Spa and Wellness Trends in Tourism

Spa and Wellness Trends in Tourism The Impact of the Spa and Wellness Trends into the Tourism Industry Introduction 1.1 Introduction 1.1.1 Growth of Spa and Wellness Spa and Wellness had become the main territory of wealthy women wanting to lose weight and look good by the mid-20th century. Its main focus was on prevention, healthy lifestyles, fitness, spirituality and relaxation. Numbers of people use spas more and more frequently to fulfill some of their most important lifestyle pursuits. Nowadays spa experience covers not only medical and spiritual programs, but also outdoor adventures and exotic travel. These spas are located in every global region, including Africa, the Middle East, and the former Eastern Bloc. The spa has turned into a popular culture, influencing everything from fashion and cosmetics, to architecture, home dà ©cor, and also cuisine. Propelled by the growing wellness trend worldwide, the spa industry is booming. European travelers number one consideration when making plans for their holidays is whether there is spa access. The growth of spa facilities and increased awareness worldwide has led to spa-inspired beauty products, as well as the opening and blossoming of groundbreaking spas and resort all over the world. 1.1.2 History of Spa and Wellness Spa- going has been practiced for many thousands of years dating back from the Mesopotamians, Egyptians and Minoans, to the Greeks and Romans and later, the Ottomans, Japanese and Western Europeans. Some say the word spa actually derives from the Latin verb spagere to pour forth. Other say the origin of the word spa comes from the Belgian town of Spa, known since Roman times for its baths. Other even claim that spa may be an acronym for the Latin phrase sanitas per aquas, which means health through water. 1.1.3 Definition of Spa The word Spa and the idea behind it derive from the time of the Roman Empire when a big number of soldiers tried to find a solution to heal their wounds. They looked for hot wells and used it as a kind of bathtub to be able to treat their aching and pain on their bodies, these places were named aquae and the bathing treatment Sanus Per Aquam (SPA), which means, health by or through water. After this incident SPA became famous throughout Europe starting in Belgium where it all started, from mineral water, to sea water and marine substances. Even until today, the ideas of these healing forms are the basis of the spa culture worldwide and hydrotherapy is seen as its major highlight. Well-being, as well as allowing you to relax, reflect, revitalise, and rejoice is the main importance in Spa. Mens sana in Corpore sanoA healthy Spirit lives in a Healthy Body 1.1.4 The West In 500 BC, the Greeks indulged in a variety of social baths, which included hot air baths. In 25 BC, the Roman Emperor designed and created the first, so called, thermae, which is a large-scale spa. Each subsequent emperor then built something new to this thermae, which made the people grow fonder of these baths. They progressively grew into large entertainment complexes offering not only sports, but also restaurants, and other various types of baths. After such baths, the next visit was to three increasingly warmer quarters, where the body was soaked, rubbed in with oils, massaged and finally exfoliated. The practice would end with a cold plunge in ice water. Besides the Roman combination of hot and cold baths, spa traditions kept growing spreading itself all over the world. For example in Japan, its first onsen (hot spring), and later the first ryoken (inns) which were built, offered exceptional food, accommodations, Zen gardens, outdoor baths as well as indoor soaking tubs.(http://www.topspahotels.com) In Finland saunas began appearing in 1000 A.D., inducting a rich Finnish spa-going tradition, which includes a treatment of sweating, as well as icy lake plunges, and to top it off plenty of beer or vodka. Nowadays these procedures still exists. And also the Ottomans were famous for their arched and beautifully mosaic hammam, the ultimate example is the Baths of Roxelana, which was built in 1556 and were equipped with the massive towering steam rooms, even containing private washing quarters, and extensive massage platforms. Roxelana became an important social center, mainly for Muslim women (http://www.topspahotels.com) After these times, Spas became famous all around, starting in Europe, namely Belgium, Germany, and England. It even stretched to the United States of America, because in 1986 New York opened the first travel agency specializing in spa vacations. Since that time, the spa industry has grown from a baby egg business into a booming billion dollar global industry. In the 19th century, Europes great spas were destinations for wealthy people, who went there to relax and rejuvenate. Until today, water treatments are still considered the heart of the spa experience in Europe. 1.2 Backgrounds This research attempts to examine strengths, threats, risks as well as opportunities and challenges Spa and Wellness Industries have to face, concerning on-going trends of the West and how they are influenced by Asian countries, as well as the changes of values and attitudes of tourists. Many people think or believe that Spa derives from Asia, due to all the marketing advertisements promotions and so on, but what they fail to realize is that, spa has also been in the west for a long period of time dating back centuries ago. Some tourists go to spa and wellness facilities to pamper themselves, relax and ease there minds as well as to get away from the hustle and bustle of their daily life style, but what they do not take into consideration, is that spas can cause more damage to their health, if they have specific pains or injuries which could worsen their condition. 1.3 Research Objectives The study can be used to have a better understanding of the Spa and Wellness Industry and the needs of consumers. It also provides strategies on how to improve Spa facilities. The specific objectives of this study are: to understand the spa and wellness market and the key factors to identify various treatments, including their benefits and risks to investigate requirements and necessities of spa- goers to recognize top spa trends that are booming to develop opportunities on how Spa facilities can progress in the future 1.4 Research Problems and Questions This research is trying to clearly respond to several questions that might be raised from this topic: 1. What are the benefits and risks of massage therapies and what could be done to minimize the risks at spa centers? 2. How did the value and attitude of tourists change, also concerning their age? 3. How was the West influenced by Asian countries, concerning the Spa and wellness industry? 4. What are top spa trends and what could be their opportunities and challenges? 