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Low income and health

Share this: Facebook Twitter Reddit LinkedIn WhatsApp Low income and Health In this essay the relation of low income, ill-health and childhood will be evaluated from the inequalities in health point of view. The first part of this essay will provide an overview of income as a one of the main reasons of health inequality. Then it will follow with analysis of income inequality, its related social and behavioural factors, and the role they play in relative poverty. Following this point it will discuss briefly Britain economic development for the past years and its effects in health inequality. Then, using different research data to illustrate how psycho-social factors affect health, a model of income and health through the life-course will be introduced and explained. Thereafter, studies in food purchasing behaviours will be used to evaluate whether unhealthy choices are irrational or situational. After having seen the behavioural side of low income inequalities and health, the essay will move to explain the social conditions that worsen the poorer people health in today’s society. The second part of the essay will be centred in the actual policies, frameworks, strategies and plans that the government and the health services are implementing to tackle income and health inequalities. However, as there are so many low income groups and their health problems are various, the essay will focus into children and families living in relative poverty. This decision is based on two factors: firstly the amount of literature found that highlights the importance to break the poverty cycle from birth. And secondly the relevance of the model of income and health explained in the first part of the essay. Initially, the recommendations the government has had for last 20 years will be explained, and the data about child poverty in Britain and Wales will be used to contrast their outcomes. Then the government plans to eradicate child poverty and its possibilities will be discussed, to review the unrealistic goals that were set initially. Following this, the plans of the National Health Service to approach to health inequalities and its social reasons will be viewed. Thereafter, the Welsh government initiatives will be discussed as the government is trying to reduce its child poverty statistics, as they are the highest in Britain. Finally, the essay will look into where the Nursing and Midwifery Council stands when nurses face problems that are not directly related to physical health, and also how the nurses’ role fits in the primary care multi-professional team. Income and health are closely related. The poorer you are the more likely to have ill-health (Quick and Wilkinson 1991 and Benzeval et al 2001). However, low income and poverty are two different things. Low income is defined as lower than half of the average income (Acheson 1998), but poverty can be split in two types: absolute or relative (UN 1995). In developed countries, such as Britain, the relative poverty is measured by using factors that stops poorer classes sharing the social commodities with upper socioeconomic groups. Absolute poverty in Britain does not exist, as shelter, access to adequate water and food are available to everybody. Lack of income, limited access to education, poor housing or homelessness are some factors of relative poverty which are directly related to health and social inequality (Barry and Yuill 2003). These authors also write that one of the groups most affected by relative poverty, and therefore more at risk of health inequality, is people in a low income and unemployed. Despite the economic growth Britain has experienced in last years and although life expectancy and health services have improved, the relation between income and health inequality has broaden. Quick and Wilkinson (1991) point out this relation as a one of the misconception when tackling inequalities. They emphasise that the income distribution is more affluent in health rather than the countries’ wealth itself. Acheson (1998) also found similar figures and compared them in relation to the population with material disadvantages and poor health. Then using Townsend deprivation score he highlighted that there were a higher mortality rate and more self-reported illnesses in the population living in areas with higher scores. It is important to remark that people in higher score areas worked in worse paid jobs or were unemployed. Nevertheless, the Black Report (1977) and the Acheson Report (1998) agreed that this data should be considered carefully as there is not enough evidence to confirm or deny a relationship between the results and the casual relationship between low income and ill-health. Acheson (1998) explains that income is one of the socio-economic determinants of health, along with education, employment, housing, safety and transport. People in low income groups tend to be less educated and work in unskilled jobs, live in areas with poor housing, reduced green spaces and unsafe. These factors broaden health inequalities. Margolis et al (1992) research showed that infants from lower socio-economic status in U.S.A. were more prone to suffer respiratory illnesses than those from higher statuses. Apparently this was partially attributed to environmentally factors such as smoking parents, housing or bottle feeding. Blow et al (2005) also found that children from low income families were more likely to smoke than those from higher income families. Moreover, if the mothers’ education level was included in the analysis the figures of smoking prevalence increased. In Richardson’s (2001) thematic discussion about smoking uses the