Chrysler Electrical Cars Essay Example | Topics and Well Written Essays - 1000 words

Chrysler Electrical Cars - Essay Example It uses a 268 horsepower electric motor and has a gas tank that can hold 10 gallons of gasoline for providing an extended range. The Chrysler town is powered by a 255 horsepower electric motor and a two-cylinder gasoline engine. It has a gas tank that can hold up to nine gallons of gasoline. The fiat 500 E which was launched in Los Angeles Auto show in the year 2012 has an electric battery propulsion control system, High voltage battery plus in charging system, an advanced thermal management system and air bags. It was designed so as to improve the performance of the electric cars and competition to the General Motors Volt and Spark and the Ford Focus electric. Several changes were made including changing the 500 ICE powering unit, fitting a new chassis and suspension for the improvement of the driving dynamics and enhancing the aerodynamics. The aerodynamics of the Fiat 500 E was improved by re-sculpturing the front and the rear fascias. The quarter panels feature concave dimples and the rear fascia includes several round holes. The rear spoiler was tested for over 140 hours in a wind tunnel so as to cut the drag and add five additional miles of the mile per gallon range. The Fiat 500 E features a Smartphone application that is available for both android and apple oper ating systems. The Smartphone application is aimed for managing the charging, tracking energy usage, locating the vehicle and charging stations that are nearby. The Smartphone application also provides real time status of the vehicle and text message notifications, tracks the use of power and the user or driver can plan and send routes to vehicle (Journal of the ATA electric vehicle interest groups Geelong and Melbourne, issue 45 December 2012) The Iconic Italian design of the Fiat is driven by an 83-Kilowatt electric motor and a Lithium-ion battery (24kw) that is mounted to the floor of the car. The electric motor delivers 147

Perioperative pratice Essay Example | Topics and Well Written Essays - 1500 words

Perioperative pratice - Essay Example A brief account of the responsibilities of operating room personnel and their functioning has been outlined. Perioperative care of patient scheduled for surgery includes practices and procedures followed prior to, during, and immediately after the surgery. This begins with a thorough evaluation of the patient’s illness, physical and mental condition, and certain vital statistics. Vaginal wall prolapse occurs due to weakening or damage of supporting structures of the pelvic organs. Prolapse of anterior wall, also known as cystocele, occurs when the bladder protrudes into the centre of anterior wall of the vagina causing stress incontinence, urinary frequency, difficult urination, vaginal bulge, and severe pain. Prolapse of the posterior vaginal wall, known as rectocele, occurs when the rectum and bowel bulge forward (Chamberlain & Browen-Simpson; 2000). Considering the physical impairment of the patient, she has to be given appropriate comfort level throughout the perioperative care period and this can be accomplished through proper communication, and involves accurate hearing, defining, organizing, interpreting, managing exchanges with the patient, the operating room multidisciplinary team, and other hospital practitioners. At the reception, information related to identification criteria, consent, specific needs and problems, fasting status, preoperative tests and situation, personal belongings etc are recorded. After the documentation process, the patient can be transferred to the preoperative room. Specific identification protocol as designed by the hospital needs to be followed, like specific ID cards or wrist bands with identification numbers etc. other identification details can include the patient’s date of birth, room number, bed number, and physician’s name. When asking for patient name, care should be taken to identify patient with similar names with extra identification specifics such as the hospital ID number (Phillips,

Nurses Shortage Definition Aspects and Solutions

Nurses Shortage Definition Aspects and Solutions Health care persists to face a momentous shortage of registered nurses. This is an old crisis and continues to be a threat to nursing career. There are plenty of studies done to find the reasons behind the nursing shortage. Moreover, it is a global problem. Nursing education, nursing retention unsafe work place, complex quality improvement and patient safety, low nurses income and complicated recruitment requirements. All these factors influence nurses shortage worldwide. The aim of this paper is to discuss and analyze global nurses shortage and highlight the causes and solutions with a recommendation to deal with nurses shortage in health care systems. Development of Nurses Shortage Sophen (1954) found that nurses shortage in the United States started 1932-1953 when the number of hospitals changed very little, but the number of beds increased 52% more and this increases nurses shortage due to the coverage need (Sophen, 1954). Thirty three years later, Aiken noted that the legislation and diminishing result on nurses salaries at a time when other professions salaries were increasing, influencing nurses to depart the career. (Aiken, 2007). During the 1990s, the nurses shortage was 11% of full time registered nurses, by 1992, the nurses shortage subsided and nurses supply was positive. In 1997, hospitals started to feel pressure of nurses vacancy rate 13%. But this time shortage has not moved away and stays a topic difficult to solve. (Rebekah, Kathreen 2009). WHO collected data of nurses, population ratios in WHO regions: The Americas, Europe, Eastern Mediterranean, Africa, South East Asia, and Western pacific. The data analysis shows that in Africa and South East Asia, the ratio declines, while the highest ratio was in Europe regions as it is almost ten times more than the lower regions. (WHO, 2006). A study conducted in the United States by Buerhaus and his colleges in 2007 and found that in 2020 the nation will be short of 76,000.00 nurses, as well as, he stated that, this nurses shortage may shut down most of the system and cause care to be rationed. (Buerhaus, 2008). The low supreme number of existing nurses in many countries is mixed by difficulties with their geographic distributions or complexities in recruiting and retaining nurses. This is a characteristic of both developed and developing countries. Definition of the Shortage of Nurses What is shortage of nursing? Shortage of nurses can be defined in two different means. First, professional standards when the number of nurses is not enough to provide high quality of care. However, administrators fail to determine the quantity of nurses needed to provide the high quality of care. (Goldfarbetat, 2008). Second, in economic terms, nurses shortage presents when there are not enough number of nurses to provide the best quality standards and no fund to supply to open additional positions. Thus, definition of nurses shortage is difficult and complex. (Rebekah, Abrahamson, 2009). A diverse definition which is more practical with the reality discovered by Bachnan, defined the nursing shortage is not by nurses number but how the health system functions to facilitate nurses to use their skills effectively. (Buchan, 2008). Nursing Education and Shortage Raising demand of Baccalaureate and graduate prepared nurses conveys nurses shortage. The National Advisory Council on Nursing Education and Practice (NACEP) is proposing at least two-third of the nurses work force hold a baccalaureate or higher degrees in nursing by 2010. (NACEP, 2004). According to American Association of College of Nursing, professional nurses must be prepared at the baccalaureate level to ward convene developing health career requires. (AACN, 2005). Professional development refers to study obligation to continue definite skill levels and career lane. This ensures nurses skills and knowledge are update and applicable. (Lannon, 2007). Each nurse should take responsibility for personal, professional development. This will enhance quality of care and keep up technological and scientific changes that are occurring in health care sitting. However, the health care systems are not assisting nurses for education development and this keeps the nurses far from the essential profession development. (Copper, 2009). According to American Association of Colleges of Nursing (AACN, 2005), over 32,000.00 qualified candidates were rejected to baccalaureate and graduate program due to the lack of experienced faculty in 2004,which means shortage in nursing faculty. (Evans, 2009). The long terms solution is to increase the pool of baccalaureate nurses who can obtain the graduate education needed for various roles like faculty. (Aiken, 2008). On the other hand, nurses will persist seeking higher degree in nursing education, because of the exciting and financially rewarding pulse opportunities for management positions. (Curtin, 2008). As per a study done in the United States by Westphal, concluded that nurses leaders turnover causes nurses shortage in registered nurses at hospitals. So, it is advised to reduce turnover of nurse leaders. (Westphal, 2009). The Impact of Workplace in Nursing Shortage Nursing work is traumatic while other professional alternatives are accessible. However, it is challenging to fight for the choice of profession which is not successful to balance financially for this daily tension. (Kaestner, 2005). Shift work nature causes physical damage to nurses and impact nurses prolong existence in the profession. According to cooper (2003), Registered nurses experiencing the physical, cognitive and emotional challenges of growing older while the profession demands more. In addition, working night and evening shifts influence nurse performance and lifestyle which motivate many nurses to move into outside hospital sitting. (Rebekah Abrahamson 2009). As well as, the new technologies into nursing daily work add a pressure and increase nurses work load and reduce the time nurses have to spend with the patient and affected the ability to detect complications early. (Beurhaus, 2008). Furthermore, nurses felt additional stress due to the idea that if they commit an error, penalizing action might be taken against them. As known that the nurses are responsible for ensuring patient safety without adequate decision making authority or impartial income. (Rebekah Abrhamson, 2009). Quality Question In 1998, the health care quality and safety started to take place, leaders noticed the strong relationship between nursing and patient outcome and realized nurses shortage. Thus, the leaders recognize the need to solve nursing shortage and as are adequate size of nurses or they will see quality suffer and low patients services. (Buerhaus, 2008). As a result, linking quality of care with adequate stuff will move nurses from the cost category in the direction of believing advantage, which will lead to increase wages and progress practice environment (Elgie, 2007) Recruitment and Retention International recruitment require great attention, where an organization in one country recruits nurses from another country. This has been mounting characteristic of global nursing labor markets, as developed countries utilize factors to attract nurses in developing countries. (WHO, 2006). These factors comprise low income, poor career configuration; reduce chance for further, education in some countries threat of violence. The risk is that action might just dislodge the shortage to another country, which may have fewer resources to solve it. (Aike of Buchan 2008). Nurses are attracted to work and remain working because of the chances to expand professionally to gains self sufficiency, and share in decision making while being reasonably rewarded. (Buchan, 2000). Aspects linked to work environment are critical, as well as some evidence that a decentralized style of management, flexible employment opportunities, and access to ongoing professional development can improve both the retention of nursing stuff level patient care. (Aiken, 2008). UAE and Nursing Shortage 3% of the UAE nationals are nurses. Although this percentage is low to UAE hospitals needs, the UAE population are not motivated to study and work in nursing profession. (Khan, 2006). On the other hand, the cause being far of nursing profession, minimum nursing education institution as compared to other specialty and the concept of cultural values (Underwood, 2010). UAE ministry of health in the process to open new education institutions which will be available in all emirates, as well as, the new council of nursing which started examining nurses skills by licensure examination (Underwood, 2010). Conclusion There is particular or universal measure or description of nursing shortage, although, obvious evidence of insufficient nursing resources in several countries, along with, evidence of poor exploit of obtainable nursing resources in many more. Many countries should augment and support their work force development capacity crossways professions and regulations to recognize the skills responsibility needed to convene identified services requirement. Furthermore, this is partially about extended term alliance between education development, work place environment improvement, quality improved and funded demand. Moreover, improving routine matching of nurses staffing with work load and maintain balance between nurses work and personal life. Health systems need to work on effective skill mix through clearance of roles and better equilibrium of registered nurses, charge nurses, assistance nurses, physicians and health professionals, in order to solve nursing shortage problem.