5. What effect does the Spa and wellness industry have on men, since the majority of spa- goers are women? 1.5 Importance of Significance of the study Hotel industries as well as spa and wellness facilities could benefit from this study, because it points out facts like for example risks that have to be looked in further when running a spa making sure water supply is in order etc. This study also states the mentalities tourists have when it comes to their values and attitudes concerning spas and furthermore how men nowadays are more interested in going to spa facilities. This could benefit these industries to change, promote or add extra facilities for men or even open spas for men only. The importance of this study is to make sure hotels and spa facilities are aware of all these changes, challenges as well as risks and how they can benefit from the stated facts and solutions for improvement. 1.6 Scope and Delimitation of the study A major weakness of this research, which was beyond the control of the researcher, was that there was a big time constrain. There were also not that many plausible literatures available. Furthermore there are various websites and opinions of the correct definition of spa and wellness, and lack of statistics. 1.7 Conceptual Framework and Theoretical Framework This research is written in a way to explain different objectives in harmonic and well associated sentences to carry out the researchers intentions clearly. It explains how all the above listed points in Figure 1 relate to the Spa and wellness Industry. It describes the popular treatments with their risks and benefits and also states the factors that are important to a human body to feel at ease and be in a relaxed state of mind. Furthermore, the Alpine Wellness is explained and how Spas in the West are influenced by other Asian countries not only concerning their therapies but more in terms of colours, lighting, dà ©cor and ambiance. Moreover the perception of consumers concerning their values and attitudes are listed and how men are more and more becoming a part of the Spa and wellness industry. Lastly, trends of this industry are explained which also goes hand in hand with opportunities and challenges they might face in the future. II Review of Related Literature: 2.1 Alpine Wellness Before, wellness was only associated with well-being and relaxation. However, now wellness is also connected with health. That is why the Alpine region is especially suited for this type of wellness, because Alpine remedies, like fresh air, pure and healthy spring water, the mild, invigorating climate, mountain freshness, herbs, stone oil combined with traditional knowledge and a balanced life has meant Alpine wellness has become a new trend, also with its interior furnishing, alpine cuisine and different atmosphere. That is why today Alpine Wellness is a special form of wellness offering hay baths to herbal saunas, natural applications and products, surrounded by South Tyrols, Austria, fascinating mountain landscape. Alpine Wellness refers to nature, culture and life quality in the area. It displays an original charm of the alpine environment, which makes the special sensuality of the Alps a unique and exclusive experience.Therefore the Alps are promoted worldwide as one of the most attractive and effective regions for wellness. (http://www.alpinewellness.com) 2.2 Facial Treatments A facial deeply cleanses and maintains the skin by exfoliating dead skin cells. The goal is to maintain smooth, clear, well-hydrated skin. Its the second most popular spa service after the massage.Trying to stop our natural ageing process is not quite possible yet, but we can help our skins age with just a few simple steps. We need a lot of fresh air, enough sleep, relaxation, lots of water and a diet of fruits and vegetables so our skin stays free from blemishes. Nevertheless, there are companies that have even come up with gadgets, which can slow down premature aging.Slendertone, the British company behind the homonymous body trainers that tone the silhouette through electric stimulation of the muscles, has released a corresponding product for the face on Sept 9. As part of a 12-week plan, the Slendertone Face is supposed to help stimulate the muscles of the face through pads that, attached to the skin, receive small electric shocks (http://www.sun2surf.com/article.cfm?id=38421) A facial is given by a licensed esthetician with special training in skin care; it involves a few basic steps: cleansing, skin analysis, exfoliation, massage, extraction of blackheads and other impurities, and application of products targeted to your skin type (dry, oily, mixed, sensitive, and mature). On the contrary of the West, the tropical Asian women have a head start on giving their skin all kinds of treatments, because the basic steps have always been a part of their traditional life style for centuries. They have easy access to the ingredients they need for the preparation of their facial treatments, because they can harvest them right off their botanical garden.The West does not have the same opportunities as Asians have and therefore use a night cream or neck cream and new oxygen creams. Asians on the other hand used and still use raw plant extract to get rid off dead skin cells, fight acne, replenish moisture or achieve an SPF.That is why a lot of women gather themselves in Asian spas, where they get traditional treatments, without any chemical input, but still giving them the softest skin and a very relaxed state of mind.They will most probably have their faces treated with some ingredients, which they will also be able to find in their refrigerator at home. Examples for these treatments are: Traditional honey- cucumber facial (honey, lime, cucumber) Traditional facial (corn, rice powder, cucumber juice, carrot juice.) 2.3 Factors of a complete well-being Although our bodies detoxify naturally every day most of us lead busy lives that make it impossible for our bodies to eliminate these toxins completely, which leads to a build-up in our systems. (http://www.mirrorreaderoffers.co.uk) Therefore the most important factors for a complete well-being are not only healthy and steady weight or solid relationships, but most importantly the rejection of tobacco, sparing of alcohol, managing stress and having a high knowledge level. Once one has fulfilled all of the points mentioned above, one will feel at ease, relaxed and out of worries, making it possible for a person to have a piece of mind. 2.3.1 Accommodation The accommodation of a Spa and wellness facility plays a very important role. The wellness hotels have to be located in a very heartwarming relaxing area, away from all the traffic, noise, pollution etc., where the guests have to be able to feel at ease and get their desired treatment in a dimmed room with a relaxing atmosphere and warm colors.For the guests it is also important