National Womens Law Center Website Review Essay Example | Topics and Well Written Essays - 500 words

National Womens Law Center Website Review - Essay Example ile reviewing the site and particularly the athletics section I found information on what a healthy school would look like for girls, the rally for Girls’ sports day and information on how to set up sports club funds. These three topics and how I found the information will be shared below in order to help anyone who may require information about Title IX or athletics information. To find the athletics information I have reviewed anyone can visit the National Women’s Law Center website by using Google or their web address: www.nwlc.org. The site is easy to navigate to any section whether it is about child care, education, employment, or any other information the National Women’s Law Center provides. Under Education and Title IX topics such as affirmative action, athletics, career and technical education, pregnant and parenting students, school reform, sexual harassment and single sex education can be located. Arriving at the site all you have to do is click on our issues, education and Title IX, and then athletics. Concentrating on the athletics section I found information detailing how the law protects women and girls in addition to such things as fact sheets. The fact sheet about healthy schools addresses the needs of a school and how to provide a â€Å"successful, safe, and healthy† environment for all students including girls (National Womens Law Center, 2011). The article creates a list of factors that should be considered like girls at risk, foster girls’ athletics, protecting girls from harassment and bullying, and ensuring transparency with parents and community members (National Womens Law Center, 2011). This information is helpful to anyone who wants to enroll their child in an athletics program or experiences trouble in school. In school sometimes girls can feel that athletics departments concentrate more on boys by providing sports boys enjoy more than girls. A recent blog was started to rally for Girls’ sports day, where more emphasis can be

Unethical Drug Marketing in the Pharmaceutical Industry Research Paper

Unethical Drug Marketing in the Pharmaceutical Industry - Research Paper Example ned the motives of Big Pharma as they market drugs without adequate regard to the effects that such marketing practices have on the patients and consumers. In their pathological pursuit of profits, drug companies have indeed thrown caution to the winds and have sacrificed ethics at the altar of profits. This paper examines the unethical drug marketing strategies used by Big Pharma by analyzing them from the perspective of utilitarianism and deontology. The emphasis in this paper is on finding out if the drug marketing strategies are justified according to the philosophical theories discussed and whether they satisfy the minimum requirements for ethical behavior. Note that there is no special emphasis on whether these strategies are completely overboard. Instead, the analysis is around whether they meet the basic criterion for ethical behavior and good conduct. The five tactics used by drug companies to market their products can be categorized according to the potential for harm that they cause to patients. This categorization would yield that the following is the order (from the least harmful to the most harmful): physicians targeted promotion, DTCDA, unethical recruitment of physicians, researchers’ conflicts of interests, and data manipulation in clinical trials (Chiu, 2005). Considering the fact that the intended beneficiaries of these strategies who are the patients stand to suffer the most because of these tactics, it is worth asking whether the drug companies have the interests of the shareholders alone in mind when they resort to these practices. The fact that they favor the interests of the few (shareholders) at the expense of the many (the patients) clearly indicates that their marketing strategies are not conscionable from either a utilitarian or deontological point of view. This would be discussed in detail in the succee ding paragraphs. Suffice to say that drug companies are indeed crossing the line as far as ethics and unethical behavior is concerned

Supermarkets And Consumer Behavior In Vietnam Marketing Essay

Supermarkets And Consumer Behavior In Vietnam Marketing Essay Introduction; product and assignment First I believe it is important to briefly fresh up the memory of what product this assignment is based on. Or at least what the outcome of this gathered information will be compared against. The product to introduce in Vietnam is CartCom. It provides the super markets with a new way to communicate with their customers. It is a plastic bracket that is clicked on the handle of the shopping cart and it can be provided with material as advertisements from suppliers or information from the chain. This material is printed on cardboards and put inside the bracket for customers to observe, read, remember and eventually shop. This assignment will emphasize on the change in the Vietnamese society concerning the way they shop and where they shop. There will be focus on numbers, statistics and facts to justify my statements. First I will concentrate on the change from the charming and typical Vietnamese street markets, to the more western way of grocery shopping: the super markets. Later on I will turn the focus on to the consumer behavior in Vietnam and how the presented information affects the introduction of CartCom to the retail chains in Vietnam. The change from traditional street markets to modern supermarkets C:UsersKamillaDesktopcoop mart in vietnam.jpgC:UsersKamillaDesktopStreet market in Vietnam.jpg There has been a remarkable change in the socio culture regarding the shopping in Vietnam. The trends have now changed the routines of grocery shopping and preferences from street markets to super markets. 56% of the total population in Vietnam is below the age of thirty.  [1]  A young population means growth in purchasing power and therefore the super markets could target Vietnam, expand and push the people of Vietnam to join in on this kind of shopping culture. Vietnam retail Industry Analysis has found that Vietnam is set to undergo a huge transformation from 2007 to 2011.  [2]  The air conditions mini marts and the supermarkets are becoming dominant. This also means that Vietnam is currently experiencing significant changes to the distribution system in particular, but also the food system it selves.  [3]   Supermarkets are replacing the traditional Vietnamese hawkers and markets. Their street life, shopping habits are changing because of western trends are taken into consideration and followed. Many are disappointed, especially guides and tourists, because local markets and street vendors are now closing. But this is all because of the change in the socio culture and the change in the peoples preferences regarding their shopping habits. The government is encouraging the boom in shopping centre development and the abandoning of traditional markets.  [4]  The supermarket business is very successful and the Vietnamese retail market is viewed as the third most promising retail market in the world.  [5]   Supermarkets versus street markets How could the supermarkets take charge in Vietnam? Do they provide the same value as the old markets? Probably they do, if not they would not survive. Concerning the consumer behavior there are three topics to touch upon regarding the Vietnamese retail market. The numbers are collected at Ac Nielsen ´s report on groceries in Vietnam from 2010. First I found that 67% of total consumer expenditure is on fresh food. This means that eventually the supermarkets became excellent in their offerings of fresh food, so the consumers could turn from the street markets (known for the splendid fresh groceries) and to the supermarkets. If the supermarkets did not offer a satisfying solution to the consumers need for fresh food, I believe this change would not be happening so quickly and maybe the local markets would survive a bit longer. The supermarket chains knew what they needed to provide to turn the consumers into supermarket shopping instead of street market shopping. And they succeeded. The second important issue to touch upon is that most consumers (64%) are aware of price changes and are continually searching for promotions. So the supermarkets have an advantage regarding their opportunity to purchase large amounts of goods and groceries, store them and offer promotions weekly and even daily. This in balance with the promise of always having fresh food. High quality goods and frequent big sales are drawing large numbers of shoppers to supermarkets and away from traditional markets. Supermarkets in Ho Chi Minh City are crammed with people during weekends and attracting most middle-income customers.  [6]  This proves the strong positions the supermarkets are now gaining in Vietnam, and Ho Chi Minh City. Finally it is said that Vietnamese people buy and use Vietnamese products. In connection with CartCom; this is why we chose not to provide the advertising material to the CartCom in addition to the bracket. The supermarkets know their suppliers and they know their customers, we have no knowledge and nothing to contribute concerning the design and decisions for the material used inside. To expand the value in our product to new highs, we will look into the possibility of introducing the screens instead of the plastic bracket. We believe this is yet to expensive and complicated, but when we have gotten the retail chains to see the effect of CartCom, we believe there is opportunities for a digital screen on the carts where you will be able to have your shopping list and also receive information and advertisements. Consumer behavior in Vietnam; south compared to north A finding concerning the consumer behavior alone is worth noticing. This is the differences in consumer behavior between north and south in Vietnam. We will introduce CartCom to Ho Chi Minh City (HCMC) primarily, so I will focus on this city describing the behavior. Regarding promotion the people here favor all types of promotion, and from my point of view they are more innovative and unrestricted. Price promotions alone will not appeal strongly to the consumers in HCMC. In north this type of promotion is the most effective. As a result the CartCom can be explored in many different ways in the south and not only be used to push sale and push information on low prices. The supermarkets can use CartCom to provide advertising using the supplier brands in other promotions like for example dinner tips and exclusiveness, quality and accessibility in stores. One last finding worth discussing is that the people in HCMC and in the south are more early adapters than in the north. It is always important to think of the decision makers. We are in the b2b market and when selling to companies, in our case the supermarket chains, the decision makers will also here be the key to success. Who are making the decisions whether or not to start using CartCom? One thing is certain; if it is people from south that makes the decisions we are more likely to be approved. The supermarkets are in the b2c market and they make decisions on the basis of what they believe their customers will approve of. People in HCMC are innovative, early adapters and approving of new ideas concerning promotions.  [7]  I believe HCMC is a right choice because CartCom has a good chance of succeeding there and also because the people here fit the description of what kind of customers needed for the desirable response we wish to achieve. Conclusion; CartCom in Vietnam We have reasons to believe that the consumer behavior inside the supermarkets in Vietnam do not differ from other countries. The reasons why that is, is the supermarkets have not done any radical changes within the stores to adapt other that of course different food and local suppliers. The customers in Vietnam is like other customers visiting supermarkets, they usually bring a shopping list and make use of a shopping cart or a basket. The customers shopping with kids can place the kids in the cart, but this will not cover the CartCom. As shown in the pictures there are still room for CartComs new advertising space. In the picture to the left a child has joined in on the shopping, the CartCom will be placed under the shoppers right hand. There are cart with baby seats on top of the handle, but they only cover the old seat like this one is using, and not he handle. The bracket is placed on the handle where the cart is being pushed, as shown in the picture to the right. C:UsersKamillaDesktopcartcom.jpgC:UsersKamillaDesktopbaby i vogn The shopping will take place as it usually does, only we see a trend for larger purchases and this may make room for larger stores and bigger amount of carts in the stores. Up until now there had been a change in consumer behavior from street market shopping to the supermarket shopping. This has been The Co-op Mart chain that is CartComs first target has had an increase in both customers and revenues by more than 40% compared to the same period last year.  [8]   There has been a sufficient increase in the supermarket industry and this gains all participants as well as the chains. CartCom we believe will be one of the participants and the increase in profitability in this industry will create opportunities for CartCom to sell more and eventually expand with the screens, as shown in the picture. C:UsersKamillaDesktopskjerm cartcom Will the consumers continue changing their behavior? Another thing worth noticing is the perceived threat of consumers changing their behavior, as they have been doing up until now. The average perception of this is analyzed in Ac Nielsens report on grocery shopping from 2010. The results tell us that Vietnamese consumers are anticipated to change their behavior on several highlighted elements. Elements like purchasing more local food, buy bigger packs to save money, purchase more on promotion and change channel of information received. However because it is expected to change on every subject, I believe this is just another hint telling us that the retail industry will continue growing. I believe the consumer behavior will keep on changing into the western way of shopping, in supermarkets with carts and postponed for in-store advertising. This way of shopping also includes the large purchases to save money and advertising for low prices. The push marketing strategy is becoming old and the chains, we believe, is in need for a new and innovative way of exposing the customers with communication material. I want to highlight one finding from this model. It states that they are anticipating the Vietnamese consumers to buy more Vietnamese products in the close future. This is likely to be a trend to support the countries operations and not import. Also it is supporting short travelled food and environmental focus. Conclusion How inhabitants do their shopping is different in every country. In Vietnam there has been a change from street markets to supermarkets and this creates opportunities for several participants. CartCom is one of them and by introducing a new way of reaching out to consumers during the shopping, we believe we can expand to using screens and that way not be duplicated easily because the plastic brackets are just the beginning of a revolution within in-store advertising. The Ac Nielsen grocery report 2010 http://docs.google.com/viewer?a=vq=cache:y_ldKXyUxcsJ:www.acnielsen.com.vn/site/documents/NielsenVietnamGroceryReportAugust2010.pdf+annual+grocery+report+vietnamhl=nopid=blsrcid=ADGEEShbEBLuDEgDbLQ2NJ5S7dE88LIKbDgtivJ7sJ2yy_M75REjQQvFQQx-1ui3bKdTaaBJi1WKPjwytuw2cjV4IsjqpxLiHUYW0vwxkVm2EwIo1FQo3N7N-INR1KExLRr7znvufnOqsig=AHIEtbSERBeXR8i9t1hcDfpPRnF00k4_7A

Right Before My Very Eyes :: Vision Brain Seeing essays

Right Before My Very Eyes "I'll believe it when I see it:" is one of many common catch phrases included in our every day vernacular. A person who declares this is asserting that they will not be fooled by another's assumptions or perceptions of the world. This understanding raises a great sense of security within us, concerning the things that we do see, and inversely, an unavoidable sense of insecurity in those beliefs that are not supported by vision. Do you believe in Ghosts? Angels? Out of body experiences? Would you believe if you could see them? Maybe not. But it is possible to offer those who are withholding there stamp of approval on things that exist but cannot be seen, a better summary of evidence, which could make the inability to see something an invalid criteria for belief. Could a summary of evidence be compiled that would support this: Our vision is incomplete, incorrect, and can even be as misleading as to create something within the brain that does not exist at all, shedding light on a b rain that is more of a visionary, and less of a reporter. Human beings rarely contemplate the significance of their own blind spot, a place where processes of neurons join together and form the optic nerve; it is here that the brain receives no input from the eye about this particular part of the world. What I discovered while entertaining myself with a simple eye exam aimed at divulging the capabilities of the brain in the face of the eyes blind spots was fundamental in my exploration of the trust we place in vision, and so I will explain it briefly. Our brain can ignore a dot that exists on the page and "fill" the spot with the color of its surroundings, no matter what the color. However, it is not that our brain cannot conceive of an image or of a shape to fill this place. Continuing with the experiment leads you to find that the brain will continue the line that is obstructed with the black dot, covering the sides of the dot in the surrounding color, and transforming the image before you into a line within your brain. A line that i s absolutely not there. This reveals more than just a weakness in the eye, but an ability of the brain! (1)

