Miss Havisham as a Mysterious and Complex Presence Essay Example

Miss Havisham as a Mysterious and Complex Presence Paper The novel Is written retrospectively using first person narration. This gives the reader the impression that they are part of an intimate and confessional storytelling. Pip first meets Miss Having when he is summoned to play with her adopted daughter Estella. Stats house is set in a very upper class area but is very run down, the windows and doors are barred and locked, to keep people in as well as out. Its gothic architecture adds to the dark and brooding Image of the house and its occupant. The readers first Introduction to Miss Having occurs when Pip enters her room which is gloomy and 11th only by candlelight. She Is dressed In rich materials. Silks, satins and ace, all in white which has now yellowed and shabby with age very similar to her jaundiced attitude towards men. She continued to wear her veil, a pagan representation of virginity and dried and decayed flowers in her hair. In contrast she wears shining jewels around her hands and neck. He observes that the dress that she Is wearing had been put on the figure of a young woman and the carcass on which It now hangs had shrunk to skin and bone. The gloomy and decaying theme continues throughout PIPs encounters with MISS Having. We will write a custom essay sample on Miss Havisham as a Mysterious and Complex Presence specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Miss Havisham as a Mysterious and Complex Presence specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Miss Havisham as a Mysterious and Complex Presence specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Dickens uses words Like faded, no brightness, like black fungus and the daylight was completely excluded to relate the atmosphere of both the house and its inhabitant. As he walks towards her he notices that all the clocks have stopped at twenty minutes to nine and she says: Look at me, you are not afraid of a woman who has not seen the sun since you were born? again emphasizing the dark aura surrounding her. Dickens uses a great deal of figurative language In the novel relating to death and decay, especially in his description of MISS Having. She openly speaks of having her heart broken. Pip notices that it is as if she has stopped living and that her life as she knew it had need once her engagement was broken. It is as if she is permanently stuck in the past and cannot or will not move forward. She literally did not see the light of day from this point. We learn later that her fiance © Composers abandoned her on her wedding morning at this exact time. Pip describes Miss Hafniums appearance when he first meets her as the strangest lady I have ever seen. He Is anxious, scared and confused and his childlike use of vivid imagery conjures up a vision of a macabre and decrepit old woman. He likens her to a ghastly waxwork he saw at a fair and also to skeleton he once saw in a church. Pips description of her represents two stages where in effect life has stopped. Here Dickens appears to suggest that although Miss Having has succeeded in stopping her own advancement when she received the letter, namely ten malting AT ten clocks, ten continual wearing AT nerd waling clothes and the wedding cake decaying on the table, she is unable to stop the passage of time, and prevent her body deteriorating. Pip notes So she sat corpse like. Another reference to death, not only physical, but that of love dying. Miss Having was bought up by her father with no maternal influence. This may explain her difficulty to bestow love on Pip and Estella and the harsh way in which she treats them. She had been badly treated by men throughout her life, her father who spoiled her and denied her nothing, ensuring that she does not have the usual boundaries of childhood, and her fiance © and half brother, the former who courted and finally Jilted her and who along with the latter swindled her out of a fortune. She is obsessive in her attempt to get revenge on Composers and in all men in general. During the Victorian era there was a great divide between rich and poor and social class was very important. Pip came from the working class and as such was not highly educated. He feels embarrassed about his social status and when Estelle mocks him for being a common labouringly boy with course hands, Miss Having does nothing to chastise her, in fact she seems to revel in his discomfiture. Miss Having taunts Pip with Estella beauty and finds a perverse pleasure in encouraging Estella to break his (and other mens) hearts. This is Just the beginning of her cruelties to Estella and Pip. Throughout the novel she tampers with their lives. She pretends that it was her who was Pips benefactress, and she is controlling from the very start, for instance when Pip comes to play at Stats House; she mutters witch-like incantations at him: Play, play, play And love her, love her, love her Pip falls madly in love with Estella, something that Miss Having in her warped frame of mind, enjoys. She relishes the fact that Pip has fallen for Estella and is enjoying seeing some-one love another person so strongly only to have their heart broken as she had many years before. Dickens makes a very interesting comparison between Miss Having and the convict Magnetic, who it turns out is Estella father, in that they were both cheated by Composers. However, there is a stark contrast in their chose n methods of revenge. She chooses to become manipulative and evil towards Pip and Estella. Whereas Magnetic remembers Pips kindness and chooses to be benevolent towards Pip in order to ease him towards the position of a gentleman. Dickens uses clever reference to color throughout his description of Miss Having. The white of her clothes, which represents purity along with the yellow of decay. When Miss Having is burning from setting her clothes on fire, the red of the flames could be seen as a representation of love. It is interesting that earlier in the text she is referred to as the witch of the place and that the conflagration could be likened to a witch being burned at the stake. The reader can recognize the comparison between her being aflame and the emotion of love which can be said to be a burning desire. This is the last reference to her being a witch-like figure in the story, and in ways can be seen to be her being cleansed by fire, a biblical reference. On Pips last visit to Cats, he is no longer a young boy, he is an adult and has a different perspective of the world. He is older and wiser and the roles of he and Miss Having have reversed. He has come to ask a favor of her, namely to borrow some money, rather than when he was young and she always asked things of him. Interestingly although she asked things of him, it was always in a demanding way and she had to be in control. However now seen Is Digging Nils Eternalness. seen reels Tanat cannot Torture nerd UT t D I Is more important to her that Pip does. Dickens ensures that the reader considers whether Miss Hafniums fate was deserved. She was indeed cruel to both Pip and Estella, however she had led a very sad and unfulfilled life and her life ended in a very cruel ay. She did in the end appear to find a friend in Pip and begs his forgiveness for her maltreatment of him. Pip like a true gentleman does in fact forgive her before she dies. A mind mortally hurt and diseased this is perhaps the most significant quote in the novel. It articulates the vital complexity of her character, describing her as a victim who became an antagonist as a consequence of her maltreatment during childhood by her father, and during womanhood by Composers. Miss Having is presented as a mysterious presence by primarily not being revealed until late in the book. However, her obsession with revenge and her likeness to a witch also are contributory factors, and conjure images and perceptions in the readers head of what Miss Having is really like and her appearance. Once revealed, she is still retains a mysterious presence especially when she is killed by being set alight a witch-like way to die, and in her time of dying she finally apologizes to Pip and Estella for all the wrong she has done to them. Bibliography Dickens, C. (1860) Great Expectations. Hawse, D (2007) Charles Dickens. London: Continuum Davis, P. (1999) Charles Dickens A-Z. Checkmate Books

history 1301 Technology in America essays

history 1301 Technology in America essays An American can be described in many ways. Americans from the 1700s, 1800s and today all have differences and similarities; these can be affected by technology, culture, location and government. Each similarity and difference tells you a little more about Americans and their role in society, making America what it is today. Technology in America has changed over the years and done so quite rapidly. In the 1700s Americans did a lot of hard farm work because they didnt have the technology to have a machine to do the work of hundreds of people in less time like Americans do today. The technology Americans had in the 1700s they brought over with them from Europe. In order to communicate with each other they had to travel down rivers and roads. They did not have cell phones or the Internet to send an e-mail from their home to anywhere in the world in a second like Americans today do. In the 1800s the technology was not much more advanced than the 1700s, but they did have ships and built canals. They were able to begin producing at a higher quality for a lower price. Americans became more intelligent through the years. They formed new opinions and tried out new ideas, some of which failed and some improved technology greatly. We are starting to witness the beginning of a new era in Americans today. It is ful l of information and technology. Today we have inventions such as the stealth fighter, the computer and nuclear power plants. Things that were only imagined in the past have now become todays reality. Single machines hold the jobs that would have taken hundreds of men to accomplish by hand in the 1700s and1800s. Technology is not always used for the best purposes though. Our great society has allowed the production of many weapons whose sole intention is to create mass destruction and kill large amounts of life. Many people now live in constant fear of the use of these weapons,...