level of depravation to show how in the affluent classes smoking has decreased and how in the more deprived areas of Britain smoking habits are prevalent over a period of time, increasing health inequality. These examples illustrate how low income, along with other socio-economic factors leads to a certain behaviours that are linked to the life-course health resources of the individual and his/her mechanisms or capabilities to prevent or cope with ill-health in the present and the future. This is a life-course perspective of health and income. Here Health Capital is the accumulation of physical and social health resources, and Income Potencial is the cumulated education, skills and learnt behaviours for the later working life (Benzeval et al 2000 see appendix 1). Dobson et al (1994) research data on food purchasing and eating is used by Barry and Yuill (2003) to discuss diet and nutrition behaviours within low income families. They argue that bad choices of food sometimes are a rational response to an irrational situation. For example mothers would shop food that their children would eat, such as crisps or sweets which are known to be unhealthy. Moreover budgeting, which is directly conditioned by income, education and transport (Dibsdall et al 2002), and lack of knowledge about healthy eating were discussed to show how other behaviour factors affected unhealthy diet choices. Acheson (1998) also mention that mothers purchase smaller amounts of food in order to avoid its consumption before it is necessary or it is wasted. He also pointed out that when there is shortage of money the mothers themselves would go by without food leading to a poor nutritional intake affecting their health. This decision appears to be irrational but here again income is conditioning a choice that affects short and long term health. Certain behaviours do not only come down to be the irrational response to income inequalities and its health related issues. Moreover there are social factors that affect decisions related to psycho-social health. New societies are built with barriers to people that cannot afford the necessary things or to participate in normal social activities (Quick and Wilkinson 1991). For example, not being able to have friends around at home to dine or play with, buying inappropriate cloths or cloths that are an embarrassment to wear, or not having the resources to visit their relatives. Theses social inequalities deteriorate poor people’s relationships and networking, driving them to a life style that might be more prone to stress or deprivation, these factors leads to related psycho-social inducted health problems. Another social factor affecting the community health is cohesion. Various authors have recalled life expectancy data from the war years in order to highlight how health improved despite the devastating situation (Quick and Wilkinson 1991 or Barry and Yuill 2003). It is thought that during war time a camaraderie feeling emerged and jointly with a more rationalized food supplied provoked an increase in the life expectancy across all classes, being more prominent in lower classes as a result of a more equal distribution of resources. Contradictorily, today’s society is driven by individual achievements, goals and appearance, becoming more fragmented and increasing the health inequalities between poorer and richer individuals. It can be said that societies in which there are feelings of belonging, security, safety and support are more likely to be healthier, despite relative materialistic or economic factors (Wilkinson 1996). This means that egalitarian societies have a better psycho-social health, resulting in happier individuals with a lower stress and deprivation levels. Social policies, their implementation and the nurse Following the above discussion where it was said that low income is a persistent issue when analysing health inequalities, two questions have emerged: What does the government do to tackle low income inequalities? and Which role multi-professional health teams have when finding, diagnosing or treating illnesses derived or triggered by this social inequality? The Black Report (1977) at first found that the Britain nation’s health had improved in general terms but its inequalities between the classes had widened, consequently it recommended setting the following objectives: creation and improvement of policies in relation to childhood, people on a cumulative ill-health and deprivation, and proactive approaches to prevention of ill-health. Later the Acheson Report (1998) found similar results as the Black Report (1977) and recognized poverty as the base of health inequalities. Therefore the report gave recommendations to increase welfare benefits and pensions, to prioritize polices to reduce income inequality for women expecting to give birth, single mothers and young children, and to help to seek advice and information to those unaware of their entitlement to welfare benefits. Despite all the recommendations encouraged in both reports, statistics still show that Britain has for long time suffered from a high percentage of child poverty. More specifically, the figures showed that in Wales 13% of children live in severe poverty and 19% in households with a low income (Crowley and Winckler 2008). It is obvious that reducing income inequalities in families and children will improve their life-course health and their opportunities to break the circle of poverty. It is important to see what the British government is doing to improve the situation and whether is doing any good or not. The government has increased benefits for families out of work, it has also increased working tax credits and in-work benefits for families and