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Tuesday, 10 October 2017

Rhetoric in Civic Life

Rhetoric in Civic Life
Student’s Name
Terministic Screens:
1.      King's presence in Montgomery was viewed as a threat to the development of the newly elected city government by the Alabama clergymen until his death in 1995. King was addressing racial issues and an immediate need for social justice in a way that created social tension between the whites and the black people in their struggle for social justice. Just after the election of a new city government, King had started to mobilize people for demonstrations and marches against racial inequality and these actions were considered risky for the progression of the newly elected government.
2.      King explains his presence as being driven by the need to fight for social change in terms of racial equality and thus the need for tremendous tension in the South to free the Negros from the passive unjust plight (Palczewski et al. 2012). King also declared to advocate for positive peace which he visualized as respect for human dignity and personality by eliminating the hidden tension that the Negros had already lived.
3.      Some realities are selected while others are deflected in view of King’s presence in Montgomery. Realities that are selected include the risk of political development in Montgomery due to the fact that King was mobilizing the masses to demonstrate against social injustice. The clergymen deflect the reality that King’s effort would help improve the way white people treated racial minorities thus improving social awareness in Montgomery.
1.      King resignifies the meaning of breaking an “unjust law” by analyzing human motives and relations through symbolic actions. Through these, he is able to identify the underlying social injustices that people had been living and would continue to live despite the election of a new city government. Breaking an “unjust law” is, therefore, a set of actions and purposes that highlights oppressive hidden concepts.
2.      King resignifies the demonstrations that were so deplored by the Alabama Clergy by writing to the Alabama Clergy to explain the importance of the tension as part of crucial phases that would eliminate the negative peace that had set the Negros in unjust plight. King also describes the demonstrations as non-violent compared to the hidden violence that the Negros already lived with (Palczewski et al. 2012). Resignification can be identified as King bringing out the issues of social justice in the open where it was clearly visible so that it would be dealt with.
3.      King uses resignification to embrace his characterization as an extremist when he leads people in demonstrations and marches against connotations of justice and exposing how the clergy viewed the demonstrators as violent as a mere construct to change the connotation of justice for the Negros.  Even after his arrest, King continues to write to the clergy about the pressing social issues and this shows how he uses resignification to embrace his characterization as an extremist.
Uses & Misuses of Language
1.      Language symbols have different meanings for different people since people are influenced by their society, culture, past experiences, and so forth. It is for this reason that rhetoric cannot be treated as an exact science.  The second major term of this definition is "social reality," which can be described as the "reality as understood through symbols humans use to represent it” (Palczewski et al. 2012). This almost explicitly means that reality is subjective and that a person's reality is defined, inescapably, by their culture, their past experience, and essentially everything that makes them who they are. A philosophical debate aside, the effect of rhetoric is reliant in part on personal identity, because it is the filter through which every symbol employed by rhetoricians is understood.
2.      With these basic explanations of the terms of the definition of rhetoric, one can begin to fully understand its impact and purpose in society. Rhetoric allows human interaction to be effective, purposeful, and meaningful. The use of rhetoric flourishes in societies where human interaction is encouraged and welcome and does not fare so well in societies in which human interaction is censored. It specifically flourishes in democratic societies because democratic societies require it if they are to consider themselves to truly be a "well-functioning civic community" (Palczewski et al. 2012). Obviously, rhetoric can only be influential if people are open to different ideas.
 There are different levels of persuasion, as laid out in the chapter: the rhetoric can attempt to create a virtual experience for the audience, alter their perception, explain his argument, formulate a belief for the audience, initiate action for the audience, and hopefully spur maintained actions for the audience.
3 b “When rights are consistently denied, a cause should be pressed in the courts and in negotiations . . .”
Since that time there had been some proof of expanded self-control and an ability to confront actualities. Capable residents had attempted to deal with different issues which cause racial contact and agitation. In Birmingham, late public demonstrations had given a sign that we as a whole had an open opportunity for another useful and practical way to deal with racial issues.
Palczewski, C. H., Ice, R., & Fritch, J. (2012). Rhetoric in civic life. Strata Publishing.

