Monday, January 13, 2020
The aim of this assignment is to citically examine the medical model in relation to a client that I am working with, for reasons of confidentiality I have used a pseudo name: The medical perspectives in Mental Health. Background Alan is a 42 yr old white british male, he was diagnosed with schitzophrenia at the age of 21yrs. He is the eldest of two children, his sister resides with her husband and children nearby. Alan resides at home with his parents, who are in their early seventies. Alan has always complied with medication, and agreed to hospitalization when necessary, compulsory admission has not been required. Scitzophrenia is a devastating mental illneess, and probably the most distressing and disabling of the severe mental disorders. The first signs of schizophrenia typically emerge in adolescence or young adult. The effects of the illness are confusing and often shocking to families and friends. Ã¢â¬ http://www. psychiatry24x7. com. schizophrenia retreived 19/01/06. Alan i s seen by his psychiatrist, every six months, unless he is unwell, when he will be seen more frequently. He is reviewed through the Care program approach at hospital out-patients. His key worker is a community psychiatric nurse, (CPN). The psychiatrist plays a central role in the diagnosis of a mental disorder. Diagnosis is made after a mental health examination. The role of the psychiatrist in the mental state examination serves two purposes: Ã¢â¬Å"A detailed history is taken to identify change and characteristic clusters indicative of a specific psychiatric disorder. Secondly the psychiatrist has to make a comparison of change against a diagnostic criteria to establish presence or not of a specific psychiatric disorder. Ã¢â¬ (Holland, 2003, p. 938) After illiminating organic cause, by physical examination, the psychiatrist makes a diagnosis by classification of the symptoms. In todays psychiatry there are two systems used to more reliably identify a mental disorder. The International Classification of Disease, 10th revision, (ICD10), and the American Classification Diagnostic and Statistical Manual, 4th revision, (DSMIV). European psychiatry are guided b y the former. The ICD10 catogarises schizophrenia under, F. 20. using the description of Kurt SchiederÃ¢â¬â¢s first rank symptoms, (1959). These are ranked as A Ã¢â¬â D, other symptoms E-I have also been added. (p. 49, ICD10, WHO 1992,). For a diagnosis of Schitzophrenia the person must show at least one of the first rank symptoms A- D and at least two of the symptoms, E- I. Alan experiences; Ã¢â¬â Thought withdrawal, insertion and broadcasting, he beleives that someone or something is responsible for this. (First Rank symptom A). Ã¢â¬â Auditory Hallucinations, he hears a running commentary about him. (First Rank symptom C). These are also known as the positive symptoms of schitzophrenia. Alan also experiences more than two of the symptoms E Ã¢â¬âI, he has thought disorder, anxiety,depression and poor motivation, referred to as negative symptoms. (Kingdom, cited Bailey, 2000) The ICD10, goes on to provide subsections for types of schizophrena, and notes; not everyone agrees with the sub-sections, due to the overlapping symptoms that can be present from one type to another. According to AlanÃ¢â¬â¢s medical notes and on asking him, he does not appear to have been diagnosed with a specific type of schizophrenia. Given the clusters of symptoms that e has experienced, at various times, it would be difficult to place Alan into one of the sub- sections. The medical model excepts that the schizoprenic brain has increased ventricles, (spaces in the brain), which leads to an imbalance of chemicals in the brain. Using their main tool pshycopharmoglogy, they prescribe drugs to correct this imbalance. (Leonard,2003). The pathology of the illness considers that the chemical wh ich is imbalanced is dopamine. Drugs used to treat mental disorders are known as; neoroleptics or psychotropics, they target the chemical dopamine by blocking the neuroreceptors. The drugs effect behaviour, psychological cognitive function and/or the sensory experience. They also effect other neurotransmitters in the brain, such as serotonan, a chemical associated with affective disorders, therefore, the same drugs are used to treat different diagnosises. (Barry,2002). Alan has been prescribed various psychotropic drugs to try and control the positive and negative symptoms of schizophrenia. His medical notes demonstrate that drugs have been introduced, decreased and increased on a number of occassions, with little effect of relieving the symptoms substancially over a long period of time. Over the years in psychiatry drugs have evolved, Alan has been prescribed some of the older drugs, Chlorpromazine and Haloperidol, these are referred to as Ã¢â¬ËtypicalÃ¢â¬â¢drugs. These drugs cause side-effects such as; pseudoparkinsonism, (uncontrolable shaking of limbs), and Akathisia, (an uncomfortable internal restlessness and anxiety). (Barry 2002). Further medication was prescribed to combat these side- effects. Following this AlanÃ¢â¬â¢s psychiatrist changed his medication to the newer Ã¢â¬ËatypicalÃ¢â¬â¢drugs olanzipane and risperidone. Alan did not respond to this medication and after a deteration in his mental health he was admitted to hospital and agreed to try another Ã¢â¬Ëatypical drugÃ¢â¬â¢clozaril thearapy. Given the toxicity of clozaril it is not used as freely as other psychtropic medication. A complication of clozaril is the effect that it has on the white blood cells, if the deficiency becomes to great the drug can kill. (Barry 2002). To reduce the possibility of this the white cells are monitered through regular blood testing. The outcome of the long term effect of these drugs is not yet fully known. (Barry, 2002). Psychiatry does not go without critisim, Szass, (1997), best known as an anti Ã¢â¬â psychiatrist, challenges the concept of mental health as an illness. For an illness to be an illness it has to be classified as having three commonalities, cause Ã¢â¬â progression Ã¢â¬â and outcome. He argues that schizophrenia does not share any commonality, and that the reason a scitzophrenic patient becomes a patient is because those around him refuses to except a behaviour beyond the norm. Laing, (1985), also supports this theory and informs the reader that psychiatry is the only medical model that does not have an exact pathology that is proven by labortory testing. Another school of thought suggests; individuals are treated for the side-effects of medication moreso than the original illness, (Illich, cited in Laing 1985). Ã¢â¬Å"They can end up fighting side effects Ã¢â¬ ¦One drug to combat anotherÃ¢â¬ ¦. Prehaps it is the medication that ends up disturbing mental behaviour, warping personalities or or conditions in to bigger problems. ( Hewitt, 2001, p. 72) Alan prosponed the decision to take clorazil due to the risk of toxicity. Since commencing treatment, the symptoms have reduced but not deminished, he still takes medication for side-effects, anxiety and depression. He continues to struggle with daily living. His anxiety levels are so intense, that this condition has preceeded the effects of schizophrenia, which has led to further isolation from society, he wou ld like to engage in employment, paid or unpaid, however in his current frame of mind this is not a possibility. Labour force 1995, reported that employment figures in mental health patients are much lower than any other disabled group. Only 21% of people with mental health problems are working or actively seeking work. (Webb&Tossell, 1999). Warnings on some medication advise that machinery must not be used, vechiles must not be driven, due to side-effects of drowsiness, alcohol should not be taken