Production and Manufacturing Vocabulary and Quiz

Health Issues Of Health Informatics - 1816 Words

Health Informatics has been around for ages, but over the pass ten plus years the profession has increased with higher demand. Health informatics is one of the nation’s largest growth industries. Health informatics have grown as a discipline with specialization in areas within the health profession. This field of study incorporates procedure, theories and concepts from computer information science. As the medical profession increases, so do the health data security and privacy has become a major growing concern. The main concern is protecting the privacy of medical patient information. Over the past few years there have been numerous medical information breaches, either by hackers or employees. Meanwhile, companies are being faced with†¦show more content†¦Informatics was really established a year later by a Germany professional organization named Gustav Wager. As 1960 came around College University’s departments began specializing in programs dealing with inf ormatics learning and training. Informatics can be obtained by education either Bachelor’s, Master’s or Certificate degree. Meanwhile, security has become the major concern within the medical field all together. President Barack Obama has offered $27 billion of government funds with the intend to make, information, technology and electronic health record the top goal, according to pdf file Developing a Health Informatics Security and Privacy Program. The US Department of Labor feels there will be a 49% growth in health informatics and health information. The article even talks about the need of 70,000 of health informatics specialists. By the year 2018 the employee for both medical records and health information personnel will increase to more than 20%. Surprisingly, the cost has grown rapidly and is expected to reach $40 million in 2012 according to the article Healthcare Data Security Cost, by City. With the high cost of security by 2015 spending will increase to $70 billion; meanwhile, most of the investment will be more focus towards electronic healthcare systems, mobile health applications and new go vernment standards. This article also states a few cities that have security cost

Swot Analysis of Indian Economy Free Essays

The economy of India is as diverse as it is large, with a number of major sectors including manufacturing industries, agriculture, textiles and handicrafts, and services. Agriculture is a major component of the Indian economy, as over 66% of the Indian population earns its livelihood from this area. However, the service sector is greatly expanding and has started to assume an increasingly important role. We will write a custom essay sample on Swot Analysis of Indian Economy or any similar topic only for you Order Now The fact that the English speaking population in India is growing by the day means that India has become a hub of outsourcing activities for some of the major economies of the world including the United Kingdom and the United States. Outsourcing to India has been primarily in the areas of technical support and customer services. In general, the Indian economy is controlled by the government, and there remains a great disparity between the rich and the poor. Ranked by the exchange rate of the United States Dollar, the Indian economy is the twelfth largest in the world. In Purchasing Power Parity GDP, the figure for India was 1. 5 trillion US Dollars in 2008. The per capita income of India is 4,542 US Dollars in the context of Purchasing Power Parity. This is primarily due to the 1. billion population of India, the second largest in the world after China. In nominal terms, the figure comes down to 1,089 US Dollars, based on 2007 figures. According to the World Bank, India is classed as a low-income economy. Recent trends have seen India exporting the services of a numerous information technology (IT) professionals. IT professionals have been sought for their expertise in software, software engineering and other fin ancial services. This has been possible as a result of the high skill levels of Indian IT professionals. Other areas where India is expected to make progress include manufacturing, construction of ships, pharmaceuticals, aviation, biotechnology, tourism, nanotechnology, retailing and telecommunications. Growth rates in these sectors are expected to increase dramatically. Over the years the Indian government has taken an economic approach that has been influenced, in part, by the Socialist movements. The Indian national government has maintained a high and authoritative level of control over certain areas of the Indian economy like the participation of the private sector, foreign direct investment, and foreign trade. It may be observed that in spite of the tremendous debate about the justification of the privatization of industries traditionally owned by the government, the process of privatization has still continued at a steady pace. One of the major challenges before the Indian economy, or those who are responsible for operating it, is to remove the economic inequalities that are still persistent in India after its independence in 1947. Poverty is still one of the major issues although these levels have dropped significantly in recent years. As per official surveys, it has been observed that in the 2004, almost 27% of the working Indian populace was living below the poverty line. Poverty is a challenge that’s becoming increasingly important in relationship to the alarming rate of new births. This implies that ever more rapid change, or birth control policies like the ‘One Child’ policy in China, are needed to reduce the numbers affected by poverty in the vast Indian economy. How to cite Swot Analysis of Indian Economy, Essay examples Swot Analysis of Indian Economy Free Essays SWOT Analysis of various sectors of Indian Economy. The India economy, which is the 9th largest in the world in terms of nominal GDP, can be broadly classified into three sectors: 1) Primary Sector or Agriculture Sector, which contributes about 15% to the GDP and employs around 57% of the total workforce. 2) Secondary Sector or Industry sector, which contributes about 28% to the DP and employs around 14% of the workforce. We will write a custom essay sample on Swot Analysis of Indian Economy or any similar topic only for you Order Now 3) Tertiary Sector or Service Sector, which contributes the maximum of 57% to the GDP and employs around 29% of the workforce. SWOT analysis of Agriculture Sector: Strengths : – * The favourable Climate and terrain of the Indian sub-continent makes it suitable for producing a variety of crops. * As it employs majority of population, it enjoys a competitive labour force. * The agriculture sector in India is competitive and hence evolving, produces a large variety of crops, and enjoys a well demanded market as Indians prefer fresh farm produce over the processed food items. Weaknesses:- * As the majority of workforce is uneducated, they are not able to make the most out of the government policies. Moreover, though the government spends enough over the agricultural reforms, but due to the low level of execution on their part, it does not produce the desired results. * Due to the lack of proper storage facilities and road connectivity of the farms with the respective market, around 60% of the fresh farm produce like vegetables, fruits etc get wasted. * Since only 40% of the land under cultivation gets irrigated through canals, tube wells etc. , the farmers depend heavily upon the annual monsoons. Opportunities:- A growing population, availability of modern agricultural techniques, easy availability of banking finance, variety of pest resistance crops, coming up of retail chains and various government schemes and policies, would make both the demand and the production go up. * Rise in demand of pulses and grains in the Asian economies, and the production of fuels like ethanol from grains, provide more market opportunities. Threats:- * More and more of the agricultural land is bei ng taken up to meet with the demands of the housing and industrial sector, thereby reducing land under cultivation. With the increase in the purchasing power of the Indians, the packaged food industry is gaining importance in the Indian market, especially in the cities and among the youth. * Some of the government policies like MGNREGA, is diverting the farm labour to other employment avenues, which could affect the agriculture adversely as it depends heavily on manual labour. * Stiff competition from the international markets, if India opens up the trade barriers in the agriculture sector. SWOT analysis of Industrial Sector: Strengths:- With over half a billion population in the age group of 25-60 years, the industrial sector enjoys a competitive labour market. * Availability of natural resources, skilled and cheap manpower, liberal national policies provide the environment for industries to thrive. Weaknesses:- * Due to India being a democratic country and a mixed economy, the ind ustry has to adhere too many of the protectionist policies of the government, which affects the industry adversely. * The complex labour laws and other political barriers, prevents the industries to work at the best of their efficiency, thus effecting productivity. Opportunities:- * With the rise in the incomes of the Indians, especially the Indian middle class, promises a lucrative domestic market for all the industries. * With the slowdown of the European American economies, Indian companies should towards the African countries like Ghana, Kenya etc. which are growing at a rate of 7-8%. Threats:- * Stiff competition from developing economies like China, Bangladesh, Indonesia because of lower cost of production. * Delay in policy decisions by Indian policy makers, corruption charges and scandals, hindering the ease to do business. Protectionist policies adopted by various European countries and America to safeguard their own interests. SWOT analysis of Service Sector: Strengths:- * With 64% of the Indian population being educated, the service industry has a large talent poll to work with. * Due to large and skilled work force, the labour market becomes competitive, providing cheap labour. * The Robust Banking and Financial system and regulati ons, provide stability not only to banking sector but also to the entire economy. Weaknesses:- Too much dependence on America and European economies for business. * The Indigenous base of the IT industry is not sufficiently developed to sustain software export. Opportunities:- * With the Increased computerization in various public and government organization, the Indian IT industry has ready-made domestic market. Threats:- * Stiff competition from developing economies like China, Bangladesh, Indonesia because of lower labour. * Due to the economic slowdown, countries like America are adopting policies to prohibit outsourcing, which will affect the IT industry. How to cite Swot Analysis of Indian Economy, Papers

