Culturally Competent Nursing Care

Culturally Competent Nursing Care: The Mexican-American Culture

Culturally Competent Nursing Care: The Mexican-American Culture
Rachael Crossgrove
Florida Keys Community College

Health care in the United States is very challenging, and is more now than ever as the population becomes more culturally diverse. As our population becomes more diverse the demand for culturally competent healthcare is on the rise. Cultural competence is a developmental process that involves the ability to understand different cultural and ethnic backgrounds. It includes the ability to understand and accept the language, culture, and behaviors of individuals and groups outside of one??™s own culture. The Mexican-American population is the most abundant growing minority group in our country. Therefore it is imperative to gain an understanding of their culture in order to provide culturally competent nursing care.

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The article I have chosen begins by stating the Mexican-American population is on the rise. The authors stress the need to increase nurses??™ awareness of this particular culture and their beliefs and values of health and illness. They decided to perform a field test in Texas because in 2000, Hispanics comprised nearly one third of the total population, Mexican-Americans representing approximately 75% of this group (U.S. Department of Commerce, 2001). The tool that they decided to use was developed in 1991 by Giger and Davidhizar, called The Transcultural Assessment Model. The model was developed to be used for those who desire to become culturally competent outside of their own culture. It is somewhat of an interview guide that includes questions pertaining to social organization, environmental control, and the selected cultures health beliefs and traditional practices. Mexican-American women were interviewed since they traditionally assume primary responsibility for the maintenance and well-being of their families. Six bilingual Mexican-American women between the ages of 64 and 84 born in the United States were interviewed.
After establishing trusting relationships with these six women, they were individually interviewed for 60 minutes each. The interview findings help to become culturally competent to the Mexican-American culture. In summary, Mexican-Americans are extremely family oriented, and rely on each other to solve problems and meet individual and family needs. The role of the Mexican-American woman is to nuture her family and maintain its health and well-being. The older women in the culture serve as the role models who give guidance and often make health care decisions for the family. The male is often viewed as the power figure, which runs the household; the wife deemed submissive. Mexican-Americans believe in external and internal locus of control when it comes to their health. Those with an external locus of control may believe that God??™s will determine their health. The participants described their strength of religious views; faith and church permeate the daily family and community life of Mexican-Americans (Kemp, 2001). Illnesses are often treated with herbs such as mint tea, chamomile tea, tamolindo (a drink made with tamarind that has been boiled, seeds removed, liquefied, then combined with sugar), and cinnamon. Folk medicine blended with traditional medicine has also been used according to the women interviewed. Folk healers (curanderas) are used, but Mexican-Americans may be hesitant to express their beliefs in folk practioners because fear of conflict with traditional medicine providers.
The information included in the article I chose is relevant for those who wish to be culturally competent. Respecting and understanding beliefs and practices of the Mexican-American culture is imperative when creating a trusting, therapeutic relationship that involves positive health outcomes. My current practice as a student nurse will change from reading this article. The information obtained enhances my knowledge of becoming culturally competent; a process that will require me to make a commitment to develop awareness, gain knowledge, and maintain cross cultural skills. I need to recognize and accept the United States as being a culturally diverse country and be a student nurse who values this diversity.
Eggenberger, S., Grassley, J., Restrepo, E. (July 19, 2006). ???Culturally Competent Nursing Care for Families: Listening to the Voices of Mexican-American Women???. OJIN: The Online Journal of Issues in Nursing. Vol.11 No.13

Identify and Answer Common Client Questions About Referral, Referral Processes and Referral Agencies.

Identify and answer common client questions about referral, referral processes and referral agencies.

How do I get a referral Your GP can refer you to see a practitioner, or you can refer yourself. If you are already seeing a practitioner, they may refer you to someone who specializes in your specific area.

How can counseling help
By discussing your concerns with you, the practitioner will be able to help you gain a better understanding of your feelings and actions, as well as suggesting ways for you to find your own solutions to your problems.

What happens next
I can either call to set up an appointment for you, or I can give you the phone number and address and you can set up a meeting yourself.

What type of counseling will I need
That depends on you, both you and your practitioner can discuss which therapy would suit you and will be best for you.

Cognitive behavioral therapy (CBT) attempts to retrain a person??™s way of thinking to help them to deal with stressful situations through tasks and goal setting. It can be used to help the client address a number of problems such as, depression, anxiety, obsessive compulsive disorder, eating disorder, addiction and schizophrenia.

Humanistic therapies take a holistic approach to a person??™s problem in order to help them develop to their full potential and live life to the full. Humanistic therapies are often used to treat problems such as depression, anxiety and addiction. N.I.C.E. (National Institute for Clinical Excellence) recommends this type of therapy for children and young people with mild depression.

Psychodynamic therapy will help a person to consider how their personality and life experiences influence their current thoughts, feelings, relationships and behavior. This understanding enables them to deal with difficult situations more successfully. Psychodynamic therapy can be used to help treat: depression, anxiety, post-traumatic stress disorder, eating disorders and addiction.

How long will it take
Again that depends on the type of therapy you require. Therapy can range from a few weeks to many months or years. It depends on the person and how much time and effort they are willing to put into addressing their issues.

Am I crazy
No. It can be easier to work on any issues if they are addressed before they reach crisis level. counselling can be used for a wide range of issues theses days, e.g., anxiety, depression, grief, relationship problems.

Summarise the types of service that organizations can offer on a range of issues.

The Salvation Army ~ is avoluntary organisation that runs support groups and self-help networks where people who have similar experiences can meet and chat. It is one of the largest, most diverse providers of social services and care in the UK and worldwide. Programs include homeless centers, drug rehabilitation centers, schools, hospitals and medical centers, as well as nearly 16,000 church and community centers.

Relate ~ is a helping organisation for relationship counselling, it offers advice on relationship counseling, sex therapy, workshops, mediation, consultations and support to those who require it.

Parentline ~ is a helpline for parents under stress; it is the leading national charity providing help and support to anyone caring for children, be it parents, grandparents, step-parents, relatives, and is for families living together as well as apart. Using a team of volunteer parents it advises families on issues both big and small.
Cruse ~ is a voluntary support network that is there to help the bereaved by enabling them to understand their grief and to cope with their loss. It focuses it many different areas, such as the military, children, traumatic loss and sudden death.
Ocean Quay ~ is a day service for anyone who has had problems with drugs or alcohol, is currently out of work. It provides people with a safe environment where they can make use of facilities such as groups on relapse prevention, life skills training, stress management, individual or group counselling. The project also provides advice on housing, benefits, volunteer opportunities, careers advice, further education and training courses accredited by National Open College Network