Education Philosophy Essay

The impact of religious studies on the education system is a subject that is increasingly making many education researchers and experts invest their time on, as the world goes global and multicultural education becomes popular. This subject is especially established in the higher education context, due to the interest multicultural education is increasingly raising to educationists. This paper examines the impact Islamic philosophy and Christian philosophy, the two major religious studies, have on higher education. In spite of the fact that higher education has been increasingly becoming secularized since the late nineteenth century (Roberts and Turner, 2000), the impact the Islamic and the Christian philosophy has on higher education, globally, is immense. The Islamic philosophy, a division of Islamic studies whose main aim is synchronizing the Islamic faith and reason, draws its impact on the global higher education from Islamic religious principles and teachings. This is the fundamental reason why the subject is a major tropic of interest in the education context, given the influence that Islamic teachings and practices have to the learning processes and strategies of a student. In his book, Philosophy of education: an encyclopedia, Joseph James Chambliss writes that one of the leading issues in the Islamic philosophy of education regards how religious teachings relate with secular knowledge, or other knowledge emanating from outside the Islamic religion. Religious knowledge, for instance, is recognized by Islam as the most important source of knowledge, a fact that has a dominant influence on the education system in countries such as in the Middle East, where Islam is the religion practiced by the majority. Chambliss notes that although it is common belief that religious instructions and secular instructions are distinct, imitation of religious methods and practices is often seen in secular settings (Hoosain & Salili, 2006). One way this happens is, for instance, the recitation by heart of chapters and quotations, a practice that is common in secular schools. This practice is also common in Christianity sectors, where many students imitate practices learnt in their However, certain practices and modes of culture may have adverse impacts to higher education. One feature of Islamic philosophy involves the modes of teaching religious knowledge, whereby the religious teacher is supposed to teach unchallenged by the students, who are not encouraged to raise difficult questions requiring clarification of more than technical ideas. This is because the teacher is viewed as a transmitter of knowledge that is not supposed to be challenged, and any attempts to challenge it are taken as Islamic criticism. Under such an environment, it would seem unusual for a student to have information that would be of value. This greatly discourages student participation in the class. Moreover, the student imaginative capabilities are discouraged since by the teacher being the custodian of the truth, any imaginative attempts of the students would be viewed as a distortion of the truth . the students are not supposed to another negative impact to the higher education is on (Chambliss, 1996). These ideas have a major impact on the higher education, since many students; in the global context make use of concepts and practices learnt in their formative years in their studies. The current trend in education, where more and more students are increasingly getting their higher education from overseas institutions, ensures that students are in touch with other students with such practices as aforementioned. References Chambliss J, (1996 ). Philosophy of education: an encyclopedia Taylor & Francis, Retrieved April 1, 2009 from

Research Methods in Health and Social Care

Research Methods in Health and Social Care Critical review of quantitative research Majid,S. Foo,S. Luyt,B. Ahang,X. Theng,YL. Chang,YK. Mokhtar,IA. (2011) Adopting and evidence-based practice in clinical decision making: nurses’ perceptions, knowledge , and barriers. Journal of the Medical Library Association 99(3) PP229-236. This essay will be a critical review on the study conducted by Majid et al (2011). The article which is titled ‘Adopting evidence-based practice in clinical decision making: Nurses’ perceptions, knowledge, and barriers’.Investigates the attitudes of Singaporean nurses regarding; evidence based practise. The researchers wanted to identify how the nurses informed were about evidence base practice. They also wanted to identify how the nurses researched literature. Evidence based practise is about good practice and improving the quality of care, this is achieved through a combination of evidence and professional expertise, integrated into clinical practice (Baker, 2012). The study reveals that the majority of nurses working in public hospitals in Singapore have positive attitudes towards evidence based practice.Literature review A literature review is a complete study and understanding of research literature that researchers examine prior or during their research study (Aveyard, 2010). Majid, et al. (2011) looked at a wide range of literature within their research, it is imperative for researchers to look at numerous research related to their research topic to gain an insight on how they conducted their study and the conclusion that was identified from the study (Aveyard, 2010). Literature reviews should have a sufficient amount of studies considered.Majid, et al. (2011) looked at a total of twenty two studies, by reading a sufficient amount of studies this ensures that the researcher does not get a misleading picture of the topic (Aveyard,2012). The sources used within the literature were relatively old; these old sources may not be relevant to current times. Literature reviewed should not be more than five years old as attitudes and beliefs change frequently meaning the studies could not be relevant to current attitudes and beliefs (Godshall, 2010). Majid, et al. 2011) found from their literature search that the general view on evidence based practice was positive. This could question whether Majid, et al. (2011) conducted a systematic review of the literature as there was no mention of any research which found that nurses found a negative view on evidence based practice (Houser,2008). The studies mentioned in the literature at were not conducted within the southeast of Asia therefore Majid, et al. (2011) wanted to investigate attitudes towards evidence based practice from the southeast of Asia.This gives justification for the study as there have only been studies conducted in North America, Europe and other developed western countries. Majid, et al. (2011) wanted to compare the result from their study with the previous studies. Majid, et al. (2011) also discovered that most of the literature that was reviewed shared the same findings on barriers to evidence based practice. The healthcare professionals claimed that lack of time was the barrier to acception, adoption and implementation of evidence based practice. Majid, et al. 2011) in addition recognised that only a few studies that they researched had explored the literature searching skills of nurses Literature reviews should be systematically y reviewed to ensure that the research reviews are reliable (Graziano and Raulin, 2007). Majid, et al. (2011) did not state whether the studies that were looked at were systematically or peer reviewed. Approach and Methodology The study was a primary study however did look at survey instrument used by other previous evidence based practise studies. Majid, et al. (2011) used a quantitative method of research.Quantitative research methods require finding a variable for concepts, operationalising them in the study and measuring them (Grix, 2010). Majid, et al. (2011) study did this by using a survey questionnaire as a means of collecting data. The questions were compiled by a team comprising information studies faculty at the Nanyang Technological University and nursing representatives from the National University hospital. Making the questionnaire unbiased towards the researchers. Marczyk, et al. (2005) states that it is important for all research to not be biased towards the researchers.Quantitative research methods are objective as it uses measurements and analysis of statistical data to answer the study question. The researchers’ opinions do not affect the outcome of the study, ensuring that the study is unbiased. Another advantage is quantitative research uses numbers and statistics which is understood universally (Houser,2008). The researchers have clearly described how they implemented their research in the methods section; the study is easily replicable as it uses a survey questionnaire to collect data.However the research study would have been better if they used qualitative methods to find out the nurse’s perceptions, knowledge and barriers towards evidence based practice in clinical decision making. Majid, et al. (2011) could have interviewed some of the participants to get detailed descriptions of how they feel about evidence based practice in clinical decision making. This would allow the researches to get an in-depth understanding making the study more valid (Saris and Gallhofer, 2007).Quantitative research is best used for quantifying relationships between variables (Hopkins, 2008). The objective of the study was not to identify relationships between variables instead was to explore the attitudes, awareness and knowledge towards evidence based practice. Some could argue that making this study more suitable for a qualitative study. Quantitative research study should have a hypothesis (Maryann, 2010). Majid, et al. (2011), did not state a hypothesis for their study neither did they define a prediction of what they think was going to be the outcome of the research.Sample The samples used for the research conducted by Majid, et al. (2011) were registered nurses in 2 public hospitals in Singapore. The researchers made 2,100 copies of the questionnaires to be completed, however 1,486 were completed. The response rate was 70% ,for quantitative research a large sample size is essential to ensure that the study is statistically accurate (Houser, 2008). The fact that not all of the questionnaires were completed means that the study cannot be fully generalised as some people did not respond.Also some staff was on annual, medical or maternity leave therefore could not participate again making the study not generalised and potentially biased. Majid, et al. (2011) used two different hospital sites to collect data from; this is a good approach as the views on Evidence based practice may be different in the two hospitals, therefore allowing for a comparison of the hospital views. However this could be a negative as only two public hospitals in Singapore were used, therefore making the study hard to generalise to other hospitals in Southeast Asia.All research must follow ethical guidelines. Researchers must ensure that their research ensures confidentiality, anonymity, legality and professionalism (Grix, 2011). Majid, et al. (2011) had ethical approval from the Domain Specific Review Board, appointed by the National Healthcare Group. The researchers did not have consent forms for the participants; however the participants were made aware that by completing the questionnaire they were giving their consent. The nursing managers were briefed and asked to hand the questionnaires out.There is no evidence that the participants were given a briefing from the nursing managers maybe it could have been more ethical if Majid, et al. (2011) briefed the nurses themselves before asking them t o complete the questionnaire. As the questionnaire was self administered the respondents may not have got the reassurance or debriefing needed ( Nosek, et al. 2002). Data collection Data collection must be appropriate, reliable and valid (Houser, 2008). Majit, et al. (2011) used a survey questionnaire. A 5-point liket scale was used in the questionnaires for collecting the nurse’s perceptions on evidence based practice.The advantages of using a likert scale are that the questions are easy to construct, furthermore the likert scale allows for easy comparison of the participants responses. The disadvantage of using a likert scale is the total score of an individual’s response does not have a clear meaning as a total score can be fixed by a variety of answer patterns (Kothari, 2004). Survey questionnaires require the participants to answer questions presented to them. The questionnaire was self administered, which allows for anonymity and less control from the researcher (Mitchell and Jolley, 2012).The first set of questions were demographic questions which as education, job title and length of experience. Majid, et al. (2011) used the results from the demographic information collected to identify a relationship between the demographic information and the ability to undertake evidence based practice activities and other related activities. Another advantage of the survey questionnaires are that a large sample group was targeted within a small space of time. The surveys were collected within a2-week period. Maybe if they waited 3-weeks they might have had a greater response rate.Lastly survey questionnaires are easily replicable as the questions are standardised therefore making them a good method of research (Mitchell and Jolley, 2012). The disadvantages of using survey questionnaires for data collection includes respondents of are usually unreliable as the participants may not have time to complete the survey. Majid, et al. (2011) had a response ra te of 70%. In addition research is also prone to the Hawthorne effect as the participants know that they are being tested, they may not answer the questions on the questionnaire truthfully (Waltz et al, 2010).This may mean the study To assess the nurses’ ability to search databases a hypothetical top was presented to the nurses, with 5 possible search statements and were asked to choose the most appropriate search statement. The validity of this method of measuring their ability to search a database could be questioned. Results The results are presented in table form making the data easy to analyse Majid, et al. (2011) seemed to make assumptions about the beliefs and attitudes towards evidence based practice. The result percentages are too close together.The results from the questions asked about beliefs and attitudes towards evidence based practice showed that 64. 3% of the nurses either disagreed or strongly disagreed with the statement that they preferred using traditional methods than new patient care approaches. Majid, et al. (2011) failed to account for the 35. 7% of respondents who didn’t disagree or strongly disagree. Majid, et al. (2011) found that 52. 8% of the nurses disagreed with the statement that they do not like people questioning their clinical practices that are based on established methods.From this Majid et al concluded that the nurses were open to adopt new health care approaches. Majid, et al. (2011) again did not take into account the 47. 9% of respondents who did not disagree. Majid, et al. (2011) used a statistical test to investigate possible relationships between the ability to undertake evidence based practice activities and other related variables. Their findings were a weak relationship was found between the ability of nurses to implement evidence based practice and their length of experience.Nurses who had higher qualifications were likely to have better abilities to undertake different evidence based practice tasks . Lastly nurses who attended evidence based practice training were likely to feel more competent in their abilities to implement evidence based practice. Majid, et al. (2011) was able to determine these results using data collected from the questionnaires. . This supports the finding s of the other literature which was mentioned in the literature reviews. Reliability and validity All research studies should have a high reliability and validity.Reliability is the ability to consistently measure what is being measured. Godshall (2010, p. 36) writes that ‘Validity is the ability to measure what is supposed to or is intended to be measured’. To ensure that the content of the questionnaire was valid Majid, et al. (2011) had the questionnaire reviewed by a team of experts. Majid, et al. (2011) used a large sample size of 1,486 making the study reliable as a large number size is important in ensuring that the research is reliable. However the responses from the questionnaire c ould not be truthful therefore making the study results unreliable.The results showed that 64% of the nurses expressed a positive attitude towards evidence based practice. 64% is not a large enough percentage to conclude the study.. Majid, et al. (2011) assessed the reliability and content validity of their questions using Cronbach alpha. Questionnaires in general have a low validity as the questions do not explore the topic in depth or detail. Majid et al, 2011 conducted a pilot study to test the survey questions. The feedback received showed that the participants wanted the language and the format of the questions changed.By conducting a pilot study this ensures that the study is reliable and valid. Conclusion and clinical implications The conclusions made from Majid et al, (2011) study were that nurses had a positive attitude towards evidence based practice. However they found adopting evidence based practice difficult due to barriers which effect adaptation of evidence based pra ctice. Majid, et al . (2011) suggest that hospital management arrange evidence based practice training and providing time off from work to learn and put into practice new techniques.To summarise the study was a conducted well, the study is easily replicable, although to further the study Majid, et al. (2011) should have considered using a mixture of quantitative and qualitative methods. Majid,et al. (2011) could have interviewed the nurses to get a further insight into the nurses attitudes and beliefs. Reference List Aveyard. H, 2010, Doing a Literature review in health and social care. A practical guide. 2nd ed, New York: Open university press. Baker. J, 2012, Evidence-Based practice for nurses, London: Sage Publications. Bowling. A and Ebrahim.S, 2005, Handbook of health research methods, Berkshire: Open University Press. Godshall. M. 2012, Fast facts for Evidence Based Practice, Newyork: Springer publishing company. Graziano. M. A and Raulin. L. M, 2007, Research methods a proces s of inquiry, 6th ed, Boston: Pearson Education. Grix. J, 2010, The Foundations of Research, 2nd Ed, Hampshire: Palgrave Macmillan Hopkins. G. W, 2008, Quantitative Research Design, Sports Science, [online] Available at http://libweb. anglia. ac. uk/referencing/harvard. htm [accessed 16th May 2012]. Houser. J, 2008, Nursing Research: Reading, Using, and Creating Evidence, London:Jones and Bartlett.Kothari. R. C, 2004, Research Methodology: Methods and Technique, 2nd ed, New Delhi: New age international. Marczyk. R. G, DeMatteo. D and Festinger. D, 2005, Essentials of Research Design and Methodology, New Jersey: John Wiley & Sons Mitchell. L. M and Jolley. M. J, 2012, Research design explained,8th ed, Wandsworth: Cengage Learning. Saris. E. W and Gallhofer. N. I, 2007, Design,Evaluation and analysis of questionnaires for survey research,Wiley-Interscience Waltz. F. C, Strickland. L. O and Lenz. R. E, 2010, Measurement in Nursing and Health Research, New York:Springer Publishing Compa ny.