Simply Intolerant Foods

Question: Discuss about theSimply Intolerant Foods. Answer: Lessons Learnt for Simply Intolerant Foods (SIF) Introduction Organizations are constantly looking at their financial numbers and left to stone unturned to improve the numbers. At the heart of any organization lies its ability to manage operations. Operations management is one such area, which is the most critical for any organizations. Efficient of management have impact on all the downstream and upstream of the supply chains and helps the organization to improve their supply chain and makes it more agile, adaptable and less vulnerable. Poor operations management however has a huge impact on supply chain and may lead to unsatisfied customer (Hill, 2012). The concept of lean management is a powerful concept that helps the organization in manufacturing sector to optimize their cost of operations. Simply defined, Lean management is an approach to running an organization that supports the concept of continuous improvement, a long-term approach to work that systematically seeks to achieve small, incremental changes in processes in order to improve efficiency and quality. It is important that the internal and external stakeholders should realize the importance of lean management (Goetsch, 2014). For instance, Logistics department is internal customer for manufacturing department. Together, both work for satisfaction of end external customers. External customers are not part of the organization. They may or may not buy from the organization as they have a choice (Kennedy, Plunkett Haider, 2013).The development of the philosophy, principles and process of lean in the context of its contribution to manufacturing industries and applicability in the food processing industry can be discussed as: Development of the Philosophy, Principles and Process of Lean One of the basic or fundamental philosophies of lean management is the focus on waste elimination. With the principles of lean management, organizations may want to reduce the waste so that they can save the cost (Kennedy, Plunkett Haider, 2013). In manufacturing industry, this cost is associated with inventory holding and and inventory ordering cost. At the same time, it is important that the cost optimization and waste minimization should not happen with any compromise with the quality. Quality customer service is very important think in this world where competition is growing continuously due to globalization (Santos, 2013). Quality service leads to more credibility and better reputation in the market through word of mouth publicity and hence translates into a better sale. Performance indicators should be identified for manufacturers and suppliers for on-time delivery Contingency time should be built in system to account for any uncertainty in the value chain. It is important that the organizations should realize the stage of their lifecycle before implementing the lean principles. There are four defined stages in the organizational life cycle: entrepreneurial, collectivity, formalization and elaboration. Of the four stages, the entrepreneurial stage is the most important, as many organizations dont ever make it out of this phase. When a business is started the owners are wrapped up in creating or selling whatever it is that made their business possible (Laosirihongthong, 2016).As it gets more successful there are more employees and those entrepreneurs have to become managers, a job for which they may or may not be suited. Organization leaders go through many emotional states during the life cycle of their business.These emotions can lead to the success or failure of their business if they are dealt with properly. It is critical that the basic groundwork for lean management should be established before the entrepreneurial stage. The princi ples of lean management for SIF can be shown as below: It is also important that the management of SIF should have a long-term plan with lean management. The organization may be required to make some initial investment to implement the lean system. However, the return on investment in long-term should justify the investment. The organization should also integrate the lean management with Information Technology systems like ERP system. Implications and Challenges for Implementing Lean at Simply Intolerant Foods The organization, Simply Intolerant Foods, can definitely use the principles of lean management to establish an effective and efficient culture in the organization. It can be inferred from the case study that SIF follows the make to order strategy due to the nature of their products. Each product is unique and can be manufactured after taking specifications from the customers. It is maintaining configure to order bills of material, which can be configured by the customer while placing their order. Therefore, SIF forecasts at subassembly level and manufacture the critical subassemblies before receiving the order, which then can be used in customer order. Sometimes the forecasts are quite accurate but when they are not accurate, it leads to huge work in process inventory at one hand and increased lead time for other products which dont have ready subassemblies required for them to get manufactured. With lean management, the organization should also improve its production planning funct ion (Kennedy, Plunkett Haider, 2013). The inefficiency in production planning department has increased the inventory because production should be scheduled when all the material is available or material is scheduled to reach when it is required in the particular job. The implementation of lean would also require an element of change management within the organization. It is possible that all the employees of SIF would not support the change to lean production system. Therefore, it is important that the management of SIF should introduce the change in an effective manner. There could also be issues with labor utilization. Lot of time is wasted in transporting material from one workstation to another because of the poor layout, which can be improved (Kennedy, Plunkett Haider, 2013). The time spent in transportation is a complete waste since it is a non-value adding activity. SIF is also not effectively utilizing the bottlenecks resources. Bottleneck resources are sometime having huge piles of inventory of jobs in front of them to be processes and sometimes are just sitting idle with no inventory at all (Souza, Sobreiro, Nagana, Manfrinato, 2013). This is a case of very poor production planning. It is because the company output depends on the output of the bottleneck resource and it cannot be greater than that of bottleneck resource. Therefore, in order to improve the output of the factory, it is very important to leverage the bottleneck resource or to use the bottleneck at its maximum capacity. Machines, which are not bottleneck, can be starved but the machines, which are bottleneck, should be starved at any cost (Dugdale, 2013). The company can also face challenges to schedule different jobs in the supply chain network of SIF. Efficient Job scheduling is very important for the organization to control the work in process inventory. Increase work in process inventory is not only a problem in itself but also a root cause of many other issues, which will be, discovered when work in process inventory is reduced (Qrunfleh, 2015). This will help in improving the efficiency of the factory. Recommendations for the Managing Director for SIF It is recommended that the management of SIF should emphasize on understanding the customer needs before taking any steps towards lean management and lean supply chain management. Once customer needs are identified, Pareto chart can be built to priorities the requirements and take actions based on that. The concepts of lean management for SIF should also include the association with different suppliers. Any default on part of supplier or manufactures should attract a penalty, which should be passed on to the customers. It can be in form of cash back, or coupons for discount on next purchase. It is recommended that SIF should have two different teams of customer management and suppliers or vendor management. SIF would be able to practice lean in true sense only when these two teams can collaborate together and work in an integrated manner. While promising order delivery data, customer facing team promises based on the date which is provided by the manufacturer who in turn takes the date given by the suppliers.There should be some contingency time build into the system for accounting any uncertainties or special events in the value chain.Collaboration among different stakeholders would be the key for SIF to move forward. Collaboration is most likely to be used first since it sets the tone on what is expected of everyone and what the goals and objectives are for a positive working environment. Collaboration also promotes communication and trusts among team members and educates each other on their strengths and weakness, which will build a positive and successful working rel ationship. Collaboration must be consistent and purposeful, with resources dedicated to its success. It is also recommended that there should be coordination between all players of supply chain so that appropriate dates should be promised to customers.Factors that contribute to poor customer service are customers are not treated well and no one is ready to listen them and understand their problems. Continuously sending them to different departments and making them explain their problem to multiple people is a high sign of improper customer service. Not only this, even making them wait and unable to provide resolution to their expectation is a sign you will lose business from those customers in the future. The management of SIF should realize that the listening skills are one of the powerful skills to eliminate the waste in the system. The listening skills are the best skill to deal with angry customers and talkative customers. Angry customers want someone who can listen and completely agree with them and ensure them of the best service. Customers get angry or frustrated for a number of reasons. Reasons may be valid or unjustifiable but no matter what, as we are in the business of customer service, we need to provide or help them with appropriate response so that they should continue to do the business with the organization. Our responses can ease the matter or make it worst. It is recommended that the key principles of lean management for SIF should also have focus on the use of Information Technology to track down the various operational activities in the organization. Tracking system should be employed and team should receive reminders set up at appropriate times. In long term, the company should have the policy to provide home delivery to end-customers. For instance, they can have express delivery where material should be delivered real fast but at some extra cost. Incoming materials from suppliers should be properly inspected and only then should be moved into stores if it fits into the criteria. To save this time, customer should define parameters for new suppliers and if they passed, add them into certified supplier lists and should accept those materials without inspection. It should also mention the clause to the supplier that for any poor quality item, there is a penalty. Although supplier may charge high for providing high quality items but it has lot of benefits for the organization (Monczka, Handfield, Guinipero, Patterson, 2015). For instance, first of all, it will save the huge time in inspecting the incoming material every time. Second, there will be fewer cases of poor quality of end items due to raw material. Third, as there will be less customer returns, it will help the organization to build its reputation. In short, correcting this first step ensures the improvement in all the downstream processes. Poor quality material is the entry point of many problems. Self Reflection Introduction I strongly believe that operations management is one of the most important areas for any organization. Since these days, there is a huge competition between the organizations due to globalization; there is also pricing pressures for the firms to reduce the prices of their products or keeping them near to their competitors. At such competitive prices, quality should also be there to build customer trust and reputation. Thus, in such times cost cutting is very important to increase the profits for the organizations in these tough times and make the products available to customer at a competitive price. Efficient management of operations at shop floor and design of supply chain help the organization to save the huge amount of money (Hill, Hill, 2012). I have learned that lean management is a powerful concept that could help the organizations to have effective operations management and efficient supply chain management in place. Here, I would discuss the concepts of lean management for Emerson electric company. A brief organizational background can be discussed as: Organizational Background Emerson electric company is global diversified manufacturing firm headquartered in St. Louis, USA. It manufactures products like regulators, precision instruments for measuring temperature, pressure and density, valves and many other instruments used in different types of industries like Automobile industry, Chemical industry, metal and refining, pulp and paper industry. It has more than 240 manufacturing locations at different locations worldwide to serve the customers globally. It operates in a very competitive industry leaded by giants like ABB, Schneider, and Honeywell. In recent times, it is facing a lot of issues like high rate of product return by the customer, poor-on time delivery, huge increase in work in process inventory, increase in inventory holding costs which is hampering its image worldwide. Discussion Emerson electric is facing many problems. It started discovering the problems as increase in customer returns were gradually going up. Once the product is returned, it is diagnosed properly with the help of serial number and lot number of various components and raw materials that are used in manufacturing that product. There were many problems that were coming because of poor quality of raw materials. This means that material supplied by the supplier is directly used for production without being inspected. If it is inspected and caught at the first stage, it would have save a lot of processing time of machines and other costs (Goetsch, Davis, 2014). Emerson should only use materials directly in production, which is supplied by the certified suppliers. The management of the company realizes that lean management is the solution for the company to move forward. However, the management of Emerson is not able to implement the lean in the system. There are various reasons for this. For ex ample, the leaders of the organization have not got the desired support from employees. The company has also faced difficulty to manage its inventory that has further added to the complexity in the implementation of lean management system. Not only this, there is huge increase in work in process inventory. There were lot of jobs that were started but were left in between to serve the more important demands or hot orders. This inappropriate scheduling has increased the work in process inventory, which is directly increasing the production costs for the company. There were also cases like when the job has been aborted in between because of non-availability of raw materials. I can say that one of the core elements of lean management is that the organization should be able to eliminate or at least reduce the waste in the system. However, Emerson is not able to eliminate the waste in the system. I can say that there the resource utilization is not effective in the organization. In fact, there was lot of time getting wasted in non-value adding activity. Sometime, the machine is already setup for processing a job but then another rush order comes and machine has to be setup again. This lead to two things: machines are poorly utilized and labor utilization is also low. Poor utilization of resources is creating problems for the company and hamper the ability of the organization to fulfill customer orders on time even when while order promising the dates were given according to the software in most of the cases that calculates the lead time of all the sub assemblies and components that are required to build the final product. Frequent breakdown of some of the m achines is another issue which delays the production and factory lost its capacity. Also, sometime sales team promises the aggressive delivery times to their customers to meet their targets. Although there is ERP software implemented that calculates the lead-time of the order quantity by considering the manufacturing time of making the quantity considering lead-time of all its child components and subassemblies. If any raw material required for all that is not available, it also calculate the buy lead time of the item to calculate the order promising dates however sometime the aggressive dates put pressure on production systems and which lead to increase in work in process inventory (Trenteasaux, Pach, Bekrar, Sallez, Berger, Bonte, Barbosa, 2013). I can conclude that there are various benefits of lean management for Emerson. However, the management should have the vision to implement the lean in the system. References Adebanjo, D., Laosirihongthong, T., Samaranayake, P. (2016). Prioritizing lean supply chain management initiatives in healthcare service operations: a fuzzy AHP approach. Production Planning Control, 1-14. Monczka, R. M., Handfield, R. B., Giunipero, L. C., Patterson, J. L. (2015).Purchasing and supply chain management. Cengage Learning Hill, A., Hill, T. (2012).Operations management. Palgrave Macmillan. Goetsch, D. L., Davis, S. B. (2014).Quality management for organizational excellence. pearson. Ruiz-de-Arbulo-Lopez, P., Fortuny-Santos, J., Cuatrecasas-Arbs, L. (2013). Lean manufacturing: costing the value stream.Industrial Management Data Systems,113(5), 647-668. De Souza, F. B., Sobreiro, V. A., Nagano, M. S., de Souza Manfrinato, J. W. (2013). When less is better: Insights from the product mix dilemma from the Theory of Constraints perspective.International Journal of Production Research,51(19), 5839-5852. Dugdale, D. (2013). The theory of constraints.The Routledge Companion to Cost Management, 145. Kennedy, I., Plunkett, A. and Haider, J., 2013. Implementation of Lean Principles in a Food Manufacturing Company. InAdvances in Sustainable and Competitive Manufacturing Systems(pp. 1579-1590). Springer International Publishing. Qrunfleh, S., Tarafdar, M. (2015). Supply chain management practicesIT utilisation alignment: impact on supply chain performance and firm performance. International Journal of Business Information Systems 5, 18(4), 364-389. Roser, C., Lorentzen, K., Deuse, J. (2015). Reliable shop floor bottleneck detection for flow lines through process and inventory observations: the bottleneck walk.Logistics Research,8(1), 1-9. Trentesaux, D., Pach, C., Bekrar, A., Sallez, Y., Berger, T., Bonte, T., ... Barbosa, J. (2013). Benchmarking flexible job-shop scheduling and control systems.Control Engineering Practice,21(9), 1204-1225.

