Between A Rock And A Hard Place Seems To Be A Very...

Between a Rock and a Hard Place seems to be a very appropriate title for this HBO documentary whose executive producer and star is Dwayne â€Å"The Rock† Johnson. Young men with serious criminal charges and significant prison sentences are provided a second chance by participating in the Miami-Dade Corrections and Rehabilitation Department’s Boot Camp Program in place of serving their entire prison sentence. Dwayne Johnson greets 38 cadets starting the program, lectures them on their opportunity and asserts that he wants the world to see the importance of the program. Lastly, he tells them bluntly, not to â€Å"†¦f**k this up.† For most people it would appear that participating in this 16 week program would be easier compared to the alternative of†¦show more content†¦The program offers each of these benefits at different phases. The documentary presents each participant in a way that it is difficult not to find some way to relate and even care for them or their sense of purpose. Notably, the program appears thorough with its design to offer support systems and provides various means of addressing potential obstacles of a cadets’ success, such as lack of education, lack of support from family, anger management and substance abuse. Even so, a viewer cannot help but question some of the harsh treatments. For example, in the beginning you are introduced to two young men who struggle with understanding the English commands that a drill instructor is barking at them. Later within the documentary, these same cadets are taken aside and told they are expected to work harder to overcome the challenge of not understanding English. Towards the end one cadet ends up breaking down sobbing because he fails one of his critical tests towards graduation, due to the language barrier. Though there are classes to help the participants learn to prepare for a GED, there are no tools to help them learn English. It appears to be an unfair hardship for these two Spanish-sp eaking young men. Another concern regarding fair treatment, is though there are many who respectfully follow every command and satisfy everyShow MoreRelatedSounds of Silence: Gordon Hempton Essay1454 Words   |  6 Pagesnature and nothing very important or specific. I think that this lack of visual interest in the B-roll really detracts from the video as a whole. Because there was nothing specific for me to focus my attention on, I was quickly bored with the clip. The clip begins with very rapid shots of morning and an industrial city. The clips are quickly flashed and then gone, not giving the viewer much time to register what they have seen, but they can understand what they have heard. It was hard to watch, but easyRead MoreThe Standing Rock Sioux Tribe Essay1359 Words   |  6 PagesThe Standing Rock Sioux Tribe currently fights to save its only water source from natural gas and oil contamination. This troubling current event has a somewhat forgotten historical analogue where very similar themes presented themselves. The Kinzua Dam Controversy, which took place in the 1950’s and early 1960’s, resulted in the displacement of over 600 Seneca Indian families and the acquisition of a large tract of traditional Seneca Land for dam building. Additionally, the acquisition of SenecaRead MoreThe Problem Of School Violence886 Words   |  4 Pagesincluding stabbing, rape, or even fist fights (in which there was serious injury or de ath). Despite this unprecedented level of aggression among our nation’s youth, the nation, in its entirety, has not dedicated an appropriate amount of time and energy to coming up with a solution. The bulk of the hard work needed in order to create a safer atmosphere for our children has been left to our teachers. 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He works at the refinery and has been working there for more than a decade. He is considered the best chemical engineer of the refinery, even though he doesn’t always feel that his coworkers give him the right or appropriate amount of recognition, whichRead MoreAnalysis and Interpretation of Crickets1115 Words   |  5 Pages and Thieu was throwing rocks at the tanks driving through the streets of Saigon. Because of the situation in Vietnam, Thieu and his wife fled to the U.S. in hope of a better life. They ended up in Louisiana just like many other refugees from Vietnam. He works at the refinery and has been working there for more tha n a decade. He is considered the best chemical engineer of the refinery, even though he doesn’t always feel that his coworkers give him the right or appropriate amount of recognition, whichRead MorePassage