Foundations for physiotherapy practice The WritePass Journal

Foundations for physiotherapy practice Introduction Foundations for physiotherapy practice IntroductionConclusionReferencingRelated Introduction   This essay will explore the disease COPD and explain the systemic effects that the disease has on the body as a whole. Exercise is investigated in the essay and shows how it may change the quality of life of a patient and decrease certain symptoms of COPD; it will also explain the negative effects that inactivity may cause a patient with COPD. There is varies interventions used to make living with COPD more tolerable for patients. It talks about how exercise benefits the body by decreasing dyspnoea, how increasing the body’s muscle strength will relieve fatigue and decrease the respiratory demand. The affects of exercising on anxiety and depression are examined also. The physiotherapists role will be included detailing all the different techniques that they use for treatment including breathing control, airway clearance, inspiratory muscle training which helps with inspiratory endurance and strength and improving mobility. Finally the important of upper body and strength e xercises will be questioned as to how it helps with improving mobility and promoting rehabilitation. Chronic obstructive pulmonary disease (COPD) is an umbrella term used to describe somebody who suffers from both Chronic bronchitis (Bronchitis is inflammation of the bronchi (the airways of the lungs) and emphysema (Emphysema is damage to the smaller airways and air sacs (alveoli) of the lungs). COPD is the term most preferred but you may also hear it called COLD (chronic obstructive lung disease) or COAD (chronic obstructive airway disease). Pulmonary means affecting the lungs. COPD causes a chronic (ongoing) cough with phlegm, is rare before the age of 35 and there is permanent damage to the airways. The narrowed airways are fixed, and so symptoms are chronic (persistent). Treatment to open up the airways is limited as a result. (patient.co.uk, 2010) As before COPD or chronic obstructive pulmonary disease is two disorders in one emphysema and chronic bronchitis. Bronchitis affects the airways with inflammation narrowing the airway sometimes with phlegm. Chronic bronchitis is a mor e specific condition and it is defined by the amount of phlegm that a person has coughed up over a particular time frame. To be described as chronic bronchitis a person has to be coughing up phlegm every morning for at least 3 consecutive months within a period of at least two years. Chronic bronchitis is mostly caused by cigarette smoking it can also occur form environmental factors. Emphysema is the other disorder you must be diagnosed with to be diagnosed with COPD. Emphysema affects your alveoli which are the little sacs of air at the end of bronchiole in your lungs where gaseous exchange occurs. These are normally made from a very elastic tissue so that they can expand when air fills the lungs. In emphysema, large numbers of the alveoli have been destroyed and there is much less area where gaseous exchange can take place so although people can breathe in it cannot get into the bloodstream. (Miles and Roberts, 2005, PP.1-3) Another systemic effect of COPD is the effect on the musculoskeletal system because of the breathlessness which reduces your exercise capacity which has a knock on effect. When you don’t exercise it has adverse effects on your body muscle wastage and weakening means you may become breathless easier as you will have less muscle and/or strength to perform the same tasks and will require more effort and put more metabolic demand on your body compared to if you had stronger muscles. Muscle weakness whatever the cause has severe consequences, including exercise limitation, reduced quality of life, more of a demand for healthcare assistance and its resources and more severely reduced survival. Physical de-conditioning may lead to a marked decrease in a patient’s ability to cope with activities of daily living, finding even the simplest of tasks to be leaving them breathless, consequently leading to a decrease in quality of life and also decreased survival. It is apparent that systemic manifestations are typical in COPD. Granted, many patients demonstrate a gradual and significant weight loss that exacerbates the course and prognosis of disease. This weight loss is also accompanied by peripheral muscle dysfunction and weakness. (Decramer, M. Et al. 2005, PP. s3-s10) With COPD it is not just the physical effects that play a role in the disease there are neuropsychiatric disorders like depression and anxiety which are more common in people with COPD. Depression in people with COPD rises with an increase in hypoxemia, carbon dioxide levels or dyspnoea. Hypoxemia may be a substantial cause in the development of depression and anxiety in COPD due to brain injury; however oxygen therapy results in little or no improvement in the severity of the depression. Another cause of morbidity of depression and anxiety is negative self-perception and restrictions in behavioural functioning due to reduced physical capacity. (Armstrong 2010 PP. 132) Although the COPD patient population is proven to be more depressed than the general medical population, it is not more anxious, the levels of anxiety observed in the general medical or surgical population on the wards were very similar to those observed in the COPD population. Despite the similarities compared to the other wards the anxiety levels are still high compared to the population without any disease or disorder. (Light, R, W.et al. 1985, PP.35-38) COPD patients with psychiatric conditions spend twice as much time in hospital compared to those without depression and anxiety. It is also found that the quality of life of COPD patients can be impaired in all dimensions compared to those without depression and anxiety, high impact was seen both on walking around, mobility, sleep and rest. (MIKKELSEN, R, L. 2004, PP.65-70) Anxious patients tend to have quite significantly shorter pre-rehabilitation exercise capacity compared with non-anxious patients as do patients with increased depression compared with those who are not depressed. Patients following a pulmonary rehabilitation program for COPD show a statistically significant fall in both anxiety and depression as they progress in their program, with no patients showing any increases in either depression or anxiety. Patients with higher star ting anxiety level show a significantly larger increase their exercise capacity than those who start off with lower anxiety levels. Exercise rehabilitation is shown to produce clear improvements in anxiety and depression and to some extent reduces the number of patients with high anxiety and depression compared to no intervention. So exercise benefits COPD suffers with anxiety and depression at least as much as do those with lower levels. (Nicholas, Rudkin, and White, 1999, PP. 362-365) COPD has effects on the cardiovascular system by increasing the risk of cardiovascular disease by up to three-fold. Several different studies have shown that the function of endothelial in COPD is abnormal in both the pulmonary and systemic circulations. The means that underlie these abnormalities are also unclear. It is obvious that tobacco smoking is a shared risk factor for both COPD and cardiovascular disease. Although, it is possible that there are other factors which may quite substantially increase the cardiovascular risk of patients with COPD. With this in mind, many authors agree that the persistent, low-grade, systemic inflammation that occurs in COPD may contribute further to the pathobiology of these cardiovascular abnormalities in COPD. If true, this may have substantial therapeutic implications in the management of these patients because anti-inflammatory therapy would be beneficial not only for the chronic inflammatory process which their lungs are undergoing but also for the prevention of cardiovascular disease. (AgustÄ ±Ã‚ ´, 2005, 367-370.) It is shown that the leading causes of mortality in those with COPD are cardiovascular in nature. Cardiovascular causes are listed as the main cause of death in nearly 50% of the cases, Nevertheless, this data, suggest that a large proportion of patients with COPD die from cardiovascular complications.   (Sin and Man, 2005, p8-11) The impact on cardiovascular function in COPD is mainly due to the increased right ventricular afterload caused by an increase in pulmonary vascular resistance resulting from the structural changes that take place in the pulmonary circulation with the disease One of the most beneficial treatments for COPD and its symptoms is exercise; exercise is proven to have a beneficial effect on your body compared to not exercising. By exercising you significantly increase your muscle strength and endurance. This means muscle dystrophy and atrophy are stopped and even reversed. You see a significant increase in endurance when you walk also as a result of exercising regularly and it also promotes increased efficiency of peripheral muscle oxygen extraction after muscle training, with less contribution from anaerobic (lactic acid) metabolism during exercise. (Clark, Cochrane, and Mackay, 1996, PP. 2590-2596) Aerobic capacity (VO2max) or maximum oxygen uptake is decreased with patients presenting with COPD, due to this the body starts to utilise the anaerobic energy system, this means that for walking the same distance as a normal person you will be utilising the phosphate and the lactic acid system which use less oxygen therefore your muscles fatigue easier. Lactate or metabolic threshold (VO2u) is known as exercise intensity with a sustained increase in blood lactate that cannot be prevented. Lactate threshold may be elevated by as much as 100% of its resting value by successful aerobic training in a normal subject. A de-conditioned individual there for has the potential for a significantly greater improvement in VO2max and VO2u with exercise training. When effective, this modality of physical reconditioning leads to improved functional exercise capacity and reduced breathlessness. Early implementation is desirable to obtain more meaningful responses. (COOPER, 2001, PP. S671-s679) Upper extremity exercise is also important for people who suffer from COPD as they are restricted in the amount of upper body exertion they can achieve even as much as to elevate their arm may cause dyspnoea and increased respiratory demands. It is shown that during unsupported arm exercise the respiratory muscles of the rib cage work actively help to maintain the posture of the upper torso and extended arms; due to this they decrease their roll in respiration in COPD patients. Therefore dyspnoea is worse with arm exercise than it is with leg exercise at the same total body oxygen consumption, suggesting that the load borne by the other inspiratory muscles must increase for the same level of increasing ventilation. (Grazzini, 2005, PP. 1403-1412) The increased demands even during a simple arm elevation may play a role in the development of the patient’s dyspnoea.   The limitation that occurs is a major problem that patients report when performing daily living activities involving the arms. It is important to apply an intervention of exercise training to try help. An upper extremity training regime for patients with COPD results in a reduction of ventilation requirements which will allow patients with COPD to perf orm sustained upper extremity activity with considerably less dyspnoea. A comprehensive pulmonary rehab programme that includes arm exercises, results in reduced metabolic and ventilator requirements for a simple arm lift. The addition of such training has been shown to improve upper extremity exercise endurances. Subjects who are in the early stages or whom are less severe may tolerate these increased loads without difficulty, whereas in severely obstructed patients with minimal reserve, increased ventilatory exertion and the associated recruitment of the diaphragm may contribute to increased dyspnoea. Although has some beneficial effects in this and most other studies to date, ventilatory capacity does not improve in terms of pulmonary function tests nor does fev or fev1. Additionally there is no cross over benefit to arm exercises or lower body exercises so it is important to incorporate both into a pulmonary rehabilitation for a patient with COPD to seek maximum benefit from the program. (Couser, Martinez and Celli, 1993, PP. 37-41) With COPD muscle wastage is quite common and 25% of all patients suffer from it. Muscle weakness and wastage also has adverse effects on fatigue. Leg fatigue for example limits patients with COPD in exercise. Normally the perception for muscle fatigue is higher in people with weak leg muscles than to those who are said to have strong legs. Patients with stronger muscles are said to have better exercise capacity this is true for people without COPD. Quadriceps strength has been found to have a significant effect on exercise capacity. So it is said that â€Å"leg fatigue is inversely proportional to leg muscle strength†. (Bourbeau, Nault, and Borycki, 