Autistic Spectrum Disorder And Offending Behaviour Psychology Essay

Autistic Spectrum Disorder And Offending Behaviour Psychology Essay Speculation is evident within both popular media and scientific literature regarding a possible association in the relationship between Autistic Spectrum Disorder and offending behaviour. The possible presence of antisocial and criminal behaviour in a sub-sample of individuals with Asperger syndrome has been of high interest to both psychological research and the general public. The research reviewed within this study suggests that people with Autistic spectrum disorders are potentially over-represented within the criminal justice system. However an accurate prevalence of Autistic Spectrum Disorder and Asperger Syndrome both within the general population and the criminal justice system is yet to be established as findings between studies are varied. It has been suggested that an individual with Autistic Spectrum disorder who has offending behaviour will be more likely to commit violent, sexual or arson-related crime however there is limited research to support this. Additionally it d oes appear that certain characteristics such as co-morbid psychiatric symptoms are important risk factors Introduction Debbaudt (2004) described how individuals with Autistic Spectrum Disorder are seven times more likely to experience contact with the criminal justice system than the general population. Howlin (2004) argues that the perceived link between Autistic Spectrum Disorder and offending behaviour can be explained by sensational media reporting. Specific stories have highlighted the Asperger syndrome status of offenders in their reports of crime. However the apparent association with offending has been generated by sensationalised, unsubstantiated in diagnostic terms , media reports. News headlines such as Autistic Boy killed baby brother, Apergers Boy locked up for Rape and A 15 year-old boy with Aspergers Syndrome ahs been locked up for an indeterminate period for raping an 8 year-old boy and photographing the attack can be extremely harmful to peoples perceptions of ASD (BBC News, 2001, BBC News, 2007a, Birmingham Post 2007). The purpose of this article is to review what literature is available relating to Autistic Spectrum Disorder and Offending Behaviour. Specifically this article will review what is meant by Autistic Spectrum Disorder, the prevalence of Autistic Spectrum Disorder within the Criminal Justice System, prevalence of offending behaviour in offenders with Autistic Spectrum Disorder, the characteristics of Autistic Spectrum Disorder that might make individuals more vulnerable to offending and the types of crime most associated with the disorder. Additionally there will be a focus on the relevant treatment and policy implications for clinicians and support staff working with this unique population. In order to identify all known studies investigating the relationship between Autistic Spectrum Disorder and offending behaviour a search was conducted of the databases Psych Info, Academic Search Complete and Google Scholar using the key terms Autis* and Crim*, Asperg* and Offen* within the parameters of 1985 to current issues. A search was also conducted regarding News and popular media sites using the key words of Autism, Asperger, offend/offending and Crime. All of the studies are organised in Table 1. Defining Autistic Spectrum Disorders Before examining prevalence rates it is important to define what is meant by Autistic Spectrum Disorder. In the Diagnostic and Statistical Manual of Mental Disorders ( DSM-IV) (APA, 1994) categories of pervasive developmental disorders (PDD) are autistic disorder, Asperger Syndrome and pervasive developmental disorder not otherwise specified (PDD-NOS). The criteria (DSM-IV) for Autistic Spectrum Disorder include a core triad of impairments. These are impairments in social interaction, social communication and social imagination including restricted repetitive and stereotyped patterns of behaviour, interests and activities. There is variance in diagnostic criteria for Asperger syndrome between DSM-IV and ICD-10. The term Autistic Spectrum Disorder is widely accepted in research and literature. The idea of the autistic spectrum is clinically useful as it illustrates the variation in symptomatology both among and within each diagnostic category. This range can include mild to very severe symptoms in each of the areas of impairment that categorise Autistic Spectrum Disorder. Those on the lower functioning end of the spectrum, such as those with classic autism, may never learn to talk using words, struggle to develop or maintain meaningful relationships and have very ritualistic/obsessional behaviour. Those on the higher functioning end of the spectrum, such as those with AS may have IQ within the average range, be verbally fluent and can be capable of leading independent lives given some support. The majority of literature regarding the relationship between Autistic Spectrum Disorder and offending behaviour has focused on individuals of whom have a diagnosis or show indicators of Asperger syndrome. Langstrom et al (2009) explored characteristrics associated with violent offending among individuals diagnosed with Autistic Spectrum Disorders over a 13 year period taking information from swedish national registers. They found that criminal violence was more common among participants diagnosed with Asperger syndrome relative to participants with autistic disorder. They attributed this factor to the reasoning that those with Asperger syndrome are more likely to have unimpaired intellectual ability, better social skills. It was also concluded that those with Autistic disorder are more likely to live in supervised settings where staff or others may help to resolve conflicts or manage anger. The fact that research study examines both autistic spectrum disorder and Asperger syndrome m ake drawing conclusions and comparisons extremely difficult. Asperger syndrome is defined as a condition which has many features of Autistic Spectrum Disorder however it is displayed in persons of average or above average intelligence. Gillberg (2002) describes features such as a tendency to engage in monologues or special interests around narrow interests, limited or inappropriate non-verbal communication and a compulsive need for routine. The term Theory of Mind has been used to describe the psychological dysfunction underlying the triad of impairments shared by all people with Autistic Spectrum Disorder (Wing, 1996). Theory of mind describes the ability to be able to put oneself in the position of another and be able to appreciate their feelings, wants and wishes. This inability to empathise and put yourself in someone elses shoes means that those with Asperger syndrome, like those with other forms of Autistic Spectrum Disorder, are unable to judge the probable actions or responses of others (Browning Caulfield, 2011). Many studies support the view that the majority of those with Autistic Spectrum Disorders and Asperger syndrome are law abiding and that very few engage in illicit criminalised behaviour. The very features of AS mean that the vast majority of this section of the population are very pedantic in their adherence to the law due to their literal thinking (Wing, 1997, Murrie et al. 2002, Myers, 2004). It may be that speculative assumptions that those with Autistic Spectrum Disorders or Asperger syndrome possess a greater propensity towards violent criminality is generated through media reporting and both factual and fictional film, television and radio. There are relatively few people in the public eye with an Autistic Spectrum Disorder