Why Effective Communication Is Important Essay Example for Free

Why Effective Communication Is Important Essay 1. Understand why effective communication is important in the work setting? Communication is the key to understating and being understood. Commotion is essential for our survival and we use it in every aspect of our lives from the moment we are born. E.g. Talking, shouting, crying, reading, writing, seeing and listening. Body language and ecpressions are also use when communtatin. We all communicate with each other to achieve goals in ife, whether it be physical or emotional. Communication allows us to convey information, thought , moods. ( Eg. Happiness , sadness,anger). As a human being we all have a basic need to relate to each other and effectively expressing ourselfe through communication. In work setting it enables us to create and maintain relationships with everyone we have contact with. Identify the different reasons people communicat? There are lots of different reasons people communicate. People need to express needs and share ideas and information to build relationships and ask questions. It essential tool a caer can use to meet the needs of children. This is a basic requirerment in all jobs to communicate with individuals and their families and staff on a daily basis. 1.2 Explain how communication affects relationships in the work setting? Communication can affct relationships in many ways in a work setting. Read more:  Explain the reasons why people communicate  essay Colleagues The manager Supervisor Parents of the children and children Effective communication- is a two way proess. When communication you need to send clear and concise message to the responding party. Everyone most be understood correctly to have a response. We can also communicate by telephone, written notes, email, text messages and vocal. 2. Be able to meet the communication and language needs, wishes and preferences of individuals? Communication can be difficult, especially when you are in a situation where you are unsure of the language and abilities of those who you are associating with. Its always best when you meet someone to begin communication on your own terms; if you speak English greet them as such, although ensure that you are speaking slowly and clearly. It should be fairly easy to work out whether they have not understood due to communication impairments or language differences based upon their reaction to your initial introduction. If they have disabilities, try to communicate through body language or they may even be able to lipread; perhaps try both to see which they are receptive to, and continue from there. If they seem to be speaking a different language, you can either try speaking in a different tongue (should you know another) or again try body language. You may even know someone nearby who may be able to help you out. 2.2 Describe the factors to consider when promoting effective communication? 3. Be able to overcome barriers to communication 3.1 Explain how people from different backgrounds may use and/or interpret communication methods in different ways 3.2 Identify barriers to effective communication 3.5 Explain how to access extra support or services to enable individuals to communicate effectively Here are some ways of access extra support or services. There is a number of services that can accessed to support communication. Interpreters Translators signers aduocators There is lots of different specialisr equipment for people that need them. Induction loops braille embossers and printers makaton. The local government body should provide language support services. British sign language interpreters deaf blind interpreters lip speakers or readers You can find services y utilised by educationa; and health sevices through a booking system. There is a local authority educational deportment access to a tea support specialistis indvding speech and language therapists. You can also find information on the internt various specialist website.

Behaviour Therapy for Child Sleep Disorder

Behaviour Therapy for Child Sleep Disorder Aims: Outlines the nature of behavioural aspects of children’s sleep and how these might be addressed by behaviour therapy. Clinical considerations concerned with the use of behavioural therapy are also highlighted. Consider behavioural aspects (ie, learned behaviours) and their relevance for our understanding of children’s sleep patterns and management of their sleep disorders. Increase awareness of how behavioural factors may play a role in the development and treatment of wide-ranging paediatric sleep disorders and to discuss clinical considerations relevant to management planning and decisions about whether to refer a child for specialist behavioural therapy. Classification: International Classification of Sleep Disorders of ‘‘behavioural insomnia of childhood’’:Â  (present with difficulty settling to sleep, nightwaking and/or early waking difficulties) Overall prevalence rates of 30% ‘‘inappropriate sleep onset associations’’ (ie, where the child has not learnt to fall asleep without a set of problematic or demanding conditions such as parents’ being present), ‘ ‘limit-setting sleep disorder’’ (ie where the care giver demonstrates insufficient or inappropriate limit-setting to establish appropriate sleep behaviour in the child) ‘‘combined’’subtype where these two problems co-exist. 25–50% of 6–12-month olds have difficulty settling to sleep or waking in the night do not decrease with age: by age 3 years, 25–30% have sleeplessness problems With similar percentages reported for the 3–5-year age group, 43% of 8–10-year olds 23% of 10– 17-year olds. These problems are not transient; an epidemiological study of a cohort of 5-year olds suggested that sleeping problems at age 5 years were significantly associated with sleeping difficulties at age 6 months (or before) and that children with sleep problems at age 5 years were more likely to have sleeping problems at 10 years. Over 80 sleep disorders listed in the International Classification of Sleep Disorders, which are divided into six main categories: insomnia, sleep-related breathing disorders, hypersomnia of central origin, circadian rhythm disorders (ex. Delayed sleep phase syndrome) parasomnias (ex. Sleep terrors, nightmares) Helped by beh therapy. sleep-related movement disorder (ex. nocturnal headbanging) (in preliminary reports) Behavioural Interventions: Classical conditioning is a form of associative learning whereby a neutral stimulus is paired with a naturally occurring stimulus, which evokes the desired behavioural response until, after multiple pairings, the neutral stimulus alone is sufficient to elicit the desired behaviour; thus behaviours are conditioned to be elicited by antecedent conditions. Operant conditioning involves the use of consequences to modify the occurrence and form of behaviour. The particular intervention strategy used will vary depending on family and child factors and the nature of the sleep disturbance one hopes to address. General Principles: (The more consistently these principles are applied, the easier it will be for the child to learn) Behaviour can be encouraged by linking it with an antecedent stimulus, which serves to trigger the desired behaviour. Reinforcement- Behaviour is likely to recur if the consequences of the behaviour were reinforcing for the child. (Can be pos or neg) Extinction, or removing reinforcement (eg, drinks, parental presence, attention) maintaining the undesired behaviour (eg, crying, refusal to settle to sleep without the above) can be achieved gradually or abruptly. Shaping- A new behaviour can be encouraged by rewarding a series of responses that more and more closely resemble the desired behaviour. Punishment- Behaviour is less likely to occur if followed by a punishing consequence. (Can be pos or neg) Rewards Success On the basis of controlled empirical data, behavioural approaches are viewed as the first-line treatment of choice for this type of sleep disorder, because they have none of the potential associated negative side effects of sedative hypnotics,20 and a systematic