2002, PP.190-191) Strength training is also appealing because it improves muscle strength and mass much better compared to aerobic training. In addition strength training causes less dyspnoea in the exercise period compared to aerobic training. Because of this it may be easier to tolerate for patients with severe cases of COPD. The re are different types of strength training can be used depending on the desired objective or the condition the patient is in. The different types are strength training where you are lifting between (90-100%) of one rep max (RM) this is using low repetitions with high weight which ameliorates strength, whereas when you use a lower weight and higher repetitions you work at a lower intensity for more reps which works on endurance. Moderate intensity work at (10-12) reps performed at 60-80% of one RM is ideal for patients with COPD as it fulfils the objective of building muscle strength and endurance while avoiding the likelihood of muscle injury which is common in high weight low repetition work. It is important to have your medication and a partner. This is important because, effectively, you may become disabled due to your breathlessness. (Bourbeau, Nault, and Borycki, 2002, PP.190-191) Physiotherapists address many of the symptoms of COPD like reducing the work of breathing, promoting clearance of the airways, improving mobility and promoting rehabilitation. Promoting successful management of these complex patients is in two parts: the accurate assessment of the patient to identify clear goals of treatment and team work, which underpins a thorough knowledge of the individual patient. (Mikelsons, 2008, PP. 2-7) There are three main techniques which may improve the efficiency of your breathing, pursed lip breathing, diaphragmatic breathing and paced breathing. These three techniques encourage complete emptying of your lungs and slower, deeper breaths, which will improve the efficiency of your breathing and encourages control of your breathing. Diaphragmatic breathing involves encouraging patients to move the abdominal wall predominantly during inspiration with reduction of rib cage movement and inhale slowly and deeply, in order to improve chest wall movement and the distribution of ventilation, decrease the work of breathing and improve exercise capacity. By utilizing the main muscle of inspiration, the diaphragm, it encourages relaxation of smaller, less efficient respiratory muscles. Using the diaphragm allows more air to move into the lungs with each breath which makes each breath more efficient. Diaphragmatic breathing also decreases the work of breathing by reducing the use smaller, less efficient muscles of the neck and shoulders. (NYU Medical Centre 1997). Diaphragmatic breathing (DB) has been claimed, but not demonstrated, to correct abnormal chest wall motion, in turn decrease the work of breathing (WOB) and dyspnoea and improve ventilation distribution. (Vitacca et al., 1998) Pursed lip breathing is commonly used in COPD patients as it is thought to alleviate dyspnoea. (Spahija, de Marchie, and Grassino, 2005, PP. 640-650) PLB is done by breathing in through the nose and out through the mouth against a resistance created by pursing the lips, this helps to prevent airway collapse. PLB helps you exhale more completely because it slows your respiratory rate and helps to keep your airways open longer. It has been shown that by performing PLB during exertion can lead to a reduction in respiratory rate and increased recovery rate compared with spontaneous breathing PLB can be used just prior to and during activities that have made you short of breath in the past.. PLB during exertion may therefore be a useful addition to the breathless patient’s regime and may be taught as a strategy to reduce respiratory rate of patients with COPD. It is good to use PLB when walking on inclines, up stairs and during any exercise or exertion. Despite the exercises being effective in reducing respiratory rate and decreasing work of breathing it is of note that it has been shown that fatigue of the diaphragm may develop earlier when using slow, deep breathing, but no differences in dyspnoea or exercise tolerance were found.12 R. Garrod, K. Dallimore and J. Cook et al., An evaluation of the acute impact of pursed lips breathing on walking distance in nonspontaneous pursed lips breathing chronic obstructive pulmonary disease patients, Chronic Respir Dis 2 (2) (2005), pp. 67–72. Full Text via CrossRef | View Record in Scopus | Cited By in Scopus (12) Paced breathing involves coordinating your breathing pattern with the activity you are doing. For example, when walking on level surfaces breathe in for a count of 2 steps and out for a count of 4 steps. This will help regulate your breathing reducing anxiety and promote good relaxed and controlled breathing allowing you to continue with your activity. Physiotherapists prescribe Breathing exercises l ike Diaphragmatic breathing, breathing control and pursed lip breathing are to relieve breathlessness and promote relaxation. (NYU Medical Centre, 1997) Physiotherapists also teach a techniques called airway clearance techniques the most popular being called active cycle breathing technique (ACBT) which is used for acute exarberations of COPD during exercise. This technique is done by using an alternating depth of breathing to move phlegm from the small airways at the bottom of your lungs to the larger airways near the top where they can be cleared more easily with huffing/coughing in turn making it easier to breath by removing obstructions. ACBT is used by 88% of physiotherapists to treat acute exarberations of COPD. (Connolly and Yohannes 2007 pp. 110-113) Airway clearance techniques have a variety of different techniques such as the ACBT which has been explained, forced expiration technique (FET), and postural drainage (PD). PD is when the physiotherapist puts the patient in positions which make it easier to remove sputum because the cilia are damaged and cannot aid in its clearance of sputum. FET is used instead of coughing to re move sputum, it is found to be more effective than coughing. The main indicator for determining which of the techniques to use of any airway clearance technique is how much sputum they can clear while coughing independently. This will be a key indicator for a patient in the self-management of their disease and patients will be taught modifications of their airway clearance regime during an acute exacerbation by their physiotherapist. (Mikelsons, 2008 pgs 2-7) Physiotherapists may prescribe inspiratory muscle training (IMT) which has been used for co-ordination of respiratory muscles allows maximization of the use of abdominal muscles as inspiratory accessory muscles and has been proven to show benefits in exercise tolerance, Inspiratory muscle endurance and strength, breathlessness and improve quality of life. (Mikelsons, 2008 pgs 2-7) state that by including IMT in an exercise programme it has been shown to increase maximal inspiratory pressure, perception of breathlessness and health-related quality of life.50 R. Magadle, A.K. McConnell, M. Beckerman and P. Weiner, Inspiratory muscle training in pulmonary rehabilitation programme in COPD patients, Respir Med 101 (2007), pp. 1500–1505. Article | PDF (465 K) | View Record in Scopus | Cited By in Scopus (8) High-intensity IMT has also been shown to produce beneficial reductions in dyspnoea and fatigue in COPD patients. Usually a physiotherapist would prescribe training that would ta ke place over 6 to 9 weeks using   from 30 to 60% of maximal inspiratory pressure depending on the patient and how much they can manage, this differs from person to person. Another study by (Lotters et al., 2002 pp. 570-577) also had positive results and stated that IMT alone significantly improves inspiratory muscle strength and endurance, whereas the sensation of dyspnoea significantly decreases in patients with COPD. Although there are no significant additional effects of IMT on exercise performance IMT plus general exercise reconditioning has strong significant training effects on inspiratory muscle strength and endurance, especially in patients with inspiratory muscle weakness. In addition, a clinically significant decrease in dyspnoea sensation at rest and during exercise is also a result of IMT. Conclusion In conclusion there is an array of benefits of exercise training demonstrated in the essay which include, increase in exercise capacity, decrease in breathlessness, substantial changes in health related quality of life, decrease in anxiety, and improvements in depression. It has been shown that the inclusion of strength training is also necessary in the exercise prescription to help reduce fatigue; it has shown benefits in relief of respiratory demand in turn reducing dyspnoea. When evaluating anxiety and depression, there have been studies that show a higher rate of depression and anxiety in COPD patients than the general public. In comparison with the general medical population the rate of anxiety was not proven to be higher but much the same, although the level of depression in patients with COPD tended to be higher due to the disease having a reduced physical capacity and knowing that it will gradually get worse. Although by including a pulmonary rehabilitation program for COPD, patients show a statistically significant fall in both anxiety and depression as they progress in their program, with no patients showing any increases in either depression or anxiety. The inclusion of IMT used by physiotherapists combined with an exercise program has been shown to significantly increase in inspiratory muscle strength and inspiratory muscle endurance leading to the reduction of dyspnoea. Combining all of these techniques help in the management of COPD however it has to be said that although exercise improves certain symptoms of COPD, there still a null outcome when it comes to improvements in lung function (FEV1 or FEV). Referencing AgustÄ ±Ã‚ ´ A. G. N. (2005) Systemic Effects of Chronic Obstructive Pulmonary Disease. American thoracic society, 2 (4), 367-370. Armstrong, C. L. Ed. (2010) Handbook of medical neuropsychology: applications of cognitive neuroscience. New York: Springer. Bourbeau, J. Nault, D. and Borycki, E. (2002) Comprehensive management of chronic obstructive pulmonary disease. Canada:   BC Decker Inc. Clark, C.J. Cochrane, L. and Mackay, E. (1996) Low intensity peripheral muscle conditioning improves exercise tolerance and breathlessness in COPD. European respiratory journal, 9 (12), 2590-2596 Connolly, M. J. and Yohannes A. M. (2007) A national survey: percussion, vibration, shaking and active cycle breathing techniques used in patients with acute exacerbations of chronic obstructive pulmonary disease. Physiotherapy, 93 (2), 110-113. COOPER C. B. (2001) Exercise in chronic pulmonary disease: aerobic exercise prescription. Medicine Science in Sports Exercise.   33 (7), S671-s679. Couser, Jr. J. I. Martinez, F. J. and Celli, B. R. (1993) Pulmonary rehabilitation that includes arm exercise reduces metabolic and ventilatory requirements for simple arm elevation. CHEST, 103 (1), 37-41. Decramer, M. et al. (2005) Systemic effects of COPD. Respiratory medicine, 99 (2), S3-s10. Grazzini, M. (2005) Pathophysiology of exercise dyspnea in healthy subjects and in patients with chronic obstructive pulmonary disease. Respiratory medicine, 99(11), 1403-1412. Light, R. W. et al. (1985) Prevalence of depression and anxiety in patients with COPD. Relationship to functional capacity. Chest, 87 (1), 35-38. Lotters, F. et al (2002), Effects of controlled inspiratory muscle training in patients with COPD: a meta-analysis. European respiratory journal, 20 (3), 570-577. Miles, J. And Roberts, J. (2005) Chronic obstructive pulmonary disease 1st ed London: Class publishing. Mikelsons, M. (2008), The role of physiotherapy in the management of COPD, COPD update: Respiratory medicine, 4(1), 2-7. MIKKELSEN, R. L. (2004) Anxiety and depression in patients with chronic obstructive pulmonary disease, A review. European respiratory society, 58 (1)65-70. Nicholas, J. Rudkin, S. T. and White, R. J. (1999) Anxiety and Depression in Severe Chronic Obstructive Pulmonary Disease: The Effects of Pulmonary Rehabilitation. Journal of Cardiopulmonary Rehabilitation, 19 (6), 362-365. NYU Medical Center (1997) COPD AND EXERCISE   [ONLINE]. Available at; http://pfrc.med.nyu.edu/handouts/pdf/proced/copdexer.pdf [Accessed 20 April 2011] Patient.co.uk (2010) Chronic Obstructive Pulmonary Disease [ONLINE]. Available at; patient.co.uk/health/Chronic-Obstructive-Pulmonary-Disease.htm [Accessed 18 August 2011] Sin, D. D. and Paul Man S. F. (2005) Chronic Obstructive Pulmonary Disease as a Risk Factor for Cardiovascular Morbidity and Mortality. The American thoracic society, 2(1) 8-11. Spahija, J. de Marchie, M. and Grassino, A. (2005) Effects of Imposed Pursed-Lips Breathing on Respiratory Mechanics and Dyspnea at Rest and During Exercise in COPD. Chest,128 (2), 640-650. Vitacca, et al., (1998) Acute effects of deep diaphragmatic breathing in COPD patients with chronic respiratory insufficiency. European respiratory journal, 11 (2), 408-415.

