Case Study Of Psychosomatic Pain Nasrin Nursing Essay

Case Study Of Psychosomatic Pain Nasrin Nursing Essay It is a case of psychosomatic pain disorder in which a twenty seven year old lady named Nasrin is suffering from lower abdomen pain. Recently she had hysterectomy due to heavy periods and regular severe uterine pain. But after six months of her surgery she still feeling pain in her lower abdomen and she have no improvement in pain after six months of her surgery. Her gynecologist confident her that everything was normal but she was not satisfied with this statement. She visits many specialists but found no relief. She felt sharp pain everyday from few minutes to hours. In recent times she felt chest pain and thought she is having heart attack. But after her checkup in emergency the physician recommended that it might be anxiety. She felt insulted .Her GP influenced her to go to psychologist. GP clarified her that at times even emotions causes difficulties in medical problems Clients problems and Diagnosis: Nasrin went to consultant and told her problems. She explained that she has severe low backache and her pain is presently radiating both legs. Pain is very sharp and brought herself to tears. Pain occurs every day at different time intervals. She has lack of motivation and interest. She didnt sleep properly in night. She felt insulted when GP told her that these are only the signs of anxiety and tell her to see a psychologist. She avoids to meet anyone and seen herself failure and weak. By studying the whole case the case is diagnosed with the help of DSM IV checklist and it is diagnosed as a case of pain disorder associated with psychological factors. The client has following features: Her main problem was significant pain from long time. There are many psychological factors which play main role in the beginning, severity, exacerbation or preservation of pain. As pain felt everyday at different times and intervals. Pain is very sharp that brings Nasrin to tears. The symptoms are not purposely produced by the patient. Background: Patient Nasrin is the youngest one in her family. Since puberty she has not good health. She was having severe recurrent headaches but those headaches were not diagnosed as the attacks of migraine. When she was twelve years old her grandmother died. She was suffered with the symptoms of after stroke for four years before her death. After the death of her grandmother her mom showed sympathy towards her and whenever she felt those headaches she told her lie down. Her mother gave cold compression to her head. Mostly she felt chest pain during the stress period of exams. She got married at the age of twenty one and she left her study because of her severe headaches. She always tried to become an ideal companion. Her husband Alfred was also caring but due to her continuous appointments with doctors and their expenses he started criticizing her. Her husband left her after two years of her marriage. She was heartbroken at that time then she started work for supporting herself but soon she l ost her job due to her health problems. Because of her continuous visits to doctors she was absent from work many times and this was the reason for her job lost. After that she joined her parents and moved to their house. Case formulation: For formulating the case, first of all the consultant assesses and socializes into cognitive therapy. CBT is the therapy of choice in various mental health problems. CBT promote patient to talk about himself in a way that how the patient think about himself, the surrounding world and the other persons surrounding him. What are the things affects patients thoughts and feelings. By knowing all these things CBT helps in patients thinking (Cognitive) and what he do (behaviour) and this can help patient to feel better regarding his life. After that assessed the detailed description of the problem of client and in this case it is recurrent lower abdominal pain. Assess the predisposing factors and in Nasrin case these are recurrent headache and chest pain during stress like in exams etc. The precipitating factors were her grandmothers death and separation from her husband soon after her marriage and the maintaining factor is long term complaint of lower abdomen pain. Then ABC analysis of pr oblem was done by the consultant. Diagnose historical context of the problem, its assumptions and core beliefs. After that constructed a treatment and management plan .Afterwards socializing the client towards the self task. When client came to consultant initially in first session he/she should tell the client about the confidentially of their conversation for gaining faith of client, tells the cognitive therapy and regarding the estimated time of the therapy. CBT sessions are depends upon the patients problems and objectives. Generally with CBT results are better realized when sessions are between 6-20 and varies from 40 minutes to one hour each session. Every session is generally has a gap of one week or fifteen days. CBT cannot remove the patients problems but it can help to handle them in an optimistic way. Therapist helps patient to find ways by changing your thoughts and behaviour so that the patient cope with the problems in better way. (Sheldon, 2011). Consultant assesses the details of the problem as in this case Nasrin has a problem of severe lower abdomen pain. She suffers from this pain from a long time. She has heavy menstrual bleeding and severe lower abdominal pain. Her gynecologist was n ot agreeing to do surgery for this pain but Nasrins frequent visits and continuous pain problem agreed her to do surgery. Because of this continuous and sharp pain she influenced her surgeon and had hysterectomy in her young age. After six months of her surgery she felt no improvement in her pain. She visited to many specialists for finding the cause of her pain problem. But nothing was found by any specialist. Recently she felt chest pain and thought that she was having heart attack. But physician told her she is normal and this all was because of anxiety. She felt insulted with this comment. At last her GP influenced her to consult a clinical psychologist and clarify her that at times emotions made worse to medical problems. GP explained her that psychological assessments will better treat her condition. ABC analysis of Nasrin case: In this case A- activating events are the hysterectomy of client which was done at young age. Nasrin is separated from her husband and stay with her parents. B-Her rational thoughts and beliefs are that she is having severe pain in her lower abdomen. She also felt chest pain. She thoughts that she is pathetic