Cyberbullying A Social Problem Education Essay

Cyberbullying A Social Problem Education Essay An old school yard problem has taken on a new electronic face for the twenty first century. No longer is the bully confined to the halls of the high school, they are now going home with students in their cell phones and in their computer monitors. Cyberbullying has become a new trend with terribly destructive consequences. The effects of cyberbullying have been linked to negative academic, social and mental consequences for targets and perpetrators alike. Due to the fresh nature of the problem, schools and parents have had difficulty in developing programs and policies that effectively deal with these behaviors at home and at school. The following paper provides a sound discussion of this new phenomenon and offers proposals for educators and parents on how to address and prevent cyberbullying among youth. It is time we combat this social problem and take a stronger stand against cyberbullies. Definition and prevalence Cyberbullying is the willful and repeated harm inflicted through the medium of electronic communication (Hoff Mitchell, 2008). Victims of cyberbullying are targeted with threatening, degrading and/or sexually explicit messages and images in chat rooms, blogs, social networking sites, cell phones, instant messaging, etc. (Katzer, Fetchenhauer, Belschak, 2009). Recent studies have found that 95 percent of American teenagers between the ages of 12 and 18 have access to the Internet and 75 percent own cell phones (Cox Communications, 2009). Of these teens, 20 percent report experiencing some form of cyberbullying during their school careers. (Hinduja Patchin, 2007). The increased access and anonymity provided by these technologies have made it possible for perpetrators to easily harm a persons social standing, peer relationships and physical safety. Children are not the only ones affected by cyberbullying where adults are increasingly targeted by perpetrators. Cyberbullies have been k nown to create slam sites where individuals are ridiculed or rated in insulting ways, gather private financial details, and share personal information with organizations that advocate for child molestation. Cyberbullies also remotely access webcams and secretly record individuals without their knowledge or permission. These behaviors are increasingly pervasive and have consequences for every member of society if action is not taken. Costs of cyberbullying The costs of ignoring and failing to prevent cyberbullying have proved immense. Targets of cyberbullying display increased signs of anger, depression, anxiety and emotional distress (Smith, 2008). Victims may also exhibit signs of failing health and decreased academic performance. In extreme cases victims have dealt with their frustration through school shootings or by committing suicide. According to research, victims of cyberbullying are almost twice as likely to attempt suicide compared to those who have not endured such bullying (Hinduja Patchin, 2007). Children who cyberbully others have difficulty in communicating their emotions and lack appropriate methods of relieving aggression. Contrary to popular belief, cyberbullies are known to have high self-esteems and bully others in order to establish dominant social roles (Agatston, Kowalski Limber, 2007). This creates a power differential where cyberbullies feel superior to others who are unable to defend themselves. These childr en are more likely to engage in other forms of anti-social behavior such as vandalism, fighting, dropping out and using drugs (Hinduja Patchin, 2007). Nearly 25 percent of school bullies will also be convicted of a criminal offense in their adult years (Juvonen Gross, 2008). For the school, cyberbullying has been attributed to high absentee rates, poor student performance, low teacher morale and negative perceptions from the community. Schools have been targeted for failing to provide a safe learning environment and in some cases have been held responsible for the suicides of students who have been victimized (Hoff Mitchell, 2008). The most significant cost for schools are the lost opportunities of children that are affected by cyberbullying. Suggestions for schools. Schools must establish that any type of bullying is unacceptable and perpetrators will be punished. By adding cyberbullying into student codes of conduct, educators and students enter a contractual agreement where penalties can be applied. Currently it is difficult for teachers and administrators to punish cyberbullies so adding this definition to student handbooks will give educators cause for suspending or expelling offenders (Calhoun Daniels, 2008). This sends the message that this type of harassment will not be tolerated. Most policies involving cyberbullying are reactive and do not address why these behaviors occur. Schools are encouraged to employ programs that openly discuss the dangers of cyberbullying and what targets can do when they become victimized. The goal is to take a proactive step and prevent cyberbullying from ever occurring. In order for students to take a proactive stance on cyberbullying they must be educated that their online interactions have real life consequences. School officials can help by adding cyberbullying to existing curriculum in health classes and allowing law enforcement officials to speak at assemblies about the legal implications of cyberbullying. Informing students on how to deal with cyberbullies in a legal sense will likely deter students from engaging in cyberbullying (Smith, 2008). Schools can also implement further programs that discuss critical thinking and the dangers of bullying behavior. This can come in the form of assemblies with guest speakers that offer a message of hope for targets as well as bullies. Students will be provided with information on how to get help and how to prevent this type of treatment. These programs can also offer tips on how to avoid becoming a target for cyberbullying. Students are encouraged to never reveal personal information to anyone that they do not know. Cyberbullies have been known to pose as trusted friends online and trick targets into revealing potentially embarrassing information. Also, students will be informed of the potential legal implications of sending or transmitting nude pictures of minors under the age of 18 through cell phones or e-mail messages in what is known as sexting (Cox Communications, 2009). Teaching students how to protect themselves though smart usages of technology decreases the chance that they will be victimized in the future. With the enthusiasm behind social media, teachers have begun using sites like Facebook to provide an engaging educational experience for students when they are not at school (Diamanduros, 2008). This extension of the classroom will require students to friend the site giving teachers access to student accounts. The point here is not to spy, but to create an online presence for teachers which sends the message that students will be held accountable for their online behavior just as in real life. This will allow administrators to appropriately handle internet interactions that are in violation with the updated student codes of conduct. By creating an online learning environment students are encouraged to participate and share their ideas while refraining from acting irresponsibly. To prevent cyberbullying while at school, school computers must be updated with recent firewall software and search restrictions. Each computer should require that students login with their real names (not pseudonyms or handles) to ensure that violators can be easily traced. Any attempt to disable protective software or damage networks should be viewed the same as destruction of other school property and handled accordingly. Computers and technology access are a privilege at school and violations of these policies can result in these privileges being removed. Students should be informed that any electronic transmission created at school is subject to school rules including text messages, e-mails and phone calls. Ultimately, the lines of communication must be kept open between students and teachers. Students will be more willing to report cyberbullying if they know that school officials will actually do something about it (Diamanduros, 2008). Teachers need to be informed on how to handle bullying they witness in person and how to report it to the proper authorities. It is important that teachers also ask the assistance of school counselors who can get involved with a students parents and the situations they face at home. These measures will ensure that students remain willing to contact trusted adults when their efforts at defusing potentially dangerous situations are unsuccessful. Suggestions for parents. Parents must learn to recognize the warning signs that their child is a perpetrator or target of cyberbullying. Common characteristics of perpetrators include frequent computer use, especially at night, combined with loud bursts of laughter. Cyberbullies tend to be secretive and attempt to disguise what they were doing when adults enter the room (Dehue, 2008). Targets are known to become noticeably sad or angry following computer use and may abruptly stop using the computer. Additional signs of bullying victimization are the avoidance of friends, family and school (Hoff Mitchell, 2008). Parents should be aware of these signs and maintain a dialogue with children about what their lives are like and what happens to the child on a day to day basis. In the ever evolving social lives of youth it is important to allow children to continue use of electronic forms of communication. This has become an essential way for them to organize events and stay in contact. For this reason a child may be less willing to report instances of cyberbullying for fear that parents will restrict Internet of cell phone access (Hinduja Patchin, 2008). It is therefore important to not restrict use, but to set rules on appropriate online behavior and internet safety. This will make children more willing to report cyberbullying to trusted adults and authority figures. To further ensure that children are not engaging in cyberbullying parents need to make use of search filters and website blockers that restrict offensive material. An additional step would be to place the computer in a common area of the house. Upon learning of of cyberbullying, parents are encouraged to openly discuss what happened and the childs role in the situation. It is necessary to ke ep these lines of communication open to prevent future instances of cyberbullying. Parents are further encouraged to inform school officials and law enforcement of potential abuses of electronic communication. The school officials are trained to take the appropriate actions in dealing with bullying behavior and may provide useful suggestions. Since cyberbullying is often an extension of pre-existing traditional bullying at school, it is important that parents are willing to communicate with the school officials (Juvonen Gross, 2008). In cases involving threats of violence, sexual content, and other illegal activities parents should notify law enforcement. Internet service providers and cell phone companies can be used to provide evidence to report illegal and malicious content (Cox Communications, 2009). Even if these companies are able to obtain transmissions parents should encourage their children to save all e-mail and text messages that contain harmful content to further support criminal investigations. In addition, when a parent informs the community that the ir child has been a target of cyberbullying, it would likely make other parents more willing to monitor their childs electronic transactions. In order to fully grasp the complexities of electronic communication parents should create a presence online by using social media for their own uses. By parents creating a Facebook or MySpace page of their own, it may create a disincentive for children to engage in cyberbullying. This will familiarize parents with this type of communication and give them a chance to keep an eye on their childs internet activity. Most social networking sites provide tips for parents and children on internet safety, user agreements and how to report pages with malicious content. These pages are then removed and offenders are denied access. The more time that a parent spends educating themselves on electronic communication, the more tools they will have in preventing cyberbullying. Conclusion The best way to address and prevent the issue of cyberbullying is to take the appropriate measures when children are still in school. Providing them with the tools of how to be respectful and the consequences of cyberbullying will dissuade them from engaging or continuing these behaviors in adulthood. Educators and parents must be willing to take a stronger stand against this form of harassment and challenge the idea that bullying of any kind is a normal part of growing up. We have reached the point where we can no longer claim unfamiliarity with technology. We must be willing to embrace electronic communication to gain a better understanding of the issue. Computer and electronic competence are the most effective tools in combating cyberbullying.

