Sunday, September 6, 2009

How Maori' health was influenced

The inequalities and disparities in health status between Maori and non-Maori have been well-documented presently. To address this issue, Nursing Council of New Zealand expected that nursing staff are able to understand and analyze the historical, economic, and political process to which Maori have been subjected, so that nurses can enhance the ability of Maori to access health services. Therefore, all barriers of Maori toward Health services and inequalities in health are reduced; and finally Maori health is improved. The purpose of this essay is to describe the impacts of colonisation on Maori as the indigenous people of Aotearoa (New zealand) and link these processes of colonization in the past and present to the health inequalities in social, economic and health between Maori and non-Maori population. First, the impacts of colonization to Maori health are described; then existing inequalities between races are discussed, lastly nursing actions toward this issue is demonstrated.

First, colonization is noted that ‘it is based on dehumanizing indigenous peoples. Dehumanizing occurs on a spectrum from genocide to neglect, from paternalism to romanticism. This dehumanization depends on colonizers having a central belief in their own superiority and that they therefore have superior rights to the territory and resources of indigenous peoples’ (Hauora, 2007, p.4).

Aoteoroa’s history is similar to many countries such as Australia, Canada, America etcetera, they were colonized by Imperial mighty Great Britain who assumed that they had a high order of civilization or authority of Gods to dismiss and deconstruct the sovereign rights of native people. For example, Englishman Lieutenant James Cook charted the Australian east in 1770; he claimed the east coast under instruction from King George III of England, naming eastern Australia 'New South Wales' 1791. Western Australia was established in 1827 and Captain James Stirling was its first Governor (European discovery, n.d). Consequently, 500,000 Aboriginal people dispossessed of land which they owned for 40,000 years and their population reduced to 31,000 by 1911.

In Aoteoroa, many traders, sailors, sealers, and missionaries introduced Maori to many European products such as musket, cigarettes, wines, cloths and etcetera since 1790. As a consequence, within less than fifty years Maori lives had changed so significantly that some Maori leaders were able not able to return to previous time. Treaty of Waitangi was believed a solution because eroded Maori social systems can be protected under British (Durie,1994). Meantime, British were urged to take their action of colonization by a rumor that French will do. This treaty is a former agreement between forty three Maori Chiefs and British Crown representative at Waitangi in 1840. It intended that Maori transferred of sovereignty of Chiefs to Crown (article 1) while the Crown guaranteed to protect Maori taonga (treasures or valuables), but Maori still retained control over their resources (article 2); and guaranteed that Maori had the same rights and privileges as British (article 3) (Wepa, 2005). Before we discuss the impacts of colonization, we briefly describe Maori health to easily understand how colonization influences to Maori health.

The first impact of colonization on Maori is land loss and land alienation. It is true that Maori owed 26,709,342 ha of land in 1840 but 2,890,000 ha in 1901 (Durie, 1994). Maori health can not separated from their wider social, cultural and economic environments; therefore, the radical changes of Maori living environment due to loss of land caused loss of shelters, foods, facilities, families, spirits that are important determents of health.

Also, the loss of land and introduction of new European life-style leaded to Maori life-style disruption. The life-style was disturbed by the balance between tapu or noa. For example, being forced to leave natural environment then embraced European technologies and measured values according to economic worth (Durie, 1994).

The declining Maori population in eighteenth- nineteenth century is a significant consequence of colonization. Maori population decreased from 150,000 people in 1800 to 43,143 people in 1901 (Durie, 1994). The introduction of muskets is a considerable contributing factor to high mortality rate. Maori realized that advantage of muskets so they avenge against each other and colonial forces (Durie, 1994). Furthermore, the contagious and infectious diseases (smallpox, yellow fever, cholera, measles and etcetera) from new European settlers killed mass of Maori because they lacked immunity to bacterial and viral infection that was common in Europe.

