Soldier X Summary

Summary: Soldier X Erik Brandt is a 16 year old half Russian half German boy. He is in a program called Jungend which is also known as Hitler's Children Army. It is like Boy Scouts for German Kids. They boys in the Jungend are also enlisted soldiers who have to fight when it is needed. One day Erik is sent to fight in the war. He is shipped to the eastern front where the Germans have to fight Russia on Russian soil. Erik is uncomfortable because he is half Russian and German.He was aware of the things Germans were doing to Jews but he was convinced it was right and that Jews were preventing Germany's world domination. While traveling to Russia he becomes acquainted with some other boys in his platoon named Oskar, Jakob, and Fassnacht. They get attacks by aircraft and very few of the Germans die but the boys are pretty scared. When they reach their destination they go into the trenches and prepare to fight.Their commander explains the plan and teaches them how to use certain equipment like mines and grenades. When the first waves of Russians attack it is mainly infantry foot soldiers. The Germans win and Erik thinks it’s over and he is exhausted and tired. Then their commander says that was the easy one and tells them to prepare for tanks to start progressing. In the second wave the Germans start to drop and German hope looks lost. Erik is hit by a grenade and he is hurt. He is lying in pain in the bottom of a trench.With many dead bodies around him, he sees that playing dead won’t help because the Russians are stabbing every body they find with a bayonet. He knew he was running out of time. To his luck a tank broke down over him. He now has to think fast. He sees a dead Russian boy and puts on him uniform to disguise himself. He leaves the trench disguised as a Russian. As he is going he get shot by a surviving German in the side. He passes out and wakes up in hospital. When the soldiers he meets asks his name he says he has amnesia.He meets a you ng nurse in the hospital named Tamara. They talk a lot and get to know each other very well. They eventually fall in love. The hospital is bombed one day and they must escape. They make a plan to go all the way to the United States. They are able to escape Russia and make it to America. While sneaking through Germany Erik loses his left arm when he gets shot. The American soldiers take care of him. He gets to America with Tamara and they start a family and live their lives there where Erik becomes a history teacher.

Three Human Skills A Administrative Medical Assistant Needs To Possess

Three skills an Administrative Medical Assistant needs to possess are planning, strategy and effective communication. Planning is a criterion that is required in the job description of a medical assistant. Medical Assistants should be able to plan appointments for the specified times needed for the availability a patient needs. Medical assistants should also be able to plan well for ordering medical supplies, if a medical assistant does not have planning or organizational skills the company he or she is working for will be out supplies and cannot care for the patients or use the materials needed to complete everyday tasks.Strategy is a skill that medical assistants need to possess in everyday job experiences. Strategy is something that every person uses on a day to day basis. A good medical assistant should be able to strategize to achieve any goal he or she desires. Working in the medical field there are chaotic days that a person needs to be able to make quick and accurate decision s within an instant. Medical assistants need to be able to strategize each course of action he or she needs to decides and it needs to be accurate and effective because the company is in stake of each strategic decision.Communication is a skills that every person possess however to be a good medical assistant effective communication is important. Medical assistants use communication at the office answering phones, planning patient’s appointments, and greeting patients with professional hospitability. The medical assistant is the first person a patient see’s when entering the office everyday therefore a medical assistant needs to possess the abilities to understand, listen and control the behavior of other individuals and groups.Medical assistants should be understanding of patient’s complaints and should have the ability to be a good listener and give professional feedback to the patients. Patients sometimes need someone other than family members and friends to listen and understand their problems and situations and as a professional healthcare employee medical assistants need to possess these skills.

Cool Foods Assignment Example | Topics and Well Written Essays - 2000 words

Cool Foods - Assignment Example While the first part of the report details the areas which the management has to have a thorough review, the later part describes the relative merits and demerits of the application of the modern quality standards. The report is concluded with an outlook of the future of the company and the recommendations that may be considered for driving the company towards an accelerated growth. While the company has already established a clear lead in the market, it becomes important that such a position is retained and at the same time the growth potential of the company is made use of. For this purpose, the company should have a clear business focus in the following two broad areas that determines the outstanding characteristics of any manufacturing enterprise. The areas are: With clear policies on the above areas the company would be able to achieve the maximization of the manufacturing platform which is at the root of the success of any organization. Apart from the above the company should also focus on the enhanced raw material sourcing facility for a drastic reduction in the manufacturing costs. Delivering outstanding customer service is an essential part of any market development exercise. In this area the company may look into the following areas which will enable the company to sustain the customer leadership established by the company: New product innovation and bringing them into the market before the competitors is the basic element in any marketing strategy. Hence much depends on the number of new premium and quality products that the company is able to focus on will further increase the market share of the company Brand Portfolio management is an area which needs the management's attention to increase the brand loyalty of the customers to the existing brands and promoting new and attractive brands to expand the market for the company's products The company can look into new streams of business in the areas of Dairy Products - Milk, Cultured, Cheese and Grocery products - Flour, Pasta, Spreads, Oils, Cake Mixes with a possibility to later on integrate these new streams of businesses with the existing Bakery Stream Another area that can be looked into the establishment of 'Cool Food Fresh' and Cool Food Home Ingredients' to market the existing as well as the new streams of products in the existing and newly expanded markets where the company can introduce new products derived out of product innovations in any of the business streams identified. Market expansion to unexplored countries and markets with long shelf life products is clearly another area the company can co

Food Marketing Essay Example | Topics and Well Written Essays - 5000 words

Food Marketing - Essay Example An alternative geography begins to emerge because the restricted ecologies of quality food production are frequently to be found in areas that have escaped the industrialization processes that support globalization. This is most apparent in agriculture, where the maintained use of â€Å"output-enhancing† technologies in the post-war period has frequently resulted in uncovered agricultural ecosystems. Thus those areas that have largely remained insignificant to industrialized agriculture are generally the very areas where quality production might bloom. The turn toward quality in consumption may then reveal a very different mixture of productivity, one that contrasts in important respects with the dominant geographic distribution of food production activities. Consumers increasingly are linking ideas of food quality to ideas of nature in the agro-food system, as though they feel that the higher the natural content of food the less susceptible it will be to hurt human interferen ce. Yet, some leading commentators on the food sector have begun to argue that the theoretical analysis of food has tended to underplay the â€Å"salience of nature†. It is now widely believed that the agro-food system is globalize, and much of the recent research into the agro-food system has taken as its main focus how processes of globalization come to be driven by the reshaping of food production processes according to patterns of capital growth.

An examination and Investigation of the UK Construction Industry Essay

An examination and Investigation of the UK Construction Industry skills shortage crisis. What strategy is being adopted to combat the current skills shortage A - Essay Example found that 1,602 people currently work within the built heritage sector in London, preserving some 891,000 pre-1919 historic buildings, including 19,096 listed buildings. However, with 27 per cent of local contractors having outstanding vacancies and the workload ever increasing, the industry needs to recruit almost 550 people at a local level in the next one year just to meet immediate demand. It includes such a diversified group of workers like carpenters, speciality bricklayers and slate and tile roofers, lead-workers and stonemasons and joiners to work in construction industry estimated to be worth over  £3.5billion across England every year. It was also felt that there will be severe shortage of different construction workers involved with skills such as drystone walling, thatching, millwrighting, earth walling, and flint-knapping in coming 15-20 years in United Kingdom. In England today, there are currently only around 270 professional members of the Dry Stone Walling Association, under 1,000 thatchers and about 50 firms who work on cob and earth buildings. In the next one year alone, there is a need for almost 200 lime plasterers, around 140 wattle and daub craftspeople, over 100 glaziers, over 80 clay dabbins craftspeople, and almost 60 cob builders and dry stone wallers. It reflects the fact that not only does the report produce yet further evidence that heritage conservation skills1 are at risk, but uniquely it puts forward an action plan to tackle specific problems. Hence it is high time for all policy makers and enterpreneurs for joined-up thinking and concerted action across the construction industry, the built heritage sector, educational establishments, careers organisations, funding bodies and government departments to tackle a vital issue that is at the heart of sustaining two In case of private buildings, almost two thirds of public and commercial stockholders and private home dwellers expressed a high level of satisfaction with the work done

When Life Imitates Video by John Leo Essay Example | Topics and Well Written Essays - 750 words

When Life Imitates Video by John Leo - Essay Example This research will begin with the statement that the article revolves around the possibility of real-life events beings strikingly similar to those portrayed in violent video games. The author, a writer by heart, has done service to the public by indulging in writing different society centered articles and serving practically for the betterment of higher academics for the past few decades. This article could well be ascertained as a continuation of the chain of his service to his fellow beings. Commencing with the mentioning of a Colorado incident in which teenagers indulged in a violent shooting spree that eventually led to the killing of themselves at their own hands, the author is pained at noticing the obvious influence of gaming on youngsters. It is perceived by the writer that the actions of youngsters were influenced by situations in video games. The opening paragraph gives an evident idea of the purpose with which the author has written it. The purpose of the writer, mainly, is to highlight how scenarios portrayed in violent video games are being adapted to real life by the youngsters who are deeply influenced by them. The audience the writer targets are individuals within the general public and also the video games’ manufacturers. The widespread use of video games and the parents’ leverage given to kids to play them with ease gives an idea that parents are unaware of the hazards involved with the games. The author aims to target these oblivious parents as the audience trying to bring them to light about the alarming problem at hand. Quoting logic and reason, the author tries to clearly signify the relationship that exists between violence in video games and real world mishaps. The argument most presumably set forth by video games promoters that there basically is no direct link that could prove the effect of violence in video games on youngsters and their real-life issues have been responded well by the customer. Understanding the opposin g viewpoint’s position, the writer accepts that there may be personal issues involved with the personalities of individuals who show being affected by the violence related mentality but this mainly is, in the words of the writer, the weakest point that should be addressed. According to the writer, the individual youngsters that come from strong-willed and well brought up families are less likely to fall prey to these violence-prone games. It mainly is the distressed and the oppressed youngsters only who find their refuge in the video games where they find all the violence to lure their oppressed and neglected thoughts, a perfect place to let go of their frustrations. The problem, according to the writer, is that millions of youngsters of the current society are indulged in activities that would do nothing but hurt their counterparts and themselves alike, considering this as being no objectionable practice whatsoever. All this is owing to the fact that oppression has been made an everyday affair by the everyday use of violence-laden video games. The author inputs logic into his writing beautifully by mentioning the point of view of Dr. David Grossman of Arkansas State University who is both a psychologist and a retired Army officer. His point of view is of immense importance as he assesses the situation from two distinct aspects, both from a psychologist’s and an army officer’s point of view. He completely seconds the stance of the author adding that enabling kids and youngsters to get indulged into electronic games at such an extensive rate has made it common for them to think of killing someone no matter what the situation. The severity of the matter has been eliminated by the realistic aspects introduced into the games such as those of the armory being just like real-world weapons and also the scenarios being very realistic as well.