to have a good choice of nutrition. The hotel has to offer light, healthy food, which also tastes excellent. They have to have a stunning, breathtaking view from their room, where they can watch and observe the scenery while having a glass of wine on the balcony.Of course facilities such as, swimming pools, whirlpools, sports club, fitness center, sauna, steam room, beauty salon, hairdresser, health center, bar and nightclub have to be put at the customers disposal as well. But of course wellness is not enough. The main relaxation of a guest to fulfill his or her stay is, hospitality, comfort, a homey ambianc e, personal care and many more comforting factors which are food for the soul. 2.4 Massage Therapy Massage therapy is seen as the oldest methods of healing, nearly 4000 years old. It is often referred to the use of many techniques to the muscular structure and soft tissues of the body. These therapies are usually done by using the hand, but other body parts such as elbows, forearms, or feet can be put into action as well. One applies fix or movable pressure, rocking, vibration, holding, kneading and compression. These massage therapies are a positive influence to the overall health and well-being of the person. Therapies are for example Acupressure (using fingers or even toes to press key points on the surface of the skin to stimulate the bodys natural ability to heal itself) and Acupuncture (stimulates key points of the body by inserting needles) 2.4.1 Benefits of Massage therapy There are many beneficial aspects of a massage therapy to a human body. For example it relaxes the whole body, by relieving tired and aching muscles, at the same time it also loosens tight muscles, and it also increases flexibility and range of motion and diminishes chronic pain. Additionally it calms the nervous system, lowers blood pressure and heart rate. Moreover it enhances skin tone and assists in recovery from injuries and illness and strengthens the immune system. Furthermore this kind of therapy can reduce tension headaches and mental stress as well as improve concentration, promote restful sleep and lastly aid in mental relaxation.They can relieve muscle tension and pain in people who suffer from chronic back pain, or who have had an injury from sports or a car accident. Mental Benefits of Massage Therapy Fosters peace of mind Promotes a relaxed state of mental alertness Helps relieve mental stress Improves ability to monitor stress signals and respond appropriately Enhances capacity for calm thinking and creativity Emotional Benefits Satisfies needs for caring nurturing touch Fosters a feeling of well-being Reduces levels of anxiety Creates body awareness Increases awareness of mind-body connection (http://www.holisticonline.com/Massage/mas_benefits.htm) 2.5 Spas for men According to the International Spa Association men are going to Spas more often, not just to get a sports massage and manicures, but also trying out new things, like cocoa butter rubdowns, body wraps etc. Men look for treatments that relieve shaving irritation or something that soothes the skin from dry weather conditions. They want to be given the impression that they do not have to be in the same room as a bunch women getting their nails done etc. so they look for a Spa that offers private rooms and other facilities like hot tubs and waiting rooms. Nowadays there are even Men only Spas like in New York City, the Nickel Spa for Men or in Washington D.C, Grooming Lounge and the Absolute Spa at the Fairmont Hotel in Vancouver. More over, according to a Malaysian Newspaper The Sun (28/09/2009), nowadays there is even extra nail polish only for men, referred to as male polish, which is supposedly to be the next big thing. Often used for filling and strengthening nails, there are also first product lines such as the one by hip Berlin label Uslu Airlines that focus on aesthetics. These nail polishes for men are ranging from RM 14 RM 105 each. Knowing that mens skin requires specific care, Nugeno Men has introduced an ultimate skincare range formulated especially for the modern men on-the-go. As healthy skin is the most important element of a great looking face, skincare solution is made easy to achieve and critical that one can do it at home on a daily fuss-free basis (http://www.sun2surf.com/section.cfm?id=24) 2.6 Body Treatments Body treatments are basically a facial for the whole body. It is just as important to wash and hydrate the skin on the body, as it is the skin of the face. Various Spa centers provide a wide variety of essential oils or scrub materials, such as orange blossom, peppermint salt glow, cucumber salt glow and many more. After the body scrub, one might want to make an additional body mask, which involves an application of mud, algae or seaweed over the entire body and afterwards wrapped in a thermal blanket, which is a treatment that stimulates the metabolic system, immediately fastening to carry away waste products. Another famous treatment is the so called body wrap , which originally was a treatment where bandages or plastic wraps was tightly wrapped around the body in order to induce weight loss through a process called vasodilatation. (http://www.populararticles.com/category160.html) . Now it is seen as a treatment used to treat or prevent cellulite. Afterwards the body wrap usually ends with an application of lotion. This treatment is also called a body cocoon or body mask 2.6.1 Benefits and threats of Body Treatments The benefits of a body wrap is to get rid off the body toxins through metabolic stimulation and softening the skin as well afterwards, by applying Shea butter and rich lotions which are hydrating treatments. On the other hand, there are different threats when it comes to a body scrub, for example one should not expect a body wrap to be a massage. You can get both treatments. Another common threat would be, that if a person has claustrophobia, body scrub, wrap or mask, may not be the right treatment. Furthermore one might be left alone during the treatment, so if there is uncomforting feeling due to that, then one should ask before booking the service. Yet, although there are some threats, there are also various positive aspects when looking at a body treatment. They are proven effective and safe for use in increasing blood circulation, improving appearance of skin, hair, and nails, as well as supporting the immune system functions, furthermore enhancing removal of toxins and waste products, also increasing the healing rate of soft tissue and finally helping relieve of discomfort and pain. Stress reduction and relief, soothing sore joints and muscles, and simply feeling better about oneself. (http://www.webmd.com/skin-problems-and-treatments/features/spas-the-risks-and-benefits) 2.7 Risks of Spas According to Elizabeth Heubeck, while spas promise to restore, refresh, and renew and some offer even more