Next, Maori cultures genocide by colonization. Maori traditional medicine was considered not suitable to treat new infectious diseases and converted to Western Medicine. In middle nineteenth century, many Maori and Tohugan (Maori healers) found that their herbal and healing methods hopeless against these new diseases and they gradually lost their confidence of their methods by introduction of very effective Western medicines. The effectiveness of this medicine and popularity of the missionary medicines assisted Maori conversion of Maori to Christianity because Maori began to believe that Christian God had superior power that contributed to European’s health and prosperity (Traditional Maori healing, n.d). However, Maori did not fully access to Western medical facilities due many barriers.

Meantime, there were many breaches of Treaty of Waitangi during period of time 1850-1930. Rights of national sovereignty and self-determination were extinguished by the colonization. According to Havemann (1999), in 1848-1863, Governor Grey extinguished native titles to the whole land of the South Island by unscrupulously purchasing land from the Ngai Tahu tribes; and native titles were extinguished in the North Island by a mix purchase, confiscation and legal artifice. Colonial domination initiated Maori nationalism by the election of a Maori King in Waikato (1858). This leaded to invasion in Waikato 1863 by Governor Grey. Consequently, the Tainui tribes were confiscated 1.2 million acres of land. These losses of lands in many places, Chiefs were disempowered; because the status of rangatina (leadership of Tapu) and ariki (leadership of Iwi confederation) based on mana whenua (land) disappeared. As a result, urban migration followed and contributed to increasing rate of unemployment in urban areas.

In addition, The Tohunga Supression Act was passed in 1907 because of concern raised over the practice and safety of some Tohunga; this Act banned all Tohunga to practice traditional Maori treatment to Maori. Because of the collapse of traditional Tohunga due to loss of Maori confidence against new infectious diseases, another type of healer took advantages of vulnerable Maori; these healers were motivated by greed and threatened Maori and Pakeha health. Besides, Maori healings were considered dangerous by Western model and it was not scientifically proven (Traditional Maori healing, n.d).

Presently, Maori population is considered as a low socio-economic that was based on deprivation index measured nine variable no access to a telephone, receiving a mean tested benefits, unemployment, low house-hold income, no access to a car, single parent family, no education qualification, not living in own home, and overcrowded house (Reid, et al, 2000).

Significantly, Maori health status appeared very poor compared to non-Maori group. Maori life expectancy at birth 8.5 years was lower than non-Maori group (Davis, 2006).

It is believed that that impacts of colonization such as loss of land, shelter, foods, natural environment, sovereignty, culture, language and depopulation caused inequalities in socio-economic position and health status.

Inequality in this country is widely used to means inequities as are the terms disparities or gaps (Hauora, 2007).

According to An indication of New zealanders’ health 2005, 2006, the rate of school completion rate in 2001 was very low in Maori group (30.5%) compared to European or other group (52.4%). The Maori unemployment rate was higher twice than European counter-part. Maori population had more low income than European with 29.3% and 24.5% respectively. The percent of Maori without access to telephone was doubled to European, 12.2% for Maori and 5.8% for European. The rate of Maori having a motor vehicle was higher two and half time than European with 12.3% and 4.7% respectively. 60.3% Maori not living in own home was greater than 43.4% European. The rate of household crowding was very high (19.2%) compared with European (4.2%).

Furthermore, the health inequalities were considered into many perspectives namely mortality, morbidity, disability and mental health. Firstly, mortality rate in Maori has been always higher than non-Maori. Maori mortality rate was significantly higher than non-Maori in different groups of age in 1975 (Pomare, 1980). Another report found that the absolute gap in mortality rate between Mäori and non-Mäori, and it was often greater for more disadvantaged income and education groups (Decades of disparity III, 2005). Moreover, according to Maori health chart (n.d), Maori was leading mortality rate of ischemic heart disease, cancers, accidents and etcetera.

Next, Maori morbidity rate of ischemic heart disease, lung cancer, liver cancer, stomach cancer, asthma, diabetes type II, chronic obstructive pulmonary disease (COPD), meningococcal disease, tuberculosis was significantly higher than non-Maori group (Maori health chart, n.d).

