Diversity and Cross Cultural Differences in Work places Essay

Diversity and Cross-Cultural Differences in Workplaces Introduction            Different people have different mental structures due to the diverse type of personality and cultural background. The study of psychology has enabled people to know about the mental functioning of others making it easier individuals and groups to understand one another. Since people must interact in the day-to-day activities, there is need to harmonize this differences and create an environment where every member feel a sense of belonging. Psychological counseling plays an important role in preparing individuals to be more appreciative the cultural and personality difference existing between people. Psychology counseling is a field of psychology focusing on the personal and interpersonal working and on the emotional, social and health related issues of individuals and groups of people. This paper addresses issues arising from interaction of people with differences culture and behaviors. It also focuses on criminal investigation process in the psychological perspect ive.            Key words: psychopathology, personality, behavioral therapy, individualistic, diversity Diversity and Cross-Cultural Differences in Workplaces            Every individual is characterized by a unique pattern of thoughts, behaviors and feeling that contribute to individual’s psychological structure. Despite the fact that each individual is unique in personality resulting in diversity in peoples’ way of lives, people have always found themselves in crowds- be it in schools, places of worship, or any other social, political or economic gathering. Leininger and McFarland (2006) writes that the need to coexist in harmony compels persons to sometimes subordinate individual goals so that they can accomplish the goals of a group. Those individuals who are not mentally ready to accept the cultural and personality diversity between different people often find it hard to coexist with others.            Psychopathology has enabled counseling psychologist to understand the various aspects of one’s mental structure including genetic and biological issues. Psychologists are able to identify people who undergo atypical or disordered development from those with normal or typical development. It is paramount for coworkers to be aware of their colleagues’ mental structure so as to engage in the right way with them. This is crucial for the creation and maintenance of a healthy and productive working environment that is composed of persons with diverse personalities. In such a set up where workplace colleagues have to cope with different personality traits, one may find it hard to maintain a stable mental behavior and physical emotions and may suffer from maladjustment in case one is in a new environment. Counseling psychologists help such persons to alleviate distress and improve their wellbeing (Woolfe & Dryden, 1996). They also provide patients with assess ment and treatment of psychological issues.            Through behavioral analysis, one is able to systematically analyze another person’s or one’s own behavior so as to know cause of certain behaviors and consequently improve social interaction. Bad behaviors can be corrected or good behaviors adopted or through behavioral therapy. This is a method that is used bypsychotherapists and psychiatrists to treat mood disorders an anxiety usually caused by variables such as; social phobia, depression, post-traumatic stress disorder and bipolar disorder. According to Lesilie (2008), behavioral treatment techniques include;Role playing, discussing about coping mechanisms, breathing and relaxation method, activities to promote focus, modifications to anger, pain or fear, social skills training, positive reinforcement.            These methods focus on individuals shaping their behavior to cope with the environment. When individuals with behavioral disorders try to change their behaviors to suit that required in the workplaces, they often find themselves struggling to relate with the others and this leads to seclusion and isolation. On the other hand behavioral therapy should focus aiding individuals acquire control over their own behavior and blending it with the requirements of the workplace. This is important because one manipulates the environmentand learns to control their own behavior without compromising their personality which is vital for maximum productivity. With one’s own personality, the reception of stimuli and the response is not affected and therefore there are no negative consequences influencing the next occasion in the brain (Lesilie, 2008).            Persons who find it hard to conform to workplace ethics due to cultural mismatches should set standards for assessing their own performance and progress in behavioral therapy. Techniques such as self-management, self-control and self-regulation are used to monitor one’s progress (Woolfe & Dryden, 1996). Behavioral modification procedures are not procedures to punish those people with different behaviors but they are techniques to eliminate non-conforming working behaviors and also facilitate cross-cultural understanding. The make the workplace to feel better and builds a sense of satisfactory. For psychologists to offer the relevant advice to a person suffering from mental disorder, they must first find out the patients’ personality and understand how they think, feel, relate, influence and get influenced by others.            For applied social psychologists to attend to a patient they must try to adopt the personality of the patient so that they can employ the best techniques to treat a patient without affecting the patients personality. In this perspective the psychologist is able to develop development strategies that are aimed at improving the important aspects, programs and policies for the patient to have a positive recovery. Psychologists should aim at eliminating the negative attitude that a patient may have towards colleagues or the workplace. This is aimed at improving intercultural understanding and to offer a neutral platform where no culture is viewed as less or more important than the other. With cross-cultural understanding people will tend to be more committed to working together improving productivity.            Nevertheless, cultural competence is healthy for the growth of an organization that comprises of people from diverse cultures (Leininger & McFarland, 2006). This should not be overshadowed by the tendency to express cultural superiority over others but should demonstrate the ability to effectively engage in cross-cultural dialogues without intimidating or negating another person’s culture. This requires one to appreciate social psychology and be in a position to balance between positive and negative criticism on another person’s culture. Since not all people are equipped with the understanding of social psychology, training on cultural competence should be conducted to avoid such problem from arising. Some cultures are individualistic while others are communists and this play a big role in defining how coworkers exist. This necessitates the need for effective cross-cultural team-building and training.            As colleagues engage in affairs of the workplaces, each and every one of them is entitled to a certain opinion which one would like to support. If such a situation gets tense, certain body changes occur such as breathing rates and emotional changes if certain people are intimidating others for decisions to go their way. Such a phenomenon may result in one becoming uncontrollable or violent. Biological psychology is concerned with balancingwhat the mind is processing and the effects it has on the body. It analyses how ones behaviors and thoughts are affected by the brain and neurotransmitters. Various neurotransmitters have different effects on the body. For instance, neurotransmitter dopamine is responsible for movement and learning. Varying quantities of excess or too little of the neurotransmitter dopamine in the body results in disorders such as schizophrenia and Parkinson’s disease respectively. (Woolfe & Dryden, 1996).The comprehensive nature of bio-psy chology encompasses diversity and cross-cultural aspects of an organization. A bio-psychologist will reconcile individuals or groups of people that are not in agreement resulting in abnormal behaviors. When addressing such a conflict a bio-psychologist figures out in which area of bio-psychology the problem is. The following are the main areas of bio-psychology; sensation and perception, emotion, learning and memory, motivated behavior and control of movement (Woolfe & Dryden, 1996). Through these areas, bio-psychological problems and concerns are addressed.            Another area of psychology is the forensic psychology – an area that deals with the relationship between psychology and law. When a crime occurs, a criminal investigative process takes place in order to determine the offender, motive and to allow the right punishment if any to be given to the offender. The investigation involves investigative psychologist who explores the relationships between the offender and the nature of the crime that has been committed. The investigation process has the following major areas; investigating the crime, gathering evidence, use of technology, search and seizure, arresting and charging the offender who may also undergo detention and interrogation (Simon, 2012). Throughout this process forensic psychologists are involved as they help to establish a connection between an offender and the crimes committed. Essentially the forensic psychologist offers the following services during investigation process: evaluating the risks of r eoffending by the offender, child custody evaluation, recommending the length of the sentence to be handed to the offender, competence evaluation and testimony as an expert witness.            Simon (2012) says that throughout this period from crime commission to when the sentence is passed, a forensic psychologist will engage with the suspected offended in an attempt to get insight on the motive behind the offence. In some cases, the offender may be suffering from a mental disorder and it is the duty of the psychologist to psychological expertise to provide analysis and recommendations in the criminal case. In addition a psychiatrics’ examination is required to determine whether the offender/suspect suffers from a mental illness an opinion that is taken to be of very high value by the court since it might require the court to charge the offender as a mentally challenged person and this also influences the type of prison the offender is to serve the sentence. In conclusion psychological is an aspects great and delicate influence on the diversity and cross cultural differences existing in workplaces. Coworkers should work towards enhancing intercul tural understanding and acceptance. References Leininger, M.M. & McFarland, R.M. (2006). Culture Care Diversity and Universality: A Worldwide Nursing Theory. Sudbury, MA: Jones and Bartlett. Lesilie, C.J. (2008). Principles of Behavioral Analysis. Hove, UA: Psychology pr.Simon ,D. (2012). In Doubt. The Psychology of the Criminal Justice Process. Cambridge, CB: Havard University Press.Woolfe, A, & Dryden, W. (1996). Handbook of Counseling Psychology. Oxfordshire, OS: Carfax International Publishers. Source document

Why do people migrate

Sample Brainstorm and Outline Topic: Why do people tell lies? (a focus-on-causes essay) Brainstorm: Ashamed of the truth Make them look better Don't want to tell someone the truth if it's uncomfortable Politicians: want to get votes Children: don't want to get In trouble Afraid of the consequences of the truth Don't remember the truth So common for them that it's habit Don't realize they're lying Example: Bill Clinton didn't want the truth of his affair to come out Example: child with chocolate on face, doesn't want to get In trouble for eating candy Example: witness In a trial can't remember what happened b/c he was drunk at the timeExample: wife asks: do you think I'm fat? Husband says: of course not because he wants her to be happy Example: someone is dying but family doesn't want to tell the children because they'll be scared Outline: l. Introduction a. Lying Is common In all parts of human life b. Parents Ill to children, children lie to parents c. Everyone believes politicians lie d. People lie for good and bad reasons II. Afraid of the consequences if the truth is known a. Bill Clinton lied about an affair he had while he was President of the U. S. I. He didn't want to lose his Job n. He TLD want the affair to be talked about more than politics b.A child Is caught eating candy before dinner I. Doesn't want to get in trouble Also might think the parents don't really know the truth; maybe he will get away with stealing candy Ill. Don't want to make the other person uncomfortable a. A wife asks her husband if he thinks she's fat. He lies and says no. L. He loves his wife and wants her to feel good about herself. II. He wants to convince himself that It's true also. B. A person cooks a terrible-tasting dinner and asks friends if they liked the food. I. They want to be encouraging to their friend. It. It would be rude to tell the truth. ‘V. Can't remember the truth .A witness In a trial was drunk when the event happened and doesn't remember. I. Not tryi ng to lie-?he Just doesn't remember the truth did you come to work last week? I. Employee forgets that he came later than the normal time it. Employee believes the he is telling the truth V. Conclusion a. People lie for lots of reasons. B. Some people lie to preserve a relationship c. Some people lie because they don't want to get in trouble d. Other people lie without knowing it-?they think they're telling the truth e. Lies are not good because they are not true. But sometimes we tell them with good motivation anyway. ‘says.