Pacific Oil Essay -- Business Analysis

The Pacific Oil Company was formed in 1902 and had been the leader in the manufacturing of a petroleum product Vinyl Chloride Monomer (VCM). This product was Pacific Oil's major product line and was the main component to the manufacturing of plastics, used in many products. In 1979, Pacific Oil had landed a major contract with reliant and had over the years establish a great working partnership. The Reliant Corporation was one of Pacific’s largest and most valued customers and Pacific Oil Company wanted to renegotiate their current contract with the Reliant Corporation, with the goal of extending before it expired. Pacific’s negotiation team, Jean Fontaine, Marketing Vice President for Europe with Paul Gaudin, Marketing Manager of VCM along with representatives Frederick Hauptmann, Senior Purchasing Manager and Egon Zinnser, Regional VP for European operation from The Reliant Corporation, where to spend nearly two year working through the extension of the contract. In the end, the contract settlement was down to a final item that Pacific was not happy about, that may my then loose the extension altogether. Facing Hard Times Pacific Oil company was facing some economic changes over the next 10 years and the demand for its VCM was going o face some fierce competition. In the next 20 - 30 months other VCM manufactures will be producing the raw product to compete directly with Pacific Oil Company. The supply of the product over the next decade was expected to grow by over 1000 MM pounds each year, nearly doubling that as each year progressed. This poses a massive threat to Pacific oil as it negotiates its contracts only five years our and is now being pressured by Reliant to only extend their contract by three years. Reliant was... ...ine and Gaudin was going to present. Reliant had done their homework on their demands, potential softness of the market and was preparing themselves adequately to be able to deal with any changes. Pacific was not as prepared at the negotiation table as Reliant, and was eventually backed into a corner on a single item in the renewed control, the option for Reliant to re-sale any VCM product they have left over. The was a major oversight on the final advice from Kelsey in securing a huge customer and giving them time in further analysis the demand and impact that the new manufacturers would cause. Reference Lewicki, R. J., Saunders, D. M., & Barry, B. (2010). Negotiation Readings, Exercises and Cases (6th ed.). New York, NY, US: McGraw-Hill. Lewicki, R. J., Saunders, D. M., & Barry, B. (2011). Essentials of Negotiation (5th ed.). New York, NY, US: McGraw-Hill.

Gaskell North and South Essay

Gaskell’s ‘North and South’, set in Victorian England, is the story of Margaret Hale, a young woman whose life is completely turned on its head when her family moves to northern England. As an outsider from the agricultural south, Margaret is initially shocked by the aggressive northerners of the dirty, smoky industrial town of Milton, but as she adapts to her new home, she defies social conventions with her ready sympathy and defense of the working poor. Her passionate advocacy of the lower classes leads her to repeatedly clash with charismatic mill owner John Thornton over his treatment of his workers. While Margaret denies her growing attraction to him, Thornton agonizes over his foolish passion for her, in spite of their heated disagreements. As tensions mount between them, a violent unionization strike explodes in Milton, leaving everyone to deal with the aftermath in the town and in their personal lives. Gaskell’s novel could certainly be described as a social commentary; England at the time was extremely class-conscious, yet In almost all cases, Margaret does not so much choose sides as acknowledge mutually dependent and beneficial relationships. Though her family has very little in the way of money or assets, her family roots are in the gentry, yet when the family is moved up North to Milton, Margaret befriends and socializes with both ends of the social spectrum, mill owners and workers. Margaret is even capable of initiating a friendship of sorts between worker and owner, Higgins and Thornton even come up with a plan together to provide a canteen for the workers to get hot food. Differences in life in the South and life in the North are compared and contrasted often in a very subtle fashion, as are the differences in values and class structure. It is also very interesting to note that the difficulties of the lives of the impoverished factory workers are highlighted, however the difficulties faced by the factory owners are also presented. Through Margaret, Gaskell is able to transcend social class and at the same time create a hero amongst the industrial poverty of Milton, she acts in a way that would have been unconventional and frowned upon at the time for the good of such people as the Higgins family. When she is seen bringing a basket of food to the house during the workers strike, her peers condemn her at a dinner at the Thornton’s. Highlighting both the differences between northern and southern culture and the clashes between social conscientiousness. It could be said that ‘North and South’ is a novel defined by the resolution of binary conflicts; Margaret Hale is presented with a number of divisions of sympathy, between industrialists and the working class, between conflicting views of Mr.  Thornton, and even between her conflicting views of her own intelligence. Nancy Mann, in her essay â€Å"Intelligence and Self-Awareness in ‘North and South’: a Matter of Sex and Class† stipulates that the novel â€Å"concentrates on a crucial problem of the development of the novel in the nineteenth century, the relationship between abstract intelligence and self-awareness, and the ways in which this relationship may be affected by factors of sex and class†(1). What Mann is saying is that Gaskell is successful in throwing off the conventional boundaries of the classic romantic Victorian with all its feminist connotations and persuasions and has created a character that transcends the constraints of class and what is proper to actually do some good in her new environment. Gaskell’s most prominent social explorations however come in the form of contrasts. For example Margaret’s relationship with the Higgins family, especially Bessie, both nineteen years old when they meet, one healthy and the other gravely ill can be seen as a dramatic comment on class iniquity. Gaskell uses Bessie as a dramatic device in the novel to draw Margaret and her father closer, a task some literary critics consider to be so well done that Bessie is often discounted from the actual story. She is also a device to show the plight of the working class woman, Bessie is even described by one critic as ‘the most extensive portrait of a factory girl in the mainstream industrial novels, and as such, she reveals the political and economic tensions surrounding working class women'(2). Even Margaret says â€Å"Bessie’s comments address the specific problems of working-class women, problems that both unions and the middle class have an interest in ignoring†. Even when Bessie’s religious beliefs and her questioning of unionism are considered she is very revealing, Margaret sees her as having â€Å"a politics of her own† which both reveals her sense of disenfranchisement from the ongoing struggle between ‘masters and men’ and presents the most telling evidence in the novel of the iniquities of the class system. Something else that has to be considered in this scenario with Bessie as a dramatic tool towards Gaskell’s social commentary Elizabeth Gaskell’s ‘North and south’: A National Bildungsroman. † Victorian Newsletter 85 (1994) Briefly traces the emergence of and critical debate on the industrial novel, noting â€Å"the industrial novels have been read largely in relation to male working-class history, not in relation to female working-class history or to the emerging nineteenth-century women’s movement. The critic also goes on to stipulate that the comments on the patriarchal foundations of both Chartism and the union movement makes a case for the need to consider Marxist and feminist issues when considering the issues raised in north and south. He goes on to suggest that â€Å"by placing her heroine, Margaret Hale, between North and South, Gaskell attempts to bring to the surface the unconscious bifurcations that produce class and gender ideologies† and that because the novel is both a Bildungsroman as well as an industrial novel it acquires â€Å"unusual dimensions in both categories†(3). Feminism also plays a big part in Gaskell’s novel, through her three main characters, Margaret, Thornton and Higgins Gaskell shows a struggle for growth and indicates what the future of society may hold for people in similar situations and how society can grow as a whole. When the novel is examined as a debate on class and gender issues, the amount of time the characters spend â€Å"arguing about word choices, definitions and analogies† it is clear that almost all interactions in the novel are affected in some way by gender or class, even in language, â€Å"every term that comes under debate is changed with class or gender import†(4). With this much importance forced upon the character’s class and gender by their social environment a reader is certainly inclined to read the novel as an exploration into the Victorian class system rather than a conventional love story of the time. Even in Margaret’s romantic capacity as a woman, her gradual sexual awareness of John Thornton and their Marriage at the end of the novel is more understandable to read in a more feminist light than a romantic one. In marrying Thornton Margaret enters into a mutually equal relationship, one where her influence and goals will be felt as well as his, â€Å"through Margaret, Gaskell subtly reveals the new directions women are taking toward independent action and freedom†(5). However at the same time recognizing that the changes she undergoes are in no way revolutionary and that though the conflicting ideas of obedience and freedom are not completely settled by the end of the novel, â€Å"at least one woman has emerged into responsible adulthood and has claimed her part in deciding the terms of that settlement†(6). What is most interesting about this novel is that all the elements of a romantic novel are there, but it is written in a way that turns the readers head from the sentimental pride and prejudice Esq. prose and makes them focus on the environment and its social deficiencies â€Å"through this story of social rejection and Christian compassion, Gaskell charges her culture to replace what she sees as a rigid and reductive old testament ethic of charity†(7). This idea of a old to new change in a religious sense is also backed by Gaskell’s own Unitarian background, her father was a Unitarian minister, as was her husband, Margaret’s father in the novel itself is also a minister it could even be suggested that â€Å"Gaskell’s beliefs provided her with an alternative vision of society and code of behavior†(8) the importance of Gaskell’s religious beliefs and Unitarianism can be found in many aspects of the novel, not least that Unitarianism believed in the cultivation of the intellect regardless of sex, she found the religious authority to challenge the patriarchal subjugation of women, especially those who failed to fulfill their designated role in society. It is ironic to think; â€Å"in a period nearly defined by its theological doubt, Gaskell’s spiritual faith authorizes her revolutionary vision†(9). When Mr. Thornton, without further verbal explication, proposes to Margaret in a â€Å"strange and presumptuous way† at the end of the novel, we see the proper structure of an intimate relationship, both sides respect each other’s power while Thornton refuses to impose a political hierarchy. This is emphasized by the exchange over the flowers, which he bought as a token of her independent self, which is a revolutionary idea in itself at this point in history and conversely, gives rise to his second comment referring to marriage as possession, saying he had â€Å"no hope of ever calling her mine†, and the second refutation of such terms. Although the novel does not strive at any point to be romantic at the expense of the real issues that Gaskell tackles in the way people lived at the time, their unspoken resolution to marry signifies the resolution of the novel the binding of two genders, halves of England, social classes, and individuals, into one. In conclusion Gaskell is very successful in going further than any of her peers in actually exploring deficiencies in Victorian culture and society, although the main components of a classic love story are there, Margaret opts for the conscientious, religious option at every turn making the novel more a serious social commentary than anything else. Gaskell’s religious persuasion adds to this in that it allows her to transcend the class system and her constraints as a woman in Victorian England to address these problems under the banner of religion.

