See instructions Research Paper Example | Topics and Well Written Essays - 750 words

See instructions - Research Paper Example With its fastly growing population rate and sprawling cities, economic disparity between the social classes is increasing. Moreover, the high population growth poses several other problems to development including poverty, living conditions, health, social progress, and most importantly economic progress. Although Brazil has always been â€Å"bullish† about their population rise (Merrick, 1976), it is true that its population is constraining its economic development. Despite its high incomes and drop in unemployment rates, Brazil still struggles to keep economic inequality to a low level. Income inequality is high and these are reflected in the historical trends that show an unequal distribution of wealth and resources among the rich and the poor. There are much evidences to show that income inequality has detrimental impacts on the economic growth and development of a particular country. These factors go beyond the usual effect on poverty but relatively more important is that fact that it essentially curbs growth (Meier and Rauch, 2000). Although Brazil’s economy is apparently doing well with high incomes and a decline in the unemployment rates however these figures are not good determinants of its general well being (Baer, 2001). Historical figures of income distribution suggest that a high percentage of the income goes to the pockets of the rich while the poor only get a small share of the income. Coupled with the increasing population, economic disparity is increasing among the people. Moreover, the migration from rural to urban areas of Brazil has created severe health and sanitary problems. It is pleasing to see, though, that Brazil has made rapid progress since the Great Depression in the 1930s in terms of demographic transformation (Baer, 2001), to doing spectacularly well between 1968-73 during the Brazilian Miracle

Law and Environment Essay Example for Free

Law and Environment Essay According to this appeals court, what errors were made by the judge at trial? The judge has made a judicial error by allowing the Plaintiffs counsel to comment on the case about Minichiellos boss being a German with an attitude of hatred and made forced analogies to Nazi Germany and the Holocaust. The judge also allowed irrelevant testimony, which asserted that the Club discriminated against Latinos, Jews, and African-Americans, to the issue of discrimination based on sexual orientation. I agree that awarding $20,000,000 was grossly excessive and has no rational basis, and was an error by the judge as well. 7. Would the police violate a suspect’s Fourth Amendment rights against unlawful search and seizure by secretly placing a GPS tracking device on the suspect’s car for an extended time without first securing a warrant to do so? Explain. See, for example, United States of America v. Lawrence Maynard, 615 F.3d 544 (D.C. Cir. 2010); petition for rehearing en bane denied, United States of America v. Antoine Jones, 625 F.3d 766 (D.C. Cir. 2010). The police would violate a suspect’s Fourth Amendment rights against unlawful search and seizure by secretly placing a GPS tracking device on the suspect’s car for an extended time without first securing a warrant to do so. They have violated his â€Å"reasonable degree of privacy†. Without having a warrant issued will give the ability to have anybody monitored whenever for whatever period of time invading privacy.

Fichtes Theory of Individuality :: Philosophy

Fichte's Theory of Individuality THEME Fichte’s Wissenschaftslehre lends itself as apparently no other philosophy of mind to the extraction or extrapolation of a theory of individuality. Moreover it proves possible to marry the key concepts on which my essay concentrates to current neurophysiological thinking on how memories are laid down and retrieved. Accordingly it is those nuptials that this essay attempts to perform. PART I The world in my mind The student of Descartes might be brought up short by Fichte’s ‘revision’ of the cogito statement: â€Å"I am I†. Soon it becomes apparent that this ‘I’ does not think: The primordial, absolutely unconditioned first principle of human knowledge . . . is an act (‘Tathandlung’) which does not and cannot appear among the empirical states of our consciousness, but rather lies at its basis and alone makes it possible. [I,91] Thus begins his effort to â€Å"complete† Kant’s system; for although the old man growled â€Å"God preserve us from friends like these†, it cannot be denied that the Critiques *presuppose* a fully-formed mind and may therefore be said to have turned a blind eye to some mandatory prior midwifery. Fichte’s solution conceives of the ‘Ich’ as essentially an act — as an amorphous consciousness brimful with psychic energy seeking instantiation as a finite thinking being. Unlike the cartesian self, the fichtean ‘Ich’ is initially a self in abstracto [I, 96 & 97], the principle of activity in all purity and lacking all predicates [I, 110]. Accordingly what the ‘Ich’ can experience in this state is nothing remotely akin to the cogito, but rather a freudian ‘oceanic feeling’ of limitless being. From this emerges the desire to ‘posit’ itself, which can mean nothing other than a striving for self-consciousness. Thus, The pure self-reverting activity of the Self is a striving . . . This boundless striving, carried to infinity, is the condition of the possibility of any object whatsoever: no striving, no object. [I, 262]. Echoes of Goethe’s apophthegm, â€Å"Im Anfang war die Tat†, itself a sovereign mind’s correction of the evangelical â€Å"In the beginning was the word†. Agency precedes the self-consciousness which commands words. But an ‘Ich’, wanting to become a ‘Self’, needs correlation to an ‘Other’. Activity, whether mental or physical, necessarily implies the existence of a correlated external reality in relation to which we think and act and which comprises the theatre where these relational activities are enacted.

Import Substitution Industries Essay

â€Å"There is a belief among some economists that a country should focus more on export sector explanation and diversification than promoting the import substitution Industries (ISI).† Critically comment on this taking Sri Lankan economy as an example. You are expected to refer relevant articles from recognized sources on the said areas and provide your own views and analysis with proper reasoning. Export means shipping the goods and services out of the port of a country. An import is a good brought into a jurisdiction, especially across a national border, from an external source. Import Substitution Industries (ISI) means an economic theory employed by developing or emerging market nations that wish to increase their self-sufficiency and decrease their dependency on developed countries. Implementation of the theory focuses on protection and incubation of domestic infant industries so they may emerge to compete with imported goods and make the local economy more self-sufficie nt. Normally importing is not bad. Importing raw materials and goods is one of the paths of increasing the profit margins. There are number of benefits in importing the goods, such as high quality, low prices, and benefits related to the international trade. But I think there are more disadvantages for country. Importing of goods could lead the erosion of the domestic markets and national economies specifically when there is trade deficit occurrence the import is higher than the export. And can also be increased due to import of goods such as conflict in the domestic values due to the acceptance of social values. The domestic industries can also be crippled due to the import of the countries where the wages are low and the domestic industries are unable to compete since they cannot lower down their prices of goods than the cost of goods. The exporting of goods is specifically difficult and disadvantageous for the small and medium size firms. The sale of services and goods into the foreign market is difficult for them rather serving the domestic market. A lack of knowledge of different languages, difference in culture, exchange regulations and trade regulations having the major impact on exporting the goods. But normally there are have more advantages than importing. One of the major advantages of export is the ownership advantage which is specific to the firms international experience, asset and ability of the exporter to  either develop the differentiated product or low cost product with in the values chain. A combination of investment risk and market potential is known as the location benefit of the particular market combination. In order to retain the core competencies within the organization and stitching it throughout the country without retaining the license, selling or outsourcing is the international advantage in export. Some of the organizations having lower level of ownership advantage may do not enter into the foreign markets. In case a company’s products and company’s ownership equipped with the international advantage and ownership advantage, the entry can be made through low risk model known as exporting under the eclectic paradigm. There is low investment requires in exporting of goods than the other modes of inter national trade and expansion such foreign direct investment. Somehow it is recognized that the lower level of risk result in ,lower level of rate of return than possibly the other modes of international trade. On the other hand the usual return on international trade in export sales might not have greater potential but also there will be no risk. In export of goods the managers are allowed to exercise the various operational control however it does not have the option over the control of marketing activities of the company. The end consumer of exported goods is far away from the exporter though the various intermediaries can manage the risk. Export performance is one of the strongest areas of Sri Lanka’s economy at the present time. It can be best described as a growth area. If you were to take exports as a whole, there has been an improvement of around 14% across the board, in terms of the foreign exchange that was realized by Sri Lankan exports. However, in some sectors, the growth has been very much more. For example, in the electronic sector, it is as high as 80%, with rubber performing at 45%, wooden products at 57%, and so on. And also emphasis that the government’s policy is not restricted to enhancing the quantum of foreign exchange that we earn from exports. Earning more foreign exchange is important as the country requires it, but we do not intend to stop there. This is a necessary condition but we do not see it as being sufficient. One of the main policy objectives is to ensure that all benefits percolate down to the grassroots level. In other words, there has to be an equitable distribution of wealth and income right throughout the country. So Sri Lanka is today referred to as a ‘middle income country’ with a per capita income  of US$ 1,370. However, one of our problems is that the distribution of income within the country is far from equitable. A good example of this is the fact that the per capita income in the district of Colombo is seven times what it is in districts such as Monaragela, Pollonnaruwa and Hambantota. Thus we need to address the inequities that are inherent in that situation. This is why the putting a particular emphasis on the concept of ‘export promotion villages’ that are being developed around the country. However in this year Imports in Sri Lanka increased to 1845.30 USD Million in July of 2014 from 1439.40 USD Million in June of 2014. Imports in Sri Lanka averaged 1035.70 USD Million from 2001 until 2014, reaching an all time high of 1986.40 USD Million in November of 2011 and a record low of 408 USD Million in February of 2002. (Reported by the Central Bank of Sri Lanka) Normally we export different type of goods like Apparel, tea, rubber coconut gems etc†¦ In those industries the tea industry is perhaps Sri Lanka’s most strategic economic sector and pure Ceylon tea our only internationally known brand. We are the world’s biggest tea exporter, manufacturing more than 300 million kilos of black tea annually, almost all of which is exported. Our orthodox teas usually sell at a premium over other orthodox teas from elsewhere. Therefore we can increase that industry and get more economical profit for our country. In importing we have to pay more money with huge taxes to other countries, and in that situation we waste our money more. But if we focus more on export sector explanation and diversification we can improve our productions, develop our manufactures, and finally we can export those productions for other countries, then we can earn more profit. Don’t want to pay unessential money for other countries if we’ll develo p our exporting industry. In that case we can increase jobs for our people also, and we can develop our economy. So, mainly Imports and exports may seem like general terms that have little bearing on everyday life, but they exert a profound influence on the consumer and the economy. In today’s interlinked global economy, consumers are used to seeing products and produce from every corner of the world in their local malls and stores. These overseas products or imports provide more choices to consumers and help them manage strained household budgets. But too many imports in relation to exports which are products shipped from a country to foreign destinations can distort a  nation’s balance of trade and devalue its currency. The value of a currency, in turn, is one of the biggest determinants of a nation’s economic performance. So finally studying about those cases I also think the country should focus more on export sector explanation and diversification than promoting the import substitution Industries (ISI).

Gatsby Expository Paragraph

His love for Daisy took him far out of reality and turned him into a temporary zombie. The imagery of foul dust floating shows that Gatsby love for Daisy is a parasite in his mind and t hat the dust is pointless, like his love for Daisy. Daisy truly takes Gatsby away from his current t state of mind, when he thinks of her that's all he can focus on. Also, after Gatsby has given N kick and Daisy a tour of his house, he describes Gatsby)ads doubtful expression and how that eve en â€Å"Daisy tumbled short of his dreams† (95).This shows that Gatsby idea of Daisy maybe even more powerful than the reality of the situation. Having committed so much time to Daisy, any thing that â€Å"falls short† of his perfect outcome with her will let hurt him very emotionally in a b ad place. This shows how Gatsby visions of Daisy take him out of reality and make his dread ms unachievable. When Gatsby is thinking about Daisy, he is taken out of reality because his ex peculations of this ex traordinary life with her are not realistic.Right after Gatsby party when In k describes Gatsby as reminiscent and â€Å"talked a lot about the past† and that â€Å"he wanted t o recover something, some idea of himself perhaps, that had gone into loving Daisy/' (1 1 0). This goes back to how unachievable something in the past is, it was already over and cannot be changed. Also, Gatsby/s idealism is taking him away from reality and its implying that part of Gatsby past has been wasted on an unrealistic situation of Daisy and Gatsby being together, w hen Daisy already was with Tom.

