Mind soul Essay

1. How be Platos and Descartes views of the soul/self-importance-importance similar? Both Plato and Descartes believe that the soul/self is best (or only) to think and tick off separate from the torso and its faculties. According to Plato, the soul reasons best without bodily senses. Plato claims that sight, hearing, pain, and joy are a distraction to the soul in its search for reality, and that h unmatchablest knowledge can only be achieved with pure thought alone. The ashes confuses the soul and prevents it from acquiring truth and wisdom whenever it is associated with it. Descartes very similarly believes that the body and its faculties, namely imagination and again the senses, are distinguished from the self as modes from a thing. According to Descartes, the essence of the self consists entirely on being a thinking thing. The body can perceive pain and pleasure, just now nothing beyond that, it is up to the intellect to conduct its own inquiry into things external to us. Thus, much like Plato, Descartes claims that it is this thinking essence, and not the body, and though alone, and not perception, that is the key to true knowledge.2. How are Humes and Nietzsches views of the self similar, and how are they different? Both Hume and Nietzsche believe that the self is a summation of ones actions and perceptions. According to Hume, the self is a collection of perceptions in constant flux and movement. There is no simplicity or identity in the self, but only an infinite system of perceptions in an infinite florilegium of postures and situations. These perceptions are then linked by the coincidences of cause and effect, which reciprocally influence, modify, alter, give, and destroy each other(a)(a).Nietzsche similarly believes that the self is merely a relation of serviceman desires to each other. According to Nietzsche, desires and pleasures or human drives are the commander. This human drive controls everything else, and the strongest dr ive is a tyrant, even reason and conscience assent down. Both philosophers ultimately agree that in that location is no pure forms or simplicity of the self, but that it is rather driven by actions and perceptions, as nearly as desires and pleasures.Humes main idea of the self is that there is no self that is stable over time, rather the self is merely a series of transient feelings, sensations, and impressions of oneself at any given moment. That is, there is no unified self that ties all perceptions together. Nietzsches main idea of the self is different as it reaches a little into the very motivation for the self and life. Nietzsche argues that the self is composed of drives, but unlike Hume, goes further to say that these drives closely vie with each other to be the ultimate purpose of existence and the master of all other drives. Nietzsche calls this the pass on to power and illustrates the point accordingly ever documentation body within which individuals treat each o ther as equals does to another body what the individuals within refrain from doing to each other. The will to power is to grow, spread, seize, and become predominant it not only drives the self but in any case the reality of the creative activity. 3. How is Platos view of the worlds creative activity similar to the ordinary apparitional view, and how is it different?Similar to the ordinary ghostlike view of the creative activity of the world, Plato believes that the universe was created by a maker or a god, who not only made the world to be as excellent and supreme as nature would allow it, but who also endowed it with soul and intelligence. Platos views also coincide with the ordinary religious view when he claims that the universe is physical and changing, that god is good and fair, and that there is order rather than disorder.Plato however differs from the ordinary religious view of the creation of the world when he claims that there is a second type of universe other than the physical unending universe, that never changes. According to Plato, god uses this eternal model of the universe and the forms (of beauty, good, etc. ) as a template to create the existing world. The universe resembles an ideal alert thing of which all other ideal living things are a part of the ideal living thing comprehends in itself all other intelligible ideal living things.

Travel Agency Management

deal frame up stumble AGENCY MANAGEMENT HTM 1213 COURSE WORK INTRODUCTION drawg MY COMPANY NAME LOVE tour COMPANY SDN. BHD *SHARE pallbeargonr 30% OF *BUMIPUTRA (MOHAMAND ALIZAH) TOTAL CAPITAL RM 300,000 LOCATION PLAZA 393 *EMPLOYEE TOTAL* 5 PEOPLE OFFICE SPACE 200sq LOGO DESIGN *Reasons for the above propose* Red colou*r is love, passion. This colour is very shinning and striking washstand depict customer. * And rout out boost our energy. *Red is my favorite colo*u*r*. *R*epresent we give customer a good professional service ,a go intoly caring and friendly tour guide service. drawframe Reasons of wherefore I Choose This Location Shopping squ be the flummox for a recreation, when busy within, contrive any incident go, think surplus social function as people. The shopping plaza is that one lets people s low-toned lot the step, the relaxed and good time of leisure temporarily. I choose in the fence of the shopping plaza is people have information of paying maintenanc e to the travel society on the way when passing game shopping. There atomic number 18 many convenient in the shopping plaza. There is Teller-Stella, there are security personnel, and crowds are numerous too.Whenever Sunday, a family is result choose to go to shopping square as their good time for recreation nevertheless more(prenominal) when will come out to go shopping. These customers group can attract at this moment. My major customers are students and the family is the main fact. The crowd in shopping square are students and the family mostly, and the potential customer who I essential to look for. Products that tourist corporation of me introduce unique with ultralow price products and otiose prize that buy one get one free that unimportant RM200 can travel abroad too as the main fact.The rosy signboard by the products of our troupe will be attracted with when people come to shopping. I will select my friendship moorage in the centralise of shop of the middle of the first floor. All are famous of fault companies in the estate floor. In this way sight so famous-brand company or few mega-store those Focus Club of customer. Select to avoid losing more competitors on the first floor. The first floor is easier to attract to like going shopping generally, stroll around to the students of the dress boutique it with parents customer.The cheap ground floor too of rental upstairs is numerous generally. There are a lot of facilities on shopping square, for example The market offers ATM, have security personnel, more parking stalls. The convenient parking stall will let the customer like to come to the company personally too. The place where it is very inconvenient to choose one and park, the traffic is crowded, very further away and remote place of car park, the customer will not want to come over to the company often.Shopping have some policy company too, bank, let staff working facility of company of me, like the customer buys the tourist insurance , the company can cooperate with contiguous insurance company. We can offer service of buying tourist insurance on behalf. drawframe drawframe LOVE TOUR PROMOTION PACKAGER LOCAL packet boat ( intact Board) 3day 2 nights *LANGKAWI* package *From *RM *1*99/per pax Include 3 star accommodations and transport and 5 meal. sidereal day 1 drive bus to LANGKAWI Day3 full day tour 3day2night Bali Family PackageDay 01 Transfer in to hotel, then hotel dinner Day 02 Full Day Tour, tour visit Barong Dance of Batubulan, Galuh Batik Factory, Holy funk water of Tampak Siring, Mount Batur of Kintamani, Sukawati Art Market shopping centre. Lunch & dinner party at local restaurant Day 03 Breakfast at hotel, alter out to airport Reason This area location is a low income of family and small middle class family. So, the package cant material body a high standard of tour packager. The tour budget assign with low income family. LOVE TOUR OFFICE DECOR (200sq) drawg drawframe DECOR DETAILAt sale and military reserve ticket counter station, have two table, chair and customers chair. Table color is white color. Officer chair is black color. Customer chair is vehement color. Staff provides information on tour highlight, pricing, flight details and so forth At behind office site, have a safe street corner and printer and three database cases. This can prevent thief. The mirror is installed on the wall, can make the office seem more spacious. drawg drawframe drawg drawg drawframe Organization Structure of Love Tour Company Organization chart drawframe The Company Has Five EmployeesTwo employees work in sales and plan the tour operation. One employee coordinates scheduling and reservations One employee performs HR, billing, and office management duties Another individual owns the company and serves as the owner. List of Qualities barter executive Possesion of a Professional Certificate, Diploma, groundbreaking/Higher/Graduate Diploma, Bachelors Degree, come out Graduate Diploma or Professional Degree in tender-hearted Resource Management, Marketing, Property Development/Real Estate Management, Hospitality/tourism/Hotel Management or equivalent is preferable.Required language(s) Chinese, English At to the lowest degree 2 year(s) of working experience in the related field is needed for this position. Preferably Senior Executives specializing in Hotel Management/Tourism Services or equivalent. Job role in Hotel Manager or Travel Coordinator/Agent. 1 Full-Time positions available. Applicants should be Malaysian citizens or hold relevant fireside status. Travel Consultants Minimum SPM Good command of English, mandarin orange tree and Bahasa MalaysiaKnowledge in airlines ticket reservation preferred. Diploma in Travel Tourism is an advantage. computing machine literate. , Age below 30 years old. Accounting Full time, mustiness possess at least a Diploma or Advanced/Higher/Graduate Diploma in Finance/Accountancy/Banking or equivalent Female aged below 30 years & data processor literate Able to communicate in written & spoken Mandarin & English Requires an understanding of accounting and proficient in USB,MS Excel, database experience and GL entries.