Evaluate ways to manage resistance ??“ Your own and clients.
Resistance is a natural reaction to any change in your life; it is the fear of the unknown, something new. In counselling, there will be times when both the practitioner and the client will face resistance and will have to try to manage it.
As a practitioner I may not believe my client is ready to finish counselling, but my client is adamant that they no longer require counselling. I can encourage my client to stay, but at the end of the day it is their decision. There is nothing I can do, except make my client aware that my door is always open and hope that they will return when they are ready to continue.
There will be times when I have a client referred to me, and it is very obvious that the client would rather be elsewhere. Despite the client??™s resistance towards my helping them, I would continue to attempt to build a therapeutic relationship and help the client. If, after numerous attempts I was still unable to build a relationship, I would have to refer on to another practitioner in the hope that they could succeed where I could not, and help the client.
As a practitioner I may have been in a counselling relationship with a client for a long period of time, it is possible that the boundaries have become blurred. As a result, the counselling relationship has become more of a friendship. This could impact on my ability to refer on, as I am no longer impartial or objective. Here I would hope that during supervision, my supervisor would make me aware of this and I would refer on.
Finally there may be times when I feel a client is pushing me to refer them to another service when I don??™t believe they require that service.
I would start by asking them why they think they require this service; maybe they see something that I am not aware of. After exploring with them their reasons for wanting to move on, if I still felt uncomfortable with them moving to another service, I would explain to my client why I believe they do not require referral. If this was not successful, I would probably seek supervision. However at the end of the day it is my client??™s right to choose and I have to respect this.

Summarise the processes of ending(s).
During your first session with your practitioner you will have gone over a counselling contract where he / she will have explained about confidentiality, boundaries etc??¦ In this contract you will initially have been offered six sessions, although you may require fewer sessions than this. Towards the end of your allotted sessions, your practitioner will have reminded you of the contract and you can discuss with him / her how you think you have progressed and if you believe you require anymore sessions. There will different options to consider on how to move forward,
??? end the counselling contract as you no longer need treatment.
??? start a new counselling contract as you both believe you require more treatment.
??? consider referral to an external agency, e.g. your G.P., specialist counselling or self help groups.
??? consider referral to another internal service such as a self help group or another service available.
Explain the reasons why you would refer a client.
There are many reasons a practitioner may find to refer a client, such as moving to a different area, if the client needs on going care, then referral to a colleague or another practice may be necessary.
The practitioner may not be qualified to deal with the specific issues a client may present, such as post traumatic stress disorder in repatriated soldiers. In this case referral to a practitioner who specializes in this area may be required.
The client may wish to only see a female practitioner, possibly due to religious beliefs, or if they had been sexually assaulted in some way; if the practitioner is male then referral is necessary.
The client may be coming to the end of a phase of treatment, such as rehabilitation for alcohol or drug misuse and require a less intensive course of action, referral to a day service may be in the client??™s best interests. The practitioner may have specialized in Humanistic counselling, when the client requires Cognitive Behavioral or Psychodynamic counselling, in which case referral to another practitioner may be necessary. The practitioner may not be qualified to the level required to deal with the client??™s issues.
There may be personality differences (which cannot be resolved) between the practitioner and the client which may interfere with effective progress.
Referral is necessary if after a period of time it may become apparent that an effective therapeutic relationship cannot be established.
I would also refer a client if I knew them outside of the counseling relationship as it would not be ethical for me to continue with treatment.

Explain how to refer ethically.
When considering whether to refer a client to another service or practitioner, you should first discuss your reasons for this with your client and get them involved in the decision. Always ensure you get their consent, preferably written, and make sure they feel happy, safe and ready with moving forward.
The practitioner can either set up the appointment for the client, or preferably offer the client your phone so they can call, encouraging them to take responsibility.
It is also essential that the practitioner gets consent, preferably written, to disclose any confidential information from the client.
If the client has agreed and wishes you to talk to on their behalf, make sure you do not discuss any personal details in front of him / her. This could cause the client to feel ???gossiped??™ about and self conscious.
When considering whether to receive a referral, the practitioner should bear in mind whether this is in the best interests of the client, if the client feels happy and has consented to being referred.

Culturally Competent Health Promotion


Culturally Competent Health Promotion
C. Howard

Culturally Competent Health Promotion
The Institute of Medicine (IOM) states that ???Nurses have the opportunity to play a central role in transforming the health care system to create a more accessible, high quality, and value driven environment for patients??? (Institute Of Medicine, 2010, pg. 85). The Affordable Care Act of 2020 describes a new care structure, with new nursing roles to deliver a more holistic and culturally competent care in the United States health care system. The main focus is centered on patient care needs. Health care is advancing care towards the community, focusing on primary preventative care rather than urgent acute care. The goal is to provide a seamless care from health care entities by allowing nursing to facilitate the transitions by practicing at their highest training, education, competencies, and abilities. The goals are to have a higher quality of care, less errors, and an increase in patient safety. Healthcare reform and its??™ delivery are necessary, and we must evaluate who and how we will deliver this care.
Many cultures have similarities in how they view health. Health is often defined as wellness of the individual or family in relation to their environment. Strong religious beliefs seem to be what many cultures have in common. Being of a Hispanic-white race, family is very important. Raised by a single mother with grandparents, all of who were white race, the only connection to the Hispanic culture has been with friends and community activities. Raised in the rural primarily white neighborhood with family traditions at major holidays, lead to a sense of identifying with the White ethnic group. Family always extends to close friends. The grandparents were of median class for the time and had specialty training and military affiliation. The mother graduated with an ADN in nursing herself and that is what inspired the knowledge of and having more of a sense of health and wellness. Insurance was available then utilized more freely to prevent illness and monitor health.
???In the U.S., health care is a commodity that can be purchased according to an individuals ability to pay??¦ Poor people cannot afford health insurance. That limits their access to health care service??¦??? (Edelman & Mandle, 2009, pg. 40). Many families and individuals are below or just at the poverty level, and lack the ability to pay out right for health care resources. With decreased ability to pay for even preventative services, patients who are ill will more likely accumulate bills for much more expensive services such as emergency room care and lengthy hospital stays. This can be financially and emotionally straining on low income families, thus keeping them in a cycle of illness and not promoting a state of wellness.
Currently today in Oregon, health care has seen an increase in the Hispanic population. The low income biracial Hispanic-white family interviewed has strong connections primarily to the ethnicity of Mexican heritage, and has a stronger belief in utilizing modern medicine when urgency of illness exceeds their ability to manage it with cultural practices. These practices have been shared and utilized throughout several generations. This Hispanic family has insurance but still feels unsure on its use and implications it will have on their health. Generally, the family looks to their eldest for remedies and spiritual healing. There is a strong connection to the Catholic teachings and they are practiced daily through prayer. Elder members have difficulty with the modern health system due to poor English speaking ability, which causes challenges communicating with the provider. Family is integral to all aspects of wellness and illness and must focus on health as a unit.
The second family is of the Chinese-Filipino-American culture, and has a somewhat different outlook on the health care system as well. They have a strong sense of family connection and belief in imbalances of energy (Ying, Yang, Chi, and Jing) within the body to the physical environment. ???An imbalance in energy can be caused, for instance, by yielding to strong emotions or eating an improper diet. In their interactions, humans and the universe are both susceptible to the elements of earth, fire, water, metal, and wood??? (Edelman & Mandle, 2009, pg 36). The use of herbs, meditation, message, and acupuncture are just some of the alternative practices used in conjunction with modern medicine. This family is very educated and takes pride in maintaining harmony or health.
Nurses have been instrumental in leading change in the health care system since its beginning of time through development of safety processes, advanced technology, education, nursing practice delivery, and development of initiatives and regulations. Nursing is very adaptable and constantly collaborating with other health care entities to redesign the delivery of care in accordance to patient needs. Further expansion of the roles of nurses and their practice delivery is crucial to the future of the health care system as it??™s developing into a quality of care rather than a pay for practice model. It is important for nurses to continue to grow and learn about their patient populations needs to deliver quality, functional nursing care to facilitate health and wellness amongst all individuals and communities.
Many cultures have practices that are based on the individual as part of a family unit, and focus on a set of religious beliefs that guide their health care. It is important as a nurse to understand the idea of different practices, such as the Jehovah??™s Witness religion and non-use of blood products, and how we need to accommodate our delivery of that care to incorporate others beliefs while promoting optimal wellness and health for the individual as well as the family and community.
Today we must be more aware of cultural differences and deliver culturally competent care. In delivering this care nursing must appreciate, respect and behave in a way that demonstrates that respect of the diverse cultural differences seen in practice today. Nursing continuously needs to work towards this competence by addressing: awareness, knowledge, skill, encounters, and the desire to have cultural competence (Cresia & Friberg, 2010). When the health profession limits their cultural spectrum it limits the delivery and ultimate goals of effective health promotion throughout all stages of health promotion.

