Health Promotion in the UK

Health Promotion in the UK Introduction Health promotion is a vast and complex subject, encompassing aspects of definitions of health, practical and political approaches to promoting health, education, social policy and particular notions related to preventative approaches to lifestyle management. As such, it requires careful examination and consideration in terms of the current UK socio-political culture and in terms of the evolution of health promotion into its current state (Scriven and Orme, 2001). Health promotion involves a great variety of people, professions and players, including politicians, doctors, nurses, social care professionals, teachers and educators, the legal profession, and of course, the general public. It touches everyone in our society in one form or another, from the advertising on cigarette packets to the nutritional information displayed on supermarket foods. Therefore, it is of concern to everyone in society, because it considers health, however it is defined, as being to a certain degree manageable, in that the manipulation of lifestyle and environmental factors can support people in achieving optimum health and wellbeing. However, its very complexity, partly due to its historical evolution, partly due to the complex social and political interactions which define the sphere of health in society, can mean that simplistic notions of health, health promotion and associated concepts are difficult to define and to achieve. This essay will address some of the complexities of the issues of health promotion. It will attempt to define what health promotion is, what ideas, ideals and concepts it includes, and how health promotion is realised in a practical sense. It will also address the need for exploration of the outcomes and interactions of health promotion activities, and their social and institutional context. It will, of necessity, discuss aspects of the healthcare systems within the United Kingdom which pertain to the subject, and of the socio-political systems and histories which underpin the current climate. It will then examine vital aspects of health promotion, such as health education and communication, participative approaches to health promotion, and evaluation of health promotion initiatives. The author will also attempt to debate ethical, political and professional dilemmas that arise in new practices and policies for promoting health and explore the development of ways of promoting health t hat tackle social and economic inequalities and that are holistic and culturally sensitive. What is Health Promotion? Tones (2001) describes health promotion as a contested concept, raising immediately the notion of differing definitions of health promotion, perhaps based on different conceptualisations of health or different social or political imperatives. Health promotion has often been viewed as synonymous with health education, while health education conversely is often believed to be a fundamental component of health promotion (Tones, 2001). It is also linked with and perhaps interchangeable with definitions of public health (Tones, 2001). This relationship with public health immediately takes the notion of health promotion away from the individual sphere and places it firmly in the public sphere, within the context of the social and political systems of the nation in question, or within a global perspective, both of which are applicable to this essay and discussion. Tones (2001) suggests a formula for health promotion where healthy public policy is multiplied with health education, establishi ng their relationship as the basis for our definitions of the concept. The World Health Organisation defines health promotion as the process of enabling people to increase control over, and to improve, their health. This generic definition suggests that health itself is an individual state over which individuals can have some measure of control. Jones et al (2002, p.xi) also suggest that for many people, health promotion means targeting behaviour, but view it as something imposed upon them which does not necessarily work for them. However, given that promoting heath is a diverse, complex and multi-faceted activity (Jones et al, 2002, p5), these definitions do not address the range of activities and ideologies associated with the process. Health promotion policy appears to combine diverse approaches which include legislation, financial measures, taxation and organizational change. Tones (2001) simplistic suggestion of a formula of the interdependence of health education and healthy public policy as a definition of health promotion does not focus on the role of the individual. Both are equally important in our understanding of this issue. Tones (2001 p4) however further goes on to discuss a model of health promotion which focuses on the purpose of healthy public policy and health education, which is argued to be the empowerment of individuals and communities to reduce or remove the various barrier spreventing the attainnment of health for all. This is a more useful definition, but rather idealistic, as it sugges ts that such a goal is achievable, and there may be vast differences in individuals’ notions of ‘health’ and their abilities to achieve this. Health promotion and health education are often also seen as synonymous. Health education can be as complex an issue as health promotion to define. Education implies somebody ‘teaching’ or educating, and somebody learning new information. Tones (2001) p 15) describes emancipatory education, a dialectical process which involves critical consciousness raising which leads to the translation of critical thinking about social issues into action. Health education involves communication and the