Discuss about DNA related topic Essay Example | Topics and Well Written Essays - 1500 words

Discuss about DNA related topic - Essay Example DNA has come a long way since the time of the famous photo 51 of Rosalind Franklin until the three-dimensional model interpretation of Jim Watson and Francis Crick of the double helical structure of the DNA strand. Even the discovery of the DNA helix was of controversy itself as discussed in an interview of Lynn Osman Elkin conducted on March 26, 2003 posted at NOVA website regarding the confusion on who to take credit for the discovery, if double helix DNA should be more on Franklin’s account (Rosalind Franklins Legacy). Deoxyribonucleic acid is the hereditary material in humans and almost all other organisms. Most DNA is located in the cell nucleus. The information in DNA is stored as a code made up of four chemical bases: adenine (A), guanine (G), cytosine (C), and thymine (T). Human DNA consists of about 3 billion bases, and more than 99 percent of those bases are the same in all people. The order, or sequence, of these bases determines the information available for building and maintaining an organism, similar to the way in which letters of the alphabet appear in a certain order to form words and sentences (DNA interactive). Series of studies have proven the role of DNA as the gene carrier. Fred Griffith and his transforming principle experimented on mice by injecting strains of the S (smooth) and R (rough) form of the Pneumococcus bacteria. The experiment showed transformation of R from to its virulent form by somehow incorporating gene from the dead S form when mixed together. Furthermore Griffith’s experiment set out Oswald Avery and colleagues Colin Macleod and MacLyn McCarty to determine what the transforming agent was by the process of elimination ruling out DNA as the transforming material. Further experiment of Hershey and Chase proved that DNA, and not protein, is the one injected by virus into their host thus establishing DNA as the hereditary

Strong Interest Inventory Essay Example | Topics and Well Written Essays - 1000 words

Strong Interest Inventory - Essay Example s which matches the interests as well as the personal styles in relation to issues such as leadership qualities and risk taking abilities of the individuals is very important for the students as there is a strong relationship between the interests, preferences and personality. The school counselor also interacts with the students who are experiencing social or personal problems, and after identifying the issues aids them by providing counseling for achieving their academic and career goals. Due to legislative compulsions, the schools are required to update their testing programs and design new assessment methods. There are standardized tests developed by the test publishers. In the recent years new editions of the Tests of Achievement and Proficiency Batteries have been released by the reputed test publishers. They also publish interest inventory tests which broadly measure the students’ vocational or academic interests. Attitude and personality scales used for measurement cover various parameters. For example the results of the  Myers-Briggs Type Indicator  (MBTI) assessment (CPP Inc., 2004) include: Scores on the level of interest on each of the six  Holland Codes  or General Occupational Themes.  Holland Code Themes  include – Realistic, Investigative, Artistic, Social, Enterprising, and Conventional. Standardization: A standardized test conducted under standard conditions and vigilance, with specified time limits and scores are either norm or criterion referenced, and interpreted as per standards consistently. The standardized tests are useful in the assessment of academic success or achievement, and could also be effectively used for diagnostic testing in counseling for identifying weaknesses such as reading and writing skills as well. ACT, SATII, GRE, MAT, GMAT, MCAT and LSAT are some of the good examples of standardized tests. Norming: Norm refers to average level of achievement or performance in relation to a group. Norm-referenced tests

Marketing Strategies For Enterprise Branding Of Tesco China Marketing Essay

Marketing Strategies For Enterprise Branding Of Tesco China Marketing Essay This essay mainly presents marketing strategies for enterprise branding in Chinese markets of the British company Tesco (Tesco Co. LTD). The marketing strategies are divided into different aspects which contain the External Analysis, Budgeting, Products, Services, Market Segmentation, the Brand and the Welfare State. As can be seen from the essay, the services seem to be known as the most important factor of the marketing strategies. Tesco (Tesco co. LTD), which was founded in 1919, is known as one of the most successful supermarkets around the world, in terms of profits, reaching  £59.4bn in sales at the end of 2009 according to the financial statements 2009 (Appendix 1). Whilst many areas of the world may have been partially penetrated by supermarkets, the Chinese mainland market is treated as a totally new opportunity for the fast-paced development of Tesco. Since 2004, the year when Tesco opened the first supermarket in China, this world famous company opened 89 mass merchandisers, 12 convenience stores and 4 Lifespace shopping plaza mainly covering 30 cities throughout China. According to Terry Leahy, the Chief Executive of Tesco, At a time when customers everywhere are feeling the economic strain, we are responding to their changing needs in all our markets by lowering prices, introducing more affordable products and offering even sharper promotions. He also points out that these actions, combined with their core strengths in selling food and everyday essentials, owning their own property and having a broad business base, are helping them to cope well with the effects of the downturn. All of this gives credit to their marketing strategies. The increasingly perfected marketing strategies seem to be defined as one of the main factors which have helped Tesco register remarkable achievements, not only in sales but also in business evolution during that period of time. This essay will explain the marketing strategies for enterprise branding of Tesco in China. Overview With the fast-paced permeation of high technology, the retail trade, which is closely bound up with peoples daily life, is becoming a focus of societys attention. However, in the retail trade industry, supermarkets are seen as the most fundamental form of marketing, not only provides consumers with the choice of food, but also non-food choices, such as electrical appliances and clothing. According to Mohan (2009), with the development of economic globalization, infinite commercial opportunities are provided for those international retail trade companies which are planning to land their ideally attractive markets. As the UKs largest and worlds third largest grocery retailers, Tesco has adequately played a role of leader in this situation through the same industrial level, in terms of the ability of using IT to excavate the referable data and the marketing strategies to strengthen the loyalty index of consumers and the brand share. On December 8, 2010, Tesco in China reported its results for the third quarter of fiscal year 2010/2011. According to the report for China, there was a strong growth in global business; group sales increased by 8.8%, international business grew by 15.7% of total sales. UK business continued