Panera Bread Essay

What are the Panera Bread’s primary sources of competitive advantage? In your judgment, are these sources of advantages sustainable? Why or why not? Panera’s primary sources of competitive advantage are: (1) the distinctive nature of its bakery products, (2) its brand strength, (3) the atmosphere of its restaurants, and (4). its position in the restaurant industry Yes,Panera Bread Co. (NASDAQ: PNRA) operates the signature restaurant chain Panera Bread, selling hand-crafted breads, sandwiches, salads, and drinks. Panera Bread bakery-cafes are often associated with the concept of â€Å"fast casual†, a mixture between fast food and more upscale casual dining. Customers still pay for their food at the counter, like a traditional fast food restaurant, but Panera arranges tables and chairs to be conducive to group meetings. Most Panera Bread restaurants are located in suburban strip malls and regional malls. As of December 29, 2009, Panera had 1,380 bakery-cafes, spanning 38 states, as well as some locations in Canada. Traditionally, companies like Panera have suffered in recessions, which decrease the frequency with which consumers eat out at restaurants. 1] However, Panera’s strategy during the recession has been â€Å"to stay consistent and not to react to the recession†, keeping costs constant and offering new salads and sandwiches. [2] As a result, Panera’s â€Å"fast casual† niche (between casual dining and fast food) contributes to its relative success; this positioning allowed it to avoid discounting wars and maintain its margins by attracting customers with a higher quality product perceived to be a good value for the money. Panera bread has a great meal of Bacon Turkey Bravo with 28G of fat per meal.

Antonym Brutes

So remember when you are making a decision, think to yourself if there will be a consequence involved that can change your life. He lives by his wiles as well as his courage. He is an intellectual. Often he openly valuates a situation, demonstrating the logic he employs in making his choices. When it proves effective, Odysseus lies to his own family, cheats, steals, in ways that we would not expect from an epic hero. Although he IS self disciplined, his courtesy is sometimes the root of his trouble.He is willing to pay a price for knowledge, for example: he insists on hearing sirens call, even though he must have himself excruciatingly strapped to the mast of his ship so that he cannot give in to the temptation. Teeter's decision of going in the kayak by herself can bring great consequences. If she ever drowns, there loud be nobody by her side to save her, and if doesn't have a phone then nobody could come help her, unless she screams for help. Since she goes far, her parents might n ot be able to hear her.Also her disability could bring dangers, including falling out, or if the waves get big for the boat to fall over. Teeter's parents should be aware of the consequences that could happen along with her decision and her parents should always help her be prepared and be aware. Brutes and his inconsistent behavior and actions lead to his death, and brought many consequences. When he knows that he will be featured by Antonym, Brutes does not ask anybody to kill him, but instead he asks if one of the soldiers will hold a sword for him to kill himself with.Because of his decision to join the assassination, Brutes loses everything that mattered to him. He fails to follow the experience of cassias, and listen to his recommendations. In conclusion, consequences can be unpleasant, and unwelcoming to anybody on this planet. Odysseus, Teresa, and Brutes all faced consequences from there decisions made, and should have decided on something different that would bring peace a nd happiness. When faced a consequent, you might just have to bare it.

6 Ways to Improve Productivity at the Workplace

6 Ways to Improve Productivity at the Workplace Employees spending long hours in the office are not an uncommon sight these days. But how much of the work day is spent productively is another matter altogether. As the saying goes â€Å"it’s not the number of hours you put into work, it is the amount of work you put in those hours†. So what can you do as an employer to increase productivity at the workplace? Here are some tips you can follow. Instill accountability in your employees. By making your workers accountable for their actions and decisions (regardless of their position), it encourages them to be more cautious and meticulous when it comes to their work, hence minimising the risk of errors. In addition, instilling accountability in your employees also gives them a sense of ownership, so that they too feel they have a stake in the company and how it performs. Manage but don’t micro-manage. The fine line between managing and micro-managing can be hard to distinguish. With micro-managing, the danger lies in your employees becoming overly dependent on you and unable to make their own decisions. To prevent such a scenario, start trusting your employees to operate in whatever style they are comfortable with to get the job done — after all, they passed the screening process during the hiring process so they must possess the necessary skills. Having faith in your workers† abilities encourages and empowers them with the confidence to give their all. On the other hand, don’t be quick to pinpoint the blame whenever trouble arises. Speak to him or her first to find out what can be done to prevent the same mistake from happening again. Motivate and reward for good results. While it may sound like common sense, many employers fail to give workers recognition for a job well done — which can result in employee morale dropping. Rewarding your hardworking employees with monetary bonuses clearly shows how much you value their work and will motivate them to continue doing their best for the company. But what if budget constraints prevent you from giving them a raise? Don’t simply remain silent and expect them to know that you recognise their efforts! In fact, it is times like these when keeping staff morale up is most important. Give your staff words of encouragement and assure them that once the situation improves, they will be rewarded accordingly. Or perhaps, offer other forms of rewards such as an increase in leave days or time off. Remember, recognition can come in many forms, not just monetary. Provide the proper equipment. When menial tasks can be automated using the office equipment, it often makes sense to do so. This helps free up manpower to work on more meaningful tasks. But it’s also important to choose equipment that is functional and easy to use. That’s why when purchasing office equipment, get the competitive edge with brands that have a history of reliability such as Canon. Offering a full spectrum of high quality imaging products from input to output, Canon business solutions are renowned for high efficiency while being low in maintenance. They also come backed with strong after-sales support to ensure your business continues to run smoothly. Provide upgrading opportunities. Just like purchasing the proper equipment helps make your employees more productive, so will upgrading their skills. By sending them for training courses, you equip them with the latest skills and introduce them to new (and potentially more efficient) ways of doing their job. However, not all skills upgrading requires spending thousands of dollars and dozens of hours in classes. Having your experienced staff share their useful knowledge with other workers can also be a form of upgrading. Break the routine. Aligning job tasks with an employee’s abilities makes perfect sense but having him or her perform the same duties 40 hours a week may become tedious and even counter-productive in the long run. To break the monotony, rotate job responsibilities from time to time and introduce new roles where possible. This allows your staff to expand their skill-set and also gives them a better understanding of how the business works. Low productivity in the workplace can jeopardise the sustainability of any business, especially SMEs, if left unresolved for some time. So be sure to monitor the efficiency of your workers; not by hovering over them like a hawk, but by communicating with them to learn about any grievances they wish to share. Tackling such issues sooner rather than later will go a long way in ensuring your business reaches its true potential.

Argumentative and Assignment Essay Example | Topics and Well Written Essays - 1250 words

Argumentative and Assignment - Essay Example One of these alternatives of giving remedies to diseases and ailment is referred to as homeopathy. In homeopathy, the proponents propose that when highly diluted form of infection substances are injected into the body of an ailing person with the same disease; he/she is able to realize normalcy since the highly diluted form of the antigens injected in the body will eradicate the ailment. This proposal has elicited serious rejection form different quarters with the proponents and the opponents maintaining equal position with reference to the effectiveness of homeopathy. Thesis Statement Having conceptualize the information surrounding homeopathy and how it gives remedies to diseases and ailment, I have not found any scientific backing as to whether the proposed form of rendering remedy can indeed work as stated. I therefore hold a contrary opinion about the process, believe that the process is short of basic science, and cannot be relied upon in giving medication in the contemporary m edication arena. In the Article titled ‘Evidence and Simplicity. Why we should Reject Homeopathy’ by Scott Sehon and Donald Stanley, there is a logical criticism on the functionality of homeopathy as a form of medication. In the criticism of the way homeopathy works, the article sought to address two fundamental questions about the remedy; is there a plausible explanatory theory about homeopathy that will make it appreciable by the opponent and if that is the case. Can we fully rely on homeopathy as a way of giving remedies given it usefulness as proposed by the proponent and is there sound and empirical evidence that the effectiveness of homeopathy is real (Sehon and Stanley, 4). The tow questions that were sought in the articles drew party answers from the proponents leaving a row of speculation on the efficacy of their proposed method of remedies. The proponents of this method of medication themselves accept that they don’t understand the science behind it and all they know is that it works miraculously, this response is irresponsible in the science domain. In science, cogent evidence, clarity, examples, and inferences are important facets of convincing eager audience about a proposal. Without scientific backing, such proposals are at best considered bad jokes. According to science, for anything to be considered able to give remedy, it must consider to explain the chemistry art of the medication and how it interacts with the body physiology. These important facts are ignored by homeopathy making its belief significantly impossible. The only defense the proponents of homeopathy are putting forth is that the medication needs not to march the western medication. The reason as to why I find the functionality of homeopathy patchy is the principle known in the medicinal field. Small microorganisms called antigens are responsible for the occurrence of diseases. The diseases are caused by the antigens, which are specific, and exhibit similar cli nical symptoms from one person to another. The antigens are different and can only be cleared by the different drugs or prevented by vaccines. In homeopathy, this is not the case; the same antigens responsible for the occurrence of a disease are also responsible for the remedies upon dilution. This argument have no scientific reasoning and that explains why it has been disregarded by most scientist as

