Critical appraisal is conducted for 3 main reasons; a) to improve nursing practice, b) to increase nursing knowledge and understanding c) to provide a baseline for the study to be conducted. There is need for thorough understanding of the research study so as to establish the study strengths and weaknesses, and to evaluate the quality if strength of the evidence developed by the study as well as the appropriateness of its use in the reader’s practice.
In this context, this essay is a critical appraisal of the following article; Ma, C., & Park, S. H. (2015). Hospital Magnet status, unit work environment, and pressure ulcers. Journal of Nursing Scholarship, 47(6), 565-573.
Critical analysis
The article introduces the topic in a way that orientates the reader to the subject. It provides the background information using succinct statements. The last sentence of the introduction part is the thesis statement (Creswell, 2014; Jaul, 2013). Pressure ulcers are critical patient issue because they are associated with prolonged hospital stays, increases patient risks for adverse events and increased consumption of the healthcare costs (Cai, Rahman, & Intrator, 2013; Buttaro et al., 2013, p. 304).
Nurses play crucial role in preventing pressure ulcers. However, the degree of patient safety is determined by the nurse work place environment, “The organizational factors in work-environments facilitate or constrain the professional nursing practice” (Ma & Parks, 2015, p. 566). The article evaluates the nursing factors at both the hospital and unit level associated with Hospital acquired pressure ulcers (HAPU).
The research problem and its significance
The research problem in this study is the organization’s factors or nurse work environment that negatively influence patient’s outcome, such as increasing HAPU incidence. “The unit-level work environments have major impact on the nurse work environment” (Ma & Sharks, 2015, p.65). The research problem is a focal point of research. It is well stated in this article and generates questions in which the research study aims to address (Stafford & Brower, 2012, p. 11; Suttipong & Sindhu, 2011, p. 373).
On the other hand, the significance of a study is the rationale of the study. The researcher proves to the audience that the research is vital and worth doing it. For instance, the study indicates that the need to reduce hospital acquired pressure ulcers has gained national attention. “There are approximately 2.5 million pressure ulcers that occur in the USA, and coasts $9.1-11.6 billion (Ma &Sharks, 2015, p. 65).”
The research design and methods
Melnyk & Fineout-Overholt state that research design is the overall strategy chosen by the researcher to integrate different components of the study. It should be constructed in a logical manner to ensure that the researcher effectively address the research problem using the appropriate data collection method and analysis of data. In this context, design includes the study setting, description of the study sample, data collection method and data analysis. This part describes all the instruments used and their rationale; (Melnyk & Fineout-Overholt, 2014; Lewis, 2014).
The research method is used in this article is qualitative. The research design used in this article is the Cross-sectional observational study of data collected from the National Database of Nursing Quality Indicators (NDNQI). This research design is appropriate for this study because it examines the relationship of exposure and outcome in a defined population at one point in time.
In addition, the research design is inexpensive, less time consuming and provides a good but quick picture of prevalence of the research problem and its outcome. Although appropriate for this study, the main issue with this research design lacks time element making it difficult to determine the temporal relationship between the research problem and the outcome of the proposed intervention (Ma & Sharks, 2015, p.567).
Data used in this article was collected from NDNQI. NDNQI is a repository for nursing quality data in the USA that enables the researchers to conduct comparative analysis in order to develop evidence based practices for nursing-sensitive patient practices and outcomes at unit level.
The data collected was supplemented with the NDNQI RN survey, which collected information related to nurse work conditions such as work content, environments and demographics. The total participants for RN survey was 33, 845 from 1,381 units in 373 healthcare facilities in 44 States. The inclusion criteria for this survey were nurses who had spent 50% of their time in general units in the hospital within the last three months.
The researcher also established measures to ensure reliability of the data collected, “To ensure reliability of the aggregated unit measures…… units with RN response rate below 50% were excluded from data analysis (Ma & Sharks, 2015, p.566).”
Data analysis of the collected data was compare the nurse work environments, staffing levels, HAPU rates and the RN skill mix of the NDQI member hospitals. Three multilevel logistic regression models were used to estimate the effect of nurse work environment and healthcare facilities management of HAPU. The data analysis used is appropriate for this nature of the study as it provides conclusive comparative analysis (Ma & Sharks, 2015, p.568).
Findings and their relevance to contemporary nursing policy and practice
The study examined work environments impact on management of HAPU at hospital and unit level. The study findings indicate that improving working environments both at hospital level and unit level results to lower HAPU rates. The data findings presentation in this article is concise and appropriately used non-textual elements such as table summaries and figures to present data findings effectively. The data provided is critical in answering the research question. For instance, Magnet hospital units had 21% low odds of having HAPU as compared to the non-magnet hospital.
There are several limitations noted in this study. To start with, participation of hospitals in NDNQI is voluntary, which indicates overrepresentation or underrepresentation of hospitals with certain characteristics. Secondly, the study omitted some specific information such as ethnicity, socioeconomic status and other co-morbidities that could introduce residual confounding effects. In addition, patient level information in most of quality indicators is limited.
Despite the limitations, the study findings are consistent with the previous studies. The nursing implication of this study is that it improves the understanding of work environments in relation to patient’s outcomes. In this context, the nurse work environment refers to the context in which the nurses provide patient centered care (Guihan et al., 2016, Matsuo, Oie, & Furukawa, 2013).
The quality of care is influenced by the nurse work environment characteristics such as the administrative support, nurse-physician relations and nurse resource adequacy. Effective nurse work environments are established through better communication, team work between the healthcare providers and higher autonomy/practice control.
Nurses in such types of environments are less likely to suffer from burnout or express intent to quit their jobs, but are likely to function efficiently, deliver superior quality of care that ultimately improves patient’s overall outcome (Demarre et al., 2014, p. 392; Singh et al., 2015, p.7; Neilson et al., 2014, p. 21).
Conclusion
The study findings in this study facilitate the understanding the link between organizational environments and the patient outcomes. This study highlights the effectiveness of unit-specific quality improvement initiatives in today’s highly specialized care. This study generates new ideas that will help improve patient safety and quality of care in nursing practice.
References
Buttaro, T. M., Trybulski, J., Polgar Bailey, P., & Sandberg-Cook, J. (2013). Primary care: A collaborative practice (4th ed.). St. Louis, MO: Mosby.
Creswell, J. W. (2014). A concise introduction to mixed methods research. Sage Publications.
Demarre, L., Verhaeghe, S., Van Hecke, A., Clays, E., Grypdonck, M., & Beeckman, D. (2014). Factors predicting the development of pressure ulcers in an at-risk population who receive standardized preventive care: secondary analyses of a multicentre randomised controlled trial. J Adv Nurs, 71(2), 391-403. http://dx.doi.org/10.1111/jan.12497
Guihan, M., Murphy, D., Rogers, T., Parachuri, R., SAE Richardson, M., Lee, K., & Bates-Jensen, B. (2016). Documentation of preventive care for pressure ulcers initiated during annual evaluations in SCI. The Journal Of Spinal Cord Medicine, 160204031040002. http://dx.doi.org/10.1080/10790268.2015.1114225
Jaul, E. (2013). Cohort study of atypical pressure ulcers development. International Wound Journal, 11(6), 696-700. http://dx.doi.org/10.1111/iwj.12033
Jaul, E. (2014). Multidisciplinary and comprehensive approaches to optimal management of chronic pressure ulcers in the elderly. Chronic Wound Care Management And Research, 3. http://dx.doi.org/10.2147/cwcmr.s44809
Matsuo, M., Oie, S., & Furukawa, H. (2013). Contamination of blood pressure cuffs by methicillin-resistant Staphylococcus aureus and preventive measures. Irish Journal Of Medical Science, 182(4), 707-709. http://dx.doi.org/10.1007/s11845-013-0961-7
Ma, C., & Park, S. H. (2015). Hospital Magnet status, unit work environment, and pressure ulcers. Journal of Nursing Scholarship, 47(6), 565-573.
Melnyk, B., & Fineout-Overholt, E. (2014).Evidence-based practice in nursing & healthcare: A guide to best practice, 3rd Edition. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins
Neilson, J., Avital, L., Willock, J., & Broad, N. (2014). Using a national guideline to prevent and manage pressure ulcers. Nursing Management – UK, 21(2), 18-21
Singh, R., Dhayal, R., Sehgal, P., & Rohilla, R. (2015). To Evaluate Antimicrobial Properties of Platelet Rich Plasma and Source of Colonization in Pressure Ulcers in Spinal Injury Patients. Ulcers, 2015, 1-7. http://dx.doi.org/10.1155/2015/749585
Suttipong, C., & Sindhu, S. (2011). Predicting factors of pressure ulcers in older Thai stroke patients living in urban communities. Journal Of Clinical Nursing, 21(3-4), 372-379. http://dx.doi.org/10.1111/j.1365-2702.2011.03889.x
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My clinical role largely involves billing, coding, and documentation of patients’ data to facilitate easy communication between insurance companies and the healthcare organization that I currently work for. My healthcare facility often sends the coding and billing information to insurance companies to claim payments. As a coding, documentation and billing specialist, I am charged with the responsibility of keeping clear health data and reviewing those records before assigning proper codes to specific diagnoses (Benoit, Bergeron and Bertrand, 2016; & Deloitte, 2016).
Coding, billing, and documentation of patients’ health data are governed by strict ethical, legal, and regulatory standards because they involve usage of confidential information. In this regard, clinicians have strict ethical and legal responsibilities to observe as far as documentation strategies, coding, and billing are concerned (Benoit, Bergeron and Bertrand, 2016).
Personally, I feel that it is in order for documentation strategies, coding, and billing to be governed by strict ethical, legal, and regulatory standards. Since clinicians have access to private patient’s records, they must maintain total confidentiality in their documentation strategies, coding, and billing (Deloitte, 2016). In addition, these clinicians have an ethical responsibility to access only that information that is related to the issue being addressed at any given time.
Their actions must comply with the ethical standards documented in the American Association of Professional Coders and the American Health Information Management Association (Benoit, Bergeron and Bertrand, 2016). As far as their legal and regulatory responsibilities are concerned, documentation, coding and billing specialists must maintain confidentiality requirements as outlined in the Health Insurance Portability and Accountability Act, (HIPAA). The ethical, legal, and regulatory standards that govern documentation strategies, coding, and billing, play a significant role in minimizing healthcare fraud and abuse (Deloitte, 2016).
Evidence-based research has become an important aspect of the healthcare industry in the recent past due to the role that it plays in improving healthcare delivery. According to JoAnn (2017), evidence-based research is necessary because it helps clinicians to generate the right type of data that they can use to improve the effectiveness of care. Clinicians often rely on different kinds of knowledge for them to make the right decisions in their relationships with sick patients.
Furthermore, they are expected to have a comprehensive understanding of the physiological, psychological, emotional, and social factors affecting their patients’ health for them to deliver the most appropriate care. Although clinicians can quickly obtain this information from existing literature, they must complement it by evidence from empirical research. Evidence-based research, therefore, provides clinicians with practical facts that they can integrate with their experiential knowledge to improve patient care (Kristensen, Nymann and Konradsen, 2015).
I incorporate evidence-based research to a large extent into my role as a clinician. I firmly believe that the safety of my patients depends on the availability of evidence that can adequately support the nature of care that I deliver to them (JoAnn, 2017). For this reason, I rely on data obtained from evidence-based research to improve healthcare services which serve to promote better outcomes for my patients.
I do not only rely on evidence-based research to change my care practices, but I also develop available evidence to fulfill existing knowledge gaps as far as improvement of patient safety is concerned. Over the coming years, I aspire to utilize evidence-based research to improve my skills as a clinician (Kristensen, Nymann and Konradsen, 2015).
Falls are common among seniors, especially those who are suffering from chronic health problems such as diabetes (Graveande and Richardson, 2016). According to Graveande and Richardson (2016), a geriatric fall is a sudden occurrence among the elderly that signifies a decline in their homeostatic reserve. Geriatric falls pose a great risk of loss of independence to the elderly in the society today.
This calls for the greatest need to identity and implements the most appropriate health maintenance strategies that would improve care for this population and their families. Mazur, Wilczynski, and Szewieczek (2016) critically explore the importance of health maintenance specific to geriatric falls as it pertains to the care of the patient and their family.
According to Mazur, Wilczynski, and Szewieczek (2016), exercise is the most appropriate health promotion strategy for geriatric falls because it helps to improve balance and minimize the risks of repeated falls. Exercise is a recommended health promotion strategy for geriatric falls because it serves to generate a greater amount of homeostatic reserve for the elderly patient. In addition to exercise, elderly patients who are at high risks of falling should eat a balanced diet as this provides them with energy that they may need to regain physical activity.