The Pentagon Papers essays

The Pentagon Papers essays On June 13 1971, governmental accountability and the American peoples faith in their government was lost as the New York Times published the top secret - sensitive Pentagon Papers. Commissioned by Defense Secretary Robert McNamara and written by Daniel Ellsberg, this 7 000-page document outlines the American Involvement in Vietnam from the 1940s to the late 1960s. It included specific details on everything from the CIAs involvement in the early 1950s up to Nixon and Kissingers discussions on using nuclear weapons during the later stages of the war. This paper will outline expert opinion on this document, some will be for the value of the papers and others will discount their true value. However the main purpose is to give a well rounded view of whether national security or public awareness takes precedence in an extremely volatile situation, such as the Vietnam War. The key to understanding the Pentagon Papers, is understanding two key men Robert McNamara and Daniel Ellsberg. It was McNamaras mind which envisioned them and Ellsbergs hand which opened them to the public; however these two arent as different from each other as they may seem. Robert McNamara was secretary of defense for both the Kennedy and Johnson presidencies; he was also keen to understand how the entire Vietnamese situation came about from 1945 onwards. This is considered by many to be the primary reason for the compilation of the Pentagon Papers, McNamara has stated he wanted to preserve the information for scholars to study in future years . McNamara could see the war was going badly and he may have also wanted background into a conflict that had been boiling over since well before the Kennedy Administration. He commissioned the document in June 1967 citing that he wanted an encyclopedic history of the Vietnam war written within the department of defense and put Leslie Gelb in charge of...

Randy Johnson essays

Randy Johnson essays Randy Johnson is a man of many fine characteristics on and off the field. Since he has come to the Diamondbacks organization he has already won a world championship and lead the team to three division titles. He has won four Cy young awards and three of the past three years. Off the field he supports foundations such as Cystic Fibrosis and ChildHaven. Johnson's main weapons are a fastball that can reach triple digits on the radar gun and an 89 MPH slider that can look like a fastball but break onto a righthanded hitters' shoetops. But on occasion he also will try to throw a backdoor slider on the outside corner. And he has added a couple pitches that he'll use a handful of times per game a split-finger pitch and a two-seam fastball. With a runner on first base, for example, Johnson might try a two-seamer to get a groundball instead of expending more pitches on a strikeout. The subject of a humorous commercial when he first came to Arizona, Johnson's hitting has improved. But he still managed just eight singles in 80 at-bats last season. His bunting ability is average. His fielding is poor; he has a tendency to hurry throws and also subject his defensive mates to the same type of movement he features on his pitches. While Johnson doesn't have a great pickoff move, he'll get some outs that way because of persistence. As much as I admire Randy's playing ability on the field, I admire his personality and generosity off the field even more. He sets a model for all of us. Randy Johnson is very active with his local chapter of the Cystic Fibrosis Foundation. Randy serves as co-chair of the Mariners' annual CF Golf Tournament and auction, which raises over $100,000 annually and is one of the CF Foundation's largest fund raisers in the country. In his tenure as co-chair (along with Jay Buhner), the golf tourney has raised over a half million dollars to help find a cure for this crippling disease. ...

Definition and Examples of Questions in English

Definition and Examples of Questions in English In grammar, a question is a type of sentence expressed in a form that requires (or appears to require) an answer. Also known as an interrogative sentence, a question is generally distinguished from a sentence that makes a statement, delivers a command, or expresses an exclamation. In terms of syntax, a question is usually characterized by inversion of the subject and the first verb in the verb phrase, beginning with an interrogative pronoun or ending with a tag question. Linguists commonly recognize three main types of questions: Yes-No Questions, Wh- Questions, and Alternative Questions. Examples and Observations This is a question that no one particularly wants to hear, but, where did they put his head?(Xander in Teachers Pet. Buffy the Vampire Slayer, 1997)I know this is a silly question before I ask it, but can you Americans speak any other language besides English?​  (Diane Kruger as Bridget von Hammersmark in Inglourious Basterds, 2009)Question is, what did camouflaged robot mercenaries want with you? And how did you get inside the TARDIS?​  (The Doctor in The Runaway Bride. Doctor Who, 2005) Structuring Questions To form a polar question (one expecting yes/no as an answer), the first auxiliary verb, which bears a tense inflection, is moved to the front of the clause. Corresponding to John was eating the halva we get Was John eating the halva? There must be at least one verb in the auxiliary for question formationif the VP contains none of have, be or a modal then do must be included to take the tense inflection; thus, corresponding to the statement John ate the halva, we get the question, Did John eat the halva?   A wh- question (expecting a phrase or clause as answer) involves the same fronting, and in addition a wh- word (who, whom, whose, what, which, how, why, where or when), which refers to the same constituent of the main clause, must precede the preposed auxiliary word. Compare John was hitting Mary with Who was hitting Mary?  Mary arrived yesterday with When did Mary arrive? and John ate the halva with What did John eat? If the constituent being questioned had a preposition associated with it, then this may either be moved to initial position, before the wh- word, or it can be left in its underlying position in the clause. Thus, corresponding to He owes his success to hard work we can have either What does he owe his success to? or To what does he owe his success?(R.M.W. Dixon, A New Approach to English Grammar, on Semantic Principles. Oxford University Press, 1991) Examples of Question Types [In the following joke, the attorneys initial wh- ​question is followed by two yes-no questions and a final alternative question.]A woman went to an attorney to ask about a divorce.What grounds do you have, madam?About six acres.No, I dont think you quite understand. Let me rephrase the question. Do you have a grudge?No, just a parking space.lll try again. Does your husband beat you up?No, l always get up at least an hour before he does.The attorney could see he was fighting a losing battle. Madam, do you want a divorce or not?Im not the one who wants a divorce, she said. My husband does. He claims we dont communicate.(adapted from The Mammoth Book of Humor, by Geoff Tibballs. Carroll Graf, 2000) Intonation in Questions American English typically has rising intonation across the utterance for what are called yes-no questions (She bought a new car?) and falling intonation for information-seeking questions (also called wh- questions) (What does she want to buy?), although there is much variation in these patterns in both American and British dialects.​  (Kristin Denham and Anne Lobeck, Linguistics for Everyone. Wadsworth, 2010) Why Ads Use Questions Questions, like commands, imply a direct address to the readerthey require someone to answer. Thats why they are often used on magazine covers, like these from one issue of Cosmopolitan: At long last love. Are you sure its the real thing?THE CONDOM. Whats in it for you?Hired or fired? How to leave your job in style. We take them as requiring a response, like a ringing phone. There is another more subtle effect questions can havethey can contain presuppositions that are almost impossible to discard if one interprets the text.​  (Greg Myers, Words in Ads. Routledge, 1994) Questions as Technologies in Disguise Questions, then, are like computers or television or stethoscopes or lie detectors, in that they are mechanisms that give direction to our thoughts, generate new ideas, venerate old ones, expose facts or hide them.​  (Neil Postman, Technopoly: The Surrender of Culture to Technology. Alfred A. Knopf, 1992)

Guarding Efficiency of Emergency Informational Systems to Protect Essay

Guarding Efficiency of Emergency Informational Systems to Protect Citizens - Essay Example With the ever-changing advancements in technology, however, many of its operations, including its 911 operations system, require improvements for efficient communication to adequately accommodate the needs and provide sufficient safety for all citizens. According to former fire Lieutenant Michael Pena, information sharing is an essential component of any rescue operation. Without proper information sharing, a rescue operation could be frustrating (Golden, 2006). Thus, a centralized source of information offers efficient communication, which is critical for the operations of many organizations (ISACA). A centralized source is even more effective when it has the capabilities to quickly relay information to other sources. Of FLPD's three major bureaus, the Support Services Bureau contains The Information Services Division, which handles all communication functions (SafirRosetti, 2006).Within the Information Services Division is the Information Systems Unit (ISU). The ISU is connected to many important systems to support and manage numerous critical functions. For example, the ISU's informational contribution to Florida Crime Information Center Systems adds pertinent information to The National Crime Information Center Systems. The Information Services Division also includes the Public Safety Communications Center, which is responsible for processing incoming calls, dispatching, and teletype (SafirRosetti, 2006). Since 1925, FLPD's communication system has upgraded from one telephone to a center that provides 911 computer and radio communications for approximately 700 police and 300 fire employees (flpd.org). Each year the center handles approximately 500,000 phone calls, which at times require that the dispatcher rely upon information from other informational sources. In response, a dispatcher must evaluate a call before dispatching the appropriate unit. A phone call requiring a police response is entered into the Computer Aided Dispatch System (CAD) before forwarded to the dispatch section. Managed and supported by the ISU, the CAD matches and relays pertinent information. Thus, a dispatcher could consult the ISU via the CAD and warn a responding officer of much need information prior to his or her arrival on a crime scene. Without knowing the priors of a violent criminal from another state, an officer responding to a 911 call would be ill prepared and vulnerable. On the other hand, an aware officer could better assess the criminal and situation and handle them accordingly. Thus, the interconnectivity of systems provides invaluable information and should be preserved and protected. Adequacy in Systems Protection Preservation and protection for vital information is essential. Further, reliability of the information retrieved from the system assures deciding officers and equips them with confidence when making decisions. Faulty information from the system could result in an officer making a grave mistake. In addition, faulty information results in time lost when a department tries to recover from

The Impact of Family Ownership on Financial Performance Essay

The Impact of Family Ownership on Financial Performance - Essay Example Another problem with application of the data to test the equation is possible existence of other variables that the used data failed to control. While the research focused on studying effect of family ownership on performance, many factors to organizational performance exist that could confound the analysis results. Ensuring control was therefore necessary and could be achieved through identification of possible confounding variables and analyzing organizations with similar levels measurement of the variables. Analysis of potential effects of the variables for adjustment measures would also remedy their confounding effect to ensure suitability of the data in testing the model. Small sample size is another problem that that testing the model with the data faces. External validity is a significant factor to quantitative research and defines the potential to generalize findings from a sample to a population. The measure is directly proportional to sample size and the small sample size m eans that developed information and conclusion from the analysis cannot be inferred to performance of the categories of companies in Hong Kong. This limits the scope of qualitative research and renders the analysis ineffective (Hays and Singh, 2011). The probability value for the coefficient estimate informs the decision on its statistical and economic relevance. The probability value of 0.15, which is relatively small, means that the coefficient estimate for the relationship is statistically significant for an 80 percent confidence interval. This high probability cannot be ignored and justifies the decision for statistical relevance. Statistical significance is however more precise than economic significance by observing set limits for the significance. Contrary to this, economic significance exists even with a minimal probability of occurrence, as well as there is a chance. A probability of 0.15 for beta means a probability of 85 percent exists for a

Love- The Gaps of the dispute settlement process of WTO Research Paper

Love- The Gaps of the dispute settlement process of WTO - Research Paper Example The WTO agreements include intellectual property, goods and services2. They state the principles of liberalizations along with the legalized exceptions. They comprise of obligations of individual countries to lessen custom tariffs along with other trade obstacles and to open service markets3. The methods of settling the conflicts are also prepared by them. The agreements tend not to be static in nature, however, they are renegotiated according to the requirements and thus newer agreements can be added to the package4. It is quite significant for the government to make their trade policies quite transparent by informing the WTO regarding the laws in force along with the measures adopted as per the WTO agreements. Numerous WTO councils’ along with the committees’ main function is to check if the requirements are being followed and the WTO agreements are being executed correctly5. In order to put into effect the rules and to ensure that the trade is conducted in a smooth way, the WTO’s method for solving the trade conflicts under the Dispute Settlement Understanding is crucial6. The countries bring into notice the disputes if they feel that their rights under the agreement are being disobeyed. Judgments by specially appointed independent experts are generally based upon interpretations of the agreements along with involvement of the individuals. The members of the WTO have approved to the fact that if they feel that their fellow-members are not obeying to the trade policy then in order to settle the disputes they will make use of the bilateral system rather than taking steps unilaterally7. This implies that it is significant for them to abide by the decided methods and thus value the judgements. The WTO’s conflict settlement conformity is also referred to as the ‘Understanding on Rules and Procedures Governing the Settlement of Disputes (DSU)’. It is the main