Communication in Economics Essay Example | Topics and Well Written Essays - 500 words

Communication in Economics - Essay Example hased in by internet and there new governmental entities such as the City of Tucson City Council trying to impose similar sales imposition to raised their revenues. This paper provides an analysis of the pros and cons on the internet sales tax controversy. The government always wants to get their hands in any revenue generating scheme at any cost. The base by which critics refuse to recognize the right of a city such as Tucson to impose city tax sales is that most of the transactions are occurring outside their regional jurisdiction. If an online store is located in Toronto, Canada how does a government official justify that they have the right of collecting a sales tax from a Tucson citizen for purchasing good from that store. It is an outrageous claim by these city officials that such a transaction is legitimate. That is the as saying that a resident that goes to Canada on a tourism leisure trip should pay taxes to the cities on the purchase they make during their vacation. The timing and precise location of where the transaction took place is also an argument against the bureaucrats illogical idea. If the resident of Tucson goes outside the city borders with their laptop and makes a purchase in an online store in a different city t here is not way that Tucson would be eligible for a sales tax since the person was not in Tucson when the purchase was made. Their sales taxing system if approved would attempt and successful collect the tax due to the shipping address in Tucson which since the information taxing system does not differentiate between transactions since it is impossible to know where the actual took place when dealing with a virtual transaction. Governmental officials and lobbyist for taxing internet sales have a different perspective on the issue. To them not taxing internet sales is a discriminatory move against local merchants which are obligated to charge people sales tax, a move which raises the price of the items purchased. The merchants with

Land Rover Acquisition Essay Example | Topics and Well Written Essays - 1000 words

Land Rover Acquisition - Essay Example Tata Motors took $3bn ($2.3bn for purchasing JLR and the remainder for supplying important parts that included engine and other parts from Ford) bridge loan so as to fund this acquisition at $2.3bn with the aim of paying back a part through right issue, its stake sale in other subsidiaries and raising the rest through long term debt. The bridge loan was raised by Tata Motors, UK (which is a 100% subsidy of Tata Motors). The margin of the interest for the initial 6months on the bridge loan was 85% over LIBOR, followed by 1.2% for the following three months and then up to the end of term at 1.5% ( Gaughan, P. A. 2011). The same was intended to be pated through the rights issue, issue of securities overseas and its portfolio investments divesting. Before, Tata Motors requested to secure the funds using three simultaneous right issues, of which, of which one was o.5% convertible preference shares. However, the company was forced to share its plan for issuing the convertible preference sh ares as the prices of the share of the company fell greatly and remained low till as recent as August 2009. The other 2 rights issue (one was meant to earning Rs.21.86 billion with each other share at Rs.340/- with every share priced at Rs. 305/-) was not able to generate the expected amount of subscriptions from the share holders and required to be bailed out by company’s promoters and the underwriters. Tata Motors was hoping from the past record with both Land Rover and Jaguar would be able to earn enough funds.

Effective work team Essay Example | Topics and Well Written Essays - 2000 words

Effective work team - Essay Example Self-Directing Teams 9 Advantages and Disadvantages of Self-directed teams 10 Advantages of Self-Directing Teams 10 Disadvantages of Self-Directing Teams 10 4. Key Characteristics 10 a.Shared goal 11 b.Interdependent 11 c.Bounded / Stable 11 d.Authority 11 5. Advantages of work team 12 Disadvantages of work teams 12 6. Recommendations for building an effective team 13 7. Conclusion 14 Works Cited 14 1. Introduction During the past few years several companies have experienced an important change from customary top-down approach and manager-employee paradigms to a contributing model formed on additional workable and work teams regarding various aspects of self-managing framework. In general, teams strengthen operational performance and augment work in addition to managing performances that definitely produce enhanced employees contentment, dedication and superior customer care, service and sophistication. Additionally, the research in business efficacy has frequently demonstrated that work teams are considered as a very important element of a business. Conversely, work teams are able to do the accurate task or these teams also possess the capability to do the incorrect. The moment work teams perform superior, then work teams have the potential to offer several high-quality effects to a business. When teams do their work defectively, then they have the capacity to deplete inspiration outside a business in a quick fashion about something. Unproductive work teams are definitely considered a poor symbol for upcoming era of a company. Hence if organizations are aimed at performing the things, they should have to accomplish the tasks rightly (AJML Group Pty Ltd ; Dettmann; Kam). This paper discusses team’s related concepts. The basic aim of this research is to discuss how effective work teams are beneficial to the businesses. 2. Why teams are required? Teams have forever been imperative however at the present they have turned into essential feature for the busin esses. This is due to several consistent aspects. In this scenario, managers found the big unit of comprehensive research representing that work teams are able to be much valuable as compared to the customary company hierarchical framework intended for arriving at decisions swiftly as well as proficiently. Although easy transformations like that supporting effort and comment from employees under threat are able to create a remarkable enhancement. Such as, QC (quality control) loops in addition to worker participation groups are frequently mediums for the worker contribution. Additionally, the devastation of hierarchical levels implies that individuals have to be much inter-reliant to allow accomplishing more work with less effort. Moreover, the overall pursuit for total quality, incessant development and enhanced customer service implies that the practical obstacles are contravened and individuals required collaborating among tasks, not only in a particular task (Sabre Corporate Dev elopment ; Thompson). Following are the main reasons of the team development: 1.1. Customer service focus The primary focus of every business is to effectively control customer services. Additionally, the companies and corporations all through the globe have shifted from an operational, financial perspective of clients and consumers to a relational perspective of customers. In this scenari

The Fair Trade Movement Research Paper Example | Topics and Well Written Essays - 2000 words

The Fair Trade Movement - Research Paper Example The contemporary fair trade movement traces its roots back in the 1950’s when it was known as the Alternative Trade Organizations (ATO). Evidently, Alternative Trade Organizations were formed by humanitarian groups that sought to address the pertinent issue of poverty in the developing countries through alleviation measures. To this end, the humanitarian groups adopted the approach of cutting off the middleman from the supply chain of trade between small scale businesses in the Southern hemisphere and small scale producers in the Northern hemisphere (Warrier, 100). Evidently, Oxfam UK intervened by selling craftwork in Oxfam shops which were produced by Chinese refugees (Hutchens, 5). To this end, the result was increased amount of profits for the labour force in developing nations. In 1988, the Dutch chapter of the Alternative Trade Organizations, Solidarid, innovatively crafted a labelling mechanism. Evidently, it aided in the introduction of products within mainstream marke ts without betraying consumer trust in their acts of humanitarian assistance. Background Information In 1964, Oxfam UK formed the first Fair Trade Organization (Warrier, 100). In this regard, there were parallel interventions being undertaken in Netherlands. Consequently, an importing organization known as Fair Trade Original was created in 1967. To this end, Dutch third world associations started to sell sugar cane under the slogan, â€Å"by buying sugar cane, you offer poor people in third world countriea a chance in the sun of prosperity†. Moreover, the third world Dutch groups proceeded to sell Southern handicrafts and by 1969, they opened the first ‘Third World Shop.’ ... Consequently, this led to the creation of numerous Southern Fair Trade Organizations which established networks with the newly created Northern organizations (Hutchens, 5). Evidently, the North and South co-operation was centred on respect, dialogue, transparency and partnership. The mutual goal was towards achieving better equity in international trade. In addition, developing countries were engaged in international political platforms towards addressing the inequality and unfairness in international trade. In this regard, during the United Nations Conference on Trade and Development that took place in Delhi in 1968, the developing nations were addressing the issue of ‘Trade not Aid.’ To this end, the third world countries emphasized on the creation of mutual, and equitable trade partnership with the South. This was in defiance to the North’s approach which was involved in getting all the benefits and offering piecemeal benefits masqueraded as developmental aid. Evidently, development trade has been attributed to the growth of Fair Trade Movement since the late 1960s. Moreover, its growth is attributed to the responsive intervention against poverty as well as partly due to disaster emanating from the South. Its major focus during its inception was the marketing promotion of craft items. The eminent founders of the Fair Trade Movement were drawn from large humanitarian and religious organizations located in European countries. Consequently, collaboration with Southern counterparts led to the creation of Southern Fair Trade Organizations (Warrier, 100). Evidently, the Southern Fair Trade Organizations performed the work of