transmission or sharing of information, but also implies that such information must be assimilated by the recipient and then utilised in order to bring about change in the self or in aspects of behaviour, lifestyle or environment. There are great benefits in adopting the curent collective approach to promoting health, which aims to involve people not only in their own health and well-being but in acting together upon theirf physical, social, political and economic environment for the sake of health (Sidell et al, 2002, p 1). Such approaches allow for the incorporation, validation and promotion of individual and group needs based on diversity in race, ethnic or religious identity, social or lifestyle identity, social status and social and geographical inequality. Historical Milestones in Health Promotion Webster and French (2003 p9) suggest that while the immediate sources of health promotion and current approaches to public health lie in the political history of the 1970s, there are roots which go much further back, arguing that all communities have had some interest in co-ordinated community action to ensure a better life. The historical link between health promotion and public health is well established, with one of the most significant milestones being the formation of the National Health Service in 1948, whose medicalised approach initially hindered public health and health promotion initiatives as we see them today in favour of a treatment-oriented approach to illness (Webster and French 2003 p 10). Webster and French (2003 p11) suggest that the three seminal documents which launched what we know perceive as the health promotion movement were: the Lalonde Report New Perspectives on the Health of Canadians (1974); the World Health Organisation’s Global Strategy for Health for All by the Year 2000 (1981) and the Ottawa Charter for Health Promotion 1986). It was these documents which, collectively, set out a vision for health improvement which exceeded the traditional approaches of sanitation engineering, lifestyle health education and preventing and caring health services which characterised health promotion to that point. Instead, health promotion became concerned principally with empowering citizens that that they could take control of their health an in so doing attain the best possible chance of a full and enjoyable life (Webster and French, 2003, p 15). This notion of empowerment appears fundamental to current perspectives on health promotion and to its influences on the National Health Service, including on such concepts as patient participation and collaboration, service user involvement and patient rights. This heralds a move away from the medicalisation of health towards a more social definition of health where power is apparently distributed more equally among those who experience and those who purport to affect health, illness and wellness. This is something that the World Health Organisation appears to have consistently advocated, a positive and holistic view of health which comprises mental, physical and social elements (Tones, 2001 p6). The Ottawa treaty, which encompasses the key principles of equity, empowerment and the reorientation of the health services, reflects this notion of demedicalisation, where collaborative working by the many agencies concerned with health promotion is believed to maximise the potential of any strategy or policy in this arena (Tones, 2001, p7). Within the UK, policy drivers which have driven health promotion initiatives are too numerous and complex to fully explore within the context of this essay. However, governmental initiatives, changes in health and social services, changes in approaches to public health and changes in statutory control and responsibility for public services have all formed part of the UK health promotion focus (Jones et al, 2002 p 9-13). However, there appears to be a counter culture of bottom up drivers as well, with empowerment leading to the enabling of the activities of community and voluntary groups to bring about change at local and even national levels. This reflects the overall picture of holistic health promotion as a community development activity rather than a policy founded in political rhetoric. Contextual and Practical Issues in Health Promotion The setting of health promotion is also of some concern, with the role of the media, community development and critical consciousness raising (Tones, 2001, p14-15) still areas of some debate. This author would argue that the media may have some merit in health promotion, but that there are likely to be many who do not trust the ‘messages’ given out given that so much advertising is false, suggestive and manipulative, and based on the need to sell products rather than truly promote health. Health and community services appear to be the most impactful arenas for health promotion to take place within. The National Health Service has already established a policy context for the promotion of health within public services (Adams, 2001 p35). Therefore, a primary and important leader for health promotion is the health authority, with its twin roles of service improvement and strategic leadership for improving health and tackling health inequalities (Adams, 2001, p38). Activities such as health needs assessments and community planning can be carried out in a collaborative and participative way with local organisations and community groups in order to target and focus health promotion activities at a policy level (Adams, 2001, p 39). Primary healthcare services and Primary Care Groups can also be a vehicle for health promotion (Velleman and Williams, 2001, p43), and given their location within communities should be ideally suited to this role. Such groups can