life. In other word, material life arena is a stimulus for life satisfaction. Personal life arena included a subjective assessment of life, measure in term of satisfaction as well measure a characteristics of people. What are mean by characteristics of people was their preferences, priorities, aspiration and values system. According to Robert J.Rogerson, type A is a research based on the accessing the material life arena and employing primary social indicators. Type B is more on the personal life arena which mean that they more on characteristic of people which representing about the feeling, behaviour and others. Type C researches are more on subjective well being research where quality of life is a direct measure of individual cognitive and effective reaction to his own life. Material life area is the concern about the condition that can influence individual quality of life. This is because types of work, housing condition, place of living can make quality of life be better or maybe become worse. This is because the influences is come from outside and the individual are cannot control it by himself. Meanwhile personal life arena is the factors that can be manipulated by the individual itself. This is because these personal life arenas are controlled by the individual. the evaluation of this types of concept are based on the individual feeling that influenced by the experience, behaviour and satisfaction from the individual itself. Robert L. Schalock, Ivan Brown, Roy Brown, Robert A. Cummins, David Felce, Leena Matikka, Kenneth D. Keith, and Trevor Parmenter (2002) in article entitle â€Å"Conceptualization, Measurement, and Application of Quality of Life for Persons With Intellectual Disabilities† described quality of life are concern about domain of well being, inter and intra personal variability, personal context, perception, values, choice and personal control. So the better understanding will be obtained if all of these criteria can be explained in detail. I. Domain of well being There be lots of aspects that must be determined by the invidual in perform their life. For example individual are allowed to determined the thing that most important domain in their life such as a emotional well being, interpersonal relationship, material well being, physical well being, self determination, social inclusion and right. So individual must able to recognise what is the important need to them. The well being is not determined on how many amount that individual can get but on how valuable that things can be in the individual life. II. Inter and intra personal variability Variability is the most domain of well being that taken by individual to experience in their life. Thus, it is consider a different individual, different community and different cultural because quality of life for each individual is different from one to another. III. Personal context People context are the understanding of people about their context of environment that are important to them in their life. This can be influenced by the place that they live, work and play. This environment should be able to accommodate individual according to their feeling, interest, need and values. This will allowed them to adapt with the surrounding environment at the place that they live. IV. Perception Perception in quality of life is a individual statements about the individuals perceives at any moment in their life. The changes of views may be happen according to the changes of time and situation. However this is needed to see the reasons of the changes to create a improvements to receive a better quality of life. V. Values, choice and personal control This is relating to choice that has been made by individual. So in other word, it is individual ability to control over their interest in term of activities, intervention and environment. This is because every aspect in quality of life brings different values into individuals life. 2.4 Important of Quality Of Life Quality of life has been used as a tool to measure the well being condition of individual and community. Changes in size and population distribution will create unstable on living standard of a community. Using indicator that have been used in measure a quality of life, level of living condition of people can easily obtain. This will help responsible parties to developed strategies in improving the quality of life of people. It will enhance a people well being level. Quality of life matter actually should be a goal on every development that creates for people. This will give benefit for people and opportunity for people to enjoy their life. There are three ways that can be use on showing how importance quality of life which is at national, community and individual level. On national purpose, quality of life can be use as a tool on measure a standard of living of population at the country. Result that obtained will show the efficient government that role country. The result can be used to measure on the current situation that happens in that country. If there is peace, it means that people are satisfied with their current quality of life. These leads on economy development by attract investors to come and invest in the country. It will create a job opportunities for local people to enhance their income. In community life, quality of life has been used as a symbol of their community power. For a country that has lots of ethic, it is important to show their achievement to the other ethnic. Strong community will enable them to spoken for their community right and fulfil their requirement. Quality of life has used as a standard to measure satisfaction levels in its community. If they do not achieve their desired quality of life, so they will try hard until they achieve to become a strong community. Same scenario will happen to when achieving a personal quality of life. Level of satisfaction on individual will determine reaction on how individual will react to the community life. 2.5 Differences between urban and rural quality of life According Annette Spellerberg, Denis Huschka and Roland Habich (2006), in article entitle ‘quality of life in rural area : Processes of divergence and convergence, rural area has its own benefit from it geographical location. Economic indicator is not a major factor when measuring rural quality of life because they enjoy on lower standard of living. They also states that