to perform well, total sales increased by 5.0%. Asian markets had a rapid growth, in terms of a sales growth of 23.4%. It is particularly worth mentioning is Tesco in China opened the fourth LifeSpace shopping plaza in Anshan with the business occupancy rate of 96%. (Data available on http://www.cn.tesco.com/en/news/tesco_news1_143.htm) The Necessity of developing the International Market The sustained and rapid development of the economy successfully promoted the international business expansion among a large number of retail trade companies; the choice of international markets can somehow extend the products life cycle and ease the pressures in the local market competition. The main factors why Tesco chose the expansion of international operations are shown below: Britains retail market is currently in the mature stage, therefore, selecting a new breakthrough is necessary; Europes retailers are faced with increasingly intense external challenges and competition at present; hence, it is a wise measure to develop the potential market outside Europe; Tesco now has established branches in 14 countries, as is shown in Appendix 2. As the UKs largest retailer, Tesco has the ability to manage and balance its worldwide operations; In order to surmount the large number of international competitors, it is necessary for Tesco to increase its market share. Tescos marketing strategy in China External Analysis Strategy development or review logically starts with external analysis, an analysis of factors external to a business that can affect strategy. Tesco uses a particularly useful concept in conducting an external analysis, which is called strategic questions; this kind of question often suggests subquestions, each of these sub-questions can, in turn, generate still another level of sub-subquestions. This really helps Tesco know what their consumers are willing to buy. Just as Aaker (1995) said: The goal of external analysis is to influence strategy by identifying opportunities, threats, trends, and strategic questions. Its ultimate goal is to improve strategic choices-decisions as to where and how to compete. Furthermore, external analysis also helps Tesco focus on a single segment or attempt to serve multiple segments, perhaps obtaining across-segment synergies. Budgeting Tesco uses the budget as the most efficient tool for management planning and controlling in China. According to McLaney (2008), Budgets do not exist in a Vacuum; they are an important part of a planning framework that is adopted by well-run businesses. Therefore, a well-prepared budgeting is necessary for a company to develop in an international market. Products Lachman (1986) pointed out that marketers can expand their range of products in order to enhance consumers satisfaction. Driven by the global economic integration, many Chinese consumers began to slowly accept Western culture, as well as the imported food which is produced by the majority of Western suppliers. As an international business, Tesco is able to leverage the advantages of a distribution for the Chinese market with a large number of imported products. While taking into account the price, the quality of the products has been paid more attention by consumers currently. Kayl, the CFO of Tesco, said that the only way to assure the establishment of a permanent link between us and consumers is strictly monitoring the quality of the products. Tesco can satisfy retailers, suppliers and customers, leading to a win-win situation. Services Firstly, although there are many 24-hour convenience stores, the size is not large enough. However, Tesco has achieved a breakthrough in this regard, that is to say building larger stores around the world. Secondly, with the fast-paced development of the Internet, a large number of consumers will choose to shop online; Tesco has not only improved their services, and its online service is also constantly being renovated, so that consumers can enjoy the fun of online shopping. According to Tescos official website, the online shopping sales in 2009 added 30.9%, profits create an increase of 49.2% compared with 2008. Tesco.com possesses 100 million customers in 2009. (Data available on Tesco official website) Thirdly, when the holidays come, it is common that there will appear problems in supply of goods suppliers and collection systems in many supermarkets. Faced with this problem, Tesco also has its own response. Tesco and suppliers are using the suppliers management systems that can have quick replenishments, in order to reduce the rate of the stores OOS (out of stock). In addition, Tesco has also installed self-service cash registers, consumers can check out by scanning their product, which greatly eases the pressure of collection, saving consumers time. Fourthly, Tesco has for a long time implemented a system of membership cards. This system is not a simple loyalty program of filling prescriptive points for exchanging prizes; it is defined as a combination between information technology, database creation, and analyses of consumers, then accordingly to guide and access to more accurate customer segments, more targeted marketing strategies and customer relationship management system. The magnetic strip card and electronic scanning technology is really helpful to analysis each members buying preferences and consumption patterns, Tesco can not only design the personalized quarterly newsletters for different sub-groups, but also greatly enhance the customer satisfaction and loyalty. Fifthly, as the saying goes: The consumers satisfaction is basically from the employees satisfaction. Therefore, Tesco is not only concerned about the interests of consumers, but also pays more attention to the interests of their employees. For example, in order to reduce the work pressure of their employees, Tesco provide every cashier with a seat when they are doing their work. To sum up, Tesco has been working to improving their products and services, in terms of always trying to make up for its own shortcomings and to enhance consumers satisfaction, for instance, some Tesco stores are planning to set up larger parking lots to satisfy Chinas increasing growth of car ownership. 3.5 Market Segmentation Based on the consumers preferences, the customers are divided into six sub-groups by Tesco; there are eight sub-groups which are distributed by life stage; and according to purchasing habits and behavior patterns consumers are divided into as many as 5,000 groups. The benefits which Tesco is gained from the detailed market segmentation include: more targeted pricing strategies more selective procurement plans more personalized promotions more attentive customer services more measurable marketing effects more convincing market research The benefits stated above provide a promotion of consumers satisfaction and loyalty to Tesco. Brand Another commendable marketing strategy is co-branding program, or in other words several strong brands federatively launch a customer loyalty program. Such as for womens Me Time, family women can accumulate points in exchange for their daily purchases in beauty, hair products, or discount coupons for some companies. In these activities, Tesco and those co-operated brands achieved the effect of win-win. At the same time, Tesco has also introduced a large number of own brand products, and compared with those brands, Tescos own brand saved a lot of costs of publicity, and packaging is relatively simple, hence, Tesco has a comparative advantage (cost of sales is lower than others) in price. 