Intergenerational Observation Scale Analysis

Intergenerational Observation Scale Analysis Abstract Innovative intergenerational programs continue to grow in number and scope. The development of standardized evaluation instruments, however, lags behind, leaving many researchers and practitioners without tools to effectively assess their programs. Evaluation data often focus on outcomes without attention to the nature of the interactions between generations. Understanding the process of intergenerational contact is central to understanding its outcomes. We developed the Intergenerational Observation Scale to assess the social interactions and affect of young and old participants during intergenerational activities. Our 3-step observer training process demonstrated good scale reliability. We present the process of developing the scale, achieving observer reliability, and next steps to continue exploring the scales utility across intergenerational populations and settings. Development of a standardized tool for intergenerational programming: The Intergenerational Observation Scale Providing opportunities for meaningful engagement to persons with dementia challenges family and professional caregivers alike. While some practitioners and researchers seek innovative means to support client well-being (e.g., Allen-Burge, Burgio, Bourgeois, Sims, Nunnikhoven, 2001; Orsulic-Jeras, Judge, Camp, 2000), many dementia care programs are characterized by extreme levels of inactivity (Ice, 2002), which may result from infantilization (Salari Rich, 2001) and can lead to agitation and depression and detract from well-being (Teri et al., 2003; Voelkl, 1986). Kitwood and Bredin (1992) emphasized caregivers responsibility for supporting the personhood of individuals with diminished capacity to do so for themselves. Personhood, or the dignity and respect owed to each individual, encompasses an individuals experiences, preferences and values. For many people, their social history involves significant time spent interacting with and caring for children. Recently, care profession als have turned to intergenerational programming (IGP) as one therapeutic method to support personhood and well-being of persons with dementia (e.g., Camp et al., 1997; Jarrott Bruno, 2001). Though contact between young and old generations remains an integral part of most families (Eggebeen Davey, 1998), non-familial IGP remains a relatively new treatment milieu in elder care. IGP as a whole varies widely, depending on the populations involved, program objectives, and available resources. Interventions targeting children at risk for drug use (Taylor, LoSciuto, Fox, Hilbert, Sonkowsky, 1999), older adults needing employment (Larkin Newman, 2001), and foster care families needing community support (Eheart Hopping, 2001) have utilized intergenerational strategies to achieve program goals. Programs have employed IGP to promote positive affect and engagement of older adults (Xaverius Matthews, 2003), improved attitudes about aging among children (Middlecamp Gross, 2002), and greater sense of community among staff (Jarrott, Morris, Kemp, Stremmel, 2004). Despite the significant cognitive impairment of many elder care clients, practitioners have found elders experiences interacting with and caring for children so ingrained that they remain able to interact appropriately and positively with children until late in the progress of a dementing illness (Camp et al., 1997). The means of assessing IGP vary as much as the programs themselves. Researchers have utilized interviews (Jarrott Bruno, 2007), observational scales (Marx, Pannell, Papura-Gill, Cohen-Mansfield, 2004; Xaverius Matthews, 2003), attitudinal surveys (Jantz, Seefeldt, Galper, Serlock, 1977; Kocarnik Ponzetti, 1986), drawings (Lichtenstein, et al., 2001), and cognitive assessments (Newman, Karip, Faux, 1995) to evaluate the impact of IGP on one or more groups of participants. While the range of scales utilized is not inherently problematic, the current state of intergenerational research tools requires significant improvement for several reasons. First, scales are often created for a single study without any report of psychometric properties (Kuehne, 2004). Consequently, researchers reinvent the wheel rather than use valid, reliable scales. Second, most scales assess the experiences of a single generation (e.g., Camp et al., 1997; Underwood Dorfman, 2006) although IGP should, by de finition (Newman Smith, 1999), provide mutual benefit for young and old participants. Third, the developmental and disease characteristics of a large portion of IGP participants, pre-school age children and frail elders (e.g., Epstein Boisvert, 2006; Middlecamp Gross, 2002; Salari, 2002), limit the opportunity for valid self-report measures. Consequently, researchers often rely on proxy report and direct observation to tap participants experiences with IGP. A critical limitation of much IGP research lies in the black box that conceals the process of bringing young and old together. That is, assessments targeting the impact of IGP often neglect what actually transpired during the IGP. Useful process data will vary from project to project; it might detail the level of activity, the type of interpersonal interactions, the physical environment, facilitators behaviors, or the activitys age appropriateness. For example, Xaverius and Matthews (2003) assessed the impact of IGP involving fourth graders and senior center participants who met for six intergenerational activities. The authors described the theme and setting of activities where elderly participants engagement was coded. Data were not gathered regarding the nature of the activities or what happened when participants were engaged in the intergenerational activity (i.e., if they engaged with the activity materials, with an age peer, or with an intergenerational partner). In contrast, Taylor and colleagues (1999) reported on a senior mentoring program targeting attitudes towards aging, drug use, and civic engagement of participating at-risk youth. The treatment group as a whole demonstrated improved attitudes towards school, civic engagement, aging, and resisting drug use compared to a control group. The authors also tapped into important process data by rating seniors intensity of involvement as a mentor. The researchers found a greater degree of attitudinal improvement among children whose senior mentors were more intensely involved with their student partners. Such studies exemplify the importance of capturing process as well as outcome data. The variety of populations and settings that avail themselves of IGP supports the study of multiple paths leading to positive outcomes. Most would agree that a one-size-fits-all model of IGP is impossible and inappropriate; however, identification of practices and processes that optimize outcomes improves the overall quality of IGP and enhances understanding of how IGP uniquely meets individuals needs across the lifecourse. In turn, greater understanding of the processes by which positive IGP outcomes are achieved informs development of theory pertaining to intergenerational relationships. For example, while the contact theory (Allport, 1954) provides necessary conditions for achieving positive intergroup contact, Allport did not describe the processes by which these outcomes would be achieved (Pettigrew, 1998). The limitations of IGP and related research stem from the relative infancy of IGP research. Researchers have been studying IGP for only the last 30 years (e.g., Jantz, et al., 1977), yet they are trying to raise the field to match those of child and adult development. Practitioners are anxious to know how IGP affects the physical, cognitive, and mental health of participants, yet the more basic question about whether and how children and elders interact with each other during proscribed IGP remains largely unanswered. Before we can reliably draw conclusions about the effects of IGP on children and elderly participants, we must determine the nature of their time spent together. Kuehnes (2003) state of our art report on intergenerational research implored researchers to tap the experiences of young and old participants and to develop and disseminate standardized measures relevant to IGP. By addressing these points, researchers can better inform practitioners efforts and build a cohesiv e body of research. The scale described in the current paper addresses each of these recommendations. We sought to address the challenge of measuring the experiences of young and old IGP participants, focusing on frail elders and pre-school age children because they constitute a large portion of participants involved in IGP (Goyer Zuses, 1998). We conducted a three-phase study to develop an observational scale tapping the social behavior and affect of both young and old IGP participants. We turned to the child development literature, with its long history of observational research, for inspiration. Partens (1933) categories of childrens play behaviors appealed to us; they encompassed categories reflecting a continuum of social behaviors ranging from non-engagement to cooperative engagement. Rubin (2001) developed the Play Observation Scale, drawing on Partens work and childrens cognitive development research. The broad social behaviors of unoccupied, watching, solitary, parallel, and cooperative captured by the Play Observation Scale reflect behaviors of interest to practitioners working to support meaningful engagement among elders and children. For example, a code for unoccupied behavior is salient given the high rates of inactivity found at elder care programs (Ice, 2002) and the goal of utilizing intergenerational strategies to promote positive social engagement. Furthermore, our experiences with IGP (e.g., Gigliotti, Morris, Smock, Jarrott, Graham, 2005; Jarrott Bruno, 2003; Jarrott Bruno, 2007; Jarrott, Gigliotti, Smock, 2006; Jarrott, Gladwell, Gigliotti, Papero 200 4; Jarrott et al., 2004; Weintraub Killian, 2007) highlighted interaction as the central mechanism for achieving mutual benefit during IGP. Thus, a code for solitary behavior is relevant as it reflects engagement in a presented activity without social interaction. The first author used the original Play Observation Scale to observe elders during structured IGP (Gladwell Jarrott, 2003), determining that older adults engagement was greater during IGP than non-IGP. However, Gladwell and Jarrott found the scale cumbersome as they gathered salient data as well as information of little contemporary significance to IGP. Furthermore, they violated some of the scales specifications by utilizing the Play Observation Scale in a structured activity setting. We made several adaptations to Rubins Play Observation Scale for use with structured IGP (see Table 1 for descriptions of the scale categories).   