rural community actually function as balancer to homogenisation and dislocation that has been causes by the international economic process. Other than that, urban area has been used as a driving force for rural area development but the reverse situation happen when the concentration development that happen in urban area has cause rural areas continue to lagging behind. Spellberg (2006) also explain that a pressure of living in urban areas has push out urban family to the rural area. In suburban area, process of culture assimilation happen between the rural and urban. Impact may happen on level quality of life for people that migrate from urban area to rural area. This is because facilities and utilities that provided at rural area are not same as the facilities that provide at urban area. Therefore, their needs and requirements may not be fulfilled when they were in rural areas. Other than that, reduction of quality of life also causes by the lack sense of place because they are not in their origin places. Indicator that has been used on measuring rural quality of life consist types of work, housing condition, income level, leisure and social relationship. Indicator of housing condition for example refers to general satisfaction of resident to their housing condition and it surrounding areas. Finding gather from the research that has been done by Spellberg (2006) show that people live in rural area enjoy a high level of satisfaction with the standard of housing than the people that living in urban areas. A gap between rural and urban in the matter of subjective well being was not clearly defined. Other satisfaction of life in term of family, leisure and health could much more important to personal happiness and general satisfaction rather than income and affluence. In conclusion, there are differences between achievement quality of life in urban and rural areas. This difference can be seen in terms of measuring quality of life between these two areas. This is because the indicators used are different due to different geographical locations and the types of development that happen surrounding it. People in urban area are more satisfied with the material values rather than people in rural area that more on satisfaction on life and social relationship. For example, sense of neighbourhoods relation or social relation is stronger in rural area rather than people in urban area. This is because in rural, they lived as a one community and depend for each other. If there is disagreement between them it will lead to uneasy environment and because of that they cannot meet their happiness in life. Different scenario occurs in urban areas due to the absence of time, the neighbourhood relations are not taken seriously by them. Therefore it is not surprising that the people in urban areas do not know their own neighbours. 2.6 Measurement Quality Of Life How to measure a quality of life? Early researches have been made is not only using a social indicator but also using an economic indicator. Both of these indicators will shows about social and economic level of a society. According to the Malaysia Quality of Life report (2004) indicators that use to measure quality of life are income level, working life, health, education, environment, family life, social participation, culture and leisure. On income indicator it will measure on gross income and standard of living. Other than that, income also uses to see whether the individual can sustain their income for their self and family. Next, the types of work also can be used to measure the level income of individual. All of this is cannot be obtain in rural areas. This have causes many people to travel several miles to find work that can provides a better living wage. Working life indicator are use to measure the types of work and working condition environment of the community. At the rural area, high-income jobs are difficult to be obtained. Other than that, there are low rates of work variety and these make them to do same jobs all the time. A type of job that usually occurs in rural area is based on agricultural activities in a small scale. So they cannot obtain a high income level with kind of jobs. Next is health indicator that uses to study about the physically and mentality of people at the study area. Good healthy will enable people to work and socialist more effectively. This indicator will enable to detect their access to the health services. Even though they government are creating more and better health facilities but the result is often denied access for those unable to travel the distance to get the needed services. Family life indicator is used to measure how strongly the chain relationship between family member. Other than that, it will enable us to see types of social structure and how it will contribute on enhance a quality of life. Social participation will show about an involvement of an individual on their community. Lack of leadership and support from the community is one of problem that can be preventing that community to be a strong community. Other than that, it is ways to see if they are willing to contribute in social, political, religious and community activities. Other than that, the measurement on quality of life also must include the level of practise among community about culture and leisure. This is one of ways to identify their community identity. Other than that, the knowledge about their custom and tradition are also can be obtain. A culture aspect gives knowledge on social behaviour of those communities. It is an important part on to see whether the communitys relationship is still practicing nowadays. 2.6.1 Ethic of measure quality of life According to the R. L. Schalock (2002), the first thing before measure quality of life understands the degree of which people enjoy good quality in life. Measure quality of life should enable to enhance people quality of life by taking an action to improve the obstacle that currently decreased people quality of life. Other than that, the measurement result must be able to help and should never encourage achieving a low quality of life. Measuring quality of life is usually carried out by identified what are the specific things that have to value by individual. After that, it must be matched with the individuals perception or their happiness. Usually this measurement is concern with the â€Å"subjective† and â€Å"Objectives† measurement. The most usually method that being use is by measuring their life experiences to know the positive values that happen to the individual across time and among their cultural. Other than that, this also can be done by describing their positive valued into something that can be measure. Next, the method that can be used is the quantitative measurement. This done by creating a scale to described the level of their satisfaction between the â€Å"best† and the â€Å"worst†. 