Reincarnation Essays - Pseudoscience, Reincarnation Research

Reincarnation Reincarnation has been the talk for thousands of years. The gospels say when the Christian Master (Jesus) asked "Whom say the people that I am?," One answered "Jesus was John the Baptist returned." It was well known by then John the Baptist had been decapitated long before. Others said "He was regarded as the reincarnation either of Elias or of Jerimias." They both had been dead for centuries. This indicates how popular the subject was then, also among the Romans, Greeks, Egyptians, Irish, and Indians on the American continents, in a time when religion did not concede of the belief in reincarnation. Jesus never denied the truth of reincarnation (Cooper intro. v-vi). In the past, it has been a very controversial issue and will continue to be widely debated. However, reincarnation is the key to our very existence and the truth to life. "Reincarnation is the means by which hosts of evolving lives, of all degrees of development, are brought into association with evolving physical forms of all degrees of complexity"(Cooper 14). The basic belief is that the soul cannot be reincarnated into the body of an animal. Humans are not reborn directly after they die either(Cooper 20-21). According to Irving S. Cooper, in past lives we have been painfully suffering because we were passionate, willful, and at times cruel. But after many centuries we began to stop wrong-doing. We have grown through contact with the people around us, the regulation of the law, and through the pressure of physical being its self(Cooper 16). There are many objections and "logical arguments" to the question of reincarnation. One of the objections being: progress can be achieved by humans without having to return to this planet(Cooper 48-51). Some of the logical arguments are: one life on earth is useless in millions of cases, it makes the achievement of perfection attainable(Cooper 59-78). There is however more direct information that favors the belief in reincarnation. Because we cannot remember our past lives, there is no way of knowing if we in fact lived them. However, the first three or four years of our present life have been entirely blocked out of our memory. We know we must have been alive and conscious then because we are alive and conscience today. We do not have any personal proof of the situation as far as memory goes. All details have also been forgotten. Not only in those three to four years but more recently as well, such as earlier today. The brain lets us forget a great amount of detail. For example: "we are careful not to put our fingers into boiling water." Why? Not because we have made the mistake recently but because many years ago before we can remember, we suffered painfully when we threw our fingers into the boiling water. It had to have caused such a horrid pain because of our present caution(Cooper 80-83). There are many proofs to reincarnation. Instinct can logically explained by reincarnation. A new born chick, just hatched from the egg, runs for its safety when it sees the shadow of a hawk grace across the ground. The experience from past lifetimes lets the baby chick escape from danger instinctively(Cooper 85). It is said that when a child takes to a certain interest, like music, it is supposedly a sign that in a past life, they were musicians. This is also true when a child grasps certain instruction quickly. Maternal instinct is often times found in girls and sometimes in boys. A child playing with dolls is most likely recalling memories of an actual maternal experience from a past life(Cooper 85). Reincarnation can also be used to explain many otherwise unexplainable things, such as the following: * Ability/ Talent Each person has a certain talent that they have an exceptional ability for naturally. Usually this is a talent that has tied over from many lives. In order to keep a talent in working order, it must be facilitated. If we don't use it in one life and let our opportunities slip by, then in the next life we are impaired by physical inability though still have the yearning for the talent(Cooper 88). * "Vice or Virtue" The voice of conscience is really the memory of past decisions concerning right and wrong. A crude person has little conscience because his past experience has been so little. Criminal parents can not stop virtue from being revealed in a child neither good parents keep bad from sneaking into their children(Cooper 89). * Genius Genius is not caused by heredity or

American Culture in the 19th Century essays

American Culture in the 19th Century essays American Culture in the 19th Century Culture means the ways in which people understand themselves and interact with each other and their environment. This essay will look at how immigration, poverty, labor disputes, and women struggling for a place in this time period shaped the 19th century. The 19th century was a time of rapid growth and change in America. It was a century of Westward expansion, and the building up of muscular new cities like Chicago. Immigrants brought their cultural traditions to their adopted land. The last three decades of the 19th century were marked by relentless capitalism, corruption, vulgar tastes and ostentatious displays of wealth. While the rich wore diamonds, many other Americans wore rags. In 1890, 11 million of the nations 12 million families earned less than $1200 per year; the average annual income for most families was $380.00, well below the poverty line. In 1871 Mark Twain was quoted as saying What is the chef end of man?-to get rich. In what way? - dishonestly if we can; honestl y if we must. There were three new social classes in America during the 19th century the first two were the industrial capitalists, it included men like Andrew Carnegie. The second social class was the urban middle class. It included mostly doctors, lawyers, shop keepers, factory clerks, and the managers. The urban poor were an extremely larger group. The frustrations of the poor factory workers transformed the labor movement into a vigorous, if often violent force. Workers saw men like Andre Carnegie getting fabulously rich, and were enraged at being left behind. Violent strikes and riots were common place throughout the turn of the century. There was a feeling of unrest and brooding revolution. Industrialists took a hard line against the formation of unions, but the labor movement continued to grow. In 1877, three national unions existed; in 1880 there were eighteen. In 1886, a nat...

Prospectus Essay Example | Topics and Well Written Essays - 250 words

Prospectus - Essay Example One of the most asked questions among several professional Historians is how the women gained the voting rights in 1893. Why didn’t they get the freedom rights in 1877 after putting all efforts pressurizing the then Colorado political rulers? Some Historians refer to the most popular theory â€Å"Myth of the Frontier† in explaining the concepts2. According to this theory, the Western women enjoyed their independence, freedom, and democracy to the maximum level during the 1870s, especially in the 1876. More reasons and answers came from certain individuals who asserted some of the Colorado Politicians granted and favored women suffrage in order to create for themselves a good image sin the political field. Another explanation or view is that the Colorado men never granted the women rights to vote such easily. They, however, fought political war; organized among themselves as suffragists with several goals, one of which the right to vote3. This argument tends to explain w hy these women never achieved gained the rights in 1877 despite their struggle. Colorado women remain in pride over the achievements of their early great grandmothers of the 19th century. The above three reasons explaining how the women achieved their independence can be discussed widely to give more and pithy explanations concerning the endlessly asked

Moral views in the development of English law Essay

Moral views in the development of English law - Essay Example 123), which calls upon a legal community's moral judgment in determining what is aptly, the common good. Moreover, within the context of English Law, this relationship is further emphasised in the role that judges play in the development of precedents embodied within case law. Thus, it is within this context that this essay aims to analyse the significance that moral views have played, if they did, in the development of English Law. As this essay will argue, moral views have played a significant role in the development of English laws, due to the consideration that the legal community has given to the collective standards of morality accepted by the English society in creating legislations, statutes, and EC (European Council) Directives; and the discretion of judges in developing precedents in common law. To prove this point, the essay will begin by presenting the sources of English Law. It will then illustrate the manner that legislations, statutes, and EC Directives are reflective of societal perceptions of morality; and the extent of judges' discretion in case law. Lastly, the essay will illustrate the role morals have played in the development of English law, as well as the effect it has had the law's legal development, before ending with concluding statements. Under English Law, legal development proceeds through a number of instruments such as precedent through courts, legislation through the UK parliament, and as a result of European legislation through directives and decisions of the European Union court adopted by the government. What is apparent among these sources is the degree of discretionary power given both to the individual judges under common law in terms of interpretation, such that disputes can be resolved in a manner that can be either just or unjust; and to the legal community in terms of legislation, which is affected by the individual judgment of each member, as well - both of which will be discussed in following sections. What is imperative as this point, however, is the need to distinguish between morality and moral views, such that while morality refers to some conventional conception of right or wrong; moral views, which is the topic of this essay, refers to the individual standards adhered to by individual judges an d members of the parliament, as well as legislators of Community law. Thus, in order to illustrate that moral views are significant in the development of laws, one must simply illustrate that discretion is evident in the legal development of English Law, regardless if this legal development is moral or not. In this respect, this essay argues that the significance of moral views are evident in the way that English Law can both either be just or unjust, depending on the consensus of legislators' moral views regarding the common good; and the moral judgment of case law judges in interpreting these rules. English Law and the Common Good The Parliament consists of the Crown, the elected House of Common and the Unelected House of Lords. As Sir E. Coke claims, it is "the highest and most honourable and absolute Court of Justice in England,' and its 'jurisdiction' is 'so transcendent' that it can make and repeal laws on any subject matter and its honour and justice cannot be doubted" (cited in Walters 2003). This is also echoed by Austin, claiming that "the sovereign, or supreme legislator, is the author of all law"

Ethics Essay Example | Topics and Well Written Essays - 1500 words - 3

Ethics - Essay Example In a business environment, the three factors must be combined to accomplish organization’s goals through a set of relationships between organization’s management, shareholders, and other stakeholders. Structures in corporate governance are provided through which the objectives of the company are set and it acts as the means of monitoring performance and achieving objectives. Equally, an organizational structure seeks to determine how the roles, responsibilities and power are assigned, coordinated and controlled and how information will flow between different managerial levels. In a decentralized structure, the decision making power is evenly distributed and divisions and departments may have different degrees of flexibility and independence In a centralized structure most of the decision making flows from the top and it may have tight control over divisions and departments. ... Owing to innovations in information and communication technology the world has become increasingly virtual. This is a concept of people with complementary skills who are equally committed to a common purpose goal where they hold themselves mutually acceptable. The first major key to this is that the finance manager will be able to work across boundaries of time and space by making use of computer driven technology. Secondly, it enables the finance manager to interact with sub teams through interdependent tasks guided by common purpose and work across links lead by transport, information and communication. Thirdly, there is quick response to changing business environments making it easier for the manager to unite experts in specialized fields working far from each other digitally. It also provides greater degree of freedom to managers involved with development projects and it saves time and money. Although this virtuosity is effective, it is different from co-relation reasons being th at a manager must build trust differently because it is measured exclusively in reliability terms. Likewise, co-located teams benefit from facilitation of the manager while in virtual teams a manager must provide clear direction. Finally, decisions must be arrived at differently to avoid cultural bias (Kelley, 2001). Discussion 3 Barriers to Change as Depicted By Gayla Holges Organizational barriers are restrictions that rise on the eve of renewing an organization direction, capabilities and structure in a bid to serve the ever changing needs of both external and internal customers. According to Gayla Holges there are three major barriers to