Traumatic Brain Injuries in Prison Essay Example | Topics and Well Written Essays - 1250 words

Traumatic Brain Injuries in Prison - Essay Example These incidences are seen to increase as one ages where one becomes a danger to those around them. When a person that has suffered from TBI gets incarcerated, the cognitive and behavioral tendencies related to TBI make it difficult for them to adjust to prison life. For this reason, rehabilitation efforts get complicated especially since TBI resultant habits such as drug dependency and psychiatric problems make it difficult for a prisoner to adjust to prison life and life after their conviction (Ferguson et al 11). A large number of prisoners serving their sentences are doing so while suffering from TBI and this complicates the rehabilitation efforts and their ability to function properly when they get back to society. There are approximately two million people living in jails and prisons in America, 25-87% of these are reported as having suffered a TBI or head injury. Further broken down, women imprisoned for violent crimes have a higher chance of having suffered a TBI or another kind of physical abuse prior to their crime. Also, women with a substance abuse disorder are likely to suffer from a TBI while in prison (â€Å"Traumatic Brain Injury†¦Ã¢â‚¬ ). This is an alarming situation as TBI often leads to long-term cognitive impairment making it difficult for persons suffering from it to go through their daily activities and sustain jobs; particularly with persons who are come from prisons or jails. It becomes important to highlight the burden that TBI casts on persons suffering from it. The long-term cognitive impairment depicts its first detrimental effect, which is that it is a disabling injury and this is evidenced by the fact productivity lost as a result of TBI is at 15.7% and this is 14 times that linked to spinal cord injury. The number of persons suffering from TBI is likely to be higher as there are persons that are likely not

Ethical Theories Essay Example | Topics and Well Written Essays - 1750 words

Ethical Theories - Essay Example The researcher will analyse this case using Consequentialist (Utilitarian) and Deontological theories of business ethics; also I would provide a discussion over possible decisions that could be taken in the light of arguments raised by proponents about the importance of these two ethical theories. The key stakeholders in the above mentioned case Star Alpha Medicines, a multinational pharmaceutical company headquartered in the UK and a leading supplier of insulin for diabetics, are the organisational customers, top management and employees, shareholders, government authorities of country X (southern-European country), industry analysts and governments of all nations where Star Alpha Medicines is operational other than country X. In addition, there are two main ethical issues as revealed in this case. The first issue is whether Star Alpha Medicines should withdraw its easy-to-use insulin pen injection product from country X to avoid financial losses and put lives of diabetes patients at stake. The second main ethical issue is whether governments of other nations (other than southern-European country) would use 25% price cut as a basis for setting drug prices and force Star Alpha to reduce the prices in all nations as well to provide relief to customers. It is worthwhile to point out that Utilitarian theory is actually developed by Consequential school of thought. This theory, in fact, talks the consequences / outcomes of various solutions and alternatives developed by organisations, individuals, governtments etc. to resolve the ethical dilemmas and scenarios. For instance, Utilitarian principle endorses the idea of providing greater welfare to greatest number in society by conducting a cost – benefit analysis. Consequentialists also use point system to analyse viability of different alternatives and to conclude which choice may lead to greatest good for society (Faculty Washington, n.d). As far as the implementation of Utilitarian ethical

The ways in whih characters adapt to the changing circumstances of Essay

The ways in whih characters adapt to the changing circumstances of their lives - Essay Example In John Steinbecks novel, East ÃŽ ¿f Eden, the characters are unusual, realistic, and interesting, all which contribute to the appeal ÃŽ ¿f the novel. These characters appeal to the reader, and the reader is able to sympathize with most characters, from the most upstanding citizen to the ruthless seductress. Faye, although the owner ÃŽ ¿f a whorehouse, is depicted a respectable, honourable woman, by the description Steinbeck gives her. Although she owns a whorehouse, she has made it the cleanest, and in many ways, the best whorehouse ÃŽ ¿f all the others around her. Steinbeck regards her as being a good citizen, and a moral person. All ÃŽ ¿f the girls who work in her whore house respect Faye, and look up to her. As the interaction between Kathy and Faye persist, many ÃŽ ¿f the girls who work at Fayes become fearful ÃŽ ¿f her safety. Kathy slowly poisons Faye, and when Faye dies, the tone at the whorehouse drastically changes, as the girls become more suspicious ÃŽ ¿f Kate. Faye, being the good person that she was, loved Kate, and left her business to her. When Kate took over, the girls suddenly live in fear ÃŽ ¿f Kate. Kate is probably the most interesting, and gripping character in East ÃŽ ¿f Eden, due to her sedectiveness, and her evil personality. In Steinbecks first description ÃŽ ¿f Kathy he depicts her as a victim ÃŽ ¿f genetics. It was just a mere coincidence that such an evil human arose from her two good parents. The reader can sympathize that she is a victim ÃŽ ¿f nature, a common trait ÃŽ ¿f realism. Her actions are merely a result ÃŽ ¿f here natural instincts to be bad. Her character is the most complex in the novel. Her most interesting aspect is her reaction to alcohol, another interesting trait that draws the reader in. Her actions shock the reader, her boldness and independence was a reflection ÃŽ ¿f the womens movement that is still a major appeal to the women ÃŽ ¿f today. The introduction ÃŽ ¿f Kathy in chapter 8 was a turning point in the novel, since her

Measures Taken for Reducing Maid Abuse in Singapore Essay Example for Free

Measures Taken for Reducing Maid Abuse in Singapore Essay There are approximately 150,000 migrant domestic workers (MDW) in Singapore and many of them suffer forms of abuse – physical and sexual violence, food deprivation, confinement in workplace and late or non-payment of salary. In 2011, an estimated 4000 MDWs ran away from their employers’ home, many of them frustrated, overworked and underpaid. (TWC2, 2011) The Singapore law doesn’t stipulate a minimum wage or mandatory rest days in contracts for these domestic workers. Instead, many initiatives have been put in place to protect the interests of these workers. (Agence France Presse, 2003) From January 2005, workers seeking to enter Singapore as MDWs have to be at least 23 years of age and have completed a minimum 8 years of formal education. They must also sit for an entry test in English to validate the worker’s linguistic, numerical and practical abilities. These measures are aimed at improving the overall quality of workers who will be working in Singapore households in an effort to promote harmonious working relationships with their employers. These workers will also be in a stronger position to understand their rights and seek protection or recourse under Singapore law should they suffer any form of abuse or ill treatment. Ministry of Manpower (MOM) has also put in place training courses to educate employers. Starting from April 2004, first time employers of MDWs have to attend a compulsory Employers Orientation Program, which educates employers on their obligations towards these workers. It underlines good employment practices to promote mutual respect between both parties. A new accreditation system has also been put in place to regulate employment agencies, which provide recruitment and placement services of these MDWs from June 2004. The accreditation requirements include proper orientation of MDWs, employer education in regards to their obligations towards the welfare of MDWs and the facilitation of written employment contracts between MDWs and their employers. Failure to achieve this accreditation will result in agency’s license being revoked. While these measures work towards protecting MDWs interests and well being, the challenge to make sure agencies and employers follows suit still exists. There are still cases of physical abuse reported and many more go undetected and unreported even though the government has stiffened penalties for acts of abuse against MDWs. Moreover, there are currently no regulations on fees charged by these agencies resulting in excessive fees being paid by MDWs to secure employment in Singapore, some of whom receive no salary for up to a year just to pay off these fees. (HRW, pg 48-51) Regulations should be passed to limit the extent these fees are being charged to MDWs. Singapore’s government also charges employers of MDWs a monthly levy of S$345 on top of a bond of $5000 per worker. This tax allows the Singapore government to collect approximately $400m each year, of which very little goes towards improving support services for these workers. The government should in turn use these taxes to help to create awareness of maid abuse or to pass it on to the various Volunteer Welfare Organisations such as Humanitarian Organization for Migration Economics and Transient Workers Count Too to work on prevention of maid abuse. It is MOMs requirement that the maid go for a medical check up every six months. Beside this measure, they could also conduct regular spot check on the maid, just like what they done for the foreign construction workers to check on safety measurements.

