Marketing Plan For Asian Food Catering - 1270 Words

Company Description Paper The business planning process is a very critical part of a business, in order for a business to be productive and successful in the end. There is no easy way to get around business planning because as a business owner you have to always use strategies that is going to work for your business and not against your business. I have always had that taste of love for Asian food and I have been to a few different events in the past through-out the United States that I have seen Asian food being catered and served. So I am going to propose too you some information on the business plan of my choice that will help my business fulfill and cater to the needs of our target customers. Also my business will always focus on providing them with great customer service and customer satisfaction at all times. Mission Statement Our Mission is to provide Asian food catering services targeting Asians communities and more that is present in the United States. 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Poverty in African American Minority Neighborhoods

Child abuse is defined as ways of treating a child that are harmful or morally wrong. (Richards 12) Child abuse is caused by so many things and usually starts with something de-menial or small. Like a snowball, the problem gets bigger as time goes on, if you do not stop it. Child abuse happens everywhere, in every neighborhood, ethnicity/racial, and religion. It is worldwide. One of the main factors of child abuse is where they live. Do they live in poverty or not? Poverty is such a broad term; when most people think of poverty, they think of the kids they see on TV. These children are usually from a third world country where there are programs set up to help feed the starving. Poverty is defined by Charles Booth, in 1886, as â€Å"very†¦show more content†¦The â€Å"estimated overlap of domestic violence and child abuse is 30 to 50 percent† of all cases (Henderson 321). As the child grows older and sees the violence in their household there is a possibility that the child will think that it is acceptable. Over half of children abused in Palm Beach County are younger than six years of age. â€Å"44% of the abused children were African American, nearly 52% of the neglected or abused children were younger than 6 [years old], and more than half of those were infants† (Wolford 1). African American children are often portrayed as children who are abused. Many times it is shown on TV or movies or in novels. People are vulnerable to information that they see every day; yet, this information may or may not be 100 % accurate. â€Å"In 1982 black children were 22 % of all child maltreatment reports. In 1984 black children were 20.8 % of all Child Protective Services cases† (Hampton 4). Many studies have been conducted to prove that there is a significant difference in child abuse among the multiple social classes. 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Iron Crowned Chapter 10 Free Essays