3.7 The Welfare State Tesco has a relatively impeccable welfare state, includes retirement security, unemployment insurance system and workers compensation. According to Maks (1990), all three types of welfare security measures effectively improved the situation that welfare state policies create failures that in the real world are more serious than those that they are imagined to cure, since the employees rights and interests are correctly ensured. Conclusion As a result, with the increasingly perfected marketing strategies in China, in terms of the external analysis, budgeting, products, service, market segmentation, the brand and the welfare state, Tesco has delivered solid sales and profits in China, whilst continuing to invest in long-term strategy for growth. Tesco has made a good start to the new financial year, 2011, and Tesco will continue to make good progress even in this unknown and unstable global economic environment. Appendix (Available on http://www.tescoplc.com/plc/media/pr/pr2009/2009-04-21/) Appendix 1 TESCO: GROWTH IN TOUGH TIMES (Financial Statement) 21 April 2009 53 weeks ended 28 February 2009 2008/9 Growth vs 2007/8 53-week basis Group sales (inc. VAT)  £59.4bn 15.1% Group revenue (ex. VAT)  £54.3bn 15.1% Group trading profit  £3,090m 12.4% Underlying profit before tax  £3,128m 10.0% Group profit before tax  £2,954m 5.5% Underlying diluted earnings per share  £28.92p 11.0% Diluted earnings per share  £27.31p 2.6% Dividend per share  £11.96p (Available on http://www.cn.tesco.com/en/news/tesco_news1_143.htm) The part of distributions of Tesco around the world Country Entrance Year Number of shops UK 1897 Czechoslovakia 1996 35 Hungary 1994 87 Poland 1995 105 Turkey 2003 8 China 2004 89 Japan 2003 111 Malaysia 2001 13 South Korea 1999 62

Essay --

Part A: Describe protein structure, the level of structure and geometry. Include in a description of the significance of structure and how it affects to analysis. Protein Structure Levels There are four levels of protein structure which are separated from one another by the degree of complication in the polypeptide chain. A protein molecule can consist of one or more of the protein structure types. 1- ) Primary Structure is the sequence of a chain of amino acids. Proteins are formed from 20 different amino acids. Amino acid are composed of a carbon (ÃŽ ± carbon) that bond to the hydrogen atom (H), a carboxyl group (-COOH), an amino group (-NH2) and a variable group, or R group. The primary structure is determined during translation. There are two tools uses to determine the primary structure; Edman degradation and mass spectrometry. Primary structure controls the secondary, tertiary and quaternary structures. It is also used to determine the molecular mass and isoelectric point. 2- )Secondary Structure describes the coiling or folding of a protein due to exclusive hydrogen bonding between its backbone amide and carbonyl groups. These secondary structures are held together by hydrogen bonds. There are three types of secondary structures in proteins. a-) Alpha helix (ÃŽ ±-helix) is a spiral arrangement around polypeptide backbone. The inner part of the coil is formed by the backbone of the peptide while the side chains extend outward from the coil. Hydrogen bonds between N-H of one amino acid and the C=O on the 4th amino acid stabilize the helix. b-) Beta pleated the beta sheet involves H bonding between the backbone residues in adjacent chains. The orientation of a beta pleated sheet can occur in two types. The strands may be paralle... ...Da) than grw175 (28 kDa) proving that the above observation is true. b-) Molecular mass of the XÃ ¸D2788 gene product = 56 kDa 1.) Loaded the image of the gel into ImageJ 2.) Labeled the MW ladder lane then other lanes of interest (lane 2 grw175, lane 3 grw19) 3.) A graph representation was then generated 4.) I selected the peaks of MW lane to be used in the molwt.macros program 5.) Based on the calculations that were generated using the molwt macros program I was then able to select the peaks of interest and compute a numerical value for them 6.) ImageJ indicated a peak of 56kda for grw19 positive and a 28kda value in grw175 positive. 7.) Using the numerical values I was able to subtract the grw175 estimated size of 28kda from the size of what is believed to be the fusion protein grw19 56kda 8.) Grw175 = 28kda – fusion protein 56kda to give you a value of = 28kda

Nurse Culture Assessment

Running head: CULTURAL ASSESSMENT Cultural Assessment June 14, 2008 Abstract In order to deliver nursing care to different cultures, nurses are expected to understand and provide culturally competent health care to diverse individuals. Culturally competent care is tailored to the specific needs of each client, while incorporating the individual’s beliefs and values (Stanhope & Lancaster, 2006, p. 90). By being culturally competent, nurses are able to help improve health outcomes by using cultural knowledge and specific skills in selecting interventions that are specific to each client (Stanhope & Lancaster). Therefore, nurses â€Å"should perform a cultural assessment on every client with whom they interact with† (Stanhope & Lancaster, 2006, p. 90) to help understand client’s perspectives of health and illness and discuss culturally appropriate interventions. In this paper, the author will demonstrate how nurses can utilize a cultural heritage assessment tool to help develop a cultural competent nursing care plan, which can be referred to in Appendix A and B. By culturally assessing client, nurses will be able to identify the needs of culturally diverse individuals and find out if what's important to the culture is really important to the person in terms of specific health needs. Introduction In order to deliver nursing care to different cultures, nurses are expected to understand and provide culturally competent health care to diverse individuals. Nurses must find out about people’s traditions, ways of life, and beliefs about health care so that the appropriate interventions can be planned and implemented to produce culturally positive health outcomes (Stanhope & Lancaster, 2006). By being aware of the client’s cultural beliefs and knowing about other cultures, â€Å"nurses may be less judgmental, more accepting of cultural differences, and less likely to engage in the behaviors that inhibit cultural competence† (Stanhope & Lancaster, 2006, p. 84). Most importantly, nurses must listen to the client’s perceptions of problems and work together to develop suggestions and recommendations for managing those problems. Therefore, cultural assessments tools have been developed and are available to help assist nurses integrate â€Å"professional knowledge with the client’s knowledge and practices to negotiate and promote culturally relevant care for a specific client† (Stanhope & Lancaster, 2006, p. 82). Part I: Cultural Assessment of Client A cultural nursing assessment is recognized as a â€Å"systematic way to identify the beliefs, values, meanings, and behaviors of people while considering health history, life experiences, and the social and physical environments in which people live† (Stanhope & Lancaster, 2006, p. 5). For this reason, cultural assessments are an essential component in providing quality care to diverse individuals of different cultures. For this reason, the author used the cultural heritage assessment tool to help assess the ethnic culture of