however the reporting of rare acts of violence within the media is potentially harmful serving only to assist in the creation of inaccurate perceptions of affected individuals ( Browning Caulfield, 2011). An accurate prevalence of Asperger syndrome within the general population is yet to be established as findings between studies are varied. Research has indicated the prevalence of Asperger syndrome to be between 2 and 60 per 10,000 (Gillberg 1991, Wing 1996). Murphy, (2003) reported that there is evidence that 3-4 in every 100 children may develop Aspergers syndrome and there is general agreement that the prevalence of Asperger syndrome is low. Current statistics provided by the National Autistic Society estimate that the prevalence of all Autistic Spectrum Disorders in the UK is approximately 1% (NAS, 2008). Attempts to assess the violence and criminality rate have also been made more difficult due to the low prevalence and problems relating to gaining valid diagnosis of Aspergers Syndrome. It must also be recognised that additional problems in this field may stem from specific difficulties. People with Autistic Spectrum Disorder or Aspergers syndrome within the criminal justice system may be being misdiagnosed and being given other labels such psychosis. There may be a form of societal reluctance to link specific disorders within criminality thus meaning an under-estimation of prevalence is given. Berney (2004) also considers the idea that there is an increasing unwillingness within the UK to pursue prsecution unless there is a high possibility of conviction. Data may also not be taking into account large numbers of people who do not enter the criminal justice system as they are subject to diversion or do not get charged (Hawk et al. (1993). Some researchers have proposed that the core features of Autistic Spectrum Disorder such as abnormal development of social interaction and development may expose those on the spectrum to commit offending (Haskins and Silva, 2006). However this does not mean that having Autistic Spectrum Disorder enhances the likelihood of offending. Researchers have used a range of different strategies in order to study any possible association between Autistic Spectrum Disorder and offending. Prevalence of persons with Autistic Spectrum Disorder in the Criminal Justice System In order to better understand if there is any relationship between Autistic Spectrum Disorder and offending behaviour some researchers have focused on Autistic Spectrum Disorder among those who have already been or are still in the criminal justice system. Scragg and Shah (1994) considered a hypothesis that there may exist co-morbid neurological disorders in those with Asperger syndrome that may be an underlying factor of violent acts committed. Their research examined the entire male population (n=392) of Broadmoor hospital using methods such as interviewing staff and patients and screening case notes. They found a prevalence rate for Asperger syndrome of 1.5% significantly exceeding the prevalence rate of 0.36% found by Elthers and Gillberg (1993) in the general population using the same diagnostic criteria. Siponmaa et al (2001) conducted a retrospective study where a much higher prevalence rate of ASD among offenders was found in Sweden. The researchers reviewed case notes of 126 mentally disordered offenders and found that 15% had pervasive developmental disorder, 12% had pervasive developmental disorder not otherwise specified/atypical autism and 3% had Asperger syndrome. However these results cannot be generalised to offender populations as the sample was recruited from a forensic population of offenders who have a mental disorder requiring treatment and the majority had committed violent offences. Hare et al (1999) examined the prevalence of individuals with Autistic Spectrum Disorders within three hospitals in the UK. They found that 67.7% of the total Autistic spectrum disorder population of these prisons had Asperger syndrome. The rough prevalence estimate was 1.6% supporting the hypothesis that there is an over representation of people with Autistic spectrum disorder and in particular Asperger syndrome within forensic hospitals in the UK. In contrast Myers (2004) found very low numbers of individuals with autistic spectrum disorders in secure forensic and specialist settings in Scotland. Through examination of the number of people with learning disabilities with or without Asperger syndrome their findings indicate a prevelance estimate of 0.93% in the prison service; 0.46% in secure units and 1.39% in mental health units It must be recognised that prevalence studies have typically been restricted to highly specialised settings and therefore highly selected samples such as those at Broodmoor prison and secure services (Scragg and Shah,1994). There also appears to be a lack of research which has investigated the prevalence of Autistic Spectrum Disorder in general populations of people who had committed crime. Additionally there is also a failure to acknowledge that the offending behaviour of their research participants could potentially be attributed to other risk factors commonly associated with offending within the general population such as co-morbid mental health issues or social circumstances. There is large variability in prevalence rates across the discussed studies however there does appear to be some sort of association between autistic spectrum disorder and offending behaviour. Differences in types of diagnosis may account for some of the varying prevalence rates between different countries.Even specific studies involving highly specialised settings have found that a diagnosis of Autistic Spectrum Disorder had not been previously made for the majority; making this study of general populations even more difficult. . In making a diagnosis of Autistic Spectrum Disorder this can help in the understanding of reasons that crimes may have taken place and can help to decide on appropriate methods of care and management Detection of Autistic Spectrum Disorder in childhood/adolescence could provide opportunity to manage pre-disposing factors to offending behaviour. In the absence of such systems it could be argued that individuals with an Autistic Spectrum Disorder are at incre ased risk of developing offending behaviours. See Table 1 for an overview of the prevalence of Autistic Spectrum Disorder found in studies within both forensic and community settings Prevalence of Offending Behaviour in individuals with Autistic Spectrum Disorder When reviewing the research a further method of investigating the relationship between Autistic Spectrum Disorder and offending behaviour has been to examine the prevalence of offending behaviour in individuals with Autistic Spectrum Disorder. The question of whether or not a person with Autistic spectrum disorder may be more likely to offend will provide richer information around any possible association. Hippler et al, (2009), completed a study to examine criminal offending in 177 former patients of Hans Asperger. No increased rate of registered convictions was found compared to the general population suggesting that people with Aspergers syndrome are not more likely to commit offences. Mourisden et al, (2008) looked at the prevalence of offending behaviours in individuals with Autistic Spectrum Disorder compared to typically developing controls using the Danish Criminal Register. Register data offers opportunity to analyse data from large populations in a historical, prospective way avoiding recall bias. Overall results found that 9% from the Autistic Spectrum Disorder group and 18% from the comparison group had convictions. This study suggests