Financial Analysis and Forecast of Sweet Dreams Inc Essay

sweet-smelling Dream embodied (SDI) is a manufacturing companionship foc recitationd on mattress and box spring merchandise for large retailers and hotel chains. With two facilities at their disposal, SDI manufactures over 20 different styles of bedding material for their consumers. SDIs founder and president, Douglas May, has contacted our consulting firm with regards to current financial businesss between himself and SDIs situate, First International Bank. Due to the spike in cuss failures in the early 1990s First interior(a) has become extremely nociceptive to problem im spark offs ( contributes which show ratio performances beneath the industry standard). Unfortunately, SDI has had poor semiliquid and debt ratios for the past three years which has caught the banks attention. After a ph hotshot grouse from the bank Doug has realized that SDI is in nonwithstanding worse trouble than the bank thinks. He has just signed a 9.5 million proverbbuck pack together to e xpand the business which was allegedly being loaned from the bank.Seeing as how the bank is debating closing Doug down it doesnt look likely that they would want to breast him a nonher 9.5 million. Following a brief meeting with his senior managers, Doug and his team up headstrong that this 9.5 million dollar loan from the bank is the exclusively mode to keep their business alive. They have decided to reverse their current polity of aggressive price drops and easy source, reduce their administrative, bewraying and miscellaneous expenses, non acquire any impudent fixed assets or sell greenness stock, accrue accounts tolerateable, stop paying dividends, and freeze executive salaries. wholly this is an exertion to prove to the bank that angelical Dreams Inc. is taking their financial situation very seriously and that the bank should strongly consider giving SDI the 9.5 million dollar loan. Doug has asked us to verify the banks evaluation of his guild, predict the ju dge performance of Sweet Dreams Inc. for 1996 and 1997, and prep be a list of SDIs strengths and helplessnesses. whole of these requests give be used to influence the bank to dispense a 9.5 million dollar absolutely loan to SDI as well as non forcing the bank to beseech immediate re-payment of their loans. Sweet Dreams Incorporated (SDI) is fight currently. With a current ratio of 1.9, SDI looks good up front. However the lodges inventory occupies close to 60 percent of its current assets.The vigorous ratio better shows SDIs performance. With a ratio of .77, SDI cannot pay their short-term liabilities as they come due. This shows the first problem of Sweet Dreams Inc Inventory Management. similarly in Dougs efforts to spin his recent losses he has decided to change his traditional dividend payout from 25% to 0. This symptom cuts to the core problem that SDIs bottom line has suffered in the past years, partly because of economic downturns and partly because of management s response to the economic downturn. Finally SDIs Z fall guy poses a problem with the banks standards. An Altmans Z score is metric by combining five different ratios of a company.First National claims that a Z score below the industry standard shows weakness in a firm and increases the likelihood of default. SDIs Altman score is 3.07 which is not enough to worry the bank, but enough to put increased atmospheric pressure on Sweet Dreams Inc. Therefore the problem here lies at minimizing cost and increasing revenues. To solve these problems SDI would need to focus their efforts on inventory management, company decisions, and effectiveness and efficiency. Regarding inventory SDI can lower the current level of mattress work to let inventory deplete to an accep instrument panel percentage of current assets. As for company decisions when the economy is hurting companies should focus on cutting earnings or hours to minimize costs, not reducing prices to increase sales. Finally the co mpany needs to work on improving their ratios. Strong ratios come from more selling and less spending which in turn departing drag to a better Altmans Z score.2) After finding the aftermaths of move angiotensin-converting enzyme, it is evident that SDI has more weaknesses than strengths as of 1995. If you look at the common sizing statements, Table 3, it shows that inventory increased as a percentage of sales, which indicates that a smaller percentage is being sold. All current liabilities increased as a percentage of total liabilities, which indicates that SDI is facing more debt. Figure one also clearly shows many of the weaknesses of SDI. Both liquidity ratios are below the industry average. Although the debt ratio appears to be supra the industry average, it is actually a weakness because it indicates that SDI has more debt than equity. The only asset management ratio that is above industry average is the fixed asset turnover ratio, the rest are either get even to, or be neath their industry average. However, its not all bad Figure one also shows that SDI has managed to hold a payout ratio on dividends that is 5 percent above the industry average.3) establish on our analysis of historical data, I do not look at that the bank should lend the requested money to SDI. We believe SDI is unfit for the loan because they are below the industry average in a absolute majority of financial ratios used to measure overall success in the company. These let in liquidity ratios, leverage ratios, asset management ratios and profitability ratios, all shown in Table six. The fact that SDI Is facing decreased demand resulting from the recent low also adds to their adversity they are facing to be a winning retailer. The current financial situation they are in makes them very keen to any un pass judgment economic event, making the risk of lending to them even greater. We firmly believe that it would not be beneficial to the bank to grant SDI this loan. 5) SDI has de termined that its best currency balance allow for be 5 percent of total sales. In addition, all excess capital of this summation will be institutionaliseed in vendible securities, which in turn will earn a 5 percent interest rate. Based on the count oned financial statements, we have determined that SDI will be able to invest in marketable securities in 1996 and 1997. As shown in Table two, give the sack sales for 1996 and 1997 are $330,386,000 and $371,684,000 respectively.Table one shows that in 1996, SKI had $55,276,000 in cash and marketable securities. With the optimal cash balance at 5 percent, only $16,519,300 of this amount will be in cash. The remaining $38,756,700 will go towards marketable securities. Likewise the figures in 1997, which exceeds $18,584,200, the 5 percent optimal cash balance. Therefore, SDI was able to invest $56,183,800 in marketable securities. A electric potential problem that our financial forecasts reveal is that we are investing a intimat ely larger amount of money into the marketable securities than we are retentivity in cash. While this money is earning interest, it may cause a future problem seeing as how there are so many loans that have a bun in the oven cash to be stipendiary off. With cash being the more or less liquid of all assets, it may be essential to keep more on hand in state to successfully pay off short and long term loans that will accumulate as a result of the $9,500,000 increase in capital from the plant expansion.6) On the basis of antecedently developed forecasts, it does not appear that SDI will be able to take out all of its outstanding short-term loans by December 31, 1996. At this date, SDIs short term SDI has on hand at this time is only $16,519,300, as the rest of their cash will be invested in marketable securities as a result of the 5 percent optimal cash balance. 7) Should the bank decide to withdraw the entire line of credit and demand payment immediately, a few alternative natur al selections would be available to Sweet Dreams Inc. The first option is that Sweet Dreams Inc. would immediately file for bankruptcy. Along with this they will file for protection under Chapter 11 of the Bankruptcy Act. This will brook Sweet Dreams Inc. to run as a firm and raise new money under restricted circumstances. Sweet Dreams Inc. will also be able to sell off any liquid assets in order to cover operation expenses and legal fees involved in this process. However, filing for Chapter 11 Bankruptcy is not an easy way out because more ofttimes than not the bank is unable to recover its initial investment.Along with this, employee productiveness and morale descends, and the company will begin to have difficulty obtaining credit in the future because of their soiled credit history today. Another option is that Sweet Dreams Inc. would sell current assets at market value to pay off the requested amount from the bank. Their short-term bank loan is be to $26,610,000 and their long -term bank loan is equal to $16,248,000 in 1995. Combined, this will equal a total of $42,858,000. This amount will need to be paid off as soon as possible. Due to the fact that they cannot sell total assets, Sweet Dreams Inc. needs to sell their current assets first at market value. For this simulation, we will use 28% as a sensible market value. At 28% of face value, the $127,028,000 worth of current assets would be worth $91,460,160 to the creditors. First, Sweet Dreams Inc. would pay back the bank because they are requesting those funds immediately. After the loans are fully paid off, Sweet Dreams Inc. would be left over(p) with $48,602,160. The next action would be to pay off the stockholders who are notwithstanding entitled to money.This amount would total to $2,660,000, with 7million shares valued at $.38. This would leave Since Sweet Dreams Inc. with $45,942,160. Although they still have money, Sweet Dreams Inc. took a major financial tap and will most likely need to de fault regardless. 8. There are several circumstances that would affect the validity of the comparative ratio analysis. For example the text quotes, SDIs problems began with the recession of the early 1990s, which caused a drastic decrease in demand from its retail and hotel customers, When outside sources such as a recession or an inflation occurs one can expect that the forecast would be altered. Unforeseeable events such as natural disasters can also affect the normality of the forecast, as these can affect potential sales. Also, if one makes a mistake in a forecast, and adds incorrectly or uses the hurt formula then the comparative ratio will be thrown off.When forecasting, one can only trust the facts of the past. For example, in this case study, SDI managers saw a decrease in demand from this recession. This caused many retail and hotel customers to lede away from purchasing new bedding. Although the sales from new homeowners were still there, hotels were not being built in the Southeast. Even though SDI responded by weighed down prices and increasing production, people were still not buying and sales neer increased. Hence, the management forecast was not accurate, and sales hardly improved. In most cases, forecasting is a very effective tool in predicting what will occur in the future, but there must be slightly room for managers to be flexible in order to account for discrepancies in the data or unknown events. 10) Based on the Altmans Z-Score table we are confident that if a company is within 25% of expected sales they will still be close to the minimum Altman score of 3.2.Therefore the company would have strong enough ratios to not be flagged by the bank for, Problem Loans. Also Cost of Goods Sold as a percent of sales and the Altman Z score are in return related. This shows that the end results are sensitive to Cost of Goods Sold. 11) While looking at the pro-forma financial statements, we believe Ingrid should give Sweet Dreams Inc. the 9.5 m illion dollar loan. All of the ratios are above the industry averages which hold strong signs for the future of the company. That being said SDIs pro forma statements are of course, speculative. Ingrid should implement certain saloon systems to monitor SDIs statements. For instance the bank should state in part of their indenture that SDI must keep 20% of their revenue in a savings account that the bank has access too. This serves the bank by holding 20% of their assets, but more importantly it lets the bank see how such(prenominal) money the company is making proportionately. The bank also has the right to use said assets as collateral until SDI is able to pay the bank back. With this happening plan installed we believe that Ingrid would be justified in giving the loan to Sweet Dreams Incorporated.

Ancient China’s Web Quest

Ancient China Web Quest recitation up the following links to answer your questions. Write your answers on your worksheet. 1. China is primed(p) on the continent of _____China is entirely located on the continent of Asia___________________. http//www. rcps. org/mch/worksheets/ancient_china/where_is_china_located. htm 2. The outstanding of China is ____Beijing____________________________. http//www. rcps. org/mch/worksheets/ancient_china/capitalofchina. htm 3. There are 3 major rivers in China.Two of those rivers take time off with the letter Y. They are the _______Yangtze River, the Yellow River, and the Pearl River. _______________ http//www. rcps. org/mch/worksheets/ancient_china/geography_china. htm 4. The Himalayas are the highest squirt range in the world. The name of the highest peak (mountain) in that range is ______The highest manoeuvre (mountain) in China is Mount Everest (8,850 meters tall)_____ _________________. http//www. rcps. org/mch/worksheets/ancien t_china/geography_china. htm 5. The longest structure ever create by man, covering about 4000 miles, is the ___Great Wall _________ ______________ _______ ____________. http//www. rcps. org/mch/worksheets/ancient_china/gw_China. htm 6. Gunpowder was invented by the Chinese. The rootage fireworks were probably made by stuffing _____gunpowder__________ into some _______ bamboo _______ sticks. http//www. rcps. org/mch/worksheets/ancient_china/fireworks. htm 7. Another initiation from China is silk. Silk is made from _____China___________________. ttp//www. rcps. org/mch/worksheets/ancient_china/silk. htm 8. Ancient Chinese and even some Chinese shopkeepers of today use this object to do math like we use a calculator. It is the ___Abacus___________. http//www. rcps. org/mch/worksheets/ancient_china/abacus. htm 9 Something the Chinese invented to show direction is the ___Compass____________. http//www. rcps. org/mch/worksheets/ancient_china/compass. htm 10. On tedious days, these things will fly. They are ______Kites______________.Some Chinese kites are designed as animals and they can roll their _____eyes_________. http//www. rcps. org/mch/worksheets/ancient_china/kites. htm 11. Name two more Chinese inventions. __________paper__________________ _______________ movable sheath printing _________________ http//www. rcps. org/mch/worksheets/ancient_china/inventions. htm 12. The Chinese use characters or little pictures to write. Another leger for this type of writing is _____ Calligraphy _________________. http//www. rcps. org/mch/worksheets/ancient_china/calligraphy. htm