Stroke Warning Signs Seen Hours or Days Before Attack

Stroke Warning Signs Seen Hours or Days Before Attack Warning signs of a stroke may appear as early as seven days before an attack and require urgent treatment to prevent serious damage to the brain, according to a study of stroke patients published in the March 8, 2005 issue of Neurology, the scientific journal of the American Academy of Neurology. A total of 80 percent of strokes are ischemic, caused by the narrowing of the large or small arteries of the brain, or by clots that block blood flow to the brain. They are often preceded by a transient ischemic attack (TIA), a â€Å"warning stroke† or â€Å"mini-stroke† that shows symptoms similar to a stroke, typically lasts less than five minutes and does not injure the brain. The study examined 2,416 people who had experienced an ischemic stroke. In 549 patients, TIAs were experienced prior to the ischemic stroke and in most cases occurred within the preceding seven days: 17 percent occurring on the day of the stroke, 9 percent on the previous day, and 43 percent at some point during the seven days prior to the stroke. â€Å"We have known for some time that TIAs are often a precursor to a major stroke,† said study author Peter M. Rothwell, MD, Ph.D., FRCP, of the Department of Clinical Neurology at Radcliffe Infirmary in Oxford, England. â€Å"What we haven’t been able to determine is how urgently patients must be assessed following a TIA in order to receive the most effective preventive treatment. This study indicates that the timing of a TIA is critical, and the most effective treatments should be initiated within hours of a TIA in order to prevent a major attack.† The American Academy of Neurology, an association of more than 18,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous systems such as stroke, Alzheimers disease, epilepsy, Parkinsons disease, autism, and multiple sclerosis. Common Symptoms of a TIA While similar to those of a stroke, the symptoms of a TIA are temporary, and include: Sudden numbness or weakness of the face, arm, or leg, especially on one side of the body.Sudden confusion or problems understanding.Sudden difficulty speaking.Sudden vision difficulty in one or both eyes.Sudden dizziness, loss of balance or coordination, or difficulty walking.Sudden, severe headache with no apparent cause.

Differences Between France and Finland †Humanities Essay

Differences Between France and Finland – Humanities Essay Free Online Research Papers Differences Between France and Finland Humanities Essay Before coming to Finland, I thought that I would be head over heels facing a strange world with no sun, long nights, and icy cold snow all around. I thought I would be disorientated by meals made of fish days after days, especially salmon. My imagination seemed quite limited about all the other aspects of a Finnish â€Å"way of life†. I didn’t know so much about Finland and I couldn’t manage to picture it as a real country: it was like a â€Å"white mystery† which attracted me a lot. The first thing I noticed when I travelled from Helsinki to Savonlinna was this flat landscape. I come from Grenoble in the south east of France, a town situated in the Alps, where, anyway you look, huge mountains prevent you from seeing on the horizon and make you feel in a safe fortress. Here, when you cross a frozen lake, you can’t see anything on the horizon but snow plains It’s an amazing landscape and I love it ! I have learnt that the highest top in Finland is Halti (1328 m) ; in France it’s the Mont Blanc (4808 m) which shows a huge difference ! The second thing I noticed, still in this journey, was the endless view of snowed trees all around for miles with an empty sky surounding the horizon and without any city. It’s something really different from Francebut easy to understand when you know the Finland’s area is 338 142 km ² for 5 183 542 inhabitants that is 15,33 inhabitants/km ² whereas France’s area is about 551 500 km ² for 59 765 983 inhabitants that is 108,37 inhabitants/km ² ! Finland has some place left for nature which can not be found easily in France The last thing I noticed during this trip was the silence on the bus! We were the only people talking, which made me feel uncomfortable at first, but after few days in Finland, I could see that Finnish people are quite shy and silent people and then I understood that nobody was dead in the bus and that there was no reason to keep quiet? !! The second thing about Finnish people which seemed quite strange for me at the beginning is the big space between people. I am under the impression that people keep a kind of distance with the others. For example, Finnish people I have met don’t kiss to say hello or goodbye, which is a highly usual thing in France. Maybe these characteristics about Finnish could be explained by the geography of the countryThere is many space here for everybody so people may be used to keep their distance and may need that to feel good. Something really typical from Finland which does not exist at all in France is sauna. It’s amazing to see how people like it and how many saunas you can find in a km ² !! But, here in Savonlinna, I got used to go at the swimming pool everyday however I was a bit stunned by the nakedness. Indeed, in sauna, you have to get naked, and people have no problem with that, girls go there with their mothers and sometimes with their grandmothers, then everybody take shower and go back, still naked, without any towel, in the changing room in which there is no cabin to change one’s clothes. For me, it’s not so much shocking, I know that everygirls is the same and so on, but I really can’t even imagine myself going naked in a sauna or in any other place with my friends, mother or grandmother! Food is a matter of state importance in France and I was surprised to see that the Finnish population does not deal with it the same way as I do. I have an insight of Finnish food habits during my training as I work in a place where elderly people come several times a week. They spend the day, have some fun and eat breakfast and lunch there. The main thing is the unbelievable number of coffees drunken everyday by almost all the Finnish!! The difference with France is not only the consumption, but also the way to drink it: loads of Finnish drink â€Å"white coffee†, with milk, which are quite long ones whereas in France, you drink only a little cup but quite a strong, and if you need milk, you have to ask as it is not an usual thing in France. When I observed people drinking coffee, I had the feeling that there is kind of a â€Å"coffee culture†: people drink coffee to start off the day, after lunch, in the afternoon and so on. However they really appreciate it as they t ake time to dress the table, to help oneself, to relish it Coffee is also always served with food: slices of bread at breakfast, biscuits, cakes or karjalan piirakka in the afternoon snack. In France, at breakfast, people usually eat some slices of bread (the most popular one is called â€Å"baguette†, it’s a long white bread) with butter and jam. Here, bread is quite always a wholegrain one on which the Finnish put some slices of cheese, ham, margarine and some vegetables (cucumber, tomatoes, salad). I have also seen many old people at work eating some porridge in the morning but not with oasts, I’m not sure of that but I think it’s wheat, that they cook in water or sometimes milk. At lunch, my first observation is that the Finnish have lunch quite early (11 am, in France it’s not usual to have lunch before 12 am). Lunch is quite the same as in France for entrà ©e and main dish which is meat or fish with vegetables, but people drink milk, and put some margarine on the slices of bread. The last thing about food I have noticed is that many people, during the day, drink sirop and no pure water. Some others differencesabout sports, I have noticed that here when you talk about ski, people think about cross country skiing whereas in France and especially in my region, ski means for everybody alpine skiing. I have noticed that the most popular sports in Finland are especially healthy ones, like cross country skiing, ice skating, running, biking, swimming, Nordic walk and so on. In a general way, I think Finnish people have a healthy life, and take a better care of themselves than French people. According to what I saw still at work, the Finnish appear less stress than the French and it even seems to be connected to the general way of life : jacouzis and saunas everywhere, healthy food, few smockers places, regularly practice of sport, and of course this peaceful environment! Last observation, life in Finland is really expensive, some people say that it is the same in all the Nordic countries? To conclude, Finland is quite a different country compared to France, in many ways. I think most of the differences can be explained by the simple fact of geography, weather and temperatures, density of people in a km ² I am pleased to live in Finland for now. I think it’s a nice and beautiful country. Moreover, it’s really interesting to live for few months in such a different cultural way of life. I am crazy about nature and sport, and here I have so many opportunities to take advantage of it ! Sometimes I’m thinking that I could live herebut the Finnish tongue seems to me so difficult that I have to think deeper about this possibility! Anyway, my stay in Finland will remain for an happy and cherish time! Research Papers on Differences Between France and Finland - Humanities EssayThe Spring and AutumnMind TravelAppeasement Policy Towards the Outbreak of World War 219 Century Society: A Deeply Divided EraWhere Wild and West MeetQuebec and CanadaUnreasonable Searches and SeizuresCapital PunishmentAssess the importance of Nationalism 1815-1850 EuropeThe Masque of the Red Death Room meanings

5 Alternate Writing Techniques in English You Havent Heard of

5 Alternate Writing Techniques in English You Havent Heard of 5 Alternate Writing Techniques in English You Havent Heard of Your professor reads through a dozen of papers each time he/she assigns an essay. If you want to get a high grade, you have to ensure that your paper stands out from the rest. How can you do that? If you have mastered the basic writing techniques, here are five more advanced ones that you can use to set yourself apart from the rest. 1. Be Original As often as possible, try to take a unique approach on the topic, offer an original perspective, or use your words in a fresh and interesting way. As your professor sifts through a dozen of papers, he/she does not want to see the same topic many times. Take a creative approach to the assignment that will help you stand out, and you will get a higher grade as a result. Depending on the assignment, you should also write in your own unique voice. For some assignments, you may need to be extremely formal and academic. However, if you have a more creative assignment, use an informative conversational tone. Write the way you would speak to someone you respect and feel comfortable with. Allow your writing to reflect your own personality and your style as well. Writing in such a manner allows you to interact with the audience. 2. Tell a Story If you have a practical, real-life anecdote that is related to the topic you are writing about, it is usually appropriate to tell briefly a story that illustrates your point. Not only this makes your point easier to understand, but it can also be entertaining for the reader. Many writers do not use this technique, so it is one of the ways to set your writing apart. However, make sure that your story is directly related to your paper and is not off topic or unnecessary. Also, get to the point quickly without spending an excessive amount of time on the story. A few sentences are usually enough to entertain the reader and to express your point. 3. Show, Do Not Tell This technique especially applies to creative writing, but it can be used in other types of writings as well. When you are writing, simple telling the reader some information, it is not really effective. It is better to show the reader through details, examples, and evidence. Paint a picture of the information you are trying to explain. In creative writing, this can include using the five senses to make your writing vital. Describe how something looks like, smells, feels, tastes, and sounds to create a vivid image in the reader’s mind. In informational or persuasive writing, such a technique can mean including examples and evidence to support the claims. Instead of saying that Abraham Lincoln is the greatest United States president, show that he is the greatest United States president by providing evidence and giving examples. Instead of saying that you were nervous, talk about your sweaty palms and racing heart. This is one of the best writing techniques in English, and it will surely impress anyone who reads your paper. 4. Use a Call to Action A call to action is better to use in persuasive writing. Such a technique invites your reader to take some sort of action, and it is an excellent item because it engages your audience and involves it in reading your paper. A call to action can be anything that is relevant to your topic. For example, if you just have spent an entire paper convincing readers that every individual is responsible for the health of the planet, you could conclude your essay by encouraging your readers to recycle or conserve water. If you write a persuasive paper about a law that everyone should think about, you can include a call to action advising your readers to call legislators or sign a petition. The call to action should invite the reader to act and make them involved in reading your paper. 5. Use of Figurative Language You have probably heard of figurative language before- this is the language that is used creatively and is not meant to be taken literally. Figurative language includes simile, metaphor, hyperbole, onomatopoeia, and symbolism. You should definitely use figurative language in creative writing, but it can also be an effective technique in informational or persuasive writing. A well-placed metaphor can impress your reader and make your point more beautiful and understandable. Next time you are assigned to write a paper, try using these techniques. Your professor will be surely impressed!