Resume Editing 10 Things You Should Remove in 2017

Resume Editing 10 Things You Should Remove in 2017 You spend so much time padding your resume and putting things in that it’s sometimes easy to lose sight of the things we’d be better off leaving out of our resumes. When resume editing, keep in mind that hiring managers give you about 6 seconds before they put your resume through the shredder. Why not give your resume a little holiday season makeover for the new year? Remember to focus on only the most relevant information- anything that isn’t clear, clean, and in support of your message or brand can go.Here are the first 10  things that can get the axe and you should avoid when resume editing.1. â€Å"Objective†The Objective statement is an irrelevant dinosaur. Replace it with a â€Å"Professional Profile† instead- something that summarizes the best parts of your background and shows you off best. Set the tone/theme and use the rest of the resume as proof. The only exception here is if you’re changing fields or industries completely, but t hat is a rare situation requiring some finessing of its own.2. Bad GrammarIt may seem like a small thing, but even the smallest error can turn off a keen-eyed recruiter. Keep faithful to first person headlines and double check that all your verbs agree.3. Mailing AddressYou don’t have room for this. No one is going to need it. And it’s probably a security risk.4. Multiple Telephone NumbersPick the best number at which you can consistently be reached, and leave out the rest. If they want multiple methods of contact, they can always email.5. Too Many BulletsDon’t bullet everything or you’ll run the risk of over-bulleting. Use this useful tool only to draw out the most important information in a clear manner.6. Irrelevant EducationExcept in specific circumstances, no one needs to know where you went to high school, what college you transferred out of, or your GPA. Include only what makes sense for the jobs you are applying for and leave out the rest.7. Refer encesObviously, you’ll provide references on request. Don’t waste valuable space saying so on your resume. If an employer wants them; don’t worry, they will ask.8. More than One PageUnless you need to for your particular field, don’t bloat your resume with piles and piles of text. Try to keep it to a clean single page with surgical detail and no extra padding.9. Mismatched FormattingWhen you’re proofreading for content and orthographical or grammatical errors, be sure to also double check your formatting. Keep your underlining, indentations, italics, etc. completely uniform.10. LiesNo bending the truth necessary. You can portray yourself to best advantage wherever possible, but you never want to include mistruths or outright lies. You will get caught and it won’t be good.

Managing time as an adult learner Research Paper

Managing time as an adult learner - Research Paper Example Adult learners are nowhere placed as target audience/reader/listener. Research journals on time management are also found to target mainly the managers. In this paper I attempt to identify the area observable for research on time management among adult learning community. Understanding the adult learning methods in vogue becomes mandatory to evolve feasible time managing techniques for adult learners. Review of literature throws light on the basic qualities of adult learners. Time management knacks are not new to them. However, inability to adhere to the techniques of time management by adult learners is found to have been caused not merely by their situational factors but also by the training modalities. Further researches are extensively required especially by the psychologists and teaching community in this regard. Literature on time management and literature on adult learning focus their targets in two different but parallel trajectories. While academic journals on time managemen t are very less in number, literature on adult learning too is meagre. (Dorothy MacKeracher, 2004) The efforts being carried out by NIACE (National Institute of Adult Continuing Education) is note worthy. However, the institute focuses its attention purely on developing Adult Education on macro level to sustain the growth and overall development of Great Britain. Adult learners, unlike youngsters who have specific goals, always have specific and ready-to-fire goals that are tangible such as qualification for current job/up skilling for promotion/ career change .1. To locate the research-deserving area with regard to time management by adult learners, the following research questions are framed: a)While time management is a universally acceptable tool for success, is it specifically adaptable to adult learning community as a whole? b)What are the causes that restrain adult learning community from adhering to time managing techniques? Understanding the course of time management as wel l as that of adult learning becomes prerequisite. Time management nuances are contained in broad classification of focussing, planning, organising, acting and learning (Dodd and Sundheim, 2008). Adult learning, as formulated by androgogy specialists is classified in to the following steps namely planning, applying and understanding(Trivette C.M et al, 2009). 1)While time management is a universally acceptable tool for success, is it specifically adaptable to adult learning community as a whole? 1.1 Interactive training: Adult learning theorists have much focussed on the teaching community enabling them to give out fruitful training to adult learners. Most of the literatures on adult learning are in the type of a trainers training module. Review of those literatures reveals that nuances of time management for adult learners are embedded here and there. By selecting a training session designed interactively, which contains application opportunities, a learner can actively take part in the learning process. Through interactive application methods one can score more learning outcomes. In contrast, content oriented sessions that render didactic sermons consume quite a long time to bring to achieve learning objectives. (Foley, 2004, p.91) 1.2 Devising ones own learning objective: Having clear cut and tangible goals in hand they (the goals) can

Effect of Gender Imbalance on Women's Status in the Colonail Period in Essay

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Chief Bill Bratton Leadership Essay Example for Free