string(90) " seizing control of it could shape the land to his or her will, instantly beautifying it\." Deanna came easily when I summoned her, making me wonder if she’d been hanging around invisibly since our last chat. Regardless, she didn’t mention the fake ultimatum, thus letting Kiyo continue to believe we were in a time crunch. I called Volusian as well, figuring it couldn’t hurt to have his protection while traveling to the ghost cutoff point. We will write a custom essay sample on Iron Crowned Chapter 10 or any similar topic only for you Order Now The two spirits didn’t interact as we traveled, no surprise seeing as they had little in common. Deanna was tied to the living because of unfinished business and love for others. Volusian’s soul was damned for eternity, forced to wander for his crimes – unless I ever sent him to the Underworld. Deanna hadn’t been able to give us a time estimate on how long it would take to reach the crown’s lair (as I was beginning to refer to it). The Otherworld’s twisted terrain always made travel hard to gauge, plus spirits could move faster than we could. I wouldn’t have minded walking, but the unknown variables made me ride horseback. Kiyo did the same out of courtesy for me, though he could have tirelessly covered miles and miles in fox form. The only thing I really knew for sure was that this wouldn’t be a day trip. Kiyo and I were as silent as the ghosts, though once we crossed out of the lands adjacent to mine, he would occasionally tell me where we were. I’d never ventured this far into the Otherworld, and it made me uneasy, though knowing we were clear of the Rowan Land was a relief. Even Kiyo, neutral as he claimed, had tensed in Katrice’s territory. â€Å"This is the Honeysuckle Land,† he said, when the road led us to a hot, riotously colored landscape. Flowers grew everywhere, and even the trees were covered in blossoms. Arizona was notorious for all its hummingbirds, but here, they swarmed like flies. â€Å"Dorian was right,† I mused. â€Å"It is beautiful.† It was hard to imagine this place mustering up a military. This seemed more like a world where people frolicked in scanty clothing, beating drums and engaging in free love. Well, since they were gentry, free love would have been a given. â€Å"Dorian would know,† said Kiyo stiffly, eyes focused straight ahead. â€Å"I’m surprised he let you come with me.† â€Å"Dorian doesn’t say what I can or can’t do,† I snapped. â€Å"If you’re going to just keep doing this the whole time, I’ll – â€Å" â€Å"You’ll what?† asked Kiyo with amusement, when I didn’t continue. â€Å"Send me back? Face death-threatening situations alone?† â€Å"I would gladly escort you back, if that is what you choose,† Volusian told Kiyo. I sighed. â€Å"Please. Just don’t get on Dorian the whole time, okay? He wants this over. It was his idea to get your help. He’s worried, believe me.† â€Å"That,† said Kiyo gravely, â€Å"I can believe. I don’t trust him. I don’t believe his alliance with you is as straightforward as it seems. But I do believe he cares about you.† The landscape suddenly shifted around us, becoming a rolling desert of white sand. It stretched out under a blazing sun, reflecting back at us in a way that was hard on the eyes. â€Å"Ugh,† I said, focusing down on the road. â€Å"What’s this?† â€Å"The Myrrh Land,† said Kiyo. Even with my eyes averted, I knew he was smiling. â€Å"Figured you’d like this place. You should go make friends with its king. They’ve got some badass fighters.† â€Å"Big difference between this and the Sonora Desert,† I said. Although harsh and scalding, the desert I’d grown up with was full of life. This place was desolate and dead. Mercifully, we soon passed out of it into sweeping moors, covered in snow. I took my leather jacket out of my pack. I’d brought it knowing we might travel through lands that were in winter. It still wasn’t much protection, and I realized I could have easily gotten one of my servants to whip up something more suitable. No doubt it would’ve been gentry-style, probably a cloak. Look human, Jasmine had said. Mostly I looked cold. Kiyo identified this place as the Birch Land. We crossed into the Honeysuckle Land again, which was typical of the Otherworld. Other places repeated as well. When the road took us through a landscape that reminded me of northern Texas, Kiyo had nothing to say. â€Å"What’s this?† I asked. â€Å"I don’t know,† he admitted. â€Å"The Pecan Land,† said Volusian. â€Å"Sounds delicious,† I teased. We’d had few stops and mostly eaten travel rations. â€Å"I could go for a pecan pie right now.† Kiyo didn’t respond. He seemed lost in thought, his expression growing darker as we passed through more and more terrain he didn’t know. He seemed to know the names, though, and didn’t like them. â€Å"You’re taking us to the Unclaimed Lands,† he said to Deanna. It was near the end of our day, the sky burning red. â€Å"I don’t know,† she said simply. â€Å"I’m only going where I was shown.† â€Å"Volusian?† I asked. â€Å"Of course we’re going to the Unclaimed Lands,† he said, sounding mildly annoyed by my stupidity. â€Å"We’re nearly upon them. Where else would you expect a coveted object to be hidden?† I glanced at Kiyo. â€Å"I’m going to go out on a limb here and guess these are kingdoms no one controls?† â€Å"‘Kingdoms’ isn’t even the right word,† he said. â€Å"No one lives here.† â€Å"Why not?† I asked. The scenery changed again. The texture of the ground was like recently dried mud, covered in a pattern of cracks that reminded me of one of my jigsaw puzzles. Odd holes were scattered here and there. This eerie landscape stretched far, far ahead, no end in sight. Not far from us – ten miles at most – the land rose sharply along the sides of the cracked road, forming high, rocky cliffs that curled in at their tops like jaws. Erratic gusts of wind blew through the tunnel they formed. The setting sun made everything blood-red. â€Å"Guess,† said Kiyo. â€Å"Because we’re here.† I peered around, studying the depressing landscape. Its superficial appearance meant little, really. Any gentry seizing control of it could shape the land to his or her will, instantly beautifying it. You read "Iron Crowned Chapter 10" in category "Essay examples" Then, a strange feeling settled in me. I couldn’t quite define it. It didn’t make me ill or disoriented. It just didn’t feel right. I squinted at the cliffs, taking in their striation. Through the red haze, I could see many of the loose rocks were a dull gray, streaked with orange. Oxidized metal. â€Å"Iron,† I realized. â€Å"We’re surrounded in iron. We’re not even in the crown’s lair yet. We can’t get to the lair without passing through iron.† â€Å"Can you feel it?† asked Kiyo. â€Å"Yes †¦Ã¢â‚¬  That was the odd feeling in the pit of my stomach. â€Å"That’s the gentry in you. Even with your human blood, you can’t help but be affected. There’s a lot of iron here.† â€Å"I don’t feel weak,† I said, astonished the iron would affect me at all. â€Å"Or sick or in pain.† I’d seen gentry scream just from the smallest touch of iron. I summoned the magic within me, letting it reach out to the air and unseen moisture, though I didn’t actively use it. â€Å"I don’t think it’s hurting my magic either.† â€Å"Good,† said Kiyo. â€Å"You’re strong, so I’m not surprised. You may just have a simple awareness of it.† I thought about this for a moment and came to another realization. â€Å"You’re not affected at all, are you?† He shook his head. â€Å"Nope.† I always thought of Kiyo and me as being alike, children born of both worlds. That part was true, as was our half-human heritage. But my Otherworldly blood came from the gentry. Only gentry were affected by iron, and kitsunes had no fairy connection. As with the demon bear and the fetch, a kitsune’s bane would be silver. At least, a full-blooded kitsune’s would be. I’d seen Kiyo handle silver objects; his human blood protected him as mine did me. The bottom line was that he was a more useful companion here than I’d realized. I wondered if Dorian had made the connection. â€Å"We will cross through no other lands until you turn back, mistress,† said Volusian. â€Å"So this is the world’s end. The Otherworld’s end, at least.† I turned to Deanna, hovering alongside us. â€Å"Will we reach the entrance before night?† She thought about it, and I braced myself for another vague response. â€Å"No. If you don’t stop, you’ll reach it in the morning.† Kiyo and I exchanged looks, both of us thinking the same thing. Get to the crown sooner or camp and be rested? I looked over at Volusian. â€Å"You said there are no other lands. But will the terrain in this one change?† â€Å"No.† â€Å"What do you think?† I asked Kiyo. â€Å"I don’t want to be tired when we face whatever’s guarding the crown, but this isn’t great camping territory.† â€Å"No,† he agreed. His eyes scanned around us, able to see more than mine in the waning light. He pointed. â€Å"There. There’s a small outcrop that’ll block most of the wind. Enough to keep a fire going. I hope.† I couldn’t see the spot but trusted him. â€Å"Camping it is.† When we reached it, I saw the site was indeed sheltered. I tethered the horses while Kiyo built up a fire. We watched it warily as the wind abruptly came and went. The fire flickered and waved but appeared capable of lasting the night. â€Å"I could hold off the wind a little,† I said. â€Å"Don’t bother,† said Kiyo, settling down beside the blaze. â€Å"Save your magic. This’ll hold.† I wondered if he really was concerned about me conserving my strength or just wanted me to avoid my magic altogether. He’d never liked it. I didn’t question him, though, and sat down as well, mostly because the cold was finally starting to get to me. I buttoned up the leather jacket, achieving little. Our dinner consisted of more travel food: jerky, granola, and some bread that would probably be stale tomorrow. â€Å"I don’t suppose you can use your wilderness skills to go hunt us something fresh?† I asked. He smiled, the campfire casting strange shadows on his face, now that night had fully come. â€Å"I would if there was anything alive out here. It’s just us.† He eyed me, taking in my shivering. â€Å"Don’t you own a warmer coat?† â€Å"Where am I going to get a down coat in Tucson?† I demanded. â€Å"This time of year? Any sporting goods store. For the skiers. Lara could order you one if you can’t be troubled.† â€Å"I think Lara and Tim are in love,† I said abruptly, remembering that bizarre development. â€Å"What?† asked Kiyo, as astonished as I had been. â€Å"Are you sure?† â€Å"Well, they’re in infatuation, at least. Volusian, were they together when you went back?† My minion was off in the shadows, only his red eyes visible. â€Å"Yes, mistress. They were in bed, their bodies naked and – â€Å" â€Å"Okay, okay, stop,† I exclaimed. â€Å"I don’t need to hear anymore.† â€Å"Well, I’ll be damned,† said Kiyo. While we’d dated, he’d been witness to their phone battles. â€Å"But I guess stranger things have happened.† â€Å"Yeah,† I agreed. â€Å"Look at us. We’re sitting in an iron landscape, being led by a ghost to a mythical object, which – if it even exists – may or may not make me scary enough to end a war.