The main concepts of the behaviorist perspective theory

The main concepts of the behaviorist perspective theory As a reaction to the introspective analysis method in psychology and the focus on the study of mental processes, conscious or unconscious that dominated the beginning of the last century and was considered the object of psychology at that time  [1]  , a new approach was developed under the name of behaviorism. This new psychotherapeutic approach was to dominate psychology for about 50 years. Precursors of this approach are the American psychologist Edward Lee Thorndike  [2]  and the Russian psychologist Ivan Pavlov  [3]  , but the one who is considered the father of behaviorism and established its theoretical and practical fundaments is John Watson  [4]  . Behavior becomes the focus of psychological investigation because it is the only one that can be scientifically studied and quantified, predicted and controlled. The behaviorist assumptions are that: psychology should be seen as a science and therefore it should deal with observable behaviors that generate empirical data; the environment plays a decisive role in determining behavior as opposed to the psychic inner processes; all behavior is learnt from environment and this learning process is similar to animals. In contrast with the vague concepts used by introspectionism, behaviorism places a high emphasis on the use of operational definitions that is defining various concepts in terms of observable events that may be used to describe human experience in terms of stimuli and responses. A specific characteristic of behaviorism is parsimony seeking the simplest possible explanation for any event  [5]  . Key concepts of behaviorism comprise the stimulus response (S-R) equation, the classical and operant conditioning, and the reinforcement and punishment notions. The method used to analyze behavior is the lab experiment which gave the possibility to manipulate the independent variable in order to study the dependent variable. Stimulus is a measurable change in the environment any object, fact, event or situation that may have an impact on behavior, while response is a measurable change in behavior any reaction to a stimulus either environmental or mental. The behaviorist theory excludes thoughts, feelings and other mental occurrences, and genetic factors as well, that is everything that cannot be study objectively, in observable terms. Watson took further Pavlovs idea of conditioning  [6]  and applied it to humans. According to him humans are born tabula rasa and the behavior is simply learnt from the environment through a process of conditioning. In a famous and controversial experiment because of its ethical implications, Watson and Rayner (1920) conditioned Little Albert an 18-months old toddler to develop a fear response to rats, by associating the rat NS with a strong noise UCS. They conducted their research following the classical conditioning scheme: Noise (UCS) Anxiety (UCR); Noise (UCS) + Rat (NS) Anxiety (UCR); Rat (CS) Anxiety (CR)  [7]  . Close related to the process of classical conditioning is the generalization that occurs. Thus, stimuli similar to the original CS would tend to elicit the same CR. In the case of Little Albert it was reported that the boy was showing strong signs of anxiety to all fluffy objects, which were similar to the white rat used in experiment. Stimulus generalization results in responding to a whole class of related stimuli, after initial learning with a single stimulus and can enable organisms to adapt better to their environment though it may not always be adaptive  [8]  . Behaviorists draw the conclusion that generalization is the first response of an organism when encountering new situations. Sometimes this generalization may take the form of stereotyping that occurs when generalizing based on group membership. To fight this phenomenon, behaviorists undertook and exemplified through research the concept of stimulus discrimination  [9]  , according to which an organism may be tr ained to discriminate between two or more stimuli that progressively increase in alikeness. As Glassman and Haddad point out stimulus discrimination always requires training in the absence of such training, organisms tend to generalize (emphasis theirs)  [10]  . Opposed to the concept of conditioning is the concept of extinction which suggests that what can be learned can also be unlearned, and that a conditional response is not necessarily permanent  [11]  . However, as some research indicate  [12]  , extinction is likely to appear in humans in some basic behaviors involving muscle responses like withdrawing from a hot surface, but not in complex behaviors which involve fear responses or other responses of the automatic nervous system and which are very hard to extinguish. Using Pavlovs extinction procedure, Watson and Rayner tried to eliminate the conditioned fear response associated with rats in Little Alberts case by presenting the rat for a period of three weeks w ithout associating it with the gongs noise. Contrary to their expectation the fear did not extinguish. Stimulus generalization and discrimination concepts as well as the extinction principle have a great importance for our discussion because they will be used in the process of developing behavioral psychotherapeutic techniques. Skinner developed the concept of operant conditioning. He argues that all behavior is modeled by complex reinforcement patterns from the environment. In his view, humans and animals actively engage with their environment, as opposed to the Watsonian emphasis on classical conditioning where they are more passive waiting for the environment to produce stimuli to which they may respond to. Skinners main idea is that human behavior is determined by the consequences of its past behavior. If from a Watsonian perspective the behavior is triggered by external stimuli, starting with Skinner the behavior may be elicited by internal stimuli as well, as a result of past internalized experiences. Thus operant conditioning is a type of learning where future behavior is determined by the consequences of past behavior. According to Skinner the past behavior may influence feature behavior depending on three types of consequences: if it had no consequence, the probability of that behavior to occur in the future is neuter; if the consequence is found pleasant, then the behavior is likely to be repeated in the future this was called positive reinforcement; if the consequence is negative, then it acts as a punishment and makes that specific behavior unlikely to appear in the future. By extrapolation, learning occurs through manipulation of positive reinforcements and punishments. Newer behaviorist approaches acknowledge that although the two types of conditioning reflex and operant were developed independent of each other by different researchers, they are interconnected and in real life situations both processes can occur simultaneously  [13]  . Practice therapeutic process and methods The behavior therapeutic approach emerged from these behavioral principles of classical and operant conditioning. All behavior is learnt and therefore abnormal behavior is seen as the result of faulty learning. In order to cure the individual needs to learn the correct behavior. The behavioral therapy applying the principle of here and now focuses on the present behavior which the patient finds problematic as opposed to the psychodynamic therapy that focuses on identifying and uncovering unconscious conflicts from childhood. The therapist sees the patient as standing at the intersection between genetic inheritance and learning that occurred through interaction between individual and environmental stimuli. These result in maladaptive thoughts, feelings, attitudes and verbal behavior. Conventionally, the psychotherapeutic process starts by behavior analysis  [14]  . The focus is on indentifying the current stimulus response relationship. Based on the disruptive behaviors identified the therapist designs a program (the psychotherapeutic process) meant to help the patient unlearn the faulty responses and if appropriate learn more adaptive behaviors. The patient is explained how the psychotherapy works, how the conditioned responses were learnt somewhere in the past and how the very same behavioral responses can be modified using the techniques of behavioral therapy. According to Bennet, behavior therapy differs from psychoanalytic therapies in the following regards: it is directive, the therapist actively involves in the therapeutic process, using methods based on learning principles; the goal of therapy is different in that it intends to change behavior not to reconstruct personality; the therapy is shorter than other forms; the interventions are symptom specific, closer to the medical model of intervention rather than the psychoanalytic catharsis or insight  [15]  . Behavioral techniques emerged from the classical conditioning principle involve systematic desensitisation, aversion therapy, implosion therapy and flooding. Operant conditioning techniques are related to what is commonly known in therapy as behavior modification, behavior shaping and token economy. Systematic desensitization is the treatment of choice for phobias and various anxiety inducing behaviors. It aims at replacing the patients anxiety response with a relaxation one, by increasingly exposing the patient to a hierarchy of stimuli from the less anxiety evoking to the anxiety evoking stimulus itself. During the process, the patient goes to the next stage of the stimulus hierarchy only after succeeding to be fully relaxed in the present of the previous stimulus. This method requires the training of the patient in relaxation techniques  [16]  and involves the use of imagination, since when is impossible to be confronted with the actual situation (like is the case in social p hobias) the patient has to imagine being in those situations, following that life itself will offer opportunities to see if the therapy is successful or not. So, the exposure can be done in vitro or in vivo, depending on the phobic stimulus. However, studies have emphasized that the important factor in curing is the exposure to the feared object or situation by breaking the avoidance cycle created and reinforced in any phobia. Aversion therapy is used to induce an aversive response to stimuli which are associated with existing undesirable behaviors. It has been used in trying to treat alcoholic addiction, by associating a nausea producing drug or a small electric shock with the undesired behavior of drinking. As a result of this stimuli association, the patient is provoked to vomit. This supposedly might determine the patient avoid drinking in the future. However, this method raises serious ethical and effectiveness problems, the rates of relapse being reportedly very high. Implosion therapy and flooding involve that the patient has to face the worst possible fear producing situation, in imagination only in the former and in the physical context in the latter. In contrast with systematic desensitization which presupposes a gradual exposure to the stimuli, these techniques are more radical and less time consuming. If successful, the patient might be cured of a phobia in one hour. The advantage of this method is that the patient learns that there are no objective bases for his/her fear by accepting to openly confront it. Ethical problems are associated as well in regard to suffering from therapy. Derived from operant conditioning, the behavior modification method is largely used in educational and clinical psychology contexts. It reinforces desired behaviors and ignores or punishes undesired ones. This techniques raises problems in choosing reinforcers since people can potentially respond to a wide range of such stimuli. Similar to behavior modification is the behavior shaping technique successfully used in working with autistic children in order to maintain a desired behavior. Another operant application has been used in institutions (for examples schools and hospitals) within the programs called token economies, where conditioned reinforcers are offered to strengthen specific behaviors. Tokens are offered in exchange of a desired behavior and can later be transformed in something that the individual wants. Token behave as a secondary reinforcement for the primary reinforcements which are in fact desired. It may be also used to extinguish undesired behaviors by taking away t he earned tokens to punish undesired behavior. Taken economies are uncommon and inefficient in treating mental disorders, although they might contribute to alleviating some disruptive behaviors associated with mental disorders, such as aggressiveness, inadequate social interaction and use of bad language  [17]  . Evaluation of the approach strengths and limits One of the major strengths of this approach is questionably considered its scientific background. Developed from lab experiments on animals (Pavlov-dogs, Thorndike cats, Watson rats, Skinner pigeons and rats) it focuses exclusively on behavior which can be observed and objectively measured. The behaviorist human being is concrete, realistic, determined in its actions by the environment and the society that he/she lives in. This theoretical approach proved to be productive in creating psychotherapeutic methods, mainly successful in the area of phobias and addictions. Compared to other approaches behaviorism is supported by many experiments. However, there are discrepancies between the empirical and the theoretical developments in behaviorism, which is considered a limitation of the approach. Initial empirical studies were made on animals (as mentioned above) while the theoretical studies are done by generalizing observations made on animals upon humans. This fact cumulated with the declared behaviorists rejection of the importance of mental processes offers a very fragmented and simplistic view of human being. Watson believed that observing and describing behavior is enough to predict and control it. Thus, he eliminated explanation from psychology. Psychic life was acknowledged but its understanding was not considered necessary because it will finally manifest itself at behavioral level. At this point we need to reconsider what meaning we give to the term scientific, in regard to our double perspective taken by the present work. If scientific means that positive methods in studying human being (similar to the study of rocks, animals, meteorological phenomena etc.) are favored, then we might as well consider this psychological approach a step forward on the terrain of positive science. But if scientific means to conceptualize the human being in all its wholeness in order to understand its starting point, its inner resorts and teleological direction, then behaviorism might be seen as an unacceptable lessening of the complexity and mystery of human being. The intense use of lab experiments present the disadvantage of a low ecological validity  [18]  . In time it became obvious that understanding of behavior cannot come from the laboratory. On the other hand behaviorism was criticized as being reductionist by eliminating the meditational processes and too deterministic by the fact that human being is presented as not possessing free will. Another weakness identified by ethnological studies show that the principles of conditioning are not as universal as was once asserted  [19]  . However, maybe the most informed criticism is provided from within, by a behavior therapist like Lazarus connected with Joseph Wolpe, who states in regard to behavior therapy that: the methods of behavior therapy are extremely effective when applied to carefully selected cases by informed practitioners. But when procedures overstep the boundaries of their legitimate terrain, ridicule and disparagement are most likely to ensue. Far from being a panacea, the methods are then held to have no merit whatsoever, and the proverbial baby gets thrown out with the bath waterà ¢Ã¢â€š ¬Ã‚ ¦ The danger lies in a premature elevation of learning principles into unwarranted scientific truths  [20]  . Comparison with psychodynamic perspective Within the behaviorist approach various theorists hold positions that may vary in some degrees but fundamentally assert the same thing: behavior is the new found object of psychology; this allows psychology to behave and to be considered a natural science; a belief that its legitimate to study the animal behavior and compare it with human behavior; the emphasis on environment as causation of behavior and consequently dismiss mental processes. The psychodynamic and behaviorist perspectives on human being are opposed. They started from very different points in defining what human being is. Furthermore, the behaviorism appeared as a reaction to psychoanalysis and other currents in psychology that used the method of introspection to define and explain the inner, immaterial and unseen mental processes. Their approach was considered by behaviorists as mysticism. The focus in psychodynamic theories and practice is on inner processes that are seen as motivating and influencing behavior, while the focus in behaviorist theories and practice is on the outer world, i.e. environment that is seen as determining behavior. The change in psychoanalysis comes by uncovering unconscious conflicts that are the underlying causes of behavior, while the change in behaviorism comes by manipulating the environment in order to remove undesirable behavior. These opposing perspectives do not completely eliminate dialogue since the unification point i s the human being itself. For example, if a Freudian theorist suggests that adult behavior can best be understood by looking at childhood experiences, Skinner agrees but suggests that the connections are based on the reinforcement history of the person, not some vague concept of conflicts between id and ego  [21]  . In the Freudian understanding of human nature, the person is born with instincts, hence the development of the drive and unconscious psychology, as opposed to the Watsonian perspective where humans are born tabula rasa. The behaviorist theorist Skinner describes the inner life as a black box. He acknowledges its existence but he sees it in behaviorist terms. For him the private inner life is also behavior  [22]  . However, in the view of the major differences presented above we are enabled to draw the conclusion that psychoanalysis and behaviorism have as a starting point different assumptions concerning human nature and therefore, develop at the conceptual- the oretical and practical-therapeutic level towards two distinct finalities. This point is very well made clear by Watson in one of his famous quotes: Give me a dozen healthy infants, well-formed, and my own specified world to bring them up in and Ill guarantee to take anyone at random and train him to become any type of specialist I might select doctor, lawyer, artist, merchant -chief and yes, even beggar-man and thief, regardless of his talents, penchants, tendencies, abilities, vocations, and race of his ancestors. I am going beyond my facts and I admit it, but so have the advocates of the contrary and they have been doing it for thousands of years  [23]  . Contributions to new developments Despite all its limitations, the behaviorist approach has some positive points as well: provided psychology with new and quantifiable concepts, opened the gate to new theories and explanations in psychology, crated more realistic methods. Somehow ironically, one of the major contributions made by behaviorism concerns the possibilities of research opened towards the investigation of cognitive processes that they initially rejected, which will fundament the new cognitive approach in psychology. For example, Edward Tolman, regarded as one of the founders of the cognitive approach, considered himself a behaviorist though not a radical behaviorist like Skinner. In addition, the study of many cognitive issues, such as observational learning imitation) and the use of hypotheses in problem solving, began with similar behaviorist studies of animals. Where the introspectionists failed in their attempts to make sense out of mental processes the behaviorists have pointed the way to new possibil ities for a scientific psychology of the mind  [24]  . Neobehaviorism introduces the meditational processes (motive, emotion) between stimuli and response.

Deir El Medina Speech. -- essays research papers

Good morning/afternoon class, Deir el-Medina is one of Egypt's archaeological gems. Located in a little valley on the west bank across from Luxor are the well-preserved foundations of a village that was used for about 500 years during the New Kingdom. Its inhabitants included the workmen and artisans who constructed the New Kingdom royal tombs in the nearby Valley of the Kings. The name Deir el-Medina comes from the Arabic meaning "monastery of the town" because of the presence of a Ptolemaic temple nearby which was once used as a Coptic monastery. I have chosen to speak to you about the architecture in deir el medina. By its final stage approximately 70 houses stood within the village walls and 50 outside. Perhaps 600 people lived here by then. A wall surrounded the village approximately six meters high built of mud-brick. Gates were located at each end. The villages of Deir El Medina made up a special government department under the vizier of Upper Egypt, and were a select largely hereditary group of scribes, quarrymen, stonemasons, artisans, and labourers, who created the final resting place for their divine rulers. Most of the houses in Deir El Medina were built in a standard elongated design, 15 by 5 meters. They had rubble bases and mud brick structures, and shared walls like today’s terrace housing. Each of these houses would have the following features. Down several steps from the street was an entrance room, with niches for offerings, stelae and busts...

Television and Media - Variety in TV Shows :: Exploratory Essays Research Papers

Variety in Television Shows There are many different television shows today, practically one for every person in the family. Comedies, dramas, action-adventure all these different forums of television, but they all seem to be about the same people. Threw all the different verity of shows on TV all the characters have common similarities with each other. They are mostly composed of white people and the upper class. Even if the show claims to be about the working class the characters are usually never seen working or even warring about money, they also never have a problem paying rent or buying new clothes. This gives a false image of the working class. The lack of a divers cast also misleads the audience the black population is expected to outnumber the white population in this country by the year 2009. Yet all major television stations don't have many if ant minority in their shows. This leaves most of America's people unrepresentative on television. If these stations where trying to portray the middle class they did not do so in an affective manor. Looking at the show "friends" the whole cast is composed of white actors and never has a minority ever been represented in the show. All the characters have jobs but are never seen at them, occasionally we see Monica in the kitchen where she works, or Rachel in the Coffey shop doing anything but work. Even with the unusual appearance at work the characters still seem to have great apartments and seem fashionably beautiful. "Friend" is one of the most popular shows on television today. How is that possible, the answer is that executives who write and produce the shows have no idea what its really like for young adults in society today. They assume things about the American public and pass it on as the real thing. This in turn is digested by the American public and watched because theirs nothing else that is entertaining enough to keep their attention the reason why television shows seem the same is because they are made and produced by the same people with a formula that i s followed by others. Look at the show "Will and Grace" it seems to have broken the mold of the usual sitcom.