Chief Bill Bratton Leadership Essay When one thinks of a leader, what type of person do we think of? Is that individual a hero that we see on television, a cartoon character, a family member, or is that person a public servant? Regardless of occupation and title, a leader is a person who inspires others and they know how to motivate people. â€Å"When they arrive, you see something about them that stands out. The inner strength of their leadership ability emerges†. (Gonzalez, 2007, February 1). Leaders are individuals in your area of work who are focused on the tasks at hand and they have a clear and concise vision on what their respective organizations are set out to do. How do you know if you are being an effective leader? A leader is a person who is looked up to and has a plan to get things accomplished. Within groups, a leader is the person who makes the final decision for the group and it is a person who is motivated to see success for their organization. â€Å"A leader is on a quest and you can see it†. (Gonzalez, 2007, February 1). In the area of law enforcement, Bob Vernon states that there are six questions that every law enforcement officer leader should ask to see if they are being effective leaders. Vernon states that each law enforcement leader should look in the mirror and ask themselves if their organization has the following: a.) Direction, b.) Teamwork, c.) Staff development, d.) Principles, values, and policies, e.) Communication, and f.) controls (Vernon 60-62). Few officers were more of a leader than William Joseph â€Å"Bill† Bratton was. Bratton was born on October 6, 1947 in Dorchester, Massachusetts which is a suburb of Boston. He attended Boston Technical High School and graduated in 1965. Bratton went on to serve in the military and he served in the Vietnam War during the 1960’s. Bratton began his police career with the Boston Police Department in 1970. Within ten years he rose to the rank of Superintendent. During Bratton’s police career he held the position of Superintendent with three of the largest police agencies in the world. Bratton served with the Boston Police Department from 1991-1993, the New York City Police Department from 1994-1996, and lastly with the Los Angeles Police Department from 2002-2009. During Bratton’s tenure with the New York Police Department, the work he did resulted in dramatic change in the level of crime in the city. For example, murder rates dropped from 2,500 per year to just less than 1,000 per year. Shootings fell from 6,000 to 3,000 a year and robberies from 85,000 to approximately 50,000 per year. (Blair, 2002, September, 23).

Excerpt From Thoreaus Walden :: Walden Thoreau Transcendentalism Essays

Excerpt From Thoreau's Walden Colonization in Plymouth I awoke before the first rays of sunlight had passed through the dew-covered trees to the west today. It had rained the evening before, and the smell of wet leaves and grass was still lingering in the air. I prepared myself for the upcoming adventurous day. I set out along a less-traveled path through the woods leading to the shore. I could hear every rustle of the newly fallen leaves covering the ground. The brown ground signaled the changing of seasons and nature's way of preparing for the long winter ahead. Soon these leaves would be covered with a thick layer of snow. The leaves still clinging to the trees above displayed a brilliant array of color, simultaneously showing the differences of each and the beauty of the entire forest. I tracked over to my favorite spot on the edge of the wood: a clearing encompassed by thick trees. The area had many sweet-smelling balsam trees that reminded me of Christmas back home. A few of the remaining leaves fell from the branches of the maple trees above me. The water was calm, like the morning; both were starting to get ready for the day ahead. The silent water signals that although rough times occurred previously, the new day was a new start for the world. As I went closer to the water, I heard the subtle lapping of the water against the small rocks on the shore. Every sign of nature signals a change in life; no matter how slight, a change is significant. We can learn a lot from nature: whatever happens in the natural world, change comes and starts a new occurrence. I gazed over the water to where the sky met the sea. The body of water seemed to be endless under the clear blue sky. The scope of nature shows endless possibilities. Nature impresses us with the brilliant colors of the sky, the leaves, the water. She keeps us all in our places and warns us when we are careless with her. After all the leaves have fallen from the trees, she will offer us the first snows of the year to coat the earth with a tranquil covering. That will only b e after we have recognized the lessons of autumn, the gradual change from warm to cold, rain to snow, summer to winter.

The Purpose of Food and Beverage Cost Control

THE PURPOSE OF FOOD AND BEVERAGE COST CONTROL 1. The principal purpose of food and beverage planning and control systems is †¢ to avoid excessive costs by reducing waste and other forms of loss to a minimum, without sacrificing the quality or quantity of the food which goes to the customer. 2. An effective control procedure will serve other purposes as well: †¢ aid in developing popular menus †¢ aid in improving the quality of the product †¢ aid in pricing for profit The Flow of Costs Through the Various Food and Beverage Activities 1. Basic Operating activities †¢ Purchasing †¢ Receiving †¢ Storing †¢ Issuing †¢ Pre-preparation (butchering, vegetable cleaning etc. ) †¢ Portioning †¢ Preparation (cooking, baking, salad and sandwich making, etc. ) †¢ Service †¢ Accounting and sales Study Highlights1 ? Food and Beverage costs in the majority of restaurant operations represent the largest single expenditure of the revenue. ? Food and beverage costs are influenced by the way the various activities such as purchasing, receiving, storing, issuing, pre-preparation, preparation and accounting are performed. Food and beverage control procedures should serve as effective â€Å"tools of management† to aid in the control of costs. They should be designed in such a way that the most effective allocation of time is made to the planning, comparing and corrective action phases of control, with the emphasis on planning. ? F&B control systems must be effectively used by management before they can be a valuable aid in the control of costs. ? F&B control systems are supported by various types of â€Å"standards: established by management e. g. , standard purchase specifications, standard portion sizes, standard recipes, etc. F&B control systems should be simple and flexible. ? Management is responsible for cost control, and should make use of every tool and technique at its disposal in order to keep costs in line with what they should be. ? In large, complex F&B operations, management is given cost control assistance in the form of staff specialists such as a food and beverage control office. ? In small F&B operations, the manager and his operating staff must alone maintain the necessary planning and control procedures as part of their day-to-day responsibilities. Four Basic Operating Procedures: 1. Food Purchasing, Receiving, Storing and Issuing The primary objective of each of the basic operating procedures should be kept in mind during this study †¢ Purchasing: to obtain the best quality of merchandise based on established specifications, at the best possible price. †¢ Receiving: to obtain the quality and quantity of merchandise ordered and at the quoted price. †¢ Storing: to maintain adequate stocks of merchandise on hand, and to avoid loss through theft or spoilage. †¢ Issuing: to insure proper authorization for the merchandise to be released and to properly account for each day’s issue. . Standard Purchase Specification †¢ A purchase specification is a concise description of the quality, size, and weight or count factors desired for a particular item †¢ Management establishes standard purchase specifications based upon a thorough study of the menu needs and their merchandising and pricing policies †¢ The purchasing agent, the purve yors of the company, and the company’s receiving clerk should each have a set of the established specifications †¢ ? Purchasing 1. There are 3 basic requisites for effective purchasing; a. a qualified and honest purchaser; . a sound set of standard purchase specifications c. effective buying methods and procedures. 2. Standard purchase specifications are concise descriptions of the quality, size, and weight or count factors desired for a particular item. 3. Copies of the purchase specifications should be in the hands of; a. the purchasing agent, b. the company’s purveyors c. the company’s receiving clerk. 4. Constant follow-up and evaluation procedures are necessary in order to insure the continuous adherence to established policies and procedures. ? Receiving 1. The personnel responsible for receiving should know all aspects of the merchandise they are called upon to evaluate and receive. 2. Food merchandise should be checked from the viewpoint of quality, quantity, specification, and price. 3. All merchandise accepted should be supported by an invoice, and the details of the invoice summarized on a daily receiving sheet. 4. Constant follow-up and evaluation checks are necessary to insure proper performance of the receiving procedures. 1. Definition of Terms †¢ 1. Cost of Food Consumed †¢ 2. Cost of Food Sold †¢ 3. Month-end Actual Cost of Food Consumed †¢ 4. Daily Actual Food Cost 5. Standard Food Cost 2. Basic Formula for Calculating Actual Food Costs †¢ Opening inventory + purchases = cost of merchandise available †¢ Merchandise available – closing inventory = cost of food consumed †¢ Food consumed + or – charges or credits = cost of food sold †¢ The Closing Inventory of the ‘Cur rent ‘ month becomes the opening inventory of the following month. Care and accuracy should be the rule in determining inventory value [pic] Paper prepared by Murage Macharia Lecturer, Mombasa Technical Training Institute P. O. BOX 81220 Mombasa 80100 Mobile: +254 726 604 340 +254 750 604340