explicit health claims they generally dont warn you of the potential risks involved, which do exist.Certain spa treatments can worsen chronic and acute health conditions. All spas can establish risks to the general public, especially when operated in a state of uncleanliness.One can never tell how clean a spas water or supply is. But one can try to minimize the risk of becoming infected by contaminated water or supplies. (http://www.webmd.com/skin-beauty/guide/risks-of-spa-treatments) Poor water quality can transform into a breeding ground for microbes or germs, which could lead to skin boils from a chain of unhygienic whirlpool footbaths, which are used as part of a pedicure treatment. A report released by the CDC in 2004 showed that more than half of all public hot tub spas in the US violate public health safety standards. Of the 5,000 spas inspected, 57% breached at least one safety violation. Poor water quality was the most common violation. (http://www.littlespeck.com/content/health/CTrendsHealth-051218.htm) Some people find it extremely relaxing to sit in a sauna, a wooden room infused with dry heat that supposedly eliminates toxins as it opens pores and promotes sweating. But if you have the flu, the cold, a respiratory infection, or an asthma flare-up, you should not be sitting in the sauna. 2.7.1 What can you do to reduce your risk of infection at spas? One has to lurk around the spa area before getting some kind of treatment as well as observe the spa for general cleanliness and also listen to the people who have been there before (word of mouth). It is recommended to bring the own equipment to avoid the threat of contamination, when asking for special treatments.One should also be very careful if there are any open cuts or wounds one the body, one should cancel the appointment until they have healed, because any open area of the skin can stimulate infection.But knowing the risks that pertain to you and carefully judging the cleanliness of a spa before making an appointment, it can take a long time to ensure ones safety and satisfaction. If one is not sure about a certain treatment, which might affect ones wellbeing, then one should consult a doctor first. (http://www.littlespeck.com/content/health/CTrendsHealth-051218.htm) 2.8 How the West is influenced by Asia The interior designs of the western modernity are the influences of the Asian culture, an example of that would be the colour pink, which plays a big role in it. The best example for this is the Yi Spa in Berlin. Since 2006 the modern Spa with an Asian flare seduces its customers in absolute relaxation. On 130 square meters diverse far eastern healing methods are applied. The team is led by three Thai women with the motto of We know the way to 7th heaven. Asian massage arts like baths, packages, and peelings and so on are provided with natural products, relaxing music, small snacks and exotic drinks for long lasting stress reduction. The hectic big city jungle immediately recedes after entering a wellness oasis. Slate, stone and dark wood in combination with magenta lures one to let him or her be spoiled from head to toe by such a peaceful atmosphere. The western people who have been to Asian countries are inspired by the beautiful surroundings and therefore remember or look forward to their relaxing, enchanting and far eastern vacation experience. One Problem that is faced is that there are various Chinese herbal pharmacies in the West, which is living proof of the crossover between east and west. These pharmacies are usually run by western biologists and supply mostly to non-Asians, where they get Chinese medical diagnosis and are prescribed herbal prescriptions, which they bring to their house and make up into a tea.The only problem is that very often there is a language and cultural difficulty, which prevents customers from coming into such kind of shops. There are differences as well as similarities of the philosophies between Eastern and Western medical models. The biggest difference in philosophy between them is how each sees the body. Western medicine looks upon the body as being very mechanistic. In former times the beginning of the scientific study of the body through autopsy and the scientific method states that the mans physical body is separate from his soul. Traditional Chinese Medicine dates back to nearly 5000 years. It views the body as an ecosystem, a garden within a garden. Their philosophy comes from Taoist teachings and is one of integration and balance. They believe in a life force called Qi, which flows through the body giving life energy. When the flow of Qi is disrupted the body becomes out of balance. A diagnosis in Traditional Medicine differs from the Western medicine. The western people go to a doctor and complain about certain illnesses or pains. Afterwards a practitioner formulates a diagnosis and treatment of the symptoms. They believe that diseases develop from established causes, which are then treated by more or less fixed protocols. (http://www.uwosh.edu/eap/updates/docs/Fall%202001%20Vol.%205%202.doc) Whereas, the Chinese relies on the three basic methods of diagnosis, namely: Tounge Pulse. Patterns 2.9 Trends Why do people go to visit Spas? The trend to wellness is the product of various overall social trends. More and more people have the opportunity nowadays of decision-making- which was unthinkable in former times, where they were forced to follow certain political, economical or social statuses. A few examples of the changes are the age of getting married is increasing, and the education nowadays takes longer and a lifetime of learning is postulated. They also feel that they are responsible for their own health and therefore are ready to change their lifestyle for it. They would like to stay in shape and also at the same time away from any possible diseases. It has been proven that people with high blood pressure, blood sugar or cholesterol have a higher chance of getting ill. Therefore more and more people have the necessity to improve these risk factors by having a wide interest in exercise and nutrition. Exercise and nutrition is also part of getting old. Wide ranges of older people want to have a longer life and therefore there is a connection between the increasing life expectancy and the wellness trend. Here in particular we find a high interest in healthy nutrition, relaxation- and concentration techniques and also food supplements (Vitamins, trace elements etc.) Women have more and more influence in social development. The increasing educational level and the growing participation of women in the workforce lead to their having a higher salary and higher influence in politics and economy. In Austria respectively Germany, women bring as much money home as men.Women are the one that show more interest in these matters. Fitness and health magazines are mostly read by women, it is more