Color :: essays research papers

What is Color? You are wondering what it is to be a color? Are you a color if you paint yourself white? Is color just an exterior or is it an interior as well? Is the color you are on the outside, the color you are on the inside? Think about it this way, many people in our culture pretend to be something that they are not, just another white man, or just another black man. The fact of life is that you are what you are, and that you cannot, excluding major reconstructive surgery change what you look like. So basically pull out your box of Crayolas and color yourself whatever color you want to be, because everybody is different in their own way. As Webster’s dictionary explains, color is defined 10 different ways. First color can be defined as: a visual attribute of bodies or substances that depends upon spectral composition of the simulating the retina and its associated neural structures. So basically what I am trying to say is that no one color is exactly the same in anyone’s eye. But is it fair to judge a book by its cover, or is it fair to assume that every Twinkie has a different flavored filling, so to speak. In our school alone it is safe to say that there are roughly seventy-five different cultural backgrounds and probably ten different main sects of religion. But it’s unfortunate that people even today are judged by the color of their skin and not the content of their character as Martin Luther King Jr. has said. Even though this is true I feel that it is equally bad that we as a nation group people together stereotyping one person in a group as all the people in a group. So in order to reach n ew heights as a nation we must come together to show that color isn’t everything, and in fact color isn’t anything at all.

Personal Statement Prompt #2 Essay

PERSONAL STATEMENT Prompt #2: Tell us about a personal quality, talent, accomplishment, contribution or experience that is important to you. What about this quality or accomplishment makes you proud, and how does it relate to the person you are? I’ve never been so interested in my spiritual life, my religion, and my service to others as I have been these past three years. One of the proudest moments of my life is when I was accepted into my school’s LIFE team, which stands for Living in Faith Experience. The trips, retreats, and activities that I have shared with my peers have formed me into a completely new person and have allowed me to experience things that I wouldn’t have been able to experience on my own. Being able to be a part of the LIFE team is an accomplishment that has given me many opportunities, and has showed me ways that I can go out into the world and grab hold of the millions of other opportunities that awaits me. This particular team isn’t like the sports a nd organizations that my school offers. You first have to be nominated by three teachers or administrators, which allows you to receive an application. The end of my freshman year, I received an application, and I was confused. I wasn’t too sure of what exactly the team was, except for the fact they were religious and helped the campus minister out. The application did not only involve basic information, it also required short answers for approximately 15 questions. I ignored the fact that it was so time consuming because I enjoyed having to think about the answers, which were new to me. Later in the week, I was called into our Campus Minister’s office and was interviewed. The questions allowed me, for once, to just be me and talk about what I’ve been through and what I want for my future. Just being myself paid off, in a way that changed my whole high school career and life. The person that LIFE team has helped make me is much more open, compassionate, and helpful. From small groups on the retreats, large group discussions in class, and getting guidance through liturgies, I have opened up to where I can more easily express myself. I learned the importance of trusting people and being trusted. From being a servant leader, I have deepened my qualities of compassion and being helpful. LIFE team is focused on being good leaders for others, while being a servant to them and to Christ. I’m able to learn something and actually feel anxious to go and teach others the same. I couldn’t be more proud of the way  that I’ve progressed in my spiritual knowledge, deepened in my faith, and have become much more willing to open up and try new things. Being a part of the LIFE team for these past 3 years is an accomplishment for myself, a contribution to our school and society, and has helped me to better portray the qualities that I want and need to expose in order to be the best person that I can be.

Black Movements of 1960

Kelsey Kindell Lauren Cherneski English 102 5 September 2012 Black Arts Movement of the 1960s The history of BAM, the types of entertainment, and their effects on society has the upmost impact on history today. Due to it being the only American literary movement to advance â€Å"social engagement† as sin qua non of its aesthetic. The movement broke from the immediate past of protest and petition (civil rights) literature and dashed forward toward an alternative that initially seemed unthinkable and unobtainable: Black Power.One of the most important figures in the Black Arts movement is Amiri Baraka (formerly Leroi Jones). Following the assassination of Malcolm X in 1965, Leroi Jones (Amiri Baraka) made a symbolic move from Manhattan’s Lower East Side to Harlem, where he founded the Black Arts Repertory Theatre/ School. According to the â€Å" Norton Anthology of African American Literature,’’ no one was more competent in the combination of the experiment al and the vernacular than Amiri Baraka, whose volume Black Magic Poetry 1961- 1967(1969) is one of the first products of the African American creative energies of the 1960s.Umbra, which produced Umbra Magazine, was the first post-civil rights Black literary group to make an impact as radical in the sense of establishing their own voice distinct from, and sometimes at odds with, the prevailing white literary establishment. The attempt to merge a Black-oriented activist thrust with a primarily artistic orientation produced a classic split in Umbra between those who wanted to be activists and those who thought of themselves as primarily writers, though to some extent all members shared both views.Black writers have always had to face the issue of whether their work was primarily political or aesthetic. Black Arts Movement influenced the world of literature, portraying different ethnic voices. Before the movement, the literary canon lacked diversity, and the ability to express ideas fr om the point of view of racial and ethnic minorities was not valued by the mainstream. Theatre groups, poetry performances, music and dance were centered on this movement, and therefore African Americans were becoming recognized in the area of literature and rts. African Americans were also able to educate others through different types of expressions and media about cultural differences. The most common form of teaching was through poetry reading. African American performances were used for their own political advertisement, organization, and community issues. The Black Arts movement was spread by the use of newspaper advertisements. The first major arts movement publication was in 1964. The movement lasted for about a decade, through the mid-1960s and into the 1970s.This was a period of controversy and change in the world of literature. One major change came through the portrayal of new ethnic voices in the United States. English- language literature, prior to the Black Arts movem ent, was dominated by white authors. The theatres, as well as cultural counters were based throughout America and were used for community meetings, study groups and film screenings. Newspapers were a major tool in spreading the Black Arts movement.In 1964, Black Dialogue was published, making it the first major arts movement publication. As the movement matured, the two major locations of Black Arts' ideological leadership, particularly for literary work, were California's Bay Area because of the Journal of Black Poetry and the Black Scholar, and the Chicago-Detroit axis because of Negro Digest/Black World and Third World Press in Chicago, and Broadside Press and Naomi Long Madgett's Lotus Press in Detroit.The only major Black Arts literary publications to come out of New York were the short-lived (six issues between 1969 and 1972) Black Theatre magazine published by the New Lafayette Theatre and Black Dialogue, which had actually started in San Francisco (1964-1968) and relocated t o New York (1969-1972). In conclusion, the impacts of Black Arts activities were the development of Black theater groups and Black poetry performances and journals, and both had close ties to community organizations and issues.Black theaters served as the focus of poetry, dance, and music performances in addition to formal and ritual drama. Black theaters were also venues for community meetings, lectures, study groups, and film screenings. Resources http://aalbc. com/authors/blackartsmovement. htm http://www. english. illinois. edu/maps/blackarts/historical. htm

Networking in professional life Essay

Networking in professional life Introduction   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In computing terms, a network is a system of interconnected computers that share a characteristic of being autonomous and have the ability to share information through the interconnection peripherals. Moreover, it is a system of connected computer hardware that are linked by communication channels and protocols that provide a rapid method of sharing information (Tanenbaum, 2011). On the other hand, Network Interface controller (NIC) is a computer system that creates computer connections to a particular network. It is also known as Network Interface Card or network adapter. On the same perspective, a bandwidth refers to the ability of a computer network to send and receive information (data) and is expressed in bits per second (bps). Network Media Types   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In broad spectrum, network media refer to the actual path through which an electronic signal in a system of a computer or computers travels as it moves from one component in the system to another. There are several types of Network media such as; twisted pair cables, coaxial cable, fiber optic cable as well as wireless media (Ciccarelli, & Faulkner, 2006). A situation of network connection problem   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   As I mostly use network connection in most of my computerization endeavors, it comes a time when network connection becomes a major problem. For instance, this problems include; difficulties in connection to home networks, problems in accessing information from other interconnected networks as well as slow network connectivity among many other problems (Chen-guang, 2008). However, through the application of my computer skills, I normally manage to deal with such problems through the employment of troubleshooting mechanisms. However the most common problem that had severe impacts on my working is the issue of slow network connection but at the end, I was able to solve it by following several steps as follows; I first identified the active applications, the available users as well as the available conversations to determine where the congestion came from. This was followed by the generation of a purpose built report to determine the applicat ions in use, in order to determine the amount of bandwidth they were consuming. Finally, I was able to set a limit for the applications that were not significant in my place of operation. This eliminated the problem of slow network connection and after all my operations worked to perfection. How will networking Influence my professional life   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In my future career, networking will be of great importance, as I will use all the learned skills to ensure that information flow is efficient by ensuring the use of the best network type considering speed, reliability, efficiency and cost too. It will be my area of strength. References Tanenbaum, A. S. (2011). Computer networks. Boston: Pearson Education. Ciccarelli, P., & Faulkner, C. (2006). Networking Foundations: Technology Fundamentals for IT Success. Hoboken: John Wiley & Sons. Chen-guang, L. I. (2008). Implementation of netwok management model based on Linux System J]. Railway Computer Application, 6, 012. Source document