A Personalised Induction Will Always Be More Effective

Introduction A personalised induction is a type of hypnotic induction that is designed to suit a certain individual. As humans, we appear to share the same traits, but in reality, we are different in various ways. This is because we have different likes, dislikes, perspectives, values, and we have diverse cultural backgrounds. Because of these unique differences, everyone has his or her way of handling various situations, and every individual has a different level of openness and resistance (Chapman 2006, p.113). Consequently, during hypnosis, it is worthwhile for the hypnotist to adopt a personalised approach because each participant has unique traits, and people normally respond to the hypnotic process in different ways. The personalised approach takes into account the client’s desires, perceptions, likes, dislikes, as well as their cultural background (James 2006, p.30). Thus, by personalising the induction, hypnotherapists can help their clients to realize better quality results that a re in line with each of the client’s goals. . In this essay, I argue that a personalised induction approach will always be more effective. As humans, we communicate with each other in various ways including gestures, facial expressions, body language, as well as tone of voice and intonation. However, during hypnosis, the hypnotist has limited techniques of communication available since the clients have their eyes closed. For instance, he or she cannot adopt non-verbal communication techniques, and this makes the message or the instructions he or she is sending to weaken. Thus, it is necessary for the hypnotist to adopt other appropriate techniques of strengthening the message being conveyed to the clients. In order to do this effectively, the hypnotist can personalise the way he or she speaks to the clients by adopting different words, tone variation, volume, and pace, but ensuring the message remains unchanged (Erickson, Rossi & Ryan 1998, p.37-59). Milton H. Erickson common ly referred to as the father of contemporary hypnotherapy recognised that people have different beliefs, values, perceptions, and cultural backgrounds, and consequently, throughout his career as a psychiatrist, he adopted the personalised induction as the best tool for hypnosis. Erickson differed with Hull’s opinion that the subject should always be a passive participant. According to Hull (1933/1968), adoption of a standardized induction would have the same effect on all the subjects (Hawkins 2006, p.36). Difference of opinion between these two great psychiatrists fuelled Erickson’s quest for a valid understanding of the best approach to the hypnotic induction. Later on, Erickson concluded that it is what the subjects do and understands that matters most, not what the operator wishes. In other words, he believed that in order to realize quality results of the therapy, the subjects must be active participants, and the suggestions given by the therapist ought to concur with the client’s desires, perceptions, values, and goals of the therapy (Zeig & Munion, 1999, p.48-51). Permissive and the authoritarian technique Erickson developed the idea that hypnosis is a natural process that needed a more viable approach such as the permissive technique, because it enhances the client’s responsiveness and cooperation. The permissive technique acknowledges that every individual has unique traits, values, perceptions, and desires. It is normally based on the assumption that every person has a unique way of entering into a trance state and receiving suggestions. In this approach, most of the clients know how to relax and enter a trance state, since the hypnotist briefs every client on how the process takes place at the start. As a result, the hypnotist simply acts as a guide as the subjects enters into a hypnotic state (Simpkins 2001, p.53). Before Erickson pioneered the permissive technique, the authoritative technique was the only available technique that was deemed effective. . The authoritative approach is commanding and direct, and its main objective is usually to establish control over the clie nt and modify his or her behaviour through adoption of repetitive commands. Pioneers of this approach believed that by establishing control over their clients, they would be able to increase the chances of getting remarkable results. However, this approach does not produce effective results as asserted by its pioneers since the subjects, who respond in a positive way to it, are only those who respect their authoritarian figures in their daily lives. As a result, authoritative technique can fail to produce quality results if the participant believes in being at the same level with all the authoritarian figures in his or her live (Sheehan 2005, p.67-70). Unlike the authoritative approach, the permissive technique mainly involves adoption of a soft tone to lull the client into relaxation. Throughout this approach, the client and the hypnotist are usually equal partners. Furthermore, more imagery is employed to increase the magnitude of the suggestions. The subject is also given greater responsibility. Since personalised imagery is incorporated in this technique, the induction becomes more real and viable than in the authoritative approach, since the suggestions used by the hypnotist conform to the clients likes and expectations (Sheehan 2005, p.70-72). Clark Hull and Sigmund Freud’s research on hypnosis Despite Erickson’s insistence on the value of the permissive technique, some people object the personalised induction approach. They claim that the personalised induction approach takes more time than the authoritative approach. Moreover, they support their stance by citing some of the works of the great traditional researchers such as Clark Hull and Sigmund Freud. Arguments involving state and the role theory are also used to analyze Erickson’s position. Hull differed with Erickson’s perspective and on the contrary, he proposed the authoritarian technique, which makes the subject a passive participant (Pintar & Lynn, 2009, p.112). He believed that adoption of a standardized approach would yield the same results on all the subjects. In 1940, Jung (1902/1957) backed him in his research, but Jung was not comfortable in using the authoritarian technique, because it involved commanding clients to do according to their therapist’s expectations. According to Jun g’s perspective, participants ought to be involved throughout the process instead of directing then to comply with suggestions that do not conform to their likes. Consequently, Jung broke away from Hull’s research (Hamill 2012, p.24). Based on this, it is clear that the authoritarian approach is not viable, and as a result, it is not logical to oppose the personalised approach based on Hull’s perspective since he does not take into account preferences and expectations of the participants. In addition, Freud’s research asserts that the process of hypnosis would give better results when the subject was on deep trance. Like Hull, Freud adopted the authoritarian technique in a more assertive manner hoping that he would get better results (Sofroniou 2010, p.12). He was particularly interested in the technique because he believed that it was the perfect way of accessing forgotten events and emotions, a cathartic process, which gave relief to his clients. Howeve r, Freud became uncomfortable with hypnosis because his patients did not respond uniformly to the process. He was also afraid that the direct suggestion technique might do away with symptoms that were important for the clients to retain. In addition, Freud had worries over the sexual perceptions that surrounded the hypnotic process, which labelled a client as ‘giving herself’ emotionally to the psychiatrist. Because of these reasons, as well as lack of sufficient experience with hypnosis both through research and clinically, Freud decided to quit hypnosis (Zeig & Munion 1999, p.48-49). If Freud had adopted the permissive approach, he would have succeeded because the personalised approach relies on suggestions that are in line with the client’s expectations, desires and likes, and as a result, the clients could not lose any important symptom. The permissive technique would also help him to eliminate the ill-sexual perception, since it gives the client greater resp onsibility unlike the authoritarian technique. State and the role theory Advocates of the state theory, which asserts that hypnotic induction arouses a unique modified state of consciousness in the patient, base their argument on the notable changes that occur to the brain during hypnosis, and to the dramatic effects, which hypnosis can cause such as the disappearance of warts and insensitivity to pain. They also claim that sometimes, both hypnotised and non-hypnotised participants take instructions differently. For instance, in a certain study, both the hypnotised and non-hypnotised were told to run their hands through their hair once they heard the word ‘experiment.’ The pretenders carried out the suggestion only when the psychiatrist said the word, but the hypnotised participants complied regardless of who gave the suggestion (Coon, Mitterer, Talbot & Vanchella, 2010, p.194). Based on this, opponents of the personalised induction claim that the authoritative approach is as effective as the permissive approach. They support their claim by a sserting that participants who do not respond to the permissive technique can respond to the authoritarian technique effectively, particularly those who respect authoritarian figures in their life. Moreover, advocates of the role theory assert that hypnosis is not a special state of consciousness. They argue that some of the changes linked with hypnosis can also take place without it. They claim that hypnotised people just comply with the demands of the situation, and act in conformity with a special role. From this point of view, hypnosis provides a socially logical reason to comply with someone’s suggestions, in the same way as a physical exam, which provides a logical reason of removing clothes on request. Supporters of the role theory justify their claims by arguing that non-hypnotised participants sometimes exhibit behaviours that are usually linked with hypnosis (Bernstein & Nash, 2008, p.153). Based on this, I disagree with the opponents of the personalised induction w ho adopt the role theory to support their stance, because the theory rejects the idea of hypnosis without providing concrete reasons. The dissociation theory The dissociation theory provides substantial reasons why the personalised inductions should be adopted during the hypnotic process. The theory suggests that hypnosis is not a single specific state, but the general condition, which temporarily reorganises our normal control over actions and thoughts. Dissociation allows body movements to occur under voluntary control and the involuntary processes to be controlled voluntarily. As Hilgard proposed this theory, he asserted that the relaxation of control occurs because of the social agreement between the hypnotist and the hypnotised person to share control (Bernstein & Nash, 2008, p.153-154). In other words, the theory supports the idea that for the process to be effective, the participant should be an active participant, something advocated in the personalised induction approach. Modern hypnosis Based on contemporary hypnosis, a personalised induction seems to be the most effective approach in hypnosis. The approach takes into account the client’s values, desires, and it views the subjects as active participants. It also supports the idea that it is imperative to have the patient as relaxed as possible, get them involved in the in the process, and discuss the expectations and goals of attending the therapy with the client. Furthermore, the modern hypnotherapist starts the therapy session by establishing a rapport with their patients, which is a key aspect of the personalised induction approach (Gaschler 2009, p.21). In the course of the personalised induction, strong relationships between the clients and the therapist are necessary in order to ensure the client is fully involved in the process. Learning Modalities Overtime, personalised induction has stood out as the best because it takes into consideration learning modalities, which are key channels through which people receive, store, and give information. Modality is comprised of perception, sensation, and memory and the key senses include smell, taste, visual, auditory, and kinaesthetic. Knowledge of modalities enables therapists to personalise screeds for each client. When a patient’s modalities are ascertained, it becomes easy to discuss with them in a way that makes them feel comfortable and relaxed (Hogan & LaBay 2007, p.226-239). As a result, it becomes easy to achieve the objective of the therapy. Conclusion The above discussion has suggested that personalised induction is more effective than the authoritarian approach. This is because we have different likes, dislikes, desires, perceptions, and we come from different cultural backgrounds. Consequently, to achieve remarkable results in the process of hypnosis, the hypnotist should take into consideration all this aspects. Although a standardized approach (authoritative approach) can be effective in some instances, it only works on subjects who respect the authoritative figures. Moreover, the authoritative technique assumes that all people react in the same manner to suggestions. However, this should not be the case since we possess different traits. Thus, the personalised induction or the permissive approach is the only method through which noteworthy results can be achieved during the hypnotic process, since it acknowledges that we have different likes, dislikes, perceptions and that we come from diverse cultural backgrounds. References Bernstein, D. A., & Nash, P. W. (2008). Essentials of psychology. Boston, MA, Houghton Mifflin. Chapman, R. A. (2006). The clinical use of hypnosis in cognitive behavior therapy a practitioner’s casebook. New York, NY, Springer Pub. Coon, D., Mitterer, J. O., Talbot, S., & Vanchella, C. M. (2010). Introduction to psychology: gateways to mind and behavior. Belmont, Calif, Wadsworth Cengage Learning. Erickson, M. H., Rossi, E. L., & Ryan, M. O. (1998). Mind-body communication in hypnosis. London, Free Association. Gaschler, T. (2009). Modern hypnosis techniques Pt. 1. Pt. 1. [Bad Sachsa], Steiner. Hamill, D. (2012). An Introduction to Hypnosis & Hypnotherapy. Bolton, MA, eBookIt.com. Hawkins, P. (2006). Hypnosis and stress a guide for clinicians. Chichester, England, Wiley. Hogan, K., & LaBay, M. (2007). Through the Open Door: Secrets of Self-hypnosis. Gretna, Louisiana: Pelican Publishing. James, U. (2006). Clinical hypnosis textbook: a guide for practical intervention. Oxford, Radcliffe Publishing. Pintar, J., & Lynn, S. J. (2009). Hypnosis a Brief History. Chichester, John Wiley & Sons Sheehan, L. (2005). Basic Hypnosis Manual. Raleigh, North Carolina: Lulu. Simpkins, C. A. (2001). Self-Hypnosis: Plain and Simple. Tuttle Pub. Sofroniou, A. (2010). The misinterpretation of Sigmund Freud. [Raleigh, N.C. ], Lulu Com. Zeig, J. K., & Munion, W. M. (1999). Milton H. Erickson. London, Sage Publications. A