And Literary Element : The Sound Of The Shell Essay2277 Words   |  10 PagesRobert, and Roger), setting (an island), and time (sometime during the morning or afternoon) are revealed. This gives the reader a sense of time and place that will help prevent confusion in future chapters. The identification of these features allows for the advancement of the plot line. 2) Fire on the Mountain â€Å"Fire on the Mountain† is an appropriate title for the second chapter because the group of boys start a signal fire on the top of the mountain. After a frenzied attempt by the hunters to rekindleRead MoreSocialization in the Films The Wildchild, The Pawnbroker, and Dr. Strangelove1302 Words   |  6 Pageswhen something is sad, disappointing, etc., how can one know when it is appropriate to cry and when it is not appropriate? How can one know what sadness or happiness is without experiencing it firsthand or seeing it? Tying in to what was said in the previous paragraph, one of the seven features of human cognition is the need for structure. As human beings, we cannot function when things are in utter chaos. It would be hard to say that Victor was not able to adequately function in the wild becauseRead MoreHard Rock Cafe Case Study5960 Words   |  24 PagesQ1.Identify the strategy changes that have taken place at Hard Rock Cafà © since its founding in 1971. The first Hard Rock Cafe opened its doors to the public on June 14, 1971, in London, England. Founded by Isaac Tigrett and Peter Morton, two enterprising and music-loving Americans, beginning with a guitar, it is only a joke among the friends at first, later on founder of the band - Cream and Derek the Dominoes sent a guitar of his here, and has booked a desk for a long time. From then on, the otherRead MoreHard Rock Cafe Case Study5950 Words   |  24 PagesQ1.Identify the strategy changes that have taken place at Hard Rock Cafà © since its founding in 1971. The first Hard Rock Cafe opened its doors to the public on June 14, 1971, in London, England. Founded by Isaac Tigrett and Peter Morton, two enterprising and music-loving Americans, beginning with a guitar, it is only a joke among the friends at first, later on founder of the band - Cream and Derek the Dominoes sent a guitar of his here, and has booked a desk for a long time. From then on, the

Alzheimer’s Disease †Essay 2 Free Essays

Alzheimer’s Disease Joy Pachowicz PSY 350 Professor Alina Sheppe Perez May 15, 201 Introduction Alzheimer’s disease, despite being so widespread, is not really considered part of the aging process. According to Robert Feldman, author of the textbook, â€Å"Understanding Psychology†, only 19% of people who are ages 75 to 84 suffer from this disease. It is only once they pass the age of 85, that the elderly need to be more concerned about the possibility of developing Alzheimer’s disease. We will write a custom essay sample on Alzheimer’s Disease – Essay 2 or any similar topic only for you Order Now ( Feldman, p. 446) Fifty percent of all people over 85 years of age suffer from Alzheimer’s disease and researchers believe that if no cure for the disease is found by the year 2050; there will be 14 million people affected by this disease. (Feldman, p. 446) What is Alzheimer’s disease and how is it diagnosed? What are its symptoms and who are most likely to develop this disease? The purpose of this paper is to explore what Alzheimer’s disease is and offer some suggestions of how to approach it in the future. What is Alzheimer’s Disease? According to the Alzheimer’s Foundation of America, Alzheimer’s Disease is a â€Å"progressive, degenerative disorder that attacks the brain’s nerve cells, or neurons, resulting in the loss of memory, thinking, language skills, and behavioral changes† (www. alzfdn. org) With Alzheimer’s disease, neuron cells are destroyed in the hippocampus, and this is what sparks the loss of short term memory; and as neuron cells die in the cerebral cortex, so too the functionality of language and clear thinking sees a marked decline in the person who has developed Alzheimer’s disease (www. lzfdn. org) With Alzheimer’s disease, there is diminished production of the neurotransmitter, acetylcholine. Acetylcholine is a neurotransmitter that is very much involved with our ability to memorize and retain information; so, if there is a decrease in Acetylcholine; our memory’s ability to function suffers greatly. (Feldman, p. 66) Symptoms of Alzheimerà ¢â‚¬â„¢s Disease How does one know to even consult with a specialist or seek out one’s physician regarding Alzheimer’s disease? There are some telltale symptoms that set up red flags of warning. If you see any of these symptoms, please see a physician to determine if you have Alzheimer’s disease: 1. Memory Loss that disrupts Daily Life 2. Difficulties in planning events or solving problems 3. Difficulties performing familiar tasks or household work 4. Confusion with time or place. 