with a lot of psyhcotropic medication. All of these restrictions impact upon AlanÃ¢â¬â¢s ability to function in society. Secondry to this, Alan has to cope with the stigma attached to mental health disorders. There is a stereo typical societal perception that individuals with mental health issues are more dangerous than others, regardless of research suggesting the opposite; Philo et al, (1993), published research to demonstrate that there is no evidence to suggest that a person with mental health issues is any more likely to harm than anyone else. Figures over the last 20 yrs demonstrate that there has been no increase in murder caused by someone with mental health problems,whilst the increase amongt the general polulation has more than doubled. Research shows that this discrimination within mental health does not stop with the lay person. White, western people have better experience of the service than other ethnic groups. (Haddad & knapp, 2000). The Sainsbury Cenre for Mental Health, (SCMH), (2002), in itÃ¢â¬â¢s aim to influence national policy high lighted the inequalities experinced by Black and African Carribean communities. SCMHÃ¢â¬â¢s findings suggest that professional have a fear of some ethnic minority groups, due to individual size or skin colour. It is these stereotypical beliefs, cultural ignorance and racist views, that prejudice assessments and influences treatment, reponses therefore rely on heavy medication and restriction. The consequences of which can be dentrimental, and have resulted in death, for people like David Bennett. In response to high profile cases, the Governement have produced various documentation to address issues of inequality. Delivering Race and Equality, (2003), set out to provide an action plan over 7yrs to improve mental health services for ethnic minority groups. The focus is on raising professional awarness around culture, ethnicity and racism. As the western world progresses towards a multi-cultural society, it is inevitable that more people from ethinic minorities will come in contact with mental health services. Fernando, (1991), considers this to be of a special concern and warns that; Ã¢â¬Å"The white domination of black people promotes, and often imposes a cultural domination so that ways of thinking, family life patterns of mental health and mental health care that are identified as Ã¢â¬ËEuropeanÃ¢â¬â¢in tradition Ã¢â¬ËwhiteÃ¢â¬â¢by racial origin, are seen as superior to others. Ã¢â¬ (p. 198) Fernando, goes on to highlight the fact that many forms of human distress medicalised by western society are not medicalised by other societies, and notes that political forces dominates what is an illness and gives ultimate power to the psychiatry to treat. Therefore suggesting that individual diagnosis can depend upon where you reside in the world. Rack, (1982), notes that western psychiatry has an important role in social control, whilst Asian psychiatry is largely concerned with spiritual development. Fenando states; Ã¢â¬Å"Ã¢â¬ ¦medicine too is part of a culture and not a system with a life of its own outside the culture in which it lives. Ã¢â¬ (P. 197) He advises that a reliable diagnosis is unlikely, unless the individual is interwiewed in their own language, as only a person with the same language knows what to look for. If Racks theory is correct then services have a lot to achieve to gain full equality. According to research it is not only the diagnosis in mental health that globally differs, it is also the recovery rate. Research under taken by WHO, (1938, 1958, 1988, 1998), ## evidenced that only 33% of individuals diagnosed with schizoprenia in western soceity were successfully treated by drugs. A further pilot study by the same organisation, in the recovery of schizophrenia demonstrated that recovery rates in London and Washington, (33%, 34%), were immensly lower than in IBADIAN AND MAGA PERDESH, (86%,87%). The variable out come appeared to be talking methods and a positve out look from the onset. People were advised that they would get better rather than being told there future would depend upon medication. Colman, (2004), suggests; Ã¢â¬Å"Most psychiatic doctors appear to be wedded to the idea that they must treat everyone with medication and that it is only through the use of medication that people recover. The evidence for ths view appears to be based on research carried out using moneys supplied by pharmacutical industry. Ã¢â¬ (p. 4). ColmanÃ¢â¬â¢s view does not stand alone, Klass, (1975), advises that drug treatment is encouraged by the profit they make for their producers, who also provide the drugs to treat the side-effects. Large profits from the industry is used to provide research and advertise what they view as successful intervention for mental disorders. (cited Pilgrim&Rogers, 1987). In relation to AlanÃ¢â¬â¢s drug therapy and the side-effects of anxiety, I have spok en to his treatment team regarding alternative therapy such as; Anxiety Management. The response was that he had this previously and is unable to sustain self help techniques. My view was that this was a funding issue, psychosocial therapy costs more than drug therapy. (Pilgrim&Rogers, 1987). It appears to come secondary to drug therapy in the view of the medical model. Ã¢â¬Å" Whilst it is generally conceded by most commenters on psychiatry that it is now electicÃ¢â¬ ¦ The bias towards physical treatment is still strong. Ã¢â¬ (p. 121. Baruch&treacher,1978, Roman,1985, Bushfield 1986, cited Pilgrim&Rogers, 1987). Alan has spoke with me regarding the conscequences of stopping treatment to combat the side-effects. Pilgrim & Rogers, (1987), amongst others acknowledge that individuals may stop complying with medication if the side effects from the drugs become intolerable and they are not listened to. Ã¢â¬Å" treating psychiatrists do not take their complaints about Ã¢â¬Ëside-effectsÃ¢â¬â¢, or their concerns about the debilitating effects of the drugs, seriously. Instead, doctors tend to be concerned only with the effectiveness of the drugs in symptom reduction (assessed by them, not the patients themselves)Ã¢â¬â¢. p. 125 ) If Alan chose not to comply to medication, experienced a deteriation in his mental health and refused voluntary admission to hospital he could be detained under the Mental Health Act 1983. (MHA). The mental state examination would be under took by a doctor who was not exculded under s12 of the act (MHA1983,cited Jones, 2004). In good practise Alan should be assessed by h is psychiatrist and his own general Practitioner. Thus meeting the requirements of s 12 , (MHA1983). Both doctors must examine the patient within five days of each other (s12,,MHA1983). As Alan is known to the clinical team, and has a specific diagnosis, admission for traetment (s3 MHA, 1983, cited Jones 2004), would possibly be the proposed section. (Code of Practise, 1999, ch5). Laing, (1985), Szass, (1997), claims that psychiatry is used to police society and not to treat the individual. Psychiatrists have been given the power to lock people up and treat them against their will, they have more power than a judge, and hospital wards provide a prison for the unconvicted individuals who do not meet societal norms. The approved social worker,(ASW), also has a powerful role under the 1983 Act and does make the ultimate decision as to whether treatment in hospital is the most appropriate form of treatment. (s13,MHA1983). As a social worker under taking the duty of an ASW, (albiet as a shadow), I have been faced with dilemaÃ¢â¬â¢s whereby the role and duty of an ASW conflict with my social work values, instead of promoting rights and autonomy I am restricting them. I am managing this by addressing the issues in debriefing following the ssessments, in supervision, and by