Personalised Induction Will Always Be More Effective Introduction A personalised induction is a type of hypnotic induction that is designed to suit a certain individual. As humans, we appear to share the same traits, but in reality, we are different in various ways. This is because we have different likes, dislikes, perspectives, values, and we have diverse cultural backgrounds. Because of these unique differences, everyone has his or her way of handling various situations, and every individual has a different level of openness and resistance (Chapman 2006, p.113). Consequently, during hypnosis, it is worthwhile for the hypnotist to adopt a personalised approach because each participant has unique traits, and people normally respond to the hypnotic process in different ways. The personalised approach takes into account the client’s desires, perceptions, likes, dislikes, as well as their cultural background (James 2006, p.30). Thus, by personalising the induction, hypnotherapists can help their clients to realize better quality results that a re in line with each of the client’s goals. . In this essay, I argue that a personalised induction approach will always be more effective. As humans, we communicate with each other in various ways including gestures, facial expressions, body language, as well as tone of voice and intonation. However, during hypnosis, the hypnotist has limited techniques of communication available since the clients have their eyes closed. For instance, he or she cannot adopt non-verbal communication techniques, and this makes the message or the instructions he or she is sending to weaken. Thus, it is necessary for the hypnotist to adopt other appropriate techniques of strengthening the message being conveyed to the clients. In order to do this effectively, the hypnotist can personalise the way he or she speaks to the clients by adopting different words, tone variation, volume, and pace, but ensuring the message remains unchanged (Erickson, Rossi & Ryan 1998, p.37-59). Milton H. Erickson common ly referred to as the father of contemporary hypnotherapy recognised that people have different beliefs, values, perceptions, and cultural backgrounds, and consequently, throughout his career as a psychiatrist, he adopted the personalised induction as the best tool for hypnosis. Erickson differed with Hull’s opinion that the subject should always be a passive participant. According to Hull (1933/1968), adoption of a standardized induction would have the same effect on all the subjects (Hawkins 2006, p.36). Difference of opinion between these two great psychiatrists fuelled Erickson’s quest for a valid understanding of the best approach to the hypnotic induction. Later on, Erickson concluded that it is what the subjects do and understands that matters most, not what the operator wishes. In other words, he believed that in order to realize quality results of the therapy, the subjects must be active participants, and the suggestions given by the therapist ought to concur with the client’s desires, perceptions, values, and goals of the therapy (Zeig & Munion, 1999, p.48-51). Permissive and the authoritarian technique Erickson developed the idea that hypnosis is a natural process that needed a more viable approach such as the permissive technique, because it enhances the client’s responsiveness and cooperation. The permissive technique acknowledges that every individual has unique traits, values, perceptions, and desires. It is normally based on the assumption that every person has a unique way of entering into a trance state and receiving suggestions. In this approach, most of the clients know how to relax and enter a trance state, since the hypnotist briefs every client on how the process takes place at the start. As a result, the hypnotist simply acts as a guide as the subjects enters into a hypnotic state (Simpkins 2001, p.53). Before Erickson pioneered the permissive technique, the authoritative technique was the only available technique that was deemed effective. . The authoritative approach is commanding and direct, and its main objective is usually to establish control over the clie nt and modify his or her behaviour through adoption of repetitive commands. Pioneers of this approach believed that by establishing control over their clients, they would be able to increase the chances of getting remarkable results. However, this approach does not produce effective results as asserted by its pioneers since the subjects, who respond in a positive way to it, are only those who respect their authoritarian figures in their daily lives. As a result, authoritative technique can fail to produce quality results if the participant believes in being at the same level with all the authoritarian figures in his or her live (Sheehan 2005, p.67-70). Unlike the authoritative approach, the permissive technique mainly involves adoption of a soft tone to lull the client into relaxation. Throughout this approach, the client and the hypnotist are usually equal partners. Furthermore, more imagery is employed to increase the magnitude of the suggestions. The subject is also given greater responsibility. Since personalised imagery is incorporated in this technique, the induction becomes more real and viable than in the authoritative approach, since the suggestions used by the hypnotist conform to the clients likes and expectations (Sheehan 2005, p.70-72). Clark Hull and Sigmund Freud’s research on hypnosis Despite Erickson’s insistence on the value of the permissive technique, some people object the personalised induction approach. They claim that the personalised induction approach takes more time than the authoritative approach. Moreover, they support their stance by citing some of the works of the great traditional researchers such as Clark Hull and Sigmund Freud. Arguments involving state and the role theory are also used to analyze Erickson’s position. Hull differed with Erickson’s perspective and on the contrary, he proposed the authoritarian technique, which makes the subject a passive participant (Pintar & Lynn, 2009, p.112). He believed that adoption of a standardized approach would yield the same results on all the subjects. In 1940, Jung (1902/1957) backed him in his research, but Jung was not comfortable in using the authoritarian technique, because it involved commanding clients to do according to their therapist’s expectations. According to Jun g’s perspective, participants ought to be involved throughout the process instead of directing then to comply with suggestions that do not conform to their likes. Consequently, Jung broke away from Hull’s research (Hamill 2012, p.24). Based on this, it is clear that the authoritarian approach is not viable, and as a result, it is not logical to oppose the personalised approach based on Hull’s perspective since he does not take into account preferences and expectations of the participants. In addition, Freud’s research asserts that the process of hypnosis would give better results when the subject was on deep trance. Like Hull, Freud adopted the authoritarian technique in a more assertive manner hoping that he would get better results (Sofroniou 2010, p.12). He was particularly interested in the technique because he believed that it was the perfect way of accessing forgotten events and emotions, a cathartic process, which gave relief to his clients. Howeve r, Freud became uncomfortable with hypnosis because his patients did not respond uniformly to the process. He was also afraid that the direct suggestion technique might do away with symptoms that were important for the clients to retain. In addition, Freud had worries over the sexual perceptions that surrounded the hypnotic process, which labelled a client as ‘giving herself’ emotionally to the psychiatrist. Because of these reasons, as well as lack of sufficient experience with hypnosis both through research and clinically, Freud decided to quit hypnosis (Zeig & Munion 1999, p.48-49). If Freud had adopted the permissive approach, he would have succeeded because the personalised approach relies on suggestions that are in line with the client’s expectations, desires and likes, and as a result, the clients could not lose any important symptom. The permissive technique would also help him to eliminate the ill-sexual perception, since it gives the client greater resp onsibility unlike the authoritarian technique. State and the role theory Advocates of the state theory, which asserts that hypnotic induction arouses a unique modified state of consciousness in the patient, base their argument on the notable changes that occur to the brain during hypnosis, and to the dramatic effects, which hypnosis can cause such as the disappearance of warts and insensitivity to pain. They also claim that sometimes, both hypnotised and non-hypnotised participants take instructions differently. For instance, in a certain study, both the hypnotised and non-hypnotised were told to run their hands through their hair once they heard the word ‘experiment.’ The pretenders carried out the suggestion only when the psychiatrist said the word, but the hypnotised participants complied regardless of who gave the suggestion (Coon, Mitterer, Talbot & Vanchella, 2010, p.194). Based on this, opponents of the personalised induction claim that the authoritative approach is as effective as the permissive approach. They support their claim by a sserting that participants who do not respond to the permissive technique can respond to the authoritarian technique effectively, particularly those who respect authoritarian figures in their life. Moreover, advocates of the role theory assert that hypnosis is not a special state of consciousness. They argue that some of the changes linked with hypnosis can also take place without it. They claim that hypnotised people just comply with the demands of the situation, and act in conformity with a special role. From this point of view, hypnosis provides a socially logical reason to comply with someone’s suggestions, in the same way as a physical exam, which provides a logical reason of removing clothes on request. Supporters of the role theory justify their claims by arguing that non-hypnotised participants sometimes exhibit behaviours that are usually linked with hypnosis (Bernstein & Nash, 2008, p.153). Based on this, I disagree with the opponents of the personalised induction w ho adopt the role theory to support their stance, because the theory rejects the idea of hypnosis without providing concrete reasons. The dissociation theory The dissociation theory provides substantial reasons why the personalised inductions should be adopted during the hypnotic process. The theory suggests that hypnosis is not a single specific state, but the general condition, which temporarily reorganises our normal control over actions and thoughts. Dissociation allows body movements to occur under voluntary control and the involuntary processes to be controlled voluntarily. As Hilgard proposed this theory, he asserted that the relaxation of control occurs because of the social agreement between the hypnotist and the hypnotised person to share control (Bernstein & Nash, 2008, p.153-154). In other words, the theory supports the idea that for the process to be effective, the participant should be an active participant, something advocated in the personalised induction approach. Modern hypnosis Based on contemporary hypnosis, a personalised induction seems to be the most effective approach in hypnosis. The approach takes into account the client’s values, desires, and it views the subjects as active participants. It also supports the idea that it is imperative to have the patient as relaxed as possible, get them involved in the in the process, and discuss the expectations and goals of attending the therapy with the client. Furthermore, the modern hypnotherapist starts the therapy session by establishing a rapport with their patients, which is a key aspect of the personalised induction approach (Gaschler 2009, p.21). In the course of the personalised induction, strong relationships between the clients and the therapist are necessary in order to ensure the client is fully involved in the process. Learning Modalities Overtime, personalised induction has stood out as the best because it takes into consideration learning modalities, which are key channels through which people receive, store, and give information. Modality is comprised of perception, sensation, and memory and the key senses include smell, taste, visual, auditory, and kinaesthetic. Knowledge of modalities enables therapists to personalise screeds for each client. When a patient’s modalities are ascertained, it becomes easy to discuss with them in a way that makes them feel comfortable and relaxed (Hogan & LaBay 2007, p.226-239). As a result, it becomes easy to achieve the objective of the therapy. Conclusion The above discussion has suggested that personalised induction is more effective than the authoritarian approach. This is because we have different likes, dislikes, desires, perceptions, and we come from different cultural backgrounds. Consequently, to achieve remarkable results in the process of hypnosis, the hypnotist should take into consideration all this aspects. Although a standardized approach (authoritative approach) can be effective in some instances, it only works on subjects who respect the authoritative figures. Moreover, the authoritative technique assumes that all people react in the same manner to suggestions. However, this should not be the case since we possess different traits. Thus, the personalised induction or the permissive approach is the only method through which noteworthy results can be achieved during the hypnotic process, since it acknowledges that we have different likes, dislikes, perceptions and that we come from diverse cultural backgrounds. References Bernstein, D. A., & Nash, P. W. (2008). Essentials of psychology. Boston, MA, Houghton Mifflin. Chapman, R. A. (2006). The clinical use of hypnosis in cognitive behavior therapy a practitioner’s casebook. New York, NY, Springer Pub. Coon, D., Mitterer, J. O., Talbot, S., & Vanchella, C. M. (2010). Introduction to psychology: gateways to mind and behavior. Belmont, Calif, Wadsworth Cengage Learning. Erickson, M. H., Rossi, E. L., & Ryan, M. O. (1998). Mind-body communication in hypnosis. London, Free Association. Gaschler, T. (2009). Modern hypnosis techniques Pt. 1. Pt. 1. [Bad Sachsa], Steiner. Hamill, D. (2012). An Introduction to Hypnosis & Hypnotherapy. Bolton, MA, eBookIt.com. Hawkins, P. (2006). Hypnosis and stress a guide for clinicians. Chichester, England, Wiley. Hogan, K., & LaBay, M. (2007). Through the Open Door: Secrets of Self-hypnosis. Gretna, Louisiana: Pelican Publishing. James, U. (2006). Clinical hypnosis textbook: a guide for practical intervention. Oxford, Radcliffe Publishing. Pintar, J., & Lynn, S. J. (2009). Hypnosis a Brief History. Chichester, John Wiley & Sons Sheehan, L. (2005). Basic Hypnosis Manual. Raleigh, North Carolina: Lulu. Simpkins, C. A. (2001). Self-Hypnosis: Plain and Simple. Tuttle Pub. Sofroniou, A. (2010). The misinterpretation of Sigmund Freud. [Raleigh, N.C. ], Lulu Com. Zeig, J. K., & Munion, W. M. (1999). Milton H. Erickson. London, Sage Publications.