Case study Example | Topics and Well Written Essays - 500 words - 16

Case Study Example Also there is a huge risk when company is putting its brand image in the hands of a few. The negative actions of the athletes can have a negative impact on the company. 1.2 If I were Adidas, I would compete with Nike by differentiating Adidas Brand from that of Nike. My marketing strategy would be to stress on producing great shoes on an international scale not just for sportsmen but for everyone and everyday use. I would create a point of difference between Nike and Adidas, and cater to a larger audience. 2.1 Building a brand in a business-to-business context is very different from doing so in the consumer market. The markets of the two are very different. B2C is product driven and a brand is built / created through imagery and repetition. The buying decision in B2C is emotional influenced and depends on factors such as price, desire and status. On the other hand, B2B market is relationship driven and the target market is focused and small. Brand is built through personal relationship. The business decision is a rational one and based on the value that the product creates for the company. Hence, building brands in the two are very different. 2.2 Yes, Cisco’s plan to reach out to consumers is a viable one as it is using integrated techniques to reach its customers. It is using a number of marketing activities to communicate and create value. Also, Cisco efforts are focused on connecting and associating with its consumer base. Cisco is attempting not only to promote itself but also the whole sector and in doing so is creating a niche for itself. 4.1 Customer service is an attitude. It’s not just doing things but building an attitude that keeps the customer happy. Nordstorm has developed attitude to a great extent and has been very successful. It can continue to provide exceptional customer service by making the customer feel important. Until now Nordstorm’s strategy has been a

Anti-aging food Research Paper Example | Topics and Well Written Essays - 1750 words

Anti-aging food - Research Paper Example They eat whatever comes their way and this is how a vicious cycle starts. Initially they spend money on fast food and as a result of which they start falling ill frequently and then they spend on medicines to get back their lost health and in this process they end up wasting a lot of money, in addition to this it also causes them a lot of trouble which can easily be avoided. Lifestyle is another factor which has serious ramifications on our health; the way one lives determines their life expectancy. People who eat healthy live a healthy life; people who do not do so are deprived of living a healthy life. Anti-aging food has been a revelation, by eating anti-aging food one can live longer and one can also live a very healthy life. People who have tried anti-aging food have been really happy with the results. â€Å"Antioxidant foods called super foods are what provides anti aging health benefits throughout the entire body. Total anti aging health provided by super foods may be the proverbial â€Å"Fountain of Youth†. Instead of 50 being middle age research is now showing that we can extend this middle age to 100 years and do it quite easily. I have been doing this kind of research for over 20 years now. It has become my passion.† (Antioxidant Foods) Not much is known about these foods but it is a well known fact that they are more than capable of curing life-threatening diseases. Diseases like cancer, diabetes and several heart diseases can be cured should one decide to feed on these anti-aging foods. â€Å"Aging is biological process which leads to progressive degenerative changes in all living creatures on earth. Aging is normal and inevitable. Throughout in the human history, people are interested in finding solutions for preventing this aging process. Anti-aging study  is certainly a wide and tough area of research for the scientists. Nowadays, the concept of

Whole Foods Market in 2008 Case Study Example | Topics and Well Written Essays - 500 words

Whole Foods Market in 2008 - Case Study Example e firm realize that provision of nutritious food products to the consumers would enhance consumers’ preferences of its products and in turn would generate competitive position in the market. The strategy for Whole Foods Market has great compatibility with the present conditions prevailing in the section of organic and natural foods in the retail food industry. This compatibility can be proved from the huge success that the firm has generated over the previous two decades or so. One of its main strategic elements i.e. the people has accepted its performance across the world and the firm is now bestowed with both satisfied customers and satisfied team members (Thompson, 2008). John Mackey, the present CEO of Whole Foods Market is deemed to hold strong strategic vision for the firm. He has kept his performance level in line with his strategic vision throughout the several years of his reign in the organization. His achievement by maintaining high level of performance is evident from the firm’s products of higher quality, firm’s stores across the home country (US) and certain locations outside the country and enhanced incentives being offered to Whole Foods’ team members operating all over the stores chains (Thompson, 2008). Company’s success is heavily dependent on the perceptions and notions of the people within an organization and the core values play the most important role in motivating the people towards achieving success. It is important for an organization to effectively design its core values. The core values determine the path to be followed by the organization’s personnel and it is the core values which creates one common goal in the minds of every person within an organization. Core values are at times so effective that they lead the organization towards framing the long term strategic vision (Collins & Porras, 1996). Considering the financial performance of Whole Foods Market, during the year 2008, it can be stated that the firm was not in

Comparative Eastern Influences Essay Example | Topics and Well Written Essays - 750 words

Comparative Eastern Influences - Essay Example Both religions employ the concepts of karma, the understanding that a person's happiness is determined by the good and evil he/she has committed in not only one lifetime but many subsequent lifetimes, and nirvana, the exemption from the repetition of living, dying, and reliving (p. 497). In Hinduism, according to Bruder and Moore (2005), "humans, though basically good, are caught up in a cycle of desire and suffering that is the direct result of ignorance and ego. In short, they are miserable. The desires that torment them are many and diverse, including sensual lusts and the desire for existence" (p. 497). Hinduism's beliefs are built upon searching for absolutism, and for a person to obtain a unity with his/her soul and with eternal life (p. 495). In a similar fashion, Buddhism targets ignorance and selfishness as the grounds for suffering. Bruder and Moore (2005) state that a person cannot have these two character flaws as a way to live "because what happens is so much beyond one' s control. For even when life goes as is hoped for, there is no guarantee that it will continue that way, and inevitably anxiety and fear overwhelm temporary satisfaction" (p. 498). The Vedas are Hinduism's doctrine that instructs the ideal way of living. It contains the Upanishads, which contains the mahavakya, or "the four great sayings" (p. 496). Atman is, simply, one person and his soul. Brahman is, as Bruder and Moore (2005) write, the "ultimate reality or principal and the source and sustainer of all things, including people and gods. It is the supreme consciousness, the one, the One-and-only-One" (p. 496). The mahavakya describe how a Hindu can unity his atman and a brahman (which can be done through much meditation): "1) Consciousness is brahman, 2) That art thou, 3) The self is brahman, and 4) I am brahman" (p. 495-6). The Vedas influenced the religion's philosophical schools, created to help its students achieve spiritual emancipation: Yoga, Vedanta, Nyaya, Vaisesika, Samkhya, and Mimamsa (p. 495). Buddhism has the Four Noble Truths and the Eightfold Path as its dogmas. The Four Noble Truths acknowledge that agony exists, the sources of agony, the actuality that the person can terminate his/her agony, and how to do so, which are illustrated in the eight statements known as the Eightfold Path (p. 498). The directions contained in the Eightfold Path are the Right View, Right Aim, Right Speech, Right Action, Right Living, Right Effort, Right Mindfulness, and Right Contemplation. These are listed in the order that the person must take in order to succeed. For example, the right aim cannot be established without first having the right view (pp. 500-502). Hindu's origins are unknown; no one knows who discovered it, when, or under what circumstances. However, Hindus accept the dogmas dictated in the Vedas (p. 495). Despite its unknown origins, Bruder and Moore (2005) state, "It is best to view it (Hinduism) as a spiritual attitude that gives rise to a wide range of religious and philosophical beliefs and practices. These range from the worship of village and forest deities, which often take zoomorphic forms, to sophisticated metaphysical theories" (p. 495). With Buddhism, there is a detailed account of its establishment by Prince Siddhartha Gautama, who would later be renowned