challenging other professionalÃ¢â¬â¢s practise when necessary. For example, on one assessment, nursing staff had observed a patient as being withdrawn because he chose not to watch television in the communial lounge. During interview, the patient advised that he was a Johava witness and was oppossed to violence which was all that was on the particular channel viewed in the lounge. On addressing this with staff, it was clear that cultural or religous needs this had not been taken in to consideration. If Alan was formally admitted to hospital his psychiatrist does have the power to treat him against his wish. (part IV, MHA1983). This could include invasive treatment such as ECT, which Alan is oppossed to. I am therefore proposing Alan prepares an advanced directive, which will be incorporated in his careplan. Although, this does not over ride the clinical desicion his treatment team will need to take his views and wishes in to consideraton. MHA Ã¢â¬âÃ¢â¬âÃ¢â¬âÃ¢â¬âÃ¢â¬âÃ¢â¬â Alan is supported by his family they have a good insight in to his illness, his father has recently been diagnosed with AlziemenÃ¢â¬â¢s disease. My current concern is that his mother is a carer for two family members. The largest proportion of community care is carried out by unpaid family members, who often miss out on employment and become isloated. (Webb&Tossell, 1999). To ensure that Mrs A, is able to continue in her role, her needs also must be met. I have therefore requested an updated assessment under The CarerÃ¢â¬â¢s (recognition and service) Act 1995. Mrs. AÃ¢â¬â¢s wellbeing is paramount in preventing deteriation of the home situation which would inevitabley impact upon AlanÃ¢â¬â¢s mental health. Mrs. A recognises the signs and symptoms when Alans mental health starts to deteriate, which in turn has historially prevented admission to hospital. Research from All Saints Hospital Birmingham evidenced that 59% of relatives recognise early warning signs one month before relapse and 75% two weeks before relapse. (cited Howe, 1998). Mrs. A feels that she is coping at present with the assistance of her support worker she is able to off load. She accesses carerÃ¢â¬â¢s groups which she finds helpful. If the situation becomes to much the family have agreed to access further support for Mr. A. nder The Community Care and National Health Service Act 1990. Alan receives support from the day centre where he is involved with Art therapy and other activities. He attends the Fountain club, (a mind project), where he has access to support through group therapy, and attends respite two days a month. Alan finds these resourses useful in helping him to live with not only schizophrena but also the sid e-effects of his medication. He is offered support and advise that is not from a medical perspective. The family also consider that alternative therapy is as important to them, as to Alan. Mrs. A considers that Alan and the familyÃ¢â¬â¢s needs have been better met since a holistic approach has been under taken, as social and pshcological factors are adressed, aswell as the pathology of the illness. Howe, ( 1998), acknowleges that this has been a general failure in the medical model. I have not progressed with my original task regarding accomodation because I feel that Alan has enough going on in his life at present, in coming to terms with his fatherÃ¢â¬â¢s illness. Although his CPN, considers that this would be in his best interest, the family do not want it and I am not convinced it is what Alan wants either. Szass, (1997), refers to how the mentally ill pateint is considered to be incompetant where as the medically ill pateint is considered to be competant. If Alan did not have a mental disorder, residing at home would not be an issue for anyone, other than the family. I will continue to project my view wtih the CPN and in supervision. In conclusion to this assignment I would agree that all those who work with in this area have far to go in developing services. My role amongst this will be to challenge oppression, by raising awarness as I have done in practise, and to promote an holistic approach towards assessment. I am of the view that medication does help certian individuals, and their life has improved with medication. However in my view this should be minimal to releive distress and enhanced with other socialogical and pyshcological intervention. Although relapse cannot be illiminated, research and literature referenced throughout this assignment suggests that there is a high colleration between staying well and receiving a combination of services. Drawing from my previous managerial experience I have know doubt that the constraints on budgets will effect resources, which will inevitable effect the services individauls receive. Pilgrim&Rogers, (1987), acknowledge that the limitation of resourses and the cost to them, which is not measurable in comparison to physical treatment has been a factor that has prevented psychological and social models from competeing against the medical model. Undoubtabley this will need to change to allow individuals a successful chance of recovery. Authors referred to who opposs psychiatry and its role do have a fair arguement, in that drug treatment and legislation polices society, however no realistic alternative is provided. In my view the way forward is through raising public and professional awareness and de-stigmatising mental disorder. Word count 3297 References Barry, P. (2003). Mental Health and Mental Illness. (7th ed). Philidelphia.. Lippincott. Colman, R. (2004). Recovery an Alien Concept. (2nd Ed). Fife. P. P press. Delivering Race and Equality, (2003) The Sainsbury Centre for Mental Health, breaking the Circles of Fear, breifing 17. A review of the relationship between mental health services and African Caribbean communities. London. Fernando, S. (1991). Menatal Health Race and Culture. London. Mind publications in association with Macmillon. Hewitt, P. (2001). So You Think Your Mad, 7 Practical Steps to Mental Health. Ppppppppppp Handsell Publishing. Howe, G. (1998). Getting in to the System, Living with Severe Mental Illness. London. Jessica Kingsley publishers Ltd. Jones, R. (2004). Mental Health Act Mannual. (9th Ed). London. Sweet &Maxwell Ltd. Laing, R. D. , (1985). Wisdom, Madness and Folly. Making sense of psychiatry. Basingstoke. Paper Mac. Leonard, B. E. (2003). Fundementals of Psychopharmocology. (3rd ed). Wiley. Pilgrim, D. ,and Rogers, A. (1987). A sociology of Mental Health and Illness. (2nd Ed). Pppppppppppp. Open University Press. Professor, Kingdom, (2000). D. Edited by Bailey D. 2000, At the Core of Mnetal Health. Key issuese for practitioners managers and mental heealth managers, Rack, P. (1982). Race Culture and Mental Disorder. forwarded by G. Morris. London. Routledge. Szass, T. (1997). Insanity. The Idea and itÃ¢â¬â¢s Consequenses. Syrcuse. University Press. WHO, (1992). The ICD10, Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidlines. Geneva. World Health Organisation. Webb. R. , & Tossell, D. , (1999). Social Issues for Carers Towards Posive Practice. (2nd ed) London. Arnold. Haddad, P. , & Knapp, M. , (2000). Health ProfessionalÃ¢â¬â¢s views of services for schizophrenia Ã¢â¬â fragmentation and Inequality. Psychiatric Bulletin (24), p 47 Ã¢â¬â 50. http://www. psychiatry24x7. com. schizophrenia retreived 19/01/06. NICE, (2003). Recommends newer antipsychotic drugs as one of the first line options for schizophenia. Press release. retrieved 19/01/06. Webb site: http://www. nice. org. uk/page. aspx? 0=32928
Sunday, January 5, 2020