Broca's Aphasia Treatment - Response Elaboration Training (RET) Research Paper

Broca's Aphasia Treatment - Response Elaboration Training (RET) - Research Paper Example Damage to the Broca’s area can cause severe aphasia or difficulty in speech. An element through which Broca’s aphasia can be treated is a technique known as the Response elaboration training. This essay would further discuss the etiology of Broca’s aphasia along with its option of treatment in adult patients (Guyton & Hall 2011; Fazio et al 2009). Aphasia generally describes a condition in which an individual has impaired language skills. It can occur due to damage to the regions of the brain which are responsible for language. Broca’s area is a non fluent type of aphasia which occurs in the frontal lobe of the brain. In this type of aphasia the individuals are not able to speak whole words or they have difficulty speaking them. In this type of aphasia some motor movements of the individual are also affected because the frontal lobe is also affected. Commonly aphasia occurs due to accidents which harm the structures in the brain, a tumor in the brain, infection of the brain and dementia. It is because of these problems that the sensory pathways do not transmit the signals properly and hence aphasia occurs (Guyton & Hall 2011; LaPointe 2005). Broca’s aphasia is characterized by problems in speaking or writing language. It is also called motor aphasia, expressive aphasia or non-fluent aphasia. The individuals are not able to speak fluently and hence have difficulties in making up sentences. The individuals face difficulties when speaking up full words. The individuals are not able to make up sense with their sentences. For example individuals would just use two words such as ‘glass, table, where the individual tries to say that the glass is on the table. (Fazio, 2009). At first it was believed that Broca’s aphasia was only associated with language comprehension but recent research suggests that it also affects other portions of cognition through which individuals cannot perform and understand actions properly (Grafton et al 1996;

Analysis of Letter to the American people Essay Example | Topics and Well Written Essays - 750 words

Analysis of Letter to the American people - Essay Example to dissolve in religious frenzy that prompts him to submit: â€Å"(Q2) As for the second question that we (bin Laden) want to answer: What are we calling you to, and what do we want from you? (1) The first thing that we are calling you to is Islam. (Letter). Thus bin Laden is merely a religious salesman and because of this does not possess the credibility to speak for the Islamic world regarding other issues. Firstly, the charges he levels against US support of Israel seem vacant in light of certain realities. He accuses us, saying, â€Å"As for the first question: Why are we fighting and opposing you? The answer is very simple: (1) Because you attacked us and continue to attack us... You attacked us in Palestine.† (Letter) Of course by this he means through our support of Israel, Palestinians have suffered. Or does he? Many critics point out that al Qaeda has been conspicuously absent from any efforts to help the Palestinians in any way other than vocal support for suicide bombers, the satisfaction of which is reflected in his statement... "Think not of those who are killed in the way of Allah as dead. Nay, they are alive with their Lord, and they are being provided for. They rejoice in what Allah has bestowed upon them from His bounty and rejoice for the sake of those who have not yet joined them, but are left behind (not yet martyred) that on them no fear shall come, nor shall they grieve. They rejoice in a grace and a bounty from Allah, and that Allah will not waste the reward of the believers." [Quran 3:169-171] (Letter) He attempts to prove a point, and it’s a religious one having nothing to do with the Palestinians securing their own state—a position forwarded by many American diplomats over the years and just recently given as a stated goal of the Obama administration. This goal, as it appears at the moment, comes over the objections of the new Israeli leadership. â€Å"...you attacked us in Palestine,† is a clear effort to connect the Palestinians with

Broca's Aphasia Treatment - Response Elaboration Training (RET) Research Paper

Broca's Aphasia Treatment - Response Elaboration Training (RET) - Research Paper Example Damage to the Broca’s area can cause severe aphasia or difficulty in speech. An element through which Broca’s aphasia can be treated is a technique known as the Response elaboration training. This essay would further discuss the etiology of Broca’s aphasia along with its option of treatment in adult patients (Guyton & Hall 2011; Fazio et al 2009). Aphasia generally describes a condition in which an individual has impaired language skills. It can occur due to damage to the regions of the brain which are responsible for language. Broca’s area is a non fluent type of aphasia which occurs in the frontal lobe of the brain. In this type of aphasia the individuals are not able to speak whole words or they have difficulty speaking them. In this type of aphasia some motor movements of the individual are also affected because the frontal lobe is also affected. Commonly aphasia occurs due to accidents which harm the structures in the brain, a tumor in the brain, infection of the brain and dementia. It is because of these problems that the sensory pathways do not transmit the signals properly and hence aphasia occurs (Guyton & Hall 2011; LaPointe 2005). Broca’s aphasia is characterized by problems in speaking or writing language. It is also called motor aphasia, expressive aphasia or non-fluent aphasia. The individuals are not able to speak fluently and hence have difficulties in making up sentences. The individuals face difficulties when speaking up full words. The individuals are not able to make up sense with their sentences. For example individuals would just use two words such as ‘glass, table, where the individual tries to say that the glass is on the table. (Fazio, 2009). At first it was believed that Broca’s aphasia was only associated with language comprehension but recent research suggests that it also affects other portions of cognition through which individuals cannot perform and understand actions properly (Grafton et al 1996;

Tools Used for Examining Frauds Term Paper Example | Topics and Well Written Essays - 2000 words

Tools Used for Examining Frauds - Term Paper Example They grab the attention of the clients by promising them quick money (Coderre, 2009). Detection of financial frauds required experienced forensic accountants. They are basically accountants, auditors, and investigators of financial and legal documents who are hired by the company to look into possible financial frauds taking place. There are different varieties of financial frauds. The range can spread from a simple theft to more complicated frauds and identity thefts. Some of the common types of financial frauds are; check fraud, banking/identity fraud directs theft, invoices and payments fraud. Four basic frauds that occur in a business are; Embezzlement, internal theft, payoffs and kickbacks and skimming (Imoniana, Antunes & Formigoni, 2013). Embezzlement which is also known as larceny occurs when the personnel who are appointed to control the funds, use them illegally for their personal gain (Petrucelli, 2013). Internal theft takes place when company assets such as company products or supplies are stolen by the employees. This causes inventories to shrink down. Pay-offs and kickbacks are kinds of bribery which are often reported by the companies. These occur when employees take money from the receipt and that transaction is not recorded. Other important frauds are Money laundering, Mortgage fraud, Racketeering/ RICO, Securities fraud, payroll-fraud, manipulation of sales figures, tax evasion, use of fictitious invoicing, stealing money from company accounts, duplicate billing, accounts receivable fraud, financial statement fraud, etc. Money Laundering is the process of movement of illicit money and other profits through legitimate channels with the purpose of disguising the illegal source of the money to prevent from tax officials (Wells, 2010).  