Four Different Article Reviews Example | Topics and Well Written Essays - 3000 words

Four Different Reviews - Article Example The main objective of this paper is to provide an in depth analysis of human resource development index mechanism and the components of the technological achievement Index, and also to find out the relation exist between them as both this parameters are very much dependent on each other. This paper is based on the relation between human resource developments and there relation with economic growth and research capacity. The research and analysis proves that human resource development index alone is not sufficient enough to analyze the economic development of any country. The main factor coming out from this paper is there is a co relation between the trained human resource of any country with the technological development as well as economic growth of that country. According to the analysis of this paper, Croatia along with other developing countries has to make critical investments as well as detail follow up in the line of growth of human capital and their labor productivity to red uce developmental lags which they are having. Key points of the Paper: Before the technological development and restructuring of the organization come in to play, land, labor and capital these three parameters were the key for the growth of any country. But as the time moves on, with the development of organization structure and also the scientific –technological revolution, all set up started to change. For any country which relies on knowledge based economics, both human resources and knowledge simultaneously become key factors for the development. From a broader perspective, human resources defined as the total psycho-physical energy at the disposal of a society, which can be used by the society to achieve its developmental goals (Aksentijevic, Jezic; 2009, pp. 263-264). In regard to evaluating the contribution of human resources to economic growth and development on macro level, education is considered as a basic parameter. In simple words, the development of any country in terms of economic perspective education level is the key factor in spite of the fact that present world is more technology oriented. The paper also suggested that in last few years, it has been a proven fact that there is a close relation between economic growth and development, human resources development, research, innovations and technology, and the theory that economic development is only based on technological and human resource development is being abandoned. In a knowledge-based economy, knowledge management becomes a success strategy, as the effective and proper use of the knowledge base becomes a necessary pre-requisite of economic development. One key finding of this paper is that, the ability to suck up knowledge and successful distribution of new technologies are the key behind development of an economy. (Aksentijevic and Jezic, 2009, pp.266-268) .The basic principle of the ability to absorb knowledge and technology is reflected in greater efficiency of labor force, w hich generates greater production, and a greater income level. The key results derived from this analysis was the Human Resources Development Index is insufficient in the analysis of economic development and it is mentioned that unambiguous explanations of technological progress of human resources development as the basic force of economic growth is no longer sufficient, is correct (Aksentijevic and Jezic, 2009, pp.269-271). According to this paper, the possible ways of developing economic conditions are: Increase in human capital, Stimulation of productivity. In

Mary Shelleys Frankenstei Essay Example for Free

Mary Shelleys Frankenstei Essay The audience is made to feel that Frankenstein himself is evil, for playing with life and mocking God. The sounds made by the monster are similar to those made by wild animals, but also they sound like the monster is in pain, which would make sense as Frankenstein has just rejected him. We see Frankensteins former professor talking through a gate. This signifies the difference of opinion and belief between the two doctors. Sound effects are used very well in the creation scene, especially the non-diagetic musical score that has been added. It is mainly in a minor key, but has drastic changes to a major key when there is extra tension in the frame. It creates a build up, and when there is suddenly a pause with no music, tension is created, then when something dramatic happens, the audience shows a greater reaction. The use of diagetic and non-diagetic sound is very good in this scene, for example when the electrical probes go into the monsters feet and there is the sound of crunching bone. This is diagetic sound. Music is an example of non-diagetic sound. The sudden silences at some points in the scene allow the audience a chance to reflect upon the immorality and reality of what Frankenstein has done. Camera angles are used to make the scene more effective and more enticing to the viewer. If there is a large quantity of movement and change in camera angles, then the shot is used to create responses in the audience. There are many randomly strange camera angles in the creation scene, and we dont really ever see the whole of the creatures body when it comes out of the copper vat, this is because the monster was made of lots of parts and wasnt really a complete person in the doctors eyes. In the creation scene, we experience many different shot types, such as an extreme low angle shot when the monster is being lifted into the air on the body tray. This is to symbolise the life being created and is mocking God. The mis-en-scene of the frame when Victor is running up to the dais in his large billowing coat is very cluttered, which in my opinion represents his mind being a jumble of thoughts. I think there are a lot of shots in the creation scene that represent the stigmata of Christ. For example, when the spikes are driven into the feet and hands of the monster when he is not alive, in the copper vat. And the extreme close-up shot of Frankensteins head, then of the creatures head. The doctors head bears no (visible) injury, but his creation has huge scars as if his head had been crowned with thorns. Also, there is the part where the monster is lowered into the copper vat, which looks oddly like a sarcophagus (a type of coffin used to bury Egyptian pharaohs in ancient times), this represents the descent into hell that Frankenstein is embarking on. This is mocking God yet again, and shows the immorality of Victor Frankenstein. When we see the low-angle shot of the monster hanging on the chains, it resembles the crucifixion of Christ. There are violins playing at this point, which symbolises the loneliness that Victor is feeling from the rest of the world. There are many different visual effects used in the creation scene, such as the lighting striking the window behind the monster, when he appears in Frankensteins bedroom. Another special effect was the make-up used on the monsters face to make it look more dramatic and horrifying. There is also the amniotic fluid that the monster is born in, when that spills out the copper vat, it makes the audience feel sick and repulsed. Only diagetic sounds are used at this point, there is no music. When the monster is lifted up to the ceiling, the circle of light around the body represents Leonardo Da Vincis Vitruvian Man, which is a drawing that shows the proportions of a perfect human body. This is ironic as most of the monster was made of murderers and criminals- hardly perfect people. The editing in the creation scene is very clever, I have previously mentioned the lecturer being super-imposed over a frame; there is also the part where all the scientific equipment is displayed. One shot dissolves into another, which resembles them being combined together to make the monster. The pace in the scene changes from being very fast when Frankenstein is giving the monster life, to a lot slower when the monster is born and trying to stand up. Overall, I think that Branagh has made the film much more appealing to the audience by using the effects available to him. He uses location, costume, characterisation, dialogue, sound effects, camera angles. Shot types, visual effects, editing, and pace to make a very effective film. I am most impressed by the way he read between the lines of the Mary Shelley novel to give the audience lots to think about. I also liked the way he used discreet blasphemy to show that what Victor Frankenstein was doing was immoral and mocking God. I think that Branagh has more than done justice to the Shelley novel. Show preview only The above preview is unformatted text This student written piece of work is one of many that can be found in our GCSE Mary Shelley section.