review suggests that, long term, they are more effective. The relative efficacy of specific behavioural strategies or components of behaviour therapy has been less well investigated so details of any behavioural plan should be explored in the context of collaborative therapy, considering the practical and emotional resources of individual families. The developmental stage of the child is also an important consideration—for example, some strategies require the child to have verbal abilities of a particular level, and reinforcement programmes are likely to be particularly important for older children. To note It should, of course, be noted that the effective use of behaviour therapy does not necessarily indicate that the sleep disturbance is behavioural in origin or being maintained by behavioural factors. Behaviour therapy may play a role in the management of disorders that are of definite organic origin. (ex. behavioural therapy including planned naps, appropriate sleep routines and well-defined 24 h schedules may have a role in management of narcolepsy, a hypersomnia of central origin, or facilitate compliance with continuous positive airways pressure therapy for children who require this form of intervention for sleep-disordered breathing). Behavioural therapy has been used successfully with a number of special populations who are at increased risk of severe and long-standing sleep disorders for a range of biological and psychological reasons. That this form of intervention does not rely on the use of verbal skills makes it especially appropriate for use with children with intellectual disabilities. Delivering behavioural therapy in a brief, booklet form (with obvious economic implications) has been found to be as successful as behaviour therapy delivered face-to face in managing the sleeplessness problems of infants with intellectual disabilities. Further considerations There is a need for development of behavioural models specific to different types of sleep disturbance, and for children of various ages, to further understanding about the development and maintenance of sleep disturbance and to suggest therapeutic strategies for evaluation. Consideration for clinicians is that multiple sleep disorders may coexist, and so behaviourally based sleep disorders may be present in children with other sleep disorders of more physiological origin or arise as a secondary problem. It may be necessary to use multiple forms of treatment to address individual sleep disorders. It may also be appropriate to combine treatments in the management of one sleep disorder. (ex. Beh interventions melatonin) Although behaviour therapy delivered in conventional face to-face format may have apparent drawbacks in terms of the time and cost of implementing the interventions, the potential to prevent long-standing sleeping difficulties and their associated problems (which, as outlined above, may include adultmental health problems) is likely to far outweigh the limitations in both economic and social terms, at both the societal and personal level. Ensuring that families can access appropriate support and advice should be a service priority, and investigation of how to improve access (eg, with brief forms of treatment, low-cost delivery methods, identifying active therapeutic components and their efficacy for particular groups of children and different sleep disorders) should be key research targets for the future.

Challenges facing mental health problems

Challenges facing mental health problems Abstract The purpose of this study was to evaluate and access the challenges facing mental health consumers to retain or rebuild a meaningful and valued life. The study was based on looking at mental health statistics, examining current trends in mental health services, treatments, pharmacology, and dual diagnosis management, and rehabilitation, vocational, educational, and transitional services. This paper is based partially on a report that came out of an invigorating collaboration between Surgeon General David Satcher, M.D., Ph.D., Substance Abuse and Mental Health Services Administration (SAMHSA), and (NIMH) who strive to improve the availability, accessibility, and quality of mental health services and support; conducting research on mental illness and mental health. This thesis gives my understanding of what this challenge involves, how this can be facilitated by supports within society at large, while evaluating the current policies and service provisions that are available. By exemplifying the current non-governmental organizations (NGO) that are already in place, I then give a synopsis of what agencies/services and resources would be required to necessitate rebuilding a meaningful and valued life for mental health patients. One in four Americans; people of all ages, races, incomes and social stratus will suffer from some form of mental illness in their lifetime. During the course of a year, more than 54 million Americans are affected by one or more mental disorder. (NMHA Tellioglu, 2009) An estimated 22.1 percent of Americans ages 18 and older suffer from a diagnosable mental disorder in a given year (NIMH, 1998) while an astonishing 5.4 percent of adults have severe mental illness. (Surgeon General, 1997). The number of people in Ireland admitted to psychiatric hospitals has dropped by 28% since 1997 with an increase in people treated in community psychiatric facilitiesà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬numbering 20,000 30,000 a year. (Irishhealth.com, 2009) Such statistics only begin to capture the level of pain and disruption in individuals, families, and communities for which mental illness is responsible. What is the definition of mental illness? According to the criteria in the American Psychiatric Associations Diagnostic and Statistical Manual of mental disorders (DSM-IV) it is a diagnosable illness that results in functional impairment that substantially interferes with or limits one or more major life activities. Some diagnoses are considered more severe such as schizophrenia, bipolar disorder, and major depression. Disability refers to the degree of limitation an illness imposes on the ability to function in life areas, such as relationships, work, independent living, and managing finances and medical care. People with mental disorders used to be thought of as a detriment to society and were removed from the community; kept in institutions and psychiatric hospitals. Patients were heavily sedated, given electroshock therapy, forgotten by professionals and family, and their condition further deteriorated, giving little or no hope of recovery. More recent research on long term recovery of individuals with mental illness shows a much better prognosis. Seven major retrospective studies done in Germany, Switzerland, Japan, and the U.S. show recovery rates of 46 68% for those with severe forms of mental illness without being institutionalized. (Harding, Zahniser, Zubin and Strauss 1984-1987) Recovery is defined as people with mental illness regaining the ability to work, live independently, maintain meaningful relationships, and contribute to their communities in a variety of ways. (Continuum, 1997) Neuropsychiatric disorders are the second greatest cause of burden of disease after cardiovascular disease, accounting for 40 percent of chronic disease. Serious mental illness can be fatal with suicide as the cause of death among adults second only to traffic accidents. More than 90% of people who kill themselves have a diagnosable mental disorder, (Baylor study, 2009) although not all with mental disorders will necessarily commit suicide; but the pain, hopelessness, and disordered thinking can lead to suicide and the impact is immeasurable. Our nations physical healthà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬as a wholeà ¢Ãƒ ¢Ã¢â‚¬Å¡Ã‚ ¬has never been better. Cancer and HIV/AIDS once termed as terminal are increasingly distinguished as treatable, survivable, and curable ailments. Medical research proves the inextricably intertwined relationship between mental health, physical health and well-being. (David Satcher, 