Korea Nuclear Weapons And the six party talks

Just recently, North Korean President King Jong Il proudly proclaimed the success of his government’s underground testing of their first-ever nuclear weapon in the barren hinterlands of the his reclusive country. Western countries, led by the United States, quickly condemned the move as an imminent threat to the security of the Korean peninsula and the international political system in general, especially in the light of the withdrawal of North Korea from the six-party talks negotiating the shutdown of North Korea’s nuclear facilities.On the other hand, the nuclear testing was hailed overwhelmingly by anti-imperialist states around the globe, led by Venezuela and Cuba, and anti-imperialist movements comprising mostly of Marxist parties of every sort, such as the Communist Party of the Philippines and the Communist Party of India-Maoist. It was seen as a triumph of the Korean people against the intense political pressure by US imperialism to bring the North Korean govern ment to its knees on all fronts – militarily and economically.Nonetheless, while the North Korean government was euphoric over its success, it earned the ire of the general international community through the United Nations that sweeping economic sanctions were imposed such as strict inspection of cargo shipments entering North Korean territory, notwithstanding the long-standing implied trade embargo by scores of countries around the world. Actually, the Korean peninsula has been the perennial site of unending geopolitical tensions in the East Asian region since the Korean War in the fifties. This paper will examine the nature of the six-party talks and North Korean brinksmanship in the context of North Korea’s acquisition of nuclear weapons.The Six-Party TalksThe Six-Party Talks include the Democratic People’s Republic of Korea (DPRK, North Korea’s official name), South Korea, United States, Russia, Japan, and the People’s Republic of China, whose essential goal has been the peaceful and verifiable denuclearization of the Korean peninsula. The talks were launched primarily due to the refusal of the United States to foster bilateral talks with the DPRK due to the latter’s breach of a 1994 Framework Agreement. Moreover, it contained economic commitments by the member states to the DPRK, in terms aiding its energy requirements for as long as the DPRK abandons its nuclear program, particularly its pursuit of nuclear weapons. On the other hand, the United States and its allies formally assured the DPRK that it shall not result to acts of aggression against the reclusive country and seek alternative ways in resolving the diplomatic issues with the DPRK.According to Dr. Edberto Villegas (personal communication, 2007), a political economist of the University of the Philippines specializing of socialist politics, the Six-Party talks was formed not only to stabilize the threat of the DPRK against the United States and South Kor ea, but to secure the geopolitical interests of the member states as well. Japanese participation in the talks is very important as the DPRK has time and again threatened Japan, due to historic tensions since the Japanese invasion of the Korean peninsula a century ago and continues even up to the present, especially as Japan is now seen as a reliable ally of the United States in enforcing its foreign policies in the region. China is also interested in the talks as it is within its national interest that the Korean peninsula is stable to prevent the undocumented and illegal migration of North Koreans to Chinese territories. (globalsecurity.org, 2007)North Korean BrinksmanshipIn international politics, the DPRK and its leader, Kim Jong Il, has been adjudged the master of nuclear brinksmanship in securing economic and military concessions from world powers, including the United States. As the DPRK knows fully well its geopolitical handicap, it continually breaches international agreeme nts in supposed pursuit and assertion of its national interest and sovereignty, especially when it deliberately withdrew from the Nuclear Non-Proliferation Treaty and insisted on producing nuclear weapons for its defense against perceptions of a conspiracy by the United States forcibly overthrow the Kim Jong Il regime by force.According Villegas (personal communication, 2007), the DPRK fully believes that only by building up its military capability, particularly nuclear power, can the DPRK secure substantial concessions from world powers, consistent with the Maoist maxim of political power emerging from the barrel of a gun. These concessions, however, are not entirely of a military or diplomatic character, but usually in terms of economic aid, as the DPRK continues to battle years of infertile agricultural lands and famine that has led to the deaths and exodus of thousands of North Koreans.As can be seen from the recent nuclear testing in the hinterlands of North Korea, the world, w hile united in its condemnation of the act, has acceded, to a certain extent, to the demands of the North Korean government such as the release of its $25 million frozen assets in Macau and the delivery of more economic aid from developed nations. Nonetheless, it can be surmised that the actuations of the DPRK and the flaunting of its military might are not exactly aimed at threatening the world, especially South Korea, Japan and the United States, but only to secure adequate leverage for political and economic agreements which would not have been possible if the DPRK acted otherwise. More so, the DPRK are not that ignorant of the military history of the world to foolishly start military aggressions against perceived enemy states, knowing fully well the superior military power of the United States and its allies. (personal communication, 2007)However, in order to fully understand the North Korean nuclear question, the DPRK strategy of Songun politics must be examined. According to H an of the Unification Institute in New York, the DPRK views the relationship of the DPRK and the United States not as co-equal states in international law but as opposing and antagonistic entities representing the conflict between imperialism and socialism, in which peaceful coexistence is never possible.King Jong Il believes that all of these are part of the efforts of the DPRK to foist an ideological confrontation against the United States and secure the socialist gains in the Korean peninsula (Han, 2003) More so, the Songun politics of the DPRK involves the building of a strong revolutionary army to save the North Korean socialist system from collapse, over and above the necessity of putting adequate food on the tables of the Korean people. Such an utterly militarist mindset is a big departure from the classical Marxist theory of empowering the working class and the withering away of the state, leading foreign policy experts to believe that King Jong Il’s brinksmanship is merely to ensure the survival of his family’s hold on the entire North Korean political system. (globalsecurity.org) Nonetheless, the military outcome of policies like these has been very effective in forcing the international community to stand at attention and listen to the demands, even blackmail, of the DPRK.Conclusion: The World and the Way ForwardThe Korean nuclear question has given the United States and the international community a terrible political headache which all must continually confront until the threat of the DPRK has been conclusively neutralized.   While it is true that independent nations such as the DPRK must assert its national sovereignty at all times against external threats, particularly imperialist countries, the manner by which the reclusive regime of King Jong Il has been conducting the defense of its homeland and revolution borders on a subjective revolutionary hysteria which the rulers of the DPRK are exploiting to the prejudice of the welfare of its people.There are many other ways to confront modern imperialism which are no less revolutionary, such as the strides achieved by the Venezuelan and Cuban governments in their experiment with socialism without adversely affecting the lives of their people. As such, it is clearly the responsibility of the international community to diplomatically convince the DPRK to gradually embrace the denuclearization of the Korean peninsula and cease using military blackmail as a ruse to secure concessions from world powers. An outright denuclearization policy as suggested by the United States and Japan might be totally unrealistic at present, and might even provoke the DPRK further. The path to a lasting peace in the Korean peninsula is an arduous one which can only be confronted if the world itself is prepared to build confidence with the DPRK that aggression against the communist country is none of the options considered to resolve the long-standing diplomatic dispute on nuclear weapon s.Works Cited:Han, Ho-sok. Songun Politics of North Korea & the Situation on the Korean   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Peninsula. Songun Politics Study Group. Sept. 8, 2003. Retrieved from   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   http://www.geocities.com/songunpoliticsstudygroup/Songuninterview.htm  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   l on April 17, 2007. Six-Party Talks. GlobalSecurity.Org. Retrieved from   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   http://www.globalsecurity.org/wmd/world/dprk/6-party.htm on April 16, 2007. Villegas, Edberto. Email Interview. April 14, 2007.