As Mazur, Wilczynski and Szewieczek (2016) explain, social support can help to reduce risk factors for future falls among the seniors because it drives away the fear that typically develops from past falls. Family members of elderly patients who are recovering from the effects of falls should pay attention to physical activity, nutritional strategies, and social support in their effort to promote positive health outcomes for their patients (Mazur, Wilczynski and Szewieczek, 2016).
I agree with the solutions provided by Mazur, Wilczynski and Szewieczek (2016) because they are supported by evidence-based research. In a well-organized research, Burton, Cavalheri and Hill (2015) have revealed that physical exercise programs help to improve balance in older adults who are at risk for falls. These researchers further assert that planned nutritional strategies contribute to induce positive health changes such as improved performance and reduced risk for falls in geriatric patients.
In a similar study, Durbin, Kharrazi and Mielenz (2016) support the use of social support, physical exercise, and dietary supplements in promoting health maintenance to geriatric patients. Since health maintenance solutions for geriatric falls are supported by evidence-based research, clinicians can utilize these ideas to make appropriate healthcare decisions for their elderly patients (Kristensen, Nymann and Konradsen, 2015).
The number of elderly adults who are being diagnosed with diabetes in the society today is on the rise. The major challenge faced by clinicians is defining the therapy goals for geriatric patients due to the existence of limited data about the aging process and drug response of this population (Kazerle, Shalev, and Barski, 2014).
Considering the complexities that surround the health status of geriatric patients, clinicians are charged with the responsibility of choosing a treatment plan that will maximize glycemic control, while at the same time avoiding exposing their patients to increased risks. Due to variations in physiological functions between adults and geriatric patients, the treatment approach for geriatric patients differs significantly from that of an adult (Graveande and Richardson, 2016).
Treatment of geriatric patients involves the use of medication as well as other interventions such as nutritional strategies and psycho-social support (Graveande and Richardson, 2016). This paper will focus on pharmacological or drug treatment alone. The best medication that should be used to treat geriatric diabetic patients includes; metformin, sulfonylureas, meglitinides, thiazolidinediones, alpha-glucosidase inhibitors, dipeptidyl peptidase-4 inhibitors, and sodium glucose co-transporters two inhibitors.
These medications are taken orally at highly controlled doses. Geriatric diabetes patients can also be treated using injectable therapies such as GLP-1 analogs, pramlintide, and insulin. Although similar medications can be used to treat diabetes in adults, the drug dosage differs significantly between the two populations due to variations in pharmacokinetic parameters. In this respect, the drug dosage given to geriatric patients are relatively lower than those administered to adults. The goal of delivering lower doses to geriatric patients as compared to adults is the need to maximize chances of glycemic control, without exposing the elderly adults to additional risks (Kazerle, Shalev, and Barski, 2014).
My learning progress in the course directly correlates to the stages in Benner’s Novice to Expert Theory. Benner’s Novice to Expert Theory assumes that a learner experiences a progressive form of knowledge acquisition that involves five stages namely; novice, advanced beginner, competent, proficient, and expert stages of skill acquisition (Josephsen, 2014). Since I began the course, I have successfully gone through the first stage of Benner’s theory known as novice stage.
When I started the course as a novice, I had no background experience, and I had difficulty differentiating between relevant and irrelevant aspects. Even now, I still take my time to understand course requirements and their significance in shaping my roles as a clinician. After familiarizing myself with a few course concepts, I will move to the second stage of advanced beginner.
At this stage, I will rely on rules provided by my instructor to perform every individual task. Furthermore, I will ask more experienced students to help me integrate practical knowledge and to set priorities for the course (Bowen and Prentice, 2016).
After learning course concepts for two years, I will progress to the competent stage of skill acquisition. Here, I will easily compare situations and make judgments on that scenario that require immediate attention. Additionally, I will integrate devised rules with those learned in the classroom to help solve complex matters. From the competent stage, I will move to proficient stage characterized by critical thinking and individual decision making (Bowen and Prentice, 2016).
While at proficient stage of skill acquisition, I will be able to easily see changes that take place in every situation and implement appropriate responses to promote success. It is at this stage where I will view the course as a whole rather than regarding its small components like I currently do. Later on, I will progress to expert stage of skill acquisition. Here, I will be able to grasp every situation more accurately than now.
Additionally, I will no longer rely on rules and guidelines to make appropriate decisions on how to tackle issues related to the course. Moreover, I will operate from a deep understanding of every situation and make judgments that will generate positive outcomes (Josephsen, 2014).
In conclusion, as a clinician, I have an obligation to observe ethical, legal, and regulatory responsibilities during documentation, coding, and billing. Also, I must acknowledge the importance of evidence-based research by making clinical decisions based on facts obtained from empirical studies. A good example of a health situation in which I can effectively utilize evidence-based research is when designing a health promotion program specific to geriatric falls.
In this case, evidence-based practice will help me to deliver the most appropriate care for the patient and his or her family. Considering the little volume of knowledge that I have gathered as a novice, I believe that my learning progress in the course effectively correlates to the stages of Benner’s Novice to Expert Theory.
References
Benoit, M., Bergeron, J. & Bertrand, G. (2016). Decision-making tool: Telepractice and digital records management in the health and human relations sectors. Quebec: Conseil Interprofessionnel du Quebec.
Bowen, K. & Prentice, D. (2016). Are Benner’s expert nurses near extinction? Nursing Philosophy, 7(2): 144-148. Doi.10.111/nup.12114.
Deloitte. (2016). International review: Secondary use of health and social care data and applicable legislation. Author: Deloitte & Touche Oy, Group of Companies.
Durbin, L., Kharrazi, R. & Mielenz, T. J. (2016). Social support and older adult fall. Injury Epidemiology, 3(1):4.doi:10.1186/s40621-016-0070-y
Grave and, J. & Richardson, J. (2016). Identifying non-pharmacological risk factors for falling in older adults with type 2 diabetes mellitus: A systematic review. Disability and Rehabilitation, 39(15): 1459-1465.doi:10.1080/09638288.2016.119974.
JoAnn, M. (2017). Call to action: How to implement evidence-based nursing practice. Nursing, 47(4):36-43.
Josephsen, J. (2014). Critically reflective theory: A proposal for nursing education. Advances in Nursing, 2014: 360-594. Doi:10.1155/2014/594360.
Kazerle, L., Shalev, L. & Barski, L. (2014). Treating the elderly diabetic patient: Special considerations. Diabetes Metabolic Syndromes and Obesity, 7: 391-400.
Kristensen, N., Nymann, C. & Konradsen, H. (2015). Implementing research results in clinical practice: The experience of healthcare professionals. BMC Health Services Research, 16:48.doi:10.1186/s12913-016-1292-y
Mazur, K., Wilczynski, K. & Szewieczek, J. (2016). Geriatric falls in the context of a hospital fall prevention program: Delirium, low body mass index, and other risk factors. Clinical Interventions in Aging, 11:1253-1261.doi:10.2147/CIA.S115755.
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The parietal lobe is located at the top region near the back of the brain. There are two parietal lobes – left and right parietal lobe. This part of the cerebral cortex is involved in vision, speech, sensation and interaction with other regions to connect sensory input from external environment and interpretation of the stimuli. Parietal lobe stroke occurs when the blood vessel supplying blood to this region ruptures or gets blocked.
This interferes with sensation of the entire opposite sides. This is because motor system of the brain is mainly found in the frontal lobes (Knoefel, 2011). It starts with promoter regions for coordination of complex movements to the primary motor cortex where output is transmitted into the spinal cord leading to contraction and movement of the muscles.
The primary motor cortex located on the left side of the brain is responsible for the movement and muscle contractions in the right side of a person’s body and the primary motor cortex on the right controls movement of the left side. This explains why patient with right parietal stroke gets return of voluntary movement in the left hand (Migliaccio et al., 2014).
Question 2
Fronto parietal stroke affects the frontal and parietal lobes part of the brain. A right fronto-parietal stroke patient with better movement in the left hand side is also likely to may not necessarily have better attention of the side. This is because the frontal lobe is responsible for solving skills, emotions, and selective attention behavior. On the other hand, the parietal lobes control sensations such as touch and pressure.
Therefore, the indication of stroke will depend on the region of the brain involved. Stroke on the right hemisphere cerebrum affects left side whereas stroke in the left hemisphere affects the right side. In addition, injury in the left lobe disrupts the patient understanding of the written and spoken word (Knoefel, 2011).
Question 3:
Visual motor integration refers to a person’s ability to perceive visual information, process it and move the motor system accordingly. The idea that the front ends of visual system is responsible for breaking down stimulus for down into their constituent’s parts such as pattern, shape, motion, color and to glue the feature in the parietal lobe neuron.
Therefore, patients with right front parietal stroke make it challenging to grasp coordination. Visual- motor integration involves three processes; a) visual stimulus analysis, b) fine-motor control and c) conceptualization. Deficit in any of the three processes influence the final outcome. For instance, if fine motor control and visual analysis are within the normal range, then the challenge lies in the conceptualization (Johansson, 2012).
Question 4:
It can be challenging to farm with Parkinson’s disease because of tremors and rigidity that makes it difficult to hold hand tools and increases the likelihood of accidental injuries to self and others. In addition, the increased diminishing balance can increase risk for secondary injuries due to fall, slip or trip.
In addition, the medications used to treat the disease are associated with light headedness, confusion, insomnia and dizziness can dramatically reduce the patient’s energy. Therefore, these are the safety risks to consider when supporting the patient engage in his chosen hobby (Santos-García & de la Fuente-Fernández, 2013).
Question 5
Parkinson disease is a neurodegenerative disease described by non motor and motor symptoms that negatively impact the patient’s quality of life. Most of PD patients are stigmatized because of the visible motor and non motor symptoms. The symptoms of this disease are difficult to hide and are perceived as unscrupulous by the public. This includes observable traits such as gait difficulties, tremor and drooling. These symptoms disrupt the autonomous integration into the society due to their exterior conditions. In addition, the deteriorated self esteem evokes feelings of embarrassment and shame which results into isolation (Santos-García & de la Fuente-Fernández, 2013).
In addition, stigma and seclusion is not only associated with the observable signs and symptoms but also due to progressive loss of functionality. This factor further contributes to bad self image, self efficacy and autonomy. In fact when interviewed about their life history, most of the patients explain symptoms as the key issue for seclusion and low self esteem due to increased physical dependence.
Stigma also arises from awkwardness and inability to do activities that require simple motor actions. This reduction to functionality results into increased social disengagement associated to stigmatization. Stigmatization may also occur due to hindrances to communication. PD patients may be mislabeled for instance as drunkards. In addition, the delayed thinking and difficulty to convey their opinions easily can make them feel frustrated and isolated. The difficultness to decipher PD patient’s mute expressions makes them feel alienated and disconnected from others (Maffoni et al., 2017).
References
Johansson, B. B. (2012). Multisensory Stimulation in Stroke Rehabilitation. Frontiers in Human Neuroscience, 6, 60. http://doi.org/10.3389/fnhum.2012.00060
Maffoni, M., Giardini, A., Pierobon, A., Ferrazzoli, D., and Frazzitta, G. (2017). “Stigma Experienced by Parkinson’s Disease Patients: A Descriptive Review of Qualitative Studies,” Parkinson’s Disease, Article ID 7203259, doi:10.1155/2017/7203259
Migliaccio, R., Bouhali, F., Rastelli, F., Ferrieux, S., Arbizu, C., Vincent, S., … & Bartolomeo, P. (2014). Damage to the medial motor system in stroke patients with motor neglect. Frontiers in human neuroscience, 8, 408.
Santos-García, D., & de la Fuente-Fernández, R. (2013). Impact of non-motor symptoms on health-related and perceived quality of life in Parkinson’s disease. Journal of the neurological sciences, 332(1), 136-140.
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DIFFERENCE BETWEEN HISTORICAL AND CONTEMPORARY MENTAL HEALTH CARE
INTRODUCTION
Mental health care practice began several years ago when relatively simple approaches to care were still being utilized. Like any other form of health care, mental health care can be evaluated based on a range of theories and models which have extensively been used to inform mental health nursing practice. This paper discusses the difference between historical and contemporary mental health care as it applies to nursing models and the nursing process.