Child Sexual Abuse Case Management

Child Sexual Abuse Case Management Rape: Child Sexual Abuse Deirdre F Smith Social Work and Criminal Justice A violent crime is a  crime  in which an offender uses or threatens force upon a victim. This entails both crimes in which the  violent  act is the objective, such as murder, as well as crimes in which violence is the means to an end, such as robbery. Violent crimes may, or may not, be committed with weapons. Depending on the jurisdiction, violent crimes may vary from homicide to harassment. (Violent Crime) Rape falls into the category as a violent crime. Rape is a type of  sexual assault  usually involving  sexual intercourse  or other forms of  sexual penetration  initiated against one or more individuals without the consent  of those individuals. The act may be carried out by physical force, coercion, abuse of authority or against a person who is incapable of valid consent, such as one who is unconscious, incapacitated, or below the legal age of consent. The term rape is sometimes used interchangeably with the term sexual assault. (Rape) It is commonly believed that rape only happens to women and children, but this is false because it can also happen to men. Rape is not about sex, but about power. One out of every six American womenhas been the victim of an attempted or completed rape in her lifetime. 17.7 million American womenhave been victims of attempted or completed rape. The Average number of rapes that occur annually in the United States is 89,000. Men make up 3% of the total rapes. Children under the age of 12 make up 15%.There is still 60% of rapes never reported and 95% of college rapes are also never reported. There are 47% of rapes that have occurred while both the victim and perpetrator had both been drinking. Victims of rape are more likely to suffer from depression, post-traumatic stress disorder, abuse alcohol and/or drugs, and contemplate suicide. (Who are the Victims?) The rape of a child is referred to as child sexual abuse. Child sexual abuse is a form of  child abuse  in which an adult or older adolescent uses a child for sexual stimulation. Forms of child sexual abuse include asking or pressuring a child to engage in  sexual activities  (regardless of the outcome),  indecent exposure(of the genitals, female nipples, etc.) to a child with intent to gratify their own sexual desires  or to intimidate or  groom  the child, physical sexual contact with a child, or using a child to produce  child pornography. The  American Psychiatric Association  states that children cannot consent to sexual activity with adults, and condemns any such action by an adult: An adult who engages in sexual activity with a child is performing a criminal and immoral act which never can be considered normal or socially acceptable behavior. Rapes can occur in either the perpetrators or victims’ home, in a vehicle, outdoors, in a bar, or anywhere. Sometimes it can occur in the home that both the victim and perpetrator share, because most people are raped by someone they know including a spouse. Since rape or sexual assault is under reported only about 3% of rapist will ever spend a day in jail. (Rape Statistics, 2014) Under federal law, the punishment for rape can range from a fine to  life imprisonment. The severity of the punishment is based on the use of violence, the age of the victim, and whether drugs or intoxicants were used to override consent. If the perpetrator is a repeat offender the law prescribes automatically doubling the maximum sentence. A person who has committed such offenses gains the label as a sex offender. Once you are given that title you will forever carry that label. Even upon release of incarceration, one still must register as a sex offender with local law enforcement and follow specific guidelines which includes, informing law enforcement if you move and update any information. You will be placed in a public database where your status is automatically known. Children who have been sexually abused may feel guilty, ashamed, or confused so, they may not tell anyone. There are symptoms that you can look for they may tell you that a child is being sexually abused. The symptoms include withdrawal from friends or activities, may become aggressive, changes in school behavior and attendance, depressed, and attempt to runway or commit suicide. There can also be physical signs of sexual abuse such as, Sexual behavior or knowledge thats inappropriate for the childs age, pregnancy, sexually transmitted diseases (STDs), trouble walking or sitting, or sexually abusing other children. (Child Abuse Symptoms) Children who have been abused sexually are 25% more likely to experience teen pregnancy. The effects of child abuse are also that they begin drug and/or alcohol use, commit violent crimes, become depressed, and have low self-esteem. Some may actually become abusers themselves. They develop psychiatric disorders that carry on into their adulthood. Some will become involve in abusive relationship and some become promiscuous. As adults they may even take jobs as prostitutes. (Rape Statistics, 2014) As a social worker, working with sexually abused children you may experience conflicts between personal values and professional values. There are certain standard you must adhere to according to the NASW when dealing with adolescence. Standards for the Practice of Social Work with Adolescents: Standard 1. Social workers shall demonstrate knowledge and understanding of adolescent development. Standard 2. Social workers shall demonstrate an understanding of and ability to assess the needs of adolescents; access social institutions, organizations, and resources within a community that provide services for adolescents and their families; and advocate for the development of needed resources. Standard 3. Social workers shall demonstrate knowledge and understanding of family dynamics. Standard 4. Social workers shall demonstrate acceptance of and contribute to the development and maintenance of culturally competent service delivery. Standard 5. Social workers shall possess or have access to specialized knowledge of the legal, regulatory, and administrative requirements and resources for youths and their families. Standard 6. Social workers shall strive to empower adolescents. Standard 7. Social workers shall advocate for an understanding of the needs of adolescents and for resources and cooperation among professionals and agencies to meet those needs. Standard 8. Social workers shall participate in multidisciplinary case consultation across agencies that provide services to adolescents and their families. Standard 9. Social workers shall maintain confidentiality in their relationship with youths and of the information obtained within that relationship. Standard 10. Social workers shall assume an active role in contributing to the improvement and quality of the work environment, agency policies and practices with clients, and their own professional development. (NASW Standards for the Practice of Social Work with Adolescents, 1993) Treatment of child sexual abuse is a complex process. Orchestration of treatment in the childs best interest is a genuine challenge. Moreover, it is often difficult to know how to proceed because there are so few outcome studies of treatment effectiveness. When working with children it may be difficult because of lack of support from the family. Establishing trust with the child may be difficult. One of the reasons sexual abuse treatment is such a challenge is that it occurs in a larger context of intervention. Therefore, coordination is of utmost importance and ideally is provided by a multidisciplinary team. Treatment issues are then handled by the team as part of overall intervention. The following issues are the most important of those the team should consider at this stage of intervention: separation of the child and/or the offender from the family, the role of the juvenile court, the role of the criminal court, the treatment plan for the family, visitation, and family reunifica tion. (Child Welfare Information Gateway) Case management decisions are often provisional; that is, they are based on what information about the family members and their functioning is available when decisions are made. Treatment is often a diagnostic process. The positive or negative responses of family members to treatment determine future case decisions. Outcomes of court proceedings can impinge upon and alter case management decisions and treatment. (Child Welfare Information Gateway) Before you can give a child a treatment plan you have to consider should the child remain a part of the family, do the courts have a role in the case, and is there a question of visitation? This is actually where the conflict of person and professional values arises. You may feel that if the child was sexually abused at home, they should never be allowed to return. Professionally, reunification with the family is the goal if at all possible. The task of the therapist is to make victims feel whole and good about themselves again. Work, mentioned above, that addresses the issue of self-blame is helpful. However, so are interventions that help children view themselves as more than merely victims of sexual abuse. Normalizing and ego-enhancing activities, such as doing well in school, participating in sports, getting involved in scouts, or helping a younger victim, can be very important in victim recovery. (Child Welfare Information Gateway) Treatment options include group therapy, individual treatment, and family therapy. Group therapy is generally regarded as the treatment of choice for sexual abuse. However, usually groups are offered concurrent with other treatment modalities, and some clients may need individual treatment before they are ready for group therapy. Individual treatmentis appropriate for victim, offender, and mother of victim (as well as for siblings of victims and survivors). As a rule, an initial function and a major one for individual treatment is alliance building. All parties have to learn to trust the therapist and come to believe that change is possible and desirable. The members of this triad may have different levels of commitment to therapy, with the victim usually the most invested and the offender the least. Family therapyis the culmination of the treatment process and is usually not undertaken until there has been a determination that reunification is in the victims best interest. (Child We lfare Information Gateway) The reason I chose to this topic is not because a family member or a friend sexually abused me, but at the age of 17 I was raped by seven guys who I did not know. I did not say anything after it occurred because I felt like it was my fault. I was somewhere I shouldn’t have been and my parents didn’t know. In a way I thought of it as punishment for being disobedient. Afterwards, I had become angry, aggressive, and rebellious. I would run away from home because I caused all types of problems there. At that time I was in college, but of course I quit going. I began cutting myself and I showed other emotions other than anger. Finally, after trips to the Detention Center my mother finally took me to St. Dominic Mental Health. My therapist tried to talk to me, but of course I refused to talk. He told my mother I had sociopathic symptoms, because I showed no emotions and would not open up. After those attempts I was still acting out. She finally took me to a place called Our House Shelter. It was a runaway shelter. There I had group therapy and individual therapy. That’s where I found my help. It was a social worker named Ms. Tara who reached me. I have a great mother because she knew something was wrong with me and tried everything she could to help me. She could’ve given up on me but she didn’t. She still doesn’t know what happened to me and chose not to tell her. She was just happy to have her daughter back to normal. I have seen a couple of the guys throughout the time, but I have heard most of them are in jail or dead. Do I regret never telling? Yes, because I could have stopped someone from experiencing what I did. Because of that situation and the fact that I’m here has made me stronger. References Child Abuse Symptoms. (n.d.). Retrieved November 2014, from Mayo Clinic: http://www.mayoclinic.org/diseases-conditions/child-abuse/basics/symptoms/CON-20033789 Child Welfare Information Gateway . (n.d.). Retrieved November 2014, from U.S. Department of Human Health Services: https://www.childwelfare.gov/pubs/usermanuals/sexabuse/sexabusef.cfm NASW Standards for the Practice of Social Work with Adolescents. (1993). Retrieved November 25014, from National Association of Social Work: http://socialworkers.org/practice/standards/sw_adolescents.asp Rape. (n.d.). Retrieved November 2014, from Wikipedia: http://en.wikipedia.org/wiki/Rape Rape Statistics. (2014, July 8). Retrieved November 2014, from http://www.statisticbrain.com/rape-statistics/ Violent Crime. (n.d.). Retrieved November 2014, from Wikipedia: http://en.wikipedia.org/wiki/Violent_crime Who are the Victims? (n.d.). Retrieved November 2014, from RAINN: https://www.rainn.org/get-information/statistics/sexual-assault-victims

The Causes of Divorce :: Expository Cause Effect Essays

The Causes of Divorce There are as many theories on this issue as there are people offering them. The usual explanations are communication, compromise, and commitment, and it’s hard to disagree with them. Indeed, if both spouses were consistently able to communicate with each other, able and willing to compromise with each other, and 100% committed to their marriage, it’s hard to see how it could fail. The vexing question, of course is HOW do they foster communication, compromise, and commitment? Here the explanations diverge. For those with a fundamental faith foundation, the answer is clear. Marriages work if both spouses obey the principles of the faith. For a more prosaic explanation, check marriagebuilders.com, where therapist Willard Harley lays out a simple set of principles he says any couple can use to help their romance survive and thrive. The principle that creates the most stir with groups I address is from Cosmopolitan magazine a few years back, namely that the most reliable indicator of the success of a marriage is the extent to which both the husband and wife had close, long-term, platonic relationships with members of the opposite sex before they met. When you think about it, this makes sense. It’s startling to reflect on how little time husbands and wives spend in genuinely romantic interaction. They will spend most of their married life relating to each other as friends. If either or both of them lacks the essential skills or inclination to do that, the marriage is unlikely to thrive. One thing I feel strongly about is how little impact adultery has on divorce, and I know that I'm going against the tide here. I hear constantly from all-knowing observers - many of them fundamentalist Christians - who proclaim that if you look behind most divorces, you'll find an adulterous affair somewhere. That may be partially true, because many divorces do involve adultery, but I believe adultery to be a symptom, not a cause, of most divorces. Adultery is a reaction to abuse, and it is a tool of abuse. Adultery is the legal "gotcha," but I don't think it causes many divorces. I think the crud that drives husbands and wives apart causes divorces.

Adding a Class to the School Curriculum Essay

Dear Principal, a class that specializes in focus, prioritizing, organization and study skills is absolutely necessary for any Middle School student. At my age and younger, students have a tendency to be disorganized both physically and mentally. I have a knack for losing and forgetting my homework assignments and my grades suffering. I know I am not alone in this struggle against clutter and forgetfulness. Critical thinking classes provide a student with structure, study skills and the art of prioritizing. I know personally the effects of school on a student who is unprepared and disorganized. The stress and sleepless nights can be avoided with a class dedicated to the student’s future. Unlike Math and Language Arts, this class would be linked with the students’ success in EVERY other class. The benefits would not only pertain to students, but to the enthusiasm and effectiveness of a teacher. Is there anything more important than preparing a student for his or her futu re? The skills learned in a critical thinking class would help a student not only through Middle and High School. The study skills and note taking strategies would also be useful and very beneficial in College and whatever career they choose to pursue in the future. A class dedicated on teaching a student to remain focused and take accurate notes in lectures would be beneficial to all the daydreamers, doodlers and dozers who can’t listen to a teacher and stay focused on the words coming out of her mouth. I know the effects all too well. As my teacher begins her daily rant, I shut my mind off and let it wander around the room. I see students snoring in the corner and others doodling in their notebook or flinging notes to each other as slyly as possible. I smile at their antics in relieving the exhausting boredom of a class like this. Only a handful of students are actually listening to the teacher and it is evident that they rather be anywhere else doing anything else. With lunch just ten minutes away the whole class is already leaning towards the door and staring hungrily at the wall clock. I am snapped out of my daydream by the shrill shrieking of the lunch bell above my head. Relief runs through me as the teacher dismisses us and our grumbling stomachs. As quickly as I possibly can I scramble to pack up all my things and rush to the lunchroom. I don’t even remember to write down the homework assignment! This forgetfulness is fueled by my inability to stay focused in any class much less the one right before lunch. The night before I had stayed up all night studying for a different test this inevitably leads to me being grumpy and unfocused for the following days. Especially since every night seemed to be a late night and with the stress and lack of sleep I am on the verge of snapping. The next day I fail the pop quiz along with almost all of the students who stopped listening to the teacher’s lecture, five minutes in. Mr. Principal, if students knew how to take accurate notes and focus, then the snoring in the back of the class would be brought to a minimum as well as all the other distractions in the room. Students would be more eager to learn if they understood how to do it in a way that works for them and they see the positive effects it can have on their lives. Grades overall would improve if students knew how to listen in class and study correctly. Instead of waiting until the night before a huge exam, reading words over and over until they become a jumbled mess of never ending letters and symbols, I could study one step at a time so that on the night before I can skim over the topics and be prepared to face the test. Being prepared keeps students from wanting to ditch school in order to avoid the test as a whole or just to sleep in and catch up on some Z’s. Preparation would also bring the lack of sleep and stress to a minimum. No longer would the piles of never ending homework and study guides hover over our worn out minds, not if we knew how to work ahead and prioritize what needs to be done now and what can be done progressively. It would help to keep students fresh, awake and ready to learn every morning. Not only could grades improve, but so would the school’s attendance record. Mr. Principal, students are more willing to come to class if there is something to look forward to. Instead of school being boring and torturous, it could be viewed as an opportunity to put the skills learned in their Critical Thinking class to the test. There would also be less problems waking up and therefore making it to class on time. No more napping in class, instead students would be note-taking and teachers would see the increased enthusiasm in their class. The teachers would be motivated to work even harder to teach their students all they can. Why would teachers want to teach if they know that the students couldn’t care less? If teachers see students participating and not acting out then they would also be motivated to help the students learn even more than what is specified in the curriculum. Regular and advanced students would surpass any of the other schools. The school would work at least ten times more efficiently and productively. Everyone would be enthusiastic and successful in school. Mr. Principal if adding a class could determine whether your school is average or above average, would you take the chance? The skills learned in Middle School Critical Thinking classes would have a lasting impression in a student’s life forever. With the added skills, advanced teachers, and motivation that a student gains while taking a Critical Thinking class would definitely up their chances of that student staying in school not only in High School, but progressing even in the College level. This is not a simple feat and many students who just don’t know how to keep their lives organized have a lot more chances of dropping out than the student who is well prepared and ready to take on anything the class has for them. In college most if not all the classes are lectures, if this bores a student or a student knows how to keep organized notes then the classes will be a lot harder. In comparison to High School, College has a lot more temptation to go party instead of studying, or hanging out with friends in your dorm instead of going over yesterday’s notes. This can lead to dropping grades and even dropping out of school. Peer pressure to drink, smoke and not study is a LOT stronger as the years go by. In college teachers are no longer on top of their students to do their assignments and to study like the teachers in Middle School and High School. Students have more freedom and a more responsibility to keep their grades intact and the choice to worry about their academic or their social life. This responsibility may be too much for an average student, but for a student who has been taught and has practiced their critical thinking skills, the choice is obvious. The students who have the discipline to prioritize correctly and put their school first will be more successful time and time again over the student who picks his social life over his â€Å"stupid† grades. The students who stay up until midnight cramming for an exam that they knew months before will also struggle with their own problems in the future. Mr. Principal, a student who has practiced discipline, prioritizing, focusing and productivity will be prepared for anything that can come at them in the future. It is your job to prepare your students and if your students aren’t improving then their academics are failing. This is not something that can be fixed with MORE work, but with a class that helps kids manage their time better. Skills like these are not only useful in college though. They are usef ul in the students’ career. Discipline and respect are very useful in an office setting especially when interning. Interns are usually put through a series of test before they are even accepted! Most of the time these tests have nothing to do with what one hundred twenty thousand times fifty is, but with how to manage two or three tasks at the same time and how to be adaptable in any situation. An intern who already knows how to take outline notes and schedule their days accordingly will have much more chances of succeeding in the business world over an unprepared slacker. Bosses look for organization and preparation in their employees, but above that they look for someone who looks the part. Before you even open your mouth in an interview, the only thing the employer sees is just how long you stayed up the night before preparing a last minute resume. The bags under your eyes and crumpled outfit won’t seem like a presentable and organized employee and the typos in your resume will stand out in comparison to the other applicant who worked on their resume for a week, reading and rereading it until it was perfection. The applicant who has her hair perfectly in place, her outfit ironed flat and fully prepared to speak to the employer has a lot more chances of being hired. This all goes back to you, Mr. Principal. The student’s ability to focus on the interview and be prepared depends fully on what opportunities YOU put in their lives when they are in your school. If Critical Thinking Classes aren’t offered in school then your students will be beat out in interview after interview not only for their careers, but for college and for advanced placement. This will hinder them in comparison to the students who have all the skill they taught in their Critical Thinking classes to help them through the interview and even to their promotions in work. Mr. Principal students deserve to have a class that will allow them to have an upperhand in classes, interviews and applications. Every student has the ability to have straight A’s and be successful, but not all of them have the skills needed to put their abilities to work and help them not only in Middle School, but for the rest of their lives. Mr.Principal you have nothing to lose and everything to gain. The admiration of both your staff and students and the incredible feeling that comes from knowing that you’ve made a difference in your students lives. Without a doubt, thanks to the Critical Thinking Class your school could benefit from the increased academic abilities of your students. This class will help students for generations to come, if you could go back in time wouldn’t you want to be given this chance?

