My Personal Philosophy Of Life - 2218 Words

Personal philosophy is something that plays a tremendous role in the life of every individual. Everyone have a different point of view about life, we cannot expect everyone to have the same philosophy of life. Philosophy of life will be different between each person. Two people will never have the same philosophy of life. Individuals might share some similarities between their philosophy of life but two people will never have the exactly same. I have a strong belief that people develop and shape their own personal philosophy during their whole life. Sometimes we might attempt to think that we already know our philosophy of life but there are some circumstances that can totally change our view. I also believe that our age plays a tremendous role in our philosophy of life. We cannot expect a twelve-year-old to have the same view of life as a forty years old. In terms of my own philosophy I cannot truly say that I completely know my entire personal philosophy of life but I know that now at this moment I am the one in charge of my own philosophy about life. Even though I am 23 years old I still don’t have my life completely figured about. I know what I want to do and what are the goals that I would like to achieve but in terms of my own philosophy about life I believe that God is in charge; and that our story about life was already written even before we were born. I can wake up with many different types of ideas or things I would like to achieve but I know that God has theShow MoreRelatedMy Personal Philosophy On Life1780 Words   |  8 PagesMy philosophy on life is constantly changing because I am constantly growing as a young man, and it is constantly being shaped by my everyday experiences. I easily adapt and I’m eager to learn and improve. I consider it dangerous to be stubborn or stuck in one’s ways. I love being around people and fostering good, healthy relationships. Family is very important to me. I love my family with all my heart a nd would do anything for them, and I know they would do the same for me. I’m grateful for my healthRead MoreMy Personal Philosophy Of Life1813 Words   |  8 Pagesof being enrolled in the Philosophy class, I have learned about the different aspects of life, the beliefs and behaviors of individuals. In this summary paper, I’m going to be discussing topics such as, the nature of humankind, diagnosis of what is wrong with humankind, the prescription for making it right, our intellectual difficulties or remaining unresolved issues, my personal values and mission, organizational values and business ethics. My personal philosophy of life is to live in peace withRead MoreMy Personal Philosophy Of My Life2135 Words   |  9 Pagesdifferent beliefs and opinions, we all live life our own ways. Our ideas about life are based on the way we view the world. It is normal that each individual follows their own slightly modified philosophy. My life, my family, my relationships, my happiness, commitment to what I love, these are what help to shape my personal philosophy. My family is the one who raised me, teaching me right from wrong. Children are only aware of what the adults in their life teach them. Children make choices around whatRead MoreMy Reflection Of My Personal Philosophy Of Life1228 Words   |  5 PagesPhilosophy of Life In my short seventeen years, I have experienced a great multitude of feelings towards my own personal experiences. My own reactions to the external circumstances that the universe has thrown at me, and I do indeed mean thrown, have allowed me to grow as a young woman and simultaneously allow me the privilege of looking at life through the lenses I wear today. Because the way I perceive my life to date is how I have been able to assemble the three things I value most in it: stayingRead MoreMy Personal Philosophy Has Changed My Life1351 Words   |  6 Pages My personal philosophy has grown greatly since starting Palmer College of Chiropractic. Before coming to school I did not know that even a philosophy existed. I knew I wanted to join this profession because I got a glimpse of what Chiropractic care can do to people. While deciding what school I wanted to attend, I weighed heavily how many techniques were taught, how many clubs were offered, and what study abroad options were available. Palmer Davenport was last on my list. I already sent in myRead MoreEthics Philosophy : Ethics And Ethics Essay976 Words   |  4 PagesEthics Philosophy A personal ethics philosophy helps a person to maintain and employ good morals and values that are important in a one’s life. Understanding the importance of ethics is critical in order to consciously work to develop and effectively utilize ethics. Therefore, accepting the importance of one’s ethical philosophy will result in ethical decision-making, therefore developing the ability to put ethical theory into practice create ethical conditions albeit, personal and professionalRead MoreMy Personal Philosophy Of Nursing1715 Words   |  7 PagesPersonal Philosophy of Nursing Throughout all of life, there is only a finite amount of time before a living organism perishes out of this world. When regarding human beings specifically, their lifespans on earth are a blink of an eye. However, this blink of an eye has varied throughout all of recorded history. Through the practice of medicine, the human race has increased life expectancy by not only years, but decades. With the help of famous theorists such as Castillo Roy, and Imogene King, theRead MoreMy Personal Philosophy Of Nursing1454 Words   |  6 Pages Personal Philosophy of Nursing Kendra Jackson Bon Secours Memorial College of Nursing October 8, 2014â€Æ' Introduction The nursing profession cannot be summarized using one word or statement. According to the American Nursing Association, nursing is â€Å"the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communitiesRead MoreEssay about Personal Educational Philosophy1069 Words   |  5 Pagespaper is my personal educational philosophy statement. It represents my ideas and values about teaching and learning; it reveals my personal teaching beliefs and their relation to the five major established educational philosophies; it shows my role and responsibilities in educational process. I place great significance on personal style of instruction and its influence on curriculum implementation. The paper also highlights my career aspiration and orientation. Personal EducationalRead MoreThe Philosophy : The Moral Life Essay1164 Words   |  5 Pagesmajor philosophies- Utilitarianism, Deontology, and Feminism. These three philosophies come up frequently in my life. I judge an event in which philosophy is the main focus. In addition, I like to use these three principles in my moral judgments and decisions. Reaching the end of this class and semester I can say that my knowledge of these three philosophies has expanded immensely. The critical, informational, and literary aspects (stories that provide analysis) of the book The Moral Life has helped

Cadbury an Ethical Company Struggles to Insure the...

yale case 07-039 november 27, 2007 (revised august 24, 2008) Cadburyâˆâ€" An Ethical Company Struggles to Insure the Integrity of Its Supply Chain Sumana Chatterjee1 Jaan Elias 2 Chocolate had always been considered an affordable little luxury, associated with romance and celebrations. Therefore in 2000 and 2001, revelations that the production of cocoa in the Cà ´te d’Ivoire involved child slave labor set chocolate companies, consumers, and governments reeling. In the United States, the House of Representatives passed legislation mandating that the FDA create standards to permit companies who could prove that their chocolate was produced without forced labor to label their chocolate â€Å"slave-labor free.† To forestall such labeling, the†¦show more content†¦(based in Minneapolis), and Nestle USA (in Glendale, CA, a subsidiary of the Swiss food giant). World prices for cocoa climbed during the 1970s, encouraging further plantings of cocoa trees. In addition, there was a flexible supply of migrant labor from adjacent countries and plentiful land not already under cultivation. During the 1980s, Cà ´te d’Ivoire became the larges t cocoa producer in the world; the country’s share of world production grew from 23 percent in 1980 to 40 percent by 1998. In the mid-1990s, cocoa contributed 35 to 40 percent of Cà ´te d’Ivoire’s exports, 14 percent of its GDP, and more than 20 percent of the government’s income. The increasing volume of production occurred during a declining world market for cocoa. Prices began falling in the 1980s and yet the Cà ´te d’Ivoire government continued to offer high price guarantees. Finally in 1990, the marketing board went bankrupt and appealed to international lending bodies for assistance. The government was forced to halve the producer price to better reflect world prices and help the government repay loans that it incurred while it was supporting the price of cocoa. This meant that Cà ´te d’Ivoire’s farmers received a smaller percentage of the declining world price of cocoa than farmers in any 4 other country. In the 1990s, the p olitical situation also deteriorated. Following the death of Fà ©lix Houphouà «t-Boigny, political tensionShow MoreRelatedCadbury an Ethical Company Struggles to Insure the Integrity of Its Supply Chain9806 Words   |  40 Pagesyale case 07-039 november 27, 2007 (revised august 24, 2008) Cadburyâˆâ€" An Ethical Company Struggles to Insure the Integrity of Its Supply Chain Sumana Chatterjee1 Jaan Elias 2 Chocolate had always been considered an affordable little luxury, associated with romance and celebrations. Therefore in 2000 and 2001, revelations that the production of cocoa in the Cà ´te d’Ivoire involved child slave labor set chocolate companies, consumers, and governments reeling. In the United States, the HouseRead MoreMarketing Mistakes and Successes175322 Words   |  702 PagesStarbucks, we have moved Entrepreneurial Adventures up to the front of the book. We have continued Marketing Wars, which many of you recommended, and reinstated Comebacks of firms iii iv †¢ Preface rising from adversity. I have also brought back Ethical Mistakes, because I believe that organizations more than ever need to be responsive to society’s best interests. Altogether, this 11th edition brings seven new cases to replace seven that were deleted from the previous edition. Some of the cases Cadbury an Ethical Company Struggles to Insure the... yale case 07-039 november 27, 2007 (revised august 24, 2008) Cadburyâˆâ€" An Ethical Company Struggles to Insure the Integrity of Its Supply Chain Sumana Chatterjee1 Jaan Elias 2 Chocolate had always been considered an affordable little luxury, associated with romance and celebrations. Therefore in 2000 and 2001, revelations that the production of cocoa in the Cà ´te d’Ivoire involved child slave labor set chocolate companies, consumers, and governments reeling. In the United States, the House of Representatives passed legislation mandating that the FDA create standards to permit companies who could prove that their chocolate was produced without forced labor to label their chocolate â€Å"slave-labor free.† To forestall such labeling, the†¦show more content†¦The trees need to be shaded from the direct sunlight and therefore grow best in the â€Å"understory† of the forest, shielded by taller trees from the rays of the sun. This distinctive growing arrangement meant that cocoa cannot be grown on monocrop farms that allow mechanized cultivation and harvesting. Cocoa farming required a good deal of manual labor to get the beans f rom the tree to the factory. Newly planted cocoa trees require five to seven years of growth before they produce appreciable fruit, but once they mature the trees could produce beans for more than 50 years. Cocoa beans grow inside large footballshaped pods on the branches of the cocoa trees. These pods are manually cut from the branches with long handled knives. Once on the ground, the woody pod is split by machete and then workers scoop out the beans and pulp. Piles of bean and pulp are then covered with leaves or burlap and left out to ferment. It is during the fermentation process that the cocoa beans take on their distinctive flavor. After five to six days of on-site fermentation the beans are uncovered, separated from additional material and allowed to dry in the sun. Once dry, they can be collected and shipped to processing factories. Because of the increasing popularity of chocolate in Europe, Europeans introduced cocoa trees in the various tropical colonies under their contr ol. The French introduced cocoa trees to Cà ´te d’Ivoire in the 1920s. Cà ´te d’IvoireShow MoreRelatedCadbury an Ethical Company Struggles to Insure the Integrity of Its Supply Chain9818 Words   |  40 Pagesyale case 07-039 november 27, 2007 (revised august 24, 2008) Cadburyâˆâ€" An Ethical Company Struggles to Insure the Integrity of Its Supply Chain Sumana Chatterjee1 Jaan Elias 2 Chocolate had always been considered an affordable little luxury, associated with romance and celebrations. Therefore in 2000 and 2001, revelations that the production of cocoa in the Cà ´te d’Ivoire involved child slave labor set chocolate companies, consumers, and governments reeling. In the United States, the House of RepresentativesRead MoreMarketing Mistakes and Successes175322 Words   |  702 PagesStarbucks, we have moved Entrepreneurial Adventures up to the front of the book. We have continued Marketing Wars, which many of you recommended, and reinstated Comebacks of firms iii iv †¢ Preface rising from adversity. I have also brought back Ethical Mistakes, because I believe that organizations more than ever need to be responsive to society’s best interests. Altogether, this 11th edition brings seven new cases to replace seven that were deleted from the previous edition. Some of the cases