1999) Fortunately, leaders in mental health, intensely devoted advocates, scientists, government officials, and consumers have been insistent that mental health flow in the mainstream of health. With the progress the medical profession has made with disorders of the mind such as dementia and Alzheimers there has also been improvement in understanding mental illness. Dementia is a loss of cognitive function with an inability to think, learn, or perceive due to changes in the brain caused by trauma or disease with blood vessel disease due to illnesses such as diabetes and hypertension as the biggest risk factors. If the illness/illnes ses are treated the dementia can be reversed. Dementia is caused by a condition whereas Alzheimers is a particular physical condition. Some of the early signs of Alzheimers and dementia can include depression. Many medical problems mask as, co-occur with, or exacerbate psychiatric crises. Any patient exhibiting psychiatric symptoms needs a medical evaluation since physical illness can masquerade as mental illness. What many people fail to understand is that dementia, Alzheimers, diabetes, and mental illness are all diseases that a person has no control over. The primary contribution of modern-day mental health research is the degree to which its mended the destructive split between mental and physical health. Researchers recognize the brain is the integrator of thought, emotion, behavior, and physical health. Yet, despite research and unprecedented knowledge about the brain and human behavior, mental health is often disregarded and ailments of the mind remain masked in ignorance and misunderstanding. The challenges involved with retaining or rebuilding a meaningful and valued life for persons with mental illness are innumerable. The closing of mental health institutions, psychiatric wards, community mental health centers, residential facilities and diversion programs has reflected a trend for the entire nation stemming partly from the governments policy of treating the mentally ill in the community, rather than in institutions. (Independent News Media. 1997) Since 1970, 90 percent of public psychiatric hospitals have closed; available beds in NHS psychiatric wards alone dropped by 50,000 since 1980. (Sheriff, 2007) Even when there are adequate mental health facilities patients need to have medication and continual therapy to retain stability. With the closing of mental health systems clients will need additional support in finding a way to continue their treatment regimens. This is especially true for those with bi-polar and schizophrenic disorders who need to be monitored for treatment compliance. With a devastating loss of mental-health services throughout the world, individuals have relapsed, scores of patients have been forced to reside in local nursing homes, become homeless, or end up in correction systems. In 1996, E. Fuller Torrey, prominent psychiatrist/mental health advocate, stated, Quietly but steadily jails and prisons are replacing public mental hospitals as the primary purveyors of public psychiatric services for individuals with serious mental illness in the U.S. With federal funding cuts agencies who could offer services spend more time worrying about who is going to pay for what, rather than how to prevent relapse or suicide. With an inadequate supply of mental health services and providers there is a presence in society of at risk people manifesting mental disorders leading to destabilizing conditions that affect society as a whole. Alcohol and illicit drug use is associated with violence, criminality, antisocial behaviors and the inability to develop into pr oductive citizens of countries and communities. With the lack of mental health dual diagnosis treatment, patients often develop behavior that places them into the legal system; jailed or imprisoned, causing an interruption in their treatment that can lead to radical decline in functioning. Detective Tony Morales, Phoenix Police Department says, all our officers have to be part-time psychiatrists. Gabe Morgan, Sheriff of Newport News, Virginia says, Acute care for the mentally ill was once provided by psychiatric hospitals but many who are severely ill are living in our communities, where the burden of managing symptomatic and psychotic behaviors often falls on law enforcement. Jails were never intended to be treatment facilities but they are replacing psychiatric hospitals. Markowitz, Northern Illinois University reports results of an influential study on how psychiatric hospital capacity impacts crime rates. Data from 81 cities around the country showed communities with greater acc ess to psychiatric beds have lower rates of arrests and crime. (Sheriff, 2007) While troubled individuals are more likely to seek help from their physician than a psychiatrist, (Kiesler, 1980) countless physicians are not trained to deal with mental problems nor willing to spend time listening to anything other than physical symptoms. (Eisenberg, 1977; Engel, 1977; Knowles, 1977; Reiser, 1981). Another challenge is that emergency rooms are becoming the most utilized form of care for those in crisis because mental health service providers are unavailable after hours and on weekends and the ER is not allowed to turn people away. Badly equipped to handle respite/mental health care patients become unnecessarily hospitalized or are medicated until they can see a psychiatrist if available. Mental health consumers who find adequate in-patient treatment often face a void when trying to bridge the gap between relapse or hospitalization and living life in the community. In their quest to achieve recovery, they find little or no intermediate services available. While pharmacotherapy can treat the symptoms of mental illness when taken as directed it cannot restore a sense of value of self nor lift the burden carried by the patient. With no way to progress through rehabilitative therapies and develop coping and life skills a person who has been hospitalized, imprisoned or institutionalized will have little hope reintegrating into society and their mental health will only decline. Often, the result is the revolving door phenomenon with a cycle of deterioration, relapse and re-hospitalization or being arrested for petty crimes, released and arrested again. (Psychiatric Services, November, 2003) Another very real and insidious challenge is the impact of stigma, shame, and isolation associated with mental illness constituting a major barrier against seeking treatment. The graphic portrayal of those labeled with a mental diagnosis confronts the patient living with a serious mental illness to try to navigate beyond the arduous challenges presented by the illness itself. Strides have been made against stigma, yet too frequently mental health is spoken of in whispers and shame. Stigma and an unwarranted sense of hopelessness for recovery from mental illness have erected barriers. These barriers have made their way into churches where those with severe mental illness have turned to seek assistance from their local pastor. Some well meaning Christians throw bible verses or phrases such as if you had enough faith or just give it to God in an effort to solve the problem by fixing the person with mental illness because of their lack of knowledge or understanding. The mentally ill may get support for awhile with prayers, talks on faith, loving and trusting God, but if the person is not progressing as they had hoped then any interest in helping may wane. Serious roadblocks arise when those with mental illness try to find encouragement from their church and get no support or try to talk to their therapist about their faith or religious beliefs and he/she responds in a negative or unsupportive way when hearing about God. Having a relationship with Jesus Christ can give great comfort and hope and provides strength for working through spiritual issues which is an essential part of healing and rehabilitation. God works through people who are willing to help a person to rebuild their life. If a church fails to give support many mental health consumers then make serial connections with church