First, Rubins social behavior categories included sub-categories indicative of cognitive development; however, given our emphasis on interactions irrespective of developmental abilities, we eliminated cognitive behaviors from our scale. Second, the Play Observation Scale was designed to be used during free play sessions where children self-initiate behaviors. However, intergenerational researchers have repeatedly emphasized the need for structure to optimize IGP (e.g., Camp et al., 1997; Jarrott, 2006; Xaverius Matthews, 2003), and so we developed the scale with planned IGP in mind. Finally, we expanded the IOS to distinguish between social behaviors with age peers and intergenerational partners (i.e., interactive peer versus interactive intergenerational). The first phase of the study involved qualitative observations of IGP conducted at a shared site intergenerational program serving frail elders and pre-school age children. The observations were then used to modify Rubins Play Observation Scale for use in a structured intergenerational setting. Phase two involved piloting the scale with two observers coding video of IGP and working with the second author to reach consensus and create a master coding scheme for the video sessions. In phase three, the scale was further modified and tested with a larger group of four observers coding video and live IGP. The current paper describes the three phases of the development and initial validation of the Intergenerational Observation Scale (IOS). While the IOS captures both behavior and affect of targeted child and elderly participants, the current paper focuses on social behaviors, which comprise the more complex sub-scale of the instrument. Method Participants Virginia Techs Neighbors Growing Together, is a shared site intergenerational program designed to improve the lives of people across the lifespan through intergenerational collaboration involving teaching, research, and outreach. Neighbors Growing Together includes two co-located programs: Adult Day Services and the Child Development Center for Learning and Research. Adult Day Services provides activities, care, and supervision daily to approximately 15 adults (50+ years old) with cognitive and/or physical impairments. The Child Development Center provides year-round, full-day care for 41 children ages 15 months to 5 years. Through daily programming designed to nurture development, enhance competencies, and facilitate positive social interactions between the generations, Neighbors Growing Together provides high quality services to children, older adults, and their families. Children from each of three classrooms have one to two weekly opportunities to join their elderly â€Å"neighb ors† for IGP, which typically involves three children and three older adults in a variety of activities, such as gardening, art, or sensory projects. Children and adults work together in a group facilitated by staff and students from the Child Development Center and Adult Day Services. Staff partners plan and implement activities that support an overarching goal of positive interactions. Activities further target developmental goals for both generations, such as fine motor skills or cooperation. Children and adults meet in a shared space adjoining the two programs. Child- and adult-sized chairs designed to put all participants at eye level and developmentally appropriate books and art materials are provided. Procedures Phase 1: Scale development In fall 2005, four research students gathered qualitative observations of IGP involving Adult Day Services participants and Child Development Center children. Observers attended different intergenerational sessions. Each week, observers had a distinct focus, starting with holistic observation to orient the observers to the setting and proceeding to target the environment, the participants, and the facilitators. Following their weekly observations, the observers and the first and second authors discussed the observational data, focusing on the interactions between participating children and elders and factors that influenced those interactions. After observing 3-5 intergenerational sessions apiece, observers read and reviewed the IOS scale and codebook developed by Gladwell and Jarrott (2003) and closely mirroring the Play Observation Scale developed by Rubin (2001). They discussed how well the categories applied to the intergenerational context they observed and how to modify the sca le to reflect the social behaviors critical to intergenerational interactions in planned activities. Through an iterative process, the first two authors used observers notes and conversations to modify the Play Observation Scale to capture data reflecting the interactive process of IGP. Based on the observations from Phase 1, we further developed and refined the IOS (see Table 1). The scale builds on earlier observational research (Rubin, 2001) by coding participants behavior and affect and the affect of intergenerational partners with whom a target participant interacts.   The IOS was developed for live coding. It captures observations for the duration of an intergenerational activity, which tends to last 15-30 minutes. Each observer identifies 4-5 participants for observation and watches them for 1-2 minutes to become familiar with the participants behaviors before beginning to record data. He or she codes a participant for one 15-second interval, then codes the next participant for 15 seconds, followed by the third participant, etc. After the last participant is coded, the observer cycles back to begin observing participant one again. All observers in a session start coding when the facilitators begin the activity and end when the activity completes. When coding, if a behavior occurs for the majority of the coding interval, it is coded as the predominant behavior. When multiple behaviors are observed for equal intervals during a 15-second coding episode, we use the following hierarchy to code the predominant behavior most indicative of intergenerational interactions: Interactive Intergenerational, Parallel Intergenerational, Interactive Peer, Parallel Peer, Staff, Watching, Solitary, and Unoccupied. Phase 2: Establishment of reliability Video coding of the observations was introduced during Phase 2 of scale development because learning the IOS through the use of video has several advantages. When first learning the scale, observers watched a 15-second interval repeatedly to better understand the IOS behavioral scoring. The video coding procedure allowed observers to review their coding with the second author, who is experienced in observational coding. Weekly meetings were held during which observers coding was reviewed and discussed until observers reached a consensus on what behaviors constituted the IOS categories. Weekly review helped observers achieve acceptable reliability in assigning predominant codes to participants social behaviors. The video procedure enabled us to refine the IOS manual. The video coding process began with two observers who both had experience with live coding during IGP. After studying the manual, observers filmed three weekly sessions of planned IGP between the elders and each of the three classrooms of children (one session per classroom per week). The procedure for using video to establish acceptable reliability was completed in three steps. First, observers independently coded sessions in 15-second intervals and re-watched these as many times as necessary to determine the predominant social behavior. In the second step, observers more closely approximated live coding by watching the 15-second intervals on video only once to code the predominant social behavior.   In the third step, observers coded live sessions (scoring participant behaviors individually but observing the same participants at the same intervals) and filmed the activities, which allowed observers to review their coding at the weekly meetings and resolve discrepancies. Based on the consensus between the two coders and the expert coder, master coding sheets were developed indicating agreement on the predominant behavior for each 15-second interval of the coded sessions. Before observers could proceed to the next step in the training process, they had to achieve acceptable inter-rater reliability measured by Cohens kappa. A kappa score of .60 or higher was considered acceptable (Cohen, 1960). The kappa scores for the two observers in Phase 2 were .67 for the first step, .85 for the second step, and .81 for the live coding in the third step. Replication of reliability In Phase 3, we used the IOS video coding procedure to train four new observers. In addition to establishing that the video coding procedure would work with observers new to the IOS, we wanted to determine the amount of training necessary to achieve acceptable reliability with our 3-step process. The observers started with an introductory period where they read the manual and watched live IGP to observe the range of behaviors common to IGP. Observers attended weekly meetings where they watched IGP videos and received instruction on using the IOS. The introductory period lasted approximately 3 weeks or until observers felt comfortable with the coding, which was an additional 2 weeks for one of the observers. After the introductory period, the observers started on step 1 in the video coding procedure. Each step lasted approximately 4 weeks. At the weekly coding meetings, observers reviewed any discrepancies between their coding and the master codes determined in Phase 2. Once the observers achieved acceptable reliability in step 1, they moved on to step 2. Coding pairs were formed, and they coded live IGP during step 3, achieving acceptable kappas of .92, .69, and .75. Discussion In the current paper, we discuss the development of the IOS, a scale designed to measure young and old participants social interaction and affect during IGP.   In developing the IOS, we began with qualitative observations of IGP to refine a well-established child development observational scale (Rubin, 2001). We modified the scale for observations of elder and child participants in a typical range of intergenerational programs.   Based on two groups of observers, we present a system for training individuals to use the scale and establish inter-rater reliability.   Currently, the use of standardized measure within the field of IGP research is extremely limited, and our goal is to develop a scale to address this need. The IOS addresses several of Kuehnes (2003) recommendations for advancing   intergenerational research and evaluation.   First, the IOS is grounded in theory that shaped our view of positive IGP outcomes. Personhood theory (Kitwood Bredin, 1992) leads us to intergenerational relationships as a once common source of positive social interaction for many elders that can continue to support their well-being in late life. Contact theory (Allport, 1954; Pettigrew Tropp, 2000) elucidates necessary conditions for positive intergroup exchange, such as that between youth and elders. The conditions of cooperation and shared goals inform our expectation that the central mechanism of effective IGP is positive intergenerational interactions. The IOS captures the level of interactive behaviors between generations, thus reflecting the presence or absence of cooperation and shared goals of participants. Second, we draw from standardized measures of social interaction, namely the work of Parten (1933) and Rubin (2001).   Working from their concepts, we qualitatively looked at the behaviors seen during IGP.   We then refined the social behaviors described within Rubins scale to fit an intergenerational population and to capture levels of social engagement or interaction during IGP.   Third, we steer away from the over-reliance on attitudinal measures, moving instead to behavioral and affective outcomes of IGP. Fourth, by taking steps to develop a standardized scale, we contribute to the research tools available to IGP researchers, which increases the capacity to compare outcomes across studies, thus advancing the collective understanding of IGP. Our results establish the IOS as a replicable measure of social interactions during IGP.   The three-step process we used to achieve acceptable inter-rater reliability proved effective with two groups of observers. The process allows observers to develop a thorough understanding of the social behaviors in the IOS. Observers coding is checked against the master coding scheme to insure observers accuracy coding observed behaviors.   The master coding scheme allows for faster, more accurate training on the use of the IOS. Now that we have developed a successful process for training observers to use the IOS and achieve acceptable inter-rater, observers could be trained relatively quickly, most likely within four to eight weeks. A reliable, quick training method will allow data collection to begin at an earlier date and will allow more researchers to use the scale with confidence. An important strength of the IOS is its utility with both generations of IGP participants. Most research on individual outcomes of IGP participation focuses on one generation or the other (e.g., Middlecamp Gross 2002), neglecting the experiences of the other generation. When researchers do evaluate both age groups, they typically use non-parallel measures because parallel scales for disparate age groups rarely exist.   Not only will the IOS allow for standardized data collection across sites; it enables standardized data collection across generations. We expect the IOS to yield valuable process and outcome data for practitioners and researchers. Considering first the IOS as a source of outcome data, a program introducing or modifying an IGP could, for example, use IOS data to determine the affect and social behavior of participants during IGP with a goal of achieving high levels of positive affect, increasing intergenerational interaction, and reducing inactivity. In regards to process data, the IOS can be used in conjunction with salient outcome measures (e.g., depression or attitudes towards aging) to help interpret the effects of IGP (another recommendation by Kuehne, 2003). In asserting that IGP positively affects (or does not affect) targeted outcomes, researchers analyses would be strengthened by including data on the level of intergenerational interaction and affect that transpired among participants. For example, Seefeldt (1987) reported that children who participated in regular intergenerational visits to a nursing home h ad worse attitudes about aging than children who did not.   