it has created more employment initiatives. Figures show that the government target is met when increasing parents’ employment status to reduce child poverty. However, there is a tendency to measure low income before housing expenses making difficult to contrast the data between earnings and poverty. The in-work benefits strategy has not taken into account the increasing cost of living, therefore low income families eventually will find themselves in the same situation (Evans and Scarborough 2006). Despite the reduction of child poverty, the government’s target to eliminate it in 2020 looks unrealistic, consequently it is now set to a reduction of 5% or lower in order to become one of the lowest in Europe. It is also a question about the role of the National Health Service (NHS) when reducing health related issues in low income families. The NHS in 2000 presented “The NHS plan” (Department of Health (DoH) 2000), which actually recognizes the importance of tackling inequalities from birth, using different programs. For example, neonatal and antenatal screening, to promote programs such as “Sure Start” to reduce children poverty (in Wales known as “Cymorth”), and to introduce and support initiatives for a better nutrition through campaigns like giving free fruit in nursery/schools, “five-a-day” and working with the Food Standards Agency. In order to progress towards these changes liaising between agencies, social services and a variety of care professionals is a key factor. Hence there is a need to review the role of the care staff and its traditional structure, as well as the past relations between NHS and social services. These altogether have denied the clients’ right to be treated in a holistic way, which is to solve physical, emotional and psycho-social issues under the same umbrella. For example, in many cases there have been clients lost in the system and never had the standards of care that they are entitle to, which is unacceptable and completely disagrees with the nursing code of practice. A part of the NHS plan is the “one-stop-care” model which is adopted by the NHS in partnership with other local authorities. This model gives children with complex needs and/or long-term health problems a wider assessment of their psycho-social and physical needs. Therefore they receive a better health planning. It also allows more disadvantaged families and their children to have an access specialized treatments locally. It also will try to provide help to youngsters through adulthood, as well as supporting young couples with parenting issues and giving mothers more support and information (DoH (2004) Children’s NSF). It is also relevant to talk about the Welsh Assembly Government (WAG) plans and policies in relation to these inequalities. The WAG in 2005 proposed its plan to halve child poverty by 2010. Therefore in 2006 it was launched the strategy “A Fair Future for Our Children” which targets were set to reduce child poverty through the improvement and promotion of education, employment and public services (WAG 2006). This strategy partly linked with the ongoing “Communities First” project that had been running since 2001. This project tackles more deprived and disadvantaged communities throughout Wales. “Communities First” aims to address community issues by learning and working in partnership with local authorities and associations. It also has engaged local residents in taking decision, in developing a role in their community, and it has empowered people to change and maintain a better lifestyle (WAG 2007). This social strategy encourages communities become stronger and safer, creating a healthier society for next generations (Wilkinson 1996). The WAG tries to bring these strategies alongside with the health sector by promoting multi-professional team work to avoid gaps in care and to reduce health inequalities in low income population. For example, WAG funds the scheme “Better Advise: Better Health” in primary care. This allows GP’s to refer families with children in need of benefits advice and social services to professional services such as Citizen Advise Bureau. It is important to remark that this initiative is also aimed to everyone. Finally, the NMC code of practice (2008) acknowledges the duty and responsibility to advocate for the clients, regarding health and social care, information and support. In most of the cases nurses are at the frontline of care in wards and within the primary care multi-professional teams. They know more the patients needs and their daily living activities than other multi-professional team members, therefore picking up earlier signs of ill-health, psycho-social problems or poverty is easier. Observation and problem solving are two essential skills in nursing profession. These are key elements to assess patients’ individual needs and to have a pro-active approach to social and physical health. These skills are easily transferable to work alongside social policies and framework that tackle poverty and social exclusion within the low income groups. For example, as part of a routine assessment or a visit, a nurse can detect indicators of relative poverty in families and children. These indicators might be related to income, childcare, education, unemployment or housing. Once they are found, for example if they are regarding income, the nurse either could give advice to the client about the welfare benefits his/her family is entitled and how to claim them, or refer the client to the social services team (Hoskins and Carter 2000). Conclusion The essay has summarised and explained the different social and behavioural factors that influence inequalities in income and its subsequence health problems. It has