after church trying to find respite and may stop going to church and even worse; turn away from God. Those whose mental illness is dismissed by clergy are not only being told they d ont have a mental illness; theyre also being told they need to stop taking their medication which can be a very dangerous thing. (Baylor, 2008) The unique internal pain of those who have a serious mental illness is only exacerbated when a pastor or members of a congregation fail to understand their condition, or even resents them or their illness because they are unable or unwilling to accept them like Jesus would. Support is essential for recovery of mental illness. Where does a person go when there is little or no treatment available, nor support from family, friends, church or therapists? People who seek God find what they need in time of hardship. Individuals can find support on the internet from mental health forums, blogs and websites. Too many other people that have no answer have given up and have died needlessly. Formidable financial barriers impede needed mental health care from too many people both those with adequate health insurance or one of the 44 million Americans who lack health insurance. If they do not have medical insurance or have other financial problems it can be difficult for the mentally ill to obtain medical care, counseling or medication. Even if they do have medical insurance, many insurance policies either do not cover the cost of treatment for mental illnesses or they only allow a minimum of 12 30 sessions of counseling a year, depending on the insurance policy. Unlike some physical diseases which may be cured with antibiotics or surgery, mental illnesses may need consistent management. For example, there is no cure for schizophrenia. Without continual treatment, these clients decline and may become homeless or worse. For those mental disorders that can be resolved such as post traumatic stress disorder, 12 sessions are not sufficient. It is not feasible to expect a vete ran who has been in active combat for 3 years to heal in three months or a woman who has been abused for most of her life to recover with so few therapy sessions a year. Patients need consistent ongoing treatment without their progress being impeded by financial and insurance restrictions. Some insurance companies have made exceptions through managed care to trade inpatient days for outpatient days to accommodate the patient needing more therapy and psychiatric sessions but this is usually limited to amending the policy for one year at the most. There is substantial research indicating that the majority of the chronically mentally ill can function outside of institutional settings where mental health services are available. A number of community support services were positively evaluated showing evidence patients can be effectively maintained in non-institutional community placement. (Kiesler, 1982) A wide range of non-governmental organizations and community support interventions vary across a spectrum from crisis clinics designed to prevent rehospitalization (Formenhaft, Kaplan, Langsley, 1969) to small self governing communities (Fairweather, 1980) such as mental health drop in centers and psychosocial clubhouses. (Taber, 1980) Primary health care physicians that are able to identify common mental disorders are facilitating and advocating support and treatment for mental health consumers, providing basic medication and psychotherapeutic interventions, while referring complex cases to community mental health services. Other provisions include 24 hour crisis hotlines offering support and encouragement; helping move the person from a state of crisis/feeling suicidal to empowering them to develop and rely on coping skills. In many countries, community mental health teams provide home-based crisis intervention services through 24 hour mobile outreach, assisting in stabilization, visiting people, helping consumers at high risk for hospitalization; providing one-on-one intensive case management, rehabilitation, and follow up. In many countries hospital diversion programs redirect people in crisis to community-based facilities such as mental health crisis shelters, family based crisis homes, apartments with in home-like milieu, or hostels as alternatives to hospitalization helping hundreds of people each year stay in the community and avoid the expense, stigma and trauma of hospitalization. Many provide the same recovery model as psychiatric inpatient treatment facilities and have found with proper support, compassion, understanding, professional mental health, and peer counseling the need for hospitalization is diminished or greatly reduced. Some hospitals have dispositional care, an alternative to hospital stays, adjacent to the ER to facilitate a short stay with discharge as the goal, offering short term acute treatment for psychiatric and substance abuse issues. Outpatient day-treatment is available in a highly structured environment and offer support services upon discharge. A study shows that 80% were successfully diverted from the hospital at considerable savings. Treatment was comparable to those admitted to psychiatric hospitals. Vocational/rehabilitation services help mental health consumers attain independent living skills necessary to move into or remain in more independent level of housing within the community. These programs teach skills such as cooking, nutrition, personal grooming, using public transportation, job skills, budgeting money, health and dental care and assistance achieving a job and/or academic education. While the goal is to stay out of crisis and prevent hospitalization these programs are primarily designed to help consumers reenter society and/or achieve a full community life. Clients take responsibility for their care with moderate support from community-based case managers who make weekly in-home visits to monitor progress and provide assistance. These particular models vary from country to country depending on various factors including the sociocultural context, how health services are organized and the availability of financial and human resources. For success, psychiatric treatment and rehabilitation needs to have integrated, seamless approaches aimed at restoring persons with major mental disorders to their best possible level of functioning and quality of life. How can this be facilitated by supports within society? Effective treatment of serious mental illness goes far beyond inpatient hospitalization and offers individuals the opportunity for community reintegration. (American Psychiatric Association, 2004) Inpatient treatment facilities would be available only for those with severe needs or those at risk to themselves or others. Hospitalization would be brief, minimally disruptive and rehabilitation services within the community could be seamlessly implemented as quickly as possible. (American Psychiatric Association, Kopelowicz and Liberman, 2003) Clients would move through a care continuum including psychiatric diagnosis and treatment, pharmacotherapy, dual diagnoses/addiction treatment, physical assessment, behavioral modification, neurocognitive science, 12-step recovery programs, employment, housing, criminal justice, education, and relapse prevention. Rehabilitation would include teaching life and coping skills, managing symptoms, dealing with memory, decision making, problem solving, and management of anger and stress. Community based programs would include residential services, crisis intervention, hospital diversion and relapse preventative resources, mental health research, and other service providers designed to reintegrate the mentally ill into society. Patients would be educated about their illness to grasp management and proper use of psychiatric medications. The perfect model would include guaranteed access to necessary medicines for people with mental health problems at a cost that the health care system and the individual can afford in order to achieve appropriate prescription and use of these medicines. Having an adequate number of psychiatrists and counselors for outpatient treatm ent in areas that