4.7E: Exercises
Practice Makes Perfect
Evaluate the Determinant of a 2 × 2 Matrix
In the following exercises, evaluate the determinate of each square matrix.
\(\left[\begin{matrix}6&−2\\3&−1\end{matrix}\right]\)
\(\left[\begin{matrix}−4&8\\−3&5\end{matrix}\right]\)
- Answer
-
\(4\)
\(\left[\begin{matrix}−3&5\\0&−4\end{matrix}\right]\)
\(\left[\begin{matrix}−2&0\\7&−5\end{matrix}\right]\)
- Answer
-
\(10\)
Evaluate the Determinant of a 3 × 3 Matrix
In the following exercises, find and then evaluate the indicated minors.
\(\left|\begin{matrix}3&−1&4\\−1&0&−2\\−4&1&5\end{matrix}\right|\)
Find the minor ⓐ \(a_1\) ⓑ \(b_2\) ⓒ \(c_3\)
\(\left|\begin{matrix}−1&−3&2\\4&−2&−1\\−2&0&−3\end{matrix}\right|\)
Find the minor ⓐ \(a_1\) ⓑ \(b_1\) ⓒ \(c_2\)
- Answer
-
ⓐ 6 ⓑ \(−14\) ⓒ \(−6\)
\(\left|\begin{matrix}2&−3&−4\\−1&2&−3\\0&−1&−2\end{matrix}\right|\)
Find the minor ⓐ \(a_2\) ⓑ \(b_2\) ⓒ \(c_2\)
\(\left|\begin{matrix}−2&−2&3\\1&−3&0\\−2&3&−2\end{matrix}\right|\)
Find the minor ⓐ \(a_3\) ⓑ \(b_3\) ⓒ \(c_3\)
- Answer
-
ⓐ 9 ⓑ \(−3\) ⓒ 8
In the following exercises, evaluate each determinant by expanding by minors along the first row.
\(\left|\begin{matrix}−2&3&−1\\−1&2&−2\\3&1&−3\end{matrix}\right|\)
\(\left|\begin{matrix}4&−1&−2\\−3&−2&1\\−2&−5&7\end{matrix}\right|\)
- Answer
-
\(−77\)
\(\left|\begin{matrix}−2&−3&−4\\5&−6&7\\−1&2&0\end{matrix}\right|\)
\(\left|\begin{matrix}1&3&−2\\5&−6&4\\0&−2&−1\end{matrix}\right|\)
- Answer
-
\(49\)
In the following exercises, evaluate each determinant by expanding by minors.
\(\left|\begin{matrix}−5&−1&−4\\4&0&−3\\2&−2&6\end{matrix}\right|\)
\(\left|\begin{matrix}4&−1&3\\3&−2&2\\−1&0&4\end{matrix}\right|\)
- Answer
-
\(−24\)
\(\left|\begin{matrix}3&5&4\\−1&3&0\\−2&6&1\end{matrix}\right|\)
\(\left|\begin{matrix}2&−4&−3\\5&−1&−4\\3&2&0\end{matrix}\right|\)
- Answer
-
\(25\)
Use Cramer’s Rule to Solve Systems of Equations
In the following exercises, solve each system of equations using Cramer’s Rule.
\(\left\{\begin{array} {l} −2x+3y=3\\x+3y=12\end{array}\right.\)
\(\left\{\begin{array} {l} x−2y=−5\\2x−3y=−4\end{array}\right.\)
- Answer
-
\((7,6)\)
\(\left\{\begin{array} {l} x−3y=−9\\2x+5y=4\end{array}\right.\)
\(\left\{\begin{array} {l} 2x+y=−4\\3x−2y=−6\end{array}\right.\)
- Answer
-
\((−2,0)\)
\(\left\{\begin{array} {l} x−2y=−5\\2x−3y=−4\end{array}\right.\)
\(\left\{\begin{array} {l} x−3y=−9\\2x+5y=4\end{array}\right.\)
- Answer
-
\((−3,2)\)
\(\left\{\begin{array} {l} 5x−3y=−1\\2x−y=2\end{array}\right.\)
\(\left\{\begin{array} {l} 3x+8y=−3\\2x+5y=−3\end{array}\right.\)
- Answer
-
\((−9,3)\)
\(\left\{\begin{array} {l} 6x−5y+2z=3\\2x+y−4z=5\\3x−3y+z=−1 \end{array}\right.\)
\(\left\{\begin{array} {l} 4x−3y+z=7\\2x−5y−4z=3\\3x−2y−2z=−7\end{array}\right.\)
- Answer
-
\((−3,−5,4)\)
\(\left\{\begin{array} {l} 2x−5y+3z=8\\3x−y+4z=7\\x+3y+2z=−3\end{array}\right.\)
\(\left\{\begin{array} {l} 11x+9y+2z=−9\\7x+5y+3z=−7\\4x+3y+z=−3\end{array}\right.\)
- Answer
-
\((2,−3,−2)\)
\(\left\{\begin{array} {l} x+2z=0\\4y+3z=−2\\2x−5y=3\end{array}\right.\)
\(\left\{\begin{array} {l} 2x+5y=4\\3y−z=3\\4x+3z=−3\end{array}\right.\)
- Answer
-
\((−3,2,3)\)
\(\left\{\begin{array} {l} 2y+3z=−1\\5x+3y=−6\\7x+z=1\end{array}\right.\)
\(\left\{\begin{array} {l} 3x−z=−3\\5y+2z=−6\\4x+3y=−8\end{array}\right.\)
- Answer
-
\((−2,0,−3)\)
\(\left\{\begin{array} {l} 2x+y=3\\6x+3y=9\end{array}\right.\)
\(\left\{\begin{array} {l} x−4y=−1\\−3x+12y=3\end{array}\right.\)
- Answer
-
infinitely many solutions
\(\left\{\begin{array} {l} −3x−y=4\\6x+2y=−16\end{array}\right.\)
\(\left\{\begin{array} {l} 4x+3y=2\\20x+15y=5\end{array}\right.\)
- Answer
-
inconsistent
\(\left\{\begin{array} {l} x+y−3z=−1\\y−z=0\\−x+2y=1\end{array}\right.\)
\(\left\{\begin{array} {l} 2x+3y+z=1\\2x+y+z=9\\3x+4y+2z=20\end{array}\right.\)
- Answer
-
inconsistent
\(\left\{\begin{array} {l} 3x+4y−3z=−2\\2x+3y−z=−1\\2x+y−2z=6\end{array}\right.\)
\(\left\{\begin{array} {l} x−2y+3z=1\\x+y−3z=7\\3x−4y+5z=7\end{array}\right.\)
- Answer
-
infinitely many solutions
Solve Applications Using Determinants
In the following exercises, determine whether the given points are collinear.
\((0,1)\), \((2,0)\), and \((−2,2)\).
\((0,−5)\), \((−2,−2)\), and \((2,−8)\).
- Answer
-
yes
\((4,−3)\), \((6,−4)\), and \((2,−2)\).
\((−2,1)\), \((−4,4)\), and \((0,−2)\).
- Answer
-
no
Writing Exercises
Explain the difference between a square matrix and its determinant. Give an example of each.
Explain what is meant by the minor of an entry in a square matrix.
- Answer
-
Answers will vary.
Explain how to decide which row or column you will use to expand a \(3×3\) determinant.
Explain the steps for solving a system of equations using Cramer’s rule.
- Answer
-
Answers will vary.