These findings would have been more easily interpreted if they incorporated process data such as the affect and level of interaction between children and elders.   Because these data were not included in the analyses, readers are left to speculate whether all IGP involving nursing home residents would negatively affect childrens attitudes or if the nature of the IGP in that study contributed to the negative outcomes. Seefeldt described IGP that yielded little support for intergenerational interaction (i.e., children performing in the center of the room, surrounded by the elders). She also indicated that elders were largely non-responsive to the children, suggesting that the negative outcomes may have been due to the nature of the IGP. While IGP professionals advocate standards of IGP practice (Epstein Boisvert, 2006; Rosebrook Larkin, 2003), significant variability on dimensions of IGP likely affects targeted outcomes and should be assessed. By capturing data that reflect the process of connecting generations, the IOS promotes understanding of why IGP succeeds or fails. As outlined above, the IOS provides many benefits for IGP research and evaluation. Our next step in establishing the scales value and utility to the intergenerational field entails establishing the reliability for coding occurrence of behaviors and predominance and occurrence of affect. Second, we plan to use a variety of means to establish validity, including video training to address substantive validity, expert panels to assess content validity, and statistical modeling of IOS data and related measures to determine convergent or divergent validity. Third, the scale was developed within the Neighbors Growing Together shared site intergenerational program, which involves structured programming between preschoolers and frail older adults. Generalizability is a critical indicator of validity and depends on the scales utility across intergenerational sites, populations, and programmatic approaches. Fourth, the behavior category codes are developmentally salient for pre-school age child ren and frail elders; we need to determine if the categories will be equally informative when applied to older children and well elders. Finally, the scale should be tested across cultures to support Kuehnes (2003) recommendation to take a more global view of IGP innovation. Initial indicators reveal that the IOS could become a useful tool to researchers and practitioners alike. As they seek to develop, improve, and sustain IGP while linking programming data to instrumental outcomes of interest to practitioners and funders, the availability of a standardized scale appropriate for use with young and old will prove invaluable. At a time characterized by tremendous creative energy and innovation in the intergenerational field, the IOS can capture the essence of IGP as practitioners support meaningful outcomes through intergenerational relationships. References Allen-Burge, R., Burgio, L. D., Bourgeois, M. S., Sims, R., Nunnikhoven, J. (2001). Increasing communication among nursing home residents.   Journal of Clinical Geropsychology, 7, 213-230. Allport, G. W. (1954). The nature of prejudice. Reading, MA: Addison-Wesley Camp, C. J., Judge, K. S., Bye, C. A., Fox, K. M., Bowden, J., Bell, M., et al.. (1997). An intergenerational program for persons with dementia using Montessori methods. The Gerontologist, 37, 688-692. Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20, 37-46. Eggebeen, D. J., Davey, A. (1998). Do safety nets work? The role of anticipated help in times of need. Journal of Marriage and the Family, 60, 939-950.   Eheart, B. K., Hopping, D. (2001). Generations of hope. Children and Youth Services Review, 23, 675-682 Epstein, A. S., Boisvert, C. (2006). Lets do something together: Identifying effective components of intergenerational programs. Journal of Intergenerational Relationships, 4(3), 87-109. Gigliotti, C. M., Morris, M., Smock, S., Jarrott, S. E., Graham, B. (2005). Supporting community through an intergenerational summer program involving persons with dementia and pre-school children. Educational Gerontology, 31, 425-441. Gladwell, M. S., Jarrott, S. E. (2003, November). An observational assessment of elders with dementia during intergenerational activities. Poster presented at the meetings of the Gerontological Society of America, San Diego, CA. Goyer, A., Zuses, R. (1998). Intergenerational Shared Site Project, A Study of Co-located Programs and Services for Children, Youth, and Older Adults: Final Report. Washington, DC: AARP. Ice, G. H. (2002). Daily life in a nursing home: Has it changed in 25 years?   Journal of Aging Studies, 16, 345-359. Jantz, R. K., Seefeldt, C., Galper, A., Serlock, K. (1977). Childrens attitudes toward the elderly. Social Education, 41, 518-523. Jarrott, S. E. (2006). Tried and true: A guide to successful intergenerational activities at shared site programs. Washington, DC: Generations United. [Electronic version available at www.gu.org] Jarrott, S. E., Bruno, K. A. (2003). Intergenerational Activities Involving Persons with Dementia: An Observational Assessment. American Journal of Alzheimers and Related Diseases, 18, 31-38. Jarrott, S. E., Bruno, K. (2007). Shared site intergenerational programs: A case study. Journal of Applied Gerontology, 26, 239-257. Jarrott, S. E. Gigliotti, C. M., Smock, S. A.,   (2006). Where do we stand? Testing the foundation of a shared site intergenerational program. Journal of Intergenerational Relationships, 4. Jarrott, S. E., Gladwell, M. S., Gigliotti, C. M., Papero, A. L. (2004). Fostering intergenerational community between child adult care programs: A Results Management approach. Canadian Children, 29(2), 4-13. Intergenerational Observation Scale Analysis Intergenerational Observation Scale Analysis Abstract Innovative intergenerational programs continue to grow in number and scope. The development of standardized evaluation instruments, however, lags behind, leaving many researchers and practitioners without tools to effectively assess their programs. Evaluation data often focus on outcomes without attention to the nature of the interactions between generations. Understanding the process of intergenerational contact is central to understanding its outcomes. We developed the Intergenerational Observation Scale to assess the social interactions and affect of young and old participants during intergenerational activities. Our 3-step observer training process demonstrated good scale reliability. We present the process of developing the scale, achieving observer reliability, and next steps to continue exploring the scales utility across intergenerational populations and settings. Development of a standardized tool for intergenerational programming: The Intergenerational Observation Scale Providing opportunities for meaningful engagement to persons with dementia challenges family and professional caregivers alike. While some practitioners and researchers seek innovative means to support client well-being (e.g., Allen-Burge, Burgio, Bourgeois, Sims, Nunnikhoven, 2001; Orsulic-Jeras, Judge, Camp, 2000), many dementia care programs are characterized by extreme levels of inactivity (Ice, 2002), which may result from infantilization (Salari Rich, 2001) and can lead to agitation and depression and detract from well-being (Teri et al., 2003; Voelkl, 1986). Kitwood and Bredin (1992) emphasized caregivers responsibility for supporting the personhood of individuals with diminished capacity to do so for themselves. Personhood, or the dignity and respect owed to each individual, encompasses an individuals experiences, preferences and values. For many people, their social history involves significant time spent interacting with and caring for children. Recently, care profession als have turned to intergenerational programming (IGP) as one therapeutic method to support personhood and well-being of persons with dementia (e.g., Camp et al., 1997; Jarrott Bruno, 2001). Though contact between young and old generations remains an integral part of most families (Eggebeen Davey, 1998), non-familial IGP remains a relatively new treatment milieu in elder care. IGP as a whole varies widely, depending on the populations involved, program objectives, and available resources. Interventions targeting children at risk for drug use (Taylor, LoSciuto, Fox, Hilbert, Sonkowsky, 1999), older adults needing employment (Larkin Newman, 2001), and foster care families needing community support (Eheart Hopping, 2001) have utilized intergenerational strategies to achieve program goals. Programs have employed IGP to promote positive affect and engagement of older adults (Xaverius Matthews, 2003), improved attitudes about aging among children (Middlecamp Gross, 2002), and greater sense of community among staff (Jarrott, Morris, Kemp, Stremmel, 2004). Despite the significant cognitive impairment of many elder care clients, practitioners have found elders experiences interacting with and caring for children so ingrained that they remain able to interact appropriately and positively with children until late in the progress of a dementing illness (Camp et al., 1997). The means of assessing IGP vary as much as the programs themselves. Researchers have utilized interviews (Jarrott Bruno, 2007), observational scales (Marx, Pannell, Papura-Gill, Cohen-Mansfield, 2004; Xaverius Matthews, 2003), attitudinal surveys (Jantz, Seefeldt, Galper, Serlock, 1977; Kocarnik Ponzetti, 1986), drawings (Lichtenstein, et al., 2001), and cognitive assessments (Newman, Karip, Faux, 1995) to evaluate the impact of IGP on one or more groups of participants. While the range of scales utilized is not inherently problematic, the current state of intergenerational research tools requires significant improvement for several reasons. First, scales are often created for a single study without any report of psychometric properties (Kuehne, 2004). Consequently, researchers reinvent the wheel rather than use valid, reliable scales. Second, most scales assess the experiences of a single generation (e.g., Camp et al., 1997; Underwood Dorfman, 2006) although IGP should, by de finition (Newman Smith, 1999), provide mutual benefit for young and old participants. Third, the developmental and disease characteristics of a large portion of IGP participants, pre-school age children and frail elders (e.g., Epstein Boisvert, 2006; Middlecamp Gross, 2002; Salari, 2002), limit the opportunity for valid self-report measures. Consequently, researchers often rely on proxy report and direct observation to tap participants experiences with IGP. A critical limitation of much IGP research lies in the black box that conceals the process of bringing young and old together. That is, assessments targeting the impact of IGP often neglect what actually transpired during the IGP. Useful process data will vary from project to project; it might detail the level of activity, the type of interpersonal interactions, the physical environment, facilitators behaviors, or the activitys age appropriateness. For example, Xaverius and Matthews (2003) assessed the impact of IGP involving fourth graders and senior center participants who met for six intergenerational activities. The authors described the theme and setting of activities where elderly participants engagement was coded. Data were not gathered regarding the nature of the activities or what happened when participants were engaged in the intergenerational activity (i.e., if they engaged with the activity materials, with an age peer, or with an intergenerational partner). In contrast, Taylor and colleagues (1999) reported on a senior mentoring program targeting attitudes towards aging, drug use, and civic engagement of participating at-risk youth. The treatment group as a whole demonstrated improved attitudes towards school, civic engagement, aging, and resisting drug use compared to a control group. The authors also tapped into