Environmental Proposal and Presentation Essay

For this assignment we chose the Patton-Fuller Community Hospital for our virtual organization. This facility is a non-for-profit social insurance association that has supplied an extremely wide cluster of preferred value aids and offices to the town of Kelsey and the encompassing groups since 1975. The healing center supplies centered utilities for example emergency restorative consideration, surgery, work and committal, private medicine and radiology for developed persons and youthful kids. â€Å"As one of the first facilities in Kelsey, they are besides dedicated to supplying a sort of projects that will underpin the health and welfare of their neighborhood inhabitant numbers† (Apollo Group, 2006). The prime causes for hospital’s actuality from a dissection of the task, dream, and objectives are to be the social insurance affiliation of elective for patients, human services masters and M.D.s. Other nexus explanations are to supply esteem honor scoring social insurance aids to the group by â€Å"viably treating contaminations and damages, supplying early mediation and preventive consideration,† and twofold-checking their workers embraces inventiveness, respectability, esteem, aid, teamwork and freedom (Gwinnett health Center, 2009). In this entry we will infer two strategies to make collusions between the Patton-Fuller Community Hospital and its arranged inner and outside stakeholders. We will likewise clarify how the contrasts between administration and administration influence organizing inside the Patton-Fuller Community Hospital. At long last, we will recommend a nature that is supportive of crew working and studying and that considers maintainable improvement and imaginatively inside the Patton-Fuller Community Hospital. BusinessDictionary.com (2009) describes stakeholders as: Persons, gathering, or cooperation that has immediate or digressive venture in an organization on the grounds that it can influence or be affected by the organization’s exercises, targets, and arrangements. Enter stakeholders in a venture affiliation envelop lenders, clients, heads, laborers, legislature, proprietors, dealers, mergers, and the group from which the venture portrayals its assets. In spite of the fact that stake holding is ordinarily self-legitimizing, not all stakeholders are equivalent and dissimilar stakeholders merit to unique concerns. Core stakeholders of the facility are the laborers, patients, guests, speculators, and the group. Smallwood, N., Sweetman, K. & Ulrich, D. (2007, November 11) state: â€Å"Employees longing to work in an area where they can meet their distinctive yearnings and likes. Pioneers who imagine assignments, work domains, and visions help laborers be both skilled and promised to their work.† Patients need to comprehend that they are getting the greatest consideration reasonable and be skilled to accept the forethought suppliers. Voyagers longing to grasp their friends and family are acquiring the finest forethought and that they can accept guardians. Communities need chiefs to construct affiliations that are collectively mindful, with hoe they treat the indigenous nature and how they help the greater group. Speculators-need supervisors to keep their vows, advance an influencing evolvement technique arrange focus abilities to the plan then afterward to twofold-watch that folks are promised to committing on these manufacturing. At the point that they do, gurus pay the affiliation with abnormal amounts of confidence sometime to come, which changes over into higher business worth. Controllers need chiefs to administer themselves in concurrence with heightened moral standards and in a kind predictable with master and legitimate guidelines. The difference between leadership is when it comes to a company you work for a manage needs to decide what the company can do to become better. The management has to come up with a conclusion to come together with a project that they can do to keep business flowing and customers to keep coming. Leaders can get the job done if the employees are doing their job. Some people do less work then others therefore that can bring a company down depending on what they are doing at the job. If you practice more on a job you can get more things done even if you have to ask a manager to give you more things to do. If you do less then less performance will get done. No practice will show and more improvement will be needed from that person. It is always areas that you will definite need improvement to do good and in areas that you fall short. You also can start off with what is easy to you and come back and do the hardest part later. Some people thrive on getting better while others are there just to get a paycheck. We all have to deal with different task at a job whether it is easy or hard. You can get ahead a lot quick then waiting for someone to do your job for you. People that doing well; it will better them later on down the road. This is the best time to get things done now and it will get you a better future later. Today is the best time to develop and accomplish new ideas in the company. Leaders will guide you and make sure you are getting the job done the right way. They also like to guide you to look at things in a very different way in life. Management means stay on task and gets focus on what your job is. There is room to self-develop in the work place. They would like to get and input on what makes people do the things they do. People are very different in many different ways no two people thinks alike. When good managers see you are doing a good job that really makes them feel good. They will let you know and mention to the boss. When you have a great manager they will make sure that the work they gave you has gotten done and therefore, you can move to the next task. They want employees to keep things done the right way in a straight and narrow. Sometimes it take good strong leadership to get people to pull together to get the work done. If you are motivate you can achieve your goals when you have good leadership it tends to make people wants to succeed motivation can come from growing and wanting to be successful. Managing stress in a workplace can depend on the mental or physical level of what could have happen in that people life. Tell the manager about your stress in the workplace can be very risky or very effective. Stress can affect you mental and physical in our personal lives. Too much stress can affect our jobs and getting things done that we tend to forget about in our daily lives with so much going on as far as school, children, work and other etc. Some signs of stress can include headaches making mistakes and being very forgetfulness. Make sure you are taking a break and eat lunch or talking to someone so you won’t get burnt out about things that are taking our attention. Don’t take alcohol or do drugs while you are stressing it really just adds to the problem. The best thing to do is get counseling or see a doctor to discuss your problems. It can be helpful for others to know how you are doing. Stress can also lead to depression it can get in the way of your daily routines and communication to others. Be aware of the stress you can cause up on yourself and continue to get help. Patton Fuller Community Hospital’s point is to come to be a trusted organization in the company of its clients and scratch stakeholders, by supplying worth client mind and utilities to all its patients and by helping and reckonings of nexus stakeholders. Today with the expansion of wellbeing forethought costs, the necessity for productive consideration administration is on the register of essential concerns. Patton-Fuller comprehends this requirement and accordingly centers on the viewpoints of nexus stakeholders, patients, suppliers and laborers in the team effort technique. In place for the group to relegate on its promise to be the medicinal services cooperation of decision for patients, medicinal services masters and M.D.s, Patton-Fuller comprehends the vitality of useful territory interrelationships in which organize, inspire and summon enter staff in the course of the attainment of lifelong organizational objectives and targets.

Summarises the themes Essay Example | Topics and Well Written Essays - 750 words

Summarises the themes - Essay Example The position seemed extremely painful and the body must have been subjected to excruciating pain through this activity. Considering this position, watching from above, the soul was extremely angry. The anger became stronger and stronger; however, he was powerless and could not do anything but watch. He screamed and shouted to let his body free and not subject it to such horrific activities. He would become quiet and listen to what they had to say and what they plan to do next and then start screaming again for mercy. After being subjected to this level of misery and not being able to do anything about it, he gave up. Once he gave up he found that everything changed. He now found himself in a place which was far away from this dreadful scene. He found peace and beauty from where he was now present. The environment was serene which left his speechless. He found himself floating in an area where there were beautiful rainbows and delicate beings. Everywhere he looked there were colors and sounds that were soothing to the ear. At once he forgot the pain he was being subjected and became lost in this beautiful world. The place seems timeless and he wanted it never to go away. The beauty was never ending, could be seen till far. In white robes, loving being welcomed him to his new home. He found them to be caring and helped him cross over to the next world. He left behind all pain and sorrow to be become a part of this new beautiful world. The being circled around him to show him that they were present at all times to comfort him and help him. The environment was such that all transparent clouds were blended together to bring about the beautiful scenario. The joy and happiness was unmatchable. It was serene and it was at once understood that it is only God who can create such an environment. The beings circling around him were sent by God to guide him into the right direction. His suffering was finally over and now he could become a part of this beautiful

1 Thessalonians 5 Essay Example | Topics and Well Written Essays - 500 words

1 Thessalonians 5 - Essay Example This directly relates to modern day life in a sense that it is important to continue to thank God for his word even after thousands of years. Chapter four in 1 Thessalonians goes on to further explain living to please God. This is very important and the apostle Paul urges the Thessalonians to stand strong in their faith. Paul urges the Thessalonians to continue to do more in more in the name of God’s son Jesus. Doing so is pleasing to God. Chapter four also brings up sexual morality. This was a trouble for the Thessalonians as it is trouble for modern day. Sexual morality has become to be something that is tolerated by society but almost forgot that it is not tolerated by God. God wants his people to respect their bodies and treat them holy. If these same values could be implemented into modern day world there would be less sexual acts before marriage and also less prostitution. Loving each other is another way that 1 Thessalonians encourages everyone to live to please God. Loving each other is very important as loving each other as God had intended would allow for a better more pure way of life. This pertains to the modern world in ways that loving each other would reduce crime, lying, deceit, divorce, and violence to almost none. Chapter five goes on to explain waiting for the coming of Gods son Jesus. It is said that Jesus will come without warning like a thief in the night. Those who are obedient to him shall receive salvation. Modern day may tend to forget that this has been written by God. Those who are pleasing to God and live life as a follower of Jesus are able to seek this salvation. It is important to remember that God says that we are all people of the day. Becoming people of the day helps to keep away wrong doings and drunkenness. God wants his people to be awake in the day and sleep at night. Those sleeping in the day are getting drunk at night and not living out God’s will. Modern day struggles with this in

The Difficulties of Using Phrasal Verbs for English Learners Research Paper

The Difficulties of Using Phrasal Verbs for English Learners - Research Paper Example The rationale behind such a theory is that there exist a wide range of levels and types of multiword expressions which includes idioms, fixed expressions, phrasal verbs, prefabs etc. Grammar courses or EFL (English as a Foreign Language) and / or ESL (English as a Second Language) curriculums and other such textbooks concerning grammar, typically emphasize on the learning of phrasal verbs. As such verbs are comprised of verbs i.e., the content word and particles i.e., the function word, such verbs can be studied and understood with respect to studies aimed at vocabulary building as multiword expressions or in grammar as transitive verbs and separable verbs. Several phrasal verbs lack transparency in terms of meanings i.e., certain phrasal verbs are complicated in structure and form and hence it is difficult to comprehend its connotation in entirety by uniting the meanings of the components, verbs, and particles. The use of such idiomatic meanings makes it difficult for English language learners study and apply such words, even if they are aware of the significance of their use. Although the difficulty in using and learning phrasal verbs is widely known, there is little research concerning this field. This paper on â€Å"The Difficulties of Learning and Using the Phrasal Verbs for English Learners† strives to analyze and understand various aspects including the significance of such words, the types of difficulties encountered by ESL / EFL learners and the various ways of overcoming such difficulties. â€Å"A unit which is a constituent at the phrase level and above† It is often identifiable with such criteria as: being the minimal possible unit in reply and has such characteristics as a regular stress pattern and phonological changes conditioned by or blocked at word boundaries. Grammar is an integral part of language learning that facilitates everyday communication. It is a key factor that influences designing of syllabus for learners, and the central point of

Outsourcing Essay Example | Topics and Well Written Essays - 1250 words

Outsourcing - Essay Example Subsequently, organizations attempting to compete globally in the 1970s and 1980s were handicapped by a lack of agility that resulted from bloated management structures (Corbett, 1996). However, most organisations were not totally self sufficient; they outsourced those functions for which they had no competency internally. Publishers, for example, have often purchased composition, printing, and fulfillment services. The use of external suppliers for these essential but ancillary services might be termed the baseline stage in the evolution of outsourcing. The main business purpose for outsourcing is to enhance the value of an organization's offerings to its customers (Earl, 1996). In the electronics industry, increased market competition identifies continuous adjustment and improvement in the production lines, outsourcing and supply chain management of companies. Interdependence and participation of suppliers and manufacturers in product design, innovation, as well as research and development characterize the current international business environment resulting to market volatility (Sobrero & Roberts, 2001; Appleyard, 2003). These organizations usually share proprietary corporate data with external suppliers and partners while ensuring maximum security to enhance efficiency across the product lifecycle by streamlining procurement, production, fulfilment, and distribution processes (Katsikeas, Schlegelmilch & Skarmeas, 2002) which requires integration of applications and data across multiple geographically dispersed supply chain partners, as well as internal integration with legacy systems (Katsikeas, Schlegelmilch & Skarmeas, 2002; Appleyard, 2003). Benefits Outsourcing manufacturing is one of vital business and supply chain strategies which are one way companies are revolutionising business operations to deliver better products faster at lowest cost possible (Domberger, 1998). It is a kind of supply chain collaboration model and strategic alliance approach, which allows the OEMs to concentrate on product development, sales and marketing (Bounfour, 2003). It eventually helps business organisations to gain competitive advantage of increased product availability, reduced inventory; minimized total logistics cost and rapidly introduce their product to market without a significant investment in plans for capital equipment (Arnold, 2000). Normally, there are two types of outsourced services, technology and business process. Each can be inert partial to the subsequent areas. The first type of outsourcing is the technology services. This type covers the electronic commerce (e-commerce), infrastructure (networks), software (applications), telecommunications and website development and hosting. The second type of outsourcing is the business process outsourcing. Under this type of outsourcing are customer contacts (customer relations management), equipment, finance/accounting, human resources, logistics, procurement/supply chain management and security. Lee et al (2002) stated that there have three major outsourcing drivers: (a) economic - expense reductions, cost control and

Telecommunications Industry of Zimbabwe Essay Example | Topics and Well Written Essays - 1500 words

Telecommunications Industry of Zimbabwe - Essay Example The telecommunications market in Zimbabwe and the world around is becoming increasingly consolidated, thus enabling the key players in the telecommunications industry to come out with products at a faster pace, so as to meet the demands of their customers and the trend of the market. The importance of investigating the relationship between project management maturity, business performance and project performance in the telecommunication industry in Zimbabwe cannot be overstated. A number of other studies have shown that the issue of what constitutes the most appropriate method of state policy restructuring as regards technological and industrial development is a matter of contention. Zimbabwe continues to open up its economy to market forces and as such more research and studies should be carried out about the country's economic and political roles and also on the social implications of telecommunications reform and reforms in other sectors of the economy. In a study carried out about contemporary south African telecommunications, the researchers noted that "while much has been written about general industrial development in that co... Zimbabwe continues to open up its economy to market forces and as such more research and studies should be carried out about the country's economic and political roles and also on the social implications of telecommunications reform and reforms in other sectors of the economy. In a study carried out about contemporary south African telecommunications, the researchers noted that "while much has been written about general industrial development in that country, there is no real detailed study of any of its major industries." (Kaplan, 1990). It can be said that the same also holds in the case of Zimbabwe. This situation can lead to some critical deficiencies in understanding because most major economics development processes can only be discerned through such detailed studies. 2. Theory and research review It should be noted that there are very few, if any publications about the telecommunications industry in Zimbabwe. Although one may find an occasional paper that discusses physical road and air transportation and communication or books about the postal history of the country, there hasn't been any prior real interest in the Zimbabwean telecommunications sector, even though this sector continues to grow in importance. As such, literature on telecommunications in Zimbabwe has mostly been manifested in papers presented at various economic, business or investment conferences. SWOT analysis: 3. Research problem statement and research objectives This study investigates the ways in which efficient management techniques can be implemented in the Zimbabwean telecommunication industry, as well as investigating the manner in which project maturity, business performance and project performance relate to one another in the industry. 3.1. Problem statement The