ChildrenÃ¢â¬â¢s language development and second language acquisition Sandra Morales Texas WomanÃ¢â¬â¢s University ChildrenÃ¢â¬â¢s language development and second language acquisition The paper investigates how children develop their cognitive and language skills in a context that is influenced by social and biological factors. The literature review discusses the Cognitive and Social Constructivism theories and their influence on the education field. In addition the author presents how children develop their language at different stages and how those stages influence the growth and development of a second language. Language acquisition is one of the most important topics in cognitive development. In the study of language developmentÃ¢â¬ ¦show more contentÃ¢â¬ ¦Literature Review Piaget Cognitive Constructivism PiagetÃ¢â¬â¢s main focus of constructivism has to do with the person and how they construct their knowledge. Piaget believed individuals must adapt to their environment, and develops as parts of the adaptation process to the environment. According to Piaget, the individual needs to understand the information that they are receiving in order to be able to use it; they must construct their own knowledge (Powell, 2009). For Piaget, language development is internal mental processes controlled by developmental processes and is done individually, without the interventions of others (Agbenyega, 2009). As a result of mastering one stage, children will be ready to move, learn, and develop according to the expectations of the next stage. In regards to language development Piaget sees language as part of the cognitive development. How children think determines when and what the child can speak. In addition Piaget, states that childrenÃ¢â¬â¢s talking abilit ies emerge naturally without any formal teaching by adults, however more sophisticated vocabulary require formal education and experiences with the language. During early stages of the development according to Piaget, words are related to schemas of actions related to the child and those schemas will later be incorporated into exiting schemas that will support future learning experiences. Through the process of assimilation and accommodation, childrenShow MoreRelatedEssay on Language Development in Childhood Development2138 Words Ã |Ã 9 Pagestremendous amount an individual. How a child developments is fundamentally important at a young age as it affects all aspect of their lives once the child matures. Throughout the class, we looked at many theorists during the course of the semester as well as looked at many articles pertaining to the concepts of the development of children. The theorists and articles opened up our minds to a world that we have never seen before and concepts a bout child development we have never been taught but have seenRead MoreLanguage And Development Of Language1810 Words Ã |Ã 8 PagesLanguage is the foundation of learning, it is the scaffold for all that occurs in an educational setting, regardless of the context. LearnersÃ¢â¬â¢ explore new concepts and make meaning of the world in which they live through interaction with language; listening, speaking, reading, writing and interpreting. Without language, one cannot communicate, create ideas/thoughts, solve problems, or express emotions to construct social and cultural identities. Language serves as a function of deeper expressionRead MoreEssay on language development582 Words Ã |Ã 3 Pages Most young children develop language rapidly, moving from crying and cooing in infancy to using hundreds of words and understanding their meanings by the time they are ready to enter kindergarten. Language development is a major accomplishment and is one of the most rewarding experiences f or anyone to share with a child. Children learn to speak and understand words by being around adults and peers who communicate with them and encourage their efforts to talk. As I observed Olivia, a typically developingRead MoreLanguage Acquisition and Development2253 Words Ã |Ã 9 PageschildrenÃ¢â¬â¢s language acquisition and language development process to analyze the condition of Tom and provide some personal suggestions for his parents. The following statements are my analysis considering to the language theories proposed by researchers and a repercussion for my personal experience. Nature versus Nurture It was suggested in Chapter 2 that there are two theories regarding the language acquisition, nurture or nature. Most behaviorists suggested that the child develops language due toRead MoreThe Development Of Language Development Essay1762 Words Ã |Ã 8 PagesAcquisition of language is a highly debated, somewhat mysterious accomplishment among humans. Children do not receive explicit rules of grammar at an early age; they do not get thorough instruction of how syntax, semantics, morphology, and phonology work. Therefore the question remains: How do humans acquire language? Throughout the years, several theories have been introduced, discussed and researched on the development of language in humans. In it s simplest form the theory of language consists ofRead MorePhysical Development Communication And Language Development1612 Words Ã |Ã 7 Pages1b.Sequence and development chart 0 to 19 yrs. Physical development Communication and language development Intellectual and cognitive development Social, emotional, behavioural and moral development 0-3 years This is a period of a faster, physical development. In order to survive and through a series of natural reflexes, babies are able to develop the ability of grasping and sucking (on a bottle of milk for example).Though during their first year babies have little control over their bodies byRead MoreLanguage, Language And Culture Development2070 Words Ã |Ã 9 Pages Language is something that defines us in a culture and gives us the voice in which we express ourselves. So it can be said that language is something that every person needs. Language can be defined as a form of communcating spoken, written, or signed that is based on a system of symbols (Santrock 2007, p.303). The importance of language is something that goes unrecognized in everyday life, but we need language to be able to speak with other people. Listen to other people read and write (SantrockRead More Language Development Essay2103 Words Ã |Ã 9 Pagesnormal. Language has many dynamics including: words, private speech, inner speech, syntagmatics, paradigmatics and much more. According to Craig and Dunn (2010) by age three, most children can use 900 to 1,000 words; by age 6, most children have a productive vocabulary of 2,600 words and can understand more than 20,000 (pg. 161). Some children I work with who are in the toddler room are able to talk, but leave out the pronouns a sentence. For example a child would say, Ã¢â¬Å"Us go on walk?Ã¢â¬ Language andRead MoreChildhood Language And Language Development Essay1693 Words Ã |Ã 7 Pageseducation, language is a vital part of the development of education. People s daily dialogue, learning, etc. are all required language skills. It requires the use of language between people convey their ideas. So in early childhood education, the development of language is very importan t. This article will relate to theories about early childhood language learning, content at different stages of children s language development, the adult children of the relationship between language and language developmentRead MoreLanguage Acquisition And Language Development1543 Words Ã |Ã 7 PagesIntroduction Our native language consists of a set of phonemes that we learn to discriminate during language acquisition. Infants are born with perceptual sensitivity for phonemes outside of their parentsÃ¢â¬â¢ native language, which is a result of the fact that they have not yet practiced nor learned the phonetic rules of their language. These feature detectors for phonemes that are not used during language development will atrophy and the native phoneme feature detectors are retained (Eimas, 1975).