Legal Ethics Essay Example | Topics and Well Written Essays - 1250 words

Legal Ethics - Essay Example A Morgan poll conducted in Australia showed that the public has a poor opinion of lawyers1 which has been deteriorating over the years, findings which replicated those of the American Harris Poll conducted in 1997, showing a deterioration in the perception of lawyer prestige from 36% in 1977 to 18% in 1997.2 The movies portray lawyers in an adversarial, litigating role at trial courts, especially in the case of women lawyers.3 This highlights the aggressive and confrontational role of lawyers and enhances this image in the public mind. Graham and Maschio have pointed out how the conventions of movies interact with the conventions of law4. Through a particular depiction of various categories of lawyers in films, such as female or gay lawyers, the general image of such lawyers may be distorted among members of the public. Rapoport has pointed out how the public images of lawyers as revealed on the silver screen could also affect the manner in which lawyers view ethical dilemmas and make ethical choices, with law students being particularly susceptible to such images.5 The notion of professional and ethical responsibility of lawyers is being increasingly undermined by the screen images and Ross and MacFarlane have highlighted evidence which suggests that students â€Å"do not take the courses in professional responsibility seriously.†6 In general, students take up courses in law for the purpose of better earnings, rather than being motivated by the desire to practice law in an ethical manner7. Moreover, films tend to portray lawyers as bad characters who conduct themselves in an unprofessional manner, which undermines the confidence of the public and also affects the perceptions of new emerging lawyers. Asimov provides several examples of such negative portrayals of lawyers in films– for example, the character of arrogant and rude lawyer Martin Vale in the film â€Å"Primal fear†, or the drug abusing character of

Leadership in an Organization Essay Example | Topics and Well Written Essays - 2000 words

Leadership in an Organization - Essay Example The leadership style involves the cooperation of both the leader and their followers in making some decisions. Many leaders apply democratic leadership which is closely related to participative leadership in so far as leadership engagement and decision making are involved. There are several advantages associated with participative leadership, of which the key ones include the possibility of achieving fast growth through innovation and creativity, high motivation among followers, and ownership of the decision and work, which, in turn, leads to greater cooperation and higher chances of success The paper will discuss the participative leadership style focusing on its application, advantages and disadvantages. The paper will further discuss the effects that good and bad leaders have on their subordinates before giving recommendations. Participative Leadership Participative leadership involves working together with team members in decision making. This, however, does not mean that the lea der involves the team members in making all key decisions. Participative leadership is essential especially when creativity and complex problem solving are part of the mix. Participative leadership is founded on engagement and respect as noted by French, Israel, and As (1960). The assumption made by participative leaders is that when people are involved in decision making, they get to understand the issues involved with respect to those who have to make the decisions. Yet again, the leadership style is founded on the assumption that people are more collaborative and less competitive when they work together to achieve joint objectives. Furthermore, when individuals work together in making decisions, they have greater social commitment to one another, which essentially raises their commitments to the decisions that are made. The participative leadership style constructively focuses on exploiting the energy that resides in every human to human encounter (Martindale, 2011). The leadersh ip style may be thought of as an advanced form of democratic leadership and is associated with high effectiveness considering that it builds community, embraces diversity, and establishes shared responsibility. Yet again, the leadership style heightens personal and collective learning which often results in effective growth and development. Participatory leaders use interactions within the organization to create meaning, purpose and growth even as they transform the organization. As opposed to autocratic leadership, participative leadership involves all people in the decision making process including peers, superiors, subordinates and other stakeholders (Martindale, 2011). Given that leaders work in various environments with various demands, they engage in participative leadership at varying levels. While some leaders may be highly participative, others may be moderately or even less participative. Some of the advantages of participative leadership are as follows. Participative lead ership is essential in the motivation of employees (Stogdill, 1948). The motivation that comes with participative leadership is seen in respect of the fact that when employees are genuinely asked for advice by their superiors, they feel valued. Furthermore, when employees are involved in decision making, they feel honored and actually embrace the work that they do to a greater extent as they feel being part of it according to

Taxation Essay Example | Topics and Well Written Essays - 1750 words - 3

Taxation - Essay Example The taxation of household savings gives five reasons for this. The first point he gives is that the way savings are taxed is an important mode of the tax base. 1If individuals savings are taxed together with incomes and toil wages and all the elements of the tax base are evenly taxed, it leads to what is called comprehensive income tax. On the other hand, if wages are not taxed till when they are utilized, then the yielding tax structure will be a consumption tax. The next reason that is stated is that the manner in which tax is levied on savings is a key factor which determines the way tax structure identifies various relational in life income, contrary to the yearly revenue. Taxation of savings separates individual wage taxation and taxation of cooperate profits. The way in which savings are taxed can effect the independent business people, small businesses and disbursement of capital to huge companies. Taxation of savings can have an impact on summation of savings in the economy as well as, apparently more vital, the manner in which those sa vings are distributed across various capitals. This can have an effect on the total sum of main money invested and how well it is invested. Savings taxation influences individuals resolution on the amount of money they want to save, the time to save and the risk they are willing to incur when apportioning their savings among assets.2 Hence it directly have an impact on their well-being especially in retired times or economic decline, when they may have a need depend on savings they have gathered. The current taxation system is based on peoples real saving action. People save so that they can be able to use their saving at a later time or during the time of need. They deny themselves the use of their money today so that they can save for a rainy day in future as well as accumulate wealth. The case of not taxing the normal

Human Resources Development Essay Example | Topics and Well Written Essays - 1000 words - 1

Human Resources Development - Essay Example ge of branded products, â€Å"backwards expansion† strategy (saturating the target’s rural market first), innovative marketing strategy and most important of all, human resource management. Walton, from the very beginning, believed that happy and satisfied employees performed well and were responsible for happy customers. Wal-Mart’s success in human resource management is keeping their workforce of 1.3 million or more from unionizing. In addition to that, Wal-Mart has achieved a very good retention rate of their employees and has also ensured discipline and uniformity in an organization that has been growing at such a rapid pace. Wal-Mart’s distinctive human resource management policies can be listed and analyzed as follows: (1) Recruitment: In the realm of employee recruitment, Wal-Mart has targeted college students to add to their workforce.   Wal-Mart achieves this recruitment by fanning out over 80 college campuses. While they are at these colleges, they are also able to expand their demographics by looking at minority fraternities and sororities, which brings all types of people from different backgrounds, races, and genders together in the Wal-Mart family.   Having a wide variety demographic for a workforce, only serves to attract more people to seek employment with Wal-Mart because they are able to show that they have a very open hiring process. (2) Training and Development: Beyond recruitment, Wal-Mart has taken an additional step with college students by offering management training for college students while they are still in school so they are more developed and prepared upon their graduation. This program serves the purpose of making college students consider careers with Wal-Mart, and over the last few years, the program has had immense success.   The company is also highly committed towards employee development and improving their career prospects. It has a policy of recruiting more than seventy percent of its personnel in managerial

Marketing Article Example | Topics and Well Written Essays - 500 words

Marketing - Article Example To some, the suggestion that an orderly and analytical process of decision making, not only on a personal level – but more so in business, should include the discussion of highly controversial ethical issues, about which honest differences of opinion are common and self-deceiving rationalization endless, is repugnant. Ethics, after all, encompass wider perspectives of human concerns ultimately affecting business organizations. Ethics and social responsibility are important in the business world for a variety of reasons. Business is not all about making money. Social responsibility is considered the â€Å"obligation of an organizations management towards the welfare and interests of the society which provides it the environment and resources to survive and flourish, and which is affected by the organizations actions and policies† (Business Dictionary, 2010, par. 1). Marketers consider the type of packaging appropriate for their products that must conform to ethical standards and environmental safety concerns. Most marketers veer away from packages which are not biodegradable and which can harm the environment such as using styropore or plastics. Plastic bags have effects which are endangering the environment at an enormously fast pace, most governmental environmental agencies have recognized the immediate need to take drastic actions to stop or minimize the use of plastic bags. Firms ultimately recognize that abiding by ethical standards pay off in terms of better financial performance with employees exhibiting higher performance and productivity due to an environment of trust, employees are therefore more loyal contributing to low turnover, and a preponderance for higher investor loyalty, among others. Firms that incorporate policies on ethics and cultural diversity, social responsibilities, the concern for the environment and the community, achieve their organizational goals more efficiently with the support from their

Accounting Essay Example | Topics and Well Written Essays - 2000 words - 9

Accounting - Essay Example According to Bierman 24 besides building power plants, buying and selling of natural gas and electricity; the company also developed new markets like internet bandwidths, weather futures, pulp and paper business, water plants and oddball products which provided broadcast time for marketers which rocketed its financial incomes. Between the periods of 1995 to 2000, its revenues rose from $9 billion to an impressive $100 billion. The company won America’s most innovative company by Fortunes Most Admired Companies Survey for six years straight which added to its successful reputation. The accounting system required that the company’s future profits were to be estimated at present value based on the signing of its long term contracts. The system was introduced by the joining CEO Jeffery Skilling, who ordered the company’s reporting system to be changed from its actual sales and supply of its natural gas to the new system. The mark to market accounting estimations were in reference to the future net value of the cash flows which were often difficult to predict. This included estimated Enron’s projects’ incomes that were irrespective of whether they were received or not and if changes were made like additional losses or incomes, they would be incorporated in subsequent periods. Enron Incorporation was the first non financial company to be given approval by the Securities and Exchange Commission (SEC) use the system. Due to the numerous discrepancies in matching their cash and profits; the shareholders were given false reports. Therefore, a strategy to appease the investors was created (Bierman 45). Based on Bierman 55 the company executed pressure on its traders in order to forecast low discount rates and high future cash-flows on long-term contracts with the company. In essence, the difference margin between the original paid value and the present calculated net value was the company’s profit. Contrarily, the estimated net

Marketing Article Example | Topics and Well Written Essays - 500 words

Marketing - Article Example To some, the suggestion that an orderly and analytical process of decision making, not only on a personal level – but more so in business, should include the discussion of highly controversial ethical issues, about which honest differences of opinion are common and self-deceiving rationalization endless, is repugnant. Ethics, after all, encompass wider perspectives of human concerns ultimately affecting business organizations. Ethics and social responsibility are important in the business world for a variety of reasons. Business is not all about making money. Social responsibility is considered the â€Å"obligation of an organizations management towards the welfare and interests of the society which provides it the environment and resources to survive and flourish, and which is affected by the organizations actions and policies† (Business Dictionary, 2010, par. 1). Marketers consider the type of packaging appropriate for their products that must conform to ethical standards and environmental safety concerns. Most marketers veer away from packages which are not biodegradable and which can harm the environment such as using styropore or plastics. Plastic bags have effects which are endangering the environment at an enormously fast pace, most governmental environmental agencies have recognized the immediate need to take drastic actions to stop or minimize the use of plastic bags. Firms ultimately recognize that abiding by ethical standards pay off in terms of better financial performance with employees exhibiting higher performance and productivity due to an environment of trust, employees are therefore more loyal contributing to low turnover, and a preponderance for higher investor loyalty, among others. Firms that incorporate policies on ethics and cultural diversity, social responsibilities, the concern for the environment and the community, achieve their organizational goals more efficiently with the support from their