Mrs. P. Referring to Appendix A, the outline shows the interview questions and answers collected by the author per Mr s. P. Reassuring the confidentiality of the client’s interview, utilization of the cultural heritage assessment tool enabled the author to gather, classify, and analyze the culture of an American Hindu Indian. Brief History of Ethnic and/or Racial Origins The client evaluated by the author was a 35 year old female named Mrs. P who lives in Poway, California. The immediate family composition consists of a wife and a husband who just recently got married. In regards to the client’s cultural background, the ethnic culture that Mrs. P identified with was an American Hindu Indian. Born and raised in Poway, California, Mrs. P’s father and the grandparents from the father and mother’s side were born in Punjab, India, while the mother was born in Utter Pradesh, India. Coming from India, the client’s parents has lived in the United States for 14 years. Living in Poway since then, Mrs. P grew up in a rural setting and lived with the parents and younger brother until recently moving out when the client got married. With Hindi as the client’s native language, Mrs. P and the brother can only speak Hindi, compared to the mother and father who can both read and speak the native language. Socioeconomic Considerations With occupation and education, the client’s dad has a master’s in business and works for Gateway computers. The client’s mom has a degree in psychology and is a housewife, and the younger brother has degree from UCSD for management science and economics and works at Boeing. As for Mrs. P, the client works as a teacher, having earned a bachelor’s degree in business administration from the University of California, Riverside, and Mr. P works as a neuro-surgeon, with a bachelor’s degree in cellular and molecular biology and in computer engineering, and masters in computer engineering. Receiving no financial assistance, the client seemed satisfied in the current socioeconomic class of upper middle class because there are no plans of changing job. Currently owning a home with 4 bedrooms, 3 bathrooms, a living room, dining room, loft, and patio, the living arrangements for Mrs. P appear sufficient for a future family to live in. Value Orientation According to Mrs. P, respect for elders, a good education, good family background and connections, religion, and good ethics for society, are values that are held highly within the family’s culture. Education and a highly held position in a career are very important because these values determine an individual’s status in society. Examples include doctors and engineers. Obviously, success is pertinent within the Indian culture. Indians are known for their hard work, vitality and dynamism. However, although looked as highly important, the family’s overall impression of these values do not define who a person is; these values are appreciated. Growing up, Mrs. P learned that every action requires thinking because any decision might have a negative effect on the family, and how society will react. Family reputation is very important and in the Indian culture, individuals must be careful not to do anything to put down the family name. The Indian culture is very family-oriented, which is why family comes first. In health and in sickness, the family takes care of each other. Cultural Sanctions and Restrictions According to the client, there are no cultural sanction and restrictions that the client is aware of. For the most part, Mrs. P believes that since the parents were open-minded to the fact of living in the United States, a strict Indian culture was not experienced during childhood. The parents understood what kind of environment the children were in and did not expect Mrs. P and the brother to be restricted to an Indian lifestyle. Communication As far as communication is concerned, Mrs. P informed the author that communication involves all members of the family, friends, and community. However, the Indian culture affects the way individuals communicate with family and friend by restricting certain topics when inappropriate. For example, foul language or sexual topics may be considered unacceptable to discuss in front of parents. For the most part, Mrs. P’s family does get along well, which is evident by the client’s close relationship with immediate and extended family members. With such open communication to some extent and having great family relationships, Mrs. P maintains contact with all members of the family and takes the time to visit family every few weeks. Health-related Beliefs & Practices & Nutrition Health-related beliefs and practices generally emphasize taking care of the health of all members in the family. According to Mrs. P, health-related beliefs and practices are related to nutrition. The only information that the client provided to the author was that Hindus perceive some foods as â€Å"hot† and some are â€Å"cold†, and therefore, should only be eaten during certain seasons and not in combination. There are different perceptions of â€Å"hot† and â€Å"cold† foods depending on the region of where individuals are from. From these perceptions, foods are thought to affect body functions. In the client’s case, Hindus love to cook and eat traditional dishes that are perceived as healthy. From raima, cholay, and saag, these Indian dishes are usually made by the client’s mother because Mrs. P does not usually make the traditional cultural dishes. As far as any specific dietary restrictions, eating meat is not considered good, but some individuals within the culture still eat meat. With Mrs. P, the client strives on well-balanced meals and does not follow the ideas of hot and cold foods. The only cultural diet that is followed is not eating meat. Cultural Aspects of Disease Incidence In regards to aspects of disease, the client’s culture customs and eliefs often contribute to the decision for medical care and choice of healthcare services. Supernatural forces and excess in human needs are recognized to contribute to illness and disease, regardless of station in life. For example, the client gives that example of eating too many sweets will cause round worms and that too much sexual activity can be associated with tuberculosis. Even more so, if a disease is sexually related, the occurrence of such diseases is looked upon as disrespectful if unmarried. In addition, diarrhea can be caused by a variety of improper eating habits. As a result, cultural treatments that may be used include homeopathic medicine, herbal remedies, mixing religion and medicine, and observing the individual within a natural environment. In the client’s case, a health problem that is currently affecting the family is high blood pressure. Religious Affiliation According to Mrs. P, the client’s religious preference is Hinduism, which is the same religion for Mr. P and all members of the immediate family. Religious beliefs and practices include believing in reincarnation and in many gods, and occasionally attending a temple. However, the client does not belong to a religious institution nor is an active member of any religious or ethnic organization. Yet, the client does practice the Hinduism when with the family. In the author’s opinion, the client expressed ideas for becoming more involved with participating in religious or spiritual activities. As for the neighborhood, there are diverse backgrounds of different ethnic cultures and religions within the community. Developmental