Self Check
ⓐ After completing the exercises, use this checklist to evaluate your mastery of the objectives of this section.
ⓑ After reviewing this checklist, what will you do to become confident for all objectives?


2.3: Communicating with Patients
Therapeutic communication is a type of professional communication used by nurses with patients and defined as, “The purposeful, interpersonal information-transmitting process through words and behaviors based on both parties’ knowledge, attitudes, and skills, which leads to patient understanding and participation.” [1] Therapeutic communication techniques used by nurses have roots going back to Florence Nightingale, who insisted on the importance of building trusting relationships with patients and believed in the therapeutic healing that resulted from nurses’ presence with patients. [2] Since then, several professional nursing associations have highlighted therapeutic communication as one of the most vital elements in nursing.
Read an example of a nursing student effectively using therapeutic communication with patients in the following box.
Ms. Z. is a nursing student who enjoys interacting with patients. When she goes to patients’ rooms, she greets them and introduces herself and her role in a calm tone. She kindly asks patients about their problems and notices their reactions. She does her best to solve their problems and answer their questions. Patients perceive that she wants to help them. She treats patients professionally by respecting boundaries and listening to them in a nonjudgmental manner. She addresses communication barriers and respects patients’ cultural beliefs. She notices patients’ health literacy and ensures they understand her messages and patient education. As a result, patients trust her and feel as if she cares about them, so they feel comfortable sharing their health care needs with her. [3] , [4]
Active Listening and Attending Behaviors
Listening is obviously an important part of communication. There are three main types of listening: competitive, passive, and active. Competitive listening happens when we are focused on sharing our own point of view instead of listening to someone else. Passive listening occurs when we are not interested in listening to the other person and we assume we understand what the person is communicating correctly without verifying. During active listening , we are communicating verbally and nonverbally that we are interested in what the other person is saying while also actively verifying our understanding with the speaker. For example, an active listening technique is to restate what the person said and then verify our understanding is correct. This feedback process is the main difference between passive listening and active listening. [5]
Touch
Touch is a powerful way to professionally communicate caring and empathy if done respectfully while being aware of the patient’s cultural beliefs. Nurses commonly use professional touch when assessing, expressing concern, or comforting patients. For example, simply holding a patient’s hand during a painful procedure can be very effective in providing comfort. See Figure 2.7 [6] for an image of a nurse using touch as a therapeutic technique when caring for a patient.
Therapeutic Techniques
Therapeutic communication techniques are specific methods used to provide patients with support and information while focusing on their concerns. Nurses assist patients to set goals and select strategies for their plan of care based on their needs, values, skills, and abilities. It is important to recognize the autonomy of the patient to make their own decisions, maintain a nonjudgmental attitude, and avoid interrupting. Depending on the developmental stage and educational needs of the patient, appropriate terminology should be used to promote patient understanding and rapport. When using therapeutic communication , nurses often ask open-ended statements and questions, repeat information, or use silence to prompt patients to work through problems on their own. [7] Table 2.3a describes a variety of therapeutic communication techniques. [8]
Table 2.3a Therapeutic Communication Techniques
| Therapeutic Technique | Description |
|---|---|
| Active Listening | By using nonverbal and verbal cues such as nodding and saying “I see,” nurses can encourage patients to continue talking. Active listening involves showing interest in what patients have to say, acknowledging that you’re listening and understanding, and engaging with them throughout the conversation. Nurses can offer general leads such as “What happened next?” to guide the conversation or propel it forward. |
| Using Silence | At times, it’s useful to not speak at all. Deliberate silence can give both nurses and patients an opportunity to think through and process what comes next in the conversation. It may give patients the time and space they need to broach a new topic. |
| Accepting | Sometimes it is important to acknowledge a patient’s message and affirm that they’ve been heard. Acceptance isn’t necessarily the same thing as agreement; it can be enough to simply make eye contact and say, “Yes, I hear what you are saying.” Patients who feel their nurses are listening to them and taking them seriously are more likely to be receptive to care. |
| Giving Recognition | Recognition acknowledges a patient’s behavior and highlights it. For example, saying something such as “I noticed you took all of your medications today” draws attention to the action and encourages it. |
| Offering Self | Hospital stays can be lonely and stressful at times. When nurses are present with their patients, it shows patients they value them and are willing to give them time and attention. Offering to simply sit with patients for a few minutes is a powerful way to create a caring connection. |
| Giving Broad Openings/Open-Ended Questions | Therapeutic communication is often most effective when patients direct the flow of conversation and decide what to talk about. To that end, giving patients a broad opening such as “What’s on your mind today?” or “What would you like to talk about?” can be a good way to allow patients an opportunity to discuss what’s on their mind. |
| Seeking Clarification | Similar to active listening, asking patients for clarification when they say something confusing or ambiguous is important. Saying something such as “I’m not sure I understand. Can you explain it to me?” helps nurses ensure they understand what’s actually being said and can help patients process their ideas more thoroughly. |
| Placing the Event in Time or Sequence | Asking questions about when certain events occurred in relation to other events can help patients (and nurses) get a clearer sense of the whole picture. It forces patients to think about the sequence of events and may prompt them to remember something they otherwise wouldn’t. |
| Making Observations | Observations about the appearance, demeanor, or behavior of patients can help draw attention to areas that may indicate a problem. Observing that they look tired may prompt patients to explain why they haven’t been getting much sleep lately, or making an observation that they haven’t been eating much may lead to the discovery of a new symptom. |
| Encouraging Descriptions of Perception | For patients experiencing sensory issues or hallucinations, it can be helpful to ask about these perceptions in an encouraging, nonjudgmental way. Phrases such as “What do you hear now?” or “What does that look like to you?” give patients a prompt to explain what they’re perceiving without casting their perceptions in a negative light. |
| Encouraging Comparisons | Patients often draw upon previous experiences to deal with current problems. By encouraging them to make comparisons to situations they have coped with before, nurses can help patients discover solutions to their problems. |
| Summarizing | It is often useful to summarize what patients have said. This demonstrates to patients that the nurse was listening and allows the nurse to verify information. Ending a summary with a phrase such as “Does that sound correct?” gives patients explicit permission to make corrections if they’re necessary. |
| Reflecting | Patients often ask nurses for advice about what they should do about particular problems. Nurses can ask patients what they think they should do, which encourages them to be accountable for their own actions and helps them come up with solutions themselves. |
| Focusing | Sometimes during a conversation, patients mention something particularly important. When this happens, nurses can focus on their statement, prompting patients to discuss it further. Patients don’t always have an objective perspective on what is relevant to their case, but as impartial observers, nurses can more easily pick out the topics on which to focus. |
| Confronting | Nurses should only apply this technique after they have established trust. In some situations, it can be vital to the care of patients to disagree with them, present them with reality, or challenge their assumptions. Confrontation, when used correctly, can help patients break destructive routines or understand the state of their current situation. |
| Voicing Doubt | Voicing doubt can be a gentler way to call attention to incorrect or delusional ideas and perceptions of patients. By expressing doubt, nurses can force patients to examine their assumptions. |