Gay Marriages Essay Example for Free

Gay Marriages Essay When newer lifestyles creep into our society, inline with our thoughts and liberties, guardians of the older versions are likely to be taken back. These lifestyle changes happen in every sphere of life, like the way we eat or work. In getting along with it, we may have to abandon our traditional ways. Sometimes these may go unnoticed, as it may be beneficial to all, having none to worry about it. But other times the issues in question may be very important and fundamental, and there would be a social debate. Homosexuality and gay marriages is one such issue, which is still being debated widely. With homosexuality and gay marriages becoming increasingly present in our society, it is important that the subject be well debated and all issues projected so that it helps people to take appropriate decisions. The issue of homosexuality is not just relevant for the partners, but also to the families they are a part of, and to the society as a whole. It is therefore important that the society be well informed of the legal and social aspects of gay marriages, while being alive to the fact that evolving lifestyle issues could knock at anyone’s door. The media has a very important and responsible role in helping the larger part of the society to come to terms with evolving lifestyles.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   This is perhaps what the film ‘The Wedding Banquet’ has attempted and succeeded. ‘The Wedding Banquet’ is a thoughtful and touching Chinese film revolving around homosexuality and family ties. The film brings into focus the perception of modern lifestyles, from the traditional point of view, and the difficulties and experiences involved in coming to terms with it (Don). The film projects homosexuality in a wider perspective. A gay relationship, in the midst of a heterosexual marriage and parenting, shows the wider realm of homosexuality and gay relationships. The film brings into focus a gay relationship between a Taiwanese expatriate Wai-Tung and his doctor boyfriend Simon. When Wai-Tung’s parents pressurize their son for his marriage, he plans to buy time by putting impossible conditions for his bride. However a dating company succeeds in finding a suitable match, when Wai-Tung strikes into a convenience marriage with his tenant Wei Wei. The marriage would help Wei Wei from being deported. It is when the parents of Wai-Tung reach America for the wedding banquet of their son, does they know of the developments in the family. The film has several turning points like when Wei Wei seduces an inebriated Wai-Tung and becomes pregnant, leading to deterioration in his relationship with Simon. Wai-Tung’s father approves of the actions of Simon, who he takes as his adopted son . His mother on the other hand is drawn affectionally to her daughter-in-law, whom his father considers as a business participant. At the end the father and mother leave for Taiwan, without any discontent. The movie definitely seems to address the issue of homosexuality in the family context. Bringing the issue of homosexuality face-to-face with traditionally heterosexual cultures, gets everyone on their toes to accept the reality. Lifestyle choices are here to stay and traditions must pave way to it and coexist. This low budget film won recognition for its director Ang Lee, who himself makes a short appearance as a banquet guest. It also won the Golden Bear award in the Berlin Film Festival of 1993 and the best film and best director awards at the 1993 Seattle International Film Festival (Berardinelli, 1993).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The rights of homosexuals are increasingly gaining support with time. Homosexuals are being more welcome in our society and their rights are becoming more obvious. Gone are those days when homosexuality was considered a serious crime and homosexuals looked upon as people with sick minds. Although there are societies which still consider homosexuality a crime, it isn’t as dreadful as it once was. These developments indicate the growing perception that homosexuals are a part of our society and therefore should be accorded equal rights, equal protection and equal support from all welfare activities. The favorable trend towards homosexuals may be attributed to the general liberalization of policies in most parts of the world, broader thinking among people and the mixing of cultures and mingling of economics. But it is indeed sad that this never before support, is not extended to gay marriages. A major part of this support and backing, of homosexuality stops short of gay marriages. This indifference to gay marriage, particularly from among supporters of homosexuality stems from their perception of marriage and homosexuality. Gays are generally thought to have multiple partners and that therefore their relationships cannot be deep or emotional. The gays are considered as uncommitted and not being capable of forming lasting relationships. This description of gays cannot be challenged, as gays do have such relationships too. However, it should be noted here that such relationships also exist in heterosexual or straight society too, maybe to a small extent and that too mainly among the youth. What most people need to understand about gays is that, as gays grow and mature, they too like their straight counterparts begin to value and seek committed lasting relationships.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   It is important to realize the basics behind the emergence of homosexuality. Homosexuality is a naturally developing phenomenon. However, most ignorant people attribute it to a defiance of heterosexual norms and an intention to experiment.   Some people feel that gays could choose being a heterosexual if they wanted, but that, only a very few consider that they have a choice. It is only like heterosexuals being asked to choose the sex they are attracted to. It should be understood that being a gay is natural and not selected. Several gay people, both men and women recall being attracted to people of their own sex from a very young age. The sexual orientation in most people emerge at a very early age like early adolescence, even prior to any sexual experience. Homosexual orientation is a complex subject and cannot be explained by any single or a simple, plain model. No consistent results have been found from research undertaken for homosexual orientation. Despite studying evolutionary and hormonal pattern in homosexuality, scientists have not yet understood the development of homosexual orientation in an individual. Therefore it is improper to assume that homosexuals have a choice, which they have chosen to bypass. Today however, most scientists agree that sexual orientation results from an influence of environment, cognitive and biological factors. Genetic and inborn hormonal traits play an important role in deciding a person’s sexual attitude. Psychologists and psychiatrists believe that homosexuality is not due to emotional or mental disorders; and it was in 1973, when the American Psychiatric Association removed homosexuality from its official list of emotional and mental disorders, after appropriate research (APA, 2008). Research based on twin studies also indicate that male homosexuality is genetically mediated. A study with about 76 gay brothers and their families in 1993 by Dean Hamer found that gay men had more gay uncles and cousins on the maternal side compared to the paternal side. One of the most reliable finding in homosexuality adoption was reported by Blanchard and Klassen in 1997, which suggested that the odds of an individual being a gay increased by 33% correpondingly for each older brother. It has been implied that the male foetus causes a maternal immune reaction which is increasingly stronger for each successive male foetus.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Gay marriages are wrongly perceived by many people to alter family environment. The customary saying that marriage is an institution between a man and a woman holds no water, as there is no real and moral judgement behind it. Such definitions of marriages only raise questions on the eligibility and authenticity of the defining person or institution. Who should be the one to define marriage?. They feel that same-sex couples cannot provide the necessary environment for children’s normal growth. In continuation of this, many consider same-sex marriage as a deterrent to births and continuation of species. They don’t realise that marriages are not just directed to bearing children, as even infertile couples choose to marry or heterosexual couples sometimes choose against having children. Marriage is more about sharing, love and commitment and less about bearing children. It should be realized that gay couples are capable of raising children as much as any straight couple. The fact that there is no significant difference between the children of gay and straight couples, has been proved by research. Psychologists are of the opinion that the gender of the parent is not important in raising the child; it’s the love and commitment on the part of the parents that matter. As for the continuation of species, human species are in no danger of dwindling due to reproductive failure. In fact the population explosion is really disturbing and serious issues are at stake for the oncoming generations. Gay marriages can only help in slowing the rate of population increase, than adding to it. Gay marriages have seen results, since it has already been experimented. Denmark legalised gay marriages in 1989. Several Dutch cities have had same-sex marriage rights for many years. The clergy at first offered opposition to the Danish law and a survey conducted at that time indicated that about 72 percent of the clergy opposed the law. However another survey conducted in 1995 revealed that 89 percent of the clergy supported the law. Gay marriages have been experimented and proved to strengthen the institution of marriage and contribute to the society. Any doubts on the success of gay marriages are fully vacated and its positive impact on the society acknowledged.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The interpretation of gay marriage in religion should not be ignored when considering gay marriages. Given the binding of religion and its influence on every aspect of life, people consider religious beliefs above all contemporary issues associated with gay marriages, when deciding on them. Some religions are against homosexuality and gay marriages while some do not consider it as something important to be preached upon. In the Old Testament only two passages are referred to homosexuality, among the several thousands (Piazza, 2007). Buddhism in fact attracts several homosexuals, as there isn’t any homophobia preaching in it. The Theravada Buddhism considers all relationships i.e.; gay, lesbian or straight as being personal matters bearing mutual consent (Robinson, 2008). Therefore all relationships are considered constructive and acceptable as long as both partners are happy. Many people, who believe in Christianity, oppose homosexuality and gay marriage, on the basis of the bible. It should primarily be noted here that the bible was written at a period when there was no understanding of homosexuality or psychosexual orientation. The bible therefore does not recognise people as lesbians or gays. The inference was only directed to homosexual acts committed by persons who were considered heterosexual. However, the bible has been successfully used to interpret the views of both advocates and opponents of homosexuality whenever homosexuality is deliberated. According to the Roman Catholic Church, any sex that does not lead to procreation should be avoided and thus the use of condoms and masturbation is condemned. However, it should also be noted that the church approves sex among sterile couples and sex during pregnancy, which do not lead to procreation (Corvino, 1997). An important aspect of bible interpretation is that, many Christians interpret all texts with much flexibility except when it comes to homosexuality, where  Ã‚   all references to homosexual acts are taken literally. The bible actually pays very little attention to this subject and most importantly Jesus speaks nothing on this topic, in the New Testament. This apart, most instructions and recommendations of the bible are of lesser relevance today, like avoiding pork. The teachings are subconsciously breached casually, as we go about our everyday lives. For instance, there was a prominent woman once spoke at length against homosexuality, in the course of which she broke several Biblical laws by Levitical standards (Piazza, 2007), namely speaking in church, she taught men and wore a cotton and polyester dress. The Bible interestingly has a few example of same sex love. David’s love for Jonathan was implied to be greater than his love for woman, Ruth’s deep love relationship with Naomi and Ruth’s words of pledge are used in most heterosexual weddings.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚     Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Even though gay couples are now socially accepted like never before, they are far from equal civil rights. The withholding of civil rights to gay couples can sometimes be life ruining and even life threatening. The inconvenience and sufferings of gay couples as a consequence of these unequal rights can be endlessly said. In most American states, gay couples are not given the right to make medical decisions for their partners, during emergencies. State laws stipulate that the hospitals should reach out to the families of the hospitalised partner, thereby ignoring the gay partner’s concern. Very often, the families are not in good terms with the gay couple, and may even be without contact for a considerable long time. It is obvious that the decisions taken by such families would not be in the best interests of the couple. It is sad that the hostile family even have the right to exclude the partner from the treatment room. Even upon death, the will of the gay partner can be easily challenged and custody decisions overturned by the family (Bidstrup, 2004). Families have the right to deny the surviving partner, even a visit to his partner’s grave. There are several cases where gay couples had been extremely careful in drafting their will, which however were overturned, leaving the surviving partner literally penniless. Whenever arrested, gay couples are forced to provide evidence and testify against their partners. Most gay couples, particularly the older ones have numerous such stories of injustices meted out to their friends or acquaintances. The testimony of a gay partner is as irrelevant as the testimony of a complete stranger, in most courts. In case the partner is jailed, the right to visit the partner is denied in most cases. In matters of law, arrest or imprisonment, the whims of a hostile family and the cooperation of a homophobic judge can have devastating effects on the gay couple. The discrimination is pathetically extended even to the children of gay couples, as gay parents are not able to get parenting rights when children are brought into their family, either by birth or through adoption. These are some civil rights issues, which are in no way connected to the nature of marriages. State laws, which provide for the rights of legally married couples, are denied for gay couples.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Gay couples are definitely not accorded equal rights, although the situation is improving and would one day catch up with those accorded to heterosexual couples. One must not forget that African-American marriages were not allowed, till the end of civil war. Until 1967, there were at least 15 states that prohibited interracial marriages. It required a US Supreme Court decision that year to ensure inter-racial marriages throughout the United States (Robinson). Same sex marriages are recent happenings, which were earlier not permitted anywhere in the world. The law is often the deciding factor in the fate of homosexuality like in November 2003 when the Massachusetts Supreme Judicial Court termed the ban on gay marriage as unconstitutional. Legislators have indeed played an important role in the acceptance of homosexuality and gay marriages. However there is a lot more for them to do. There are many states in the US, which have yet not legalized gay marriages. Apart from US, there are only a few countries that have recognized homosexual relationships. Social acceptance is a major struggle for homosexuality, which however can begin only after its legalization. Given the progress in acceptability of homosexuality till now, it is evident that all constitutions should and one day, would legalize homosexuality. It should be noted here that the European Union had demanded Turkey to form more liberal laws on sex, as a condition for its membership. Once homosexuality and gay marriages are legalized, the law should provide for the rights of gay couples, and for individual partners. Gay couples should be allowed to live peacefully like any other family, raise children and plan for their future. Homophobic attitudes should be better identified and punished when it attempts to hinder the rights of gay couples. Gay couples too have the responsibility to stand up against victimization rather than suffer alone in silence, fearing social stigma. It is rightly appropriate here to mention the fact that Brendan Fay had lodged a complaint against the Polish president for using his marriage images to warn his countrymen against gay marriages. Fay’s marriage to his partner Tom Moulton, and their marriage certificate was shown in his televised address to the nation. Fay said he considered it to be an insult and has complained to the Polish Consulate in New York (Salazar).   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The debate on providing equal rights to same-sex couples would go on. The public support for gay couples, would gradually translate to more support for marriage rights. However it is the law, which ultimately dictates on the right to gay marriages. The right of the individual to exercise his choice on his personal matters would ultimately be given to him, to enable him to select the gender of his partner. When South Africa’s highest court recognised same-sex marriages and decided to extend legal marital rights to gay couples, it became the first country to do so in a continent, which condemns homosexuality. It must be noteworthy to mention here that South Africa’s constitution is one of world’s most advanced and progressive constitutions. Constitutional reforms are important for any society to meet its trends and demands. Conservative societies should recognise and be willing to accept newer trends and passions. Just like racist discrimination was ruled out, a new dawn awaits the universal removal of discrimination to gay marriage; a dawn when all gay couples can live happily with all rights and liberties, without any fear or discrimination. â€Å"Although we cannot find that a fundamental right to same-sex marriage exists in this state, the unequal dispensation of rights and benefits to committed same-sex partners can no longer be tolerated under our state constitution,† said New Jersey Supreme Court Justice Barry T. Albin, while offering equal rights to same-sex couples.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Education too has an important role to play in understanding homosexuality. Understanding the demands and options of today’s lifestyle, is very crucial for any individual, and one should have the relevant education to take appropriate decisions. Our traditional educational policies should be revamped with the realities of today. Educators must let people know to what extent the law currently permits one to select the gender of the person he or she wishes to marry. Educators must be prepared to transform individuals as responsible persons capable of loving, marrying and raising a family, irrespective of the gender of the partner he or she would be married to. Recognition of same sex relationships as being equal to traditional marriages would drastically redefine the meaning of family (Knight, 1997). Educational policy makers should realize that they hold a sacred duty of imparting education and social skills incorporating relevance to homosexual society too. As the legalization of homosexuality and gay marriages are slowly but steadily gaining ground, one thing is clear; these steps will always progress in the same direction. Therefore education must also keep up closely in the same direction for the welfare of its beneficiaries.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The legislators have a moral responsibility to provide and ensure proper implementation of the marriage rights of gay couples, as civil and partnership laws cannot provide the same benefits as that of marriage (Johnson, 2007). The educators have a responsibility of not only transforming the society to be receptive of gay marriages, but also ensuring that gay couples succeed in every aspect of life. The society as a whole should not only integrate gay couples into its fold, unconditionally, but also be fully prepared to welcome newer lifestyle changes of tomorrow.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   REFERENCES Don Willmott (2004) The Wedding Banquet [Electronic version]. Retrieved on March 19, 2008 from http://www.filmcritic.com/misc/emporium.nsf/reviews/The-Wedding-Banquet Berardinelli, James (1993) The Wedding Banquet [Electronic version]. Retrieved on March 19, 2008, from http://www.reelviews.net/movies/w/wedding_ban.html Salazar C. New York man files complaint against Polish president for anti-gay marriage speech. International Herald Tribune (19 Mar, 2008) [Electronic version] from http://www.iht.com/articles/ap/2008/03/19/europe/EU-GEN-Poland-Gay-Rights.php American Psychological Association. Sexuality [Electronic version]. Retrieved on March 19, 2008, from http://www.apa.org/topics/orientation.html#whatcauses   2008 Piazza M.S. Homosexuality and Christianity [Electronic version]. Retrieved on March 20, 2008, from http://www.cathedralofhope.com Robinson B.A, (2008). The Buddhist religion and homosexuality [Electronic version]. Retrieved on March 18, 2008, from http://www.religioustolerance.org/hom_budd.htm Corvino John. Why shouldn’t Tommy and Jim have sex? A defence of homosexuality. Same Sex: Debating the ethics, Science and Culture of Homosexuality, Rowman and Littlefield Publishers. (1997). Bidstrup Scott, (2004). Gay Marriage: The arguments and the motives [Electronic version]. Retrieved on March 18, 2008, from http://www.bidstrup.com/marriage.htm Knight Robert,. How domestic partnerships and Gay marriage threaten the family. Insight bulletin, Family Research Council. (1997) Johnson, Ramon. (2007) Gay marriage around the world. [Electronic version]. Retrieved on March 20, 2008, from http://gaylife.about.com/od/samesexmarriage/a/legalgaymarriag.htm