Evaluating Treating Through Therapy For Borderline Personality Disorder Nursing Essay

Evaluating Treating Through Therapy For Borderline Personality Disorder Nursing Essay Despite the many treatment options for people with 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. In the 1800s, Philippe Pinel first used the French term manie sans delire (mania without delirium) to designate those individuals engaging in deviant behavior but showing no signs of a thought disorder such as hallucinations or delusions, psychiatry began to think about borderline personality disorders as early as 1801. 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 reality 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). In 1938, the psychoanalyst Adolph Stern first described most of the symptoms that are now considered as criteria of borderline disorder. He suggested the possible causes of the disorder, and what he believed to be the most successful form of psychotherapy for these patients, he also renamed the disorder again, and he named the disorder by referring to patients with the symptoms he described as the border line group (Freidel 2004). In 1940, the psychoanalyst Robert Knight introduced the concept of ego psychology into his explanation of borderline disorder. Ego psychology deals with mental functions that allow us to effectively combine our thoughts and feelings and to develop helpful responses to life around us. He suggested that people with borderline disorder 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). Roy Grinker in 1968 published results of the first research conducted on patients with borderline disorder, which he referred to as the borderline syndrome (Friedel 2004). The next major advance in the field occurred when Gunderson and Singer (1975) published a widely acclaimed article that synthesized the relevant, published information on borderline disorder, and defined its major characteristics. Gunderson then published a specific research instrument to enhance the accurate diagnosis of borderline disorder. This instrument enabled researchers over the world to verify the validity and integrity of borderline disorder. Subsequently, borderline personality disorder first appeared in DSM-III as a bona fide psychiatric diagnosis in 1980 (Friedel 2004). 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). 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). For many, the severity of symptoms and behaviours that characterise borderline personality disorder, correlate with the severity of personal, social and occupational impairments. However, this is not always the case, and some people with what appears to be, in other ways, marked borderline personality disorder may be able to function at very high levels in their careers (Stone, 1993). Paris (1994) stated that about one-third of patients with BPD report severe abuse involving an incestuous perpetrator; about one-third report 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. Until recently, personality disorder services in the NHS had been diverse, spasmodic and inconsistent (Department of Health, 2003). Besides functional impairment and emotional distress, borderline personality disorder is also associated with significant financial costs to the healthcare system, social services 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. Borderline personality disorder is present in just under 1% of the population, and is most common in early adulthood. Women present to services more often than men. Borderline personality disorder is often not formally diagnosed before the age of 18, but the features of the disorder can be identified earlier. Its course is variable and although many people 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 provide 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 li mited 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. The most appropriate research design to answer this is the RCT; therefore the evidence base reviewed comprised available RCTs undertaken in people with a diagnosis of borderline personality disorder. The causes of borderline personality disorder are complex and remain uncertain. The following may all be contributing factors: genetics and constitutional vulnerabilities; neurophysiological and neurobiological dysfunctions of emotional regulation and stress; psychosocial histories of childhood maltreatment and abuse; and disorganisation of aspects of the behavioural system, most particularly the attachment system (NICE 2009). 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. Given the confusion that surrounds the nature of personality disorder, it is not surprising that this has impacted on NHS care for people with this diagnosis. Until recently, personality disorder services in the NHS had been diverse, spasmodic and inconsistent (Department of Health, 2003). Borderline personality disorder is particularly common among people who are drug and/or alcohol dependent, and within drug and alcohol services there will be more women with a diagnosis of borderline personality disorder than men (Swartz 1990). Borderline personality disorder is also more common in those with an eating disorder (Zanarini et al., 1998), and also among people presenting with chronic self-harming behaviour (Linehan et al., 1991). 2.1 Defining Cognitive Behaviour Therapy and Dialectical Behaviour Therapy Cognitive behavioural therapy (CBT) is a structured psychological treatment that focuses on helping a person make connections between their thoughts, feelings and behaviour. CBT was originally developed as a treatment for depression, and has since been modified for the treatment of people with personality disorders including borderline personality disorder. 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 decrease the conviction of delusional beliefs, and hence their severity, and to promote more effective coping and reductions in distress. This essay will attempt to assess the contribution of CBT the disorder by discussing reviews on efficacy and long term effects. Cognitive behavioral therapy  for borderline personality disorder (CBT for BPD) was developed on the premise that people with the disorder have learned distorted beliefs and thought patterns. These, in turn, result in the distressing emotional responses and behaviors that characterize borderline personality disorder. It is the initial objective of CBT for  BPD  to  identify the distorted, automatic thoughts and  beliefs held by the patient with borderline disorder.  Such beliefs outlined by Beck Freeman(1990) typically include those related to dependency (I am needy and weak),  distrust  (People will get me if I dont get them first), rigid, all-or-nothing (dichotomous) perceptions,  and other thought patterns  that characterize the main cognitive-perceptual symptoms of the disorder. These distorted thoughts are then modified by self-monitoring,  logical analysis and by questioning and testing them.  It is adapted for people with borderline personality disorder and pays attention to the structure of the therapy and the problems that can disrupt the therapeutic relationship , such as non-engagement in treatment, shifting problems and goals, losing focus on the aims of therapy, losing structure and lack of compliance with assignments (Davidson, 2000). In addition, CBT for BPD attempts to produce positive change by improving the attitude of the patient toward treatment, the enhancement of specific skills, and the reduction of hopelessness. The CBT therapist and the patient typically construct a list of specific problem areas. They then develop a set of tasks or exercises that generate and reinforce new attitudes, behaviors, and interpersonal strategies that replace the ones that have proven to be ineffective. Within the past 15 years, another, newer psychosocial treatment termed Dialectical Behaviour Therapy (DBT) was developed. DBT combines 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 frequent self-destructive and self-injurious behaviours. DBT is based on the belief that the symptoms of BPD result from biological impairments in the brain mechanisms that regulate emotional responses. The early behavioural effects of this impairment are magnified, as the person with this biological risk factor interacts with people who dont validate their emotional pain and dont help them learn effective coping skills. DBT has gained considerable favour in the treatment of BPD because of the results it ha s achieved in several research 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 limits the broad use of this effective 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 others, and the fear and guilt aroused by such excessive 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). In practice, the limiting factor in providing access to psychological therapies is the very small prop ortion of NHS staff trained to deliver these to a competent standard. Fourteen women with borderline personality disorder were interviewed to ascertain what is effective about DBT and why (Cunningham et al., 2004).Participants reported that DBT allowed them to see the disorder as a controllable part of themselves rather than something that controlled them, providing them with tools to help them deal with the illness. Service users reported that DBT had had a positive effect on their relationships in day-to-day interactions, and although problems with friends and family did not disappear, they were more manageable (NICE 2009). Clients also expressed higher levels of hope and a desire to live more independently (Cunningham et al., 2004) 2.2 Suicidal acts Definition: deliberate; life threatening; resulted in medical attention; medical assessment consistent with suicide attempt. Suicide is common in people with borderline personality disorder and may occur several years after the first presentation of symptoms (Paris Zweig-Frank, 2001). A well-documented association exists between borderline personality disorder and depression (Skodol et al., 1999; Zanarini et al., 1998), and the combination of the two conditions has been shown to increase the number and seriousness of suicide attempts (Soloff et al., 2000). People with borderline personality disorder may engage in a variety of destructive and impulsive behaviours including self-harm, eating problems and excessive use of alcohol and illicit substances. Self-harming behaviour in borderline personality disorder is associated with a variety of different meanings for the person, including relief from acute distress and feelings, such as emptiness and anger, and to reconnect with feelings after a period of dissociation. As a result of the frequency with which they self-harm, people with borderline personality di sorder are at increased risk of suicide (Cheng et al, 1997), with 60 to 70% attempting suicide at some point in their life (Oldham, 2006). The rate of completed suicide in people with borderline personality disorder has been estimated to be approximately 10% (Oldham, 2006). A behavioural approach to self-harm and suicidality that incorporated skills training in emotion regulation and validation of client experience developed into dialectical behaviour therapy (DBT), a specific intervention for borderline personality disorder. 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. A randomized clinical trial was conducted by Linehan et al. (1991) with 44 subjects to evaluate the effectiveness of DBT for the treatment of chronically parasuicidal women who met criteria for BPD. Patients who received DBT had an average of 8.46 inpatient days per year compared to 38.86 days for the control group. It was also noted that it did not appear that there were differences between the two groups on measures of depression, hopelessness, suicide ideation, or reasons for living. Linehan et al. (1993) conducted a naturalistic follow-up review of 39 of these subjects to determine whether the effects of DBT were maintained over one year post treatment. In the 12 to 18 month period, subjects completing DBT had fewer parasuicidal episodes and fewer medically treated episodes. In the 18- to 24-month period, there were no significant between-group differences on parasuicide measurements, although psychiatric inpatient days during this time were lower for subjects in the DBT group. Rathus et al. (2002) conducted a study with a group of suicidal adolescents with borderline personality features. Participants included 111 outpatient admissions. Eighty-two participants were assigned to treatment as usual (TAU) and 29 were assigned to DBT. The groups were not randomized, but it was noted that there was more severe pre-treatment symptomtology in the DBT group than the TAU group. The group treated with DBT had significantly fewer inpatient psychiatric hospitalisations during the 12 weeks of treatment. The groups did not differ significantly in number of suicide attempts made during treatment. There was a slightly higher rate of treatment completion in the DBT group. Hengeveld et al (1996) report a case series of nine female outpatients who had attempted suicide on at least two occasions and were offered up to ten sessions of group CBT. Seven of the nine met criteria for personality disorder and of these four had borderline personality disorder. Ten months after the last session, recurrence of self-harm was examined using telephone contacts with participants and examination of hospital records. Four of the seven participants reported further suicide attempts all four had borderline personality disorder. 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 Suicidal acts Definition: deliberate; resulted in visible tissue damage, nursing or medical intervention required. Self-harming behaviour in borderline personality disorder is associated with a variety of different meanings for the person, including relief from acute distress and feelings, such as emptiness and anger, and to reconnect with feelings after a period of dissociation. As a result of the frequency with which they self-harm, people with borderline personality disorder are at increased risk of suicide (Cheng et al., 1997). Service users have been positive about DBT because it has helped them to improve their relationships and their ability to control their emotions and reduce self harm. However, while some valued the structure of the approach, others preferred the programme to be more tailored and flexible. 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. Brown (2004) conducted an uncontrolled cohort study participants with borderline personality disorder who reported suicidal ideation or engaged in self-injurious behaviour received weekly CBT over a 12-month period and were followed up over an 18-month period. Individual sessions lasting 1 hour were supplemented by access to emergency telephone contact with an on-call therapist between sessions. Verheul et al. (2003) conducted a randomized controlled study for the purpose of comparing the effectiveness of DBT with TAU for patients with BPD and to examine the impact of baseline severity on effectiveness. The study included 58 women who were randomized to either DBT or TAU and who received treatment over one year. The results included: DBT had a substantially lower 12-month attrition rate (37%) compared with TAU (77%); treatment with DBT resulted in greater reduction of self-mutilating and self-damaging impulsive acts than TAU. Van den Bosch et al. (2005) published a follow-up review of this study that examined whether the treatment results in the Verheul study were sustained over six-month follow-up or up to week 78. It was noted that in the six months after treatment discontinuation, the benefits of DBT over TAU in terms of lower levels of impulsive and self-mutilating behaviours were sustained. However, it must be noted that parasuicide activity had been defined in slightly different ways in the RCTs and therefore might not be comparable across studies. Alper (2001) presents outcome data on a case series of 15 court committed women with a clinical diagnosis of borderline personality disorder that underwent treatment with nurse-led DBT in an inpatient forensic setting. There was a reduction in the frequency of self-harm over the 4-week period. In addition, the authors conducted qualitative interviews with four nurses to describe their experience of administering DBT; their responses were uniformly positive. Bateman Tryer (2004) state that the widespread adoption of dialectical behaviour therapy is a tribute both to the energy and charisma of its founder, Marsha Linehan, and to the attractiveness of the treatment, with its combination of acceptance and change, skills training, excellent manualisation, and a climate of opinion that is willing and able to embrace this multifaceted approach. It is not, however, justified by the strength of the evidence (Tyrer, 2002b) and conclusions about the long-term effectiveness of this therapy as a treatment for the personality itself are premature. Since the original trial which was handicapped by many methodological limitations, there has only been one randomised study that supports the findings unequivocally, that of Verheul et al (2003). 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) According to service users interviewed by Haigh (2002), services could be improved if: professionals acknowledged that personality disorder is treatable; they received a more positive experience on initial referral as this would make engagement with a service more likely; if the ending of a therapeutic relationship was addressed adequately; and if services were not removed as soon as people showed any signs of improvement, because this tended to increase anxiety and discourage maintenance of any improvement. In a study by Hodgetts and colleagues (2007) of five people with borderline personality disorder being treated in a DBT service, the participants reported that DBT was presented to them as the only treatment for personality disorder. This may have raised anxieties in service users about what was expected of them. While some valued the sense of structure to the treatment, others would have preferred a more tailored and flexible approach. There were also mixed feelings about the co mbination of individual therapy and group skills training. For one person the challenges of DBT proved too much so she left the programme. Another factor in her leaving was that she believed she was refused supp