18 ACT Tips and Tricks to Improve Your Score

18 ACT Tips and Tricks to Improve Your Score SAT / ACT Prep Online Guides and Tips Looking for some quick fixes to improve your ACT scores? Look no further. In this article, we give you severaltips and tricks for the ACT so that you can get your best possible scores on every section. First, I'll go through specific tips for each of the five sections (English, Math, Reading, Science, and Writing). Then, I'll provide you with overall tips you can use throughout the test.Note that these are all last-minute test-taking advice tidbits rather than in-depth study hacks. Therefore,it's best to view them as light icing on top of a delicious cake representing the ACT expertise you've developed over a longer period of time. ACT English Tips The first section you'll take on the ACT is the English section, which focuses on your knowledge of grammar as well as your editing skills. #1: Choose the Most Concise Answer ACT English questions look for answers that result in the most straightforward, logical sentence structure, so try to find the choice that provides all of the necessary information for the sentence to make grammatical sense- and nothing extra. The best writing says what it needs to say clearly and concisely! #2: Read the Paragraph First A good plan of attack for ACT English is to read the whole paragraph that has the sentence you must revise before you look at the answer choices.This will give you context for your choices and a better grasp on the structure of the sentence and how you might need to change it.With this strategy, you can reduce the number of errors you make caused by careless misreadings. #3: Be Careful With "No Change" Answers On ACT English questions that ask you to choose the answer that makes a sentence grammatically correct, you'll have the option to pick "No Change." This is a dangerous choice because if you aren’t aware of more obscure grammar rules, you might be tempted to choose it on some questions for which the sentence actually can be improved. Thus, it’s really important to double-check all other answers before settling on "No Change" as the correct choice. That said, keep in mind that "No Change" really is the correct answer around25-30% of the time it's an option, so don't second-guess yourself if you're relatively certain there isn't an error. Read the sentence through with each of the possible suggested changes before you bubble in â€Å"No Change† to ensure that you’re ultimately making the right call. ACT Math Tips Up next is the ACT Math section. Here, we give you two key tips you'll need to know in order to get a high Math score on test day. #4: Pay Attention to Diagrams The ACT Math section will often provide you with diagrams of figures that describe the problem you’re trying to answer.It’s important to pay attention to these figures, asthey will give you clues about which answer choices are the most logical. If a problem asks you to figure out an angle, for example, and some of the choices are acute while others are obtuse, you’ll be able to eliminate at least a couple of these answers just by looking at the diagram.If it doesn’t seem like an answer is possible based on the visual aid alone, it’s usually safe to cross it out. #5: Plug In Answers and Numbers Two of the most important strategies to help you confirm you've got the correct answer on a math problem are to plug in answersand plug in numbers. Here's how to plug in answers: if a question asks you to solve for x,simplyplug each answer choice back into the original equation and see which one works. This will tell you which answer choice is the correct one. You don’t even need to really solve the problem! Plugging in numbers is a little different. With this strategy, you'll choose random numbers to plug into algebraic variables. This strategy lets you analyze the problem using real numbers instead of unknowns, and works best for questions with multiple variables. While helpful, these strategies can sometimes be more time consuming than just solving the equation directly, so only use them as a last resort if you're stumped. All you gotta do is find the right answer cord. ACT Reading Tips With ACT Reading- the third section on the test- you'll need to know how to read and interpret passages both quickly and accurately. #6: Start With Your Strengths The ACT Reading section is always structured the same way with four topic areas in the same order. Each topic corresponds to a passage or pair of passages.These topics are as follows: Prose fiction/literary narrative Social science Humanities Natural science To make sure you’re getting the most out of this section, start by reading the passage(s) that correspond to the topic area in which you are most comfortable.This might simply mean starting with subject matter that is most interesting to you and will thus make for a quicker read. This way, you can get the questions that are easiest for you out of the way first and won’t risk running out of time before you have a chance to answer others. #7: Skim Passages There’s a lot of time pressure on the ACT Reading section, so try to read the passages as efficiently as possible.For some students, it might be manageable to read passages normally and still have enough time to finish the section, but you have to be a really quick and thorough reader in order to pull this off. The best strategy for most people is to skim the passages instead.In order to skim effectively,read the introduction and conclusion paragraphs as well as the first and last sentences of every body paragraph.This will give you a good overview of the main ideas and allow you to answer most main point questions.When you get to questions about details, you can then reread specific parts of the passage if necessary. ACT Science Tips For the Science section, you'll need to know how to interpret data and must answer questions dealing with graphs, tables, and scientific experiments. Here are our two best tips. #8: Do the Conflicting Viewpoints Section Last Theconflicting viewpoints section on ACT Science is usually the most time consuming for students. In case you’re not familiar with it, this part of the section asks you to read two or three passages that detail different viewpoints on a scientific issue.You'll then answer questions about these viewpoints and how they relate to one another. Since this is more reading-intensive and can eat up a lot of time, it’s best to save this part for last so that you don’t end up missing other questions later on in the section that will be quicker and easier for you to answer. #9: Rely On Visuals The ACT Science section hits you with a lot of complicated terminology and unfamiliar facts that make it seem overwhelming.The best policy when faced with all of this information is to ignore it and go straight for the graphs, which should provide enough information for you to answer the majority of the questions you’re faced with. Most of the information you’re given is just extra stuff thrown in there to make this section seem more difficult than it really is. In reality,ACT Science is more about logical reasoning and data interpretation than it is about actually knowing any science. As long as you can read the graphs, you'll be fine! If you can't read this graph, drink more coffee. ACT Essay Tips The ACT Writing section, or Essay, is an optional section and the last one you'll take (if you signed up to take it). Below, we give you two expert tips to help you get the Essay score you deserve. #10: Pres Since ACT Essay prompts are relatively predictable, you can do some of your own essay planning before the test to save yourself time and stress.Choose concrete examples from art, history, literature, and/or personal experience; try not to use hypothetical or vague examples to support your points. Keep in mind that all of the facts you use in your essay don’t necessarily have to be true. Graders don’t have time to fact-check, so they'll take everything you write at face value. This means you can make up statistics or historical facts to support your thesis, and you won't be penalized! #: Write a Great Intro and Conclusion It’s likely that the essay graders will read your introduction and conclusion more closely than they will the rest of your essay. If they can find your thesis easily, you're already on the right track to earning a great Essay score.As long as you have body paragraphs that make sense and support the points outlined in your thesis, graders will likely give you at least a 4 in the Organization and Ideas and Analysis domains. You'll also need to write a conclusion paragraph thatrestates your thesis andshows a strong understanding of how all your points relate to one another. If you can demonstrate basic knowledge of how to logically structure an essay and stay on topic, you'll be good to go. Overall ACT Tips Now, let's wrap up with some general ACT tips to help you feel more confident for test day. #12: Skip Hard Questions On the ACT, time pressure is a very real problem for many students. To avoid losing points, you need to learn to skip questions that are giving you trouble before they eat up too much of your time.â€Å"Too much of your time† means something different for each section: English: more than 30 seconds per question Math: more than 60 seconds per question Reading: more than 45 seconds per question Science: more than 45 seconds per question As a rule of thumb, if you feel like you’re not any closer to figuring out a question after about 30 seconds, move on.Circle that question so that it’s easier to spot later on when you want to go back to it. Then, make a quick pass through the whole section and answer all of the easy questions first so you don’t miss points by running out of time before you're able to get through everything. #13: Use the Process of Elimination For every section of the ACT, use the process of elimination as your main strategy for attacking tough or confusing questions.This ties into the fundamental rule of ACT reading, which says that for every question there is only one completely correct answer- the rest can be eliminated based on evidence in the passage. The process of elimination is more foolproof than trying to pick out the correct answer from the pack. Look for reasons to get rid of choices rather than reasons why they might work. This will help you be more picky about which answer you bubble in, and will also prevent you from thinking that more than one answer might be correct.If there’s even one tiny thing out of place in an answer choice, get rid of it! #14: Bubble at the End You can save time on the ACT bywaiting until the end of a section to bubble in your answers. This cuts down on your time per question by letting you avoid the process of going back and forth between your test booklet and answer sheet.It’s more efficient to circle the answers you choose in your test booklet and then fill them in all at once later. Before using this tip, though,make sure you can reliably finish the section with at least three to five minutes to spare!Don't risk running into a situation in which you don’t have enough time to bubble in your answers even though you’ve gone through all of the questions. Just as you are legally obligated to pop all of the bubbles in a sheet of bubble wrap, so too must you fill in all bubbles on the ACT. #15: Answer Every Question Since there isno penalty for guessingon the ACT, make sure youfill ineverybubble!An incorrect answer and an unanswered question both have the same impact on your raw score, so even if you have no idea how to answer something, it's best to go ahead and guess anyway. #16: Get a Good Night's Sleep the Day Before the Test It might sound cheesy, but you'll feel a lot more prepared (and awake) on test day if you get a solid amount of shuteye the night before the test. How many hours you need to feel well rested varies depending on the person, but generally it's good to aim for at least eight hours of sleep. Heading into test day feeling sleepy and exhausted can dramatically affect your ability to focus and potentially lower your score. So get to bed early! #17: Eat a Hearty Breakfast In addition to the tip above, it's equally important to eat a healthy, satisfying breakfast before you take the ACT. This way you'll feel more awake and energized before taking the test. What's more, you won't have to worry about a growling stomach later on! #18: Stay Calm The most important thing to remember during the ACT is to keep a cool head.Especially given the time pressure, students who suffer from test anxiety often freak out if they have to skip a few questions.Don’t let this happen to you! Keep moving forward and answer what you can.You might find questions that initially seemed impossible are much easier when you come back to them. The nice thing about the ACT is that once you get through a section, you’re completely done with that subject. So you won’t have to worry about it until the next time you take the test (if that time even comes!). Review: 18 Tips for Improving Your ACT Score You can quickly improve your section scores on the ACT if you remember to use these 18 tips before and during the test. Let's recap: ACT English Tips Choose the Most Concise Answer Read the Whole Paragraph First Be Careful With "No Change" Answers ACT Math Tips Pay Attention to Diagrams Plug In Answers and Numbers ACT Reading Tips Start With Your Strengths Skim Passages ACT Science Tips Do the Conflicting Viewpoints Section Last Rely On Visuals ACT Essay Tips Pres Write a Great Intro and Conclusion Overall ACT Tips Skip Hard Questions Use the Process of Elimination Bubble at the End Answer Every Question Get a Good Night's Sleep the Day Before the Test Eat a Hearty Breakfast Stay Calm Remember, these are quick fixes that aren’t substitutes for studying content and gaining a deeper understanding of your mistakes.You should read some of our other articles, like this one on how to get a 36 on the ACT, to supplement your use of these tips and tricks! What's Next? If you're looking to do some more hardcore studying, take a look at this list of the top 10 books you should be using for ACT prepand this list of the best websites for ACT prep. Are you taking the ACT soon and need some advice on last-minute strategies you can use? Here are the bestguides to read for last-minute ACT prep. Haven't scheduled your test date yet? Find out the best ACT date for you! Want to improve your ACT score by 4 points? Check out our best-in-class online ACT prep classes. We guarantee your money back if you don't improve your ACT score by 4 points or more. Our classes are entirely online, and they're taught by ACT experts. If you liked this article, you'll love our classes. Along with expert-led classes, you'll get personalized homework with thousands of practice problems organized by individual skills so you learn most effectively. We'll also give you a step-by-step, custom program to follow so you'll never be confused about what to study next. Try it risk-free today:

University of New Haven Admissions and SAT Scores

University of New Haven Admissions and SAT Scores If youre interested in applying to the University of New Haven, the good news is that they admit the majority of applicants. Learn more about their admission requirements. About the University of New Haven The University of New Haven is a private university located on an 82-acre campus in West Haven, Connecticut. New Haven and Long Island Sound beaches are just minutes away. Undergraduates at the university can choose from nearly 100 degree programs, and the school has notable strengths in criminal justice, fire science, and forensics. The university emphasizes hands-on experiential learning. Academics are supported by a 16 to 1 student/faculty ratio. Student life is active with over 100 student clubs and organizations and 70 percent of undergraduates living on campus or in university housing. In athletics, the UNH Chargers compete in the NCAA Division II Northeast-10 Conference. The university fields eight mens and nine womens intercollegiate sports. Will you get in? Calculate your chances of getting in with this free tool from Cappex. Admissions Data (2016) University of New Haven Acceptance Rate: 81Â  percentGPA, SAT and ACT Graph for UNH AdmissionsTest Scores: 25th / 75th PercentileSAT Critical Reading: 470 / 570SAT Math: 460 / 570SAT Writing: - / -What these SAT numbers meanCompare SAT scores for Connecticut collegesACT Composite: 20Â  / 26ACT English: 19 / 25ACT Math: 18Â  / 26What these ACT numbers meanCompare ACT scores for Connecticut colleges Enrollment (2016) Total Enrollment: 6,835Â  (4,936 undergraduates)Gender Breakdown: 50 percent Male / 50 percent Female92 percent Full-time Costs (2016-17) Tuition and Fees: $37,060Books: $1,000 (why so much?)Room and Board: $15,130Other Expenses: $1,660Total Cost: $54,850 University of New Haven Financial Aid (2015-16) Percentage of New Students Receiving Aid: 96Â  percentPercentage of New Students Receiving Types of AidGrants: 96 percentLoans: 78 percentAverage Amount of AidGrants: $20,569Loans: $11,245 Academic Programs Most Popular Majors: Biology, Business Administration, Criminal Justice, Fire Science, Forensic Science, MusicWhat major is right for you? Sign up to take the free My Careers and Majors Quiz at Cappex. Transfer, Graduation and Retention Rates First Year Student Retention (full-time students) 80Â  percent4-Year Graduation Rate: 45 percent6-Year Graduation Rate: 56Â  percent Intercollegiate Athletic Programs Mens Sports: Soccer, Football, Basketball, Baseball, Cross Country, Track and FieldWomens Sports: Lacrosse, Tennis, Volleyball, Softball, Basketball, Track and Field, Soccer, Cross Country If You Like the University of New Haven, You May Also Like These Schools University of Bridgeport: ProfileYale University: Profile | GPA-SAT-ACT GraphAlbertus Magnus College: ProfileSouthern Connecticut State University: ProfileQuinnipiac University: Profile | GPA-SAT-ACT GraphBrown University: Profile | GPA-SAT-ACT GraphBoston College: Profile | GPA-SAT-ACT GraphUniversity of Rhode Island: Profile | GPA-SAT-ACT GraphHofstra University: Profile | GPA-SAT-ACT GraphUniversity of Hartford: Profile | GPA-SAT-ACT GraphDrexel University: Profile | GPA-SAT-ACT GraphSacred Heart University: Profile | GPA-SAT-ACT Graph University of New Haven Mission Statement mission statement from https://www.newhaven.edu/about/ The University of New Haven is a student-centered comprehensive university with an emphasis on excellence in liberal arts and professional education. Our mission is to prepare our students to lead purposeful and fulfilling lives in a global society by providing the highest-quality education through experiential, collaborative and discovery-based learning. Data Source: National Center for Educational Statistics

