An Overview Of The Digital Divide

An Overview Of The Digital Divide This essay defines and addresses the significance of the digital divide providing evidence to support its existence in the United States. It analyzes findings from various research reports and case studies identifying factors that cause the divide. The digital divide is a technology gap between the haves and the have-nots. As a result of these gaps, 21st century learners will fall further behind and will not be able to reap the full benefits of our fast-growing technology driven society. The digital divide is the technology gap between people with access to digital and information technology and those with limited or no access (NTIS, 1998). The digital divide is often referred to as the technology gap between the haves and the have-nots. There are many factors that inhibit student access to computers and the internet. There is a digital divide among computer and internet access by race, income, education and location, as well as physical disabilities (Fourie Bothma, 2006). Research shows that Caucasian Americans access to digital and information technology at 46.1% nearly doubles that of African Americans at 23.5% and Hispanic Americans at 23.6%. Asian Americans and Pacific Islanders exceed all racial/ethnic groups at 56.8% (Athena Alliance, 2001). Minority groups are at a disadvantage when it comes to having access to computers and the internet but it is not because they are minorities. Their limited access is because they are at a socio-economic disadvantage due to lower education levels and poorer incomes (Solomon, 2002). The technology gap by race seems to be closing significantly. This is due to the availability of computers and internet access at schools, libraries and community centers. Yet, there is still a technology gap in low-income and rural communities. Socio-economic factors play a major role in the technology gap between students. Poverty remains a major factor that limits students access to technology. Only 35% of households in lower socio-economic groups have internet access while 59% of middle income groups, 73% of upper middle income groups, and 83% of those in top income groups have access to the internet (Gartner Group, 2000). Now more than ever, unequal adoption of technology excludes many from reaping the fruits of the economy. Sectors of the population are excluded from the power and the economical benefits offered (Fourie Bothma, 2006). Divisions among the population are not just due to income but also location. There is a digital divide by geographical location. For students in high-poverty and rural areas, libraries can be the only way to get online (Barack, 2005). A digital divide separates rural America from the rest of the nation when it comes to broadband internet use and access. Only 24% of adults in rural America have high-speed internet access, compared to 38% of urban Americans and 40% of suburban Americans who have access (Perkins, 2006). Efforts are being made by the government and the private sector to increase connectivity in rural America. People with disabilities face a significant digital divide as well. Despite regular increases, both metro and non-metro people with disabilities have lower rates of internet use than their geographic counterparts with no disability (Dobransky, 2006). Surveys consistently report that people with disabilities have only half the rate of internet access of people without a disability (RTC, 2006). Obstacles that Americans with disabilities face include how costly adapted hardware and software can be, limited locations for internet access, workplace internet access maybe unavailable because of unemployment, and internet content may be frustrating because sites are not accessible to people using assistive technology (NTIS, 2000). Educators at all levels must keep up with the digital world inhabited by a new type of learner whose worldview is often developed through surfing the web, instant-messaging, and online activities like video games or social networking sites like Facebook and Myspace (Menard, 2008). To level the playing field for these 21st century learners or digital natives, we must bridge the technology gap that exists among these students by racial/ethnic, socio-economic, educational and geographical factors, as well as limited accessibility due to physical disabilities. According to Menard (2008), todays young people were born into the Internet era and face a life saturated by digital media. Their interaction with technology will deeply affect the way these learners interact with their environment. To be successful in todays technology driven society, students must have equal access to computers and information technology. References Barack, L. (2005). Gauging the digital divide. School Library Journal, 51(8), 21. Retrieved August 12, 2009, from Research Library. (Document ID: 882387801). Dobranksky, K. Hargittai, E. (2006). The disability divide in Internet access and use. Information, Communication Society, 9, 3, 313-334. Fourie, I. Bothma, T. (2006). Addressing the digital divide in teaching information retrieval: A theoretical view on taking students from ICT access to knowledge sharing. The Electronic Library, 24(4), 469-489. Retrieved August 12, 2009, from Research Library. (Document ID: 1142659581). Gartner Group (2000). The digital divide and American society. Available: http://www.3gartner.com Menard, J. (2008). Higher ed responds to the digital generation. The New England Journal of Higher Education, 23(1), 13. Retrieved August 12, 2009, from ProQuest Education Journals. (Document ID: 1529959711). NTIA (1998). Falling through the net: Defining the digital divide. NTIA No. PB99156614 Available: http://www.ntia.doc.gov/ NTIA (2000). Falling through the net: Toward digital inclusion. A report on Americans access to technology tools. NTIA No. PB99144487. Available: http://www.ntia.doc.gov/ NTIA (2000). Falling through the net: A survey of the have nots in rural and urban America. Available: http://www.ntia.doc.gov/ntiahome/net2/falling.html Perkins, B. (2006). Location spawned digital divide can cost you. Realty Times. Available: http://realtytimes.com RTC (2006). Disability and the Digital Divide: Comparing Surveys with Disability Data. Available: http://rtc.ruralinstitute.umt.edu Solomon, G. (2002). Digital equity. Its not just about access anymore. Technology Learning, 22(9), 18-26. Retrieved August 12, 2009, from ProQuest Computing. (Document ID: 115857641).