| Offering Hope and Humor | Because hospitals can be stressful places for patients, sharing hope that they can persevere through their current situation and lightening the mood with humor can help nurses establish rapport quickly. This technique can keep patients in a more positive state of mind. However, it is important to tailor humor to the patient’s sense of humor. |
In addition to the therapeutic techniques listed in Table 2.3a, nurses and nursing students should genuinely communicate with empathy. Communicating honestly, genuinely, and authentically is powerful. It opens the door to creating true connections with others. [9] Communicating with empathy has also been described as providing “unconditional positive regard.” Research has demonstrated that when health care teams communicate with empathy, there is improved patient healing, reduced symptoms of depression, and decreased medical errors. [10]
Nurses and nursing students must be aware of potential barriers to communication. In addition to considering common communication barriers discussed in the previous section, there are several nontherapeutic responses to avoid. These responses often block the patient’s communication of their feelings or ideas. See Table 2.3b for a description of nontherapeutic responses. [11]
Table 2.3b Nontherapeutic Responses
| Nontherapeutic Response | Description |
|---|---|
| Asking Personal Questions | Asking personal questions that are not relevant to the situation is not professional or appropriate. Don’t ask questions just to satisfy your curiosity. For example, asking, “Why have you and Mary never married?” is not appropriate. A more therapeutic question would be, “How would you describe your relationship with Mary?” |
| Giving Personal Opinions | Giving personal opinions takes away the decision-making from the patient. Effective problem-solving must be accomplished by the patient and not the nurse. For example, stating, “If I were you, I’d put your father in a nursing home” is not therapeutic. Instead, it is more therapeutic to say, “Let’s talk about what options are available to your father.” |
| Changing the Subject | Changing the subject when someone is trying to communicate with you demonstrates lack of empathy and blocks further communication. It seems to say that you don’t care about what they are sharing. For example, stating, “Let’s not talk about your insurance problems; it’s time for your walk now” is not therapeutic. A more therapeutic response would be, “After your walk, let’s talk some more about what’s going on with your insurance company.” |
| Stating Generalizations and Stereotypes | Generalizations and stereotypes can threaten nurse-patient relationships. For example, it is not therapeutic to state the stereotype, “Older adults are always confused.” It is better to focus on the patient’s concern and ask, “Tell me more about your concerns about your father’s confusion.” |
| Providing False Reassurances | When a patient is seriously ill or distressed, the nurse may be tempted to offer hope with statements such as “You’ll be fine,” or “Don’t worry; everything will be alright.” These comments tend to discourage further expressions of feelings by the patient. A more therapeutic response would be, “It must be difficult not to know what the surgeon will find. What can I do to help?” |
| Showing Sympathy | Sympathy focuses on the nurse’s feelings rather than the patient. Saying “I’m so sorry about your amputation; I can’t imagine losing a leg.” This statement shows pity rather than trying to help the patient cope with the situation. A more therapeutic response would be, “The loss of your leg is a major change; how do you think this will affect your life?” |
| Asking “Why” Questions | A nurse may be tempted to ask the patient to explain “why” they believe, feel, or act in a certain way. However, patients and family members interpret “why” questions as accusations and become defensive. It is best to phrase a question by avoiding the word “why.” For example, instead of asking, “Why are you so upset?” it is better to rephrase the statement as, “You seem upset. What’s on your mind?” |
| Approving or Disapproving | Nurses should not impose their own attitudes, values, beliefs, and moral standards on others while in the professional nursing role. Judgmental messages contain terms such as “should,” “shouldn’t,” “ought to,” “good,” “bad,” “right,” or “wrong.” Agreeing or disagreeing sends the subtle message that nurses have the right to make value judgments about the patient’s decisions. Approving implies that the behavior being praised is the only acceptable one, and disapproving implies that the patient must meet the nurse’s expectations or standards. Instead, the nurse should help the patient explore their own beliefs and decisions. For example, it is nontherapeutic to state, “You shouldn’t consider elective surgery; there are too many risks involved.” A more therapeutic response would be, “So you are considering elective surgery. Tell me more about it…” gives the patient a chance to express their ideas or feelings without fear of being judged. |
| Giving Defensive Responses | When patients or family members express criticism, nurses should listen to what they are saying. Listening does not imply agreement. To discover reasons for the patient’s anger or dissatisfaction, the nurse should listen without criticism, avoid being defensive or accusatory, and attempt to defuse anger. For example, it is not therapeutic to state, “No one here would intentionally lie to you.” Instead, a more therapeutic response would be, “You believe people have been dishonest with you. Tell me more about what happened.” (After obtaining additional information, the nurse may elect to follow the chain of command at the agency and report the patient’s concerns for follow-up.) |
| Providing Passive or Aggressive Responses | Passive responses serve to avoid conflict or sidestep issues, whereas aggressive responses provoke confrontation. Nurses should use assertive communication as described in the “ Basic Communication Concepts ” section. |
| Arguing | Challenging or arguing against patient perceptions denies that they are real and valid to the other person. They imply that the other person is lying, misinformed, or uneducated. The skillful nurse can provide information or present reality in a way that avoids argument. For example, it is not therapeutic to state, “How can you say you didn’t sleep a wink when I heard you snoring all night long!” A more therapeutic response would be, “You don’t feel rested this morning? Let’s talk about ways to improve your rest.” |
Strategies for Effective Communication
In addition to using therapeutic communication techniques, avoiding nontherapeutic responses, and overcoming common barriers to communication, there are additional strategies for promoting effective communication when providing patient-centered care. Specific questions to ask patients are as follows:
- What concerns do you have about your plan of care?
- What questions do you have about your medications?
- Did I answer your question(s) clearly or is there additional information you would like? [12]
Listen closely for feedback from patients. Feedback provides an opportunity to improve patient understanding, improve the patient-care experience, and provide high-quality care. Other suggestions for effective communication with hospitalized patients include the following:
- Round with the providers and read progress notes from other health care team members to ensure you have the most up-to-date information about the patient’s treatment plan and progress. This information helps you to provide safe patient care as changes occur and also to accurately answer the patient’s questions.
- Review information periodically with the patient to improve understanding.
- Use patient communication boards in their room to set goals and communicate important reminders with the patient, family members, and other health care team members. This strategy can reduce call light usage for questions related to diet and activity orders and also gives patients and families the feeling that they always know the current plan of care. However, keep patient confidentiality in mind regarding information to publicly share on the board that visitors may see.
- Provide printed information on medical procedures, conditions, and medications. It helps patients and family members to have multiple ways to provide information. [13]
Adapting Your Communication
When communicating with patients and family members, take note of your audience and adapt your message based on their characteristics such as age, developmental level, cognitive abilities, and any communication disorders. For patients with language differences, it is vital to provide trained medical interpreters when important information is communicated.
Adapting communication according to the patient’s age and developmental level includes the following strategies:
- When communicating with children, speak calmly and gently. It is often helpful to demonstrate what will be done during a procedure on a doll or stuffed animal. To establish trust, try using play or drawing pictures.
- When communicating with adolescents, give freedom to make choices within established limits.