Training Cycle Roles and Responsibilities

Describe what your roles and responsibilities are at each stage of the training cycle and explain what your boundaries are as a teacher The training cycle consists of four stages 1. Training need 2. Design/Planning 3. Delivery/Implementation 4. Evaluation Training need This is the initial stage of the training process. As a trainer/teacher I would require to identify the needs of the student/class. This would be to ensure that the direction of instruction is specific to their requirements. What is their role.What are they expected to do with the new knowledge. Is it being given at the correct time for their developmental needs. I would to do this by setting up initial assessment. Completion of pre course questionnaire. Enrolment/information sheet. In my role of Motorcycle instructor this would have taken place in a pre course assessment ride during which a face to face evaluation of their riding history would have taken place. All of this would identify to me their present knowledge and future learning requirements and enable me to structure the training correctly.I would be restricted in this area by the need to ensure there is adequate resources to give the training identified and that it meets the constraint of costings. Design/Planning This part has to be systematic and consistent. This can be achieved by having set aims and objectives. Decide what learning method is best suited to the student/class. Use of visual aids (flip charts, power point), discussions or involvement by participation (kinaesthetic). I would ensure that the content takes the student through from simple to complex learning.Build in assessments. This will allow me to check and monitor progress of delivery but also allow a check of knowledge. As a result a lesson plan would be formulated. I would consider the implications of costs, not only monetary but time as well. Does the design/plan fit within the time constraints to allow the subject matter to be delivered effectively. Delivery/Impl ementation Establish at the start my credibility to gain trust and confidence from the student/class. Ensure that I am fully prepared and have correct resources.Consider the student /class so that the pitch of the delivery can be gauged. This can be affected by class size, location and environment in which it is given. I would also have to consider welfare issues. I would ensure that the student/class feel free to engage in the lesson and contribute their ideas. I would not put pressure on them to give answers/thoughts. Make sure that if the pause and pounce method is used it is done with the correct timing to encourage response and not close the student down. Consider cultural differences.For instance some cultural etiquette would preclude male to female approach, gaining eye contact although good to establish rapport to some might seem a challenge or threat to others. Evaluation Evaluation would allow me to identify that the lesson has been learned. Have the aims and objectives be en met. Can or is the student/class able to transpose this new knowledge into their workplace or role. I would evaluate this by use of tests, exams, knowledge checks and feedback. This would highlight any further training need which in turn would be fed back into the training cycle.This aids me and also those who have initiated the training to establish, has it met the training aims/objectives (training needs). Can the design/delivery be improved. Is it cost effective. Was it effective. Conclusion As a teacher my role would be to allow and encourage student dialogue. Make sure that aims and objectives are met and are specific to their needs. Ensure that that there is a means of assessing the student knowledge. All students to have equal and appropriate advantages to learn, in a safe environment. I am responsible for the development of the student in their learning cycle.This is done by continual assessment or reassessment of both the student and the content/method of learning. Encou raging the broadening of student knowledge. I am bound to ensure that the balance of teacher/student relationship is maintained. I must also ensure that my opinion does not impose. This allows the student to have defined direction within the learning influence so that lines of order and respect are not blurred.Ref Points Practical Teaching a guide to PTLLS & CTLLS – Linda Wilson. Course Workbook. Internet.

How does Tony Harrison use language, form and structure to present grief in ‘Long Distance II’?

The poem ‘Long Distance II’ tackles the issue of bereavement and the emotions that are connected. In this poem, the speaker seems to be able to cope with the death of his mother and believes in a matter-of-factly fashion that â€Å"life ends with death†, however we learn that in reality he still feels grief and â€Å"calls the disconnected number† for his mother and father who have both passed away. The poet (Tony Harrison) uses few devices. This avoids an overly constructed and artificial style as Harrison wants to strike a more natural conversational tone.He uses words such as â€Å"he’d† and â€Å"can’t† to make the piece more understated and less theatrical. The use of enjambment also reinforces this idea. By running over lines, the poem becomes less methodical and well-planned out and more natural, as if it’s more of private confession rather than a structured poem. However the poet does discretely insert a slight per sonification when he mention’s his father’s â€Å"raw love†. Love is an abstract noun – something you can’t hear, taste, smell, see or touch. However Harrison decides to personify it, making it more human and fleshy.He makes love seem no longer invincible and robust, but instead makes it seem vulnerable and subject to injury. On the other hand, you could interpret the personified phrase â€Å"raw love†, in the way of his father’s heart being torn open by grief, revealing the fleshy wound which is still taking time to heal over. The poet bases his poem on the traditional sonnet. A sonnet is usually about love, and although this doesn’t immediately strike you as being a love poem, the primary message is that love and affection never truly dies.The writer has chosen to stick to the basic, monotone â€Å"abab† rhyme scheme of a sonnet. This shows him as being level-headed and emotionless, as the scheme is very rigid and regu lar. The use of iambic pentameter furthermore backs this up. Iambic pentameter is very regimental with emphasis on every other syllable. This again demonstrates his ability to remain stable during the grieving period. However, in the final quatrain, instead of ending it with the usual conclusive rhyming couplet, he brings in a completely new rhyme scheme.This shows him losing control, letting go of expectations and pouring out his raw emotions that he was earlier masking with his practical and detached appearance. This surprises the reader as it invites a completely new dimension and tone to the poem that is very unexpected. The poem is exactly 16 lines long. Although a sonnet is usually 14 lines long, this too reinforces the idea of a sonnet. Initially, the speaker uses blunt language to expose his seemingly practical and pragmatic response to bereavement.Harrison uses the word â€Å"dead† to show the speakers lack of euphemism. Whereas many people would subtly say that some one passed away, the speaker tells us in a straight forward way that his mum is â€Å"dead†. This coincides with when he tells us in a no-nonsense way that â€Å"life ends with death, and that is all†. However later on in the poem we find out that the speaker does miss his parents and still has their number in his â€Å"black leather phone book† which he calls.Although we may now think that the speaker is over his earlier emotionless self, the use of the words â€Å"black† and â€Å"leather† connotates coldness and masculinity linking directly back to his previous business-like attitude. Tony Harrison has used language, form and structure very effectively to capture the emotions of those grieving. He used specifically chosen language that showed informality yet decisiveness and structured his poem so that it represented the classic love sonnet but with a modern twist.

Depressive Disorders in Children and Adolescents Research Paper

Depressive Disorders in Children and Adolescents - Research Paper Example Son & Kirchner (2000) have conducted their research on the same topic and have pointed out the causes and consequences of depression upon children, according to which the family background as well as domestic environment certainly invite sadness among the young innocent individuals at large. The authors are of the view that depression is affecting 2 percent of pre-pubertal children and 5 to 8 percent of adolescents in the United States. While discussing the main reasons for increase in the depression level among the individuals belonging to early years, the authors also blame poor performance at school as one of the most prominent causes behind such gloomy mood of children. The authors have also mentioned the symptoms of depressive attitude, which include lack of mixing in family, disinterest in studies, recreational activities, including both indoor and outdoor, and reluctance to join the peers in sports and games. Greenberg (2009) has also conducted his study while focusing upon th e symptoms of depressive attitude in children and adolescence. The researcher submits to state that it was misconception that only the adults may experience depression; however the same disorder is frequently observed by the young ones.

Foreign Direct Investments in Bulgaria Assignment

Foreign Direct Investments in Bulgaria - Assignment Example This paper looks at these problems using a strategic analysis framework and proposes a few key solutions that will help the country find clear answers. The investment climate is a country's ability to attract or encourage foreign individuals or corporations to invest or bring in funds that will start or develop an ongoing business (Kotler et al., 1997, p. 189). Foreign investors pay attention to at least four attributes of a country's investment climate: its comparative and competitive advantages, its domestic economic and political stability, property rights protection, and foreign trade zones. Foreign investors will put in money in another country only if the investment climate is attractive, which means that there is a good chance the funds invested will make money and profits, that the government will not give the business difficult problems, and that the country can also benefit from the investment. Examples of FDI are funds to construct public roads and schools, to modernize the country's telecommunications facilities, or to develop energy generation plants. Countries like Bulgaria that want to develop its economy are doing its best to attract foreign businessmen so they will invest. Investors will know the four attributes of a country's investment climate by using a strategic analysis approach, where the country is treated like a bus... strategic analysis approach, where the country is treated like a business that wants to attract capital from foreign investors for business projects that will result in long-term profits for the investors and give benefits to the country and its people. There are many strategic analysis frameworks to choose from: Porter's Five Forces (1980) or Ansoff's Strategy Matrix (1965) applied to firms, or Porter's Diamond (1990) and Yip's Drivers (2003) used to analyse countries and firms strategically. A simple framework that applies to both firms and countries combines both the SWOT (Andrews, 1971/1987; Ansoff, 1965; Chandler, 1962) and PESTEL (Steiner, 1979; Andrews, 1987) techniques of strategic analysis into what is called the SWOT-PESTEL approach. We will use this to analyse Bulgaria's investment climate. Method of SWOT-PESTEL Analysis SWOT analysis is a review of the country's internal (Strengths and Weaknesses) and external (Opportunities and Threats) environment. PESTEL analysis studies the effects on the country's foreign direct investment environment of six general factors: Political, Economic, Social, Technological, Environmental, and Legal. The strategic analysis combines four SWOT and six PESTEL factors. We will do this by conducting a SWOT analysis of each of the six PESTEL factors based on literature available from our research and summarise our findings on table format, before we conclude with a list of four investment climate attributes as they apply to Bulgaria. This will help foreign investors make decisions, allowing them to compare Bulgaria's investment climate with that of other countries. We begin the paper with a brief write-up on Bulgaria, highlighting important issues the country is currently facing. Then, we proceed with our analysis by