Meaning and History of the Term Robber Baron

Meaning and History of the Term Robber Baron Robber Baron was a term applied to a businessman in the 19th century who engaged in unethical and monopolistic practices, utilized corrupt  political influence, faced almost no business regulation, and amassed enormous wealth. The term itself was not coined in the 1800s, but actually dated back centuries It was originally applied to noblemen in the Middle Ages who functioned as feudal warlords and were literally â€Å"robber barons.† In the 1870s the term began to be used to describe business tycoons, and the usage persisted throughout the rest of the 19th century. The late 1800s and the first decade of the 20th century are sometimes referred to as an age of robber barons. The Rise of Robber Barons As the United States transformed into an industrial society with little regulation of business, it was possible for small numbers of men to dominate crucial industries. Conditions which favored vast accumulations of wealth included the extensive natural resources being discovered as the country expanded, the enormous potential workforce of immigrants arriving in the country, and the general acceleration of business in the years following the Civil War. Railroad builders, in particular, needing political influence to build their railways, became adept at influencing politicians through the use of lobbyists, or in some cases, outright bribery. In the public mind, robber barons were often associated with political corruption. The concept of laissez faire capitalism, which dictated no government regulation of business, was promoted.  Facing few  impediments to creating  monopolies, engaging in  shady stock trading practices,  or exploiting workers, some individuals made enormous fortunes. Examples of Robber Barons As the term robber baron came into common usage, it was often applied to a small group of men. Notable examples were: Cornelius Vanderbilt, owner of steamship lines and railroads.Andrew Carnegie, steel manufacturer.J.P. Morgan, financier, and banker.John D. Rockefeller, founder of Standard Oil.Jay Gould, Wall Street trader.Jim  Fisk, Wall Street trader.Russell Sage, financier. The men who were called robber barons were often  portrayed in a positive light, as â€Å"self-made men† who had helped build the nation and in the process created many jobs for American workers. However, the public mood turned against them in the late 19th century. Criticism from newspapers and social critics began to find an audience. And American workers began to organize in great numbers as the labor movement accelerated. Events in labor history, such as the Homestead Strike and the Pullman Strike, intensified public resentment toward the wealthy. The conditions of workers, when contrasted with the lavish lifestyles of millionaire industrialists, created widespread resentment. Even other businessmen felt exploited by monopolistic practices as it was virtually impossible to compete in some fields. Common citizens became aware that monopolists could more easily exploit workers. There was even a public backlash against the lavish displays of wealth often exhibited by the very wealthy of the age. Critics noted the concentration of wealth as evil or weakness of society, and satirists, such as Mark Twain, derided the showiness of the robber barons as â€Å"the Gilded Age.† In the 1880s journalists such as Nellie Bly performed pioneering work exposing the practices of unscrupulous businessmen. And Blys newspaper, Joseph Pulitzers New York World, positioned itself as the newspaper of the people and often criticized wealthy businessmen. In 1894 the protest march by Coxeys Army drew enormous publicity to a group of protesters who often spoke out against a wealthy ruling class that exploited workers. And the pioneering photojournalist Jacob Riis, in his classic book How the Other Half Lives, helped to highlight the great gap between the wealthy and the suffering poor in New York Citys slum neighborhoods. Legislation Aimed at Robber Barons The public’s increasingly negative view of trusts, or monopolies, transformed into legislation with the passage of the Sherman Anti-Trust Act in 1890. The law did not end the reign of robber barons, but it signaled that the era of unregulated business would be coming to an end. Over time, many of the practices of the robber barons would become illegal as further legislation sought to ensure  fairness in  American business. Sources: The Robber Barons.  Development of the Industrial U.S. Reference Library, edited by Sonia G. Benson, et al., vol. 1: Almanac, UXL, 2006, pp. 84-99. Robber Barons.  Gale Encyclopedia of U.S. Economic History, edited by Thomas Carson and Mary Bonk, vol. 2, Gale, 2000, pp. 879-880.