2.7 Malaysia rural social policy and it characteristic According to the Malaysia rural social policy journal (2008), Malaysia rural policy is cover a policy that helps farmer through providing a basic living needs to improve quality and productivity of the crops. Although Malaysia has a faced great process of urbanization as a tool on develop the country, agricultural sector has not be ignored but still practicing particularly in rural area. This is because rural area is places where the indigenous Malaysia practicing an agricultural activity. Through a ‘new economic policy that has been implement after an ethnic conflict 1969 to reduce of poverty especially for indigenous Malaysia, government has come on several strategies which are : Development of land, increase the cultivated land area and resettlement of landless farmers to grow cash crops. To improve a firm land capital construction which are drainage project in Kelantan State plan and Ji Muda Kedah. Provide a fertilize, high yield seeds, subsidies for high yield crops and a agricultural technique to improve agricultural crop yield, expanding oil palm and other economic crop planting area. The implementation of the price subsidy system, reduce market risks, to protect the interests of production for farmers. Provide loans for a farmer to enhance their agricultural production. Create a farmer market in urban centre to allowed farmer to sell directly to consumer without involve the third parties. With all these strategies, Malaysia has able to bring out rural people out of poverty while at the same time protect a basic living needs of the farmers. Since 2001, government has launch a ‘National Vision Policy with an anti poverty program that focus on the indigenous ethnic minorities in remote areas. Other than that, government also provide housing, water supply and sanitation system, basic living conditions and medical social services for those targeted people. Other than that, by think that only education that will help people to enhance their quality of life, government has come out with the ‘Compulsory Education Law for 6 to 15 year children. This is one ways that will encourage and forcing people especially in rural areas that has high percentages of not going to school. This policy is supported by done the development of new school building and school improvement in term of study condition and quality of teaching. In conclusion, government actually play a huge role on enhancing a quality of life for the rural. Government has been behind of the scene for every development that happens. Government and private sectors must be cooperating to provide a development that can bring happiness and welfare for the Malaysia people. 2.8 Application of quality of life in different country Quality of life research has been conduct almost on every country that exists in the earth. This is one ways to measure a level of living standard in that country. It will help to bring people from other country to become resident or just for travel. So the result of quality of life will be as a tool to know the actual level of quality of life in that country. There is differentness between urban and rural quality of life. So it is importance to well understand about urban and rural quality of life. 2.8.1 Quality of life in urban area 2.8.1.1 Singapore Singapore for example is one of the country has done quality of life research several times. As a F.T. Seik, Yuen and L. Chin (1999) mention, there are about three studies has been done on the measurement of quality of life in Singapore. This study has been done by Kau and Wang (1995), Foo (1998) and Kau (1998). First study by Kau and Wang (199) is about the life satisfaction from 329 respondents aged 15 year and above 1993. The indicator that has been used is more on about the social, health and economic condition. Second studies made by Foo (1998) are to measure overall life satisfaction as well as to measure an importance and satisfaction towards various aspects of life. Third studies made by Kau (1998) are measure satisfaction with life in the Singapore. It measure using a likert-scale with ‘1 is for very dissatisfaction level and ‘6 as a very satisfied level. Conclusion and finding that can be found are people in Singapore are moderately satisfied with their overall quality of life. Education and income is two indicators that have impact on Singaporean overall life satisfaction. They score high in term of value healthy and family life but low level on the leisure and consumer goods. 2.8.1.2 Hong Kong This is the summary on studies of subjective that has been done by Wan, P. S., Law, K. W. K., Wong, T. K. Y. (2008) entitle Subjective well-being. Studies on the quality of life at Hong Kong are concern about the subjective indicator which is based on the respondent subjective perception and evaluation of their lives and experiences. This study is done by the Hong Kong Institute of Asia-Pacific Studies in year 1988 under the project ‘Indicator of Hong Kong Social Development. The project has been done for several years until they develop an index, the SDI 2000 which uses to measure the social development in Hong Kong. The study is about subjective well being of the respondent. The findings of the study indicate that Hong Kong Chinese are more satisfied with their own personal lives rather than societal condition. The subjective well being is declines in 1995, although they still satisfied with their personal lives. Other than that, their confidence in the territory future is significantly lower. It also found that, there are considered a good health, peace of mind and money as the most important thing that could lead to their happiness. Using same questionnaire set just like the first study, Wan, P. S., Law, K. W. K., Wong, T. K. Y. (2008) launch another study that examined the mean self reported to develop a composite index to reflect