Stresses for Trainee Counselling Psychologists | Review

Stresses for Trainee Counselling Psychologists | Review Title: A critical commentary on the following research paper: Kumary, A Martyn, B. (2008) Stresses reported by UK trainee counselling psychologists. Counselling Psychology Quarterly, March; 21:19-28 The prospect of entering any postgraduate training program can often be intimidating. Not only due to the academic commitment required, but because of the emotional demands and potential financial stranglehold placed on a student. These issues alone can leave trainees in both counselling and related psychological professions vulnerable to stress, which can not only damage the well-being of the student, but lower the overall quality of care experienced by patients when trainees are on placement (Cushway Tyler 1996; Kumary Baker 2008). Kumary Martyns make the simple argument, based loosely around Crushways (1992) study of UK clinical psychology trainees, that there are key aspects of training that impact on self-reported stress levels. These included poor supervision, financial costs, childcare, personal therapy and extra supervision. Some of these stressors identified cannot be thought of as essential or necessary aspects of training but this in itself is an area of key debate. (Kumary et al 2008). Other research has also highlighted the same key issues within counselling (Szymanska 2002), but has only looked at one issue in isolation and with this in mind, the present study was an investigation of UK counselling psychology trainees self-reports of their experiences of stress when training. One might go as far to question the rational of any study examining potential stress within such professions considering that having gone through an undergraduate degree already, students are already accustomed to a moderate l evel of stress and it simply goes with the territory (Cooper Quick 2003). On the other hand, such a study has never been conducted and may produce compelling results. Subjects were easy to identify and obtain although only UK counselling trainees who were studying for Part 1 of the BPS diploma were recruited. Are we to assume that this is when stress levels are at an optimal level? Questionnaires were sent out to all institutions. While the general characteristics of the sample are well represented, there was only a 41% return rate. This is good, but not outstanding in comparison to research conducted in similar domains, despite numerous follow-up e-mails and telephone calls (Robertson Sundstorm 1990). A financial incentive might have improved this return rate, but pre-paid return envelops were provided. However this data was collected in 2003, but not submitted for publication until 2007. Ethically, this delay in analysis and publication produces results that are already four years out of date in an education system that is constantly evolving (Hadley et al 1995). While such a simple methodology may initially seem sound, on closer inspection, the differences between the training programs of clinical and counselling are only glossed over and there is some evidence to suggest that the disparity between the two hinder a repetition of a seemingly straightforward approach last consulted in 1992 by Cushway. Aside from the time lapse, it is therefore important to consider the other issues surrounding the modification of a methodology previously used to investigate stress in clinical trainees. Firstly, counselling psychologist training tends to be less scientifically orientated than its clinical counterpart and most NHS posts are only open to Clinical Psychologists (Mayne, Norcross Sayette 2000). For example, it is generally accepted that counselling psychologists focus more on the therapeutic alliance with clients having to complete 450 hours of contact by the end of 3rd year training (Hadley et al 1995). While there are considerable similarities between the two disciplines, Norcorss (2000) documents many salient differences including professional activities, theoretical orientations, employment and training settings, graduate admissions and research areas. The question what are the differences in training clinical and counselling psychologists? -does not lend itself to an easy answer because psychology can be applied in so many ways. Traditionally, the main difference is in their training and perspective (Mayne et al 2000). It would appear to be an oversight on Kumary et als (2008) part to use a similar, modified methodology, previously applied to clinical trainees when the stress causing factors may be quite different. With these differences outlined in more detail, the old methodology would appear to require a more radical modification or adaptation from that used previously. Two main instruments were used to examine stress within the sample. The Counselling Psychology Trainee Stress Survey (CPTSS) and The General Health Questionnaire (GHQ12) (Wemeke, Goldberg Yalcin 2000). The CPTSS was developed from Cushways (1992) stress survey for clinical psychology trainees with four categories (academic stressors, placement stressors, organizational stressors and personal stressors). What is concerning is the lack of both research confirming the validity of the measure and the small brainstorm session using five trainees under those headings. Furthermore, from their discussion the CPTSS, constructed from 36 items, was only piloted on a further six trainees. This did lead to some changes being made with the authors settling on four descriptive categories slightly different from Cushways; academic demands, lack of support systems, placement stressors and personal and professional development. This displays neither convergent or discriminant validity. Finally, despi te other more valid forms of questionnaires available measuring stress (for example the Psychological Stress Measure (PMS), this study chose one which was quickly devised from a brief investigation and remains untested in the general population (Lemyre Tessier 2003; Trovato et al 2006). The General Health Questionnaire (GHQ12) on the other hand has been specifically validated for use in non-psychotic populations (Wemeke et al 2000). Because it is a shortened, 12-item version of the GHQ, it allows for quick completion, is likely to increase participant response, is quick to code and statistical mistakes also become less likely. For the purposes of this study, it appears to be the ideal choice and has been used to great effect in a large body of pervious work (Winefield, Goldney, Winefield, Tiggemann 1989; Vaglum Falkum 1999; Quek, Low, Razack, Loh 2001). A recent review by Jackson (2007) however, pointed out that the 28 item is usually used because the GHQ28 has been more widely used in other working populations, which allows for better comparisons, but the reliability coefficients have ranged from 0.78 to 0.95 in numerous studies and Jackson concludes (2007, p. 57) that: ‘In using this tool with postgraduate students conducting research in many areas of occupational health, the GHQ rarely fails to provide reliable and effective measures of well-being that usually correlate very highly with other measures of working environments or organizations Regardless of how carefully survey data is collected and analyzed, the value of the final result depends on the truthfulness of the respondents answers to the questions asked. Over the last twenty years, researchers have debated extensively about the truthfulness of peoples self-reports, and no clear cut conclusion has emerged (Zechmeister, Zechmesiter, Shaughnessy 2001). If someone is asked whether or not they enjoyed their bath, there is generally no need to question whether this accurately reflects their real feelings. However, in everyday life there are some situations in which researchers should have reason to be suspect. Survey research involves reactive measurement because respondents know that their responses are being recorded. Pressures may be strong for people to respond as they think they should rather than what they actually feel or believe (Zechmeister et al 2001). The term used to describe theses pressures is social desirability and in Kumary Martyns study (2008) the se issues are present in their entirety (Zechmeister et al 2001). For example, a trainee counselling psychologists attitudes towards their own stress and health levels, may be a far cry from their actual stressful behavioural responses. Both the questioners administered rely solely on self report and this gives rise to some further criticism. The approach is straightforward, but there is a trade-off between allowing for a simple analysis and the complex use of questionnaires in any survey based study. It is a fine balance that is difficult to maintain. Self-report questionnaires are all answered at different times and in different locations by each subject. As a result, the measures are vulnerable to inaccuracies caused by confounding variables. For example, a trainee filling in a stress based measure might have just had a particularly stressful day or experience that will effect their score. They could even have exams in a few weeks. Alternatively, reporting the issue of time-management and stress may be meaningless when the respondent evidently has time to sit down and take part in such a study anyway. The results from any self report also lack directness. While there is no ideal direct measure of stress, it is possible to get a better indication by measuring some of the physiological effects in the body. For example, stress might be better measured via heart rate, blood pressure, breathing rate, brain waves, muscle tension, skin conductance or temperature (Lemyre et al 2003). While more costly, such a study could be replicated using skin conductance monitors, worn by trainee counselling psychologists and correlate daily activities with any changes. This might produce results documenting what aspects of the course give rise to more stress and allow for re-development and changes to be applied where necessary. A more elementary approach might be to use an electronic pager device which asks every hour, how stressed are you now and what are your currently doing? In summary, researchers and clinicians must be careful when adapting clinical tools and methodologies to assess stress. They were designed for pathological disorders and validated using clinical populations and so the statistical distributions are not normal (Trovato et al 2006). As Lemyre et al (2003, p. 1159) state: The concept of stress refers to a set of affective, cognitive, somatic and behavioral manifestations within the range of functional integrity Despite this, thirteen items from the CPTSS were identified as being the most stressful issues in the sample population (none came from lack of support), which were split into two groups. The first included practical issues of finding time, funds and suitable placements. One item was also linked with negotiating these three key areas and could have a subsequent impact on their social life. A second group comprised of more general postgraduate issues: academic pressure and professional socialization. In order to determine a basis for the four groupings within the 37 single items of the CPTSS they were employed as four sub-scales (academic, placement, PPD and lack of support). These also gave acceptable levels of reliability. (Kumary et al 2008). The authors also found some good evidence for demographic variants in stress, with significantly higher stress ratings reported by younger participants and lower for those who were older. The GHQ12 results were in two scoring forms casesness and extend of distress with 54 participants identified as cases had significantly higher CPTSS scores than the 39 non-cases. Key findings from Kumary et al (2008, p. 24) included: The higher the stress rated for an aspect of counselling psychology training, the clearer the indicators of psychiatric distress became older participants had lower CPTSS ratings especially on placement issues men reported lower CPTSS ratings, most notably on academic items The support items attracted less attribution in comparison to academic, placement and PPD issues, despite pilot discussions (Kumary et al 2008), suggesting again that the methodology behind this study was flawed from the start. This does to some extent mirror Cushways (1992) data in that support was viewed by participants as a resource to ease training-induced stress, and participants viewed it as a resource to be used rather than a cause of stress because it was insufficiently provided. Again, with this knowledge available at the outset, why was the same methodology used? At this point, one might mention the issue of correlation and how this does not imply causation, but no profile of a stressed student was possible because most of the results were not significant. The authors admit themselves that the data collected is nothing to be proud of (2008, p. 25). It is difficult to believe that Krumary et al (2008) did not clearly see the unsophisticated and non-standardized status of the CPTSS as a serious issue before conducting such a study particularly when compared with more experimental research methods (Lemyre et al 2003). It is possible that the measures used were not sensitive enough to pick up on individual stress differences between participants. The fact remains however, that the fundamental assumptions were wrong and the question remains, do trainees in professions such as clinical and counselling psychology experience more stress than those within the normal population and if so are such emotional demands a critical part of training? Should t rainees be exposed to unacceptable stress levels and their apparent resilience used as an assessment criterion of professional suitability? (Hadley Mitchell 1995) The basis of this study is not sound enough to warrant any overall generalizations within the target population. The approach was oversimplified at the expense of generalized, poor-quality results. In this sense, the study has contributed little to our knowledge into how trainee counselling psychologists experience stress. The lack of an original approach is a reminder of how academic journals vary in the quality of the research they publish. It is nevertheless important that it was published to illustrate a methodology that clearly failed and thus prevents further repetition. This is the constant winding road of modern applied psychological research. References Cooper, L. C., Quick, C. J. (2003). The stress and loneliness of success. Counselling Psychology Quarterly, 16, 1-7 Cushway, D. (1992). Stress in clinical psychology trainees. British Journal of Clinical Psychology, 31, 169-179 Cushway, D., Tyler, P. (1996). Stress in clinical psychologists. British Journal of Clinical Psychologists, 31, 169-179 Goldberg DP, et al. (1978) Manual of the General Health Questionnaire (NFER Publishing, Windsor, England). Hadley Mitchell (1995). Counselling Research and Program Evaluation. London: Brooks/Cole Publishing Company Jackson, C. (2007). The General Health Questionnaire. Occupational Medicine, 57, 79 Kumary, A Martyn, B. (2008). Stresses reported by UK trainee counselling psychologists. Counselling Psychology Quarterly, 21,19-28 Lemyre, L., Tessier, R. (2003). Measuring psychological stress concept, model and measurement instrument in primary care research. Canadian Family Physician, 49, 1159-1160 Mayne, T. J., Norcross, J. C., Sayette, M. A. (2000). Insiders guide to graduate programs in clinical and counseling psychology (2000-2001 ed). New York: Guilford. Norcross C. J. (2000) Clinical Versus Counselling Psychology: Whats the Diff? Eye on Psi Chi, 