Creasia, J. L., Friberg, E. E. (2010). Conceptual Foundations: The Bridge to Professional Nursing Practice. 5. VitalSource Bookshelf, Mosby.
Edelman, C. L., Mandle, C.L. (2009). Health Promotion Throughout the Life Span. 7. VitalSource bookshelf. Mosby.
Institute Of Medicine of The National Academies. The Future of Nursing: Leading Change, Advancing Health. Released October 5, 2010. Accessed January 17, 2012.

Identifies the Impact of Potential Change Factors Including the Role of Technology

BUSN105-1203B-275 Introduction to Business
Assignment Name: Unit 5 Individual Project
Professor : Nichole Anderson Harris
Student: Luis Rafael Zeledon

Describes the organization??™s
As a review of the scenario 1 there are three types of business the sole proprietorship, Business with partnerships and a bigger organization of business called the Corporation.
Lets review the brief meaning of these important topics of the known classification of business
Sole Proprietorship:
Is a Business that is going to be run by a person with the Idea of an inventor Which he thinks the proposed product,his Invention will succeed .But the problem in this case is that he or she does not have the right funding ,the Management Experience,The Investors Knowledge to back up his product.. His economy also does not help his situation and the only way to get started is to start getting the right advice for his Idea to be Funded and to be supported properly .

Basic Legal Environment of a Business:

???The laws that govern businesses are formulated within state statutes; there are no federal laws regulating the formation of businesses. Typically a business will organize under the laws of the state in which its main office is located. A business can, however, organize under any state of its choice, and must abide by the laws of whatever state they choose to incorporate under. Most laws are fairly uniform from state to state, with minor variations in processing procedures. The Small Business Administration (SBA) has outlined basic protocols for establishing a business that has been incorporated by virtually every state in the union.???

Read more: Legal Aspects of Setting Up a Business |

???A business operates within a legal framework that, for the most part, works. This legal framework has a long history and many reams of laws and regulations that will make your head spin. At some point, most companies will have to deal with some sort of legal issue related to their business. Don??™t be afraid of this. I won??™t lie. It??™s scary when someone wants to sue your company but the legal system, for all it faults and issues, does provide a reasonable framework for resolving business disputes.???

Topic #22: Legal Aspects of Business

Every business needs to have in order to operate some sort of legal representation to have a support in case that something goes wrong and the company gets sued.

???Small business owners often choose a sole proprietor business structure when starting up. The road to entrepreneurship can lonely. Greater rewards may result from forming a business partnership. Partnerships offer more freedom for business owners with shared business tasks and the potential to earn greater profits. Yet, according to Biz, over 72% of all small businesses are sole proprietors as opposed to 6% in the form of partnerships.???

Partnership is a company that has more than two owners,Directors in which the Financial , taxes and profits are split

Which are businesses that have property rights and separate status of the owners, and they are financially responsible. . Every business starts small at some point and then when it gets enough sales and revenue to expand is when you go to a partnership or become a corporation.
??? Deciding what type of business company structure is best for your small business can be a confusing exercise. Is an S Corporation advantageous for your small business Learn the pros and cons of becoming an S Corporation.
???What is an S Corporation???
A S Corporation (Small Business Corporation) is a business elected for S Corporation Status through the IRS. This status allows the taxation of the company to be similar to a partnership or sole proprietor as opposed to paying taxes based on a corporate tax structure.
No Corporate Tax: The biggest attraction of this business ownership is the tax advantages. The profits and losses of the business pass through to the corporation owners personal income tax. Like a Limited Liability Company, the tax “pass through” allows you to avoid “double taxation”.

Social Environment of a Business

???The growing social media scene has given small business owners yet another way to promote their businesses online for relatively little investment. In fact, time is the most significant cost when it comes to social media. Since most small business owners are busy running all aspects of their businesses, they do not have much extra time to spend on social media. This is why it is so important to create a marketing plan, set goals for your social media activity, and learn as much as you can about each network you plan to participate in so you can reduce the learning curve and avoid wasting time
This collection of articles provides an overview of social media for small business, as well as tips and advice for using specific networks as effectively as possible in your business.
Here are examples of how to save money starting with a free or low cost website
http://www.go daddy. Com

Economic Environment of a Business:
???The totality of economic factors, such as employment, income, inflation, interest rates, productivity, and wealth, that influence the buying behavior of consumers and institutions.???
Read more:

Describe the Management Structure of a Business

The Main purpose of a business is Profits,Revenues and not less.In Order to accomplish this they need to have in their personal Specialized People with Helpful skills. This employee is needed to be organized in order to work together under a well-structured organization. Under an Industrial Organization, it is highly recommended to have a Dynamic plan in order to succeed in the product that is demanded and appreciated by their customers.
Any employee under any Organized and Structured Organization needs to know that are their functions and where in the organization they are going to be assigned. Also the roles and responsibilities according to their skills,training.
It is Important that As Managers the authority of delegating functions,tasks under any part of their Organization or assignment. Any organizational structure, which implies the combination of activities, is impossible without delegation.
Therefore it is Imperative that a company organize,plan and control all of their activities and coordinate company as a whole is heading and can take responsible decisions accordingly.