Moving On With a Disability :: Papers

Moving On With a Disability 'Disability' something that disables a person, a physical incapacity caused by injury or disease. To me the word was somewhat closer to home. I am going on fourteen and am seated in a wheelchair permanently, I always have been. Cameron is the name, walking is the game. The wish more like. Being stuck in a wheelchair is very infuriating and when I am in that mood, just don't try and get me out. Talking of going out I don't. Well very rarely. I stay in my room most of the time with my books and my tutor. It is where I want to be. It is no-one's fault I am in this way and there is nothing anyone can do about it. I need to face facts; I am glued to the chair. " Good morning Cam!". He stood there like he did every morning at 9am sharp, but DiÃÆ'Â ¡z was not a sharp man. Messy struck me as more of the correct word. My tutor was in his mid thirties with short, brown hair. He hadn't shaved. Stubble the colour of cigarette ash clung to his jaw. His big round glasses bounced as he walked. His clothes were shabby and he often wore the same items for days running. DiÃÆ'Â ¡z was a good friend; my only friend and he shared my love of books. He often brought me a book from his collection. They were about all sorts but I liked the detective ones best. I wished I was Sherlock Holmes. Mind you I wished I could walk too but as Mum always says, ' Life does not come on a silver plate.' Well it should come on a gold one, that's what I think! I don't think you can understand what it is like not to be able to do something that everyone else can. I definitely don't think I can explain it! When I wake up, I cannot dress myself. How would that make you feel? Incompetent maybe? That's how it makes me feel. Everyone else can dress themselves, why can't I?

John Steinbeck section Essay

â€Å"Yea, an’ besides we gunna have to if we wanna have any fun, you know, won’t be much fun jus’ me and George. † Candy observed innocently. Slim chuckled fondly, while George whispered a soft, â€Å"Yea, won’t be much fun†¦ † He sighed contemplatively and looked down at the ground in deep thought. He was jerked out of his daydream at the sound of a bullet, the bullet coming from Carlson’s gun. He looked up and around at the nearby tree, the tree that towered over the ranch, casting a long shadow over a part of the bunkhouse. He took one last glance and turned away. The gunshot was heard again as Carlson pulled closer to the cart. â€Å"Can’t let ya leave wit’ out saying goodbye†¦ ya kno’†¦ † Carlson shifted uncomfortably while looking down at the ground. â€Å"Ok then. Thanks for the concern. † George said abruptly. â€Å"ppreciate it. † With that, George joined Candy at the front of the cart, and set off. A few days had passed and things seemed to be going as slow as ever, the days seemed like months and the nights like years. Nothing exciting had happened to George and Candy, all except for a frog that was hopping along. The monotonous sound of the horse’s hooves threatened to send George into a deep slumber. And Candy, he just sat next to George occasionally lifting his left hand to rub his stumped wrist. Just then, a woman appeared. Not just any woman, the most beautiful woman in the world according to George. Her light brown hair with streaks of a deep red that almost looked brown in the light was delicately waved. It framed her oval face perfectly. Her emerald green eyes looked at George wistfully, as if to decide whether he was approachable. Her soft pink lips parted as she slid her perfectly manicured fingers into her mouth. She whistled at the cart to grab George’s already given attention. Show preview only The above preview is unformatted text This student written piece of work is one of many that can be found in our GCSE John Steinbeck section.