This paper has described in details, the concepts of “nursing process” and “nursing model” and how they have evolved since conception. Moreover, this paper uses a case study to describe how the nursing process and a nursing model have been applied in nursing care provision for a patient who is suffering from a sexually transmitted infection characterized by depression.
CONTEMPORARY AND HISTORICAL MENTAL HEALTH CARE
2.1 The Nursing Process and how it has Evolved since Conception
The principles of nursing process largely dominate mental health care practice in today’s nursing and health industry. The term “nursing process” is defined as the application of a scientific approach to care provision that involves strict adherence to distinct steps which are aimed at generating positive health outcomes for patients (Perez-Rivas, Martin-Iqlesias, Pacheco del Cerro, Arenas, Lopez and Lagos, 2016, p. 43).
According to Perez-Rivas et. al., (2016, p. 43), for a nursing process to be considered effective, the health care practitioner must complete all the documented steps because information gained from one step results into the success of subsequent steps. Approaching mental health care based on the principles of “nursing process” helps to develop critical thinking skills of nurses, which eventually translates into improved problem-solving and positive health outcomes for mentally-ill patients (Perez-Rivas et. al., 2016, p. 44).
Nursing process and its application in mental health care has greatly evolved from when it was introduced up to date. Traditionally, the nursing process extensively emphasized on health care assessment, implementation of intervention, and planning as the only phases involved in mental health care delivery. In those days, the process did not recognize the significant role played by cognitive processes in influencing decision making during care (Zamanzadeh et. al., 2015, p. 411).
However, as nurses continued to utilize the historical principles of the nursing process into practice, increasingly advanced nursing processes were integrated and this has greatly improved the overall image of the nursing process. For instance, the advanced nursing process currently integrates diagnostic reasoning that facilitates decision making which was absent in the traditional nursing process.
Through continued nursing research and practice, nursing professionals have contributed greatly to the evolution of the nursing process by identifying the need to incorporate health outcomes identification and planning into the nursing process. To date, health care professionals who handle mental health cases view the nursing process as an advanced form or practice that involves five steps: “assessment, diagnosis, outcome identification and planning, intervention implementation, and evaluation (Zamanzadeh et. al., 2015, p. 412).
2.2 How the Nursing Process was First Developed and How it is used in Contemporary Nursing
The nursing process that is used in contemporary nursing differs significantly from the one used in traditional nursing as it applies to mental health care. This is attributed to the changes that have been made on the “nursing process” since it was developed (Perez-Rivas et. al., 2016, p. 44). Nursing was first viewed as a process rather than a distinct activity in 1955 by Lydia Hall from United Kingdom.
Although many professionals in the nursing field were not sure as to whether Hall’s views were right, a few of them dwelled extensively on the topic and they began to refer to nursing as a process. Examples of authors who supported Hull in describing nursing as a process include Johnson, Orlando, and Wiedenbach and their opinions on the nursing process are available in their publications of 1959, 1961, and 1963 respectively.
By then, only three steps were used to define the nursing process and they include, “assessment, planning, and evaluation (Zamanzadeh et. al., 2015, p. 411).” These three steps provided the basis of the nursing process that traditional nurses used to deliver mental health care to patients.
Later on in 1967, an additional step described as implementation of intervention was added to the nursing process by Walsh and Yura. It is not until 1973 when the American Nurses Association (ANA) felt in necessary to incorporate diagnosis into the nursing process. During the final revision and publication of the ANA standards in 1991, another step known as identification of outcome was integrated into the nursing process.
The step was made part of the planning phase and this resulted into the generation of a nursing process that comprised of five steps namely; “assessment, diagnosis, outcome identification and planning, intervention implementation, and evaluation (Zamanzadeh et. al., 2015, p. 412).” The development of the nursing process has progressed through a number of steps which have been modified across years to generate the process that is currently used in contemporary nursing to provide care for mentally-ill patients.
Based on the nursing process, contemporary nurses frequently assess, diagnose, identity outcomes, implement interventions, and finally evaluate the effectiveness of interventions whenever they are delivering mental health care to patients.
2.3 The Nursing Model and How they Have Evolved Since Conception
Nursing models play a very important role in nursing practice in the sense that, they largely influence decision making processes by nurses concerning the most appropriate ways through which patients should be handled. A nursing model is defined as a framework of nursing concepts that act as a foundation for nursing care and that describe how given health care practices should be performed (Murphy, Williams and Pridmore, 2010, p. 23).
Nursing models have been developed to help direct nurses on the best approaches they should take to improve patient outcomes and to explain why certain approaches as relevant. Different nursing models exist and their goal is to assist nurses to achieve various nursing components based on the nature of a mental health issue they are handling at any given time (Springer and Casey-Lockyer, 2016, p. 647).
Nursing models have significantly evolved since their conception due to constant changes in patients’ needs and due to rapid technological advancements in the contemporary world which tend to change approaches to care. Nursing models were first developed in the United States way back in 1960s (Murphy, Williams and Pridmore, 2010, p. 23). In 1960, the United States was characterized by a number of cultural, technological and social transformations which influenced nursing professionals to make changes that were aimed at improving nursing practice.
For this reason, traditional nursing models were developed based on their effectiveness in meeting basic medical goals. For instance, the “medical model” provided a foundation only for the management of physical health problems. Nurses in the United Kingdom began to apply nursing models into practice in 1970s (Murphy, Williams and Pridmore, 2010, p. 24).
Since then, significant transformations in the world have helped nurses to build a body of knowledge that has been used to develop modern nursing models. Nursing models which are used in contemporary nursing to deliver mental health care have been developed to guide nurses on how they can handle patients with a wide variety of health problems as opposed to traditional models (Springer and Casey-Lockyer, 2016, p. 660).
2.4 Total Patient Care: A Historical Nursing Model
An example of a historical nursing model that is rarely used by today’s nurses is Total Patient Care which is also known as Private Duty Nurses. Total Patient Care is a nursing model that conceptualizes that, for nurses to deliver quality patient care, they must have a small number of patients that they can effectively handle at any given time. The nurse should then work in collaboration with other registered nurses to ensure that the patients being attended to receive maximum care.
Total Patient Care model guided traditional nurses to work with small groups of mentally-ill patients that they could effectively handle at any given time. Although Total Patient Care can still be used to guide clinical decisions in today’s health care settings, today’s health care organizations rarely utilize this model to deliver mental health care (Mary and Sandra, 2004, p. 291).
2.5 Watson’s Theory of Caring: A Contemporary Nursing Model
Through his theory of caring, Jean Watson greatly influences clinical decision making processes by today’s nurses, especially those who deliver care to patients with mental health problems. This contemporary nursing theory conceptualizes that there are four major factors that determine positive patient outcome during care delivery. These factors include the personality of the care giver, the patient’s health status, the environment in which care is delivered, and the nursing process (Ozan, Okumus and Aytekin, 2015, p. 26).
These factors influenced Watson to assume that the most effective form of care is that which is delivered interpersonally. In addition, the nurse should take time to understand specific health problem that a patient is suffering from. Again, it is the responsibility of the nurse to create caring environment for his or her patient. Furthermore, nursing lies at the center of caring and intended health outcomes will only be achieved if the right nursing processes are followed. Watson’s theory of caring is widely used in nursing practice today (Ozan, Okumus and Aytekin, 2015, p. 25).
SERVICE USER’S HISTORY
A service user whom I have cared for in the past is a female patient aged 16 years and who suspected that she was suffering from a sexually transmitted infection and was therefore in need of medical care. I had to take historical data before I could identify the best component of the nursing process to use in order to confirm presence or absence of a sexually transmitted infection.
My patient was an orphan who stayed with her uncle at the time of visit. At the time of visit, she was feeling depressed and psychologically disturbed because of her health condition. In addition, she was part of a group of commercial sex workers in the city despite her young age, and she uses money earned from the business to earn a living. She had also been in an intimate relation with different partners without protection.
Her uncle used to beat her up every time he was at home and therefore, she feared staying at home. The patient had not taken any medication prior to visiting the health care facility. I applied the nursing process to deliver the most appropriate nursing care for the patient.
When I was handling my patient, I greatly relied on the nursing process that is majorly used in contemporary nursing. By following the five steps of the nursing process, contemporary nurses are able to provide quality care that addresses specific patients’ needs. During assessment phase, the contemporary nurse collects, verifies, organizes, interprets, and documents patients’ health data that will be used to accomplish the subsequent steps.
After collecting relevant data, the contemporary nurse ensues to diagnosis phase where he or she analyzes the collected data to make a clinical judgment which is aimed at identifying a specific health problem that the patient is suffering from (Perez-Rivas et. al., 2016, p. 44).
Once a specific health problem is identified, the contemporary nurse proceeds to the third phase where he or she identifies the most appropriate health outcomes that the patient should be assisted to achieve. It is in this phase where the nurse documents a plan of how the patient can be helped to achieve the proposed outcomes. In the fourth phase, the contemporary nurse implements the right intervention as documented in the plan (Zamanzadeh et. al., 2015, p. 416).
The nurse then proceeds to the fifth phase where he or she evaluates the effectiveness of the implemented intervention in generating the proposed health outcomes for the patient. In case the proposed health outcomes are not realized following intervention implementation, the nurse is compelled to change the intervention until the intended results are obtained (Perez-Rivas et. al., 2016, p. 44).
A component of the nursing process that I used to exercise care for the patient was taken from the Assessment, Diagnosis, Planning, Implementation, and Evaluation (ADPIE) model described above, considering the fact that it is the one that is widely used in contemporary nursing. I decided to use Diagnosis component of the ADPIE to maximize nursing care for my patient.
By choosing diagnosis component, I wanted to bring together all the historical data that I had gathered into meaningful information. Specifically, when conducting diagnosis on the patient, I used the data that I had already collected to make clinical judgment about my patient and the family. This enabled me to understand that risk factors that exposed by patient to acquiring sexually transmitted infections.
Furthermore, I was able to predict possible responses that she could receive from family members if she approached them with her health problem. Generally, diagnosis provided me with the basis for selecting the most appropriate nursing intervention that could generate positive health outcomes for my patient.
The type of diagnosis that I conducted on the patient was possible nursing diagnosis. A possible nursing diagnosis is conducted when a patient’s problem requires additional analysis for the presence or absence of a health problem to be confirmed (Perez-Rivas et. al., 2016, p. 44). In the case that I was handling, it was not yet confirmed that the patient was suffering from sexually transmitted infections. The client was worried that she might have acquired sexually transmitted infections owing to her sexual behaviours in the recent past. Such thoughts had severe impact on her mental health. Data obtained from this diagnosis helped me to confirm presence of a sexually transmitted infection (Zamanzadeh et. al., 2015, p. 416).
Diagnosis was a very important component of ADPIE for my patient because it acted as a link to the other aspects of the nursing process namely; planning, implementation, and evaluation. The diagnosis was the second phase of the nursing process that was performed after collecting data in the assessment phase. Information gathered during diagnosis phase was extremely useful in the subsequent steps because I utilized it to identify the best health outcomes for my patient and to select a nursing intervention that could generate those outcomes for my patients. Diagnosis was very important in the overall nursing process because it helped me to come up with the right interventions that were intended to generate improved health outcomes for the patient (Zamanzadeh et. al., 2015, p. 416).
When I was providing nursing care to my patient, I paid greatest attention to Watson’s Theory of Caring mode. I utilized the four major factors that determine positive patient outcome during care delivery as described in Watson’s theory of caring. Specifically, I strived to; build strong interpersonal relationship with the client, establish specific health problem the patient was suffering prove, create an environment suitable for nursing care, and to adhere to all steps of the nursing process (Ozan, Okumus and Aytekin, 2015, p. 25).
CONCLUSION
Historical and contemporary mental health care differ significantly due to evolutions in nursing theories and models which have taken place over the years. For instance, while traditional mental health care was delivered using a nursing process that only involved three steps, delivery of contemporary mental care utilizes a nursing process with five steps.
Additionally, while traditional mental health care was based on historical nursing models, today’s mental health care is guided by contemporary nursing models such as Watson’s theory of caring model. The evolutions of the nursing process and the developments of nursing models have brought about significant improvements in health care delivery particularly in mental health care.
From this case study, I have learnt the importance of implementing contemporary nursing processes and nursing models in care delivery. I will utilize this knowledge to improve the quality of mental health care that I will deliver in future. As a student nurse, I will take my time to evaluate and understand changes in nursing models and components of the nursing process as they apply to mental health care.