† â€Å"Fair point,† said Kiyo, his smile returning. We sat in companionable silence. It was a nice change from the animosity and tension that had surrounded us for so long. I’d missed him, I realized. â€Å"Eugenie?† â€Å"Hmm?† I glanced up, feeling embarrassed by my thoughts. â€Å"Why didn’t you bring Roland with you? He could’ve fought unaffected. And God knows he doesn’t want gentry power.† I looked away from those dark eyes, down at the fire’s blue heart. â€Å"He doesn’t want me to have gentry power either.† â€Å"Yeah, but he’d put that aside if he knew you were walking into – â€Å" â€Å"He doesn’t know anything,† I said bluntly. My voice then grew soft. â€Å"We aren’t speaking anymore.† â€Å"How †¦Ã¢â‚¬  Kiyo paused, no doubt trying to wrap his mind around this. â€Å"How is this possible?† I shrugged. â€Å"He cut me off. When he found out I’d been keeping the truth from him, about the Thorn Land and everything else †¦ Well, ever since what happened with Leith, he’s refused to speak to or acknowledge me.† â€Å"But your mom †¦Ã¢â‚¬  â€Å"Talks to me occasionally. She’s caught in the middle, and I don’t want to make it harder on her than it already is. She shouldn’t have to go against her husband.† Kiyo’s confusion was becoming anger. â€Å"Yeah, but you’re her daughter! She should be able to – â€Å" â€Å"Just forget it, okay?† I drew my knees up to me and wrapped my arms around them to draw in more warmth. â€Å"I don’t want to talk about it.† â€Å"Eug, I’m sorry.† I kept quiet. There was nothing to say. He cleared his throat. â€Å"I don’t suppose you brought anything else to keep you warm? Blankets? Camping supplies?† â€Å"I didn’t think about the possible overnight part,† I said, grateful for the subject shift. â€Å"I’ve got a change of clothes like these, food, weapons, and first aid supplies.† â€Å"You brought first aid stuff?† He sounded impressed. â€Å"It’s not like you to think ahead. Er, I mean, you don’t usually worry about – â€Å" â€Å"I know what you mean,† I said with a weary smile. â€Å"And don’t worry, the universe is the same. I didn’t plan ahead. It’s for current injuries.† â€Å"Current?† â€Å"I got hit by a table.† There might be a million reasons that Kiyo and I were wrong for each other, but one nice thing was that when I made a statement like that, he just didn’t question it. I was still freezing when it came time to sleep, forcing Kiyo into a bold suggestion. â€Å"Come sleep over here, between me and the fire. The cold doesn’t bug me as much, and I can block the wind.† â€Å"Kiyo – â€Å" â€Å"Yeah, yeah. I know. Dorian. But if he wanted me here to protect you, then here’s the perfect chance. Besides, we all know you can kick my ass if I try anything.† I said and did nothing. When this continued for about a minute, he sighed and lay down on his side, back to the wind. I attempted the same, after ordering Volusian to stay on watch, but even with the fire’s warmth, I was still cold. I’m tough, I’m tough. I played those words over and over through my head, not wanting to admit weakness. After about fifteen minutes, I gave in and crawled over to Kiyo’s side of the fire. There was no â€Å"I told you so.† He simply made room but was surprised when I positioned myself to face him. â€Å"I thought you’d want your back to me.† â€Å"Can’t,† I said. â€Å"That’s where the injuries are.† â€Å"From the table.† â€Å"Right.† He could have attempted propriety by turning over so his back faced me, but that would have put his face to the wind. He didn’t deserve that. I wiggled myself closer, curling myself against his body, and resting my head against his chest. He was big enough that he did almost completely shield me. His whole body stood still as I made myself comfortable, either from his astonishment or for my ease. Once I was settled, he relaxed slightly and tried to put his arms around me. He suddenly fumbled and pulled them away, grazing my breast as he did. I don’t know if he noticed. I certainly did. â€Å"Wait. Where are you hurt?† â€Å"Back. Left shoulder.† Tentatively, he reached out again and wrapped his arms around my waist. â€Å"This okay?† â€Å"Mmm-hmm.† Holding me, he shifted closer so that our bodies pressed together, holding in the warmth. â€Å"This?† â€Å"Fine.† He relaxed again and exhaled. Tucked against him, I couldn’t see his face but had the sneaking suspicion that I wouldn’t be getting much sleep tonight. Survival-wise, this plan was sound. I was warm(ish) now, protected and heated by him. But I was also pressed up against a body that I knew intimately, one that used to move in mine with a possessive fierceness. Dorian claimed me with mind games and exquisite acts of dominance. Kiyo had always done it through strength and ferocity, an animal taking his mate. I bit my lip and closed my eyes, hoping I’d fall asleep if I mentally enumerated the reasons we’d broken up. But mostly, I kept remembering how his hand had lightly rubbed my breast. Sleep finally took me, but it was a long time in coming. As I drifted off, I wondered how he was coping. This probably didn’t affect him at all. If he really wasn’t sleeping with Maiwenn again, then he was probably out picking up women all the time. Kitsunes had kind of a supernatural allure, and God knew he’d been pretty persuasive the night we’d met. I awoke a couple hours before dawn – and not by choice. Volusian’s warning came only seconds before the surface below us began to tremble. I was up in a flash, but unsurprisingly, Kiyo had already beaten me. I’d gone to sleep with weapons, uncomfortable though it was. I hadn’t known what I’d need out here, except that I wouldn’t need the iron athame since this was a gentry-free zone. I had my gun (safety on) and the silver athame. Both were out as Kiyo and I stood back to back, staring around us. The tremors shook the ground, forcing some fancy footwork, and creating more of the cracks that already covered the ground. A few more seconds passed, and then all went still. â€Å"An earthquake?† I asked uncertainly. â€Å"No,† said Volusian. He was in his solid, two-legged form, staring around with narrowed eyes. It was a little disconcerting that he didn’t seem to know precisely what the problem was. â€Å"Then what are we – â€Å" The ground below us suddenly split open. With only the light of the fire, my vision was bad, but I thought I saw what looked kind of like a serpentine shape emerge from the earth. No, it was exactly like a serpentine shape because a moment later, a giant fucking snake shot up and landed neatly in a perfect coil, its head towered over Kiyo and me as it regarded us with glowing green eyes. The light from them illuminated a flicking, forked tongue, and the loud hissing that followed was kind of a given. â€Å"Volusian!† I yelled. My minion sprang into action. The deadly touch of his hands made the snake jerk in surprise. Beside me, Kiyo was shifting into fox form, and I decided a gun was probably going to get me farther here than the athame’s small blade. A drop of venom fell from the snake’s mouth, and it sizzled when it hit the ground in front of me. Lovely. Still, I felt confident the three of us could take this thing. At least until the ground shook again, and another snake popped up. It was soon followed by a third. â€Å"Son of a bitch.† I deliberated, wondering if mass force on one snake at a time was the way to go. No. I’d leave Kiyo and Volusian to the first. I yelled a warning to Kiyo that the snake was poisonous, but it was hard to say if he understood. I turned on the two new snakes. Even with part of their bodies coiled, their heads stood a good ten feet above mine. More venom dropped before me. Deciding not to play favorites, I aimed the gun and quickly fired off a couple of rounds into each. I’d had the foresight to load up silver bullets, but it didn’t look like the gun was going to kill the snakes anytime soon – at least not without fifty more shots. Mostly, the bullets seemed to piss them off more. Still, I kept firing since that seemed to make the snakes keep their distance. It proved to be a short-term solution, seeing as my bullets soon ran out. I reached for another clip. I could reload a gun quickly, but that pause gave one of the snakes an opening. Its head – no pun intended – snaked toward me, giving me a close-up view of large fangs. I’d been on guard for such an attack and jumped out of its way, only to be struck by the other’s tail. It knocked me several feet away, causing me to lose my grip on the new cartridge. The cartridge disappeared into the night, and I landed hard on the ground. My back and shoulder screamed in agony, but I had no time to baby them. There were two other clips in my belt, but as one of the snakes came for me again, my hand went to the athame after all. The snake that had hit me leaned down, its face and dripping jaw inches from me. Rather than run again, I leaped forward and plunged the blade into its eye. It cried out in pain, suffering from the silver, just as any Otherworldy creature would. Well, actually, any creature with a knife in its eye would probably suffer, magical or not. I had the sense to jerk my athame out, having no desire either to lose the blade or get pulled along as the snake reared back up. The suffering of its pal made the other hold off. In those moments, I shoved the athame back into my belt, yelping in surprise. Apparently, the snake’s eye was poisonous too, and whatever liquid had come away with the blade ate through my jeans and burned my skin. Nonetheless, I managed to get another cartridge loaded. Without hesitation, I turned and emptied the entire gun into the snake’s head. I wasn’t precise enough to hit the eye, but all those bullets took their toll. The snake wavered in the air, blood mixing with venom on its skin, and with a last hiss of pain, it fell over and slammed into the ground. Wondering why the other snake hadn’t come for me, I spun around and saw Volusian and Kiyo attacking it. I took it on faith that the first one was dead and loaded the gun with my last cartridge. Volusian’s touch was searing the snake’s skin, and Kiyo was simply ripping into it with his teeth. Opting for what seemed tried and true, I fired into the snake’s head again. Between the three of us, we soon literally took the snake down. I stood there tense and ready, empty gun in one hand and athame in the other. The world was silent except for the wind and the occasional twitching of the third snake as it died. Moments later, Kiyo morphed out of the fox shape, giving me a better view of any injuries now that he wasn’t covered in fur. He grimaced and spit on the ground a few times, but biting the snake apparently hadn’t destroyed his mouth or face. A couple red spots on his arms made me think he too had been splattered with the venom. Otherwise, he looked unharmed. He sighed and raked a hand through his black hair, which was curling slightly from sweat. â€Å"You know,† he said. â€Å"I don’t think I’ll ever be able to bring myself to watch Dune again.† How to cite Iron Crowned Chapter 10, Essay examples