Dove Campaign For Real Beauty Media Essay

Dove Campaign For Real Beauty Media Essay VIDEO: The video Evolution starts with an ordinary fair girl sitting against a camera. Now the movement starts with some professionals (make-up artists) start applying make-up on her step by step and finally it shows how this ordinary looking girl is converted to a beautiful model. Not only this, the further step involved the digital alteration of a picture of her to make her even better looking. Afterwards, this final picture is used at a billboard and the line below it captures this: No wonder our perception of beauty is distorted. To move further, this final picture is used to advertise an unreal beauty product on a billboard. This whole make-up video was posted on Youtube and it was viewed 40,000 times on the first day of its release and 1,700,000 times within a month of the upload . http://fashionrules.com/wp-content/uploads/2009/10/dove-campaign-for-real-beauty.jpg Message: This viral message was aimed to raise awareness about the Dove Self-Esteem Fund. The objective of the fund was to help women and girls from Canada trying to build a stronger self-esteem and a better positive self-image than the negative one which had been running them anxious. This campaign was created by Ogilvy Mather Toronto for the Canadian market only but it soon became a rage and had a huge impact not only in Canada but all over the world. Effect: The video had a strong effect and it gradually spread much beyond the Canadian Market- the initial target market for this message, thanks to the advent of social media especially the use of YouTube here. The audience got to know that the advertisement in magazines and on the television is not the real thing. The model girls are made better looking than they actually are; but the problem once that women tend to take it as true and thus develop a with low self-esteem as they are not able to understand the true side of it. But this video helped them understand this and thus had a positive impact on their psyche as far as they perceive the beauty as shown to them. Reasons for impact: It becomes an interesting study to find out what were the reasons that made this video so popular. Some major reasons that can be though off are: Emotional connection: For any viral message to be successful, it should be able to connect to the audience on an emotional level. If anyone feels emotional by watching a video, it is bound to encourage the person to share it with like-minded people and feel good about it and this is the way a viral grows making it infectious. This video directly hit the identity and the self-image of girls and women by exposing to them the reality behind the beauty industry and increasing their confidence in their own inner beauty with less emphasis on the external beauty thus helping them create a positive and optimistic self-image and staying away from fake beauties shown by the media. A Sticky and memorable message: In addition to being emotional, the message should be substantial in itself and should be strong enough to directly reach the memory of the audience. In this video, a message was created telling people that the way they see the beauty is not the real one, its just make up and not the real natural stuff, the reality being something else. Most people did or do not know how fake the beauty industry really is. This is why the message made such a big impact on peoples perception and resulted in remembering who sent the message.For Dove,it helped in creating a brand loyalty where audience would remember not only the message but develop a strong brand recall and reputation for Dove. A Novel idea: With this video, Dove did something different and extra-ordinary wherein it not only tried to promote its brand but tried to show the audience that I actually cared for them and wanted to show them the real picture. Audience liked the idea in which the perception about the beautiful ad models was changed and the reality was exposed by this video. This novelty in the idea played a huge role in the spread of this video through online media at such a rapid pace. The Indirect and subtle approach One of the best things that happen with this video was the trust that it developed among the audience and it happened because of the subtle manner in which the brand was conveyed along with the message. There was no direct and over-the-face mention of the products or the company or its name. But at the same time, the message behind the message, from Doves perspective, was that the female segment should get the real picture, should aim to be supermodels, instead just try to enjoy their normal beauty and for that they dont need cosmetics or surgeries, all they need a bar of soap, one which cares for them. The continuity in approach One of the major problems with a viral message is that the enthusiasm generated by the message can easily fall down and thus there should be a disciplined way to counter this. After the fast spread of this videos and the message, the company realized fast that it needs to keep the fire up and thus it released few other videos with same message fast along with behind the scene coverings and also did everything through other ways like interviews, surveys etc. to keep the buzz alive. The likeability The video was very much likeable and it generated a feel good factor among the audience by negating the negative self-image resulting from the wrong perception portrayed by the beauty industry. This was huge and had a big impact on the appeal and attraction of the video. Power of social media: Today, Online internet media is a very powerful tool to spread your message across at a very high speed and across very wide reach. There was a lot of talk about this video on different blogs or through comments and responses in the form of more videos on YouTube that were not only serious ones but were spoofs too like Slob Evolution. Through all this, the power of the video viral grew manifolds and bigger and bigger which created a buzz and thus reached a large audience across the globe. Talking about the other side of this viral, the audience which was exposed to this video viral reported a positive change in their attitude and perception towards the brand, and not only those, this was also among the people that had only heard about it and yet not seen it. Thus through this campaign, Dove proved that viral marketing through social media is a very powerful tool if used it the right manner. It can go a long way in changing the attitudes of people towards a brand with good viral marketing, which results in more sales. Not only this, Even without having appeared anywhere through offline means, the video and it effects were discussed by a good number of TV programs, which includes Good Morning America,  The View, The Ellen DeGeneres Show, and news channels such as  CNN,  NBC, and  News, showing support for the message with an overwhelming majority. It produced double-figure growth in product sales for Dove , and also Unilever reported that its overall sales rose by 5.8%, up from 3.9% the previous year in the duration following the release of  Evolution. Also now, Dove has a page on Facebook which mentions their mission as being committed towards helping all women to realize their real beauty potential by creating products that would deliver genuine improvement to their skin and hair. It believes that beauty must be for everyone, the reason that when one looks and feels the best, one feels better about self. To get an idea about how successful this campaign has been, the count on the fans of this page is 283,808 people. Major characteristics of a viral that enhance its ability to spread Outstanding story like the success of an underdog in some competition etc.Latest on Facebook is the video of interview of a student from a very poor family who went on to become the topper of the IAS exam this year 2010. Stickiness : Sticky  content  refers to content published on a  website, which has the purpose of getting a user to return to that particular website or hold their attention and get them to spend longer periods of time at that site.  Uploaded links or tagging pictures are such examples as consumers tend to come back to same messages to post some comment Relevance A viral tends to spread fast through online media if it is relevant to the target friends. E.g. messages related to Business may be more relevant for a MBA student and so have higher chances of getting forwarded through e-mails, blogs or commented high on Facebook. Portability Share ability Timing and actuality Seeding hook Natures of viral Today use of social media is almost indispensible especially for the current generation. This can be seen with the ever-increasing users of blogs, Facebook, twitter etc. With the tremendous amount of information easily available on internet today, there is a huge emphasis on sharing today and everyone wants to be more and more aware about various things. But that does not mean that everything on this earth is shared. Rather there has to be some value, some relevance in the message for it to be important enough to be forwarded and propagated. To know about these characteristics, 47 internet users were interviewed( 28 from IIM K personally and 19 through online survey) and they were asked about the top 3 types of messages they are more inclined to share and were given 9 options to choose from. Following were the results:- The results showed that the major types of the viral messages that are likely to be propagated fast through social media are Comic content, socially relevant stuff or some inspirational/motivational information. Further, these users were asked about their medium of their sharing and following were the results:- Around 48% use social networking sites like Facebook, Orkut etc. to share the messages whereas forwarding of e-mails was a distant second and seems to be losing its charm with the advent of other better means of sharing like networking sites etc. But then if looked closely, use of a particular medium for sharing by a user depends on his location and access to various media.To have a better understanding of this, the 47 respondents were then divided into 2 separate sections Students and Working users and the data were collated separately as shown:- The results show the changes in preference of the medium used due to the constained access. For instance figure 1 which has all IIM K students as the respondentd show that majority of them use Facebook or other networking sites as their most preferred medium of message propagation and here e-mail forwards form a very small(only 7%) of their media usage for information sharing. On the contrary,the working respondendts who generally have a constained accees to social netwokring sites instead use more of e-mail forwards.

Profits in the Checkout Zone :: essays research papers

Top profits in the checkout zone Productivity per unit area in the impulse buying zone at the checkout is as much as five times higher than in the rest of a store. And every retailer should rely in this zone on the proven sales getters tobacco, chewing gum and sweets, take very good care of these assortments, and present them in well arranged, tidy fashion – this is the upshot of a new EHI study. wThe sales area of an up-to-date checkout zone is the result of 20 years of continuous, joint optimisation by retailers and manufacturers. Product range and display are so highly developed in this area that as much as five per cent of overall turnover, and an even higher percentage of profits, are generated by goods placed in the checkout area. For this reason, checkout zone planning requires utmost attention. So if you are into self-scanning solutions with â€Å"zero waiting time†, if receptacles for those disposable containers carrying deposits take up precious (because scarce) space, if â€Å"exotic† articles carrying listing charges threaten tried and tested sales getters, you should always consider the influence these measures have on the sales performance in the checkout zones. No point in non-food articles The branded products producers BAT, Ferrero, Langnese and Wrigley commissioned EHI International Retail Network to perform a current product mix analysis. Aim: to investigate the sales, costs and earnings of the checkout zone product range and to draw up an operating result calculation for full-line distributors. For the three sales outlet types supermarket/small hypermarket (average 1,200 sqm), large hypermarket (2,400 sqm), and superstore (6,700 sqm), nation-wide and across retail chains the checkout assortments were recorded article for article according to turnover, profit and space requirement and grouped into merchandise categories. The underlying idea was to define the optimal assortment for a checkout zone. Whereas â€Å"normal† shopping in the general selling area mostly involves rational, targeted buying, the checkout area is the place for impulse buying. However, if the impulse threshold is to be crossed, the price and the brand must be right. The average prices of articles offered in the checkout areas of the three outlet types examined do not differ significantly. The average prices established were 69 cents for sweets and 93 cents for ice cream, i.e., prices which the buyer does not have to think about for long. The examined merchandise groups were tobacco products, sweets, ice cream in small packages, small alcoholic drinks and non-foods.