important process data by rating seniors intensity of involvement as a mentor. The researchers found a greater degree of attitudinal improvement among children whose senior mentors were more intensely involved with their student partners. Such studies exemplify the importance of capturing process as well as outcome data. The variety of populations and settings that avail themselves of IGP supports the study of multiple paths leading to positive outcomes. Most would agree that a one-size-fits-all model of IGP is impossible and inappropriate; however, identification of practices and processes that optimize outcomes improves the overall quality of IGP and enhances understanding of how IGP uniquely meets individuals needs across the lifecourse. In turn, greater understanding of the processes by which positive IGP outcomes are achieved informs development of theory pertaining to intergenerational relationships. For example, while the contact theory (Allport, 1954) provides necessary conditions for achieving positive intergroup contact, Allport did not describe the processes by which these outcomes would be achieved (Pettigrew, 1998). The limitations of IGP and related research stem from the relative infancy of IGP research. Researchers have been studying IGP for only the last 30 years (e.g., Jantz, et al., 1977), yet they are trying to raise the field to match those of child and adult development. Practitioners are anxious to know how IGP affects the physical, cognitive, and mental health of participants, yet the more basic question about whether and how children and elders interact with each other during proscribed IGP remains largely unanswered. Before we can reliably draw conclusions about the effects of IGP on children and elderly participants, we must determine the nature of their time spent together. Kuehnes (2003) state of our art report on intergenerational research implored researchers to tap the experiences of young and old participants and to develop and disseminate standardized measures relevant to IGP. By addressing these points, researchers can better inform practitioners efforts and build a cohesiv e body of research. The scale described in the current paper addresses each of these recommendations. We sought to address the challenge of measuring the experiences of young and old IGP participants, focusing on frail elders and pre-school age children because they constitute a large portion of participants involved in IGP (Goyer Zuses, 1998). We conducted a three-phase study to develop an observational scale tapping the social behavior and affect of both young and old IGP participants. We turned to the child development literature, with its long history of observational research, for inspiration. Partens (1933) categories of childrens play behaviors appealed to us; they encompassed categories reflecting a continuum of social behaviors ranging from non-engagement to cooperative engagement. Rubin (2001) developed the Play Observation Scale, drawing on Partens work and childrens cognitive development research. The broad social behaviors of unoccupied, watching, solitary, parallel, and cooperative captured by the Play Observation Scale reflect behaviors of interest to practitioners working to support meaningful engagement among elders and children. For example, a code for unoccupied behavior is salient given the high rates of inactivity found at elder care programs (Ice, 2002) and the goal of utilizing intergenerational strategies to promote positive social engagement. Furthermore, our experiences with IGP (e.g., Gigliotti, Morris, Smock, Jarrott, Graham, 2005; Jarrott Bruno, 2003; Jarrott Bruno, 2007; Jarrott, Gigliotti, Smock, 2006; Jarrott, Gladwell, Gigliotti, Papero 200 4; Jarrott et al., 2004; Weintraub Killian, 2007) highlighted interaction as the central mechanism for achieving mutual benefit during IGP. Thus, a code for solitary behavior is relevant as it reflects engagement in a presented activity without social interaction. The first author used the original Play Observation Scale to observe elders during structured IGP (Gladwell Jarrott, 2003), determining that older adults engagement was greater during IGP than non-IGP. However, Gladwell and Jarrott found the scale cumbersome as they gathered salient data as well as information of little contemporary significance to IGP. Furthermore, they violated some of the scales specifications by utilizing the Play Observation Scale in a structured activity setting. We made several adaptations to Rubins Play Observation Scale for use with structured IGP (see Table 1 for descriptions of the scale categories).   First, Rubins social behavior categories included sub-categories indicative of cognitive development; however, given our emphasis on interactions irrespective of developmental abilities, we eliminated cognitive behaviors from our scale. Second, the Play Observation Scale was designed to be used during free play sessions where children self-initiate behaviors. However, intergenerational researchers have repeatedly emphasized the need for structure to optimize IGP (e.g., Camp et al., 1997; Jarrott, 2006; Xaverius Matthews, 2003), and so we developed the scale with planned IGP in mind. Finally, we expanded the IOS to distinguish between social behaviors with age peers and intergenerational partners (i.e., interactive peer versus interactive intergenerational). The first phase of the study involved qualitative observations of IGP conducted at a shared site intergenerational program serving frail elders and pre-school age children. The observations were then used to modify Rubins Play Observation Scale for use in a structured intergenerational setting. Phase two involved piloting the scale with two observers coding video of IGP and working with the second author to reach consensus and create a master coding scheme for the video sessions. In phase three, the scale was further modified and tested with a larger group of four observers coding video and live IGP. The current paper describes the three phases of the development and initial validation of the Intergenerational Observation Scale (IOS). While the IOS captures both behavior and affect of targeted child and elderly participants, the current paper focuses on social behaviors, which comprise the more complex sub-scale of the instrument. Method Participants Virginia Techs Neighbors Growing Together, is a shared site intergenerational program designed to improve the lives of people across the lifespan through intergenerational collaboration involving teaching, research, and outreach. Neighbors Growing Together includes two co-located programs: Adult Day Services and the Child Development Center for Learning and Research. Adult Day Services provides activities, care, and supervision daily to approximately 15 adults (50+ years old) with cognitive and/or physical impairments. The Child Development Center provides year-round, full-day care for 41 children ages 15 months to 5 years. Through daily programming designed to nurture development, enhance competencies, and facilitate positive social interactions between the generations, Neighbors Growing Together provides high quality services to children, older adults, and their families. Children from each of three classrooms have one to two weekly opportunities to join their elderly â€Å"neighb ors† for IGP, which typically involves three children and three older adults in a variety of activities, such as gardening, art, or sensory projects. Children and adults work together in a group facilitated by staff and students from the Child Development Center and Adult Day Services. Staff partners plan and implement activities that support an overarching goal of positive interactions. Activities further target developmental goals for both generations, such as fine motor skills or cooperation. Children and adults meet in a shared space adjoining the two programs. Child- and adult-sized chairs designed to put all participants at eye level and developmentally appropriate books and art materials are provided. Procedures Phase 1: Scale development In fall 2005, four research students gathered qualitative observations of IGP involving Adult Day Services participants and Child Development Center children. Observers attended different intergenerational sessions. Each week, observers had a distinct focus, starting with holistic observation to orient the observers to the setting and proceeding to target the environment, the participants, and the facilitators. Following their weekly observations, the observers and the first and second authors discussed the observational data, focusing on the interactions between participating children and elders and factors that influenced those interactions. After observing 3-5 intergenerational sessions apiece, observers read and reviewed the IOS scale and codebook developed by Gladwell and Jarrott (2003) and closely mirroring the Play Observation Scale developed by Rubin (2001). They discussed how well the categories applied to the intergenerational context they observed and how to modify the sca le to reflect the social behaviors critical to intergenerational interactions in planned activities. Through an iterative process, the first two authors used observers notes and conversations to modify the Play Observation Scale to capture data reflecting the interactive process of IGP. Based on the observations from Phase 1, we further developed and refined the IOS (see Table 1). The scale builds on earlier observational research (Rubin, 2001) by coding participants behavior and affect and the affect of intergenerational partners with whom a target participant interacts.   The IOS was developed for live coding. It captures observations for the duration of an intergenerational activity, which tends to last 15-30 minutes. Each observer identifies 4-5 participants for observation and watches them for 1-2 minutes to become familiar with the participants behaviors before beginning to record data. He or she codes a participant for one 15-second interval, then codes the next participant for 15 seconds, followed by the third participant, etc. After the last participant is coded, the observer cycles back to begin observing participant one again. All observers in a session start coding when the facilitators begin the activity and end when the activity completes. When coding, if a behavior occurs for the majority of the coding interval, it is coded as the predominant behavior. When multiple behaviors are observed for equal intervals during a 15-second coding episode, we use the following hierarchy to code the predominant behavior most indicative of intergenerational interactions: Interactive Intergenerational, Parallel Intergenerational, Interactive Peer, Parallel Peer, Staff, Watching, Solitary, and Unoccupied. Phase 2: Establishment of reliability Video coding of the observations was introduced during Phase 2 of scale development because learning the IOS through the use of video has several advantages. When first learning the scale, observers watched a 15-second interval repeatedly to better understand the IOS behavioral scoring. The video coding procedure allowed observers to review their coding with the second author, who is experienced in observational coding. Weekly meetings were held during which observers coding was reviewed and discussed until observers reached a consensus on what behaviors constituted the IOS categories. Weekly review helped observers achieve acceptable reliability in assigning predominant codes to participants social behaviors. The video procedure enabled us to refine the IOS manual. The video coding process began with two observers who both had experience with live coding during IGP. After studying the manual, observers filmed three weekly sessions of planned IGP between the elders and each of the three classrooms of children (one session per classroom per week). The procedure for using video to establish acceptable reliability was completed in three steps. First, observers independently coded sessions in 15-second intervals and re-watched these as many times as necessary to determine the predominant social behavior. In the second step, observers more closely approximated live coding by watching the 15-second intervals on video only once to code the predominant social behavior.   