Aids India Free Essays

string(138) " before marriage and in most cases are disowned or face harsh consequences for their actions from family members and other social groups\." Matter of Life or Death India is the seventh largest Country in the world, home to one billion people and vast ethnic diversity. It has been making great leaps with education, industrialization and technology. Literacy rates are continuously going up along with life expectancy. We will write a custom essay sample on Aids India or any similar topic only for you Order Now India has been making continuous progress in many aspects for a country that has been relatively poor and extremely poverty-stricken. India is also one of the world’s largest democracies meaning that citizens have a great deal of political freedom. The average Indian citizen lives in a rural area and consumes 30 times less resources than an American citizen consumes. Although India is making many improvements, there are certain issues that continue to creep around and into the lives of Indian people and will continue to do so for a very long time. HIV/AIDS is one of these issues, an issue that has been taking millions of lives and affecting the lifestyles of many Indian people. HIV/AIDS is one of the most concerning problems for India; it continues to manifest regardless of the many efforts made by the Indian government. HIV/AIDS is not just a problem that India must deal with; it has affected nearly every region in the world but every country and population responds to epidemics with a different approach and one must consider all the different aspects. In India, many unique factors have been linked with the growth, prevention and treatment of HIV/AIDS. The causes for the emergence of HIV/AIDS in India are still unclear however; some believe that foreign visitors that had sexual contact with the sex workers in India are to blame. Many believe this because initial cases were found in sex worker and truck drivers. HIV/AIDS emerged into India later than most other countries and the first cases were reported in Chennai, Tamil Nadu. Studies also indicate that heterosexual sex was the method in which most initial cases occurred through. It was first identified in the early 80’s in sex workers from Tamil Nadu. The infection rates of the disease peaked in the early 90’s and it had made its way into low – risk individuals across the whole country in just ten years. (Avert, 2011) The most recent estimates state that there are currently 2. million individuals living with HIV in India and of that, 39% are females and 3. 5% are children. Considering age as a factor, the highest infection rates occur in people aged 30-34 in India. HIV rates for the nation have been decreasing according to recent studies (NACO, 2007) and the area of southern India which was impacted the most by this epidemic has shown a decrease in infection rates (Kumar R. , Jha P. et al. , 2006). Seventy percent of i nfections are reported in six states: Andhra Pradesh, Tamil Nadu, Maharashtra, Manipur, Nagaland and Karnataka. Currently the state of Andhra Pradesh holds the highest prevalence rate (1%) out of the 28 states and out of the high-risk groups in this Andhra Pradesh; the highest rate is among MSM (17%) (Avert, 2011). In recent years the rate of injection drug users has been increasing in many states and has given HIV an opportunity to spread. One of these states are Punjab in the northeast of India where a third of the population is addicted to drugs and has become one of the world’s leading areas in drug trafficking and usage (Glut, 2011). In the Punjab’s capital city Amritsar, the prevalence rate among IDU’s is as high as 30%. In many states of India drug use has become another concerning phenomenon that is helping with the spread of HIV/AIDS. Although the nation’s prevalence rates of HIV have decreased, it does not mean that the situation is getting better. This disease will continue to claim millions of lives because India does not have the equipment or resources needed in most areas; along with that the taboos, and stigma in India will negatively affect the treatment and prevention of HIV/AIDS. The way that Indians think about HIV/AIDS plays a major role in treatment and prevention efforts. There are many parts of the world where one with HIV/AIDS is able to go to a doctor, friend or family member to get support. In India, this is not the case for the most part. It is a country with a strict social hierarchy and most Indian people still believe in arranged marriages. The people of India stigmatize HIV/AIDS, which often leads to discrimination, denial, humiliation and rejection from family/community and medical staff. HIV/AIDS is not just any disease in India, since it is linked to controversial behaviours HIV/AIDS comes with a lot more baggage than for instance cancer does. HIV/AIDS is extremely under reported due to the many psychological hardships one must face in order to get the help that they need. Currently 50% of people with HIV are aware of their status; people that seek treatment often face traumatizing experiences with the medical staff. The government of India supports voluntary testing however, a very high percentage of cases have been reported in which the patient had been tested against their will, which in return would dictate the quality of medical care they would receive. In many cases, individuals have been denied medical services because of their status and people that are HIV+ and belong to a high-risk group face double the discrimination and stigma because they are a part of a controversial group. There is a direct correlation with Indian culture and the identification of HIV/AIDS in India. In order to successfully educate and treat the Indian population we must take into account the very sensitive cultural values of Indian people and customize action plans accordingly. Sex in India is highly discouraged amongst non-married couples and the topic is hushed. Indians greatly value marriage and hold the lowest divorce rate in world (Divorce Mag, 2011). Woman are seen as disgraceful, worthless and disgusting if they engage in sex with a partner before marriage and in most cases are disowned or face harsh consequences for their actions from family members and other social groups. You read "Aids India" in category "Papers" For Indian people it is ideal to have and maintain one sexual partner although woman in India face double standards while men are able to participate in sexual intercourse with multiple partners there for the HIV status of women is highly dependent on the behaviour of their partner(s)/spouse. The taboo of talking about sex publically and sex in general is the main reason for the hardships faced by educators, organizations and other public figures who try to make efforts with the awareness of HIV/AIDS. India is a place where a bar can possibly be shut down if any public display of affection is shown. There can be many explanations for the way Indian people think about sex that date back to the history of the first civilizations and religious texts that may have influenced and shaped the ideology of Indian people today. This is a way of thinking that has existed in India for thousands of year and will continue to do so for a very long time. Education and communication is extremely difficult in a place where the population is not willing to listen, Indian people tend to ignore and underestimate HIV/AIDS because they are unwilling to talk about it. Most Indian people are unaware of the facts that in return cause them to link it to unacceptable behaviours creating stigma, discrimination and denial due to lack of knowledge. People are hesitant to expose their HIV status and discuss issues with people. HIV/AIDS has claimed many lives in India, more so then many other parts of the world. The world fact book estimated 170 000 deaths in the year 2009 (ranked third highest in the world). Causality rates of HIV/AIDS related deaths have been decreasing in recent years. Many efforts have been made to prevent the spread of the disease by the government and other organizations yet India ranks as one of the top countries on HIV/AIDS hit list. The people of India have a hard time explaining and discussing the impact that HIV/AIDS has left on their country. People often are surprised and thrown off when they are presented with actual statistics, they see the disease as someone else’s problem with the attitude that it is a disease that infects the â€Å"scum of society† but once they are presented with the statistics they are immediately appalled. Indian youth is continuously encouraged to ignore such topics and refrain from talking about sex by their families. Another interesting issue is the misleading statistics that the government of India presents which understates the real statistics, Indian people lose trust in the government and don’t know which statistics to believe (Drynan, 2001). Indian people that live in poor areas with very low income believe that the spread of infection is mainly because a family member has to migrate to another location for a long period of time to find work and make an income to support his/her family. Since the majority of the population in India is poor, this is the leading explanation that most families will have. Indian people that are HIV + believe that the spread of the disease is linked to the decision of keeping HIV statuses a secret. Some sex workers admit that they do not expose their status to clients in fear of losing their job. Indian people are aware that health care systems need to improve in order to stop HIV/AIDS from spreading. There also a large portion of people who believe in fate and that if someone is infected with HIV/AIDS it is in their fate to die that way. â€Å"In the past I never thought that I would contract such a big disease, or neither would my husband. I had that much faith in him because we wouldn’t do such things. Now I don’t talk to my husband, I don’t know his whereabouts. God gave me this disease, what God metes out, Only God can judge. I have a daughter who is HIV + as well. I feel bad that my child has it but what can one do. I have a lot of problems at work, my co-workers tease me and shun me. They do not come near me† Anita who is HIV+ explained her thoughts about her status (Lets Break Through, 2006). Since the creation of antiretroviral therapy (ART/ARV) many lives have been extended and maybe even saved. In India these drugs are becoming more available and the price of these drugs is declining as time goes by how ever not everyone has access to these drugs. Many areas of India where these drugs are needed are poor areas where Doctors refuse to practise due to lack of income available. Many villages do not have access to someone who can administrate these drugs. The main factor is money, these drugs are expensive and many families simply cannot afford them. Recently the government has been focusing on distributing free antiretroviral drugs but it is impossible to reach everyone in need with the available funds. India is also actively manufacturing generic low-cost ARV’s. Out of all the people that need treatment only ? are receiving it (Avert, 2011) and many are not adhering due to high costs of drugs/testing, poor counselling, inadequate understanding and intolerance to drugs. Treatment centres are located in every state where HIV/AIDS is prevalent, screening is voluntary (ideally) and counselling is provided. The types of screening available are: Western blot test, ELISA, viral load test, CD4 count and blood biochemistry. Luckily India has a strong pharmaceutical industry and is taking advantage of it by reaching out to its patients. Another issue is drug resistant people; in Mumbai 18% of newly diagnosed people were resistant to at least one drug (World Bank, 2011) so second-line therapy is required. Another concerning problem is that therapy in India is unstructured. Although these drugs are becoming more available in India, those in need are often denied access by the health care providers. The poor are ignored and usually do not have the funds or the resources to obtain the drugs. HIV/AIDS Treatment and Prevention in India, 2011) Some other popular alternative traditional therapy in India includes Chinese medicine, Homeopathy, acupuncture and siddha medicine (Life Positive, 2011). The impact that HIV/AIDS will have on India in the future may be devastating if the current trends do not change. Treatment needs to be made more available, Health care providers need to be trained adequately and the general population needs to be educated. Many organizations and government have helped with the control of this epidemic such as promoting condom use are making improvements. Condoms are now used among many sex workers who ecite the policy of â€Å"no condom, no sex† to their customers and this is important because as of today condoms are the single most convenient and effective way of preventing the transmission of sexually transmitted diseases. There is no doubt that India is putting resources towards organizations that will provide services for the Indian population but this alone is not enough, Indian people themselves will need to accept and face this issue in order to make progress. Since India has a large portion of High-risk groups, there is always going t o be danger and opportunity for HIV/AIDS to spread. The rates vary from state to state but World Banks estimates that by 2033 mortality by infectious diseases will increase and of that, AIDS will represent 22% of total deaths. India has economic, cultural and other demographic factors that hamper prevention efforts. Discrimination, denial and stigma will continue to cause damaged relationships, torn families, physical isolation, desertion, economic implications, lower quality of life and death. This disease will continue to control the lives of people that are infected. How to cite Aids India, Papers