5 (1), 20-22 Quek, F. K, Low, Y. W., Razack, H. A., Loh, S. C. (2001). Reliability and validity of the General Health Questionnaire (GHQ-12) among urological patents: A Malaysian study. Psychiatry and Clinical Neurosciences, 55 (5), 509-513 Robertson, M. T., Sundstrom, E. (1990). Questionnaire design, return rates, and response favorableness in an employee attitude questionnaire. Journal of Applied Psychology, 75 (3), 354-357 Szymanska, K. (2002). Trainee expectations in counselling psychology as compared to the reality of the training experience. Counselling Psychology Review, 17, 22-27 Trovato, M. G., Catalano, D., Martines, G. F., Spadaro, D., DI Corrado, D., Crispi, V., Garufi, G., Nuovo, S. (2006). Psychological stress measure in type 2 diabetes. European Review for Medical and Pharmacological Sciences, 10, 69-74 Vaglum, P., Falkum, E. (1999). Self-criticism, dependency and depressive symptoms in a nationwide sample of Norwegian physicians. Journal of Affective Disorders, 52 (1-3), 153-159 Wemeke, U., Goldberg, D., Yalcin, I. (2000). The stability of the factor structure of the General Health Questionaire. Psychological Medicine, 30, 823-829 Winefield, R. H., Goldney, D. R., Winefield, H. A., Tiggemann, M. (1989) The General Health Questionnaire: Reliability and Validity For Australian Youth. Australian and New Zealand Journal of Psychiatry, 23 (1), 53-58 Zechmeister, S. J., Zechmesiter, B. E., Shaughnessy, J. J. (2001). Essentials of Research Methods in Psychology, McGraw-Hill Higher Education Schizophrenia: the biological and psychological effect Schizophrenia: the biological and psychological effect The study of psychosis has been much published within the literature. Investigations into the biological, psychological and clinical aspects of the disorder have been greatly seen. An approach which views schizophrenia as a disturbance of information processing appears promising as a way of linking all of the aspects of the disorder. A review of the research in this area led to the suggestion that the basic disturbance in schizophrenia is a weakening of the influences of stored memories of regularities of previous input on current perception. It is argued that the link between information processing disturbances and biological abnormalities may be facilitated by the use of paradigms derived from animal learning theory (latent inhibition and Kamins blocking effect). In a number of animal model studies and indeed human subject studies, on an individuals pattern of performance in acute schizophrenics, the information gained is consistent with the cognitive model. The ways in which such an information-processing disturbance may lead to schizophrenic symptomatology will thus be outlined, with particular reference to the formation and maintenance of delusional beliefs. The core cognitive abnormality may result from a disturbance in any of the brain structures involved in the prediction of subsequent sensory input. The proposed circuit implicates in particular the hippocampus and related areas and is consistent with studies of brain pathology in schizophrenia. Thus, this paper will aim to provide an insight into the biological and psychological effects of schizophrenia and will give an insight into the current treatments available and their effects on the individual and their biological status. Introduction Understanding the varied presentation of the many types of psychotic disorders is still a major challenge within todays scientific capacity. The approaches utilized to clarify their complex nature of such disorders of the neurological system present an ongoing challenge, due to the complexity of the interaction between both biological entities (the brain) and the psychological effects. Thus, the aim of this paper is to review the evolution of our understanding of schizophrenia in terms of the biological and psychological effects of the disorder, based upon a review of the literature findings. Studies, which have been conducted regarding the life-long evolution of mental illnesses, especially schizophrenia, have been publicized for decades and this has managed to initiate the early standing of schizophrenia and of the nature of its chronic states. These experiences have further contributed to the views we hold today regarding the illness, leading in a third phase to the development of a biological-psychosocial model of its evolution which has proved useful for both theoretical and practical purposes. Finally, an understanding of therapeutic experiences and theoretical explorations based on the biological and psychological has helped to minimize the effects of the disease within the patient population. Biological basis of schizophrenia Across the findings within the literature, the question of whether schizophrenia is associated with structural or functional abnormalities of the nervous system, or both, appears to have become the principal focus in many of the biological studies of schizophrenia. A number of different methods of investigation of this system have been conducted including computed tomography studies, which have been able to reveal ventricular enlargement and cortical atrophy in a subgroup of schizophrenic patients. When such enlargement is found within the brain of the majority of patients in the early stages of the illness, they appear to be most severe in patients with negative symptoms and poor outcome. Quantitative neuropathological studies have tentatively demonstrated decreased volume of specific brain areas, neuronal loss, and other changes in the limbic system, basal ganglia, and frontal cortex. Dopamine (DA) remains the neurotransmitter most likely to be involved in schizophrenia, although t here is also evidence for disturbances of serotonin and norepinephrine. Post-mortem and positron emission tomographic studies suggest an increased number of D2 DA receptors in some schizophrenics. Neuroendocrine studies reinforce the role of DA in schizophrenics. Viral infections and autoimmune disturbances may be responsible for some types of schizophrenia, but there is no firm experimental evidence to support either hypothesis. The possibility that mixtures of structural abnormalities and functional changes involving DA occur in the same patients rather than independently as part of two syndromes (Type I, II) seems attractive. The symptoms of schizophrenia patients appear to be diverse, with different elements of the disease having different impacts on different individuals. Since Bleulers (1950) conception of the schizophrenias as a heterogenous disease composed of symptomaticlly different subgroups, attempts have been made to identify biological correlates of specific behavioral dysfunction. Diagnosis of the illness could be seen to have been fraught with difficulties. The initial lack of differentiation between the manic episodes of bipolar affective disorder and schizophrenia still presents as being greatly problematic within studies published within the literature, and subsequent attempts to differentiate between subgroups of schizophrenics have yielded no discrete classification system. The search for an etiology has also been bedeviled by this lack of distinct classification. Nevertheless, the publication of and the conduction of a number of biological theories have contributed to an understanding o f schizophrenia by identifying specific dysfunctional neural areas in determining biochemical changes associated with symptomatology and in formulating new etiological hypotheses. Neurological correlation between neurological studies and the effects of schizophrenia have been examined by research conducted through the use of magnetic resonance imaging, computed and positron emission tomography, and, also postmortem morphological changes (Koning et al, 2010). Studies of cognitive function in association with metabolic and cerebrovascular activity have contributed to the identification of discrete neural dysfunction. In addition, development of the dopamine theory and its relationship to positive symptoms has assisted in diagnostic differentiation, while recent studies on the modulatory role of neuropeptides on neurotransmitters have expanded the scope of the dopamine theory. Several biological theories have been proposed for an etiology of schizophrenia. (Krabbendam et al, 2004) Perinatal complications and viral infection have been suggested either in isolation or in conjunction with genetic factors. Low birth weight has also been proposed as a predisposing or associated factor in the subsequent development of schizophrenia. The viral hypothesis has received impetus from recent research into retroviruses capable of genetic transmission and causing latent disease onset. It is also recognized that factors other than biological, in particular, Psychosocial influences may play an etiological role in schizophrenia. Discussion of these factors, however, will not be discussed in great detail in this paper due to time restrictions. The difficulty of diagnosis As etiological studies rely to a large extent on accurate diagnosis, it is important initially to identify diagnostic problems because this aids an understanding between the interplay between biological and psychological effects, which can be noted in schizophrenics. It has long been recognized that the term schizophrenia incorporates a heterogeneous collection of subgroups, possibly with different etiologies, disease processes, and outcomes. The subsequent categorization of such patients into meaningful groups therefore relies upon differences in symptomatology and long term outcome, and fall broadly into three categories- paranoid versus nonparanoid, negative versus positive, and chronic versus acute (Goldstein Tsuang, 1988) The literature proposes that paranoid groups show a better premorbid adjustment, cognitive performance, and prognosis than the nonparanoid group (Kumra and Schulz, 2008), it has been suggested that this represents a measurement artifact and depends on whether absolute or relative measures of paranoia are used. Studies using absolute predominance measures to the exclusion of other symptoms reject many subjects displaying both sets of symptoms. Many nonpredominance studies show no differences between the groups of an increase in negative outcome as paranoid symptoms increase. Other researchers have proposed that schizophrenics could be categorized into two types placed into their category upon the basis of positive or negative symptom preponderence. Type I, or the positive symptom group, display some of the Schneiderian first rank symptoms of hallucinations and delusions, while Type 2, or the negative symptom group, show affective loss or extinction, speech content poverty, psychomotor deficits, and a general loss of drive or will. One of the problems with this categorization is that many schizophrenics display both sets of symptoms and that schizophrenics with primary positive symptoms often develop negative symptoms over time (Phillips and Silverstein, 2003). This would mean that studies using young subjects showing predominantly Positive symptoms may not be adequately differentiating between groups. Recent refinements of the positive/negative dichotomy have led to a redefinition of negative symptoms congruent with familial genetic factors, developmental dys- function, and the development of psychometric scales to measure relative symptomatology (Pickett-Schnenk et al, 2006). However, the influence of neuroleptic drugs on attentional and extrapyramidal functioning could also contribute to the development of differential symptoms. Furthermore, the effects of early environmental factors, such as perinatal trauma and familial environment, and of concurrent disorders, such as depression, are not adequately taken into account in such studies. Thus, this highlights the difficulties, which can be seen when trying to relate the biological and psychological effects of schizophrenia to a certain pathological aspect of brain development. Within the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R; APA, 1987) chronicity is defined as persistence of disturbance for more than two years with further residual diagnosis if subsequent symptoms are primarily negative. It is assumed to be associated with negative symptoms within Crows typography (Crow, 1980). This classification is the most common in the literature because of its basis in psychiatric diagnosis and its relationship to poor prognosis and to biological and cognitive deficits. For the purpose of biological research, the argument appears to be somewhat circular however because, for example, research attempts to find biological correlates of subgroups that are often operationally defined by their biological correlates. Moreover, there is significant overlap between the two groups in that many initially acute schizophrenics subsequently become chronic (by definition). While researchers across the literature publications acknowledge the heterogeneity of the disease, they continue to rely operationally on a dichotomous diagnosis. Multiple research strategies on the same subgroup would assist in isolating behavioural and biological attributions and in refining diagnostic criteria. Biochemical research and the impact on our understanding of the effects of schizophrenia Disruptions of neural biochemical processes have been extrapolated both from the effects of psychomimetic drugs and from the actions of symptom-reducing neuroleptic drugs. Drugs such as amphetamine and L-dopa, which cause psychotic conditions (e.g., hallucinations and paranoia), are known to involve excesses of dopamine release (Goodwin, 1972). Although different classes of neuroleptics are known to block acetylcholine, noradrenaline, or serotinin transmission, all of them block dopamine, and symptom reduction is thought to emanate from the latter (Millar et al, 2001). Within the dopamine theory two models of dysfunction have been proposed: autoreceptor excess, and postsynaptic receptor mechanism deficit. Different classes of neuroleptics vary in whether action is pre- or postsynaptic, but an inhibition of dopamine transmission is effected by all classes. Two classes of dopamine receptors have been identified-D1 and DP as previously mentioned, and it is believed that they are related to schizophrenia and neuroleptic effects. Distinctions between the two are based upon their actions on adenylate cyclase: stimulatory for Dl and distinct or inhibitory for D2 (Murray et al, 2008). Dl neurons, which project from the substantia nigra to the corpus striatum, are implicated in Parkinsons disease. Inhibition of Dl receptors is believed to be the origin of neuroleptic side effects, such as tardive dyskinesia and parkinsonianism. D2 receptors are associated with the antipsychotic effects of neuroleptic drugs and form the mesolimbic dopamine system which projects to the frontal cortex and some limbic forebrain structures (Tseng et al, 2008). The proposition that schizophrenic symptoms are caused by an excess of D2 receptors was initially difficult to substantiate due to drug effects and disease process. In most postmortem studies showing higher densities of dopamine receptors, previous antipsychotic drug use is also implicated (Seeman, 1986). However, in several studies subjects had never been treated with neuroleptics and still evinced increased dopamine receptor density (Trower et al, 2004). The role of dopamine receptor anomalies has also been studied using differential effects of classes of neuroleptics on dopamine receptors. In vivo Positron Emission Tomography (PET) research using the ligand [Cl raclopride has indicated that diverse classes of neuroleptic drugs administered in