Bullying and Violence Prevention Programs †MyAssignmenthelp.com

Question: Discuss about the Bullying and Violence Prevention Programs. Answer: Introduction: Administering working condition culture is an inflexibly fundamental issue in the present affiliations. In research, it has developed that the 'right kind of culture' is a wellspring of high ground since it impacts in travel an affiliation drives its business and its responsiveness to change and capacity. Workplace culture furthermore shapes the essential administration process and effects the attitudes and practices of definitive people. Right when culture is futile, for instance, when the estimations of people are not agreed with various leveled regards the threat of definitive underperformance increases. Culture brokenness normally shows up as impelling conduct, factionalism, or the climb of storerooms and countercultures, which effectively battle with the best inclinations of the association general (Bazarko, Cate, Azocar and Kreitzer, 2013; pp 107-33). Working environment or authoritative culture can be solid (generally shared by individuals), feeble (not generally shared), or transitional (portrayed by the continuous substitution of one culture by another). A broken working environment culture likewise dissolves representative engagement and can prompt an expansion in spontaneous unlucky deficiencies and stress-related word related wellbeing and security claims. Culture can likewise exist at many levels, counting a prevailing authoritative culture; subcultures which are related with particular units and countercultures which exhibit an immediate test to the support of a prevailing hierarchical culture and can be found in work units that are ineffectively coordinated with the bigger association (Speroff, Nwosu, Greevy, Weinger, Talbot, Wall, Deshpande, France, Ely, Burgess, Englebright, Williams and Dittus, 2010; pp 592-596). Definitely, efficiency and nature of administration will diminish. Eventually, an association with a broken culture is at a higher danger of flopping in its part by dismissing the desires of its partners and those that depend on the administration it gives. It ought to be noticed that individuals from subcultures comprehensively share an indistinguishable esteems from whatever is left of the association yet vary in routes extraordinary to their individuals. For instance, a subculture of long serving representatives may show a solid sense of duty regarding the association and its esteems consequently giving a decent case to others, especially newcomers whose sense of duty regarding the association may not be as solid (Cameron and Quinn, 2011). Consequently subcultures don't really debilitate the more extensive culture. They can upgrade it by giving a level of consolation and can here and there even be rousing. Working environment culture likewise influences key worker results. For case, thinks about have discovered positive connections between culture (e.g., compelling initiative, correspondence transparency, participative administration, and powerful clash administration) and worker prosperity, for example, fulfillment, spirit, engagement, and larger amounts of optional work exertion and participation (Bazarko, Cate, Azocar and Kreitzer, 2013; pp 107-33). Organizational culture is a wellspring of reasonable upper hand and influences key hierarchical results, for example, staff resolve, turnover, benefit quality, and benefit results. The costs of a substandard legitimate culture fuse irritating in the workplace, poor agent mental and physical prosperity, detachment and underperformance. Exactly when progressive culture isn't utilitarian, basic resources are facilitated to containing and overseeing specialist practices and workplace strife (Gazi and Zyphur, 2009; pp 114-139). An instance of the stunning impact of a pointless culture starts from the 2010 examination concerning the Mid Staffordshire NHS Foundation trust, in which up to 1200 patient passings were attributed to 'a culture of flexibility for poor rules' (Castro and Martins, 2010; pp 1-11). At the point when authoritative culture is useful then again, workers share useful esteems, standards and methods for associating, which control how they react when there is vulnerability or difficulties. This can assist lessen stretch when managing uncertainty and complexity (Newsome, Waldo and Gruszka, 2012; pp 297-311). Also culture shapes the notoriety of associations, as how workers feel inside an association impacts how they discuss it to partners, the general population, even their patients. At last when there is an utilitarian authoritative culture representatives flourish and are roused to convey better administrations (Hartmann, Meterko and Rosen, 2009; p 66). One of the fundamental difficulties looked by numerous associations is the manner by which to move forward working environment culture and realize positive behavioral change. Research demonstrates that authoritative culture can be enhanced with arranged hierarchical mediations. In this report we depict the aftereffects of a broad audit of work environment culture change intercessions directed at all levels of the association (individual, gathering, and association wide) and connected over a scope of various enterprises (Henderson, Schoonbeek, Ossenberg, Caddick, Wing, Capell, et al., 2013; pp 1653-61). The investigations were assessed and appraised concurring two noteworthy criteria: I) The notoriety of the diaries where the examination is distributed (in light of the Australian Research Council (ARC) diary positioning and the diary's effect factor), and ii) the nature of the plan and examination utilized in the examination (Eugeni, 2013; pp 48-58). These criteria give direction with regards to the constancy and unwavering quality of the discoveries announced in each examination. Hierarchical wide culture mediations: These are bigger scale work environment culture mediations went for changing society over the entirety association. These mediations have a tendency to be more intricate, longer term, and include change methodologies at various levels of the association. Work environment affability and staff engagement mediations: These intercessions are gone for bringing issues to light of the significance of working environment respectfulness and encouraging a culture that maintains the estimations of regard, joint effort and engagement. Collaboration mediations: These are intercessions gone for moving forward work environment culture through teambuilding, enhancing correspondence inside groups, peace promotion and cultivating a culture of collaboration and joint effort. Administration intercessions: These are mediations focused at chiefs and pioneers, intended to outfit them with the aptitudes to oversee culture change and utilize distinctive preparing procedures to create authority capacities. Against tormenting intercessions: These medications are gone for lessening inadmissible, tormenting sort practices in the workforce and include both deterrent and receptive measures. Care and stress/burnout intercessions: These have a tendency to be more individual-construct intercessions centered in light of altering people's reactions to stretch and empowering care as methods for upgrading representatives' general prosperity. Health system reforms have until recently tended to focus primarily on structural change. As indicated by Scott the presentation of oversaw mind in the United States, the foundation of standard-setting bodies, for example, the National Institute for Clinical Excellence (Department of Wellbeing 1998) in the United Kingdom, the improvement of therapeutic mistake announcing frameworks in Australia, are cases of this approach (Jenkins, Woith, Stenger and Kerber, 2013; pp 116-6). In any case, late investigations demonstrate that basic changes alone don't convey foreseen enhancements in quality and execution in medicinal services. Subsequently, we hear calls for "social change" to be fashioned close by auxiliary change keeping in mind the end goal to convey upgrades in quality and execution. In this system, a specialist's office's lifestyle is reflected by what is regarded, the overwhelming authoritative and expert styles, the tongue and pictures, the frameworks and plans, and the implications of achievement that make a facility unique. In the human administrations affiliations' specialists and orderlies are generally OK with culture and its hugeness in the game plan of individualized patient care (Kalisch, Aebersold, McLaughlin, Tschannen and Lane, 2014; pp 1-16). A center's lifestyle is reflected by what is regarded the predominant managerial and expert styles, the tongue and pictures, the methodologies and plans, and the implications of accomplishment that make a mending office unique. In the restorative administrations affiliations specialists and therapeutic orderlies are all things considered understood with culture and its importance in the course of action of individualized patient care (Kalisch, Xie and Ronis, 2013; pp 405-13). Thus, definitive culture has been considered as a variable influencing specialist's office execution that add to nature of care, likewise, a gadget that can be used for better nursing, remedial, tolerant, additionally, system comes about including improved workplace circumstances and patient and staff prosperity. Also, it has been suggested that paying little regard to individual's motivation, capacities and resources, a solid work culture may have immense impact on the opinions towards one nature of working life and furthermore on prosperity results in this prosperity region (Roberts, Williams, Schwind, Sutyak, McDowell, Griffen, et al. 2014; 170-8). In the healthcare system, medical caretakers are universal and have both formal and casual influential positions. Medical caretakers are in a position to impact working environment culture, access and nature of human services arrangement. Work environment culture can be inherently connected to administration frequently with a 'thump on' impact on profitability and quality. Successful initiative can light up a way through circumstances of vulnerability. Despite the fact that there are just few investigations on changing work environment culture at the organizational level, these examinations plainly demonstrate that painstakingly arranged mediations that have solid help from the senior administration group and great investment from representatives result in positive changes. These investigations additionally feature new methodologies and procedures to be consolidated as a component of authoritative practices. Generally speaking, the majority of the mediations with the exception of Scheeres and Rhodes (2006; pp 223-36) included best administration bolster and a honest to goodness participative way to deal with lock in representatives over all levels. The special case, Scheeres and Rhodes (2006; pp 223-36), announced an intercession that was transcendently commanded starting from the top. Scheeres and Rhodes (2006; pp 223-36) did not discover huge culture change because of the mediation and feature the need to see how workers encounte r the association's corporate culture before concentrating on changing the way of life. At last an as of late distributed paper in another diary (open access) by Park and Kim (2009) (which is excluded in the survey as it does exclude a mediation) gives a far reaching review of the drivers and empowering agents of working environment culture. A positive constant association creates, the feeling of groupship: a positive introduction to comprehend and replicate a mentality of sense making about the normal enrollment setting. In the event that everybody feels a positive feeling of holding in the gathering what's more, the procedure can duplicate itself, to an ever increasing extent, as a winding, as a prudent hover or, in negative, endless loop. In short the hover of certainty is a self and gathering viability articulation, a positive Member Leadership Context for all, and this cicle of certainty is connected with the clinic's way of life and association's way of life straightforwardly (Robbins and Sanghi, 2007; pp 170-8). Conclusion Changing working environment culture is hugely testing, however the results of not changing a broken culture can decimate for the association's adequacy and individual representative prosperity. At the point when 'sufficient' turns into the 'way we get things done around here', and workers never again endeavor to give the best conceivable care, at that point the association is never again meeting the desires of any of its partners. From the audit of culture change intercessions obviously evolving culture is mind boggling and requires some serious energy, assurance and assets from all parts of the association. Additions are ease back to develop and set backs are normal. Furthermore culture change isn't a discrete action performed by Human Resource Departments, however or maybe a reliable approach by all pioneers to all choices about the association. Positive patient results dependably start things out for conveying phenomenal care; in any case, regardless of what an attendant's task is, negative musings and emotions can affect the working environment culture. Discover how demeanor can enhance spirit, tolerant care, and at last patient results in social insurance. Medical attendants shouldn't waver to attempt new systems to enhance the nursing work environment culture. Enhancing the hierarchical atmosphere can help in expanding maintenance, enhancing persistent security and diminishing general social insurance costs because of positive patient results. Extending the straightforwardness of operations can help relationship to make progress delegate satisfaction. For a couple of affiliations, getting the chance to be clear requires a social change. Direct affiliations empower specialists to see and offer information moreover, make proposition. They pass on philosophies and goals to delegates, and give standard updates about progress toward achieving those goals. Updates may consolidate specific estimations the affiliation is trying, challenges perceived for the future, cash related information, and the affiliation's progress in tending to assemble needs. Conspicuous evidence and affirmation of the troubles going up against the workforce enables specialist's offices to refresh work and workplace conditions with the objective that they can offer jobs that attract, hold, and develop the "best and the brightest" in tasteful numbers. Supporting a positive workplace culture should be a discernible bit of the board's crucial inspiration. References Bazarko D, Cate RA, Azocar F and Kreitzer MJ. (2013). The impact of an innovative mindfulness-based stress reduction program on the health and well-being of nurses employed in a corporate setting. J Workplace Behav Health;28(2):10733. Available from: https://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=3646311tool=pmcentrezrendertype=abstract Cameron, K.S.and Quinn, R.E. (2011), Diagnosing and Changing Organizational Culture: Based on the Competing Values Framework, San Francisco: Jossey Bass.-John Willey sons. Castro, M., and Martins, N. (2010), The relationship between organisational climate and employee satisfaction in a South African information and technology organization, SA Journal of Industrial Psychology/SA TydskrifvirBedryfsielkunde, 36(1), A., 1-11. Eugeni, B., (2013), Theoretical approaches to the organizational culture and the organizational climate: Exploratory research examples and best policies in health care services, Journal of Human Resource Management, 1(4): 48-58. doi: 10.11648/j.jhrm.20130104.11 Gazi, I.and Zyphur, M. J. (2009), Rituals in Organizations: A Review and Expansion of Current Theory. Group Organization Management February 2009; 34:1, 114-139. Hartmann, C.W., Meterko, M and Rosen, A. (2009), Relationship of hospital organizational culture to patient safety climate in the veterans health administration. Med Care Res Rev (2009) 66, 320-338. Henderson A, Schoonbeek S, Ossenberg C, Caddick A, Wing D, Capell L, et al., (2013), Achieving success in intervention studies: an analysis of variable staff engagement across three midwifery settings. J Clin Nurs, 23(11-12):165361. Available from: https://www.ncbi.nlm.nih.gov/pubmed/23815392 Jenkins SH, Woith WM, Stenger DA and Kerber CS. (2013), Using an innovative journal club strategy to teach civility to nursing students: Lessons learned. J Nurs Educ Pract. 4(3):1616. Available from: https://www.sciedu.ca/journal/index.php/jnep/article/view/3377 Kalisch BJ, Aebersold M, McLaughlin M, Tschannen D and Lane S (2014).An Intervention to Improve Nursing Teamwork Using Virtual Simulation. West J Nurs Res. 116. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24763705 Kalisch BJ, Xie B and Ronis DL (2013). Train-the-trainer intervention to increase nursing teamwork and decrease missed nursing care in acute care patient units. Nurs Res. 62(6):40513. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24165216 Newsome S, Waldo M and Gruszka C (2012). Mindfulness group work: Preventing stress and increasing self-compassion among helping professionals in training. J Spec Gr Work.37(4):297311. Available from: https://www.tandfonline.com/doi/abs/10.1080/01933922.2012.690832 Park, JS. and Kim, TH.(2009),Do types of organizational culture matter in nurse job satisfaction and turnover intention? Leadership in Health Services , 22, 20-38. Robbins, SP. and Sanghi, S. (2007). Organizational Behavior, NewDelhi: Pearson Education Roberts NK, Williams RG, Schwind CJ, Sutyak JA, McDowell C, Griffen D, et al. The impact of brief team communication, leadership and team behavior training on ad hoc team performance in trauma care settings. Am J Surg. 2014:1708. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24468024 Roberts NK, Williams RG, Schwind CJ, Sutyak JA, McDowell C, Griffen D, et al. (2014). The impact of brief team communication, leadership and team behavior training on ad hoc team performance in trauma care settings. Am J Surg. 1708. Available from: https://www.ncbi.nlm.nih.gov/pubmed/24468024 Scheeres H and Rhodes C (2006). Between cultures: values, training and identity in a manufacturing firm. J Organ Chang. 19(2):22336. Available from: https://www.emeraldinsight.com/10.1108/09534810610648924 Speroff. T., Nwosu, S., Greevy, R., Weinger, M.B., Talbot, T.R., Wall, R.J., Deshpande, J.K., France, D.J., Ely, E.W., Burgess, H., Englebright, J., Williams, M.V and Dittus, R.S. (2010), Organizational culture: variation across hospitals and connection to patient safety climate, Qual.Saf. Health Care. 2010 Dec., vol.19, (6), 592-596 Stagg SJ and Sheridan D, (2010). Effectiveness of bullying and violence prevention programs. Am Assoc Occup Heal Nurses J.58(10):41924. Available from: https://www.ncbi.nlm.nih.gov/pubmed/20873686