formerly had only a few or none is essential. There is a need to improve coordination between health care providers and governmental and private mental service providers along with community based programs for the mentally ill to advance and improve the referral system and evaluate if the needs of mental health consumers are being met. The government could support mental health consumers by creating laws that restrict discrimination of treatment among insurance providers. Mental illness needs to be viewed as equal to other form of physical disabilities. Mental illness is not a lack of willpower. Medication for depression is just as vital as insulin is for the diabetic. The threat of suicide for mental illness is as dangerous as a heart attack is for heart disease. Promoting good mental health for people of all countries will require scientific know-how but, even more importantly, a societal resolve that we will make the needed investment; not for budgets but for each of us to educate ourselves and others about mental health/illness, and to confront the attitudes, fear, and misunderstanding that remain as barriers before us. (David Satcher, M.D., Ph.D., Surgeon General) To remove the stigma and secrecy surrounding mental illness families, churches and others who once offered no support need to sustain those who suffer in shame. There is still a long way to go with reintegrating and rebuilding the lives of those with mental illness. I have learned however that mental health consumers grow emotionally during this process we call recovery through enhanced self esteem, meaningful work, connections to others, a sense of hope and empowerment. They grow physically through increased fitness, improved diet and nutrition, and better health care. They grow intellectually through a better understanding of their disability, effective coping mechanisms, and the development and implementation of personal goals. They grow spiritually through pastors and churches that are willing to offer support, understanding and biblical counseling. It is through our connections with people who are experiencing mental illnesses that we will continue to learn and to grow in our knowledge about mental illness and recovery and have some of the best, richest relationships we could possibly have. In conclusion, the World Health Organization predicts that in the next 20 years more people will be affected by depression than any other cause of ill health worldwide. With this knowledge I would like to challenge the world, our nation, our countries, our cities, our communities, both physical and mental health care models, researchers, our employers, and our citizens to take action to collaborate with mental health consumers. There is no health without mental health and mental health is fundamental to quality of life and to the most creative and productive life that people can live. (Indian Journal, 2006) References Mental Health America Resource Center. 800-969-6642. http://www.nmha.org/ Neugeboren J: Imagining Robert: My Brother, Madness, and Survival. New York, Morrow, 1997 Hall LL: Review of Imagining Robert: My Brother, Madness, and Survival. Psychiatric Services 48:1470-1471, 1997 Harding, Zahniser, Zubin and Strauss (1984 1997). Mental Health Statistics. Continuum, 4, 3-15. Tahir Tellioglu M.D., APA, AAAP (2009). Mental Health Rehabilitation. National Mental Health Association Unknown (2003). Psychiatric Services. American Psychiatric Association, 54, 1491-1498. Alex Kopelowicz, M.D. and Robert Paul Liberman, M.D. Integration of Care: Integrating Treatment with Rehabilitation for Persons with Major Mental Illness. William D. Spaulding, Mary E. Sullivan, and Jeffrey S. Poland, New York, Guilford Publications (2004). Treatment and Rehabilitation of Severe Mental Illness. Am. J. Psychiatry, 161, 937 Alex Kopelowicz, M.D. and Robert Paul Liberman, M.D. (2003). Integration of Care: Integrating with Rehabilitation for Persons with Major Mental Illnesses. American Psychiatric Association, 54, 1491-1498. David Satcher, M.D., Ph.D. Surgeon General (1999). Collaboration between (SAMSHA) Substance Abuse and Mental Health Services Administration and (NIMH) National Institute of Mental Health Report. Surgeon Generals Response to Mental Health. Healthy Living Clinic. Irish Health. Retrieved 2009, from http://www.irishhealth.com/clin/healthliv/health_ire.html#s6 H. Russel Searlight and Paul J. Handal with Kramer, Kiesler, Flomenhaft, Kaplan Langsley, Fairweather, Taber (September 1986). Psychiatric Deinstitutionalization: The Possibilities and the Reality. Psychiatric Quarterly, Volume 58, 3. S; Steven. Mental-health policy: Iowa doesnt get it. Telegraph Herald (Dubuque). Telegraph Herald (Dubuque). 2007. Retrieved October 08, 2009 from HighBeam Research: J. Health Services: Mental hospitals provision slashed. The Independent (London, England). Independent News Media. 1997. Retrieved October 08, 2009 from HighBeam Research: Mental Health Policies Are Cause for Alarm in the Corrections Community. Sheriff. National Sherriffs Association. 2007. Retrieved October 08, 2009 from HighBeam Research: Mental health: Facing the challenges, building solutions. Indian Journal of Medical Research. Indian Council of Medical Research. 2006. Retrieved October 08, 2009 from HighBeam Research: Baylor Study Finds Serious Mental Illness Often Dismissed by Local Church. US Fed News Service, Including US State News. HT Media Ltd. 2008. Retrieved October 09, 2009 from HighBeam

The Transformation of a King Essay -- Literary Analysis

Debatable is the story of Prince Hal and how he undergoes a transformation so infinite we may have difficulty comprehending the struggles he endured. Throughout the course of events in Henry IV, Part I, By William Shakespeare, first impressions of the characters are depicted and remain strong during most of the play. From the beginning of the play it is understood that Hal is an immature extrovert who sees no need for careful behaviors. Unlike his father, King Henry IV, Hal puts forth insufficient effort to prove he can hold the power that will eventually be his when he succeeds his father in the throne. Throughout the play there is controversy between the King and Hal as a direct result of Hal’s performance as a Prince. From gallivanting in the tavern, to fighting in the battle of Shrewsbury, Hal becomes the son that King Henry has been pressuring him to be all along. The father/son relationship is a significant theme in this play, alongside Prince Hal’s other relationships with important male figures such as Hotspur and Falstaff. Falstaff is one of the favorites of this play, rather obvious that he is the brunt of a multitude of jokes; somehow maintains certain poise. On the other hand, we have Hotspur, a talented and brave young man the King wishes were his son: â€Å"That some night-tripping fairy had exchanged/ In cradle-clothes our children where they lay/ And called mine â€Å"Percy,† his â€Å"Plantagenet†!/ Then would I have his Harry, and he mine† (1.1.86-89). Both Hotspur and Hal are the intended future leaders of their country, but Hal doesn’t seem to understand his role in its entirety (at least his actions haven’t proven his maturity to the likes of King Henry IV). The King would prefer Hal act in a more appropriate manner when... ...ove to his father that he has what it takes to be the next king, but in the end his father couldn’t be more pleased with Hal’s performance. Works Cited Kastan, David Scott. Introduction. King Henry IV, Part I. London: Arden, 2002. 44-51. Print. Kastan, David Scott. "The King Hath Many Marching in His Coat." 1 Henry IV. By William Shakespeare. Ed. Gordon McMullan. 3rd ed. New York: Norton, 2003. 330-346. Print. Khan, Coppelia. â€Å"Masculine Identifies.† 1 Henry IV. By William Shakespeare. Ed. Gordon McMullan. 3rd ed. New York: Norton, 2003. 330-346. Print. Reno, Raymond H. â€Å"Hotspur: The Integration of Character and Theme.† Henry the Fourth, Part I, by William Shakespeare. Ed. James L. Sanderson. 2nd ed. New York: Norton, 1969. 235-244. Print. Shakespeare, William. 1 Henry IV. Ed. Gordon McMullan. 3rd ed. New York: Norton, 2003. Print.