Positive Psychology in the Workplace

Positive Psychology in the Workplace Sandie Tharp University of Charleston English II Nada Najjar March 30th, 2013 Positive Psychology in the Workplace It has been proven that positive psychology in the workplace can improve and enhance workplace satisfaction because employees are more confident and are better able to manage stress and adversity. Employees that are happier with their work environment are typically more motivated and are more likely to pursue growth and development. Job satisfaction is an engine that drives organizations to success and keeps turnover rate to a minimum.An article from Harvard Business Review states that â€Å"a decade of research proves that happiness raises nearly every business and educational outcome: raising sales by 37%, productivity by 31%, and accuracy on tasks by 19%, as well as a myriad of health and quality of life improvements† (2011, Archor). Additionally, the author Archor asks if there is anything that a company can do to affect em ployee happiness and should a company invest resources into happiness. One avenue to happiness is using training as a tool that can be used to help employees to learn to manage stress.The first step is explaining the goal of the organization and how the employee contributes to that goal. Clear goals and expectations set out the mile post marking the marathon, by having clearly marked points of achievement for individuals or teams giving them a clear map to their success. It’s the manager’s responsibility to verify the goals of the team members, identify the common goal, and verify that they are in alignment with the organization goals. The King James Version of the Bible states â€Å"train up a child in the way he should go: and when he is old, he will not depart from it† (Proverbs. 2:6- King James Version). On the job training is the adult equivalent to raising a child. Putting subordinates on the path of success by providing the focus of the organizational ins tead of having the employee assuming or guessing about what to do causing stress and uncertainty. The economics of happiness in the workplace means that happy employees can help achieve organizational goals more easily because they are ready to give their best. Companies like Google and DreamWorks empower employees to use creative freedom in every day decision making.Google was a company that had to come up with a quick plan to reduce the turnover rate of their women employees because the turnover rate was affecting Google’s bottom line. In response, Google implemented a 5 month paid maternity plan, which gave new mothers the ability to take all the time upfront or to divide the time as needed. This new incentive plan reduced turnover by 50 percent among women and cost the firm no more than hiring a new employee. Google’s President Laszlo Bock, states â€Å"that if you factor in the savings in recruitment costs, granting mothers five months of leave doesn’t cos t Google any more money† (2013,Manjool).The new maternity policy that Google has implemented exemplifies why Google has become one of the best employers in the world, taking a major cause of employee turnover from a crippling weakness to a world class strength. Carolinas Healthcare is a system that contains 32 affiliated hospitals in North and South Carolina and is one of the leading healthcare systems in the southeast; Carolinas Healthcare employs over 44,000 employees. Managing such a large number of employees would be a challenge for any organization, but CHS has stepped up to the plate and has met that challenge and is leading the way for positive work environment.During a recent employee survey conducted by Morehead and Associates, CHS ranked in the 90th percentile in the national ranking of employee satisfaction. Carolinas Healthcare System already has a reputation of being â€Å"An Employer of Choice,† recognized by the JD Power and Associates in 2011† (201 2,Tarwater). This recognition has helped attracted top doctors and other medical professionals from all over the world. CHS concentrates on growth and expansion which helps generate excitement throughout the organization. Carolinas HealthCare System ecognizes that the employees are its most valuable asset and is dedicated to the growth and contentment of its employees. CHS recognizes that encouraging employees to continue educational growth will result in higher functioning, more competent workforce. Currently CHS offers an educational plan that reimburses employees for covered educational expenses and flexible scheduling around educational opportunities. Like Google with its maternity benefit, CHS has recognized that employees need and desire a clear path to growth and addresses this need with the educational assistance plan.Many organizations recognize the value of multiple bottom lines beyond monetary profit. Today the focus is on providing an environment based on positive intera ctions, outcomes and sustainability of the workforce. Organizations have come to realize that emotional intelligence and understanding is what allows employees to create positive interactions with customers and co-workers. According to Psych Central â€Å"research has shown that employees who are fully engaged in the work they do, and who have a sense of intrinsic motivation, are likely to perform better and a have better work outcomes† (2011, Wilner).To achieve these outcomes it is up to the organization to involve the employees and allow them to uncover their individual gifts and have the independence to use them for the common goals. Allowing employees to be involved gives them accountability for the success of the organization and a sense of pride, happiness and fulfillment. Positive psychology in the workplace can improve and enhance workplace satisfaction and have a positive impact on the organization’s bottom line. Companies like Google and Carolinas Healthcare understand the importance of a positive work environment.Both have provided pathways to fulfillment, whether through providing enhancement programs or through fostering positive interaction. Firms must continually look for avenues to promote growth, fulfillment and ultimately employee satisfaction if they are continue to improve the bottom line. It has been said that cheaper isn’t better; better is better. Today a better work force is cheaper than a cheap one. By continuing to harvest the fruits of a cohesive team built over time, an organization creates synergies that have a much greater return than the firm invests to create them. References Archor, S. (2011). â€Å"The Happiness Dividend†.Retrieved from http://blogs. hbr. org/cs/2011/06/the_happiness_dividend. html Bible – King James Version (1997). Proverbs 22:6. Hendrickson Publishers: Peabody. MA. Manjool, F. (2013). â€Å"Here's How Google Became Such A Great Place To Work. Retrieved from http://www. huf fingtonpost. com/2013/01/22/working-at-google_n_2526889. html Tarwater, M. (2012). â€Å"Employee Satisfaction†. Retrieved from www. carolinashealthcare. org Wilner, J. (2011). â€Å"5 Ways Positive Psychology can Improve the Workplace†. Retrieved from http://blogs. psychcentral. com/positive-psychology/2011/11/5-ways-positive-psychology-can-improve-the-workplace/

Escher essays

Escher essays Maurits Cornelis Escher was born on June 17, 1898, in Leeuwarden, Netherlands. His parents were George Arnold Escher and Sarah Gleichman Escher. They had three sons and Maurits, called Mauk for short, was the youngest. The family lived in a big and nice house named "Princessehof," which would later become a museum and hosted exhibitions of M.C. Escher's works. Young M.C. Escher and his family later moved to Arnhem. He attended elementary and secondary school there, and also in the seaside town of Zandvoort, where he lived for a while to improve his health. In 1907, he started learning carpentry and piano. In secondary school, his marks were poor except in drawing. His art teacher took an interest in his artistic talent, and taught him to make linocuts. He failed his final exam and never graduated. Also, in 1917, the Escher family moved to Oosterbeek, Holland. During this year and the following few years, M.C. Escher became very involved in literature, and began to write some of his own poems and essays. Trying to pursue a career in architecture, M.C. Escher next moved to Haarlem and began studies as the School for Architecture and Decorative Arts. There he met the artist Jessurun de Mesquita. After seeing Escher's drawings, Mesquita and the school's director advised him to continue with them. He began full-time study of the graphic and decorative arts in 1919. In 1922, Escher and a couple of friends visited Italy. He did a great deal of serious drawing in San Gimignano, Volterra, and Siena. He spent all of the spring of 1922 roaming the Italian countryside, drawing landscapes, plants, and even insects. In On June 12, 1924, Escher married Jetta in Viareggio, Italy. The new couple traveled much that year. They visited Genoa, Annecy, and Brussels. Upon their return home, Escher and Jetter bought a house just outside Rome and moved into it in October of 1925. Shortly after Escher and ...

Moving from SMD (Single Member District) System to PR (Proportional Representation) System

Moving from SMD (Single Member District) System to PR (Proportional Representation) System As political disillusionment intensifies in America, Diamond and Plattner (2006) show that parties and candidates are becoming more cynical thus culminating into low voter turnout. Several proposals have been brought forth to revolutionize the American electoral system among them the campaign finance reform.Advertising We will write a custom essay sample on Moving from SMD (Single Member District) System to PR (Proportional Representation) System specifically for you for only $16.05 $11/page Learn More However, the attention given to the most recent reform (PR system) has made more people to consider replacing the current SMD (winner-takes-it-all) system with the PR system. United States is a democratic and a multi-party state. Therefore, an effective electoral system should cater for the interests of the parties present and the people without compromising on democracy. What impact is the change likely to have on (a) party-system and (b) democracy in U.S.? T hese are the most fundamental questions that people should seek to answer before replacing the SMD system. It is important that we understand the party-system and the democratic deficiencies present in SMD so that we can decide whether PR will be a practical option. The SMD system discriminates against third parties, does not represent all voters, discourages people from voting and enacts laws that do not correspond with the public views. These problems reveal a fundamental flaw in the electoral system; the only persons represented are those who elect the winning candidate. The rest, about 49% in every district never get any representation as the election system shuts out the minorities from participating in elections. What happens is that a Republican who is in a Democrats dominated district votes but his/her votes go to waste because the Republican candidate never wins. Due to lack of minorities’ representation in the electoral system, Shively (2011) asserts that there is h eightened lack of democracy in the electoral system. This explains why there is distorted representation in the state, local legislatures and Congress. The SMD system also shows evidence of unequal representation of political parties. Parties end up getting more or less, than what they deserve. For instance, the House of Representative Elections (1994) saw the Democrats in Washington get 22% of the seats despite winning with over 50% votes.Advertising Looking for essay on political sciences? Let's see if we can help you! Get your first paper with 15% OFF Learn More As put across by Diamond and Plattner (2006), PR systems make use of multi-member districts and uses larger districts to elect the members required as an alternative to voting a single member in every small district. In addition, the number of candidates who win seats in the multi-member districts is dependent on the votes each party gets. For instance, in a PR district consisting of 20 members, if the Democratic Party gets 50%, the Democratic candidates get ten seats. If the Republican Party gets 30%, the party’s candidates secure six seats and if there is a third party with 20%, four seats are reserved for its candidates. A PR system would make sure that all people and parties get a fair and just representation. This is because under PR, there is representation of all significant groups including the political minorities who might only garner 10 or 20 % of the votes. The PR system ensures that the legislature reflects the parties’ voting strengths. For instance, a party with 40% of the votes gets 40% of the seats. Presently, the party-system reflects the unfairness of SDM. The Republican Party and Democratic Party, which are the winning parties, dominate the electoral system thus limiting other parties from winning. The PR system will offer diversity and make sure that emerging third parties such as the Liberation party, the New Party and the Greens get realis tic chances to challenge the two major parties. Such parties will only need 10% of the votes to elect a candidate hence guaranteeing the viability of the minor parties. Shively (2011) notes that this would lead to a healthy multi-party state where there is fair and free representation and competition among political parties. This would also guarantee that there are varied choices during elections. Each person can find a party or candidate that he/she can enthusiastically support. As a result, the public would exercise its voting rights in a democratic manner and with the assurance that their votes are not wasted; there is a guarantee that a 10% vote would see a candidate who can represent their views/needs in parliament. For this reason, voter turnout would be high meaning that the multi-party system formed would be heterogeneous. Thus, varied political perspectives present in the electorate would guarantee that there is a wide-ranging political debate that would uphold democracy, l ead to new ideas and sound decision-making.Advertising We will write a custom essay sample on Moving from SMD (Single Member District) System to PR (Proportional Representation) System specifically for you for only $16.05 $11/page Learn More To maintain or uphold democracy, Shively (2011) emphasizes that the government should allow all people to participate equally in every decision that affects them. The PR system will enhance democracy by giving the party-system a complete overhaul whereby the dominance of the winning parties will be eradicated and equal representation of all political parties, including the minor ones guaranteed. The PR system will also ensure that the electoral system upholds democratic rights, including voting rights and political representation rights of all citizens. Simply stated, PR system will cater for the party-system and democratic deficiencies in the SMD system without compromising on the role of the electoral system. Diamond , Larry Jay., and Marc F. Plattner. Electoral Systems and Democracy. Baltimore, MD: JHU Press, 2006. Print. Shively, W. Phillips. Power and Choice: An Introduction to Political Science. 12th  Edition. Dubuque, IA: McGraw-Hill, 2011. Print.