5. Troubles interpreting visual images and spacial relationships 6. Problems with forming words or with communicating Losing items and not being able to remember what one recently did. 7. Failing and poor judgement 8. Withdrawal from work or social activities 9. Changes in Mood or Behavioral ( www. lz. org) Now just because you may have one or all these doesn’t necessarily mean you have Alzheimer’s disease. Time is very much a key element in acting on these symptoms. If these symptoms persist over a long period of time; then it’s time to have a professional evaluation of the symptoms. . Diagnosing Alzheimer’s Disease According to the Alzheimer’s Association , there are several steps to take when trying to diagnose Alzheimer’s disease. First, one must consult with his/her medical doctor. When going, it’s important to take a copy of one’s whole medical history. While at the consultation, one can be given a mental status test. Along with this test, a physical and neurological exam should be given. Blood tests should be taken to rule out other possible causes of memory loss. (www. alz. org) The specialists one could see to determine whether one is suffering from Alzheimer’s disease and not some other illness are: Psychologists, Neurologists and Psychiatrist. (www. alz. org) Stages of Alzheimer’s Disease As with other diseases, Alzheimer’s has varying stages it progresses through as it develops in the body and affects the brain. The first stage consists of the mere manifestation of the symptoms of Alzheimer’s disease, which we have already listed: memory problems, difficulty forming words, forgetfulness etc. ( www. nia. nih. gov) The next stage would be what doctors would label the mild stage of Alzheimer’s disease. During this stage, cognitive abilities are more impaired. There are difficulties with handling money or paying bills. Repeating things over and over again begin to be notice. (www. nia. nih. gov) The mild stage gives way to the moderate stage of Alzheimer’s disease. New symptoms appear and older ones worsen. Memory continues to decline in this stage. In this stage it becomes more and more difficult to recognize family and friends. In the moderate stage of Alzheimer’s disease there are hallucinations and paranoia. It’s more difficult to get dressed, wash and perform simple task. ( www. nia. nih. gov) The final stage of Alzheimer’s disease is the severe stage. People with severe Alzheimer’s disease spend most their time in bed, sleeping. Their body shuts down. ( www. nia. nih. gov) Treating Alzheimer’s disease Since Alzheimer’s disease is caused by a plaque buildup in the synapse that prevents the communication of neurons, one to another; researchers have found a way to allow these neurons to communicate despite this buildup. Donepezil is one such drug that has been released for the treatment of Alzheimer’s disease. Another name for this drug is Aricept. What Aricept does is increases the memory’s capacity. ( Feldman, p. 229) There are other drugs being tested; but, right now the most popular treatment for Alzheimer’s disease is the use of Aricept. In the News Researchers of Banner Sun Health Research Institute have been studying the relationship that copper and cholesterol have to Alzheimer’s disease. They believe that dementia is caused by tangles and plaque in the brain. Copper has been implicated in the increased progression of Alzheimer’s disease in those who have the disease. Cholesterol, which is a major cause of plaque buildup in other parts of the body, therefore, it can be a contributing cause of plaque buildup in the brain. (redorbit. com) â€Å"In the BSHRI study, Sparks and his team performed a pilot study of long-term dietary cholesterol in four groups of rabbits. One group was administered normal food and water and three groups were administered increasing levels of a cholesterol diet for five months. Significantly, plasma levels of tau increased by 40 to 50 percent in each of the cholesterol-fed animal groups after five months of the experimental diet† (redorbit. com) In another research program being conducted by scientists through the USF Health Byrd Alzheimer’s Institute, Indiana University and Florida’s Alzheimer’s Disease Research Center; a certain protein: beta amyloid was singled out to be the cause of neurons malfunctioning that causes memory oss which is associated with Alzheimer’s Disease. (redorbit. com) â€Å"By identifying a brand new