that rates of convictions are actually lower in individuals with Autistic Spectrum Disorder than in the general population. The research also indicated that criminal offences are very uncommon in childhood autism but more common in Aspergers syndrome. Allen et als (2008) study investigated the prevalence of Asperger syndrome and offending within a large geographical area. A survey methodology was used to identify adults with a recorded clinical diagnosis of Asperger syndrome in the South Wales area of the UK. The services contacted included mental health teams, local health practitioners, forensic practitioners and learning disability teams. Their results were generally not supportive of there being a significant association between Asperger syndrome and offending, attributing this to methodological problems including individuals with learning disabilities skewering the data, the focus on adults and misdiagnosis. Woodbury-Smith et al. (2006) identified that previous research had focused specifically on violent offending and suggested a need for community based research. Their reasoning was that statistical findings of research conducted within high security psychiatric or forensic settings only represented the prevalence of very serious offences therefore failing to be more representative of more generalised common-place criminality. They responded by conducting a study of offending by those with Asperger syndrome and Autistic Spectrum Disorders in the community. Although it must be acknowledged that the sample size was very small it was the first to look at offending patterns of individuals with Autistic Spectrum Disorders in the community. Their findings found that the level of offending occurring within the Autistic Spectrum Disorder group was lower than that of the neuro-typical group. Issues with these particular studies include the difficulties that some studies have such small, unrepresentative samples that make any estimates of prevalence epidemiologically insubstantial. Consequently whilst these studies do not give a true picture, this limited evidence also suggests that individuals with classic autistic disorder are very unlikely to offend and those with a diagnosis of Asperger syndrome are no more likely to offend than people in the general population. Table 1 Prevalence of Autistic Spectrum Disorder studies within both forensic and community settings Study No. of participants Prevalence estimation Ghaziuddin et al (1991) Review of 132 published case studies 2.27% Scragg and Shah (1994) 392 1.5%-2.3% Hare et al. (1999) 22 1.6% Sipionmaa (2001) 135 15% diagnosed with ASD Myers (2004) 0.46% in secure psychiatric units 0.93% in the prison service 1.39% in mental health units Mouridson (2008) 313 0.89% Hippler et al (2009) 177 No increased prevalence compared to the general population Predisposing Risk Factors of Autistic Spectrum Disorder that might make a person more vulnerable to offending In order to examine if there is any relationship between Autistic Spectrum Disorder and offending behaviour it is important to investigate whether there are any innate vulnerabilities that make it more likely that a person with Autistic Spectrum Disorder will offend. It must also be recognised that general vulnerability factors as identified in criminological literature such as low IQ, poor school achievement and Attention deficit hyperactivity disorder will still all be relevant (Farrington, 2002). More general knowledge within this area will enhance both preventative programmes and forms of treatment and rehabilitation. Woodbury- Smith et al. (2006) completed an exploratory study where participants were recruited from different sources in the UK. These adult groups included 21 individuals with Autistic Spectrum Disorder and a history of offending, 23 individuals with Autistic Spectrum Disorder and no history of offending and a general population group of 23 people without Autistic Spectrum Disorder and no history of offending. Cognition areas known to be impaired in people with Autistic Spectrum Disorder such as theory of mind and emotional recognition were compared. Results showed that the Autistic Spectrum Disorder offenders showed a significantly greater impairment in the recognition of emotional expressions of fear, but no difference in theory of mind, executive function, and recognition of facial expressions of sadness. This finding indicates that this lack of ability to recognise fear in others may cause individuals with Autistic Spectrum Disorder to continue behaviour that is distressing to o thers thus possibly increasing the likelihood of offending. Langstrom et al (2009), used data from Swedish longitudinal registers for 422 individuals hospitalised with Autistic Spectrum Disorder during a thirteen year period . Their research compared those committing violent or sexual offences with those who did not. Their results found that violent individuals with Autistic Spectrum Disorder are generally male and diagnosed with Asperger syndrome rather than Autistic Spectrum Disorder. Conclusions also found that violent offending in Autistic Spectrum Disorder is related to similar co-occurring psychopathology as found in violent individuals without Autistic Spectrum Disorder, Limitations to this study must be cautiously interpreted as the sample was based on being hospitalised and are again therefore not necessarily representative of all individuals with Autistic Spectrum Disorder in the community There are very few reports that investigate the importance of co-morbid psychiatric factors when understanding if any relationship between Autistic Spectrum Disorder and offending behaviour exists. Newman and Ghaziuddin (2008), reviewed 37 published cases with violent behaviour and AS in respect to concurrent psychiatric disorders and found that 29.7% of the reviewed cases had a definite psychiatric disorder whilst 54.0% had a probable psychiatric disorder. Subsequently when offending occurs within an individual with Autistic Spectrum Disorder it is important to exclude other psychiatric conditions because these can independently influence the risk of offending, as it does in the general population. Murphys (2003) study examined in the setting of a high-security psychiatric hospital whether male patients with AS could be distinguished from patients with personality disorder or schizophrenia on the basis of admission and neuropsychological details. This study adds to the review of research on Autistic Spectrum Disorder and offending behaviour as exploratory comparisons found that patients with Asperger syndrome were less likely to have a history of alcohol or illicit substance abuse and had lower index violence rations. Qualitative observations in this study suggested that whilst circumstances varied, offending behaviour tended to be associated with particular problems such as externalised misplaced blame, difficulty understanding consequence of their actions and difficulty with prospective taking. Murphy (2006) compared in-patients with schizophrenia, personality disorder and Aspergers syndrome in Broadmoor high security psychiatric hospital. The research indicated that those with AS were less likely to have histories of substance abuse or alcohol misuse and their offences had lower violence ratings than those of other patient groups. Palermo, (2004) examined the relationship between complex developmental disorders and delinquency by analysing three adult patients with Pervasive Developmental Disorder whose admission to hospital was precipitated by criminal behaviour. The patients all shared similar difficulties including struggling to understand social cues, showing mannerisms ad prosodic