References
Mary, T. & Sandra, L. 2004, “Traditional models of care delivery: What have we learned?” Journal of Nursing Administration, vol. 34, issue 6, pp 291-297.
Murphy, N., Williams, A. & Pridmore, J. A. 2010, “Nursing models and contemporary nursing 1: The development, uses and limitations,” Nursing Times, vol. 1, issue 106, p. 23-24.
Ozan, Y., Okumus, H., & Aytekin, A. 2015, “Implementation of Watson’s theory of human caring: A case study,” International Journal of Caring Sciences, vol. 8, issue 1, pp. 25-35.
Perez-Rivas, F., Martin-Iqlesias, S., Pacheco del Cerro, K., Arenas, C., Lopez, M. & Lagos, M. B. 2016 “Effectiveness of nursing process use in primary care,” International Journal of Nursing Knowledge, vol. 27, no. 1, pp. 43-47.
Springer, J. & Casey-Lockyer, M. 2016, “Evolution of a nursing model for identifying client needs in a disaster shelter: A case study with the American Red Cross,” Nursing Clinics of North America, vol. 15, no. 4, pp. 647-662.
Zamanzadeh, V., Valizadeh, L., Tabrizi, F., Behshid, M. & Lotfi, M. 2015 “Challenges associated with the implementation of the nursing process: A systematic review,” Irarian Journal of Midewifery Research, vol. 20, no. 4, pp. 411-419.
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All over the world, the criminal justice system of any state serves two major objectives; enforcement of the law of the land, and correction of offenders through various reform institutions. In this regard, criminal justice can be construed to mean a system governed by standard practices that aim to uphold social control, detecting and preventing crime, and most importantly sanctioning offenders through the use of various forms of punishments.
Significantly, criminal punishment is applied as a way to encourage proper conduct between individuals in the society and at the same time make one take responsibility for a wrongful act committed against another. In this respect, retaliatory acts are avoided because victims of crime will be satisfied that the wrongdoer has faced equal punishment in comparison with the act done. Notably, Lollar (2014) asserts that punishments can also be used as a compensatory tool towards victims of crime.
Retributive punishment
Foremost, this type of punishment is founded on the belief that the best way to respond to a wrongful act is by using a proportionate punishment. According to Flanders (2014) retributivists are of the opinion that when an offender commits an illegal act, the criminal justice system should make such a person suffer an equal and proportionate punishment.
Amusingly, retributivists attach their justification for proportionate punishment from ancient religious laws such as the ones contained in the Holy Bible, for instance, Exodus 21:23 avers that if any person commits harm, then the resulting punishment should be equal, hence the catchphrase “a life for a life, an eye for an eye, tooth for tooth, hand for hand, foot for foot.” Notably, similar sentiments are proclaimed in Biblical verses such as 5:38 and Deuteronomy 19:21.
Retributivists argue that as long as the damage has been done, there is nothing that can be done to reverse such damage hence the only way to administer justice is by giving equal punishment (Flanders, 2014). Seemingly, such reasoning can be said to be backward looking such that it does not take into consideration that at times crime may be committed in a unpremeditated way such that punishing an offender for the same would be harsh or excessive.
Another going concern for this form of punishment is that it may encourage revenge and promote retaliation in the society. Also, in some instances, it may be hard to draw the line between punishment that is sufficient and from the punishment that is excessive.
An example of a retributive form of punishment is the death penalty which according to Luliano (2015) is no punishment at all because it only seeks to insert pain as a measure of administering justice but does not address the root causes of crime or even ways of helping individuals refrain from such crime.
Utilitarian Punishment
First, from a wider scope, the utilitarian theory developed by Jeremy Bentham emphasizes that any action within the society should be directed towards achieving maximum satisfaction and catering for the well being of the majority members of the society. The utilitarian form of punishment, threads on the same footing by asserting that the laws that guide the conduct of the people in the society, should be used to maximize the happiness of the society (FERRARO, 2013).
Hence, crime and punishment should be kept to a minimum because they are inconsistent with happiness which the utilitarian theory of punishment asserts. Importantly, proponents of this theory of punishment recognize that having a crime free society may be a fallacy as such recommend that the form of punishment handed down to a wrongdoer should be directed to producing “good” from the person. In this respect, the punishment should not be unlimited.
Unlike the retributive form of punishment, which is said to be backward looking, the utilitarian form of punishment is largely presumed to be proactive on crime. For instance, the laws that direct how punishment should be handed down on crime should be designed to deter future crimes of the same nature.
Accordingly, rehabilitation of criminal offenders can be said to be one of the methods that the utilitarian form of punishment emphasizes as a way of administering justice. Rehabilitation mainly aims at reforming an offender rather than punish so that they may be integrated back into the society. Equally, jailing as a form of incapacitation of an offender also falls under the utilitarian form of punishment because, by removal of the offender’s ability to commit offenses from the society, future crimes of the same nature may be prevented.
Preferred rationale/form of punishment
First, it is important to appreciate the fact that in certain instances, the commission of a criminal act may not be planned such that one will be deemed unswervingly guilty of the act. Offenses such as murder may happen due to provocation such that one may end up taking another one’s life in the heat of passion. Similarly, minors and persons of unsound mind are not spared either when it comes to the commission of a crime. However, such a category of persons may be deemed to a special group because of the underlying issues such as the lack of understanding of the consequence that a particular act may lead to.
From the examples mentioned above, a retributive form of punishment will certainly administer justice in the wrong way because of its backward-looking nature of offering proportionate punishment. Without taking into consideration factors that may have led to a crime, any form of punishment handed down to an individual may be excessive or uncalled for.
By the same token, criminals are presumed to be ordinary persons such that one factor changed that status, for instance, one may seek to steal due to poverty. Alternatively, another person may engage in crime as an act of revenge for a wrongful act done on them. Under such circumstances, the form of punishment handed down should be directed towards enabling such a person reform and be integrated back into the society so as to continue developing.
Notably, even under religious laws, the principle of forgiveness is widely discussed. In this respect, retributive punishment does not give individuals any opportunity to reform or even afford the wrong persons with the chance to deliberate on pardoning the person after serving their sentence as an act of compassion.
Hence, I will argue that the utilitarian form of punishment stands out as the best-placed method for punishing offenders because it not only takes into considerations of the underlying factors that may have led to a crime but it also focuses on handing down the punishment that in the long run will stem out goodness from a person. Goralski (2015) is of the same views by asserting that models of punishment that presume criminals to be bad people who deserve harsh punishments should be relatively be avoided because this leads to vengeance rather than reform.
Philosophy of Imprisonment
Borrowing meaning from the Law Dictionary (2016), imprisonment means restraining or putting an individual in confinement such that his liberty is subjugated. In this respect, imprisonment can be said to be a tool of crime deterrence going by the fact that is limits one’s movement and activities.
Arguably, the rationale for imprisonment as a form of punishment can be said to have stemmed from the belief that by subjecting a person to a place whereby their rights and freedoms were limited to a minimal level, then people would be careful not to commit crime because of the hardships that one would experience while in prison.
However, one can say that imprisonment only acts as a form of banishment of an individual. This is to say, prisons only act as means of putting an individual away from his ordinary life such that he is disassociated with the society. Hence, for imprisonment to reform an individual, an extra effort must be provided a failure to which the individual will only lack his privileges which may not be enough to deter future crimes.
Stuart Greenstreet (2017) argues that imprisonment does not serve its purpose of preventing crime. In his discourse, “Prison Doesn’t work” he asserts that the reason why prisoners even after being released are likely to commit crime is based on the fact that by putting together equal minded people that share similar criminal mindsets, the likelihood of having a worse crime is high because of the perception that jail is used as a way of punishing them.
Also, innocent persons may be subjected to imprisonment such that if they are not helped in having a changed mentality of a criminal justice system, then the likelihood of prisons remodeling such a person by just having them locked up can be equaled to a time bomb.
From a personal point of view, imprisonment only serves to confine people to a place whereby they can no longer commit the crime, but it is not effective in deterring the occurrence of future crimes. Imprisonment should be supported with other special programs that help prisoners have a different perception of prisons and importantly assist them on being integrated back to the society.
Restorative Justice
Restorative Justice largely emphasizes on the usage of alternative measures to solve crimes and social disorders. According to Walgrave (2013) restorative justice embraces the ideology that wrongdoers should be empowered to rehabilitate, reform and be reconciled back to the community. Seemingly, any form of crime causes harmto another as such focusing on repairing the harm in perceived to be vital in assisting the warring parties. United Nation’s office on drug and crime asserts that restorative justice seeks to put things right between conflicting parties while at the same time preventing occurrences of similar misconducts through the use of corrective strategies and programs.
Nevertheless, this concept has been purported as being too ambitious in a bid to restore ties between the victims of crime and the offenders, especially when compared with traditional models which emphasizes on the punishment of offenders for any crimes committed. However, restorative justice must be applauded for promoting values such as forgiveness, dialogue, accountability and fraternity (Arlene Gadreault, 2015). Evidently, the main aim of restorative justice is to give both the offenders and victims of crime a bigger role to play within the criminal justice system so as to yield positive outcomes and at the same time offer the necessary assistance to both parties.
Notably, restorative justice can be regarded as an alternative dispute resolution mechanism, which uses less punitive channels often in the form of diversion programs under various state agencies that are meant to aid the involved parties to resolve the previous conflict. Accordingly, restorative justice affords offenders with the opportunity to take responsibility for the harm or injuries caused to victims and consequently, make adequate compensation.
Bentham project
Foremost, Bentham being a prominent law scholar that developed various law theories such as the utilitarian school of thought theory, it is then important to have a deep understanding of the message that he intended to put across through the use of his works. Thus, the Bentham project can be said to largely focus on Bentham’s writings and how they can be made relevant to the modern world’s activities.
The Bentham Project also can be said to focus on how to formulate basic codes of conduct within the society. For instance, the utilitarian theory of punishment can be said to follow the guidelines of Bentham’s utilitarian theory.
Lastly, this project is of great significance especially for learners to get to know the foundation and originality of various concepts that are applicable in today’s world. Having a deep understanding of the origin of things or events is important in assisting one to comprehend their significance in the society.
References
Arlene Gadreault (2015, January 7th). The Limits of Restorative Justice, School of Criminology,
Art in the Renaissance period was characterized by creativity, learning, and development of new forms of art. The purpose of this paper is to discuss an example of Renaissance art, in order to determine factors that identify it as the renaissance. In this regard, the Mona Lisa painting done by Leonardo da Vinci is used as an example.
Description of the Mona Lisa
This piece of art remains among the most popular across the globe and its replication is still largely used for decoration purposes and as an adornment. The painting which is considered one of the greatest pieces in the 15th and 16th centuries is classified in the Renaissance portrait art genre and was done by Leonardo da Vinci (Visual Arts 1). The Mona Lisa can be found in the Louvre Museum in Paris and is valued at over $1 billion. So famous is the portrait that one can only catch a glimpse of it in the Louvre.
The Mona Lisa features the wife of rich silk merchant Francesco del Giocondo, Lisa Gherardini. Lisa sits on a chair, upright and sideways, and her face and chest slightly facing the viewer. Her left arm is placed on the armrest and clasped by the right arm. The position is said to be protective, thus creating a distance between her and the viewer.
Renaissance art characteristics in the Mona Lisa
Renaissance art had various characteristics that were evident in a majority of pieces. These characteristics are discussed with reference to Mona Lisa.
3.1 Focus on the human figure
The human figure gained considerable importance during the Renaissance as artists rediscovered the human body’s beauty (Fichner-Rathus 270). This is the most notable characteristic in Mona Lisa, given Leonardo’s focus on detail to ensure that he brought out Lisa’s beauty on the painting. This is achieved through ensuring symmetry and proportion.
3.2 Realism and expression
Images were developed to be as realistic as possible, with emphasis on emotions and gestures (Fichner-Rathus 270). Consequently, portraits of real people were common. In Mona Lisa, it is evident that the portrait appears realistic and shows emotion. It is reported that Leonardo hired musicians to keep Lisa entertained during the drawing and this may explain why she was half smiling (Visual Arts 1). The subject also appears like they are directly looking at the viewer, thus making it life-like. Additionally, the three-dimensional painting, which is also a characteristic of Renaissance makes the image appear more realistic.
3.3 Use of perspective
Artists in the Renaissance created perspective through the use of lines and angles, light and shadow, and color, to create depth and distance (Fichner-Rathus 270). A notable characteristic of Renaissance art is the use of blue backgrounds in a bid to create depth. The background landscape in Mona Lisa consists of smoky blues and has no vanishing point. This creates an impression of great serenity and mystery as well as depth. In this painting, da Vinci uses the sfumato painting technique, where the artist uses ultra-subtle tonal graduations to create smooth and almost undetectable color transitions (Visual Arts 1).