Marine Reserve Area (MPA) Essay Example | Topics and Well Written Essays - 1000 words

Marine Reserve Area (MPA) - Essay Example The term MPA is used in the generic sense covering all marine sites that meet the International Union for the Conservation of Nature and Natural Resources’s (IUCN) protected area definition â€Å"regardless of purpose, design, management approach, or gazetted name including marine reserve, sanctuary, and marine park† (UNEP-WCMC, 2008, p.18). â€Å"Historically, protected areas were established on an individual ad hoc basis rather than through a systematic, planned process† (UNEP-WCMC, 2008, p.13). In the case of Marine Protected Areas (MPAs), from as early as 1988, the need for a global protective system was recognized at various important global conferences. The establishment of marine protected areas were to be consistent with international law, based on scientific information, and required the formation of a global network of Marine Protected Areas. While regional action and targets aimed to establish protected area systems by 2010 based on regional and environmental conventions and protocols, the Congress also recommended the establishment of MPA networks across 20 to 30% of the world’s oceans by 2012. The Convention on Biological Diversity (CBD) took into consideration all the recommendations, and responded by making it mandatory for all parties to establish protected areas as planned and managed as a system or network. Marine protected areas are developed for fulfilling multiple objectives. They take into consideration conservation of the biodiversity and genetic diversity of the area, preserving ecosystems and maintaining ecological processes, and sustainable use of natural resources. Further, MPAs protect commercially valuable species, replenish depleted stocks, provide protection from natural hazards, and undertake education and research in related fields. Marine protected areas also ensure benefits to society and the economy, and promote

Library extension Essay Example | Topics and Well Written Essays - 1250 words

Library extension - Essay Example The roof beams are supported by the exterior main columns and are placed as a rafter. A truss is not included since a roof beam can carry the roof loads and also for the reason of abiding by the design intent of having a "high ceiling" and unobstructed natural light from the glazed section of the roof. The foundation is composed of isolated footings and retaining walls for the basement part. The longest span involved is 13 meters which is located at the faade of the building. Since the requirement is for the faade to be entirely composed of glass, two columns are supporting two roof beams propped against each other. The load transfer is synonymous to that of an arch frame. The two columns are supported by a main beam at ground level and beams that connect it to the next span. In the event that a huge lateral load or a very heavy roof load is applied way beyond the structure can support, these columns likely would be the first components to fail. No attachments are made to the existing museum and library, thus the new extension is structurally independent from them. Spans of 4.5 meters and 9 meters are designed for the beams wherein intermediate beams are provided for beams supporting a span of 9 meters. This would yield smaller members in the subsequent analysis and design. Tie beams are also found in the foundation and ground floor framing to support lateral movements. Further, aside from beam-to-column connections, there are beam-to-beam connections as well, and a planted column supporting the stairs. 3. Accommodation of Services Building services are accommodated and are given 0.8 meters. For services located in the basement, ground floor, and first floor; there is enough space for the conveyance of building utilities and at the same time, their pipe runs can be concealed. However, cladding must be made at the 1st floor overhead utilities (e.g. lighting), since there is no ceiling at the 1st floor. C. Scheme 2: 1. Functional Framing Scheme 2 is designed to have the least number of structural members as possible. The advantage to this approach is less members and longer spans that would give to larger uninterrupted spaces. However, members would have to be bigger or deeper to support longer spans. The framing for the basement remains the same as in the previous scheme. The framing support for the ground floor is remarkably decreased. This is for the reason that tie beams have been eliminated considering that the ground floor slab would be slab-on-fill. A wall footing tie beam is designated as support for the admin office wall. For the first floor framing, only one intermediate beam is designated for the slab at the adult's reading area. The span of 9-meters on the side of the cavity wall side is supported by two columns only. The roof framing is the same as in scheme 1. 2. Load Transfer and Stability Aspects As in scheme 1, the area of concern is on the supports at the faade since no column is located on the center of the faade that would possibly support a

MHE509 - Emergency Planning and Methodology Module 3 - SLP Essay

MHE509 - Emergency Planning and Methodology Module 3 - SLP - Essay Example This emergency management and disaster preparedness plan is developed to save the lives and assets of the Barnard college student’s society in the situations of emergencies. This also protects the arranged operation of the college society throughout disasters. This policy will also facilitate in to manage and deploy the right help, manpower and resources in the occurrence of a disaster. For the critical analyses of the emergency or disaster management plan for the Barnard college I have reviewed the whole report and tried to find out the main weak points and flaws that are present in this emergency or disaster management policy. From the section onward I will discuss these points in detail. As we study the mission statement of the Barnard College’s emergency or disaster management plan or policy then we will be able to perceive lot of weaknesses in the better management of any critical situation. Here I will elaborate few of them. The main weakness I have perceived is about the handling of that situation. Here this emergency or disaster management plan it is mentioned that in case of any disaster situation will be assessed and then the necessary resources will be made available for that situation to address the emergency. As I perceive this is not feasible in state of emergency because at the time of emergency we have very short time to handle the situation. Assessment and planning at that time will take time and we would not be able to handle the situation properly. In this disaster management policy the main flaw is the lack of preplanning for all type of critical situation. There is a strong need of preplanning for all the types of situation in case of any mishap. So we can say that the Barnard College needs more established preplanning for better handling of the situation and circumstances. The weakness and failure of the emergency or disaster management plan is the lack of the enough

Different kinds of festivals Essay Example for Free

Different kinds of festivals Essay In a year we have celebrated different kinds of festivals.Sometimes,we do celebrate festivals following our religion.Different religions have different festivals to celebrate.Festival are celebrated in a grand way and gives much joy. The same thing goes for me.I am a Hindu and I celebrate many festivals.The best festival I have ever experienced is Deepavali.Deepavali comes on the month of November and it is usually on the second week of the month.Deepavali is known as the festival of lights for the Hindus. Last year,my family and I celebrated Deepavali at our grandparent’s house.After we woke up,we had to take an oil bath which was massaged from the head down to our toes.Then, we wore our new traditional clothes,dhoti and sari.We got ready to go to the temple near the house. The priest in the temple made a special offering and prayers to the God on this special day. After prayers in the temple,we went back home.A fe w minutes later,my relatives and neighbours came to our house.My grandmother served them with scrumptious traditional food.For instance,murukku,vadai,and tose.They really enjoyed their food and they said it was very tasty. Before the guest left the house,my grandfather gave them â€Å"ang pows†.I was really shocked because throughout I know only Chinese gave â€Å"ang pows† during their festival,Chinese New Year but I never knew that Indiansdid that too. Then, it was time to take our lunch.My father prepared some banana leaves to use as plates.It had really a different taste when eating from a banana leaf.It really potraits a traditional style. In the evening,we packed our things to get ready to go back home.We really missed our grandparents because they were the only ones who celebrated Deepavali in a special way. Among all the Hindu festival,I think the last Deepavali was the best festival I had ever experienced.I like the way they celebrate the festival with lighting up lights around their house.It shows that our life always brightens with ha

Cognitive And Dialectical Behaviour Therapy Borderline Personality Disorder Nursing Essay