The history of ancient India. Harppan Culture Research Paper

The history of ancient India. Harppan Culture - Research Paper Example But excavations at Harappa and Mohanjo-Daro changed the complete viewpoint and old beliefs. Starting with the finding of Harappa, almost thousand conclusions with comparable characters have been exposed. Scholars named it ‘Indus valley civilization’ (Around the Indus in 90 Slides par. 1). Indus valley civilization developed at two centers-Harappa and Mohanjodaro. Harappa is in Montgomery district of the Punjab (now in Pakistan). Mohanjodaro is in Larkana district of Sind (now in Pakistan). Mohanjodaro means ‘the mount of the dead’. The distance between these two centers is 650 Kms. According to the famous archeologist Sir John Marshall, Harappan civilization is about 5000 years old. The town planning and material life of the Harappan culture were really great. Archeologist like â€Å"Mortimer Wheeler and Stuart Piggot believed that the Harappan towns had a remarkable unity of conception† (Unit 6: Material Characteristics 21). Each town was divided int o two parts. In one part, the citadel indicated where the rulers lived. In the other part of the town, the ruled, and the poor lived. â€Å"The most ancient paw marks of human actions in India go back to the Paleolithic Age, around between 400,000 and 200,000 B.C.

American-Spanish War Essay Example | Topics and Well Written Essays - 750 words

American-Spanish War - Essay Example In the history of the United States, the Spanish-American War (SAW) is one of the most important foreign wars. The result of the war was the victory for the United States, and this victory became possible due to the hard work and efforts of far-sighted Americans, particularly known as â€Å"Navalists†. The contemporary world would have looked quite different today, if the United States had not won this war. The United States was able to defeat Spain so easily because some far-sighted Americans, such as Theodore Roosevelt and Henry Cabot Lodge, were able to develop a strong American fleet. Creating a strong navy was one of the most important ways to protect the national interest and sovereignty of the United States. The navy was to be the backbone of the American power for years to come . The U.S. was able to defeat Spain at considerably low cost as it got prepared better both military and psychologically, to a large extent The background of the war actually propelled the United States to embark on the policy of revenge, and to take wide public opinion. On February 15, 1898, an explosion occurred in the USS Maine, in the Havana Harbor, which led to the war. Another reason was the idea of freeing Cuba from Spanish domination. However, the USA was able to rapidly gain control, and build an empire effectively. After it had drive Spain from Cuba, the United States was able to gain control of Puerto Rico, and eventually Samoa, Guam, Wake Island, Philippines, and then eventually Hawaii . The war only lasted around 3 months, and resulted in very few casualties, around 400 killed and wounded. In fact, the anti-Spanish press was able to raise the public against Spain, which led to mass support, which is essential in wars. Such anti-Spanish press included the â€Å"Yellow Journalism†. ... It was also because of the misrule by Spanish in Cuba, and the misery that it had caused, which led to huge nationalistic outburst.6 The fact that the United States was so strong militarily also paved the way for the swift and relatively easy victory. The U.S did not have to protect any colonies abroad. Additionally, the strong navy was built, which was encouraged by both business and government leaders. A modernization program had been started back in 1881, which had included innovations, which included new ships having steel hulls, large, rifled guns and steam engines. The strong U.S navy was able to defeat Spain easily, because Spain could not compete with the all-steel and steam navy, which had ranked one of the top five navies in the world at that particular period. The Spanish navy was easily defeated. 7 Additionally, the government policies, as well as the high quality of leadership also made Spanish defeat extremely easy. Theodore Roosevelt had a policy, which was summarized â€Å"Speak softly but carry a big stick† showed that there were masterminds behind the development of this plan. The building up of the navy, and the subsequent annexations that the U.S pursued ensured that Spain no longer stood a chance. 8 The Monroe Doctrine also stated that the New World would not be part of foreign colonization, which is why American leadership did not want Spanish presence in Cuba. The leadership eventually turned against Spain, and America’s policies and strength diverted to driving out Spain. Additionally, as historians have examined, Spain was an old and weak country, while the United States was vigorous, new and energetic. It had new strategies.9 As Barrett wrote: â€Å"When Dewey’s squadron sailed out from Mires

Reflective Statement Essay Example for Free

Reflective Statement Essay For this module, we are required to do an assignment with regards of SME company. The purpose of writing the report is to analyze the key internal issues the management is likely to face when strategizing their marketing formula. Besides, we are also required to provide a practical recommendation for the company. For this project, the class was divided into 3 groups and each group consists of 3 members. My group members are Miss Tai Geok Yeong and Miss Sharanya. Discussions among group members were held 4 times, on the 29th October, 2nd November, 4th November and 6th November, respectively. Besides of our normal eeting in college, the discussions also were held through the MSN chat and email. Each of our group members was allocated with task and although conflicts arise during the discussion, we still managed to solve the problem. In my opinion, conflict in a group is not necessarily bad and we use several of techniques in order to resolve conflicts like compromising and exercises work delegation. Throughout completing the task CareKoolTint Sdn Bhd, I have gained lots of new information about SME and the company. In order to get more facts about the company, we held an interview with one of their sales representatives on 2nd November 2009. From the 1 hour interview, we managed to gather the information needed for this project, which for example are, their current marketing strategies and the companys internal issues. One important lesson I learnt from the interview is that, even though small firms is not properly structured, it does not mean that SMEs do not engage in marketing. It is only that, they are doing marketing according to their own terms and not according to a theoretical framework. Other than interviewing the sales representatives, my group and I also did a research based from their websites and also by reading books. It is important so that e will have a broader view on the business environment and help us to write the task more accurately. In order to complete the task, I read Marketing and Entrepreneurship in SMEs, Principles of Marketing by Philip Kotler and Fundamentals of Management to have a better understanding about SME and its management as well as several websites related to the topic which for example SME Info Portal. This whole process, I believe has improved both my knowledge and skills. I learnt how to work with others as a team, it taught me how to compromise as I need to be open in accepting other people ideas or opinion and also in handling conflicts. In addition to that, basically, I am more knowledgeable on this topic. From the research, I discovered various type of SME in Malaysia which can classified under 3 category that are Primary Agriculture, Manufacturing (including Agro-Based) ; MRS, Services Sector (including CT) . Furthermore, I am also more aware on characteristics needed to be an entrepreneur, and one essential trait they must have is to be a risk taker. This is important as SME business environment is very uncertain and whenever they make a wrong decision, it may affect their business as a whole.

A Critical Analysis on William Blake Essay Example for Free

A Critical Analysis on William Blake Essay As romanticism flourished in Europe in the late eighteenth and early nineteenth century in European culture one of the figures that stood foremost was William Blake. A poet, an engraver-putting it simply, an artist, many have raised an eyebrow with his lifestyle and works. Being a lyric poet, a visionary and even a mystic at times people have come to doubt his state of mind, whether or not he truly was an artist or simply insane. Wordsworth, for example, commented that there is no doubt that this poor man was mad, but there is something in his madness which interests me more than the sanity of Lord Byron and Walter Scott and John Ruskin similarly felt that Blakes work was diseased and wild, even if his mind was great and wise(Dover,1998). Looking into Blake’s background, we find that he lived an impoverished life in what we could say, was almost absolute seclusion. His interest in outside ideas rested on being able to refute them. Blake’s seclusion was not simply limited to isolation from other beings, it was also an isolation of the mind; which has lead to many great works which differ in style. Blake’s writings have ranged from lyrical such as his Auguries of Innocence (Erdman and Bloom, 1965) as seen: To see a world in a grain of sand And heaven in a wild flower Hold infinity in the palm of your hand And eternity in an hour. through highly elaborate apocalyptic and visionary . He purposely wrote in the manner of the Hebrew prophets and apocalyptic writers. See more: how to write a critical analysis essay step by step He envisioned his works as expressions of prophecy, following in the footsteps (or, more precisely stepping into the shoes) of Elijah and Milton. In fact, he clearly believed himself to be the living embodiment of the spirit of Milton (Gastfield, 2007). On other occasions, Blake’s way of writing shifted to a highly speculative and paradoxical view which is very much evident in his The marriage of Heaven and Hell (Erdman and Bloom, 1965) where he writes: If the doors of perception were cleansed everything would appear to man as it is, infinite. This also particularly expressed his rebellion against the established values during this era. Blake accepted nothing and had a yearning so deep, for all that is intangible and unbounded to man under the dominion of God, matter, and reason (Kazin,1997). He was a man who had all the divergence of human existence in his hands, and he never forgot that it is the role of man to be able to find a solution for them. Although his contemporaries may have thought him as insane and having a diseased mind, William Blake was far ahead of his time being a visionary. A non conformist who embraced radical thinking, his works have influenced the lives of a great number of people, even being acclaimed by the underground movement. Having such great talent, and having so many ideas go through his mind, his works were merely an expression of the world that he lived in. A mind which privileged imagination over reason; and believed that ideal forms should be created not by which our eyes allow us to see but by that which our mind allows us to see. It is indeed only through the mind of a genius that such great works could be produced. REFERENCES Dover, Richard. â€Å"William Blake and English Poetry† Willaim Blake: A Helpfile 21October 1998 North East Wales Institute, K. 12 September 2007 http://www. newi. ac. uk/rdover/blake/index. htm Erdman, David and Bloom, Harold. The Complete Poetry and Prose of William Blake. Berkley: UC Press, 1965 Gastfield, Gail. â€Å"William Blake† The William Blake Page, 2007, The William Blake Page 12 September 2007 http://www. gailgastfield. com/Blake. html Kazin, Alfred. â€Å"AN INTRODUCTION TO WILLIAM BLAKE† 4 July 2007. Multi Media Library. 12 September 2007 http://www. multimedialibrary. com/Articles/kazin/alfredblake. asp