and extremely important target of the amyloid protein’s toxicity, we can develop drugs for Alzheimer’s disease that may protect the motors from inhibition and allow the brain to regenerate properly,† said principal investigator Huntington Potte r, PhD, a professor of Molecular Medicine who holds the Pfeiffer Endowed Chair for Alzheimer’s Disease Research. † (redorbit. com) Coping with Alzheimer’s disease â€Å"There are many ways to fight the adverse symptoms of Alzheimer’s disease. Below are some ways a person can cope with Alzheimer’s disease: †¢ Keep a notebook handy to record important numbers, appointments and dates. †¢ Use sticky note to help remember things of importance †¢ Keep important phone numbers next to telephone (in large print) †¢ Have a contact who will call to remind of meal times, appointments or other. †¢ Use a calendar to keep track of the day of week. †¢ Keep photos of important people around; have names of who these important people are somewhere on the picture. †¢ When going out always have another person to go along, to avoid getting lost. For Care Providers †¢ â€Å"Providing a healthy lifestyle is a must. Good nutrition, exercise and appropriate social interactions all help to develop a healthy environment for the Alzheimer’s patient. †¢ Have a planned daily routine .. so that Alzheimer’s patient can develop a sense of accomplishment and value. †¢ Choose proper tim es for activities. Many times night time is not a good time for Alzheimer’s patients. †¢ Encourage independence with the Alzheimer’s patient, let them do for themselves as much as possible. †¢ Speak slowly and calmly †¢ Make eye contact. Give simple instructions â€Å" (webmd. com) Conclusion Alzheimer’s disease is a widely spread disease that affects a great number of elderly people worldwide. While it is frequently associated with old age; it is not considered part of the aging process. Recent studies provided some hopeful ways to help stop the spread of Alzheimer’s disease, and also provided warnings of what can happen if a cure to Alzheimer’s disease is not found.. While a person may show many symptoms of Alzheimer’s disease, only a medical doctor can confirm whether Alzheimer’s disease is present. Through various tests, doctors rule out other possible diseases before focusing on Alzheimer’s disease. Alzheimer’s disease has many stages and faces and the best approach is to arrest it while it’s in its early stages. Once Alzheimer’s settles in and brain cells start dying, the only thing left to do is to accommodate the limitations that come with the disease. Educating oneself about Alzheimer’s disease is a must for everyone. More than likely, every one of us will come face to face with it in one fashion or another. We will either be taking care of someone who has it; or, we will develop it ourselves. Alzheimer’s disease affects both the patient and those around him/her. Take time to become knowledgeable of this disease, id worth the effort. . References Alzheimer’s Disease: Special Tips for Maintaining a Normal life. Retrieved From. http://www. webmd. com/alzheimers/caregivers-09/memory-tips Coping With Alzheimer’s: Special Instructions for Care Providers. Retrieved From http://www. webmd. com/alzheimers/caregivers-09/caregivers-tips Feldman. R. F. (2008). Understanding Psychology. (8th Edition). NYC. New York. McGraw/Hill. National Institute On Aging. Care giver Guide. Retrieved from. http://www. nia. nih. gov/Alzheimers/Publications/caregiverguide. htm National Institute on Aging. Tips for Care Givers. Retrieved from. http://www. nia. nih. gov/nia. nih. gov Researchers Find Further Evidence Linking Alzheimer’s Disease to Copper and Cholesterol Retrieved from. http://www. redorbit. com/news/health/2046137/banner_sun_health_research_institute_res earchers_find_further_evidence_linking/index. html How to cite Alzheimer’s Disease – Essay 2, Essays

Concept Analysis free essay sample

Concept analysis is a form of research that allows a person to explore a theory/ concept to the fullest degree in an organized way. This concept analysis will take Walker amp; Avant’s steps to form a better understanding into pain. The steps include: selection on concept (pain), Aims or purposes, literature on the pain, concept uses, determine defining attributes, model cases, alternative cases, identify antecedents and consequences, and empirical referents. Aims or Purposes of Pain Analysis Patient occurs in every person in some form. An understanding of what pain is and how to treat and assess it will allow the patients and nurses to achieve a better outcome. With an understanding of the concept of pain and how it affects the care nurses