Hamlet - Plot Summary :: essays research papers

Act 1 Scene 1 The scene is the Castle at Elsinore. Bernardo relieves Francisco, at about midnight. Marcellus who joins Bernardo in the watch along with Horatio who was told of the appearance the previous night. Horatio believes it to be a illusion until it appears. You learn that the ghost has appeared twice in the same armor that the king wore to fight Fortinbras, king of Norway, and the Poles who he defeated. The ghost appears again and again Horatio challenges it to speak. At the crow of the cock it moves and disappears. The three agree that they should tell Hamlet of this appearance. Act 1 Scene 2 The scene is in a stateroom at Elsinore. The Lord Chamberlain Polonius, his son Laertes and other members of the court accompany the king and Queen, Claudius and Gertrude. They speak of the mourning of the death of his brother, King Hamlet. He also says that desecration prohibit excessive grief. Next he speaks of Fortinbras who demands the surrender of the lands lost by his father to King Hamlet. Claudius has sent Cornelius and Voltimand with a letter to the bedridden king of Norway to restrain his nephew. The suit of Laertes asks if he should leave for France after attending Denmark for the coronation ceremonies. And his father and the king give him permission. The king and queens attention is now towards young hamlet. They are wondering why he is still grieving of his father's death. They then realize that it is sweet and commendable for hamlet to show love for is father by immediate grief. The queen asks hamlet to stay at Elsinore and hamlet says that he will obey her and the king commends him. Hamlet is left alone in the room and expresses his innermost thoughts, and admits that he would commit suicide if it were not against god's law. Horatio, Marcellus and Bernardo then join hamlet. Hamlet greet them, but when Horatio explains that he has come for the funeral of his father, Hamlet responds that he has only come for the wedding. Hamlet in talking mentions that he has seen his father and Horatio expresses interest because of there own sighting. Alone once more the prince expresses his convection that the ghost appareled like his father, is an omen the "All is not well." Act 1 Scene 3 At Polpnius' house Laertes is saying farewell to his sister, Ophelia.

Friar Lawrence is to Blame for the Deaths of Romeo and Juliet in Shakespeares Work :: Free Romeo and Juliet Essays

"Romeo and Juliet," a famous love story about two star-crossed lovers who take their lives in order to be together. Their deaths are at the fault of one Friar Lawrence who, being an adult, a man of God and a trusted person in the community, betrayed that trust and attempted to cover up his wrong doings with a plan that ended in tragedy. The Friar was supposed to be a responsible adult and a man of God. This means that people would have come to him to confess their sins. Romeo and Juliet were young and naive and Friar Lawrence understood that very well. He also understood their personalities and circumstances, but still chose to marry them in hope that it would end the feud between the two families. As an adult he was also supposed to be a lot smarter ands wiser. Neither of those qualities were shown in any of his decision making. The lines ?For this alliance may so happy prove to turn your households? rancour to pure love,? (said by the Friar) is proof that he truly married them to end the feud. The position of trust that the families had given Friar Lawrence, he misused. This indicates that he didn?t really value that position of trust very much, because he proceeded in the marriage of Romeo and Juliet. When Friar Lawrence says ?In one respect I?ll thy assistant me for this alliance may so happy prove,? is the exact moment when the trust is broken because he has agreed to t marry the young lovers who were obviously too blinded by love to see the reality side of things. The Friar knew this, and he knew what was right, the fact that Romeo was incredibly impulsive and in love with being in love, and Juliet was naive enough to fall for him, but aside from that he gave in and made the wrong decision. The attempt that Friar Lawrence had made to fix up his wrong doings was a mistake and took a huge role in leading up to the two deaths. He had a second chance to come clean and tell the families the truth, but he chose to ignore that opportunity and came up with a plan that resulted in the deaths of Romeo and Juliet. After Romeo had been banished, the plan that the Friar conjured up was for Juliet to take a potion which would make her appear dead.