In addition, Maori is leading in use of mental health services. In 2002, 4,985 Maori clients were served compared to 2,283 Pacific Islander and 4,555 clients in other group (Health and independence report,2003). Maori have a high admission rate to mental institution for schizophrenia and paranoid status (Pomare, 1980). Also, dual diagnosis related to alcohol or drug and mental disorder is high incidence in Maori population (Maori health chart, n.d).

Lastly, disability rate in Maori population is greatly increased recently. According to statistic in 1991, one in five of Maori has a disability; about 107,200 Maori reported in disability status. More Maori boys (16%) have a disability state than girls (13%). The most common is physical disability.

The low socio-economic position is related directly health inequalities between two races as It was confirmed in Otago Research that socio-economic factors account for about half of the widening gap in mortality between Māori and non-Māori during the 1980s and 1990s new Otago research shows (Economic status, 2007).
can be understood that is impacts of colonization. First, Maori have low rate of qualification because the Western education system was not appropriate for Maori. According to Maori education (n.d). Before 1840, Maori children learnt the language and standards of behaviour from their families; they gained skills in fishing, hunting, gardening, house-building, cooking, mat-making, and basketry in the community. After 1840, schools were established by European missionaries. Specially, the regulation published in 1903 which forced Maori children to attend an ordinary school if a native school was not handy. The curriculum of Maori schools gradually became similar to the public schools; until in 1928 all schools were the same curriculum. Obviously, Maori children was educated in English by European system, that resulted in many Maori children did not reach an acceptable level of European education. Consequently, many young Maori students leave school early.

Secondly, Maori have a higher unemployment rate than non-Maori. Because assimilation of Maori into a European population which pursued by government in 1950’s. It was believed that Maori had social and economic disadvantages in their rural and natural place; therefore, urbanization is a good solution to help Maori integrate European population (Durie, 1994). The assimilation process would produce a ‘National Blend weld all in one nation’. Consequently, by 1976 over 80% of Maori were living in urban areas and a quarter of that population in the greater Auckland area (Durie, 2004). In urban areas, Maori were considered as unskilled low skilled labour. Specially, rising Maori unemployment rate from the level similar to non-Maori in the early 1980’s to three times that of non-Maori in the late 1980’s when New Zealand implemented major social and economic changes such as market rentals for housing, privatized major utilities, user-charger for health and education and other government services and restructured labour market to facilitate flexibility in 1980’s. These significant changes negatively impacted on Maori who was considered as “blue collar” with low skills, qualification.

Moreover, the health inequalities in Maori and non-Maori can be explained by many reasons. First, European hospital system was proven ineffective in Maori population. Hospitals were introduced in New Zealand in middle nineteenth century. Maori was willing to utilize these hospitals at the beginning; nonetheless, thirteen Maori inpatients died from 1849-1851. These deaths had negative effects on Maori perception, and these hospitals were classified as “tapu”.

In early 1860s, the high rate of mortality in these hospitals due to the severity of war injuries discouraged Maori admission. They concluded that “hospitals had a bad name among Maori, they were thought of as places where one went to die” (Dow, 1999,p.64).

As consequence of expanding Pakeha population, hospitals were quickly dominant by European inpatients and toward treating Pakeha. It was considered that most hospitals were too small or too far from centres of Maori population to accommodate Maori patients (Dow, 1999).

Secondly, Maori had many barriers to access to these hospitals due to territoriality and funding. All Hospital Board had some disputes with neighboring authorities over financial responsibilities for Maori patients. “In 1905, the Auckland board agreed to admit a Maori patient for ophthalmic treatment only on condition that Bay of Plenty guaranteed to payment” (Dow, 1999, p.105). This situation leaded to a mistaken perception that hospitals did not want to admit Maori and caused a negative effect on Maori.

Thirdly, the negative impact of colonization is not only land confiscation, disruption of Maori life-style but also social discrimination and racism (McCreanor & Nairn, 2002). According to Haris, et al. (2006). Some studies confirm that racial discrimination in many countries caused bad health outcomes in mental health, physical health (hypertension) and poor behaviours (smoking, drinking alcohol and etcetera).This is explained by negative effects of environmental and social behaviors and poor access to health services or quality of care as well as direct effects such as traumas or stresses toward to racial discrimination. A research carried in 2003 found that very high incidence of Maori experiencing in interpersonal discrimination of physical attacks, verbal attacks and institutional discriminations of work, health-care, housing-related unfair treatment in New Zealand (Haris, et al., 2006).