Product Placement in Music Videos free essay sample

In today’s society, we are bombarded by advertisements everyday of our lives. On average, Americans are potentially exposed to about 600-625 commercial messages in a single day, according to the American Association of Advertising Agencies. These can be in any form, from television or radio commercials, to outdoor billboards, to even the clothes that we wear. Typically, when watching any kind of broadcast media program, we know when the commercial breaks are on and are aware that we are viewing an attempt at getting us to buy something or go somewhere. This, however, is not always the case when advertisers seek to get our attention. A large category for advertising is known as Product placement, where advertisers pay to have products featured during programming or in movies, in addition to the ad’s we see every day. Today, these methods have managed to cross into the Music Video platform, using artists to promote certain brands or companies inside their own promotional visuals. We will write a custom essay sample on Product Placement in Music Videos or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page When MTV first broadcast in 1981, they were known for music, not just music videos. The station was the new â€Å"it† venue for the latest on music and news and opened new artistic doors for a generation. The station even had a ban on blatant marketing plugs in music videos and would blur or edit it out of the video completely. Nowadays, not only is MTV now known for such television gems as â€Å"The Jersey Shore† and â€Å"The Real World†, they also don’t play many music videos. However, when they do, you realize the ban on products in music videos has been given some heavy leeway. You can’t watch many of the latest popular music videos without suddenly realizing that Kodak Cameras are the bee’s knees, or that you want to go out to the bar tonight to try some â€Å"Revolucion Tequila†. Marshall McLuhan said in his book, Understanding Media: The Extensions of Man, â€Å"Ideally, advertising aims at the goal of a programmed harmony among all human impulses and aspirations and endeavors. Using handicraft methods, t stretches out toward the ultimate electronic goal of a collective consciousness. When all production and all consumption are brought into a pre-established harmony with all desire and all effort, then advertising will have liquidated itself by its own success†. I feel like product placement falls into what he was talking about and has become one of the more successful ways of advertising a product or service, sometimes even over traditional television spot advertising. In music videos, it’s something that people watch over and over again. It was reported that 57% of young adults in the UK watch music videos on YouTube. When people watch music videos on the internet, they tend to watch them again. Unlike with traditional advertising, product placement in music videos opens the door for the product to be seen repeatedly and in a closer time frame. Unlike advertisements on television that, now with the DVR age, can be fast forwarded and skipped entirely, the target is seeing the product while seeing the music video, which he or she is not so inclined to skip through. Marshall McLuhan’s theory that says â€Å"the medium is the message†, meaning people will get the message effectively or not based on what medium is used as a delivery system. This is where his theory of hot and cool media comes into effect. When delivering a subliminal message, which is what product placement does, you have to have a medium that involves higher sensory participation. For example if a song is playing on the radio, you cannot see that the singer is holding a bottle of Fiji Water. They would have to say during the commercial break that they are sponsored by Fiji. That is unless, of course, you’re like Pitbul and throw some Kodak references in your lyrics. To effectively infiltrate your product into your media, there have to be visuals, which is why product placement is effective. The consumer knows they’re being marketed to, but it still creates a level of intrigue between the consumer and the product. Product placement in music videos was boosted by The Kluger Agency, an Advertising Agency that boasts a non-traditional approach to advertising. Their focus is on strategic partnerships and product placement throughout the music industry. They represent both the artists and the products so that brands can work personally with the musicians, as well as a creative team to come up with the best possible solution for advertising campaigns. The Agency has named this approach â€Å"Brand dropping†, most times incorporating brands into the song lyrics as well as their accompanying videos. For example, in the music video for â€Å"The Time (Dirty Bit)† by The Black Eyed Peas, â€Å"brand dropping† fails when BEP member apl. e. ap raps the line â€Å"its gotta be the Apple, I’m the Mac daddy, y’all† while showing a Blackberry Tablet (a product that actually does not exist yet, although there were plans to release such a product). While not always effective, in an industry whose profits are being diminished by music pirating, these kinds of product placement solutions for artists create funds for album and music video production. In addition to large corporations integrating their products into music videos, the artists themselves often take time to push their own endeavors. Britney Spears often drops the name of her perfume â€Å"Radiance† in her music videos, specifically in the videos for â€Å"Hold It Against Me† and â€Å"Criminal†. Avril Lavigne is also seen running through the â€Å"Abbey Dawn† section of a clothing store and putting the clothes on, with Abbey Dawn incorporated into the clothing’s designs. Even Lady Gaga can be seen sporting her own designed pair of Heartbeats By Lady Gaga headphones, a project she embarked on in partnership with the Beats by Dre brand. In addition to putting products in the music videos themselves, advertisers take advantage of the medium used for broadcast. Forty-eight percent of American consumers, according to Nielsen, view online video and advertisers are ready to take advantage of that. With music videos receiving little to no airtime outside of the late night time slots, people have turned to the internet to view their favorite artist’s creations and it shows, with eight out of ten of the Top Viral Videos being music videos. Advertisements prevail on websites such as YouTube, where there is an ad before your video starts, a banner that is shown during the video, a smaller banner above the video, and, most times, links to other videos, which also contain more advertisements. The first video I watched was Lady Gaga’s music video for the song â€Å"Telephone† on YouTube. It started with an ad for Mary J. Blidge in American Express Presents: Unstaged, an online series made as part of a partnership with YouTube and Vevo. I noticed there was also a small banner ad to the right of the video above the four promoted Music Videos for the same series that was advertised before the video. The music video itself had tons of examples to pull from in regards to Product Placement. To begin with, the first product to make an appearance was Lady Gaga herself with her song â€Å"Paper Gangster† playing in the exercise yard. This was followed by a close up of an inmate wearing Lady Gaga Heartbeat’s headphones, playing another one of her songs â€Å"I Like It Rough†. From there it went on a tirade of scenes that seemed to be designed to promote ads, such as a close up of her stealing a Virgin Mobile telephone (shown in two separate scenes), wearing coke cans in her hair and coach sunglasses, browsing the dating site Plentyoffish. om on an HP Beats by Dre computer, eating a Honey Bun, using a Polaroid camera (also shown in two different scenes), Miracle Whip (again, 2 different scenes! ), and Wonder Bread. The only two products that did not have any financial contribution were Coke and Wonder Bread, both being additions made by Gaga. Purposely, there was a tie-in between Lady Gaga and all the products that were paid to be put into her video. The laptop used in the video, the HP Envy 15 Beats Edition, comes with headphones and software by rapper Dr. Dre.Monster, the company that makes Dr. Dre’s Beats headphones, makes Lady Gaga’s Heartbeats headphones as well. Also, soon before the release of the video, Lady Gaga was named the Creative Director for a specialty line of Polaroid products. Even the dating website shown in her video had done a promotional contest to win a date with Lady Gaga and tickets to her concert, not to mention Plenty Of Fishs partnership with Interscope Records, Lady Gaga’s record label. Lastly, Gaga’s worldwide Monster Ball Tour was sponsored by Virgin Mobile. This video was an excellent example of â€Å"Brand Dropping†, due to all the products featured in her video were directly related to her and a product that she was trying to sell, alongside the hosting companies. That is to say, except for Miracle Whip, which has no ties to Lady Gaga, and, in my opinion, opted to be in Gaga’s video to support the new edgier Branding strategy they’ve been putting out lately with their commercials. The second video I watched was Britney Spears’ â€Å"Hold It Against Me† video. Again, before the video started, I was shown an advertisement for the Xbox Kinect Game â€Å"Dance Central 2†. Just as with the previous video, there was a banner ad on the right of the video for the same game. In the video, Spears rather shamelessly and spokes womanly, holds up a bottle of her own â€Å"Radiance† Perfume, applies eye shadow from Makeup Forever, and rises mystically surrounded by 360 degrees of Sony television screens playing her music video repertoire. She also, seemingly out of place with the rest of the video, is seen surfing the website Plentyoffish. com (yes, Britney Spears is also an Interscope artist) on a touch screen Sony Computer. I actually could not count the amount of times the word Sony showed up in the four and a half minute video, between actual use and just flashes of the word Sony, which I thought was unusual seeing as Sony’s Record company is the second largest of the â€Å"Big Four† record companies, behind Universal Music Group, which owns Interscope Records. It has been noted that Spears earned Five hundred thousand dollars in revenue from the Product placement in the video, two hundred thousand coming from Plenty Of Fish alone. For my third and final example, I chose to use an artist that doesn’t have the same level of video views as the big LG and Britney. While Telephone and Hold It Against Me boast 128,498,663 and 70,284,020 views, respectively, Minogue’s â€Å"All The Lovers† only claims 11,635,129 views and has been available for the same amount of time as Telephone, and came out months before Hold It Against Me. The difference in advertising was evident right away. Unlike the previous two videos, â€Å"All The Lovers† was not preceded by a commercial. Instead, at the 10 second mark in the video, a banner came up from the bottom of the video promoting a singer named Kari Jobe and her new single â€Å"We Are†. I did not know who Kari Jobe was before seeing it and out of curiosity, stopped to find out about her. As it turned out, she is a Christian Singer signed to EMI Music, the parent label of Parlophone, which Kylie Minogue is signed to. As far as product placement in the video, there is only one product featured and it is not heavily used in the â€Å"story† of the video, and that is BMW. Used more in a visual aesthetic kind of way, the car is only seen releasing white balloons and is parked all along the sides of the road seen in the video. While not the perfect camouflage, the product is incorporated well into the video and blends well with the visual theme of the video. While no one denies Minogue’s success as an artist, she has always been one of moderate success in the United States, and therefore isn’t used the same way as â€Å"Mega Stars† like Lady Gaga and Beyonce, where their star power gives them the leeway to do the things they do as far as advertising. In conclusion, as we look back on the last decade, Product placement in music videos has definitely come a long way, to being prevalent in many of the videos we see. McLuhan had relevant theories in regard to advertising, even back in a time where we did not have the same technology that we have now that revolutionized how we distribute information and reach mass peoples. Those theories have proven well, even in the category of product placement. Thanks to McLuhan, we can analyze every aspect of a media delivery system and find the best and most efficient way to utilize its strengths and make people aware of products and services in a more streamlined and efficient way. While the thought of being solicited while watching artists we enjoy for their music or showmanship feels like it should be unsettling, the business is growing bigger than ever with brands shelling out 6 figures for about 10 seconds of actual screen time, and the videos are doing better than ever.