Friday, December 27, 2019
Technology and Social Change in Healthcare Today there are many technologies that have provided change in our social environments. For example, we have access to laptop/computers, the Internet, cell phones, and android pads. This is beneficial because we can use the Internet to obtain information almost instantly to assist in research and education as well as staying in communication with friends and family. I believe that every household should have access to these technologies but due to socioeconomic conditions that is not possible. I feel that the technology today has evolved from landline telephones and going to the library to being able to make calls anytime from anywhere and find information at the touch of our fingertips. TheÃ¢â¬ ¦show more contentÃ¢â¬ ¦The digital divide is defined by the interaction between people and computers. Assumptions are made on a daily basis that everyone has equal access to computers, the Internet and the most upgraded technology and software. This assumption is not true; the digital divide speaks to the fact that not everyone has the same access. The sociological perspective known as conflict best represents the digital divide. Conflict is molded by the competition that society generates through individuals and groups in an effort to determine how power will be distributed. Clearly, if all people do not have the same access to technology due to social status there will be conflict in defining what is fair regarding education, employment and even social status. Cultural lag is described where changes or advancements in technology in our society happen quicker than our culture can maintain, therefore, producing new and different social norms. The sociological perspective symbolic best represents cultural lag. Symbolic is the sociological perspective that helps give meaning and structure to our life experiences. We tend to put importance on the symbols and languages in our lives. We will change the way we act based on our social interactions. What others thinkShow MoreRelatedThe Shift Of Modern Technology1622 Words Ã |Ã 7 PagesShift of Modern Technology Technology has always been changing and evolving. Whether it is discovering ways to cultivate plants and animals or if it is developing the smallest nano-technology to be used in space, there is never a time where scientists and inventors are not coming up with new things to better our quality of life and to change how we work in society. The last decade has been especially important to the development of technology in many different aspects such as healthcare, or globalizationRead MoreThe Impact of Innovative Health Technologies in Nursing and Health Care997 Words Ã |Ã 4 PagesTechnology in Nursing and Health Care: The continuous transformation of the health care field through the introduction of new technology tools has contributed to the need for nurses to stay current with new trends and keep track of what is on the horizon. However, these rapid technological changes and advancements in the health care field have seemingly precluded any probability of anticipating the future. As a result, nurses and other health care professionals can prepare for the future by remainingRead MoreHow Mobile Technology Can Be Integrated With The Army Surgeon General s Performance Triad1437 Words Ã |Ã 6 PagesAbstract Problem/Purpose Statement: To discuss how mobile technology can be integrated with the Army Surgeon GeneralÃ¢â¬â¢s Performance Triad in order to exceed the 100 minutes the average patient has in a healthcare setting. Why the study is being conducted: Mobile technology has become ubiquitous making it the ideal platform to promote healthy lifestyles. The Performance Triad is a comprehensive plan that focuses on promoting better sleep, activity, and nutrition habits. The Performance Triad addressesRead MoreChanges in the Healthcare Industry1281 Words Ã |Ã 5 Pagesgreat many changes in the healthcare industry in the past two decades, largely due to the globalization of the workforce and changing demographic patterns, and technological advances. The industry changed in terms of a reliance on hospital-based care to more emergency clinics, outpatient and nursing home services, and managed care. More hospitals merged, and many doctors have banded together to form larger, more cost-effective, speciality groups. One of the largest and most obvious changes has beenRead MoreSystems Thinking And The Health Care System832 Words Ã |Ã 4 Pagesthinking allows new and useful methods to improve patient safe ty, it comes with it its own intangible challenges that, if not documented and addressed, will both slow improvement and present new harm. This SMAC allowed us to see the challenges that healthcare system faces and how they analyzed and apply systems thinking in assessing them. Understanding the challenges by completion of a SWOT analysis. Which required the development of an action plan of improvement for patient safety by implementingRead MoreRelationship Between Employment, Health Coverage And Costs, And Access For Care And Health Outcomes1735 Words Ã |Ã 7 PagesIn the United States, the economy is set up to explain the complex relationship between employment, health coverage and costs, and access to care and health outcomes. Economics a social science that explains how a society uses its resources and makes decisions. Economics analyzes the priority of certain choices in order to use the resources efficiently. In society there is cooperative decision-making done by consumers and suppliers focusing solely on price theories. For example, consumers andRead MoreHealth Coverage Needle And Its Impact On America s Healthcare Landscape886 Words Ã |Ã 4 Pagesrecent years, healthcare in the United States has drastically changed. The industry has experienced continuous growth, due to an array of events. The introduction and passing of Affordable Care Act, the increase of Baby Boomers (individuals born between 1946-1960) reaching the age of retirement, and potential passing of immigration inclusion laws has impacted and will continue to impact AmericaÃ¢â¬â¢s healthcare landscape. Numerous factors associated with the political, economic, social, technologicalRead More Nursing Essay1428 Words Ã |Ã 6 PagesIn this era of increasing medical technology, changing modes of communication and the expansion of nursing professional roles, ethical, legal and social issues in nursing are increasing. Nurses operate in situations that put them under ethical, legal and social challenges on a daily basis. These issues are linked to legislative changes and ethics of medical technologies geared toward s helping nurses to provide better healthcare, for patients. They govern issues of confidentiality, practice, medicalRead MoreHealth Care Changes and Challenges1177 Words Ã |Ã 5 PagesHealth Care Changes and Challenges Dindi White HSC490 May 18, 2015 Jennifer Johnson Health Care Changes and Challenges Some people may believe that health care is not changing. However, todays health care system is changing. TodayÃ¢â¬â¢s advanced technology and growing population have required health care organizations to evolve. Changes in health care can present challenges, and the challenges must be addressed and dealt with accordingly. TodayÃ¢â¬â¢s health care system is changing. In order forRead MoreThe Impact Of Social Media On Modern Society1703 Words Ã |Ã 7 PagesSocial media is a dynamic form of communication that breaks physical and geographic boundaries via mediums that allow individuals to commute from anywhere at any time. Its popularity is a phenomenon that continues to grow as it encourages participants to exchange content and ideas thus making it a very engaging form of communication (Everson, Gundlach Miller 2013). I will be assessing my current use of social media, drawing conclusions from the Ã¢â¬ËStripling modelÃ¢â¬â¢ to identify how my practices will
Thursday, December 19, 2019