Doing yoga at a local recreation center can cause harm to Hinduism Essay

Doing yoga at a local recreation center can cause harm to Hinduism - Essay Example Currently, yoga has been influenced by modern world. In most cases, modern day yoga has been misrepresented; it has less spiritual essence, and has more emphasis on financial gain. This is because modern day yoga has been reduced to physical exercise program, with yoga specialists releasing yoga videos, as well as magazines for sale. This situation has been worsened by the fact that more yoga specialist especially those in the secular field have no background on Hinduism and they do not appreciate Hinduism and Buddhism religions. In the United States, it is estimated that approximately, 20 million people practice yoga. It is estimated that the practiced has been there since 1970 with majority of the US citizen pursuing yoga for medical reasons with few individuals pursuing it for purposes of acquiring body energy and stamina, spirituality and to magnify self esteem and creativity (Syman, 2010). In this regard, due to beneficial aspects of modern day yoga, the practice has been integrated in recreation facilities in developed nation. In Ohio, the integration of yoga at Snowpea City Recreation Center has been critiqued by majority of the residents due to the fact that the center which was funded by resident taxes should , therefore, not promote Hindi practices like yoga, since most of the residents are non-Hindi believers (Syman, 2010). In this regard majority of the residents have criticized the yoga practices due to the fact that it downplays the Monism principle of Christianity (the philosophy of existence of one God, the distinction between one God and the universe). The practice of yoga where an individual is recommended to repeat the phrase â€Å"So-ham† during deep breaths is violation of Christian faith since the quote translates to identification of oneself to the divine and the merging of oneself with the divine. In addition, yoga advocates for an individual’s spiritual detachment and freedom from body and material constraint, while

The global financial crisis-Brand management Essay

The global financial crisis-Brand management - Essay Example One strategy that the companies can use to maintain the unique value of their brands during global financial crisis is by engaging the customers as during these economic downturns excellent opportunities for innovation are provided (Roll, pp6). Customers cut down on consumption during financial crises, thus brands can initiate measures that take off their minds from the difficulties of consumption and focus them on the worthy features of the brand and co-create value with them. This strategy also helps minimize loses and more importantly, it successfully protects the companies brand image and brand equity. Singapore Airlines is a company that perfectly used this strategy to maintain the value of its unique brand. During the deadly SARS breakout in South East Asia when customers were afraid of flying, Singapore Airlines offered its customers very innovative vacation packages that encouraged customers to travel thus maintaining their status (Roll, pp7). Creating exciting customer interactions through activities such as product bundling to enhance value and promotions with creative alliances such as celebrities and travelling can also be used to maintain the unique value of a brand during such situations. This strategy takes off the focus of the customers on price and reiterates the commitment of the brand to engage and value customer support (Gelder, p102) Although this paper has discussed two strategies to be used during such situations, there are other strategies that are equally viable. Financial upheavals negatively impact the trust of customers on a brand. Therefore, during such situations it is the responsibility of the companies to devise new strategies that can maintain the trust of their customers on their brands. Brand differentiation is a very important strategy in today’s competitive market where new products are coming in everyday. In

Social care workers need to develop the knowledge and skills to work Essay

Social care workers need to develop the knowledge and skills to work effectively with people from similar and diverse background - Essay Example Thus, in discharging the professional duties and accomplishing social tasks, social care workers need to work hard and develop adequate cultural competence. Acceptance among the masses is a precondition to the successful workability of a care giver. Anti-oppressive practice should, therefore, be adopted and proper changes in the service-user communities should be initiated. In the course of cultural competence development, anti-racist practice must focus on the discriminations based on colour and race (Sue, 2006). Improvement in social work development and training can be brought about by the means of thorough comprehension of people’s family arrangements, social norms and values. Social work and support in a culturally sensitive environment has to be based on exploration of the diverse cultural heritages (Laird, 2008). Finally, the research question is in the form of the following statement: Social care workers need to develop knowledge and skills to work effectively with peo ple from similar and diverse backgrounds. Describe one model of cultural competence and discuss the potential benefits and limitations of applying the model. Therefore, this paper will explore a suitable cultural competence model and proceed on related discussions. ... A cultural group’s objective cultural attributes, such as art and music, are important and are included as implied assumptions. The primary and secondary characteristics of culture, developed from and expanded upon from Hage’s (1972) variable and non-variable concepts are nationality, race, colour, gender, age, and religious affiliation. Secondary characteristics are educational status, socioeconomic status, occupation, military experience, political beliefs, urban versus rural residence, enclave identity, marital status, parental status, physical characteristics, sexual orientation, gender issues, reason for migration, and immigration status. (Purnell, 2002) At the outermost interface of the model, the global society is placed. Next, there is the interface of community followed by the layer of family. The inner interface represents the person, the metaparadigm concepts. Inside this interface related to the individual, twelve cultural domains have been depicted. The dom ains are interrelated and they affect each other. The twelve domains are: 1. Overview/ Heritage: Includes concepts related to the current residence and country of origin, reasons for emigration, occupations, educational status, etc. 2. Communication: Includes concepts related to the contextual use of language, dominant language and dialects, paralanguage variations, nonverbal communication, etc. 3. Family roles and organisation: Includes concepts related to social status, lifestyle issues, child rearing, gender roles, family roles, etc. 4. Workforce issues: Includes concepts related to ethnic communication styles, assimilation, acculturation, autonomy, individualism and healthcare practices from the country of origin. 5. Biocultural ecology: Includes variations in ethnic and racial origins,

Technology and being a nurse educator Assignment

Technology and being a nurse educator - Assignment Example The field of nursing education needs a nurse educator that is competent, with unique application of nursing knowledge as well as responds to the knowledge evolution. Nursing education evolves from simple, traditional classroom teaching to complicated, online learning, use of informatics, and virtual simulations ( Bonnel, & Smith, 2010, p. 3). Along with this evolution is the need for nursing educators who can embrace technology and use it appropriately to meet the ever-changing needs of nurses, educators, students, patients, and society. Effects of Technology to a Nurse Educator The integration of technology in the field of nursing education affects nurse educators positively and negatively. The positive effects include the nurse educators’ enhancement of teaching opportunities, improved access to teaching materials saving both time and cost, provides educational options or strategies of teaching (used of printout, electronic sources, classroom interaction etc.), presents educ ational materials more challenging, knowledgeable, and presentable, promotes clinical safety and gain efficiency in teaching and learning, and guides evidenced-based practice. On the other hand, one possible negative effect noted is the difficulty encountered by nursing educators to adapt to technological advancements resulting in poor teaching and learning outcome.