focus on practical initiatives to reduce inequalities in health and to target issues such as heart disease, cancer, teenage pregnancies and accidents, on the back of governmental initiatives, alongside emergent and self-defined local issues (Velleman and Williams, 2001, p43). An example of an activity by a primary care group is of a stop smoking initiative, whereby health professionals were trained and located in GP practices to provide one to one support to smokers who want to quit, and practices were supported in developing systems that deliver stop smoking interventions effectively (Velleman and Williams, 2001 p 44). Such practices can have multiple benefits, both to the individuals whose health is improved by the intervention, and to their communities. The wider impact is also that such practices can serve as examples and provide evidence for other groups wishing to develop similar interventions. So it would seem that local initiatives can be of much wider importance. GPs have, following changes in contracts, been charged with the responsibility of improving the public’s health (Jones et al, 2002). But the limitations of their services, their training and their scope are still apparent (Jones et al, 2002). The National Health Service also has an already established professional context which is ideally suited to taking forward notions of true, holistic health promotion whereby communities and individuals become empowered as agents of their own wellbeing. Community nursing services, again on the frontline of NHS care and which function fully within the communities they serve, can be a vehicle for such activities (Wright, 2001, p58). These work alongside specialist health promotion services who act as catalysts and facilitators at local levels (Learmonth, 2001 p 66). Such professionals and services can be active in organisation development, through leadership, partnership, development, training, education and support and policy and strategy development (Learmonth, 2001, p66). They can also engage in evidence based practice, market research, communication and publicity, and programme management (Learmonth, 2001, p67). The benefits of having such professionals are obvious, particularly wit hin the already overstretched and under-funded health and social services sector. Such activities appear vitally important to achieving health promotion goals, and in particular to ensuring collaborative working and full community engagement. Therefore, specialist services can also support community development through advocacy, needs assessment, community participation, information for health, and evaluation of services (Learmonth, 2001, p 67). However, there are challenges, particularly in the capacity and recognition of such services and their location, which may fall between traditional services and serve to hinder their function (Learmonth, 2001, p75). Hospital nursing practice also provides vast scope for health promotion (Latter, 2001, p77). Among other potentialities, the role of the hospital nurse as the primary caregiver for individual patients equates to a significant scope for health education (Latter, 2001, p78). However, there is also the need to further develop this role, and support its expression in the beleaguered health service (Latter, 2001, p 79). Despite the challenges of this, it could be argued that nurses have a strong role to play in creating environments that are supportive of health, encouraging community participation in health and helping to generate healthy policies (Latter, 2001). It should be remembered, however, that nurses are themselves individuals, whose own health needs support and input, and so any drive towards increasing their functions within health promotion may also need to address their working conditions, and the demands which place a strain on their own health. Environment is another contextual issue in health promotion. The role of Local Authorities in supporting healthier environments and communities is described by Allen (2001, p 91), who argues that such authorities can act as role models, and through the work of environmental health services, can promote the health of communities through: food inspection and maintenance of food safety; housing standards; health and safety at work and during recreation; environmental protection; communicable disease prevention and control; licensing; drinking water surveillance; refuse collection and street cleaning; and pest control. These are statutory functions, but if effective and efficient, have obvious public health benefits and therefore health promotion benefits. In addition, the discretionary powers of local authorities can affect issues of HIV and AIDS, alcohol and drug addiction, nutrition, women and men’s health, heating and energy advice, occupational health, environmental enhanceme nt and poverty issues (Allen, 2001 p 91). Their limitations are apparent, but this is where the voluntary sector comes in, and often voluntary groups and agencies fill some of the gaps where statutory services cannot stretch to cover all areas. Social services address the social aspects of health, by engaging in preventive work with children and families, by involvement in the care of older people, and by engagement with the health and wellbeing of people with special needs (Jones and Rose, 2001 p 95-102.) Diversity issues can be addressed by some aspects of social services (Jones and Rose, 2001 p 95-102), but again, there are gaps, where in some areas voluntary agencies can fulfil identified needs that cannot be met by health and social care services. Another arena for health promotion is that of health education in schools (Scriven, 2001 p 115). This is another growth area, supported by a range of policy drivers (Scriven, 2001, p121; Beattie 2001 p 133). School nurses have always had a role in health promotion for specific age groups, and this is another area where health promotion opportunities can be maximised (Farrow, 2001 p 151). Similarly, there is some evidence that Universities can be effective loci of health promo tion activities, with the integration of visions of health within plans and policies and promotion of sustainable health within the wider community (Dooris and Thompson, 2001 p 160). For those who perhaps cannot be reached through these contexts, there is also the Youth Work setting, which also provides considerable scope for health information and advice, though this too is not without its challenges (Robertson, 2001 p 173-176). Where services fail to meet need, as already suggested, the voluntary sector may cover the shortfall. The greatest value of the voluntary sector lies in its diversity and its motivation, which stems from free will, moral purpose and individual personal engagement (Anderson, 2001 p 181). Voluntary agencies are non-profit-making and occupy a singular position within society. Conversely, profit-making agencies can also contribute to health promotion through health working policies and health promotion in the workplace (Daykin, 2001 p 204). Good occupational he alth services, for example, can also play a vital role in health promotion, both generally and in specific issues related to the type of employment and activities concerned (Lisle, 2001). What all of these point to is this notion of collaborative, interagency working, where health promotion becomes the common goal of diverse populations, agencies, services, professions and of course individuals. Some believe that effective interagency working lies at the heart of improving health outcomes for vulnerable populations (Jones and Rose, 2001, p 95). However, such a standard of working is difficult to achieve (Jones and Rose, 2001, p 95), perhaps because of the boundaries and restrictions within which such groups work, and the historical context which makes them protective of their own ‘territory’. It is obvious that such limitations must be overcome if health promotion goals are to be met. It we are to achieve the goal of a holistic, socio-ecological model of health fully applied to our societies, then new ways of working and communicating must be developed, building on current evidence from innovations and practice. Debates and Dilemmas in Health Promotion It would be reasonable to raise the question, in the light of all these services, policies and drivers which promote health in our arguably well-endowed nation, why indeed is health promotion still such a challenge? Why are so many still suffering from ill health, social injustice, health inequalities and supposedly eminently preventable diseases? There may be many possible answers to this. Health is believed to be ultimately determined by the existence of equity and social justice, which is in turn rooted in people’s material, social, economic and cultural circumstances (Tones, 2001 p7). It is also believed that community action for health is based on the premise that health chances and health choices are shaped, to a great extent, by the social, political and economic conditions in which people live, and that ability of individuals to shape and control these structures is limited (Jones et al, 2002 p 25). It has been argued that the creation of healthy public policy is the prerequisite for changing adverse environments in order to facilitate the development of health (Tones, 2001 p8), but this author would also argue that adverse environments must be ‘ owned’ by those who live within them, and no amount of policy, imposed ‘top-down’ will improve environments if those who live within them do not equally invest in their amelioration and long-term development. Tones (2001 p 9) does argue that individual empowerment and community empowerment are linked, and that these are partly dependant on a sense of community where individuals have some notion of membership of some kind of community or group. The term community implies a common bond between individuals (Jones et al, 2002 p 25). Therefore we see the individual in a different context, a context comprised of various relationships and connections with other individuals. These must surely affect health and health p romotion behaviours, positively and negatively. But what of the individuals who fall outside such communities? Is it the remit of government, at any level, to force or coerce individuals into a state of ‘belonging’? Definitions of communities and group identities may serve to alienate those who do not feel associated with them, but in this case it might be necessary to focus on the good of the many, and to address the larger issues before addressing individual differences of this kind. If self-empowerment is attainable (Tones, 2001 p 11) then such individuals may take control of their own health. Activities such as community campaign groups, self-help groups and even more politicised groups related to notions of women’s or men’s health may all engage in action for health (Jones et al, 2002), and therefore it could be argued that any one individual should find a group or action which ‘concerns’ them or some aspect of their life or lifestyle. This may be particularly important in terms of dive rsity, where so-called ‘minority’ groups can both campaign for issues pertaining to their own identities and needs, and develop services which meet those needs. This returns us to the work of the voluntary sector, which is where such activities tend to find expression. But surely it is the role of government, and the services provided, at a locally devolved level, through central funding, to