3.4 Depictions of nature
Renaissance artists took a high interest in nature and were depicted through the inclusion of landscapes in their paintings. In Mona Lisa, the background scenery consists of a natural landscape with trees, hills, river, and bridge. This gives a natural look on the portrait.
Conclusion
The Mona Lisa is an outstanding example of Renaissance art as demonstrated by its portrayal of Renaissance characteristics. The painting is not only intriguing but it also captures various characteristics of Renaissance art including a focus on the human figure, realism, and expression, use of perspective depictions of nature and three-dimensional painting.
Works Cited
Fichner-Rathus, Lois. Foundations of Art and Design. Cengage Learning, 2014.
Visual Arts. Mona Lisa (La Gioconda) (1503-6). Visual Arts Cork, 2017.
Agriculture has been an imperative supporter of the GDP of Bhutan since the absolute starting point. Its commitment to the GDP has been recorded at 38% in the year 1995 with 85% of the populace subordinate upon it; the commitment was 35.9% in the year 2010. In spite of the fact that the commitment of agribusiness declined from 55 % (1985) to 33% (2013) of GDP, despite everything it stays as a prevailing element in the economy of the nation. However, in the most recent decade, the commitment of agribusiness has tumbled to 16.7% of GDP. The issue of accomplishing independence lies intensely on the shoulder of this part as, without improvement of the essential segment, the advancement of the auxiliary area and thusly, advancement of the country can’t be accomplished to the full. The decline of roughly half in 10 years flags that this area requires quick consideration. This examination goes for distinguishing how, the foundation of particular Financial Institutions for Agriculture like; ‘National Bank for Agriculture and Rural Development’ (NABARD, India), can help in building up this segment. This examination endeavors to take shape the part that such particular organizations need to play, since they can give tweaked answers for various necessities in the agrarian segment of a nation, as structures, plans, plans, approaches and methodology, and open the ranchers to the present day innovations and techniques for horticulture.
Introduction
A standout amongst the most imperative parts of the lives of individuals and the financial state of a country is agribusiness. For millenniums, rural exercises have overwhelmed the lives of individuals around the world. In the cutting edge world, horticulture has turned out to be more logical and Innovation situated pointed towards accomplishing higher generation, and in this way, financing farming assumes a crucial part today. This is the place Agricultural Micro finance ends up plainly significant. It assumes an exceedingly critical part in empowering horticultural exercises in many countries. In 2019, there were more than 74 million micro finance borrowers around the world, and the aggregate credit portfolio was about $38 billion USD. On the off chance that we consider Bhutan, horticulture remains the second biggest supporter of GDP quickly after hydro power era. In the meantime, the present rupee emergency in Bhutan has demonstrated that one of the zones in which Bhutan needs to gain a quick and relentless ground is accomplishing self-manageability in nourishment generation. In 2011, Bhutan imported about Nu.286 million worth of vegetables and Nu.1.1 billion worth of rice2, and there couldn’t be a superior time for the country to truly respect the conceivable methods for enhancing its farming generation and diminish its reliance on imports, which channels profitable and hard earned remote cash adding up to Rs.4 billion in the year 2011. The nation has a potential for building up its agribusiness further. One method for achieving this is to guarantee the accessibility of simple credit to the agriculturists in the nation.
This paper endeavors to comprehend the present circumstance of farming micro credit in Bhutan and tries to comprehend the conceivable advantages of extending the extent of rural micro credit and auxiliary administrations through particular foundations in the nation.
Literature Behind Research on Agriculture in Bhutan
On the off chance that we consider micro finance, or all the more particularly microcredit, which concentrates on stretching out little credits to ranchers and was made well known by Grameen Bank in Bangladesh, is a moderately new idea. The advancement and extension of micro finance on the planet can be clarified by the accompanying outline:
2010 – 2012
2012-2014
2014-2015
2015-2017
Expansion
Increase
Commercialization
Transformation
As portrayed by Srnec K., et al. (2018), micro finance establishments around the globe experienced approximately four phases of advancement to be specific, the mid 80’s the place numerous MFIs (micro finance organizations) had a superior rate of return than banks. In the mid 90’s, the place a couple of MFIs started taking care of every one of their costs, a couple of best MFIs started to pull in noteworthy business subsidizing, and were never again restricted to a little gathering of scattered organizations, making it a quickly developing industry and today where MFIs have changed from being casual micro finance foundations to more formal establishments.
The very structure of micro finance foundations has experienced a critical change as of late. Micro finance organizations, as well as standard banks the world over have started to understand the estimation of micro finance and are starting to take into account this division. As indicated by a report distributed by Infosys4, just 28 percent of the aggregate requests for micro finance administrations were secured by the MFIs all inclusive by 2010. The World Bank assessed a micro finance necessity of USD 300 billion out of 2010.
However, in spite of being the centerpiece of provincial and agrarian advancement programs in numerous nations for quite a while, micro finance has likewise pulled in impressive feedback, and many individuals question the adequacy of micro finance establishments. As clarified by Hendrayadi, Irfan, et al, in their paper ‘What is ‘Afflict ing’ the Agricultural Micro Finance Model?’, the objective of the country fund was to advance agrarian improvement through focused medications intended to increment provincial loaning while at the same time decreasing the expenses and dangers to moneylenders. The ultimate result of this approach neglected to achieve its Objective. Initially, sponsored loan costs did not permit provincial back organizations (RFIs) to take care of their expenses. Besides, financed credit extremely regularly focused on the wrong items, which prompted expansion underway wasteful aspects. Therefore, the quantity of nonperforming advances expanded drastically. In the 1970s, horticultural loaning represented more than 30 percent of all World Bank loaning; in any case, by 2010, this number dipped to 10 percent. The measure of Official Development Assistance (ODA) given by OECD nations to rural ventures dropped impressively also. Subsequently, the genuine net guide to farming in the 1990s dropped to a 35 percent of its level in the 1980s.
Another trouble confronted by micro finance establishments around the world was that, in spite of being organizations of simple credit, the loan fees charged by these foundations was still very high. As clarified by Bateman (2011), in the beginning of micro finance organizations, higher rates were important to take care of the high operational expenses of giving small advances to poor people, yet that financing costs would fall in view of rivalry. This contention had some legitimacy at first. In any case, loan costs have not fallen as much as anticipated, and in a few nations (quite Mexico), they have stayed high. To some degree, this was a direct result of the accentuation on.
The business show, with MFIs, now required producing high monetary prizes for their directors (pay rates, rewards) and proprietors/investors (profits and capital increases). Different impediments that hampered the development of micro finance was an absence of legitimate insurance from agriculturists as they were frequently excessively poor, making it impossible to keep resources as guarantee, however as clarified by Llanto (2017), endeavor credits, including advances to poor people (for the most part ladies), did not really require the customary land guarantee as security. MFIs have loaned to resource fewer people and have effectively recuperated the credits. However, nothing from what was just mentioned issues are without arrangement. Bateman (2011) and Llanto (2017) have worried on the requirement for hearty money related control to guarantee that neighborhood budgetary establishments act in a way helpful for maintainable nearby financial improvement and to building and holding neighborhood social capital, yet with a notice that exorbitant direction may suffocate creative micro finance rehearses. Llanto (2017), Hendrayadi, Irfan, et al. what’s more, Miller (2011), have likewise worried on broadening credit portfolios by micro finance foundations, which can be expert by consolidating horticultural advances with different sorts of advances, for example, urban advances, lodging advances, investment funds, protection, etc. Bateman (2011) has even recommended that nearby smaller scale reserve funds ought to be considered as an initial phase in the collection of capital. One of the components unfavourable to establishments occupied with rural loaning as recommended by Llanto (2017) is inordinate government intercession and government endowments, which may not be manageable over the long haul. This is one region where Bhutan ought to be particularly watchful about. We will next consider the micro finance situation in Bhutan and attempt to comprehend its present patterns and future prospects.
Research METHODOLOGY and Design
Planning reasonable strategy and choice of logical instruments is imperative for an important investigation of any exploration issues. This segment is dedicated to the announcement of the technique, which incorporates accumulation of information, examining the system, strategy for investigation and apparatuses of examination.
Gathering of Data
Both essential and optional information has been utilized for the present investigation. An observational study was made among the chosen recipients to get to know the advance sum got, used and reimbursed. On the premise of the data assembled, a very much outlined pre-tried meeting plan was drafted and utilized as a part of the field review to gather the essential information (Vide Appendix-I). Before undertaking the principal review, a provisional meeting plan was arranged and regulated to 25 recipients so as to test the legitimacy of the meeting plan. It encouraged tresearchhe expulsion of the none–response and undesirable inquiries and the altered last timetable in view of this were readied.
The chose recipients were reached face to face and the goals of the examination were obviously disclosed to them and their co-operation was guaranteed. The insights with respect to the general attributes of the example recipients, their families, salary, use, and investment funds identifying with the general targets of the investigation were gathered from the specimen recipients through the immediate individual meeting technique.
Auxiliary wellsprings of information identifying with the readiness to benefit from advances, the number of advances endorsed, advance sums were gathered from the distributed and unpublished reports and records of the BDFCL.
Inspecting Procedure
Bhutan Development Finance Corporation Limited has 22 branches in every one of the twenty locales in Bhutan. With the end goal of gathering essential information from the recipients and recuperation execution, all the 22 branches were incorporated for the present investigation. Out of 22 branches, a sum of 300 borrowers under different plans was chosen indiscriminately for the investigation.
Time Line
Keeping in perspective of the goals of the investigation, 300 example recipients were stratified into two classes specifically, the individuals who have occupied with non-modern exercises and others taking part in mechanical exercises. Out of 300 specimen recipients, 182 (66.67 for each penny) recipients were going to non-mechanical gathering and the staying 118 (39.33 for every penny) fell under the modern gathering.
Objectives of Study:
i. To comprehend the difficulties and openings that specific money related foundations taking into account the farming part have.
ii. To assess the condition of agrarian micro finance in Bhutan.
iii. To propose strategies that may be valuable in assist improvement of such specific monetary establishments.
Research Design: Descriptive research
Information Sources: Optional information gathered from different electronic sources, for example, sites, articles and daily paper diaries accessible on the web, and so forth.
Land reaches out of the examination:
Impediments: The investing+ation is restricted by the way that there has is just a single budgetary organization taking into account rural micro finance in Bhutan. Hence, the measure of data accessible here is very restricted, and not very many examinations have been led identified with this decision, and this has constrained the extent of our investigation.
Research Questions:
Why couldn’t farmers grab the funds in order to approach the require GDP prescribed by the Governmental Agencies of Agricultural Development fields and lands?
What are the major correlations and stats of Agricultural Development Land Authority of Bhutan regarding the production of crops from the year 2014 to 2017?
What are the aspects of agricultural development regarding farmers low budget criteria and how can governmental agencies handle this crisis?
What are the GDP targets regarding farmers infrastructure development at agricultural lands?
The state of Specialized Micro Finance Institutions in Bhutan
As we consider micro finance establishments in Bhutan, we understand that it is still in an incipient stage. Country credit in Bhutan was begun in 1980. It was ordered for Bank of Bhutan (BOB) to loan 44% of its portfolio in country credit, be that as it may, it loaned under 1% of its portfolio. The reasons were ranchers’ failure to meet the security and assurance prerequisite of the BOB and RICB (Royal Insurance Corporation of Bhutan). At that point, the provincial loaning program was depended to Food Corporation of Bhutan in 1980. Nourishment Corporation of Bhutan acquired cash at 14% enthusiasm from BOB and RICB and re-loaned the sum at 6% to 10% to agriculturists. This program kept going just two years. The program was then moved to Royal Monetary Authority (the national bank of Bhutan). As BOB and RICB were discovered one-sided towards general exchange, transport, and land, it was felt important to build up a different budgetary establishment to give advances to mechanical and farming related exercises. In this unique circumstance, with the marking of Royal Charter (RC) on January 31, 1988, Bhutan Development Finance Corporation Ltd. (BDFC) (which is right now known as Bhutan Development Bank Limited (BDBL)) was built up. At that point, the rustic credit program was given over to BDFC. From that point, forward BDFC (now, BDBL) has been executing Agricultural Credit in Bhutan.