Finance in Hospitality Industry

Question: Describe about theFinance in the Hospitality Industry?. Answer: 1. Sources of Funding for Businesses Service Industries:- The term funding can be described as offering financial support for any program, project, business or personal need. In the business sector, funding can be classified into two segments. The owners of the business can provide the required financial support from their own reserve. In case of companies, the requirement is fulfilled from the various reserves of the company. It can be referred as internal funding. On the other hand, external funding can be described as the funding provided by the outsiders, mainly banks, other financial organizations and personal investors. In most of the time, the businesses have to bear additional expenses for the external funding, such as, interest (Nyide et al. 2014). Various sources of business funding are discussed below:- Personal Funding:- As discussed above, business owners can fund the businesses from the personal resources. The owners can collect the fund from personal savings and other family members. They can also borrow the required amount from family members or friends. Most of the time, this kind of funding are used to be interest-free (Jones et al. 2012). Loan from Financial Institutions:- The funds are also collected through loans from various financial institutions, such as, banks, insurance, other financial companies etc. The owner has to convince the investors about the profitability of the venture for taking the loan. In many cases, the loans are granted by keeping any asset as mortgage to the loan givers. The owners have to repay the loan amount in terms of monthly, quarterly or annuals repayments along with the interest. Issue of Shares:- Fund generation by the issue of shares is possible only if the business is registered as a company. In that case, the entrepreneurs use to publish the prospective of the business and issue share in the open market. It must be noted that the purchaser of the equity shares are considered as owners of the company and the dividend, paid to them, is the share of profit, not any kind of interest. Income Generation Method for Businesses Service Industries:- Generally, the income of any business is used to be generated various means. For purpose of disclosure, these various methods of income generation have been classified on the nature of the financial activities. The business activities related to the generation of income, can be differentiated into two groups Operating and Non-operating activities. The Non-operating activities are further categorized into two groups Financing and Investing Activities. The methods of income generation are discussed below:- 2. Operating Activity:- According to the International Accounting Standard, the operating activities can be defined as the main income generating activities of an entity and other activities, which cannot be categorized as financing or investing activities. Incomes, generated from such activity, are described as operating income (Brtland 2012). Operating income is mainly earned from the basic or primary activities of any business. For example, for any manufacturing business, the operating income is the revenue, generated by the sale of manufactured products, whereas, for any service related business, it is earned by rendering service to the customers. The various sources of operating income are as follows:- Income from the sale of products or service, rendered Income from other activities, such as, royalties, discounts, commissions etc. These type of incomes are not the direct income but closely related with the operating activities Income from refunds, especially, taxes, if the tax was not paid for any financing or investing incomes. Financing Activities:- Financing activities are related to the capital acquiring processes. It reflects the amount of capital, collected from various sources and also the amount of expenses, incurred for acquiring and maintaining the capital. The main financing activities for income generation include two methods. The business can generate financing income by either equity financing or debt financing. Equity financing is the method to raise capital by issuing shares in exchange of the ownership of the company. The income from debt financing are generated by borrowing loans from market at certain interest rates. It should be noted that the income generated by debt financing is the liability for the business (Drury 2012). Investing Activities:- Investment activities are linked with the various investments made by the business entity in different type of assets. Incomes, generated from such activities, are called as Investment incomes. Generally, the term investment is meant to invest money in other business or deposit money in banks or same type of institutions. In business sector, investment activities not only include the normal investment but also the purchase of fixed assets or acquisition of other firm. The various sources of investment incomes are- Sale of equity or bonds of other businesses Sale of fixed assets Interest earned from loans given to other entities Dividend received for the equities of other businesses 3. Assessment of the Sources Structure of Trial Balance:- Trial Balance is the financial statement, prepared in the end of an accounting period for an accounting entity, by listing the closing balances of all the accounts in the debit and credit columns properly to check the accuracy of the accounting system of that entity. Though the purpose of Trial Balance is to verify the accurateness of the accounting system, it has been observed that there are many accounting errors, which cannot be detected from trial balance. The trial balance provides better results for ensuring the mathematical accuracy and detecting the single-sided errors (Mroczkowski and Flanders 2015). Sources of the Trial Balance:- The main sources of the Trial Balance are the various ledger accounts of the accounting entity, which have balances. The sources of the given trial balance are Credit balances of Capital A/c., Bank Loan A/c., Accumulated Depreciation on Fixture Fittings A/c. Trade Payables A/c. and, Debit balances of Bank A/c., Cash Cash Equivalent A/c., Furniture Fittings A/c. Trade Receivables A/c. Structure of the Trial Balance:- The basic structure of the trial balance is given below:- Accounts Type Allocated column in Trial Balance Assets Debit Column Liabilities Credit Column Revenue Credit Column Expenses Debit Column Profit Credit Column Loss Debit Column Capital Credit Column Reserve Credit Column In the given trial balance, all the accounts are either asset type or liability type, except the Capital A/c. Hence, the balances of the assets are allocated in the debit column and the liabilities Capital A/c. are listed in the credit column (Bragg 2013). Evaluation of Business Accounts, Adjustments and Notes:- Evaluation of Business Accounts:- From the accounting extracts of Faith Restaurant, it can be stated that:- The accounts are not differentiated into debit and credit columns The administrative and distribution expenses are marked differently, but the cost of sales, though being an expense item, not marked separately. There is no amount given for capital or any type of liabilities The profit and assets are different type of accounts, but in the extract these items are listed together The furniture fixture is shown at the cost price, but there is no accumulated depreciation account created for the asset Adjustments:- The adjustment entries for the transactions mentioned in the notes are as follows:- Capital A/c..Dr. 2250 [(25000-2500)x10%] To, Furniture Fixtures A/c. 2250 (Being the depreciation for the previous year charged on Furniture Fixture and adjusted with the Capital A/c.) Furniture Fixture A/cDr. 2500 To, Cost of Sales A/c. 2500 (Being the purchase of furniture, wrongly included in Cost of Sales, adjusted with Furniture Fixtures A/c.) Distribution Expenses A/c.Dr. 250 To, Administrative Expenses A/c. 250 (Being the diesel cost for distribution, wrongly included in the administrative expenses, adjusted with the Distribution Expenses A/c.) Note on Adjustments:- The adjustments entries, made above, is affecting the accounts of the business in the following manner:- According to the accounting standards taxation acts, depreciation should be charged on the assets from the first year of purchase. As, the depreciation was not charged on furniture in previous year, the profit of the firm had become overvalued and as the profit is used to be added with the Capital A/c., the Capital A/c. would also reflect an overvalued amount. Hence, in the current year, the Capital A/c. is debited to reduce it to the actual amount and the Furniture Fixtures A/c. is reduced also by crediting it for amount of depreciation, which should have been charges on the furniture previous year. The wrong entry made for purchase of furniture, has increased the amount of Cost of Sales, which in result has reduced the amount of Gross Profit, whereas, the total amount of assets has also become undervalued. Therefore, the necessary adjustment entry has been made to reduce to cost of sales and increase the value of furnitures. The last entry does not have any material effect on the business. But as per the accounting rules, the cost of diesel, used for distribution purpose, should be included in the distribution expenses rather than administrative expenses (Box 2013). Purpose Processes of Budgetary Control:- Budgetary control is the method, where the management uses to estimate certain budgetary goals, compare the goals with the actual performance and, if required, make necessary adjustments to maintain the budget (Jones 2012). Purpose of Budgetary Control:- The purposes for budgetary control are described below:- Better planning for future cost, performance and requirements of an enterprise Cost effective and efficient operations through several departments or cost centres Reduction of wastage and labor idle time Estimation of future capital expenses Amendments for the disparities in the budgeted and actual performances Centralization of the cost control system Increase in the total profitability by cost effective operation Proper job allocation and distribution of responsibility amongst the staffs (Marginson 2013) Processes of Budgetary Control:- The