provide such sensitivity in the services and policies it underwrites? Some would argue that such sensitivity exists, but we have yet to see it fully realised in action, and have yet to see evidence of the efficacy of these great policy drivers in real practical terms. Jones et al (2002 p 47) suggest that community groups may find it useful to develop partnerships with local authorities, the education sector, other groups, NHS services, employers and even the media in order to ensure a fully participative, collaborative and comprehensive approach to locally-suited health promotion activities. This author would argue that with the best will in the world, there will always be a divergence between the goals of different groups, and an imbalance of power betw een these different agencies. The agendas of central government may end up dominating those of the community, and while such collaborative working is the ideal, it may need to be undertaken with awareness and caution. Farrant (2003 p 230) argues that the recent moves towards community development may simply mirror or reinforce the existing power inequalities within social systems, and such activities simply serve as another vehicle for governmental control. It is therefore important to be aware of the policy context within social action on health promotion, and to engage in true community or communal activities rather than those made possible by the current political and funding context. The paternalism of our current political system is evident in the media and the governmental policy drivers which shape public services. Such paternalism may be of some benefit in highlighting health promotion issues which need to be addressed, but the media reports demonstrate an over-generalisation of the issues. It is at the community level that the real needs can be identified (Jones et al, 2002 p 100). Part of this process is the evaluation of health promotion initiatives and actions, particularly participatory evaluation of community action with dissemination of findings (Jones et al, 2002 p 100). This serves two purposes. It allows communities themselves to build on evidence and continue to grow and develop such initiatives in a reflexive manner, and it establishes their work within the fields of health and social care on a more critical, intellectual level as an evidence-base which can educate and empower others. This essay has touched on the notion of public health and policy drivers, and has equated health promotion, to a certain degree, with the notion of public health. It is important, therefore, to consider the public health debate and the politics of health promotion. The context of public health within the UK is very much concerned with the notion of health inequalities, again, as mentioned in the above discussion. The evidence from the UK still points to considerable inequalities in health depending on region, and on individual occupation, and suggests that these inequalities are widening, despite significant improvements in aspects of social and economic wellbeing (Graham, 2003 p 20). Changing distributions of work and income, changing access to housing (such as increases in owner-occupation), changing patterns of working and domestic lives are all affecting social determinants of health (Graham, 2003 p 24-25). It has long been believed that income inequality is an important determin ant of health in richer societies, but research suggests that population health is related less to how wealthy a society is, and more to how equally or unequally this wealth is distributed (Graham, 2003 p 25). But individual factors must be taken into consideration, particularly in terms of health and illness. It is no surprise that an individual’s health is a determinant a well as an outcome of socio-economic circumstances, where those in better health are more likely to move up the occupational and economic ladder, while those in poorer health will not (Graham, 2003 p 26-27). Factors on the individual level include material factors, such and the physical environment of the home, the neighbourhood and workplace, and living standards; behavioural factors, such as health-related routines and habits, leisure activities and diet; and psychosocial factors in particular increased stress and risk-taking behaviours (Graham, 2003 p 27-28). Public health therefore has a dual remit – to address the socio-economic factors which affect health, and to address the individual factors which influence health. There is evidence of addressing individual lifestyle factors in governmental paternalism in such campaigns as the no-smoking campaigns and legislation, and the current debate on obesity. However, the notion of the evidence which underpins these drivers is debatable. There has been in recent years, a strong trend towards evidence-based practice in all aspects of health care, and this includes health promotion and public health (McQueen and Anderson, 2003 p 165). Ideally the theory informing practice should arise from multiple disciplines and represent diverse research (McQueen and Anderson, 2003 p 167). However, there is a divergence between empirical evidence and so called qualitative evidence, the latter of which does not enjoy the validity or acceptance of the former in terms of evidence. While health promotion is widely assumed to be based on science and a scientific basis for human behaviour, a scientific paradigm does not underlie our notions of health, public health and health promotion (McQueen and Anderson, 2003 p 168). The whole concept of public health and health promotion stems from an holistic and almost communalist paradigm, rejecting the view that human behaviour is simply a response to physiological and neural processes (MqQueen and Anderson, 