also discussed a psycho-social perspective of health and income during the live-course. Therefore the importance of learning good health behaviours and coping mechanisms from birth has been explained in order to have a better future health when becoming an adult. In relation to this the essay has also shown the NHS plans to reduce health inequalities by creating more easy reachable services for families and by promoting health campaigns targeting children and youngsters. Moreover, as it was explained, there are also social factors adhered to ill-health. By reviewing nowadays problems faced by society, the essay discussed the local authorities polices to improve their communities, and highlighted their future repercussion in health improvement. Through the presentation and analysis of the more relevant reports that have been published in Britain during the last 30 years, the actual social strategies and their implementation in health have been reviewed and analyzed, in order to highlight the importance of partnership between agencies when tackling inequalities. The last part of the essay has put together the work of different government institutions and their plans to reduce inequalities, in the social and health context. Using this discussion the nurse role has been looked as a part of the multi-professional team, and it is important to conclude that despite social problems might be overlooked as apart of the medical side of nursing, it has been shown through the essay that ill-health is the product of a wide range of factors. As a part of a professional body with a code of practice, nurses should not underestimate or dismiss the implementation of social policies and the liaison within agencies, as it is in their duty to provide the best of care for their patients. References Acheson D (1998) Independent Inquiry into Inequalities in Health Report. London. Stationery Office Books. http://www.archive.official-documents.co.uk/document/doh/ih/ih.htm Accessed: 10/04/09 Barry A M Yuill C (2003) Understanding Health: A Social Introduction. (p.74) London. SAGE. Benzeval M Dilnot A Judge K and Taylor J (2001) Income and Health over the Lifecourse: Evidence and Policy Implications (p.96) In Graham H (2001) Understanding Health Inequalities. Buckingham. Open University Press. Benzeval MTaylor JJudge K (2000) Evidence on the Relationship between Low Income and Poor Health: Is the Government Doing Enough? Fiscal Studies 21(3) 375-399. Black D Morris J N Smith C Townsend P Blume S (1980) Inequalities in health: report of a working group. London; Department of Health and Social Security. http://www.sochealth.co.uk/history/black.htm Accessed: 10/04/09 Crowley A Winckler V (2008) Children in severe poverty in Wales: an agenda for action. Cardiff. Wales Programme of Save the Children. http://wales.gov.uk/dsjlg/research/children/reporte.pdf?lang=en Accessed: 10/04/09 Department of Health (2000) The NHS Plan: A plan for investment. A plan for reform (Chapters 7, 9 and 13). London. DoH. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4002960 Accessed: 10/04/09 Department of Health (2004) National Service Framework for Children, Young People and Maternity Services: Core Standards (Chapters 4 and 8). London. DoH http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4089099 Accessed: 10/04/09 Dibsdall L A Lambert N Bobbin R F and Frewer L J (2002) Low-income consumers’ attitudes and behaviour towards access, availability and motivation to eat fruit and vegetables Public Health Nutrition: 6(2), 159-168 Evans M Scarborough J (2006) Can current policy end child poverty in Britain by 2020? (Summary). York. Joseph Rowntree Foundation. http://www.jrf.org.uk/sites/files/jrf/0376.pdf Accessed: 10/04/09 Hoskins R Carter D E (2000) Welfare bene?ts’ screening and referral: a new direction for community nurses? Health and Social Care in the Community 8(6), 390-397. Margolis P A Greenberg R A Keyes L L LaVange L M Chapman R S Denny F W Bauman K E and Boat B W (1992) Lower respiratory illness in infants and low socioeconomic status. Am J Public Health. 82(8), 1119-1126. http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1695725 Accessed: 10/04/09 Nursing and Midwifery Council (NMC) (2008) The Code. London; NMC. Quick A Wilkinson R (1991) Income and Health. London; Socialist Health Association. http://www.sochealth.co.uk/Incomehealth/IncomeHealth.htm Accessed: 10/04/09 Richardson K (2001) Smoking, Low Income and Health Inequalities: Thematic Discussion Document. http://www.nice.org.uk/niceMedia/documents/smoking_low_income.pdf Accessed: 10/04/09 United Nations (1995) The Copenhagen declaration and programme of action: World summit for social development 6-12 March 1995. New York; United Nations Department of Publications. Welsh Assembly Government (2006) A Fair Future for Our Children: The Strategy of the Welsh Assembly Government for Tackling Child Poverty. Cardiff; WAG http://new.wales.gov.uk/dsjlg/publications/childrenyoung/fairfuture/strategye?lang=en

Edward Hopper and Tim Eitel Comparison