Homebuying 101: An Affordable Challenge Essay -- Journalism Essays

Homebuying 101: An Affordable Challenge For the past four weeks, Natalie Delsoin and 24 other Boston residents have been spending their Tuesday nights learning the ins and outs of affordable housing. Delsoin recently moved to Dorcester after a military stint in Germany, and she hopes to someday own a home. She plans on that day coming sooner rather than later. Delsoin’s biggest concern is her 2 year-old daughter. â€Å"I need a single family home that is safe†¦ and safe for my child,† she said. The class’ instructor, Tanya Townshend, teaches 30 to 60 people in each of her homebuyers classes. Townshend works as an assistant property manager for Maloney Properties, a New England real estate chain that sponsors a number of sessions for homebuyers. Townshend said â€Å"about 10% (of class attendants) seem to be ready to buy† after her four week seminar. The rest attend more classes or work on improving their credit rating before bidding on a home. Boston is one of the tightest housing markets in the country. Many first-time homebuyers are looking for any advantage they can get in finding their first home. For many homebuyers, affordable housing is the only realistic option. However, affordable housing is limited and there are a number of obstacles for families seeking to go that route. To help with the process, the city of Boston and a handful of community development groups sponsor first-time homeowner courses and support programs for people interested in affordable housing. According to a August 2000 U.S. Department of Housing and Urban Development (HUD) low income housing study, â€Å"the overall vacancy rate for rental units in the Boston was 4.1% in 1998 compared to 6.7% for the Northeast region and 7.9% for the country.† The h... ... at the assessment shows this duplex has no remodeling work done, the exterior and interior structures are poor, and the interior finish is graded as substandard. For a two-family home, it offers a decent accommodation – each residence has three bedrooms and one and a half bathrooms, as well as over 1,700 feet of living space. Significant depreciation in property value indicates the place is extremely run down. For prospective first-time homeowners, a tight housing market and constantly changing neighborhoods make finding the right home a difficult choice. The market is full of wrong choices. Potential buyers like Natalie Delsoin and James Creed hold out hope when their lottery number is picked, there are still affordable housing options waiting for them. Creed says that regardless of when that time comes, the classes â€Å"make you go in with your eyes more wide open.†

William Faulkners As I Lay Dying :: Lay Dying William Faulkner Essays

William Faulkner's As I Lay Dying Works Cited Missing   Ã‚  Ã‚  Ã‚  Ã‚  Fulfilling a promise they had made to their mother, Addie, Cash, Darl, Jewel, Dewey Dell, and Vardaman, in William Faulkner's As I Lay Dying, journey across the Mississippi countryside to bring her body to be buried in Jefferson, alongside her immediate family. Each one, in turn, narrates the events of this excursion as they are perceived. Though all of the family members are going through the same experiences, each one expresses what they see and how they feel by exercising their individual powers and limitations of language. What each character says as well as how he/she says it gives insight into that character's underlying meanings.   Ã‚  Ã‚  Ã‚  Ã‚  Darl, for example, uses his linguistic skills to gain power as narrator. He possesses the ability to pick up on things unsaid and to read other people's actions. Dewey Dell describes his intuitiveness when she says that â€Å" he said he knew without the words, and I knew he knew because if he had said he knew with words I would not have believed†¦and that's why I can talk to him with knowing with hating with because he knows† (27). He uses his gift of realizing things without them having to actually be told to him to gain credibility with the reader. Who would doubt a narrator who possesses that type of adroitness? Also, his language is clear and reflective. He uses similes and metaphors and appears to have an acute awareness of spatial relationships. Darl's sophisticated perception and poetic linguistics give him the means of reaching for and maintaining his role as a competent observer and reporter. However, his position does create certain problems for his siblings. Tull describes Darl's â€Å"look† as being uncanny. "He is looking at me. He dont say nothing; just looks at me with them queer eyes of hisn that makes folks talk. I always say it aint never been what he done so much or said or anything so much as how he looks at you. It's like he had got into the inside of you, someway. Like somehow you was looking at yourself and your doing outen his eyes." (125)   Ã‚  Ã‚  Ã‚  Ã‚  It is the same penetrating gaze that gives Darl so much power that makes the others around him so uncomfortable, especially Dewey Dell. She feels that his strange knowledge of what has not been said is an invasion of her privacy. â€Å"The land runs out of Darl's eyes; they swim to pin points. They begin at my feet and rise along my body to my face, and then my dress is gone: I sit naked on the seat above the unhurrying mules, above the travail† (121).