for being like this .C- Consequences regarding the emotions she is nervous, irritated, shame and hurt also. In her behaviour she is always sad, there were crying episodes as sometimes the pain bring her to tears and she feels isolated also. After assessing Nasrin problem consultant gave her a questionnaire to do at her home .It is a questionnaire based on Hamilton anxiety rating scale (HAM-A). The main reason for giving this questionnaire to know the severity of symptoms of anxiety in patient. This scale contains 14 items and each of these items distinct by a number of symptoms. This scale calculates both psychic and somatic anxiety. Each item is scaled on 0-4 in which 0 means not present and 4 means severe. Total score range is 0-56 and if a person scores less than 17 it shows less severity and 18-24 means mild to moderate severity 25-30 means moderate to severe symptoms of anxiety ( Guy,1976,Hamilton, 1959). In her next visit Nasrin has to bring that filled questionnaire and consultant assessed those answers. In the next session consultant go through that filled questionnaire and identifies and clarified Nasrin problems by DSM IV checklist. The DSM (Diagnostic and Statistical Manual of Mental Disorders) is the usual classification regarding mental disorders and is used by mental health professionals in America. This has five axis in which Axis I covers clinical disorders, Axis II includes personality disorders and mental retardation. Axis III includes general medical conditions, Axis IV psychosocial and environmental conditions and Axis IV global assessment of functioning scale (American psychiatric association, 2000). Consultant assesses and found that she has a problem of pain disorder associated with psychological factors. Consultant took a detailed historical background in this visit. When consultant asked Nasrin about her background she told him that she was the youngest in her brother sisters. She has poor health since teenage. She has recurrent headaches from puberty but those head aches were not fit into migraine attacks and her grandmother died when she was 12 and her mother shows sympathy towards her after her grandmothers death. She has chest pain during stress. She was married when she was only 21 years old and left her university study because of her severe headache problem. Her husband left her after two years of her marriage. The reason for her separation was the high expenses due to frequent visits to doctors for her complaint of lower abdomen pain. After her separation she started work as personal assistant for supporting her. She lost her job soon because of continuous absent from her job due to her health problems. After that she shifted to her parents place and stay with them. Consultant listen all the background and gave Nasrin a homework task to maintain a daily pain dairy. In which she has to write at what time she has the pain as the pain starts in morning, afternoon or evening. Where is the pain in the scale of 0-10, in which 0 means no pain, 5 means moderate pain and 10 means worst possible pain. She has to write in dairy that what she was doing when the pain started. Did she take any medicine and what was the dose of that medicine? What were the other treatments she used? After one hour what the pain rate was in the rating scale like is it relived or gone worse. What are the other problems she faces? She has to maintain this daily pain dairy (AGS Foundation for Health in Aging, 2006) for one week till her next visit and bring it with her in her next visit. In her next visit the consultant gone through her daily pain dairy and identify her problem. Consultant done a counseling session about her hobbies and her likes and dislikes with her and in that conversation she told that she was previously used to write a personal dairy daily. But due to her health problems she didnt do this now. By knowing this entire, consultant asked her that why not she again start writing a book on her life and choose this as a smart goal for her. But she said that she is not able to do all this because of her health problems then consultant told her to just give this a try. In smart goal it is specific for Nasrin to write a book on her life story. This is measureable as the book will have 150 pages and her progress would be measured monthly. It will be an attainable goal as if she complete twelve and half pages in a month then she would have 150 pages by the deadline. This smart goal is realistic also as at times it will be difficult for Nasrin to get her tho ughts on paper, so she give herself enough time to complete her book. For time she has to finish this book in twelve months that means twelve and half pages in a month and150 pages in a year. So consultant advised her to work on this smart goal and she agreed on that. Generating Solution: For Nasrin consultant planned cognitive behaviour therapy for 6-12 weeks in which she has to continue her pharmacotherapy that means she has to continue her drugs prescribed by physician. She is advised for relaxation therapy and supportive psychotherapy for her anxiety problem. For relaxation therapy she has to do some relaxation techniques which helps in reducing tension of muscles and improving patients in general feeling of wellness and minimizes anxiety. Deep relaxation for 20-30 minutes reduces general anxiety, reduces the incidence and harshness of panic attacks. These techniques also good for sleeplessness and fatigue. It also increases self confidence and reduces the symptom of self blame (Bourne, 1995). In supportive psychotherapy, patient has to be supported for coping with stressors by many actions like carefully paying attention and cheering expressions regarding thoughts and feelings. Supporting the patient to understand the situation and its alternatives and trying to give a hope to patient (Douglas, 2008). Â   She has advised for some physiotherapy to support and tone up her lower abdominal muscles and keeps her body fit. Consultant advised Nasrin some preferred solutions for her problem. She has advised to do early morning yoga for half an hour. Then after her breakfast she is advised to visit local library for reading books on biographies. And coming back to home relax for some time and do some household works and after lunch go out for shopping and start socialising with friends and neighbours. In the evening watch tele with her parents. After dinner chat for some time with parents. Before going to bed while listening music try to write her biography. She has to follow the same till her next visit. After all these visits Nasrin is quiet satisfied and relaxed. Her episodes of pain are reducing day by day.