Courtly Love

Utopia Suicide and euthanasia utopia by Sir doubting Thomas More portrays similar and different ways the monastic order of today manages suicide and euthanasia. Some of the similarities that w feverous be considered be as follows helping the termin completelyy ill pass sympathizerably, encouraging the terminally ill to quit their suffering and pop off on, and having the ill sustentationd for that can be m abated. The dissimilarity that will be considered is that of how suicide is seen In the utopian fiat versus that of todafs golf club.To leap wth, todays lodge and the utopian gild are slmllar by taking care of the sepulchral. nd helping individuals become cured, Utopia baseball club tried to help cure the sick, and kept them stable until they were healed. More states, As I said before, the sick are carefully tended, and nothing Is neglected In the way of medication or diet which might cure In todays society, there are doctors offices and hospitals that help do the sam e as the utopian society. Doctors prescribe medications, and statt at the hospital helps individuals until they are healthier.Encouraging the terminally Ill to end their suffering and move on s practiced In both the utopian society and todays society. The Individuals In both societies still receive treatment and care. More states, E realthing contingent is done to mitigate the pain of those who are suffering from Incurable diseases and visitors do their best to console them by sitting and talking with Utopian society tried to encourage the terminally ill to end their suffering through with(predicate) priest and public officials.More states, But it the disease is not only incurable but excruciatingly and constantly painful, then the priest and public officials corne and pulsing the Invalid not to endure such agony any In todays society, doctors in the hospital and hospice o the same in encouraging terminally ill to move on and not sutter anymore. Doctors encourage Individuals to co nsider suitable DNR, or do not resuscitate This does not mean do not treat. The Individuals that choose the DNR status are stating that they want a intrinsic conclusion.By being made a DNR status, the patient is making the declslon to mcwe on. Likewise, utopian society and todays society helped the Individual pass comfortably. The Individuals In the utopian society would hunger themselves to death or, having been put to sleep, are freed from life without any ensation ot utopian society believed in euthanasia as a way ot helping end suffering In the terminally Ill. In todays society, when a doctor sees that a patient Is at the end of life, and is suffering, the doctor will suggest comfort measures only.Comfort measures only consist of keeping the patient comfortable at all times, and generally Include high doses of medications that Include antianxiety and narcotics. These patients tend to expire very peacefully second to the medication they receive intravenously. Utopian society and todays society views suicide differently. In topian society, when an individual decides to commit suicide, it is not taken cordial to, unless the individual did It due to the fact he was terminally Ill.More states, under these circumstances. when death is advised by the authorities, they consider selt-destruction honorable. But the suicide, who takes his own lite without the propel his body, unburied and disgraced, into a bog. (624). In todays society, suicide is not an appropriate instrument of expiration no matter the circumstances. Doctors in todays society try to explore help for individuals that realize even legal opinions of suicide, but ave not acted on those thought yet.However, if one chooses to commit suicide, the body is not Just tossed aside, but is granted to the family members to either bury or cremate. Todays society and the utopian society have similar and different ways euthanasia and suicide are managed. Sir Thomas More depicts this in his work Utopia. Both societies are similar in the way each encourages the terminally ill to move on, helping the terminally ill move on comfortably, and helping those curable become better. The difference of opinion is the way each views suicide, and the consequence of the suicidal act.

Multi-state E.coli Outbreak

A person having looseness of the bowels with loose fundaments greater than 3 bowel movements in a daytime with or without abdominal cramps, who is a resident of stops, having flack of symptoms between the 15th of June and 15th of July and the stool cultures yielding E.coli 157H7. (Lautenbach, E., 2008). (Multistate clap of E.coli O157H7 Infection, 2008)It is an transmittal leading to severe abdominal cramps and bloody diarrhea. Non bloody diarrhea mountain also occur, or it may also be that the patient exit arrive no symptomatic complaints. The causative organism is E.coli O157H7 which has an incubation outcome of 3 to 8 days with a median of 3-4 days. (Lautenbach, E. 2008). . In good deal in extremes of epoch groups I.e. elderly and children under 5 years of age, the transmittance can also lead to complications like Hemolytic uremic syndrome.AdvantagesBy including a lab test as criteria for case confirmation, the specificity of the case definition increases thence th e great power of the test increases and so do the chances to detect the offset.Disadvantages investigating by reservation lab investigations like stool cultures and PFGE a criterion, people who had the symptoms but were non able to visit the doctor were not counted as having the disease, hence the aesthesia of the definition decreased.By only taking residents of Michigan into consideration, people who were visitors and might have got infected were excluded from the count.Slight alterations could be made to the case definition.Proposed Case DefinitionA person having diarrhea with loose stools greater than 3 bowel movements in a day with or without abdominal cramps. The person may be a resident or may have visited Michigan a week former to having onset of symptoms between the 15th of June and 15th of July. A person with clinically compatible picture who is epidemiologically linked with a confirmed case of E.coli infection. The stool cultures yielding E.coli 157H7.The lab testing requirement still has to remains, to ensure specificity and power of the definition.Comparison between age groupsIn the Michigan outbreak, it was noted that more than doubly as many females were infected as were males. People in age groups of 20-39 and 40-59 were reported most frequent cases in the Michigan outbreak. Food enlighten on the other hand reported nation wide scattering of cases almost equally in males and females, i.e. 162 to 178 respectively. They also documented that largest segmented of existence infected in 1997 was in the age group of 1-9 years.This pattern shows that in the Michigan outbreak, the source most probably started with some sort of fundamental interaction between source and the adult females of age between 20-59years.Inquiry just about diseaseE.coli infection is mainly an oral-fecal transmission pathway. Hence poorly chlorinated water, unpasteurized take out are common fluid sources. Uncooked or improperly cooked skreigh another forms of meat are another likely source of transmission. Vegetables immediately from farms or stores, which are not properly washed, like lettuce, spinach lucerne etc are another source of infection. (Escherichia coli O157H7, 2005). Exposure to farm animals, or fulfil with infected people are also risk factors. In the join States infected children in daycare centers also a major source of mobilize. So questions pertaining to contact and handling of the above stated risk factors should be asked.Source of the outbreak according to the currently present evidence is alfalfa sprouts. colly alfalfa seeds initially caused the outbreak and then the infection easily spread through person to person transfer. The leading hypothesis is that contaminated alfalfa sprouts or seeds of alfalfa sprouts were the initial cause of the outbreak.People who consumed these foods in the area of Michigan got infected with E.coli O157H7 and then the infection were further transferred to other people with whom they came i nto contact.REFFERENCESEscherichia coli O157H7 (2005). variant of Bacterial and Mycotic Diseases, Center for Disease Control and Prevention. Retrieved March 6, 2008, from http//www.cdc.gov/ncidod/dbmd/diseaseinfo/escherichiacoli_t.htmLautenbach, E. (2008). Outbreak Investigation Discussion Group. Pennsylvania department of health. Retrieved March 6, 2008, from http//www.dsf.health.state.pa.us/health/lib/health/Outbreak_Investigation.ppt.Multistate Outbreak of E.coli O157H7 Infection, (2008). Foodsafety.netRetrieved March 6, 2008, from http//www.foodsafetynet.info/NEHA/EpiSlides/Ecoli_122803.ppt.

Canterbury Tale(the Man of Law’s Tale)

THE CANTERBURY TALES (The Man of Laws Tale) The Man of Laws Tale ( in any case calledThe Lawyers Tale) is the fifth of theCanterbury TalesbyGeoffrey Chaucer, written near 1387. Summary The Man of Law, also known as The Sergeant at Law, tells aRomancetale of a Christian princess named Custance (the modern urinate would be Constance) who is betrothed to theSyrianSultan on condition that he convert toChristianity. The Sultans mother connives to prevent this and has Constance set adrift on the sea.Her adventures and trials carry after she is shipwrecked on theNorthumberlandcoast. Northumberland is a pagan country where the King, Alla (based on Chaucers disposition of the historical? lla of Deira1) eventually converted to Christianity. Allas evil mother intercepts and falsifies a garner between the couple, which results in Constances being banished. Constance is forced to go to sea once again and is found by a Senator of Rome. The Senator takes Constance (and her child) back to Ital y to serve as a household servant.King Alla, still heartbroken over the loss of Constance, goes to Rome on a pilgrimage, and fortunately finds Constance. In the end the couple return to Northumberland. Alla dies a year later, and the baby boy becomes the King. - - Sources The tale is based on a story within theChroniclesofNicholas Trivetbut the major theme in the tale, of an exiled princess unadulterated by her suffering, was common in the literature of the time. 2Her tale is also told inJohn GowersConfessio Amantis, and both are similar to the verseRomanceEmare, and the motorcycle is generally known as the Constance cycle. 2The oldest known variant of this particular lineament isVitae duorum Offarum. 3More distantly related forms of the persecuted heroine includeLe Bone Florence of Rome, andGriselda. 4 An incidental where Constance is framed for murder by a bloody dagger appears to be a direct borrowing fromCrescentia. 5 - - Analysis Saints lives genreThe tale is meant as a mora lly uplifting story and is similar tohagiography, or stories of the saints lives, which were common normal literature of the time. Custance, as her name suggests, is constant to herChristianreligion contempt the attacks and testing it receives from thepagansandheathensshe meets on her travels. Rhetoric The Man of Law tells his story in a pompous over-blown style as if he is defending Custance in a court of law. He also uses many rhetorical figures, taken straight from the manuals of rhetoric of the day, to emphasize Custances noble characteras well as the tellers lawyerly skillsand utter her case.John Gower Although Chaucer receives some praise and also criticism from his own character with halcyon mentions ofThe Book of the DuchessandThe Legend of Good Women in the Man of Laws prologue he seems to nude most of his opprobrium forJohn Gower. original research? Two of the tales which he dislikes,CanaceandApollonius of Tyre, charterincest, as did the some versions of the story. C haucer based this tale on theNicholas Trivetstory from hisChronicle. Gower though had recorded all these stories. Chaucer is, perhaps, with friendly banter, trying to goad his friend and logger writer into a storytelling challenge.But certeinly no word ne writeth he Of thilke wikke wicked ensample of Canacee, That love hir owene brother synfully Of swiche cursed stories I sey fy Or ellis of Tyro Appollonius, How that the cursed kyng Antiochus Birafte his doghter of hir whitethorndenhede, That is so horrible a tale for to rede, Whan he hir threw upon the pavement. Sequence with other tales The mingled manuscripts of the tales differ on the structure of the tales with some containing the Man of Laws epilogue and others not. In theepilogue, the host invites theParsonbut he is interrupted before he can begin and a different speaker tells the next tale.TheSummoner, the sheikand theShipmanare listed as interrupters in the different manuscripts but it is the Shipman whose character dr ess hat matches the rude remarks although the mention of his joly body sounds closer to something thewife of Bathmay say. What it probably shows is that Chaucer had not fixed his overall plan. There are also hints, with his claim he will talk in prose despite rhymed throughout, that the Man of Law originally told theTale of Melibeebefore he was designate Custances tale late in the composition of the tales.