Considerations The only achievements and tasks fulfilled by the client’s family include having both children graduate from college and finding successful careers. With having such high values in education and career, the author is not surprised that the parents consider graduation and a new job as very important achievements that a family member can accomplish. Even more, in the client’s sake, getting married, starting a new job, and moving into a new home were life changing fulfillments that the client has longed to achieve. As far as failures and achievements, being Indian has affected the fulfillment of achievements and perspectives of failures by placing the pressure to always be â€Å"on top of [the] game. Competition is what brings out the best in people and achieves the best results. Growing up, the client was always encouraged to excel. The expectations of families towards children were very high. With Mrs. P, the client strived to be the best because expectations were high and from the author’s point of view, the client has done very well to be at the point where the client is. Since the client’s family first sta rt, the only health and health-related events and experiences that Mrs. P has gone through is dealing with the removal of cataracts in client’s father’s eyes. Fortunately for Mrs. P, there have been no immediate deaths or births have taken place since the client has been born. Since the client’s the new marriage life, no health related events has occurred. Part II: Self Assessment Health-related Attitudes regarding this Cultural Group From the author’s self assessment about health-related attitudes regarding Indians, the author presumed that the most Indians are prone to respiratory infections such as tuberculosis and pneumonia, hypertension, nutritional deficits, and high risk behavior such as alcoholism and cigarette smoking. To be perfectly honest, the main assumption that the author had in regards to this cultural groups is that individuals of the Indian culture prone to strive dietary restrictions, which lead to a number of health problems. In addition, having had an Indian roommate, the author believed that individuals of this culture hold strong cultural beliefs and values because of the parents. Parents have a strong hold in the way Indian children think and behave. From family, friends, school, and community relationships to sexual activities, education, and work, Indians are expected to be smart, careful, and successful in all aspects of life. In the author’s opinion, such values and beliefs definitely influence and contribute to the health-related attitudes held by author because American Indians’ physical, psychological, social, and spiritual dimensions of life can eventually affect the health of these individuals. Evaluation of Author’s Values, Beliefs, & Practices In regards to the author’s values, beliefs, and practices, much of what has been embedded into the value and belief system of the author, including lifestyle practices, has been due to family, friends, and personal experience. From respect, obedience, and honesty, to work, education, religion, rationality and practicality, and the quality of life and health, the author strives to maintain a positive outlook in life, believes that hard work and determination will lead to a successful career, marriage, and family upbringing, and appreciates life and all the fortunate blessings that are often taken for granted like ambulation, breathing, and a healthy, loving family. Family, school, health, and religion are the most important values that the author holds. As a Catholic, the author believes that God has a plan for everything and whether life experiences are good or bad, God has a reason. Although the author does not religiously attend Church, prayer is often performed at home and at school. With school, education is an important aspect to a successful career. In the author’s opinion, knowledge is pertinent to success. Even more so, being aware of beneficial and risky lifestyle practices are necessary to maintain a healthy life. Such practices include exercise, a well-balanced diet, no smoking or drugs, and safe sexual practices. Obviously, values, beliefs, and practices may affect the physical, psychological, social, and spiritual dimensions in life. However, being only 25 years old, the author is aware that there is still so much more to learn about life. Therefore, the author remains open to new ideas and opportunities so that additional knowledge, mistakes, achievements, and failures will continue to add to the author’s life experiences. How might Author’s values, beliefs, & practices affect Delivery of Nursing Care to this Culture Group? The author’s values, beliefs, and practices may affect the delivery of nursing care to this culture group with the inability to empathize and understand complaints and concerns about health which leads to inaccurate assumptions about patient needs and creates assumptions that may impose ideas and interventions that may be unacceptable to the plan of care. Being unable to step outside the author’s box of values, beliefs, and practices may prevent the author from learning about another culture. As a result, the overall affect of delivering nursing care for this culture group is making incorrect assumptions about the needs of the clients and developing a care plan that may serve no benefit in improving the quality of life. Part III- Developing a Plan of Care After culturally assessing Mrs. P, the author identified the client’s readiness for enhanced religiosity. With a new marriage, a new house, and a new job, the client expresses concern that being away from the parents may lead to decreasing active lifestyle of practicing the beliefs and practices of the Indian culture. Even more so, the client acknowledges and expresses a desire to maintain the beliefs, values, practices that the parents have taught. Being married to a husband who does not actively practice the Indian culture, along with dealing with the expected stressors of being a new wife, taking care of a new house, and starting a new job, Mrs. P. strongly believes that maintain the values and practices of the Indian culture may be an effective coping strategy that Mrs. P is willing and ready to do. Obviously, Mrs. P. recognizes the importance of the Indian culture and is ready to enhance what had been taught to cope with the new life changes. Referring to Appendix B, the author’s goal for the client includes verbalizing the willingness to seek help to regain desired religious beliefs and practices and acknowledging the need to strengthen religious affiliations and become involved in spiritually based programs. These two goals seem appropriate for the client because if Mrs. P is willing to seek help with maintain the Indian culture and acknowledges the need for additional resources to participate in religious activities; the client can enhance religiosity within the newly accepted life transitions. Therefore, the interventions that the author has planned include determining the spiritual state/motivation for growth by ascertaining religious beliefs of family of origin and climate in which client grew up, discussing client’s spiritual commitment, beliefs and values, assisting the client to integrate values and beliefs to achieve a sense of wholeness and optimum balance in daily living by exploring connection of desire to strengthen belief patterns and customs of daily life, and encouraging participation