processes of any type of budgetary control include the following basic steps:- Preparation of Budget according to the requirements, policies and future planning of the enterprise, Comparison of the estimated budgetary performance with the actual performance of the project or business in a continuous and systematic manner Modification in the budget in accordance to the changes in the actual circumstances (Nunes and Machado 2014) Analysis and Suggestions for Variation in Budget:- Variation from Budgeted Performance:- The variation between the budget and actual performances are shown in table:- Budget Actual Budgeted Standard for Actual Participants Variance % of Variance Number of participants 20,000 15000 -5,000 -25.00% 000 000 000 000 Revenue 2000 1700 1500 200 13.33% Cost of sales -1500 -1390 -1125 265 23.56% Gross profit 500 310 375 -65 -17.33% Administrative expenses -200 -210 -150 60 40.00% Distribution expenses -150 -90 -112.5 -23 -20.00% Net Profit 150 10 112.5 103 -91.11% Many of the cost items use to vary according to quantity of the output. Therefore, the differences are calculated on the basis of budgeted standard for actual participants and actual amounts. The differences in the amounts are represented in the following chart:- The rates of variance for different items are also shown in the following chart:- From the above graphs, it can be stated that though the revenue earned from event was higher than the budgeted standard, the gross profit and net profit were significantly lower than the standard. It is mainly caused because of the drastic increase in the administrative expenses and the cost of sales. Suggestion for Future Management Actions:- As the business operation is related to event management services, the output should be budgeted in conservative manner. The administrative expense was not only higher than the budgeted amount for actual performance, but also from the budget made for 2000 participants. Hence, in future the administrative expenses should be estimated properly. Moreover, this expenses are more or less fixed type of costs. If, the output changes from the budget, these costs remain quite unchanged. The cost of sales uses to vary according to the output. In this case, the number of participants has reduced but the cost of sales has increased significantly. In future, the management should control the cost of sales more effectively (Whitecotton et al. 2013). 4. Calculation and Analysis of Ratios:- Calculation of Ratios:- a) Gross Profit Margin Ratio Paticulars 2015 2014 Sales revenue A 100,000 80,000 Gross Profit B 60,000 50,000 Gross Profit Margin Ratio B/A x 100 60.00% 62.50% b) Operating Profit Margin Ratio Paticulars 2015 2014 Sales revenue A 100,000 80,000 Operating profit C 10,000 4000 Operating Profit Margin Ratio C/A x 100 10.00% 5.00% c) Current Ratio:- Paticulars 2015 2014 Trade Receivables 9500 9200 Inventories 10000 8000 Current Assets D 19500 17200 Trade Payable 9000 9000 Current Liabilities E 9000 9000 Current Ratio D/E 2.17 1.91 d) Return on Capital Employed:- Paticulars Amount Capital Employed in 2014 F 35000 Capital Employed in 2015 G 60000 Average Capital Employed H = (F+G)/2 47500 Profit before Taxation I 5000 Interest on Loan J 5000 Profit before Interest Tax K= I+J 10000 Return on Capital Employed K/H x 100 21.05% e) Trade Receivables Period:- Paticulars Amount Opening Balance of Trade Receivables L 9200 Closing Balance of Trade Receivables M 9500 Average Trade Receivables N = (L+M)/2 9350 Sales Revenue O 100000 Trade Receivable Period N/(O/365) 34.13 f) Trade Payables Period:- Paticulars Amount Opening Balance of Trade Payables P 9000 Closing Balance of Trade Payables Q 9000 Average Trade Payables R = (P+Q)/2 9000 Cost of Sales S 40000 Trade Payable Period R/(S/365) 82.13 g) Gearing Ratio:- Paticulars 2015 2014 Bank Loan T 50000 30000 Closing Balance of Capital Employed G 60000 35000 Gearing Ratio T/G 0.83 0.86 Ratio Analysis:- The financial performance of the business is analyzed below on the basis of the ratios, calculated above:- The gross profit margin ratio is above 60%, which clarifies that the business is running quite well. But the ratio has declined from the previous year, which is matter of concern. The Operating profit margin ratio has increased to 10%. The ratio is quite low in comparison to the gross profit margin ratio. The current ratio is 2.17. It indicates that the current asset of the company is more than two times of current liabilities, which can be regarded as an ideal ratio. Return on Capital Employed rate is 21.05%. It explains that the owner is earning more than 20% on the invested capital. The business seems to be quite profitable for the owners (Muradolu and Sivaprasad 2014). The trade receivables period is 34.13 days, which can be regarded as normal average period for credit recovery. But for a restaurant business, the period is little higher than the average. The trade payables period is 82.13 days. The period is too longer for restaurant businesses. Though the gearing ratio in the current year has decreased to 0.83 from 0.86 of previous year, it is very high. It denotes that most of the business capital, invested is collected by debt financing. Recommendation for Future Management Strategies:- From the above ratio analysis, the following recommendations are suggested for the businesses:- The management should detect the reasons for decrease in the gross profit margin ratio. The operating profit ratio is very low in comparison to gross profit margin ratio. It indicates that the operating expenses other than cost of sales, are very high. The management should reduce the other operating expenses to increase the amount of operating profit. The trade payables period are quite longer. Though, it will not affect the profits of the business, to maintain proper business ethics, the management should repay their creditors earlier than the average period. The owners should decrease the amount of bank loans and rely more on personal funding (Healy and Palepu 2012). 5. Categorization of Costs:- The costs, provided in the information are categorized in the following table: Cost Details Type of Cost Reasoning Cost of Wages Variable Cost The total amount of these cost items are totally depended on the numbers of tickets. If the number of ticket varies, then it will also change accordingly. Cost of Printing Cost of Popcorn per Ticket Rent for the Hall Fixed Cost The rent of hall use to be paid as per agreements. The quantity of output does not create any imact on it. If the organizer cannot sell a single ticket, he still have to bear this cost. Electricity Bill Semi-Variable Cost In this cost item, there are some fixed amounts, which have to bear by the business as fixed costs and balance amount depends on the consumption of electricity and number of phone calls (Weygandt et al. 2015). Telephone Bill Calculation of Contribution and Estimated Sales:- Contribution per Ticket:- Calculation of Contribution Per Ticket:- Particulars Amount Per Unit Total Unit Total Amount (no. of Tickets) TOTAL SALES (A) 30 5000 150000 Variable Costs: Cost of Wages 10 5000 50000 Cost of Printing 1 5000 5000 Cost of Popcorn 2 5000 10000 TOTAL VARIABLE COST (B) 13 65000 CONTRIBUTION (A-B) 17 85000 As per the above calculation sheet, the contribution per ticket should be 17 per ticket. Estimation of Number of Tickets Sold:- The numbers of tickets, required to be sold, for achieving the targeted profit of 20,000, are calculated in the following table:- Calculation of the Number of Tickets:- Particulars Amount Per Unit Total Unit Total Amount (no. of Tickets) TOTAL TARGETED PROFIT (A) 20000 Fixed Cost: Rent of Hall 45,000 p.a. 45000 Semi Variable Cost:- Electricity Bill 7000 7000 Telephone Charge 1000 1000 TOTAL FIXED SEMI-VARIABLE COST (B) 53000 CONTRIBUTION [ C= (A+B)] 73000 Contribution Per Ticket (D) 17 Required Number of Tickets (C/D) 4294 Break Even Analysis:- If the selling price per ticket would cost to 14, then the Break-even Point in units will be, Calculation of Break-Even Point in Units:- Particulars Amount SELLING PRICE PER UNIT (A) 14 Variable Costs per unit: Cost of Wages 10 Cost of Printing 1 Cost of Popcorn 2 TOTAL VARIABLE COST PER UNIT(B) 13 Fixed Cost: Rent of Hall 45000 Semi Variable Cost:- Electricity Bill 7000 Telephone Charge 1000 TOTAL FIXED SEMI-VARIABLE COST ( C) 53000 BREAK-EVEN POINT in UNITS [C/(A-B)] 53000 The Break-Even Point in units for the selling price of 14 per ticket, would be 53000 tickets. Hence, it can be advised that the management should not go ahead with the concert, as it would generate huge loss (Kaplan and Atkinson 2015). Reference List:- Box, N. 2013,Accounting, News Limited, Melbourne, Vic Bragg, S.M. 2013,Accounting Best Practices,7. Aufl.;7th;7; edn, Wiley, US Brtland, J. 2012, "Entrepreneurial strategy v. accounting accuracy in calculating capital and income",The Review of Austrian Economics,vol. 25, no. 2, pp. 93-114 Drury, C. 2012,Management and cost accounting,8th edn, Cengage Learning, Andover Guilding, C. 2009,Accounting essentials for hospitality managers,2nd edn, Elsevier/Butterworth-Heinemann, Amsterdam;London;Boston; Healy, P. and Palepu, K., 2012.Business Analysis Valuation: Using Financial Statements. Cengage Learning. Jones, T. 2012,Strategic Managerial Accounting: Hospitality, Tourism Events Applications,6th edn, Goodfellow Publishers Limited, GB Jones, T., Atkinson, H. and Lorenz, A., 2012.Strategic managerial accounting: hospitality, tourism events applications. Goodfellow Kaplan, R.S. and Atkinson, A.A., 2015.Advanced management accounting. PHI Learning Marginson, D., 2013. Budgetary control.The Routledge Companion to Cost Management, p.9 Mroczkowski, N.A. Flanders, D. 2015,Accounting: to trial balance,11th edn, Cengage Learning Australia, South Melbourne, Victoria Muradolu, Y.G. and Sivaprasad, S., 2014. The impact of leverage on stock returns in the hospitality sector: evidence from the UK.Tourism Analysis,19(2), pp.161-171 Nunes, C.R. and Machado, M.J.C.V., 2014. Performance evaluation methods in the hotel industry.Tourism Management Studies,10(1), pp.24-30. Nyide, C.J., Zwane, B.K. and Nxumalo, B.H., 2014. Financial Accounting 1 Module II Weygandt, J.J., Kimmel, P.D. and Kieso, D.E., 2015.Financial Managerial Accounting. John Wiley Sons Whitecotton, S., Libby, R. and Phillips, F., 2013.Managerial accounting. McGraw-Hill Higher Education.