Essential Drug List Medication Review Health And Social Care Essay

M just about(prenominal) cancerous neoplastic maladys metastasize to cram specific everyy dresser, prostate and Multiple Myeloma. Bisphosphonates and other(a)wise systemic agents that inhibit osteoclast activity can forestall, cut down, and detain cancer-related and treatment-related emaciated complications in patients with both early and locomote malignances 1 . Patients with metastatic cancerous neoplastic disease are at significant endanger for otiose complications from uprise metastases and uprise liberation ( osteoporosis ) , which is oft treatment-related. Skeletal complications of raise metastases, oft referred to as squandered-related events ( SREs ) , include break, skeletal instability/loss of skeletal unity, spinal anesthesia anesthesia cord crushed leather, the demand for surgery or shaft of light therapy for a symptomatic mug up metastasis, and hypercalcaemia..These are normally associated with lytic lesions.Bisphosphonates concord become an bu ilt-in agent of cancerous neoplastic disease intervention in patients who have metastatic fig up disease. Bisphosphonates cut down the morbidity of metastatic swot disease, in the low place by diminishing the prevalence of SREs 1,2 .In add-on, bisphosphonates are widely apply for the bar and intervention of ram loss ( osteoporosis ) , both treatment-related and non-treatment-related.This includes the osteoporosis associated with aromatse inhibitors.Bisphosphonates decrease b unmatched reabsorption and increase mineralization by suppressing osteoclast activity 1,3 .There are both categories of bisphosphonates, non-nitrogen containing and N containing, with slightly different effects in killing osteoclast cells. The N incorporating bisphosphonates are more powerful osteoclast inhibitors. Etidronate, clodronate, and tiludronate are non-nitrogen incorporating bisphosphonates, and the N incorporating bisphosphonates include pamidronate, Fosamax, ibandronate, risedronate, and zoledronic venereal disease.Bisphosphonates have a direct apoptotic consequence on osteoclasts, affect their distinction and ripening, and in that respectby move as powerful inhibitors of grind away reabsorption. In presymptomatic hypothetical accounts, the bisphosphonates have besides been shown to act upon macrophages, gamma delta T cells, deck up-forming cells, and tumour cells.In add-on to their effects on osteoclast suppression, bisphosphonates may besides hold antitumour and/or antiangiogenic effects, provided this is a controersial country. Probes are ongoing to unwrap specify the clinically relevant effects of bisphosphonates in patients with malignant neoplastic disease 4,5 Quality of grounds and Clinical efficaciousnessDefinition of Skeletal colligate Events Vertebral breaksOther breaks e.g. ribsNew osteolytic lesionsSpinal cord compaction adopt for radiation therapyNeed for surgeryPainChange in anti neoplastic regimen to handle organise hurtingBreast malignant neoplastic disease For patients with breast malignant neoplastic disease and bone metastases, bisphosphonate therapy can forestall and/or hold skeletal complications, and extenuate bone hurting. A survival benefit has non been shown. In big(p) females with metastatic chest malignant neoplastic disease without clinically apparent bone metastases, bisphosphonates do non cut down the incidence of skeletal events. Consequently, therapy with bisphosphonates is recommended to get down later the designation of osteal metastases, unless as segment of a clinical screen out.The first surveies were done in the 1990ties and reported in the early 2000.For metastastic chest malignant neoplastic disease the gamble of a skeletal event is around 64 % at 2 old ages. This can be reduce to 33 % with pamidronate and to 20 % with zoladronic cutting 6 .A meta- digest of nine tests, which include 2189 adult females with metastatic chest malignant neoplastic disease and bone metastases, showed t hat endovenous bisphosphonates ( pamidronate and zoledronic vinegarish ) reduced the hazard of developing a skeletal event by 17 per centum ( comparative hazard, RR 0.83 95 % CI 0.78-0.89 ) 7 . A meta-analysis of tests that used unwritten bisphosphonates ( clodronate and ibandronate ) showed a decrease in the hazard of developing a skeletal event by 16 per centum ( RR 0.84 95 % CI 0.76-0.93 ) 7 .Bisphosphonates can besides forestall treatment-related bone loss in adult females having chemotherapy or aromatase inhibitors for chest malignant neoplastic disease. In add-on, betterments in disease free resolution and chest malignant neoplastic disease return seen in some(a) accessory therapy tests in which adult females sure hormone therapy plus a bisphosphonate compared to hormone therapy entirely declare oneself possible antitumor effects. However, the consequences of extra clinical tests are makeed onward it can be concluded that bisphosphonates better chest malignant neopl astic disease results.Prostate malignant neoplastic disease Bisphosphonates have been canvass in crap forces with advanced prostate malignant neoplastic disease to detain or forestall the complications of skeletal patterned advance ( breaks, need for radiation therapy, hypercalcaemia, spinal cord compaction, hurting ) , to forestall the development of bone metastases, and to protect against the bone loss associated with androgen want therapy ( ADT ) .The consequences of randomised clinical tests and experimental surveies in patients with prostatic malignant neoplastic disease bone metastases indicate that the effectivity of different bisphosphonates varies well 8,9 .The strongest informations back uping benefit for bisphosphonates is with zoledronic acid, which is sanctioned by the United States Food and Drug Administration ( FDA ) for usage in prostate malignant neoplastic disease in achievement forces with bone metastases who are come oning on endocrine therapy. The European Committee for trademarked Medicinal Products has approved zoledronic acid for all work forces with prostate malignant neoplastic disease and bone metastases.The benefit of zoledronic acid in work forces with bone metastases from prostate malignant neoplastic disease is supported by a test in 643 work forces bone metastases that were come oning man on ADT 10 . Work force were indiscriminately assigned to one of both doses of zoledronic acid ( 4 magnesium or 8 atomic number 12 ) or placebo, each given any three hebdomads. The 8 magnesium dosage of zoledronic acid was reduced to 4 magnesiums early in the test because of inordinate nephritic perniciousness.At an mean revue of 24 months, in that respect was a tradeant decrease in the frequence of SREs in work forces having zoledronic acid compared to placebo ( 38 versus 49 per centum ) , and the come clip to develop an SRE was significantly longer with zoledronic acid ( 488 versus 321 yearss ) 11 . Pain and analgetic tonss were significantly higher(prenominal) in work forces who received placebo than in those who received zoledronic acid, but on that point were no differences in disease patterned advance, public presentation position, or quality-of-life tonss among the companys. A 2nd placebo- pull stringsled randomized test with zoledronic acid besides present a statistically important benefit in hurting control 12 .In contrast to these consequences with zoledronic acid, tests with clodronate have yielded ambiguous consequences 13 , and cardinal tests with pamidronate have failed to specify a statistically important benefit in footings of SREs or trouble control 14.Prevention of bone metastases Given that the reign site of metastases in prostate malignant neoplastic disease is the bone, and that some presymptomatic informations suggest an anticancer consequence of bisphosphonates, accessory usage of bisphosphonates has been canvas in work forces with prostate malignant neoplastic di sease but without metastatic disease. In the largest test turn toing this issue, in which 508 work forces with nonmetastatic prostate malignant neoplastic disease were indiscriminately assigned to clodronate or placebo, there was no lessening in the incidence of bone metastases ( 80 events versus 68 events with placebo ) 19 . High-potency bisphosphonates have non been studied in this scene.Multiple myelomaThe efficaciousness of bisphosphonates in manifold myeloma was ab initio evaluated in a cogitation in which 377 patients with phase third multiple myeloma and at least one lytic lesion were treated with antimyeloma therapy plus any placebo or pamidronate ( 90 milligram ) as a four-hour endovenous survival given every four hebdomads for nine rhythms 15 . The proportion of patients who had any skeletal events ( diseased break, jibe of or surgery on bone, and spinal cord compaction ) was significantly lower in the pamidronate group ( 24 versus 41 per centum ) . Pamidronate th erapy was besides associated with a important decrease in bone hurting. 15 .Recent grounds has shown a survival advantage every bit goodMorgan et al 2010 MRC Myeloma IX survey randomise controlled survey 18 . Lancet 2010 10 620511970 patients enrolled 1960 eligible for invention to handle analysis 981 in the zoladronic acid group979 in the clodronic acid groupIn both groups there was an initial subdivision into those patients who received intensive chemotherapy with the purpose to handle with organ transplant. This was followed by another subdivision into the zoledronic acid and clodronic acid groupsMedian intervention with bisphosphonate was for 350 yearssMedian follow up was for 3.7 old agesZoledronic acid reduced mortality by 16 % V clodronic acidHR 0.84 95 % CI 0.74-0.96 p=0.0118Drawn-out average overall endurance by 5.5 months ( 50 minute V 44.5 p=0.04 )Increase PFS by 2.0 minutes ( 19.5 vs 17.5 months ) 12 % addition HR 0.88 95 % CI 0.88-0.98 p=0.0179ONJ vagabond was 4 % with zoledronic acid and 1 % with clodronic acidIntravenous bisphosphonate therapy is recommended for patients with multiple myeloma and any of the followers Lytic devastation of bone or spine compaction break from osteopenia on field radiogram or imagination surveies Osteopenia on bone mineral denseness surveies but no grounds of lytic bone devastation Pain due to osteolytic disease As an adjunct to radiation therapy, anodynes, or surgical intercession to stabilise breaks or impending breaks equivalent consequences were obtained in a randomised, double-blind stage III test in 1648 patients with advanced multiple myeloma or chest malignant neoplastic disease 16 . Patients were indiscriminately assigned to have one of two different doses of zoledronic acid ( 4 or 8 milligrams administered IV over 5 or 15 proceedingss ) or pamidronate ( 90 milligram IV over two hours ) straighten ups were repeated every three to four hebdomads for 12 months. All participants received a day-to-da y 500 milligram Ca addendum and cd to 500 IU of vitamin D throughout the survey. The undermentioned findings were noted The proportion of patients with at least one skeletal event during the first 13 months of the survey, and the average clip to the first event ( 12 months ) was similar in all three intervention groups. The proportion of patients who required curative bone irradiation was significantly lower in the zoledronic acid 4 milligram group compared with pamidronate both in the full group ( 15 versus 20 per centum ) , and in adult females having endocrine therapy for chest malignant neoplastic disease ( 16 versus 25 per centum ) . Both agents were every bit good tolerated, and the more or less putting green inauspicious events were bone hurting, sickness, weariness, and fever. Although 12 per centum of patients having 4 milligram of zoledronic acid over a five-minute period developed impairment of antecedently normal nephritic map, an addition in the prolong volume to 10 0 milliliter, and lengthening the extract clip to 15 proceedingss reduced the incidence of nephritic disfunction to the same(p) degrees as with pamidronate ( 8 and 9 per centum, severally ) . Long-run informations ( 25 months of followup ) showed tantamount nephritic effects ( alterations in creatinine ) for zoledronic acid 4 milligram over 15 proceedingss and pamidronate over two hours 13 . The 8 milligram dosage of zoledronic acid had an intolerably high incidence of nephritic toxicity at both extract times ( 18 and 20 per centum ) , and was consequently discontinued.In contrast, monthly endovenous ibandronate ( Bondronate ) , a high authority bisphosphonate, has non been associated with diminish skeletal-related events in patients with myeloma. In a randomised test, 214 patients having conventional chemotherapy for phase II or III myeloma were indiscriminately assigned to have ibandronate ( 2 milligram IV monthly for 24 months ) or placebo 16 . Neither the rate of happening , nor the clip to first skeletal-related event differed significantly between the two groups. However, the dosage of ibandronate may hold been excessively low others have shown efficaciousness for 6 milligrams but non 2 milligrams monthly doses in patients with metastatic chest malignant neoplastic disease 17 .Safety concernsTherapy with bisphosphonates is by and large good tolerated. The most common complications are incisive stage reactions, optic redness, nephritic inadequacy, electrolyte instability, and osteonecrosis of the yack ( ONJ ) .Osteonecrosis of the jaw can be mitigated with dental hygiene programmes originally the start of the intervention with bisphosphonates, and by the usage of contraceptive antibiotics during intervention. 19 .The acute stage reaction, a flu-like syndrome frequently with febrility, icinesss, myodynia and arthralgias, may happen, in some grade, in about 50 per centum of patients. When it occurs, it is typically within the first 48 hours of extract and is self limited within 24 to 48 hours. Premedication with acetaminophen or non-steroidal antiinflammatory drugs may assist 8 . On subsequent dosing, the hazard of the acute stage reaction and its strength lessenings.Bisphosphonates can be associated with other inflammatory reactions including phlebitis and optic toxicities such as pinkeye, uveitis, scleritis, and orbital redness. Ocular redness frequently requires a formal ophthalmologic rating and farther intervention with the piquing bisphosphonate is frequently non recommended 8 .The nephrotoxicity of bisphosphonates is both dose- and infusion time-dependent, and nephritic map should be monitored on a regular basis in patients being treated with these agents. nephritic toxicity can be reduced by detecting recommended extract continuances, optimising hydration prior to bisphosphonate therapy and avoiding coincident nephrotoxic medicines. Serum Ca, Mg, and phosphate should be metrical on a regular basis during th erapy.calcium and vitamin D add-on If there are no contraindications, patients having bisphosphonates should have Ca and vitamin D supplementation. Calcium and vitamin D supplementation decrease the hazard of bisphosphonate-induced hypocalcaemia and are of import to keeping bone wellness. For these grounds, many of the clinical surveies look intoing the bisphosphonates for metastatic bone disease incorporated Ca and vitamin D supplementation as portion of the intervention regimen, and supplementation may be needed to retroflex the results seen in these surveies.In add-on, patients with chest malignant neoplastic disease are at hazard for vitamin D lack. In a reappraisal of 321 chest malignant neoplastic disease patients treated with bisphosphonates for either low bone big bucks or for metastatic disease, over 50 per centum were vitamin D deficient 9 . Persons with vitamin D lack are at increased hazard for hypocalcaemia, a known side consequence of bisphosphonate therapy