Salvidor Dali essays

Salvidor Dali essays The People Who Influenced Salvador Dali The extraordinary Salvador Dali has been described as flamboyant, egocentric and enigmatic. Few art critics would deny that this talented and brilliant man is considered today to be one of the most influential artists of the twentieth century. Paintings such as The Persistence of Memory and The Sacrament of the Last Supper reflect various artistic influences. Although considered to be the great surrealist, Dali was influenced by much more than just the Surrealism movement. From the moment of his birth, this unusual individual would draw from himself and his acquaintances some of the most memorable art the world would ever see. Salvador Dali was born on May 11, 1904. He was named after his brother, the first Salvador Dali, who died August 1, 1903, at the age of twenty-one months. Dali himself has claimed that his parents had committed a subconscious crime by giving him the same name as his brother and thereby forcing him to live up to an impossible ideal(qtd. in Gibson 52). He created a tribute to his brother in 1963 when he painted Portrait of My Dead Brother, but remained resentful of being made to live in the shadow of a brother he never met. Throughout his life, Dali would behave like two different people; the hardworking artist locked up in his studio for days at a time in casual clothes and then, the very public avant-garde flashy Dali, with heavily waxed mustache, purple cape, and cane. Dalis obsession with double images also appears in several of his paintings throughout his career, most notably being The Hallucinogenic Salvador. His parents, recognizing his growing artistic abilities, sent him to stay at the Muli de la Torre with the family of Ramon Pitchot. Pitchot was a gifted painter and provided Dali with a large, whitewashed room as a studio. The Pitchot family was considerably talented and left a deep impression on Dali. During his stay with...

A Study of Human Speech and Language Term Paper

A Study of Human Speech and Language - Term Paper Example The development of language and speech starts as early as in infancy. Studies show that speech and language learning begin in the uterus with the infant’s recognition of its mother’s voice. Lieberman explains that anatomical changes and modifications in the human vocals for example the increase in length and the lower lying larynx compared to other animals is thought to play a crucial role in the development of human speech (2013). These improvements have been found to enable humans to produce a wide range of repertoire. However, changes in human genetic makeup have been shown to impact aspects related to neurologic system. Neurological aspects that control human motor control ability as well as those that lead to higher cognitive capabilities involved in speech development and language have been shown to be gene-determined. This research aims at investigating factors that influence development of speech and language in human beings to promote the conclusion that genes are responsible for human being’s speech and language development. The research questions are: The world is really being unlocked by advances in technology and is high end application in science. Voice, language, and speech are the tools used by humans to communicate with each other. Additionally, language is a significant and unique system that distinguishes humans from other animals and results to the development of race and heritage in normal child in terms of mother tongue inheritance (Dorothea, 2012). However, lack of sufficient technology and scientific knowledge has seen heated debates emerge over the development of science and language. Proponents have held strongly that human language depends on factors like adequate intelligence and environmental simulation (Mesoudi, Alan, McElligott, and David, 2011). Conversely, opponents held that human speech originated genetically. The result has been two perspectives of

Paraphrase Essay Example | Topics and Well Written Essays - 1000 words - 2

Paraphrase - Essay Example Needless to say, there is a favourable connection between job feat and high levels of acumen. Self-awareness is the most important components of all. Individuals with an internal locus of control can be managed and motivated easily. Managers can employ the use of apprehension of selective perceptual and organizational perceptual to gain insights on why different people perceive things differently. These principles can be enforced in communication and responses to attract attention. Managers can employ catchy stimuli to â€Å"cut through the noise† of the environment. This assists in improving communication between the managers and the employees. The learning techniques of an accommodator are fundamental in improving management decision making. Needless to say b, an accommodator is proficient at enforcing decisions, plans and innovation. Such a learning style is appropriate for a practicing manager like me. In essence, this depends on the condition or the surrounding where a manger is to carry out the learning style. In this case, Daphne portrays high level of extraversion. This si portrayed by rapid open relations with her daughter. She shows moderate levels of meticulousness, openness to experience and kindness. Kindness is portrayed by her good-natured character while her meticulousness is shown by her yearning to help Millie. In addition, her openness to experience is depicted by her need to talk to Jason. In essence, low emotional steadiness in Daphne’s dealings with Millie typifies her behavior. Perceptual selectivity refers to the process by which an individual tests and chooses numerous stimuli which content for their attending. Individuals emphasize on stimuli that fulfills their desires and which are coherent to their values, personality and attitudes. Stimuli attributes affects perceptual selectivity. A catchy stimulus attracts the attention of most people. In addition, people recognize both familiar

Managing Change and Innovation in Health Care Essay

Managing Change and Innovation in Health Care - Essay Example It has not been an easy process since the health care unlike other sectors is sensitive since it deals with the pertinent information about clients. However, with adequate planning, implementation and intervention, electronic record keeping has been a success in the health sector. In bid of this insight, this paper will present a summary of managing change and innovation in Health care as pertains to electronic record keeping. Three academic concepts will be highlighted within the discussion; foundation of planning, motivating employees, and understanding individual behavior. This will be aimed at affirming the thesis statement that asses the success and failure of electronic record keeping in the health care sector (Hayrinen, Saranto, and Nykanen, 2008). ... This has led to the adoption of the Health Information Accountability Act (HIPAA) that sets rules and standards to ensure that only authorized individuals access the patient’s information. In bid to encourage hospitals to implement electronic record keeping, the United States has posed an ultimatum of up to 2014 where all health care facilities will be expected to have implemented and electronic record keeping system. This will accrue benefits from Medicaid and Medicare while those that will have not have implemented will bear sanctions and penalties from the government. This is aimed at networking the health care system and thus increasing the efficiency of the health care system (Hayrinen, Saranto, and Nykanen, 2008). The greatest benefit of electronic record keeping in heath care organization is associated with swift access to health information. Once the information of the patient is entered into a networked computer, its access is faster compared to manual record keeping. This is consequently increases the speed with which the patients are attended to and reduces delay in the provision of care to the patients. This further enhances the continuity of care for the patient attributed to the fact that the information of the patient’s previous information is easily accessible. Consequently, upon referral of the patient, it is possible to convey the relevant information of the patient to the next care provider. Also this information is essential as it acts as a reference point in assessing the progress of the patient since the baseline data can still be accessed. This method of record keeping not only aids the health care organization but also helps the patient since they can confirm appointments from their homes and do not have to travel to the