changes in quality of life over the period from 1990 to 1997. It was found that the personal well being index was more robust to the changes and only get change with the global trend. Other than that, the societal well being index showed more obvious changes over time. 2.8.2 Quality of life in rural area 2.8.2.1 New Zealand New Zealand is a one of the country that has done a quality of life research in a rural area. Maori people are an aboriginal people that usually live in New Zealand rural area. This research has been done by the Social Policy Research Unit of the Family Centre (Lower Hutt) and the Population Studies Centre, University of Waikato. Study case of the study is on Wellinton Tent Trust and the Palmerston North Maori Trust. The research is about understanding the wellbeing of Maori people because they (Royal Commission on Social Policy: 1988) believe that ‘a good society is one that allows people to be heard, to have say in their future and choice in life. For them, social well being includes that sense of belonging that affirms claims their dignity and identity and allows them to function in their everydays roles. First of all it is important to know what Maori people understand on quality of life. According New Zealand Maori Case Study 1 (2007) report, that refers on Love, Maulaulau and Pratt (2005) study, they identify that Maori people understanding concept quality of life would emphasise spiritual, family, tribal and social spiritual connection on responsibility, community relationship, authority and use of ancestral land as a component of Maori wellbeing with other generally shared component such as health care, adequate housing and other resources. Finding of the research shows that Maori community is more concern of human relationship with in detail is on the family relationship. This is because the entire respondent that has been interview states that social activities that happen around them is not only for themselves but also for the young generations. Other than that, they need to be able with the family and close to their own environment which are places that they are close to family. If we look on detail, it supposes to show how the strong is family bond between them. Studies also sho

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Nursing leaders look at the bigger picture, such as patient satisfaction but are also required to look at fiscal responsibilities that the facility has, as well as community events and support projects. Leaders look to improve and promote positive changes that will benefit the community served by the facility. Nurse leaders can evaluate how the policies and procedures are working, if they need to be changes to provide better quality of care. Nurse leaders also assist in educating staff on the reasons change is necessary and the steps that can be taken to effectively implement changes. Nurse managers are there to provide direction on daily tasks, support and as a resource  to staff. Typically, nurse managers deal with day to day running of the floor and issues that arise with staff and/or patients. Managers typically see issues that arise with current policies, provide direction to staff. It is understandable how management can be pulled in opposite directions such as what is best for nursing staff and patients may not be the same as what is good for the facility. Upper management does not always seem to have a grasp on the reality of the floor, the day to day issues of providing patient care and just what is necessary to maintain patient satisfaction. The theories and principles that best describe this writers philosophy is a mix. One theory or principle does not fit. A mix of situational, servant and participative includes the theories followed. Different situations can bring out different needs. An example in my facility is, with concerns regarding financial changes occurring in healthcare, rising costs to healthcare, a poor economy and decreased reimbursments, the leaders have to look at all those aspects, and evaluate the risk vs. benefits to nurse ratios. The nurse managers have to follow the rules set forth, and try to comply with the demands from upper management. It is expected by me that nurse managers look at the reality of the floor while keeping the needs of the facility in mind. Floor nurses are the advocates for the patient, and have a unique perspective of the needs of the floor. Managing staffing, acuities and patient care while also dealing with physicians, and upper  management requires effort and active participation. Leaders need to think outside the box, look at the bigger picture and then convince everyone that the changes are necessary, needed and beneficial. Both positions require skills such as good communication, good listening, being able to lead without dictatorship or by fear. Creating a positive environment while maintaining authority is not an easy task. Creating an atmosphere conducive to change while providing high quality care and keeping everyone happy is an even more difficult task. But both of these tasks require a relationship, trust and communication between all parties or departments involved. Staffing ratios have been studied, as seen in the study regarding work satisfaction (Nursing Economics, 2012) discusses the first staffing law that went into effect in California in 2004. The study showed that nurses with a lower nurse to patient ratio had a higher job satisfaction rate, as well as better patient satisfaction. The costs associated with high nurse turnover include more than just monetary costs. The safety risks to patients can not be ignored. Nurse managers can evaluate the effectiveness of the policies as they are closest to the floor nurses and patients. Nurse managers have a different and unique experience, as do nurse leaders. Both areas require active participation with daily interaction with staff. The staff needs to feel a part of the team, respected and listened to. To have an effective unit, collaboration between all levels needs to be in place. Effective managers and effective leaders can work together to achieve goals, while providing high quality patient care. References Hinno, S., Partanen, P., & Vehvilà ¤inen-Julkunen, K. (2012). Nursing activities, nurse staffing and adverse patient outcomes as perceived by hospital nurses. Journal Of Clinical Nursing, 21(11/12), 1584-1593. doi:10.1111/j.1365-2702.2011.03956.x Tellez, M. (2012). Work Satisfaction Among California Registered Nurses: A Longitudinal Comparative Analysis. Nursing Economic$, 30(2), 73-81.

