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How do the mental health service respond to the rising incidents of self harm among young people. The Oxford Medical Dictionary defines suicide as self-destruction that is performed as a deliberate act. Although it is strongly linked to self-harm , it is noteworthy that self-harm is often not a suicide attempt, but actually a parasuicide -when self-harm is carried out for other reasons other than killing oneself. In Shakespeare´s? Deliberate self-harm refers to “a wide range of behaviours and intentions including attempted hanging, impulsive self-poisoning, and superficial self-cutting in response to uk unemployment rate, intolerable tension” (Skegg, 2005). According to The National Institute of Clinical Excellence (NICE), self-harm is an expression of personal distress, and is not in itself, and illness. It is a situation in which a person inflicts harm on himself or herself in an attempt to Tragedy, end one’s life, relieve tension, escape anguish, change others’ behaviours, show desperation or cry for help (Hawton and James, 2005). Thus it ranges from behaviours with no suicidal intent through to actual suicide.

However, is has been proposed that some successful suicides are actually self-harming episodes that go wrong. Suicide and self-harm among teenagers usually occurs by means of self-cutting or self-poisoning. Other common examples include hitting or burning oneself, pulling hair or picking skins and self-strangulation. Genetic Engineering Dangers? Generally, teenagers tend to use means that are readily available within their homes. Self-poisoning accounts for approximately 90% of reported hospital cases -usually involving over-the-counter preparations such as paracetamol and aspirin, or psychotropic agents. Rarely, self-harm is carried out by more violent acts such as attempted hanging; in which case, it is generally associated with higher suicidal intent.

While previous self-harm is Essay Tragedy, a major determining factor for future suicides, the reverse is obviously not the case. Possibly, a major difference between these two increasingly prevalent occurrences is complete hopelessness often associated with suicide victims. It is widely believed that adolescents who commit suicides are products of genetic engineering dangers, broken homes, have history of family of self-psychiatric disorders or suicidal behaviour, substance misuse or have previously self-harmed. In self-harm, oftentimes the individual is merely crying for of Revenage Hamlet help in genetic an extreme manner. This is Essay Tragedy in Shakespeare´s Hamlet, fundamental to the rationale behind the extensive assessment recommended for all patients who have self-harmed.

Although these two conditions often overlap, differences have been highlighted between suicides and deliberate self-harm in terms of epidemiology and prevalence. While suicide rates increase with age, the majority of deliberate self-harm occur in people under 35 years of age. Gender variation has also been widely observed, with suicides being more common in Social Movements males and deliberate self-harm in females. Also, differences arise in the psychiatric status of the patients. Post mortem studies of suicide victims show that there is usually an underlying psychiatric disorder such as depression associated with the victim’s mental health. This is not always the case with self-harm patients. Although there could be a history of depressive illness, self-harm is frequently an impulsive act, probably enhanced by alcohol or drug consumption (Hawton and Essay of Revenage in Shakespeare´s Hamlet, James, 2005). Self-harm is a serious public health problem and uk unemployment rate, young people are particularly affected by it (Mental Health Foundation, 2006). A case of a patient who has self-harmed is a chance for the health services to Essay Hamlet, effectively evaluate and address any relevant underlying problems and is an opportunity to successfully avert potential future suicides.

The extent of self-harm and suicides among young people has been accurately described as an unknown quantity (Bywaters and Rolfe, 2002). Reportedly, 8 out of every 100,000 deaths in dangers England and Wales each year are suicide cases. Essay Hamlet? There are an of lords house of commons, estimated 25,000 adolescent self-harm presentations annually in hospitals in England and Wales (Hawton et al, 2000) and government research report that as many as 1 in Essay Tragedy of Revenage in Shakespeare´s Hamlet 17 young people have attempted to harm themselves. The Influence In Art And Architecture Essay? Suicide is the Tragedy, second most common cause of death among 15- to Essay on LGBT Social Movements, 34-year olds. These rates are even higher (20-50 times) in psychotic patients than in Tragedy of Revenage in Shakespeare´s the general population. The often-vast variation between different prevalence sources is chorus play, most likely an indicator of geographic, epidemiogical and cultural variation in self-harm trends. Global suicide rates in young people have increased during the past three decades. According to the Office of National Statistics (1999), 1.3% of 5-10 year olds have tried to Hamlet, harm, hurt or kill himself/herself.

More than four times this proportion (5.8%) of the older children aged 11 to chorus play, 15 years old report having attempted to Essay Tragedy of Revenage in Shakespeare´s Hamlet, self-harm or commit suicide. Most child and adolescent mental the current rate, health services take the school-leaving age of Essay of Revenage, 16 as their upper limit. Thus most available statistics are only for rate children up to the age of 16. It is important that children who fall within this narrow and oft-omitted age-gap (16-18 year olds) are not neglected, and are properly catered for. The statistics also show that among the 5-10 year olds, boys were almost twice as likely to self-harm than their female counterparts. Likewise, children of single-parent homes also had more tendencies for deliberate self-harm than children of Essay in Shakespeare´s Hamlet, couple-parent families. Surprisingly, children with no siblings had slightly more chance of committing self-harm than children from larger families.

40% of current, these children who had tried to self-harm had a mental disorder, and one in three had experienced 3 or more stressful life events. In contrast, among the Tragedy of Revenage in Shakespeare´s Hamlet, 11-15 year olds, self-harm appears to engineering dangers, be more prevalent among girls (58%) than boys. Essay Tragedy Of Revenage In Shakespeare´s Hamlet? However, these older children are apparently more likely to self-harm if they have a lot of siblings. 50% of house, these adolescents who had tried to harm, hurt or kill themselves had a mental disorder and over 40% had experienced 3 or more stressful life events. Parents generally tend to underestimate their children’s self-harm tendencies and history, as illustrated by the vast differences in Tragedy of Revenage parents and children’s accounts of The Influence in Art Essay, self-harm and suicide attempts. This gives an insight into the level of Essay Tragedy, shrouding and secrecy that is associated with these phenomena and casts doubts on the validity and reliability of these widely accepted statistics. Stigmatisation and ostracization commonly associated with suicide and self-harm victims and only parents influence children genetic, families is the most likely reason behind under-reporting and Essay Tragedy of Revenage Hamlet, denial. In addition, prevalence of suicides is largely underestimated because of reluctance of coroners to classify cause of death as suicides, especially in children.

A large proportion of the so-called “open verdicts” are, in fact, suicides (Hawton and James, 2005). Self-harm techniques such as self-cutting usually go unnoticed. As the most common method of DSH by teenagers, the implications are that the rates of self-harm amongst adolescents are grossly under-reported. Thus it is important to note that these daunting statistics might actually represent a conservative estimate of the reality of self-harm and suicide attempts among young people . Investigating potential socio-demographic and clinical predictors of suicide, Cooper et al (2005) concluded that there was an approximately 30-fold increase in risk of suicide in deliberate self-harm patients than in the general population. Furthermore, suicide rates were found to chorus play, be highest within the first 6 months after the initial self-harm episode. This is the basis for early assessment and treatment as will be discussed in Essay Tragedy of Revenage in Shakespeare´s Hamlet subsequent sections. Examining trends and characteristics of self-harm in adolescents between 1990 and 2000, Hawton et al (2003) found that the prevalence of self-harm among young females was on the increase.

These rising rates could reflect latent negative effects of a number of uk unemployment, social changes. Possible reasons for this increase include increased rates of family breakdowns, increasing rates of in Shakespeare´s Hamlet, substance misuse, media influences and chorus play, common peer behaviours. In a self-report survey, Hawton et al (2002) studied the Essay Tragedy of Revenage in Shakespeare´s Hamlet, prevalence of The Influence and Architecture Essay, deliberate self-harm in adolescents aged 15 and 16 years old, and the factors associated with it. Essay In Shakespeare´s? In this age group, females were more likely to self-harm than males. Ethnicity-wise, teenagers of white origin were more likely to self-harm than their Asian counterparts. Black young people were the least likely to self-harm. In addition, teenagers who lived with other family members apart from their parents were more likely to self-harm than those who live with one or both parents. Smokers also had more incidents of Essay Movements, self-harm than non-smokers, with frequency increasing with number of cigarettes smoked in girls. Similar trends were observed with young people who consumed alcohol. Expectedly, bullying and other forms of abuse (physical or sexual) was a major determining factor for adolescents who self-harm. Other factors which played a role in Essay Hamlet self-harm amongst young people were sexual orientation worries, trouble with police and family or friends who harm themselves.

Although self-harm is observed in all age-groups, it has an average age of Essay, onset of 12 years old (Fox and Hawton, 2004). Thus the importance of addressing this problem in adolescents is blatantly obvious. Factors that have been substantiated to be strongly associated with self-harm amongst adolescents are very similar to characteristics associated with suicidal patients. In Shakespeare´s? These include: Depression Substance misuse Physical or sexual abuse Low self esteem Physical ill-health Disputes with parents, siblings or friends School or work problems. In an ecological and chorus play, person-based study, Hawton et al (2001) investigated the influence of the economic and social environment on of Revenage deliberate self-harm and Movements, suicide. Improving on the methodical limitations of previous studies, the researchers studied DSH patients over 10 years.

The relationship between socio-economic deprivations was shown to be very significant in of Revenage in Shakespeare´s Hamlet males and females. These findings have been collaborated by a more specific study (patients under 18 years old). Socio-economic deprivation was significantly associated with overdose, self-injury and poisoning by only parents influence children through traits., illicit substances (Ayton et al, 2003). Accounting for confounding factors, correlations remained significant, further validating the in Shakespeare´s Hamlet, results of the study. Although the relationship between ethnic density and deliberate self-harm tendencies is current, not well established, Neeleman and colleagues (2001) demonstrated variable deliberate self-harm rates in various minority groups, suggesting protection and risk in different areas. This is Essay Tragedy of Revenage, a gap in the literature for future research. School stress has also been shown to play a role in DSH in teenagers (Hawton et al, 2003). The findings from widespread international research suggest that the chorus play, most determining risk factors for youth suicide are mental disorders and a history of psychopathology (Beautrais, 2000). Others could be individual and personal vulnerabilities, social, cultural and contextual factors. Possible motives for self-harming behaviour other than death are highlighted below (Hawton and James, 2005): To escape from unbearable anguish.

To change the behaviour of others. To escape from a situation. To show desperation to others. Tragedy In Shakespeare´s Hamlet? To make others feel guilty. To gain relief of tension. Movements? To seek help.

Furthermore, research has provided a useful insight into Tragedy Hamlet the factors that can influence repetitive self-harm behaviours despite aftercare and treatment. This is house of commons, important in the assessment of patients who have self-harmed to identify those who are likely to self-harm again and prevent such episodes. Tragedy Of Revenage In Shakespeare´s Hamlet? Factors that are associated with repeated self-harm as highlighted by Essay on LGBT Movements, Hawton and James (2005) include personality disturbance, depression, alcohol or substance misuse, disturbed family relationships, social isolation and poor school records. Hawton et al (1999) demonstrated that self-harm repeaters differed from the non-repeaters in having higher scores for depression, hopelessness and trait anger, and in Shakespeare´s, lower scores for self-esteem. Specific reasons that have been cited for self-harm by young people, as highlighted by house, the National Inquiry (2006) include: · Strained relationships with parents. · Worry about academic performance.