likely for them to change their lifestyle to a healthier one.However Wellness is not only a trend for women. A lot of men are starting to take more interest in it as well and will in some degree- grow stronger in the future. Spiritual tourism adds to this education of people seeking for a meaning while on vacation. The increasing individualism of our society and the loss of common traditions have combined to expand the need to find something deeper and more meaningful.Bookstores have a lot of literature about self-healing, Buddhism or esoteric subjects. That is why more and more people are also starting to use their holidays to look for a new kind of inner peace. Spiritual tourism has become one of the fastest growing segments in the travel industry worldwide; even it might be one of the oldest forms of tourism. Examples for this are Muslims traveling to Mecca, or Sikhs visiting the Golden Temple and Christians and Jews visiting the Holy Land. 2.9.1 Top Spa Trends One trend is the Healthy Sleep at the Spa. With sleep comes exercise, nutrition and stress management. Hotels and resorts will put greater importance on creating ideal sleep environments, by minimal light and sound, aromatherapy, and ultra-relaxing spa treatments. Also Detox at the Spa became a trend. As culture continues to discover more toxins such as stress, environmental pollution etc, Spas look for more people to turn to spas for a range of detox solutions, which usually includes relaxation, all-organic diets, sweating, exercise, steams and saunas. The next trend is Spa Retreats at Resort Spas. For years destination spas have offered specialty weeks in yoga, sexual health, or medical concerns such as quitting smoking. Now resorts and hotels are getting into the retreat business, adding specialty programs or special accommodations that appeal to their past guests. Another trend is Medical Tourism. Western people are travelling to global destinations, often in beautiful, culturally rich Asian countries like Bangkok, South Africa and India, where treatments are more affordable than in their own countr

Patients and Cancer

This paper explores different peer-reviewed articles that attempts to shed some light on the phenomenon of the lived experience of patients with cancer; supporting the fact that individuality is a huge factor in the care of cancer patients. Manu types of cancers exist and patients should be treated as individuals versus as a disease or diagnosis. As oncology nurses we accumulate knowledge on a daily basis that may be revised in practice. Therefore, it becomes our innate duty to visit the literature and gain the understanding and evidence that will help us in improving our practice of nursing.The articles, however, vary in the type of cancer with different treatment modalities and the collection methods but have the commonality of all participants being diagnosed with Cancer. The findings showed that patients have many unmet psychosocial and emotional needs among others but exercise hope when family support is present. These shortcomings or gaps in knowledge can alter how care is rece ived and administered. We as nurses, have a lot of work to do in assisting patients feel more individualized with the diagnosis of Cancer.Each day in practice we meet new patients and see old ones and we may see them smile or get sad or display other emotions but as nurses do not take enough time to find out what our patients face and how they handle their diagnoses of cancer. As nurses we get so wrapped up in our daily tasks. Cancer is an experience that can threaten not only the end of one’s life, but also touch all aspects of the person’s existence, making it significant to them and if it is significant to them then it should also be the same to us.Cancer also imposes so many burdens on patients, families and the society at large. So large that it is labeled the silent killer and will overtake disease as top killer by the end of 2010 (foxnews. com). I chose this topic because I realize the gap in knowledge and communication between what happens to patients between d iagnoses, treatment and discharge, up to the time they return for follow -up cycles to the time they may hear that the cancer has either metastasis or have been cured (in remission).Just knowing that your life will change is significant enough. We, as nurses are first line in the patient care area. The Doctor walks in and tells the patient that they have cancer and then walk out and the nurse is faced with the aftermath, the questions and the emotions that follow. The nurse is also the one that administers the chemotherapy and various radiation treatments and again is faced with questions and emotions. At discharge the nurse again becomes the one that is faced with questions and emotions.It may not be possible to answer all the questions and for the ones that we are not sure of, we can refer or ask the doctor to explain but having the knowledge of what it may be like for these cancer patients can help with how we approach these questions and the treatment options. Having this knowle dge can help in terms of support, teaching, prevention and alleviation of suffering, enabling us to give more culturally congruent care. Literature Review In Arber et al. s (2008) article on the lived experience of patients with pleural mesothelioma it was found that these patients had many unmet psychosocial and emotional needs and that there was a lack of information provided to patients . A feeling of isolation was also reported. All patients and care givers experienced frustration due to the physical experience (Arber et al. , 2008). It was showed that these patients wanted to tell their stories and wanted people to listen. The methodology was phenomenology which was appropriate for the study with unstructured interview questions allowing for participants to speak their mind and their experiences.As nurses sometimes we are unsure of what to say for fear of saying the wrong thing. There was also evidence of loss of intimacy with partners. Macmillan Cancer support (2006) states th at four out of ten couples where one partner has cancer report sexual problems (Arber et al. , 2008). The study was done only on patients with mesothelioma and was very small making it hard to generalize to other cancer areas. The patients and families were only from a specialist palliative community center assuming that these patients had incurable mesothelioma.Benzein et al. , (2005) studied cancer in palliative care in home care and made hope the center of the study. The findings showed that the participants used hope to live as normally as possible. The meaning of the experience of hope seemed to be a will to live for a while longer (Benzein et al. , 2005). The structural analysis revealed the hope of being cured, a hope of living as normally as possible, a presence of confirmative relationships and reconciliation