Games to Support Skills for Children with Disabilities

Games are an effective tool to support instruction in special education. When your students know how to play a game, they can play it independently. Some board games and many electronic games are available commercially or online, but they dont always support the skills that your students need to build. At the same time, many online computer games fail to support social interaction, which is an important benefit of supporting instruction with board games. Reasons for Games Drill and Repetition: Students with disabilities often need lots and lots of practice on skills, beyond what they would receive in a general education class, in a more naturalistic approach to instruction. We also know that students have difficulty generalizing skills, so games that use math or reading skills in a game will motivate children to use those skills across more social settings.Social Skill Training and Practice: Many children with disabilities, especially developmental disabilities such as autism spectrum disorders, have difficulty with social interactions. Board games support waiting, turn taking, and even losing gracefully, which both typical, and children with special needs struggle with. Games can even be designed to support social skills, such as a social skill game that requires students to complete a social task successfully (Say hello to a friend, etc.), to stay on a square on the board, or you can make some social skills cards for existing games (Chance cards on Monopoly?).Peer-Mediated Instruction:  Children with disabilities benefit from having skills modeled by typically developing, non-disabled peers. Those skills will include both academic and social skills. The typical peers will be sure to check the work of their challenged peers and can supervise play. Games as part of inclusion give both groups opportunities to practice skills, exercise some socially appropriate behavior, and build positive peer relationships. Bingo Kids love bingo. Kids with disabilities love bingo because it doesnt require knowing lots of rules, and since everyone plays through every game, it scores well on the engagement scale. It requires that they listen; identify the numbers, words, or pictures on the card; place a cover on the squares (fine motor skills), and recognize the pattern of covered squares. Many bingo games are commercial and available through online or brick and mortar stores. Teaching Made Easier, an online subscription tool for making games is an excellent way to make sight word, number, or other sorts of bingos, including picture bingos. Kinds of Bingo Games   Vocabulary Building Bingos: These bingos have children cover pictures of animals or items in other categories to build receptive language.  Number Recognition Bingos: Teaching Made Easier makes it possible to customize the range of numbers used for Bingo. You can make one set of cards that uses numbers from twenty to forty to give students practice in recognizing numbers larger than twenty, but not the whole shooting match up to 100. You can also ask students with strong number recognition to read the cards, as it helps them build their skills in reading numbers aloud. Educators often recommend that some recitation in math instruction is included to be sure the numbers also get into students mouths.  Math Fact Bingo: Call numbers and have students cover matching math facts (i.e., call 12 and students can cover 2 x 6 or 3 x 4) Board Games You can build a board game based on any number of different games: Parchesi, Sorry, Monopoly. The simplest games are simple games that start at one place and end at the finish line. They can be used to support counting, or they can be used to support specific skills. You can use dice, or you can create spinners. Many Math series provide spinners that you can adapt: Once again, Teaching Made Easier provides a template for spinners. Kinds of Board Games Counting Games: An example is Halloween Rumble. Start with a serpentine path divided into squares, use dice (to building counting and adding skills) or a spinner. You can use a spinner for skip counting games (by 2s and 5s).Social Skills Games: Design this after games like Life or Monopoly, where students take cards to complete a social skill. Perhaps you might have a stack of requests such as, Ask a friend for help on your math, or a greeting: Greet a teacher in school. Quiz Show Games A great way to help students prepare for a test is a Quiz Show format. Build your game like Jeopardy and make you categories support whatever topic your students are preparing for. This is an especially good tactic for a secondary teacher who can pull a group from a content area class to prepare for a test. Games Create Winners! Games are a great way to engage your students, as well as give them lots of opportunities to practice skills and content knowledge. They seldom realize that the whole time they are competing with their classmates, they are supporting learning with their peers. It can provide some formative assessment information, letting you see whether a student understands a skill, a content area or a set of concepts.

Societal Standards Of Female Beauty - 1282 Words