· Childhood abuse (sexual, physical or emotional) · Low self-esteem or rejection. · Problems to do with race, culture or religion. 2. Of Revenage? Responding To Young People Who Self-Harm. 2.1 Guidelines And Evidence For Good Practice. The National Institute for chorus play Clinical Excellence (NICE, 2004) has proposed guidelines for the short-term physical and Essay Hamlet, psychological management and secondary prevention of self-harm in primary and secondary care. In addition, The Royal College of Psychiatrists (RCPSYCH) also provides guidance on managing young people up to the age of 16 who deliberately harm themselves.

Such guidelines are readily applicable to the Health service i.e. Accident and uk unemployment rate, Emergency departments and Child and Adolescents Mental Health Services. Integrating these treatment guidelines and the findings of related research, the management of these young self-harm patients will be extensively discussed under the following sub-titles: Assessment Treatment planning Admission to Essay Tragedy of Revenage Hamlet, hospital Treatment options Medical and surgical management Referral and discharge following self-harm Pharmacological interventions Family support Prevention. A comprehensive child and adolescent mental health service needs to take all the above facets into consideration when treating this group of extremely vulnerable patients.

The NICE guidelines (2004) emphasize the The Influence of Renaissance and Architecture Essay, importance of treating patients who have self-harmed with the Tragedy Hamlet, same care, respect and privacy as any other patient. In fact, the likely distress associated with self-harm may necessitate additional care and tact when dealing with these patients. Also, health services are urged to provide appropriate training to all staff (clinical and non-clinical) that has any form of contact with the patients to fully equip them with the necessary skills and knowledge to only children through genetic, effectively understand and care for people who have self-harmed. Ideally, training should cover areas such as crisis counselling, risk assessment, stress management, mental health triage, cultural awareness, working with families and confidentiality issues (Wynaden et al, 2000). Clearly, the importance of ensuring patients’ safety while in Essay of Revenage hospital is and Architecture Essay, colossal. These patients should be offered an of Revenage Hamlet, environment that is safe, supportive and minimises any distress. The NICE guidelines (2004) suggest a separate, quiet room with supervision and regular contact with a named member of staff to ensure safety at all times.

The high rate of self-harm patients who repeatedly self-harm or go ahead to commit suicide in house house the future makes it imperative to conduct an extensive and detailed assessment of young people who self-harm . Young people who have self-harmed in Essay Tragedy of Revenage in Shakespeare´s Hamlet a potentially serious or violent way should be assessed either by chorus play, a child and adolescent psychiatrist, a specialist mental worker, a psychologist, a psychotherapist or a psychiatric nurse (Hawton and James, 2005). The NICE guidelines propose that all people who have self-harmed should be offered this preliminary assessment at triage, regardless of the severity of the attack. Apart from the obligatory emergency physical assessment, this will give an insight into Hamlet the patient’s mental health, the level of distress and their willingness to co-operate with the medical team. In addition, the patient’s psychosocial situation and the ability of parents or guardians to ensure their safety should be addressed (RCPSYCH, 2006). As the first point of contact, ambulance staff have a crucial role to play in the initial assessment of young people who have self-harmed (NICE, 2004). Only The Environments Of Their Children? The Australian Mental Health Triage Scale is a validated comprehensive assessment scale that provides a means of efficiently rating clinical urgency so that patients can be seen in Essay Tragedy of Revenage Hamlet a timely manner. This scale has been shown to genetic engineering dangers, improve staff confidence and attitudes in dealing with clients with mental health problems, thus improving patients’ outcomes in Tragedy Hamlet the long-run (Broadbent et al, 2004). Research has shown the importance of cultural, ethnic and racial awareness and sensitivity in of lords the assessment process.

Some cultures regard suicide attempts as taboo, and it is always good practice to take such factors into consideration. In addition, a language interpreter may be required to communicate effectively with the patient and family. 2.1.2 Treatment Planning. Following the Essay Tragedy of Revenage in Shakespeare´s Hamlet, preliminary assessment, it is considered good practice to uk unemployment rate, have an Tragedy of Revenage Hamlet, action or treatment plan (Hawton and Social Movements, James, 2005). Essay Tragedy Of Revenage? The treatment plan should take into account all aspects of the patient’s management in on LGBT hospital, ranging from treatment options to Tragedy, pharmacological and psychological interventions to discharge planning. 2.1.3 Admission To Hospital. At this point, temporary admission should be considered especially for parents influence the environments children through genetic patients who are who are very distressed, for people who may be returning to an unsafe or harmful environment and for people in whom psychosocial assessment proves too difficult for Tragedy in Shakespeare´s any number of reasons (NICE, 2004). If admission is indicated, a paediatric, medical adolescent, or designated unit should be utilised as appropriate. Despite the NICE guidelines, some schools of though believe that regardless of the toxicological or physical state of the chorus play, young person, hospital admission is desirable, so that adequate further physical and psychosocial assessments can be carried out, and of Revenage Hamlet, management/crisis interventions can be planned and initiated (Hawton and James, 2000). The paediatric ward will usually suffice, unless, and especially with patients in the older end of the age range, there is a more suitable unit available.

Waterhouse and Platt (1990) investigated the difference in outcomes between self-harm patients who were admitted to hospital and Essay Social, those were discharged as outpatients. The findings of the Essay Tragedy of Revenage in Shakespeare´s Hamlet, study showed slight significance between the two intervention groups. It is the role of the admitting staff to obtain agreement for the mental health assessment of the patient from of Renaissance in Art and Architecture parents or relevant guardians, and to alert all members of Essay of Revenage, staff of Essay on LGBT, each young person’s needs. As with all in-patients, hospitalised young patients who have self-harmed should be properly cared for Essay Tragedy of Revenage in Shakespeare´s and monitored. In addition, responsibilities of staff of the mental health team will include providing consultation to the young person and his/her family, the paediatric team and staff of the social services and education departments. The Crisis Recovery Unit at the Bethlem Hospital in genetic London, a national specialist unit for people of 17 years and above who repeatedly self-harm, have a different and slightly radical approach to the in-patient treatment of these patients (Mental Health Foundation, 2006). Their philosophy is Tragedy of Revenage Hamlet, that the individuals should take responsibility for their actions. This practice-supported technique focuses on helping young people realise for themselves that self-harm is not an effective strategy for dealing with their problems.

It encourages these patients to talk about their problems and explore alternative coping strategies, including strategies for house dealing with the urge to self-harm. However, the effectiveness of such an intervention in younger patients (11-16) is not certain, as these children might not be mentally mature for such self-realisation tactics. 2.1.4 Treatment Options. Treatment options for adolescents who have harmed themselves could be individual-based, family-based or group-based. Essay Tragedy Hamlet? Individual-based interventions include but are not limited to problem-solving, cognitive behavioural therapy and anger management. Family therapy could be in the form of problem-solving or structural or systemic therapy, and group therapy could involve any of these techniques performed in teams or groups. Problem-solving therapy or brief psychological therapy as it is otherwise known, is a brief treatment that is aimed at helping the chorus play, young patient to acquire basic-problem solving skills to identify and prioritise their problems (Mental Health Foundation, 2006). The process involves implementing discussed possible solutions to a specific problem, and reassessing the situation to review progress -sort of like a self-audit process. In Shakespeare´s? The basics of problem-solving therapy as identified by Hawton and James (2006) are highlighted below: · Identifying and deciding what problems to tackle first. · Agreeing goals of therapy with the patient as much as is possible.

· Working out steps to achieve goals. · Deciding how to tackle the engineering, first step. · Dealing with psychological factors that obstruct progress. · Working through subsequent steps. This method of problem-solving therapy appears to improve depression, hopelessness and general problems in deliberate self-harm patients significantly more than control therapy (Townsend et al, 2001). Essay Tragedy? This finding has been variously collaborated in other studies and the results are considered reliable. This therapeutic process usually takes 5 to 6 one-hour sessions, and can be delivered by any experienced mental health professional with suitable training and supervision (Mental Health Foundation, 2006). It is direct and easily understood and is thus suitable for the younger patients. Current? It helps the adolescent when he or she is faced with future crisis or trigger factors. Cognitive Behavioural Therapy. This form of Essay Tragedy in Shakespeare´s, psychotherapy is based on the belief that psychological problems are the product of an individual’s faulty way of viewing the world.

In this case, the therapist aims to chorus play, modify the patients’ cognitive processes and beliefs using techniques that are similar to those described above (problem-solving therapy), but with behavioural techniques. Although widely used adopted in psychotherapy in the treatment of depression, cognitive behavioural therapy (CBT) has limited evidence of use in Essay in Shakespeare´s self-harm patients. Even in depression, its use has been shown to be less effective as monotherapy than fluoxetine monotherapy and in combination with fluoxetine (March et al, 2004). Dialectical Behaviour Therapy. Dialectical Behaviour Therapy (DBT) is an intensive therapeutic technique that was introduced to help those who repeatedly harm themselves. It could involve as long as a full year of individual therapy, group sessions, social skills training and access to crisis contact (Mental Health Foundation, 2006). Fewer behavioural incidents have been reported with this treatment when compared with an input unit run on psycho dynamically oriented principles (Katz et al, 2004), thus strengthening findings by Rathus and Miller in 2002. In addition, an older study (Linehan et al, 1991) had shown very significant differences in likeliness to repeat self-harm in patients undergoing dialectical behaviour therapy and the control group.

The NICE guidelines (2004) suggest the use of dialectical behaviour therapy in self-harm patients who have a diagnosis of borderline personality disorder, but stress that this should not preclude the chorus play, use of other strongly validated psychological treatments with vast evidence-based support. As the Essay Tragedy, name implies, family therapy is genetic, a branch of psychotherapy that treats family problems as a source of the of Revenage, adolescent’s underlying therapy. Family interventions can be structured or systemic and can also be home-based. House Of Lords House? Basic aspects of this treatment option would include improvement of specific skills and emotions to promote sharing of feelings and negotiation between family members. Essay Tragedy Hamlet? Elements of assessment of families of only parents of their children through, self-harm victim should include (Hawton and James, 2005): · Family structure and relationships. · Recent family life events, e.g. death, relocation, divorce e.t.c.

· History of psychiatric disorder, including suicide attempts in the family. There is some anecdotal evidence that demonstrate the importance of family therapy in of Revenage Hamlet young people who self-harm, especially those have well-documented family issues or strained family relationships. However, evidence base to support the use of family therapy interventions is scarce and in Art and Architecture, quite weak. In a randomly controlled case study, Harrington et al (1998) compared an Essay Tragedy of Revenage, intensive family therapy intervention with standard self-harm aftercare. The results of the study found no significant differences between the house of commons, two groups of of Revenage in Shakespeare´s, subjects in terms of engineering, improved outcomes. Group therapy could include the previously discussed problem solving and cognitive behavioural therapy. The Oxford Medical Dictionary defines group therapy as psychotherapy involving at Tragedy in Shakespeare´s Hamlet least two patients and a therapist. Simply put, it is the administration of any psychological therapeutic methods described above in groups.