Gerald Ford Essays - Vice Presidents Of The United States

Gerald Ford When Gerald R. Ford took the oath of office on August 9, 1974, he declared, I assume the Presidency under extraordinary circumstances.... This is an hour of history that troubles our minds and hurts our hearts. It was indeed an unprecedented time. He had been the first Vice President chosen under the terms of the Twenty-fifth Amendment and, in the aftermath of the Watergate scandal, was succeeding the first President ever to resign. Ford was confronted with almost insuperable tasks. There were the challenges of mastering inflation, reviving a depressed economy, solving chronic energy shortages, and trying to ensure world peace. The President acted to curb the trend toward Government intervention and spending as a means of solving the problems of American society and the economy. In the long run, he believed, this shift would bring a better life for all Americans. Ford's reputation for integrity and openness had made him popular during his 25 years in Congress. From 1965 to 1973, he was House Minority Leader. Born in Omaha, Nebraska, in 1913, he grew up in Grand Rapids, Michigan. He starred on the University of Michigan football team, then went to Yale, where he served as assistant coach while earning his law degree. During World War II he attained the rank of lieutenant commander in the Navy. After the war he returned to Grand Rapids, where he began the practice of law, and entered Republican politics. A few weeks before his election to Congress in 1948, he married Elizabeth Bloomer. They have four children: Michael, John, Steven, and Susan. As President, Ford tried to calm earlier controversies by granting former President Nixon a full pardon. His nominee for Vice President, former Governor Nelson Rockefeller of New York, was the second person to fill that office by appointment. Gradually, Ford selected a cabinet of his own. Ford established his policies during his first year in office, despite opposition from a heavily Democratic Congress. His first goal was to curb inflation. Then, when recession became the Nation's most serious domestic problem, he shifted to measures aimed at stimulating the economy. But, still fearing inflation, Ford vetoed a number of non-military appropriations bills that would have further increased the already heavy budgetary deficit. During his first 14 months as President he vetoed 39 measures. His vetoes were usually sustained. Ford continued as he had in his Congressional days to view himself as a moderate in domestic affairs, a conservative in fiscal affairs, and a dyed-in-the-wool internationalist in foreign affairs. A major goal was to help business operate more freely by reducing taxes upon it and easing the controls exercised by regulatory agencies. We...declared our independence 200 years ago, and we are not about to lose it now to paper shufflers and computers, he said. In foreign affairs Ford acted vigorously to maintain U. S. power and prestige after the collapse of Cambodia and South Viet Nam. Preventing a new war in the Middle East remained a major objective; by providing aid to both Israel and Egypt, the Ford Administration helped persuade the two countries to accept an interim truce agreement. Detente with the Soviet Union continued. President Ford and Soviet leader Leonid I. Brezhnev set new limitations upon nuclear weapons. President Ford won the Republican nomination for the Presidency in 1976, but lost the election to his Democratic opponent, former Governor Jimmy Carter of Georgia. On Inauguration Day, President Carter began his speech: For myself and for our Nation, I want to thank my predecessor for all he has done to heal our land. A grateful people concurred. Bibliography When Gerald R. Ford took the oath of office on August 9, 1974, he declared, I assume the Presidency under extraordinary circumstances.... This is an hour of history that troubles our minds and hurts our hearts. It was indeed an unprecedented time. He had been the first Vice President chosen under the terms of the Twenty-fifth Amendment and, in the aftermath of the Watergate scandal, was succeeding the first President ever to resign. Ford was confronted with almost insuperable tasks. There were the challenges of mastering inflation, reviving a depressed economy, solving chronic energy shortages, and trying to ensure world peace. The President acted to curb the trend toward Government intervention and spending as a means of solving the problems of American society and the economy. In the long run, he

How to make the first date unforgettable

How to make the first date unforgettable 7 Awesome Indoor First Date Ideas If you have met someone truly special, you will probably want to impress him or her with something, whether it is your personality and charm, or a cool date. Many people think that a dinner is the very best option you eat, you talk, you wear nice clothes. However, there is something unbearably boring and predictable about it. Why not do something original instead? Here are a couple of more imaginative ideas for a first date that you might want to try. A fitness class or a yoga session can offer a great opportunity to showcase your body. And, of course, stare at your partners. Remember to pick something that both of you would feel comfortable doing. Your date becoming self-conscious for not being able to keep up is definitely not the result you want. Most importantly, have fun! On a related note, a dance class would also allow you to touch each other for a completely innocent reason. Paying a visit to a psychic may show that you are thinking about future. This is a great option for people with a sense of humor and adventure. Just do not try this if your date is a staunch rationalist. Volunteer together! This might seem like more of an established relationship thing to do, but try to think about it from a different perspective. This will allow you to learn more about you dates character and ideas about life. Everyone wants a kind and compassionate person in his or her life, and doing something for those in need will help you find out whether you have already found one. Dare them to play video games with you. Personally, I am very competitive, so playing computer games with my partner is always a lot of fun. We play, laugh, throw pillows at each other, and generally have great time together. So, grab a console and enjoy a match or two. If you win, you can also get to know whether you date is a sore loser! Visit a used bookstore. Or go to your local BarnesNoble. It does not really matter. If both of you appreciate good literature, going between the isle, reminiscing about your favorites, giving each other recommendation, laughing about some terrible reads, you have had, is an incredible bonding experience. Go shopping for gifts.Christmas season is soon, and now it is the best time to buy presents. Going shopping will give you a chance to learn about each others families and friends and the way you feel about them. You can also ask for gift ideas and recommendations, so if your date is successful, you will know what to buy as a Christmas present!Hopefully, these ideas will help you organize a great first date that will impress your chosen one and set you on the course to true love. Just remember, that if you want your relationship to succeed, all the consecutive dates are just as important as the first rendezvous!

Qualities of Successful Marriages Personal Statement

Qualities of Successful Marriages - Personal Statement Example But they have become the best of companions while respecting and incorporating each other's differences. What I learned from my family's positive example has translated into my relationships with friends and boyfriends. I try to keep an open mind so that I can enjoy what they enjoy and really be part of their life. During my early teenage years I went through a phase of thinking that I needed to have as many friends as possible to seem "popular." This led me to choose quantity over quality and although I became "friends" with more people, the depth of each friendship became less and less. I could tell what was happening because I barely spent time with the close friends I had before. I went back to the way I was before, because being a really good companion felt better than being a companion to lots of people. This is a lesson that I hope to remember throughout my life so that all of my relationships with people are deep and meaningful. One of my first major relationships was not a very honest one. I cheated on him a lot, and lied about it. But I think I may have been hurting myself more than I was hurting him. The complications of that relationship have created problems in more recent relationships. Because I cheated on someone and he didn't know about it for such a long time, I started to think about the possibility and likelihood of it happening to me. My own actions have led me to paranoia and an inability to trust trustworthy people. Every time a boyfriend tells me about his day, I find myself questioning the reality of his story. I have noticed this in other Hispanic girls and think it may be true of me also that my parents are very overprotective of me when it comes to boys. This has led me to lie to my parents on more than one occasion about where I am and who I'm with. The lies I used to tell my parents led to a lot of hurt, both on their side and mine. What I have taken from my past is a stronger personal adherence to honesty. I have experienced first-hand the bad things that come from dishonesty and now know how important it is to be honest. I still have trouble trusting people who have done nothing bad to earn my distrust, so there is certainly room to grow. I think that as I continue being honest and surrounding myself in positive, honest relationships, I will regain my trust in other people. Responsibility Because my parents were so overprotective of me, I was always trying to prove to them and myself that I was independent. This need for independence led me to do responsible things. I started taking care of younger children as a babysitter when I was only thirteen, and got a "real job" when I was old enough. I was always on time to work and never missed a day. This responsibility was also reflected in school, as I always did my homework and made good grades. I reached a rebellious point in my life (perhaps because now my parents expected me to be responsible and I always wanted to disprove them) and I started to disregard my schoolwork and job commitments. I quickly realized that my irresponsibility had no positive benefits and only made me feel bad about myself, so my rebellious phase was short-lived. I also think that my job as a babysitter helped me know what it was like to be responsible for other people. As a youngest child, I never had any younger siblings to take care of and be responsible

Consider MOOCs and discuss whether they are a revolutionary Essay

Consider MOOCs and discuss whether they are a revolutionary breakthrough in education or simply a fad - Essay Example Traditional forms of learning like classroom settings and direct lecturing are slowly fading (Sharpe 27). In this context, we can say that advancement in technology remains the main attribute for these dynamics in the social aspect of education. On the other hand, the aspect of globalization also contributes towards witnessed shifts in education patterns. Students from various parts of the world are converging at the best learning institutions in search of knowledge (Sharpe 34). In this case, increase in student population necessitates changes in order to adjust service delivery programs. Presence of cut-edge technology facilitates the development of such desired service delivery systems. This essay appraises a developing program within the education sector in terms of its impacts and expected future trends and resourcefulness. In 2010, leading universities in Europe and America were striving to formulate new learning policies meant to address increasing influence of globalization. S takeholders wanted to restructure education models, especially within institutions of higher learning. This development largely focused on the role played by teachers in modern learning environments characterized by huge student-teacher population ratio (Adrie and Finegan 72). As a result, researchers from the University of Michigan and Stanford University conducted objective evaluation on existing teaching methods. Towards the end of their research articles, they postulated appropriate recommendations meant to deal with new developments in the education sector. As a result, the two research bodies termed massive open online courses, abbreviated as MOOCs as the most suitable educational program (Bowen 45). This program aimed at developing a method meant to address the need to change teachers’ roles in learning activities. In addition, MOOCs will serve as the best technique of dealing with an increase in student population. In actual practice, the University of Miami in 2012 f eatured as one university adopting a massive open online course program. Subsequently, MOOCs rolled into other parts of the world like Australia, where the nation’s university of South Wales adopted a course of computing using the MOOCs program. Currently, extrapolated research on education methods suggest that open online courses can literary feature as knocking down campus boundaries. According to one researcher, who is a professor of research at Stanford College, the scholar says that MOOCs will take over as new methods of delivering knowledge to students. Big breakthroughs happen when what is suddenly possible meets what is desperately necessary (Friedman 01). In order to appreciate the role played by MOOCs, we will evaluate its components in functioning and design. Creation of MOOCs seeks to address the increasing number of interested learners within academic environments. In this context, technical developments of MOOCs programs seek to facilitate timely and professiona l delivery of information to a large student population. MOOCs use internet connectivity in creating interaction platforms through collaboration groups or peer-reviews (Bowen 65). On the other hand, delivery of information integrated appropriate feedback mechanisms meant to assess the success of learning among the student population. In this case, MOOCs has a feedback provision, which involves automated online assessment through exams and quizzes. At the end of the assessment process, students’