Applied Linguistics Essay Example for Free

Applied Linguistics Essay Second language learning has always become an important work-field both in schools and other private sectors dealing with language teaching and learning process especially in the time of global integration. It is a complex activity involving a mix of internal factors such as age, aptitude, motivation, personality, or learning strategies†¦and external factors such as socio-economic and cultural background, learning and teaching contexts†¦ All these factors play a very important role in learners? success in acquiring and using a second language. Thus, learners’ second language achievement can be greatly improved when teachers have a better understanding of the learner, of the learning process and of the variables that may help or hinder learner’s language achievement. Because of the limited size of this article, I am going to discuss some of the most important factors affecting learner’s second language achievement: motivation, age, personality, social and cultural factor in order to analyze what stimulates successful language learning and what places obstacles in the learner’ s path to language proficiency. II. DEVELOPMENT II. 1. Some factors affecting learner’s L2 achievement II. 1. 1. Internal factors II. 1. 1. 1. Motivation It is undeniable that motivation is one of the major factors in deciding the learner’s failure or success in second language achievement. Motivation is a kind of desire for learning. It is very difficult to teach a second language in a learning environment if the learner does not have a desire to learn a language. Reece Walker (1997) stress that a less able student who is highly motivated can achieve greater success than the more intelligent student who is not well motivated. In this article, we are concerned with motivation related to foreign language teaching and learning. Wilkins (1972) points out that â€Å"motivation is not a general covert term for possibly distinct concept such as energy, interest and enjoyment, but instead, restricted to the degree of willingness to learn which depends largely on the learner’s needs in learning the language. Psychologists have distinguished two major types of motivation which play an important role in determining how willing the learner is to persevere with the task: instrumental and integrative motivation The first motivation will be discussed is instrumental motivation. It is generally characterized by the desire to obtain something practical or concrete from the study of a second language (Hudson 2000). With instrumental motivation, the purpose of language acquisition is more utilitarian, such as meeting the requirements for school or university graduation, applying for a job, requesting higher pay based on language ability, reading technical material, translation work or achieving higher social status. Instrumental motivation is often characteristic of second language acquisition, where little or no social integration of the learner into a community using the target language takes place. According to Richards (1976) simply learning a language to acquire course credits, or to carry out a limited range of tasks that do not involve the learner in close face – to – face interaction ( for example a person learning enough English to sell souvenirs to tourists does not generally lead to a high degree of accomplishment in learning). However, in recent years, according to Brown (1977), he stated that Indian English is one example of a variety of English which can be acquired very successful for instrumental reasons alone. Another motivation will be taken into consideration is integrative motivation. According to Gardner and Lambert (1959), this kind of motivation means learning a language because the learner wishes to identify himself with or become integrated in the society whose language it is. It has generally been thought that integrative motivation is the more powerful of the two because it implies a desire to integrate with speakers of the target language. Instrumentally oriented students would be expected to acquire the second language only to the point where their instrumented goals were satisfied. It is likely that when the learner merely wanted to be able to buy food and take public transportation he could achieve those goals with a very low level of proficiency in the second language and if the learner had to use the target language in his professional life, his level of learning would be much higher. Learners with integrative motivation view the language as a key to social and cultural enrichment through the opportunities to provide for association with members of a different culture. Then their goal in learning the language is to be able to use the language as a means of  communication and also for acceptance by the people who speak the language. Such motivation often leads to high accomplishment. In settings such as Vietnam, learners who learn English for special purposes have a great deal of instrumental motivation to acquire English in order to be able to be applied for a good job with a high salary. They learn English very fast just because they want to communicate orally, in a very simple English with other speakers of English. In Vietnam, English is a compulsory subjects so almost all of students learn English just to pass the exam. Thus, the type of language learned namely forms as mainly for communicative use will be directly affected by the type of examination students need to pass. As a result, it is likely that learners will not achieve a high standard of English. II. 1. 1. 2. Language aptitude As has been discussed in the previous section, success in mastering a foreign language depends very much on the learner’s motivation. Beside the motivation factor, social psychologists have also found out that whether a student can learn a foreign language very successfully or not also depends on his language aptitude. This section is an attempt to discuss an intrinsic factor influencing foreign language learning that is language aptitude. Aptitude for language learning is usually composed of four different types of abilities: the ability to identify and memorize new sounds, the ability to understand the function of particular words in sentences, the ability to figure out grammatical rules from language samples, the ability to memorize new words. Many tests of language aptitude have proven extremely effective in predicting which learners will be successful in learning. However, considerable controversy remains about whether language aptitude is properly regarded as a unitary concept, an organic property of the brain, or as a complex of factors including motivation and short-term memory. Research has generally shown that language aptitude is quite distinct from general aptitude or intelligence, as measured by various tests, and is itself fairly consistently measurable by different tests. Language aptitude research is often criticized for being irrelevant to the problems of language learners, who must attempt to learn a language regardless of whether they are gifted for the task or not. This claim is reinforced by research findings that aptitude is largely unchangeable. In addition, traditional language aptitude measures such as the Modern Language Aptitude Test strongly favor decontextualized knowledge of the sort used in taking tests, rather than the sort used in conversation. For this reason little research is carried out on aptitude today. However, operators of selective language programs such as the United States Defense Language Institute continue to use language aptitude testing as part of applicant screening. In my opinion, as a teacher of English, aptitude plays an important role in learner’s language achievement. How is it that some people can learn a foreign language quickly while others, given the same opportunity experience utter failure? Does this depend on how language is taught? Partly this is true as when the teacher is equipped with a better language teaching method, his students can learn faster. But partly it is not true as in the same group there always exists fast and slow learners. Another answer to the question is the problem of â€Å"motivation† but not all students with the same motivation can have the same accomplishment. Another possible answer to the question is that some people have language aptitude while others do not. II. 1. 1. 3. Learner’s age The previous section dealt with the learner’s language aptitude, a factor that influences language acquisition a great deal. This section will take into consideration another factor age which has received a number of opinions so far. In the past few decades, the comparisons among child, adolescent and adult learners have been made by many researchers, and the different findings as well as explanations have been reported. Traditionally, research in Critical Period Hypothesis and other variables has derived two major aspects of language learningthe younger = the better and the older = the better. However, recently the scholars in the fields of linguistics, psychology and psycholinguistics have reported their study or experiment results continually, resulting in completely different points of view so the argument for or against the Critical Period Hypothesis has never stopped. The question of how developmental stages interact with individual learning differences is still a question of great debate. Is there an optimal age, a critical period or a sensitive period? How does the age factor affect the development of linguistic abilities? Are adults really inferior to children and even to adolescents? There exists a belief that younger learners have certain advantages over older learners in language learning. According to Ellis in 2008; Larsen-Freeman in 2008; Mayberry Lock in 2003, Robert Dekeyser in 2000, younger children learn L2 easily and quickly in comparison to older children. Larsen-Freeman Long in 2008 also suggest that there is a period of time, between birth and somewhere around the age when a child enters puberty, exists in which the learning a second language can be accomplished more rapidly and easily than times falling outside of this period (i. e. post puberty). This is because children are in the most flexible condition learning a foreign language. This stage might be strongly impressed on their brain, which can stimulate nervous function system, and the further learning can help them to form language habit and competency easi1y. however Researchers also disagree with withdrawing home language support too soon and suggest that although oral communication skills in a second language may be acquired within 2 or 3 years, it may take 4 to 6 years to acquire the level of proficiency needed for understanding the language in its academic uses (Collier, 1989; Cummins, 1981). So children who are taught L2 intensively too early will damage their L1 acquisition. Another belief reported by Johnson and Newport, Dekeyser, Asher and Price, Politzer and Weiss, Olson and Samuel, Lightbown and Spada (2008) that older learners have a higher level of problem solving and metalinguistics abilities than younger learners.. The young learners are considered fluent in communication of the second language and achieve native like accent. Learners after the age of puberty do not acquire native like accent of a second language but have complex learning pattern. Research suggests that children and adults L2 learners pass through different developmental states in second language learning. Learning depends on the cognitive maturity and neurological factors. Adults’ cerebra nerve network has come into being completely, and their thinking habits have become mature in this period. They can deal with complicated language form and contents easily, because their meta-language consciousnesses, common sense and literary knowledge are better than children. In general, age is important but not everything in second language learning. There are some factors related to the age, for example the learning opportunities, the motivation to learn, individual differences, and learning styles, are also important determining variables that affect the rate of second language learning in various developmental stages of the learners. II. 1. 1. 