Responsibility of Designers to the General Public :: essays research papers fc

As this topic could in most cases be considered controversial, this paper is simply the written with views and opinions that I feel about this specific topic. According to Merriam-Webster’s Online Dictionary the term â€Å"responsibility is defined as â€Å"1 : the quality or state of being responsible : as a : moral, legal, or mental accountability.† (http://www.m-w.com/cgi-bin/dictionary?book=Dictionary&va=responsibility&x=0&y=0 ) The question raised in this topic is what, if any, responsibility do graphic designers have to the general public? Should graphic designers be held liable for what their employers have them to do? In my humble opinion, I say no. There is no responsibility of designers to the general public. It is the ones who pay for these designs to be held accountable. It is in my opinion that only the laws of the country and the moral laws or character of the person determine the responsibility of that person. While one could contest that a graphic artist should be responsible for making something that they knew could have a negative impact on others, I contest.   Ã‚  Ã‚  Ã‚  Ã‚  The freedom of speech granted to us by the First Amendment of the U.S. Constitution allows people and graphic artists to express themselves in ways that some or even most of us would not approve. However it is well within their legal rights to do so. No matter how much we may despise or dislike the views that someone else has presented in the form of graphic images for whatever purpose, we cannot take away their freedom of expression. That is what makes this country great, because it is that freedom, which allows the people who dislike or oppose a specific ideal, to oppose it. It also allows them to present their contrasting view. I feel that as long as the graphic artist is abiding by the laws of the land then he/she is protected in a legal sense. However since he/she is putting forth some work for the public to view, he/she is open to public scrutiny. I feel it is up to the person viewing the artistic piece to take responsibility for what they view or do not view. For far too long now, we as a society have tried to shift or lay blame elsewhere rather than on ourselves. It is up to the individual to educate themselves on the topic the piece presents so they can have a firm stance in their position.

Nu Shu – The Women’s Writing of China

Nu Shu, also known as the women's writing of China, was a major part of Chinese women's lives throughout the 20th century. Unlike any other writing, it is the only known hidden written language. Women used Nu Shu as a way to escape from the oppressive outside world and enter into a peaceful state of mind. Life was hard enough for women; it's scary to think how hard Nu Shu was probably the most commonly valued thing for women in China during this time period. It was valued so much because it was used to share women's miseries. China was ruled by men, and women were nothing more than ousewives and sometime field workers. What made it so special was that only women knew about it. It was a written language expressed by songs and stories. Any other language besides Chinese was forbidden by Emperors. Women couldn't use any form of education, so it had to be formed in secret. Having been something only women knew, it was an easy way for them to express their hardships and sufferings. Every woman at that time was going through the same thing, so it was seen as the easiest way for women to let out their feelings. Males dominated society completely, and Nu Shu was the nly true form of power that women had. If it had been leaked to the public, not only would it have been banned, but many women would have been sent to jail and killed if found using it. Women were beaten and abused to the point where a good day in marriage was a day you cried. Marriages were always arranged, and many women didn't even have feelings towards their husbands. They had to put up with the abuse and couldn't complain. At any point in time, a man could tell his wife what to do and when to do it. Women had no say in the government, their marriage, and in everyday society. The only time they could speak freely was when writing in Nu Shu. Their only audience willing to listen was other women, and Nu Shu was the only way to get in touch with other women without anyone finding out. Whether or not Nu Shu was good or bad is often debated. I happen to think it was good for many reasons. Women weren't educated in any way. Nu Shu was the closest thing they had to education. With education comes power, and that was exactly what women needed. In a time when men ruled society, power is everything. While it wasn't power that everyone recognized, it helped women have better mindsets. In a way, it was creating a more equal society for these women. Equal was definitely something the Chinese culture wasn't centered around, but it was something all women strived for one day. It was often believed that Nu Shu taught women to accept their suffering, but I actually think it was the opposite. No women would ever accept that feet binding were okay, or that the beatings from their husbands should be allowed. Instead, they learned how to cope with these struggles. Knowing how to handle yourself in bad times is a very good quality to have. When thrown a curveball in life, instead of sulking about t, the better thing to do is to take a step back and learn how to deal with it. I think that is something people in Western society do well and in the long run made the Chinese women stronger. Unfortunately, the last living person proficient in Nu Shu died several years ago. I think it's a shame that Nu Shu is closer to being extinct. While the actual writing itself may have no significance to anyone in today's world, I think a great lesson can be learned from it. It's fascinating how long women were successful in keeping it a secret, and overall made the Chinese women stronger people.

Health care challenges Essay

Our country is set to face a new way of managing health which could potentially change the environment on how nurses deliver care. As our nation prepares for the implementation of Patient Protection and Affordable Care Act, nursing as a healing profession has to be open to what the future of health management holds. The goal is to have all registered nurses reach a high level of understanding and acquire tools necessary to provide the best possible way at a low cost. It is both moral and professional obligation of our leaders to ensure that highly competent and well trained nurses are available throughout this transition. To achieve this goal, nurse educators are the key players to train both novice and seasoned nurses to the change based on the new policies and evidence-based research. However, our Nurse Educators are overwhelmed with their current workload hence causing faculty shortage in the country. A recent study published on 2011 aimed to explore the relation of nursing faculty shortage to their workload, determine if there are evidences that the faculty workload is not equitable and the implication/effect to the nursing research and nursing academic. According to this study, there are multiple factors that influence the nursing faculty shortage such as lack of interest from the nurses to try academic careers, time spends to clinical practice defers pursuance into academic positions, low salaries, high educational costs, nursing education dissatisfaction and most importantly low institutional funding for additional nurse educator positions. Nancy Falk stated in her article that â€Å"despite current critical shortage and growing demand for nurses and nurse educators, federal funding falls far short of addressing these healthcare workforce challenges. Workforce projections suggest that the US will face a shortage of 285,000 nurses by 2015 and 500, 000 by 2025.† (Mason, Leavitt & Chaffee, 2012, p 58). Also, American Association Colleges of Nursing reported on 2011-2012, that nursing schools turned away 75,587 applicants who are qualified for baccalaureate and graduate nursing programs because of inadequate nursing faculty including clinical preceptors. These challenges ultimately impact the future of patient care if not addressed. Faculty leaders must work in partnership to create a strategy that will help prevent further faculty shortage by focusing on balanced faculty workload to avoid burnout. This article emphasized on the continuous support by government officials especially adequate funding to nursing education. AACN is allocating its resources to protect federal funding for academic development programs, identify strategies to prevent nursing educator shortage. Additional solution is to create a mentorship program for nurse faculty. This strategy was confirmed by various literature and studies to promote nursing faculty recruitment and retention. Mentorship brings encouragement and direction to clinical educators who are new to the role and prevent burnout. Health care system will be lost without nurses in our society. Statistic shows that there are currently 2.9 million nurses in the United States but nurses with special skills such as in education is extremely needed. Nurse Educators, in some ways, affect the lives of everyone. It is through this role where highly competent, compassionate healers such as nurses are produced. â€Å"The future of the nursing profession depends on a steady supply of nurses to provide the quality care to patients† (Cowen & Moorhead, 2011, p. 60)