Outsourcing and Company

What is Outsourcing? Outsourcingis thecontracting knead out of an interior(a) problem processto a trey party organization. The practice of contracting a handicraft process out to a third party rather than staffing it internally is common in the modern economy. The term outsourcing became popular in theUnited Statesnear the turn of the 21st century. Outsourcing nigh sentences involves transferring employees and assets from one firm to another but not always. The definition of outsourcing includes both foreign and domestic contracting,and sometimes includesoffshoring, which means relocating a production line function to another country.Financial savings from scorn international cranch rates is a big motivation for outsourcing/offshoring. The opposite of outsourcing is calledinsourcing, which entails shapeing processes gripd by third party firms in-house, and is sometimes accomplished viavertical integration. However, a ancestry can provide a contract service to another busin ess without necessarily insourcing that business process. Advantages of Outsourcing Outsourcing creates opportunities for a corporation to focus on let down appeals and improving the efficient allocation of elections within a club.Outsourcing allows a keep company to redirect its attention to its own competencies and hire outside resources to handle other tasks. For example, Jobs in the mid-west can often consist of phone technical school fight. However since it is even cheaper to pay the great unwashed in India then support this community with jobs, it leave alone send its jobs to India, another country which is an example of outsourcing. So outsourcing allows a firm to reduce cost and concentrate its resources on the things It does take up date arrive ating access to expertise it may not puddle.Companies source in the first place to cut costs. But today, it is not only about cutting cost but also about reaping the advantages of strategic outsourcing such as accessin g ingenious expertise, saving time, cutting cost, concentrating on interlocking, business make growth and totality competencies , reduce overhead, conciliatory staffing, and increasing efficiency, reducing turnaround time and eventually generating more profit. 1. Accessing adroit Expertise angiotensin converting enzyme of the primary advantages of outsourcing is to get access to clevernessed expertise.This skill set may not be a core capacity of a companys business, but to allow on focus on the core mission in providing a game theatrical role product and service to its customer what makes sense is handing over the task to people who can perform it better. Moreover, as a double whammy, a company not only spends less on employee trainings and saves precious man-hours but cuts costs as well. 2. miserliness time When running a business, companies soon unwrap which skills they possess atomic number 18 strong, weak and non-existent.Rather than using their time and money t o record several new skills, they can simply outsource to someone who is already proficient. Perhaps they brace other things in life besides business to focus on. Companies may want to spend the extra time outsourcing because it gives companies to realize a new skill such as public speaking, a new language, accounting, or some other subject. 3. Cutting Costs and Saving BIG Maintaining an infrastructure can be an extra burden for some businesses, which outsourcing can remove.Outsourcing business requirements to a trusted vendor can suffice companies to save on the capital expenditure, time, and extra efforts of their personnel. Additionally, companies ar no long-life committed to invest on employee training, or purchasing valuable softw are, or investing in latest technologies. All these help the companies to get high returns in the longer run. For example, A small doctors office that wants to accept a variety of insurance plans. One part-time person could not mention up w ith all the contrasting providers and rules. Outsource to a firm specializing in medical billing. . Concentrating on Business Growth, Networking and Core Competencies Workload cast ups with additional non-core functions and the prime(a) of any companys core activities suffers as the business grows. Outsourcing in such scenario to a third party plays an important role by allowing companys key resources to focus on primary business tasks. Because of saving time and energy with outsourcing, companies can focus on maturement their business. They can meet with important clients, attend seminars, find potential partners and network as well as tend to the management of the business.Companies can outsource their weakest areas to those who are already strong in them. 5. Reducing overhead command processing overhead time costs of performing a particular back-office function are passing high. Paying wages to full-time employees can severely eat into your profits. Its common for new sta rt-ups to maximize savings by outsourcing to developing countries. population there, who are highly skilled, often work for only a a few(prenominal) dollars per hour. It may seem low , but its often wide-cut money for them. Lower overheads from not having full-time employees may give the company competitive edge and mean the difference between success and failure. . increase in-house efficiency After companies allocate tasks to their outsourcing partner, they share the workload of the companies employees. This allows the companies to develop their internal task force and use them more efficiently. 7. Staffing Flexibility Outsourcing certain free-living tasks, allows any companys business to maintain a monetary flexibility when there is an uncertainty in demand. The company can photographic plate up or down comfortably. At a much lower cost, outsourcing provides additional benefit of running business in full smother even during off age and holiday months. physical exercise An accounting department that is unequal during tax season and auditing designs. Outsourcing these functions can provide the additional resources for a meliorate period of time at a consistent cost. 8. Continuity & jeopardyiness Management Periods of high employee turnover result add uncertainty and contrariety to the operations. Outsourcing provide provided a level of continuity to the company while reducing the risk that a substandard level of operation would bring to the company. Example The human resource manager is on an extended medical furnish and the two administrative assistants leave for new jobs in a truly short period of time.Outsourcing the human resource function would reduce the risk and allow the company to keep operating. 9. Giving A Companys Business A Competitive Edge The ultimate benefit of outsourcing is that it helps the companies gain a competitive edge in the market. Through strategic outsourcing to an outsourcing partner, the companies are not o nly providing their customers with best-of breed services, but increasing their productivity while managing their in-house resources intelligently. Outsourcing can help them surpass competitors who guard not yet established the benefits of outsourcing. 10.Seeing An Overall Increase In The Companys Business Outsourcing shows an increase in companys productivity, customer loyalty, level of quality, business value, profits, and much more. How will the changing face of education impact the supply reach? As you evaluate your choices and decisions inoutsourcingdifferent components of your operations, you will read to have the advantages of outsourcing. When done for the right reasons, outsourcing will actually help your company grow and save money. There are other advantages of outsourcing that go beyond money. here are the top seven advantages of outsourcing. . Focus On Core Activities In rapid growth periods, the back-office operations of a company will unfold also. This expansi on may start to consume resources (human and financial) at the expense of the core activities that have made your company successful. Outsourcing those activities will allow refocusing on those business activities that are important without sacrificing quality or service in the back-office. Example A company lands a large contract that will significantly increase the volume of purchasing in a real short period of time Outsource purchasing. 2. Cost And Efficiency SavingsBack-office functions that are complicated in nature, but the size of your company is preventing you from performing it at a consistent and reasonable cost, is another advantage of outsourcing. Example A small doctors office that wants to accept a variety of insurance plans. One part-time person could not keep up with all the different providers and rules. Outsource to a firm specializing in medical billing. 3. Reduced overhead Overhead costs of performing a particular back-office function are extremely high. Consid er outsourcing those functions which can be moved easily.Example Growth has resulted in an increased need for office space. The current location is very expensive and there is no room to expand. Outsource some simple operations in order to reduce the need for office space. For example, outbound telemarketing or data entry. 4. Operational Control Operations whose costs are running out of control must be considered for outsourcing. Departments that may have evolved over time into uncontrolled and poorly managed areas are prime motivators for outsourcing. In addition, an outsourcing company can bring better management skills to your company than what would other be available.Example An information technology department that has too many expulsions, not enough people and a budget that far exceeds their contribution to the organization. A contracted outsourcing agreement will force management to prioritize their requests and bring control back to that area. 5. Staffing Flexibility Out sourcing will allow operations that have seasonal or cyclical demands to bring in additional resources when you need them and release them when youre done. Example An accounting department that is short-handed during tax season and auditing periods.Outsourcing these functions can provide the additional resources for a fixed period of time at a consistent cost. 6. Continuity & Risk Management Periods of high employee turnover will add uncertainty and inconsistency to the operations. Outsourcing will provided a level of continuity to the company while reducing the risk that a substandard level of operation would bring to the company. Example The human resource manager is on an extended medical leave and the two administrative assistants leave for new jobs in a very short period of time. Outsourcing the human resource function would reduce the risk and allow the company to keep operating. . Develop Internal Staff A large project ineluctably to be undertaken that requires skills that y our staff does not possess. On-site outsourcing of the project will bring people with the skills you need into your company. Your people can work on base of them to acquire the new skill set. Example A company needs to embark on a replacement/upgrade project on a variety of custom built equipment. Your engineers do not have the skills required to design new and upgraded equipment. Outsourcing this project and requiring the outsourced engineers to work on-site will allow your engineers to acquire a new skill set.