help me with my homework Edward Hopper and Tim Eitel Comparison. Introduction The following pages will analyse and compare American realist Edward Hopper (1882-1967) and German contemporary realist Tim Eitel (b. 1971). The works selected are Office in a Small City, painted by Hopper in 1953 with oils on canvas, and Ohne Titel (Ausblick)/ Without Title (View) by Tim Eitel in 2002 with acrylic paints on canvas. Both artists portray loneliness, and share a common theme of isolation. This was conveyed in my fifth studio work, which is a semi-realist painting of a childhood photograph of me after my family and I moved to the United States from Germany. The event influenced my identity to a large extent, and I wanted to convey the isolation I felt. Therefore, I used similar techniques as Hopper and Eitel, mainly in terms of composition, tone, and shading. Hopper Analysis of formal qualities Stated to be one of the most prominent American artists, Hopper depicted realist urban and rural scenes of post-war American life, and rendered his personal vision of it. Born in 1882 in New York, Hopper studied illustration at university, though shifted to fine arts and was drawn to oil painting. He was heavily influenced by Edgar Degas and Èduard Manet, particularly their use of compositional devices and their depictions of modern urban life, which is apparent in his works. The height of Hopper’s fame was achieved through his oil painting Nighthawks (1942) which renders weariness, concern, and tension of customers and a waiter in an urban, anonymous diner in the depths of the night. Like many of Hopper’s works, it is believed to echo wartime anxiety and uncertainty through the sense of isolation produced through Hopper’s use of composition. This theme of isolation is apparent in Hopper’s later works as well, such as Office in a Small City (1952, oil on canvas, 71.1 cm * 101.6 cm). Arranged in a minimalist composition, the work depicts a man looking out at urban architecture and cityscapes. He seems isolated both physically and emotionally. Through the two large and open windows which almost seem to have no glass, the viewer can see in and out of the office. The figure is staring out of the window, and does not seem to be actively working, and instead perhaps waiting for something or daydreaming. He is the only figure in the piece and is detached from unseen possible co-workers. This triggers the sense of physical isolation. In the cold environment of a corner office which contrasts open windows and a blue sky, the man seems trapped, which furthers his physical isolation. Furthermore, he is framed by the office windows, and his head is profiled towards the windows and the wall of buildings beyond, which suggests containment within his environment. The figure is staring detachedly outside towards the nearby buildings and brilliant blue sky, perhaps with something akin to yearning of breaking free of the physical boundaries set which trigger his isolation. There is no indication of any particular profession, and the viewer cannot see any details of his face. The office features bland, mass-produced office furniture and the white walls indicate a similarly bland building. The anonymity, facelessness, and sombre solitude of the figure could be representative of Hopper’s criticism towards post-war American business culture, as the man seems to be trapped by the boundaries set by his workplace. Therefore, Hopper could be criticising the surge in post-war American capitalism and perhaps the isolating effect this had on ordinary workers such as the figure portrayed. Furthermore, there is a strong contrast between the stark, utilitarian appearance of office building and the decorative, false front of the building opposite. This could indicate Hopper’s ambivalence towards modern urban life which is demonstrated in his other works which also portray modern and urban American society. Annotations The subject matter of the piece is the common features of post-war American life and of its inhabitants, which was commonly portrayed by Hopper. In terms of visual properties, Hopper uses light, shadows, and cold colours to increase sense of loneliness, as well as an ambience of a mass produced and industrialised environment. The building itself is of bland design with large windows, which seem to trap the figure and is also an almost surrealist element, seeing as it is possible that the room has no windows at all, as there is so visible indication of glass. The stark, pronounced and parallel composition furthers the clean lines of the work. A sense of unity is produced through the solid grey colour of the wall, and the strong shade of blue of the sky. The overall technique and style of the piece is simplified realism, demonstrated through the clear and pronounced shadows and strong tones that have little variation. Quotes “In general it can be said that a nation’s art is greatest when it reflects the character of its people.” – Hopper (via edwardhopper.net) Interpretation of function and purpose Hopper himself states that his “aim was to try and give the sense of an isolated and lonely office interior rather high in the air, with the office furniture which has a very definite meaning to me.” (metmuseum.org) He did not further state what “definite meaning” this was, yet as the office furniture is bland, plain, and mass-produced, one can assume that Hopper wished to further the idea of an isolated, melancholic and lonely worker confined both literally and physically by his environment, be it his work specifically or the larger society of post-war America. Produced in 1953, the society Hopper lived in during the time the piece was made experienced great change. The post-war economic boom caused the United States to become increasingly materialistic and capitalist, which triggered a large expansion of the middle-class and people who worked in large organisation, such as offices as portrayed in the piece. This shift of working in a more familiar, smaller environment to working in a large business as a mere employee, similarly to a cog in a machine. Furthermore, previously small industrial cities grew massively during this time. Therefore, one would have often felt isolated, which could be a possible reason why Hopper chose to portray the worker as physically and mentally isolated and distant. Hopper used emblematic and anti-narrative symbolism to