Normally, people with similar problems meet to house, discuss and analyse their problems and possible ways of Tragedy of Revenage Hamlet, overcoming them. Although this intervention could be time-saving, the genetic dangers, possibility of confrontation and tension between the group members is a potential barrier to its effective implementation. Essay Of Revenage Hamlet? Also, the negative connotation of suicide and self-harm might prevent patients from influence the environments genetic traits. effectively participating in such group sessions. In a small-randomised parallel trial in Manchester, England, Wood et al (2001) strove to Tragedy Hamlet, evaluate the effectiveness of group therapy for repeated deliberate self-harm in adolescents by comparing combination of routine care and group therapy with routine care alone. Results showed that adolescents who had group therapy were less likely to repeat self-harm than those who only chorus play, received routine therapy. Overall, the Essay Tragedy of Revenage, evidence for clinical management and only parents influence the environments of their children through, prevention of repeated episodes of deliberate self-harm in young people is limited. A systematic review by Burns and Tragedy of Revenage in Shakespeare´s, colleagues (2005) found that group therapy was the only specific programme that had significant effects on the rates of repetition of self-harm. Expensive interventions such as intensive aftercare have no clear advantages over standard aftercare. 2.1.5 Medical And Surgical Management.

Clearly a person who has harmed himself/ herself will have some form of injury, whether superficial or systemic. Responding to adolescents who self-harm will obviously include treatment of consequences of the self-afflicted injury. The treatment of self-injury would be the same as for The Influence of Renaissance in Art Essay any other injury, taking into account the level of Essay Tragedy of Revenage Hamlet, distress and emotional disturbance experienced by the patient (NICE, 2004). The most common products of self-injury -wounds and chorus play, poisoning must be treated accordingly. Wounds may require wound assessment and exploration and together with a full discussion of the patient’s preferences should be cleaned and dressed appropriately. In more severe cases, minor surgery might be necessary to properly mend any damages. Treatment for ingested substances would be dependent on the nature of the of Revenage, poison. Samples should be collected as soon as possible for laboratory analysis. The overall aim would be to uk unemployment, reduce absorption, increase elimination or chemically neutralize the adverse biological effects of the poison.

The guidelines proposed by the National Institute of Clinical Excellence emphasizes the consideration of gastro-intestinal decontamination only in self-harm patients who present early, are fully conscious with a protected airway, and Tragedy of Revenage in Shakespeare´s, are at risk of significant harm as a result of the poisoning. Activated charcoal could be administered 1 to 2 hours after ingestion. Emetics and chorus play, cathartics should not be used in the management of Tragedy in Shakespeare´s Hamlet, self-poisoning. Recommendations by The Influence in Art, TOXBASE or the Essay of Revenage, National Poisons Information Service (NPIS) should be followed to prevent further complications and harm. Gastric lavage and whole bowel irrigation should only be used when specifically recommended by relevant bodies.

2.1.6 Pharmacological Interventions. Generally, the use of pharmacological agents in treating adolescents who have self-harmed is built on the basis that depression is an underlying problem in these patients. Of Commons? Comparing antidepressant therapy with placebo in patients who had deliberately initiated self-poisoning or self-injury, significant odds ratios were achieved. Furthermore, significantly reduced rates of further self-harm were observed for depot flupenthixol compared to placebo. The current controversy over in Shakespeare´s selective serotonin reuptake inhibitors in children and adolescents (Wong et al, 2004), especially those with suicidal ideation must be taken into of Renaissance and Architecture account when prescribing for of Revenage in Shakespeare´s this group of current uk unemployment, patients. Like with all aspects of health care, and particularly mental health care, the choice of intervention depends on the individual patient’s condition. Montgomery et al (1979) have demonstrated a significantly greater likelihood of repeated self-harm in patients treated with the placebo agent compared with those treated with flupenthixol.

Differences in the outcomes of patients treated with antidepressants and those treated with placebo, though not as large, were still significant (Montgomery et al, 1983). The introduction of pharmacological agents in the management of such patients would ultimately depend on the outcomes of psychosocial and physical assessment, and should be aimed at treating the patient’s underlying problems or particular diagnosis rather than simply treating self-harming behaviour. Whatever, therapeutic decisions are made, clinicians should ensure that the patient (or where not possible, parents or guardians) are made aware of the treatment options available, including the likely advantages and disadvantages, and Essay Tragedy of Revenage in Shakespeare´s, involved in making a choice. 2.1.7 Referral and Discharge Following Self-Harm. Referral and discharge of an adolescent after self-harm would depend on the outcomes of the house house of commons, extensive assessment that would have been previously conducted (section 2.1.1).

It is important that the patient remains as involved as possible in decisions that are made regarding his/ her management. Adolescents who have harmed themselves may need a range of other health or social services. Referral to these professionals and other relevant agencies bears witness to the importance of adopting a multi agency approach (section 2.3). Proper documentation of of Revenage in Shakespeare´s Hamlet, all relevant interventions and conversations will ensure a seamless transfer from one health service to another and culminate in improved quality of care and better outcomes. 2.1.8 Family Support. This is quite different from engineering dangers family therapy as discussed under treatment options (section 2.1.4). Rather than attempt to Tragedy of Revenage in Shakespeare´s Hamlet, resolve underlying family problems in a bid to address the source of the adolescent’s problems like the genetic dangers, latter, family support refers to moves that could be taken to help parents and siblings deal with the traumatic experience of self-harm in the family. Common family reactions following suicide or self-harm by adolescents include denial, guilt, shame, anger, depression, substance misuse and overprotection of Essay in Shakespeare´s, other children and siblings.

These issues have to be addressed effectively and in a timely manner to avert further tragic family occurrences. It would be the responsibility of the resident psychologist to evaluate family members and provide the appropriate counselling and treatment. A large part of responding to the increasing rates of self-harm among adolescents in the UK is initiating preventive measures. The National Inquiry into self-harm among young people found that school-based work appears to be one of the most promising areas where prevention of self-harm among young people can be effectively tackled. Only Influence The Environments Through Genetic Traits.? Also it is widely recognised that young people would rather turn to young people than adults in Tragedy Hamlet their time of need. In response to this, schools have started implementing peer support schemes. Parents Of Their Through? It must be appreciated that prevention strategies should be both primary and secondary, i.e. Essay Tragedy Of Revenage In Shakespeare´s Hamlet? should target self-harmers as well as the current uk unemployment rate, general young population as appropriate. Child and Essay of Revenage in Shakespeare´s Hamlet, adolescent mental health services must put in place programmes to effectively reach their target population.

Measures should be put into action to only parents influence the environments children genetic, promote good mental health and emotional well being (Mental Health Foundation, 2006). In addition, educational awareness programmes should be initiated to in Shakespeare´s Hamlet, provide information to the general public towards reducing the stigmatisation associated with self-harm and suicides. The mental health service could pilot a 24-hour help line to address adolescent’s problems. This would provide an avenue to discuss one’s problems and of commons, obtain advice and Tragedy in Shakespeare´s, support on how to deal with them. 25% of young people who were asked what could be done to prevent adolescents from engineering dangers harming themselves responded that someone to listen, advise and support in times of need would be beneficial (Fortune et al, 2005). Secondary prevention is even more crucial as a 30-fold increase in risk of suicide has been demonstrated in Tragedy in Shakespeare´s young people who had previously self-harmed.

Direct intervention is indicated for these patients to influence the environments of their through genetic, prevent repeated self-harm. Various distraction techniques have been reported by these young people as helping to take their minds off the urge to inflict harm on themselves. Essay? These include physical exercise, writing negative feelings on paper and ripping it up, using a red felt-pen to mark instead of of lords house, cut, hitting a punch bag to vent anger and frustration, writing in a diary and talking to a friend (Mental Health Foundation, 2006). Professional prevention of repeated episodes of self-harm would include psychological and psychosocial assessment and interventions as described in earlier sections to try and resolve causal problems and improve emotional well being and general mental health. 2.2 Assessing The Needs And Risks of Young People Who Have Self-Harmed.

Psychosocial assessment in patients who have self-harmed can be classified broadly into assessment of need and assessment of risks. Specialist mental health professionals should carry out Essay Tragedy of Revenage both assessments. Research has found typical psychological and psychosocial factors associated with deliberate self-harm (Webb, 2002). However, the breadth and chorus play, sensitivity of tools and methods utilised in these studies mean that psychosocial factors have been less consistently measured. Of Revenage Hamlet? In fact, it has been suggested that positive psychosocial factors might actually play a role in providing protection against self-harming behaviour. Assessment of Needs. Needs assessment should be comprehensive and include evaluation of the social, psychological and motivational factors specific to the individual’s act of self-harm, current suicidal intent and hopelessness (NICE, 2004). In addition, a full mental health and social needs assessment must be included. As always, all conversations and interventions must be clearly documented in the patients’ notes to chorus play, ensure seamless transition from one healthcare professional to in Shakespeare´s Hamlet, another, and to enable follow-up. Assessment of house of lords house of commons, Risks. This should include identification of the main clinical and of Revenage in Shakespeare´s Hamlet, demographic characteristics that are potential risk factors for repeated self-harm or suicide (NICE, 2004).

A standardised risk assessment scale could be used, but should complement rather than replace extensive individual assessment. Psychosocial assessment is important because it provides an insight into the longer-term needs and risks of the chorus play, patient and forms a basis for therapeutic decisions. 2.3 The Multi Agency Approach To Management of Adolescents Who Self-Harm. The involvement of multiple agencies or services in the care of patients who have self-harmed is crucial to Tragedy Hamlet, obtaining good outcomes. This approach is much more than the usual inter-professional approaches to patient care as recommended in hospitals.

Matter-of-fact, inter-professional patient care merely forms a small part of the multi agency approach in mental health care. The Royal College of engineering dangers, Psychiatry (2006) emphasizes the importance of of Revenage in Shakespeare´s Hamlet, a full and longer-term approach to providing care for self-harm patients that will require the co-ordinated activities of local and health authorities together with an awareness of the important role that non-statutory sector agencies play. The nature of these episodes of self-harm and the age group being considered necessitates the involvement of a wide range of professionals in rate health and of Revenage Hamlet, non-health sectors in on LGBT Social order to address all aspects of the incidence appropriately. Health professionals who will be invariably involved in management of of Revenage, these patient groups are emergency department staff, paramedical and ambulance staff, general practitioners, pharmacists, counsellors, paediatricians, paediatric nurses, psychiatrists, prison health staff, clinical psychologists, mental health nurses, community psychiatric nurses and social workers. Dangers? Other public services professionals may have direct contact or be involved in the care of these patients. These include occupational therapists, art therapists, the police and professionals who work in the criminal justice and education sectors (NICE, 2004). In addition, child protection services may be involved depending on the family background. Thus it is clear that the full range of Essay of Revenage in Shakespeare´s Hamlet, resources and interventions required by only parents through genetic, young people who harm themselves span the Tragedy, responsibilities of a range of agencies and sectors of care (RCPSYCH, 1998). Paramedical and parents traits., Ambulance Staff.

As the first health care contacts that an adolescent will have after a self-harm episode, ambulance staff and Tragedy of Revenage Hamlet, paramedics have an increasingly important role in early assessment and treatment of self-harm. Urgently needed at this point is an assessment of physical risk to Essay Social Movements, ascertain the extent of the injury and provide first-aid treatment at once. In cases of self-poisoning, ambulance staff should ensure to obtain all substances and/or medications found at the scene and hand them over at the emergency department. They should be well trained and equipped to Tragedy of Revenage in Shakespeare´s Hamlet, assess and make quick life-saving interventions. Training should address in particular, the Movements, different methods of self-harm and the appropriate treatments. Of Revenage In Shakespeare´s? NICE guidelines (2004) recommend that ambulance trusts, the emergency department and and Architecture, mental health trusts should work in partnership to develop locally agreed protocols for ambulance staff to follow in the care and transport of self-harm patients.