- When communicating with older adults, be aware of potential vision and hearing impairments that commonly occur and address these barriers accordingly. For example, if a patient has glasses and/or hearing aids, be sure these devices are in place before communicating. See the following box for evidence-based strategies for communication with patients who have impaired hearing and vision. [14]
Impaired Hearing
- Gain the patient’s attention before speaking (e.g., through touch)
- Minimize background noise
- Position yourself 2-3 feet away from the patient
- Facilitate lip-reading by facing the patient directly in a well-lit environment
- Use gestures, when necessary
- Listen attentively, allowing the patient adequate time to process communication and respond
- Refrain from shouting at the patient
- Ask the patient to suggest strategies for improved communication (e.g., speaking toward better ear and moving to well-lit area)
- Face the patient directly, establish eye contact, and avoid turning away mid sentence
- Simplify language (i.e., do not use slang but do use short, simple sentences), as appropriate
- Note and document the patient’s preferred method of communication (e.g., verbal, written, lip-reading, or American Sign Language) in plan of care
- Assist the patient in acquiring a hearing aid or assistive listening device
- Refer to the primary care provider or specialist for evaluation, treatment, and hearing rehabilitation [15]
Impaired Vision
- Identify yourself when entering the patient’s space
- Ensure the patient’s eyeglasses or contact lenses have current prescription, are cleaned, and stored properly when not in use
- Provide adequate room lighting
- Minimize glare (i.e., offer sunglasses or draw window covering)
- Provide educational materials in large print
- Apply labels to frequently used items (i.e., mark medication bottles using high-contrasting colors)
- Read pertinent information to the patient
- Provide magnifying devices
- Provide referral for supportive services (e.g., social, occupational, and psychological) [16]
Patients with communication disorders require additional strategies to ensure effective communication. For example, aphasia is a communication disorder that results from damage to portions of the brain that are responsible for language. Aphasia usually occurs suddenly, often following a stroke or head injury, and impairs the patient’s expression and understanding of language. Global aphasia is caused by injuries to multiple language-processing areas of the brain, including those known as Wernicke’s and Broca’s areas. These brain areas are particularly important for understanding spoken language, accessing vocabulary, using grammar, and producing words and sentences. Individuals with global aphasia may be unable to say even a few words or may repeat the same words or phrases over and over again. They may have trouble understanding even simple words and sentences. [17]
The most common type of aphasia is Broca's aphasia . People with Broca’s aphasia often understand speech and know what they want to say, but frequently speak in short phrases that are produced with great effort. For example, they may intend to say, “I would like to go to the bathroom,” but instead the words, “Bathroom, Go,” are expressed. They are often aware of their difficulties and can become easily frustrated. See the hyperlink in the box below for evidence-based strategies to enhance communication with a person with impaired speech. [18]
- Modify the environment to minimize excess noise and decrease emotional distress
- Phrase questions so the patient can answer using a simple “Yes” or “No,” being aware that patients with expressive aphasia may provide automatic responses that are incorrect
- Monitor the patient for frustration, anger, depression, or other responses to impaired speech capabilities
- Provide alternative methods of speech communication (e.g., writing tablet, flash cards, eye blinking, communication board with pictures and letters, hand signals or gestures, and computer)
- Adjust your communication style to meet the needs of the patient (e.g., stand in front of the patient while speaking, listen attentively, present one idea or thought at a time, speak slowly but avoid shouting, use written communication, or solicit family’s assistance in understanding the patient’s speech)
- Ensure the call light is within reach and central call light system is marked to indicate the patient has difficulty with speech
- Repeat what the patient said to ensure accuracy
- Instruct the patient to speak slowly
- Collaborate with the family and a speech therapist to develop a plan for effective communication [19]
Maintaining Patient Confidentiality
When communicating with patients, their friends, their family members, and other members of the health care team, it is vital for the nurse to maintain patient confidentiality. The Health Insurance Portability and Accountability Act (HIPAA) provides standards for ensuring privacy of patient information that are enforceable by law. Nurses must always be aware of where and with whom they share patient information. For example, information related to patient care should not be discussed in public areas, paper charts must be kept in secure areas, computers must be logged off when walked away from, and patient information should only be shared with those directly involved in patient care. For more information about patient confidentiality, see the “ Legal Considerations & Ethics ” section in the “Scope of Practice” chapter.
Read more information about the Health Insurance Portability and Accountability Act of 1996 (HIPAA) .
- Abdolrahimi, M., Ghiyasvandian, S., Zakerimoghadam, M., & Ebadi, A. (2017). Therapeutic communication in nursing students: A Walker & Avant concept analysis. Electronic Physician, 9 (8), 4968–4977. https://doi.org/10.19082/4968 ↵
- Karimi, H., & Masoudi Alavi, N. (2015). Florence Nightingale: The mother of nursing. Nursing and Midwifery Studies, 4 (2), e29475. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4557413/ . ↵
- Abdolrahimi, M., Ghiyasvandian, S., Zakerimoghadam, M., & Ebadi, A. (2017). Therapeutic communication in nursing students: A Walker & Avant concept analysis. Electronic Physician, 9 (8), 4968–4977. https://doi.org/10.19082/4968 ↵
- “ beautiful african nurse taking care of senior patient in wheelchair ” by agilemktg1 is in the Public Domain ↵
- This work is a derivative of Human Relations by LibreTexts and is licensed under CC BY-NC-SA 4.0 ↵
- Flickr - Official U.S. Navy Imagery - A nurse examines a newborn baby..jpg ” by MC2 John O'Neill Herrera/ U.S. Navy is in the Public Domain ↵
- American Nurse. (n.d.). Therapeutic communication techniques . https://www.myamericannurse.com/therapeutic-communication-techniques/ ↵
- American Nurse. (n.d.). Therapeutic communication techniques . https://www.myamericannurse.com/therapeutic-communication-techniques/ ↵
- Balchan, M. (2016). The Magic of Genuine Communication. http://michaelbalchan.com/communication/ ↵
- Morrison, E. (2019). Empathetic Communication in Healthcare. https://www.cibhs.org/sites/main/files/file-attachments/empathic_communication_in_healthcare_workbook.pdf?1594162691 ↵
- Burke, A. (2021). Therapeutic Communication: NCLEX-RN. https://www.registerednursing.org/nclex/therapeutic-communication/ ↵
- Smith, L. L. (2018, June 12). Strategies for effective patient communication. American Nurse . https://www.myamericannurse.com/strategies-for-effective-patient-communication/ ↵
- Smith, L. L. (2018, June 12). Strategies for effective patient communication. American Nurse. https://www.myamericannurse.com/strategies-for-effective-patient-communication/ ↵
- Butcher, H., Bulechek, G., Dochterman, J., & Wagner, C. (2018). Nursing interventions classification (NIC) . Elsevier, pp. 115-116 ↵
- Butcher, H., Bulechek, G., Dochterman, J., & Wagner, C. (2018 ). Nursing interventions classification (NIC) . Elsevier, pp. 115-116 ↵
- Butcher, H., Bulechek, G., Dochterman, J., & Wagner, C. (2018). Nursing interventions classification (NIC) . Elsevier, pp. 115-116 ↵
- National Institute on Deafness and Other Communication Disorders (NIDCD). (2017, March 6). Aphasia. https://www.nidcd.nih.gov/health/aphasia ↵
- Butcher, H., Bulechek, G., Dochterman, J., & Wagner, C. (2018). Nursing interventions classification (NIC) . Elsevier, pp. 115-116. ↵
- Butcher, H., Bulechek, G., Dochterman, J., & Wagner, C. (2018). Nursing interventions classification (NIC). Elsevier, pp. 115-116. ↵


7.19A: RNA Regulation and Antisense RNA
- Explain RNA regulation via antisense RNA
Gene regulation, the ability to control whether a gene is expressed or not, is critical in controlling cellular and metabolic processes and contributes to diversity and variation in organisms. Furthermore, it is the key determinant in cellular differentiation and morphogenesis. There are specific types of RNA molecules that can be utilized to control gene regulation, including messenger RNAs (mRNAs), small RNAs such as microRNAs and lastly, antisense RNAs. The following is a brief overview of antisense RNAs and their role in RNA regulation. Antisense RNAs have been recently investigated as a new class of antiviral drugs.