Linking instruction Essay

Teaching is always perceived as a straightforward process whereby teachers provide instruction and students learn. With this perspective, teaching is seen as a simple instruction–learning process. In actual practice, it is more realistic to view assessment as an integral component of the teaching process. In fact, it has been estimated that teachers devote at least one-third of their professional time to assessment-related activities (Stiggins & Conklin, 1992). Assessment can and should provide relevant information that both enhances instruction and promotes learning. In other words, there should be a close alignment between theory, instruction and assessment. With this expanded conceptualization of teaching, instruction and assessment are integrally related, with assessment providing objective feedback about what the students have learned, how well they have learned it, how effective the instruction has been, and what information, concepts, and objectives require more attention. Instead of teaching being limited to an instruction–learning process, it is conceptualized more accurately as an instruction–learning–assessment process. For example, a misaligned curriculum, instruction, and assessment had been seen as one factor that led to poor student achievement. In the past, standardized norm-referenced tests, used traditionally for accountability, have only partially aligned with curricular materials and classroom instruction. These conditions obviously result in poor test scores (Burger, n. d. ). Using the standards-led alignment approach, this policy sought to align, integrate, and connect components of schools as systems (e. g. , assessments, curriculum, instruction, and accountability). According to Linn & Herman (1997), standards-led alignment should use local content standards as the focal point to: †¢ foster the use of multiple assessment sources and methods, †¢ describe how classroom and accountability assessment relate to each other, †¢ align accountability and classroom assessment with learner outcomes, and †¢ ensure that teachers and administrators use appropriate forms of assessment, are skilled in interpreting data, can plan for re-teaching activities using data, and can evaluate the impact of specific programs and instructional strategies. To begin the alignment process, Allington and Cunningham (2002) advocated a comprehensive policy review to determine where all system elements connect (e. g. , curriculum, instruction, and leadership). Stiggins and Conklin (1992) illustrated the important role that teachers play in the process of aligning instruction and assessment methods with theory: As a nation, we spend billions of dollars on educational assessment, including hundreds of millions for international and national assessments, and additional hundreds of millions for statewide testing programs. On top of these, the standardized tests that form the basis of district-wide testing programs represent a billion dollar industry. If we total all of these expensive, highly visible, politically important assessments, we still account for less than 1 percent of all the assessments conducted in America’s schools. The other 99 percent are conducted by teachers in their classrooms on a moment-to-moment, day-to-day, and week-to-week basis. In summary, if an educational institution wants to have effective teachers, they needs incorporate in their educational paradigm to link theory in the methods of instruction and assessment. Instruction and assessment are both instrumental parts of the teaching process, and assessment is a major component of a teacher’s day-to-day job. Knowing the connection of these, teachers can obtain information that promotes self-understanding and they will have more ability to help students plan for the future. For example, parents and students can use assessment information to make educational plans and select careers that best match a student’s abilities and interests. References Allington, R. L. , & Cunningham, P. M. (2002). Schools that work: Where All Children Read and Write.Boston, MA: Allyn and Bacon. Linn, R. , & Herman, J. L. (1997, February). A Policy Maker’s Guide to Standards-Led Assessment. Denver, CO: Education Commission of the States. Burger, D. (n. d. ). Using Standards-Led Policy to Align Assessment and Accountability Systems. Honolulu: Pacific Resources for Education and Learning. Retrieved 2 November 2006 at http://www. prel. org/products/re_/standards-led. htm. Stiggins, R. & Conklin, N. (1992). In Teachers’ Hands: Investigating the Practice of Classroom Assessment. New York: SUNY Press.

Health And Social Care Policy Health And Social Care Essay

Social, economic and industrial alterations have changed the forms of life globally. Changes in diet and physical activity forms have been cardinal to the rise of fleshiness among many of the universe ‘s population. Obesity was traditionally seen as a disease of high-income states merely, but it is now replacing malnutrition and infective diseases as a job exceeding societal divides. Obesity carries a higher incidence of chronic unwellness including diabetes, bosom disease and malignant neoplastic disease. This paper will critically measure the current UK and NI policies aimed at turn toing the fleshiness epidemic. There will besides be a treatment around definition of policies, function of authorities in health care, old and current health care policies sing fleshiness in both Britain and Northern Ireland. The official computation for specifying fleshiness was set by the World Health Organisation ( WHO ) where grownups are registered fleshy and corpulent utilizing a expression of Body Mass Index or ( BMI ) , that is a individual ‘s weight in kgs divided by the tallness in meters squared ( DWP, 2012 ) . The chief restraint with utilizing organic structure mass index as an index is that it does non separate fat mass from thin mass ; so a individual could be healthy and have a low organic structure fat, but be clinically fleshy if they have a high plenty BMI. A individual is thought to be overweight if they have a BMI of 25.0 or more and corpulent if the BMI is 30.0 or more. Fleshiness has three categorizations: aˆ? Class 1 BMI 