Other casual methods for loaning to ranchers likewise exist in Bhutan as portrayed by Hussein (2019, for example, moneylenders, who exist inadequately in a few districts and charge an enthusiasm of 3%-5% and well to do families and people who additionally advance out to poor villagers now and again. Different banks incorporate devout foundations that loan at a higher rate of 15%-25%, and semi-formal loaning organizations, for example, the National Women Association of Bhutan (NWAB), which goes for giving gifted preparing and gathering loaning to ladies in country zones. The organization depends on the Grameen Bank model and advances are progressed with an enthusiasm of 14%.
In any case, regardless of consistent endeavors by the administration, rustic cr alter confronts real hindrances, as portrayed by Pathak (2010). Factors, for example, the scattered low populace, uneven territory, low foundation advancement, low advance recuperation rate, high hazard and high overhead cost have reared the effect on the improvement of micro finance establishments in country zones of Bhutan. In 2010, under 44% of ranchers approached credit from balance uncial establishments, (this was out of an expected 87,500 homestead families), and this figure was impressively lower for littler agriculturists at around 10%. The nonattendance of other committed micro finance foundations and the peak smaller scale fund body in Bhutan being BDBL alone has altogether controlled the extent of micro finance in the nation. From the customers’ point of view, few loaning establishments bringing about constrained access to advances, long and antagonistic obtaining techniques, contract pre requisites notwithstanding for little credits, high financing cost structure, and so forth., has postured huge hardships in getting advances.
On the off chance that we consider ventures made by money related establishments in Bhutan by segments, agribusiness comes in eighth, with add up to speculation by monetary divisions (as advances), which is a pitiful 1.39% of aggregate venture (adding up to Nu. 36,005.02 million) in the year 2010 (from the Statistical Yearbook k of Bhutan 2011, National Statistics Bureau , RGoB). Taking a gander at the pattern over a time of years, the rate of assets given to agribusiness regarding credits by budgetary organizations has really diminished from 1.92% of every 2016 to 1.39% out of 2010.
In fact, of the ten biggest parts which represented more than 99% of the credits, the best five were individual, Building and Construction, Manufacturing, Trade and business, Service and
Personal Loans for Agriculture
The above diagram obviously demonstrates the carelessness and lack of concern towards farming part loaning by monetary establishments. In the year 2010, an aggregate of Nu.499.45 million was put by money related foundations in the agribusiness part. In the event that we consider the expansion in interest in agribusiness area, there has scarcely been an increment of more than 105% contrasted with five years prior (somewhat finished twofold). In the examination, individual credits have expanded about five times and, vehicle advances (for overwhelming vehicles) have expanded more than six times (Statistical Yearbook of Bhutan 2011, RGoB).
Of the credits given to horticulture division in 2010, 99.10% originated from BDBL. Just a little rate of the advances was given by Bank of Bhutan (0.60%) and T-Bank (0.30%). The loaning rate in horticulture segment (for advances rendered by budgetary organizations) was static at 13% in the vicinity of 2018 and 2010 (for a reimbursement time of 10 years), though in the ‘other traveler vehicles’ part, financing costs really descended from 14% (for reimbursement in 5 years) in 2018 to 12% (for reimbursement in 7 years) in 2010 (Statistical Yearbook of Bhutan 2011, RGoB).
A current overview directed in Samtse has demonstrated that micro finance customers in Bhutan apparently obtained Nu.30, 000 to Nu.50, 000, and paid an enthusiasm of 5 to 10 percent to Bhutanese moneylenders or, 3 to 10 percent to Indian moneylenders. This is really a little sum, and shouldn’t require security by any stretch of the imagination. Such credits can be effectively given by specific micro finance organizations and can truly go far in helping the agriculturists in the midst of need.
While the improvements in the rural segment have made expansion openings, there are imperatives that can hamper the capacity of agriculturists; particularly that dominant part of Bhutanese ranchers are poor and peripheral agriculturists. The absence of sufficient framework, restricted access to data, credit, and different resources (land, water, and mechanical know-how), can seriously compel the extent of broadening activities.
These boundaries, data holes, and limit confinements display an open door, as well as a requirement for specialists’ concerned (Ministries, offices, contributors) to offer help and help to manufacture the limit with respect to expert poor broadening exercises.
Expansion activities require a multi-segment approach including numerous particular venture ranges. Approach and institutional condition, water system and seepage, science and innovation, and country framework are only a couple of illustrations. Every one of these speculations won’t originated from the general population part.
For long haul arranging, government needs to make the empowering conditions for the private segment to give sources of info and administrations to ranchers important for enhancement; (FDIs), be that as it may, the administration needs to contribute to enlarge the extent of research establishments to cover rising issues of broadening, enhance the scientific capacities of agriculturists to blend the expansion opportunity, and build up the productive learning and data frameworks.
Besides wage era, broadening will, in many cases, increment work for the country poor. For instance, von Braun evaluates that because of broadening to send out vegetable creation in Guatemala, work expanded by 45 percent on members’ homesteads. It is normal that the advantages of expanded business openings are significant as well as are circulated over a wide range of the economy and in this way are to a substantial degree “expert poor.”
Ali and Abedullah (2012) exhibited the potential for country work era emerging from enhancement out of oats to high-esteem products, for example, vegetables, by looking at the work force in the two frameworks. Considerable business openings are created in seed and seedling generation, accuracy arrives planning, and the water system, collecting, cleaning, evaluating, and bundling of high-esteem crops.
It was evaluated that a one-hectare move of grain to vegetables in one season creates over one year round all day business (that is, the contrast amongst oats and vegetables was more than 220 working days for each hectare). The off-cultivate work impact of comparative greatness was anticipated through the extension in the farming business exercises. Joshi and Gulati et al. (2012) likewise detailed comparative outcomes.
Because of developing customer interest for exceedingly bundled and prepared horticultural items, enhancement ordinarily includes the development far from customary wares (requiring negligible auxiliary preparing) toward higher esteem products (requiring critical preparing and dealing with). Moreover, the new creation frameworks are regularly more concentrated and produce interest for a more prominent amount and an assortment of homestead inputs.
Since high-esteem crops, contrasted with oats, are all the more emphatically interlinked with different divisions of the economy regarding giving their yields and accepting contributions from these segments, there is a more grounded multiplier impact of the underlying increment in pay. For instance, it was evaluated that a unit increment in beginning salary in oats has a multiplier impact of two, while comparable increment in vegetables will create a multiplier impact of three (Ali and Abedullah 2012).
With the move far from subsistence harvests to more beneficial money crops like vegetables, comes back to arrive, work, manure, and water are fundamentally higher. The level of change in cultivating pay in the long and medium term will rely on the idea of relative changes in wage and use and in addition the degree of home utilization.
Country family units in Bhutan procuring the greater part of their salary from the generation of exportable merchandise will encounter a net welfare increase paying little mind to their utilization crate, while the effect for those families that are net customers might be vague, contingent upon the impact on nearby nourishment costs. Regardless, broadening will bring about more prominent nourishment security at the family unit level.
Given the above situation, the Royal Government should play a dynamic part in instigating manageable development by empowering economical generation frameworks in accordance with the accessible assets of agriculturists and micro environments of soil and land, catching on the regular focal points Bhutan has over its neighbors like India and Bangladesh. To advance the star poor enhancement with high-esteem crops, speculation ought to be coordinated to diminish yield change by creating stress-tolerant innovations and safe cultivars of these harvests and to enhance Homestead to showcase linkages.
In addition, approach advancements ought to animate market components to grow little ranchers’ association with the end goal of defeating the economies of scale issue and enhancing their entrance to business sectors and data. Preparing on little scale horticultural business improvement can likewise empower smallholder ranchers and landless destitute individuals to change.
With suitable arrangements, some of these speculations may originate from the private area, while venture identified with the foundation of makers’ association to enhance their capacity in investigating expansion openings and meeting the exploration needs identified with these open doors should originate from the general population private division joint effort. Delgado (a researcher at Agricultural field) perceived that there are three prerequisites for strategy level consolation of expansion.
In the first place, enhancement methodologies need to target staple sustenance generation and showcasing issues to such an extent that approaches accommodating more prominent nourishment security are composed and executed. Increments in high-esteem creation are not prone to happen unless nourishment security dangers are impressively brought down, especially with regards to Bhutan where at present a high offer of assets is given to subsistence sustenance generation.
Second, the exchange costs related with the stream of assets and items amongst areas and districts should be diminished. This is so picked up from the creation of surplus can stream to ranges delivering non-excess, which thusly are required to help the generation of surpluses.
Third, there is a need to advance non-conventional fares as a wellspring of remote trade to abroad markets. For example, comparative fare things along the lines of mushrooms, Cordyceps, apples, and oranges should be additionally broadened. This can be accomplished by putting resources into investigating, expansion, preparing and data frameworks of high-esteem crops, natural creation, restorative and sweet-smelling plants, and by creating the quality foundation. It requires supported endeavors to beat institutional and infrastructural limitations.
A further essential part of the administration is guaranteeing that ranchers have the ability to benefit from the innovative and market openings display in the outer condition. This type of maker strengthening requires sound instruction and expansion frameworks at all levels, and in addition meditation when important to conquer any boundaries to the stream of the market and specialized data and learning.
Decentralization (DYTs, GYTs) has made an instrument to encourage the procedure yet additionally fortifying of such bodies as far as overhauling know-how, and mindfulness is considered essential. The significance of giving the agriculturists a choice of choices for their generation ought to be perceived inside the projects and subprojects of vocal arranging.
The up and coming national nourishment security arrangements archive need to address both the nationwide generation and the neighborhood accessibility of sustenance in ranges with low efficiency as well as zones more suited for the creation of tradable products, for instance.
Wellbeing and sanitation must be elevated to completely abuse the welfare impacts of commercialization and expansion, and strategy should concentrate on preparing and work versatility programs on the grounds that “all things considered, the minimum diversifiable gift is most likely uneducated work” (Quiroz and Valdés 2011, p. 297).
Furthermore, ultimately, proper exchange arrangement is basic, particularly given that the nation has started participation to joining the World Trade Organization (WTO), openings are progressively fixing to the abuse of developing markets in remote nations.
Bhutan-Export Strategy, 2010, UNCTAD/WTO.Bhutan Trade Statistics Up To 30th June 2012, Department of Revenue & Customs, Royal Government of Bhutan.
Delgado, C. (2012) “Agricultural diversification and export promotion in sub-Saharan Africa.” Food policy, volume 34, number 7, pages 243-279.
Delgado, C. and A. Siamwalla (2012). “Rural economy and farm income diversification in developing countries.” In; Proceedings of the 23rd international conference of agricultural economists, August 2014, Sacramento, California. Pages 129-198.
Druk Seed Corporation, (2012) Strategic Options, Ministry of Agriculture, Paro.
Export Oriented Vegetable Production Proposal, (date unknown) Ministry of Agriculture.
Forest Resource Development Section, “Non-Wood Forestry Products, A Report on Thimphu & Paro Dzongkhags”.
Identification Mission for Agricultural Production Project/IPM Phase II Draft Report November 2013.
Joshi, P.K., A. Gulati, P. S. Birthal and L. Tewari. (2012). “Agriculture Diversification in South Asia: Patterns, Determinants, and Policy Implications”. RGoB, MoA-NCAP-IFPRI Workshop on “Agricultural Diversification in South Asia”. Paro, Bhutan. November 21-23, 2012. (paper and slide presentation) Policy, Strategies and Plans, October 2011. Engineering Division, DOA (9th Five Year Plan 2012-2017),.
Quiroz, J., and A. Valdés. (2015). “Agricultural diversification and policy reform”. Food Policy. Volume 44, Number 9, Pages 267-295
Renewable Natural Resources statistics, 2010, Ministry of Agriculture.
Renewable Natural Resources statistics, 2015, Ministry of Agriculture.
Renewable Natural Resources Section, 2012-2017, Ninth Five Year Plan Document, Ministry of Agriculture.
Statistical Year Book of Bhujtan, (2014). National Statistical Bureau, Royal Government of Bhutan.
Tobgay, Sonam (2015). “Small Farmers and Food Systems in Bhutan”. A paper presented at the FAO Symposium on Agricultural Commercialization and the Small Farmer, Rome.von Braun, J. (2015). “Agricultural Commercialization: Impacts on Income and Nutrition and Implications for Policy”.
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Terrorism is founded on carefully planned structures. This paper intends to discuss terrorist organizations by developing a case study of Aum Shinrikyo terrorist group.