Media is something every female and male look to for guidance when it comes to fashion, beauty, and information. â€Å"Magazines and advertisements are used to help women better themselves by giving information and products to make them look and feel better† (Serdar 1). Without magazines and advertisements there wouldn t be an exact focus on beauty standards.. People would have the freedom to choose what they like and what they consider beautiful instead of following the crowd. â€Å"Sociocultural standards of female beauty are in every aspect of popular media. Mass media s use of unrealistic models sends the message that in order for a woman to be beautiful, she must be unhealthy. Women are negatively affected by the constant exposure to unrealistic media ideas of beauty†(Serdar 1). Because women of the American culture constantly compare themselves to models and actors, they push themselves to diet and exercise in an unhealthy manner to achieve a goal that is both bad for them physically and mentally. â€Å"The ideal of beauty is a form of self-oppression. Women see themselves in pieces† (Sontag 1). Because females are so self observant of themselves they tend to put more attention on things that don’t actually need attention. Therefore, they feel as if their not as beautiful as a person they see on television. â€Å"Very small percent of women in western countries meet the criteria the media uses to define beauty. So many women repeatedly exposed the media images that send a message thatShow MoreRelatedVisual Kei : A New Subculture1691 Words   |  7 Pageshair with extensions, and bizarre face makeup that will make anyone take a second look. Yamanba is virtually a female only subculture that emerged from the ashes of the ganguro subculture of the mid to late 1990’s. 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Beauty standards not only tell women that you are only beautiful if you are skinny, it also tells themRead MoreMass Media s Influence On Society962 Words   |  4 Pagesresulted in an unrealistic ideal societal body image. Media portrayal the standard for beauty Mass media has depicted slender body types as the standard for beauty (Grabe, Ward, Hyde, 2008). Constantly in magazines, movies, print ads, and social media has been able to beautify the ideal of a slenderness for a female body by using touch up thinner models to promotion and to set trends (Cash Pruzinsky, 1990). For example, in 1950 media was able to portrayed female beauty by using popular pin-up glamourizeRead MoreEating Disorder Reflection Paper1341 Words   |  6 PagesReflection on impact of societal ideas on body image and eating disorder. Nah! you are not skinny enough, no one wants a fat guy or a girl, do not eat that you will never get skinny, sadly but truly we are consistently being reminded with phrases like these to pursue a socially accepted thin and trimmed figure. Eating disorders are chronic and serious illness that engages a person into severe irregular eating behaviors to satisfy their distress about maintaining a thin figure and low body weightRead MoreThe Basic Myth Of Our Culture Is That Consumption Is The Goal Of Life1176 Words   |  5 Pagesagencies to come up with ways to effectively market their products and create demand. Advertisement agencies make use of profiling and niche marketing to target the groups of customers that the product will appeal to (McFall 5). Advertisers use societal stereotypes, for example, gender stereotypes to link a particular product to a group of consumers in order to create a demand for the product. To be successful at this, advertisers use persuasive advertisements t o manipulate the relationship between

Writing Today by Richard Johnson-Sheehan Book Report/Review

Essays on Writing Today by Richard Johnson-Sheehan Book Report/Review The paper "Writing Today by Richard Johnson-Sheehan" is a worthy example of a book review on literature. Richard Johnson in chapter seven - literary analysis, shows how literary analysis works. To deduce the inner meaning of literary works, it is important to develop utter concentration to identify some information that may appear insignificant yet they contain vital information in analyzing the text. Herein is an analysis of chapter seven of Richard Johnson’s text, Writing today, indicating the major issues in this chapter.   In this chapter, Johnson puts it clearly that it is important to conduct a self-audit to become aware of one’s analyzing capabilities. To become aware of one’s potentiality to critically analyze a literary work, one needs to do so much practice by trying to analyze and to critique as many literary works as possible (Johnson-Sheehan 53). To become a good analyst, one must start by organizing and drafting his or her capabilities to make it easy to improve on the areas that an individual has some difficulty. In this chapter, Johnson recommends that a person needs to practice by reading books and attempting more questions in areas that a person has some difficulty to handle. This chapter also recommends that a person develops his analysis styles following various ways to offer a wider perspective of analyzing literary materials.Chapter seven of this book recommends that a person should be able to revise and edit his analysis skills. This means that an individual needs to be dynamic in the way he tackles literary problems. It is helpful to try different ways of analyzing a text or movie. To attain this, Johnson indicates that a person may approach different texts using different questions and ideas. To attain success, teachers, and students need to be critical analyzers of any literary material that they encounter. To attain this, it is important to think out of the ordinary by developing questions in the text and coming up with viable answers from the literary material.

Teaching and Learning Communication Skills System