30 to 34.9 ( waist margin 102cm asset for males and 88cm asset for females ) . Person is categorised as corpulence aˆ? Class 2 BMI 35 to 39.9. Person is classed as corpulent aˆ? Class 3 BMI 40 and over. Is when a individual with a BMI of 40+ is said to be morbidly corpulent ( WHO, 2012 ) . Policy originates from the authorities that are in power, who are besides the legal authorization and have a position and counsel over all policy whether they be private or public ( Crinson, 2009 ) . Harmonizing to Crinson 2009 Health policy is hypothesised in footings of macro and micro societal developments, with the macro degree reading the working of societal and formal constructions, such as the economic context of the province and the market, and the National Health Service ( NHS ) . The micro side focuses on the influence of policy from the degree of the health care professionals and the experience of the users ( Crinson, 2009 ) . Policy devising, harmonizing to a White Paper published by the Labour Government in 1999 provinces that it is a method in which a authorities construe their political vision into programmes and actions in order to do alterations that are required and wanted by the population ( Cabinet Office, 1999 ) . It was besides focused on modernizing the authorities scheme ( Cabinet Office, 1999a ) and the demand for more inclusive and reactive policy ‘s linked to people ‘s demands. It planned to vouch that policy devising was to go more forward thought and evidence-based, every bit good as right assessed and based on best pattern. It went on to observe the demand for improved grounds when addressing policy devising and to guarantee a more joined-up attack across authorities sections and bureaus ( Cabinet Office, 1999 ) . Harmonizing to the World Health Organisation wellness policy signifies determinations, programs and actions that are started in order to make elaborate wellness attention ends within a society. It goes on to observe that and clear and string policy can sketch an thought for the hereafter whilst helps to set up aims and points of orientation. A wellness policy can besides assist to plan a model and construct understanding in add-on to informing people ( WHO, 2006 ) . There are three cardinal policies countries within the Department of Health and they are National Health ( NH ) , Public Health ( PH ) , and Social Care ( SC ) ( Kouvonen, 2012 ) . The current theory has two dissimilar backgrounds ; the first is a public policy analysis that is favoured by the United States and Northern Ireland. The 2nd is favoured in the United Kingdom and is a societal policy theoretical construction ( Kouvonen, 2012 ) . Policies are intended to better on current commissariats in wellness and societal attention in the UK and purpose to vouch services that are funded or supported by the Department of Health are delivered in an unfastened and patient-centred manner ( www.dh.gov.uk ) . This was non ever the instance, as harmonizing to Crinson authoritiess were apathetic to the type of attention delivered within the healthcare service ; that was the concern of the physician. This was to alter in the 1970s when the economic system declined and revenue enhancement gross was reduced ( Crinson, 2009 ) . The axial rotation of the province in supplying wellness and public assistance to the public harmonizing to Crinson 2009 takes the position that there are five diverse conceptualizations and they echo differences between political and conceptual actions of the function that the province should play when presenting wellness and public assistance services ( Crinson, 2009 ) . The author goes on to give illustrations of these conceptualizations one of which is the neoliberal prospective that influenced the alteration in the wellness and societal public assistance policies of the Thatcher Government in the 1980s ( Crinson, 2009 ) . In the Political-Economic Critique, harmonizing to O'Connor et Al welfarism serves to construct consent for capitalist economy through the procedure of spliting the population into groups with specific demands. This he notes had the consequence of individualizing what are widespread societal and wellness jobs associates with life in a capitalist ‘s societ y ( Gough, 1979 ) . In a paper by David Berreby in which he asks the inquiry, why do people acquire fat and hazard major wellness job? , He believes the reply to this inquiry is capitalist economy and sites it as the chief cause of planetary fleshiness ( Berreby, 2012 ) . Conversely in a programme series aired on the BBC on the 11th July 2012 the newsman Jacques Peretti reports that our eating wonts were changed by a determination made in America 40 old ages ago. Peretti travelled to America to analyze the narrative of high-fructose maize sirup ( HFCS ) a calorie-providing sweetening used to dulcify nutrients and drinks, chiefly processed and shop-bought nutrients. The sweetening was backed in America in the 1970s by Richard Nixon ‘s agriculture decision maker Earl Butz to utilize extra maize grown by husbandmans. Cheap and sweeter than sugar, it quickly found its manner into about all convenience nutrients and soft drinks. HFCS is non merely sweeter than sugar ; it besides inhibits leptin, the en docrine that controls hunger, ensuing in the inability to halt feeding ( BBC, 2012 ) . This was backed up by grounds from Robert Lustrig an endocrinologist, who harmonizing to this study, was the first to place the dangers of high-fructose maize sirup ( HFCS ) . His findings nevertheless, were discredited at the clip. and a US Congress study sited fat, non sugar, for the dismaying rise in cardio-vascular unwellness and the nutrient industry responded with a series of low fat and ‘heart healthy nutrients in which the fat was removed. ( BBC, 2012 ) . Policy shapers encouraged husbandmans to overproduce maize and soy with the promise of foreign trade ( Philpott, 2008 ) . It was besides in the seventiess that Britain ‘s nutrient industries used publicizing thrusts to promote the thought of noshing between repasts. A fast nutrient civilization besides developed and fast nutrient ironss offered alluring nutrients and clients served themselves, and harmonizing to Ritzer this was the beginning of McDonaldization of Society. He goes on to compose how fast nutrient eating house contribute to the development of fleshiness and it accent on supersizing