give then the better the patients’ outcomes. Working on a surgical unit I am faced with pain daily and learning how to assess it allows me to understand each patient’s views of pain. I can be faced with two patients with the same surgery, but the pain scale totally different. â€Å"All pain is Real and Pain is what the patient says it is† (McCaffery, 2002). The Purpose of this analysis of pain is to take the Walker amp; Avant steps to unfold what pain is. Literature On Pain First one needs to define pain. Pain is as (a) the sensation which one feels when hurt (in body or mind); (b) suffering, distress, the opposite of pleasure; (c) in specifically physical and psychical senses: bodily suffering; mental suffering, trouble, grief, sorrow: (d) trouble as taken for the accomplishment of something difficult according to the Oxford English Dictionary (2013). Pain can breakdown into four theories: specificity theory, pattern theory, gate control theory, and psychological/ behavioral theory. Specificity theory† proposed that injury activates specific pain receptors and fibres that, in turn, project pain impulses through a spinal pain pathway to a pain centre in the brain† (Melzach, 1996, p130). With the specificity theory many chronic back pain patient were diagnosis as psychologically disturbed not with pain. Out of the testing the specificity theory come the pattern theory which had multiple theories which mostly lead to the Gate control theory. One of the pattern theories looked at all ‘cutaneous qualities are produced by spatiotemporal patterns of the nerve impulses rather than by separate modality-specific transmission† (Melzach amp; Wall, 1965, p973). Next came the Gateway control theory. The Gateway Control theory is a stimulation of the skin evokes nerve impulses that are transmitted to three spinal cord: cells in the substantia gelatinosa, dorsal-column fibers, and central transmission cells (Melzach amp; Wall, 1965, p974). This theory explains how pain can increase to a person. If one of the three areas is triggered than the response aka pain increases. Finally we have the psychological/ behavioral theory. This theory looks at pain being a result of emotions, feelings, and mental behavioral no physical injury needed ( Turk amp; Okifuji, 2002). In this theory explains how pain can be expressed by feelings. There need not be injury, but looks at how someone thinking. Reviewing all the different literature, there is a clear point that I can make. It is that pain can be one or two: physical or psychological. The other subtopics of pain like environment, social get fix into one of the top two. I feel that pain is felt different in each patient, and their bodies have chemical to let them know. Possible use of Pain Concept There are different uses of the pain concept in the medical field. First pain is an everyday experiences that is expressed through the use of language and is then legitimized (Waddie, 1996). If a patient as a history of depression or chronic pain they have pain every day and the concept is used to help explain their pain. As nurse we use the concept of pain to find base line of the pain and to assess new pain. In surgical patients they may have multiple types of pain from the incision, emotional, and history. The concept educates the nurse of the different form that pain can present itself. Pain can also guide how we treat the patient. Emotional pain would not be treated with the â€Å"so know pain pills†, but with talking or listening to patient. Concept of pain a lso address the different form of patient and how the nurse and patient response to it. If a patient is having somatic pain from an incision the nurse could react by applying heat or ice. Pain is what the patient says it is. Defining Attributes Defining attributes is to list the characteristics that are associated with a concept. According to Walker amp; Avant, concept analysis needs to consist of more than one defining attribute: however determine the attributes that are appropriate for the purpose of exploration of the concept (1995). With this principle in place, the attributes of pain are: physical and psychological responses to the stimulus, and unpleasant and distressful experiences originating from physical sensation and having both positive and negative meaning to the individual. When looking at the first attribute of physical and psychological responses to the stimulus, studies show that patients with pain score three or less to function well in their recovery and have a better mood (McCaffery, 2002). In the second attribute, an unpleasant and distressful experience from a physical sensation and having both positive and negative