in religious activities, worship/religious services, reading religious materials, etc and provide referral to community sources. In the author’s opinion, the overall plan of care has been adapted to the specific ethnic or cultural beliefs of Mrs. P because the plan addresses the cultural needs of the client. The interventions are client-centered and do not force any assumptions or beliefs of the author or of any other culture. The client has control of the care given. Even more so, communication, education, and religion being incorporated into the plan of care which were what the client expressed as the values and beliefs that are recognized as important. Hence, keeping what is important to the client. Conclusion To review, nurses must be able to provide culturally competent care to diverse individuals of different cultures. Culturally competent care can be accomplished by utilizing cultural assessment tools to better understand clients and other cultures in the community. Assessing the culture of an individual is an essential component in providing quality nursing care. In order to provide culturally diverse care, nurses need to take the time to learn about each client: who the client is, what the client feels and, most importantly, what the client needs. By doing so, nurses will be able to tailor a plan of care that implements interventions that are best appropriate to a client’s specific need, delivering quality nursing care, especially when of a different culture. References Doenges, M. , Moorhouse, M. , & Murr, A. (2006). Nurse’s pocket guide: Diagnoses, prioritized interventions, and rationales (10th ed. ). Philadelphia, PA: F. A. Davis. Stanhope, M. & Lancaster, J. (2006). Foundations of nursing in the community (2nd ed). St Louis, MO: Mosby, Inc. Appendices Appendix A Cultural Assessment of Client I. Brief History of Ethnic and/or racial origins of the cultural group with which the client identifies Q1. What ethnic culture do you identify with? A1. American Indian. Q2. Can you describe a brief history of your ethnic culture? A2. Okay. Q3. Where were your parents born? Where did they grow up? A3. India – Punjab (dad) mom – U. P (Utter Pradesh) Q4. Where were your grandparents born? A4. India Q5. Mother’s parents? A5. Punjab – India Q6. Father’s parents? A6. Punjab – India Q7. How many siblings do you have? A7. 1 younger brother. He is 28 years old. I am 35 years old. Q8. What setting did you grow up in? urban or rural? A8. I’ve lived in Poway, California, all my life. I love it here. My area looks more rural than urban. There is a lot of open land and green grass. We’re near the mountains so we are pretty far from the city life. Q9. What is your native language? A9. Hindi Q10. Do you speak this language? A10. Yes, everyone in my family can. Q11. Do you read your native language? A11. No, just my parents. Q12. Was your original family name changed? A12. No. Well, I just recently got married, so I carry my husband’s name now. Q13. How old were you when you came to the US? (if applicable? ) A13. I was born in U. S. A. My parents, on the other hand, came about 14 years ago. Q14. Who lived with you growing up? A14. Parents and brother II. Values Orientation Q1. What does your culture value? A1. Respect for elders, good education, good family background and connections, and good ethics for the society. Religion is also important. Our culture strives on hard work, vitality, and dynamism. Q2. Compared to western culture, how do you value achievement, materialism, ducation, work, equality, understanding of the environment, rationality and practicality, orderliness, and the quality of life and health? (in terms from your culture, if different? ) A2. I value all these things, especially education and high status in career is important. The type of careers you do are also very important and sets your status in society (doctors and engineers looked upon highly). Growing up, I learned the reputation was highly looked upon so whatever I did, I had to think before I act. Q3. How does your family value these things? A3. My family believes these are also all important, but they do not see these things as items that define a person, but they do appreciate these things. For the most part, upholding the family name and image in society is an important aspect in our culture because family comes first. My family is very family-oriented and respect is expected within our immediate and extended relationships. III. Cultural Sanctions and Restrictions Q1. Any cultural sanctions and restrictions? A1. None that I am aware of. If there were, I certainly was not informed. I guess because my parents do not carry the Indian culture as strict as other families. They try to be very open-minded to living in the United States and understanding the kind of environment that me and my brother live in. IV. Communication Q1. How does your family communicate with each other? A1. We talk to everyone, openly and respectfully. We talk to family, friends, and the people of the community. Q2. How does culture affect the way you communicate to family and with friends? A2. Certain things might not be accepted to be talked about in front of parents such as foul language or sexual topics. Q3. Does your family get along? A3. Definitely! Family is very important, unless something is inappropriate or unacceptable, then that causes problems. But for the most part, being close to family is an essential aspect of our culture. Q4. Have you or do you maintain contact with: Q4a. Aunts, uncles, cousins? Brothers and sisters? Parents? A4a. Yes, especially since I moved out of the house. I try to remain in close contact with everyone. Q5. Did most of your aunts, uncles and cousins live near your home? A5. Yes Q6. How often did you visit family members who lived outside of your home? A6. Every few weeks V. Health-related beliefs and practices Q1. Does your culture believe in traditional health beliefs or practices? A1. Much of what we believe in is related to nutrition. What we eat affects the way we function. For example, some foods are â€Å"hot† and some are â€Å"cold†, and therefore, should only be eaten during certain seasons and not in combination. Depending on what region individuals are from, different families have a different perspective of â€Å"hot† and â€Å"cold† foods. Hindus love to cook and everyone has their own perception of healthy foods, so individuals usually cook dishes that they believe are nutritional to how one may function. Q2. Do you follow any traditional health beliefs or practices? A2. No, not really. I eat whatever my mom used to cook for me. But now that I moved out, I cook whatever I have in the fridge. I don’t really believe in the hot and cold stuff. Q3. Do you do anything to keep healthy or prevent illness? A3. Just eat right and workout. I try to eat well-balanced meals and exercise. VI. Nutrition Q1. Do you prepare foods special to your ethnic background? If yes, describe. A1. I don’t make them since I don’t know how, but my mom makes many different dishes and I enjoy eating them. rajma, cholay, saag) Q2. Are there specific dietary restrictions in your culture? A2. Eating meat is not considered good in our culture, but people still eat it. I, on the other hand, have kept that dietary restriction so I don’t eat meat. VII. Socioeconomic considerations Q1. What is your family’s occupation and education? A1. Well, my dad has masters in business and he works wit h Gateway computers. Mom is a housewife; brother works at