Big Brother

â€Å"Oh you’re Johnny’s little brother? You must be sick bro.† Not quite. He played like he was born with a stick in his hand. And he went through school like he already knew the answers. Having dyslexia, school has never been easy for me. But for him, he aced tests with no problem, could read a book in just a few days, and solved math problems like his brain was a calculator. â€Å"Oh you’re Johnny’s little brother? You must be so smart.† Not quite. Every teacher I had after him had huge expectations for me that i wasn’t able to meet. As I got older, I fell further and further behind my big brother in all of these places, and it was making me miserable. Then everything changed. Four years ago on Christmas morning I opened up that beautiful ukulele and start playing immediately. Of course, I wasn’t as good as my big brother was, but I was drawn to it like Winnie the Pooh and the last jar of honey. Months later, as my brother gained interest in other things, my passion took over. I realized that just because my big brother didn’t do something, doesn’t mean that I shouldn’t either. From that point on, I was obsessed with my own hobbies. I started yo-yoing, playing guitar, and tie-dying everything I could find. This realization also helped me with school, sports, and being happy in general. Instead of trying to get grades as good as my big brother, I worked the hardest I could, for me. And in lacrosse, I started having fun again. Instead of always comparing myself after a game, I would just enjoy my time playing with my friends. Now people say, â€Å"Oh you’re Johnny’s little brother? I’ve heard so much about you! What he taught me changed my life. My big brother didn’t inspire me to be the best, he inspired me to be different. To be my own person. To be me.

Political Science - Is there a 'Clash of civilization' or a 'Clash of Essay

Political Science - Is there a 'Clash of civilization' or a 'Clash of fundamentalism' in contemporary International Relations - Essay Example While each conflict may have a unique cause, and very specific and exclusive factors that lead to the build-up and escalation, thinkers and scholars have spent considerable time and efforts in exploring and establishing any common underlying factors that may be leading to the present day conflicts. A well known proposition about the causes of conflict and clash in the current international relations is that different civilizations cannot co-exists and hence conflict is inevitable. ‘The clash of civilization’ theory was proposed by Huntington, (1993) and attributes the basic cause of all international conflict to the assumption that different civilizations are unable to interact with each other in a peaceful manner as inherently their culture, religion, values and beliefs may be contradictory. This theory had postulates that clashes between civilizations would continue to rise after the end of the Cold War. An other proposition explains the conflicts as a result of fundamentalist thinking in political and international relations. The cause of conflict therefore is not the inherent nature of the different civilizations, but the adoption of a fundamentalist outlook in dealing with other countries and people. The paper will first elaborate on the meanings of the two clashes by highlighting the works of other researchers who have contributed in the development of the concepts. Secondly, a literature survey will be conducted to gather material in support or against of The Clash of Civilization Theory, as proposed by Huntington, rests on the premise that there are basically several different kinds if civilizations, namely, the Western Civilization, The Islamic Civilization, The Sinic Civilization, The African Civilization, and The Latin American Civilization. Conflicts may arise within the nation’s boundaries where there is a

Illustration Essay Example | Topics and Well Written Essays - 1000 words

Illustration - Essay Example It is in this role, that graphic designing has gained importance. What once began as the artist's job with hand painting, went over to screen printing and has today reached the desktops of millions of visualizers. Amongst the various elements of graphic design, the art of illustration is interesting and rather challenging. Thus while words need to be read, illustrations can capture a million words in a single expression. This is because they capture and combine photography and art in an appealing and attractive manner. As we pointed out before, illustrations have been with us since the advent of mankind where they took the shape of cave paintings. Woodcut illustrations became popular in the 15th century, followed by lithography in the 18th century. In the early 19th century, journals became popular for mass circulation and illustration gained new meaning. Soon wood engraving was preferred over steel engraving to incorporate illustrations in the pages. However what was a mere painter's mindscape, evolved to touch more people with the advent of advertising. During the 20th century, many graphic designers were also illustrators of high repute and the art was viewed with great reverence, some considering it greater than graphic design. Many illustrators would even sign their work and many enjoyed great fame. Gustavo Dore was a renowned figure in those times. Today the modern illustrator has with him various new software to assist the design process. Most training institutes also encourage that the ill ustrator uses both traditional and modern techniques to recreate the image in his mind on paper. Today there are many associations that bring together illustrators. These include the Association of Illustrators (AOI), Society of Illustrators and Society of Children's book writers and illustrators. Various awards are also handed out every year to support the efforts of these artists. New media Today illustrations benefit from a range of media. From print media like newspapers, greeting cards, books and magazines where these were commonly used, today the scope is much wider. Technologies allow for these to be used in movies, television shows and video games. With the advent of computers and the Internet, illustrations are also highly popular on web sites. Finally advertising has allowed for illustrations to be used on all its media spanning billboards, print advertising, television advertising and the Internet. Great works of great minds Illustration has been a popular form of art and communication with many great works being produced by great names like Andy Warhol, Roy Lichtenstein, Santiago Martinez Delgado etc. However in the current day scenario, works of two reputed illustrators are illustrated here. 28 year old Vladimir Dubko is one great name to reckon with in this scenario. At a time when many find the world of illustration distressing in the least, he created a niche for himself in fashion illustration, doing what every illustrator could only dream of in Italy. He experimented with diverse disciplines, obtained a grant at Fabrica (Benetton research center for communication) and worked with various young artists from across the world. While most of his work is

Follow the details Essay Example | Topics and Well Written Essays - 500 words

Follow the details - Essay Example Like many photographs, this one is one in which my entire family is gathered about the time when I was celebrating my 10th birthday. One of the reasons that the photograph bears so much importance to me is that it has both sets of my grandparents as well as my mother and father in it. Only a few years after the photo was taken, three of my four grandparents had passed away. In this way, the photo itself is a way to remember the happiest memories of my childhood. The second object is one that I have brought with me in my travels abroad; a leather bound copy of the Holy Koran. The book belonged to my father and my grandfather before him. It was always something that was unique and holy within our household and I remember being fascinated by it since I was very young. This fascination was due in part to the fact that it was physically different than all other books that we had in our house. The leather engraving on the cover and on the back was exquisite and the Arabic calligraphy that covered it had always sparked my imagination. In this way, when my father learned that I would be going overseas to study, he entrusted me with this family treasure. This was done not as a way to keep me safe or as a good luck charm but to remind me of my culture and of the importance of my upbringing even though I would be far away in the land of different customs and interpretations of right and wrong. This type of moral compass and guiding principle of my fai th and of my ethnicity was and is something that I keep close to my heart and treasure to this very day. The final article that this brief essay will discuss is that of my high school graduation diploma. Although having a high school graduation diploma in and of itself signifies little within the current era, it is not the receipt of the diploma itself that is of the most importance. Rather, it is the strong memories that are associated with it, the friendships I made, the times I spent, and the

Marks & Spencer Essay Example | Topics and Well Written Essays - 3000 words

Marks & Spencer - Essay Example The company's preferred method of returning cash is by using the B shares scheme. Since it does not want to use the traditional share repurchase, it has created a conversion of shares – for every 21 current ordinary shares, investors will receive 17 new ordinary shares along with 1 B share for every current ordinary share (Marks & Spencer Plc 20020). The purpose of the conversion is to decrease the company's shareholding without using the traditional repurchase approach, while the use of B shares intends to give back the cash by redeeming it under two choices (Vandermewe 2003).  This B share scheme has offered both the company and the investors with regard to payout policy. The scheme addresses both the concerns of investors when cash is distributed by using the traditional shares repurchase, as well as their concerns when funds are distributed by increasing the amount dividend payout – that is, the high amount of income taxes that investors incur when they receive di vidends (Hakanson 1982). From the point of view of the company, it also uses this scheme in order to leverage certain payout policy theories.  For one, the B share scheme addresses the issues of payout policy such as information asymmetry, residual theory, and expectations theory (Keown 2002). When the company has decided to return the  £2 billion to its shareholders, it aims to reorganize its capital structure in line with the strategic changes that aims to implement (Marks & Spencer 2002). However, if the company chooses to repurchase its stock, investors will be skeptical about the company's moves and would have a more risky perception of the company, thus affecting the company's price/earnings ratio and the value of the stock (Brealey & Myers 2003). As with residual theory, the level of the cash that should be given back to the investors should be its residual earnings, after additional profitable investments have been made (Keown 2002).