meaning to the individual, can relate to postoperative patients. Turn, cough and deep breathe causes both positive and negative pain to the patient. Post-surgical patients have positive pain when they are decrease postoperative complications like PE and pneumonia by turn, cough, and deep breathing. The negative side is that the patients increase their surgical pain may adding pressure to it (Al-Jurf, 1979). Model Cases Model cases need to include all for the attribute listed in the analysis of pain. An example could be a 35 years old women admitted with a bowel obstruction followed by a laparoscopic colon resection with ostomy placement. Patients reported no history of surgeries, no bowel history, no chronic pain, and no home medications. Patient follows no special diet. When admitted to the surgical unit she was sad, scared, and in increase pain. Physically the patient presented with tears in eyes, high blood pressure of 167/99, holding abdomen, and would not look at the nurse. As the nurse, I gave pain medication and explained that I would do as much as I could to help make her comfortable. See refused to look at me. Later that day, when taking care of the ostomy she turned away and told me â€Å"Now I am ugly and everyone with look at me like I am crazy†. As the nurse I ensure her no one will know unless she wanted them to. I showed her to dress cover up the ostomy. I also told her that the ostomy was just here for three months to give her bowels a time to heal and then she will be back to take it down. This story was able to show both attributes of pain. A first, physical and psychological response to the stimulus was the pain forms the incision and ostomy (physical) and psychological to the body change she faced with. Both are a form of pain. Next, in the second attribute, an unpleasant and distressful experience from a physical sensation and having both positive and negative meaning to the individual, the ostomy care was painful physically in the fact that I had to give pain medication this was negative, but on the other hand the pain allow her to learn a new way to cover her ostomy so others would not know she had it (positive). In a study by Lawrentschuk, Pritchard, Hewitt, and Campbell, they researched the pain in two groups of patients: group one surgery patients with same size dressing and group two with double dressings (2003). The patients were asked pain level 12 and 24 hour post-surgery, pain dimension, pain intensity, and post-surgical analgesia (simple oral and Morphine). The results showed that patients described pain as physical pain and emotional stress. Most patient in the end marked that the pain was hard to handle, but got better each day. This study relates the two attributes of pain by the physical pain form the surgery and the psychology pain as the emotional stress. Plus the patient agreed that the pain they had was positive and negative because it hurt in the beginning but got better. Alternate cases When looking at pain I can think of children in regard to contrary cases of pain. In Cheng, Foster, and Huany concept analysis of pain, story of a child going to the clinic of hepatitis B shot. Next the mother later brought her back for a well visit and the child would not let the mother go â€Å"held her mother tightly with her eyes closed† (Cheng, Foster, amp; Huany, 2003, p25). The moment the nurse walked into room the child cried and wanted to go home. This was not pain but fear therefore it is contrary cases of pain. In borderline cases same critical attributes of the concept are present not all of them. In different cultures and ethnicity it is hard to assess pain and the concept of pain may be borderline. In Sheiner, Sheiner, Shoham-Vardi, Mazor, and Katz, Articles talk about how different ethnic groups react to pain and how the nursing team needs to assess for pain. The study looked at Jewish and Bedouin women in labor. The Bedouin women would report to staff that pain was ok, but the staff evaluate physical signs of pain like tears, holding abdomens, and balling up in bed (Sheiner, Sheiner, Shoham-Vardi, Mazor, and Katz, 1999). The Bedouin women showed some parts of the concept of pain by physical expression, but also not showing pain by saying that the pain was ok. Antecedent and Consequences When looking at the concept of pain one needs to evaluate the patient’s culture. Antecedents are the events or incidents that happen before the existing concept (Walker amp; Avant, 1995). One can take the study from Sheiner, Sheiner, Shoham-Vardi, Mazor amp; Katz on the Bedouin women. In this culture the women are not to ask or request pain invention. It is part of their culture to