In addition, the poor outcome of Maori health is explained by limited access or discriminatory effects of the delivery of care. A research shown that low rates of specialist procedures, such as angioplasty, by minor ethnic minor group; however, higher rate in use by the majority population (Davis, et al., 2006). Similarly, it is evident that despite of having twice the mortality of coronary heart disease, Maori was admitted to hospital for diagnosis in proportion to the mortality nor received appropriate levels of specialist procedure such as coronary artery bypass and graft (CABG) and angioplasty (Reid & Robson, 2006).



Next, another reason of negative Maori health is that Maori were more likely receive suboptimum care in our health system. A research found that Maori patient in 1998 had a higher risk of preventable adverse events than non-Maori population. The preventable adverse events is defined unintended injuries that resulted in disability, with any evidence of causation by health-care management due to failure to follow accepted practice at an individual to system level (Davis, et al., 2006).
………………………..

As a health professional, nurses would realize that Maori lost the self-determination due to colonization; that allows nurses encourage Maori to involve in Maori health policies and work along with Maori population. Also, nurses would detect and protect against any racial discriminations in health care system to treat Maori fairly to improve Maori health status.
Recognizing the inequalities between races, nurses would help Maori to access effectively to our different service available such as housing, education or employment to maximize the material resources distributed to Maori. In inpatient settings, understanding the Maori history and how the impacts of colonization on Maori population, nurses can explain of the existing health inequalities; therefore, nurse will not have “victim blame” attitudes as providing care to Maori clients. In addition, nurses would identify the Maori barriers of health access; then, nurses help Maori clients access to our health service effectively. Furthermore, nurses protect Maori culture and provide nursing care in cultural safety by applying Tikanga Best Practice Policy. In community, nurses would do more health promotion in Maori population to empower Maori so that Maori can take over control their health. Besides, nurses utilize any health initiatives held by central or local government such as “cervical screening programme” or “eating healthy and living health programme” by focusing on Maori population to reduce health inequalities so that it can maximize Maori health.

In conclusion, this essay demonstrated the impacts of colonization on Maori such as loss of land, shelter, foods, natural environments, cultures and sovereignty and declining Maori population. This leaded to social negative effects of Maori life-style disruption, urbanization, loss of Maori traditional medicine (herbal and healing approach), loss of language, western health care system ineffectiveness on Maori and European education system inappropriateness to Maori students. Specially, the New Zealand major economic change in 1980- 1990 contributed to widen the gaps. All these caused socio-economic position and ethnic inequalities which resulted in health inequalities between Maori and non-Maori population. The recognition of these existing inequalities, nurse would promote health in individual and population level to empower Maori to take control their health. Also, nurses would eliminate all existing barriers on Maori population to access our health services to improve and restore Maori health.