Origin of Aum Shinrikyo
Aum Shinrikyo refers to a doomsday cult whose origin is in Japan. The cult was formed by Shoko Asahara in the year 1984 (Ingram, 2017). Aum Shinrikyo earned international infamy after carrying out a deadly attack on Tokyo subway in the year 1995. Furthermore, in 1994 Aum Shinrikyo was also involved in a small sarin attack (Ingram, 2017). However, initially, Aum Shinrikyo conducted its activities in secret and never confessed. Shoko Asahara, the founder of Aum Shinkyo, bought a signal in Russia, which he directed to Japan and uses it in broadcasting his singing and persisting on his blamelessness (Ingram, 2017).
In 2007 Aum Shinrikyo was divided into two groups a group known as Aleph and a group called “Hikari no Wa” (Ingram, 2017). Thus, Aum Shinkyo became designated by many countries as a terrorist association. Among the countries is Japan and North Korea. For instance, in Korea, the commission in charge of examining public security made a public announcement in 2015 in the month of January that the group Aleph along with “Hikari no Wa” group is both branches of religion, which is considered as dangerous (Ingram, 2017). The commission also added that it would continue surveillance on the two groups for three subsequent years.
As a logistical set-up, Aum Shinkyo inspired and is still inspiring acts of terrorism globally. Notably, Aleph which is one of the groups of Aum Shinrikyo is a system based on syncretism belief (Kearns, Conlon & Young, 2014). Aleph draws upon an idiosyncratic understanding of elements by Shoko Asahara regarding ancient Indian Buddhism, Tibetan Buddhism, and Hinduism. The main icon of worship was taken to be Shiva (Kearns, Conlon & Young, 2014). Aleph also incorporates millennialism ideas, which it borrows from the Bible’s Revelation book (Orsini, 2015).
Aleph also borrows from Yoga and Nostradamus writings (Kearns, Conlon & Young, 2014). Aum Shinrikyo’s group Aleph was founded by Chizuo Matsumoto who alleged that he was seeking to reinstate original Buddhism. Thus, in the year 1992, Chizuo Matsumoto started calling himself Shoko Asahara, which became his name (Kearns, Conlon & Young, 2014).
In the same year 1992, Shoko Asahara was able to publish an introductory book where he declared himself to be “Christ.” Furthermore, in the book Shoko Asahara refers to himself as the only master who is fully enlightened and identifies with “God’s Lamb” (Kearns, Conlon & Young, 2014).
Command structure of Aum Shinrikyo
Aum Shinrikyo is known to apply precise methodologies. Furthermore, Aum Shinrikyo has a prearranged study of doctrine which is in harmony with a particular system of learning. For a follower of Aum Shinrikyo to reach another stage, it is expected that the member successfully passes a given exam (Orsini, 2015). The practice of meditation is combined with hypothetical studies.
However, Shoko Asahara emphasized to his followers that hypothetical studies cannot serve any purpose when practical experience is not achieved. Additionally, Shoko Asahara also advised members of Aum Shinrikyo never to try explaining anything if they could not mostly experience it (Orsini, 2015).
Aum Shinrikyo’s followers were grouped into two. The first group was lay practitioners. The lay practitioners are Aum Shin rik yo’s members who live together with their families (Orsini, 2015). A second group is a group of members who lived a lifestyle that is ascetic. In most cases, the second group included individuals who usually live as a group (Orsini, 2015). For any follower to earn the status of an attained member, it was an obligation for the member to meet precise conditions so as to influence senior members to recognize that the member has reached a state of higher spirituality (Orsini, 2015).
For instance, in the stage of Kundalini Yoga a member was required to give a demonstration regarding his or her ability in showing abridged oxygen consumption, modification of electromagnetic activities of the brain, and reduced rate of the heart, which was to be proven by being measured using a corresponding equipment (Richards, 2014). When a member demonstrated all the changes described above, then he or she was considered having entered a higher state referred as Samadhi (Richards, 2014). Thus, a member who has attained Samadhi state was given permission to educate other members.
The purported mission of Shoko Asahara was taking all the sins that people in the world have committed. Shoko Asahara claimed that he had the ability to transfer spiritual power to Aum Shinrikyo’s members (Richards, 2014). Additionally, Shoko Asahara claimed he would ultimately cleanse Aum Shinrikyo’s members’ sins by taking them away. Consequently, scholars view Aum Shinrikyo as an outcome from Japanese Buddhism. The view by scholars influenced how Aum Shinrikyo’s definition and view of itself. Notably, Shoko Asahara made an outline of a prophecy on doomsday that integrated the “World War III” to be prompted by the United States (Richards, 2014).
Leadership of Aum Shinrikyo
Shoko Asahara is known to be the historical leader of Aum Shinrikyo. Furthermore, Shoko Asahara was also the chief of senior operations for Aum Shinrikyo (Sageman, 2014). Shoko Asahara came from a Japanese family that was poor. After realizing a personal enlightenment in religion, Shoko Asahara formed Aum Shinrikyo, a religious cult (Sageman, 2014).
Shoko Asahara had recruited almost 10,000 followers to Aum Shinrikyo during the 1990s. Notably, Shoko Asahara dreamt of being an emperor in Japan. Thus, Shoko Asahara assumed the role of interim commander of Aum Shinrikyo (Sageman, 2014).
Shoko Asahara tried to register Aum Shinrikyo with Japan’s government based on the law of religious corporations known as “Shukyo-hojin-Ho” in 1989 (Shapiro, 2013). The registration was to include benefits such as privileges regarding taxation, rights of owning property as Aum Shinrikyo organization, along with protection from interference by the state and other external bodies (Shapiro, 2013).
Initially, the Japanese government denied permission of registration to Aum Shinrikyo citing a string of complaints raised by families with members practicing the Shukkesha (Shapiro, 2013). Shukkesha refers to a practice where members are demanded to sever all the ties they have with family and ensure they cease communication (Shapiro, 2013).
Aum Shinrikyo gave a response to the Japanese government’s rejection by holding public demonstrations, holding lawsuits, and starting legal appeals to counter the government’s decision. Consequently, in the month of August in the year 1989 Aum Shinrikyo was approved of a legal status (Zúquete, 2015).
Thus, Aum Shinrikyo started a new trend in 1989 of greeting every difficulty that comes their way with vigorous denials accompanied by lawsuits (Zúquete, 2015). Notably, in May of 1989 many parents had hired a lawyer from Yokohama known as Sakamoto Tsutsumi. However, Sakamoto uncovered claims that were faulty arguing that tests had been carried out in Kyoto University revealing that he had a unique DNA in his blood (Zúquete, 2015).
Afterward, Aum Shinrikyo started the practice of blood initiation, which was assumed to increase the spiritual power of an individual though no tests were run (Shapiro, 2013). Later, Sakamoto, his wife along with infant son disappeared. An Aum badge was found indicating that Aum Shinrikyo was involved with the disappearance, but no direct evidence was available to link the group.
Thus, Aum Shinrikyo embraced the accusations as an opportunity of getting publicity. Asahara professed the need for political action in saving the world thus, launching “Shinrito” political party which translates to “Supreme Truth Party” (Shapiro, 2013).
Motivation of Aum Shinrikyo
Aum Shinrikyo is motivated by both general reasons and particular motives. For instance, Tomomitsu Niimi attacked a VX victim at 7 am on the 12th of December in 1994 after Shoko Asahara reported of suspecting the victim of being a spy (Zúquete, 2015). The victim was murdered by being sprinkled on the neck for being a nerve agent. Aum Shinrikyo capitalizes on visions of the millennium along with predictions of the apocalypse in framing its doctrine. Consequently, Aum Shinrikyo is highly prejudiced by Nostradamus work. Notably, Nostradamus work provides a cornerstone to Aum Shinrikyo’s teachings.
Markedly, the followers of Aum Shinrikyo actively recruit students along with professionals working in the medicine field, field of science, field of computers, the engineering field, along with other areas, which are technical. Therefore, the charisma by Shoko Asahara and his messages appeared to have more appeal to a majority of people who felt estranged by the modern society, the secular society and the conformist features of the Society of Japan (Zúquete, 2015).
At the crest of Aum Shinrikyo, it is approximated to be worth over $1.5 billion. Notably, having enormous financial resources, Aum Shinrikyo is motivated to invest its capital in high-technology, laboratories for “state-of-the-art,” and funding Aum’s research. Thus, Aum Shinrikyo can circumvent restrictions, which are associated with large laboratories for corporate research.
Additionally, for Aum Shinrikyo to raise funds, they collect money from donations, followers tithe, and selling of sacred materials. Aum Shinrikyo also conducts seminars along with courses regarding the teachings of the cult where it charges all individuals who are participating in the sessions (Kearns, Conlon & Young, 2014). Furthermore, Aum Shinrikyo diversifies its enterprises through running a string of hotels in Tokyo and a firm for manufacturing computers that assembles and sells computers within Japan using parts traded in from Taiwan.
Aum Shinrikyo is also motivated by the support it gets from a Japanese mafia known as the Yakuza, who provide the group with an agreement for marketing illegal drugs manufactured by Aum Shinrikyo. Aum Shinrikyo is also motivated by cooperation given by community leaders through engaging in greenmail practice, which involves extorting money from community leaders (Kearns, Conlon & Young, 2014).
Aum Shinrikyo extorts money from community leaders through threatening them about establishing Aum Shinrikwo’s branch office or an Aum Shinrikwo’s school in the local community in question. Consequently, Aum Shinrikyo also aims at gaining leverage by engaging in extortion, acts of coercion, engaging in theft along with murder as a way of raising money for the group.
Goals of Aum Shinrikyo
The primary goal of Aum Shinrikyo is to defend the ancient faith by promoting worldwide operations that endorse theologies collected from diverse sources. Furthermore, Aum Shinrikyo also operates on a goal of collapsing dictatorship from western countries and institutions within the Middle East. According to Shoko Asahara, Aum Shinrikyo has the goal of uniting all doctrines and establishing, forcefully a desperate need of the society adhering to rules given by the original Caliphs (Kearns, Conlon & Young, 2014).
For instance, in his religious decree, Shoko Asahara talks of individuals duty globally being leading a holy life through cleaning one’s sins based on the doctrine of Aum Shinrikyo, with Shoko Asahara as the self-proclaimed “Christ”. Furthermore, in the book Shoko Asahara refers to himself as the only master who is fully enlightened and identifies with “God’s Lamb” (Kearns, Conlon & Young, 2014).
The ideology of Aum Shinrikyo is based on an idiosyncratic understanding of elements by Shoko Asahara regarding ancient Indian Buddhism, Tibetan Buddhism, and Hinduism. The main icon of worship was taken to be Shiva (Kearns, Conlon & Young, 2014). Aleph one of the groups of Aum Shinrikyo also incorporates millennialism ideas, which it borrows from the Bible’s Revelation book (Orsini, 2015).
Furthermore, Aleph also borrows from Yoga and Nostradamus writings (Kearns, Conlon & Young, 2014). The ideology is manifested by Tomomitsu Niimi’s willingness to attack and murder a VX victim at 7 am on the 12th of December in 1994 after Shoko Asahara reported of suspecting the victim of being a spy.
Even though most doctrines disagree with almost all thoughts of Shoko Asahara, Aum Shinrikyo is rooted in earning a status (Kearns, Conlon & Young, 2014). For instance, the doctrine of Aum Shinrikyo dictates that in order for any follower to earn the status of an attained member, it is the obligation that member to meet precise conditions so as to influence senior members to recognize that the member has attained a state of higher spirituality (Orsini, 2015).
In one of the stages known as Kundalini Yoga a member was required to give a demonstration regarding his or her ability in showing abridged oxygen consumption, modification of electromagnetic activities of the brain, and reduced rate of the heart, which was to be proven by being measured using a corresponding equipment (Richards, 2014).
Threat posed by Aum Shinrikyo
Aum Shinrikyo poses a number of threats. According to an annual report by the department of state in the United States regarding global terrorism, Aum Shinrikyo is a great threat as it has evolved. Aum Shinrikyo has evolved leading to its current dispersion in the Middle East. The two groups Aleph and a group known as “Hikari no Wa”, which are operationally self-governing affiliates of Aum Shinrikyo are developing to be increasingly aggressive (Kearns, Conlon & Young, 2014).