2003 p 168). Therefore, simplistic, reductionist and scientific principles of evidence derived from statistics and experimental research will of necessity be woefully inadequate in addressing the very real complexities of health promotion in the practical and real community context. Therefore there is a need to identify news way s of seeking and defining appropriate evidence, in a developmental process which mirrors that of the health promotion activities themselves. Conclusion It is evident that health promotion, particularly within the UK context, is a complex concept with a wealth of diverse yet oddly inter-related issues and problems. This essay has attempted to discuss some of the issues raised in the set books for the K301 course, with an exploration of key issues and some debate of current provision. Health promotion is a governmental initiative, but remains also an ideogical and idealistic goal. It is best viewed as an holistic concept with contextual characteristics which must be taken into consideration. Some of these contextual characteristics are national, some are local or locational, and some are individual. It is the relationship between these three that defines both the need and the processes required to meet that need, fundamentally at a local level. The very complexity of the context requires that health promotion activities occur through collaborative, communal and partnership working, which means a change from traditional methods of organising health and social services. If we accept the principle that coordinated action leads to improved health, income and social policies that foster greater equity, then we understand the fact that collaborative action contributes to ensuring safer and healthier goods and services, better and more locally suitable public services, and cleaner, more healthful environments. It also requires that policy-makers, groups and individuals identify barriers and challenges to the adoption of healthier policies and behaviours, throughout society, and develop collaborative approaches to addressing these. However, avoiding paternalism and the mimicking of governmental agendas is also vital. What is most apparent from this discussion is that despite the debates, and there are many, the systems and resources are already in place to foster improved public health and health promotion activties and to engage all sectors of the community in these actions. Such resources include primary healthcare services and groups, nurses working in acute hospitals and within the community, specialist health promotion professionals, social services, schools, voluntary agencies, statutory agencies, youth groups, social and self-help groups, and many more. The potential of these groups in and of themsleves to engage in health promotion, and to evaluate and communicate these activties to others as a form of evidence, is already apparent from the literature. In particular, the literature also suggests that the notion of evidence in this arena should move away from reductionist, scientific principles to mirror the holistic nature of the health promotion context. But the efficacy of these diverse players in the arena is limited until such time as full collaboration, partnership and inter-agency working is realised.

My Ántonia, Individualism Essay

(Individualism: Its Influence over Lena, Jim and à ntonia During Their Childhood, Adolescence and Adulthood) â€Å"The longest journey is the journey inwards. Of him who has chosen his destiny, Who has started upon his quest for the source of his being†Ã¢â‚¬â€ Dag Hammarskjold.1 This individualist journey, Hammarskjold refers to, consists of two very important elements which contribute to individualism: (1) having the awareness of personal accountability before the Lord and Savior and (2) having a self-sufficient nature as a fountainhead of a person’s individuality which was required to settle the American frontier. These key ingredients mixed with an untamed land tempered the settlers into what we know them today as Americans which may be observed within Willa Cather’s My Antonia as the reader follows the lives of three key characters: Lena, Jimmy, and Antonia. Cather herself searched for her own individualism which she juxtaposed in this 1918 literary work with the character Jimmy. Both he and the author of the story were born in Virginia and at an early age were sent to Nebraska to join their grandparents. And much like the author, he had the pleasure of growing up with a variety of immigrants and stories. Such narratives inspired the author throughout her writing career. My Antonia follows the endeavors of the female protagonist, Antonia, and her foil, Lena, as they struggle in a new country, language, and culture seeking happiness and fulfillment in their lives which Cather so often observed in her childhood immigrant neighbors. Likewise, the reader learns about Jimmy with his own personal struggles as he strives for autonomy in a rugged territory with strict moral codes. Willa Cather’s My à ntonia addresses the notion of individualism which is best seen through direct and indirect characterization of three dynamic characters: Lena, Jimmy, and à ntonia by means of analyzing three stages of life: childhood, youth, and adulthood. A remarkable example of individualistic growth is depicted in Lena Lingard who lived in the countryside with her newly transplanted Norwegian family outside Black Hawk, Nebraska. The reader first encounters Lena through direct characterization as she is described as being â€Å"bareheaded and barefooted, scantily dressed in tattered clothing† (106)2 when she was just a child looking after her family’s herd. In the first part of the book she is introduced as a wild, poorly dressed working girl in charge of farm tasks much like other foreign girls: â€Å"Lena lived in the Norwegian settlement west of Squaw Creek, and she used to herd her father’s cattle in the open country between his place and the Shimerdas† (106). Further along in the novel, there is a clear change in this character’s life. She grows-up and changes her worn out rags for dressmaker quality clothing with hat and gloves as she begins a new phase in her life as a dressmaker’s apprentice in the town of Black Hawk: â€Å"’So you have come to town,’ said Mrs. Harling, her eyes still fixed on Lena.  ´Where are you working?’  ´For Mrs. Thomas, the dressmaker. She is going to teach me to sew. She says I have quite a knack’† (104). As a young adult, Lena strikes-out on her own to the city of Lincoln in a supreme final exhibition of the independence she has forged for herself throughout her life through hard work and determination. â€Å"‘I live in Lincoln now, too, Jim. I’m in business for myself. I have a dressmaking shop in the Raleigh Block, out on O Street. I’ve made a real good start’† (170-171). The path Lena has walked since her childhood, through her adolescence, and then adulthood has illustrated a noticeable achievement in becoming a self-sufficient young woman who quested for her destiny in an untamed land far from her native home. Lena’s personal accountability should also be explored, being one of the key elements of individualism, as she never turned her back on her family but always sent them money from her sewing work: â€Å"’After I learn to do sewing, I can make money and help . . . [my mother]’† (104). These individualistic elements were key in developing her character as she was noted in taking care of herself as well as her parents and siblings which was required of those immigrants who founded America and became a new breed of people known as Americans. Individualism was also reached by two other primary characters within this classic American literature novel: Jimmy and Antonia. Jim Burden, the narrator of the story and also one of the major characters of Willa Cather ´s My Antonia, is as well and important example of how a human being can evolve trough his life to find completeness and self-sufficiency. At the beginning of the book, Jim had just suffered the loss of his parents; and sent to his grandparents. While he was in the train on his way to Nebraska he was in deep grieve and uncertain about his future. â€Å" ´ I don’t think I was homesick. If we never arrived anywhere, it did not matter. Between that earth and that sky I felt erased, blotted out. I did not say my prayers that night: here, I felt, what would be would be ´Ã¢â‚¬ . Nevertheless, that sad passage in his life did not let Jim down. In the same train that he was travelling there was a Bohemian family. One of the members of that family was à ntonia Shimerda, who would become his best friend in the near future. When Jim had enough age to start studying at School, coincidentally his grandparents also had to move to Black Hawk due to Mrs. Burden health situation. There he met new friends, worked hard on his studies, and also had fun. Despite being sad and scared in the past, Jim managed to overcome these difficulties and successfully improve at school. So much so, that soon he would move to Lincoln to start his college career. There he met Gaston Cleric who joined him in his new adventure, and helped Jim to get over some obstacles that he had to face while living in Lincoln. â€Å"At the university I had the good fortune to come immediately under the influence of a brilliant and inspiring young scholar. Gaston Cleric had arrived in Lincoln only a few weeks earlier than I . . .† (165). Cleric also convinced him to move to Boston to finish his career, where Jim would finally reach his goal of becoming a professional. â€Å"Two years after I left Lincoln I completed my academic course at Harvard. Before I entered the Law School I went home for the summer vacation.† (191) Just after getting his college degree, Jim travelled back to Black Hawk where he would find everything different, his friends either dead or gone, the kids were not the same, and even the town itself was all changed. He left Black Hawk being an adolescent with dreams and now he had returned as a professional. He felt he was complete, despite of the fact that he still had very present that sorrowful night in which he was moving from Virginia to Nebraska. â€Å" ´I had only to close my eyes to hear the rumbling of the wagons in the dark, and to be again overcome by that obliterating strangeness. The feelings of that night were so near that I could reach out and touch them with my hand. I had the sense of coming home to myself, and of having found out what a little circle man’s experience is ´. (238)† By the time he came back to Black Hawk he knew that he had seized the opportunities he had and felt that his life had been worthy living. While back in town, he went to visit his beloved friend à ntonia, which also was happy. The happenings in Antonia’s life, and how she evolved from being a little girl in a foreign country to the women she became will be thoroughly developed next. à ntonia Shimerda is the main character that we find in Willa Cather’s My à ntonia. As well as Lena and Jim she is characterized during different stages of her life (childhood, adolescence and adulthood). One example of this characterization is portrayed in how à ntonia was developing her new language (English) and how it was influenced by the different periods of time she went through, as well as the places she moved to. At the beginning of the story we find à ntonia and her family moving from Bohemia to the prairie of Nebraska. In the prairie and as a child she met Lena Lingard and Jim Burden who