Planning, preparing and creating a Business Research Paper

Planning, preparing and creating a Business - Research Paper Example â€Å"An effective work environment is vital to the success of small businesses and large corporations alike†. Business environments have been changed a lot in the recent past because of Globalization, Privatization and Liberalization. It is easy for an entrepreneur to set up business in overseas countries easily at present because of the changing business environment. In other words, before starting a business, an entrepreneur should evaluate the possibility of competition not only from the domestic firms, but also from international firms as well. The business idea should be selected after the careful evaluation of all internal and external parameters of business. The fluctuations in world economy in the recent past have affected almost all types of businesses badly. The waves of recession not only created problems to poor countries or developing countries, but it has created big problems to even developed economies like America Britain etc. Before starting a business in the changing business environment, an entrepreneur should take extreme precautions. This paper analyses various dimensions of starting a business like planning, preparing etc. Lots of people have very good business ideas, but they often fail to implement their business ideas successfully because of the poor planning and implementation. Many people stay away from because of the financial constraints even though they have better business idea. As stated in the earlier, money is the last thing required to start a business. It is not necessary that a person with enough financial capabilities may become good entrepreneurs; at the same time there are many successful stories of entrepreneurs who started their business without enough financial resources. Innovative business ideas and proper implementation of the business ideas at the right place at the right time with the help of the right people are the major success factors of a business. The entrepreneur should be accurate and realistic while presenting of his business to the public (Start Up Planning). Conceptualization of business is an important aspect as far as an entrepreneur is concerned. The meaning of business, product/services, customers etc should be well defined before the start of the business. The entrepreneurs should find answers to the following questions before starting a business; what business are we in? What do we want to do? What are we committed to? What results do we want to achieve? The answers to these questions help shaping the mission and the vision of a business before starting it. Shaping a mission and a vision helps the small business owner to remain focused and this will bring results in his work. The mission and vision should be fully understandable and viable to the customers since it is the customer who ultimately decides the success and failures of a business. For example, in order to start a baby cloth store, the vision and mission should be focussed entirely on the wellbeing of the babies. The vision should offer complete comfort and a germ free, healthy dressing experience to the babies. It should ensure protection of the babies from the changing climate conditions. Moreover the vision should ensure cheap price along with better quality of the products, as these are the two main factors mostly the customers are looking for. â€Å"If you’re thinking about starting a small business, you should start by weighing the pros and cons, so that you can make a wise decision†