Take home mid term Essay Example | Topics and Well Written Essays - 1500 words

Take home mid term - Essay Example This was during the Second World War. On the other hand, Soviet Union scientists were busy also developing their own nuclear weapons. The USA undertook the Manhattan project in secrecy since Britain and America did not trust the Soviet Union despite their allegiance at the time (Haass 67). America was the only nation after World War II which had nuclear power. It hoped that with the possession of nuclear weapons, it would manipulate and draw concessions from the Soviet Union. However, this was not to be the case since the Soviet Union also was continuously working behind the scenes to develop their own nuclear weapon. The Soviet Union was initially unable to build its own atomic weapon since the war limited its access to uranium. Thus, after the end of World War II, uranium deposits in Eastern Europe became readily available. The Soviet Union detonated its first nuclear bomb in 1949. Subsequently, both the United States of America and the Soviet Union commenced the construction of a hydrogen bomb. The United States tested the hydrogen bomb on November 1952. Also, the United States gain tested another hydrogen bomb in 1954 on bikini atoll. The introduction of the ICBMs (intercontinental ballistic missiles) was a major development during the arms race period (Weir Jr 87). Unlike bombers, missiles were seen as better carriers of nuclear warheads. To show the world that they could deploy a missile which could reach anywhere in the world, the Soviet Union launched into the earth orbit the sputnik satellite in 1957. The USA launched its version in 1959. The notion behind the nuclear arms race during the cold war was for supremacy purposes. The country with the largest arsenal would manipulate the other. Also, the mutual assured destruction concept or notion ensured that both the United States and the Soviet Union could not attack each other. Although both nations invested heavily in military defence programs, none of these were secure (Caldicott

Role and Functions of Law Paper Essay Example | Topics and Well Written Essays - 750 words

Role and Functions of Law Paper - Essay Example This paper outlines the roles and functions of law in the well-being of a venture in the corporate sector. It also outlines the necessity of business law professionals in a global perspective. In many occasions, law takes a significant role in regulating social behavior and supplying ethical standards in the society. This is evident from the rules of conduct, measures to enforce the rules and an effective channel of settling disputes. In the current society, laws play a vital role in peace keeping, promoting the freedom of business persons and checking power of the government. The laws are bound together by constitutions, statutes and treaties. In this case, constitutions establish the fundamental principles of government in regulating the commercial activities of a given venture. At the same time, the statutes and common law involve elected representatives of the legislative branch of the state in implementing the rules at hand. On the other hand, the treaties and executive laws are laws enacted between states and countries or president and governors. Such laws regulate the economic and political well-being of a given state in running its commercial activities. That is why they are classified in different categories in regard to their necessities in commercial activities in the society. ... These rules benefit the society in various ways and must be uphold in governing a business venture. It entails maintaining order and letting business partners and customers understand the ethics of the business. At the same time, criminal law assists in resolving disputes and conflict between quarrelling individuals. Over the years, the laws have been used in identifying conduct and protecting individuals and property. This secures the wellbeing of business people and facilitates their survival probability in the market. That is why the government reinforces criminal laws that safeguard civil liberties and ensure a smooth functioning of the business (Clarkson, 2005, p, 253). Substantive law in investments is not an exceptional in regulating the rules and ethics of the business. In a free market, substantive laws are used as statutory laws that define the rights and duties of every individual in the commercial set up. The rules confer legal and social rights to the business persons th rough guidelines enforced by government bodies. In most cases, it encompasses principles of right and wrong before outlining the conviction of the case. Commercial entities use substantive law in resolving issues related to the rights and freedom of citizens. The law establishes a basis for the extent of freedom of individuals to own property or run business at a given place. In return, all the members of a populous business set up are obligated to respect the business and property of commercial entities. When carrying out substantive law, the court plays an upper hand in examining the situation and determining the conduct of the parties alleged. In either way, the court resolves the issues at hand based on the values of business surrounding the commercial

Education & Identity Essay Example | Topics and Well Written Essays - 750 words

Education & Identity - Essay Example Douglass’ account Frederick Douglass is a prime example of this theory. He was born into slavery and lived through his early life serving his Master. His story revolves around the hunt for freedom and is engulfed in the concept of education affecting his perception of his own life. Since he started life as a slave, living to serve another was a norm for him and while his Mistress treated him with utter care in the beginning, she soon became wary of his thirst for knowledge. It is perhaps this thirst for knowledge that is equally influential in altering a person’s perception as without it, one may not pursue education and knowledge in the first place. Thus, Douglass was taught the beginnings of education by his new mistress Mrs. Auld. She later became extremely cautious of teaching him anything else or him learning anything else himself; â€Å"Mistress, in teaching me the alphabet, had given me the ~inch,~ and no precaution could prevent me from taking the ~ell.~† (Douglass). What this implies is that the educated elite were also wary of the power of education and it was not such a peculiar phenomenon. Ever since he learnt the alphabet, and realized that any further progress in education was scorned upon, he became all the more wary of acquiring knowledge and went to extreme lengths to learn to read and write. His efforts show his inclination and dedication to the task. His shrewdness gave way to several ingenious ways in the pursuit of education. He would employ several friends in the street and run his errands quicker than expected in order to save time for gaining knowledge through them. He started pondering over things he did not ponder over before, questioning his right to be free and why it was so difficult to attain: "You will be free as soon as you are twenty-one, ~but I am a slave for life!~ Have not I as good a right to be free as you have?" (Douglass). At times this newfound thinking became a measure of pain as well, and would dou se him in anguish whenever the question of slavery would arise in discussion. As his ability to read improved, so did his taste for newer books. He eventually read a book entitled The Columbian Orator which became the epitome of his changing perception. The story was very similar to his own wherein a slave who wished to be free from his master ran away thrice only to be returned to him. Eventually, after an intellectual discussion between him and the master, the slave is discharged of all duties at the master’s discretion. Of course, this sparked a growing urge within Douglass to be free himself. Notice how it incited a new drive inside of him to be free from anyone else’s possession rather than simply nurturing his old desire to read and write. While the old desire still persisted, the new feelings and emotions as a result of perceived education transpired within him superficially to overtake his old inclinations to read and write. Thus, it had a dual effect. This can be judged from the fact that he describes himself as a chattel earlier but later grows in feelings and emotions as a direct result of the knowledge he acquires, completely opposite to the description of a chattel. His perception was no longer the same regarding slavery. It did not just stop there. Once the perception changed, so did his desires in life. This revelation came as soon as he understood the meaning of abolition which,

Of mice and men Comparison Essay Example for Free

Of mice and men Comparison Essay Of mice and men by John Steinbeck- Consider the character of crooks. How does he contribute to our understanding of the society in which he lives? This essay will answer the question above. I will be looking at the character Crooks and the society and the racial issues at that time. I will also look into the American dream of the majority. John Steinbeck was born in 1902 in Salinas, California, and many of his novels are set in this part of America. Before his career as a writer began, Steinbeck worked as a construction labourer and a caretaker. His first novel Cup of Gold was published in 1929. Of Mice and Men was published in 1939. He died at the age of 66 in 1968. In this paragraph, I will describe the character of Crooks and some of the difficulties faced by the racial minority. Crooks is a Black-American who stands out to the other ranch-men. He has a crooked back, where he has been kicked by a horse. He is known by many names, like the stable-buck negro or nigger. In the time where Crooks was living, Americans treated the Black-Americans very differently because they were niggers. The black people where not allowed in white areas, even though it wasnt a law, it was made this way, but there where laws of the segregation of the black and white people. In the ranch, it was exactly the same, Crooks wasnt allowed in the other ranch peoples bunk house to play blackjack or rummy I aint wanted in the bunk-house and you aint wanted in my room (page 72). He just had to sleep in the barn by himself; he had no rights, except the choice of invitation of his room. He is only allowed to play horse shoes with the other ranch workers because he is so good at it. Although C1rooks is part of the lowest chain of respect, he knows himself as a proud aloof man; he doesnt care what the others say about him. As Crooks is the only black man in the ranch, he has no rights at all, he didnt even have an identity, he was known as Crooks because his real name was not important to the ranch workers. Ku Klux Klan is the name of a number of past and present organisations in America that believed in white supremacy, anti-Semitism, racism and anti-Catholicism. These organisations promoted violence and terrorism, sometimes intimidation like burning a cross. The Klan was founded 1866, it mainly focused on intimidating people, but rapidly adapted to violent methods. This is what happens to crooks as he becomes intimidated and abused by other ranch workers. . A quick reaction set in as the Klans leader left, by the early 1870s. Crooks had a book in his room called the California Civil Code, this tells him what rights he has and what rights he doesnt have, he does this so he can avoid being lynched. Every American worker has an American dream, the base of this is respect the people working in the ranch want to have their own ranch, people working for them and some nice crops. Crooks dream is to be treated equally, and to be respected. Candy wants to relax for his last few years and seeks the opportunity in George and Lennies dream which is to have a big vegetable patch and a rabbit-hutch and some chickens (page 15), Curleys wife wants to star in the movies, wear nice clothes and be rich. All their dreams are quite similar as they all want something for their own and also respect. What Crooks really wants is equality; he wants to be treated as another human being and not differently and to have friends. I tell ya a guy gets too lonely an he gets sick. (Page 77) There are many characters that have disabilities in the story, these people are: Crooks, Candy, Lennie and Curleys wife, these people are affected in their own way. Crooks disability is none other than being black and his crooked back, he has to have his own room in the smelly, cramped barn, and he cannot go to the bunk house and play rummy with the white characters. Lennie has a mental disability which makes him different from the other characters because he still has a mind of a child; this affects him as the others underestimate him. Curleys wife is the only female at the barn, she cannot do the things the boys can do, she is also controlled by Curley as she is a woman because men had more power than women in the past, this mean that she couldnt do what she wanted to do. Candy has the disadvantage of being old, the other guys think that he is useless, he stays behind and cleans up the bunk house, he has also lost a hand which makes that others think of him more useless. This shows us that he is not the only one which is different to the ranch workers. Crooks contributes to our understanding of the society of which he lives by showing us how he lives in separation and inequality, he cannot do any of the things that the white people do, he doesnt even sleep in the same place as them as they think he stinks. The also refer to him as the nigger because he is not respected enough to be called by he real name.