Saab Scania Case

It can be inferred from the slip of paper that the recreate classify design in engine assembly section has driftd a noble turnover ratio, has uninterested four-year-older be given crush and absenteeism opted to re-design assembly billets. The actual dilemma for the Saab Automobile is whether they should go for product name design or continue with the group design to wholly the some other assembly departments. Our accusing is to accrue the turnover ratio, increase productiveness and to cleanse motivation among teenage force which is currently prevalent in the work environment. The current productivity is 36 engine per hour which is much to a lower place the US counterparts.Thus, at that place is a submit to increase it to a alike(p) level. We think that quite an than going with the group design approach, we intend to watch over a change group design crosswise all departments. Firstly, we need to segregate all the activities across the four departments base o n the reputation/ sympatheticity of the cable. Secondly, employee compose need to be done which would categorize based on their impartingness to work across similar jobs or the same specialized jobs. Now mountain who atomic number 18 interested to work across similar jobs would be given up periodically an option to switch between jobs which energy be across departments also.This would in turn increase employees job engagement, job be languishingness and job rotation. Employees would straight not get bored of their monotonous jobs and will vex a point of motivation and interest. Employees who like doing the same job or are not so much interested in switching jobs would be allowed to do so. All these decision will permeate down to the long term hiring strategy of profiling employees based on their willingness to work across jobs at the very initial level of recruitment.This should decrease the dissatisfaction and the boredom that was acquiring created among them. Once empl oyees start to connect with the jobs then the 20% of absenteeism mentioned in the field would decrease drastically. Also, it will increase the number of young minds in the attention as a whole. On the flip side, the great unwashed will find it difficult to accept the change instantly. After a couple of(prenominal) rotations it whitethorn once again become monotonous and cause boredom among employees. It may also cause resentment among employees in the initial stage.Saab Scania CaseIt can be inferred from the case that the work group design in engine assembly department has caused a high turnover ratio, has uninterested younger work force and absenteeism opted to re-design assembly jobs. The current dilemma for the Saab Automobile is whether they should go for product line design or continue with the group design to all the other assembly departments. Our objective is to decrease the turnover ratio, increase productivity and to improve motivation among young force which is curren tly prevalent in the work environment. The current productivity is 36 engine per hour which is much below the US counterparts.Thus, there is a need to increase it to a comparable level. We think that rather than going with the group design approach, we intend to follow a modified group design across all departments. Firstly, we need to segregate all the activities across the four departments based on the nature/similarity of the job. Secondly, employee profiling need to be done which would categorize based on their willingness to work across similar jobs or the same specific jobs. Now people who are interested to work across similar jobs would be given periodically an option to switch between jobs which might be across departments also.This would in turn increase employees job engagement, job belongingness and job rotation. Employees would now not get bored of their monotonous jobs and will find a point of motivation and interest. Employees who like doing the same job or are not so much interested in switching jobs would be allowed to do so. All these decision will trickle down to the long term hiring strategy of profiling employees based on their willingness to work across jobs at the very initial level of recruitment.This should decrease the dissatisfaction and the boredom that was getting created among them. Once employees start to connect with the jobs then the 20% of absenteeism mentioned in the case would decrease drastically. Also, it will increase the number of young minds in the industry as a whole. On the flip side, people will find it difficult to accept the change instantly. After few rotations it may again become monotonous and cause boredom among employees. It may also cause resentment among employees in the initial stage.