Personality Disorder Carer and Family Support Impact

Personality Disorder Carer and Family Support Impact ARE PSYCHO-EDUCATIONAL AND SUPPORT PROGRAMMES FOR FAMILY AND CARERS EFFECTIVE IN REDUCING RELAPSES AND FACILITATING RECOVERY OF PEOPLE SUFFERING FROM PERSONALITY DISORDERS? ABSTRACT Background Carers and families of people suffering from personality disorder are in desperate need of support and services. Providing these services can reduce relapses and facilitate recovery in sufferers of personality disorder. The Research Question How can psycho-educational and support programmes for carers and families of those with personality disorder improve their recovery? Methodology The results of this study were obtained through a systematic literature review. Results Diagnosis and treatment of personality disorder are still complex and often confusing issues, even for professionals. Still, treatment can produce recovery and this recovery can be expedited if carers and families are provided with programmes to equip them to effectively face the challenges that personality disorder presents. Conclusions Providing psycho-educational and support programmes makes carers more effective and can help treat personality disorder. Social Workers can help to bridge a gap in the services that is adversely affecting the treatment outcomes of sufferers and hence placing greater strain on the Health System than is necessary. Contextualisation The carers and families of individuals suffering from personality disorders are an underserved population. Considerable strain is placed upon them and their loved ones and they are often at a loss as to how to effectively perform their duties and assist the recovery of those they care for. If more psycho-educational and support programmes for carers and families were provided, it is possible that treatment for personality disorder could be improved. Personality disorders can be defined as: â€Å". . . psychiatric conditions relating to functional impairment, or psychological distress resulting from inflexible and maladaptive personality traits.†1 Personality disorders are explained in the two most prominent classification schemes, the DSM-IV, where personality disorders can be found in Axis II, and the ICD-10. The definitions in these diagnostic classification systems are much the same. Defining ‘severe personality disorder has proved problematic for experts, who have yet to establish a generally accepted definition. The suggestion of the Royal College of Psychiatrists (1999) that severe personality disorder is marked by extreme societal disturbance and at least one extreme personality disorder has provided some guidance.2 Alternatively, having two severe disorders could mean that the sufferer has one disorder that expresses itself in more than one extreme way, or could simply indicate one deeply disturbing disorder. One study graded the severity of personality disorder on 163 subjects and found that the patients whose personality disorder was described as ‘complex demonstrated the greatest number of symptoms and recovered the least. Personality disorder carers are people who support a person who suffers from any form of personality disorder, whether they are relatives, friends or partners. Often, carers give sufferers emotional and financial support and may even act as informal social workers. Previous studies have shown that carers of people with personality disorder benefit from psycho-educational and support programmes. Psycho-educational programmes are educational programmes that contain an element of counselling or therapeutic activity for the family. The main aim of these programmes is to minimise the strain experienced by families and carers of people with mental illnesses, here personality disorder. Psycho-educational and counselling programmes exist ultimately to facilitate recovery and reduce relapses; indeed, the success of programmes is usually measured by examining relapse rates. Programmes attempt to provide adequate support, information, signposting to appropriate resources, advocacy and respite for carers. They also coach carers to increase their problem solving abilities, improve their communication and help them construct their own support networks. Support programmes for carers of people with a mental illness attempt to support the contribution that carers make to the lives of those they care for. They work toward advances in policy that will augment the services that satisfy carer requirements. Support programmes prompt dialogue between members of the government and carers, as well as encouraging carer involvement in the creation and delivery of carer and patient services. Further, support services connect carers with agencies to assist them in their role and facilitate modes of best practice in aiding carers. The Research Question This literature review examines a number of studies on personality disorder, its effect on carers and issues connected with diagnosis and treatment in an attempt to determine whether psycho-educational and support programmes for family and carers are effective in reducing relapses and facilitating recovery of people suffering from personality disorders. If social workers are to work effectively with this client base, they must put aside antiquated beliefs that personality disorder cases are hopeless and that those who suffer from personality disorder never get better. This study reveals that one of the greatest challenges to carers and families is obtaining the support they need and the services they are entitled to, and Social Workers can be instrumental in bridging gaps in the Mental Health system. Methodology This dissertation undertakes a systematic literature review of health care and psychological literature to address key issues in the support of carers of people suffering from personality disorders. Several different studies and a range of approaches were examined. Although the number and breadth of studies was a strength of the review, the variety of approaches made it challenging to compare the overall merits of one study against another. The literature was obtained through a variety of means. Google searches, journal articles, working group reports, service provider reports and academic papers were used. The research methods that appear in the utilised material included telephone interviews, questionnaires and surveys, face-to-face interviews and meta-analysis. Some were literature reviews themselves and some simply reported on the outcomes when a group of treated individuals was observed. Of the studies that involved observation of a group, very few included a control group in the study so methodological rigour was not as great as it could have been. Neither is it certain that studies where self-reporting was used are as empirically reliable as one would like, as sufferers of personality disorder tend to over- or under-report their symptoms . Some of the studies that were conducted recently showed positive outcomes, but the long-term follow-up for the same groups may make the figures less significant. Even where there has been longterm follow-up, some of those who took part in the initial study may not be included because of death, inability or unwillingness to participate, or inability to be located. The methodological rigour of the studies is further complicated by the fact that the process of diagnosis and treatment of personality disorder is fraught with complexities. The categories for personality disorder are somewhat defined by behaviours and are not theoretically based or grounded in common mechanisms of the disorder. The actions and symptoms of patients are so extremely varied that both diagnosis and treatment are difficult to present, much less to assess. Yet just because a comprehensive catalogue of truths about personality disorder cannot be presented does not mean that no reliable statements can be made. The evidence that is presented here is solid enough to make general assertions regarding the affects of carer support on patients based upon the evidence, and that is what it intends to do. Assessing the impact of support and education for carers upon the sufferers of personality disorder themselves proved more challenging than, for example, assessing the impact of treatment on sufferers, for which there is abundant literature. Still, the impact of psycho-educational and support programmes on consumers has been assessed and outcomes observed. Additionally, the evidence for the improvement of the lives of carers and the quality of care they give their charges is strong, and this fact bolsters the hypothesis that improved care for carers improves the mental health of those for whom they care. These conclusions are definitely linked, especially given the statistics that show that improvement for personality disorder takes place over a long period of time and is facilitated by positive interpersonal relationships with people who are equipped to deal with the symptoms that people with personality disorder exhibit. The presence of positive relationships with carers who are tr ained, educated and supported will assuredly improve the ‘treatment conditions for those with personality disorder. In narrowing the scope of the literature to be included in the study, several factors had to be noted. Some of the literature was so grounded in certain programmes for certain countries that many sections were not transferable to this review. For example, the results of the Network for Carers (2004) report were based upon specific programmes offered in Australia, so some information had to be excluded. However, this document was very helpful in establishing general facts about the needs of carers and the impact of programmes upon their ability to care for sufferers. It was also a thorough exposition of the opinions of carers,through which their voice was clearly heard. There were also other limitations regarding the particular demographic studied. The NHS National Programme on Forensic Mental Health Research and Development Expert Paper on Personality Disorders primarily assessed offenders with personality disorder and not merely members of the wider public suffering from the disorde r. Because of this, significant sections of the material had to be ignored. Still, this paper was useful in understanding the complexities of treatment and diagnosis of personality disorder, and provided definitions for contextualisation. In evaluating the quality of the data, the analytical tool Critical Appraisal Skills Programme (CASP) was used to assist in making sense of the evidence. This tool is advantageous to those who are strangers to qualitative research, assessing the merits of a source with regard to rigour, credibility and relevance.CASP initially asks two screening questions, the first addressing research aims and significance. The second screening question considers whether the research interprets subjective experiences of participants.Answering these two questions with a ‘yes then leads to eight more questions covering issues such as recruitment strategies, collection of data and ethical issues. In a literature review there are several ethical issues that must be considered, especially when dealing with a vulnerable population such as sufferers of mental illness. For each study used in the review it was necessary to consider whether ethical standards were maintained throughout the study, includi ng the manner in which consent was obtained and the way that confidentiality was upheld. Another ethical consideration is the handling of the outcomes of the study with the participants after the study.9 In the data observed here, it is not always explicit that consent was obtained but is often implied. Eliciting feedback from carers carries implied consent even if consent was not explicit, for obviously no individual would be forced to comment against his or her will. Confidentiality is maintained through omitting names and keeping the results impersonal. Yet the information given for studies is in its final and often abbreviated form, and the background work is not always documented comprehensively enough to ascertain whether all ethical considerations have been taken into account. One ethical consideration that is not always considered is the treatment of ethnic minorities in research projects, especially those for whom English is not their first language. The wording of questions and the criteria by which outcomes are judged is often tainted by cultural bias for those being assessed outside their native surroundings. It is practically impossible to remedy this, because part of the methodological rigour of the study depends upon all participants being treated and assessed in the same way. Differentiation on the basis of cultural differences would compromise the consistency of the study, but the impact of cultural factors is most certainly felt by those of foreign origin. Discussion of Findings Traits The traits exhibited by sufferers of personality disorder differ immensely because of the wide scope of the disorder. Examples of traits range from anxiety, narcissism and compulsivity to defiance, abnormal attachments and avoidance of social situations. Sufferers may demonstrate an arrogant interpersonal style, or may show extreme submissiveness. Personality disorders are linked with negative results in the wider population such as marital breakdown, criminal actions and professional difficulties.The anomalies of personality disorder are apparent in the thought patters, expressions and levels of self-control of sufferers. The patient will display abnormalities in the way that he or she interacts with others which will appear in a range of circumstances. There are various types of personality disorders, and each has its own banners of dysfunction. It has been recognised that the kinds of personality disorders covered in DSM and ICD are a small cluster when contrasted with the array o f personality impairments that can be identified in large configurations of people.11 Personality disorders can be divided into three clusters, A-C. In the first cluster disorders relating to paranoia and schizophrenia are found. Cluster B includes antisocial and narcissistic disorders, and Cluster C focuses on avoidant, dependent and obsessive-compulsive disorders. Prevalence It is estimated that between 6% and 15% of the population have one or more personality disorders of some kind—different studies produce different results.13 The goal of one study was to estimate the prevalence of personality disorders in a local sample and discern the most common demographic groups therein. The frequency of the DSM and ICD personality disorders and the interactions between disorder clusters and demographic qualities was assessed in a local sample of 742 participants between the ages of 34 and 94 over two years.14 The results showed that the overall prevalence of DSM-IV personality disorders was approximately 9%. Among the disorders, antisocial personality disorder was the most common and appeared in almost 5% of those assessed. Dependent personality disorder and narcissistic personality disorders were rare. The prevalence of many of the individual disorders was only 1% to 2%. For ICD-10 disorders, the overall presence in the surveyed group was 7%. Again, the prevalence for individual disorders was 1% to 2%. The most common disorder in for the ICD disorders was dissocial personality disorder at 3%. Dependent personality disorder was, again, very rare. Who is affected? Studies dedicated to uncovering the risk factors for personality disorder produced a variety of results. Prominent factors that may lead to a personality disorder include having a parent who is involved in or has been convicted of a crime, having a parent with deficient parenting abilities and being part of a large family. Factors such as low intelligence also feature in the list of risk factors. However, this study and studies that are similar raise certain issues about the nature of judging which factors should be included as risk factors for personality disorder. These sorts of factors could be criticised for having prejudicial antecedent assumptions regarding what it means to be a functioning human being. It is likely that people from lower socio-economic classes will have a tendency to fit these categories more than their middle- or upper class counterparts.Care should be taken in describing risk factors to ensure the language used is not biased by class. In the study mentioned above, several demographic characteristics were assessed with regard to prevalence of personality disorder. The outcomes demonstrated that Cluster A disorders were more common in males than in females. Cluster A disorders were also more prevalent in participants who were divorced or separated than those who were married or widowed. Subjects who had never been married were the most susceptible sub-group of all. In the Cluster B category, men were again more prone to having a personality disorder than women. Cluster B disorders were most common in the youngest age range surveyed and least common in the oldest range. Further, this cluster was most prevalent in participants who lacked a high school diploma and was least prevalent in participants who graduated from high school and continued their education afterwards. The odds of having one of these disorders decreased approximately 6% for each year an individual aged. One possible explanation for the increase of prevalence of disorder with age could be that people of more mature generations are less likely to have, know about or report symptoms of personality disorder. The prevalence of Cluster C disorders was most closely related to marital status, again showing that participants who had never been married were most likely to have one of these disorders. The likelihood of having a Cluster C disorder was almost 7 times greater in those never married when contrasted with those who were married or widowed. The results of this study broadly match a number of previous studies whose results showed the prevalence of personality disorders in the general population to be 9-13%. However, there were some differences between previous studies on prevalence and this study. The present study found a notably higher prevalence of antisocial personality disorder and a much lower prevalence of histrionic and dependent personality disorders than previous studies. These differences could have been caused by methodological variants and the diagnostic criteria used such as which version of the DSM was utilised. The differences could also be a result of participant source, form of assessment, assessors experience and data collection methods. Notable strengths of the study were that the participants were obtained through a community sample and personally interviewed by psychologists who have a significant amount of experience in cross-examination. The limitations included the fact that not all subjects coul d be interviewed and that the sample size was not really large enough to pick up on very rare disorders. The results of other studies have been less conclusive. An American study examined the theory that personality traits stop transforming by the time an individual reaches the age of 30. One of the major strengths of this study was the sample size of 132,515. The subjects, aged 21-60, participated in a web-based Big Five personality measurement. The results of this study showed that qualities such as being agreeable and conscientious increased during adulthood up through middle age. The quality of being neurotic diminished for women but remained static for men.20 Both men and women decreased in openness after the age of 30, and while men increased in extraversion from 31 to 60, the same quality diminished in women in the same age range.21 While the sample size of this study was certainly impressive, one concern was that conducting the study over the internet might bias it toward younger subjects. Another concern was the cohort effect, since people of