Cognitive And Dialectical Behaviour Therapy Borderline Personality Disorder Nursing Essay AIM: To give a brief history of Borderline Personality Disorder and research the effectiveness of Cognitive Behavioural Therapy and Dialectical Behaviour Therapy. Method: A review of the literature and review of controlled trials and uncontrolled trials. Conclusion: In the management of Borderline Personality Disorder, there are many problems to consider, out of these problems self-harm and suicidal tendencies are considered the most important to treat. Chapter 1 Introduction 1.0 Despite the many treatment options for people with Borderline Personality Disorder (BPD), many professionals in mental health services continue to believe that personality disorders are untreatable. This essay provides evidence the effectiveness of Cognitive Behaviour Therapy (CBT) and Dialectical Behaviour Therapy (DBT) with Borderline Personality Disorder. Background To understand BPD, I will attempt to give a historical overview of BPD. Philippe Pinel in the 1800s, first described people who engage in deviant behaviour, but with no signs of thought disorder such as hallucinations or delusions as mania without delirium or in French manie sans delire (Friedel, 2004). Although the meaning of the term has changed through many writings on the subject over time, the writing of Cleckley and his use of the label psychopath in The Mask of Sanity brought the term into accepted usage (Meloy, 1998). The Mask of Sanity is a book written by Hervey Cleckley first published in 1941; he gave the most significant clinical description of psychopathy in the 20th century. An expanded edition of the book was published in 1982, when the name was changed from psychopathy to Personality Disorder. In 1972, newer editions of the book reflected a closer alliance with Kernbergss (1984) borderline level of personality organization, in particular defining the structural criteria of the psychopaths identity integration, defensive operations and re ality testing. The diagnosis borderline was introduced in the 1930s to label patients with problems that seemed to fall somewhere in between neurosis and psychosis (Stern, 1938). Adolph Stern a psychoanalyst described the symptoms, which are now considered to be the criteria of BPD. He suggested the possible causes and what he thought the most successful psychotherapy treatments were. He renamed the disorder, by referring to patients with symptoms as the borderline group (Friedel, 2004). In 1940, the psychoanalyst Robert Knight introduced his explanation theory of borderline disorder. Ego or sense of self psychology deals with mental function, which allows us to effectively combine our thoughts and to develop helpful responses to our life around us. He stated that people with BPD have impairments in a lot of of these functions, and he referred to them as borderline states (Friedel 2004). The next important input was made by the psychoanalyst Otto Kernberg (1967); he introduced the term borderline personality organisation. He proposed that mental disorders were determined by three distinctive personality organisations: psychotic, neurotic and borderline personality. Kernberg has been a strong promoter of modified psychoanalytic therapy for patients with borderline disorder (Friedel 2004). The first research on BPD was published by Roy Grinker in 1968, which he called Borderline Syndrome (Friedel 2004). The next major article was published in 1975 by Gunderson and Singer. They defined the major characteristics of BPD. Gunderson then went on to publish a research instrument to enable an accurate diagnosis. Internationally researchers were then able to verify the validity and integrity of BPD (Friedel, 2004). This followed with BPD becoming a genuine psychiatric diagnosis and appeared in the DSM-111 in 1980. Personality disorder categories are not firmly grounded in theory, nor are they empirically based (Livesley, 1998). Some critics say that personality disorder categories are so flawed that the best option is to abolish them and start afresh, but most pragmatists recognise that so much has been invested in them that they are very likely here to stay (Blackburn 2000a; Livesley, 1998). The Nice Guidelines for Personality Disorder (2009) state that borderline personality disorder is associated with significant impairment, especially in relation to the capacity to sustain stable relationships as a result of personal and emotional instability (NICE 2009). The severity of the symptoms, are related to the severity of the individuals personal/social situations. Stone (1993) argues that some people with BPD can still function at high levels in their lives and careers. Paris (1994) stated that about one-third of patients with BPD reported severe abuse involving an incestuous perpetrator; about one-third reported milder forms of abuse; and about one-third do not report abuse. Personality disorders are common conditions; studies indicate prevalence of 10-13% of the adult population in the community and are more common among younger age groups (24-44 yrs) and equally distributed between males and females. However, the sex ratio for specific types of personality disorder is variable e.g. antisocial personality disorder is more common among males, and borderline personality disorder more common amongst females (DOH 2003). Cognitive Behaviour Therapy (CBT) can be seen as an umbrella term for many different therapies that share some common elements. The earliest form of Cognitive Behavior Therapy was developed by Albert Ellis in the early 1950s. Aaron T.Beck independently developed another CBT approach, called Cognitive Therapy, in the 1960s. Cognitive Therapy rapidly became a favorite intervention to study in psychotherapy research in academic settings. In initial studies, it was often contrasted with behavioral treatments to see which was most effective. However, in recent years, cognitive and behavioral techniques have often been combined into cognitive behavioral treatment. This is arguably the primary type of psychological treatment being studied in research today. One specific form of cognitive-behavioural therapy is dialectical behaviour therapy (DBT), a broad-based, cognitive-behavioural programme developed specifically to reduce self-harm in women with borderline personality disorders (Linehan, 1993a; Linehan 1993b). Recent research has shown that dialectical behaviour therapy (DBT) is one of the first therapies that have demonstrated to be effective for treating borderline personality disorder as well as being effective in treating people who display varied symptoms and behaviours associated with mood disorders, including self-harm. DBT combines standard cognitive-behavioural techniques for emotion regulation and reality-testing with concepts of mindful-awareness, distress tolerance, and acceptance. 1.2 Rationale As a mental health nurse coming from a forensic background, I have experience of working with clients with personality disorder. I feel that by getting more of an understanding of CBT interventions, it will make a huge difference to my future practice in the future. McKenna et al (1999) state that it is unacceptable for health care not to be based on sound evidence of its effectiveness, and back up their practice with research-based evidence (NMC, 2008) to ensure effective clinical practice. Often nurses find it frustrating working with disorders of personality. These clients can be manipulative, socially inappropriate and difficult, for these reasons, such clients need all the patience and skills nurses have to offer. But despite this service in the NHS, services have been varied and inconsistent (DoH, 2003). Besides functional impairment and emotional distress, borderline personality disorder is also associated with significant financial costs to the healthcare system, social servi ces and the wider society (NICE 2009). 1.3 Aims and objectives The aims and objectives of this project are to review the evidence on the efficacy of Cognitive Behavioural Therapy and Dialectical Behaviour Therapy with people who have Borderline Personality. 1.4 Methodology and parameters This literature review was conducted using the following resources Electronic databases: Cochrane library, CINHAL, Medline, Psychinfo, Psychology and Behavioural Sciences and Academic Search Premier Key journals were hand searched: British Journal of Psychiatry, Journal of Personality Disorders, Mental Health Practice, Journal of Personality and Mental Health University and Trust libraries Google Google scholar The following types of literature were sought and reviewed where available Randomised control trials Systematic and structured review Quantitative and Qualitative research studies Position statements/guidelines from professional bodies Government policies (NICE (2009), NSF (1999) Text Books Inclusion and exclusion criteria Eligibility for this review was determined by the following criteria: à ¢-  Participants: adults with BPD (diagnosed according to DSM-III/DSM-III-R, DSM-IV, DSM-IV-TR or ICD-10 criteria for BPD), with or without co-morbidity. à ¢-  Intervention: psychological therapies, including CBT, DBT à ¢-  Comparators: CBT/DBT or treatment as usual à ¢-  Outcomes: self-harm, suicide, interpersonal and social functioning à ¢-  Study type: published papers were assessed according to the accepted hierarchy of evidence, whereby systematic reviews of RCTs are taken to be the most authoritative forms of evidence, with uncontrolled observational studies the least authoritative. à ¢-  Exclusion criteria: papers on personality disorder without separate BPD subgroup analyses. The studies were obtained through a number of sources, as above. Searches were performed by entering the key words Borderline Personality Disorder, Cognitive behaviour therapy into several databases, which yielded many secondary references of current best evidence. Search filters developed consisted of a combination of subject headings. The topic-specific filters were combined with appropriate research design filters developed for systematic reviews, RCTs and other appropriate research designs. These articles were selected after careful reading of the title and abstract to identify the most useful. I then limited my search to full articles which made my search a lot easier. The definitive text that will be used to aid my search will be NICE Clinical Guidelines for Personality disorder 78. This guideline makes recommendations for the treatment and management of borderline personality disorder in adults and young people (under the age of 18) who meet criteria for the diagnosis in prim ary, secondary and tertiary care (NICE, 2009). BPD is present in 1% of the population, and is most frequent in early adulthood. Women present to services more often than men. BPD is not often formally diagnosed before the age of 18, but the features of the disorder can be identified earlier. Its path is changeable but many people do recover (NICE 2009). This search will comprise both British and international articles. When choosing which articles were going to be relevant, I found it impossible to ignore the amount of articles I had on DBT and as DBT was evolved from CBT and made specifically for BPD, I decided to bring it into my research project. The articles are mixed quantitative and qualitative research. The qualitative means of gathering subjective data is centred on an individuals experience, beliefs, empowerment and quality of care and does not solely concentrate on clinical outcomes for the individual. One could argue that this is the most appropriate aspect of research for mental health nurses as mental illness is individual for each person involved in the process and although BPD is not a mental illness. The National Service Framework for adult mental health sets out our responsibilities to offer evidence based, effective services for all those with severe mental illness, including people with personality disorder who experience significant distress or difficulty (NIMH 2003). While these can be misconceived as an easy option form of research, qualitative research offers rich, reflective and exhaustive data that is invaluable and has a profound contribution to make to take to practice. The qualitative evidence was lim ited with regards to the treatments reviewed, with an emphasis on DBT. Quantitative research is a formal, objective, and rigorous statistical process for generating information about the world (Burns Grove 1999), whereby the researcher would gather a range of numerical data in order to answer the research question, or prove, disprove a hypothesis (Parahoo 2006). Philosophies or schools of thought in research are called paradigms (Parahoo 2006). One such paradigm is positivism. Parahoo (2006) asserts that positivism relies on observations by the human senses to create fact (empiricism), and believe in the unity of science, and the notion of cause and effect (determinism). The positivist researcher will endeavour to test a hypothesis or theory using the deductive process of a course of experiments. This paradigm utilises a quantitative approach in its research methods. For the positivists, quantitative research is believed to provide hard evidence and objective fact that can provide knowledge on which to base best practice (Parahoo 2006). Efficacy studies focus on the usefulness of a specific helping methodology for a particular kind of problem. Comparisons are made between the methodology in question and some other methodology between clients with some disorder who do receive the treatment and those who do not or between two different methodologies for treating the same disorder. These studies are carried out under controlled conditions. Many of the studies are well designed and demonstrate efficacy. In a healthcare context, efficacy indicates the capacity for beneficial change (or therapeutic effect) of a given intervention. Chapter 2 The Literature Review Having undertaken a critical review of the literature, I have come to explore a number of issues which I feel necessary to consider, key themes emerging from this literature review are the impact of CBT DBT on suicidal behaviours, the impact of CBT DBT on self-harming behaviours, and the impact of CBT DBT on engagement. This chapter sets out to explore these themes in more detail. On the whole the most suitable research design to answer this is the Randomised Controlled Trials (RCT); hence the evidence base reviewed include accessible RCTs undertaken in those with a diagnosis of BPD (NICE, 2009). The causes of BPD are complicated and remain uncertain. Contributing factors may include an inherited vulnerability, a particular temperament, early life experiences and, in subtle neurological or hormonal disturbances (NICE 2009). NICE (2009) state that the history of specific psychological interventions designed to help people with borderline personality disorder is intertwined with changing conceptions of the nature of the disorder itself. Swartz (1990) wrote that BPD is more common among drug and alcohol users. And within these dependents there will be more women diagnosed than men. Zanarini (1998) also adds that the disorder is more common in those with eating disorders, and also among people with self-harming behaviours (Linehan et al., 1991) 2.1 Defining Cognitive Behaviour Therapy and Dialectical Behaviour Therapy NICE (2009) define CBT as a structured psychological treatment that focuses on helping a person make connections between their thoughts, feelings and behaviour. Originally CBT was used as a treatment for depression which has now been modified to treat BPD. CBT focuses on altering the thoughts, emotions, and behaviours of patients by teaching them skills to challenge and modify beliefs, to engage in experimental reality testing, and to develop better coping strategies. The goals of these interventions are to reduce the delusional beliefs, and consequently their severity, and to encourage effective coping and decreasing distress. This essay will attempt to assess the contribution of CBT and the disorder by discussing reviews on effectiveness. CBT for BPD was developed with the idea that people with BPD have learned distorted beliefs and thoughts overtime. Distressing emotional responses and behaviours develop as a result. Beck Freeman (1990) outlined such beliefs, relating to dependen cy, distrust, and rigid perceptions. The distorted thoughts are modified by monitoring,  analysis and questioning.   