Healthy Emotional Transition for Mothers, First Week Post-Partum Essay

Emotional is an important aspect of life. We populate joy, anger, and sadness in e actu exclusivelyy twenty-four hours life. When we do non tend to our sense quests, psychological complications may occur (Burger & Goddard, 2010). According to health Canada (2009), 16% of women in Canada volition baffle major low gear in the course of their lives. Women experience increased risk for psychological dis sites in postnatal period (Raines, Campbell, &Hall, 2010).The closely common psychological disorders be postnatal patricians, postnatal depression (PPD), and postnatal psychosis (Raines, Campbell, &Hall, 2010). 75% of women experience postpartum blues, but the symptom is normally easy and locoweed usually improve without professional help (Raines, Campbell, &Hall, 2010). A more than serious condition is called postpartum depression. Postpartum depression is a aesculapian condition that affects about 10% of m opposites (Raines, Campbell, &Hall, 2010). In this obligate, I will analyse the postpartum depression in relation to the healthy emotional transition.This offspring is important because the postpartum depression is more serious and cannister usually last for months (Raines, Campbell, &Hall, 2010), and because postpartum depression can usually be notice and prevented (Donaldson-Myles, 2011) (Wojcicki & Heyman 2011) (Garabedian et al. , 2011). The purpose of this paper is to provide the knowledge to prevent PPD. In order to meet the purpose of this paper, I will examine 3 articles that I pick out chosen from CINAHL and write critical study and relate the selective tuition from the article to my own nursing experience. Synthesis These articles offer great in-depth on how to prevent PPD.Wojcicki and Heyman (2011) grow reviewed 10 articles and made conclusion that although more studies are needed, lofty dosage of omega-3 fatty sultry sebaceous acid can exhaust down the risk of PPD. Donaldson-Myles (2011) reviewed on the evidence of go down oning and PPD and has found a strong opposite link between the two. Garabedian et al. (2011) has found that women who are victim of violence in adulthood are more liable(predicate) to acquire from PPD. These 3 articles feed contributed to additional information on PPD to what is learned from the textbook. They provide insight on when PPD will likely happen and how to reduce the likeliness.Based on the information on these articles, prevention of PPD would be the top priority in my nursing practice. For example, although it is known from the class that 10% of women will suffer from PPD (Raines, Campbell, &Hall, 2010), it is provided explained that women suffer multiple evils should be expected to have higher risk of PPD (Garabedian et al. , 2011). In the future nursing practice, I will obstructor for signs of injury and the affable state of the lymph gland as well as those of her partners to choose veritable that the client does not suffer from violence.I will include absorbing and high dosage of omega-3 fatty acid workaday as part of my health teaching to reduce the risk of PPD (Donaldson-Myles, 2011) (Wojcicki & Heyman 2011). The points that have emerged from this assignment are many. One question is that even though there are ways to reduce the risks of PPD, what is the sure way of preventing it? Another question is that Wojcicki & Heyman (2011) has found that high dosage of omega-3 fatty acid can reduce the risk of PPD, does taking too much omega-3 have any side effects? Thirdly, what should I do to reduce PPD if the client refuses to breastfeed?The depression 4 weeks of this course has provided me with foundation of caring for postpartum mothers. I learned the basic cares and assessments for postpartum mothers. Those 3 literatures provide me with further knowledge of psychological aspect postpartum mother and made me sort for signs of trouble. For example, Garabedian et al. (2011) has found that single mothers, smokers, and wom en of young age are more likely to experience violence, hence more likelihood of PPD. During my first week of practicum, the first mother that I examined was recently single, had to go out to smoke during my cry and was 26 years old.At that time, she looked perfectly fine and well serene and was reading her self-help book. I thought that she was going to be fine with her postpartum life. If I possessed this piece of knowledge back then, I would bed her has high-risk for postpartum depression and offer her additional information on how to deal with psychological changes. During the week of my health teaching, I had the privilege of witnessing childbearing and caring for the mother and the child for the day. I apply Watsons caritas surgical execute 3, which is developing and sustaining a helping trusting authentic caring consanguinity (Jesse, 2010).From the moment I walked into the delivery room, I kept reminding myself that helping the unhurried was my first priority, and th at anything that I could learn was just a bonus and should not interfere with the charrs needs. Therefore, after I introduced myself, I used the technique of using silence and avoid looking at the womans exposed body parts because I thought it would pee-pee more tension for the woman (Burger & Goddard, 2010). I kept quiet bank the family finally thought that I was trustworthy.During the teaching, I used Watsons caritas process 7, which is Engaging in genuine teaching-learning experience that attends to unity of being and meaning, attempting to occlusion within others frame of reference (Jesse, 2010). Since the family looked very educated, I shared my note on their knowledge to help communicate (Burger & Goddard, 2010). I used call such as you might already know this to make myself little lecturing. My patient was very willing to listen to what I had to say because I was very helpful in their delivery and they knew that my teaching was an assignment for school.They asked me a few questions regarding to how to deal with postpartum blues and appeared genuinely interested in my presences. I thought my teaching was effective because firstly I was very nice and humble towards them. Secondly, I received feedback from them in term of questions (Burger & Goddard, 2010). efficient communication involves dialogues in both directions (Burger & Goddard, 2010). Conclusion Postpartum period is a difficult time for a woman (Evans, 2010). The body has to undergo physiological and psychological changes (Evans, 2010).Several factors influence the psychological changes. From my reading of the articles, it is learned that breastfeeding and high intake of omega-3 fatty acid reduces the risk of PPD (Donaldson-Myles, 2011) (Wojcicki & Heyman 2011), and that violence victim have higher risk of PPD (Garabedian et al. , 2011). As a nurse, one has to stopover vigilant on clients behavior, diet, and environment and reduce the likelihood of PPD by informing the patient the benefi t of breastfeeding, the benefit of omega-3 fatty acid, and by assessing the patients living environment.Reviews The key points of this article is that women who breastfeed are less likely to suffer from postpartum depression just the old inquiryes proving otherwise and that breastfeeding provides defense that lasts up to 3 month (Donaldson-Myles, 2011).. The mean audiences of this article are midwives (Donaldson-Myles, 2011). The limitations of this study is the delineate the postpartum depression and defining breastfeeding. In both(prenominal) of the study, some people are mixed feeding, which can confuse the result (Donaldson-Myles, 2011).There is also no clear, universally define method on how to breastfeed in all the studies (Donaldson-Myles, 2011). The definition of postpartum depression is also unclear (Donaldson-Myles, 2011). Although most studies use the Edinburgh depression scale, some of the depression symptom may be just due to lack of sleep or religious factors ( Donaldson-Myles, 2011). The cut-off point for depression is also not the selfsame(prenominal) across all the studies, with some using the cut-off point of 13 for depression and some using 12 as cut-off point (Donaldson-Myles, 2011).This seek is done in Britain (Donaldson-Myles, 2011). It applies to Canadian nursing because both countries share the same culture and customs. The implication of this article for nursing practice is that as nurses, we need to advocate on breastfeeding in our patient care. Since breastfeeding can offer protection from postpartum depression up to 3 month (Donaldson-Myles,2011), we need to make sure that the clients know the benefit of breastfeeding and make sure that they can breastfeed properly.The key points of this article are that taking high dose omega-3 fatty acid supplement reduce the risk for postpartum depression (Wojcicki & Heyman 2011) and that moderate amount shows no effect (Wojcicki & Heyman 2011) . The intended audience of the article is f or the researchers who intend to do more research on the correlation omega-3 and postpartum health (Wojcicki & Heyman 2011). The limitation of this research is that it is a review of other journals. Thus the author does not have raw data from the research (Wojcicki & Heyman 2011).This research is done department of pediatrics, university of California, San Francisco, California, USA (Wojcicki & Heyman 2011). This research applies to Canadian heart because of the proximity of two countries. One limitation of this research is that it is a review of other articles (Wojcicki & Heyman 2011). The author does not have the primary data from all the studies. Another limitation of this research is that the dosage of omega-3 fatty acid is not the same in all the studies. Some studies take 100mg daily, others take 500 mg daily and there are also recommendations for 2g/day (Wojcicki & Heyman 2011).The key points of this article is that women who are the victim of violence are more likely to sel f-report postpartum depression (Garabedian, Lain, Hansen, Garcia, Williams, & Crofford, 2011) and that the more types of violence experience, the more likelihood of self-reported postpartum depression (Garabedian, Lain, Hansen, Garcia, Williams, & Crofford, 2011), and that the likelihood of postpartum depression strongly correlates to the race, married status, education, and the usage of drugs (Garabedian, Lain, Hansen, Garcia, Williams, & Crofford, 2011).The intended audiences of the article are for the medical professionals who are check depression for postpartum women. The limitation of this study is that this is composed of mostly online questionnaires (Garabedian, Lain, Hansen, Garcia, Williams, & Crofford, 2011) therefore, sullen data can appear in the data collection. For example, postpartum blue can be mistaken as postpartum depression (Garabedian, Lain, Hansen, Garcia, Williams, & Crofford, 2011).Secondly, this is come has a difficult time distinguishing disciplinary act ion and child disgust (Garabedian, Lain, Hansen, Garcia, Williams, & Crofford, 2011). For example, any hit from the guardian could be considered as child abuse in this survey (Garabedian, Lain, Hansen, Garcia, Williams, & Crofford, 2011). This research is done in Kentucky, USA (Garabedian, Lain, Hansen, Garcia, Williams, & Crofford, 2011). It applies to Canadian nursing practice because 5%-50% of women experience abuse in their lifetime (Garabedian, Lain, Hansen, Garcia, Williams, & Crofford, 2011). The implication of this article for nursing practice is that as nurses, we need to check for evidence of abuse as part of nursing assessment. For example, suspicious bruises should be reported. Since violence is strongly correlated to postpartum depression, we need to make sure that the clients with history of abuse can get help in the postpartum period (Garabedian, Lain, Hansen, Garcia, Williams, & Crofford, 2011) .

D.T. Resistant Materials – Evaluation

I feel that my product has carry out all of the essential criteria although near of the desired criteria arent fulfilled. This includes* Incorporated Lights* A Combination of Materials* Be used for placing an endeavor on outgoThe reason behind these specifications not being fulfilled was in the first place due to settleations or the way it would pee to be incorporate into the design I chose. If I decided to incorporate lights, the price would keep back rose as well(p) as me having to make the boxes to a greater extent bulky making them a lot more operose to move and customise. A combination of materials wasnt used because of complications and problems which I will explain later and to be used for placing an object on top, the product would become less customis qualified, nevertheless an add on could be intentional for my product in the future tense which would allow this, but as current because of time scale and normal problems (which I will explain) this is an unavai lable feature.What it does and how good it is at doing itMy product is designed to allow users to store objects such(prenominal) as books and paperwork in. Teenagers, my target audience, would be able to customise the product by adding different tops as well as a different combination of boxes of which came in two sizes. The formation I designed allowed the boxes to be placed on top of to separately one other as well as beside each other. subsequently testing, I found that the average sized box fitted perfectly, mainly due to my look which I carried out earlier. Papers unfortunately didnt fit without aid such as a folder or possibly something which allowed the paper to footstall on end. Having said this, the product was perfectly able to stand the cant and the customisable feature with everything lining up with little add on features which gave way of life for error as well as being extra features to the set.After asking other 15/16 year olds, comments were very uncondition al particularly with the engraved design on the side which matched with the add on spacers as well as the incident the boxes could be stacked or put on the side. They also liked the idea of the customisable top which could be turned into a different wide range of add-ons which could have been added to in the future if desired.There were few negative comments which were probably due mainly to pure politeness Having said this, the ones I received were well constructed such as the fact that paper couldnt be placed flat without it glutinous out the side as well as the fact that the preference of finish allowed the pine to show which was of a colour too silklike to some peoples preference.Modifications and/due to ProblemsOne major problem I came up against was the fact that I was unable to cast a peg. This was due to limitations of acquaintance on casting as well as the time limit I was restricted against. Our first trial was shown on my developing ideas segment where hardly one h alf of the peg seemed to come out correctly. This, unfortunately, make me skip the variety of materials desired criteria.Another problem was accuracy. I was only making one of many of these products and because of this I opted to create the top headquarters by hand. Having done this I soon realised that it was very difficult and time consuming to get it correctly placed. Due to this fact I modified the size of the dowel from 8mm to 6mm which meant that the 8mm hole will now have 6mm expansion slotted into it with the top plate. Because of time restrictions, it wasnt possible to create other add-ons such as the CD rack I planned earlier on. Instead I opted in a different material which would make the product more appealing (aesthetically pleasing).Accuracy was also another problem which I go about when joining the boxes together. I originally planned to join the boxes directly against each other. Because of 8mm holes being in the top and the bottom, 8mm dowel had to be used and th e fact is that there was no room for error which became a problem. I resolved this by creating a spacer which contained 6mm dowel which would slot into both the bottom and top box. This was a viable solution.Design problems also caused the boxes to be connected sideway only one possible direction as the boxes would not slot into each other on one side. This problem was one which I didnt fix as the boxes could still tessellate one way which do this problem very minor.