Effective methods of understanding and treating PTSD

Effective methods of understanding and treating PTSD The treatment related publications of the last twenty years places a large amount of attention on determining the most useful psychological therapy for clients with a diagnosis of posttraumatic stress disorder, PTSD. The overall aim of this paper is to critically evaluate current cognitive models of PTSD and literature on the effectiveness of cognitive behavioural therapies to treat this disorder based on these models. Definitions of PTSD The 4th edition of the Diagnostic and Statistical Manual of Mental Disorders, DSM-IV (APA, 1994) defines trauma as: (a) The individual experienced, witnessed or was confronted with an event that involved actual or perceived threat to life or physical integrity; and (b) the individuals emotional response to this event included horror, helplessness or intense fear, Foa and Meadows (1997, p. 450). The psychological symptoms connected with PTSD are categorised into three groups of symptoms in DSM-IV: The main characteristics include re-experiencing (in the form of flashbacks, intrusive thoughts, and distressing dreams), avoidance/numbing and heightened arousal, after the person is subjected to a traumatic incident. (Foa Rothbaurn, 1992). The next group includes avoidance of stimuli trauma-reminding stimuli and symptoms of emotional numbing (Foa, Hearst-Ikeda, Perry, 1995; Litz, 1993). The final symptom group includes heightened arousal e.g. hypervigilance, exaggerated startle response, difficulty sleeping and irritability (APA, 1994). Current Government Guidelines on the treatment of PTSD Determining effective and efficient treatments for PTSD has come to be seen as important due to the conditions prevalence and the many techniques and interventions available. The National Institute for Clinical Excellence, NICE, reviewed the most robust outcome research and produced guidelines, to provide information and direction for the psychological management of PTSD in adult sufferers (NICE, 2005). The guidelines were developed from an independent, methodical, rigorous and multistage procedure of selecting, examining and assessing evidence for the successful treatment of PTSD. These guidelines conclude that individuals with PTSD should receive either trauma focused Cognitive Behavioural Therapy (TFCBT) or Eye Movement Desensitisation and Reprocessing (EMDR). However, a distinction is made between single incident trauma and more complex presentations, and the guidelines suggest increasing the total number of sessions accordingly. Although the guidelines appear helpful for the tre atment of single incident PTSD, they are arguably not as informative for treatment approaches for a large group of individuals with complex PTSD. This presents difficulties for the clinician and patient in deciding the most effective therapeutic options. Cognitive Behavioural Therapy (CBT) is the most extensively studied therapy for individuals with PTSD (Foa Meadows, 1997) and many studies support its efficacy in reducing symptom severity (e.g. Resick Schnicke, 1992; Foa, Rothbaurn, 1992; Foa et al., 1995; Foa Jaycox, 1996; Riggs, Murdock, 1991; Richards, Lovell, Marks, 1994; Thompson, Charlton, Kerry, Lee, Turner, 1995). However, CBT for PTSD encompasses diverse techniques. These include exposure procedures, cognitive restructuring procedures, and combinations of both these techniques. Exposure Therapy Exposure therapy is derived from the idea that imaginal exposure (IE) to the trauma or feared situation, leads to a decrease in symptoms. The theory argues enduring activation of traumatic memories result in processing of the emotional information, lessening of anxiety and assimilation of accurate memories (Foa et al., 1995). Much research has shown that treatment involving exposure therapy is effective in decreasing PTSD symptoms (e.g. Foa et al., 1999; Frueh, Turner, Beidel, Mirabella, Jones, 1996; Keane, Fairbank, Cadell, Zimmering, 1989). Foa, Rothbaum, Riggs, and Murdoch (1991) investigated exposure therapy, stress inoculation (a type of Anxity Management Treatment, AMT), supportive counselling, and a non-treatment group in the management of rape-related PTSD. Clinical measures of symptoms and standardized psychometric tests were examined before and after treatment as well as at a three month follow-up. The stress inoculation intervention showed superior results to the counselling and non-treatment conditions at post-test. However, at the follow-up, the individuals participating in exposure therapy showed more improvements of PTSD symptoms than individuals in the other groups. Research has investigated the efficiency of exposure therapy compared to different methods of treatment. For instance, exposure therapy and cognitive therapy were investigated by Tarrier et al. (1999) for the management of individuals with PTSD arising from various traumatic incidents. Although both approaches demonstrated a noteworthy decrease in PTSD symptoms that was still present at 6-months follow up there was no non-treatment control against which these two treatments could be evaluated. Similarly, Foa et al. (1999) compared exposure therapy to AMT and then combined the two treatments. These three groups were compared to a non-treatment control group. All three of these treatments successfully decreased symptoms of rape-related PTSD and improved more than the non-treatment control group. However there was no significant variation among the treatment groups on outcome measures. In a study that once again compared exposure therapy to cognitive therapy, Marks, Lovell, Noshirvani, Livanou, and Thrasher (1998) examined these two treatments alone and in combination in outpatients with PTSD secondary to a wide range of traumatic events. A relaxation therapy condition was employed as the comparison group. The three active treatment groups demonstrated significant reduction in symptoms compared to the relaxation sample. These intervention groups were not markedly different from on another on the main treatment outcome measures. Several investigations have advanced the field of PTSD treatment, even though the methodology utilized in the outcome study limited the conclusions that could be drawn. Frank and Stewart (1983) reported the effects of systematic desensitization on women who had been raped and who developed significant psychological symptomatology. Compared to an untreated comparison group, those women treated with graduated exposure improved most on a range of anxiety and depression symptom measures. Imaginal and in-vivo exposure was compared in a randomized study of survivors of varying traumatic events (Richards, Lovell, and Marks,1994). At the 12-month follow-up, patients reported consistent reductions in PTSD symptoms and improved social adjustment. This data further substantiates the efficiency of exposure treatment for some individuals, and also suggest that improvements in symptoms are also reflected in critical domains of life functioning. In conclusion, the existing data advocates the use of exposure therapy in the treatment of PTSD. In a previous review of this literature, Solomon, Gerrity, and Muff, (1992), (Sited in Shapiro, 1995) derived the same conclusion from data available at that time. Similar conclusions were drawn by Otto, Penava, Pollack, and Smoller (1996) in a more recent review of the literature. In what may prove to be an important lesson for the treatment of individuals exposed to traumatic events, Foa, Hearst-Ikeda, and Perry (1995) investigated the effectiveness of a short-term intervention to prevent the development of chronic PTSD in females who had been recently raped. The program was based upon that which worked well in earlier trials with chronic PTSD. Exposure therapy figured prominently in the package of treatment and also included elements of education, breathing retraining, and cognitive restructuring. When individuals receiving the package were compared to a control group, this study found that at 2 months post-treatment only ten percent of the treatment sample met the diagnosis for PTSD, while seventy percent of the untreated comparison group did. As information continues to grow on exposure therapy, there is a clear requirement for research to investigate combinations of psychological treatment, to utilize screening measures that consider occupational and social performance, and to access the outcome of interventions on co-morbid psychological difficulties. Unmistakably, the existing empirical research reveals the importance of extending the application of exposure approaches to PTSD patients. However future studies assessing the generalization of exposure therapy from laboratory trials to clinical settings would be particularly useful. When exposure therapy has been compared to other forms of cognitive therapy, such as cognitive restructuring (see below), it has proved to be more successful in reducing PTSD. Tarrier et al., (1999) assigned 72 people with chronic PTSD to either a Cognitive Therapy (CT) group or an imaginal exposure (IE) therapy group, and concluded that there was no noteworthy differentiation between the two treatment conditions initially or at 12 months post treatment. Participants recruited were obtained from a sample of referrals to primary and secondary mental health services and voluntary services, indicating that they were representative of a genuine clinical sample. However, 50% of the sample remained above clinical significance for PTSD symptoms after treatment was completed, although this dropped to 25% at six-month follow-up. This lack of improvement may have been influenced by participants failure to attend sessions regularly. Furthermore, those who did not show improvement rated the trea tment as less convincing and were rated as not as motivated by the clinician. Therefore, it is argued that motivation for therapy and regular attendance plays an important role in outcome of therapy regardless of treatment model. A further limitation of this study was that no control group was used and non-specific treatment factors and spontaneous remission could also account for the improvements in reported symptoms. Cognitive Restructuring Cognitive restructuring is derived from the theory that discovering and altering catastrophic and inaccurate interpretation of the trauma leads to a decrease in symptoms. Some of the latest models have emphasised the significance of altering thinking distortions in the rehabilitation of individuals who have experienced trauma (Ehlers Clarke, 2000). Ehlers, Clark, Hackmann, McManus, and Fennell (2005) utilized cognitive therapy based on the cognitive model of PTSD (see figure 1. Ehlers Clarke, 2000). From this model, the aim of therapy is to alter overly negative interpretations, amend the disturbance in autobiographical recollection and to eliminate the unhelpful behavioural and cognitive strategies (see figure 2, Ehlers et al., 2005). In a randomised controlled trial of twenty-eight participants diagnosed with PTSD. Fourteen participants were assigned at random to cognitive therapy treatment or a 13-week waiting-list condition. Those receiving cognitive therapy had 12 weekly treatment sessions, based on the Ehlers and Clarke (2000) model of trauma focused CBT. Participants completed self-report screenings of anxiety, mood and PTSD symptoms, and the Sheehan Disability Scale (APA, 2000). Measures were administered before and after treatment and at 6-months follow up. Findings revealed that cognitive therapy for PTSD was signifi cantly better than a three month waiting-list group on symptoms of PTSD, disability and symptoms of anxiety and affect. This study had no dropouts, which is a significant improvement on other studies, which yielded high dropout rates, (e.g. Tarrier et al., 1999). Participants displayed a positive change in cognitive appraisals. The Ehlers and Clarke (2000) model suggest that two additional paths of change; alteration in the autobiographical recollection of the trauma, and the discontinuation of maintenance behaviours and cognitive strategies are integral in reducing symptoms of PTSD. While the treatment incorporated these other aspects, these have not been measured systematically, so it is difficult to conclude whether clients experienced a change in these two areas. Further analysis indicated that demographic, trauma and diagnostic variable did not predict intervention results, signifying that the approach is pertinent to a broad scope of individual who have experienced trauma. Conversely, the extent of discrepancy of trauma and small sample numbers suggests that this finding would not be present in a larger sample. Co-morbid depression and previous trauma history, which was present in over half the sample, did not negatively affect outcome. Combinations of therapy Resick and Schnicke (1992) have proffered a multidimensional behavioural treatment for females who have PTSD associated with sexual assault. This treatment, known as cognitive processing therapy (CPT), includes components of exposure therapy, AMT, and cognitive restructuring. The cognitive therapy element of CPT involves tackling central thinking distortions found among females who have been assaulted. These authors have developed interventions which particularly deal with concerns of trust, self-confidence, safety and intimacy in the lives of trauma victims. In a preliminary evaluation of CPT, the authors compared outcomes at pre-treatment, post-treatment, 3 months follow-up, and 6 months follow-up for an intervention group and a non-treatment group (no random assignment was used). On clinician ratings and psychometric inventories of PTSD, the individuals receiving CPT improved significantly. Impressively at the post-treatment assessment, none of the treated patients met criteria fo r PTSD. In another study, Resick, Nishith, and Astin (2000) evaluated CPT and exposure therapy in the management of sexual assault-related PTSD. Both approaches proved successful in general and were more successful than a non-treatment control group. CPT did also seem to reduce comorbid symptoms of depression, as well as those of PTSD. Combination therapy that incorporates a number of cognitive-behavioural techniques have the advantage of addressing various difficulties that individuals with PTSD may experience, in addition to integrating methods that have a considerable scientific evidence base in the clinical literature. An intervention incorporating exposure therapy, AMT, and cognitive restructuring as the main elements for treating PTSD was proposed by Keane, Fisher, Krinsley, and Niles (1994). This treatment utilizes six stages as a means of treating severe and chronic PTSD, it incorporates the following: (1) behavioural stabilization; (2) trauma psycho-education; (3) AMT; (4) trauma focus work; (5) relapse prevention skills; and (6) aftercare procedures. Although this