Autism Ã¢â¬Å"We start with an imageÃ¢â¬âa tiny, golden child on hands and knees, circling round and round a spot on the floor in mysterious, self-absorbed delight. She does not look up, though she is smiling and laughing; she does not call our attention to the mysterious object of her pleasure. She does not see us at all. She and the spot are all there is, and though she is eighteen months old, an age for touching, tasting, pointing, pushing, exploring, she is doing none of these. She does not walk, or crawl up stairs, or pull herself to her feet to reach for objects. She doesnÃ¢â¬â¢t want any objects. Instead, she circles her spot. Or she sits, a long chain in her hand, snaking it up and down, up and down, watching it coil and uncoil,Ã¢â¬ ¦show more contentÃ¢â¬ ¦Ã¢â¬Å"Currently, autism is considered a unique disorder that occurs in approximately fifteen out of every 10,000 births. Autism is four times more common in boys than girls. It has been found throughout the wor ld in families of all racial, ethnic, and social backgroundsÃ¢â¬ (Cash, 22). Family income, lifestyle, and educational levels do not affect the chance of autismÃ¢â¬â¢s occurrence. Researchers all over the world are devoting considerable time, and energy into finding the answer to the critical question, Ã¢â¬Å"What exactly causes autism?Ã¢â¬ Although a single specific cause of autism is not known, researchers believe several genes as well as environmental factors such as viruses or chemicals, contribute to the disorder. Ã¢â¬Å"But finding the genes that cause the disorder has proven far more complicated than originally thoughtÃ¢â¬ (DeNoon). Scientists estimate that, in families with one autistic child, the risk of having a second child with the disorder is approximately 5%, or 1 in 20, which is greater than the risk for the general population. This genetic basis is believed by researchers to be highly complex, probably involving several genes in combination. CLSA study co-author Susan Santangelo portrays autism as a constellation of deficits. Ã¢â¬Å"Some may be relatively benign in the absence of others. I think itÃ¢â¬â¢s relativelyShow MoreRelatedAutism And Childhood Of Autism Essay1382 Words Ã |Ã 6 Pagesexplored of all youth psychiatric disorders, Autism continues to be a captivating condition. The conception and description of the disorder has evolved significantly over time leaving some philosophies once held with principle to later verify to be unproven. Scientists and clinicians have provided the highest influences to the understanding of the illness, however, history does illustrate countless teachings and initial interpretations of a possible genesis of autism to be uncertain. The socio-politicalRead MoreAutism Between Autism And Autism756 Words Ã |Ã 4 PagesMany people believe that autism is its own disorder that children are diagnosed with. However, autism is actually a term used for a wide range of disorders. Aut ism s clinical name is Autism Spectrum Disorder. The term spectrum is used because of the range of symptoms, intensity, and behaviors autism effects. There are also many different types of autism. There is classic autism which is associated with being non-verbal and anti-social. Another form of autism is Asperger Syndrome which is associatedRead MoreAutism Between Autism And Autism2229 Words Ã |Ã 9 Pagesand love. The Centers for Disease Control and Prevention estimates that 1 in 68 children are diagnosed with autism spectrum disorders in the United States alone, including almost five times more boys than girls (2015). Autism is a neurobiological developmental disability that has swiftly become the fastest-growing developmental disability, as the rate of diagnosis continues to rise. Autism encompasses an entire spectrum of disorders, meaning that symptoms and severity can vary greatly from childRead MoreAutism On Children : Autism1066 Words Ã |Ã 5 PagesPamela Sulger 27 November 2016 Autism in Children Autism according to Merriam-Webster Dictionary is defined as Ã¢â¬Å"a variable developmental disorder that appears by age three and is characterized by impairment of the ability to form normal social relationships, to commutate with others, and by stereotyped behavior patterns.Ã¢â¬ Autism was believed to be a psychiatric or emotional illness, and doctors told mothers that they were the cause. They were wrong. The cause for autism is still a mystery, howeverRead MoreAutism And The National Autism1994 Words Ã |Ã 8 PagesAutism has become an increasingly important public health concern as the number of yearly diagnoses of the disorder has increased since the late 20th century. The National Institute of Health estimates that 1 in 88 children in the United States are classified as having an Autism Spectrum Disorder (ASD) (NINDS, 2009), a genetic neurodevelopmental disorder that impairs children s ability to learn and causes issues with social interaction and communication. Symptoms of ASD include delays in speechRead MoreAutism : Children With Autism2199 Words Ã |Ã 9 PagesRunning head: AUTISM 1 AUTISM 10 Autism Name: Institution: Autism Introduction Autism is a disorder that is encompassed in the autism spectrum (ASDs) (Landa, 2007). Autism spectrum disorders describe the brain development disorders and encompass Asperger syndrome, autism, and pervasive developmental disorder not otherwise specified (PDD-NOS) disorders. Features of the ASDs includes sensory and cognition problems, difficulty in communicating with other people, and repetitiveRead MoreThe Link Between Autism And Autism1580 Words Ã |Ã 7 PagesIntroduction There have been several controversies regarding the cause of autism over the years. For example, the main cause was assumed by some to be bad parenting. Today, however, there is general agreement that the symptoms of autism, with the exception of those of abandoned children, are a behavioral response by young children to an organic disease affecting their brains. In fact, it is now generally understood that autism is a complex developmental syndrome representing a heterogeneous group ofRead MoreAutism Spectrum Disorder ( Autism )900 Words Ã |Ã 4 Pages Autism Disorder Mohamed Ayoub Community College of Aurora Autism Spectrum Disorder We are living in a time where a remarkable and advanced medical treatments exist. However, scientists and medical professionals are constantly faced with diseases and disorders that contemporary humanity needs a cure and treatment. Amongst the disorders that affecting our young people today is the autism spectrum disorder. It is a Ã¢â¬Å"complex and life long behavioral disorder marked by impairment in socialRead MoreAutism And The Autism Spectrum Essay984 Words Ã |Ã 4 PagesAutism is a developmental disorder, which is characterized by a dyad of difficulties in a) communication and social interaction and b) restricted interests and imagination (American Psychiatric Association, 2013). Individuals on the Autism Spectrum might find it challenging to understand what other people think or what the reasons for their behaviours are, as their Ã¢â¬Ëtheory of mindÃ¢â¬â¢ may not be well developed (Schuwerk, Vuori Sodian, 2015). It is possible that this is why they might behave in soci allyRead MoreAutism : What Causes Autism? Essay1112 Words Ã |Ã 5 Pages What is Autism? How is Autism classified? What causes Autism? Why do Autism happen? There are some many questions about Autism, and what it is. Many of those questions are still unknown. Everyday researchers are exploring reasons for these questions. However, Autism was introduced in the 1940s autism was first described in the 1940s. Leo Kanner in the United States and Hans Asperger in Austria independently published papers describing children with severe social and communicative impairments. Both
Wednesday, December 11, 2019