Antisense RNAs are single-stranded RNA molecules that exhibit a complementary relationship to specific mRNAs. Antisense RNAs are utilized for gene regulation and specifically target mRNA molecules that are used for protein synthesis. The antisense RNA can physically pair and bind to the complementary mRNA, thus inhibiting the ability of the mRNA to be processed in the translation machinery. Pairing antisense RNA is a technique that can be utilized within the laboratory for gene regulation — however, it is not without limitations. Naturally occurring antisense RNAs have been isolated in a various microbes, including the E. coli RI plasmid, which uses a hok/sok system.  The hok gene is a toxic gene and the sok gene is an antitoxin. Hence, E. coli utilizing this system can regulate the expression of hok (toxin) and inhibits its translation by producing sok RNA (antitoxin). The outcome is the repression of hok mRNA translation.
Key Points
- Antisense RNAs are specific to mRNAs based on the principle of complementary base pairs.
- Antisense RNAs bind to mRNAs and inhibit the ability of these mRNAs to be translated into functioning protein.
- Naturally occurring antisense RNAs have been identified in E. coli, which carry an R1 plasmid and control the hok/sok system that involves the production of toxic and antitoxic products.
Key Terms
- morphogenesis : The differentiation of tissues and growth in organisms.


5.3.2: Ethics and Business Ethics Defined
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- Jamie Hammond and Western Technical College
- OpenStax
Learning Objectives
- Understand what ethics and business ethics are
Ethics essentially involves how we act, live, lead our lives, and treat others. Our choices and decision-making processes and our moral principles and values that govern our behaviors regarding what is right and wrong are also part of ethics. 1
Normative ethics refers to the field of ethics concerned with our asking how should and ought we live and act? Business ethics is applied ethics that focuses on real-world situations and the context and environment in which transactions occur—How should we apply our values to the way we conduct business?
Ethics and business ethics continue to gain influence in corporations, universities, and colleges nationally and internationally. No longer considered a luxury but a necessity, business ethics has awakened a need in the public consciousness due to crises in many areas. For example, the 2008 subprime lending crisis—economic effects of which still persist—revealed widespread corruption of large investment banks and lending institutions internationally. Unsupported mortgages were fraudulently offered with no legitimate financial backing. Some large financial institutions, such as Lehman Brothers Holdings, Inc., went bankrupt; millions of mortgage holders lost their homes. An estimated cost of that crisis to the global economy is over $22 trillion U.S. dollars. 2
In the early 2000s, CEOs and top-level leaders from notable corporations such as Enron, Tyco, WorldCom, and others were caught committing outrageously greedy and fraudulent crimes of white-collar theft from their organizations and shareholders. The now classic film The Smartest Guys in the Room depict how Enron’s leaders during that time, Kenneth Lay (now deceased), Jeff Skilling (still serving prison time), and Andrew Fastow (released from prison in 2011), deceived employees, Wall Street, and shareholders. Enron’s crisis took an estimated $67 billion of shareholder wealth out of the U.S. economy. 3 These criminal activities ushered in national laws such as the Sarbanes-Oxley Act, which we discuss below.
While these recent historical crises illustrate the continuing relevance and importance of business ethics, ethical issues are not only concerned with financial and economically motivated crimes and misbehaviors. Fast forward to the rise of artificial intelligence (AI), which also is calling attention to the relevance and need for ethics in scientific institutions, businesses, and governments. The public needs to be informed of potential and actual harmful consequences—as well as all the recognizable benefits—of these technologies that are in large part driven by algorithms (“a sequence of instructions telling a computer what to do”). 4 Intentional and unintentional misuses of such designs embedded in artificially intelligent technologies can negatively and harmfully affect individual lives as well as entire societies. For example, studies show that a number of minority members of society are often discriminated against by institutions using faulty algorithms to qualify customers for mortgages and to predict who is at risk of being incarcerated. Often times, racial and low-income minorities are discriminated against by such technology designs. 5
At a societal level, another now classic film, The Minority Report , illustrates how misuses of technology can threaten individual rights, privacy, free will, and choice. While this may sound like science fiction, scientific and business luminaries such as Elon Musk, Stephen Hawking, Bill Gates, and others have openly declared that we as a society must be cautious and ethically aware and active to fend off the ill effects of the control and dominant influences of certain AI algorithms in our lives. Scientific and ethical practices in corporate social responsibility (CSR) are one way that ethicists, business leaders, and consumers can support moral self-regulation of technologies. Some scientific and technological firms have adopted ethics boards to help safeguard against harmful social uses of AI technologies. 6 The European Union (EU) has produced policy studies that are forerunners of laws to safeguard against potentially harmful uses of robotics. 7
Another timely ethical issue is climate change and the environment. Lack of sustainable environmental practices that curb air pollution and destructive uses of land, water, and natural resources have, according to a large community of reputable scientists, threatened Earth’s—and our neighborhoods’—atmosphere. 8 Scientific studies and United Nations reports affirm that changes to the earth’s atmosphere, melting glaciers, and rising seas are occurring at accelerated rates. For example, “California's coastline could rise up to 10 feet by 2100, about 30 to 40 times faster than sea-level rise experienced over the last century.” 9 While university, business, and local community groups are rallying for legal actions to curtail and reverse environmental polluters, current political executive orders push against such regulations designed to protect against further erosion of the physical environment. 10 The point here is that as these issues described above are not only technological, economic, and political in nature, but also moral and ethical, as the public’s health, welfare, and safety are at risk.
Relevant ethical questions can be asked to prevent a crisis: Who is responsible for preventing and addressing what happens to individuals, the public, our institutions, and government and who is responsible for preventing such crises and harmful effects from occurring and reoccurring? At whose and what costs? Whose responsibility is it to protect and preserve the common good of societies? What ethical and moral principles should and can motivate individuals, groups, and society members to act to change course?
Universities and colleges are taking notice. Business ethics and corporate social responsibility courses and offerings are becoming increasingly important. The accrediting national body of business schools, AACSB (Association to Advance Collegiate Schools of Business), reported that “[i]n their curricula, research, and outreach, business schools must be advocates for the human dimension of business, with attention to ethics, diversity, and personal well-being.” 11 In addition, NGOs (nongovernmental organizations), emergent groups internationally representing the public’s interests and common good, and political action movements are beginning again to give voice to injustices and potentially dangerous ethical as well as fiscal (income inequality), health (the environment), and discriminatory (racism and stereotyping large segments of the society) problems that require stakeholder as well as stockholder actions.
In this chapter, we begin by presenting an overview of the dimensions of business ethics at the individual, professional, and leadership levels, followed by the organizational, societal, and global levels.
Concept Check
- What individual and organizational ethical issues can we expect to occur?
- What are some signs of unethical activities you might notice individually and organizationally?
References
1. Hartman, L., J. DesJardins and MacDonald, C. (2018). Business Ethics: Decision Making for Personal Integrity and Social Responsibility, 4th ed., McGraw-Hill, New York, New York; and Weiss, J.W. (2014). Business Ethics, A Stakeholder and Issues Management Approach, 6th ed. Oakland, CA: Berrett-Koehler Publishers.