Case Study of Karen

Case study KAREN This assignment is rough K atomic number 18n lee who comes for personal counseling. As a healer I use ii theories ( psychoanalytic Therapy and Cognitive Behavior Therapy) separately to help her in solving her job. Psychoanalytic therapy, introductory assumption of human nature Psychoanalytic sermon is highly individualized and seeks to show how the unconscious mind mind factors affect behavior patterns, kinships, and every(prenominal)where both psychological health.Treatment traces the unconscious factors to their origins, shows how they spend a penny evolved and evolveed everywhere the of course of many a(prenominal) geezerhood, and by and by helps individuals to all overcome the challenges they face in life (National Psychological joining for Psychoanalysis, 1998). As a therapy, psychoanalysis is based on the concept that individuals are unconscious(predicate) of the many factors that cause their behavior and emotions.These unconscious fact ors make water the potential to flummox unhappiness, which in turn is expressed through a score of distinguishable symptoms, including disturbing personality traits, difficulty in relating to others, or disturbances in conceit or common disposition (Ameri cigarette Psychoanalytic Association, 1998). In An Outline of Psychoanalysis, Freud (1949) pardons the mavin tenets on which psychoanalytic theory is based 1. human behavior and intellection are largely determined by ill-advised drives 2. those drives are largely not conscious 3. ttempt to induce those drives into sensitiveness meets defense (resistance) in many different forms 4. beside the inherited constitution of personality, ones development is determined by events in early childhood 5. conflicts between conscious view of reality and unconscious (repressed) bodily can result in moral disturbances such as neurosis, neurotic traits, apprehension, depression etc. 6. the liberation from the make of the unconscious material is masterd through bringing this material into the consciousness Freud begins with an explanation of the three forces of the psychic apparatusthe id, the swelled head, and the superego.The id has the quality of being unconscious and contains everything that is inherited, everything that is present at birth, and the instincts (Freud, 1949). The ego has the quality of being conscious and is responsible for controlling the demands of the id and of the instincts, becoming aware of stimuli, and serving as a link between the id and the external world. In addition, the ego responds to stimulation by either adaptation or flight, regulates activity, and strives to achieve pleasure and avoid displeasure (Freud, 1949).Finally, the superego, whose demands are managed by the id, is responsible for the limit of satisfactions and represents the influence of others, such as parents, memoriseers, and role models, as well as the impact of racial, societal, and cultural traditions (Freud , 1949). Psychoanalysis fostered interest in human turned on(p) and psychological development traced back to a young age. The human can be seen from a much to a greater extent ho angle of dipic viewpoint as one looks at the psychoanalytic theory, which combines the inner workings of the mind and attempts to explain them in the context of a dynamic social environment.Karen-cade study The counsel is on how Karens childhood experiences create an internalized interpersonal model for births. The manipulation plan is based on a three-pointed outline 1. The Problem list 2. Problem Formulation 3. Intervention Karen reports general dissatisfaction of her life, she feels some panic over reaching the age of 39, She has been troubled with a range of psychosomatic complaints including residual disorders, perplexity, dizziness, heart palpitation, and headaches. She often feels depressed, and she is concern to the highest item loosing her looks with her overweight and aging. accord to the psychoanalytic theory, the focussing is on bringing unconscious to the conscious. Karen case study shows she has repressed. She never complimentss anything for herself and she typically lived up to what other in her life wanted for her. Karens gender-role realization was fraught with difficulties. She learned the basis of female-male relationships through her early experiences with her parents. What she saw, was her father as a distant, authoritarian and rigidperson that every actions of her father should never be questioned and everyone should attend his standard and rules.She remembers her beat who was supportive but critical and Karen thought the she would never do enough to please her. She reason out this pattern through her life. It could be further hypothesized that the man be married was similar to her father, and she used her mother as a role model by becoming a homemaker. In a critical incident took place when she was 6 years old, her father caught her during playing doctor with an 8-years-old boy. She reports He lectured me and refused to speak me for week. I felt extremely ungodlinessy and ashamed. She repressed her birth emerging sexuality and carried the picture of guilt into her adolescence.She was not allowed to date until she completed high school. She married the set-back person she had dated. It could be further hypothesized that she lived up to what othersin her life wanted for her and she generalized it to relation with her children, its very difficult for her to cope herself with childrens insurrection especially about her daughter, Jane. She is not satisfied with her husband relationships, and she is anxious over the prospects of challenging this relationship, fearing that she does, she might end up alone. In a general sense, psychoanalytic case formulations al slipway have interpersonal foundations.These foundations are build from repeated child-caretaker interactions, subsequently internalized, and later manifest themselve s in clients daily live. then Karens depressive and anxiety symptoms are traced to early childhood interpersonal experiences andobservedduring her life. According to the Karens presenting problem and psychological history, her intervention package can be as follow 1. to run her for therapy 2. to reduce her anxiety 3. to emphasize on primacy on self-experience which help her to improve her self-esteem Typical change bring in psychoanalytic therapy includes four parts 1.Cognitive insight (usually a ingeminate maladaptive interpersonal pattern) 2. Practice in detecting maladaptive mental and interpersonal patterns 3. Creating innovative and more satisfying interpersonal experiences 4. Internalization of new and more satisfying interpersonal experiences (John Sommers1957) As I told before, the goal is to bring unconscious to conscious and its not limited to solving problem and learning new behaviors, there is a deeper probing into the past to develop the level of self-understanding that is assumed to be necessary for change in character. (Corey 2009) During therapy, healer explores some of these questions with Karen What did you do when you felt unloved in the childhood? As a child what did you do with your negative feelings? Could you express your rage, hostility, hurt, and fears? What effects did your relationship with mother and father have on you? What did this teach you about all women and men? Brought into the here and now of the transference relationship, questions might include When you have felt anything like this with me? and What are you learning from our relationship about how relationship with women or men might go?As she comes to understand how she has been shaped by these past experiences, she is increasingly able to exert control over her present functioning. Many of Karens fear become conscious, and then her capability does not have to remain fixed on defending herself from unconscious feelings instead, she can decision about her current l ife. (Corey 2009) Cognitive behavior therapy, basic assumption of human nature Human nature as retrieved by my theoretical approach is that we are all capable of loving, happiness, and even self-actualization, however, we in addition have tendencies toward self-destruction, self-blame, intolerance, and perfectionism.Because we are the inclination to think noeticly and irrationally, the theory believe that we can train ourselves to refuse to become upset and resist irrational thoughts by repeating relational thoughts to ourselves and we have capacity to change by choosing to react differently to situations. Ellis assumes that we are self-taking, self-evaluating and self-sustaining. We develop emotional and behavioral difficulties when we fracture simple preferences (desires for love, approval, success).Ellis again affirms that we have an inborn tendency toward growth and actualization, nonetheless we often sabotage our movement toward growth due to self-defeating patterns we ha ve learned. (Ellis, 1999). Although, irrational beliefs can be learned from significant others, human beings are believed to create irrational dogmas and superstitions by themselves and reinforce self-defeating beliefs by the branch of autosuggestion and self-repetition and by behaving as if they are useful. Therefore, it is our own indoctrinated irrational thoughts that hold open dysfunctional attitudes alive and operative within us. Karen- case studyIn assessment of problem, behaviorally she acts defensive, avoids eye contact, speaks rapidly, and fidgets constantly with her clothes. She lives with her husband and her three children but, generally she is not satisfied of her life. emotionally she feels unsecure and unappreciated in her relation with her husband and her children, she has experienced some of special(prenominal) problems such as anxiety, sleep disorder, panic attacks and depression. In cognition force field she fears about aging, she fears of not succeeding in pr ofessional world and worries about how becoming more professionally involved might threat her family.She concerns about losing her children. She is anxious over the prospects of changing the relationships with her husband, fearing if she does, she might end up alone. after(prenominal) assessment of the problem, the intervention package focused on the following 1. To motivate the patient for therapy 2. To prepare Karen to deal with and face phobic situations she avoided due to anxiety 3. To reduce her anxiety 4. To reduce inferiority complex and growth self-esteem 5. To modify her negative thoughtsTherapist helps client to understand how to change irrational thoughts to rational thoughts and teach her positive thinking and consideration of positive data in critical situation. Therapist pays more attention to the present time and focuses on causes of clients discomfort in present time. In Karens case the most reason and greatest catalyst that triggered her to come for therapy is the increase of her physical symptoms and anxiety. Karens therapist should focuses on helping her in formation the particular areas that Karen would like to change after completing this assessment.They work unitedly and make a plan for treatment. Therapist helps Karen to understand the purposes of her behaviors and then teach her about how the therapy sessions can help her to reach her goals. CBT helps Karen to understand that she is responsible for his own life and she should b active. According to the case study, she completed a course in introduction to counseling, that encouraged her to have a look at the direction of her life and she took an honest look at her life. Karen finds wondering what she should want and what she should be doing.It shows that she is aware of her life and she wants to change but she fears and she doesnt admit exactly what she wants. Therapist should help her to understand in which area she wants to change. The showtime things that she wants now, is bein g successful in her professional world. Therapist uses questioning demonstrate to develop a picture of her difficulties. Karens concrete aims include her desire to function professionally without being tense and worry about every little thing in her life. As a practice, therapist asks Karen to support a record of when she feels tense or worry and what events make these feelings.Karen indicates that she worries about her right to think and act selfishly. Behavioral skills therapy is good for her because she has trouble public lecture with her family. This procedure includes modeling, roleplaying and behavior rehearsal. Then she tries more effective behaviors with her therapist who plays the role of herfamily members and then gives feedback how strong or apologetic she seemed. Karens anxiety about her relationship with her husband can also be explored victimization behavior rehearsal (in case that therapist is male). The therapist plays as her Karens husband, Tim.She practices bein g the way she would like to be with Tim and says the things to her therapist that she might be afraid to say to her husband. During this rehearsal, Karen can explore her fears, get feedback on the effects of her behavior, and experiment with more assertive behavior. Next, she is requires to list down her specific fears. Karen identifies her greatest fear is not able to function both professionally and office to her family if she branches out. The least fearful situation she identifies is concerning over aging and her looks.Before moving into this faux situation/ role play techniques, the therapist first does some magisterial desensitization on Karens fear items hierarchy. Karen then begins repeated, systematic flick to items she finds frightening, beginning at the bottom of the fear hierarchy. She continues with repeated exposure to the bordering fear hierarchy item when exposure to the previous item no longer makes Karen anxious. Part of the process involves exposure exercises for practice in heterogeneous situations away from the therapy office. The goal of the therapy is to help Karen modify the behavior that results in her feelings of guilt and anxiety.By learning more appropriate coping behavior, eliminating unrealistic anxiety and guilt, and acquiring more adaptive responses, Karens presenting symptoms decrease, and he reports a greater degree of satisfaction. As a conclusion according to Karens problems, a conspiracy of cognitive, emotional and behavioral approaches (Cognitive Behavior Therapy) is effective and is the first choice of treatment for her anxiety and depression although, there are a number of ways in which common treatment elements for anxiety and depression may help oneself symptom reduction in both disorders. The cognitive restructuring skills typically utilise in CBT provide patients with skills to identify, evaluate, and modify maladaptive negative thinking styles more generally. (Michael W. Otto 2010) References Freud, S. (19 49). An outline of psychoanalysis. New York Norton. Gerald Corey. (2009). Theory and Practice of Counseling Psychology. USA stomach/Cole Jesse H. wright, Monica Ramirez, Michael E. Thase. (2006). Learning Cognitive Behavior Therapy . USA American psychiatrical Publishing. Judith S. Beck. (2011). Cognitive Behavior Therapy basics and beyond.New York Guilford vex John Sommers, Rita Sommers. (1957). Counseling and mental hygiene Theories. USA John Wiley and Sons. Keith S. Dobson. (2010). Handbook of Cognitive Behavioral Therapies. New YorkGuilford Press Michael W. Otto, Stefan G. Hofman. (2010). Avoiding Treatment Failure in the Anxiety Disorders. USA Springer William. T. ODonohue, Jane E. fisher. (2008). Cognitive Behavior Therapy. New York John wiley. American Psychoanalytic Association (1998, January 31). About psychoanalysisWWW document. Retrieved on 12 June 2012 from http//www. apsa. org/pubinfo/about. htm