Furthermore, the affiliates of Aum Shinrikyo in the Middle East use the instability of their regions to their advantage. Moreover, affiliates of Aum Shinrikyo tend to be financially sovereign from the central leadership of Aum Shinrikyo. Notably, affiliates of Aum Shinrikyo raise funds to run their operations from illegal activities such as extorting money from community leaders, acts of coercion, engaging in theft along with murder-kidnapping people and requesting for ransom or fraud of credit cards.
Aum Shinrikyo is also highly active in Japan according to the department of the state of the United States. Compared to all affiliates Aum Shinrikyo in Aleph is the greatest threat to the United States. The head of Aleph in Japan was appointed in 2013 to be the deputy leader of the entire system of Aum Shinrikyo globally (Finn & Momani, 2017). Furthermore, in 2013, acts of terrorism were influenced by sectarian reasons, which present a major threat.
It was also revealed that there was the resurgence in the activities conducted by Iranian security forces along with Iranian intelligence, as the two institutions were linked to primarily supporting Iran for its Assad administration in Syria. Iran also was revealed to have allies in Japan, known as “Hikari no Wa”. “Hikari no Wa” is a renowned terrorist group known for its high-level illegal activities and affiliation to Aum Shinrikyo.
Policies of combating Aum Shinrikyo
There are various policies of combating Aum Shinrikyo. Notably, Aum Shinrikyo is no longer hiding when performing its operations. At the moment Aum Shinrikyo controls its operations mainly from Japan. Thus, America is faced with a great challenge regarding its lifestyle. Aum Shinrikyo constantly fights against the United States with the aim of creating a global caliphate. Consequently, it has been globally recognized that there is need to acknowledge the terrorism problem intensity, and the magnitude required in terms of effort for combating the problem (Eid, 2014).
One of the policies of combating the problem of terrorism is having coordinated regional counterinsurgency operation. Markedly, this policy involves robust efforts of stabilization and combination of diplomatic efforts, political attempts, security endeavors, and informational attempts. The second policy is to end the brutality that averts regional cohorts from fighting Aum Shinrikyo, thus creating space or energy for Aum Shinrikyo to make recruitments and execute its operations.
The third policy is a unification of the private sector with the government in an effort of fighting Aum Shinrikyo. The fourth policy is creating strong partnerships locally as a way of ensuring the stability of governments (Eid, 2014). Notably, a majority of countries have developed less responsiveness to terrorism while others have been overpowered by terrorism through terrorists acquiring and staying on their land.
The main aim of having partnerships is to ensure that Aum Shinrikyo will not reemerge after it has been defeated. The fifth policy is analyzing the position held by key players who notably are within the majority world of Buddhism, Muslims, and Hinduism (Eid, 2014). For instance, partnering with Russia requires careful diplomatic engagement as its presence of forces within Aum Shinrikwo’s territories develops a challenge.
Conclusion
Terrorism is a global problem. For years the problem of terrorism has been shifting from one continent to another. Consequently, it has been established that terrorism is founded on carefully planned structures. Thus, this paper has discussed terrorism foundations by developing a case study of Aum Shinrikyo terrorist group. Aum Shinrikyo is known for dominating its operations within Japan along with the Middle East.
The paper above has revealed that initially, Aum Shinrikyo was a logistical set-up that aimed at defending the ancient faith by promoting worldwide operations that endorse theologies collected from diverse sources. Furthermore, it has come out clearly through the paper above that there are two separate groups of Aum Shinrikyo terrorist group. A group is known as Aleph and a group known as “Hikari no Wa”.
However, the paper has also revealed that Aum Shinrikyo cannot be termed as an organization rather Aum Shinrikyo refers to a doomsday cult whose origin is in Japan. Furthermore, the paper has revealed that activities of Aum Shinrikyo are motivated by both general reasons and specific motives. Thus, Aum Shinrikyo tends to engage in illegal acts as a way of gaining leverage. The illegal acts include engaging in extortion, acts of coercion, engaging in theft along with murder, as a way of raising money for the group.
Finn, M., & Momani, B. (2017). Building foundations for the comparative study of state and non-state terrorism. Critical Studies On Terrorism, 1-25. http://dx.doi.org/10.1080/17539153.2017.1287753.
Ingram, H. (2017). The Strategic Logic of the “Linkage-Based” Approach to Combating Militant Islamist Propaganda: Conceptual and Empirical Foundations. Terrorism And Counter-Terrorism Studies. http://dx.doi.org/10.19165/2017.1.06
Orsini, A. (2015). Are Terrorists Courageous? Micro-Sociology of Extreme Left Terrorism. Studies In Conflict & Terrorism, 38(3), 179-198. http://dx.doi.org/10.1080/1057610x.2014.987593
Shapiro, S. (2013). The Intellectual Foundations of Jewish National Terrorism: Avraham Stern and the Lehi. Terrorism And Political Violence, 25(4), 606-620. http://dx.doi.org/10.1080/09546553.2013.814502
Zúquete, J. (2015). Martin A. Miller.The Foundations of Modern Terrorism: State, Society and the Dynamics of Political Violence. Terrorism And Political Violence, 27(4), 786-788. http://dx.doi.org/10.1080/09546553.2015.1068094
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The various counter terrorism units in the country play an integral role in ensuring that the fight against terrorism is won. They are focussed on ensuring that not only the USA but the world in general is peaceful. A number of agencies are involved in the fight against terrorism in the USA but the focus of the paper will be centered on the Federal Bureau of Investigation (FBI).
The FBI serves as an intelligence and law enforcement agency and has its headquarters in Washington D.C. The agency was started in 1908 and has grown immensely to cover a wider range of responsibilities. It currently has over 35,104 employees that have a wide range of skills and knowledge that are essential in protecting the citizens of the USA from terrorism attack (Gulati, Raffaelli, and Rivkin, 2016).
Counter terrorism: Structure of FBI
The FBI has a centralized organizational structure that ensures a seamless flow of information. The head of the agency is the director who works in close conjunction with the office of the General Counsel, chief of staff, inspection division. The next in line is the deputy director who works in close conjunction with the office of professional responsibility, office of equal employment, office of the public and congressional affairs.
The other units that are controlled directly by the director and deputy director are criminal justice information service division, tracking division, administrative services division, training division, information resource division, information resources division, national security division, criminal investigative division, laboratory division, finance division, investigative services division, and counter- terrorism division ( United States Federal Bureau of Investigations(FBI) Academy Handbook, 2014, p.89).
From an international perspective, the FBI has over 64 legats and smaller sub offices in various cities around the world. The presence of the agency is present in over 200 countries and they have been set up through a mutual understanding from the governments and the agency. Most of the offices are located within the U.S embassy or the consulate. Their main aim is to ensure that they share intelligence information that will benefit the country they are operating and the USA (International operations, 2017).
The agencies that they work with are Interpol, foreign police, CIA and other international organizations that safe guard the people. The interactions between the country they are hosted and the USA is based on the treaties, statues, executive orders and Attorney general guidelines that are agreed upon by all the agencies.
The Legat program goes further ahead to offer international intelligence training to the security agencies in the different countries that they operate. The training does provide an opportunity to strengthen the relationship between the agency, USA and the countries they operate in. Moreover, it does provide an opportunity to consolidate the security of the entire world with respect to combating terrorism activities (International operations, 2017).
After the 9/11 attacks in the USA, the agency’s responsibility, intelligence work increased immensely to ensure efficiency in the operations to combat terrorism (McClintock, 2016). The counter terrorism division within the FBI is divided into four branches which are operations Branch 1, operations Branch II, analytical and operations support branch.
The Operations Branch I is further divided into two sections which are the international Terrorism Section I that does concentrate on al Qaeda activities on a regional and international basis. The second section concentrates on terrorism affiliated groups in Iraq/Syria/Libya, Palestinian rejectionist groups, Iran and Hezbollah, and other terrorist groups that are present in different parts of the globe (Anderson, 2010, p. 19).
The second branch, operations branch II, concentrates on weapons of mass destruction, terrorist financing operations, domestic terrorism and communications exploitation sections. The FBI does provide intelligence information on nuclear, radiological, biological, chemical or other weapons that are used by terrorist groups to clear a large number of people or cause extreme damage to the infrastructure of any nation. The second section, terrorist financing operations section, focuses on the investigating the funding of the terrorism groups and freezing their assets to decapitate their operations (Gulati et al., 2016).
The section does play a vital role in carrying out in depth investigation, prosecution, disruption and continuous demolishment of the terrorist activities that are tied down to fund-raising activities. The section has been further divided into four units to enhance efficiency, they are financial intelligence analysis, global extremist financial investigations, radical fundamentalist financial investigative, and domestic WMD, and global financial investigations unit (Gulati et al., 2016).
The third branch is the counter terrorism branch that deals with analysis and preparation of the intelligence reports. The branch does serve as the clearing house for all the intelligence gathering and processing. The branch has five divisions which are activities, ideology, linkages, trade craft and terrorist group composition. The branch does identify intelligence assets, blind spots and gaps in the intelligence system, evaluating the threat levels within the country, and the source of funding for all the terror groups.
The most dangerous groups that the branch monitors are the Al Qaeda, Hezbollah and Hamas. Last but not least it does share the intelligence they have gathered with other security agencies in the country to consolidated their work efforts (FBI Counter terrorism Analysis Branch Jobs and Salary, 2017).
The last branch, operations support branch, does focus on handling a number of responsibilities that are essential in ensuring that the tactical personnel are able to operate efficiently in the various missions. They develop budgets, organize training programs for the units, formulate CTD strategies, and consolidate partnerships with external private entities in the intelligence security organizations (FBI Counterterrorism Operational Support Branch Jobs and Salary, 2017).
The branch has two divisions which are the national threat center and the counter terrorism operational response section. The division is the backbone of the FBI and does share intelligence information with the Joint Terrorism Task Force and the Department of Homeland Security to counter terrorism. Moreover, the unit also shares information with the general public when it comes to counter terrorism programs.
Additionally, the branch oversees the FBI personnel who have been seconded to other security agency and finally it does work in close conjunction with the Department of Defense when it comes to coordinating operations (FBI Counterterrorism Operational Support Branch Jobs and Salary, 2017).
On the logistic perspective focuses on ensuring that the agency can be able to work effectively in their operations. The employees in the logistic centre work in construction, space management employee health and safety, telecommunications management, facilities operations, mail/freight management, and security electronics. The logistics of the team does go beyond consolidating the operations within the Washington D.C offices and the legate in different parts of the world (Our very own global logistics Service, 2017).
Logistic aspect also does come into action when the FBI is engaged in field activities. The team that handles their logistics is referred to as the Rapid Deployment Logistic Unit (RDLU), the unit is the first respondents when the agency is called to handle an attack and it does constitute counter terrorism experts, communicators, medical staff, military liaisons, lab personnel among others. They also have the Crisis Advance Team (CAT) that does determine the number of specialist that are required to combat counter terrorism.
When the specialist responds to any attack the field specialists segregate areas to set up the command post, and other machines that will be essential in linking the operation to the FBI offices in the USA. The RDLU also does work in setting up temporary operation centers that provide the team with an opportunity of hosting major diplomatic meetings, international sports and other special events (Our very own global logistics Service, 2017).
On the financing aspects the agency does receive funds for operations mainly from the federal government. The president does provide the agency with the finances required to run the operations each financial year based on the budget prepared by the operational support branch of the FBI. The machinery and weapons used by the tactical team vary based on the mission that the agents are carrying out. As discussed, the unit has different agents handling varying issues with respect to countering terrorism (Operational Technology, 2017).
The one aspect that is clear is that the agency uses the latest technology in their role to combat terrorism in the USA and the world at large. The FBI has launched the operational technology division located in Virginia that does incorporate technology in the intelligence, law enforcement and national security aspect of the nation. Some of the specific areas that they focus on are advanced electronic surveillance and search, digital forensics, radio program, specialized support and coordination, tactical operations, technical personnel and defensive programs among others (Operational Technology, 2017).
In conclusion, counter terrorism is an issue that does affect everyone in the different parts of the world. The FBI is one of the agencies that our focus group concentrated on evaluating their organizational structure, size, the different responsibilities of the branches, the finances and the type of machinery that is used. The FBI is not the only agency that tackles terrorism issues, but it does play an effective role by collaborating with the internal and external agency to combat terrorism.
REFERENCE
Anderson, J. W. (2010). Disrupting Threat Finances: Utilization of Financial information to Disrupt terrorism. Diane Publishing.
Gulati, R., Raffaelli, R., & Rivkin, J.W. (2016). Does “what We Do” Make Us” who We Are”? Organizational Design and Identity Change at the Federal Bureau of Investigation. Harvard Business School.