2. Eleazar Melendez. (2013). Financial Crisis Cost Tops $22 Trillion. www.huffingtonpost.co/2013/02/14/ financial-crisis-cost-gao_n_2687553.html
3. James Flanigan. (2002). Enron Is Proving Costly to Economy, articles.latimes.com/2002/jan/20/news/ mn-23790
4. David Auerbach. (2015). The Programs That Become the Programmers, http://www.slate.com/articles/ technology/bitwise/2015/09/ pedro_domingos_master_algorithm_how_machine_learning_is_reshaping_how_we.html
5. Julia Angwin, Jeff Larson, Surya Mattu and Lauren Kirchner. (2016). Machine Bias. ProPublica analysis of data from Broward County, Fla., www.propublica.org/article/m...inalsentencing
6. Hern, A. “Growth of AI Could Boost Cybercrime and Security Threats, Report Warns”, The Guardian, February 21, 2018. www.theguardian.com/technolo...attacks-report
7. Nevejans, N. (2016). European Civil Law Rules in Robotics, www.europarl.europa.eu/RegData/etudes/ STUD/2016/571379/IPOL_STU(2016)571379_EN.pdf
8. Ripple, W., World Scientists’ Warning to Humanity: A Second Warning”, XXXX / Vol. XX No. X • BioScience , 2017, scientists.forestry.oregonsta...rning_2017.pdf.
9. Samuel Chiu. (2017). Climate experts release latest science on sea level rise projections, https://phys.org/ news/2017-04-climate-experts-latest-science-sea.html
10. Friedman, Z. (2018). Trump Administration Requests $0 In Funding For Consumer Protection Agency, https://www.forbes.com/sites/zackfri.../#61dd837c1826
11. AACSB, A Collective Vision for Business Education , AACSB International, 2016, www.aacsb.edu//media/aacsb/p...education.ashx


10: Nature of Stars
Everything we know about stars—how they are born, what they are made of, how far away they are, how long they live, and how they will die—we learn by decoding the messages contained in the light and radiation that reaches Earth. What questions should we ask, and how do we find the answers?
We can begin our voyage to the stars by looking at the night sky. It is obvious that stars do not all appear equally bright, nor are they all the same color. To understand the stars, we must first determine their basic properties, such as what their temperatures are, how much material they contain (their masses), and how much energy they produce. Since our Sun is a star, of course the same techniques, including spectroscopy, used to study the Sun can be used to find out what stars are like. As we learn more about the stars, we will use these characteristics to begin assembling clues to the main problems we are interested in solving: How do stars form? How long do they survive? What is their ultimate fate?
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- 10.1: The Brightness of Stars
- The total energy emitted per second by a star is called its luminosity. How bright a star looks from the perspective of Earth is its apparent brightness. The apparent brightness of a star depends on both its luminosity and its distance from Earth. Thus, the determination of apparent brightness and measurement of the distance to a star provide enough information to calculate its luminosity.
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- 10.2: Colors of Stars
- Stars have different colors, which are indicators of temperature. The hottest stars tend to appear blue or blue-white, whereas the coolest stars are red. A color index of a star is the difference in the magnitudes measured at any two wavelengths and is one way that astronomers measure and express the temperature of stars.
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- 10.3: The Spectra of Stars (and Brown Dwarfs)
- The differences in the spectra of stars are principally due to differences in temperature, not composition. The spectra of stars are described in terms of spectral classes. In order of decreasing temperature, these spectral classes are O, B, A, F, G, K, M, L, T, and Y. These are further divided into subclasses numbered from 0 to 9. The classes L, T, and Y have been added recently to describe newly discovered star-like objects—mainly brown dwarfs—that are cooler than M9. Our Sun has is a G2 type.
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- 10.4: Using Spectra to Measure Stellar Radius, Composition, and Motion
- Analyzing the spectrum of a star can teach us all kinds of things in addition to its temperature. We can measure its detailed chemical composition as well as the pressure in its atmosphere. From the pressure, we get clues about its size. We can also measure its motion toward or away from us and estimate its rotation.
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- 10.5: Measuring Stellar Masses Part 1
- To understand the properties of stars, we must make wide-ranging surveys. We find the stars that appear brightest to our eyes are bright primarily because they are intrinsically very luminous, not because they are the closest to us. Most of the nearest stars are intrinsically so faint that they can be seen only with the aid of a telescope. Stars with low mass and low luminosity are much more common than stars with high mass and high luminosity.
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- 10.6: Measuring Stellar Masses Part 2
- The masses of stars can be determined by analysis of the orbit of binary stars—two stars that orbit a common center of mass. In visual binaries, the two stars can be seen separately in a telescope; in a spectroscopic binary, only the spectrum reveals the presence of two stars. Stellar masses range from about 1/12 to more than 100 times the mass of the Sun (in rare cases, going to 250 times the Sun’s mass). Objects with masses between 1/12 and 1/100 that of the Sun are called brown dwarfs.
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- 10.7: Diameters of Stars
- The diameters of stars can be determined by measuring the time it takes an object (the Moon, a planet, or a companion star) to pass in front of it and block its light. Diameters of members of eclipsing binary systems (where the stars pass in front of each other) can be determined through analysis of their orbital motions.
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- 10.8: The H-R Diagram
- The Hertzsprung–Russell diagram, or H–R diagram, is a plot of stellar luminosity against surface temperature. Most stars lie on the main sequence, which extends diagonally across the H–R diagram from high temperature and high luminosity to low temperature and low luminosity. The position of a star along the main sequence is determined by its mass. High-mass stars emit more energy and are hotter than low-mass stars on the main sequence.
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- 10.9: Fundamental Units of Distance
- Early measurements of length were based on human dimensions, but today, we use worldwide standards that specify lengths in units such as the meter. Distances within the solar system are now determined by timing how long it takes radar signals to travel from Earth to the surface of a planet or other body and then return.
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- 10.10: Surveying the Stars
- For stars that are relatively nearby, we can “triangulate” the distances from a baseline created by Earth’s annual motion around the Sun. Half the shift in a nearby star’s position relative to very distant background stars, as viewed from opposite sides of Earth’s orbit, is called the parallax of that star and is a measure of its distance. Parallax measurements are a fundamental link in the chain of cosmic distances.
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- 10.11: Variable Stars- One Key to Cosmic Distances
- Cepheids and RR Lyrae stars are two types of pulsating variable stars. Light curves of these stars show that their luminosities vary with a regularly repeating period. RR Lyrae stars can be used as standard bulbs, and cepheid variables obey a period-luminosity relation, so measuring their periods can tell us their luminosities. Then, we can calculate their distances by comparing their luminosities with their apparent brightnesses, allowing us to measure distances to these stars.
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- 10.12: The H-R and Cosmic Distances
- Stars with identical temperatures but different pressures (and diameters) have somewhat different spectra. Spectral classification can therefore be used to estimate the luminosity class of a star as well as its temperature. As a result, a spectrum can allow us to pinpoint where the star is located on an H–R diagram and establish its luminosity. This, with the star’s apparent brightness, again yields its distance. The various distance methods can be used to check one against another.
Thumbnail: This long time exposure shows the colors of the stars. The circular motion of the stars across the image is provided by Earth’s rotation. The various colors of the stars are caused by their different temperatures. (credit: modification of work by ESO/A.Santerne).
Contributors and Attributions
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Andrew Fraknoi (Foothill College), David Morrison (NASA Ames Research Center), Sidney C. Wolff (National Optical Astronomy Observatory) with many contributing authors. Textbook content produced by OpenStax College is licensed under a Creative Commons Attribution License 4.0 license. Download for free at https://openstax.org/details/books/astronomy ).