Question: Discuss about the Teaching and Learning Communication Skills System. Answer: Introduction In the given case study, the patient named John is currently receiving his last cycle of chemotherapy that is adjuvant chemotherapy for colorectal cancer. It is an additional treatment that is given to the patient after the surgery that assists in lowering the risk of the cancer from returning (Mitry et al., 2008). Follow-up regime is also important after the curative treatment and makes the patient aware of the signs and symptoms that illustrate the recurrence of the colorectal cancer. After the procedure, he will be discharged from the hospital with his wife. Before this procedure, John along with his wife needs to meet the cancer care coordinator to discuss and learn about the self-management that follows his active treatment. Patient education is an important aspect of learning which demonstrates self-care and healthy living (Anderson Funnell, 2010). Apart from self-care, self-management is also important that supports his recovery and well-being after the active colorectal canc er treatment. Therefore, it is important for John and his wife to learn about self-management and focus on healthy behaviors so that there are positive health outcomes. The following essay deals with the discharge and self-management plan for John as discussed with the cancer care coordinator. The essay will also cover the survivorship issues that John might experience and the communication strategies that are required to facilitate effective education about his discharge and self-management plan. It will also deal with the evaluation of the patient education that is required for the successful education of John after his discharge from the hospital. Discharge plan Also, In Australian setting, it is highly recommended to determine the implications of follow-up on the quality of patient's life, timing and tests required for John along with the follow-up with general practitioner (Takagawa et al., 2008). Follow-up is highly recommended after the curative treatment of colorectal cancer for John. Apart from follow-up, it is crucial to know the signs and symptoms of the recurrence of colorectal cancer. According to World Health Organization (WHO), intense follow-ups and surveillance programs are important after the curative treatment as to detect the early chances of asymptomatic recurrences. According to WHO, follow-up is recommended every three to six months up to three years and then six to twelve months for the next two years followed by annual follow-ups. After the curative treatment, in many cases, there is recurrence of the disease if some of the cancer cells survive during the treatment and grow to for tumors eventually. This occurs at the original tumor location called local recurrence or in some other area of the body with distant or regional relapse. This indicates metastasis where it spreads to other parts of the body and shows recurrence signs and symptoms. It can occur after months or years after the treatment. The signs and symptoms include; changes in the frequency of bowel movements, constipation, dark or blood stools and changes in the consistency of the stool like watery or loose stools with abdominal pain, weight loss and tiredness. There is also a feeling of fullness or cramps of bloating gas in the stomach. Early detection of the relapse symptoms in colorectal cancer is not apparent (Astin et al., 2011). This requires regular follow-ups along with the recommended health plan after the curative treatment as the symptom s might not develop until the progression of the disease. The cancer stage decides the chances of the recurrence of the disease along with treatment received and risk factors of the patient. This recurrence develops within the two years after the curative treatment has completed, so it is recommended for John to have intense follow-up up to two years. Self-management plan Self-management after colorectal cancer treatment is important for John that encompasses the both physical and psychosocial well-being as according to World Health Organization (WHO) the fullest health realization includes the social, physical, psychosocial, spiritual and economic aspects (World Health Organization, 2010). There is fear of recurrence of the cancer that includes that it might return or spread to other parts of the body. There are survivor issues that John might experience like physical, social, psychosocial and spiritual after the curative treatment of the colorectal cancer (Foster Fenlon, 2011). According to the practice guideline provided by Cancer Australia, May 2012, it is stated that there is fear of cancer recurrence and require strategies to support the cancer patients (Coleman et al., 2011). The return of the cancer is the major cause of distress in the cancer patients and evidence shows that majority of the people adapt to the life after the curative treatme nt, however, there are some cancer survivors who experience high levels of social and psychosocial distress (Holland Alici, 2010). According to the Australian Government in collaboration with the National Cancer Control Initiative and National Breast Cancer Centre have recognized and developed the survivorship issues for the cancer patients. The emotional issues include the intense episodes of distressing and unpleasant emotions like fear, anger or helplessness to cancer (Stanton, Rowland Ganz, 2015). The social issues include the extent of the patient to adjust to the disease after the treatment and the effects of the disease on the patients family members (Jarrett et al., 2013). Psychosocial issues include the anxiety or depression, traumatic symptoms and difficulties in the relationships that the cancer survivors might experience (Duijts et al., 2014). Physical issues are the direct manifestations after cancer treatment like pain and fatigue (Van Londen et al., 2014). Survivor issues are also evident in the cancer survivors like John where there are changes in the lifestyle, life priorities, coping with the side-effects of the treatment and medications, social exclusion and the recurrence of the colorectal cancer (Gramatges et al., 2014). There are also some special issues that John might experience like spiritual issues that include the confrontations with meaning of life and morality (Rowland Bellizzi, 2014). This also has implications on the social relationships and on the family (Gao et al., 2010). There is a need to provide support for these above-identified survivorship issues that John might be experiencing. Self-management