would become one of the most important persons in her life. Jim was going to be the one in charge of teaching English to à ntonia who did not speak much English before the arrival to the prairie; â€Å" ´Ãƒ ntonia had opinions about everything, and she was soon able to make them known. Almost every day she came running across the prairie to have her reading lesson with me. Mrs. Shimerda grumbled, but realized it was important that one member of the family should learn English’† (24). It is evident that Mrs. Shimerda did not like the idea of à ntonia learning English. But, she understood it was important for à ntonia to learn the language in order to adapt herself and to find herself in her new country and home, also this would help à ntonia to take care of her family as she felt it as an obligation. As à ntonia was evolving her English was growing with her and with this some traits of her personality too. As explained before in the paper, Jim had to move to Black Hawk due to study reasons, but it was not going to be a long time before à ntonia also moved to Black Hawk, but with different intentions from one’s of Jim. à ntonia moved to Black Hawk to get a job, here she runs into Jim and Lena again. Now in her adolescence Jim says that à ntonia has very good English, â€Å"Tony learned English so quickly that by the time school began she could speak as well as any of us† (107). This shows that à ntonia kept practicing English to improve herself, as she felt that was one way to become better to help her family, and now in Black Hawk and with her job it was evident how the improvement in her English helped her. However, à ntonia would began to attend to dances with her friend Lena and this would carry a lot of problems with it for her, including losing her job because she did not want to quit attending to dances as requested by her bosses. The story carried on and further ahead in the story, when Jim comes back from Lincoln and the time he spent at Harvard to finish his studies, he finds a happily married grown-up à ntonia with children. à ntonia had married a bohemian guy called Anton and now she has a family, and she is very happy with them. While Jim is talking with à ntonia, he notices that her English has become bad as it used to be when she was a child and she was learning it. à ntonia tells him that now she has many troubles with English because at home they speak almost only in Bohemian, â€Å" ´I can’t think of what I want to say, you’ve got me so stirred up. And then, I’ve forgot my English so. I don’t often talk it any more. I tell the children I used to speak real well. She said they always spoke Bohemian at home. The little ones could not speak English at all—didn’t learn it until they went to school† (224). Now in her adulthood à ntonia was really worried and a good mother as well as a good wife who take care of her family. Here is where the change that à ntonia suffered from childhood to adolescence to adulthood is characterized, how she passed from a little girl to a loving mother. Throughout this essay three fundamental characters that we find in the novel My à ntonia by the author Willa Cather have been characterized, these characters are: Lena Lingard, Jim Burden and à ntonia Shimerda. The characterization of these characters has been done under the perception of individualism that is represented with each one of them. This perception of individualism of the characters has been shown based on the pursuit for autonomy that each character went through. At the same time three different moments in characters lives’ were chosen to describe them; the childhood, adolescence and adulthood. These moments in character’s lives’ were chosen because they are prior important stages in a person’s life. So, it was important to illustrate how the notion of individualism of each character could be characterized in these stages, taking into account crucial aspects that the characters faced in the search for themselves. Examples of these important aspects faced by the characters are a new country, language and culture in the case of Lena and à ntonia. Another example is the personal struggles of Jim as he attempts for autonomy in a rugged territory with strict moral codes.

Research on Patterns of Online Consumer Behavior - 1374 Words

In an analysis of the consumer behavior online, with focus group as young adults aged between eighteen and thirty-four interested in buying a mobile phone or a related product ,Petrovic Dejan explained that the most relevant behavioral characteristics of online consumers and examine several ways they find, evaluate and compare product’s information. Comparison of the freshly collected surveyed data with the present existing consumer behavior theory resulted in number of issues related to a specific consumer group. The motive of this report is to translate these findings into a set of implementation activities on strategic and technological level and the execution of these recommendations will result in better conversion of visitors into†¦show more content†¦On 6/10/09 San Francisco, CA the leader in online Customer Experience Management software (CEM), announces the results of the 5th annual survey of online consumer behavior, commissioned by Tealeaf and c onducted by Harris Interactives. The survey concludes that 48% of U.S. adults are now conducting more online transactions than they did in the past given the current economic climate. However, 80% of adults who have conducted an online transaction in the past year experience problems when doing so in 2009. Previously it was around 87%. This improvement over prior years is the result of a better focus on delivering perfect experiences to online customer. 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