Pharmacy is a health profession

Pharmacy is a health profession Chapter 1 The word is derived from the Greek word pharmakon meaning drug or medicine and has been used since the 15th and 17th centuries 1. Pharmacy is a health profession that combines the health sciences with the chemical sciences. It ensures the safe and effective use of pharmaceutical drugs. Pharmacy practice includes modern services that are related to health care: clinical services, providing drug information and reviewing medications for safety and efficacy purposes 1. 1.1.1 The various disciplines of Pharmacy Pharmacy can be divided into three major disciplines: a) Pharmaceutics b) Medicinal Chemistry and Pharmacognosy c) Pharmacy Practice Pharmacology is often considered to be a fourth discipline but is not specific to pharmacy, even though it is essential. The boundaries between the different disciplines and other sciences like biochemistry are not clear cut. Hence, research work from the various disciplines is often done concurrently 2. 1 The Hormone Shop LLC. The History of Pharmaceutical Compunding. [home page on the Internet]. 2010 [cited 2010 Oct 10]. Available from: http://www.thehormoneshop.com/historyofcompoundingpharmacy.htm 2 Dayanada Sagar College of Pharmacy, Bangalore, India. History of Pharmacy. [home page on the Internet]. 2008 [cited 2010 Oct 10]. Available from: http://www.dscpharmacy.org/pharmacy.php 1.1.2 The Pharmacist and Community Pharmacy Pharmacists are skilled and highly-trained health care professionals who ensure optimal health outcomes for their patients. In the community pharmacy, the pharmacist has various roles and these include amongst others (Azzopardi, 2010): a) the procurement of medications that are suitable for human consumption b) ensuring the appropriate conditions for the storage of medicines c) ensuring the appropriate and safe disposal of expired medicines d) dispensing of medications that are either on a prescription, or pharmacist-recommended or asked for directly by the patient e) point-of-care testing f) offering general medical advice without the need of a prior appointment. The practice of community pharmacy varies between countries. Nevertheless, the basic functions and responsibilities are the same. A community pharmacist builds a special relationship with the clients, especially the regular ones. Hence, communication skills are of major importance. The pharmacist finds him / herself comforting and hearing out the patient when necessary, and is expected to be understanding and also a good listener. 1.2 History of Pharmacy The first pharmacies, apothecaries as they were formerly known, were founded in the Middle Ages in Baghdad. The first one was founded in the year 754 AD by Muslim pharmacists during the Islamic Golden Age 2. During the 11th century, community pharmacies were established in southern France and southern Italy. In 1240, Emperor Frederick II issued a decree the medical profession was to be separated from the pharmacy profession. Pharmacy practice was to be supervised so that drugs of a suitable quality would be prepared and produced (Azzopardi, 2010). The history of pharmacy can be classified into three stages: a) compounding and dispensing b) clinical pharmacy c) pharmaceutical care. Originally, the pharmacists had to prepare and dispense medicines so they had to excel at compounding. The community pharmacist was therefore highly esteemed because the preparation of medicines was greatly valued in society. In fact, at that time, the pharmacists and other professionals such as lawyers, medical doctors and parish priests were the leaders in the community. As time passed, newly discovered drugs became more dangerous and potent so they started being prepared by manufacturing companies. The pharmacists role was only to dispense these drugs (Al-Shaqha, Zairi, 2001). 2 Dayanada Sagar College of Pharmacy, Bangalore, India. History of Pharmacy. [home page on the Internet]. 2008 [cited 2010 Oct 10]. Available from: http://www.dscpharmacy.org/pharmacy.php Pharmacists moved to clinical practice about 25 years ago. The original concept of clinical pharmacy services was based on the fact that pharmacists ought to use their professional knowledge to ensure the appropriate and safe use of drugs in patients. As a result, several pharmacists nowadays work in hospitals, nursing homes and some ambulatory clinics. Problems remained within the drug-use-system despite the advances made in clinical pharmacy and documenting and recognising these problems has led to the concept of pharmaceutical care becoming the new basis for pharmacy practice (Al-Shaqha, Zairi, 2001). 1.2.1 History of pharmacy in Malta 1.2.1.1 History of pharmacy in Malta from the late 15th century until the arrival of the Knights of the Order of St. John of Jerusalem in 1530 Before 1500, the pharmacists in Malta were almost all Sicilian. In the early 15th century, pharmacists were employed either by the Universita or by the Hospital of Santo Spirito. Mastru Salvatore Passa is the first documented pharmacist in Malta who practised in Mdina and the Hospital of Santo Spirito in Rabat from 1450 to 1475. The medicines prescribed in those days were mainly herbal. During this period, Passa often travelled to Sicily due to his work, presumably to import medicinal herbs as many herbs did not form part of the local flora (Borg, 1998). 1.2.1.2 Pharmacy under the Knights of the Order of St. John of Jerusalem The Knights of the Order of St. John of Jerusalem arrived in Malta on the 26th October, 1530 and they applied their knowledge of pharmacy to the practice in Malta. A Holy Infirmary in Birgu was built and the Greek pharmacist, Giacomo Gualterio, who had accompanied the Order to Malta was the apothecary (Borg, 1998). Grand Master Nicholas Cottoner established the School of Anatomy and Surgery at the Holy Infirmary in 1676. It is very probable that a Pharmacy course was established in the school (Borg, 1998). Under the Knights, the practice of pharmacy in Malta changed gradually, but continuously, occurring in a similar way to that in Europe. However, extemporaneous preparations remained the same from the times of Mastru Salvatore Passa because the enlargement of the pharmaceutical industry still had to occur (Borg, 1998). 1.2.1.3 Pharmacy under the French and British colonies The French arrived in Malta in 1798. There were no more than 32 pharmacies under their dominion, each one having an average clientele of 3,000 patients. No changes were made to the laws governing the practice of pharmacy under the French. Hence, the daily activities of the pharmacists were identical to those of under the Knights. The laws established by the Knights of the Order of St. John remained in force until 1900. In their stay in Malta, which lasted for about one hundred years, the British left their mark on the pharmacy profession. The use of the English language, the names of pharmacies pertaining to Britain or England and the consulting room in the pharmacy are all such examples (Borg, 1998). 1.2.1.4 Pharmacy in the 20th century The Medical and Kindred Professions Ordinance of the Laws of Malta, governs pharmacy laws. This was enacted in 1900 as the laws governing the profession at that time had become outdated and needed restructuring. A legislation that allowed pharmacists to dispense certain medicaments without a prescription was enacted in October 1955 and on the 12th October 1955, a list of these substances was published in the Malta Government Gazette (Borg, 1998). The Malta Chamber of Pharmacists was founded in 1900 in order to protect the common interests of the pharmacists and also to maintain the professions dignity. Hence, the professions standards were raised by enabling the profession to keep abreast of the changes that were occurring internationally (Borg, 1998). In April 1961, an Extraordinary General Meeting was held by the Chamber to discuss the issue of forming a Trade Union that would represent pharmacists; all 33 pharmacists present agreed that this was necessary. One of the Unions objectives, among others, was to improve the conditions under which the profession was exercised and to promote the interests of pharmacists. The Pharmacy Board was set up in 1968 and this was the greatest achievement of the Chamber and Union. The Union worked very closely with the Chamber and in 1979 they formed one association, i.e. the Chamber of Pharmacists Trade Union. This association worked very hard and it affected the current state of the profession and also the legislation governing the practice of pharmacy (Borg, 1998). In 1984, after several meetings with the Chamber, it was finally decided that new pharmacies ought to be owned by pharmacists and that before granting new permits, the population ratio has to be taken into consideration (Borg, 1998). Patients could get their free medications from the Central Hospital Dispensary and Government Dispensaries throughout the first fifty years of the 20th century. The latter could be found in most villages around Malta. In 1954, the Central Hospital at Floriana was turned into the Headquarters of The Malta Police Force as by the late 1940s, St. Lukes Hospital became Maltas General Hospital. Hence, the Out-Patient Dispensary of St. Lukes Hospital became the Central Government Dispensary (Borg, 1998). Pharmamed, the first local pharmaceutical enterprise, was founded in 1974. This gave rise to several job opportunities in the industrial field, besides enhancing Maltas image abroad. In 1995, as a result of strong and consistent negotiations and representations by the Maltese Chamber of Pharmacists, there was the appointment of the first director of the Government Pharmaceutical Services (GPS). This was part of the reform of the GPS and the career progression of pharmacists in Government service. It was concluded in 1998 in agreement with the Ministry of Health on the full implementation of the GPS reform. 1.2.1.5 Pharmacy in the 21st century In June 2007, Mater Dei Hospital replaced St. Lukes Hospital as the national hospital of Malta. The last of the personnel migrated to Mater Dei by November of that year. Hence, the main Government Dispensary was moved to Mater Dei as well 3. In 2008, the much awaited and debated Scheme of the Pharmacy of Your Choice (POYC) was introduced. This Scheme enables the people to have an easier and more comfortable access to the medicaments that are given for free by the Government. 3 Mater Dei Hospital Malta. [homepage on the Internet]. 2009 [cited 2010 Oct 23]. Available from: http://malta.cc/health-care/mater-dei-hospital-malta/ Thus the service that was previously provided for by the village Health Centre Dispensaries was transferred to the community pharmacies. The patients chose the pharmacy of their choice. The initial stages of the POYC Scheme do not envisage any changes in the reimbursement system. Therefore, patients who are entitled to take free medication will continue to do so; there is no co-payment (Grima IC). Until January 2011, the POYC Scheme had spread to 96 Maltese community pharmacies and to 17 community pharmacies in Gozo. Following the introduction of the Scheme, the village Health Centre Dispensaries where the Scheme was initiated, were closed down after sufficient time had elapsed. Over the past few years, the number of local pharmaceutical manufacturing companies has dramatically increased. So has the number of locally licensed pharmaceutical wholesalers who import medications from EU countries. There are more pharmaceutical products registered with the local Medicines Authority. This has had a positive impact on both the private and public pharmaceutical sectors due to the availability of more different therapeutic classes of medicines and more medicines that fall within the same therapeutic class (Grima IC). Recently, the number of generic medicinals in the private sector has also increased considerably. Nowadays, a pharmacist can substitute a branded prescribed medicinal with a generic product that is cheaper for the patient (Bugeja, 2007). Accession into the European Union in May 2004 had a great impact on the medicines in Malta, especially with regards to their availability. Some medicines that were previously available were not registered due to the high registration costs. Hence, EU accession improved the quality of medicines. On the other hand, it had a negative impact on their availability and affordability (Bugeja, 2008). The prices of medicines in Malta increased considerably after EU accession in 2004. In fact, according to studies carried out, the Maltese are paying about 40% more than the average price for medicinal products in the European Union 4. In July 2010, the Parliamentary Secretary, Chris Said, announced reductions in prices of 62 medicines. Some of these reductions were to be implemented immediately whereas with others, when stocks were sold out. Many medicines in Malta are overpriced when compared to other EU countries, so this was a step in the right direction 5,6. 1.3 Pharmaceutical Care In 1990, Hepler and Strand looked at the responsibilities of the pharmacist and at pharmacy services in a new way. They applied the term pharmaceutical care and over the years pharmacists have endeavoured to develop pharmaceutical care practices (Foppe, Schulz 2006). According to Hepler and Strand (1990): 4 Maltastar. The price of medicines in Malta under European Commission scrutiny. [homepage on the Internet]. 2010 [cited 2010 Oct 27]. Available from: http://www.maltastar.com/pages/rl/ms10dart.asp?a=11804 5 Xuereb M. Makers cut prices of 62 medicines. Times of Malta [serial on the Internet]. 2010 [cited 2010 Oct 27]. Available from: http://www.timesofmalta.com/articles/view/20100703/local/makers-cut-prices-of-62-medicines 6 Vella Matthew. Medicine importers agree to cuts in prices of up to 67%. MaltaToday [serial on the Internet]. 2010 [cited 2010 Oct 27]. Available from: http://www.maltatoday.com.mt/news/medicines/medicine-importers-agree-to-cuts-in-prices-of-up-to-6 Pharmaceutical care is the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patients quality of life. These outcomes are (1) cure of a disease, (2) elimination or reduction of a patients symptomatology, (3) arresting or slowing of a disease process, or (4) preventing a disease or symptomatology. In their definition of pharmaceutical care, Hepler and Strand looked at the patients quality of life (Strand et al, 1991). Pharmaceutical care involves a pharmacist cooperating with the patient and members of other health care professions 7. This interprofessional relationship allows the implementation, design and monitoring of a therapeutic plan that will have specific therapeutic outcomes for the patient to benefit from (Ford, Jones, 1995). Pharmacists are the last health care professionals to come in contact with the patients. They thus have a major role in educating them regarding drug use. For this reason, pharmacists must be adequately trained and have excellent communication skills in order to provide this service in an effective manner (Alkhawajah, 1992). Pharmaceutical care can therefore be seen as the component of pharmacy practice that has to be performed by a competent pharmacist who must be committed, honest, accountable and loyal to the patient (Strand et al, 1991). 