oddities and all had the presence of a major psychiatric illness whilst meeting the diagnostic criteria for Asperger syndrome. Their findings found that the reported behaviours resulted from co-morbid psychopathology and not as a direct consequence of a developmental disorder. Howlin (2004) suggests that the innate levels of empathy may be associated in particular with violent and sexual offending. Additionally Haskins and Silva, 2006. discuss how the illegal behaviours of a person with Asperger syndrome are predominantly associated with either a deficient theory of mind or an intense preoccupation with a narrow interest. The term weak central coherence refers to the detail focused processing style that is proposed to characterise autism spectrum disorders (Happe and Frith, 2006). A persistent preoccupation with parts of objects is one of the diagnostic criteria for autistic disorder in current practice (DSM-IV, 1994) Subsequently it has been proposed that this weak central coherence may make it difficult for an individual with Autistic spectrum disorder to think about the consequence of their actions. To confirm factors that predispose a person to commit a particular type of crime, further large scale, longitudinal prospective studies are needed. See Table 2 Table 2 Factors mediating offending in Autistic Spectrum Disorders in key studies Study Factors mediating offending in AS Murphy (2003) externalised misplaced blame difficulty understanding consequence of actions difficulty with prospective taking Barry-Walsh and Mullen (2004) narrow focus and preoccupation with a special interest Palermo (2004) struggling to understand social cues Co-morbid psychopathology Lack of empathy Howlin (2004) innate levels of empathy Happe Frith (2006) weak central coherence Haskins and Silva, (2006) deficient theory of mind An intense preoccupation with a narrow interest. Woodbury-Smith et al. (2006) significantly greater impairment in the recognition of emotional expressions of fear Newman and Ghaziuddin (2008) Co-morbid Psychiatric factors Allen et al (2008) Lack of concern and awareness Social naivety Impulsivity and mis-interpretation of the rules Overriding obsessions Types of Crime most associated with the disorder It is difficult to ascertain the types of offending behaviour in individuals with Autistic Spectrum Disorder due to the lack of valid epidemiologic studies. Clinical studies within the case study literature have also explored the hypothesised relationship between Autism and Offending behaviour. The offense type most commonly described within these studies tends to be sexual offences, arson and violent offenses. Studies of single cases and referred samples can provide indications of the types of offending which may be found in people with Autistic Spectrum Disorder (Baron-Cohen, 1988, Barry-Walsh Mullen, 2004, Haskins Silva, 2006, Murrie et al. 2002, Schartz-Watts 2005). Mawson et al, (1985) case study focused on a 44 year old man cataloguing a series of strange violent behaviours including dropping a firework into a girls car, assaulting a crying baby at a railway station by putting his hand over its mouth to stop the noise, following a female teacher, getting close to her at every possibility. The authors speculate that there is an association between Asperger syndrome and violent behaviour however they do not put the offences in context of the mans diagnosis and significant impairments including sensory, theory of mind and inability to read social situations. Palermos, (2004) case studies behaviours respectively included threatening to kill a police officer, threatening to burn down a family members house and touching a prepubescent boy at a playground. Several case reports associated with Arson and Asperger syndrome have appeared in the literature. Mouridsen et als, (2007) study looked at the prevalence of offending behaviours in individuals with Autistic Spectrum Disorder compared to typically developing controls and found that only arson statistically separated Asperger syndrome cases from the comparison group. Haskins and Silva (2006), discuss a range of particular cases highlighting specific issues that might make a person with Autistic Spectrum Disorder have heightened risk for engaging in criminal behaviour. One reviewed case history involved a young man who was accused of starting a fire in his apartment to obtain insurance money. This fire killed his young daughter and nearly killed his wife. Additionally Sionmaa et al, (2001) reported that 10 (63%) of 16 crimes of Arson were perpetrated by individuals with AS. Barry-Walsh and Mullen, (2004), reported on two cases that had a history of fire-starting. Reasons for the offence of arson vary within each study however it is hypothesised that a major reason includes the narrowed fixations that some people with Autistic Spectrum Disorder may have and the lack of understanding of consequences and reasoning. It could be suggested that Arson may be more specifically related to behaviours seen in Autistic Spectrum Disorder . Epidemiological studies indicate that people with AS do commit sexual offences (Hare, 1999; Murphy 2003) but there is evidence that the rates of sex offending and child sex offences in particular are lower than in general populations ( Hare, 1999, Elvish, 2007). It has been suggested that individuals with Asperger syndrome display criminal behaviour due to their sexual preoccupations. Cases include that of a 21 year old male who had a history of stealing cotton lingerie and masturbating whilst holding womens night-dresses (Chesterman Rutter, 1993) and a young male with Asperger syndrome who had a history of recurrent sexual offences including touching the privates of young women; watching women in toilets and making obscene phone-calls (Milton et al, 2002). It appears that when individuals with autistic spectrum disorder do commit crimes they are less likely to involve alcohol, substance misuse and/or drugs (OBrian Bell, 2001). Additionally the offences of individuals with autistic spectrum disorder did not generally provide any direct gain to the individual. Wahlund Kristiannsson (2006) investigated 35 male offenders with diagnosis of ASD or anti-social behaviour referred for psychiatric assessment in Sweden. It was found that those with autistic spectrum disorder were less likely to be intoxicated and did not use knives or guns as frequently as the personality disorder group. It was also hypothesised that individuals with autistic spectrum disorders may offend at an earlier age than other neuro-typical offenders as difficulties in social interaction will start to be marked in early adulthood and youth resulting in a higher risk of offending behaviour. Recommendations to support individuals with ASD with Offending Behaviour There must be recognition that a number of people with Autistic Spectrum Disorder are involved with the criminal justice system whether that be as victims, witnesses or perpetrators of crime. Professionals working within the CJS must be educated regarding the unique diversity that may be found within people with Autistic Spectrum Disorder in order to improve the likelihood that these individuals will be treated more appropriately. Tiffin Nadkarni (2010) discuss how specialised assessments can identify risk factors associated with violent behaviour even if social and communication problems consistent with an Autistic Spectrum Disorder are present. However there is recognition that these tools compliment but do not replace structured clinical assessment. Subsequently a formulation of risk that recognises complexity but accepts limitations enables useful management plans to be made. The treatment of vulnerable groups within the criminal justice system has been focused on within specific research and it must be recognised that the process of arrest, questioning and trial may be more difficult for a person with Asperger syndrome then others. Difficulties may include misinterpreting what they hear, being unable to function effectively in unpractised, unfamiliar environments and using words without fully understanding their meaning (Mayes, 2003, Barry-Walsh and Mullen, 2004) Subsequently these difficulties may be considered to be the individual being un