Comparing Apocalypse Now and Heart of Darkness Essay -- Movie Film com

Comparing Apocalypse Now and Heart of Darkness   Ã‚   In the opening scenes of the documentary film "Hearts of Darkness-A Filmmaker's Apocalypse," Eleanor Coppola describes her husband Francis's film, "Apocalypse Now," as being "loosely based" on Joseph Conrad's Heart of Darkness. Indeed, "loosely" is the word; the period, setting, and circumstances of the film are totally different from those of the novella. Yet, a close analysis of character, plot, and theme in each respective work reveals that Conrad's classic story of savagery and madness is present in its cinematic reworking. The story of Heart of Darkness is narrated by its central character, the seasoned mariner Marlowe, a recurring figure in Conrad's work. "Apocalypse Now" features a corollary to Marlowe in Captain Willard, a U.S. Army special forces operative assigned to go up the Nung river from Viet Nam into Cambodia in order to "terminate the command" of one Colonel Walter Kurtz whom, he is told, has gone totally insane. It is fitting that Marlowe's character should be renamed, as Willard differs from Marlowe in several significant ways: 1) He is not the captain of the boat which takes him and a party of others up the river; 2) He does not reflect the deep psychological and philosophical insights that are a signal feature in Marlowe's character, and 3) He is sent on his mission specifically to kill Kurtz, unlike Marlowe who is simply piloting others in the capacity of captain of a steamboat. However, Willard does communicate Marlowe's fascination (growing, in fact, into an obsession) with Kurtz. Al so significant is the fact that he holds the rank of captain, tying in with Marlowe's occupation. As to the character of Kurtz, it is worth noting that while signi... ...it, and Kurtz, whose soul went mad, all remain relatively in tact.  Ã‚   One can still feel "The horror, the horror,"    Works Cited and Consulted Brooke, Riley. "’Heart’ Transplant." Film Comment Sept.-Oct 1979: 26-27. Browne, Ray B, ed. Rituals and Ceremonies in Popular Culture. Bowling Green: Bowling Green University Popular Press, 1980. Conrad, Joseph. Heart of Darkness and The Secret Sharer (New York: Doubleday & Co., 1978) Coppolla, Francis Ford, dir. Apocalypse Now. Perf. Marlon Brando, Martin Sheen. 1981. Dittmar, Linda and Michaud, Gene, ed. From Hanoi to Hollywood: The Vietnam War in American Film. USA: Rutgers University Press, 1990. Hellman, John. American Myth and the Legacy of Vietnam. New York: Columbia University Press, 1977. Philips, Gene D. Conrad and Cinema: The Art of Adaptation. Dallas: Peter Lang, 1995.      