Important Steps of a Good Operation of an Organized Company

1.A Mission Statements
2. Plan and Direction of the success of the operations respectively
3- Organize employees and production according to the company needs.
4- Lead under the Delegation of Functions and Authority.
5- Control the Resources , equipment, labor , Manpower Profits and loss.

???Business organizations are generally divided into specific departments ??“ personnel,
Purchasing, production, sales, finance, distribution ??“ are examples. None of these
Departments can function properly without the other departments.
In large companies there must be departmentalization. This means, activities must be
Coordinated by organizing them into departments. A company obviously faces the
The problem of how best to organize it departments???.

???Departments can be organized by
(1) Function ??“ for example, personnel, production, marketing;
(2) Product
(3) Territory (geographical region)
(4) Market segment or customer
(5) Time ??“ for example, by shift
(6) Numbers ??“ that is, to produce teams of a specific size
(7) Equipment ???

Describes the operational issues of a Business

Describes the financial issues of a business
Financial planning, Project Monthly,Yearly the Profit and loss of the Business.
A starting capital is always needed to start the business.
Cash flow of the Financial Operations.
Specialized tools to be able to provide a good service.
Will the business be profitable
Rental of the property to operate the business.
Adequate quantity of employees for the planned work.

Identifies the impact of potential change factors including the role of technology

Culturally Competent Ethical Decision Making

Subject: NRS520

Assessment: 3 Culturally Competent Ethical Decision Making

Due Date: 19/10/2010

Length: 2000-2500

The world is multicultural and with this comes a diversity of morals, values and beliefs. Working in regional Australia as a community mental health clinician presents many challenges one of which is working with refugees from Nepal. The following assessment will explore conflicting values and beliefs at three different levels consisting of individual, organisational, and societal levels. Some women experience post natal depression, a significant health problem after the birth of a baby. There are many factors connected to the cause including a past history of depression, past history of abuse, relationship issues and stressful life events (Beyondblue, 2010). For some cultures the stigma associated with mental health causes many problems. There has been minimal mental health and psychosocial support or mental health care in Nepal (Jordans, et al. 2010). Research has found depressive symptoms of women from Nepal after childbirth affects both the mother and child and often the symptoms are related to the woman??™s relationship with her husband (Ho-Yen, Bondevik, Ebberhard & Bjovatn, 2007).
As globilisation becomes the norm it is expected that nurses will encounter ethical dilemmas within areas of their occupations. The following ethical dilemma being discussed will identify how humans can have different beliefs and values within their varied cultures and how it can sometimes be difficult to work with these cultural beliefs. The Nepalese population have the belief that anyone who encounters a mental illness will always remain unwell and the stigma reflects badly onto the family (Krishnan & Cutler, 2005).
The inter-relationship between cultural practice and disease including identification of health and illness in their social context will be discussed whilst the goals of the discipline of nursing with the provision of meaningful humanistic and safe care to people of the many diverse cultures worldwide will be respected (Leininger, 2008). The development of health care systems around medical and nursing knowledge and practices will identify the beliefs of inequity and disadvantage in the cultural context.

The chosen framework for the analysis of the above mentioned ethical dilemma is the ???Culturally Competent Model of Ethical Decision Making??™ (Andrews & Boyle, 2008). This model was designed by (Pacquiao, 2001). There are three sections consisting of human rights, ethics and cultural competence. Every living person has the right to have input into their own care decisions while having an assessment within the paradigm of the nursing process (Andrew & Boyle, 2008). It is everyone??™s human right to receive equality care.
As a nurse there will always be cultural differences and ethical dilemmas. Ethical dilemmas are common in areas where clients are vulnerable and disenfranchised (Elders, Evans & Nizette, 2005). The dispossession and destruction of traditional lifestyles, disruption to families and communities, discrimination, cultural exclusion, poor health, lack of education and poverty are some of the barriers that inflict these dilemmas on refugees, asylum seekers and indigenous populations (Hollinsworth, 2006).
Nurses have always been identified as a professional group where ethical principles are guided by the law and expected from consumers. It is vital that nurses have an understanding of cultural differences, and respect their values and beliefs, of any decisions made by them and their family (Elders, Evans & Nizettes 2005).
Language barriers and interpreters are a common concern working in the health area. However they are a necessity that cannot be overlooked when providing quality mental health assessments to avoid clinical ethical dilemmas. It is obvious given our culturally diverse society that everyone requires multicultural training to ensure effective provision of services and equality of care is provided (Hollingsworth, 2006).
The professional practice and ethical conduct of nurses is guided by their professional bodies which is a set of nursing standards expected of all professional nurses (Australian Nursing and Midwifery Council). Anyone experiencing a mental health illness belongs to a very vulnerable group within any culture. The principle of autonomy for nurses highlights many implications especially when the nurse is to respect the patient as a chooser of care within their domain. Non-maleficence relates to the nurse ensuring no harm or potential harm comes to the patient in their care. Beneficence in clinical care is the promotion of wellbeing of the patient through affirmative action or interception. Justice relates to society??™s view of a fair and right outcome. So therefore autonomy, non-maleficence, beneficence and justice are the core principles of ethical conduct (Elders, et al., 2005).
The conflicting values and beliefs of every individual, organisation and society influence the awareness and communication between clients and carers (Andrews and Boyle, 2008). Nurses practice within a wide variety of areas one of which is the community setting. Community nursing practices require a base assessment on the first meeting to identify and evaluate the cultural differences to incorporate interventions to assist the client. The assessment needs to recognise and respect the spiritual and religious beliefs and values and appreciate the influence these may have on their health (Elders, et al., 2005). The provision of quality care requires the understanding of the lived experience. There is also the need to design and organise a comprehensive care plan that is appropriate for the individual and the family and to identify what the problem is for the individual and to develop mutually shared goals (Andrews & Boyle, 2008).
Every contact with another person is culturally different. To provide culturally competent care nurses need to value cultural diversity, have the ability to formulate a cultural self assessment, have an understanding of the predictable dynamics that interaction of cultures create and an understanding of the diversities of cultures (Mays, Siantz, & Viehweg, 2002). While working with Mary there have been many hurdles to overcome. Apart from her lack of English, her husband is always present when meetings are arranged. This is not an issue except John can speak some English and has adamantly informed the team of the belief of Nepalese people that his wife can never be freed of her mental illness as mental health is caused by bad fortune (Jha, 2007). John also disagrees with any medications prescribed by the psychiatrist and does not assist in encouraging his wife to comply with medical treatments that are prescribed (Jha, 2007).
The data in the assessment is very limited. Mary was referred into the service through her case manager at the refugee centre, after conversations with an interpreter. The current standard universal assessment framework used by New South Wales Health is not appropriate for all cultures. There is no mention of values, cultural aspects, cultural values or social structural factors such as educational, religious, political or legal factors (Omeri, 2003). There is no information regarding the birth of the baby in Nepal, the length of time in Australia, past medical and mental health history, understanding of the settlement into Australia or past trauma. Showing professional interest and seeking their views on the problem will encourage empowerment of the persons involved. Being non-judgemental will also create a relaxed atmosphere that will enable clients to divulge the use of traditional medicines without feeling intimidated (Silove, 2004).
Mary??™s diagnosis is post natal depression and minimal treatment has been provided prior to her arriving in Australia. It would be of benefit to ascertain the background information of her pregnancy and the type of delivery she experienced. A better understanding of the stigma related to her diagnosis as mental health in Nepal is seen as a disease that is never cured. The cultural values and beliefs held by Nepalese people are very different to those of the clinician working with them. Our lives have all been shaped very differently. It is paramount that we all understand biocultural differences obvious in types of illness, in health care practices and in reaction to medications. Resources available in the regional area are all generic and for the best outcomes for Mary and her husband John, a specialist transcultural mental health service would be more beneficial.
The community mental health setting where the author works is a learning organisation. This organisation is powerful in continually encouraging education, and providing the most up to date knowledge for its staff. As it consists of a multidisciplinary team it has the added strengths of integrating the many different knowledge groups to enhance everyone??™s knowledge base. This generative organisation is performance based. The leadership is one of trust, amenable to criticism and caring. Everyone is supported in learning roles (Tapp, Edwards, Braspenning, Eriksson, Elwyn, 2008).
Nurses are well placed to be educationally trained through their organisations with continuing education and through formal education. An understanding of policies within the organisation will enlighten staff of the influences amongst the diverse populations enabling advocacy for health discrepancies and promotion in the quality of life (Douglas, et al. 2009). Culturally challenging patients will receive better care if all staff gains an understanding of cultural competence. This will alleviate discomfort and enable quality care that is culturally suitable for everyone (Christma, 2007). It will also provide staff with support from one another in identifying the required treatments.
The world is slowly progressing towards equality for everyone. The code of ethics for the Australian Nursing profession recognises the responsibility of morally suitable universal rights inclusive of respect, recognition, and protection of the many varied cultural, political, economical, and social rights afforded to everyone (Australian Nurses Federation Union).The human rights of the traditional owners of Australia, Australia??™s Aboriginal and Torres Strait Islanders people, are also respected for their viability, spirituality, emotional, physical and cultural wellbeing. Every health care setting has racism, prejudice, ethnocentrism and stereotyping. To eradicate this problem, organisations need to educate their staff to be inclusive in their workplace and utilise universal care theories. These should consist of genuine concern and respect for clients and fellow staff (Andrews & Boyle,2008).
Everyone is responsible for culturally competent care. Globilisation has huge impacts on everyone. As barriers are broken, access for all cultures is becoming more accessible to health care services. The interaction and integration of all humans from all countries ensure the increased availability and accessibility of all information. Culturally competent care is everyone??™s responsibility. With the high movement of globilsation everyone needs to have a better understanding of cultural differences (Papadapolous & Omeri, 2008).
Transcultural theories and models of care require education, research and practice. These crucial elements form the basis of providing appropriate care needs to all diverse cultures whilst assisting in the removal of health inequalities provided to vulnerable and marginalised populations (Papadapolous & Omeri, 2008). Flexibility and adaptability is required. As Nurses are bound by a professional code of ethics it is important that nurses provide culturally competent, culturally responsive, compassionate care to everyone (Australian Nursing Federation).
Ethical dilemmas will always be experienced by individuals worldwide. It is, however, important and obvious given our culturally diverse society, that everyone requires multicultural training to ensure effective provision of services and equality of care (Hollingsworth, 2006). Conflicting values and beliefs have been discussed when working with people from other cultures and the power members of family units possess.
Education for cultural competency requires the promotion of social, cultural, linguistic, religious and spiritual backgrounds. A supportive management to engage other staff members in understanding the requirements of culturally appropriate care for consumers is essential. An understanding of the many diverse groups being serviced by a health sector will enable a better understanding of the implications derived from the lack of cultural competence (Australian Government, 2005). Self reflection of our own practices is necessary to identify discrepancies in our practices.