Modern History Essay on USA Civil Rights Movement Essay

In the USA from 1865, when slavery was abolished and African American people where supposedly considered separate but equal by the constitution, to the 1960s, when the African Americans where actually considered equal, segregation practises where being endorsed throughout the USA. Segregation was the practice of separating the white Americans and the African Americans. Segregation occurred when the white Americans continued their upper status on the previously enslaved African Americans, therefore maintaining the African Americans status of repression. However throughout the later 1950s to 1960s American went through the Civil Rights Movement, in which the African Americans aimed for a desegregated society that maintained equality. Throughout the Civil Rights Movement many non-violent protests were held creating direct confrontation urging changes to be made within segregated social areas. Therefore non-violent direct confrontation was the successful means which helped to end segregation practises in the USA. Non-violence was the concept of holding a protest that was peaceful and did not retaliate to violence that was likely to be present. The most successful aspect of these protests was direct confrontation. This was when the African Americans would directly break one of the rules in public segregation, causing direct friction within the segregated society, to push the boundaries in which African American people where confined. The confrontation along with the friction created by these peaceful protests predominantly concluded with change due to the persistence of the African Americans. Despite the escalating violence that was waiting at the majority of the African Americans protests they continued, fighting for their civil rights as humans. One of the most supported organisations for African Americans, by not only African Americans themselves but also white Americans in support of desegregation, was the National Association for the Advancement of Coloured People (the NAACP). As well one of the most historically supported leaders of the NAACP, Martin Luther King’s virtues for desegregation was non-violent protesting. The increasing levels of support for the NAACP helped create mass protest to which those higher up within the government would be forced into acting upon to eradicate the chance of the protest escalating into a violent scene caused by the white Americans. Therefore it is clearly evident that non-violent, direct confrontation was a marginally successful approach to the Civil Rights Movement. Throughout the Civil Rights Movement the media played a major role in the method of non-violence in the ending of segregation. Although the African Americans had a great dedication to their protests they would not have been as greatly supported through these protests without the media. Television station camera men, reporters and photographers, where able to capture the violence and abuse directed at the African American’s, thus demonstrating the resilience of the protesters. Furthermore showing the general American public that in these situations of protests the aggressors where the white Americans and the treatment of the African Americans were unjust. Not only was this evidence of repression upon the African Americans displayed amongst the American media but also global media. Therefore effecting America’s superior reputation amidst the Cold War, giving the current enemy reason as to why capitalism was potentially failing and to their acquainted supporters and potential supporters. This global recognition for a Civil Rights struggle gave motivation to politics to act upon this situation to maintain their global reputation. Therefore the recognition of the African Americans repression and unjust treatment was national and globally recognised, thus gaining support from white Americans after this realisation. Hence the global realisation of this unjust treatment emphasised the need of social change to the government therefore giving some explanation as to the equality that becomes desegregation. Many of the non-violent protests African Americans undertook where simple acts however they caused extravagant aggravation due to racist view that the superior percentage of Americans had grown up amongst. One of the protests conducted by seven African Americans and six white Americans was abruptly ended when bus companies refused to carry them on further through their journey as they were confronted with a brutal mob that violently physically abused them and destroyed the busses that carried them. This protest was the Freedom Rides, protesting to desegregate bus terminals and associated facilities. However other protest groups pushed forward with the Freedom Rides continuing the journey and withstanding the violence until significant action was taken by the government. The desegregation for bus terminal and associated facilities was finally arranged after a major uprise in support for these freedom Riders. Much alike the Freedom Rides, Lunch Counter Sit-Ins were a peaceful protest than ended the desegregation of lunch counters. It started with the simple act on February 4th with of four African American college students sitting at a Woolworths lunch counter until the stores closing after being refused serves due to their race. This protest escalated in size and expanded rapidly due to the support it received. Over 50,000 people participated in one or more of the sit in’s within a year in over 15 different states and various cities. Due to the size and direct confrontation of this protest, abuse and violence erupted in many of the Sit-Ins encouraging the government to desegregate to maintain the countries reputation. Thus although many of the protests conducted where simple acts of rebellion for the African Americans the persistence of them where found confronting to the white Americans therefore resulting in change. Further on during the Civil Rights Movement it became apparent that many other organisations for African Americans gained further support, this including the Muslim religion and in particular those surrounding Malcolm X. Although Malcolm X’s and Martin Luther King’s values for the equality of African Americans differ, their main aim was equality with the white Americans. Malcolm X supported maintaining the separation of the races where as King supported the integration of the races in an equal society. Malcolm X was an activist of the Muslim religion; he focused in eradicating the repression on the African Americans that was being held upon by the white Americans, much alike Martin Luther King. However they differ as King’s protests were supporting the integration of the races and living peacefully together, were as Malcolm believed in the maintaining of the separation of the races. However as history has proven within American prior to the late 1950s that separate is not equal, as much as that may be the aim. Hence it becomes evident that Malcolm X’s protests didn’t succeed in the equality of African American, whereas Martin Luther King’s non-violent protests to integrate proved very successful. Therefore throughout the Civil Rights Movement many different protests where held, and many different organisations where supported however the most successfully was non-violence. These non-violence tactics as stated earlier, where the most effective due to the media coverage, persistence of the large quantity and direct confrontation. Without these aspects the non-violence practices for ending segregation within the USA wold not have been as nearly as efficient. Thus using non-violent methods as a means for ending segregation within the USA proved to be highly successful.