convey this. Evaluation of cultural significance The work depicts isolation and loneliness of man in a uniquely stark fashion, which could be representative of post-war American consumerist and capitalist society through depicting an anonymous working man trapped in a confining and isolating environment. In another sense, it is important to note the context of the work. Painted in the 1950s, the piece features a reductive style, which is defined by clear lines, reduced formed, streamlined composition, and a clear composition. This style opposed abstract expressionism. Also a post- war movement, abstract expressionism sought to create works fuelled by the subconscious. Painting was seen as an automatic and spontaneous action. Hopper’s realist style is in direct opposition to the works of Pollack and Rothko. Unlike prominent artists of the time, Hopper did not paint freely. Due to this, Hopper was often labelled as passé old fashioned. Post-war, Hopper’s success gradually declined, yet, he continued to work. His paintings remained carefully planned with an eye for composition. He continued to interpret American life with very little dramatics. His staged scenes seem ordinary, with isolated, frozen figures in almost awkward poses. Whilst other works at the time were lively and abstract, his pieces remained monotone, yet authentic. Hopper removes any superfluous details, and indeed, this authentic and uneasy realist style captivates and resonates with the viewer, even decades later. Eitel Analysis of formal qualities Born in 1971, German contemporary artist Tim Eitel is one of the most prominent realist painters of the twenty-first century in the European art scene. Eitel studied German language, literature, and philosophy before studying painting at university, resulting in his solo-debut in 2006. Eitel’s primary medium is oil on canvas, with which he creates minimalistic scenes in a realist style with a sense of abstract composition. Eitel is best known for depictions of a somewhat altered and staged reality, and especially his choice of background and composition are often abstract and, in a sense, surreal. This can be seen in his work Ohne Titel (Ausblick)/ Without Title (View) (acrylic on canvas, 2002, 30 cm * 30c cm). The piece shows a man staring out into a forest, perhaps standing before a window or door of some kind. It is not en-face. Dark blue borders surround a landscape of a forest. The interior has a Mondrian-like aspect through solid blocks of colour; mint and dark blue. It is unsure whether these are windows or doors, or a surrealist element of the piece. The man is alone, and gives a sense of solitude. The composition of the work- with the reflection of the figure on the floor and the man gazing out into the distance- reiterates the reflective nature of the work, as well as the loneliness portrayed. The thick, dark blue borders around the man create emphasis on the figure and isolate him physically. Mentally, the figure seems isolated in that we cannot see his face, and he is simply staring out into the distance. He is not interacting with the viewer, which creates a cold detachment. The dark borders seem to trap and constrain the figure, giving the work a somewhat surreal and ominous aura. The man, however, does not seem to acknowledge the borders, and instead stares longingly outside towards the forest, perhaps in an effort to escape this isolation. The environment is cold, an effect created through the cold colours used of white, light green, dark green and dark blue, which furthers the sense of isolation and creates unity through tone. It also highlights omnipresent solitude, and creates an ambiguous environment. The figure could be anywhere; inside or outside. Eitel’s technique of realism is very minimal and taken-aback. It seems to be ‘boiled-down’ to clean lines and shading. He chooses to paint some features in greater detail, such as the man’s head, in which he has striking variations of tone to create a lifelike quality. In his technique, he creates a contrast between the soft, light and varied tones of mint green of the forest and the harsh, manufactured, artificial dark blue border with no variation in tone. In the work, the man is in the focal point, and is accentuated through the contrast of light and shadows, as well as composition. He is placed in the centre of the square work, and surrounded by the dark blue borders. This theatrical and staged composition, with elements of surrealism and the unreal, are typical to Eitel. Through his realistic technique, the contrast between the real and staged is particularly effective. He seems to question how much of our true reality is staged through his inconspicuous depictions of ordinary and everyday scenes, which could have been imagined or real. Annotations The subject matter portrayed is a single man staring out into a forest. Eitel uses minimalist and cold tones to further a sense of isolation. The stark and thick borders of solid colours physically isolate the figure. Quotes “I do not want to tell stories.” – Eitel (via youtube.com) “It is painting and transposes our world into another world. In this way, painting is more like theatre. It is abstract. (…) Just imagine a stage all in black, no light and just one spotlight on the protagonist. It is a lot like that. It creates this artificiality.” – Eitel (via freudevonfreunden.com/workplaces/tim-eitel) “It’s a weird kind of ambiguity I’m looking for. It has this sense of space and depth, but it’s also in a way abstract, like this big void.” – Eitel (via artnews.com/2006/11/01/optical-delusions) Interpretation of function and purpose Eitel has explained that he does not “want to tell stories”. There is little narrative