Weekly essay Example | Topics and Well Written Essays - 250 words - 2

Weekly - Essay Example As such, Roosevelt suspects culpability in the tradition of monetary culture whereby he holds prominent figures of trade as the ones responsible for the country’s failure to redress the unfavorable situations of American living in general. He specifically locates emphasis on the stubbornness, incompetence, and unscrupulous practice of the financial institutions at the time which brought about taxation imposed heavily, drastic lowering of income, unemployment, frozen means of exchange, industrial and agricultural conflicts, as well as ruined credits across the nation. Based on the overall thought and sentiment of the president’s speech, there occurs intent to summon forth concern and interest to realize how appalling the crises were which U.S. had been confronted by in the process of coping with major traumatic encounters. Roosevelt seems to encourage the citizens at depth to take a serious part in not just being critical toward such issues but for Americans to understand the purpose of inauguration remarks in the light that would engage them with the truth and deeds to sustain the goodness developed around this truth despite time and revolutionary changes in economy and

Exclusion clause Essay Example | Topics and Well Written Essays - 1500 words

Exclusion clause - Essay Example Exclusion clauses are guided by statutory provision and case law (Barker, 2007). In English Law, Simon (1981) noted the Unfair Contract Terms Act 1977 (UCTA) seeks to regulate exclusion clauses in contracts by limiting their applicability to cases where they are absolutely necessary. The Act regulates all contracts (Beale, 2012). One of the statute’s primary roles is to restrict the legality of disclaimers of liability to reasonableness, depending on the kind of the duty which is claimed to be exempted and whether the offerer who intended to benefit from such clauses harmed the consumer’s interests (Brawn, 2012). The UCTA is usually applied in combination with the Sale of Goods Act 1979, the Supply of Goods and Services Act 1982 and the Unfair Terms in Consumer Contracts Regulations 1999. Firstly, under the UCTA, a party cannot excuse himself or herself from negligence under section 2(1) of UCTA 1977 when the breach of duty results in death or personal injury (Hughes-Jennett and Anslow, 2009). Secondly, under section 5(a), a company cannot exempt itself from liability caused by faulty goods or distributor negligence, particularly where commodities are meant for consumption (Stone, 2013). The doctrine that cushions the consumer is referred to as manufacturer liability. Thirdly, in light of the need to protect the consumer, sections 12-15 of the Sale of Goods Act 1979 outlaw the exclusion of implied terms or terms which provide details of value or sample of goods (Walsh, 2009). In addition, the Consumer Protection Act 1987, and the Occupiers Liability Act 1984 are also vital pieces of legislation whose enactment contributes to the regulation of exclusion clauses (Page, 1994). Despite the enactment of these rafts of legislation to regulate a relatively small area of law, the fundamental reason behind them is to protect unsuspecting consumers from death, personal injury or material losses

Weekly essay Example | Topics and Well Written Essays - 250 words - 2

Weekly - Essay Example As such, Roosevelt suspects culpability in the tradition of monetary culture whereby he holds prominent figures of trade as the ones responsible for the country’s failure to redress the unfavorable situations of American living in general. He specifically locates emphasis on the stubbornness, incompetence, and unscrupulous practice of the financial institutions at the time which brought about taxation imposed heavily, drastic lowering of income, unemployment, frozen means of exchange, industrial and agricultural conflicts, as well as ruined credits across the nation. Based on the overall thought and sentiment of the president’s speech, there occurs intent to summon forth concern and interest to realize how appalling the crises were which U.S. had been confronted by in the process of coping with major traumatic encounters. Roosevelt seems to encourage the citizens at depth to take a serious part in not just being critical toward such issues but for Americans to understand the purpose of inauguration remarks in the light that would engage them with the truth and deeds to sustain the goodness developed around this truth despite time and revolutionary changes in economy and

Siemens Bribery Scandal Essay Example for Free

Siemens Bribery Scandal Essay Automobiles are now an indispensable way for citizens to go out for working and shopping. Cars have shaped the development of motorization, which leads to the increase in private car use. As a result of automobiles’ growing popularity, a network of roads is built to satisfy the need for car travelers. Therefore motorization finally stimulates urban sprawl, which is the spread of cities into impoverished and rural areas on the periphery of cities. Urban sprawl obviously has led to some serious social and environmental problems such as inequality in society and climate change. Several organizations support to develop advanced technology in order to restrict urban sprawl and decrease greenhouse gas emissions while some experts disapprove of this opinion. This essay will argue that technological solutions just reduce social and ecological pressure to delay the consequence. The reasons why it is impossible that technology can absolutely cope with these problems also will be explained in the essay. In terms of surroundings, at present technology is not perfect enough to protect the natural environment and to deal with the greenhouse effect throughout the world. According to Gonzalez (2005), urban sprawl promotes automobile industry and gasoline manufacturers, which eventually increase carbon emissions. The extensive use of private cars causes rising greenhouse gases, which create global warming. In addition, negative ecological influences can directly cause public health problems such as asthma and lung diseases (Freund and Martin, 2005). Although technology can partially reduce certain environmental strain, it may also create some additional problems (Gonzalez, 2005). For an instance, nuclear energy can indeed reduce carbon emission though the waste in a nuclear power plant can also pollute the environment. Moreover, Gonzalez (2005) stresses that scientists at present do not develop any technology to completely cope with climate change. It may take a long time and considerable resource to find an effective technological method. Thus, there is no efficient technology to deal with ecological problems like global warming. With respect to problems in society, technology cannot prohibit main reliance on automobiles. Motorized urban expansion brings severe social problems, such as food supply threats from loss of farmland, transport injustice and health problem. Urban sprawl increases reliance on automobile transport, which means more car owners, more frequent and longer trips and, therefore, more greenhouse gas emissions. Except harmful gas exhaustion from vehicles and annoying noise, dominance of private cars still does harm to citizens’ health, because the drivers exercise less and become fat. The crowded traffic degrades the shared space and makes squares and parks useless (Martin, 2007). It may be true that clean and energy-efficient automobile can be manufactured in science and technology. However, such technologies cannot stop the growth of travel distance (Martin, 2007). Furthermore, Martin (2005) claims that there is no or few technology available for problems of land consumption and the degradation of public space. Therefore, technological solution cannot categorically handle some serious problems such as the deterioration of public space and loss of farmland. Technological methods are expected to work out problems in society and environment. However, social and ecological injustice cannot be addressed by technology. People in poverty who are unable to afford personal cars have to live in the fringes of the city which has inadequate public transportation and infrastructures just like supermarkets and hospitals (Martin, 2007). In general, the edge of the city is industrialized, where factories emit harmful gases and let out waste into nearby rivers. Thus, the poor’s health problem is more serious than the citizens in the inner city. With different circles of people supplied with separately various resources, the imbalance between classes results in societal polarization, fragmentation and segregation (Martin 2007). As a result of inequality, people who want to have a better life migrate from rural area to urban area because of well-paid jobs in the city. More facilities and houses need to be constructed so as to fulfill the demand of increasing people in the centre of city. Construction of homes and commercial buildings in urban peripheries also consumes a lot of energy. Therefore uncontrolled urbanization leads to land consumption and loss of farmland, which decline the food production. In some way, technology can manufacture economical and fuel-efficient automobiles with shoddy materials so that the poor can afford this kind of car, whereas, it cannot cope with the gap between the rich and the poor. In addition, technological methods cannot intervene in collective civilization such as culture and social cohesion. Thus, social and ecological inequality cannot be intervened by technology in any way. To sum up, this essay has analyzed how motorized urban sprawl leads to social and environmental problems. The essay also explained that technological solutions are incapable of solving the ecological and social problems originating from urban sprawl due to the lack of core technology. Even if the competent technology appeared, it would be too late to solve these problems. The technology cannot stop people from relying on cars to go out. Public health problems are also one of the main consequences of increasing car use and industrialized countryside. Technology solutions ignore the underlying causes of global warming- urban sprawl. It is necessary to limit the expansion of cities and to efficiently use the limited area. Otherwise, environmental degradation could not be reversed at all. Governments should pay more attention to urban sprawl even give up some financial and political policy. No. of word: 890 References: Freund, P., Martin, G., â€Å"Fast Cars/Fast Foods: Hyper consumption and its Health and Environmental Consequences†, Frontiers of Sociology, The 37th World Congress of the International Institute of sociology, Stockholm, Sweden, 5-9, July 2005. Gonzalez, G.A (2005), â€Å"Urban Sprawl, Global Warming and the Limits of Ecological Modernisation†, Environmental Politics, 14:3, pp. 34-362. Martin, G., 2007, â€Å"Motorization, Social Ecology and China†, Area, Vol. 39:1, pp. 66-73.

Evaluating Treating Through Therapy For Borderline Personality Disorder Nursing Essay