4. Learner’s personality We have mentioned some important factors influencing learner’s second language achievement such as motivation, language aptitude and age. In this section we continues with some specific personality factors in human behavior in relation to second language acquisition. The psychological factors to be discussed here are self-esteem, inhibition, extroversion/ introversion. Self –esteem is the degree of value, a worthiness which an individual ascribes to himself. According to Schuman in 1978 and Brown in 1980, there are three kinds of self- esteem: global, specific and task self – esteem. How is self –esteem related to second language acquisition? Brown (1980) states that specific self- esteem might refer to second language acquisition in general but task- esteem might approximately refer to one’s self-evaluation of a particular aspect of the language process: speaking, writing†¦ A study by Adelaide Heyde (1979) revealed that all three aspects of self-esteem correlated positively with performance in oral production and student with high self –esteem actually performed better in the foreign language. Inhibition sets of defences built to protect the ego, a concept closely related to self-esteem and of course has to be considered by teachers. Language learners, children or adults, make progress by learning from making mistakes but at the same time, making mistakes can be viewed as a threat to one’s ego. As a result, the learner tends to build a certain degree of defence to protect himself. Guiora et al (1972a) produced one of the few studies in inhibition in relation to second language learning, and the experiments have been high-lighted a possibility that the inhibition, the defence which we place between ourselves and others can prevent us from communicating in a foreign language. . Another factor which also needs some examination is extraversion and introversion. Language teachers often assume that the extraverts are better language learner than introverts. In a language class, the teacher tends to prefer to have more students with an outgoing and talkative personality. At an early stage, extroverts seem to speak the language better than the introverts, but this does not mean that the proficiency of a more introverted student will be lower. This depends very much on the goal of learning. It can be argued that the reserved learner may be very quiet but he can be a good language learner in the sense that he is good in aural and reading comprehension even though he cannot speak. Thus, it is not clear then that extraversion or introversion helps or hinders the process of second language acquisition and it is hard to say which is ideal for language learning. II. 1. 2. External factors The previous section examined some aspects of internal factors. This section accounts for some equally important external factors which also affect learner’s second language achievement. As language teachers we are faced with factors such as the social context of learning, the cultural differences between two language involved. The learning environment of the educational context and the teaching method being used. Most of these are largely beyond our control but nevertheless they are important because they can affect, sometimes decide the learner’s internal factors in learning. To improve teaching and stimulate better learning, these factors should be taken into consideration. II. 1. 2. 1.  Social factor The child’s acquisition of his mother tongue is affected by the condition under which it takes place. The same influence is also relevant to learning of a second or foreign language. The classroom itself is a kind of social setting where each student has a role, so his success of learning a foreign language is, to some extent, determined by the teacher- student relationship and the student- student relationship. The teacher’s love for his job is often an encouragement to his students in their learning. According to Cheatain (1976), student is also strongly encouraged to learn the language when his teacher is always hopeful. The student- student relationship is no less important. This instance concerns face- saving. No students likes to let his errors be known to his friends, so correction of errors by the group is helpful when there is non- hostile trusting climate in the classroom. In addition to the classroom features of the learning situation itself, there are factors in the wider social context that influence language learning. Teaching never occurs in a vacuum. Any subject occupies a position in the syllabus in order to meet a need of all part of the school population. Second language or foreign language teaching is not an exception. As the political, economic and historical conditions change, the course objectives are altered. In a great number of countries it so happens that shifting political economic and social conditions often bring about the change in status of a second or foreign language. For example, English was not introduced into the school curriculum in Vietnam until 1971. Nowadays, when Vietnam is a member of WTO, English becomes a compulsory subject as it is an international language of commercial and official communication. Political factors are not the only ones that influence second language learning. Other attitudes towards language learning which are characteristic of the society to which the learner belongs are particularly important to the success of language learners. In Vietnam, the ability of using English fluently is a special qualification for certain favored jobs, but in others like the UK or the USA, learning another language is little more than a hobby. Obviously, all the different attitudes, which actually stem from political, economic or historical causes play an important part in the overall achievement in foreign language learning. II. 1. 2. 2. Cultural factors It is obvious that knowing a second language no longer means merely having acquired some linguistic competence: the ability to construct grammatically correct sentences. It also includes the acquisition of communicative competence: the ability to communicate the second language. To the extent that language is culturally acquired, one can never learn a second language successfully without learning the culture of that language. In the article â€Å"Talking across culture† in 1981, Richards argues that those who are supposed to know a foreign language must have linguistic competence, communicative competence and social competence as well. By social competence, he means that the learner is expected to know how to behave in a speech community of speakers of the target language. In other words, he must be familiar with the culture of the native speakers otherwise, he will be shocked, or fail to understand native speakers even though he is linguistically competent. It can be concluded that anyone decides to learn a certain language properly, culture is something he cannot avoid in the process. In teaching English, we need to be aware of the cultural assumptions that the students already possess. We also need to be aware of the cultural assumptions that surround the use of English. Functions and structures used to be examined for cultural content, it cannot be assumed that they are neutral. II. 2. Language teaching implications. For the reason that motivation plays a very important role in second language achievement, the task of the teacher is to maximize the motivation. Teachers should raise students’ interest in learning English so that they no longer learn English to pass the exam or to fulfill curriculum’s requirement but for the desire to interact and communicate with foreigners†¦ In order to achieve these goals, teachers should vary the activities, tasks and materials, provide students with opportunities for interaction in the target language in and outside the language learning environment through preplanned, and authentic activities. As a result, students will be more interested in learning English. Not many researchers have carried out research about language aptitude because it is something that teachers are powerless to alter. Students vary in terms of aptitude so teachers should categorize them according to their aptitude profiles. For example, one group was identified as having particularly good memory abilities (relative to other abilities), and another group was identified as being high in verbal analytical abilities. It is the duty of teachers to select appropriate teaching approaches and activities based on learners’ aptitude profiles to accommodate their differences in aptitude. If the methodology matches students, they will learn better otherwise it may decrease students’ second language achievement. We all know that different ages have different ways of learning and different ways of achieving language. The differences among the three age groups (children, adolescents and adults) are really existent and the biological L2 learning conditions are unchangeable. Learners of different ages and stages should use different strategies. Thus, the teacher’s duty is different in the three groups and the teaching approaches and strategies should cater for the traits of students. For example, children use strategies unconsciously and their teacher should help them form good learning habits in this period. Some adolescents might be unable to be aware of using learning strategies, and others use too many complex and sophisticated learning strategies in L2 language learning, which might not ensure to achieve high level. Adult learners prefer analytic-style strategies such as comparative and contrastive analysis, generalization rules learning, and dissecting words and phrases. As a result, teachers should manipulate a number of options according to the aim of the teaching and learning, such as different reading materials, the speed of teaching procedures, etc Suitable approach and strategies for each trait of age will help learners achieve language better, compensate the shortcomings and take good advantage of in three groups. As the results listed in the previous part indicate, learners differ in terms of personality. Some students are very reserved, some are self- confident, some are ready to take a risk but others do not. Understanding each student’s personality is extremely important to every teacher not except for teacher of English. When teacher know students’ characteristics, they can use appropriate methods for each of them. For example, most of Vietnamese students are still basically shy and withdrawn. Then teachers should involve a lot of pair and group work instead of using the teacher- students questions and answers. Teachers should use cooperative rather than competitive goals to create a supportive and non-threatening learning atmosphere. Besides, teachers should encourage and support students all the time especially when they are struggling or lacking confidence in certain areas. Good teachers will know how to adapt their methods of teaching to different learners’ personalities to have best results in second language achievement. It cannot be denied that social context has a big influence on situation of second language teaching and learning of each nation. Thus, in order to create a good learning condition for second language learning to flourish is the duty of everyone: parents, authority of school, community, ministry†¦ For example, parents should give children favorable condition to learn second language, school should be concerned about students’ language learning and teaching to make it better, ministry of education should pay more attention to the quality of language teacher, textbooks and facilities necessary for effective second language teaching and learning to happen. Culture is very important in second language learning so the duty of teachers is to raise students’ awareness of cultural differences between countries. When teaching a foreign language such as English, teachers should teach students language competence along with socio- cultural competence. Both teachers and authorities should bear in mind that learning about other cultures does not mean changing one’s own values and world outlook. On the contrary, by comparing some aspects of cultures in different societies, students may better appreciate their own culture and tradition and avoid false stereotypes which may result in either prejudice against other culture or blind belief that other cultures are superior. A successful language learner is a person who not only knows how to make grammatical and meaningful sentences but also knows how to use them in appropriate situations and a good language teacher is a person who knows how to help them do so successfully. III. CONCLUSION In conclusion, the success in second language acquisition depends largely on many factors but some of the most important factors can be mentioned are motivation, language aptitude, learner’s age and personality, social and cultural context. Thus, knowing these factors and how they influences learners’ second language achievement is very crucial to teachers of foreign languages in general and English in particular. Their language can be greatly improved when teachers have a better understanding of the learner, of the learning process and of the variables that may help or hinder learner’s language achievement. IV. REFERENCE Krishna K.  B , â€Å"Age as an Affective Factor in Second Language Acquisition†, Troy Universityn Press. HIDASI, Judit, (2005) â€Å"The Impact of Culture on Second Language Acquisition†, Annals of the International Business School. Hoan, P. K, (1985), â€Å"Psychological and cultural factors related to methodologies to Hanoi foreign languages Teachers’ college student†, Sydney Zhang . J, (2006) Sociocultural Factors in Second Language Acquisition, Sino-US English Teaching, Volume 3, No. 5 (Serial No. 29) Mehmet, N. G, (2001) â€Å"the effects of age and motivation factors on second language acquisition† F? rat University Journal of Social Science. tic