element to the piece, yet it is powerful nonetheless. The solitude and isolation portrayed is chilling, which is furthered through the figure’s detachment and lack of interaction with the viewer. Whilst there is no direct criticism to a larger idea or a clear narrative, the work depicts the solitude, loneliness, and isolation of man. Evaluation of cultural significance Whilst Eitel is a famous, up-and-coming contemporary painter- particularly in Europe- the work Ohne Titel (Ausblick)/ Without Title (View) is not his most famous work, yet it accurately portrays Eitel’s signature features. Realism traditionally portrays scenes truthfully and without artificiality, yet Eitel’s pieces have an ominous aura of mystery. They question the viewer’s idea of what is real and what is not through combining stylised and abstract environments and compositions with realist figures. A contrast between reality and staged theatrics can be seen in most of Eitel’s work. In another sense, Eitel’s work contrasts other German contemporary art pieces. As a realist, Eitel stands in opposition with surrealist realists such as Neo Rauch or the abstract works of Arno Rink. Specifically, Eitel distances himself from the prominent Neue Leipziger Schule, established in the 1970s. Students of the school were predominantly working with figurative and abstract elements. Eitel, however, is distinctly realist, and his paintings are more reminiscent of photographs in their clean composition, tones, and composition. Hence, Eitel’s pieces differ greatly from those of other key contemporary German painters. HopperEdward Hopper and Tim Eitel Comparison

NUR 416 ST Thomas University Providing Chronic Pain Management Discussion

NUR 416 ST Thomas University Providing Chronic Pain Management Discussion.

I’m working on a nursing discussion question and need support to help me study.

From a nursing stand point of view give your opinion. Please use APA style, 150 words on each document opiniondocument 1: Correlational: What is the relationship between pain management and patient satisfaction?Comparative: Do chronic pain patients who use complementary and alternative medication report better pain management than those who only use pharmacological interventions alone?Experimental: What is the difference in reported pain score among patients that have used complementary and alternative medication versus patients that have only used pharmacological intervention alone?Phenomenological: What is the meaning of effective pain management for nurses?Components of Research Questions and Related CriteriaThe selected research question is the comparative research question; Do chronic pain patients who use complementary and alternative medication report better pain management than those who only use pharmacological interventions alone?The independent variable in the research question is the pain management while the dependent variables include the CAM strategies use and pharmacological interventions. The effective way to measure the effectiveness of the pain management is through the use of a questionnaire that captures the key components that are considered as an indication of effective pain management. The answers of the questions from the questionnaires would then be compared to each other to determine which of the two approaches is effective. The process can entail the use of both quantitative and qualitative research with qualitative research being the best approach given that the research will mainly entail the collection of subjective data. The population group for the research question is patients that suffer from chronic pain.Why this QuestionPain is among the most common health problems across the United States and the world. A majority of the American population report to have experienced back pain in their lives. According to Kuehn, B. (2018), 1 in every 5 Americans reported chronic pain in 2016 and it is estimated that 8% had high–impact chronic pain whose definition is one that limits life or work activities on most days or every day during the past 6 months. Given the high statistics, it is important to evaluate the most effective approaches to pain management. Opioid is the most effective approach to pain management. However, there have been significant concerns about the use of opioids across the United States. The use of the class of medication has led to an epidemic in the nation with a significant percentage of the population suffering from an opioid addiction (Marshall et al., 2019). Despite the use of opioids and its reported effectiveness in pain management, a majority of patients still report poor pain management. Therefore, it is time to consider other alternatives to pain management that would help lower the risks of opioid addiction while providing the most effective pain management approach. The use of complementary and alternative medicine presents such an opportunity as a majority of the CAM interventions are usually non-invasive in nature. Therefore, further research to understand the best CAM approaches to effective pain management is necessary as this will help in saving costs and improving the health outcome of a majority of the population.ReferencesKuehn, B. (2018). Chronic pain prevalence. Jama, 320(16), 1632-1632.Marshall, B., Bland, M. K., Hulla, R., & Gatchel, R. J. (2019). Considerations in addressing the opioid epidemic and chronic pain within the USA. Pain Management, 9(2), 131-138.document 2: Does exercising instead of not exercising help reduce the risk of Diabetes type 2 in female African Americans? I decided to discuss question number 1. According to the U.S department of health, the risk for a black female to be diagnosed with type 2 diabetes is 