REFERENCE:
An indication of new Zealanders’ health 2005 (2006). ……
Blakely, T., Ajwani, S., Robson B., Tobias, M., & Bonne, M. (2004). Decades of disparity: widening ethnic mortality gaps from 1980-1999. Retrieved March 3, 008 from
http://www.nzma.org.nz/journal/117-1199/995/
Davis, p., Lay-Yee, R., Dyall, L., Briant, R., Sporle, A., Brnt, D., & Scott, A. (2006). Quality of hospital care for maori patients in new Zealand: retrospective cross-sectional assessment. The lancet 2006, 367,1920-25.
Decades of disparity III: Ethnic and Socioeconomic Inequalities in
Socio-economic status half the story in ethnic death rate differences(2007). Retrieved March 5, 2008 from
http://www.otago.ac.nz/news/news/2006/08-05-06_press_release.html
Mortality, New Zealand 1981–1999 (n.d). Retrieved March 05, 2008 from
http://www.moh.govt.nz/moh.nsf/by+unid/D6D0FD57954B0AB3CC2571680013454B?Open
Dow, A.D (1999). Maori health & government policy 1840-1940. Auckland, New Zeland: Publishing Press .
Durie, M. (1994). Whaiora: Maori health development. Oxford: Oxford University Press.
Haris, R., Robias, M. Jeffreys, M., Waldegrave, K., Karlsen, S., & Nazroo J. (2006). Effects of self-reported racial discrimination and deprivation
on Māori health and inequalities in New Zealand. The lancet 2006, 367, 2005-2009.
Hauora: Maori standards of health IV.A study of the years 2000-2005.
Retrieved March 05, 2008 from
http://www.hauora.maori.nz
Health and independence report (2003). Retrieved March 05, 2008 from
http://www.moh.govt.nz/moh.nsf/0/BCC2EF21C59DEA6ECC256DFC00795D38/$File/HealthandIndependenceReport2003.pdf
European Discovery and colonization of Australian (n.d). Retrieved March 05, 2008
Havemann, P. (1999). Indigenous peoles’s rights in australia, canada, & new zealand. Oxford: Oxford University Press New Zealand.
Maori health chart (n.d). Retrieved March 05, 2008 from http://www.moh.govt.nz/moh.nsf/0/CE9CA594D388BE4FCC25714600729978
Maori education (n.d). Retrieved March 05, 2008 from
http://www.teara.govt.nz/1966/M/MaoriEducation/Government
Control/en
McCreanor, T, & Nairn, R (2002). Tauiwi general practitioners’ talk about Maori health: interpretative repertoires. New Zealand Medical journal. Retrieved February 26, 2008 from
http://www.nzma.org.nz/journal/115-1167/272/
Reid, P., & Robson, B. (2006). The state of maori health. Mullholand, M. (Eds.), The state of Maori health: Twenty-first century issue in Aoteaora. Auckland: Oxford Express.
Reid, P., RobB., & Jones, C.P (2000). Disparity in health: common myths and uncommom truth. Pacific health dialog, 7(1) , 38-47.
Pomare,E.W.(1980). Maori standards of health : a study of the 20 years period 1955-75. ……………………………….
The Maori (n.d). Retrieved February 29, 2008 from
http://history-nz.org/maori7.html
Traditional maori healing (n.d). Retrieved February 20, 2008 from http://pharmacy.otago.ac.nz/rongoa/pages/history.html
Wepa, D. (2005). Cultural safety in aoteaora new zealand: Auckland: Pearson Education.

Saturday, September 5, 2009

diabetes type 2/ tim hieu so luoc ve binh tieu duong

PATIENTS WITH DIABETES TYPE II AND NURSING ROLES

In diabetes type II, the pancreas usually continues to produce insulin but it is insufficient for the body needs or poorly utilised by the tissues.

Some patients think diabetes is a progression to disability and death with or without medical intervention. Also, many patients feel vulnerable and feel self-inflicted.

Patients physically experience pain, discomfort and anxiety. Diabetes mentally causes worry, fear, stress, anxiety and depression.. Socially, diabetic patients become less social.

In some cultures, obesity causes shame and low-self esteem and their routines are interupted. Diabetics are sufferred by reduced personal incomes by disability, early retirement, work absenteeism, premature mortality.

There are different services in inpatient and outpatient settings such as diabetes nurses, multidisciplinary team, chronic care management etc. Registered nurses are to assess patient health’s needs, provide care, advise and support patients.

Nurses can educate patients about medications and side effects, healthy lifestyle, exercises, hyperglycaemic and hypoglycaemic symptoms. Also, nurses should advise insulin administration, BSL monitor and diabetes complications.

Honesty, Auckland, New zealand

Làm sao học English hieu quả

Các bạn thân mến

Học English cần đòi hỏi kiên nhẫn và nỗ lực thì mới có thể trở thành có kĩ năng nghe, nói , đọc, viết tốt . Bản thân tôi đã họ English rất lâu, khoảng 10 năm ở Việt Nam, tại nhiều trung tâm nổi tiếng. Tuy nhiên, khi sang nước ngoài học English để vào Đại học, tôi vẫn thấy English của mình vẫn rất dở, nhiều sai sót trong nói và không lưu loát. Tôi đã cố gắng phân tích và so sánh việc học English ở trong và ngoài nước, để hi vọng giúp các bạn học English có hiệu quả hơn và nhanh hơn.