with life and death.The commonality between this article and Arber et al. , 2008 is that these cancers were incurable, however in this article the study group was a mi x of males and females ages 54-83 with a median age of 65. The previous article failed to reveal the ages of the participants, making it difficult to impact practice. The other difference is that the latter was done in the patient’s own homes while the study on patients with mesothelioma was done in a different setting that may influence the outcome.Being surrounded by loved ones in the home setting would allow the patient to feel more human, than being in a hospital setting where they are just another patient and loved ones may not be able to visit at lib, which in the end has a negative impact on recovery. Demir et al. , (2008) in their quest to understand the experience of breast cancer survivors that underwent biopsies used a phenomenological approach to reveal three themes that were evident among participants, namely, the need for information, fear and spiritual needs.The study also suggests that results may be different considering different emotional investments in the ir breasts, sociocultural factors and age. The study was a very small group of twenty with the interviews being held in an unused room outside the clinic before the patients postoperative visits. Having the interviews on postoperative days may further aggravate feelings of fear that could invalidate the study. When compared to the study done by Perreault et al. , (2005) similarities were evident as participants exhibited fear and uncertainty. This study studied women with breast cancer and examined their experiences.Both studies used the interpretative phenomenological approach to gain insights. What this study included that would help with validity that Demir et al. , (2008) did not include was the staging. The staging of the cancer can have a great impact on the emotions and fear and response to experience. This sample size was only six person who lowered the reliability and generalizability. Lacey, (2005), researched breast cancer and support aides revealed that participants were identified as being too overwhelmed and stressed to make decisions about their care.They trusted their physicians to make the appropriate choices and appreciated and welcomed the support of family members. They also expressed hope. These same sentiments were echoed somewhat in Demir et al. , (2008) and Perreault et al. , (2005). All 3 studies involved breast cancer and the study method was the same and even though the same size and ages may have varied, it may prove to offer some insight as to what these women face adding to the validity. All 3 papers also suggest that more research may be necessary to facilitate the different decision- making and emotional abilities. The definite commonality expressed and assumed mong all these articles so far is the need for information especially at different stages. Molen, (2000) study sought to identify the different information needed for people with cancer. Adequate, appropriate and timely information can be a key element for many people in managing the experience of cancer. Different themes emerged from the research. There was a deficit in information regarding self-identity, body image, and family, social and work relationships. A cancer diagnoses impacts all areas of an individual’s life, and life management information is equally as important as medical information. Molen, 2000). Cancer was viewed as an intrusion and illness engendered feelings of vulnerability that impacted on their normal coping mechanisms. This research had six participants all with different types of cancer with ages ranging from 45 to 65. The end results showed feelings and questions received on a daily basis but the sample size was so small and the age range was so limited that may lessen the reliability. However, further research may be needed to identify the different ages when information becomes such a deciding factor or the processing of information since all the participants were older.Similarly, information needs proved to be a big part of the equation as evidenced in another research study done by Molen (2005). However the type of information, the amount and to what depth varied considerably between individuals proving that information needs are unlikely to remain static and consequently, will change throughout the cancer experience. The literature highlights the importance of information giving, however; many problems are encountered with its provision. People with cancer frequently express dissatisfaction with the information given to them and experience difficulty in retaining and processing information.The cancer experience invariably begins before the point of diagnoses and information needs clearly change over time. (Molen 2005) Jones et al. , (2006) in researching the lived experience showed similarity with the Molen, (2000) themes that emerged from the different stories including changing concepts of self, the significant of relationships, being different from the past and temporality. These patie nts were bone marrow transplant candidates who were experiencing a mountain of emotions that they believed were affecting them negatively.From their stories it was clear that all participants underwent many physical and emotional changes. Taking it to a different level Meenaghan et al. , (2010) researched elderly patients and their lived experience and concluded that all participants experienced fear and shock at diagnoses but also experienced hope despite their age. With good support from family and friends participants exhibited hope and revealed that they learned to cope with the diagnoses and its treatments. As expressed in Perreault et al. (2005), the same fear and uncertainty was revealed and the same method of data collection and interview was used. Walker et al. , (2009) attempted to understand the lived experience of cancer patients undergoing photodynamic therapy. Analysis of the data yielded six themes, the impact on day –to- day life, existential meaning, the phys ical effects of treatment, and the kaleidoscope of emotions, information gap and family burden. This article summarizes all the feelings expressed by all the previously reviewed articles.If not all a least one of the articles expressed the same feelings which leads nurses to believe that these are the expected emotions, fears and expressions that can be experienced and that we all should be mindful of the factors that to suffering and the nursing interventions that can be used to address these multiple dimensions of suffering. All these studies used the phenomenological approach which is appropriate and if not the interpretative design the descriptive. Sample sizes and ages vary but the information and end results remained the same or close to the same throughout this literature review.