Evaluating Treating Through Therapy For Borderline Personality Disorder Nursing Essay Despite the many treatment options for people with BPD, Many professionals in mental health services continue to believe that personality disorders are untreatable. This essay provides evidence the effectiveness of Cognitive Behaviour Therapy (CBT) and Dialectical Behaviour Therapy (DBT) with Borderline Personality Disorder. Background To understand BPD, I will attempt to give a historical overview of BPD. In the 1800s, Philippe Pinel first used the French term manie sans delire (mania without delirium) to designate those individuals engaging in deviant behavior but showing no signs of a thought disorder such as hallucinations or delusions, psychiatry began to think about borderline personality disorders as early as 1801. Although the meaning of the term has changed through many writings on the subject over time, the writing of Cleckley and his use of the label psychopath in The Mask of Sanity brought the term into accepted usage (Meloy 1998). The Mask of Sanity is a book written by Hervey Cleckley first published in 1941; he gave the most significant clinical description of psychopathy in the 20th century. An expanded edition of the book was published in 1982, when the name was changed from psychopathy to Personality Disorder. In 1972, newer editions of the book reflected a closer alliance with Kernbergss (1984) borderline level of personality organization, in particular defining the structural criteria of the psychopaths identity integration, defensive operations and reality testing. The diagnosis borderline was introduced in the 1930s to label patients with problems that seemed to fall somewhere in between neurosis and psychosis (Stern, 1938). In 1938, the psychoanalyst Adolph Stern first described most of the symptoms that are now considered as criteria of borderline disorder. He suggested the possible causes of the disorder, and what he believed to be the most successful form of psychotherapy for these patients, he also renamed the disorder again, and he named the disorder by referring to patients with the symptoms he described as the border line group (Freidel 2004). In 1940, the psychoanalyst Robert Knight introduced the concept of ego psychology into his explanation of borderline disorder. Ego psychology deals with mental functions that allow us to effectively combine our thoughts and feelings and to develop helpful responses to life around us. He suggested that people with borderline disorder have impairments in a lot of of these functions, and he referred to them as borderline states (Friedel 2004). The next important input was made by the psychoanalyst Otto Kernberg (1967); he introduced the term borderline personality organisation. He proposed that mental disorders were determined by three distinctive personality organisations: psychotic, neurotic and borderline personality. Kernberg has been a strong promoter of modified psychoanalytic therapy for patients with borderline disorder (Friedel 2004). Roy Grinker in 1968 published results of the first research conducted on patients with borderline disorder, which he referred to as the borderline syndrome (Friedel 2004). The next major advance in the field occurred when Gunderson and Singer (1975) published a widely acclaimed article that synthesized the relevant, published information on borderline disorder, and defined its major characteristics. Gunderson then published a specific research instrument to enhance the accurate diagnosis of borderline disorder. This instrument enabled researchers over the world to verify the validity and integrity of borderline disorder. Subsequently, borderline personality disorder first appeared in DSM-III as a bona fide psychiatric diagnosis in 1980 (Friedel 2004). Personality disorder categories are not firmly grounded in theory, nor are they empirically based (Livesley, 1998). Some critics say that personality disorder categories are so flawed that the best option is to abolish them and start afresh, but most pragmatists recognise that so much has been invested in them that they are very likely here to stay (Blackburn 2000a; Livesley, 1998). Borderline personality disorder is associated with significant impairment, especially in relation to the capacity to sustain stable relationships as a result of personal and emotional instability (NICE 2009). For many, the severity of symptoms and behaviours that characterise borderline personality disorder, correlate with the severity of personal, social and occupational impairments. However, this is not always the case, and some people with what appears to be, in other ways, marked borderline personality disorder may be able to function at very high levels in their careers (Stone, 1993). Paris (1994) stated that about one-third of patients with BPD report severe abuse involving an incestuous perpetrator; about one-third report milder forms of abuse; and about one-third do not report abuse. Personality disorders are common conditions; studies indicate prevalence of 10-13% of the adult population in the community and are more common among younger age groups (24-44 yrs) and equally distributed between males and females. However, the sex ratio for specific types of personality disorder is variable e.g. antisocial personality disorder is more common among males, and borderline personality disorder more common amongst females (DOH 2003). Cognitive Behaviour Therapy (CBT) can be seen as an umbrella term for many different therapies that share some common elements. The earliest form of Cognitive Behavior Therapy was developed by Albert Ellis in the early 1950s. Aaron T.Beck independently developed another CBT approach, called Cognitive Therapy, in the 1960s. Cognitive Therapy rapidly became a favorite intervention to study in psychotherapy research in academic settings. In initial studies, it was often contrasted with behavioral treatments to see which was most effective. However, in recent years, cognitive and behavioral techniques have often been combined into cognitive behavioral treatment. This is arguably the primary type of psychological treatment being studied in research today. One specific form of cognitive-behavioural therapy is dialectical behaviour therapy (DBT), a broad-based, cognitive-behavioural programme developed specifically to reduce self-harm in women with borderline personality disorders (Linehan, 1993a; Linehan 1993b). Recent research has shown that dialectical behaviour therapy (DBT) is one of the first therapies that have demonstrated to be effective for treating borderline personality disorder as well as being effective in treating people who display varied symptoms and behaviours associated with mood disorders, including self-harm. DBT combines standard cognitive-behavioural techniques for emotion regulation and reality-testing with concepts of mindful-awareness, distress tolerance, and acceptance. 1.2 Rationale As a mental health nurse coming from a forensic background, I have experience of working with clients with personality disorder. I feel that by getting more of an understanding of CBT interventions, it will make a huge difference to my future practice in the future. McKenna et al (1999) state that it is unacceptable for health care not to be based on sound evidence of its effectiveness, and back up their practice with research-based evidence (NMC, 2008) to ensure effective clinical practice. Often nurses find it frustrating working with disorders of personality. These clients can be manipulative, socially inappropriate and difficult, for these reasons, such clients need all the patience and skills nurses have to offer. Until recently, personality disorder services in the NHS had been diverse, spasmodic and inconsistent (Department of Health, 2003). Besides functional impairment and emotional distress, borderline personality disorder is also associated with significant financial costs to the healthcare system, social services and the wider society (NICE 2009). 1.3 Aims and objectives The aims and objectives of this project are to review the evidence on the efficacy of Cognitive Behavioural Therapy and Dialectical Behaviour Therapy with people who have Borderline Personality. 1.4 Methodology and parameters This literature review was conducted using the following resources Electronic databases: Cochrane library, CINHAL, Medline, Psychinfo, Psychology and Behavioural Sciences and Academic Search Premier Key journals were hand searched: British Journal of Psychiatry, Journal of Personality Disorders, Mental Health Practice, Journal of Personality and Mental Health University and Trust libraries Google Google scholar The following types of literature were sought and reviewed where available Randomised control trials Systematic and structured review Quantitative and Qualitative research studies Position statements/guidelines from professional bodies Government policies (NICE (2009), NSF (1999) Text Books Inclusion and exclusion criteria Eligibility for this review was determined by the following criteria: à ¢-  Participants: adults with BPD (diagnosed according to DSM-III/DSM-III-R, DSM-IV, DSM-IV-TR or ICD-10 criteria for BPD), with or without co-morbidity. à ¢-  Intervention: psychological therapies, including CBT, DBT à ¢-  Comparators: CBT/DBT or treatment as usual à ¢-  Outcomes: self-harm, suicide, interpersonal and social functioning à ¢-  Study type: published papers were assessed according to the accepted hierarchy of evidence, whereby systematic reviews of RCTs are taken to be the most authoritative forms of evidence, with uncontrolled observational studies the least authoritative. à ¢-  Exclusion criteria: papers on personality disorder without separate BPD subgroup analyses. The studies were obtained through a number of sources, as above. Searches were performed by entering the key words Borderline Personality Disorder, Cognitive behaviour therapy into several databases, which yielded many secondary references of current best evidence. Search filters developed consisted of a combination of subject headings. The topic-specific filters were combined with appropriate research design filters developed for systematic reviews, RCTs and other appropriate research designs. These articles were selected after careful reading of the title and abstract to identify the most useful. I then limited my search to full articles which made my search a lot easier. The definitive text that will be used to aid my search will be NICE Clinical Guidelines for Personality disorder 78. This guideline makes recommendations for the treatment and management of borderline personality disorder in adults and young people (under the age of 18) who meet criteria for the diagnosis in prim ary, secondary and tertiary care. Borderline personality disorder is present in just under 1% of the population, and is most common in early adulthood. Women present to services more often than men. Borderline personality disorder is often not formally diagnosed before the age of 18, but the features of the disorder can be identified earlier. Its course is variable and although many people recover (NICE 2009). This search will comprise both British and international articles. When choosing which articles were going to be relevant, I found it impossible to ignore the amount of articles I had on DBT and as DBT was evolved from CBT and made specifically for BPD, I decided to bring it into my research project. The articles are mixed quantitative and qualitative research. The qualitative means of gathering subjective data is centred on an individuals experience, beliefs, empowerment and quality of care and does not solely concentrate on clinical outcomes for the individual. One could argue that this is the most appropriate aspect of research for mental health nurses as mental illness is individual for each person involved in the process and although BPD is not a mental illness The National Service Framework for adult mental health sets out our responsibilities to provide evidence based, effective services for all those with severe mental illness, including people with personality disorder who experience significant distress or difficulty (NIMH 2003). While these can be misconceived as an easy option form of research, qualitative research offers rich, reflective and exhaustive data that is invaluable and has a profound contribution to make to take to practice. The qualitative evidence was li mited with regards to the treatments reviewed, with an emphasis on DBT. Quantitative research is a formal, objective, and rigorous statistical process for generating information about the world (Burns Grove 1999), whereby the researcher would gather a range of numerical data in order to answer the research question, or prove, disprove a hypothesis (Parahoo 2006). Philosophies or schools of thought in research are called paradigms (Parahoo 2006). One such paradigm is positivism. Parahoo (2006) asserts that positivism relies on observations by the human senses to create fact (empiricism), and believe in the unity of science, and the notion of cause and effect (determinism). The positivist researcher will endeavour to test a hypothesis or theory using the deductive process of a course of experiments. This paradigm utilises a quantitative approach in its research methods. For the positivists, quantitative research is believed to provide hard evidence and objective fact that can provide knowledge on which to base best practice (Parahoo 2006). Efficacy studies focus on the usefulness of a specific helping methodology for a particular kind of problem. Comparisons are made between the methodology in question and some other methodology between clients with some disorder who do receive the treatment and those who do not or between two different methodologies for treating the same disorder. These studies are carried out under controlled conditions. Many of the studies are well designed and demonstrate efficacy. In a healthcare context, efficacy indicates the capacity for beneficial change (or therapeutic effect) of a given intervention. Chapter 2 The Literature Review Having undertaken a critical review of the literature, I have come to explore a number of issues which I feel necessary to consider, key themes emerging from this literature review are the impact of CBT DBT on suicidal behaviours, the impact of CBT DBT on self-harming behaviours, and the impact of CBT DBT on engagement. This chapter sets out to explore these themes in more detail. The most appropriate research design to answer this is the RCT; therefore the evidence base reviewed comprised available RCTs undertaken in people with a diagnosis of borderline personality disorder. The causes of borderline personality disorder are complex and remain uncertain. The following may all be contributing factors: genetics and constitutional vulnerabilities; neurophysiological and neurobiological dysfunctions of emotional regulation and stress; psychosocial histories of childhood maltreatment and abuse; and disorganisation of aspects of the behavioural system, most particularly the attachment system (NICE 2009). The history of specific psychological interventions designed to help people with borderline personality disorder is intertwined with changing conceptions of the nature of the disorder itself. Given the confusion that surrounds the nature of personality disorder, it is not surprising that this has impacted on NHS care for people with this diagnosis. Until recently, personality disorder services in the NHS had been diverse, spasmodic and inconsistent (Department of Health, 2003). Borderline personality disorder is particularly common among people who are drug and/or alcohol dependent, and within drug and alcohol services there will be more women with a diagnosis of borderline personality disorder than men (Swartz 1990). Borderline personality disorder is also more common in those with an eating disorder (Zanarini et al., 1998), and also among people presenting with chronic self-harming behaviour (Linehan et al., 1991). 