Trước hết, tôi nói sự khác biệt trong cách phát âm của English có khác biệt với Tiếng Việt. English có lượng âm trong 1 từ, ví dụ : từ “pronunciation” [prə,nʌnsi'ei∫n], rõ ràng là khi đọc, chúng ta phải đọc là : pro nan ci a tion. Khác với tiếng việt chỉ chứa 1 âm trong 1 từ, ví dụ : :”đọc” hay “nói”. Do đó, khi phát âm, các bạn cần phải đọc rõ âm và không để mất đi âm nào. Vì nếu mất đi 1 âm, các bạn sẽ làm người nghe hiểu lầm. Đồng thời, các bạn cần đọc 1 cách chậm và nhẹ nhàng theo âm, không nên cứ phát âm nhanh và đều đều như nhau. Người thầy bản xứ của tôi nhận xét rằng nghe các bạn người Việt nói Tiếng Anh cứ như là bắn súng vậy, nghĩa là không có âm ngữ điệu, cứ liên tục và đều đều như nhau.

Nhấn âm là rất quan trọng để giúp người bán xứ phân biệt sự khác nhau giữa các từ khác nhau , ví dụ : từ “college” và “colleague”. Từ college các bạn phải nhấn âm đầu và colleague thì nhấn âm sau. Nếu các bạn nhấn âm sai, sẽ làm người bản xứ hiểu sai hoặc là không hiểu.

Một điều quan trọng nữa là phải phát âm âm cuối của từ, đó cũng là cách để phân biệt các từ khác nhau trong English, ví dụ : word, wall, word, world, walk. Trong Vietnamese thì không có âm cuối, nến tôi và nhiều bạn người Việt đã không phân biệt trong phát âm và kết quả là người bản xứ không hiểu. Cách để làm người ta hiểu phụ thuộc và cách bạn phát âm âm tận cùng thật rõ và đúng.

Về cách học Englich, các bạn nên học 1 cách tự nhiên và khoa học. Các bạn hãy quan sát đứa trẻ học ngôn ngữ như thế nào ? Muốn học 1 ngôn ngữ tự nhiên là cần học nghe trước để rồi bạn biết được từng âm và từ khác nhau và bắt đầu học phát âm theo những điều đã nghe, và rồi sẽ nhớ.

Cách học này ngược lại ở Việt Nam , vì các thầy cứ bắt chúng ta học từ mới. Trong khi ta chưa biết cách phát âm, để bắt chước cho đúng, từ đó sẽ dẫn đến một thói quen phát âm sai. Thực sự cho thấy là ở Việt Nam, tôi và cạc bạn đã học nhiều từ mới nhưng khi sử dụng thì không thể phát âm chính xác và nhanh chóng được. Đây là lý do tại sao việc học Tiếng Anh trở nên không hiệu quả. Do đó, để học English thì các bạn cứ học nghe và đọc nhiều lần từng chữ và từng câu. Như thế bạn sẽ dễ nhớ, phát âm 1 cách tự nhiên hơn.

Khi học English, các bạn nên tập trung vào học nghe rồi nói, sau đó mới đến đọc và viết, giống như em bé học Tiếng Việt vậy. Đó là cách học tự nhiên , não chúng ta sẽ thu nhập ngôn ngữ ( âm từ và từ vựng ) trước khi tạo ra sản phẩm ngôn ngữ là nói và viết.

Để học nghe, các bạn cần tận dụng các điều kiện để nghe như : nghe băng, coi phim , nghe nhạc, nghe đài bằng Tiếng Anh. Lúc đầu , các bạn không cần nghe hết và hiểu hết, chỉ cần nghe nhiều lần và bắt ý chính, nghe những từ chính mà bạn có thể nghe được, rồi từ từ sẽ nghe nhiều hơn.