Theories and a biopsychology of addiction

Theories and a biopsychology of addiction The biopsychology of addiction examines the interaction of biological aspects associated with addictive behaviors. The word addiction comes from the Latin verb addicere meaning to enslave (Yucel, Lubman, Solowij, Brewer, 2007). The Diagnostic and Statistical Manual, Fourth Edition-Text Revision identifies drug addiction as a dependence syndrome with essential features of a lack of control over drug use despite significant drug-related problems (Kranzler Li, 2008). The prevalence and problems associated with drug addiction cost an estimated $524 billion a year, including health care, productivity loss, crime, incarceration, and drug enforcement (NIDA, 2009). Advanced research confirms that addiction is a disease because it alters the brain. It shares common attributes with other chronic diseases, such as heart disease and diabetes. The underlying concept is that there is a disruption in healthy functioning that results in serious, harmful consequences, although treatable, that can potentially last a lifetime (NIDA, 2009). Recreational drug use usually begins in adolescents at a stage in development most vulnerable to executive functioning impairment. Executive functioning impacts decision making, judgments, and emotional regulation. Brown, et al. (2008) found an increase in drinking during the age span between 16 to 20 years that fuels neurological damage and social impairments. Beckson (2005) reported an increase in adolescent drug use. Preven tion of drug addiction needs to start during adolescents because it usually begins during this stage in development. The goal of this paper is to explore multiple factors related to the biopsychology of addiction, including the molecular level of synaptic neuron communication, neurotransmitters, brain anatomy, drugs of abuse, relapse, and long-term effects of addiction. The genetic and environmental influences along with stress play significant roles in drug addiction. Theories of addiction exist with a growing agreement among experts that the Incentive Sensitization Theory of Addiction provides the best explanation. Robinson and Berridge (2003) describe several theories. Opponent Process Theory of Addiction The first theory described by Robinson and Berridge (2003), is the Opponent Process Theory of Addiction representing the traditional view of addiction. Pinel (2009) refers to this theory as the Physical-dependence Theories of Addiction. Initially drugs are taken for the positive feelings, but gradually build tolerance and dependence to the drug. Withdrawal symptoms begin and compulsive drug cravings take over. Drug use continues in an effort to avoid negative withdrawal symptoms and achieve the pleasurable effects again. Other names for this traditional theory of addiction include pleasure-pain, positive-negative reinforcement, opponent process, hedonic homeostasis, hedonic dysregulation, and reward allostasis (Robinson Berridge, 2003). Limitations exist with this theory because not all drugs, such as heroin, produce serious withdrawal symptoms. A major argument against this theory is that after a period of abstinence the rate of relapse remains high despite the lack of withdrawal s ymptoms. Positive-incentive Theory of Addiction Another theory described by Robinson and Berridge (2003) involves aberrant learning suggesting that drugs create a strong connection to natural reward centers based on learning through classical conditioning. Pinel (2009) refers to this theory as the Positive-incentive theories of drug addiction. Explicit learning as a subcategory of aberrant learning describes the learning process through declarative associations at a conscious level between actions and outcome. Explicit learning also involves the declarative predictive relationships between environmental cues and expectation or anticipation of rewards, such as drugs. Declarative learning does not sufficiently explain the transition from recreational drug use to drug addiction. Addicts do not report exaggerated declarative memories or expectations of drug pleasure because they know the pleasure gained is not worth the consequences suffered (Robinson and Berridge, 2003). Implicit learning as a second subcategory of aberrant learning describes the unconscious procedural learning that occurs automatically by pairing a stimulus and response. Drug use becomes an automatic response through the corticostriatal loops operating through the dorsal striatum (Robinson Berridge, 2003). The aberrant learning theory does not hold up under scrutiny either because implicit learning does not actually generate an automatic response, such as tying your shoe, because it is compulsion that motivates the continuation of drug use and drives the cycle of addiction. Incentive Sensitization Theory of Addiction The Incentive Sensitization Theory of Addiction best explains the transition from drug use to drug addiction. According to Robinson and Berridge (2008), the theory states that repeated drug use changes brain cells and brain neural circuitry creating a hypersensitivity to repeated drug use and associated drug cues. Incentive sensitization generates a pathological motivation or wanting of drugs that last for years, even after abstinence. The wanting of drugs may be implicit by an unconscious wanting or explicit by a conscious craving. The addicts focus on drugs is created from an interaction between incentive salience mechanisms with associated learning mechanisms. Pathological motivation generated from sensitization of brain circuits stems from a Pavlovian conditioned incentive or motivational process, known as incentive sensitization. Associative learning can trigger the motivation for drugs through incentive attributes, such as within the context of associated drug experiences and i nteractions. The pathological motivation drives the addict to seek and obtain drugs at any cost. However, the stimulus-response learned association does not fully explain the core problem of addiction. Damage or dysfunction in cortical regions creates changes in executive functioning resulting in impairments. These impairments play an important role in the addicts poor choices about drugs coupled with pathological incentive motivation for drugs triggered through incentive sensitization. Sensitization specifically refers to the increase in drug effect caused by repeated drug use. Incentive sensitization is essence of the theory. Engagement of brain incentive or reward systems, include the mesotelencephalic dopamine systems. It is the hypersensitivity in the motivation circuitry that contributes mostly to the addictive wanting of drugs. Evidence in favor of the incentive sensitization from past studies includes three features of incentive stimulus: Pavlovian conditioned approach to behavior, Pavlovian instrumental transfers, and conditioned reinforcement. The sensitization related changes in the brain are important for the transition from casual to compulsive drug use. Changes in the brain include a much larger increase in the density of dendritic spines on medium spiny neurons in the core of the nucleus accumbens. It relates to development of psychomotor sensitization. Studies further indicate that the neural changes underlying sensitization may be sufficient to promote subsequent addict-like behaviors. The essential factor in addiction is neural sensitization. Nature versus Nurture On the one hand, a genetic predisposition toward drug addiction appears evident for a substantial number of individuals. Researchers are continuing to identify specific genes related to drug addiction. The use of Quantitative Trait Locus Mapping contributes to identify specific genes for the risk and protection against addictive behavior (Crabbe, 2002). On the other hand, the learning hypothesis suggest drugs promote the learning of strong stimulus-response habits leading to compulsive behavior paired with rituals involved in consuming drugs (Robinson Berridge, 2008). Associative learning occurs in drug addiction through Pavlovian conditioning. The motivation for drugs becomes incentive sensitive when encountering familiar associations within the context and surrounding of the drug use, friends, location, and the like. Churchland (2004) argues that everything we know is the result of both our genetic makeup and our environmental experiences. Science has shown that development depends upon both genes and experience. Genes produce the hardware and experience provides the software. Learning occurs through genetic unfolding that generates changes in cells through memory systems of learning experiences constructed from environmental experiences. Our brain neuromodulators act upon synapses and become strengthened with repeated exposure that provides the foundation for learning. According to Kranzler and Li (2008) drug addiction stems from a combination of genetic, environmental, social, and psychological factors. The study of addiction involves multiple disciplines, including neuroscience, epidemiology, genetics, molecular biology, pharmacology, psychology, psychiatry, and sociology. It is not a matter of nature versus nurture, but more accurately nature and nurture. It is well known that addiction stems from a genetic predisposition and environmental stress and influences. Li, Mao, and Wei (2008) report that an estimated 40% to 60% of genetic factors appear responsible for drug addiction and the remaining percentage of factors relate to environmental factors. Genes and common pathways appear to underlie drug addictions. In a study conducted by Li, Mao, and Wei (2008), an extensive review of the genetic research associated with drug addiction resulted in the creation of the Knowledgebase of Addiction-Related Genes (KARG). The KARG is the first database of a bioinformatic compilation of genetic research on addiction. Through statistical analysis of the database, the authors found five common pathways in addiction, including neuroactive ligand-receptor interaction, long-term potentiation, GnRH signaling pathway, MAPK signaling pathway, and Gap junctions. Advances in science from the use of new technology, such as tillingarray and proteomics, provid e new avenues in studying the underlying pathways and genetic composition of addiction and how addiction forms from environmental influences. Brain Communication Chemical messengers called neurotransmitters carry information across tiny spaces, called synapses that exist between neurons (Cruz, Bajo, Schweitzer, Roberts, 2008). The brain communicates through electrical and chemical signals transmitted from neuron to neuron. A neuron represents the brains communication network. A neurotransmitter is released from one neuron into the synapse within 20 to 50 nanometers of the receiving neuron (Lovinger, 2008). The releasing neuron is referred to as presynaptic neuron and has at the tip of its axon terminals small pockets known as vesicles. These vesicles contain neurotransmitters that release molecules when activated by the action potential stimulated by the presynaptic neuron. The neurotransmitter is released into the synaptic gap between the two neurons. The post-synaptic neuron receives the neurotransmitter and binds it to the receptor site. According to Lovinger (2008) two major categories of neurotransmitter receptors, include the ligand-gated ion channel (LGIC) receptors and G-protein-coupled receptors (GPCR). The LGIC produces an excitatory or an inhibitory reaction depending on the action potential. The GPCRs represent proteins that bind neurotransmitter molecules and activate intercellular reactions. Once the neurotransmitter is released it becomes rapidly removed by neurotransmitter transporters. The neurotransmitter transporters are housed on the surface of the neurons cell membrane and rapidly retrieve the neurotransmitter pulling it inside the neuron. The uptake reloads the neurotransmitter into vesicles and the cycle repeats. Other brain chemicals exist, such as neurotrophins and steroid hormones. Lovington (2008) describes neurotrophins as peptides or amino acids secreted from different neuron structures, such as axon terminals and dendrites. Neurotrophins support neurons and assist in synaptic plasticity and neuron survival. Many are located within the central nervous system and the neural mechanisms that contribute to addiction (Lovinger, 2008). Steroid hormones represent small molecules that assist with intercellular communication. These hormones are found throughout the central nervous system as well. Lovinger (2008) further describes agonist as molecules that bind to and activate receptors. Antagonists also bind to neurotransmitter receptor sites by competing and blocking receptor activation. Many molecules serve as neurotransmitters, such as the amino acids, glutamate, and glycine. Histamines and different peptides also act as neurotransmitters. Neurotransmitters play a significant role in addiction. Neurotransmitters Fitzell (2007) defines neurotransmitters as molecules in the brain that transmit chemical reactions in order for neural communication to occur. There are approximately 100 billons neurons in the brain. Neurons release neurotransmitters from one neuron to the next via a presynapitc nerve terminal and receptor site at the synapse. The releasing of a neurotransmitter either triggers a message to other neurons in a chain reaction or a message to disengage signals. There are several neurotransmitters that activate specific receptors site referred to as fitting a key into a lock (Fitzell, 2007). The neurotransmitters include noradrenaline (norepinephrine), and adrenaline (epinephrine), acetylcholine, GABA, glutamate, dopamine, serotonin, opioids and other peptides, and endocannbinoids. Endorphins and enkephalins produce natural opiates in the brain related to intense pleasure. Noradrenaline (norepinephrine) has a stimulating effect on the brain. It is responsible for regulating the heart, breathing, body temperature, and blood pressure. It also may play a role in hallucinations and depression (Fitzell, 2007). Adrenaline (epinephrine) controls paranoia and the fight-or-flight response. It is also responsible for our appetite and feelings of thirst (Fitzell, 2007). Acetylcholine is responsible for muscle coordination, nerve cells, memory, and is involved in the transmission of nerve impulses in the body (Fitzell, 2007). It has a significant role in reaction to stress. GABA is found throughout the brain and in numerous sensory neurons (Cruz, Bajo, Schweitzer, Roberto, 2008). It functions as a regulator of transmitting nerve signals, and it acts on receptor sites, including GPCR, by functioning as an inhibitor. Activation of the receptor sites prohibit the release of neurotransmitters. Ethanol acts as an excitatory for the release of GABA and has a role in alcohol intoxication and contributes to the brains hyperexcitable during alcohol withdrawal. Opiods, cannabinoids, and alcohol all act on GABA through the same brain regions. Glutamate functions as a major excitatory neurotransmitter in the lower brain region (Clapp, Bhave, Hoffman, 2008). It serves most brain neurons and is found throughout the brain. Two receptors, AMPA and NMDA, appear to be involved in learning and memory. Acute alcohol consumption inhibits the release of glutamate and appears to play a role in inhibiting synaptic plasticity and impairment of memory (Lovinger, 2008). Gass and Olive (2008) studied glutamates influence on drug addiction. Studies found that all drugs of abuse utilize glutamate transmissions producing a long-term neuroplasticity in the brain. Glutamate contributes to compulsive drug-seeking behavior and drug-associated memories. Dopamine serves as the most significant neurotransmitter in the brain. It is responsible for controlling our