clinically effective doses block D2 dopamine receptors in the putamen. suggesting increased D2 dopamine density in schizophrenic subjects (Thompson et al, 2001). Research on the role of the atypical neuroleptic, clozapine, on dopamine receptors has however yielded inconsistent results. It is thought that the relative absence of extrapyramidal side effects with clozapine administration is due to a selective effect on D2 dopamine activity in the ventral tegmental area and nucleus accumbens but not in the substantia nigra or striatum. Haloperidol, on the other hand, reduces dopamine activity in both areas. The effects of both drug classes have been observed in rats using in vivo extracellular sing le-unit recordings (Tseng et al, 2009). However, clozapine also acts antagonistically on cholinergic, a-adrenergic, his- tamine, and serotonin receptors and, in addition, the combination of haloperidol with the a-noradrenergic antagonist, prazosin, produces similar effects to clozapine administration, namely, reduced basal dopamine release in the striatum but not in the nucleus accumbens (Thimm et al, 2010). Studies on cerebrospinal fluid (CSF) levels of prolactin following clozapine administration have also yielded inconsistent reslults. Prolactin release is inhibited by dopamine and increased by conventional neuroleptics. However, in at least one study it has been found that administration of clozapine to human schizophrenic subjects produced no significant increase in prolactin levels 11 hours after administration, despite moderate to marked therapeutic effects (Meltzer, Goode, Schyve, Young, Fang, 1979). Several recent studies have also implicated Dl receptor blocks in the therapeutic effects of clozapine. A further obstacle to the initial acceptance of the dopamine theory has been the time discrepancy between drug administration and antipsychotic symptomatic effects. PET studies have shown immediate binding to dopamine receptor sites, yet their clinical effect is often delayed for several weeks (Tarrier et al, 1999). There have been suggestions that receptors blocks produce an initial overactivity of dopamine release to compensate for inhibition. Further evidence for the dopamine theory has come from measurements of CSF, and plasma levels of the dopamine metabolite, homovanillic acid (HVA). Although findings in unmedicated patients have not yielded consistent differences in HVA levels between schizophrenics and controls, neuroleptic treatment increases HVA levels (Abubaker et al, 2008). In unmedicated patients, a correlation between low HVA levels and cortical atrophy and ventricular enlargement has been found in at least one study. This has led to the suggestion that dopamine excess is related to Type 1 schizophrenia, an interpretation which is supported by a good response to neuroleptic drugs in this group (Crow, 1985). In addition, Allen et al (2008) has suggested a possible deficiency of dopamine in Type 2 schizophrenics. However, the Type l-Type 2 typography has not been fully supported, and there is evidence that neuroleptic drugs elicit response in negative symptom sufferers (Allen et al, 2008). From the evidence there is little doubt of the biological role of dopamine within some forms of schizophrenia. The influence of serotonin in schizophrenia was suggested by the antagonistic activity of the psychomimetic drug, D-lysergic acid diethylamide (LSD), on serotonin transmission (Addinton and Addington, 1993). This has been studied in CSF by measuring levels of the serotonin precuresor, tryptophan, and the metabolite 5- hydroxyindole acetic acid (5-HIAA). At least one study has found reduced levels of 5-HIAA in schizophrenics and no difference between those on and off neuroleptics, but the latter group had only been drug free for a short time (three weeks). Therefore residual effects cannot be discounted. It was not stated whether subjects were also suffering from depression, which is known to decrease serotonin levels (Akbarian and Huang, 2009). Neither increasing nor decreasing serotonin levels have had a beneficial effect on schizophrenic symptoms (Akbarian and Huang, 2009). Monoamine oxidase (MAO) metabolizes dopamine, serotonin, and noradrenaline, as well as endogenous stimulants or hallucinogens such as phenylethylamine and diethltryptamine. It has therefore been hypothesized that decreased MAO activity could be contributory to schizophrenia. Studies have been conducted into platelet MAO activity in schizophrenics with varying results. Meltzer and Arora (1980) found that decreased MAO platelet activity was positively correlated with paraniod and positive symptoms. Other studies have found no un- usual MAO platelet activity in paranoid or hallucinating schizophrenics (Arts et al, 2008) Recent research has also considered the role of neuro-peptides in modulating CNS functions and the possible implications for schizophrenic symptomatology. Endorphins have been the subject of the most intensive study because of their association to proposed neural deficit areas both in biochemical and neuropathlogical research. The B, y, and (Y endorphins originate in the basal hypothalamus and modulate neurotransmitter activity in several structures of the limbic system and brain stem. Of all the biochemical theories of schizophrenia, the dopamine hypothesis has been the most consistently substantiated in research. The implication of other neurotransmitters, however, suggests a possible diffuse dysfunction with dopamine eliciting the most severe disruption. Efforts have been made to control for medication, but residual drug effects cannot be discounted. Many studies now use chlorpromazine equivalents to control for the effects of varying medication levels. The problem with this method is that, although different classes of neuroleptics all reduce dopamine levels either pre- or postsynaptically, they do not have equivalent effects on serotonin, MAO, or noradrenalin. Further problems are encountered when attempts are made to ascribe an etiological function to neurotransmitter activity. It is equally probable that any such changes are caused by the disease process rather than their being causal. Structual brain abnormalities The neuropathology of schizophrenia has received considerable recent interest in the light of positron emmission tomography (PET), postmortem, cognitive function and cerebral blood flow (CBF) research. While PET scans and postmortem investigation have concentrated on structural measurements, cognitive studies have provided tacit support for such structural changes. It has been hypothosized that neuropathological abnormalities identified in subgroups of schizophrenics could be in vitro developmental disorders either genetically transmitted or resulting from prenatal trauma (Ashburner et al, 2008). The most consistent findings across the publications within the literature have been differences in ventricular size, in some sections of the temporal limbic and nigrostriatal systems and basal ganglia, and in the prefrontal cortex. Measurements of ventricular size have however, shown considerable inconsistency, with some studies finding no significant difference between subjects and non-schizophrenic controls (Bles et al, 2010), and some reporting significant differences between chronic paranoid and hebephrenic subjects and normal controls (Bales et al, 2010). Evidence to date suggests that ventricular enlargement is only salient for a small subgroup of schizophrenics subject to chronicity or other, as yet unidentified, factors. Inconsistency in the results could be due to deviations in subject samples. It has been proposed that atrophy of specific neural areas could account for some schizophrenic symptoms. While some evidence has come directly from postmortem studies. Abnormalities have also been inferred from the results of PET and CAT scans and CBF measurements performed in conjunction with cognitive tasks designed to activate specific neural areas. Postmortem studies have identified significant cortical atrophy in the lateral nigro-striatal area (Birchwood et al, 2004) and in the limbic portions of the temporal lobe, specifically the amygdala, hippocampus, and parahippocampal gyrus (Birchwood et al, 2004). Psychotherapies and social treatments The psychological effects and impacts of schizophrenia must be emphasized. Due to the impact of the different, aforementioned parts of the brain and the CNS in schizophrenia, the psychological impact of the disease is obviously one, which takes great effect as previously mentioned. Psychotherapies are thought to be important within the current treatment lines in schizophrenia and although antipsychotic medications are the mainstay of treatment for schizophrenia, pharmacotherapy alone produces only limited improvement in negative symptoms, cognitive function, social functioning and quality of life. Additionally, it has been found that a great number of patients continue to suffer from persistent positive symptoms and relapses particularly when they fail to adhere to prescribed medications. This underlines the need for multi-modal care including psychosocial therapies as adjuncts to antipsychotic medications to help alleviate symptoms and to improve adherence, social functioning and qu ality of life (Patterson and Leeuwenkamp, 20008). A short review of the evidence that has accumulated on the efficacy of the major modalities of psychosocial treatment highlights that treatments involving social skills training, psychoeducation and cognitive behavioural therapies (CBTs) can all have a role in the treatment of individuals with schizophrenia. The reasoning behind the success of each treatment can give guidance into the psychological effects of the disease. For example, Psychoeducational interventions provide information about the disorder and its treatment to patients and their family members, and additionally inform the patients and family members about strategies to cope with schizophrenic illness. From the literature findings, it is evident that an extensive body of literature has accumulated regarding the efficacy of these interventions. Meta-analyses suggest that these interventions reduce high expressed emotion among relatives, and decrease relapse and rehospita lization rates (Pitschel et al, 2002; Giron et al, 2010). In general, interventions that include family members are found to have a much greater level of success (Pharaoh et al, 2006). Multi-family psychoeducation group approaches, which provide family psychoeducation and additionally offer an expanded social network, are found to reduce rates of relapse as are peer-to-peer education programs for families and patients (Chien et al, 2006). Cognitive Behavior Therapy (CBT) About a third of patients with schizophrenia continue to suffer from persistent psychotic symptoms despite adequate pharmacotherapy. Cognitive Behavior Therapy (CBT) has therefore been presented as a system of treatment which has emerged to address this need, and is based on the hypothesis that psychotic symptoms such as delusions and hallucinations stem from misinterpretations and irrational attributions caused by self-monitoring deficits. CBT seeks to help patients rationally appraise their experience of disease symptoms and how they respond to them, thereby reducing symptoms and preventing relapse (Turkington et al, 2008). Meta-analytic evaluations of this data have found CBT to be effective in ameliorating positive symptoms (Rector and Beck, 2001) although effect sizes of CBT have been noted to be inconsistent across studies and a recent meta-analysis of six blinded studies (Lynch et al, 2010) found CBT to be ineffective in reducing any symptoms of schizophrenia or in preventing relapse; the fairness of this analysis has been questioned (Kingdon et al, 2010). CBT is reported to be ineffective in targeting negative symptoms and its effects on other treatment domains are not well studied. Although CBT is recommended as a standard of care for persons with schizophrenia (NICE, 2009) the results are thought to give the best outcomes in patients who are willing to comply with treatment. Cognitive remediation A substantive proportion of schizophrenia patients have impaired cognition, particularly in the domains of psychomotor speed, attention, working memory and executive function, verbal learning and social cognition. These deficits are robust and persist during the illness, and serve as rate limiting factors for functional recovery (Tandon et al, 2009). Several cognitive remediation approaches have been developed over the past two decades which involve compensation strategies to organize information, use of environmental aids such as reminders and prompts, and a range of techniques designed to enhance executive function and social cognition (Eack et al, 2010). Earlier reviews and meta-analyses which have been presented and published within the literature findings have suggested that cognitive remediation leads to modest improvements in performance on neuropsychological tests but has limited generalization to functional outcomes (Pilling et al, 2002) One large meta-analysis published by McGurk et al, (2007), however, found that cognitive remediation was associated with significant improvements in cognitive performance and symptoms, as well as psychosocial functioning in schizophrenia. Cognitive remediation has been found to be more effective in studies that provided adjunctive psychiatric rehabilitation in addition to cognitive remediation. Thus, it appears to be the case that the durability of benefits of cognitive remediation are not yet set in stone. Social skills training (SST) Schizophrenia patients manifest deficits in social competence and these contribute to poor outcome. The goal of SST is to improve day-to-day living skills by focusing on components of social competence such as self-care, basic conversation, vocational skills, and recreation. These skills are practiced mostly in group settings using techniques based on operant and social learning theory. Historically, token economy was the first such intervention that sought to improve the social behavior of patients with psychiatric illness. While effective, the results did not generalize beyond the therapeutic setting. A recent meta-analysis of randomized controlled trials of social skills training in schizophrenia showed a large effect size for improvement in skills, a moderate effect size for performance-based social and community skills and for community functioning, and a small effect size for symptoms and relapse (Kurts and Mueser, 2008) Conclusions Thus, in conclusion, and in review of the findings published within the literature, it si clear that the impact of both biological aspects of the disease and psychological impacts are prevalent within the schizophrenic population. In summary, research on psychosocial approaches to treatment of schizophrenia has yielded incremental evidence of efficacy of CBT, SST, family psychoeducation, ACT and supported employment. Relatively few rigorously conducted trials of psychosocial interventions have been reported in the early course of schizophrenia, a phase of the illness when effective interventions may yield long-term outcome benefits . More hypothesis-driven research is needed to examine active ingredients of the therapeutic modalities that work, to identify the synergistic effects of combinations of interventions, and to use the knowledge which we have gained from the biological impact of the disease and the understandings of the neurological circuitry and its implications in schizoph renia to aid the development of new methods of reducing the effects of schizophrenia on the patient population.