GAP company information

It was the year of 1969 when man has taken its first step toward the moon and â€Å"Doris and Don Fisher opened the first Gap store in US in San Francisco. † The fast change in style between teenagers and adult lead to formation of company name called â€Å"GAP†. From Justa single store In 1969. our story Doris and Don Fisher opened the first Gap store in 1969. The reason was simple. Don couldnt find a pair of jeans that fit. They never expected to transform retail. But they did. Guided by humility, compassion and a strong desire to win, the Fishers grew their company thoughtfully. ustomers responded.Today, Gap Inc. Is a leading International specialty retailer with six brands – Gap, Banana Republic, Old Navy, Piperlime, Athleta and INTERMIX – more than 3,500 stores and more than 137. 000 employees. We're growing globally, and Just within the last few years, we opened our first stores In china and Italy. we're expanding online shopping to customers, too. T oday, customers in about 90 countries can buy our products. While many things have changed since 1969, the principles on which we were founded have stayed the same: creativity, delivering results, doing what's right and lways thinking of our customers first.Key Facts Founded: 1969, with a single store in San Francisco The original brand that brought American casual style to the world. Founded In 1909 In San Francisco, cap offers Iconic, yet modern clothing and accessories for adults, kids and babies. Gap gives customers the freedom to express their individual sense of style. Brand Includes Gap, GapKids, babyGap, GapMaternity and Gap30dy. Franchise stores: More than 350 stores in locations across Asia, Australia, Eastern Europe, Latin America, the Middle East and Africa Brands: cap Intermix Old Navvy PiperlimeAthleta Headquarters World HQ: San Francisco Bay Area Product Design: New York City, San Francisco, Los Angeles, London Store Management, distribution and product manufacturing: Worldwide. Stores Total: More than 3,500 stores worldwide Fun Facts The average cost of a pair of Jeans at Gap in 1969? About $7! Gap's 1988 Individuals of Style campaign was the first time the company specifically hired celebrities as models. In 2004, Banana Republic was among the first sponsors of the Emmy-nominated sleeper hit â€Å"Project Runway. † Gap has about 10 miles of storefront windows around the world. Old Navvy was named after a bar in Paris! Retired New York Times fashion editor Carrie Donovan was tapped to be the â€Å"Old Navvy Lady† in 1997 after Joking in one of her columns that she'd be great for TV spots for the brand. After a wildly successful pilot, Gap Factory Outlet was founded and opened its first store in August 1994. Glenn Murphy is our fourth CEO since our founding in 1969. (Bob Fisher served as interim CEO in 2007 before Glenn was hired. ) Celebrity stylist Rachel Zoe can be found on Piperlime. com, where she shares her picks on her favor ite fashions from the site. ? Athleta, which has served women thletes since 1998, opened its first full-sized store in 2011. How They Do Business: From the start, Gap Inc. ‘s story wasn't going to be limited to Just selling Jeans. Doris and Don Fisher made certain that integrity would become a hallmark of their business. As they continue to expand their presence internationally, They're more aware than ever how their decisions affect the communities in which they do business. And their philosophy is simple: They seek to make a positive, lasting impact on the people and in the places where they operate.They listen to their customers around the world, and share their expectations. For hey, that means looking deeper into their supply chain to ensure that they take a responsible path throughout the product lifecycle, from the source to their stores. Financial and Strategic Analysis Company Overview The Gap, Inc. (Gap) is a specialty apparel company. The product line of the company consists of casual apparel care products, accessories and fashion apparel. The company distributes its products through its retail stores, internet and catalog stores. The company is also operates wholesale and franchisee businesses.Gap operates company owned stores in the US, Canada, France, Ireland, Italy, Japan and the I-JK. Financial Performance: The company reported revenues of (U. S. Dollars) USD14,549. OO million during the fiscal year ended January2012, a decrease of 0. 78% from 2011. The operatingprofit of the company was USD 1,438. 00 million duringthe fiscal year 2012, a decrease of 26. 93% from 2011. The net profit of the company was USD 833. 00 millionduring the fiscal year 2012, a decrease of 30. 81% from2011 Share Data THE GAP, INC. , Share Data pnce (USD) as on 01-NOV-2012 35. 5 EPS (USD) Book value per share (USD) 1. 56 5. 68 Shares Outstanding (in million) 533 Performance Chart SWOT Analysts THE GAP, INC. , SWOT Analysts Strengths Weaknesses Strong Liquidity Posit ion Strong Product Portfolio and Brand Recognition Wide Geographic Presence Product Recall Dependency on Third Party Manufacturers Decreasing Comparable Store Sales Opportunities Threats Growing Apparel Market Increasing Online Presence Expansion into New Markets Competitive Environment Changing Consumer Behavior Decreasing Shopping Trips SWOT Analysis – Overview The Gap, Inc. Gap) is a specialty retailer of apparel, footwear and accessories. The I-JK, France, Ireland and Japan. The company also has online and catalog stores. The company's broad product portfolio and brand recognition and wide geographic resence provide strong foundation for its future growth . However, intense competition and changing consumer behavior are the major areas of concern for the company. THE GAP, INC. – strengths Strength – Strong Liquidity Position The company's liquidity position strengthen significantly during the fiscal year 2010.The company recorded current ratio of 2. 19 at th e fiscal year ended 2010, as compared to 1. 86 in 2009. Gap had significant increase in its cash and short term investments during the fiscal year 2010. It recorded cash and short term investments of USD 2573. 00 million in 2010, as compared to USD 1715. 0 million during the fiscal year ended 2009. Moreover the company reported a net change in cash of USD 633. 00 million in 2010, as compared to a negative net change in cash of USD 9 million at the fiscal year ended 2009.This was principally due to increase in cash inflow from operating activities. The company' cash flow from operating activities increased 36. 54% to USD 1928. 00 during the fiscal year ended 2010. Increasing cash and cash equivalent represents the companys ability to fund its business opportunities, working capital needs, meeting short term obligations and other capital requirements in the future. Strength – Strong Product Portfolio and Brand Recognition The company's strong product portfolio and brand recogni tion ensures financial stability through a diversified customer base.Gap through its retail and online stores engaged in providing a wide range of apparel and accessories for men, women and children. The company markets its products under the well known brands, namely Gap, Old Navvy, GapKids, babyGap, GapBody, Banana Republic, and Piperlime. Under the Gap brand, the company provides denim, khakis and T-shirts, fashion apparel, accessories and personal care products. The company also provides a wide collection f apparel and accessories under the brand names GapKids and babyGap.Under the Old Navvy brand, the company offers apparel, shoes and accessories for both children and adults. The company also provides casual and tailored apparel, shoes and accessories for men and women under its Banana Republic brand. In addition, the company also offers its products through its websites. The company, through its multiple store banners, caters to a wide range of customers across the world. Stre ngth – Wide Geographic Presence The company's wide geographic presence insulates it from the risk of operating in a single economy. Gap operates 3,082 stores across North America, Europe and Asia.In products across several geographies. The company's franchised stores are located in Bahrain, Indonesia, Kuwait, Malaysia, the Philippines, the Oman, Qatar, The Kingdom of Saudi Arabia, Singapore, South