moods, energy, and feelings of pleasure (Fizell, 2007). Dopamine influences brain mechanisms of reward, evaluation of environmental stimuli, general behavioral activity level, and some brain disorders. According to Cruz, Bajo, Schweitzer, and Roberto (2008), dopamine becomes pervasive throughout the brain and is produced by only a few neurons. It is considered a pure neuromodulator because it becomes activated only by GPCRs. There are five dopamine receptor sites, D1 through D5. Half of the neurons connect to the substantia nigra pars reticulate forming the direct pathway to activating the cortex (Cruz, Bajo, Schweitzer, Roberto, 2008). The other half connect to the globus pallidus internal segmane forming the indirect pathway to slow down cortical output. Dopamine controls performance of action, including the intoxication from alcohol and other drugs (Cruz, Bajo, Schweitzer, Roberto, 2008). Many drugs target dopamine transmission, and dopamine plays a significant role with all drugs. Cocaine, amphetamine and other stimulant drugs either block or reverse the action of the dopamine transporter (Lovington, 2008). As a result, the level of dopamine in the synapse increases. Research shows that interference with dopamine transmission generates an intoxicating and addictive effect with drugs and alcohol Nicotine and alcohol stimulate dopamine. Morphine and other opiates slow GABA activity and indirectly increase the activity of dopamine. It also contributes to learning environmental cues in relation to the context of drug use that encourages drug and alcohol use. Fitzell (2007) describes serotonins role in the brain as relating to the five senses, sleep, aggressive behavior, eating, and hunger. Its release brings about a sense of calm, happiness, peace, satisfaction, signals of fullness, and reduced appetite. A decrease of serotonin or blockage in the brain cells results in aggression and violent behavior. Low levels of serotonin are associated with depression and increased appetite. Serotonin is a very powerful mood enhancer and appetite regulator located in the base of the brain (Fitzell, 2007). According to Lovinger (2008), neurons connect to other neurons through the central nervous system, including the cerebral cortex and other forebrain structures. Serotonin influences sensations related to environmental stimuli, perception, learning and memory, and sleep and mood. Serotonin activity involves 15 CPCRs that either increase or decrease neuron output. It is the target of psychoactive drugs, such as LSD, mescaline, and psilocybin that serve as agonists of serotonin. Amphetamines, such as MDMA also known as ecstasy, interfere with serotonin transporters and increase serotonin levels. It is suspected that the effect may result in sensory-enhanced effects. Alcohol appears to cause a reduction of serotonin uptake. Opioids and other peptides contribute to the brains communication by decreasing excitatory glutamate and inhibitory GABA at the cell level (Cruz, Bajo, Schweitzer, Roberto, 2008). However, GABA continues to have an excitatory effect throughout the brain producing the pain-relieving effect of opioids as well as opioid dependence. Peptides help neuromodulation of the brain through GPCRs. These peptides serve as agonists to receptor sites for morphine, heroine, and other opiate drugs (Lovington, 2008). Three opiate receptors of importance include mu-type, delta-type, and kappa-type (Befort, et al., 2008). Reduction in opioid peptide actions interfere with promoting an increase in dopamine. Lovinger (2008) describes another hormone of particular importance, the corticotrophin-releasing hormone (CRH). CRH communicates signals of stress, mood, and changes in bodily functions. CRH and its receptors play a role in stress, drug addiction, and relapse. The opioid peptides, endorphins, and enk ephalins affect mood, produce intense feelings of pleasure, and can reduce and relieve pain. Endorphins also help in managing stress. Enkephalins help the body fight pain (Fitzell, 2007). Wand (2008) describes a the stress response as involving a glucocorticoid response generated from the hypothalamic pituitary-adrenal (HPA), activation of peptides corticotrophin-releasing factor (CRF), and activation of the sympathetic nervous system releasing epinephrine and nonrepinephrine. Endocannabinoids (endogenously formed cannabinoids) and other lipid-derived neuromodulators are involved in synaptic communication and acute reinforcing effects of drugs (Cruz, Bajo, Schweitzer, Roberto, 2008). Lovinger (2008) describes the receptor site CB1 linked to GPCR as functioning to inhibit the release of neurotransmitters. CB1 acts as agonists and influences both inhibitory and excitatory synaptic transmissions (Cruz, Bajo, Schweitzer, Roberto, 2008). As a result, a decrease in several neurotransmitters occurs, including GABA and glutamate. A long-term synaptic depression may occur produced by retrograde endocannabinoid signaling. A consequence of this occurrence plays a key role in learning and memory and associated addiction (Lovinger, 2008). Brain Anatomy of Addiction The brain attempts to counteract the chemical changes caused by drug addiction. The process of neuroadaption or neuromodulation strives to reinstate homeostasis in the brain. Drug addiction influences all aspects of the brain with several significant regions serving more dominant roles. The mesotelencephalic dopamine system is a diffuse pathway consisting of dopamine neurons associated with pleasure (Pinel, 1998). Its cell bodies are connected to two structures in the midbrain tegmentum: substantia nigra or the ventral tegmental area. The axons of these two structures extend into different structures in the telencephalic sites. These structures include frontal cortex, striatum, septum, cingulated cortex, amygdala, and nucleus accumbens. The mesotelencephalic dopamine system is associated with motivation of behaviors and self-administering addictive drugs, sexual behavior, and eating (Pinel, 1998) The substania nigra is a midbrain nucleus of the tegmentum and contains cell bodies of many of the neurons of the mesotelencephalic dopamine system. Its dopaminergic neurons terminate in the striatum (Pinel, 1998). The nigrostriatal pathway is a dopaminergic tract from the substantia nigra to the striatum. The striatum is composed of the caudate and putamen and serves as the terminal of the dopaminergic nigrostriatal pathway. The ventral tegmental area is located medial to the substania nigra and contains cell body of many neurons in the mesotelecephalic dopamine system (Pinel, 1998). The nucleus accumbens is a nucleus located between the striatum and the basal forebrain. It is a major terminal in the mesotelencephalic dopamine system. It plays a critical role in the experience of pleasure (Pinel, 1998). Koob and Simon (2009) indicate that the mesocorticolimbic pathway is the brain circuit that transmits dopamine in the rewarding effects of alcohol and other drugs. The mesocorticolimbic dopamine system represents the reward system in the brain. Neural inputs and outputs interact with the dopamine projections from the ventral tegmental area to the basal forebrain (Koob Simon, 2009; Ikemoto, 2007). Pinel (1998) describes the prefrontal cortex as the large area of the frontal cortex anterior to the primary and secondary motor cortex. It consists of three large areas: dorsolateral prefrontal cortex, orbitofrontal cortex, and medial prefrontal cortex (Pinel, 1998). The dorsolateral prefrontal cortex is the large area on the lateral surface of the prefrontal lobes and plays a role in memory for temporal sequence of events but not the actual events, response sequencing, inhibiting incorrect but previously correct responses, developing and following plans of action, and creative thinking. Pinel (1998), indicates that the orbitofrontal cortex is the large area of prefrontal cortex on its anterior pole and inferior surface. Damage to the orbitofrontal cortex results in marked personality changes, an inability to inhibit inappropriate behaviors, and influences social behaviors. The medial prefrontal cortex is the area of the prefrontal cortex on the medial surface of the prefrontal lobe s that when damaged, produces a blunting affect (Pinel, 1998). Amygdala is a major structure in the limbic system. It is an almond-shaped nucleus of the anterior temporal lobe. The central nucleus of the amygdala has the highest density of enkephalins. Enkephalins are found in the cell bodies of GABA neurons, the most abundant type of neuron in the nucleus of the amygdala (Cruz, Bajo, Schweitzer, Roberto, 2008). The amygdala is responsible for the fight or flight emotional reaction. The extended amygdala signifies brain structures located near the front of the lower brain region, referred to as the basal forebrain (Befort, et al.). The extended amygdala is comprised of a number of structures, including the nucleus accumbens (NAcc), the central nucleus of the amygdala (CeA), and the bed nucleus of stria terminals (BNST). It plays a role in relation to the acute reinforcing effects of drugs and the negative effects of compulsive drug use and reward. The CeA consists mostly of GABA as inhibitory neurons with neuron connections or project to the brainstem or BNST. It is considered the gate that controls information through the intra-amygdaloidal circuits. Befort, et al. (2008) describes the central extended amygdala (EAc) as a network formed by the central amygdala and the BNST controls. It plays a significant role in drug cravings, drug-seeking behaviors, drug rewards, and drug dependence. Hippocampus is the allocortical limbic system structure of the medial temporal lobes and extends from the amygdala at its anterior end to the cingulated cortex and fornix at itsposterior end (Pinel, 1998). The basolateral amygdala mediates motivational effects of drug use and the context associated with drug use in forming emotional memories (Koob, 2009). It plays a major role in learning and memory, particularly in relation to associated drug behaviors. Feltenstein and See (2008) provide a depiction of the brain anatomy and drug related connections in the mesocorticolimbic system. Dopamine projects from cell bodies in the VTA and connect to limbic structures via the mesolimbic pathway (amaygdala, ventral pallidum, hippocampus, and NAcc, and cortical areas (mesocortical pathway, including the prefrontal cortex, the orbitofrontal cortex, and the anterior cingulated gyrus) (Feltenstein See, 2008); Ikemoto, 2007). The NAcc and ventral pallidum serve as the primary effects of drug abuse. The amygdala and hippocampus serve a role in learning as it relates to the process of addiction. The amygdala and ventral hippocampus impact learning in discrete stimulus-response associations. The amygdala and dorsal hippocampus impact learning through stimulus-to-stimulus associations important in contextual learning. The prefrontal cortex, orbitofrontal cortex, and anterior cingulate gyrus regulate emotional responses, cognitive control, and executive functioning (Feltenstein See, 2008). Feltenstein See (2008) further indicated that repeated drug exposure leads to neuroadaptions at the cellular level of the prefrontal NAcc glutamatergic pathway that contributes to the persistent addictive behaviors, including diminished cognitive control and hyper-responsiveness to drug-associated stimuli. The mesolimbic pathway is involved in the acute reinforcing effects of drugs and various conditioned responses related to drug cravings and relapse. Cycle of Addiction Drug addiction forms through progressive stages of drug use, impulsivity, and compulsion. Addiction begins with the choice to use drugs for a variety of reasons, such as peer pressure or curiosity; however not everyone who uses drugs develop an addiction. As the drug begins to change neuron interactions, the brain develops neuroadaptive reactions to the drugs invasion. Drug use gradually shifts from recreational drug use to a compulsive drug need based on changes in the brain circuitry. Everitt, et al. (2008) discovered that low levels of dopamine receptors in the nucleus accumbens predict the propensity to escalate cocaine intake and the shift to compulsive drug-seeking and drug addiction. Kobb (2009) describes three stages of addiction: preoccupation/anticipation, binge intoxication, and withdrawal/negative effect. The three stages feed into each other, become intensified over time, and shift from positive reinforcement to negative reinforcement (Kobb, 2009). Drug use starts with experimentation and enjoying the pleasurable attributes of the drug. In time the addict focuses more on obtaining and using drugs that begins to shift impulsivity to tolerance and cravings in the drug relationship. As the drug begins to control the addict, the positive emotions begin to shift to negative emotions. The addict requires continued use of the drug in order to avoid negative reinforcement and to achieve positive reinforcement. The addict shifts into a compulsive need for the drug. According to Koob and Simon (2009), the binge/intoxication stage of addiction involves the nucleus accumbens-amygdala reward system, dopamine inputs from the ventral tegmental area, local opioid peptide circuits, and opioid peptide inputs in the arcuate nucleus of the hypothalamus. The stage of negative withdrawal involves a decrease in function of the reward system and the brain stress neurocircuitry. The preoccupation/anticipation (craving) stage involves key afferent projections to the extended amygdala and nucleus accumbens, specifically the prefrontal cortex (for drug-induced reinstatement), and the basolateral amygdala (for cue-induced reinstatement). Compulsvie drug-seeking behavior appears driven by ventral striatal-ventral pallidalthalamic-cortical loops. In particular, the orbitofrontal cortex in the prefrontal cortex area influences impulsivity and compulsivity in drug addiction (Torregrossa, Quinn, Taylor, 2008). It is also critical in decision making and response selection. The orbitofrontal cortex influences impulsivity in three specific ways: delaying gratification, inability to inhibit strengthened motor responses, and an inability to reflect on potential consequences of action (Torregrossa, Quinn, Taylor, 2008). Schoenbaum and Shaham (2008) concur with the concept of an altered orbitofrontal cortex in drug addicts with a lasting decline in plasticity or the ability to encode new information. Drugs Classifications Commonly Abused Drugs commonly abused change the brains chemistry by interfering with the neurotransmitters and receptor sites. Different classes of drugs appear to affect different receptors either through overproducing a neurotransmitter or blocking the production of a neurotransmitter. All drugs of abuse share enhancement in the mesocorticolimbic dopamine activity, although at different levels. Depressants Ethanol is the primary drug in alcochol. It changes serotonin levels, and acts as a substitute for endorphins. According to Frezell (2007), behaviors that occur when under the influence of the drug include sleepiness, possible violence or aggression, depression, and a dulling of psychological pain. After the effect of alcohol wears off, sleep disturbance, depression, lack of endorphins to relieve normal pain, and cravings for more alcohol occur in reaction to the brains reduction in producing endorphins. Cruz, Bajo, Schweitzer, and Roberto (2008), indicate that alcohol increases the inhibitory effect of GABA and decreases the excitatory action of glutamate. GABA is involved with the intoxication effects of alcohol and the long-term effects, including tolerance and dependence. The CeA adapts to the changes as alcohol dependence forms. Feltenstein and See (2008) indicate that ethanol interacts with a wide variety o