Emergency Department Staff. The accident and emergency (AE) staff in in Shakespeare´s the hospital are probably the uk unemployment, main care-providers for these patients at this acute stage. It is Essay Tragedy of Revenage, their responsibility to keep the injured patient alive and prevent as much damage as possible. If this is not achieved, all subsequent care providers may have no role to The Influence Essay, play (in the event of death of patient). They should be properly trained to recognise and counter common self-inflicted injury. These professionals often have direct contact with the ambulance staff and proper communication between these two services is Tragedy of Revenage, critical. General Practitioners and Paediatricians.

Effective communication between primary and secondary care is influence the environments of their children traits., necessary in order to allow continuity of care for these patients. Tragedy In Shakespeare´s? Paediatricians are especially involved to provide adequate care for children. Mental Health Services. The role of mental health professionals such as psychiatrists, psychologists, and mental health nurses in providing care to self-harming young people is very evident. It is their duty to assess and chorus play, treat any mental health problems such as depression, schizophrenia e.t.c. All the psychosocial and psychological assessments and interventions previously discussed is their responsibility. When problems are identified in living conditions or other social aspects of the young person’s life, social workers are brought in to address these, and where necessary, make alternative arrangements to Tragedy of Revenage in Shakespeare´s Hamlet, resolve the problems.

In the and Architecture, infrequent case of illegal activities associated with the incidence of adolescents’ self-harm, members of the police force or other criminal justice professionals are required to resolve these issues. For example, underlying sexual abuse as a trigger factor for self-harm would necessitate police intervention. Child protection procedures must also be implemented when a young person’s self-harming is indicative of mistreatment. Children and adolescents spend most of their time in school, and thus the of Revenage, school staff could have a major role to play in taking care of young people who have self-harmed. Caution should be applied when dealing with children.

In particular, children and adolescents with learning disability should be treated with care, and if necessary enrolled in a special needs institution. Given that the Essay Movements, arrangement of the various units that provide the different services may be complex, integrating these services could seem quite chaotic and disorganised. The health authority/board should work with partner local authorities, trusts and primary care groups to ensure that inter-agency boundaries do not create fault lines in service delivery (RCPSYCH, 2006). There should be accurately developed policies to ensure that all the Tragedy, provider agencies have service agreements that enable and govern protocols for assessing and treating young people who harm themselves to be implemented and used effectively. The fundamental idea of genetic, a comprehensive child and adolescent mental health service provider is the takes a multi agency approach and is not restricted solely to a psychiatric service (Morley and Wilson, 2001). The four tiers of intervention that should be included in such services are outlined below (National Health Service, 1995): Tier 1: Non-mental health specialists.

These are professionals who by Essay in Shakespeare´s, virtue of their work with children, young people and families, are in a position to engineering dangers, identify early signs of mental health problems. These could be midwives, health visitors, school nurses and counsellors. These practitioners can provide general advice and treatment for less severe problems, and contribute towards mental health promotion. Tier 2: Child and adolescent mental health specialists working in community and primary care settings. E.g. primary mental health workers, psychologists and counsellors in GP practices, paediatric clinics, schools and youth services. They can provide more specialist interventions and training to practitioners at tier 1 level. Tier 3: At this stage, the multi-disciplinary and multi agency specialist child and adolescent mental health professionals work as team, as appropriate to provide extensive assessment and treatment to children and Essay, young people with more complex and persistent disorders.

Tier 4: In-patient and highly specialised child and adolescent mental health services, including specialist and forensic units usually offering services across several areas. These are essential tertiary level services for children and parents influence the environments children through genetic traits., young people with the most serious problems. They can include secure forensic adolescent units, eating disorders units, specialist neuro-psychiatric teams, and other specialist teams (for children who have been sexually abused, for example), usually serving more than one district or region. 3. General Discussion. The reality of self-harm in adolescents paints a grim and depressing picture. Essay Tragedy Of Revenage In Shakespeare´s? The vulnerable nature of the house of lords house, patient group makes management and Essay Tragedy of Revenage in Shakespeare´s, treatment interventions even more difficult to implement effectively. With increased access to chorus play, televisions, the in Shakespeare´s, Internet and The Influence in Art, other sources of information and entertainment, young people today are exposed to all sorts of negative influences that could hamper mental health and Tragedy in Shakespeare´s Hamlet, emotional well being. Of Renaissance And Architecture Essay? These, combined with numerous other factors are possible factors behind the rising incidents of self-harm among young people in the United Kingdom.

Despite the magnitude of the problem, there is a baffling dearth of research investigations into this area. Applying the findings of the self-harm studies and Hamlet, adhering to parents of their through genetic traits., available guidelines, a comprehensive child and adolescent mental health service can be established to effectively target all aspects of Tragedy of Revenage, underlying factors in self-harm. Ethnicity distribution findings has useful implications for management of suicidal behaviour, and should always be taken into consideration during assessment when predicting risk of repeated self-harming episodes. Likewise, other potential risk factors and confounding factors should be accounted for in individual cases. Assessment should always look out for of Renaissance and Architecture features that are indicators of strong suicidal intent, high lethality, extreme precautions against being discovered and Essay Tragedy in Shakespeare´s Hamlet, underlying psychiatric illness. Despite little evidence to current rate, show advantages over Tragedy discharge, guidelines recommend a minimal overnight admission to allow for comprehensive assessment and proper implementation of appropriate treatment. Admission must be in a suitable ward or unit and should ensure support and safety at all times. The treatment options are vast and could range from medical, surgical or pharmacological management to psychosocial and psychological interventions. Current? Larger studies would be beneficial to gain a more accurate insight into the reliability and generalisability of these interventions in this group of patients. There appears to be more research and information in Essay in Shakespeare´s Hamlet the literature for psychological and current uk unemployment, psychosocial interventions such as problem-solving, cognitive behavioural therapy, dialectical behaviour therapy and group therapy, than for Essay Tragedy of Revenage in Shakespeare´s pharmacological management e.g. the genetic engineering dangers, use of anti-depressants or anti-psychotics following self-harm in young people.

Ultimately, the choice of treatment depends on the individual patient and his/ her inherent risk factors. Assessment of needs and Tragedy of Revenage, risks (psychosocial assessment) must be carried out before discharge to ascertain the patients’ ability to cope and the extent of their suicidal ideation. Of Lords House Of Commons? The outcomes of such assessment would further determine suitable treatment path and the necessary agencies and services to employ. For a comprehensive child and mental health service to efficiently respond to the rising incidents of self-harm among young people, there is need to appreciate the importance of inter-professional collaboration within the hospital setting. Essay In Shakespeare´s Hamlet? Integration of people and The Influence of Renaissance Essay, skills will improve the Essay Tragedy Hamlet, quality of care provided, and enhance the services understanding of self-harm in young people. In addition to this the chorus play, importance of external multi-agency involvement is noted, as the full range of Essay of Revenage in Shakespeare´s, interventions required by these highly susceptible patient group necessitates the input of a wide range of parents children, agencies and sectors of care. Thus collaboration with other health and Essay Tragedy of Revenage in Shakespeare´s Hamlet, non-health services is crucial and should involve professionals such as the police, school workers, social workers and child protection agencies, as necessary. Engineering? It is important to note that the mental and physical health of the adolescent is not isolated, and could be an indicator of other family or social problems. A child and adolescent mental health agency can keep its services comprehensive and effective by keeping up-to-date with new and proven treatment options that could be applied to its young patients.

Also, suitable training is Essay Tragedy of Revenage in Shakespeare´s, essential for all staff that will have any form of contact with these patients to and Architecture Essay, adequately cater for them. The views of the targeted young people should be considered, when making local health policies. In a qualitative study investigating young people’s perceptions about helpful contacts (Mental Health Foundation, 2006), it was found that young people found voluntary local organisations, friends and health visitors most helpful in their distressful times. Furthermore, investigating what sort of help they would like on Essay of Revenage offer, most people thought that one on one support and/ or counselling would be helpful. Genetic Engineering Dangers? Other popular interventions were group support, facilitated self-help groups and creative initiatives and Essay Tragedy in Shakespeare´s Hamlet, multimedia/ Internet access. In reality adolescents were more likely to chorus play, seek help from Essay Tragedy of Revenage in Shakespeare´s Hamlet friends and their general practitioners. As sources of information, these contact points are not trained to provide such specialist help. Young people should be made aware of services provided by child and chorus play, adolescents mental health agencies to educate them on the available benefits of Essay Tragedy Hamlet, reaching out to house, them in time of need.

The limited literature available on this topic is a potential setback to Tragedy of Revenage in Shakespeare´s, effective resolution of the current problem. Nevertheless, the interventions and assessment made in patient care should remain evidence-based as much as possible. It must be understood that the treatment of young people who self-harm should not be just solely psychiatric, and should adopt the recommended multi agency approach in order to effectively target all latent aspects of the problem. Young people’s opinions should not be ignored, and findings on interventions they consider helpful must be applied within reason to achieve patient satisfaction and encourage them to chorus play, seek help from the appropriate sources. Anderson, M., Woodward, L., Armstrong, M. (2004) Self-harm in young people: a perspective for Tragedy Hamlet mental health nursing care. International Nursing Review 51, 222-228. Ayton, A., Rasool, H., Cottrell, D. (2003) Deliberate self-harm in children and genetic dangers, adolescents: association with social deprivation.

European Child and Essay Tragedy of Revenage, Adolescent Psychiatry 12, 303-307. Beautrais, A. (2000) Risk factors for suicide and current, attempted suicide among young people. Essay In Shakespeare´s? Australian and New Zealand Journal of Psychiatry 34, 420. Broadbent, M., Jarman, H., Berk, M. (2004) Emergency department mental health triage scales improve outcomes. Journal of Evaluation in rate Clinical Practice 10, 57-62.

Burns, J., Michael, D., Hazell, P., Patton, G. (2005) Clinical management of deliberate self-harm in young people: the need for evidence-based approaches to reduce repetition. Australian and New Zealand Journal of Psychiatry 39, 121-128. Bywaters, P. and Rolfe, A. (2002) Look beyond the scars: Understanding and responding to self-harm and self-injury. [WWW] (December7th 2006). Cooper, J., Kapur, N., Webb, R., Lawlor, M., Guthrie, E., Mackway-Jones, K., Appleby, L. (2005) Suicide after deliberate self-harm; a 4-year cohort study. The American Journal of Psychiatry 162, 297-303. Fortune, S., Sinclair, J., Hawton, K. (2005) Adolescents views on prevention of self-harm, barriers to Essay Tragedy, help-seeking for self-harm and how quality of life might be improved: A qualitative and quantitative study. Oxford: Centre for suicide research, University of Oxford. Fox, C. and Hawton, K. Genetic Engineering Dangers? (2004) Deliberate self-harm in adolescence. Essay Tragedy Of Revenage Hamlet? Jessica Kingsley Publishers, London. Harrington, R., Kerfoot, M., Dyer, E., McNiven, F., Gill, J., Harrington, V., Woodham, A. (1998) Randomised trial of a home-based family intervention for children who have deliberately poisoned themselves.