Andrews, M. M.,& Boyle, J. S., (2008). Transcultural concepts in nursing care (5th ed.).
Philadelphia: Wolters Kluwer Health / Lippincot Williams and Wilkins. (2010). What is post natal depression retrieved October 10th, 2010,
Chrisman, N. (2007). Extending cultural competence through systems change: Academic,
hospital and community partnerships. Journal of Transcultural Nursing, 18, 68S
Douglas, M., Pierce, J., Rosenkoetter, M., Callister, L., Hattar-Pollara, M., Lauderdale, J.,
Miller,J. Milstead, J., Nardi, D., Pacquiao, D. (2009). Standards of practice for culturally competent care: A request for comments. Journal of Transcultural Nursing, 20, 257-269.
Elders, R., Evans, K., & Nizette, D. (2005). Psychiatric and mental health nursing.
Sydney, Mosby Elsevier.
Hollinsworth, D. (2006). Race and racism in Australia (3rd ed.). Australia, Thomson Social
Ho-Yen, S., Bondevik, G., Eberhard, M., & Bjorvatn, B. (2007). Factors associated with
depressive symptoms among postnatal women in Nepal. Acta Obstetricia et Gynecologica, 86, 291-297.
Jha, A., (2007). Nepalese psychiatrists??™ struggle for evolution. Psychiatric Bulletin,
31, 348-350
Jordans, M., Upadhaya, N., Tol, W., Shrestha, P., Doucet, J., Gurung, R., Aguettant, J.,
et al. (2010). Introducing the IASC mental health and psychosocial support guidelines in emergencies in Nepal, Intervention, 8(1), 52-63.
Krishnan, M., & Cutler, D. (2005). A Resident??™s experience in cross cultural/community
psychiatry, Community Mental Health Journal, 41(5), 599-611.
National Health and Medical Research Council (2005). Cultural competency in health: A
guide for policy partnership and participation. Australian Government.
Omeri, A. (2003). Meeting diversity challenges: Pathway of ???Advanced??™ Transcultural
Nursing practice in Australia. Contemporary Nurse, 15, 175-187.
Pacquiao, D. (2001). Addressing cultural incongruities of advance directives. Bioethics
Forum, 17(1), 27-31.
Silove, D. (2004). How to treat mental health problems in migrants and refugees. Australian
Doctor, 16, 33-38.
Tapp, L., Edwards, A. Braspenning, J., Eriksson, T., Elwyn, G. (2008). Developing
Organisational maturity: considering the role of culture typologies for primary care
Practices. Education for Primary Care, 19, 1-12

Identification of Legal Risks and Contraction Negotiation

| |Span Systems |


To: Kevin Grant

From: Deardra Woods

CC: Harold Smith

Date: 3/8/2010

Re: Identification of legal risks and contraction negotiation

In todays litigious business environment, it is imperative that upper management and boards of directors make ethical decisions geared toward mitigating legal risk. People handle contracts everyday whenever there is an exchange of promises. ?  In the business world it has a bit more depth to it than the simple idea of slipping a few coins in a vending machine. Business leaders should have enough understanding of the law to make decisions that are legal or they should hire competent counsel. The opportunity to serve as the project manager over one of our biggest deals has been a privilege. And because of the dedication that has gone into this project, there must be an understanding of how we can prevent the possibility of breeching contracts with Citizen-Schwarz AG or in business opportunities later granted to Span Systems. ???The contract details what the parties are required to do for complete performance??? (Jennings, 2006).