1.4 The Health Care System in Malta Maltas health care system is divided into the public / national health care system and the private health care system in which pharmaceutical services are provided for by 211 pharmacies that are distributed around Malta and Gozo. The public / national health system is based on a model that is founded on the principles of Equity, Solidarity and Justice. 7 American Pharmacists Association. Principles of practice for pharmaceutical care. [homepage on the Internet]. 2005 [cited 2010 Oct 12]. Available from: https://www.caremark.com/portal/assset/Principles_of_Practice_for_Pharmaceutical_Care.pdf 1.4.1 The Public Health Care System The Maltese Government consists of different Ministries, one of these being the Ministry of Health, Elderly and Community Care. This deals with the healthcare needs of the people and ensures that adequate services are provided for 8. The main goals of the Government for the public health services include 9: The concern of the patient, which is a constant issue The provision of health care and its management The value for money The sustainability of public health care. The Maltese Medicines Authority controls and ensures the quality, safety and efficacy of the pharmaceuticals that are available locally. It also authorizes the medicines that are to be placed on the local market. The Government Health Procurement Services (GHPS) is responsible for the purchasing, storage and distribution of all the pharmaceuticals that are required by the Government Health Services (GHS) in Malta. This entity operates with the funds that are allocated annually by the Government. Procurement of pharmaceuticals is done via tendering procedures that are regulated by the Public Service (Procurement) and Public Contracts regulations. 8 Government of Malta. The health care system in Malta. [homepage on the Internet]. No date [cited 2010 Oct 25]. Available from: The Government of Malta, Web site: http://www.sahha.gov.mt/pages.aspx?page=156 9 Integrated health information system phase 2. [homepage on the Internet]. 2010 [cited 2010 Oct 24]. Available from: The Government of Malta, The Malta Information Technology Agency Web site: https://www.mita.gov.mt/TenderFile.aspx?tfid=727 1.4.1.1 Primary Health Care The Government delivers primary health care via the Health Centres that are distributed around various villages in Malta and Gozo. These centres were set up in 1980 in order to provide free health care services 9. Besides providing the free services of general practitioners, these centres also provide a vast range of other services, including: Specialist clinics eg: gynaecological clinics and diabetes clinics Laboratory diagnostic facilities Radiology. Many people choose to have the services of private general practitioners and / or specialists who work in the primary health care sector. In the private scenario, their services are against payment. 1.4.1.2 Secondary and Tertiary Health Care These are provided for by public and private hospitals, found in different locations in Malta. The main public hospital is Mater Dei Hospital and it provides a wide range of services, including transplant surgery, open heart surgery, emergency care and diagnostic services. Sir Paul Boffa Hospital, another public hospital, has an oncology and dermatology unit. Mount Carmel Hospital is the islands public psychiatric hospital. There are a number of private hospitals in Malta, amongst which is Saint James Capua Hospital. 9 Integrated health information system phase 2. [homepage on the Internet]. 2010 [cited 2010 Oct 24]. Available from: The Government of Malta, The Malta Information Technology Agency Web site: https://www.mita.gov.mt/TenderFile.aspx?tfid=727 1.5 Free health services provided by the government The Government provides free health services; free at the point of delivery, as these are directly funded from general taxation. In Malta, the boundary between the private and public sectors can be seen from two different aspects: medical and pharmaceutical (Wismayer, 2010). 1.5.1 The Medical Aspect The healthcare is available to ALL Maltese citizens, irrespective of the social and financial background of the patient. Anybody can turn up at a Health Centre or public hospital and be given the necessary treatment. Hence, up to a certain extent there is a holistic attitude as no distinction is made between citizens and whoever requires a healthcare service is provided with what is needed (Wismayer, 2010). The seams start to show up when the services available in the public health system are not accessible. That sector of society who can afford to pay, will therefore have to seek the services from the private sector. A case in point is the long waiting lists for certain required procedures at Mater Dei Hospital. 1.5.2 The Pharmaceutical Aspect One of the major tools to achieve good healthcare is to provide good pharmaceutical care. From this aspect, there is a clearer distinction between the private and public sectors. The Government offers free medications to a number of people who fall under different categories: The Schedule II Patients (Pink Card Holders) These cards are issued from the Department of Social Security. They are accompanied by a pink form which bears the name of the pink card holder. The total household income is assessed and the entitlement is based on this. Each household has one pink form that lists all members. However, every member of the household has his / her pink card. The pink form and pink card entitle their holders to free medication that is listed on the Government Formulary. Diabetics also have a pink card issued in their name. There are several faults in the administration of this system, as there does not seem to be a distinction between the strata of society, as is the case with some affluent people who are also in possession of a pink card. Also, no distinction is made between hospital in-patients and out-patients; there is only one formulary for all. 10. The Schedule V Patients (Yellow Card Holders) If a person suffers from a medical condition that is listed under the fifth schedule of the Social Security Act, then he / she can benefit from this free service, irrespective of the financial position. Examples of these conditions include: Respiratory conditions Cardiovascular diseases Malignant diseases Schizophrenia Liver diseases CNS diseases 10. 10 Ministry for Health, the Elderly and Community Care. Free medicinals. [homepage on the Internet]. No date [cited 2010 Oct 12]. Available from: The Government of Malta, Web site: http://www.sahha.gov.mt/pages.aspx?page=8 When a patient is diagnosed with such a condition, he / she is referred to a Consultant by the General Practitioner. The Consultant applies for a Schedule V Card for the patient listing the required medications. Subsequently, the patient is issued with the Card from the Almoner Section at St. Lukes Hospital. People who possess a yellow card are only entitled to take the medications that are listed on the card for free. The list must be amended if the treatment is changed. The Government Hospital In-Patients Any patient resident in the Government Hospitals is entitled to free medication. To date, there is only one Government formulary for all public hospitals. It would make more sense if each hospital had its own formulary due to the specialisation of the hospitals that varies accordingly. These formularies ought to be put together by the doctors who work at the hospitals and by the pharmacists who know what medications are available and which are best suited for the patients. Other people entitled to free medicines include amongst others: Members of certain religious orders Inmates of charitable institutions Refuse collection employees Prisoners People who are injured on duty Members of the Police Forces below the grade of Sub Inspector AFM personnel 11. 11 Ministry for Health, the Elderly and Community Care. Free medicinals. [homepage on the Internet]. No date [cited 2010 Oct 12]. Available from: The Government of Malta, Web site: http://www.sahha.gov.mt/pages.aspx?page=172 1.6 The Pharmacy of Your Choice Scheme The Pharmacy of your choice Scheme (POYC) falls under the umbrella of the Health Division in Malta. The latter is under the portfolio of the Ministry of Health, the Elderly and Community Care. POYC is under the direct responsibility of the Permanent Secretary of Health. The Scheme started in 2008 after several years of discussions and debates. It enables the people to have an easier and more comfortable access to the medicaments that they are entitled to take for free from the Government. The Scheme started in 2008 with an estimate budget of à ¢Ã¢â‚¬Å¡Ã‚ ¬460,000 and the actual expenditure for that year amounted to à ¢Ã¢â‚¬Å¡Ã‚ ¬366,000. In 2009, the estimate budget was of à ¢Ã¢â‚¬Å¡Ã‚ ¬400,000 and that for 2010 was of à ¢Ã¢â‚¬Å¡Ã‚ ¬1.5 million. The 2011 budget allocated à ¢Ã¢â‚¬Å¡Ã‚ ¬1 million to the Scheme apart from the additional à ¢Ã¢â‚¬Å¡Ã‚ ¬400,000 which had to be injected to strengthen the electronic system. The POYC pilot study started in December 2007 in two pharmacies in the Ghargur area. About 550 patients were registered in these pharmacies. Mgarr was next (one community pharmacy having approximately 600 patients), followed by Mellieha (three pharmacies having approximately 1500 pateints) in January 2008 and Naxxar in February 2008 ( Sant Fournier, 2008). Most community pharmacies enrolled in the POYC when the Scheme was introduced in their villages. For example, in the Mosta area, which includes Naxxar, St. Pauls Bay, Xemxija, Gharghur, Mgarr, Mellieha and Mosta, only one out of the 24 community pharmacies did not join in the Scheme due to lack of space (Zahra, 2007). With the introduction of the POYC Scheme, the village Health Centre Dispensaries were closed down after sufficient time had elapsed to allow for a seamless transition. 1.6.1 Advantages associated with the POYC Scheme The main scope of the POYC Scheme was to reduce the long queues at the Health Centre Government Dispensaries. Also, patients are monitored better by the community pharmacists who ensure that the medicines are taken in the correct way as more patient advice is given on a one-to-one basis when compared to the previous system (Zahra, 2007). Pharmacy practice in the community has always focussed on the establishment of an excellent patient-pharmacist relationship (Sant Fournier, 2007). This advice is lacking in the public sector as the patients are given the medicines they require with haste, due to the large number of people waiting to collect their medications. Dosage regimen advice is usually the only advice given. Many people used to turn to their community pharmacists anyway to seek advice and to solve any queries they may have had. With this Scheme, there is also a decrease in wastage because patients are not given the medicines if these are not required, despite the fact that they are entitled to them. Sant Fournier, the President of the Malta Chamber of Pharmacists, claimed that most patients have become more educated and as a result acknowledge the fact that medicines are not to be taken as a for granted privilege but must be used rationally (Borg, Bonello, 2009). The patients find it easier to confide in their habitual pharmacist rather than talk to someone who they do not know. 1.6.2 Problems associated with The POYC Scheme According to Mario Debono, the then General Retailers Trade Union (GRTU) Pharmacy and Health Division President, this system has been a success even though it would improve if more money is allocated by the Government and if it receives more attention (Borg, Bonello, 2009). As with any other recently introduced systems, there are flaws. Nevertheless, several efforts are being made to sort them out. The main problem that is associated with the POYC Scheme is the large number of medicines that are out of stock. This is causing unnecessary stress on the pharmacists and patients. The latter have to go to a Government Health Centre Dispensary that is still open or to Mater Dei Out-Patients Pharmacy to get the medications that are not available from the Scheme. However, this out of stock problem is not the fault of the POYC Department but it has got to do with the purchasing system of the Government. In October 2009, Debono stated that a possible reason why such a large number of medicines is out of stock is that some suppliers have not been paid for their services. Shortages of certain medicines abroad could also lead to decreased stock levels (Borg, Bonello, 2009). The Government did not organise any educational campaigns for the general public regarding the implementation of the POYC Scheme, even though it was advised to do so (Sant Fournier, 2009). Hence, pharmacists were faced with several problems, including sometimes, heated arguments with their patients. It was recommended to have the campaign based on the one used for the introduction of the Euro in Malta, the Malta Euro Changeover Campaign. In October 2009. Reginald Fava, the then President of the Malta Chamber of Commerce, Enterprise and Industry, made new proposals to upgrade the POYC system which were estimated to cut at least a third of present consumption and abuse. He described the current POYC system as being obscene because according to him medicines were being collected even when they were not required by the patients. Fava suggested that patients ought to pay for the medicines they require and will be reimbursed by the Government at a later stage. With this proposed system, the patients would also have the option to go for more advanced or more expensive medications as compared to their entitlement, and will only have to pay the difference in price. Hence, with this proposal, the POYC Scheme would be allowing superior medicines to be taken for free. It would also make the Scheme more sustainable as it would reduce the out of stock problem, be more cost-effective for the Government, reduce wastage and abuse. Th e Government would thus be saving on costs and would be in a better position to widen the National Formulary with more recent and advanced medications (Borg, 2009). At the moment, this is not possible due to financial constraints. The POYC Scheme affected the daily running of the community pharmacies. Due to the increased work load, some pharmacy owners had to employ further staff. The owners had to purchase a computer and a printer for labels to be issued with every dispensed prescription. They also had to apply for internet service at the pharmacy. Also, some pharmacies had to make the necessary arrangements to increase shelving space to accommodate the weekly delivery of medicines from the POYC Department. Some pharmacies even needed to install another air-conditioning unit. Admittedly, the Government subsidized these expenses to a maximum capital expenditure of à ¢Ã¢â‚¬Å¡Ã‚ ¬6,990 (Lm 3,000). After the Memorandum of Understanding was signed, negotiations were held and the amount was capped at à ¢Ã¢â‚¬Å¡Ã‚ ¬9,000. According to an article on the The Malta Business Weekly that was published in November 2009, only the pharmacists who own the pharmacy are happy with this new system. The employed pharmacists have had their work load doubled, if not trebled. Hence, they do not give their patients the service that they used to give before the implementation of the Scheme (Attard, 2009). 1.6.3 The Memorandum of Understanding The very first document on the POYC Scheme was submitted to the Government by the Malta Chamber of Pharmacis