 People may use sexual fantasies either when they are alone or to heighten sexual excitement with others. Some people find it sexually arousing to share fantasies or to enact them. Sexual fantasies may also be experienced without sexual behavior, as in erotic dreams or daydreams. Masturbation often requires some form of cognitive stimulation, such as fantasy or viewing erotica, to reach orgasm.
Research shows that many Americans have inaccurate perception about which sexual fantasies and desires are “normal” and the types of fantasies that “should” turn them on. This may cause them to “censor” and repress the majority of the urges and wants and try to carry on what they think “normal” is. The real problem in this approach is an internalized shame about sexuality, and a lack of sexual communication with the partner. The truth is that these fantasies are likely normal and healthy. Once a person understands how common their sexual fantasies are and the meaning of those fantasies, it will be easier to express them to partners and achieve greater sexual satisfaction and intimacy. When partners understand the diversity of human sexual desire, it helps to see the disclosure as an opportunity to strengthen mutual trust and intimacy, and to give new energy to their sex lives.
Dr. Justin Lehmiller conducted the largest survey of sexual fantasies in America, which is the subject of his 2018 book, Tell Me What You Want: The Science of Sexual Desire and How It Can Help You Improve Your Sex Life . He surveyed more than four thousand Americans, including persons from all fifty states. The group included all sexual identities, political and religious affiliation, and relationship types, from singles to swingers. Below are a few of the many insights.
- 97% of respondents reported having sexual fantasies. The vast majority said they fantasize somewhere between several times per week and several times per day.
- Sex with multiple partners is the most common sexual fantasy among Americans. When asked whether they had ever fantasized about different forms of group sex, 89 % reported fantasizing about threesomes, 74 % about orgies, and 61 % about gangbangs. Men were more likely to have all of these multi-partner fantasies, but majority of women also reported having each of these sex fantasies.
- Sadomasochism, or the desire to link pleasure and pain during sex, is another extremely popular American fantasy. 60 % of participants reported having fantasized about inflicting physical pain on someone else during sex, while 65 % reported having fantasized about receiving physical pain during sex. Women were more likely than men to have fantasized about both giving and receiving pain.
- People mostly fantasize about real-life, everyday people and not about celebrities. 51 % said that they fantasize about their current partner often and just 7 % of participants said that they fantasize about celebrities often.
- Porn-viewing habits influence who and what people fantasize about. One in seven participants said that their biggest sexual fantasy of all time directly stems from something they saw in porn. Porn consumption is related to the size and shape of the bodies and genitals that appear in fantasies. For example, the more porn that heterosexual men watch, the bigger women’s breasts are in their fantasies.
- In fantasies people often change themselves in some way, whether it’s having a different body shape, genital appearance, or personality. This tendency to fantasize about changing one’s physical or psychological characteristics sometimes reflects deep-seated insecurities.
- The more political and moral restrictions people place on their sexuality, the more intensely they fantasize about breaking free of them. For example, compared to Democrats, Republicans were more likely to fantasize about sexual activities that are typically considered immoral - like infidelity and orgies - or taboo - like voyeurism.
- Less than one-third of participants said they had previously acted out their biggest sexual fantasy. The remainder reported holding back for a range of reasons, but especially due to uncertainty about how to act on it, and fears that one’s partner would disapprove of or be unwilling to participate in the activity (Lehmiller, 2018).
Dr. Lehmiller extracted seven broad themes that accounted for the vast majority of all fantasies.  Have some fun here for a moment. Give yourself a full 5 minutes at a minimum to create a fantasy all your own. Does it involve role play? Does it involve other people? Does it feel naughty? Or is it completely G rated? Whatever it is, go with it. Allow it to entertain you for just a little while. Perhaps jot down some notes from it, and use it in the future for whatever purpose you like.
How to Tell What You Really Want?
Most of us have never been taught how to start a conversation with our partners about sexual desire. For many this conversation may seem awkward; however, there are many benefits of disclosing your sexual fantasies to a partner. First, if your fantasy revolves around a partnered activity, the disclosure may set the stage for you to act on your desire. Second, it may improve your relationship because self-disclosure has been shown to be the most powerful way of establishing intimacy (Laurenceau et al, 1998). When a person reveals a secret to us and we reciprocate, we build trust and feelings of closeness. Through mutual self-disclosure, we come to know someone the way other people do not, and this makes the bond all the more special, and there is potential to build a longer-lasting relationship. Dr. Lehmiller offers some tips that can help to make your conversation with partners about sexual desire more productive.
First, choose the timing of your sexual self-disclosures wisely, avoiding revealing everything at once. Self-disclosure is a careful process that unfolds gradually.
Second, be clear to your partner the reason why you are sharing these fantasies. Your partner would want to know whether you want to know more about each other or your goal is to act your fantasies out. When you tell your partner that you desire something different may lead to feelings of insecurity, so stress how you love and trust your partner, and this makes you want to reveal things you’ve never felt comfortable disclosing to anyone else.
Third, when your partner learns about you, you will be learning about your partner too. Self-disclosure is a transaction and goes both ways. You may discover that you and your partner do not share exact the same set of interests, but it does not mean that you are sexually incompatible. It is likely that almost every couple may have at least some shared interest given how common most fantasies are. If you do not share all the fantasies at the time of the disclosure, you may grow to desire the same things later.
Fourth, be mindful of how you will respond to your partner’s disclosures. Think not just about what you say or do if your partner expresses a desire that seems strange to you, but what your body language and facial expressions can convey. The goal of communication with your partner is to express care and respect, both verbally and nonverbally (Lehmiller, 2018).
In this podcast, How to Initiate Sex Doctor of Human Sexuality, Emily Morse is helping you calm your nerves, recover from failed initiations, and walk into each sexual encounter with more confidence.


4.7: Conclusion
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In this chapter we have discussed different approaches to designing online courses to address the issues of diversity where diversity is viewed as a strength to be exploited rather than a problem to be solved.
We envisage that in the near future mashups of different technologies will be easier, and students will be able to create their own learning environment by dragging and dropping different tools into one common platform, and access their personalized learning environment with one login.
The online learning environment should be flexible with respect to time and pace of learning. It should provide different forms of active learning and ways of assessment, and give control and choices to the learner. It should allow for the synthesis of formal, informal, and non formal learning to address the issues of diversity.
There is a major issue in that everyday informal learning is disconnected from the formal learning that takes place in our educational institutions. For younger people there is a danger that they will increasingly see school as a turn off—as something irrelevant to their identities and to their lives. Personal learning environments have the potential to bring together these different worlds and inter-relate learning from life with learning from school and college (Pontydysgu, 2007).
Social software and Web 2.0 technologies are increasingly allowing people to create their own learning environments, creating and publishing material, sharing ideas with people, and receiving feedback from not only the teacher or peers but from anyone, anywhere. Our future online courses will have to be dynamic and process-oriented to address the fast-changing nature of the electronic age.
More research, innovation, and developmental work are needed to cater to the demands of future learners. We need to work on developing theories of e-learning to guide teachers and developers of online learning environments (Bhattacharya, 2007). In future students will develop their own personalized learning environments and build their learning communities. Students will be equal partners with teachers in designing assessment activities. Students will have the freedom and right to choose how and when they would like to be assessed.