Cognitive Behavior Therapy: Palliative Care

Cognitive Behavior Therapy: Palliative Care Individuals that have been deemed by their medical team to have serious diseases that are resistant, nonresponsive or have failed reasonable treatments are often referred to specialists for comfort measures only. According to the World Health Organization, Palliative care is the active total care of patients whose disease is not responsive to curative treatment. Control of pain, of other symptoms, and of psychological, social and spiritual problems is paramount. The goal of palliative care is the achievement of the best possible quality of life for patients and their families (WHO, 1990). The National Center for Health Statistics (1996) estimated that 20% of all deaths and 30% of the deaths of elderly individuals occurred in extended care facilities. Extended care facilities are but one place where end-of-life issues are a common fact of daily life. However, regardless of the setting, each individual faces the end of life with his or her own view of life, death and the dying process. The estimated number of patients in palliative care varies due to the difficulty in capturing the actual numbers from hospitals, primary care practitioners, families and emergency rooms. The estimate of patients receiving the Medicare benefit for hospice and palliative care is approximately  ½ million, and it is estimated that, in 2000, approximately 20% of patients dying in the United States received hospice or palliative care services. It should be noted that although many, if not most, individuals in hospice/palliative care settings are age 85 or older, this level of care is not limited to older adults. Motor vehicle accidents, post-traumatic incidents, drug overdoses and other physiologically devastating disorders may result in permanent damage to the younger body as well as the older body. Mortality rates at a young age for those with mental illnesses is decreasing therefore it is estimated that by 2030 there will be 15 million individuals with mental illness residing in long term care facilities (SAMHSA, 2004). This chapter will focus on the reduction or modification of autonomic, psychiatric, or sensory symptom experience of these individuals through use of cognitive behavioral therapy. Cognitive behavior therapy (CBT) uses a structured and collaborative approach while helping individuals to recognize, evaluate and restructure the relationships between their thoughts, feelings and behaviors. Through a process of targeted interventions, the therapist assists individuals to identify, monitor and cognitively restructure the dysfunctional thoughts and/or to modify behaviors that are maladaptive, useless or even harmful (Beck, 1976; Turk, Meichenbaum, Genest, 1987; Freeman Freeman, 2005). CBT includes a range of both cognitive and behavioral techniques such as relaxation, guided imagery/visualization, biofeedback, behavioral experiments, guided discovery, stress management, training in pain or stress management strategies, and cognitive restructuring for dysfunctional thinking and many others . Although there is a paucity of research on the use of CBT in palliative care settings, CBT is effective for many of the psychological issues that are prevalent in palliative care including, depression, anxiety, pain management, and insomnia. The purpose of this chapter is to provide an overview on the use of CBT for assessment and treatment of psychological distress in palliative care settings. Assessment of Emotional Functioning in Palliative Care There are many challenges to the assessment of mood disorders in palliative care settings. An initial challenge is the myth that psychological distress is a normal reaction to end of life. Despite expectations, most individuals in palliative care settings do not have symptoms of anxiety, depression or dementia. Many individuals arrive at this stage of their lives or illnesses with a sense of calm resignation, if not expectations of relief and of going home to God, heaven or family members waiting for them in the hereafter. Therefore those individuals that are experiencing symptoms that require intervention may achieve significant benefit from the interventions. The most common presentations are those of depression, anxiety, pain management failures with exhaustion and anguish, and sleep disorders. The healthcare provider requires tools necessary to differentiate major depression from anger, sadness, and anxiety associated with the symptoms of an untreatable or chronic illness. Assessment of preparatory grief and depression. Another obstacle to the assessment process is simply overcoming the challenges of differentiating symptoms from normal grief of the illness itself. Differentiating between preparatory grief and depression is a key component to the proper assessment of depression in palliative care and has important treatment implications. Preparatory grief can be defined as what an individual must undergo in order to prepare himself for his final separation from this world (Kubler-Ross, 1997). Symptoms of preparatory grief include 1) Mood waxes and wanes with time, 2) Normal self-esteem, 3) Occasional fleeting thoughts of suicide, and 4) Worries about separations from loved ones (Periyakoil and Hallenbeck, 2002). Preparatory grief is a normal, not pathological, life cycle event (Axtell, 2008; Periyakoil and Hallenbeck, 2002). Major depression is defined as five or more of the following symptoms during the same two week period: depressed mood, marked diminish in pleasure, weight loss or gain, insomnia or hypersomnia, psychomotor agitation/retardation, fatigue/loss of energy, feelings of worthlessness or inappropriate guilt, lack of concentration/indecisiveness, and recurrent thoughts of death and suicidal thoughts or plans (APA, 1994). Table 1 provides a symptom list. The list is not intended to be all inclusive however it gives the clinician an overall view of symptoms that may be observed in the individual dealing with depression in a palliative care setting. Although some symptoms of grief and depression overlap, there are ways to distinguish between grief and depression. Table 2 summarizes the ways to differentiate symptoms of grief versus depression according to temporal variation, self-image, hope, anheonia, response to support, and active desire for an early death (Periyakoil Hallenbeck, 2002). The first step to proper recognition of depression involves the identification of possible risk factors (Wilson, Chochinov, de Faye, and Breitbart, 2000). Certain demographic characteristics, such as younger age, poor social support, limited financial resources and family history of a mood disorder, as well as a personal history of previous mood disorders place individuals at a greater risk for developing depression or anxiety in end of life situations. Risk for developing a mood disorder also is elevated with certain types of diagnoses, including pancreatic cancer and brain tumors, and particular medical interventions such as radiation therapy (Hirschfeld, 2000). Symptoms of the illness, including poor symptom control, physical disability, and malnutrition also place individuals at higher risk. The second step to the proper assessment of depression includes utilization of appropriate assessment tools. Many times it is the degree and persistence of symptoms that provide the information necessary when considering major depression. Major depression, which is estimated to occur in fewer than 25% of patients in end of life care, may be best screened with targeted questions such as: How much of the time do you feel depressed? In addition, for those individuals that have a difficult time describing their symptoms or history, asking family members to provide information about a previous history of depression or a family history can be very useful. Although studies validating assessment tools vary greatly, many of the self-report measures have been shown to be effective in palliative care patients. The most common utilized tools in palliative care settings frequently omit physical symptoms of depression. Many symptoms of depression overlap with the terminal disease process (Noorani Montagnini, 2007). Examples of self-report measures that omit somatic symptoms include the Beck Depression Inventory II (Beck, Steer, and Brown, 1996), Hospital Anxiety and Depression Inventory (Zigmond Snaith, 1983), and the Geriatric Depression Scale (Yesavage et al., 1983). The Hayes and Lohse Non-Verbal Depression Scale (Hayes, Lohse, and Bernstein, 1991) is a third party observational measure that can be completed by staff, family, or friends to assist with the diagnostic process. Terminally Ill Grief or Depression Scale (TIGDS), comprising of grief and depression subscales, is the first self-report measure designed and validated to differenti ate between preparatory grief and depression in adult inpatients (Periyakoil et al., 2005). Assessment of anxiety. The symptoms of anxiety may differ in individuals in the palliative care environment. Many times symptoms of anxiety have a physiologic component. For example in those individuals with chronic obstructive pulmonary diseases difficulty breathing, low oxygen levels and overall compromised respiratory function causes air hunger which is experienced as anxiety and even panic. Table 3 lists some of the common anxiety symptoms seen in this population. Family members are often at a loss as to what they can do to assist their loved one that is experiencing anxiety, and especially fearfulness. It is often useful to provide significant others with a checklist of items that are important to report to the healthcare provider. Involving the family has the benefit of giving them a structured guide for response which reduces their own anxiety in response to the patient. In addition the patient may relax more knowing that a family member is involved with their care in an approved, helpful manner. An example of a list of items for family members to watch for and report to the healthcare team is listed in Appendix 1. Cognitive Behavioral Interventions in Palliative Care Psychological intervention in the palliative care setting includes those aspects of treatment that would provide relief from emotional distress while an individual is dying. Often this time period includes depression, anxiety, grief and organic brain dysfunctions such as dementia and/or cerebral vascular diseases. Individuals and their family members are both considered the patient during these times. Many of these individuals are suffering from chronic, unremitting pain conditions which negatively impact their emotional health. Treatments for pain and chronic conditions also play a part in the individuals mental status. The use of Cognitive Behavior Therapy (CBT) is extremely useful for these individuals. Cognitive Behavioral Therapy has the strongest empirical support of any psychological intervention for the management of symptoms typically seen in a palliative care setting. The most common presentations of psychological distress in the dying patient include anxiety, depression, hopelessness, guilt over perceived life failures and remorse. Persistence of these thoughts and feelings interfere with functioning, makes the person generally miserable as well as those around them and can severely affect his/her quality of life. Medical treatments, such as antidepressants, anxiolytics and cholinesterase inhibitors, exist for these problems however supportive psychotherapy such as relaxation training, imagery, distraction, skill training, and negative thought restructuring improves the possibility of remission. CBT can also improve the symptoms of spiritual distress that may include feelings of disappointment, guilt, loss of hope, remorse, and loss of identity. CBT for depression. Symptoms of depression are common in end of life care. It can be one of the most distressing groups of symptoms an individual can experience and may interfere significantly with daily tasks of life. Some experts have estimated that up to 75% of patients with terminal illnesses experience symptoms of depression. Amelioration of some of the symptoms of depression can increase the amount of pleasure and meaning in life, as well as add hope and peace. Treatment for depression can reduce the experience of physical pain as well as general misery and suffering. In addition, reduction of the symptoms of depression may improve the treatment of coexisting illnesses more effective. Most importantly, given that one of the most serious symptoms of depression is suicidal ideation, it makes sense to treat depression in order to prevent successful suicidal outcomes. There is a paucity of literature in the area of the use of CBT with depression in Palliative Care, due to the high attrition rate resulting from physical morbidity and mortality (Moorey et al., 2009). Therefore, these factors pose significant barriers to conducting randomized clinical trials in Palliative Care to address these components. The following is a review of the sparse literature on CBT in Palliative Care with depression. In an attempt to address this problem, Moorey et al., conducted a cluster randomized controlled trial in order to determine if it was possible to teach nurses CBT techniques in order to reduce anxiety and depression symptoms in patients with advanced cancer (2009). Eight nurses were trained in CBT by attending several 1- and 2-day workshops and then were rated on the Cognitive Therapy First Aid Rating Scale (CTFARS) for CBT competence. Seven nurses did not receive training and served in the control group. A total of 80 home care patients entered the trial; however most of these participants were excluded due to being too ill to participate. A total of 16 patients were in the CBT group and 18 patients were in the control group. The participants received home care nursing visits in which assessments were conducted at 6-, 10-, and 16-week intervals. The individuals who received CBT reported lower anxiety scores over time, but no effect of the training was found regarding depression. It was noted that both groups experienced lower rates of depression over the course of the study. The authors noted the heterogeneity of the sample and the high attrition rate due to physical morbidity and mortality presented several barriers to conducting the study and may have played in a role in the findings (Moorey et al., 2009). Cole and Vaughan (2005), in their review on the feasibility of using CBT for depression associated with Parkinsons disease (PD), found that it is a promising option. The authors noted that depressed inviduals with comorbid PD experienced a significant reduction in depressive symptoms and negative cognitions. In addition they experienced an increased perception of social support over the course of treatment (Cole Vaughan, 2005). The recommended course of action for individuals in this setting included: stress management training, relaxation training, behavioral modification techniques for sleep hygiene, and cognitive restructuring. Modification of life stressors contributing to depressed mood should be identified and plans made to minimize stress and maximize quality of life. The use of thought restructuring is recommended in order to maintain a sense of purpose and fulfillment through meaningful activity and to adjust expectations of self and others. Individuals are also encouraged to return to previously enjoyed activities in order to maximize feelings of pleasure and happiness. Through systematic defocusing on physical conditions the person is able to experience more pleasant activities, which are also encouraged. Similarly, Dobkin et al, conducted a study which explored the effects of modified CBT for depressed patients with PD, in conjunction with a separate social support intervention for caregivers (2007). The patients received 10-14 sessions of modified CBT, while caregivers attended three to four separate psychoeducational classes. The modified CBT sessions were