How You Are Using Reflective Practice Nursing Essay

How You Are Using Reflective Practice Nursing Essay The aim of this assignment is to discuss how I am using reflective practice and codes of conduct in my journey to becoming a health professional. Through this discussion, the relationship between reflection, codes of conduct, and professional development will be demonstrated. For the purposes of this assignment, references to a reflection on an aspect of my clinical practice; namely maintaining patient confidentiality, will be made (see appendix). This reflection is guided by Gibbs Reflective Cycle (1988) (cited in Jasper, 2003, p. 77). I selected this framework as it allows one to reflect in a systematic manner on positive aspects of the experience as well as areas for improvement. Indeed, this aspect of my clinical practice will form the context of this assignment, as well as other relevant standards of conduct (Nursing Midwifery Council (NMC), 2008). The following paragraphs will discuss codes of conduct and the process of reflection with reference to my professional development. Nursing practice is underpinned by clear regulatory principles (the NMC code of conduct, 2008). The code provides standards of conduct, performance and ethics for nurses and midwives and is a tool in safeguarding the wellbeing of the public. As Goldsmith (2011, p. 12) states, the code should be used to guide daily practice. However, Sutcliffe (2011) argues that the code can be difficult to implement in practice. Sutcliffes argument is supported by first-hand experience during my placement. The following excerpt summarises the experience on which I reflected: During visiting hours on the ward a gentleman approached me to ask for the whereabouts of a patient (this patient had recently gone to theatre). In a helpful manner, I proceeded to inform the gentleman of the patients location. However, the conversation was interrupted by a member of staff who correctly established the identity of the visitor. In these circumstances, I did not uphold a key principle of the code: to respect peoples right to confidentiality (NMC, 2008, p.3); in spite of the fact that I had learnt about this principle prior to going on placement. This key standard of conduct is reiterated in the guidance published by the Department of Health (DH, 2003) and by the Caldicott report (1997) (cited in Crook, 2003). Whilst reflecting-on-action following this experience, the code offered a benchmark against which I evaluated my professional conduct. As a developing health professional I learnt that I must respect a persons right to confidentiality and I must act as an advocate for those who I am helping to care for. My reflective process highlighted the importance of regularly referring to the code and other supporting guidance so as to develop my professional practice in this area. In my reflection, I propose an action plan for managing subsequent situations. This action plan applies other pertinent aspects of the code, for example, to work effectively as part of a team, to share information with your colleagues (NMC, 2008, p.5) and to keep clear and accurate records (NMC, 2008, p. 6). With reference to applying these principles to my practice hereafter, I would consult the patients notes to confirm next of kin and patients location (i.e. theatre) and effectively communicate with colleagues about this situation. Furthermore, confidentiality is underpinned by trust (Pattison Wainwright, 2010). Gibbs action plan (1988) functioned as an aid to my learning and development. Throughout my career I plan to consider and reflect on the fundamentals of the code whenever I am thinking of my learning obje ctives and professional development (Goldsmith, 2011). Johns (2004, p. 1) proposes that the reflective process is a way of being within everyday practice. To illustrate this further, the technique allows the practitioner to become mindful of self within the context of a particular experience. The intention is to resolve incongruity between a practitioners own vision and actual experience (Johns, 2004). Schà ¶n (1987) (cited in Johns, 2004, p.1) distinguishes between reflection-on-action (as shown by my reflection) and reflection-in-action. For example, reflection-in-action refers to occasions when a practitioner takes a momentary pause during a particular experience in order to make sense of it and to consider how best to proceed. Consequently, as we become accustomed to thoughtfully analysing our practice following an event (on-action), the ability to reflect-in-action becomes a part of everyday practice (Johns, 2004). Mention should be made here of an absence of conventional research to support this argument; although anecdotal eviden ce has been found (Johns, 2004). These two layers of reflection; namely in-action and on-action, are the cornerstone of professional development. For me, reflection as a learning process will facilitate the move from a novice learner to an intuitive expert, by means of developing implicit knowledge accumulated from past experiences (ORegan Fawcett, 2006). As I reflect on subsequent experiences in the remit of patient confidentiality, I will develop practical and professional knowledge. The benefits of using reflective practice have been well documented. ORegan Fawcett (2006) explains that the process reduces the gap between theoretical knowledge and nursing practice and fosters the development wisdom and implicit knowledge. Fawcetts argument has been illustrated by my reflective process. It is important to discuss what it means to be a professional nurse in order to evaluate its significance to the reflective process and codes of conduct. A registered nurse acquires a body of specialist knowledge from the educational and practical setting. However, the idea of holding a body of knowledge is arguably less important than the ability to draw on intuitive knowledge, tuned through previous practical experimentation and reflection (Schà ¶n, 1987 Stevenson, 1990). My personal experience of the reflective process is that it facilitates the move from reflection-on-action to reflection-in-action. Similarly, this sophisticated skill reduces the perceived theory-practice gap. ( To summarise this discussion, I have used Gibbs reflective cycle to reflect on an aspect of my clinical practice; namely patient confidentiality. The code (NMC, 2008) has functioned as a benchmark against which I have evaluated my professional knowledge and behaviour. Indeed, the NMC advocates the use of reflective practice for professional growth. I can conclude that an improved skill in reflective thinking will drive my professional growth. Similarly, the values highlighted by the code are equally essential for the development of my professional accountability. It is important to note that the mutual function of reflective practice, codes of conduct and professional development is to ultimately deliver excellent nursing care to our patients. References Crook, M. A. (2003) The Caldicott report and patient confidentiality. Journal of Clinical Pathology, 56 (6): 426-428. Department of Health (DH). (2003) Confidentiality: NHS code of practice. Leeds: DH. Gibbs, G. (1988) Learning by doing: a guide to teaching and learning methods. Oxford: Further Education Unit, Oxford Brookes University. Goldsmith, J. (2011) The NMC code: conduct, performance and ethics. Nursing Times, 107 (37): 12-14. Institute of Health Records and Information Management. (1997) The Caldicott Report. London: IHRIM. Jasper, M. (eds.) (2003) Beginning reflective practice. Cheltenham: Nelson Thornes. Johns, C. (2004) Becoming a reflective practitioner. 2nd ed. Oxford: Blackwell Publishing. Nursing Midwifery Council (NMC). (2008) The code: standards of conduct, performance and ethics for nurses and midwives [online]. Available from: http://www.nmc-uk.org/Documents/Standards/The-code-A4-20100406.pdf [Accessed 25 February 2013]. ORegan, H. Fawcett, T. (2006) Learning to nurse: reflections on bathing a patient. Nursing Standard, 20 (46): 60-64. Pattison, S. Wainwright, P. (2010) Is the 2008 NMC code ethical? Nursing Ethics, 17 (1): 9-18. Schà ¶n, D. (1987) Educating the Reflective Practitioner. San Francisco: Jossey-Bass. Stevenson, J. S. (1990) The development of nursing knowledge: accelerating the pace. In Chaska, N. I. (ed.) The nursing profession: turning points. St Louis: The C.V. Mosby Company. pp. 597-607. Sutcliffe, H. (2011) Understanding the NMC code of conduct: a student perspective. Nursing Standard, 25 (52): 35-39.