education strategies and interventions are required to prevent and support John for the effective management of the disease and prevent the further complications and improve his quality of life. Psychosocial interventions are required for John to address the fear of cancer recurrence and uncertainty about the recurrence which is a major concern after the completion of the treatment. The interventions include knowledge regarding the side-effects, symptoms of recurrence and coping skills that are directed towards reduction and prevention of the fear and concerns in cancer survivors (Koller et al., 2012). Self-management also provides supportive care for John as it helps to improve his quality of care, healthy lifestyle and proper psychosocial functioning. It would also empower him and build self-esteem in John. The healthcare practitioners need to be empathetic towards John and apply supportive expressive therapy and effective communication skills while communicating with the cancer survivors that help to address and also prevent the survivorship issues of John (Jefford et al., 2008). The transtheoretical model of health behavior change is a vital self-management model for coping with survivorship issues that progresses through five stages requiring change; precontemplation, contemplation, preparation, action and maintenance. It promotes self-efficacy and self-esteem in the cancer survivors (Riekert, Ockene Pbert, 2013). This model can be applied to John's self-management of the survivorship issues. The first stage is the precontemplation stage where John is unaware of the problems and issues that are associated with the cancer survival. The healthcare professional in the second stage makes John aware of the problems and the desire to behavior change like the transtheoretical model of health behavior change (Prochaska, 2013). It is commonly used in client-centered approach where the clinician acts as coach to build confidence and work towards the goal of behavior change and healthy lifestyle. This can be done through patient education and learn about the risk and complications associated with the unhealthy behavior. The healthcare professional should educate John and motivate him to adopt the changes healthy behavior called the preparation stage. In the action stage, John should practice the healthy behavior that promotes self-management of the disease after the curative treatment. Healthy behavior like weight management, energy restriction, exercise and healthy behaviors helps to manage overall health and reduce the changes of asymptomatic cancer recurrence. In the maintenance stage, there is sustenance of the healthy behavior change and facilitation of the change. In this stage, there is requirement of communication strategies that reinforces change. Before the implementation of the transtheoretical model of health behavior change, it is important for the healthcare professionals to have communication skills to interact and motivate John to self-care management and addressing of the survivorship issues (Schwarzer, 2008). Self- care manage ment includes a healthy diet, regular medications, physical exercise and regular health check-ups that promote self-efficacy, fast recovery and reduce the risks and complications associated with the colorectal cancer and recurrence. In a study conducted by Hawkins et al., (2010) reported that positive behavior change is associated with low levels of psychosocial issues that promote positive health outcomes and well-being. Cluze et al., (2012) showed that the positive health behavior change like contact with the general practitioner, follow-up visits and compliance with medications and healthy lifestyle ensures reduction in psychosocial levels in the cancer survivors. In addition, the transtheoretical model of positive behavior change model is an effective way to motivate for the behavior change to prevent recurrence and promote positive health. To facilitate positive self-care management, effective communication skills are required while communicating with John and in promoting self-efficacy and self-esteem that reduces the survivorship issues (Uitterhoeve et al., 2010). Communication with John should include the information that helps him and his family to understand the circumstances, expectations, beliefs, values and personality (Gleason-Comstock et al., 2015). This includes the emotional reactions of John that provide information about the management of colorectal cancer and reduce chances of recurrence. Effective communication by healthcare professionals enhance the patient understanding and recall, improve patient satisfaction and reduce the survivorship issues and emotional distress (National Health and Medical Research Council, Department of Australia (Kurtz, Silverman Draper, 2016). The information provided to John regarding metastases or a recurrence should be succinct, pertinent in a private place and uninterrup ted time. Communication strategies are required provide high social support, health education and literacy and self-efficacy. It also promotes empowerment, overcome fear of cancer and emotional distress. The strategies include establishing support and trust that addresses John's emotions and concerns (Berkhof et al., 2011). Both verbal and non-verbal communication methods are important to establish feeling of trust and in reducing the knowledge gap that gives rise to psychosocial issues (Garg et al., 2016). The verbal strategies include open-ended questions that include questions that are related to the disease or treatment (Paternotte et al., 2015). Non-verbal strategies include looking, smiling, affective touch, careful listening and physical proximity. According to Kissane et al., (2012) the communication skills that healthcare professionals may adopt an effective conversation with John include open mind that welcomes any