its parts ( Ritzer, 2004 ) . Conversely poorness increased in the 1970s under Thatcher Government and harmonizing to the Institute for Fiscal Studies in 1979 13.40 % of people in Britain lived below 60 % on average income before lodging costs. With this came a large rise in inequality and under the gini mark for Britain was up to 0.339 from 0.253 ( Crib, et al 2012 ) . Due to the comorbidities associated with fleshiness and their increasing cost to the NHS, the effects of fleshiness are presently and will go on to be of import public wellness challenges globally and in the UK. It impacts through society and across all life classs, and can increase the hazard of life endangering disease ( Kouvonen, 2012 ) .Appendix 1. Presently there is a model in Northern Ireland titled ‘A Fitter Future for All ‘ , this docket spans from 2012 to 2022. Within this paper it explains that in Northern Ireland 59 % of grownups are either fleshy ( 36 % ) or corpulent ( 23 % ) ( DHSSPSNI, 2012 ) . This policy addresses the demand to move from childhood based on grounds from the Foresight Report 2007, and is now a cross sectorial cohesive life class docket that will turn to fleshiness over the following 10 old ages ( Foresight Review, 2012 ) . The Department of Health has published a follow-on papers to the Public Health White Paper called ‘Healthy lives, healthy people: A call to action on fleshiness in England ‘ , which sets new national thrusts for a falling tendency in extra weight by 2020. The Undertaking Fleshinesss: Future Choices undertaking presented its findings on 17 October 2007 and the Undertaking aims to present a executable response to fleshiness in the UK over the following 40 old ages. It besides sets out illustrations of what is intended on a national degree to assist dispute fleshiness, one of these is called Change4life programme. In this programme it states it will assist consumers make healthier nutrient picks ( www.dh.gov.uk ) . This could be linked to Professor Marmot point, when he discussed behavioral picks as persons such as where to shop for nutrient, and how these determinations are dictated by the person ‘s socio-economic circumstance, and if they can afford the recommended good nutrient ( UCL Institute of Health Equity, 2012 ) . ‘A fitter Future for All ‘ and ‘Healthy Lifes, healthy people ‘ are policies that both the British and Northern Ireland authorities support, but there are wider determiners of hapless wellness such as poorness and inequalities that play an of import function in fleshiness ( HM Government, 2010 ) . It could be argued that while policies such as these are aiming the causes of fleshiness, they are non actively seeking out realistic solutions to the job ; people may cognize they need to eat healthier, but merely can non afford to purchase the better nutrient. In developing states rates of fleshiness are inclined to lift, and this is associated with turning societal disadvantage ; turn toing societal want and material disadvantage is likely to cut down fleshiness ( Kouvonen. 2012 ) . Socio-economic category as a factor in wellness is non a new phoneme in the United Kingdom, as it has a history of many 100s of old ages. Harmonizing to Edwin Chadwick ‘s study on healthful conditions of the laboring population in Britain in 1842 showed that in Liverpool the mean age of mortality for people in the upper categories was 35 old ages, and 15 old ages for labor and retainers ( Richardson, 2008 ) . Inequalities still exist today, but have improved and in the Black study published in 1980 it states that there are still inequalities with respect to life anticipation and the usage of medical services ( Whitehead et al, 1992 ) . Harmonizing to the Foresight study ( 2007 ) a authorities scientific discipline think armored combat vehicle reported that most grownups are already overweight. It goes on to observe that modern life will guarantee that approaching coevalss will be heavier than the last, and by 2050, 60 % of work forces and 50 % of adult females possibly clinically corpulent. The study besides states the fleshiness is a many-sided and there is no grounds anyplace in the universe where fleshiness has reversed. Social policy models are overriding harmonizing to this study ( Foresight Review, 2012 ) . The Marmot Report the 3rd such officially approved analysis in every bit many decennaries examining the nexus between wellness and wealth. The findings confirmed an dismaying societal slope, the hapless non merely decease seven old ages earlier than the rich, but they can anticipate to go handicapped 17 old ages earlier. Professor Marmot continues to discourse behavioral picks we make as persons are portion of our societal and economic scenes. He believes that people born into more flush surroundings tend to follow a healthy life style, ensuing in health care differences between the societal categories ( UCL Institute of Health Equity, 2012 ) . In 2011 the Chief medical Officers ( CMOs ) from across the UK published new schemes for physical activity, and they addressed a life class methodological analysis, and included guidelines for early old ages ( www.ic.nhs.uk ) . It could be argued this is a cover policy and it is widely known that poorer people have limited picks with respects to lifestyle picks such as gym ranks. Besides the study appears to put the duty of exercising on the person. Peoples from poorer socio-economic backgrounds have poorer lodging and environments that do n't promote physical exercising which could be due to societal civilization of where these people live and deficiency of resources ( UCL Institute of Health Equity, 2012 ) . Addressing fleshy kids that become corpulent in ulterior life was issue raised by Dr Hilary Jones on Good Morning Britain, when he stated that fleshiness begins in childhood. He went on to state that the National Health Service and the Government know causes of fleshiness but a ctively forestalling it in childhood demands to be addressed ( www.gm.tv ) . Prevention of fleshiness is more accomplishable end than turn toing fleshiness when it becomes established, as some wellness jobs that are acquired through fleshiness remain an issue even after weight loss. Therefore authorities policies are largely directed at primary bar of fleshiness such as eating good, exercising and no smoke ( Kouvonen, 2012 ) . Social determiners of wellness are besides a