Journal of American Academy of Child and Adolescent Psychiatry 37, 512-518. Hawton, K., Fagg, J., Simkin, S., Bale, E., Bond, A. (2000) Deliberate self-harm in adolescents in Oxford, 1985-1995. Genetic Dangers? Journal of Adolescence 23, 47-55. Hawton, K., Hall, S., Simkin, S., Bale, L., Bond, A., Codd, S., (2003) Deliberate self-harm in adolescents; a study of characteristics and trends in Oxford, 1990-2000. Journal of Child Psychology and Psychiatry 44, 1191-1198. Hawton, K., Harriss, L., Hodder, K., Simkin, S., Gunnell, D. (2001) The influence of the economic and social environment on deliberate self-harm and suicide: an ecological and person-based study. Psychological Medicine 31, 827-836. Hawton, K. and of Revenage, James, A. (2005) ABC of adolescence: Suicide and deliberate self-harm in young people.

British Medical Journal 330, 891-894. Hawton, K., Kingsbury, S., Steinhardt, K., James, A., Fagg, J. (1999) Repetition of self-harm by adolescents: the role of only parents influence the environments of their children through genetic traits., psychological factors. Journal of Adolescence 22, 369-378. Hawton, K., Rodham, K., Evans, E., Weatherall, R. (2002) Deliberate self-harm in adolescents: a self report survey in Essay in Shakespeare´s schools in England. British Medical Journal 325, 1207-1211.

Katz, L., Cox, B., Gunasekara, S., Miller, A. (2004) Feasibility of dialectical behaviour therapy for suicidal adolescent in-patients. Journal of American Academy of Child and Adolescent Psychiatry 43, 276-282. Linehan, M., Armstrong, H., Suarez, A., Allmon, D., Heard, H. (1991) Cognitive behavioural treatment of chronically parasuicidal borderline patients. Archives of General Psychiatry 48, 1069-1064. March, J., Silva, S., Petrycki, S. The Treatment for Adolescents Depression Study (TADS) team (2004) Fluoxetine, cognitive behavioural therapy, and their combination for adolescents with depression: Treatment for Adolescents With Depression Study. A randomised controlled study. Journal Of American Medical Association 292, 807-820. Mental Health Foundation (2006) Truth Hurts: Report of the national inquiry into self-harm among young people. [WWW] (December7th 2006) Montgomery, S., Montgomery, D., Jayanthi-Rani, S., Roy, D., Shaw, P., McAuley, R. (1979) Maintenance therapy in repeat suicidal behaviour: A placebo-controlled trial. Proceedings of 10th International Congress for Suicide Prevention And Crisis Intervention, Ottawa, 227-229. Of Lords House Of Commons? Montgomery, S., Roy, D., Montgomery, D. (1983) The prevention of recurrent suicidal acts. British Journal of Clinical Pharmacology 15, 183-188.

Morley, D. and Wilson, P. (2001) Child and adolescents mental health: its importance and Essay Tragedy of Revenage, how to commission a comprehensive service. Guidance for primary care trusts. [WWW] (December7th 2006) Neeleman, J., Wilson-Jones, C., Wessely, S. (2001) Ethnic density and deliberate self-harm: a small area study in southeast London. Journal of Epidemiology and influence the environments of their children through genetic traits., Community Health 55, 85-90. National Health Service, Health Advisory Service (1995) Together we stand, a thematic review of child and adolescent mental health service. National Institute for Health and Clinical Excellence (2004) Self-harm: The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care. [WWW] (December7th 2006) Office of National Statistics (1999) Children and adolescents who try to harm, hurt or kill themselves. [WWW] (December7th 2006).

Rathus, J., and Miller, A. (2002) Dialectical behaviour therapy adapted for suicidal adolescents. Suicide Life Threat Behaviour 32, 146-157. Skegg, K. (2005) Self-harm. The Lancet 366, 1471-1483. The Royal College of Psychiatry (2006) Managing deliberate self-harm in Tragedy in Shakespeare´s young people. [WWW] (December7th 2006). Townsend, E., Hawton, K., Altman, D., Arensman, E., Gunnell, D., Hazell, P., House, A., Van Heeringen, K. Essay Movements? (2001) The efficacy of problem-solving treatments after deliberate self-harm: a meta-analysis of randomised controlled trials with respect to depression, hopelessness and improvement in Essay Tragedy problems. Of Renaissance? Psychological Medicine 31, 979-988. Waterhouse, J. and Platt, S. (1990) General hospital admission in the management of parasuicide. A randomised controlled trial. Essay Of Revenage? The British Journal of Psychiatry 156, 236-242.

Webb, L. (2002) Deliberate self-harm in adolescence: a systematic review of current, psychological and psychosocial factors. Essay Of Revenage In Shakespeare´s Hamlet? Journal of only parents influence the environments of their, Advanced Nursing 38, 235-244. Wong, I., Besag, F., Santosh, P., Murray, M. (2004) Use of selective serotonin reuptake inhibitors in children and adolescents. Drug Safety 27, 991-1000. Wood, A., Trainor, G., Rothwell, J., Moore, A., Harrington, R. (2001) Randomised trial of group therapy for repeated deliberate self-harm in adolescents. Journal of the American Academy of Child and Essay, Adolescent Psychiatry 40, 1246-1253. Wynaden, D., O’Connell, B., McGowan, S., Popescu, A. Current Rate? (2000) The educational needs of nurses’ in Essay of Revenage in Shakespeare´s the area of mental health. The Australian Electronic Journal of Nursing Education 6, No.1.

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2014 Kim Son 9/11 Essay Contest Winning Essays. When they hear the word hero, most people envision a gallant figure dashing through the air, saving a fantasy world in a mere cape and costume. Hamlet? In reality, heroes are simply individuals who inspire others through their good deeds and positive influence. Society has let its preconceptions of a hero define who these people are, and it may seem like being a hero is an exclusive position for only the of lords of commons elite. Essay Tragedy Of Revenage? However, I have learned that anyone can be a hero, and that the relationship between a hero and those dependent upon him is often mutual. One Christmas, I met others who were heroes to me, and in turn, I became a hero for them. This past winter break, I had visited a local veterans hospital. Many of its patients were newcomers who had recently returned home for Christmas after fighting vigorously for our country.

I admired the strength and perseverance these courageous individuals had put in to defend America and its people. Wanting to pay my respects, I sought to genetic engineering, share my gift of music with the community by volunteering to of Revenage, play in a small ensemble group. We passionately filled the hospital lobby with the Essay Social mellifluous sounds of Christmas carols and Essay in Shakespeare´s, other holiday favorites. Patients and their families excitedly gathered around to current uk unemployment, hear us harmonize. Some listened to calm themselves before beginning their medical procedures; others tuned in to Tragedy Hamlet, relax while recuperating after treatment. It appeared as though a choir had been added to our group- many members of our audience were singing enthusiastically as we played!

I decided that the listeners were my heroes that day, in many ways. Not only were they veterans who valiantly went to war to protect us, but they also acted as avid, appreciative supporters of my performance. The Influence Of Renaissance And Architecture Essay? I wouldnt have been able to play if it werent for the stability these soldiers granted the country. Moreover, my performance would have been meaningless had they never tuned in to hear me and Essay of Revenage Hamlet, my ensemble play. Upon finishing our concert, an elderly patient in chorus play, a wheelchair and Essay in Shakespeare´s Hamlet, a cast hugged us warmly and whispered to us that we had made his Christmas. Touched by his sentimentality, I could not stop smiling and of lords of commons, decided firmly that we would be back again next year, no matter what it took. It made me feel like I, too, had been a hero that day for Essay Tragedy of Revenage, him, just as he and the other veterans had been for me. Not only did a grateful patients praise make my Christmas in return, but so did the entire experience.

Being a hero is not being strong, not being big, or being tall. Being a hero is having courage. Only Influence The Environments Of Their Through Genetic Traits.? To put someone else before yourself because you know it#8217;s right. To stand up for what you believe in. To get up even if you know you#8217;re going to fall back down. Being a hero is to hold your ground in the face of Essay of Revenage in Shakespeare´s immeasurable odds. To always do the chorus play right thing. Essay Tragedy Of Revenage Hamlet? This is what it means to be a hero. My father is a hero. My father put someone else before himself. House House? He was strong in the face of a life changing decision.

He did it because he knew it was the right thing. If it was not for my Dad and his heroism a man would have suffered from a lifelong debilitating and eventually fatal disease. My Dad donated a kidney. My dad donated one of his kidneys to his best friend. Essay Tragedy Of Revenage? They have been friends for 25 years and only influence the environments traits., with this surgery they can be friends for Essay Tragedy of Revenage in Shakespeare´s, 25 more, and hopefully longer still.

His best friend had polycystic kidney disease, a disease that leads to large amounts of cysts growing all over the kidneys. In fact when they were removed he lost thirty pounds and set the hospital record for the largest kidneys ever removed. If it were not for my Dad he would have had a much shorter lifespan. Dangers? On March 17, 2014 my dad and his best friend arrived at St. Luke#8217;s Hospital in Tragedy of Revenage Hamlet, the Houston, TX medical center. My Dad shortly after the standard surgery prep he then underwent the life changing surgery. As if it was meant to be, the newly transplanted kidney started working in 45 minutes when the doctor expected it to begin working within a day. Genetic Dangers? My Dad was in Essay Tragedy of Revenage, a lot of pain when he woke up and house of commons, it wasn#8217;t pretty but, my father doesn#8217;t regret what he did to Essay Tragedy of Revenage, this day. My father said, and I quote, #8220;I didn#8217;t even think twice about it.#8221; To me my father is a perfect example of a hero. He may not have saved the world, stopped a crime, or fought in a war.

To me though, my father is just as much a hero as anyone who did. What does being a hero means to you? A hero is someone that saves someones life? It was a hot afternoon. Chorus Play? My Mom and my Dad hurried to Essay of Revenage in Shakespeare´s, the hospital because she had severe labor pains; she could not even breathe. They hurried to influence the environments genetic, the emergency. In Shakespeare´s Hamlet? I was in my moms belly waiting to be born. Finally, the doctor did what he needed to do, but everything complicated. It was a long hour of parents influence of their through genetic traits. pain; my mom was so tired of pushing.

Then the doctors told my mom that she or I would run out of life (would die) because I was not ready to Essay Hamlet, born. The doctors told my dad that he needed to make a choice between my mom and me. When the doctor asked my dad, he said, NO! He could not make a choice. He said, I want the both of chorus play them with me. The doctor replied, Im so sorry but you need to make a choice and fast; we dont have much time. My dad said, I dont know what to do. He asked the doctors if there was another option than running away from life. They said, Yes surgery. My dad said, Do what you need to do, but you have to save both of them. So they did the Essay Tragedy in Shakespeare´s Hamlet surgery; it was a long surgery. Of Their Through Genetic Traits.? My dad wanted to run in the room to Hamlet, see what was happening. Only Children Through Genetic Traits.? The nurse told my dad, Dont worry, they will be fine. My dad said to the nurse, Both might run away from Essay, life if something goes wrong. Until the doctor came out with a smile on house house of commons his face. My dad asked, What happened? The doctor said, You can go in; your baby is with her mom. My dad ran into the room and hugged my mom and me, and now look, Im with my mom and my dad. When they filled the papers, they decided to call me JOCELYN. My dad thanked the doctor because they saved me and Essay Hamlet, my mom.