Health literacy and self-care activities, self-efficacy, and health related outcome of patients with type 2 Diabetes

Theoretical Framework
The theoretical framework helps to explain the reason for a specific theory and a concept that is being used in a research, related to a practice problem.  The researcher will use the theoretical framework to connect the research to an existing nursing theory (Grove, Burns, & Gray, 2013).  A theory can be tested with the research to prove or a new theory can be developed by conducting a research (Lunney, 2008).
Identified Article and Theoretical Framework
The article that I chose to use for this week’s discussion is about the health literacy and self-care activities, self-efficacy, and health-related outcome of patients with type 2 Diabetes. The poor health literacy among the population will increase the complications, decrease the patient outcomes, and escalates the health care costs.  There are many factors that may lead to poor health literacy (Weld, Padden, Ramsey, & Garmon Bibb, 2008).  I work in a community hospital and our patient population has a higher number of homeless population and Hispanic patients.  In this population, there is an identifiable knowledge deficit about health is seen due to low economic status to access health care and minimal knowledge due to language barriers.  Social cognitive theory was used in this research about self-care, self-efficacy, and quality of life in patients with type 2 Diabetes.  The study revealed that the health care literacy is directly linked with patient’s self-efficacy. Self-efficacy can be improved by health literacy about diet, self-monitoring blood glucose levels, compliance with medications and treatment, and lifestyle modification with exercise (Lee, Lee, & Moon, 2016). 
Framework and the Research
Health belief model (HBM) and social cognitive theory (SCT) was used in the research.  The concept of HBM is when there is an increased patient awareness of a disease condition; it will decrease the negative health outcomes (, 2008).  Albert Bandura developed the SCT.  Self-efficacy is one of the constructs of this theory.  SCT is being used in many community-based researches that involve public health problems and health literacy (, 2008).  The selected research study was conducted to assess the health literacy level of the participants in 12 items related to diabetes management and compared with HbA1c results of the participants.  The study revealed that the self-efficacy and self-care activities were linked with improved health care outcomes (Lee, Lee, & Moon, 2016).  The selected framework was appropriate for the research as it revealed the association of health literacy in improving the patient outcomes. 
My Insights and Application to a practice problem
Theories guide nursing practice (McEwen & Wills, 2014).  I learned about how health belief model and social cognitive theory can be applied to a practical problem that relates to health literacy.  In my workplace, many patients are readmitted with chronic obstructive pulmonary disease (COPD).  I can correlate the health literacy to minimize the readmissions due to acute exacerbation of COPD.  The readmissions can be minimized by improving the health literacy of the population by incorporating HBM and SCT in the clinical practice.
Treatment of diabetes is known to be a lifelong commitment to medication, monitoring of blood sugar and lifestyle modification. It involves a physical and emotional commitment that may decrease the life expectancy of a diabetic patient.  Due to their instability, diabetic patients must maintain their blood sugar within a certain range to avoid hypo or hyperglycemia.  Non-adherence to treatment leads to retinopathy (blindness), diabetic nephropathy (kidney disease), neuropathy (amputation) strokes and heart diseases. Diabetes shouldn't be a death sentence if there's a proper collaboration between a patient's primary doctor, psychiatrist, and psychology. 
Depression treatment, self- efficacy, peer support, lifestyle intervention, literacy, self -management and involvement of social worker when put into consideration can determine longevity in a patient with diabetes. Compliance with treatment in the care of a patient with Type 2 Diabetes can be affected by implementing cognitive behavioral therapy, mental contrasting, community resource involvement, and peer support. Addition of supportive therapy increases compliance to therapy and longevity in the adult with Type 2 diabetes. The responsibility of compliance with diabetic care lies within the patient; patient must accept and be receptive to the treatment of this chronic disease in other to have a positive and optimum outcome.