questions, attentiveness, genuine interest and empathetic listening. Friendliness, initialization of conversations that provide him scope for questions and invest time and effort in patient education. These skills are beneficial for fostering the collaborative ca re, two-way communication via feedback that build mutual respect and trust in the treatment and management. The emphasis on the contextual information aids to enable patient engagement and tailoring of care for John. The cultural background of the patient is also an important factor that acts as a barrier to effective communication between the healthcare professional and the patient. Understanding and assessing of John's cultural background provide a non-judgmental atmosphere and comfortable conversations in regards to the personal and difficult issues of John. The evaluation criteria that illustrate effective patient teaching are enhancing the two-way communication that includes feedback. When the patient provides feedback, it is possible for the healthcare professionals to assess and evaluate the level of understanding to reduce the knowledge gap about the disease and treatment. It also enhances collaborative care and promotes patent satisfaction. By encouraging open-ended questions help to assess the understanding of the disease by Teach-back method is an important method that can be used to evaluate the effectiveness of patient education (Tamura-Lis, 2013). This communication method is adopted by healthcare professionals to confirm the understanding that is being explained to the patient. Health education questionnaire would also help to evaluate the level of knowledge of the patient education session to assess the knowledge regarding the disease, treatment and self-management. Behavioral determinants assessment like physical activity, symptom monitoring and medication adherence would also help to evaluate the effectiveness of the patient education session (Dohmen et al., 2011 ). Conclusion The above case study deals with the patient education of John after he had undergone the curative treatment for colorectal cancer. The colorectal cancer follow-up is required for the investigation of the pathways that would help to investigate the recurrence of the disease. Intense follow-up regime is recommended for John that includes the hematological, colonoscopic and radiological evaluation. The return of the cancer is the major cause of distress in the cancer patients and evidence shows that majority of the people adapt to the life after the curative treatment, however, there are some cancer survivors who experience high levels of social and psychosocial distress. Self-management after colorectal cancer treatment is important for John that encompasses the both physical and psychosocial well-being as according to World Health Organization (WHO) the fullest health realization includes the social, physical, psychosocial, spiritual and economic aspects (World Health Organization, 20 10). The transtheoretical model of health behavior change is a vital self-management model that progresses through five stages requiring change; precontemplation, contemplation, preparation, action and maintenance. Before the implementation of the transtheoretical model of health behavior change, it is important for the healthcare professionals to have communication skills to interact and motivate John to self-care management and addressing of the survivorship issues (Schwarzer, 2008). It promotes self-efficacy and self-esteem in the cancer survivors. Both verbal and non-verbal communication methods are important to establish feeling of trust and in reducing the knowledge gap that gives rise to psychosocial issues. References Anderson, R. M., Funnell, M. M. (2010). Patient empowerment: myths and misconceptions.Patient education and counseling,79(3), 277-282. Astin, M., Griffin, T., Neal, R. D., Rose, P., Hamilton, W. (2011). The diagnostic value of symptoms for colorectal cancer in primary care: a systematic review.Br J Gen Pract,61(586), e231-e243. Battersby, N. J., Coupland, A., Bouliotis, G., Mirza, N., Williams, J. G. (2014). Metachronous colorectal cancer: a competing risks analysis with consideration for a stratified approach to surveillance colonoscopy.Journal of surgical oncology,109(5), 445-450. Berkhof, M., van Rijssen, H. J., Schellart, A. J., Anema, J. R., van der Beek, A. J. (2011). Effective training strategies for teaching communication skills to physicians: an overview of systematic reviews.Patient education and counseling,84(2), 152-162. Cluze, C., Rey, D., Huiart, L., BenDiane, M. K., Bouhnik, A. D., Berenger, C., ... Giorgi, R. (2012). Adjuvant endocrine therapy with tamoxifen in young women with breast cancer: determinants of interruptions vary over time.Annals of oncology,23(4), 882-890. Coleman, M. P., Forman, D., Bryant, H., Butler, J., Rachet, B., Maringe, C., ... McGahan, C. E. (2011). Cancer survival in Australia, Canada, Denmark, Norway, Sweden, and the UK, 19952007 (the International Cancer Benchmarking Partnership): an analysis of population-based cancer registry data.The Lancet,377(9760), 127-138. Dohmen, T., Falk, A., Huffman, D., Sunde, U., Schupp, J., Wagner, G. G. (2011). Individual risk attitudes: Measurement, determinants, and behavioral consequences.Journal of the European Economic Association,9(3), 522-550. Duijts, S. F., Egmond, M. P., Spelten, E., Muijen, P., Anema, J. R., Beek, A. J. (2014). Physical and psychosocial problems in cancer survivors beyond return to work: a systematic review.Psycho?Oncology,23(5), 481-492. Foster, C., Fenlon, D. (2011). Recovery and self-management support following primary cancer treatment.British journal of cancer,105, S21-S28. Gao, W., Bennett, M. I., Stark, D., Murray, S., Higginson, I. J. (2010). Psychological distress in cancer from survivorship to end of life care: prevalence, associated factors and clinical