Davidson (2000), adds that particular attention should be paid to the problems that can disrupt therapy, and so disrupt the therapeutic relationship (NICE, 2009), such as non-engagement, loss of structure, losing focus and lack of compliance. CBT for BPD attempts to create change by improving the attitude of the patient toward treatment, the enhancement of specific skills, and the reduction of hopelessness (Friedel, 2004). The therapist and patient will construct a list of problem areas. A set of tasks will be developed that will generate and reinforce new attitudes and behaviours, which will replace the old attitudes and behaviors that have caused problems in the past. Within the past 15 years, another, newer psychosocial treatment termed Dialectical Behaviour Therapy (DBT) was developed. DBT joins standard cognitive behavioural techniques with acceptance based strategies, as well as strategies designed to keep the therapy balanced between change and acceptance (dialectical strategies). Marsha M. Linehan, a psychologist from the University of Washington in Seattle, developed DBT specifically for people with BPD, especially those who engage in self-destructive and self-injurious behaviours. DBT is based on the belief that the symptoms of BPD result from organic impairments in the brain that control emotional responses. The early behavioural effects of this impairment are exaggerated, as the person with this biological risk factor interacts with people who do not validate their emotional pain and dont help them learn effective coping skills. DBT has gained significant support in the treatment of BPD because of the results it has achieved in several r esearch studies. It has been shown that DBT can be taught to and used by many, but not all, mental health professionals. For the time being this seriously restricts the use of this helpful treatment approach. DBT seeks to validate feelings and problems, but it balances this acceptance by gently pushing to make productive changes. DBT also deals with other opposing or dialectical tensions or conflicts that arise, such as the patients perceived need for a high level of dependence on the therapists, and the fear and guilt aroused by such extreme dependency. DBT combines both cognitive and behavioural techniques and designed specifically to treat BPD. It is a combination of individual psychotherapy and psychosocial skills training that has been shown via controlled clinical trial to be effective in treating individuals with BPD (Linehan, 1993b). One of the most limiting factors of treating and delivering therapies is that there is not enough staff in the NHS trained to a high standard ( NICE 2009). Cunningham (2004) interviewed fourteen women with BPD to discover why and how DBT is effective. The women were provided with tools to help them deal with their problems and so enabled them to to see the disorder as a controllable part of themselves rather than something that controlled them (NICE, 2009). Cunningham (2004) found that although their problems did not disappear, they became more manageable. It also seemed to have encouraging results on their relationship interactions, and, in addition DBT instilled hope and an ability to try to live independently (NICE, 2009) 2.2 Suicidal acts NICE (2009) define suicidal acts as, deliberate; life threatening; resulted in medical attention; medical assessment consistent with suicide attempt. The main problem staff face in managing BPD is suicidal behaviour (Paris Zweig-Frank, 2001). There is also an association between BPD and depression (Skodol et al., 1999; Zanarini et al, 1998), and Solof (2000) adds that the combination of the two disorders increases the number of suicide attempts. People with BPD possibly will take part in a number of negative and reckless behaviours including self-harm, eating disorders and substance misuse. Self-harming in BPD has different meanings to each individual, including relief from feelings and distress, such anger, or to reconnect with feelings after episodes of emptiness (NICE, 2009). Because of the high occurrence of self-harm, the risk of suicide is higher (Cheng et al, 1997), with 60-70% of patients with BPD making suicide attempts at some point in their lives (Oldham, 2006), however, unsuccessful attempts are far more common and the actual rate of completed suicides is estimated at between 8-10%. A specific therapy for BPD, DBT tak es a behavioural approach to self-harm and suicidal acts that include skills training in emotional regulation and validation of client experience (NICE, 2009). Cognitive-behavioural therapy along the lines of Beck, Freeman, Associates (1990) has been investigated in at least two uncontrolled trials. Brown, Newman, Charlesworth, and Chrits-Cristoph (2003) found significant decreases on suicide ideation, hopelessness, depression, number of BPD symptoms, and dysfunctional beliefs after 1 year of cognitive-behavioural therapy for suicidal or self-mutilating patients with BPD. Results were maintained at a 6 months follow-up. Effect sizes were moderate (0.22-0.55). Dropout rate was 9.4%. Arntz (1999a) found positive effects of long-lasting cognitive-behavioural therapy in a mixed sample of personality disorders, including 6 patients with BPD. Two patients with BPD dropped out prematurely, but the other four attained good results. Linehan et al (1991) conducted a randomised controlled trial using 44 chronically parasuicidal women with BPD to assess the effectiveness of DBT. Among the two groups, there was very little difference between measures of depression, hopelessness and suicidal ideation. Overall the group which received DBT had an average of 8.46 inpatient days compared to the controlled group which had 38.86 days. A naturalistic follow up review was conducted on 39 on the women one year later, to determine the effects of DBT. The women that had completed the DBT course had fewer parasuicidal episodes, but after 18-24 months there were no significant differences between the two groups, although psychiatric inpatient days were still lower for the DBT group. Rathus et al. (2002) went on to conduct a study with a group of 111 suicidal teenagers. 29 were assigned to DBT, while the other 82 had treatment as usual (TAU). It is worth mentioning that the DBT group had far more severe symptoms pre-treatment. The study therefore was not randomised. During the 12 week treatment, the DBT group had fewer inpatient hospitalisations, although the number of suicide attempts made during the treatment did not differ between the groups, but, the attendance and completion was higher in the DBT group. A smaller case study was conducted by Hengeveld et al (1996); he reported of 9 female patients who were given a 10 week course of CBT, they had all attempted suicide at least twice. Of the 9 women, four of those were diagnosed with BPD. Following up the women 10 months later, by phone or examining medical records, all four BPD patients had reports of further suicide attempts (NICE, 2009). Linehan et al. (2006) conducted a one-year randomized controlled trial with one year of post-treatment follow up. The objective was to evaluate the hypothesis that unique aspects of DBT are more efficacious compared to treatment offered by non-behavioural psychotherapy experts. The study included 101 female participants with recent suicidal and self-injurious behaviours that met DSM-IV criteria. The subjects who received DBT were half as likely to make a suicide attempt. 2.3 Self-harm NICE guidelines (2009) use the definition that self-harm is self-poisoning or self-injury, irrespective of the apparent purpose of the act. Self-harm BPD is connected with a range of diverse meanings for the individual, including release from distress and feelings, such as emptiness and anger, and to reconnect with feelings after an episode of dissociation (NICE, 2009). There have been positive attitudes from patients about DBT, as it has helped improve their ability to control their emotions, improves their relationships and significantly reduces the occurrence of self-harm (NICE, 2009). In a large sample, Tyrer et al (2003) found that CBT was equivalent to TAU for the treatment of recurrent self-harm and noted that this method was less effective for patients with BPD. In an uncontrolled study by Brown (2004), patients with BPD with self-harming tendencies received CBT over 12 months; they then stayed in contact with them by phone over the next 6 months. Therapists were on call to emergency phone calls throughout. A randomised controlled study by Verheul et al (2003) was carried out to compare DBT with TAU for patients with BPD, 58 women received treatment for a year were randomised to DBT or TAU. The results: the 12 month attrition rate (37%) for DBT was substantially lower, compared to TAU (77%); DBT treatment also resulted in a large reduction of self-harming behaviours than TAU. A follow up review of this study was carried out by Van den Bosch et al (2005), to ascertain whether the previous results were continued over the following 6 months. It was discovered that the benefits of DBT after the treatment were sustained, and levels of self-harm were lower. It must be said, however, that the definitions of self-harm were all slightly different in each of the RCTs, this can make it very difficult to compare results (NICE, 2009). Another case study series by Alper (2001), presents data on 15 women in a forensic setting, with a diagnosis of BPD. Nurses in the hospital carried out the DBT, and over 4 weeks there was a significant reduction in the occurrence of self-harm. Alper (2001) also carried out qualitative interviews with the nurses to describe how they felt about the treatment, they were all very positive. Bateman Tryer (2004) state that the extensive implementation of DBT is a acknowledgment of its founder, Marsha Linehan, with its mixture of acceptance and change, skills training, manualisation, and an opinion that is willing to embrace this comprehensive approach (NICE, 2009). The evidence strength though, is not justified, however (Tyrer, 2002b), and answers about the long-term success of this therapy as a treatment for BPD are premature. In view of the fact that the original trial, which was handicapped by many methodological limitations, there has only been one study that supports the findings clearly, which was that of Verheul et al (2003) (NICE, 2009). 2.4 Non-engagement For effective treatment, commitment to therapy is required, and research shows that fewer people drop out of DBT than other therapies (Verheul et al 2003) Haigh (2003) interviewed service users and according to them the services could be improved if staff recognised and accepted that BPD can be treated; they felt a more positive experience at their preliminary referral would aid further engagement with services; therapeutic relationship endings were dealt with effectively; and when signs of improvement are observed, services should not be removed immediately, as this tends to raise anxiety and discourage future progression (NICE, 2009). Hodgetts et al (2007) studied five people with BPD. The participants were told that DBT was the only treatment for BPD. This raised expectations and anxieties in the service users. Some preferred the structure of DBT, but others would have preferred a more flexible treatment that is adjusted to each individuals needs. Service users each felt differently about individual therapy and group therapy. One participant dropped out of therapy as she found the challenges too much to deal with. The same lady reported that she was turned away from the crisis team as she was already involved in the DBT group; this was another reason for her departure. All of the participants in this study found that the therapeutic relationship is essential, also they appreciated the importance of collaborative working and sharing their experiences (NICE, 2009). Other studies have reported quite high drop out rates from CBT, for example up to 37% (Verheul et al, 2003). It is probable that some patients did not engage because they did not find the therapy useful, but ratings from patients who had at least five sessions of CBT suggest that both the patients and therapists view the experience of therapy to have been a positive one. Even so, some patients simply did not attend. Chapter 3 Discussion and Conclusion This research project has tried to look at research evidence on the efficacy CBT and DBT in the management of Borderline Personality Disorder. This work has been done using the NICE Guideline (2009) as the definitive text. This is because this guideline is main reference document in clinical practice. Borderline Personality Disorder is one of the most challenging entities for todays therapist; in fact, this category originated as a repository for patients who fail to improve with ordinary treatment methods and whose particular pathology is most likely to provoke a negative emotional reaction in the therapist. Comfort and effectiveness in the treatment of BPD implies mastery both of ones own emotions and of therapeutic techniques in general. It is not realistic to expect success in every case, and successful treatments are usually long and stormy. Because the BPD diagnosis have common characteristics with schizophrenia, psychoses, anxiety and depression, Gunderson (2001) believes it to be a wastebasket diagnosis, which lacks diagnostic accuracy and strength, and so would only be useful to service users that did not fall into other diagnostic types. It is thought that BPD has responded badly to the treatments, and a lot of health professionals also unfortunately, believe this to be true (Friedel 2004). It seems that overall the non-RCT outcomes suggest that individual therapies are more suitable to people with BPD. Positive outcomes were shown generally, these need to be compared to the RCTs before definite conclusions can be made (NICE, 2009). It seems that the evidence base is fairly poor for therapies of BPD, the studies are minimal, the number of patients are low and the outcomes too numerous, with very little commonalities between studies (NICE, 2009) Giesen-Bloo et al (2006) are critical of DBT, stating that it fails to reduce core symptoms related to deeper personality change. The most difficult problem is that DBT is resource-intensive and expensive. Where it is available, there are usually long waiting lists. However, DBT is the treatment of choice for individuals experiencing severe impulse and self-harming behaviours. 3.1 Strengths and limitations of the review Having never done a substantial piece of work before, I did not realise the amount of work required to achieve it. I was aware of how to narrow down a search, which was needed due to vast amount of information available, but the confusion came as I particularly wanted to look at standard CBT for BPD, which very little research has been done. There was far more research for DBT, and so I decided I would explore this t