Interprofessional And Interagency Working

Interprofessional And Interagency Working This assignment will critically analyse two examples of interprofessional and interagency practice using examples from my current practice placement. Relevant literature will be used to identify what factors support or constrain interprofessional and interagency collaboration (IPIAC). IPIAC is often described as a holistic approach to an individuals needs. When used effectively, a holistic approach allows for better service delivery to the service user. Hammick et al (2009, p.10) states that being interprofessional is learning and working or working and learning with others as appropriate, when necessary and sometimes both. Interagency working concentrates more on the organisational roles and responsibilities of those involved in collaboration (http://www.scie.org.uk). Interprofessional is relationships between individuals and interagency is relationships between organisations. IPIAC was a modernisation agenda introduced in public policy by the New Labour Government. Government recognition suggests that many social problems cannot be effectively addressed by any given organisation acting in isolation from others. That is, when professionals work together effectively they provide a better service to the complex needs of the most vulnerable people in society. New Labour also specified that there was a Berlin Wall type division between agencies and professionals and that there was a barrier to co-operation and this barrier should be confronted so that services worked in partnership with service users. However according to research conducted by Hiscock and Pearson (2002, p.11) several government reports have criticised the lack of coordination between health and social services in the community. So, in essence when professions work collaboratively the service user gets a better deal. Willing participation (Henneman et al, 1995, cited in Barrett et al, 2005, p.1 9) and a high level of motivation (Molyneux, 2001, cited in Barrett et al, p.19) have been stated as vital aspects of effective IPIAC. My current practice placement is within a voluntary organisation in a domestic abuse service. I am a project worker at a Refuge for women and children who are escaping domestic abuse. My role is to co-link work with permanent Refuge staff and co-ordinate each service users support needs whilst maintaining links with appropriate statutory and voluntary sectors. INTERPROFESSIONAL PRACTICE ONE The first example of IPIAC to be discussed and analysed within my practice placement will be a weekly meeting held between Refuge staff, health visitors and the play-worker from Womens Aid. The aim and purpose of these meetings is to share information so that identified needs of the families in the Refuge can be addressed and where possible be signposted to other services as required. The meetings are designed for professionals to share information and knowledge about the familys lives but not make decisions on their behalf (except where there are child protection issues). The meetings also aim to provide support to families according to assessment of need using professional judgement. Within these meetings everyone discusses and communicates the personal development and progress of the women and children in the Refuge so that all professions involved are kept up to date with the familys circumstances and situation. This supports IPIAC and is effective in that it is a chance for ever yone involved to gain further advice and guidance from other professionals in relation to their current level of involvement with the families. This in turn supports the families and assists them with their future goals and plans. However these meetings could be interpreted to some as secretive as they are held behind closed doors and it is a meeting in which the families are not involved in. This could be construed as an expert power relationship to some (Maclean and Harrison, 2011, p.31). For IPIAC and these meetings to be effective it is vital that all professionals involved support one another and are not be seen as self-interested or see themselves as higher than another profession. This is when problems occur as there is not a logical distribution of power. Unequal power distribution can be oppressive (Payne, 2000, cited in Barrett et al, 2005, p.23) and can limit participation for some professionals. Power in IPIAC should be shared and distributed and no hierarchy of power should exist. If some professionals see themselves as more powerful than another they are not meeting the needs of the service user. Sharing of information and knowledge about the families in the Refuge is the purpose of these weekly meetings so as to achieve the best possible outcome for the service user. A constraint of IPIAC is that some professionals are territorial and do not like to share information and knowledge. Molyneux (2001, cited in Barrett et al, 2005, p20) found that professionals who were confident in their own role were able to work flexibly across professional boundaries without feeling jealous or threatened. Professional adulthood was an expression used by Laidler (1991, cited in Barrett et al, 2005, p.20) to describe professionals who were confident in their own role to share information and communicate effectively with other professionals. These professionals do not feel territorial about relinquishing their knowledge and understanding to further enhance good IPIAC. Stapleton (1998, cited in Barrett et al, 2005, p.20) suggests that a combination of personal and professional confidence enables individuals to assert their own perspectives and challenge the viewpoints of others. Active listening is an important skill to maintain in order to achieve effective IPIAC. To be able to recognise and respond to what is being communicated is fundamental. Professionals working collaboratively should be able to demonstrate this verbally and non-verbally to each other. This is greatly helped if all concerned put aside the typical stereotyping of each others professions in order to hear and listen to what is being said. Effective open and honest communication is vital and probably one of the most important aspects of IPIAC. It requires professionals to take into account each others views, be respectful, dignified and to listen to each other without being highly critical of one another. Constructive feedback about the family needs to be undertaken alongside constructive suggestions and encouragement and should take place at a time when other professionals are receptive. However, being receptive to what is being said does not always occur during these meetings. At times, o ne professional does not like what another is conveying and this can create conflict within the professions. However the need here is to remember that it is the service user that is central to the process and that the goal is to achieve the best outcome for them and their family. There are elements within this example that both support and constrain IPIAC. To achieve the goal and not result in a poor outcome for the service user it is important for