In the future, if Citizen-Schwarz AG continues to change their original contract requirements there needs to be sign offs from both Span Systems and Citizen-Schwarz AG directors. Prior to Span Systems director signing off Citizen-Schwarz AGs request, a panel of senior programmers here at Span Systems needs to approve the request, so programming changes can be adequately evaluated. Span System programmers should be assured that timetables and schedules can still be met within the agreed upon contract. If Citizen-Schwarz AGs request requires more time to meet the deliverables of the project then Span Systems and Citizen-Schwarz AG need to exercise the Requirement Change clause within the contract. This clause is meant to formalize a change and suppose to notify and bring in upper management from both sides to handle a change request by following the Information Technology Project Methodology Standard this wasn??™t done in the past. This clause is not written to handle out of the ordinary requests. This clause needs to be able to handle difficult requests and effectively document a procedure that can hold both sides accountable for changes made to the original contract. This clause also needs to be streamlined, so that both parties can act quickly upon agreed changes to the contract. It would be best to amend a clause to the current contract that is specially written to handle requirement changes throughout the project. This clause should document the process to effectively make difficult change request. This process should also require sign offs from project directors from both companies. In addition, each change request needs to be a legal contract that carefully documents how the scope of the project changes with each request. Each request absolutely needs to document how the timetables and schedules will be affected through the continuation of the project.
In retrospect, Span Systems and Citizen-Schwarz AG negotiations over the low quality of deliverables along with being behind schedule was purely an interest-based negotiation. This negotiation was interest-based or win-win, because in the end both Span Systems and Citizen-Schwarz AG compromised by continuing to work together and moving forward towards our goals. Span Systems will continue to finish our one-year $6 million contract with Citizen-Schwarz AG with high quality, so our organization can get the bigger e-CRM project that is scheduled for later down the road. At the same time, Citizen-Schwarz AG want to get a high quality, on time big- ticket Java-based transaction processing software. If both Span Systems and Citizen-Schwarz had taken a positional bargaining strategy instead of an interest-based strategy these negotiations would have produced a much different result. It would be likely that Span Systems and Citizen-Schwarz would be contesting this dispute either in court or through arbitration. If Citizen-Schwarz had gone with a positional bargaining strategy, they would have held their position on wanting Span Systems to transfer all unfinished code and wanted to severe the contract between the two companies. This strategy would have forced our company to legally come after Citizen-Schwarz AG, because of breach of contract. Citizen-Schwarz would clearly be in breach of the Intellectual Property Rights clause of the contract. Although not a favorable move, Span Systems would most likely have used this clause as a part of their negotiations in order to make Citizen-Schwarz AG change their position or pay up in full. This clause could backfire on us, but Citizen-Schwarz AG is forcing Span Systems to make bold moves since they are taking a bold stance. Clauses like Internal Escalation Procedure for Disputes would not have much validity during negotiations since Citizen-Schwarz AG is using a positional bargaining strategy, and they are not leaving much room to rectify the underlying problem. The Requirements Change clause would defiantly come into play if this dispute ever came to litigation since there were defiantly changes made during the project. This would be a tough clause to litigate, because it will come down to the quality of the deliverables. The most important clause that will make or break Spans Systems relationship with Citizen-Schwarz AG will be the Intellectual Property Rights clause. This clause will either make Citizen-Schwarz AG reconsider rekindling their working relationship with Span Systems or pay up and go there separate ways.
It is possible that Spans Systems and Citizen-Schwarz AG could have come to a compromise, even though; they took a positional bargaining strategy stance. In this situation, Spans Systems and Citizen-Schwarz agreed upon a win-win solution easier, because both companies wanted to achieve their interests as quickly as possible. Positional bargaining strategy in this situation would have delayed and undermined both companies goals. A positional bargaining strategy also carries a bigger legal threat since delays cost companies money, which forces companies to take legal action in order to try to recuperate such losses.
In the future, Span Systems should have more on going communication with customers through out projects, so expectations are constantly maintained. It would be beneficial for Span Systems to invite project managers from our customers to participate in a quality control capacity. Allowing a project manager from the customer to be a witness to Span Systems operations could serve as an asset if a dispute ever arises regarding the quality of deliverables. Having a project manager on board from the customer should also put more confidence in the customer, because there will be less barriers between Span Systems and the customer.
Overall, Span Systems did the right things to resolve the issues with Citizen-Schwarz AG. During this incident, interested-based negotiations proved to be a better angle for both parties. This incident taught my team to be more proactive in communicating with the customer. This incident also taught Span Systems to hold their customer to the provisions of their contract. Through out this incident, it was made clear that Span Systems needs to be selective and careful when deciding what clauses to bring up in dispute negotiations.

University of Phoenix. (2008) Contract Creation and Management Simulation. Retrieved
March 7, 2010 from University of Phoenix.

Jennings, M.M. (2006). Business: its legal, ethical, and global environment, 7e. Thomason Learning, Inc.