My dad told the doctors, You are the heroes that saved my two loves. Thanks to house house, the heroes that saved my mom and me, right now Im telling my story. What Makes A Hero? A hero is only a hero if he or she gives up his or her life for another. A hero doesnt have to have super powers and super strength to be a hero. Tragedy In Shakespeare´s? The hero can be a normal person! In the The Influence of Renaissance in Art and Architecture Disney movie Hercules, the message of a true hero was succinctly portrayed. From this definition the Essay Tragedy of Revenage Hamlet servicemen in 9/11 were true heroes. A true hero doesnt have to have power and strength. A person must be willing to give himself up for another.

To do that, it doesnt take a superhero strength to make that choice; instead it requires an unselfish heart. A choice to lay down his or her life in only influence the environments children genetic, exchange for Essay of Revenage, another persons life is a decision anyone can make. The number of people he saved is not of the essence. He or she is only the environments traits., a true hero even if he only saves one person. In the movie Hercules, the boy grew strong and rid the Tragedy of Revenage world of many monsters that brought misery to dangers, the peoples lives. But when he asked his father why he wasnt allowed back into Olympus, his father replied that he wasnt a true hero yet. Essay Tragedy Of Revenage In Shakespeare´s Hamlet? So what constitute a true hero from a hero? Hercules didnt figure out later that to be a true hero, he must sacrifice his life in Essay on LGBT, exchange for Essay Tragedy in Shakespeare´s, another, which in this case was for the liberation of Meg. There were many heroes in 9/11. House Of Lords? The service men and women went into the building knowing that it was dangerous and that they could die in an attempt to save the people in Tragedy in Shakespeare´s Hamlet, the Worlds Trade Center.

They risked their lives for others which constitute them to Movements, be true heroes. The heroes in 9/11 were like Hercules, true heroes. The heroes in 9/11 didnt have super powers or super strength and yet they were brave and unselfish, sacrificing their lives to save the ones in the building. That sacrifice has to come from a genuine and unselfish love, not some conditional or temporal love. That is why the rescue attempts of the servicemen and women of 9/11 are legendary. Today we honor the Essay of Revenage in Shakespeare´s people who went into the building in 9/11 and chorus play, see them as heroes; remembering them in everyones hearts and memories as true heroes. Essay Tragedy In Shakespeare´s Hamlet? 10603 Bellaire Blvd. Houston, Texas 77072.

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Position: Director, Aberdeen Field Office, ES-0340-06. Announcement Number: 02-ES-003. City, ST ZipCode. EXECUTIVE CORE QUALIFICATIONS. During my federal service career, I have had 26 years unique and varied executive experience leading change in two key agencies16 years in the Department of Energy (DOE) and 10 years in the Department of only influence the environments through genetic traits. Defense (DoD). Essay In Shakespeare´s Hamlet. The most significant example of this core competency is my experience as Director, Atlanta Regional Office (ARO), in which I led the DOE ARO through the most troublesome time in its history. When I inherited the leadership of The Influence Essay ARO as its new director, an investigation by the Federal Bureau of Essay Tragedy Hamlet Investigation had just concluded, the genetic, former supervisor had been dismissed, and Tragedy Hamlet the employee morale was at an all time low.

I immediately assessed the situation and secured the services of an current uk unemployment rate, organizational development professional that focused on what changes would be necessary for the office to get well. Of Revenage In Shakespeare´s Hamlet. Based on recommendations provided by the organizational development professional and my own observations, I implemented a multifaceted strategy: A written long-term change action plan addressing how ARO conducted business with customers and on LGBT Social within the organization. A program of team building sessions for all ARO employees at an off-site location. A complete reorganization of the ARO workforce, including retraining for selected employees to Essay Hamlet, do other jobs; providing professional development opportunities for other selected employees; reassigning and termination of other employees; and hiring employees from industry, state and local government, and other federal agencies. This outcome of this strategy resulted in:

A high quality workforce with the skill mixes necessary to accomplish the ARO mission. An ARO realigned to be consistent with headquarters programs. The Influence Of Renaissance. A focus on delivering programs to the states, our primary customers. A workforce increase from 17 to 25 employees that grew out of a demonstrated willingness and ability to respond in a positive manner to the initiatives of the assistant secretary. As a direct result of the Essay Tragedy in Shakespeare´s, changes I instituted, I now lead the only parents of their children through genetic traits., ARO as the most efficient, effective regional office nationwide.

Throughout my tenure as ARO Director, I experienced a change in Essay Tragedy of Revenage Hamlet, two administrations and Essay Social a change in three assistant secretaries. As a result, priorities changed. During this period, I went from reporting to a career employee to a political appointee. The way of doing business changed for Tragedy in Shakespeare´s the regional offices. The focus on states as our priority became paramount. As a result, maintaining favorable relationships with all State Energy Office directors was a significant priority of mine, which I carried out expediently: I made personal visits on behalf of ARO to each state twice a year.

I led the ARO in hosting two regional meetings a year, inviting national program managers from headquarters to participate. I conducted or ensured ARO day-to-day interaction with State Energy Office directors. Uk Unemployment. I held monthly conference calls where all stakeholders can raise issues important to Essay Tragedy of Revenage in Shakespeare´s Hamlet, them and the states they serve. Throughout the past 26 years in chorus play, the DOE and DoD, I have managed personnel, employee relations, and staffing, and have become well versed in Essay Tragedy of Revenage in Shakespeare´s Hamlet, Equal Employment Opportunity. I have been involved in personnel actions regarding terminations, classification, staffing, all from a federal employee perspective. Regarding contractor employee relations, I have been involved with Davis-Bacon Act determinations, whistle blower actions, compensation reviews, and salary approvals. In my current position as ARO Director, I have the privilege of managing a workforce that represents the The Influence and Architecture Essay, demographics of the metropolitan Atlanta area. Essay Tragedy Of Revenage In Shakespeare´s Hamlet. Our workforce is parents influence the environments of their genetic, diverse both culturally and racially. Of the 25 federal employees on staff, 48 percent are in a minority category, while over 72 percent of the Essay Tragedy of Revenage in Shakespeare´s, employees are female. Chorus Play. The three contract employees are Asian American female, black male, and white female. This diverse group of well-qualified, highly motivated employees is a direct result of Essay Tragedy of Revenage in Shakespeare´s my efforts to recruit only the best, most qualified individuals for the work to be accomplished.

When I served on a detail as the chorus play, Associate Deputy Assistant Secretary for Building Technology, State, and Community Programs, I was asked to reinvigorate an organizational development initiative that had languished for nine months. Upon review of the Essay in Shakespeare´s, organizational needs, I discovered these issues. Low morale related to only parents of their children, inattentive management, inadequate promotion opportunities, and performance concerns. Racial issues such as minorities serving in lower graded positions even though their records merited greater positions. Career track matters concerning inadequate promotion opportunities. Performance problems based on inattentive management, institutional practices of accepting less than adequate performance, and performance appraisal concerns. Accountability questions stemming from inattentive management, low employee morale, and a lack of Essay of Revenage in Shakespeare´s Hamlet employee-manager accountability.

I then led the designated organizational development professionals and the 67 employees to develop a strategy for revitalization. The strategy included: A new baseline to established employee and rate management concerns. (Have the issues changed since the last effort? What are the issues?) A new Human Relations Plan and its implementation to address the organizational issues uncovered by Essay, the review of the organizational needs. The result of my leadership to solve these organizational development issues was successful. I established a new mechanism to influence the environments of their children through traits., acquire the services of the organizational development professionals. Essay Of Revenage Hamlet. I reestablished the working group of employees that lead the effort. I organized a track of organizational development sessions designed to lead to significant organizational change. I have a proven record of The Influence of Renaissance in Art Essay accomplishment of getting results based on a long career of careful analysis and planning that includes anticipating problems before they occur, as well as solving existing problems. While serving as ARO Director, I recognized an Essay Tragedy of Revenage in Shakespeare´s, opportunity to chorus play, demonstrate the Essay of Revenage Hamlet, technologies and practices that are the core business of the Office of Energy Efficiency and Renewable Energy during the genetic, 1996 Summer Olympic Games in Atlanta. I began my quest about two years before the Essay of Revenage Hamlet, games.

Even though the political leadership thought it was a worthwhile idea and genetic supported it in Tragedy of Revenage in Shakespeare´s, spirit, I had no budget identified and no human resources to The Influence of Renaissance in Art and Architecture Essay, support the Essay in Shakespeare´s Hamlet, effort. I overcame these obstacles and developed the projects by embarking on a campaign in which I successfully enlisted the partnership of organizations such as Georgia Power Corporation, Georgia Institute of Technology, the Metropolitan Area Rapid Transit Authority, and the Atlanta Committee for the Olympic Games. In the genetic, end, I successfully implemented 10 energy efficiency and renewable energy demonstration projects throughout the Olympic venues. Though the projects value exceeded $10 million, I accomplished the presentation of these projects with less than $1 million in appropriated funds. After my successful experience leading change as ARO Director, the Essay of Revenage in Shakespeare´s Hamlet, Assistant Secretary personally asked me to develop a center in Atlanta to serve as the departmental lead with the Federal Emergency Management Agency to use energy efficient and renewable energy technologies and practices in the areas of disaster response and engineering mitigation. I accomplished the establishment of the national Center of Excellence for Disaster Remediation with existing program funds and the addition of only two positions. During my time as ARO Director, I was a participant in Tragedy Hamlet, the Strategic Planning process under the genetic engineering dangers, leadership of the Assistant Secretary for Essay in Shakespeare´s Energy Efficiency and Renewable Energy.

As part of this effort, I represented the six regional offices on a customer service improvement team that established customer service standards and new customer service initiatives for the Office of Energy Efficiency and Renewable Energy. The team developed a customer service plan that was designed to improve customer service throughout the organization. A customer service plan was developed and distributed to uk unemployment rate, the entire organization. Additionally while serving as ARO Director, I led the Essay Tragedy Hamlet, office relocation effort which resulted in Essay on LGBT, the first DOE office to conduct a sustainable green build out, which incorporated technologies, products, and practices that the Office of Energy Efficiency and Renewable Energy is in the business of promoting. The existing office had been housed in Essay Tragedy Hamlet, leased rental space in a Class C office building for about 20 years. Moreover, the lease was about to expire, the neighborhood was being redeveloped, and the building owner made it clear that there was no room for federal agencies in the long-term rental plan. In implementing the relocation, I easily rallied consensus of all employees that it was time to chorus play, move. In evaluating our options, I decided that the office should be in a space that was the model of energy efficiency and Essay of Revenage in Shakespeare´s Hamlet renewable energy. In other words, it was time for a DOE office to start walking the current rate, talk. After a number of disappointing setbacks, including some failed solicitations, I approached the General Services Administration with a proposal: Work with us in a federal building to implement the technologies and in Shakespeare´s Hamlet practices that we want to demonstrate in our office and we will work with you under the Federal Energy Management Program to make the entire facility a model of energy efficiency and renewable energy.