all professionals involved to communicate honestly and openly and for there to not be a significant power imbalance between the professions. INTERPROFESSIONAL PRACTICE TWO The second example of IPIAC to be discussed and analysed within my practice placement will be a Multi-Agency Risk Assessment Conference (MARAC). A member of the Refuge staff attends these meetings on a fortnightly basis. A MARAC meeting is a community response to domestic abuse. Cases are referred to a MARAC by the Refuge as a result of completing a CAADA-DASH risk identification checklist (RIC) (see appendix one) with the victim of the domestic abuse. This checklist determines the victims level of risk/need. If the risk identification score is 14 or more on the RIC, the MARAC threshold for high-risk has been meet and a referral to a MARAC meeting is made. Cases can also be referred to the MARAC either as a result of a high risk domestic crime/incident recorded by the police or by a direct referral from a participating agency. Participating agencies attending the meetings can include representatives of statutory services such as the police, criminal justice, health, child protection, housing practitioners and Independent Domestic Violence Advocates (IDVAs). The purpose of the meetings is for professionals to implement a risk management plan that provides professional support to all those at risk and which reduces the risk of harm. The aim is then to produce a safety plan for each victim of domestic abuse. The MARACs aim is to share information to increase the safety, health and well-being of victims/survivors of domestic abuse. They can determine whether the alleged perpetrator poses a significant risk to any particular individual or to the general community. According to Bowen (2011, chapter 5.) MARAC functions through meetings designed to facilitate multi-agency information sharing, with a view to implementing an agreed-upon risk management and victim safety plan. Effective communication and information sharing supports IPIAC as it can assist to build relationships between agencies across a much broader range. A MARAC with effective communication and information sharing between agencies can also promote IPIAC in developing much stronger relationships between the voluntary and statutory sector. Barrett et el (2008, p.21) states that communication competence contributes to effective interprofessional working and enables those involved to articulate their own perspectives, listen to th e views of others and negotiate outcomes. An effective MARAC meeting which supports IPIAC is when professionals work collaboratively to ensure that victims/survivors and/or their children are safeguarded from further abuse. The governments action plan Call to End All Violence Against Women and Girls states that we all have to work together to achieve our goal of ending violence against women and girls. It is not a task for central government alone. It suggests that agencies need to work together to meet the needs of their local communities and that agencies are held accountable. However, a constraint of a MARAC meeting that I witnessed was that not all professionals brought the appropriate information to the meetings which lead to an inefficiency and delay of the case which frustrated others professionals attending. Poor timekeeping was another avenue that at times would frustrate other professionals attending the meetings. This seemed to alienate them as I would hear comments such as we are all professionals here and should act as such and as professionals attending important meetings like this, we should always strive to be on time. I also found at the MARAC that some agencies only had snippets of information that on their own did not raise any particular concern. It was only when the jigsaw of information was pieced together that the risk factors could begin to be understood. This example shows that when MARAC meetings support and strengthen interagency working and is effective, it is IPIAC at its best. This approach to working more collaboratively is beneficial as all organisations are coming together for the purpose of a common goal, with that goal being the best possible outcome for the service user. However some of the MARAC meetings that I had attended were not always that effective due to the fact that not all key agencies or organisations attended the meetings when required to do so or did not have the appropriate information to hand. It is beneficial that all agencies have as much information to hand as possible to facilitate IPIAC and have a profound positive impact on the outcome for the service user. In conclusion, IPIAC has many elements and all these different elements require that the different professions adopt them so that effective outcomes are achieved for the service user. Although IPIAC has been around for many years and is not new, it still needs to be continued, developed and incorporated into the daily work of all professions. When organisations and professions from different disciplines truly understand each others roles, responsibilities and challenges, the potential of IPIAC could be fully realised and many of the barriers alleviated. This in turn will contribute to a more successful outcome to the service user which of course is central to effective IPIAC. If IPIAC is ineffective it can limit choice for the service user and also increase risk. Word Count: 1966

Updike, Harry Angstrom and Me :: essays research papers

This is a prose-poem on Updike. It follows Updike through his Rabbit Tetralogy. _______________________________ UPDIKE John Updike’s Rabbit tetralogy chronicles reflectively the decades since I first had contact with the Baha’i Faith back in 1953. With the help of a Guggenheim Fellowship Updike was working on the first of these four books, Rabbit, Run, when I became a Baha’i in October 1959. The book was published a few months later in 1960 and is the story of a young man, one Harry ‘Rabbit’ Angstrom, from a small town in the USA. The book concerns Harry’s attempts to escape the constraints of life. In my teens I, too, lived in a small town and, although I could see the attractiveness of escaping from social constraints, I also left the need for a set of limits. I was only too well aware of just how easily I could go beyond the appropriate limits. By the late fifties I could see what happened to those who did escape from life’s, from society’s, constraints. I knew from personal experience by my early teens, by 1957, what it was like to be c aught stealing, breaking and entering, going too far sexually, misbehaving around the family home, at school or with my play-mates and pushing the envelope of life. Had I read Updike’s book, Rabbit, Run I think I would have had my need, my desire, for limits reinforced. The Baha’i Faith provided that framework, those limits, at a critical stage in my life, my mid-teens. This Faith also provided that sense of the sacredness of life which is at the centre of Updike’s work. When I was preparing to leave North America for Australia in 1970/1 people were watching the movie Rabbit, Run. It had opened just as I began planning to leave Canada in 1970. Rabbit Redux, Updike’s sequel to Rabbit, Run came out four months after I arrived in Sydney for what became my life in Australia. Harry Angstrom took to the road in 1971 in Rabbit Redux as I took to a different road in the southern hemisphere. Updike’s final two Rabbit books took Harry Angstrom into the 1990s and his rather bleak retirement and old age. The following prose-poem compares and contrasts my life with Harry’s. –Ron Price with thanks to â€Å"Articles on John Updike’s Works,† in The New York Times on the Web.