It was called this because its rhythm and timing sounded raggedy. Like improvisational jazz, this was one of the first types of jazz. It was played in cakewalks and was usually played with a piano. (3) Some of the great musicians who made jazz more popular are, Art Datum, Earl Hines, Joseph Lamb, James Scott, Scott Joplin, Hot Five and Louis Armstrong. Some of the jazz musicians of today are Kenny G and Rosemary Clooney. Jazz remains a rich and vital presence in the world of music today. The next type is country and western music.Country and western music was primarily produced by white Southerners beginning in the early 1 sass and came from the folk music of Southern Appalachia and is rooted in the folk ones of immigrants from Great Britain. (5) Some of the country music styles are Western swing, honk-ton, bluegrass, rockabilly, and new country. Although originally known by the derisive label hillbillys music, country has since moved into the popular music mainstream and gained wide international Most country music is based on the lyrics rather than the musical content. Allot of country music is based on the lives and experiences of ordinary people. They include things such as love, breaking up with someone, maybe even the artist themselves telling a story in there music of their younger days growing up. Some of the instruments that are used in country music are the fiddle, the banjo, the guitar, and the piano. (5) Some country artists of past are The Carter Family, Johnny Cash, Willie Nelson, Patsy Cline and Hank Williams. Some of the country artists of today are Alan Jackson, Brooks and Dunn, Shania Twain, and Kenny Cheney.One place known to all country music artists and musicians is The Grand Ole Pry, which is in Nashville, Tennessee. (5) Another type of music style is Rhythm-and-Blues Music or better know as RB. Jerry Waxier is credited with the term R This type of music laid the groundwork for rock roll. Early rock roll is basically blended with country western and pop influences. (6) During the ass, RB was dominated by vocalists like Ray Charles and Ruth Brown, as well as vocal groups like the Drifters and the The term R B was replaced in the sass by soul music and Mouton, but has re-emerged in recent years. In this context only the abbreviation RB is used, not the full expression. (6) Today there are some great R B artists as well, like Barry White, All-4-One, India Rare, Eureka Baud and Alicia Keys. Remains a crucial part of rock, soul, and rap. Rock music is next on the list of types of music. Rock music has dominated popular music in the West since about 1955. (8) Rock music started in the united States. The term rock music commonly refers to music styles after 1959 predominantly influenced by white musicians. (8) Disc jockey Alan Freed Was the one who introduced this music and later gave it the name Of Rock n Roll. The electric guitar is the instrument most associated with rock music. Another instrument is the electric bass guitar, which was introduced by Fender in 1951. (8) The drum set is used in rock music also. Rock-and-roll guitarist Chuck Berry established a style of playing in the late 1 sass that mains a great influence on rock music. (8)Jim Hendrix, Eric Clayton, and Carols Santa are a few more rock musicians.One of my favorite rock groups is The Rolling Stones. Closely connected with youth culture, rock music and musicians have helped to establish new fashions, forms of language, attitudes, and political views. However, rock music is no longer limited to an audience of teenagers, since many current listeners formed their musical tastes during the golden age of rock and roll. Similarly, while rock has historically encouraged new creative expressions, the innovations ofChuck Berry, Elvis Presley, Bob Dylan, the Beetles, and Jim Hendrix have defined a tradition to which successive generations of musicians have repeatedly turned for inspiration A special day in the history of rock music was February 7, 1 964; it was the day that a band called the Beetles that came from Liverpool, England to the United States. On February 11, 1964, the Beetles sang their first concert in the united States, at the Washington Coliseum. (12) The Beetles, one of the most popular rock and roll sensations in history, created frenzy in the U. S. As they became a model for rock and roll. The Beetles dominated the record industries and with their dominant instrumentation, which included, electric leads, rhythm, and bass guitar, drums and sometimes an electric organ, changed the name of Rock n Roll to just Rock. Rock music and society have mirrored each other since the bad boy image of Elvis Presley, through fads like the dance craze, and through the rebellious years of the counterculture. Rock and roll has been a key player in bringing differing cultures together; most predominantly, it began to bring white and black people together.Although it has not completely dissolved call intolerance, it has significantly blurred the lines separating us. Music, especially rock and roll is an open forum for all people to shout out their individual and varied viewpoints. It is a showcase of life and a reflection of society. (13) The last type of music I would like to touch on is rap, which is also known as hip-hop. Rap is defined as spoken words with an underlying rhythm section consisting of bass, drums, and occasional keyboard sounds. The words are spoken rhythmically, and accents in this speaking are very important.Hip Hop is considered the spouse of rap; it is essentially the background music, which accompanies the rapper. Raps roots can be traced to the following influences: Cab Galloway is known for his signature Hi-De-hi-De-hi-De-ho chant from Minnie the Moocher. Starting back in the 1 asss, Galloway used a call and response format with his audience, which is one of the foundations of rap. Other musicians who have utilized this technique, or have utilized a monologue-style in their music, include the following: Lou Rails, Charlie Daniels, Bob Diddled and Peter, Paul, and Mary.The Hip Hop subculture and rap music seemed to have originated in the united States in the Bronx. The iris rap record to make it big was Rappers Delight released by the Sugar Hill Gang on Saliva and Joey Robinsons Sugar Hill label. Run-D. M. C. Was the first black rap group to break through to a very white audience with their albums, Run-D. M. C and King of Rock. These albums led the way that rap would travel into the musical mainstream. Even though Run-D. M. C. Dressed as if they came right off the street corner, this was not the case. Run and D.M. C came from middle class families, they were never deprived of anything and they never ran with a gang. One could never tell this by their dress or room the raps, they made. As rap music evolved and became popular, women tended to be the targets of male rap lyrics and generally were not portrayed in a favorable light. Rap music producers also seemed to be hesitant to produce female rap artists. (9) David Twigging in his article, Not for Men Only; Women Rappers are Breaking the Mold with a Message of their Own, offers two reasons for this reluctance.One being rap producers were apprehensive about signing female rappers because they feared tampering with their proven formula of success of producing macho male rappers. The other being, rap producers did not feel hat female voices could supply the requisite loudness and abrasiveness that they felt was a major feature of rap music. (10) A New York City female rap trio by the name of Salt N EPA would provide the rap music industry with the incentive to produce more female rappers with the success of its debut album, Hot, Cool, Vicious, which sold over a million copies.Besides the fact that people like what they heard, Russell Simmons who was quoted in Thesiss article offers another explanation. Simmons stated, There are more women buying rap records who would like to relate to women artists ND there are more guys who want to he ar a womens point of view. (1 0) Salt N Pepper rapped over soul-tinged RB melodies with teasing, street- sway raps about maturity, independence from men, and sexual responsibility. Another female rapper, Minnie Love, tried not to be too serious with her rap messages.