Korea, Turkey, the United Arab Emirates, Greece, Romania, Bulgaria, Cyprus and Croatia. The company also operates its online stores through www. gap. com, www. bananarepublic. com, www. oldnavy. com, and www. piperlime. com websites. The company's global presence enables it to build its brand image and maintain its strong position in the market.THE GAP, INC. – Weaknesses Weakness – Product Recall The company's various product recalls not only generate substantial negative publicity about its products and business, but also prevent commercialization of other future prod uct candidates. During April 2010, the company recalled its babyGap Marrakesh and Gap Outlet baby one-piece swimsuits . This recall was mainly due to presence of a halter straps that were manufactured too short causing the plastic ring located at the center of the swimsuit to press against the child's throat and obstruct the airway.This poses a strangulation hazard to the child. Weakness – Dependency on Third Party Manufacturers The company is highly dependent on the vendors outside the US, which may adversely affect its ability to meet any urgent requirements. The company purchases private label merchandise from approximately 650 vendors and non-private label merchandise from approximately 350 vendors having facilities in approximately 60 countries. During the fiscal year 2010, approximately 98% of the merchandise was produced outside the US.These outside vendors require to comply with certain vendor conducts and environmental, labor, health, and safety standards in domestic and international markets. Any noncompliance with the standards might delay the delivery of the goods and significantly affect the company's reputation. Thus, the company's high dependence on third party manufacturers may have an adverse affect on its business operations. Weakness – Decreasing Comparable Store Sales The comparable store sales have been decreasing over the past few years, which is adversely affecting the growth of the company.The stores segment accounts for more than 90% of the company's total revenue. During the fiscal year ended 2010, the company generated USD 13,079 million as compared to USD 13,496 million in the iscal year ending 2009, a decrease of 3. 18%. Over the past three years, the comparable store sales figures have been declining as demonstrated by a decrease of 9. 17% in the fiscal year 2009 and a decrease of 2. 19 % in the fiscal year 2008. As a result, Gap recorded a negative CAGR of 2. 97% during the period 2006-2010.The decrease has been pri marily due to a decline in net sales in all the brands due to the weakening retail environment and a shift of consumers from department stores to supermarkets and discount stores. THE GAP, INC. – opportunities The performance of the industry is forecasted to accelerate, with an anticipated CAGR rate of 2. 6% during 2006-2011. According to research, the US apparel retailing industry is expected to drive to a value of USD336. 7 billion by the end of 2011. Gap's stores and direct segments provide branded apparel, footwear and accessories for men, women and children through their retail and online stores.The company offering state of the art products and solutions through their wide distribution channel is likely to utilize opportunity of the growing apparel industry and thereby boost their top line growth. Opportunity – Increasing Online Presence With the rising trend of e-commerce business, there is huge potential for the ompany to increase its profitability through the direct-to-customer segment. In the fiscal year ending 2009, the direct-to-customer segment accounted for 7. 87% of the total revenue of the company and it increased by 8. 4% as compared to the sales at the end of the fiscal year 2010. The company can increase the contribution of this segment to the revenue by increasing its online presence. According to Forrester, online sales are expected to increase 13% to about USD 176. 9 billion in 2010. The growth is forecast to be 10%, 9% and 8% for 2011, 2012 and 2013, respectively. Moreover according to a report published by U. S. Census Bureau the non-store retail sales for the 10 month period from January to October 2010 increased by 12. 7% from the same period in 2009.Such web-based store concept provides consumers the convenience of shopping from home, doing away with the time consuming Journey and saving on the transportation cost. Thus, web sales are expected to register substantial growth in the coming years as e-commerce continues to capture market share from physical stores. The company stands to benefit from the growth trend of e-retail, which is supported by rising internet penetration and increasing familiarity o online shopping. Opportunity – Expansion into New Markets The company has taken several initiatives to enter new geographies in recent financial years.During November 2010, the company opened its firsh Gap store in Italy. This new store is located on Corso Vittorio Emanuele in Milan's premier shopping district. It also entered into an agreement with Armin Systems Limited to bring Gap stores in Thailand. Moreover during November 2010, the company announced to open its first store in Latin America during the fiscal year 2011. The store will be located in Santiago, Chile. The company also had taken initiatives to launch its Gap, Banana Republic and Old Navvy online brands in Canada, and Gap and Banana Republic online in the UK and nine other European countries.The company also has renewed inter est for a possible foray into India's specialty clothing market through possible venture with Reliance Retail. The company's several initiatives to enter new markets may provide significant exposure to more diversified customer base and strengthen its brand image. THE GAP, INC. – Threats Gap operates in a highly competitive specialty apparel retail industry. It faces intense ompetition from local, national, and global department stores, specialty and discount store chains, independent retail stores, and online businesses, which are dealing with similar products.The company also faces significant competition from the local players in European, Japanese, and Canadian markets. The company's franchisees also faces competition in the respective markets. Increasing global competition in the apparel retailing market may significantly affect the company's market share in the future financial years. Threat – Changing Consumer Behavior Owing to recession, consumers in the US are left with lesser disposable incomes. It is showing in their purchase attitude Consumers tend to reduce their discretionary shopping.According to a consumer survey conducted in the US by Harris Interactive, more than half of adults (54%) say they would reduce discretionary spending during an economic recession and the majority (63%) of adults said they would not make a purchase if there was no deal attached. It clearly states that during an economic recession, consumers would cut budgets, yet will continue to shop when discounts are available. The scenario is a threat to specialty retailers like the company, which ell discretionary products. They will see a decreased footfalls and reduced revenues.In order to attract customers, these retailers will have to spend more on coupons and discounts, which will reduce their margins. Threat – Decreasing Shopping Trips The business of Gap may significantly affected due to decreasing shopping trips of consumers in the US. The US operati ons contributed to 82. 1% of the total revenue of the company in the fiscal year ending 2010. According to a study by Nielsen, outlet shopping trips in the US has shown an average monthly decline of 4% from July 2008 o February 2010.The company has already been recording a decline in comparable store sales over the past few years, which accounts for Change Factors: In the beginning Gap was sell only Levi's products where they have to depend on that particular brand by and large. Later on when they realized depending too much on a particular product may harm the business in the future, they have changed there course of depending on a single particular product . Gradually they have came up with there own product name and different supplier in order to reduce risks. In 1983 Gap purchased Banana Republic