approach has clinical appeal, it wasnt until psychologists Fecteau and Nicki (1999) examined such a package in a randomized clinical trial for PTSD resulting from automobile accidents that the impact of a combination package such as that proposed by Keane et al. (1994) was assessed. Their intervention consisted of psycho-education, relaxation, exposure, cognitive restructuring, and guided behavioural exercises. Patients were randomly assigned to the treatment group or non-treatment comparison group and received some 8-10 sessions of individualized treatment. The outcome of the treatment was effective as assessed by clinical ratings, self-report questionnaires, and lab-based psycho-physiological evaluation methods. Described by the authors as clinically and statistically significant, these treatment outcomes were sustained at the 6-month post treatment evaluation. Bryant, Moulds, Guthrie, Dang, and Nixon (2003) studied the effects of IE alone or IE with CR in the treatment of PTSD. They hypothesised a CR and IE treatment combination would lead to significantly better decrease in PTSD symptoms than exposure on its own, which would be more beneficial than a supportive counselling condition. Fifty-eight civilian trauma victims, diagnosed with PTSD as measured by the Clinician Administered PTSD Scale, version II, CAPS-2, (Blake et al., 1995) were randomly allocated to one of the 3 conditions. Each participant received eight weekly 90-minute sessions of either IE, CR and IE or supportive counselling. Participants completed assessments at pre and post intervention and six months following. These measured PTSD symptoms and psychopathology. Forty-five participants completed treatment and analysis indicated that dropouts had higher scores for depression, avoidance and higher catastrophic cognitions than those who completed. Results indicated that parti cipants receiving both IE and IE/CR had a siginifcantly better decrease in PTSD symptoms and anxiety than supportive counselling (SC). The main revelation of this investigation was that treatment comprising of IE and CR leads to significantly better reductions in CAPS-II scores compared to treatment involving IE alone. Furthermore, those receiving IE/CR, but not IE on its own, gave accounts of less avoidance, depression and catastrophic thoughts than individuals in receipt SC. The findings from this research indicated that the combination of IE and CR are successful in decreasing symptoms of PTSD. It can be argued that the reasons why IE/CR may have been more effective than augmented treatments in the past (e.g. Foa et al., 1999) was that the research prudently controlled for the duration of time spent on every section of treatment. Furthermore, participants were instructed on CR before commencing IE so they understood the rationale behind the techniques prior to addressing the strong emotional components of IE. This may have increased their understanding and belief that it was a credible treatment approach. The outcome that CR improved the benefits of IE treatment could have been a result of a number of likely mechanisms. IE and CR may consist of similar aspects, such as processing of emotional memories, amalgamation of corrective information and acomplishment of self-mastery (Marks, 2000). Combining the two approaches may give the patient more chances to achieve treatment gains. CR may have lead to greater decrease in symptoms as it explicitly attended to identifying and changing unhelpful thoughts that may add to the maintenance of PTSD and related difficulties (Ehlers Clarke, 2000). Paunovic and Ost (2001), compared treatment outcome data for CBT and exposure therapy for sixteen refugees with PTSD. The authors excluded those who became too distressed in the initial interview, expressed a lack of confidence in the therapist or were misusing alcohol or drugs. Results indicated there was no significant difference between participants completing CBT or exposure therapy, being similar to Tarrier et als (1999) findings. Criticisms of Paunovic and Ost (2001)s study are that participants did not use a self-report trauma measure, so although results are positive, there is no clear analysis of whether participants felt their trauma symptoms decreased as a result of the treatment. Further, it is not possible to generalise these findings to traumatised refugees in general, as this work is unique. Working with the use of an interpreter raises several ethical and sensitive issues, as the participant must be able to develop a therapeutic alliance with the therapist and trust the interpreter (Tribe, 2007). It could be argued that participants may have been experiencing a greater degree of trauma, not least because they had not yet learned the native language. Discussion The most successful CBT treatments seem to be those that involve repeated exposure to the traumatic memory (Foa et al., 1991; Foa et al., 1999; Foa Rothbaum, 1992) on cognitive restructuring of the interpretation of the traumatic event, (Ehlers Clarke, 2000) or a combination of these approaches, (Resick Schnicke, 1992). Importantly, studies have concluded that trauma focused CBT is more successful than supportive counselling (Blanchard et al., 2003; Bryant et al., 2003). Whilst the studies reviewed have helpfully added to our understanding of PTSD there are numerous limitations of the applications of the findings. One in particular is an over-reliance on non-clinical samples of participants such that many claims of clinically effective therapy have been made from research with participants who were not within mental health systems, and despite having PTSD symptoms had not actively sought treatment. In addition, dropout rates in studies are high, particularly for those studies that did not use a clinical sample. This might have skewed the evidence particularly with approaches that used exposure-based therapy. Furthermore, most of the studies reviewed screened out those individuals experiencing the greatest amount of distress, avoidance and co-morbidity. Therefore results are biased towards those clients who were able to tolerate treatment and whose symptoms were not as chronic. Indeed, inclusion and exclusion criteria appear to have a great impact on outcome of treatment. For example, studies with a strict inclusion criteria (e.g. no co-morbidity, substance misuse, self harm) appear to have significant improvements, whilst other studies i.e. Kubany et al., (2003), allowed participants to continue with other therapy while embarking on their therapy. This makes it methodologically difficult to ascertain exactly what has been effective in reducing PTSD symptoms. As inclusion and exclusion criteria are idiosyncratic across studies, it makes it difficult to draw general conclusions regarding treatment effectiveness with a clinical population across studies. Studies often chose to focus therapy on identified groups, e.g. police officers. However, clients who experience PTSD do not form a homogeneous group and further, the symptoms experienced may be diverse even within a sample of individuals who have experienced the same trauma. Treatment studies often do not control for other factors that may be important contributing factors in outcome such as the role of education, quality of the therapeutic relationship, therapeutic alliance and other nonspecific factors. The literature was generally from American, British or European sources although clearly trauma is intercultural. This raises issues about how different cultures interpret PTSD, an essentially Western concept, and also whether the treatments advocated would be effective cross-culturally. Previous research has strongly indicated that PTSD is not an appropriate term to use in non-western situations (Summerfield, 1997), hence therapeutic approaches need to account for this. It is not clear in the majority of studies when the participant experienced the trauma, and at what point therapy started. Frequently these characteristics are omitted from studies, therefore making it difficult to compare effectiveness of studies. It is essential to think about the types of individuals that have been represented in the research and to look at whether it is representative of those who seek treatment. Finally, very little has been reported on the impact of other difficulties an individual is experiencing as PTSD can have a broad ranging effect on an individuals quality of life and functioning and most often clients have more complex presentations. Only very few studies reviewed controlled for this variable (see Ehlers et al., 2005). This is an inherent difficulty when completing resea rch with a trauma population as within research it is important to obtain a sample that have a similar degree of difficulties in order to assess treatment efficacy. Several papers have evaluated different types of therapy according to particular groups. However, it appears that one size does not fit all in relation to PTSID. In particular the issues of culture and gender are of importance (see Liebling Ojiambo-Ochieng, 2000; Sheppard, 2000). Individual formulations of presenting problems and contexts, which informs therapy that is adapted to suit individual clients needs, may in fact be more helpful. It remains important to consider individual differences and client choice when offering trauma therapy. Trauma therapy outcome studies are limited by the fact that sufferers usually have other mental health problems alongside PTSD such as depression or social anxiety. Evaluation of effective treatment of trauma survivors therefore might need to go beyond medical diagnostic categories as most of the research excludes clients with co-morbid problems. A multifaceted intervention, based on clients own views, which addressed these other difficulties, could assist in decreasing relapse and greaten the long-lasting effectiveness of any PTSD intervention. As outlined in the methodological limitations section, much of the research reviewed has not used a genuine clinical sample, there are high dropout rates, widely variable inclusion and exclusion criteria, and the heterogeneity of PTSD has perhaps not yet been accounted for. It is therefore difficult to ascertain what is specifically helpful or effective within the treatment components. This seems to be the next area for consideration in resea rch. Further research into the optimal length of treatment and timing of therapy, the effect of co-morbidity and the differing effects of individual and group therapy approaches for traumatised clients are required. Further controlled research is needed to ascertain if the types of therapies reviewed can provide long term lasting effects in reducing PTSD symptomatology. At present the scientific evidence is mainly restricted to the evaluation of short term, focused treatment approaches, and it would be helpful to have controlled studies on longer-term interventions for more complex cases of trauma. Further research would benefit from considering the clients views and experiences of therapy, this perspective was lacking in the literature reviewed. Service user and carer perspectives are beyond the scope of this review, however they have been highlighted as an important consideration within the NICE guidelines and therefore require further consideration in future research. Conclusion There appear to be at least three approaches with exceptional empirical evidence for treating PTSD; exposure therapy, cognitive therapy or a combination of these methods. These three interventions have empirical validation in well-controlled clinical trials, demonstrate strong treatment effect sizes, and seem to work well across varied populations of trauma sufferers. However future research to examine the efficacy of these methods in clinical environments is necessary. There is much to be learned about the treatment of PTSD. It is certain there will be no simple answers for treating people who have experienced the most horrific events life offers. Undoubtedly, combinations of treatments as proposed by Keane et al. (1994) and Resick and Schnicke (1992) may prove to be the most powerful interventions. PTSD research in this area is only in the earliest stages of its development. Finally, an assumption about the uniformity of traumatic events has been made in the literature in general. Although it is reasonable to speculate that fundamental similarities exist among patients who have experienced diverse traumatic events and then develop PTSD, whether these patients will respond to clinical interventions in the same way is an empirical question that has yet to be addressed. Studies posing a question such as this would be a welcome addition to the clinical literature: Will people with PTSD resulting from combat, torture, genocide, and natural disasters all improve as well as those treated successfully following rape, motor vehicle accidents, and assaults? This is a crucial issue that requires additional scientific study in order to provide clinicians with the requisite evidence supporting the use of available techniques. Research on the prevalence of exposure to traumatic events and the prevalence of PTSD has mainly been carried out in the United States. Yet there are fundamental errors in assuming that these prevalence rates apply even to other Western, developed countries. Studies that examine the prevalence of PTSD and other disorders internationally are clearly warranted. Implicit in this recommendation is the need to examine the extent to which current assessment instrumentation is culturally sensitive to the ways in which traumatic reactions are expressed internationally. Much work on this topic will be required before definitive conclusions regarding prevalence rates of PTSD internationally can be drawn. Studies of the effectiveness of the psychological treatments across cultures and ethnic groups are also needed. What may be effective for Western populations may be inadequate or possibly even unacceptable treatment for people who reside in other areas of the world and who have different world views, beliefs, and perspectives. This issue will need to be more closely examined before we can draw definitive conclusions. It is suggested that despite the type of treatment provided to individuals with trauma there is ultimately a necessity for a flexible, integrative approach to treatment in order to address the multifaceted and changing requirements of individual trauma survivors. A range of outcomes has been revealed with the types of treatments outlined in this review, it is uncertain which individuals will respond greatest to various treatment approaches. Nevertheless, what is important in determining the effectiveness of any psychological treatment of PTSD is that it is reliant upon forming and upholding a therapeutic alliance that is strong enough for the client to experience as safe and trusting for positive emotional modifications to take place.