Roles of Women During the Renaissance as Seen in Shakespeares Henry IV

Roles of Women During the Renaissance as Seen in Shakespeare's Henry IV      Ã‚  Ã‚  Ã‚  Ã‚   The plays of Shakespeare can be used as a window upon Renaissance society. However, if one looks through this window and does not leave behind the ideals of a modern society, the view may become distorted and not be as pleasing as it was for Shakespeare's contemporaries. In I Henry IV, the characters of the women are not equally developed as the male characters; but their interaction, or lack thereof, depicts the changing, yet somehow stagnant, roles of women during the English Renaissance.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In I Henry IV, the "themes of public and private life are brought together" (Speaight, 163). Elizabethan society was marked by gender seperation, both publicly and privately. Lady Percy does not play an active role outside of Hotspur's private life. To Hotspur, a woman's world was "To play with mammets and to tilt with lips (2. 2. 91), a gentle powerless occupation that did not mix with man's domain of "bloody noses and cracked crowns" (2. 2. 92). Although women writing during this time affirmed that women are "tender foft and beautifull, fo doth her difpofition in minde correfponde accordingly; she is milde, yielding, and and vertuous"(Sowernam, 43), women among the higher social classes began to question their inferiority to men as a result of the new emphasis on education for women. The heightened exposure to Biblical and classical influences among Renaissance women created paradoxical results. "Education was designed to fill specific private functions and responsabilities" (Travitsky, 5). Women were not encouraged to leave their place within the home, but instead were encouraged on the "development of the home as a school of faith" ... ...lewd, froward, and unconstant men, and Husbands. Divided into Two Parts. The first proveth the dignity and worthinesse of Women, out of divine Testimonies. The second shewing the estimation of the Foe-minine Sexe, in ancient and Pagan times: all which is acknowledged by men themselves in their actions. Written by Ester Sowernam, neither Maide,Wife, nor Widdowe, yet really all, and therefore experienced to defend all. London: Printed for Nicholas Bourne, 1617. STC 22974. University Microfilms Reel no 1188. 4. Spaight, Robert. Shakespeare: The Man and his Achievement. London: J.M. Dent and Sons Ltd., 1977. 5. Travitsky, Betty, ed. The Paradise of Women: Writings by Englishwomen of the Renaissance. Westport: Greenwood Press, 1981. 6. Watson, Curtis Brown. Shakespeare and the Renaissance Concept of Honor. Princeton: Princeton University Press, 1960.

BaBar Experiment :: Chemistry Science Scientific Essays

BaBar Experiment Abstract I investigated the L = 1 mesons D*2(2460)0 and D1(2420)0 using data gathered by the BaBar detector at Pep-II. The decay process of these particles is interesting because it could serve to confirm or deny certain predictions made by HQET models. Thus far, the data gathered rougly conforms with measurements made by the CLEO and ARGUS collaborations. The data is still preliminary, however, and as such this paper should be considered merely a summary of the work done thus far. 1 Introduction 1.1 The BaBar experiment The BaBar detector at Pep-II was designed to study B mesons produced in asymmetric e+e- collisions. \Asymmetric" refers to the fact that the colliding electrons and positrons have different energies. This gives the resulting particles momentum in the laboratory reference frame, allowing their lifetimes to be measured even if they carry away most of the collision energy. In the current run at Pep-II, electrons are stored in one ring at 9 GeV and positrons in the other at 3.1 GeV. This sets the collision energy right at the T(4S) resonance, a short-lived combination of a bottom quark and its antiquark. This decays preferentially into a pair of mesons B and B|hence the name of the detector. Mesons are short-lived systems made up of a quark and an anti-quark; Bs are mesons in which one quark is a bottom (or an anti-bottom) and the other is a light quark (up, down, strange, or their corresponding antiquarks). The BaBar detector is optimized to measure the decay process of these B's as precisely as possible. It is hoped that differences between the B and the B decay processes will be uncovered and measured, which will lead to a better understanding of CP symmetry violation. \CP violation" describes an event that breaks the so-called Charge{ Parity symmetry. For a time, it was believed that if matter and antimatter were interchanged (hence, Charge) and if right and left were reversed (Parity), systems would behave in an identical manner. This symmetry has since been found to be broken in certain kaon decays, and it is suspected that further violations will be discovered in B decays. Note that if time is reversed as well as charge and parity, then the system will behave in an indentical manner; this is known as CPT symmetry, and is required for Lorentz transformations. It is hoped that learning more about events that violate the \broken" CP symmetry will shed some light on the relative scarcity of antimatter in the universe.

A Case of Digital Divide in Bangladesh Essay

A case of Digital Divide in Bangladesh Anisur Rahman Senior Asst. Director and Head Library and Information Division Northern University Bangladesh Anisur Rahman, â€Å"Access to Global Information—A case of Digital Divide in Bangladesh. † Proceedings of the IATUL Conferences. Paper 25. http://docs. lib. purdue. edu/iatul/2007/papers/25 This document has been made available through Purdue e-Pubs, a service of the Purdue University Libraries. Please contact epubs@purdue. edu for additional information. Access to Global Information—A case of Digital Divide in Bangladesh Md. Anisur Rahman Senior Asst. Director and Head Library and Information Division Northern University Bangladesh 3/18 Iqbal Road, Asad Avenue Mohammadpur, Dhaka 1207 Bangladesh Email: anisdacca@gmail. com Abstract. ICTs can reduce communication costs and break down geographical borders. In the developed nations government policies are being established which attempt to ensure that all citizens will get the opportunity to access the effective use of ICTs in order to enable them to participate in the educational, social and economic activities and democratic processes. Developed countries are getting much benefit from the advancement of ICTs. There is digital divide between developed and developing countries. The term digital divide has been applied to the gap that exists in most countries between those with ready access to the tools of ICTs, and those without such access or skills. In other words, it is the gap between the have’s and the have not’s. The digital divide around the world is usually measured through statistical indices such as the number of telephone lines, personal computers, websites and Internet users and their ratio to the total population. This paper reviews the papers on issues related to digital divide that are affecting so many citizen in developing countries especially in Bangladesh and the factors that alienate people from enjoying the benefits of ICTs. The author recommends possible strategies that can be implemented in developing countries to reverse the widening gap of digital divide. Keywords: Digital divide, ICT, Internet, Bangladesh 1. Introduction Computers, modern telecommunication and the Internet all reduce communication costs and break down geographical borders. Information and communication technologies serve as powerful tools for empowering people, benefit business and virtually link people around the world to share their views, ideas and innovation. 2. Concept of Information Technology Information technology today handles information in every conceivable form, whether music, video, graphics, speech, data, text. It also embraces an increasing range of technologies. Information technology is the use of modern technology to aid the capture, processing, storage and retrieval, and communication of information, whether in the form of numerical data, text, sound, or image. IT has a great impact on the societies. IT has impact on employment, education and training, commerce, at home, arts (music, animation and visual effects, writing, games), and all aspects of public administration and national defense. 