8.4: Love Styles
Attitudes toward love and perceptions of love may change throughout an individual’s life. College students may perceive love very differently from their parents or guardians. College students are in a different stage of life and their decisions reflect this. College students are living among people their age who are more than likely single or unmarried. There are more prospects for dating, and experimentation. College students are at the time in their life when committed relationships and the work involved may not be their best option. Instead they may choose “hooking up”. In contrast, individuals with children who are financially tied may view romantic relationships as partnerships, in which goal achievement (pay off the house, send kids to college, pay off debt, etc.) is as important as romance. We can trace these differences in perception of love as far back as the classical age. The Greeks distinguished four concepts of love:
- Storge : loving attachment and non-sexual affection; the type that binds parents and children
- Agape : selfless love similar to generosity and charity
- Philia : friendship love, liking and respect rather than sexual desire
- Eros : passionate love similar to modern concept of passion
Color Wheel Theory of Love
The color wheel theory of love was conceptualized by Canadian psychologist John Alan Lee in 1973. Lee describes six love styles, using several Latin and Greek words for love. First introduced in his book, Colours of Love: An Exploration of the Ways of Loving (1973), Lee defines three primary, three secondary, and nine tertiary love styles, describing them in the traditional color wheel. The three primary types are Eros, Ludus and Storge, and the three secondary types are Mania, Pragma and Agape.
Eros is the Greek term for romantic, passionate, or sexual love, from which the term "erotic" is derived. Lee describes Eros as a passionate physical and emotional love feeling of wanting to satisfy, create sexual contentment, security, and aesthetic enjoyment for each other, it also includes creating sexual security for the other by striving to forsake options of sharing one's intimate and sexual self with outsiders. It is a highly sensual, intense, passionate style of love. Erotic lovers choose their lovers by intuition or "chemistry". They are more likely to say they fell in love at first sight than those of other love styles.
Storge is the Greek term for familial love. Lee defines Storge as growing slowly out of friendship and based more on similar interests and a commitment to one another rather than on passion. However, he chooses Storge , rather than the term Philia (the usual term for friendship) to describe this kind of love.
Ludic means "game" or "school" in Latin. Lee uses the term to describe those who see love as a desire to want to have fun with each other, to do activities indoor and outdoor, tease, indulge, and play harmless pranks on each other. The acquisition of love and attention itself may be part of the game. Individuals with this love style have a low tolerance for commitment, jealousy, and strong emotional attachment.
In contrast, agape love involves altruism, giving, and other-centered love. This love style approaches relationships in a non-demanding style with gentle caring and tolerance for others. Lee describes agape as an altruistic love, given by the lover who sees it as his obligation without expecting reciprocity. According to Lee, Agapic lovers are usually older and more emotionally mature, thus a love guided by will and reason rather than emotion or attraction.
Pragma love is known as practical love involving logic and reason. Arranged marriages were often arranged for functional purposes. Kings and Queens of different countries often married to form alliances. This love style may seek out a romantic partner for financial stability, ability to parent, or simple companionship.
Mania is the final love style characterized by dependence, uncertainty, jealousy, and emotional upheaval. This type of love is insecure and needs constant reassurance.
These love styles are not mutually independent. An individual may approach love from a pragmatic stance and have found love that provides financial stability. However, they still feel insecure (representative of mania) about whether their romantic partner will remain with them, thus ensuring continued financial stability. People engage in each of these love styles, and it is simply a matter of how much of each love style a person possesses.
Sternberg's Triangular Theory of Love
Is all love the same or are there different types of love? Examining these questions more closely, Robert Sternberg’s ( 2004 , 2007 ) work has focused on the notion that all types of love are comprised of three distinct areas: intimacy, passion, and commitment. Intimacy includes caring, closeness, and emotional support. The passion component of love is comprised of physiological and emotional arousal; these can include physical attraction, emotional responses that promote physiological changes, and sexual arousal. Lastly, commitment refers to the cognitive process and decision to commit to love another person and the willingness to work to keep that love over the course of your life. The elements involved in intimacy (caring, closeness, and emotional support) are generally found in all types of close relationships—for example, a mother’s love for a child or the love that friends share. Interestingly, this is not true for passion. Passion is unique to romantic love, differentiating friends from lovers. In sum, depending on the type of love and the stage of the relationship (i.e., newly in love), different combinations of these elements are present.
- Liking in this case is not used in a trivial sense. Sternberg says that this intimate liking characterizes true friendships, in which a person feels a bondedness, a warmth, and a closeness with another but not intense passion or long-term commitment.
- Infatuated love is often what is felt as "love at first sight." But without the intimacy and the commitment components of love, infatuated love may disappear suddenly.
- Empty love: Sometimes, a stronger love deteriorates into empty love, in which the commitment remains, but the intimacy and passion have died. In cultures in which arranged marriages are common, relationships often begin as empty love.
- Romantic love: Romantic lovers are bonded emotionally (as in liking) and physically through passionate arousal.
- Companionate love is often found in marriages in which the passion has gone out of the relationship, but a deep affection and commitment remain. Companionate love is generally a personal relation you build with somebody you share your life with, but with no sexual or physical desire. It is stronger than friendship because of the extra element of commitment.
- Fatuous love can be exemplified by a whirlwind courtship and marriage in which a commitment is motivated largely by passion, without the stabilizing influence of intimacy.
- Consummate love is the complete form of love, representing the ideal relationship toward which many people strive but which apparently few achieve. Sternberg cautions that maintaining a consummate love may be even harder than achieving it. He stresses the importance of translating the components of love into action. "Without expression," he warns, "even the greatest of loves can die" (Sternberg 1988, p.341). Consummate love may not be permanent. For example, if passion is lost over time, it may change into companionate love.
The balance among Sternberg’s three aspects of love is likely to shift through the course of a relationship. A strong dose of all three components-found in consummate love-typifies, for many of us, an ideal relationship. However, time alone does not cause intimacy, passion, and commitment to occur and grow. Knowing about these components of love may help couples avoid pitfalls in their relationship, work on the areas that need improvement, or help them recognize when it might be time for a relationship to come to an end.
Taking this the study of love a step further, Anthropologist Helen Fisher studied fMRI brain scans of people who had just fallen in love and observed that their brain chemistry was “going crazy,” similar to the brain of an addict on a drug high ( Cohen, 2007 ). Specifically, serotonin production increased by as much as 40% in newly in-love individuals. Further, those newly in love tended to show obsessive-compulsive tendencies. Conversely, when a person experiences a breakup, the brain processes it in a similar way to quitting a heroin habit ( Fisher, Brown, Aron, Strong, & Mashek, 2009 ). Thus, those who believe that breakups are physically painful are correct! Another interesting finding is that long-term love and sexual desire activate different areas of the brain. Sexual needs activate the part of the brain that is particularly sensitive to innately pleasurable things such as food, sex, and drugs (i.e., the striatum—a rather simplistic reward system), whereas love requires conditioning—it is more like a habit. When sexual needs are rewarded consistently, then love can develop. In other words, love grows out of positive rewards, expectancies, and habit ( Cacioppo, Bianchi-Demicheli, Hatfield & Rapson, 2012 ).
Dr. Helen Fisher, senior research fellow at the Kinsey Institute, discusses how intense romantic love affects our long-term goals here . They explain how to maintain novelty, the fuel of romantic love, and how to be aware of the brain regions that affect satisfaction in a relationship


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