Wednesday, December 4, 2019
Knowing Minds of Others Is it possible to know what is going on in another person's mind? I wouldn't say that it is possible to know what is going on in another person's mind, but I would say that you can have a pretty good idea of what is going on in their mind. I don't think that there is any possibility that anyone could know what is going on in someone else's mind without having that person be hooked up to some kind of electrical devise that outputs what is going on in their mind. Then and only then do I think that that is the only way someone can tell what someone else is thinking. With the example of having a pretty good idea of what is going on in someone else's head; I have three friends that are girls and they are pretty much inseparable, but when they are apart they always know what the other one is doing and have a pretty good idea of what they are thinking and doing at that particular time. They know each other so well that they can finish each others sentences, just look at each other and know what the other one is probably thinking, and kind of sense what the other one is thinking and might do. Going back to the question of being able to know what is going on in another person's mind; Like I said before, I don't believe that there is a way that someone can possibly know what is going on in another person's mind. Of course, people will say that there are psychics that can know what is going on in someone else's mind or be able to know of things that only that person would know. This is all fake because psychics have a way of luring out things from people and making them think that they know things about them or know what they are thinking or feeling. I have some really good friends that I have know all of my life, and we know pretty much everything about each other. Even though we know so much about each other, there is no way that any of us could know what is going on in each other's mind. Of course, we can have a pretty good idea of what each other is thinking, but we can't know what the other person or person's is thinking. I mean, there are times when someone has asked us a question and one of us has answered for all of us because of the fact that we know each other so well and we know the other people would say or how they would respond. But that doesn't mean that you know what someone else is thinking, that only mean that you probably know the other people to well. Let's say that you have to go and get something for one of your friend's birthday; so some of your friends and you go out and find something. You all know of what he/she likes and when you are out shopping you see many things, but then you always seem to find something that always sticks out and this something is what you and your friends all know your other friend will like, because you know just about everything about your friend and what he/she likes. Everyone has been in situations where they try to look a certain way or act a certain way around people to make those people think a certain way about them. They worry too much about what others may think about them, they try to figure out what others are thinking and this is impossible. Some times people try to figure out what is going on in another person's mind by looking at them. Facial expressions show greatly what people are feeling and these feelings are related to the thoughts going on in other people's minds. But, you can never totally rely on the facial expressions of people to tell you what is going on in their minds. Some people hide their true feelings behind these faces and display the opposite or whatever seems to fit the situation. If you really know the person really good, these facial expressions don't do them any good. Sometimes body expressions can show or tell what is going on in another person's mind. The way people use their hands and body display what is going on in their minds and this is a way to
Wednesday, November 27, 2019
Pestel Analysis of Genting Group Political : Had top political support from Tunku Abdul Rahman. One and only casino in Malaysia issued with a gaming license Economic : Key economic contributor to the tourism industry in Malaysia registering a new high of 19. 6 million visitors in year 2007. Creation of vast job opportunities Ã¢â¬â provided leisure-related jobs to over 13,000 people (mainly Malaysians) Social : Genting has become the Ã¢â¬Ëcity of entertainmentÃ¢â¬â¢ and have thus attracted visitors from around the world. Malaysia is an Islamic country with approximately 60% of the population being Muslims who uphold religious teachings strongly against gambling Ã¢â¬â potential uproar on encouraging the Ã¢â¬Ësin of gamblingÃ¢â¬â¢. Technological : Genting Skyway is recognized as the Ã¢â¬ËWorldÃ¢â¬â¢s Fastest Mono Cable Car SystemÃ¢â¬â¢ with a maximum speed of 21. km/hour and Ã¢â¬ËLongest Cable Car in Malaysia and Southeast AsiaÃ¢â¬â¢. WorldCard Ã¢â¬â Customer loyalty programme has over 650 participating merchants, with more than 2,200 outlets throughout Malaysia, Singapore and Hong Kong. Launching of WorldCard Powered in 2007 Ã¢â¬â a new prepaid service platform for retail merchant partners such as Parkson Corporation, Sushi King Malaysia, G2000 and Lazo Diamond. We will write a custom essay sample on Pestel Genting Group or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Worldcard also partnered SoHoKL, Warisan Square (West Malaysia) and 1Borneo (East Malaysia) as their integrated marketing solutions provider. Environmental : Located on a hilltop Ã¢â¬â potential transport problems which were foreseen and resolved by the introduction of the cable car route. Alternative route available is the service road that can be utilized by public vehicles. Legal: One and only casino in Malaysia issued with a gaming license which only allows the entrance of non-muslims