Satan in paradise lost

Satan Satan is the first major character introduced in the poem. Formerly called Lucifer, the most beautiful of all angels in Heaven, he's a tragic fgure who describes himself with the now-famous quote â€Å"Better to reign in Hell, than serve in Heav'n. † He is introduced to Hell after he leads a failed rebellion to wrestle control of Heaven from God. Satan's desire to rebel against his creator stems from his unwillingness to be subjugated by God and his Son, claiming that angels are â€Å"self-begot, self-raised†,[4] thereby denyingGod's authority over them as their creator. Satan is deeply arrogant, albeit powerful and charismatic. Satan's persuasive powers are evident throughout the book; not only is he cunning and deceptive, but he also is able to rally the angels to continue in the rebellion after their agonising defeat in the Angelic War. He argues that God rules as a tyrant and that all the angels ought to rule as gods. [5] Satan is comparable in many ways to th e tragic heroes of classic Greek literature, but Satan's hubris far surpasses those of previous tragedies.Though at times he plays the narrative role of an anti-hero, he is still commonly understood to be the antagonist of the epic. However, the true nature of his role in the poem has been the subject of much notoriety and scholarly debate. While some scholars, like the critic and writer C. S. Lewis, interpret the poem as a genuine Christian morality tale, other critics, like William Empson, view it as a more ambiguous work, with Milton's complex characterisation of Satan playing a large part in that perceived ambiguity. [6]

Peace Corps Women Reporting Rape and Sexual Assault

Is the Peace Corps safe for women? The news that over a thousand female Peace Corps Volunteers (PCVs) have been raped or sexually assaulted in the past decade has prompted Congress to hold hearings on the matter. These findings, reported by ABC News on their investigative news show 20/20 in mid-January 2011, are the most recent in a long line of stories that suggest the Peace Corps is more interested in protecting its reputation than its female volunteers throughout their two-year volunteer overseas assignments. Peace Corps Background and Demographics Since its founding in 1961 by President John F. Kennedy, the Peace Corps has appealed to idealists and humanitarians who dream of living and working in an underdeveloped nation helping locals improve their lives. Its a dream that attracts a predominantly white population and draws much more women than men: 74% of Peace Corps Volunteers are Caucasian, 60% are female, 85% are younger than 30, 95% are single, and the majority are recent college grads. Statistics It is precisely these women—young, in their early-to-mid 20s, single—that are at greatest risk, and theres ample evidence that the Peace Corps has routinely ignored the dangers and downplayed the rapes, assaults, and even deaths of volunteers so as not to tarnish the iconic Peace Corps image. In 2009, 69% of Peace Corp crime victims were women, 88% were under 30, and 82% were Caucasian. In 2009, 15 cases of rape/attempted rape and 96 cases of sexual assault were reported for a total of 111 sexual crimes committed against female PCVs. Survivors Stories In nearly all cases of rape or sexual assault, the incident occurred in the PCVs first six months of service. However, the incidence of intimidation and death threats against PCVs occur most frequently during a PCVs second six months of service. Like rape and sexual assault, females and Caucasians experience higher rates of intimidation and threat. The six young women—all former Peace Corps Volunteers—who stepped forward to tell their stories on ABCs 20/20 each described events of brutality and violence. Jess Smochek was 23 and volunteering in Bangladesh when she was gang-raped by a group of young men who had stalked her for weeks. On the very first day she arrived, they pushed her to the ground and groped her. The group also went after two other female PCVs living in the same city as Smochek, groping, harassing, and fondling the women. Despite repeated reports to Peace Corps officials that the three PCVs didnt feel safe and wanted to be reassigned, the volunteers were ignored. The young men—realizing Smochek had spoken up about what was going on—attacked her, telling her they were going to kill her. They raped her physically and with foreign objects and left her unconscious in a back alley. When the Peace Corps took her out of Bangladesh and back to Washington, D.C., she was told to tell other volunteers that shed left to have her wisdom teeth removed. According to Smochek, Peace Corps counselors who met with her to discuss the rape attempted to place the blame on her for going out alone at night, although night in this case translated to just past 5 pm. This odd emphasis is reflected in the Peace Corps own statistical reports on rape and sexual assault; its Annual Report of Volunteer Safety cites the time of day and day of the week each type of crime occurs and notes whether or not alcohol was consumed by the victim or the perpetrator. Casey Frazee, who was sexually assaulted in South Africa in 2009 and went on to found a support group and website for PCV victims, says the Peace Corps implicit message that if you have a drink, youre to blame if youre assaulted, is hurting victims of rape and sexual assault. Adrianna Ault Nolan, who was raped in Haiti in 1998, agrees. She told ABC News, When bad things happen, you say to yourself, How did I bring this upon myself? and I think, unfortunately, Peace Corps is hoping youll think in that direction, too. Although the ABC News