        In addition to aforementioned determinants, the role of social worker as part of determinants of longevity in patients with diabetes was emphasized.  Information from the (Avalon et al., 2008) acknowledged diabetes as a biopsychosocial disease; that brings the role of social worker in as an aid to assist the patients with diabetes to achieve longevity. Management of diabetes involves a change in lifestyle that includes keeping a low sugar diet, maintaining an exercise regime, monitoring daily blood sugar and taking oral or insulin supplement". These changes are overwhelming that the patients who did not have a support or an assist in getting medical needs will not be able to perform. The social worker has a unique impact in helping patients with diabetes to maintain a healthy lifestyle (Avalon et al., 2008).
According to (Yin et al, 2015), one method of reducing hierarchical relationships, as related to diabetic care, and increasing compliance in care of the adult with Type 2 diabetes has been accomplished in “train the trainer” programs.  These programs enlist individuals with diabetes ready to be trained as a trainer.  “Train the trainer” programs provide basic knowledge and emotional support to individuals with Type 2 diabetes.  The training focuses on peer to peer communication, diabetic diet reviews, weight management, and physical activity.  This “train the trainer” method of diabetic teaching helped to increase compliance through per support, thereby helping to increase longevity in the adult diagnosed with Type 2 diabetes.
As per (Chuenijid et al., 2014), Parental advice and psycho-socio-economic support like self -value and esteem, group psychotherapy, along with the use of antidepressant helped children in overcoming the impediment of adherence. As patient move along his or her lifespan, he or she must be willing to move more independently toward self- care to increase longevity.  These findings affirmed that a collaboration of care through multidisciplinary treatment, such as cognitive therapy, the patient’s own acceptance of his diagnosis, and his willingness to participate in treatment will improve treatment outcomes. Acceptance is demonstrated through various self-care activities such as blood sugar monitoring, adherence to medications and insulin when necessary. 
The trainer will be taught how to be an empathetic listener to be able to appropriately answer questions that the patient might have. The training includes the use a licensed dietician to educate diabetic patients on the misconception of diabetes diet, cooking tips and suggested ways on weight management. Qualified nurse educator can deliver a training on physical activity, precaution to take during exercise and how to acquired motivation for daily exercise. (Yin et al, 2015). Furthermore, individual’s confidence in the ability to perform routine glucose monitoring, diet compliance and weight reduction exercises and treatment will influence involvement in the overall treatment. A patient with diabetes has to have self-efficacy, meaning believing in one’s ability to succeed in a particular situation. If interventions are made towards self-efficacy, then patients will display improvement in self-management of chronic disease and positive health outcome.
According to a study by (McCleary-Jones, 2011), Diabetes was an irreversible autoimmune disorder, the disease of the endocrine system that developed when there is an impaired fasting glucose or impaired glucose tolerance. Due to these, the research was based on how the healthcare professional can effectively improve the quality of life and increase the longevity of diabetes patients. In the study, it was found out that to determine the longevity of diabetes patients there must be collaboration in treatment. The treatment needs to involve psychiatrist, psychology, social worker and level of literacy of patient with type 2 diabetes. The study emphasizes on Depression, Quality of life, Peer support, Literacy, Self-efficacy, Lifestyle Intervention and Cognitive Behavioral treatment as the intervention for the determinant of longevity for a patient with diabetes.
Diabetes is known to be an irreversible autoimmune disorder that attacks pancreatic bĂȘte cell and there are many compensatory hormonal and inflammatory changes that may exacerbate depression in an adult with type 2 diabetes. If the healthcare provider can collaborate with each other on the treatment of diabetes with the review of suggested determinants of longevity as discussed above, a patient with diabetes will have a good quality of life and have long longevity.  When self-efficacy is enhanced, stress management, goal setting, and decision- making will improve metabolic control in people with diabetes.

Grove, S. K., Burns, N., & Gray, J. R. (2013).  The practice of nursing research:  Appraisal, synthesis, and generation of evidence (7 ed.).  St. Louis, MO: Elsevier Saunders.
Ayalon, Liat. Gross, Revital. Tabenkin, Hava. (2008, August). Determinants of Quality of Life in Primary Care Patients with Diabetes: Implications for Social workers. Health and Social Work, 33(3), 229-236. Retrieved from

Wednesday, 12 June 2013

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