comprised of the same components of the previous Cole Vaughan, (2005) study, such as, stress management training, behavioral modification techniques for sleep hygiene, relaxation training, cognitive restructuring, modification of life stressors, and increasing engagement in pleasurable activities. The classes were targeted at providing caregivers with ways to respond to the patients negative thoughts and beliefs, as well as, strategies to offer appropriate support. As in the previous study, the modified CBT sessions were comprised of training in stress management, behavioral modification, sleep hygiene, relaxation techniques, an d cognitive restructuring. Participants reported a significant reduction in their depressive symptoms and cognitions and increased perception of social support at treatment termination and one-month post-treatment. CBT for anxiety. Along with depression, anxiety is a common mental health problem in palliative care settings and also appears to be alleviated with CBT interventions. In a small feasibility study examining the use of cognitive behavioral therapy techniques for mild to moderate anxiety and depression in hospice patients, four sessions of CBT techniques was found to significantly reduce anxiety and depression in a majority of patients (Anderson, Watson, Davidson, and Davidson, 2008). Overall, participants in the study found the CBT techniques acceptable, helpful, and qualitatively reported improved mood. A significant reduction in anxiety symptoms also was seen in a randomized controlled trial of CBT administered by home care nurses in patients with advanced cancer (Moorey et al., 2009). CBT techniques are particularly effective to assist with the management of anxiety related to breathing difficulties commonly seen with pulmonary diseases, such as chronic obstructive pulmonary disease (COPD). In a group of individuals with COPD, six sessions of guided imagery, a CBT relaxation technique, was found to significantly increase the partial percentage of oxygen saturation, which is a physiological indicator signaling more effective breathing (Louie, 2004). In another study, as little as 2 hours of CBT group therapy yielded a decrease in depression and anxiety among older patients with COPD, but there was no change in physical functioning (Kunik et al., 2001). CBT for pain management. Pain is not simply a biological response to unpleasant stimuli. It is a complex phenomenon that includes biological, psychological, behavioral and social factors that interact in complex ways to influence the pain experience. Some of the factors that can influence a persons experience of pain include: a) previous pain experiences, b) biologic and genetic predispositions, c) mood disorders such as anxiety and depression d) their beliefs about pain, e) fear about the pain experience, f) their individual pain threshold and pain tolerance level, and f) their skill with coping methods. Cognitive-Behavioral Therapy has the most empirical support for the management of chronic pain, especially when used as part of an interdisciplinary treatment approach to manage pain symptoms (Turk, Swanson, Tunks, 2008). Cognitive behavioral techniques can be used independently to assist with pain management or integrated into a comprehensive cognitive-behavioral case conceptualization framework to address pain (Turk, Swanson, Tunks, 2008). The three components to CBT for pain management are 1) Education and rationale for the use of CBT, 2) Coping skills training, and 3) Application and maintenance of CBT skills (Keefe, 1996). Useful behavioral interventions to assist with pain management include goal setting, relaxation strategies, such as deep breathing and guided imagery, and activities scheduling. Cognitive interventions would include increasing problem-solving skills and addressing an individuals maladaptive thoughts related to pain management. Examples of maladaptive thoughts include: 1) Ive tried every pain management intervention with no success, 2) I cannot do any of the things that I used to do, 3) nothing will help manage my pain, and 4) no one can help me feel better. CBT for pain manage ment has demonstrated efficacy in various diagnoses often addressed in palliative care. CBT has been found to be efficacious in the management of cancer-related pain in single studies (Syrjala, Donaldson, Davis, et al., 1995) as well as in systematic reviews (Abernethy, Keefe, McCrory, Scipio, Matchar, 2006). CBT for sleep hygeine. Insomnia, sleep duration and quality are major concerns for people with pain disorders such as osteoarthritis (Vitiello, 2009). Approximately 60 percent of individuals with chronic pain disorders report frequent nighttime awakening due to pain during the night. Disrupted sleep patterns exacerbate chronic pain intensity and experience which in turn causes more disturbance of the sleep/wake cycle. Successful treatment of interrupted sleep may reduce the pain experience as well as improve the overall quality of life for these individuals. Psychotherapeutic techniques that target sleep disturbances are easily incorporated within behavioral and cognitive management of other co-occurring disorders as well. Sleep disorders are common in patients who suffer from Parkinsons disease (PD) (Stocchi, Barbato, Nordera, Berardelli and Ruggieri, (1998). Specifically, insomnia, nightmares, REM sleep behavior disorder, sleep attacks, sleep apnea syndrome, excessive daytime sleepiness, and periodic limb movement in sleep result from changes in sleep structure, movement disturbances in sleep, disturbances in neurotransmission and medications. Individuals who are sleep deprived are at risk to develop infections, cardiovascular disease, hypertension, diabetes, depression, and require increased time to recover from stress (Schutte-Rodin, Broch, Buysse, Dorsey, and Sateia, 2008). CBT improves sleep by addressing unhelpful beliefs regarding sleep and misperceptions about the amount of sleep that one obtains. Many misperceive the amount of time they are actually asleep. People who suffer from insomnia actually sleep more than they are aware of because they are only attentive of when they are awake. Furthe rmore, many people believe they require 8 hours of sleep in order to be able to function during the day and any amount of sleep that is less is insufficient and will result in reduced ability to function during the day. Therefore, these beliefs and misperceptions can increase ones stress level about sleep and a stress response may result when one thinks about going to sleep. Clearly, a heightened stress response is not conducive to sleeping. CBT increases ones control over their unhelpful and inaccurate beliefs and enables them to replace them with more helpful and accurate beliefs (Whitworth, Crownover, and Nichols, 2007). CBT also addresses the behavioral components of ones sleep routine or patterns that interfere with ones ability to obtain restful sleep. Exercising, smoking, or drinking caffeinated drinks just prior to bedtime can interfere with ones sleep. All of these activities are stimulants that energize the body. Also, not having a bedtime routine, a regular sleep-wake pattern, or taking naps may interfere with ones ability to get restful sleep. Increasing ones sleep hygiene by developing positive habits that influence sleep such as, having a bedtime routine to prepare ones mind and body for sleep, regular exercise several hours before one intends to prepare for sleep, and avoiding coffee, alcohol, and smoking in the evening, as well as, increasing activities that produce relaxation (e.g., taking a hot bath one to two hours before going to bed, meditation, deep breathing, or muscle relaxation) can increase the likelihood of obtaining restful sleep. Another behavioral strategy utilized in CBT i s sleep restriction. This technique attempts to match ones actual sleep requirement with the amount of time one spends in his/her bed. The theory behind this approach is that reducing the amount of time spent in bed without sleep will increase ones desire to sleep (Harvey, Ree, Sharpley, Stinson, and Clark, 2007). Results of a study by Vitiello showed that treatment improves both immediate and long-term self-reported sleep and pain in older patients with osteoarthritis and comorbid insomnia without directly addressing pain control (2009). This study included 23 patients with a mean age of 69 years were randomly assigned to CBT, while 28 patients with a mean age of 66.5 years were assigned to a stress management and wellness control group. Participants in the control group reported no significant improvements in any measure while Individuals treated with CBT reported significantly decreased sleep latency (onset of sleep) by an average of 16.9 minutes and 11 minutes a year after treatment. Interruptions in sleep after sleep onset decreased from an average of 47 minutes initially to an average of 21 minutes after one year. Pain symptoms improved by 9.7 points initially to 4.7 points. Sleep efficacy (how rested does the person feel upon awakening) initially increased by 13 percent and 8 percent a year after treatment. The improvements remained robust in 19 of 23 individuals at a one-year follow-up visit. Furthermore, while many older adults experience insomnia, it is reported that up to two-thirds of those who experience these symptoms have limited knowledge regarding available treatment options. Sivertsen (2006), conducted a randomized controlled trial to compare the efficacy of non-benzodiazepine sleep medications with CBT. This study included 46 patients with a mean age of 60.8 years who were diagnosed with chronic primary insomnia. Participants were randomly assigned to either the CBT intervention (information on sleep hygiene, sleep restriction, stimulus control, cognitive therapy, and progressive relaxation), sleep medication (7.5 mg zopiclone each night), or placebo medication. Treatment lasted 6 weeks, and the CBT intervention and sleep medication treatments were followed up at 6 months. Data regarding total wake time, total sleep time, sleep efficiency, and slow-wave sleep was collected utilizing sleep diaries, and polysomnography (PSG; monitors physiological activity during sleep). Results revealed that total time spent awake improved significantly more for those in the CBT group compared to the placebo group at 6 weeks and the zopiclone group at both 6 weeks and 6 months. In comparison, the zopiclone group did not reveal significant results from the placebo group (Sivertsen, 2006). The CBT group experienced a 52 percent reduction in total wake time at 6 weeks compared with 4 percent and 16 percent in the zopiclone and placebo groups respectively. A statistically and clinically significant finding was that participants receiving CBT improved their PSG-registered sleep efficiency by 9 percent at posttreatment, opposed to a decline of 1 percent in the zopiclone group. Total sleep time increased significantly between 6 weeks and 6 months for the CBT group. The zopiclone group showed improvements at 6 weeks and maintained these improvements at 6 months, but did not show further improvements. The CBT group showed significant improvements compared to the zo piclone group in total wake time, sleep efficiency, and slow-wave sleep; total sleep was the only area that did not yield a significant difference (Sivertsen, 2006). ADAPTING CBT TO THE PALLIATIVE CARE SETTING Overview of CBT in Palliative Care Cognitive-behavioral therapy is effective for many of common mental health issues seen in palliative care and often augments the success of pharmacological interventions. In addition to the individual with the terminal illness, their family members, as well as multiple health providers are considered integral members to the success of the collaborative relationship. Use of a CBT case conceptualization framework and various components offer flexibility, which makes the CBT approach feasible to implement within a palliative care setting. The following section provides an overview of the components of cognitive-behavioral therapy and necessary adaptations to palliative care settings. Collaborative Relationship As mentioned in previous chapters in this book, a collaborative relationship is a core component of an effective cognitive-behavioral intervention. In a palliative care setting, the collaborative relationship often involves more than just the client and the therapist. The interdisciplinary treatment team works with the individual to develop an individualized treatment plan that is central to the case conceptualization and goal setting of CBT. A variety of disciplines, such as nursing and social work, use CBT techniques in palliative care settings. Individuals receiving palliative care often need assistance with CBT interventions as their illness progresses. Individuals receiving palliative care often need assistance from the treatment team with practicing skills, such as relaxation techniques, and adapting CBT interventions as goals of care change. Some individuals in the Palliative Care setting may not be facing death in the near future, and if they are facing impending death, they may not be aware of it. In these cases the primary patient may be the family member or significant other. It is also common practice for most individuals to seek help for mental health problems from their family practitioner even though the typical family practitioner has very little training in psychiatric/mental health assessment, diagnosis and treatment. In cases where the family is relying on an under-trained health care provider it may be incumbent upon the mental health provider to negotiate the gap between family and medical care. Case Conceptualization and Goal Setting Therapy with the dying person should begin with having the person identify, explore and determine outcome goals regarding the issues at hand. Similarly to the primary care setting, case conceptualization and goal setting need to occur almost immediately. The therapist uses the Socratic Dialogue to explore the persons concerns and worries. This gives the individual more of a sense of control over what will be happening in the therapy session. Once this sense of control is established it becomes easier to explore other, more emotion laden topics. Goals should be small, obtainable and proximal to the session to be most effective. For example, Mrs. Jones I will be back to see you tomorrow. One of the things you have decided to practice is your deep breathing at least twice tonight and again in the morning. When I return I will check with you to see how you are doing with the practice. In palliative care setting, it may be necessary to discuss how other people involved in care can assist with reaching goals. For example, nurses might remind individuals to practice relaxation strategies during wakeful periods, as well as talk an individual through the relaxation technique when experiencing a high level of pain. Behavioral Interventions Pleasant Events Scheduling. Activities scheduling is a useful intervention to assist with mood disorders, pain management, and sleep hygiene issues seen in a palliative care setting. Engaging in pleasant events distracts an individual from negative thoughts and provides experimental evidence to support more adaptive thinking styles. Often times in palliative care the first barrier to overcome is identifying pleasant events that can occur in a palliative care setting due to health limitations. Pleasant events need to be person-centered, meaningful, and feasible activities that can be built into a daily routine. Meaningful pleasant events can be identified through both clinical interview and self-report methods. Clinical interview queries should include taking a history of an individuals daily schedule and identify activities the individual enjoyed engaging in on a routine basis prior to their illness. From the generated list of previously enjoyed pleasant events it needs to be determined which activities the individual can continue to enga