80% higher among non-Hispanic Blacks than White counter parts (Healthline, 2019). Type 2 diabetes is a disease that can be prevented, it is also a chronic condition that if left untreated can cause complications that can be life-threatening. Such as heart disease, stroke, and high-risk pregnancy. Based on a study that was done by the National Institutes of Health in January 2018, black adults have a higher chance of developing diabetes type 2 than for white adults. The highest number was between black women and white women. Black women are more likely to develop diabetes type 2 between the age of 45 or older. One of the most common conditions that increase the risk of diabetes type 2 in black women is obesity. In the black community, there is a lack of education regarding certain diseases. Many African American females have diabetes and don’t know about it. For example, I had a patient who recently was admitted because of covid-19 symptoms and was found to have diabetes type 2. Of course, she was surprised and in denial at the same time. She wasn’t interested in the education that we were trying to provide her. The first thing I noticed is that she was overweight. My question to her was when the last time was you visited a doctor and her answer was 5 years ago. My point is that more education needs to be provided to black women in regards of certain diseases, lifestyles, and diet that can help them. In summary, I believe that exercising can help prevent diabetes type 2 in black women. Black women need to be educated about how to prioritize their health by making appointments with their primary care providers in order to take care of themselves. Many women tend to stay up to date with their pap smears and even their mammograms but not curious enough to know their blood sugar level, their blood pressure, and cholesterol. This needs to change. They need to know that by exercising regularly, eating a healthy diet, and maintain a normal weight can help prevent this disease. I chose to discuss this question because of how important it is for me to educate other black women like myself about the prevention of diabetes. ReferencesSeixas, A. A., Henclewood, D. A., Langford, A. T., McFarlane, S. I., Zizi, F., & Jean-Louis, G. (2017). Differential and Combined Effects of Physical Activity Profiles and Prohealth Behaviors on Diabetes Prevalence among Blacks and Whites in the US Population: A Novel Bayesian Belief Network Machine Learning Analysis. Journal of Diabetes Research, 1–10. https://doi.org/10.1155/2017/5906034 (Links to an external site.) LoBiondo-Wood, G., & Haber, J. (2018). Nursing research: methods and critical appraisal for evidence-based practice. Elsevier.
NUR 416 ST Thomas University Providing Chronic Pain Management Discussion

“In Praise of Oversharing” an Article by Steven Johnson Essay

Introduction This article was written by Steven Johnson. In this article, Johnson discusses the impacts and effects of the internet on the social and personal lives of individuals. Due to the technological advancements that have been experienced in the world of information technology since the late 1990s the rate at which people share their personal information has increased. This began with the project that was launched by Josh Harris in the late 1990s where he had the personal life of around 100 individuals recorded and broadcasted all over the world for anyone to see. Although law enforcement officials of the U.S government cut the project short, Harris went further ahead to broadcast the personal life of himself and his girlfriend. This project too was cut short by the U.S government. This article thus explores the manner in which people utilize social media and networks and the kind of information that people should share, especially with strangers. Purpose, diction, and tone of the article The main purpose of this article was to advise people on what kind of information they should share with others through social networks and media and the extent to which this can go. In the article, Steven stated that people should learn how to draw lines on the extremes that they are willing to share information with others to protect themselves and their interests. The writer has also presented diction in a smooth and articulate way. The manner in which he has chosen his words, vocabularies, and sentence structure clearly bring out the information that he wants to pass to his audience. In his article, he has used words like a crevasse, klieg, and bacchanalian to express the feelings that he had on the issue at hand. The choice of these words among many others has clearly brought out the idea and the emphasis that Steven had on the issue. They clearly show the tone of emphasis that he had while writing the article. Steven keeps on emphasizing that we should gauge what kind of information we want to share and the people with whom we share that information with. That is why he said that he has discussed with his family about what information they can share and what they cannot. He went on further and said that when one talks to a stranger, it is different from giving their house keys. Altogether, he just wants people to be careful while using social media and networks since they may result in either positive or negative impacts. Conclusion The manner in which people socialize these days has changed. Social media and networks offer us the chance to share whatever information we want with whoever we want. At the same time, we can get in touch with people we know and strangers. Therefore, one has to be careful with the information that he/she wants to share to ensure their safety and at the same time maintain their privacy and morals and standards of the society.