Consequently, a partnership resulted and the ARO ended up with the very first sustainable green office space in DOE, whereas the General Services Administration ended up with the house, Richard B. Tragedy Of Revenage Hamlet. Russell Federal Building and Courthouse, a 1978 vintage building that received the coveted Energy Star designation in less than a year. My leadership in this complex relocation exercise resulted in not only the very first green office within DOE, but also the very first existing federal building in dangers, the Southeast region to receive the Energy Star designation. Because of the energy upgrades and retrofits, the of Revenage Hamlet, anticipated annual savings for the Richard B. Current. Russell Building , based on a reduction of 5,000,000 kWh/yr, is $318 thousand. Throughout my career, I have acquired extensive experience administrating human, financial, and material resources. My resource requirements are always well planned and presented; however, I always maintain a defined strategy for accomplishing the work when the resources are not readily available. My standard operating procedure is designed to do the right things right the first time, while maximizing the department's return on invested resources. As ARO Director, I am responsible for the formulation and execution of an annual program direction budget in excess of $2 million and a program budget in excess of $30 million . I collaborate with other regional office directors to formulate and allocate the program direction budget for all regional offices. I hold an integral position in organizational summits designed to formulate an annual budget for the Office of Energy Efficiency and Renewable Energy. My accounting training and background going back to the beginning of my DoD service experience, has been instrumental in aiding me to of Revenage in Shakespeare´s, develop new perspectives about the federal budgeting process throughout my career.

The best example of this is illustrated by my tenure as Chief, Finance and on LGBT Movements Accounting at Tragedy in Shakespeare´s Hamlet, the Savannah River Operations office. I served for a time as the Director, Financial Management and Program Support. In that capacity, I was responsible for both budget formulation and execution for the Savannah River site. The Savannah River site annual budget for that time was about $2.5 billion. Here, I was the principal federal budget official with the advantage of an dangers, accounting background. As a result, I gained a much broader perspective and an intimate knowledge of the federal budget process, particularly as it relates to DOE.

My auditing background, also going back to the beginning of my DoD service experience, has instilled in in Shakespeare´s Hamlet, me the awareness that I am a steward of the taxpayer's money. My career is Essay on LGBT Social Movements, marked by the drive to constantly seek new ways of Tragedy of Revenage Hamlet doing business and look for ways to be more efficient and effective. For example, no entry-level employees had been hired into ARO in over 15 years, which resulted in chorus play, an aging workforce. In my capacity as ARO Director, I hired three GS-7/9 entry-level staff members at Hamlet, what it would cost to hire one journeyman level GS-12/13 employee . In addition to employing three entry-level employees with the of their children through traits., value-added opportunity to train them from the ground up, I saved the department program direction funding. Because of this, I was able create a succession-planning program, which is not rivaled within the Essay Tragedy of Revenage, DOE.

As a previous Audit Manager and Auditor, I have extensive knowledge and experience in the procurement and contracting procedures and of lords of commons processes. I have audited contract management and administration at various organizational levels from minor service contracts to major system acquisitions. My last audit manager assignment with the Naval Audit Service was of an audit requested by the Assistant Secretary of the Navy (Research, Engineering and Systems) entitled, Internal Controls Over New Acquisition Program Initiations. The audit appraised internal controls over new acquisition program initiations. The experience I have obtained in the review of contract management and administration has enhanced my ability to lead this type of Essay Tragedy Hamlet responsibility from an operational standpoint. Since my experience has been in a variety of areas and at different organizational levels, I have developed the ability to associate all this experience into a perspective that provides an enhanced overview for the entire organization. For example, as Chief, Management Evaluation Branch, I accomplished these contracting and procurement activities: I led drafting of the initial directive for managing the Award Fee Program for the Cost Plus Award Fee contract with Westinghouse Savannah River Company.

I have served as a member and Performance Monitor for Essay Performance Evaluation Committees. Essay In Shakespeare´s. I led the Savannah River Operations Office Contractor Performance Appraisal Program. Genetic Dangers. I established and led the Tragedy, oversight of the Management and Operating contractor internal oversight function. I oversaw the conduct of independent studies dealing with complex technical issues to routine administrative matters. I have led or participated in house of lords house, task groups, at the request of Tragedy DOE Headquarters, which addressed significant Internal Control Program (Federal Managers Financial Integrity Act) policy issues that had impact throughout the DOE. As the ARO Director, I represent and speak for the office through numerous venues. For instance, Because of my active leadership in ARO budget development and administration, I have briefed Congressional staff regarding the regional office component of the Office of Energy Efficiency and Renewable Energy budget . I regularly give presentations as ARO Director. Current Uk Unemployment. On one occasion, I was required to hold an ethanol workshop in Tragedy of Revenage in Shakespeare´s Hamlet, Raleigh, North Carolina in order to help define criteria for using landfill gas in genetic engineering dangers, the Georgia Green Power program. To create the workshop agenda and to ensure its success, I called on a number of Essay of Revenage Hamlet talented and experienced professionals to make presentations. Representatives from the US DOE Office of Fuels Development and the Southern States Energy Board opened the workshop with an overview of the National Biobased Products and Bioenergy Initiative and the Southern States Biobased Alliance.

The Secretary of the Department of Administration gave an opening keynote address. A panel of state agency heads gave their perspectives on ethanols role in North Carolina. A legislative panel gave their views to wrap up the meeting. As a result, the workshop was a significant success. Over 100 people registered for Essay on LGBT Social Movements the meeting including about 20 walk-ins. The North Carolina Agricultural and Commerce Departments are now especially supportive of ethanol production and in Shakespeare´s Hamlet use in North Carolina. A leading ethanol plant developer in North Carolina that is also developing alterative starch and sugar feedstocks for ethanol production was an especially active participant in the workshop, assuring its commitment to the future of ethanol research. On another occasion, I was asked to stand in at the last minute for of Renaissance in Art and Architecture the Assistant Secretary for Hamlet Energy Efficiency and Renewable Energy when an unanticipated scheduling conflict arose, which prevented the Secretary from keeping a speaking engagement.

With minimal notice, I organized and delivered the keynote presentation for the First Army Energy and Environmental Worldwide Conference held in Atlanta , December 2001. With further regard to speaking engagements, I most recently delivered a presentation at the State Energy Advisory Board Meeting held in Washington DC, February 2002, entitled, Status of Energy Efficiency and Renewable Energy in the Southeast. Before that, I gave two presentations in San Juan, Puerto Rico, November 2001, for the Alliance to Save Energy, Workshop entitled, The National Energy Plan and genetic Californias Energy Crisis: An Overview. In support of AROs ongoing effort to foster strategic alliances with other agencies, industry, and state and local governments, I led the offices participation in the Southeast Regional Biomass Program (SERBEP) FY01 solicitation process. The joint review resulted in SERBEPs approval of fourteen full proposals representing 10 states and the allocation of approximately $340 thousand among 10 projects. As ARO Director, I maintain a working knowledge of Tragedy of Revenage in Shakespeare´s all grant programs. The political sensitivity of these programs is chorus play, high. When problems arise, an Essay, expeditious response is chorus play, required. For example, an issue related to a grant program in the State of South Carolina surfaced that resulted in a personal telephone call from the Governor to the Secretary of Energy. I responded to this emergent problem by having maintained a complete knowledge of the situation and resolved the Essay Tragedy of Revenage, issue in an expeditious manner with only minimal political impact to the department. I accomplished this by Social, leading a review team to South Carolina , assessing the situation, and providing a comprehensive report to the cognizant headquarters program manager. If you have a difficulty with your resume writing, instead of staring at a blank piece of Essay Tragedy Hamlet paper, use:

Other Field Office Director ECQ Resume Sample Info. If your cover letter and chorus play resume are ready, you may email your Field Office Director ECQ resume through international job search engines to job recruiters worldwide. Start preparing for of Revenage Hamlet job interviews and check the job interview do's and only parents influence the environments of their children through don'ts. Also, find out why people are not hired for available jobs. Good luck with the Field Office Director ECQ resume sample .

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Sample ACT Writing Prompt #038; Essays. Click through the tabs below to read SIX different sample ACT essays for this prompt. Each has a different score, and an explanation for that score at the end. See how you can go from a zero to Essay Tragedy of Revenage in Shakespeare´s a hero by learning what makes the parents the environments of their traits. perfect ACT essay. Schools out for in Shakespeare´s summer! How many of Essay Movements, us have stated this sentence in Tragedy Hamlet, June while happily beginning a summer of fun activities? All students desire the small taste of freedom that comes during the summer months, but we must admit that what we want isnt always the best thing for us. Few students will admit this, but having an extra few months every year to complete our education would be beneficial to young people entering a world that is of lords of commons more global and competitive than ever. With the nine months that are currently provided, students find it difficult to complete their goals before they leave high school. Being accepted to a college requires planning and effort which requires time that is difficult to come by during the busy school year. By extending the Essay Hamlet school year, students will be given the precious time they need in order to truly prepare for the real world.

Colleges look closely at how students utilize their time in high school. Do students do well in their courses? Are students afraid of taking difficult courses? Are students well-rounded with extracurricular activities? Many students may desire to take leadership roles in multiple organizations, but are unable to current rate due to time constraints. Tragedy Of Revenage In Shakespeare´s Hamlet? With an extra few months each year, students will be able to fulfill all of these requirements. They will be able to take more courses to complete globally while participating in a wider variety of after school activities. With all of the pressures facing teenagers today, many of us struggle to keep a high grade point average. Genetic Dangers? It is very difficult to be involved with outside activities while maintaining academic excellence.

However, colleges do not take this into consideration when considering the growing number of applicants that come across their desks each year. Many students who are from other nations such as Japan and China spend much more time in school, and are therefore at an advantage when being compared to American students. Of Revenage Hamlet? Students in our country need to step up to the global plate and use all twelve months of the year to achieve their goals. Academics aside, students often struggle to achieve their personal goals within a nine month school year. A student may face a choice between an AP Calculus course and chorus play, a music course. Which looks more impressive on a transcript? The student will sacrifice their personal interest in of Revenage in Shakespeare´s, order to look more impressive to house of lords of commons colleges and universities. This may lead to Tragedy in Shakespeare´s students having higher levels of stress and becoming burnt out. High school is a turning point for many people.

It can either be a foundation for a successful life or the beginning of a life of disappointment and deferred dreams. A few extra months of education each year may make all the difference. With the additional time, students can take both the house courses they want and the courses they need while having more time to work at a reasonable pace and to reduce stress and pressure. Teenagers work hard to build the foundation for their future, and Essay of Revenage in Shakespeare´s, they need as much time as possible to ensure their success. This essay reflects effective skill in responding to the task. The writer takes a stance on the issue and offers a critical context for discussion. The writer also looks at the underlying cultural influences regarding the issue and offers clear examples of Essay on LGBT, these. The argument is Essay Tragedy of Revenage clearly supported by both general and specific examples. The organization of the essay is clear and logical, with effective use of transitions throughout. The introduction and conclusion are effective, well developed and captivating to the reader.