Eleanor Roosevelt Essay

And strength, courage and confidence she possessed. Forty-six years after Eleanor Roosevelt’s death yet she the former First Lady still remains an influential women in the world. She supported her husband’s political career. In fact, President Franklin Roosevelt often called his wife his â€Å"eyes and ears† (Bradgon, McCutchen, and Ritchie 776). Eleanor Roosevelt played a pivotal role in the Roosevelt administration especially when paralysis hit the president (776). She used this power to advocate for civil rights, especially for the women (Goodwin 1998). The was the first woman to become the voice of the ordinary people, she spoke in national conventions, held press conferences, lectured, and wrote a syndicated column (1998). She fought for the plight of the poor, the women, and the African Americans (777). She was a super woman, so to speak. Her fight for social justice was perhaps what Roosevelt is famed and revered for. She helped laid the cornerstone of the civil rights and women’s movement. It was her greatest achievement, one that the world will forever be grateful for. Eleanor Roosevelt was born October 11, 1884 to Elliott Roosevelt and Anna Hall (Caroli 2008). Although she came from an influential family (her uncle was Theodore Roosevelt), her life story did not start out smoothly (2008). Hers was what people would call a â€Å"dysfunctional family† (Tindall and Shi 1266). Her father was described was an alcoholic who got servant girl pregnant while her mother was said to be a â€Å"cold, self-absorbed socialite† (Tindall and Shi 1266). Despite this, Eleanor loved her parents deeply. However, tragedy struck the family. By age ten, both her parents died and Eleanor, together with her brother, was brought to be raised by relatives (Caroli 2008). Eleanor’s other brother had died a year before (2008). Eleanor was extremely close to her father and his death deeply affected the young girl (2008). The siblings were brought to their grandmother Mary Hall to become their guardian (Black 2008). An introvert, Eleanor was sent to Allenswood, a girls’ boarding school by age 15 (Caroli 2008). Under the wing of Mademoiselle Marie Souvestre, Eleanor’s intellectual curiosity was awakened. Souvestre was a confident woman who was a staunch believer in the liberal causes (Black 2008). In Eleanor’s three years at Allenswood, she forged friendship not just with Souvestre but with young girls her age; she learned language, literature and history; expressed her opinions on political events; and discovered Europe in summers (2008). She was, to say the least, transformed into a â€Å"tall, willowy, outgoing woman† (Tindall and Shi 1266). In 1902, Eleanor went back to New York for her â€Å"coming out† into society (Caroli 2008). Following her family’s tradition, she immersed herself into social responsibilities, enlisting with the National Consumers League and the Junior League for the Promotion of Settlement Movements (Black 2008). She also volunteered to teach at the College Settlement on Rivington Street (2008). Her endeavors soon reached the attention of the New York reform group (2008). One summer, on a train ride to Tivoli, she bumped into her fifth cousin Franklin Delano Roosevelt (Black 2008). A secret courtship began and on November 22, 1903, the two became engaged (2008). The two were different. Eleanor was often described as a serious person, someone of â€Å"high ideals and principles† while Franklin was a confident man, who grew with love and affection from his family (Tindall and Shi 1267). Franklin’s mother, Sara was against the relationship and tried in vain to separate the two. On March 17, 1905, Eleanor and Franklin were married in New York (2008). The wedding, wherein President Theodore Roosevelt gave the bride away, was on the front page of the New York Times (2008). In a span of 10 years, Eleanor gave birth to six children, one of whom died after birth (Caroli 2008). In 1911, Franklin won a seat in the New York senate and the family relocated to Albany (Black 2008). Eleanor looked forward to moving out, especially since in their old home, her mother-in-law was constantly breathing down her neck. She was said to comment that the move ignited her desire to become independent and be an individual (2008). As Franklin started to carve his political career, Eleanor took on the role of a political wife- gracing formal parties and â€Å"making social calls† (2008). When World War I broke in 1917, Eleanor found herself returning to volunteer work. She spent her free time helping the Navy- Marine Corps Relief Society and the Red Cross (Caroli 2008). Her unwavering commitment opened another door in her life- that of being able to be of service to others. For some time, she was in the shadow of her political husband. The War ignited her desire to pursue other plans outside her husband. It helped boost her confidence. Ruby Black, Eleanor’s friend, once commented that the war became her first work â€Å"outside her family† (Black 2008). But this awakening of sorts was dampened when Eleanor found that her husband was involved romantically with another woman, Lucy Mercer. Mercer was Eleanor’s social secretary (Caroli 2008). This caused a dent in the couple’s relationship and Eleanor suggested to have a divorce, which Franklin refused (2008). Franklin ended the relationship with Mercer and tried to patch things with Eleanor. Though they continued on with the marriage, it was said that they remained affectionate but no longer intimate (2008). In 1921, Franklin fell ill with polio and was paralyzed (Tindall and Shi 1267). Despite what had happened in their relationship, Eleanor did not leave her husband. She helped him in his career, attending political gatherings and speaking on his behalf (1267). According to their daughter Anna, polio was instrumental in bringing their parents together (1267). While Eleanor supported her husband, she started to carve her own name. She became active with the Women’s Trade Union League and the Democratic Party of the New York state (Caroli 2008). As Chair of the League of Women Voters Legislative Affairs Committee, Eleanor read the Congressional Record, talked with members of Congress and the State Assembly and presented a report on a monthly basis (Black 2008). She was especially interested in non-legislative issues like primary reform, voter registration and party identification (2008). Eleanor also wrote for the Women’s Democratic News (2008). Three years after, Eleanor was part of a group whose purpose was to inform women on participating in political and social issues. As board member of the bi-partisan Women’s City Club, Eleanor led the City Planning Department, tackling issues such as housing and transportation, child labor, and the distribution of birth control information on married people (Black 2008). She also taught at a school (2008). When Franklin was elected governor, Eleanor divided her time equally, ensuring that she pursued her personal interest and that of being a governor’s wife. When the Governor’s inner circle had disagreements with Eleanor’s League of Women Voters, Eleanor acted as arbitrator (Black 2008). Her political grace, no doubt, was shaping up. Following Franklin’s successful crack at the presidential election, the now First Lady continued with her passion. With her own staff, Eleanor carried on with her causes. She had press conferences with women correspondents, something she was keen on. She also talked to her husband about employing women in his cabinet (Tindall and Shi 1268). In fact, she backed the successful appointment of France Perkins as Secretary of Labor (Caroli 2008). Like the First Lady, Perkins was an advocate of minimum wage and maximum hour laws, child-labor restrictions and other reforms (Bradgon, McCutchen, and Ritchie 776). Eleanor was not afraid to speak her mind, even if it meant carping on her husband’s plan regarding unemployment insurance (Caroli 2008). In 1936, she started her own daily syndicated newspaper column â€Å"My Day† (2008). This was her channel for expressions her opinion publicly. While some greeted her write-up with criticisms, many people admired her for taking interest in their plight. She often tackled child welfare, racial minorities, housing reform and women equality (2008). Following her husband’s death in 1945, President Harry Truman her to the US delegation in the United Nations (UN) (Caroli 2008). She was responsible for the drafting and adoption of the Universal Declaration of Human Rights (UDHR) (2008). The UDHR was approved on Dec. 10, 1948 at a U. N meeting in Paris, for which the former First Lady received a standing ovation from the delegates (Gardner 1988). The UDHR is deemed the touchstone of human rights (1988). It is also used to measure the performance of UN entities and NGOs (1988). Likewise, the UDHR continued to serve as inspiration for other human rights treaties in Europe and Latin American (1988). Based on the American Bill or Rights, the British Magna Carta, and the French Declaration of the Rights of the Man, the UDHD comprises a preamble and 30 articles on basic rights and freedoms (1988). When John F. Kennedy became president, she appointed Eleanor as chair of the Commission on the Status of Women (Caroli 2008). She continued to work and fought for the underprivileged. Even at her age, Eleanor travelled the globe to conduct meetings with world leaders (2008). She also did not stop writing books and articles. In 1962, she contacted a rare form of tuberculosis and succumbed. She was buried at Hyde Park. Works Cited Black, Allida. â€Å"Anna Eleanor Roosevelt. † The Eleanor Roosevelt Papers Project. Jan. 31, 2008. May 7, 2008 < http://www. gwu. edu/~erpapers/>. Bragdon, Henry, Samuel McCutchen and Donald Ritchie. History of a Free Nation. Ohio: McGraw-Hill, 1996. Caroli, Betty. â€Å"Eleanor Roosevelt. † Britannica. com. 2008. May 7, 2008 . Gardner, Richard. â€Å"Eleanor Roosevelt’s Legacy: Human Rights. † Dec. 10, 1988. May 7, 2008 . Goodwin, Doris. â€Å"Leaders and Revolutionaries. † TIME. com April 13, 1998. May 7, 2008 . Lewis, Jone. â€Å"Eleanor Roosevelt Quotes. † Womenhistory. about. com 2008 May 7, 2008 . Tindall, George and David Shi. America A Narrative History 5th ed. USA:W. W. Norton and Company, 1999.

IT Strategic Planning Essay Example | Topics and Well Written Essays - 250 words

IT Strategic Planning - Essay Example As a human resource manager in the organization, it is important to develop the best IT strategic planning. It will align the organization’s daily activities with the human resource department. A good IT strategic plan will help the business fulfill its general business strategy.The business-driven priorities are important for a company to develop efficient IT strategic plans. For instance, if the most important priority is to increase sales targets, the priority could be used to create the following year’s technology. The human resource manager has to interview various business leaders in order to the technology’s plans.The organization has key business processes. The company builds and provides access to services. The company identifies high-quality goods and services. The identification begins at the lower stage of the company, up to the top level. The organization then supports teaching and learning of its employees. Such case is successful when the organizat ion provides funds and leaves for extension of studies. Additionally, the organization enables research. The top management has developed collections of research materials and provided experts who offer a high level of advice to the employees.The company has created an optimum business environment. It has ensured the customers enjoy the highest level of services. The management provides the employees with enhanced working spaces and environment that meet a variety of working styles and encourages working and research.

Terminology & Experiences & Beliefs Case Study Example | Topics and Well Written Essays - 250 words

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Scientific Uncertainty Web-Based Assignment Example | Topics and Well Written Essays - 750 words

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