Cultural Views

Cultural Views on Health
Darlene Smith
July 31, 2011
Gayla Meyers

Cultural Views on Health

People from different cultures have their own perspectives on health and disease. Some cultures believe in using traditional medicine, and some just believe in the healing power of praying and herbal healing. People are often affected by their own cultural beliefs when it comes to overcoming diseases and how they can find the right cure. Sometimes, religion and culture can get in the way of receiving proper medical help. ???The belief that illness grows from emotional, moral, and social causes coexists with the formal medical system. Folk healers, generally women, are sometimes called upon to use spells, divination, and herbal remedies to fight against both sickness and such forces as the evil eye??? (Sutton, 2007, Greeks, para 4).
People believe that advanced technology is able to diagnose and cure when herbal remedies fail to work. ???The practice of Western medicine is as firmly established in Puerto Rico as it is throughout much of the United States even though the Latin American and Caribbean traditions continue to provide solutions where Western medicine is weak, especially in the realm of prevention. ???Curanderos??? and ???brujas???, also known as native curers and witches in Spanish, are still prevalent throughout that island and they are known to often mix religious ritual and Western medicines with herbal remedies in their cures??? (Griffith, 2007, Religion and Expressive Culture, para.5). Every culture has a concept of health that is probably different to that of others. People??™s lives and morals are a combination of the different areas is what makes them who they are, and this does not change because of the area where they are from.
The health benefits of organic food are more perceived than real. However, the public opinion that organic food is healthier than conventional food is quite strong and is the sole reason for about 30% growth in the organic food industry since the past 5-6 years. There is little scientific evidence to prove that organic food is better in quality than conventional food. Scientific research conducted so far on various organic food items have not been able to give strong signals about the superiority of organic food over non organic food. As a result, even the FDA and the USDA clearly mention that non organic food is as healthy as organic food. Since organic food is not prepared using chemical fertilizers and pesticides, it does not contain, any traces of these strong chemicals and might not affect the human body. People strongly believe that organic food tastes better than non organic food. Medical decisions are now mostly based on scientific researches. Organic perspective is also based on scientific research and notes that the absence of germs means a health body.
In the cosmology of traditional Oriental Medicine, in between Heaven and Earth is the person. To enjoy perfect health, we need to live in harmony with God or Nature, according to our understanding of our universe. A person??™s health is influenced by his or her relationship with society, family, partner, and self. Someone who struggles bitterly with family members is unlikely to be completely health. Within a person??™s own self, vibrant health results from a dynamic balance of opposing forces. Illness is a state of imbalance or disharmony. Traditional Chinese Medicine has various treatments for illnesses, for example, if you have a stubborn, dry cough, there are acupuncture points for moistening. There are points to help restore the appetite and points to calm it down when you??™re ravenously hungry all the time. Your acupuncturist is skilled in selecting the right combination of points for you during each treatment. Modern practitioners of Chinese herbal medicine have studied for years to learn how to prescribe the best combinations for your specific health problem. Modern herbal pharmaceutical companies are working to adapt their products for western consumers. Generations of patients have been successfully treated with herbs alone or combined with acupuncture.
Stigma (plural, stigmata) is a Greed word in its origins referred to a kind of tattoo mark that was cut or burned into the skin of criminals, slaves, or traitors in order to visibly identify them as blemished or morally polluted. The word was later applied to other personal attributes that are considered shameful or discrediting. In some cases not only the Greed but the rest of the world will learn to accept diseases and physical deformities as neither a curse nor a stigma.
Perlick, D. A., R.A Rosenheck, J. F. Clarkin, ???Stigma as a Barrier to Recovery, 2001

Identification of Forms of Abuse

Awareness of what is child abuse is essential to protect children.
There are four main forms of abuse:[1]
? Physical abuse (involves: hitting, throwing, shaking, squeezing, burning /sometimes by cigarettes/, poisonous and harmful substances /including alcohol/, suffocating and any other physical harm)
? Emotional abuse (all forms of abuse involve emotional harm but some children may be emotional abuse whilst receiving good physical care. It may include failing to show love and attention for a child such as continuous criticism, ridiculing, and severe, persistent rejection.)
? Sexual abuse (it is where an adult uses child to satisfy their own sexual needs and involves forcing or enticing a child to take part in sexual activities, whether or not the child is aware of what is happening. Physical activities may include penetrative acts, including fondling, masturbation, or sexual intercourse)
? Neglect (persistent failure to meet the basic physical, emotional or psychological needs of the child, including: failing to provide food, warmth, clothing and appropriate stimulation.)

The others met often are:
? Harassment and bullying (e.g. name calling, sarcasm, racist or sexual taunts, physical gestures, interference with personal belongings and physical assaults)

Abused children present various signs and symptoms. It is divided into behavioural and physical indicators of abuse:

o Physical indicators of physical neglect: [2]
? Child may be underweight;
? Clothing may be inappropriate for the weather, and be smelly and dirty;
? Child may have poor skin tone and dull matted hair; a baby may have a persistent rash from infrequent nappy changing;
? Child may be constantly hungry, tired and listless;
? Child has frequent health problems, and is prone to accidents.

o Behavioural indicators of physical abuse and neglect. Changes in behaviour may include:[3]
? Being sad, listless, preoccupied or withdrawn;
? Being extra vigilant about what is going on around them (sometimes referred to as an expression of ???frozen watchfulness???);
? Showing signs of poor self-esteem;
? Being aggressive towards other children;
? Showing signs of false independence or offering indiscriminate attention to any adult who shows interest;
? Bedwetting, bizarre behaviour or eating problems;
? A delay in physical and emotional development;
? Lacking concentration.

o Physical indicators of emotional abuse and neglect:[4]
? Physical signs are mainly in terms of body language: there may be withdrawn movements, or signs of frustration; anger and sadness in the form of temper tantrums. Emotional abuse or neglect is, therefore, not easy to detect.

o Behavioural indicators of emotional abuse and neglect:[5]
? Some children become withdrawn and will not play or take an active part in things. Life does not seem to be fun to them. Their self-esteem might be low, showing itself in a lack of confidence and reluctance to ???have a go??? at doing things.
? Other children react by constantly seeking attention. Tantrums might continue to a later age then usual, and speech disorders might emerge, the child might tell lies, and even steal.

o Physical indicators of sexual abuse:[6]
? Children may have bruises or scratches, as in an accidental injury;
? There may be itching, or even pain, in the genital area. This might make walking or sitting uncomfortable for the child. Often infections of genital area and urine system might occur;
? It might lead to bed-wetting and poor sleeping and eating patterns;
? Underclothes might be bloody or torn, and there may be discharges from the penis or vagina.

o Behavioural indicators of sexual abuse:[7]
? Child might become rather withdrawn from other children or from adults;
? Child may seem to be lacking in self-confidence, and wanting to be ???babied???;
? Sexual abuse leads to poor self-esteem and feelings of being dirty or bad on the part of the child;
? Child may not eat or sleep well;
? Child might show an unusual knowledge of sexual behaviour, demonstrated by the things that they say, play with (often in the home area) or draw;
? Child might seem fascinated by sexual behaviour and may flirt with adults, as if trying to please.

[1] ???Take Ten for Play??? group work Furzeham Publishing and Playwork Partnerships, p. 4-5, module 8
[2] Followed by: ???Child Care and Education??? by T. Bruce and C. Meggitt, 2002, p. 513
[3] Followed by: ???Child Care and Education??? by T. Bruce and C. Meggitt, 2002, p. 513
[4] Followed by: ???Child Care and Education??? by T. Bruce and C. Meggitt, 2002, p. 514
[5] as above
[6] Followed by: ???Child Care and Education??? by T. Bruce and C. Meggitt, 2002, p. 515
[7] Followed by: ???Child Care and Education??? by T. Bruce and C. Meggitt, 2002, p. 515