Daniel Hale Williams, Heart Surgery Pioneer

Daniel Hale Williams, Heart Surgery Pioneer American physician Daniel Hale Williams (January 18, 1856- August 4, 1931), a pioneer in the field of medicine, was the first African American to perform successful open heart surgery. Dr. Williams also founded Chicagos Provident Hospital and co-founded the National Medical Association. Fast Facts: Dr. Daniel Hale Williams Full Name: Daniel Hale Williams, IIIBorn: January 18, 1856 in Hollidaysburg, PennsylvaniaDied: August 4, 1931 in Idlewild, MichiganParents: Daniel Hale Williams, II and Sarah Price WilliamsSpouse: Alice Johnson (m. 1898-1924)Education: M.D. from Chicago Medical College (now Northwestern University Medical School)Key Accomplishments: First African American to perform successful open heart surgery, founder of Provident Hospital (the first  black owned and operated interracial hospital in the U.S.), and co-founder of the National Medical Association. Early Years Daniel Hale Williams, III, was born on January 18, 1856 to Daniel Hale and Sarah Price Williams in Hollidaysburg, Pennsylvania. His father was a barber and the family, including Daniel and his six siblings, moved to Annapolis, Maryland, when Daniel was a young boy. Shortly after the move, his father died from tuberculosis and his mother moved the family to Baltimore, Maryland. Daniel became a shoemakers apprentice for a while and later moved to Wisconsin, where he became a barber. After graduating from high school, Daniel grew interested in medicine and served as an apprentice to a well known local surgeon, Dr. Henry Palmer. This apprenticeship lasted two years, and then Daniel was accepted to the Chicago Medical College, affiliated with Northwestern University. He graduated in 1883 with an M.D. degree. Career and Accomplishments Dr. Daniel Hale Williams began practicing medicine and surgery at Chicagos South Side Dispensary. He was also the first African American anatomy instructor at Chicago Medical College, where he taught notable future physicians such as Mayo Clinics co-founder Charles Mayo. By 1889, other notable appointments for Dr. Williams included the City Railway Company, the Protestant Orphan Asylum, and the Illinois State Board of Health. These were very unique accomplishments for the time, considering that there were very few black doctors at this point in African American history. Dr. Williams gained a reputation as a highly skilled surgeon whose practice included treatment for all patients, regardless of race. This was life-saving for African Americans at the time because they were not allowed admittance to hospitals. African American doctors were not allowed on staff in hospitals either. In 1890, a friend of Dr. Williams asked him for help as his sister was being denied entrance into nursing school because she was black. In 1891, Dr. Williams founded the Provident Hospital and Nursing Training School. This was the first  black owned and operated interracial hospital in the U.S. and served as a training ground for nurses and African American doctors. First Open Heart Surgery In 1893, Dr. Williams gained notoriety for successfully treating a man, James Cornish, with stab wounds to the heart. Although physicians at the time were aware of the revolutionary works of Louis Pastuer and Joseph Lister in relation to germs and medical surgery, open heart surgery was generally avoided due to the high risk of infection and subsequent death. Williams had no access to X-rays, antibiotics, anesthetics, blood transfusions, or modern equipment. Employing Listers antiseptic technique, he performed the surgery suturing the pericardium (protective lining) of the heart. This would be the first successful heart surgery performed by an African American and second by an American doctor. In 1891, Henry C. Dalton had surgically repaired a pericardial wound of the heart on a patient in St. Louis. Later Years In 1894, Dr. Williams obtained the position of surgeon-in-chief at Freedmens Hospital in Washington, D.C. This hospital served the needs of the poor and newly freed slaves after the Civil War. In four years, Williams transformed the hospital, making dramatic improvements in the admission of surgical cases and drastically reducing the hospitals mortality rate. Dr. Daniel Hale Williams succeeded in the face of discrimination his entire life. In 1895, he co-founded the National Medical Association in response to the American Medical Associations denial of membership to blacks. The National Medical Association became the only national professional organization available for black physicians. In 1898, Williams resigned from Freedmens Hospital and married Alice Johnson, daughter of sculptor Moses Jacob Ezekiel. The newlyweds returned to Chicago, where Williams became chief of surgery at Provident Hospital. Death and Legacy After resigning from his position at Provident Hospital in 1912, Williams was appointed staff surgeon at St. Lukes Hospital in Chicago. Among his many honors, he was named the American College of Surgeons first black fellow. He remained at St. Lukes Hospital until suffering a stroke in 1926. Upon his retirement, Williams spent his remaining days in Idlewild, Michigan, where he died on August 4, 1931. Dr. Daniel Hale Williams would leave a legacy of greatness in the face of discrimination. He demonstrated that African Americans are no less intelligent or valuable than any other Americans. He saved many lives by establishing Provident Hospital and provided proficient medical care, and he also helped train a new generation of African American physicians and nurses. Sources Daniel Hale Willaims : Alumni Exhibit. Walter Dill Scott, University Archives, Northwestern University Library, Northwestern University Archives (NUL), exhibits.library.northwestern.edu/archives/exhibits/alumni/williams.html.Daniel Hale Williams. Biography.com, AE Networks Television, 19 Jan. 2018, www.biography.com/people/daniel-hale-williams-9532269.History - Dr. Daniel Hale Williams. The Provident Foundation, www.providentfoundation.org/index.php/history/history-dr-daniel-hale-williams.Nations Second Open-Heart Surgery Performed In Chicago 119 Years Ago. The Huffington Post, TheHuffingtonPost.com, 10 July 2017, www.huffingtonpost.com/2012/07/09/daniel-hale-williams-perf_n_1659949.html.

To what extent is it in the interest of business to engage in Essay

To what extent is it in the interest of business to engage in Corporate Social Responsibility (CSR) - Essay Example The business case for CSR can be considered. Many economists have the view that CSR is not actually the demand of social ones. One of them has the view that it is not socially desired. Milton Friedman mentioned that the only social responsibility of a business is to maximize profits. Before going into the pool of Corporate Social Responsibility, we should be familiar with the term Corporate Social Responsibility, which is abbreviated as CSR. It can be profitable for the businesses and so for businessmen. Corporate Social Responsibility cannot be defined as a specific term. Different researchers and economists gave different definitions to it according to their point of view. Most of the researchers agree that, ‘Corporate Social Responsibility is a process by which, businesses are monitored.’ It has its own standards that are internationally accepted as the rules and regulations through which businesses are monitored. The word ‘responsibility’ describes that it takes the responsibility of concerned companies and appreciates their impact on customers, employees and stakeholders. The history of Corporate Social Responsibility is not as old as business; however, as the business community realised the importance of the Corporate Social Responsibility, the knowledge about the term is continuously increasing. In late 1960s, Corporate Social responsibility appeared as an important pillar in the development of a business. With the emergence of Corporate Social responsibility, different multinational companies (MNCs) started using the term stakeholder. This term was initially used to give explanation of the corporate owners (beyond the shareholders of a company), as a result of an influential book by R. Edward Freeman, Strategic management: a stakeholder approach in 1984 (Freeman, 1984). Corporate Social Responsibility is also accountable for the actions of concerned companies and it answers some questions such

Drugs in sport, I'm looking at the use of EPO in Essay

Drugs in sport, I'm looking at the use of EPO in - Essay Example The paper would also briefly show the picture of what this type of behavior could do in the long run for the sports world as well as on the actions of younger generations. Any state taking part in the Olympics would be familiar with this: ``The important thing in the games is not winning but taking part. the essential thing is not conquering, but fighting well, since this is the creed of the said event (Baron, 54). But could it still be reconciled with the reality of the modern sports world? Sports now after all is not just playing some game, one could discern that it is really more than that. Thats why sports get a separate section in every major daily newspaper, stadiums are filled along with arenas around the world regularly with fans rooting and screaming their lungs out for someone or some group, they receive massive funds from schools and they occupy hours of commercial TV and radio air time (Washigton, 188). This kind of situation leads to a reward system wherein incentives are given not to a job well done or a battle well fought but to winning. Athletes and their coaches know that. Largely, as it could be associated from the above described sp orts world, this is because winning today do not just give you a shining image (if only they could be satisfied with that), but in this time and age, it is absolutely associated with unbelievably huge amount of money. Winning open the doors for athletes as well as the coaches to multimillion dollar contracts, appearance fees, and various international endorsements and exposures. Something nobody except for a few rare souls, could reject. However, the issue is not even about the abnormal financial gains these performers could acquire when they succeed, but what this drive to excel lead them to do. A conspicuous issue that arises from such situation is the use of performance enhancers in