2.1 Defining Cognitive Behaviour Therapy and Dialectical Behaviour Therapy Cognitive behavioural therapy (CBT) is a structured psychological treatment that focuses on helping a person make connections between their thoughts, feelings and behaviour. CBT was originally developed as a treatment for depression, and has since been modified for the treatment of people with personality disorders including borderline personality disorder. CBT focuses on altering the thoughts, emotions, and behaviours of patients by teaching them skills to challenge and modify beliefs, to engage in experimental reality testing, and to develop better coping strategies. The goals of these interventions are to decrease the conviction of delusional beliefs, and hence their severity, and to promote more effective coping and reductions in distress. This essay will attempt to assess the contribution of CBT the disorder by discussing reviews on efficacy and long term effects. Cognitive behavioral therapy  for borderline personality disorder (CBT for BPD) was developed on the premise that people with the disorder have learned distorted beliefs and thought patterns. These, in turn, result in the distressing emotional responses and behaviors that characterize borderline personality disorder. It is the initial objective of CBT for  BPD  to  identify the distorted, automatic thoughts and  beliefs held by the patient with borderline disorder.  Such beliefs outlined by Beck Freeman(1990) typically include those related to dependency (I am needy and weak),  distrust  (People will get me if I dont get them first), rigid, all-or-nothing (dichotomous) perceptions,  and other thought patterns  that characterize the main cognitive-perceptual symptoms of the disorder. These distorted thoughts are then modified by self-monitoring,  logical analysis and by questioning and testing them.  It is adapted for people with borderline personality disorder and pays attention to the structure of the therapy and the problems that can disrupt the therapeutic relationship , such as non-engagement in treatment, shifting problems and goals, losing focus on the aims of therapy, losing structure and lack of compliance with assignments (Davidson, 2000). In addition, CBT for BPD attempts to produce positive change by improving the attitude of the patient toward treatment, the enhancement of specific skills, and the reduction of hopelessness. The CBT therapist and the patient typically construct a list of specific problem areas. They then develop a set of tasks or exercises that generate and reinforce new attitudes, behaviors, and interpersonal strategies that replace the ones that have proven to be ineffective. Within the past 15 years, another, newer psychosocial treatment termed Dialectical Behaviour Therapy (DBT) was developed. DBT combines standard cognitive behavioural techniques with acceptance based strategies, as well as strategies designed to keep the therapy balanced between change and acceptance (dialectical strategies). Marsha M. Linehan, a psychologist from the University of Washington in Seattle, developed DBT specifically for people with BPD, especially those who engage in frequent self-destructive and self-injurious behaviours. DBT is based on the belief that the symptoms of BPD result from biological impairments in the brain mechanisms that regulate emotional responses. The early behavioural effects of this impairment are magnified, as the person with this biological risk factor interacts with people who dont validate their emotional pain and dont help them learn effective coping skills. DBT has gained considerable favour in the treatment of BPD because of the results it ha s achieved in several research studies. It has been shown that DBT can be taught to and used by many, but not all, mental health professionals. For the time being this seriously limits the broad use of this effective treatment approach. DBT seeks to validate feelings and problems, but it balances this acceptance by gently pushing to make productive changes. DBT also deals with other opposing or dialectical tensions or conflicts that arise, such as the patients perceived need for a high level of dependence on the therapists and others, and the fear and guilt aroused by such excessive dependency. DBT combines both cognitive and behavioural techniques and designed specifically to treat BPD. It is a combination of individual psychotherapy and psychosocial skills training that has been shown via controlled clinical trial to be effective in treating individuals with BPD (Linehan, 1993b). In practice, the limiting factor in providing access to psychological therapies is the very small prop ortion of NHS staff trained to deliver these to a competent standard. Fourteen women with borderline personality disorder were interviewed to ascertain what is effective about DBT and why (Cunningham et al., 2004).Participants reported that DBT allowed them to see the disorder as a controllable part of themselves rather than something that controlled them, providing them with tools to help them deal with the illness. Service users reported that DBT had had a positive effect on their relationships in day-to-day interactions, and although problems with friends and family did not disappear, they were more manageable (NICE 2009). Clients also expressed higher levels of hope and a desire to live more independently (Cunningham et al., 2004) 2.2 Suicidal acts Definition: deliberate; life threatening; resulted in medical attention; medical assessment consistent with suicide attempt. Suicide is common in people with borderline personality disorder and may occur several years after the first presentation of symptoms (Paris Zweig-Frank, 2001). A well-documented association exists between borderline personality disorder and depression (Skodol et al., 1999; Zanarini et al., 1998), and the combination of the two conditions has been shown to increase the number and seriousness of suicide attempts (Soloff et al., 2000). People with borderline personality disorder may engage in a variety of destructive and impulsive behaviours including self-harm, eating problems and excessive use of alcohol and illicit substances. Self-harming behaviour in borderline personality disorder is associated with a variety of different meanings for the person, including relief from acute distress and feelings, such as emptiness and anger, and to reconnect with feelings after a period of dissociation. As a result of the frequency with which they self-harm, people with borderline personality di sorder are at increased risk of suicide (Cheng et al, 1997), with 60 to 70% attempting suicide at some point in their life (Oldham, 2006). The rate of completed suicide in people with borderline personality disorder has been estimated to be approximately 10% (Oldham, 2006). A behavioural approach to self-harm and suicidality that incorporated skills training in emotion regulation and validation of client experience developed into dialectical behaviour therapy (DBT), a specific intervention for borderline personality disorder. Cognitive-behavioural therapy along the lines of Beck, Freeman, Associates (1990) has been investigated in at least two uncontrolled trials. Brown, Newman, Charlesworth, and Chrits-Cristoph (2003) found significant decreases on suicide ideation, hopelessness, depression, number of BPD symptoms, and dysfunctional beliefs after 1 year of cognitive-behavioural therapy for suicidal or self-mutilating patients with BPD. Results were maintained at a 6 months follow- up. Effect sizes were moderate (0.22-0.55). Dropout rate was 9.4%. Arntz (1999a) found positive effects of long-lasting cognitive-behavioural therapy in a mixed sample of personality disorders, including 6 patients with BPD. Two patients with BPD dropped out prematurely, but the other four attained good results. A randomized clinical trial was conducted by Linehan et al. (1991) with 44 subjects to evaluate the effectiveness of DBT for the treatment of chronically parasuicidal women who met criteria for BPD. Patients who received DBT had an average of 8.46 inpatient days per year compared to 38.86 days for the control group. It was also noted that it did not appear that there were differences between the two groups on measures of depression, hopelessness, suicide ideation, or reasons for living. Linehan et al. (1993) conducted a naturalistic follow-up review of 39 of these subjects to determine whether the effects of DBT were maintained over one year post treatment. In the 12 to 18 month period, subjects completing DBT had fewer parasuicidal episodes and fewer medically treated episodes. In the 18- to 24-month period, there were no significant between-group differences on parasuicide measurements, although psychiatric inpatient days during this time were lower for subjects in the DBT group. Rathus et al. (2002) conducted a study with a group of suicidal adolescents with borderline personality features. Participants included 111 outpatient admissions. Eighty-two participants were assigned to treatment as usual (TAU) and 29 were assigned to DBT. The groups were not randomized, but it was noted that there was more severe pre-treatment symptomtology in the DBT group than the TAU group. The group treated with DBT had significantly fewer inpatient psychiatric hospitalisations during the 12 weeks of treatment. The groups did not differ significantly in number of suicide attempts made during treatment. There was a slightly higher rate of treatment completion in the DBT group. Hengeveld et al (1996) report a case series of nine female outpatients who had attempted suicide on at least two occasions and were offered up to ten sessions of group CBT. Seven of the nine met criteria for personality disorder and of these four had borderline personality disorder. Ten months after the last session, recurrence of self-harm was examined using telephone contacts with participants and examination of hospital records. Four of the seven participants reported further suicide attempts all four had borderline personality disorder. Linehan et al. (2006) conducted a one-year randomized controlled trial with one year of post-treatment follow up. The objective was to evaluate the hypothesis that unique aspects of DBT are more efficacious compared to treatment offered by non-behavioural psychotherapy experts. The study included 101 female participants with recent suicidal and self-injurious behaviours that met DSM-IV criteria. The subjects who received DBT were half as likely to make a suicide attempt. 2.3 Suicidal acts Definition: deliberate; resulted in visible tissue damage, nursing or medical intervention required. Self-harming behaviour in borderline personality disorder is associated with a variety of different meanings for the person, including relief from acute distress and feelings, such as emptiness and anger, and to reconnect with feelings after a period of dissociation. As a result of the frequency with which they self-harm, people with borderline personality disorder are at increased risk of suicide (Cheng et al., 1997). Service users have been positive about DBT because it has helped them to improve their relationships and their ability to control their emotions and reduce self harm. However, while some valued the structure of the approach, others preferred the programme to be more tailored and flexible. In a large sample, Tyrer et al (2003) found that CBT was equivalent to TAU for the treatment of recurrent self-harm and noted that this method was less effective for patients with BPD. Brown (2004) conducted an uncontrolled cohort study participants with borderline personality disorder who reported suicidal ideation or engaged in self-injurious behaviour received weekly CBT over a 12-month period and were followed up over an 18-month period. Individual sessions lasting 1 hour were supplemented by access to emergency telephone contact with an on-call therapist between sessions. Verheul et al. (2003) conducted a randomized controlled study for the purpose of comparing the effectiveness of DBT with TAU for patients with BPD and to examine the impact of baseline severity on effectiveness. The study included 58 women who were randomized to either DBT or TAU and who received treatment over one year. The results included: DBT had a substantially lower 12-month attrition rate (37%) compared with TAU (77%); treatment with DBT resulted in greater reduction of self-mutilating and self-damaging impulsive acts than TAU. Van den Bosch et al. (2005) published a follow-up review of this study that examined whether the treatment results in the Verheul study were sustained over six-month follow-up or up to week 78. It was noted that in the six months after treatment discontinuation, the benefits of DBT over TAU in terms of lower levels of impulsive and self-mutilating behaviours were sustained. However, it must be noted that parasuicide activity had been defined in slightly different ways in the RCTs and therefore might not be comparable across studies. Alper (2001) presents outcome data on a case series of 15 court committed women with a clinical diagnosis of borderline personality disorder that underwent treatment with nurse-led DBT in an inpatient forensic setting. There was a reduction in the frequency of self-harm over the 4-week period. In addition, the authors conducted qualitative interviews with four nurses to describe their experience of administering DBT; their responses were uniformly positive. Bateman Tryer (2004) state that the widespread adoption of dialectical behaviour therapy is a tribute both to the energy and charisma of its founder, Marsha Linehan, and to the attractiveness of the treatment, with its combination of acceptance and change, skills training, excellent manualisation, and a climate of opinion that is willing and able to embrace this multifaceted approach. It is not, however, justified by the strength of the evidence (Tyrer, 2002b) and conclusions about the long-term effectiveness of this therapy as a treatment for the personality itself are premature. Since the original trial which was handicapped by many methodological limitations, there has only been one randomised study that supports the findings unequivocally, that of Verheul et al (2003). 2.4 Non-engagement For effective treatment, commitment to therapy is required, and research shows that fewer people drop out of DBT than other therapies (verheul et al 2003) According to service users interviewed by Haigh (2002), services could be improved if: professionals acknowledged that personality disorder is treatable; they received a more positive experience on initial referral as this would make engagement with a service more likely; if the ending of a therapeutic relationship was addressed adequately; and if services were not removed as soon as people showed any signs of improvement, because this tended to increase anxiety and discourage maintenance of any improvement. In a study by Hodgetts and colleagues (2007) of five people with borderline personality disorder being treated in a DBT service, the participants reported that DBT was presented to them as the only treatment for personality disorder. This may have raised anxieties in service users about what was expected of them. While some valued the sense of structure to the treatment, others would have preferred a more tailored and flexible approach. There were also mixed feelings about the co mbination of individual therapy and group skills training. For one person the challenges of DBT proved too much so she left the programme. Another factor in her leaving was that she believed she was refused supp