Management and its Functions Essay

Management is the process of coordinating people and other resources to achieve the goals of the organization. One key characteristic is the ability to empower rather than order employees to do their jobs. Effective empowerment depends on the leader and the employees building mutual respect, trust, and commitment. Leadership also possesses the ability to communicate by fostering an ongoing dialogue rather than issuing mandates. Now the leadership and management are defined, we can move on to describe management in terms of its four functions. These functions are identified as planning, organizing, leading, and controlling. How well managers perform these key functions determines whether a business is successful. Planning, in its simplest form, is establishing organizational goals and objectives and deciding how to accomplish them. It is the primary function, often referred as the â€Å"first† management function because all the management functions depend on planning. Managers engage in planning by determining where the firm should be going and how best to get there. Once goals and objectives have been set for the organization, managers must develop plans (or actions) for achieving them. A plan could be defined as an outline of the actions by which the organization intends to accomplish its goals and objectives. The company that I work for, 7-Eleven, I, as a manager, set a goal to sell as many products as possible to increase the sales. I have to ensure that the customer knows about the products we are selling. My number one target is the customer and the way to achieve is through my employees, who can provide the outstanding customer service and thus, the customer will come back. After goal setting and planning, the second major function of the management is organizing. Organizing is the grouping of resources and activities to accomplish effective and efficient results. From the reading, â€Å"Organizing activities include attracting people to the organization, specifying job responsibilities, grouping jobs into work unit, marshaling and allocating resources, and creating conditions so that people and things work together to achieve maximum success† (Bateman, 2004). Let’s first consider the example of an inventor who creates a new product and goes into the market to sell it. Eventually, as business grows, he/she will find that he/she needs  help. To begin with, he/she might hire a professional sales representative. Later, he/she might need to hire full-time sales staff, other people to assist with production, and an accountant. As he/she hires new personnel, he/she must decide what each person will do, and generally how that person can best take part in the organization’s activities. The way I work toward the organizing for the benefits of my organization is by providing at least week training to my staff about the products we are selling and its prices, promoting products to the customers, and ways to deliver excellent customer service. After a week of training, I oversee the employee I have trained, what I call as â€Å"shadow shift,† in which the trainee is evaluated for his/her performance. In addition, I hold weekly meeting with my employees for any questions, concerns, issues, and/or responsibilities. I delegate tasks to my personnel on daily basis and ensure that their obligations are understood clearly. The leading function is concerned with human resources within the organization. It is the process of influencing people to work toward a common goal as well as proving reasons for people to work in best interests of the organization. In other words, â€Å"It is directing, motivating, and communicating with employees, individually and in groups† (Bateman, 2004). Leading and motivating are critical activities for a growing company. Obviously, different people do things for different reasons – that is, they have different motivations. Some people are primarily interested in earning as much money as they can. Others may be spurred on by opportunities to get ahead in an organization. It is part of the manager’s jobs to determine what factors motivate workers and to try to provide those incentives in ways that encourage effective performance. For me, directing and motivating the employees is the most important function for the success of the company. I always tell my employees, â€Å"Be happy, and keep customers happy.† I believe that the communication is very important to keep the firm running smoothly; a good manager would always take care of his/her employees and make sure that they are appreciated for the hard work they put in. Therefore, I always encourage my personnel to talk over any issues or problems, if they have any, with me. Not only this, I always value them and make them realize that they are the most important component of the company and without them the  company can not move ahead. This way, a good relationship and trust is built between me and the employees and hence, the employees stay happy. With this, it gives them motivation to work for the best interests of the company. Regardless of how hard managers try, sometimes business activities don’t go as planned. Then, the fourth function, controlling, comes into play that evaluates and regulates ongoing activities to ensure that organizational goals are achieved. Reckon a rocket, for instance, launched to place a satellite. Do personnel simply fire the rocket and then check back in few days to find out whether the satellite is in place? Of course not. The rocket is constantly supervised, and its course is regulated and adjusted as needed to get the satellite to its destination. Thus, during this function, changes might be made to the plans in order to attain better success in the future. Therefore, the performance is compared and actions are taken according if necessary. Another example would be suppose that a specific firm establishes a goal of increasing its profit by, let’s say, 15 percent in a year. To ensure that its goal is reached, management might monitor its profit on monthly basis. After three to four months, if its profits have increased by 4-5 percent, then management might assume that the plans are going according to the schedule. Then, probably no action will be taken. However, if the profit has only increased by 1-2 percent, then the firm might take some actions or make some amendments to the planning to get things back on track. I can relate controlling to my organization because when the target is not reached to sell as many products as possible, I lower the price on the materials to meet the demands of the customers. For instance, if there’s a specific drink that is not selling as planned, I would try to sell it by promoting it for buying one sandwich and getting the drink free. A successful organization understands not only basic management functions, but also how to integrate these functions – planning, organizing, leading, and controlling – to improve revenues and profit and to win customer satisfaction needs. Each function tends to lead naturally to others; and if any one of the four functions is not conducted in effective manner, the company’s performance might fail. References Bateman, Thomas S. (2004). Management: The New Competitive Landscape, 6e. The McGaw-Hill Companies. Retrieved on August 10, 2004 from https://ecampus.phoenix.edu/content/eBookLibrary/content/eReader.h