cardinal factor in fleshiness in both kids and grownups. Harmonizing to the World Health Organisation the societal conditions in which people live are paramount to their wellness. It goes on to observe that deficiency of income, hapless lodging and deficiency of entree to healthcare installations are merely some of the factors taking to inequalities ( www.who.int ) . Medical attention on its ain can non adequately better person ‘s wellness and turn toing where people live and work is besides of import The societal determiners of wellness are the â€Å" upstream † societal, economic, and environmental factors that affect the wellness of persons and populations, including income, societal support, instruction and literacy, employment and working conditions. Downstream determiners, which include physical activity, clean air and H2O and healthy lodging. These factors can act upon wellness inequalities difference between societal groups that can ensue in fleshiness in poorer countries ( Kouvonen, 2012 ) . Incidents of Childhood fleshiness are higher in countries with a lower socioeconomic population harmonizing to National Health Service Information Centre study on fleshiness. It besides states that fleshiness is more widespread in schools in deprived countries. It besides noted that with Reception kids ( kids in the primary school age group ) 6.9 % of those in least disadvantaged countries were corpulent, in comparing to 12.1 per centum of kids in most disadvantaged countries ( www.ic.nhs.uk ) . In Northern Ireland statistics show that 8 per centum of kids ages between 2 and 15 old ages are corpulent, harmonizing to the Health Minister Edwin Poots. The wellness Minister went on to state that the likeliness of corpulent kids become corpulent grownups was likely ; this would set greater strain on the wellness and societal attention services due to the comorbidities associated with the status ( Northern Ireland Executive, 2012 ) . Governments province that wellness policies are micro driven, but in world it could be argued that they are macro driven as ultimately fleshiness will be more in the long tally due to fleshiness related unwellness such as diabetes and heat disease, and harmonizing to NHS website the cost will be ?4.20 billion per twelvemonth ( HM Government ) . Undertaking fleshiness is a challenge for non merely the UK, but globally and harmonizing to the Department of Health and Social Services Northern Ireland web site, corpulence and fleshiness will catch malnutrition and infective disease in footings of their cost to the wellness services and people enduring from the status ( www.dhsspsni.gov.uk ) . Appendix 2. It was non until 1999 that fleshiness was declared an epidemic in America and was considered to impact all racial groups and across all ages in United States ( National Medical Association, 1999 ) . Harmonizing to the information published there was an addition from 12 % to 18 % over a seven twelvemonth period utilizing a organic structure mass index ( BMI ) that was greater than 30 ( National Medical Association, 1999 ) . Historically obesity rates were low and unaffected until 1970s and 80s, and the obesogentic environment ( an environment that encourages and leads to fleshiness in persons that relates to the influence that contribute towards fleshiness such as nutrient, physical activity and environment. Many broader determiners of hapless wellness such as wellness inequalities, poorness and want play a important function, and these factors have non swayed over the old ages. In pre-war Britain big differences in mortality and morbidity degrees between rich and hapless were recogni sed as the norm by policy shapers. It was the debut of the National Health Service in the fortiess that brought with it hope that the societal category differences impacting wellness would worsen. It was n't until the seventiess that the Marmot Report stated people ‘s life style and fortunes have a direct consequence on their wellness ( Crinson, 2009 ) . The wellness deductions from fleshiness are huge and can finally ensue in a premature decease. Although fleshiness is caused by consumption of more energy through nutrient and drink than needed and the ensuing extra stored in fat in the organic structure, the position that obesogenic environment besides plays a portion in fleshiness is going widely accepted. Social and economic fortunes are besides evaluated in this paper as are the function of authoritiess and policy shapers, both in the United Kingdom and Northern Ireland. The overall position of this paper would be that policies are made by persons that have no penetration into what portion of society they are directed at such as disadvantaged and socio-economic countries that lack the agency and installations whereby persons feel that their part to society is valued and of import sufficiency for them to care about their ain well-being. Policies are non directed at one specific group such and the one size fits all does n't look to be working as fleshiness is now a planetary epidemic.BibliographyBBC ( 2012 ) ‘The Work force who made us fat: episode 3 ‘ , available at www.bbc.co.uk/programmes/b01kd06l ( Accessed 06/11/2012 @ 20.05 ) Berreby, David. ( 2012 ) . ‘Is Capitalism To Blame for Worldwide Obesity? ‘ Available at hypertext transfer protocol: //bigthink.com/Mind-Matters/is-capitalism-to-blame-for-worldwide-obesity ( Accessed 5/11/2012 ) Braveman, Paula. Egeter, Susan. Williams, R. 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( 2004 ) ‘The McDonaldization of Society ‘ , SAGE, California UCL Institute of Health Equity ( 2012 ) ‘Strategic Review of Health Inequalities in England: Post-2010 ( The Marmot Review ) ‘ , available at www.marmotreview.org ( Accessed 9/11/2012 ) Whitehead, M. , Townsend, P. , Davidson, N. , Daivdsen, N. , ( 1992 ) ‘Inequalities in Health: The Black Report and the Health Divide ‘ , Penguin Books Ltd ; New edition ( 29 Oct 1992 ) World Health Organisation ( 2006 ) ‘Commission on Social Determinants of Health ‘ , available at www.who.int/social_determinants/resources/csdh_brochure.pdf ( Accessed 09/11/2012 @ 17.56 ) World Health Organisation ( 2012 ) ‘Health Policy ‘ , available at www.who.int/topics/health_policy/en/ ( Accessed 05/11/2012 @ 8.50 ) World Health Organisation ( 2012 ) ‘Obesity ‘ , available at www.who.int/topics/obesity/en/ ( Accessed 05/11/2012 @ 17.43 )Appendix 1