3. Digitization The globalization and localization of information and cultural values are basically predicated on digital technology. The invention of e-mail and the WWW leading to digital transmission 1 is the certainly the second digital revolution. Digital scanners and cameras can now be used to capture digital images for importation into computer systems. In the current information revolution, almost everything is digital TV, radio, air-conditioned, cars, airplane, refrigerators, industrial plants and telecommunication systems. 4. Digital divide This digital revolution has created a brand new economic sector that simply did not exist before. Computers, modern telecommunication and the Internet all reduce communication costs and break down geographical borders. In addition, ICT can be an important driver in poverty reduction and assure sustained conomic growth, better public welfare, and strong social solidity and democratic forms of government. In the developed nations government policies are being established which attempts to ensure that all citizens will get opportunity to access the effective use of ICTs in order to enable them to participate in the educational, social and economic activities and democratic process. Developed countries are getting much benefit from the advancement of ICT. So, there is a digital divide between deve loped and developing countries. The concept of the digital divide has been used to highlight difference in electronic access to information based on economic, race, ethnic or social group and/or geographical location. The term digital divide has been applied to the gap that exists in most countries between those with ready access to the tools of ICTs, and those without such access or skills. It is â€Å"a gap, which tends to deepen, is produced between those individuals that can access new information and communication tools such as phones, TV sets or the Internet, and those who are too poor to get them between the have’s and the have nots† (de Munster, 2004). Population residing in developing countries or in low-income countries may be unable to gain access to IT because of the inability to purchase the required equipment, Internet provider service or other necessary resources. It may not be possible to bridge the divide, but it is important to prevent it from deepening, as a minimum, and to attempt to narrow it as much as possible. According to Reuter’s reports at Berlin on Wednesday, April 26, 2006 â€Å"the digital divide is narrowing as citizens in emerging markets get online via computers and mobile phones, with some regions now on a par with developed nations† (Reuters, 2006). Peter korsten, European director at IBM’s Institute for Business value said â€Å"within China and India, regions like Shanghai and Bangalore have almost the same level of Internet and mobile phone connections as developed nations† (Reuters, 2006). 5. ICT status in Bangladesh The ICT status of Bangladesh is not remarkable without some favorable initiatives by the Government and by private entrepreneurs. Computer use in Bangladesh started with a mainframe computer in 1964.

On the Relationship between Writing and Thinking

Stephen King’s On Writing serves as a memoir and a writing instructional book which provides King’s views regarding the relationship between writing and thinking through the discussion of the intrinsic rewards involved in the process of writing a text as well as the skills that one must master in order to become an effective writer. In line with this, what follows is a discussion of King’s thoughts regarding the relationship between writing and thinking in relation to creation of literary texts. According to King, writing is a product of intrinsic interests toward the act itself. He states, â€Å"I never set a single word down on paper with the thought of being paid for it†¦I have written because it fulfilled me†¦I did it for the buzz. I did it for the pure joy of the thing† (King 248-9). Within this context, one might note that King perceived the writing process as a form of spiritual union with the self in the sense that it enables the individual to gain fulfillment and hence to a certain extent further knowledge and mastery of his self. The mastery of the self is achieved during the process of mastering the art of writing. Such an art however may only be mastered if the individual possesses the fundamental skills necessary in the process of writing a text. These skills are laid down by King by using the metaphor of a toolbox. He lays out a three-level expanding toolbox that his grandfather used during his childhood (King 21-55). On the top level of the toolbox are vocabulary and grammar which serve as the rudimentary tools that an individual ought to master before mastering creative writing. He states, â€Å"good writing consists of mastering the fundamentals† (King 144). King claims, that these tools are absorbed at a very young age and hence the initial tools for creative writing necessitates that an individual possesses good background knowledge and mastery of these rudimentary aspects. The second layer of King’s toolbox contains writing style and structure. He argues that once an individual has mastery of both vocabulary and grammar, it is possible for him to develop his own writing style as well as create his own structural style. This style however must continuously be developed through an individual’s continuous immersion on the various developments within the different genres of literature. The last level of King’s toolbox contains the act of writing itself. He claims, â€Å"if you want to be a writer, you must do two things above all others: read a lot and write a lot. There’s no way around these two things that I am aware of, no shortcuts†¦There is a learning process going on† (King 145). Within this context, creative writing for King may be understood as the process of mastering and enjoying the writing process. King himself notes that â€Å"the skill necessary for creative writing comes from years of practice; the art comes from a creative imagination which is working hard and having fun† (King 195). The relationship between thinking and writing, for King, may thereby be seen as involving the process of mastering one’s craft through the continuous development and exercise of a creative mind. Such an exercise however does not imply that the writer ought to be fully absorbed in the literary world; it also requires the writer’s recognition and observation of the events that occur within both the private and public spheres of life. King notes that the relationship between the act of writing and thinking involves a contact between the author’s mind and the mind of the reader (106-7). Such a contact may only be achieved through the writer’s awareness of the events in world since like the characters and events within a literary text, a writer’s audience and the events surrounding his audience is continuously changing. King presents examples of how these observations have affected his works. He states, These deep interests†¦include how difficult it is†¦to close Pandora’s technobox once it’s open†¦; the question of why, if there is a God, such terrible things happen†¦; the thin line between reality and fantasy†¦;and most of all, the terrible attraction violence sometimes has for fundamentally good people. King 207) .In a sense, one might state that creative writing enables an individual’s discovery and knowledge of his self as it enables the individual to grapple with the fundamental issues involved in existence such as the morality of an action, the existence of moral standards, as well as other existential issues which a writer’s audience may either choose to confront or forget. Within the context of King’s explanation of creative writing as well as his explanation of the relationship between the author and the reader, it is possible to posit a view of literature as a chronicle of life. Literature serves as a chronicle of life not in the usual sense that it presents the history of an individual or the history of a nation but in the sense that it presents humanity’s continuous discovery of its existence as well humanity’s continuous discovery of its skills. The discovery of its existence is enabled through the additional views presented by literary texts regarding the sorrows, joys, and enigmas involved in human life and the discovery of the its skills is enabled through the additional styles that have developed in the various literary texts that have been published throughout the years.