Các bạn có thể học nói bằng cách nói một mình trong gương, trong những lúc lái xe hay trước khi đi ngủ. Khi tập nói, các bạn nên liên tưởng đến hoản cảnh cụ thể rồi hãy bắt đầu nói. Có thể các bạn nghe 1 bài đàm thoại rồi sau đó nhớ và tự nói theo. Hay là chat với người nước ngoài trên Internet. Cách học này tự nhiên nhưng cần nhiều thời gian để thực hành. Các bạn nên nhớ rằng học ngôn ngữ là thực hành, càng nói nhiều thì sẽ trôi chảy và nhớ nhiều từ. Khi nói nhiều, lười các bạn trở nên dễ dàng hơn khi phát âm, cũng như việc truy suất từ từ não bộ.

Để học đọc và viết, các bạn nên đọc theo chủ đề mà các bạn cảm thấy thú vị, khi đó các bạn sẽ dành nhiều thời gian đọc và học những cách dùng từ khác nhau. Đồng thời tranh thủ tra từ điển cho các từ mới. Tuy nhiên, các bạn nên đoán thử nghĩa của từ trước. Với cách này bắt buộc các bạn phải động não và suy nghĩ từ ngữ thích hợp trong câu. Nghĩa của từ thay đổi theo cú pháp vá ý từ của từng câu văn, cho nên nhờ sự suy luận này, các bạn có thể học được nhiều cách sự dụng trong những câu khác nhau. Đồng thời khi các bạn gặp từ này nhiều lần mà vẫn không biết nghĩa là gì thì khi bạn tra từ điển, sẽ giúp cho bạn nhớ lâu hơn.

Về vấn đề lựa chọn tại liệu, các bạn nên chọn những tại liệu mang tính thực hành cao, nhiều đàm thoại để đọc và để nhớ hơn là học nghiêng về lý thuyết.

Các bạn cũng nên luyện các kĩ năng : Nghe, nói ,đọc viết theo chương tr ình IELTS. Chương trình này có ưu điểm giúp bạn phát triển từng kĩ năng và cũng là chương trình đang đượng công nhận ở nhiều nước trên thế giới như Anh, Úc, NewZealand, Canada, Mỹ…

Cuối cùng, thân chúc các bạn sẽ học tốt English !

Tôi cũng hi vọng những kinh nghiệm của tôi chia sẻ trên đây sẽ hữu ích đối với việc học English của các bạn.

Nếu các bạn có nhu cầu trao đổi những vấn để liên quan tới học English, cũng như du học, hãy liên lạc với tôi. Tôi rất vui được làm quen và chia sẻ với các bạn

Honesty, New Zealand .

Thursday, September 3, 2009

a real story about true love and life
















The Wedding…


Her name is Katie Kirkpatrick, 21 yrs old. Next to her is her fiancé, Nick, 23. This picture was taken prior to their wedding January 11th, 2005. Katie has terminal cancer and spends hours in chemotherapy.Here Nick awaits while she finishes one of the sessions...Even in pain and dealing with her organs shutting down, with the help of morphine, Katie took care of every single part of the wedding planning. Her dress had to be adjusted several times due to Katie's constant weight loss. An expected guest was her oxygen tank. Katie had to use it during the ceremony and reception. The other couple in this picture is Nick's parents, very emotional with the wedding and of course to see their son marrying the girl he fell in love when he was an adolescent. Katie, in a wheel chair listening to her husband and friends singing to her.In the middle of the party, Katie had to rest for a bit and catch her breath. The pain does not allow her to stand for long period of time. Katie died 5 days after her wedding. To see a fragile woman dress as bride with a beautiful smile makes you think... happiness is always there within reach, no matter how long it lasts.....lets enjoy life and don't live a complicated life. Life is too short. Work as if it was your first day. Forgive as soon as possible. Love without boundaries. Laugh without control and never stop smiling. Please pray for those suffering from cancer. We all have close to our heart. Keep this going. Prayers are always answered.

Attitudes are contagious, Is yours worth catching?
It is a pleasure to meet and share life experience and value of life with you, young Vietnamese and others. I will write and share what I saw and thought to help you see the world better