teaching and migration in belgium essays

teaching and migration in belgium essays Het migrantenbeleid in Europa valt uiteen in twee delen: het migratiebeheersingsbeleid en het integratiebeleid of minderhedenbeleid, een term die in de Angelsaksische landen wordt gebruikt. Het migratiebeheersingsbeleid betreft nieuwkomers die geen verblijfsvergunning hebben. Er zijn vier mogelijke scenarios. Een eerste scenario is het huwelijk van een niet-EU-lid met een EU-lid. Zo komt het bijvoorbeeld in Limburg vaak voor dat Turkse migranten die in Belgi zijn opgegroeid trouwen met mensen uit Turkije. Een ander scenario is het asielbeleid waarbij de nieuwkomers asiel aanvragen in Belgi. Vervolgens is er het binnenkomen van nieuw-komers via een arbeidsvergunning. Zon arbeidsvergunning wordt in eerste instantie altijd voorlopig afgeleverd: meestal geldt ze n jaar en kan ze daarna verlengd worden. In principe wordt er na drie jaar een definitieve arbeidsvergunning gegeven. Dit gebeurt echter vaak alleen maar wanneer het beroepen betreft waarvoor men niemand vindt in Belgi en bij hooggekwalificeerden zoals Japanners en Scandinavirs. Ten slotte kan men ook nog binnenkomen als illegaal die al dan niet eerst in een asiel heeft gezeten. Het integratie- of minderhedenbeleid houdt rekening met de Belgische staatsstructuur. Op verschillende niveaus wordt een bepaald beleid gevoerd. Zo zijn de bevoegdheden van het federaal niveau de nationaliteit, de godsdienst en de ordehandhaving: het al dan niet toekennen van stemrecht, het toestaan van erediensten in een bepaalde godsdienst, de toegang tot het openbaar ambt... De gemeenschappen staan dan weer in voor onderwijs en vorming, cultuur, welzijn, taal- en jeugdbeleid. In de regel zijn aan deze bevoegdheden telkens een minister of een kabinet verbonden. Dan is er het niveau van de gewesten: het Vlaams, Brussels en Waals gewest. Deze zorgen voor de tewerkstelling (priv en openbaar ambt), de huisvesting en de gezondheid. Ten slotte ko...