Boeing and got a degree from UCSD for management science and economics. Q2. Do you receive financial assistance? A2. No Q3. Are there any plans of changing jobs to earn a little more income? A3. Well, I just recently got hired as a teacher and I have no plans for changing my career any time soon. Honestly, my husband makes money that is definitely sufficient for our income, and I am very fortunate to find a successful man. Q4. Do you own or rent a house? A4. Eventually, we plan to own the new house we just moved into. Q5. How are living arrangements? A5. We currently own a home with 4 bedrooms, 3 bathrooms, a living room, dining room, loft, and patio. I love it here. We’re the only ones living in the house right since we just moved in. So there is a lot of privacy and a lot of space. We are ready to start a family. XIII. Organizations providing cultural support Q1. Are there any organizations that provide cultural support for you or your family? A1. No, but I’m very interested in finding out every since I got married. XIV. Educational background Q1. Describe your educational background? And your husband? A1. I have a BS in Business Administration and my husband has a bachelor’s degree in cellular and molecular biology and in computer engineering, and masters in computer engineering. Q2. Describe your parent’s educational background? A2. Dad – masters in business, mom has degree in psychology XV. Religious affiliation Q1. What is your religious preference? A1. Hinduism Q2. Describe your religious background, beliefs, and practices. Does your family attend Church? A2. Believe in reincarnation and many gods, occasionally attend a temple. For the most part, since I’ve moved out and my husband is not that religious, I tend to practice Hinduism at home and when I’m with my family. My parents strive on religion and since I’ve moved out, I feel like I am not as active as I used to be. Q3. Is your boyfriend/girlfriend the same religion as you, if any? A3. Yes, husband is same religion, but he doesn’t really practice any religious or spiritual activities. Q4. Is your girlfriend/boyfriend the same ethnic background as you? A4. Yes, he is also an American Indian Q5. Do you live in a neighborhood where the neighbors are the same religion and ethnic background as yourself? A5. No, diverse backgrounds in our apartment complex Q6. Do you belong to a religious institution? A6. No, but I think it would be great if I was. Q7. Would you describe yourself as an active member? A7. No. But again, I think being newly married; I think that being religious and spiritual may be a good thing. It’s hard to find the time to participate in religious or spiritual activities, but being a new wife with a new home and job, I think it would be good for me. Q8. How often do you attend your religious institution? A8. Very rarely anymore. I used to with my parents. Q9. Do you practice your religion in your home? A9. Yes Q10. Are your friends from the same religious background as you? A10. No Q11. Are your friends from the same ethnic background as you? A11. No XVI. Cultural aspects of disease incidence Q1. What does your culture believe in when it comes to aspects of disease? A1. Disease and illness is often thought be caused by our culture’s customs and beliefs. From supernatural forces to having excess human needs, individuals can be affected regardless of education and status in life. Some examples I can give you is eating too many candies can lead to ringworm, excessive sexual activity can cause tuberculosis, and diarrhea can be caused by not eating a well-balanced diet. Q2. Any cultural treatments? A2. Some like homeopathic medicines, herbal remedies, others like to mix religion with medicine and observe the patient with the natural environment. Q3. How does your culture view the occurrence of diseases? A3. If it’s a sexual disease it can be looked upon as disrespectful if you are unmarried. Q4. Are there any health problems that could affect your family now? A4. High blood pressure XVII. Biocultural variations Q1. Are you any other culture besides Indian? A1. No. Full American Indian. XVIII. Developmental considerations Q1. Describe family achievements and tasks fulfillment since your family’s start? A1. My parents’ best achievement, as they always tell me, was having me and my brother. Other than that, my family has not had significant achievements. With a stable career and a good neighborhood, my parents have had a good life without changing their line of profession or participating in life-changing events. However, me and my brother graduated from college and have found successful careers. Even more so, I just recently got married and my parents are very proud of me to have found such a good man at the right time. Q2. How has your culture or ethnic identify affected fulfillment of achievements or failures? A2. Growing up, my parents always encouraged me to excel. The expectations of each member were high. From work to school to even household chores, my parents expected the best out of me. In our culture it is expected to always be at the top of your game. This makes you want to always strive for the best and reach for the stars. Q4. From your family’s first start, what health and health-related events and experiences have happened? A4. Well, since I got married, there haven’t been any significant health-related experiences to note. Yet, during my family’ first start, my dad recently had his cataracts taken out. Other than that, I have been blessed with a healthy family for the most part. Appendix B Plan of Care |Interventions |Rationales | |A. Nurse will determine spiritual state/motivation for growth by |A. Early religious training deeply affects children and is carried on | |ascertaining religious beliefs of family of origin and climate in which|into adulthood. Any conflict may family’s beliefs and client’s current | |client grew up. |learning may need to be addressed. | | | |B. Discuss client’s spiritual commitment, beliefs and values. |B. Enables examination of these issues and helps client learn more about| | |self and what he or she desires. | | | | |C. Nurse will assist client to integrate values and beliefs to achieve |C. Becoming aware of how these issues affect the individual’s daily life| |a sense of wholeness and optimum balance in daily living by exploring |can enhance ability to incorporate them into everything he or she does. | |connection of desire to strengthen belief patterns and customs of daily| | |life. | | | | | |D. Nurse will enhance optimum wellness by encouraging participating in |D. Encouragement allows individual to pursue what he or she wants and | |religious activities, worship/religious services, reading religious |referrals allow clients to become aware of what options are available. | |materials, etc and provide referral to community sources. | | ———————– Nursing Diagnosis: Readiness of Enhanced Religiosity related to life changes secondary to getting married, a new house, and a new job AEB by client’s desire to strengthen religious belief patterns and customs that had provided comfort in the past, request for assistance to increase participation in religious beliefs through prayer, and requests for referrals to religious affiliation. Goal 2: Patient will acknowledge need to strengthen religious affiliations and become involved in spiritually based programs of own choice Goal 1: Patient will verbalize willingness to seek help to regain desired religious beliefs and practices Interventions