In the third step, observers coded live sessions (scoring participant behaviors individually but observing the same participants at the same intervals) and filmed the activities, which allowed observers to review their coding at the weekly meetings and resolve discrepancies. Based on the consensus between the two coders and the expert coder, master coding sheets were developed indicating agreement on the predominant behavior for each 15-second interval of the coded sessions. Before observers could proceed to the next step in the training process, they had to achieve acceptable inter-rater reliability measured by Cohens kappa. A kappa score of .60 or higher was considered acceptable (Cohen, 1960). The kappa scores for the two observers in Phase 2 were .67 for the first step, .85 for the second step, and .81 for the live coding in the third step. Replication of reliability In Phase 3, we used the IOS video coding procedure to train four new observers. In addition to establishing that the video coding procedure would work with observers new to the IOS, we wanted to determine the amount of training necessary to achieve acceptable reliability with our 3-step process. The observers started with an introductory period where they read the manual and watched live IGP to observe the range of behaviors common to IGP. Observers attended weekly meetings where they watched IGP videos and received instruction on using the IOS. The introductory period lasted approximately 3 weeks or until observers felt comfortable with the coding, which was an additional 2 weeks for one of the observers. After the introductory period, the observers started on step 1 in the video coding procedure. Each step lasted approximately 4 weeks. At the weekly coding meetings, observers reviewed any discrepancies between their coding and the master codes determined in Phase 2. Once the observers achieved acceptable reliability in step 1, they moved on to step 2. Coding pairs were formed, and they coded live IGP during step 3, achieving acceptable kappas of .92, .69, and .75. Discussion In the current paper, we discuss the development of the IOS, a scale designed to measure young and old participants social interaction and affect during IGP.   In developing the IOS, we began with qualitative observations of IGP to refine a well-established child development observational scale (Rubin, 2001). We modified the scale for observations of elder and child participants in a typical range of intergenerational programs.   Based on two groups of observers, we present a system for training individuals to use the scale and establish inter-rater reliability.   Currently, the use of standardized measure within the field of IGP research is extremely limited, and our goal is to develop a scale to address this need. The IOS addresses several of Kuehnes (2003) recommendations for advancing   intergenerational research and evaluation.   First, the IOS is grounded in theory that shaped our view of positive IGP outcomes. Personhood theory (Kitwood Bredin, 1992) leads us to intergenerational relationships as a once common source of positive social interaction for many elders that can continue to support their well-being in late life. Contact theory (Allport, 1954; Pettigrew Tropp, 2000) elucidates necessary conditions for positive intergroup exchange, such as that between youth and elders. The conditions of cooperation and shared goals inform our expectation that the central mechanism of effective IGP is positive intergenerational interactions. The IOS captures the level of interactive behaviors between generations, thus reflecting the presence or absence of cooperation and shared goals of participants. Second, we draw from standardized measures of social interaction, namely the work of Parten (1933) and Rubin (2001).   Working from their concepts, we qualitatively looked at the behaviors seen during IGP.   We then refined the social behaviors described within Rubins scale to fit an intergenerational population and to capture levels of social engagement or interaction during IGP.   Third, we steer away from the over-reliance on attitudinal measures, moving instead to behavioral and affective outcomes of IGP. Fourth, by taking steps to develop a standardized scale, we contribute to the research tools available to IGP researchers, which increases the capacity to compare outcomes across studies, thus advancing the collective understanding of IGP. Our results establish the IOS as a replicable measure of social interactions during IGP.   The three-step process we used to achieve acceptable inter-rater reliability proved effective with two groups of observers. The process allows observers to develop a thorough understanding of the social behaviors in the IOS. Observers coding is checked against the master coding scheme to insure observers accuracy coding observed behaviors.   The master coding scheme allows for faster, more accurate training on the use of the IOS. Now that we have developed a successful process for training observers to use the IOS and achieve acceptable inter-rater, observers could be trained relatively quickly, most likely within four to eight weeks. A reliable, quick training method will allow data collection to begin at an earlier date and will allow more researchers to use the scale with confidence. An important strength of the IOS is its utility with both generations of IGP participants. Most research on individual outcomes of IGP participation focuses on one generation or the other (e.g., Middlecamp Gross 2002), neglecting the experiences of the other generation. When researchers do evaluate both age groups, they typically use non-parallel measures because parallel scales for disparate age groups rarely exist.   Not only will the IOS allow for standardized data collection across sites; it enables standardized data collection across generations. We expect the IOS to yield valuable process and outcome data for practitioners and researchers. Considering first the IOS as a source of outcome data, a program introducing or modifying an IGP could, for example, use IOS data to determine the affect and social behavior of participants during IGP with a goal of achieving high levels of positive affect, increasing intergenerational interaction, and reducing inactivity. In regards to process data, the IOS can be used in conjunction with salient outcome measures (e.g., depression or attitudes towards aging) to help interpret the effects of IGP (another recommendation by Kuehne, 2003). In asserting that IGP positively affects (or does not affect) targeted outcomes, researchers analyses would be strengthened by including data on the level of intergenerational interaction and affect that transpired among participants. For example, Seefeldt (1987) reported that children who participated in regular intergenerational visits to a nursing home h ad worse attitudes about aging than children who did not.   These findings would have been more easily interpreted if they incorporated process data such as the affect and level of interaction between children and elders.   Because these data were not included in the analyses, readers are left to speculate whether all IGP involving nursing home residents would negatively affect childrens attitudes or if the nature of the IGP in that study contributed to the negative outcomes. Seefeldt described IGP that yielded little support for intergenerational interaction (i.e., children performing in the center of the room, surrounded by the elders). She also indicated that elders were largely non-responsive to the children, suggesting that the negative outcomes may have been due to the nature of the IGP. While IGP professionals advocate standards of IGP practice (Epstein Boisvert, 2006; Rosebrook Larkin, 2003), significant variability on dimensions of IGP likely affects targeted outcomes and should be assessed. By capturing data that reflect the process of connecting generations, the IOS promotes understanding of why IGP succeeds or fails. As outlined above, the IOS provides many benefits for IGP research and evaluation. Our next step in establishing the scales value and utility to the intergenerational field entails establishing the reliability for coding occurrence of behaviors and predominance and occurrence of affect. Second, we plan to use a variety of means to establish validity, including video training to address substantive validity, expert panels to assess content validity, and statistical modeling of IOS data and related measures to determine convergent or divergent validity. Third, the scale was developed within the Neighbors Growing Together shared site intergenerational program, which involves structured programming between preschoolers and frail older adults. Generalizability is a critical indicator of validity and depends on the scales utility across intergenerational sites, populations, and programmatic approaches. Fourth, the behavior category codes are developmentally salient for pre-school age child ren and frail elders; we need to determine if the categories will be equally informative when applied to older children and well elders. Finally, the scale should be tested across cultures to support Kuehnes (2003) recommendation to take a more global view of IGP innovation. Initial indicators reveal that the IOS could become a useful tool to researchers and practitioners alike. As they seek to develop, improve, and sustain IGP while linking programming data to instrumental outcomes of interest to practitioners and funders, the availability of a standardized scale appropriate for use with young and old will prove invaluable. At a time characterized by tremendous creative energy and innovation in the intergenerational field, the IOS can capture the essence of IGP as practitioners support meaningful outcomes through intergenerational relationships. References Allen-Burge, R., Burgio, L. D., Bourgeois, M. S., Sims, R., Nunnikhoven, J. (2001). Increasing communication among nursing home residents.   Journal of Clinical Geropsychology, 7, 213-230. Allport, G. W. (1954). The nature of prejudice. Reading, MA: Addison-Wesley Camp, C. J., Judge, K. S., Bye, C. A., Fox, K. M., Bowden, J., Bell, M., et al.. (1997). An intergenerational program for persons with dementia using Montessori methods. The Gerontologist, 37, 688-692. Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20, 37-46. Eggebeen, D. J., Davey, A. (1998). Do safety nets work? The role of anticipated help in times of need. Journal of Marriage and the Family, 60, 939-950.   Eheart, B. K., Hopping, D. (2001). Generations of hope. Children and Youth Services Review, 23, 675-682 Epstein, A. S., Boisvert, C. (2006). Lets do something together: Identifying effective components of intergenerational programs. Journal of Intergenerational Relationships, 4(3), 87-109. Gigliotti, C. M., Morris, M., Smock, S., Jarrott, S. E., Graham, B. (2005). Supporting community through an intergenerational summer program involving persons with dementia and pre-school children. Educational Gerontology, 31, 425-441. Gladwell, M. S., Jarrott, S. E. (2003, November). An observational assessment of elders with dementia during intergenerational activities. Poster presented at the meetings of the Gerontological Society of America, San Diego, CA. Goyer, A., Zuses, R. (1998). Intergenerational Shared Site Project, A Study of Co-located Programs and Services for Children, Youth, and Older Adults: Final Report. Washington, DC: AARP. Ice, G. H. (2002). Daily life in a nursing home: Has it changed in 25 years?   Journal of Aging Studies, 16, 345-359. Jantz, R. K., Seefeldt, C., Galper, A., Serlock, K. (1977). Childrens attitudes toward the elderly. Social Education, 41, 518-523. Jarrott, S. E. (2006). Tried and true: A guide to successful intergenerational activities at shared site programs. Washington, DC: Generations United. [Electronic version available at www.gu.org] Jarrott, S. E., Bruno, K. A. (2003). Intergenerational Activities Involving Persons with Dementia: An Observational Assessment. American Journal of Alzheimers and Related Diseases, 18, 31-38. Jarrott, S. E., Bruno, K. (2007). Shared site intergenerational programs: A case study. Journal of Applied Gerontology, 26, 239-257. Jarrott, S. E. Gigliotti, C. M., Smock, S. A.,   (2006). Where do we stand? Testing the foundation of a shared site intergenerational program. Journal of Intergenerational Relationships, 4. Jarrott, S. E., Gladwell, M. S., Gigliotti, C. M., Papero, A. L. (2004). Fostering intergenerational community between child adult care programs: A Results Management approach. Canadian Children, 29(2), 4-13.