handle what the body gives them. During labor the patient is in pain, but before they get there, there is already an understanding that pain is to be handle without medications or asking for help (Sheiner, Sheiner, Shoham-Vardi, Mazor amp; Katz, 1999). According to Walker and Avant, consequences are events or incident that happen as result of the concept (1995). This can be seen in surgical patients. Before we patient goes to surgery we ask them what they think their pain should be on the scale 0-10. Pain is a reaction to an individual’s own interpretation of the meaning. If a patient states pain is a 5, a 5 may be interpreted different for another patient. A patient may state pain will be higher or just always give the same number for pain. The request for pain medications is consequence of the concept of pain. Empirical Referents Due to pain being different in each patient the best way to evaluate it is by patient’s own verbalization. There are different pain charts and scale made to make assessing patient pain easier. The nurse needs to know which tool is best for the patient. In â€Å"Teaching your patient to use a pain rating scale†, it is important to educate on how to use the scale and what you mean by pain (McCaffery , 2002). Pain is different in each patient, therefor the scale needs to be explained that pain is what the patient says it is. The McGill Pain Questionnaire is the most preferred tool. In some patients that are unable to give a number of pain, like children, confused, and behavioral reasons, an assessment of the nonverbal cues are used. Assess for crying, restlessness, and avoiding moving (McCaffery, 2002). Conclusion During the concept analysis steps I found that pain is not clear cut way to assess by patient’s pain. There is more involved in what pain is and how patients may represent pain. As a nurse working on the floor we forget that pain is indeed what the patient says it is not what we think it is. Pain can be explained as four different theories: specificity theory, pattern theory, gate control theory, and psychological/ behavioral theory. Each theory as it’s only view and could fix to express a patient’s pain. Pain contains many different attributes in this paper I forced on the physical and psychological responses to the stimulus, and unpleasant and distressful experiences originating from physical sensation and having both positive and negative meaning to the individual. I learned that pain can represent itself in different ways; from an incision causing pain to emotional pain from a new ostomy. Model cases will represent the concept in all it’s glory. The model case will show all of the attribute present in the case. Next, there can be cases that may not have all or none of the attributes present. In borderline cases, there is a gray line between pain concept and not. There are some attributes but not all of them. In the contrary cases, none of the attributes are present. The end product is that pain is important to assess and to take notice of in all patients. Remember that pain is what the patient says it is. References Al-Jurf, A. (1979). Turn, Cough and Deep breathe. Surgery, Gynecology amp; Obstetrics. 149(6), p 887-888. Cheng, S. , Foster, R. amp; Huang, C. (2003). Concept Analysis of Pain. Tzu Chi Nursing Journal, 2(3), p20-30. Retrieved from http://www. docstoc. com/docs/94932886/Concept-Analysis-of-Pain. Sheiner, E. , Sheiner, E. , Shoham-Vardi, I, Mazor, M. , amp; Katz, M. (1999). Ethnic differences influence care giver’s estimates of pain during labour. Pain. 81(3), p299-305. Retrieved from http://www. sciencedirect. com/science/article/pii/S0304395999000196. Lawrentschuk, N. , Pritchard, M. , Hewitt, P. , amp; Campbell, C. (2003). Dressing Size and Pain : A Prospective Trail. ANZ Journal of Surgery. 73(4), p 217-219. McCaffery, M. (2002). Teaching your patient to use a pain rating scale. Nursing, 32(8). Melzach, R. (1996). Gate control theory: on the evolution of pain concepts. Journal of the American Pain Society. 5, p 128-138. Melzach, R. amp; Wall, P. (1965). Pain mechanism: A New Theory. Science, New Series. 50(3699), p 971-979. Oxford University Press. (2013). Pain. Oxford Dictionaries. Retrieved from http://oxforddictionaries. com/us/definition/american_english/pain? q=pain. Turk, D. amp; Okifuji, A. (2002). Psychological Factors in Chronic Pain: Evolution and Revolution. Journal of Consulting and clinical Psychology. 70(3), p 678-690. Waddie, N. (1996). Pain, anxiety, and powerlessness. Journal of Advanced Nursing. 16, p 388-397. Walker, L, amp; A vant, K. (1995). Strategies for theory construction in nursing (3rd ed. ). Norwalk, Ct: Appleton amp; Lange.