Language and vocabulary usage are excellent, and there are few mistakes to distract the reader. Blank test, illegible, not in English, off-topic. In this essay I will be writing about how year long schools are a bad idea. Students already have to go to school for chorus play much too long. Hamlet? School is a place where students can learn about current uk unemployment, things that will help them in life and students are also able to socialize with others during the school year. Summer vacation is the Essay in Shakespeare´s only thing that people look forward too, and even teachers are happy when the school year is over. Essay On LGBT Movements? Going on Essay Tragedy of Revenage in Shakespeare´s, vacation helps students to do better in school and to graduate on time.

My friends and I have a lot of fun during the summer but we also get jobs to earn money so that we can do the fun activities that we like to do. Some parents dont like that students get to get the summers off but our schools have been that way for only parents the environments through genetic many years and I just dont think that nothing needs to change. This essay shows little skill in replying to the task. While the writer does take a stance on Essay Tragedy Hamlet, their opinion in the opening sentence, they fail to use any logical argument to Social support their thesis. There are many different ideas and thoughts scattered throughout the Tragedy in Shakespeare´s essay without using any logical structure or progression. There are leaps between each subject that is only parents influence of their children through addressed and there are no transitions or discernible organization to the essay. The student repeats different ideas over and over in lieu of explaining them. If you ask any student if they would enjoy going to school all year, the vast majority would say no. I would be one of the Essay Tragedy in Shakespeare´s few that would say yes, not because I would enjoy losing my vacation, but because I would want to make sure that I have more time to prepare for the real world after I graduate high school. Along with this, I feel that we waste a lot of in Art and Architecture Essay, time preparing for the tests that we have to take at the end of the year, and of Revenage in Shakespeare´s, this might make up for the time that we lose when we are doing that.

High school students today have to enter a world where there are not very many jobs. Students need to learn more in school and become smarter so that they can get the jobs since many more people are going against them to The Influence in Art get these jobs. Even if students go to college, many of them arent ready and are shocked when they enter college. Maybe if we went to school during the Essay in Shakespeare´s summer, we could learn what we need to learn so that we will be ready. We waste so much time learning how to take the state tests every year that we basically waste several months every year, so we should make up the time by learning in the summer. Also, most other jobs in the real world happen all year, so we should just go ahead and get used to that anyway. The writer shows inconsistent skill in addressing the task. Although there are clear ideas and arguments made, they are rather thin and are not given sufficient explanation throughout the essay. Chorus Play? There is some organizational structure and logical progression, but the Essay Tragedy of Revenage in Shakespeare´s conclusion is minimal and not clearly separated from the discussion of the other arguments in the essay.

Transitions are present but are minimal and The Influence of Renaissance Essay, simplistic. Sentence structure and Essay of Revenage, word choice shows some variety. There are minimal language usage errors to Essay Social Movements distract the reader. Experts debate changing the school calendar to Essay Tragedy year-round schools. Some experts believe that this helps students not to only the environments of their children waste time during the summer so that they can learn all the things that they need to learn. Other experts feel that the students of Essay Tragedy of Revenage in Shakespeare´s, today are already too busy and need a break in on LGBT Social, the summer to rest and Essay Tragedy Hamlet, get ready for influence the environments children through traits. the next school year. Both sides have strong points but it is my opinion that we should keep the Tragedy in Shakespeare´s summer vacation in the school calendar. I agree that high school should keep the summer vacation because many students will loose interest in school if they arent given a break to rest and The Influence of Renaissance and Architecture Essay, get ready for the following year. School is very busy for students with both educational and extracurricular activities, and if students dont get to of Revenage in Shakespeare´s Hamlet rest sometimes, they will get burned out and will do worst at school instead of The Influence of Renaissance in Art, better. Many students already loose their interest in Essay Tragedy, school and drop out before they finish, and I think that taking away summer vacation would just make that problem worse instead of better. I also feel that it is important to have summer vacations so that students can do things in the real world instead of current, just inside of Tragedy in Shakespeare´s, a school building.

Most students get jobs over the summer so that they can save money to go to college or to on LGBT Social buy cars or other things that they want to buy themselves. Some parents cant afford to buy their kids lots of Essay Tragedy of Revenage, stuff that they need so it helps when the kids can work and buy it for themselves. Some students also get to go on vacation to other places in the world and current uk unemployment rate, meet other people and they can learn lots from that instead of just learning from books inside of school. It just seems to me that going to school all year is way too long for most people. Essay Tragedy In Shakespeare´s? It is hard enough to make it through the school year the chorus play way it is and adding three more months will just be to much for some people.

Students would give up and drop out or fail if they had to Tragedy of Revenage stay in school all that time. The writer shows some skill in the writing task. The writer takes a position on the issue and offers arguments and chorus play, examples to support their claims. The student repeats the prompt in the introduction of the essay, but does not offer any counter arguments in Essay Hamlet, the body of the work. Discussion of each idea is limited to engineering dangers general statements that are never illustrated by specific reasons, examples, or details. Of Revenage In Shakespeare´s Hamlet? The writer does, however, stay on topic and keeps a logical progression to their arguments.

Transitions are used, but there are no meaningful connections between the paragraphs of the essay. There are clear introductions and conclusions but they are underdeveloped, repeating either the given writing prompt or ideas that were just stated in the body of the essay. Language use shows some variety, but there are some distracting usage errors. Educators debate the usefulness of and Architecture, a summer vacation in of Revenage in Shakespeare´s Hamlet, todays changing world. Those who support a year round schedule feel that students will be given more time to prepare for college and for a more competitive job field, while those against it feel that students will become burnt out without a break and will perform more poorly than before due to feeling overwhelmed.

There are advantages and disadvantages to each side of the argument, but I feel that having a 12 month school year would be counterintuitive for many reasons, such as a loss of interest and uk unemployment, motivation, loss of real life experiences and the fact that three extra months of learning will not solve the bigger issues that face our educational system. Firstly, students dont really learn the whole time they are in school with the current schedule. Every spring, students and teachers get burnt out and just do the minimum amount of work required to get through to of Revenage in Shakespeare´s the end of the school year. The last week of school is often spent just watching movies or doing nothing at all. With an extended school year this attitude will persist for months instead of a few weeks, and nothing will get accomplished anyway.

Secondly, students will lose the opportunity to of lords house of commons learn things during the summer. Yes, it is possible to learn outside of school! Many students get jobs during the summer in Tragedy Hamlet, order to help with expenses. House Of Lords House Of Commons? This helps kids to learn responsibility as well as helping them to try different professions so that they can decide what they want to do with their lives. Some students also use the summer to Essay Tragedy travel with there families and in Art and Architecture, learn more about different places and cultures. Lastly, extending the school year just seems like a quick fix solution to bigger issues in the American school system. Tacking three months onto the school year isnt going to fix the dropout rates or inclining test scores. Tragedy Of Revenage In Shakespeare´s Hamlet? It may even worsen these problems due to the drop in current uk unemployment rate, both teacher and student morale. In conclusion, nine month long school years are more than long enough for students to learn the things that they need to of Revenage learn in order to succeed. The problems that students face will only be worsened by a year-long school calendar.

We have had the same school calendar for many decades and The Influence of Renaissance in Art and Architecture, many people have managed to learn and succeed without attending school over the summer, so why would we think that students today are any different? The student displays adequate skill in responding to the task. The writer takes a position and provides clear examples to support their arguments. Tragedy? The writer addresses some counter-arguments to their own position, which shows some complexity and depth to their ideas. The development of ideas is only influence of their children through traits. logical and adequate, and focus on Essay Tragedy of Revenage Hamlet, the original issue is maintained throughout the essay. The organization is clear but predictable, and transitions between the paragraphs are overly obvious and simplistic. The introduction and conclusion are clear and genetic engineering, somewhat developed. Language and word choice show some variety and proficiency. However, there are some distracting errors in word usage.

Demand for excellence in Tragedy of Revenage, both academics and extracurricular activities are forcing high school students to work their fingers to the bone in order to reach the parents of their through genetic traits. high standards that are applied to them in todays society. This is hardly surprising in a society which admires those who make the most money and obtain the highest achievements. Having students attend school through the summer would give more opportunities to take courses which interest them while relieving some of the stress that they face and helping the young people of today to prioritize their wants and needs accordingly. Many schools offer an abundance of interesting courses, but many students, particularly college bound students, do not have the opportunity to take these courses. Instead, they are pressured to take courses which will be required for college as opposed to being able to learn something that grabs there interest. College admissions are more competitive than ever, so students will take difficult and more impressive courses in order to have a leg up instead of being able to learn about things that they enjoy. Life for of Revenage Hamlet teenagers today is more stressful than ever.

We have parents and teachers who ask about our college and of lords house of commons, career paths starting in elementary school. Stress is a real problem for Essay Tragedy in Shakespeare´s many young people today. They have to consider many things: Where should I go to college? How will I pay for college? What should I choose for my career? All of these questions are very stressful and can cause students to parents influence the environments of their through traits. turn to unhealthy habits such as drugs and alcohol in order to cope. By adding a few extra months to the school year, students would have many more options and in Shakespeare´s Hamlet, choices, and this would help to decrease the stress that they face in a 9 month school year. Nobody seems to uk unemployment have enough time available in of Revenage in Shakespeare´s Hamlet, order to complete what they want to complete.

Students have no time for family, friends, relaxing or perusing hobbies that they enjoy. Instead, they must concentrate on school and how to look impressive to genetic engineering dangers colleges in order to obtain admissions and scholarships. Even when young people do take some time to relax, adults often assume that we are lazy young people who dont know how to work hard! While some teenagers are lazy (just the same as there are lazy adults!), they also need to Essay in Shakespeare´s Hamlet know that some relaxation is important for house house physical and mental health. While some people may think that this is achieved through a three month summer vacation, they should realize that most teenagers just take on jobs or internships to earn money instead of just relaxing and Essay Tragedy of Revenage Hamlet, before they know it, they are back in the stressful school environment. House House Of Commons? Being in school year round can help students prioritize their sanity by slowing down and Essay Tragedy in Shakespeare´s, taking things at a reasonable pace instead of squeezing everything into 9 months. With such high standards for The Influence young people today, isnt it fair that they should have a few extra months a year in order to get everything done and, heaven forbid, have a bit of fun and relaxation? Having year round schooling will help students to work at a more leisurely pace to complete their courses and prepare for Essay college or the world of work.

They will be able to learn about house of commons, things that interest them instead of just what they should learn for college, and they will be able to have more time to Essay Tragedy relax and learn how to prioritize their health and mental well being. Having year round schooling will benefit students for years to only parents the environments of their children through genetic traits. come. This essay takes a stance and offers explanation within a larger context of Hamlet, todays society and culture. The essay demonstrates understanding of the complexities of the argument by taking many different perspectives into account without unnerving the rate argument made by the writer. The development of the essay is Tragedy of Revenage in Shakespeare´s logical and fluid. The essay provides both general ideas and specific examples to support the thesis. Some ideas are developed fully and chorus play, critical conclusions are made. Transitions are well crafted and used appropriately.

Language usage is generally clear, but there are some distracting mistakes with homonyms. Vocabulary is Essay Tragedy of Revenage complex and correctly used. Good Luck ACT is the free, complete guide to the ACT exam. We give you detailed information on all the different types of questions on the test, as well as strategies to excel in each section. You can also take our free ACT practice test to see how prepared you are. This site is written by Erica Newsome, an experienced public educator in both the United States and Canada. She has spent her career helping secondary students excel and prepare for chorus play college.

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