Essay on the Departure from the Romantic Novel in Pride and Prejudice

A Departure from the Romantic Novel in Pride and Prejudice      Ã‚  Ã‚   In Pride and Prejudice, Austen describes the union of 4 couples -- namely, Elizabeth and Darcy, Jane and Bingley, Lydia and Wickham, and Charlotte and Collins. For the Elizabeth-Darcy relationship, it is clearly an inversion of romantic expectations, and Austen makes it clear that this steadfast, rational relationship is desirable, yet the Charlotte-Collins relationship, [very rational] while also being unconventional, suffers some criticism. Jane and Bingley, though playing very much to expectations of a romantic-story, are dealt with gently and not unkindly by Austen. The same sort of tempestuous emotional impulsiveness of Lydia and Wickham, so typical of romantic novels at that time, is clearly criticized.    Many critics in the nineteenth century approved of Austen's work, as she was vastly different from other novelists, injecting little of the "screams along the corridor" variety of novels that is suitable only for "maids and chamberwomen". This is characterised largely by the story of Elizabeth and Darcy, which is an inversion of romantic book expectations. Unlike the instantaneous, fiery passion that Heathcliff in Wuthering Heights had for Catherine, [not true, but I see what you mean] for this couple, it was more akin to extreme dislike-at-first-sight. Haughty, reserved Darcy, revealing none of the gushing, wondrous, she-is-the-most-beautiful-creature-in-the-world type of sentiment, caustically notes that she is "tolerable ... but not handsome enough to tempt me." Elizabeth, rightly incensed, takes a "decided dislike" for him throughout much of the first 2 volumes of the novel. This inauspicious beginning, in no way signifies to readers the fir... ...ald Gray.   New York: W.W. Norton & Company, 1996. Hennelly, Jr., Mark M. "Pride and Prejudice." Jane Austen: New Perspectives. ed. Janet Todd. New York: Holmes & Meier Publishers, Inc., 1983. Jane Austen Info Page. Henry Churchyard. U of Texas, Austin. 23 Nov. 2000.   Ã‚  Ã‚  Ã‚   <http://www.pemberly.com/janeinfo/janeinfo/html>. Monaghan, David.   Jane Austen Structure and Social Vision.   New York: Barnes & Noble Books, 1980. Poplawski, Paul.   A Jane Austen Encyclopedia.   Westport, Connecticut: Greenwood Press, 1998. Reidhead, Julia, ed. Norton Anthology of English Literature vol. 7, 2nd ed. New York: W.W. Norton & Company, 2000. Ward, David Allen. "Pride and Prejudice." Explicator. 51.1: (1992). Wright, Andrew H. "Feeling and Complexity in Pride and Prejudice." Ed. Donald Gray. New York: W.W. Norton & Company, 1966. 410-420.      

The summary of The Fall of the House of Usher :: essays research papers

The Narrator had received a letter from a boyhood acquaintance, Roderick Usher, begging that he come to him "posthaste." Usher had written to explain that he was suffering from a terrible mental and bodily illness, and longed for the companionship of "his only personal friend." The plea seemed so heartfelt that the Narrator immediately set out for the Usher ancestral home. Approaching the ivy-covered, decaying old house, the Narrator was struck b y an overwhelming sense of gloom which seemed to envelop the estate. The very sight of the manor caused within him "an illness, a sickening of the heart, an unredeemed dreariness." But even though the"eye-like" windows of the mansion seemed to be staring at him, he managed to swallow his fear and continue in his carriage up the path to the door. As he rode, he tried to recall Roderick Usher as he had once known him; years had passed since they had last met. He remembered his old friend as an extremely reserved fellow, quite handsome but possessing an eerie, morbid demeanor. Roderick's family was noted for its particular musical genius - and for the fact that no new branch of the family had ever been generated. For centuries, the title of the estate had passed directly from father to son, so that the term "House of Usher" had come to refer both to the family and to the mansion. Sad ly, though, Roderick was the last surviving male issue of the Usher clan. Finally, the carriage crossed over the creaking moat bridge to the door, and a servant admitted the Narrator. He was led through intricate passageways and past hung armored trophies to Roderick Usher's inner chamber, a sorrowful room where sunlight had never entered. Usher himself looked equally shut in, almost terrifying: pallid skin like that of a corpse, lustrous eyes, and long hair that seemed to float about his head. Moreover, he was plagued by a kind of sullen, intense, nervous agitation, similar to that of a drug-addict experiencing withdrawal. The list of his complaints was dismaying: He suffered much from a morbid acuteness of the senses; the most insipid food was alone endurable; he could wear only garments of a certain texture; the odors of all flowers were oppressive; his eyes were tortured even by faint light; and there were but peculiar sounds, and these from stringed instruments, which did not inspire him with horror.

The True Meaning Of A Religion Essay -- Religion

The True Meaning of a Religion Religion can be found almost everywhere around us, influencing ones lifestyle and surroundings much more than we are aware of. Often becoming a huge element of society in several areas of our lives. Though some argue one is born already knowing their religious faith, classifying religion as something that cannot be learned but more as an inner spirituality present at birth. Other would say there is no doubt religion is socially constructed and subconsciously learned plus spread through peers, family or close ones, strongly impacting societies and cultures. Some sort of hidden objective or purpose whether is it political, spiritual or other, motivates the creation of a religion through a "designated" individual, claimed to be here to spread the word, send a message to members of society and make changes or corrections in the name of faith. Often, we witness activists or political figures use religion to emphasize and point out the spiritual aspect behind their messages or motivation s to attract followers. Every so often new faiths emerge, giving people hope and spiritual strength to fight for their happiness in times of despair and oppression, the Rastafarian Religion being a perfect reflection of that. An unusual and still barely recognized religion surfacing in hope for a better life, giving them the power to rebel against their oppressors and enforcing a stronger sense of community and understanding between each others. Centuries ago Africans were kidnapped from their native home and enslaved by Europeans. Many were taken from Ethiopia and brought to the Western world. In the process the Europeans introduced them to the Bible in effort to "civilize" them. Slaves were not allowed to read, b... ...en found behind the new creation and development of a new religion or way of life. Most Often the case of a social problem, leading to furthermore say that religion is socially constructed for a reason or another. Whether is because of political and economic oppression or simply going back to ones roots and being able to emphasize and bring out ones race and heritages by using the principles of a religion. WORK CITED PAGE Dubb, Adjua. "Rastafari-way of life." JamWork.org. 2000-2005 http://www.jahworks.org/music/features/rastafari.html, April 22, 2006. Napti P. "Jamaicans of Ethiopian Origin and Rastafarian Faith." Caribbean Lifestyles Magazine. Peter Simeon. feb/march 1995. http://web.syr.edu/~affellem/napti.html April 22, 2006. Rastafari Movement. April 22, 2006. Wikimedia Foundation, Inc http://en.wikipedia.org/wiki/Rastafari. April 22, 2006.