Solare Energy Through Relays

Solare Energy Through Relays Free Online Research Papers INTRODUCTION: Solar energy, radiant light and heat from the sun, has been harnessed by humans since ancient times using a range of ever-evolving technologies. The Earth receives 174 petawatts (PW) of incoming solar radiation at the upper atmosphere. Approximately 30% is reflected back to space while the rest is absorbed by clouds, oceans and land masses. The total solar energy absorbed by Earths atmosphere, oceans and land masses is approximately 3,850,000 exajoules (EJ) per year. The amount of solar energy reaching the surface of the planet is so vast that in one year it is about twice as much as will ever be obtained from all of the Earths non-renewable resources of coal, oil, natural gas, and mined uranium combined. Solar energys uses are limited only by human ingenuity. A partial list of solar applications includes space heating and cooling through solar architecture, potable water via distillation and disinfection, day lighting, solar hot water, solar cooking, and high temperature process h eat for industrial purposes. To harvest the solar energy, the most common way is to use solar panels which are oriented in a specific direction. PURPOSE OF PROJECT: Since the solar panel is oriented in a specific direction, it uses the maximum possible solar energy when the Sun is exactly in front of it (i.e. the sun rays are normal to the solar panel). As the Earth moves around the sun or about its own axis, the solar energy striking the panel decreases and, therefore, the production of electricity from the panel decreases. In order to get the maximum benefit of solar energy, the solar panel must move relative to the Sun, as the Earth moves, without using any manpower. In this project, we have made the solar panel to move as the source of light moves to achieve the target of maximum electricity production with less labour. MATERIALS USED: Relays, Transistors, LDR, Motor, 12 volt supply METHOD: In this project, two LDRs control the motion of panel through motor. When the light falling on these LDRs is same the motor brings the panel in static condition by stopping its rotation. As the light source moves, it changes the intensities of light on both LDRs i.e. more intensity on the LDR which is near to the source of light. This results in the rotation of motor in order to move the panel so that the light falling on both LDRs becomes equal. The polarity of the motor is controlled by H-bridge which is made by means of relays. A third LDR, whose sensitivity is greater than the two LDRs, is also used in order to cut the main supply when the two LDRs are in dark. CONCLUSION: Since the solar energy is very much available and is also a safe source from environmental point of view, its use is increasing day by day. Still we are not making the most of solar energy but the benefits of solar energy can be increased to a large extent if use solar energy tracking systems like this in order to meet the recent demands of energy in the World. This system requires no labour to change the orientation of solar panel. So it is also attracting from economical point of view. AKNOWLEDGMENT: In the making of this project, a great support of our university, teachers and friends is also involved. We are very thankful to all our teachers and friends who helped us and gave their valuable time as well as guidance to us. Research Papers on Solare Energy Through RelaysBionic Assembly System: A New Concept of SelfPETSTEL analysis of IndiaAnalysis Of A Cosmetics AdvertisementMind TravelGenetic EngineeringRiordan Manufacturing Production PlanThe Project Managment Office SystemThe Spring and AutumnIncorporating Risk and Uncertainty Factor in CapitalOpen Architechture a white paper

Discussion Coursework Example | Topics and Well Written Essays - 250 words - 11

Discussion - Coursework Example Older adults with lower education levels are not able to monitor their blood pressure, therefore, medical practitioners should focus in aiding such individuals. These medical practitioners can focus on educating the community on the risks, causes, and treatment plans for the condition. In regard to the setting, resources that are available in this community that can aid in meeting the requirements of the target population include education, group counselling, and community empowerment fairs at senior homes. Dire areas of education in prevention and management of this condition include increasing the nutritional standards and engaging in regular exercise programs. Programs such as farm to school programs and health assessment and screening ought to be implanted in this area (McDonald, Hertz, Unger, & Lustik, 2009). Challenges I anticipate includes illiteracy in the target population, communication barriers as I may use medical terms which the community members may find hard to comprehend, and lack of participation of some community members. Despite these challenges, I aim to achieve my set goal of lowering the rate of hypertension among the elderly in this

Essay quextions Assignment Example | Topics and Well Written Essays - 1000 words

Essay quextions - Assignment Example ndergone through historical changes way back from pre-capitalist societies, capitalist societies, mercantilism as well as neoliberalism it can also be changed to suit the changing trends in market economy. To improve on our ability to live in a multicultural world; we should have a keen attention on our consumption patterns, have knowledge on circumstances and impacts of what we consume to enable us act responsibly. This will give us room to be able to join others in challenging inequity and injustice brought about with the capitalists to laborers and consumers. This is because the intrinsic nature of man will not allow others to also benefit the same, instead, the capitalists will continue with their spirit of accumulation not considering the working conditions of the laborers and consumers not able to have the right quality of goods that they are suppose to have in the name of cultural capitalism across the globe (Sorrells 177). Since cultural and ethnic diversity is not a new phenomenon; the argument of the three scholars about difference is that people should accept the reality and desirability of diversity and then be able to structure political and economic life accordingly. The difference is only created by the few individuals whose motives are only embedded in a capitalist system that which is organized around competition over the scarce resources, domination, identity and self-centered ambitions. Therefore, what is more important is a notion of the common good to any political society; from a multicultural perspective, this common good must be generated not by transcending or ignoring cultural and other differences, but through their interplay in a dialogical, agonistic political life (Allan 52). A sense of belonging must ultimately be political, based on a shared commitment to a political community. Since commitment, or belonging, must be reciprocal, citizen will not feel these things unless their p olitical community is also committed to them and makes