Cultural Views

We as American??™s take out Healthcare system for granted. When an individual gets sick we automatically think we can go the hospital or doctors office. America itself has much different kind of cultures and races, and each one believes in something differently. The question is does the healthcare provider have an idea what is accepted or not through the different cultures
It is good to not make a generalization of the different cultures towards the patients. The Buddhists have been known to believe in the good health which comes from the equilibrium. Some of the people call this either chi or yi and yang each one of them goes towards the balance of the body. There should be no toxins that goes into the body such as; tobacco, alcohol or drugs of any kind. It has been known that mean can also be a form of toxin that goes into the body. This process can put the balance off which then can lead to illnesses. Vegetarians can have a lack of B12 in their body so there should be more vegetable. With these cultures there??™s really no nutrition plan that can put into place to make them healthier.
Part of being culturally competent health care professional is being careful not to make any kind of judgment on the patients, (ElGindy, 2005). The Buddhists have been known to use the natural healings such as; herbal teas and whatever kind of medications. The Buddhists also try to concentrate on not suffering as much and keeping a focus on both the mind and body when their going through an illness or some kind of injury. The Australia and the Aborigines towards the indigenous people there illness came from the supernatural form. It was stated by Shahid, Finn, Bessarab and Thompson (2009), that ???effects of the Aborigines have been diagnosed with cancer or another life threatning illness. When this happens the individual was cursed by some sort of black magic which leads to doing something wrong. The Aborigines have also been known to either hide from their symptoms or not deal with any kind of treatment. When the subject about illnesses is talked about this can put a scare or fear of the idea of getting the illness. If they believe that the illness can come from supernatural itself then the healing can take affect and dying from the disease could happen. There has been the belief that doctors can cure cancer and there??™s some kind of miracle, but when individuals were dying from cancer, Aborigines began to think negatively towards western medicine. When this happened the whole aspect turned into a negative experience in receiving care. The Indigenous people believed in the use of bush medicines and their way of thinking became holistic. The healing process for the Indigenous people is both emotional and physical. To have efficient communication towards the Indigenous people the health care workers need to have the acknowledgment of the treatment and the healing. The organic way of life is how the Buddhist lives so they can have the balance in the body, which lead to their beliefs. If an individual can live and eat correctly then the balance of their life is correct. The Indigenous people believe in the organic way of life, but disease to them can become a curse and can make and feel stigmatized.
In conclusion, the patient can become influenced by how they are taken care of and different cultures do not follow the medical ways. The health care worker needs to be open-minded in how the western ways are by listening and communicating and keeping in mind of the fears or the beliefs of the patient. When the health care worker keeps in mind of all the different cultures and how they live their lives in medicine we can all better understand each other.

ElGindy, G (2005). Understand Buddhist Patient??™s Dietary. Retrieved, May 30, 2010
Shahid, S., Finn, L., Bessarab, D., and Thompson, S. (2009).
Understanding, beliefs and perspectives of Aboriginal people in Western Australia about cancer
and its impact on access to cancer services. BMC Health Services Research 2009,
Retrieved, May 30, 2010

Cultural Trends in the Victorian Era

Cultural Trends

The Victorian age was a time greatly influenced by cultural trends influenced the growing industrialization of the era. Trends and movements such as The Great Exhibition of 1851, The Pre-Raphaelite Brotherhood, The Arts and Crafts Movement and the Medieval/Gothic Revival, transformed England into a culture with a passion for visual advancement.
In 1849, Paris held one of several national exhibitions, showcasing products of craft and industry. Successfully hoping to advance interest in the industries, the idea of such an exhibition was emulated by the Great Exhibition of 1851 in London, England. The idea of holding such an event in London was presented to Prince Albert by an engineer named John Scott Russell. Although those of England did not favor the engineer, the plan for the exhibition won the favor of the Prince, with influence by the Queen since she ???wanted Albert to be a success??? (Dugan). The Great Exhibition was commonly referred to as The Crystal Palace Exhibition, due to the cast-iron and glass building in which the fair was held.

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The Great Exhibition boosted Victorian culture, creating a vast appeal to a visual culture specifically. London exploded with an array of ???public amusements, popular shows, traveling exhibitions, circuses, sporting events, holiday resorts, and public gardens??? (Broadview LIV). This advancement in a culture that celebrated leisure time was even expanded to the working and lower classes, allowing them to entertain music and dance performances. During this time, London landmarks commonly recognized today were established, such as museums and department stores. Print technology also advanced, releasing ???the world??™s first illustrated weekly paper to hit newsstands, The Illustrated London News??? (Broadview LV).
Since the Victorian??™s became so fascinated with visual culture, naturally, painters of the era profited. A style known as ???Social Realism??? became quite popular, with portrayals of contemporary industrial culture, as well as domestic life. The Pre-Raphaelite Brotherhood has been considered the most influential movement of painters of the Victorian Era. The Brotherhood was founded in 1849 by Ruskin influenced avante garde painters such as, William Holman Hunt, D.G. Rossetti, John Everett Millais, William Michael Rossetti, James Collinson, Thomas Woolner and F.G. Stephens in attempt to ???revitalize the arts??? (Landow). This movement challenged the domineering taste and conventional views in art by: ???painting bright colored, evenly lit pictures that appeared almost flat???, ???emphasizing precise, almost photographic representation of humble objects???, and ???attempting to transform hard edge realism by combining it with typological symbolism??? (Landow). The PRB had two stages, the second influencing the Arts and Crafts Movement, part of the Gothic Revival.
John Ruskin, an art critic and social thinker who ???criticized the industrialism of the Victorian age???, not only greatly influenced painters like the Pre-Raphaelite Brotherhood, but also Victorian architecture and design (Kim). The Arts and Crafts Movement, lead by ideas of Ruskin and others, emphasized that the ???Industrial Revolution both greatly damaged popular taste and did much to destroy traditional crafts skills???, making the role of the crafts underappreciated (Landow). This movement held the idea of importance of handcrafted goods, ???rejecting the mass-produced manufactures of the assembly line in favor of the freedom and spontaneity of craft and its makers??? (Broadview LVII). This movement goes alongside with the Victorian Medieval Revival, or the Gothic Revival. This was a time were the Victorian??™s began to revaluate everything from art, architecture and religious practice with a passion for the aesthetics of Medieval and Gothic times. ???The birth of the medieval revival can be characterized as a reaction against modern developments during the Victorian era??? (Kim). The revival encouraged artists to express their individuality and ???spiritual nature??? (Broadview LVII).
The Victorian Era experienced a time of industrialization, creating cultural trends and movements that greatly influenced the views and passions of the people. The Great Exhibition of 1851 introduced a fascination with the visual world and time of leisure. Movements in the arts and architecture transformed the Victorian age into a time of cultural revival.

Works Cited Page
1. Broadview Press. ???Cultural Trends???. The Broadview Anthology of British Literature: The Victorian Era. Ontario. 2009 LIII-LVII.

2. Dugan, John. ???The Engineers and the Crystal Palace???. The Victorian Web: literature, history & culture in the age of Victoria. 31 December 2005. 17 March.

3. Kim, Angela Y. ???The Medieval Revival: An Influential Movement that First Met Opposition???. The Victorian Web: literature, history & culture in the age of Victoria. 22 November 2004. 17 March.

4. Landow, George P. ???The Arts and Crafts Movement: A Brief Introduction???. The Victorian Web: literature, history & culture in the age of Victoria. 22 November 2006. 17 March.

5. Landow, George P. ???Pre-Raphaelites: An Introduction???. The Victorian Web: literature, history & culture in the age of Victoria. 7 June 2007. 17 March.