A View From the Bridge

‘A View From The Bridge’ is a play that was first staged in 1955. It was written by Arthur Miller. Arthur Miller was born into a Jewish family in New York in 1915, whose grandparents had come to America from Poland. When the family business failed, they moved to Brooklyn, where A View from the Bridge is set. There, Miller worked in a warehouse to earn money for his university fees. He began to write plays when he was in university and continued to write them after he graduated and became a journalist. In the play, loyalty dictates the events very strongly as because of Eddies mixed emotions for Catharine he chooses to be more loyal to her than to all of his family. Miller shows the importance of loyalty through Eddie telling Catharine the ‘Vinnie Bolzano’ story. Catharine’s reaction shows the audience that in Italy, family loyalty is the most important thing as Catharine is both shocked and horrified that Vinnie snitched on his own Uncle this is why she shockingly says ‘The kid snitched? . Miller uses this as an opportunity to tell the audience that the Italian American community is very loyal, which makes Eddie’s betrayal even more shocking. Because Vinnie snitched on his Uncle he could never show his face in public because every one despised and loathed him this is why Beatrice says ‘I never seen him again’. This also shows that the Italian American Community has a very ‘if you snitch on one of us, you snitch on all of us’ mentality. Another way that Arthur Miller portrays the importance of loyalty in the play is the references Eddie uses to Catharine’s Mother. this quote shows that Eddie tries to use the promise he made to Catharine’s Mother as an excuse for being so strict and this is why he says ‘I promised your Mother on her death bed’. This is why he doesn’t want her working in the dodgy part of town; where as it is because of the emotions he feels toward Catharine and he doesn’t want her to have another male figure in her life who could be more important than he is. One of the most important scenes in the play is the ‘Phone Call’ scene which shows Eddie changing his loyalties from his family and friends, to just Catharine. ‘Give me the number for the immigration bureau’ this shows Eddie doing what Vinnie Bolzano didand snitching on Marco and Rodolpho, he does this because of the mixed and confusing emotions he feels for Catharine. Miller also uses stage irections in the scene such as ‘A phone booth begins to glow on the opposite side of the stage; a faint, lonely blue’ I think that Miller uses the Lighting on the phone booth to show the audience the conflict going on in Eddie’s head; to loose every thing (his family and friends friendship, love, trust and loyalty) but keep Catharine for himself When the immigration officers arrive at the house, Eddie looses the respect and loyalty from his family. Beatrice realizes what Eddie has done when she says‘My God, what did you do? ’. She is completely shocked and horrified as Eddie was a loyal and family orientated man. Miller uses this quote to show the audience that Beatrice is astounded and aghast that Eddie has chosen Catherine over her, even though she is his wife. Marco is furious with the fact that Eddie has just ruined any chance of him getting an American citizenship, this now means that Marco wouldn’t be able to get a well paid job and support his family back in Italy. This is why he says ‘That one! He killed my children! That one stole the food from my children’ this is because although Eddie hasn’t directly murdered Marco’s family, his actions will lead to Marco getting deported and he wouldn’t be able to give his family money to buy food and they would consequently die. The audience would be shocked by what he is saying as he is insulting Eddie who Miller has made out to be the confused character who although he is doing something terrible he thinks that he is doing it for the right reasons, and the audience would therefore feel sorry for him. Miller uses the loyalty theme to show the weakness of men, Eddie betrays his family and community because of the mixed emotions he feels for Catharine

The Purpose Of Barium Swallow Health And Social Care Essay

The most common positive or radiopaque, contrast medium used to visualise the GI system in Ba sulfate which normally merely referred as Ba merely. There is contraindication to barium sulfate. These mixtures are contraindicated and might hold possible opportunity to get away into the peritoneal pit. If big sum of Ba sulphate flight into the peritoneal pit, this can take to enteric infarcts or peritoneal inflammation. This flight may happen through a pierced syrupy or during surgery that follow the radiographic process. Pathologic indicant for Ba sups This process is done to bespeak when the patient have anemia, mechanical hurting on swallowing, reflux, Preoperative anatomical presentation, appraisal of trachea-esophageal fistulous withers and besides the appraisal of the side of perforation and besides indigestion. The diseased indicant for the Ba swallow scrutiny is achalasia, anatomic anomalousnesss, barrette ‘s gorge, carcinoma gorge, dyspigia and esophageal varices. Achalasia is a motor upset of the gorge in which vermiculation is reduced along the gorge. Next is anatomic anomalousnesss which caused by disease, such as malignant neoplastic disease of the gorge or possibly. Patients who suffer a shot frequently develop impaired get downing mechanism. Certain nutrients and contrast agents are administrated during the scrutiny for rating of the swelling forms. Dysphagia is trouble in get downing this may due to a congenital or acquired status, a at bay bolus of nutrient or redness. Narrowing and enlarged, flaccid visual aspect of the gorge may be seen during the Ba sup, depending on the cause of the dysphagia. The other indicant for Ba sup is, to bespeak carcinoma of the gorge includes one of the most common malignant of the gorge is ardeno carcinoma. The one of the symptoms of this pathology include dysphagia ( trouble in get downing ) . Last, foreign organic structure are besides can be detect by utilizing this process to the patient that ingest assortment of nutrient including a bolus of nutrient, metallic object and other stuff that will lodge the gorge. Contraindications Nonspecific, nevertheless low solar H2O soluble contrast agents are best used in probes where aspiration may happen. Preparation Patient readying.Before Patient readyingNo readying for Ba swallow scrutiny needed because gorge is empty most of the clip unless an upper GI series is to follow. If the patient is have oning anything metallic from the most to the waist must be removed. Ask the patient to alter to hospital gown. Before the fluoroscopic process is perform, a patients history should be taken and the scrutiny carefully explained to the patient.After readyingWhen the process is done, the patient can go on their regular diet as usual. Take orally administered medicines unless the physician asks non to make so. In 48 to 72 hours after the process, patient stool possibly in grey or white coloring material. Patient may see irregularity and normally been treated by eating laxative. Ask the patient to imbibe a batch of H2O for several yearss to avoid irregularity excessively. If the patient experienced any unable intestine motion or undergo important alterations after the process, inquire them to reach their d octor. Equipment readying Before making this process, the radiographer should fix some equipment such as fluoroscopy table with 90/20 jousts, rapid consecutive skiagraphy ( to border per second ) or video entering possibly required for appraisal if the laryngopharynx and upper gorge during swallow. Some extra equipment besides should necessitate such as disposable cup, little cup for sparkling agent, tissue and besides a straw possibly required for consumption of Ba when the tabular array is horizontal and besides injection disposal equipment. Contrast agent readying In this process, 250 % w/v Ba sulfate suspensions of 100 milliliters are required. Gastrografin ( should non be used for the probe of a trachea-esophageal fistulous withers or when aspiration is possible ) . An sparkling agent will be required for illustration a combination of Na hydrogen carbonate and citric acid, to bring forth C dioxide to dilate the tummy. This will besides move as dual contrast agent against the Ba to heighten the visual image of the mucous membrane. Last, LOCM for about around 350mg I/ml is besides required in this process. Procedure The patient will be place behind the roentgenoscope equipment for the x beam exposure. The process begins with the patient in the vertical or vertical place and the cup of thin Ba is placed in the patients left manus closed to the left shoulder. Then, the patient is asked to get down the liquid in the cup utilizing a straw. The patient is so inquiring to take the effervescent granules ( either dry or assorted with a little sum of H2O if dry granule is excessively hard ) or other effervescent assistance, followed by citric acid. It is of import to affect on the patient that this will bring forth gas in the tummy and may give them the make fulling that they need to burp. To avoid this, the best manner is to state them to maintain swallowing. The enteric piece of land of the next gorge, tummy and duodenum are seeable when the Ba fills and coated it. The radiotherapist observes the flow of the Ba with the roentgenoscope. Swallowing of the thin Ba is observed with the patients in assorted places. The patient will inquire to revolve true 360o at their ain topographic point. This will guarantee all the surfacing facet of the stomachic mucous membrane is ready for the appraisal of the tummy. The patient is inquiring to turn to their left ( LPO ) where a topographic point image is taken. Then, patient will turn their organic structure back to the supine ( AP ) place and bend to their right ( RPO ) . Last, the patient is return to the vertical place, turn somewhat to their left and erect ( LPO ) . Film is taken to demo the distal gorge and the fundus of the tummy. The similar place will be used when the patient get down the thick Ba. The used of the thick Ba allows better visual image of mucosal forms and any lesions within the gorge. The type of Ba used is determined by the radiotherapist. After the vertical survey has been complete, horizontal and trendeleburg places with midst and thin Ba may follow. The x beam radiation is directing by the ten beam machine ( fluoroscopy ) through the patient ‘s tissue organic structure and to a movie on the opposite side of the patient ‘s organic structure. Different organic structure tissue will absorbed different sum of radiation that penetrates the organic structure tissue. The abnormalcies, different organ, and some conditions all become seeable on the x beam movie due to difference in the composing since the incursion of the x beam beam is block by them. Radiation Protection Radiation protection is used to except clinically unhelpful scrutinies. They are many ways to cut down unserviceable radiation like minimise the fluoroscopy clip and current so that merely the exact radiation is given to the patient. Use collimation during the process to minimise the field size. Give screening to the sensitive organ of the patient when possible. Introduce QA coder to optimise staff and equipment public presentation and to do regular cheques on. Use video recording equipment alternatively of utilizing cine camera during fluoroscopy. Install modern image intensives with digital image processing possible and sensitive ( e.g. CsI ) photocathodes. Use modern image intensive and topographic point movie photofluoroscopy with 100mm camera alternatively of skiagraphy whenever appropriate. Benefit Upper GI piece of land scrutiny is really safe and noninvasive process. This scrutiny besides leads to an accurate analysis of the gorge, tummy and duodenum. This is because, Ba is non absorbed by the blood the organic structure and allergic reaction due this scrutiny is really rare. No radiation will stay in patient ‘s organic structure after the process is done n X beam has really less side consequence in the diagnostic scope. Hazards Some patient may see allergic to the flavorer that is added in the Ba. The patient must state the physician if they are allergic to chocolate, citrus fruit or certain berries before the process. There is merely little opportunity that some Ba will stay in the organic structure, taking to a obstruction of the digestive system. So, patient who have an obstructor in the GI piece of land they are non allow undergoing this scrutiny. The effectual radiation dosage for this process is 6mSv which is the same as the mean individual receives from the background radiation in two old ages. Precaution Barium is non be used if perforation is suspected. Pregnant adult females are advised to avoid this process because the radiation exposure may impact the foetus. Role of radiographer Before Arrange the assignment and state the patient about the clip, the day of the month and the topographic point where the scrutiny will be held. As the radiographer, gave the radiation protection to the patient is really of import. Give the patient a shielding to protect them from the radiation that can harm them. The room must be set up decently before the scrutiny took topographic point. Make certain the room is clean and ready to be used. All the equipment ‘s like cassette 24Ãâ€"30 centimeter, little cup and straw and contrast media ( Ba sulfate/gastrografi ) must be prepared before the scrutiny started. Make certain that fluoroscopy unit is in good status. State the patient what they should make and do certain they are all prepared. When the radiographer fix the list for the scrutiny, do certain that the diabetic patient is on the first list. This is because, they have to take their medicine on clip and if the diabetic patient are being ignored, this will do injury to them. During Patient placement Focus oning Collimation Radiologists penchant Adequate supply of cassettes Identity of exposed and unexposed cassettes Exposure factor choice Table position- patient comfort and safety Hand clasps, pes remainder, pillow, reassuarance Drip if any Drumhead