implications.European journal of cancer,46(11), 2036-2044. Garg, R., Shen, C., Sambamoorthi, N., Kelly, K., Sambamoorthi, U. (2016). Type of Multimorbidity and Patient-Doctor Communication and Trust among Elderly Medicare Beneficiaries.International Journal of Family Medicine,2016. Gleason-Comstock, J., Streater, A., Ager, J., Goodman, A., Brody, A., Kivell, L., ... Levy, P. (2015). Patient education and follow-up as an intervention for hypertensive patients discharged from an emergency department: a randomized control trial study protocol.BMC emergency medicine,15(1), 38. Gramatges, M. M., Liu, Q., Yasui, Y., Okcu, M. F., Neglia, J. P., Strong, L. C., ... Bhatia, S. (2014). Telomere content and risk of second malignant neoplasm in survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.Clinical Cancer Research,20(4), 904-911. Hawkins, N. A., Smith, T., Zhao, L., Rodriguez, J., Berkowitz, Z., Stein, K. D. (2010). Health-related behavior change after cancer: results of the American Cancer Societys studies of cancer survivors (SCS).Journal of cancer survivorship,4(1), 20-32. Holland, J. C., Alici, Y. (2010). Management of distress in cancer patients.J Support Oncol,8(1), 4-12. Jarrett, N., Scott, I., Addington-Hall, J., Amir, Z., Brearley, S., Hodges, L., ... Siller, C. (2013). Informing future research priorities into the psychological and social problems faced by cancer survivors: a rapid review and synthesis of the literature.European Journal of Oncology Nursing,17(5), 510-520. Jayne, D. G., Thorpe, H. C., Copeland, J., Quirke, P., Brown, J. M., Guillou, P. J. (2010). Five?year follow?up of the Medical Research Council CLASICC trial of laparoscopically assisted versus open surgery for colorectal cancer.British journal of surgery,97(11), 1638-1645. Jefford, M., Karahalios, E., Pollard, A., Baravelli, C., Carey, M., Franklin, J., ... Schofield, P. (2008). Survivorship issues following treatment completionresults from focus groups with Australian cancer survivors and health professionals.Journal of Cancer Survivorship,2(1), 20-32. Kissane, D. W., Bylund, C. L., Banerjee, S. C., Bialer, P. A., Levin, T. T., Maloney, E. K., D'Agostino, T. A. (2012). Communication skills training for oncology professionals.Journal of Clinical Oncology,30(11), 1242-1247. Koller, A., Miaskowski, C., De Geest, S., Opitz, O., Spichiger, E. (2012). A systematic evaluation of content, structure, and efficacy of interventions to improve patients' self-management of cancer pain.Journal of pain and symptom management,44(2), 264-284. Kurtz, S., Silverman, J., Draper, J. (2016).Teaching and learning communication skills in medicine. CRC press. Labianca, R., Nordlinger, B., Beretta, G. D., Brouquet, A., Cervantes, A. (2010). Primary colon cancer: ESMO Clinical Practice Guidelines for diagnosis, adjuvant treatment and follow-up.Annals of Oncology,21(suppl_5), v70-v77. Labianca, R., Nordlinger, B., Beretta, G. D., Mosconi, S., Mandal, M., Cervantes, A., ... ESMO Guidelines Working Group. (2013). Early colon cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up.Annals of oncology,24(suppl 6), vi64-vi72. Lovell, M. R., Luckett, T., Boyle, F. M., Phillips, J., Agar, M., Davidson, P. M. (2014). Patient education, coaching, and self-management for cancer pain.Journal of Clinical Oncology,32(16), 1712-1720. Mitry, E., Fields, A. L., Bleiberg, H., Labianca, R., Portier, G., Tu, D., ... Langer, B. (2008). Adjuvant chemotherapy after potentially curative resection of metastases from colorectal cancer: a pooled analysis of two randomized trials.Journal of Clinical Oncology,26(30), 4906-4911. Paternotte, E., van Dulmen, S., van der Lee, N., Scherpbier, A. J., Scheele, F. (2015). Factors influencing intercultural doctorpatient communication: A realist review.Patient education and counseling,98(4), 420-445. Primrose, J. N., Perera, R., Gray, A., Rose, P., Fuller, A., Corkhill, A., ... Mant, D. (2014). Effect of 3 to 5 years of scheduled CEA and CT follow-up to detect recurrence of colorectal cancer: the FACS randomized clinical trial.Jama,311(3), 263-270. Prochaska, J. O. (2013). Transtheoretical model of behavior change. InEncyclopedia of behavioral medicine(pp. 1997-2000). Springer New York. Riekert, K. A., Ockene, J. K., Pbert, L. (Eds.). (2013).The handbook of health behavior change. Springer Publishing Company. Rowland, J. H., Bellizzi, K. M. (2014). Cancer survivorship issues: life after treatment and implications for an aging population.Journal of Clinical Oncology,32(24), 2662-2668. Schwarzer, R. (2008). Modeling health behavior change: How to predict and modify the adoption and maintenance of health behaviors.Applied Psychology,57(1), 1-29. Stanton, A. L., Rowland, J. H., Ganz, P. A. (2015). Life after diagnosis and treatment of cancer in adulthood: contributions from psychosocial oncology research.American Psychologist,70(2), 159. Takagawa, R., Fujii, S., Ohta, M., Nagano, Y., Kunisaki, C., Yamagishi, S., ... Shimada, H. (2008). Preoperative serum carcinoembryonic antigen level as a predictive factor of recurrence after curative resection of colorectal cancer.Annals of surgical oncology,15(12), 3433-3439. Tamura-Lis, W. (2013). Teach-back for quality education and patient safety.Urologic Nursing,33(6), 267. Uitterhoeve, R. J., Bensing, J. M., Grol, R. P., Demulder, P. H. M., van Achterberg, T. (2010). The effect of communication skills training on patient outcomes in cancer care: a systematic review of the literature.European journal of cancer care,19(4), 442-457. Van Londen, G. J., Beckjord, E. B., Dew, M. A., Cooper, K. L., Davidson, N. E., Bovbjerg, D. H., ... Rechis, R. (2014). Associations between adjuvant endocrine therapy and onset of physical and emotional concerns among breast cancer survivors.Supportive Care in Cancer,22(4), 937-945. World Health Organization. (2010).World health statistics 2010. World Health Organization.