story has received national attention, it is not the first in-depth investigation into the underreported incidence of rape, sexual assault, and murder in the Peace Corps. On October 26, 2003, the  Dayton Daily News  published an article its reporters had researched for nearly two years. Combing through thousands of records on assaults on PCVs over four decades, the  News  staff also found stories of rape, violence, and death. In El Salvador on Christmas night 1996, Diana Gilmour was forced to watch the gang-rape of two female PCVs on a lonely stretch of beach. Gilmour was subsequently raped by a man holding a gun. Seven months later, those same two female PCVs were attacked yet again, this time in Guatemala City, walking home from a downtown movie theater. While one woman managed to get away, the other was gang raped with a T-shirt pulled over her head and a pistol shoved in her mouth. The twice-violated victim was only 25 years old. Within two months, three other female PCVs in Guatemala stepped forward to report theyd been raped as well. According to the  Dayton Daily News: [Y]oung Americans - many just out of college and the majority of them women - are put in danger by fundamental practices of the Peace Corps that have remained unchanged for decades. Though many volunteers have little or no experience traveling outside the United States, minimum language skills and virtually no background in their assigned jobs, they are sent to live alone in remote areas of some of the worlds most dangerous countries and left unsupervised for months at a time. In 62 percent of the more than 2,900 assault cases since 1990, the victim was identified as being alone....In 59 percent of assault cases, the victim was identified as a woman in her 20s. Interviewing more than 500 people in 11 countries, the papers reporters heard many gut-wrenching first-hand accounts from frightened young women: I am ready to go home. I dont like living in fear every single day, said Michelle Ervin of Buckeye Lake, Ohio, a 1998 University of Dayton graduate who was 25 when the Daily News visited her in the African country of Cape Verde in the summer of 2002. Every day, I walk out of my house wondering who is going to rob me. Similar to the ABC News investigation, the  Dayton Daily News  article revealed a culture within the Peace Corps that deliberately downplays any incident that might tarnish its reputation: The extent of the dangers faced by volunteers has been disguised for years, partly because the attacks occur thousands of miles away, partly because the agency has made little effort to publicize them, and partly because it has deliberately kept some people from finding out - while emphasizing the positive aspects of Peace Corps service. Two top agency officials overseeing security over the last 12 years said they warned the Peace Corps about increased dangers to volunteers, but many of their concerns were ignored. Nobody wanted to talk about security. It suppresses the recruitment numbers, said Michael ONeill, the Peace Corps security director from 1995 to August 2002. When asked by the  Dayton Daily News  about the rise in sexual assault numbers, Peace Corps Director Gaddi H. Vasquez claimed that recent statistics indicated those numbers were in decline. That was in 2003. In January 2011, when asked by ABC News reporter Brian Ross about the rapes and alleged coverups, Peace Corps deputy director Carrie Hessler-Radelet denied her agency had participated in anything of the sort. In response to Smocheks claims, Hessler-Radelet stated that she was new to the position and unaware of Jess Smocheks story. Just as Vasquez had done in 2003, Peace Corps officials in 2011 claimed that the number of rapes had been in decline. Rape and sexual assault are not the only threats facing women in the Peace Corps. The murders of Kate Puzey in 2009 and Deborah Gardner in 1976, and the unexplained death of Stephanie Chance in 2010 are not the types of volunteer stories the Peace Corps wants associated with its image. The fact that Gardners murderer was a fellow Peace Corps Volunteer who never served time for the crime—and was given an exemplary rating for his service by the Peace Corps—led New York writer Philip Weiss to dig further into the tragedy. Although his 2004 book  American Taboo: A Murder in the Peace Corps  brought Gardners decades-old story to light, the Peace Corps failed to hold Gardners killer accountable, even when the agencys many missteps in the matter were uncovered. Impact on the Peace Corps Despite these incidents, the Peace Corp has retained its nostalgic JFK-era aura of idealism and service and continues to attract eager new recruits. The agency receives 10,000 applications annually, sends out between 3500 and 4000 volunteers to work in over 70 countries around the world, and celebrated its 50th anniversary in March 2011. Sources Carollo, Russell and Mei-Ling Hopgood. Mission of sacrifice: Peace Corps volunteers face injury, death in foreign lands. Dayton Daily News, daytondailynews.com. 26 October 2003.Krajicek, David.  Murder in the Peace Corps.  TruTV Crime Library, trutv.com. Retrieved 28 January 2011.Safety of the Volunteer 2009: Annual Report of Volunteer Safety.  Peace Corps, peacecorps.gov. December 2010.Schecter, Anna.  Congress to Investigate Peace Corps Treatment of Sex Assault Victims.  ABC News The Blotter, ABCNews.go.com. 27 January 2011.Schecter, Anna.  What Killed Stephanie Chance?  ABC News The Blotter, ABCNews.go.com. 20 January 2011.Schecter, Anna and Brian Ross.  Peace Corps Gang Rape: Volunteer Says U.S. Agency Ignored Warnings.  ABC News The Blotter, ABCNews.go.com. 12 January 2011.