earlier generations might not engag e with psychological instruments with the same ease as those who are younger. Overall, the multiplicity in paradigms of change did not affirm either that personality does not change after 30 or that it does. The study concludes that the traits examined are complex in nature and subject to an array of developmental influences. Historical View The onset of the de-institutionalisation of mental health establishments has produced a number of benefits. There is now less public stigma placed upon sufferers of mental illness and their traits and presence in wider society has come a long way toward normalisation. Suffers of mental illness have become less isolated and enjoy greater freedoms, including the freedom to choose from a selection of services. From a governmental point of view, deinstitutionalisation has saved them an enormous amount of money. However, the responsibility for managing and caring for mental illness sufferers has been transferred from the institution to the local community, and specifically to carers. Carers are involved in every possible aspect of the lives of their charges, even to the extent that their role could be characterised as an informal social worker. But the burden of the role combined with the lack of training, education and support often results in the damage of the psychological health of th e carer, as well as strict limitations on their life outside the caring role. The striking impact of caring on the lives of carers and other factors led to the undertaking of research on the involvement of families in managing and treating mental illness. From this came solid evidence of the benefits of such involvement, and the needs of carers began to be recognised. In recent years services have been put in place to assure that the needs of carers are met, and education for carers has been pinpointed as the most beneficial service for carers and consumers. Carers need to be educated in order to feel equipped to perform their tasks effectively. Specifically, carers named a need for â€Å"education about mental disorders† and information about treatment options† as their most salient needs. These statements are reinforced by studies from various countries where carers named the same things as most important for their success. Historically, studies examining the impact of educational programmes for carers have come from two different hypotheses. The first is that the chances of a consumer recovering from a mental illness are augmented if an educated and informed family surrounds him or her. Such a family will have deeper knowledge and sympathy for the condition of the sufferer and will be equipped to manage challenging behaviours. The second hypothesis is that because of the implications of their role, carers have an inherent right to access to adequate services. They have a right to services that will enhance their individual welfare and their effectiveness as carers. Assigning a course of treatment to personality disorder has always been an inexact science. Personality disorder is particularly complex to treat because the prime method of treatment is not always apparent after a diagnosis has been arrived at. The type of treatment which will prove most effective for the patient differs from individual to individual. Case conceptualisations can be helpful in assessing the individuals issues, identifying areas of risk and determining proper treatment goals.24 There is an abundance of research about treating personality disorder, but the studies cannot always be relied upon due to their lack of sound methodology. While some forms of treatment for personality disorder can reduce relapses and facilitate recovery, there is no simple panacea for this ailment. Cognitive treatments including cognitive-behavioural approaches have produced some pleasing results with personality disorder patients, as have psychodynamic treatments. Diagnosis Individuals who suffer from personality disorder encounter several issues with their diagnoses. They may be diagnosed through the means of an interview, a self assessment questionnaire or other means. Clinical psychiatrists often diagnose patients through interviewing them with regard to the DSM or ICD categories. This method is slightly better for detecting the existence or not of a personality disorder, but shows low accuracy for particular types of disorder. Self-report questionnaires like the Personality Diagnostic Questionnaire (PDQ-IV) and the Millon Clinical Multi-axial Inventory (MCMI) are also used to diagnose personality disorder. These questionnaires are considered imprecise because individuals tend to over-emphasise or under-emphasise the issues they are having. In addition to these methods of diagnosis, there are several semi-structured interview schedules to assist professionals. These schedules feature lists of questions that correlate to the DSM or ICD and the clinici an may then mark the patient and determine whether he or she has a disorder according to the criteria. Interview schedules have shown that they are slightly more reliable than other forms of diagnosis, but this success is only relative and the results are still much less valid than is needed. Really none of the diagnostic tools should be considered better than any of the others, for they are all faulty to the extent that they cannot be relied upon. There is a problematic absence of consensus regarding the reliability of diagnosing in general and the consistency of different diagnostic schemes. Part of the problem is that the explanations of personality disorders in the DSM and ICD feature a concoction of psychological traits and displayed behaviours, so that it becomes uncertain whether the diagnoses are attempting merely to pinpoint deviant actions or to identify traits whose presence is significant for determining personality disorder. The solidity of diagnoses for personality disorder is frequently questioned, and there are only a few disorders whose diagnoses are considered reliable. The diagnosis that can be made with the most certainty is antisocial personality disorder, because this problem can be identified by external actions that can be easily observed. Those who diagnose individuals with personality disorder are not always able to be precise in identifying which personality disorder they are dealing with, therefore m ultiple personality disorder diagnoses are common. Clinicians often find themselves confronting comorbidity, and prudent professionals test for the full scope of disorders. Comorbidity is quite common, with male legal psychopaths having an average of three disorders each. Women may have four.28 There is a great amount of interaction between the descriptors of the various types of personality disorder and so it is difficult to tell them apart. When dealing with multiple diagnoses, it is advisable to keep all disorders in mind when constructing a treatment regime, even if many of the features of the respective disorders overlap. The classification of disorders is also problematic, because the categories lack the quality of homogeneity present in reliable psychological categories of other types. Categories of psychological dysfunction work best when each class is different from others and common elements are contained within one class. This is not the case with personality disorders. For example, there are literally hundreds of ways to satisfy the criteria for borderline personality disorder, and so individuals with the same diagnosis may have utterly distinct behaviours, symptoms and needs. Axis I disorders feature frequently in those who suffer from personality disorder, particularly where there is substance abuse or depression. The classifications for personality disorder tend neither to be theoretically based, nor to stem from statistical research, which is presumably part of the reason that precise diagnoses are so elusive. The categories are so unreliable that abandoning the categories altogether and composing a new classification system is often proposed. While this may be the ideal way to correct the flaws, the time and effort already invested in the use of the present system is likely to ensure its continued existence. One approach to dealing with personality disorder is the trait approach. This approach states that a minimal amount of theories can illumine the majority of human behaviour. Observing the personality traits exhibited by an individual and placing them on a continuum from truly normal to extremely dysfunctional is more faithful to the structure of t he human psyche and tells clinicians more about the true nature of the dysfunction suffered by the patient. Currently, the most extensively developed trait theory relating to personality disorder is the theory of psychopathology. Treatment Cognitive-behavioural treatments (CBT) aimed at treating personality disorders have a tendency to take a broad approach. CBTs engage an array of behaviours, thoughts, preconceptions and internal emotional mechanisms. Many treatments are residential and are conducted with a group. They frequently include tenets of other methods such as psychodynamic therapy. Therefore it is an arduous task to pick out what, if any, elements are effective in a multi-dimensional approach so that they can be improved and repeated. Dialectical behaviour therapy (DBT) is a method of CBT focusing on female patients with borderline personality disorder. The goal of the therapy is to reduce or eliminate incidents of self-harm through group skills training. Group sessions address destructive thought patterns and social skills. Individual therapy can also be used. The outcomes for one study showed that women who were treated experienced reduced anger and self-destructive or suicidal thoughts. Their social skills improved and they required less psychiatric treatment. Arnold Lodge Regional Secure Unit has produced a treatment method aimed specifically at offenders with a personality disorder. The treatment programme centres on teaching patients socially acceptable mechanisms for problem solving. The patients work individually and with others and receive regular counselling. This regime is supplemented with services that are individually tailored to the needs of the individual, such as anger management sessions or substance abuse education. This form of treatment has been shown to reduce deficiencies in social functioning and self-control.32 While the initial studies are promising, long-term analysis will confirm or refute the true effectiveness of this type of treatment. Therapeutic communities, cognitive therapies and dynamic therapies may also be used to treat personality disorder. Therapeutic communities are tailored primarily for offenders and have produced promising results in terms of reduced recidivism and improved social integration. A study into the effectiveness of therapeutic community treatment of personality disorder explored whether this type of treatment improved the health of patients to the extent that the burden on Health Services eased. Several previous studies reported reductions in the use of psychiatric services after therapeutic community treatment. The previous studies were limited by the fact that they observed participants for one year only and lacked thorough follow-up. This study sought to fill the methodological gaps of the previous studies by tracking patients for years after treatment. They assessed the impact of treatment on Health Services by counting the number of admissions to hospital before and after treatment. Th e study found that therapeutic community treatment resulted in a statistically significant drop in in-patient admissions over the 3-year period. Those who were admitted to hospital tended to be the subjects who had the briefest experience of therapeutic community treatment. Another study involving therapeutic community treatment focused on individuals with severe personality disorder. The effect of p Personality Disorder Carer and Family Support Impact Personality Disorder Carer and Family Support Impact ARE PSYCHO-EDUCATIONAL AND SUPPORT PROGRAMMES FOR FAMILY AND CARERS EFFECTIVE IN REDUCING RELAPSES AND FACILITATING RECOVERY OF PEOPLE SUFFERING FROM PERSONALITY DISORDERS? ABSTRACT Background Carers and families of people suffering from personality disorder are in desperate need of support and services. Providing these services can reduce relapses and facilitate recovery in sufferers of personality disorder. The Research Question How can psycho-educational and support programmes for carers and families of those with personality disorder improve their recovery? Methodology The results of this study were obtained through a systematic literature review. Results Diagnosis and treatment of personality disorder are still complex and often confusing issues, even for professionals. Still, treatment can produce recovery and this recovery can be expedited if carers and families are provided with programmes to equip them to effectively face the challenges that personality disorder presents. Conclusions Providing psycho-educational and support programmes makes carers more effective and can help treat personality disorder. Social Workers can help to bridge a gap in the services that is adversely affecting the treatment outcomes of sufferers and hence placing greater strain on the Health System than is necessary. Contextualisation The carers and families of individuals suffering from personality disorders are an underserved population. Considerable strain is placed upon them and their loved ones and they are often at a loss as to how to effectively perform their duties and assist the recovery of those they care for. If more psycho-educational and support programmes for carers and families were provided, it is possible that treatment for personality disorder could be improved. Personality disorders can be defined as: â€Å". . . psychiatric conditions relating to functional impairment, or psychological distress resulting from inflexible and maladaptive personality traits.†1 Personality disorders are explained in the two most prominent classification schemes, the DSM-IV, where personality disorders can be found in Axis II, and the ICD-10. The definitions in these diagnostic classification systems are much the same. Defining ‘severe personality disorder has proved problematic for experts, who have yet to establish a generally accepted definition. The suggestion of the Royal College of Psychiatrists (1999) that severe personality disorder is marked by extreme societal disturbance and at least one extreme personality disorder has provided some guidance.2 Alternatively, having two severe disorders could mean that the sufferer has one disorder that expresses itself in more than one extreme way, or could simply indicate one deeply disturbing disorder. One study graded the severity of personality disorder on 163 subjects and found that the patients whose personality disorder was described as ‘complex demonstrated the greatest number of symptoms and recovered the least. Personality disorder carers are people who support a person who suffers from any form of personality disorder, whether they are relatives, friends or partners. Often, carers give sufferers emotional and financial support and may even act as informal social workers. Previous studies have shown that carers of people with personality disorder benefit from psycho-educational and support programmes. Psycho-educational programmes are educational programmes that contain an element of counselling or therapeutic activity for the family. The main aim of these programmes is to minimise the strain experienced by families and carers of people with mental illnesses, here personality disorder. Psycho-educational and counselling programmes exist ultimately to facilitate recovery and reduce relapses; indeed, the success of programmes is usually measured by examining relapse rates. Programmes attempt to provide adequate support, information, signposting to appropriate resources, advocacy and respite for carers. They also coach carers to increase their problem solving abilities, improve their communication and help them construct their own support networks. Support programmes for carers of people with a mental illness attempt to support the contribution that carers make to the lives of those they care for. They work toward advances in policy that will augment the services that satisfy carer requirements. Support programmes prompt dialogue between members of the government and carers, as well as encouraging carer involvement in the creation and delivery of carer and patient services. Further, support services connect carers with agencies to assist them in their role and facilitate modes of best practice in aiding carers. The Research Question This literature review examines a number of studies on personality disorder, its effect on carers and issues connected with diagnosis and treatment in an attempt to determine whether psycho-educational and support programmes for family and carers are effective in reducing relapses and facilitating recovery of people suffering from personality disorders. If social workers are to work effectively with this client base, they must put aside antiquated beliefs that personality disorder cases are hopeless and that those who suffer from personality disorder never get better. This study reveals that one of the greatest challenges to carers and families is obtaining the support they need and the services they are entitled to, and Social Workers can be instrumental in bridging gaps in the Mental Health system. Methodology This dissertation undertakes a systematic literature review of health care and psychological literature to address key issues in the support of carers of people suffering from personality disorders. Several different studies and a range of approaches were examined. Although the number and breadth of studies was a strength of the review, the variety of approaches made it challenging to compare the overall merits of one study against another. The literature was obtained through a variety of means. Google searches, journal articles, working group reports, service provider reports and academic papers were used. The research methods that appear in the utilised material included telephone interviews, questionnaires and surveys, face-to-face interviews and meta-analysis. Some were literature reviews themselves and some simply reported on the outcomes when a group of treated individuals was observed. Of the studies that involved observation of a group, very few included a control group in the study so methodological rigour was not as great as it could have been. Neither is it certain that studies where self-reporting was used are as empirically reliable as one would like, as sufferers of personality disorder tend to over- or under-report their symptoms . Some of the studies that were conducted recently showed positive outcomes, but the long-term follow-up for the same groups may make the figures less significant. Even where there has been longterm follow-up, some of those who took part in the initial study may not be included because of death, inability or unwillingness to participate, or inability to be located. The methodological rigour of the studies is further complicated by the fact that the process of diagnosis and treatment of personality disorder is fraught with complexities. The categories for personality disorder are somewhat defined by behaviours and are not theoretically based or grounded in common mechanisms of the disorder. The actions and symptoms of patients are so extremely varied that both diagnosis and treatment are difficult to present, much less to assess. Yet just because a comprehensive catalogue of truths about personality disorder cannot be presented does not mean that no reliable statements can be made. The evidence that is presented here is solid enough to make general assertions regarding the affects of carer support on patients based upon the evidence, and that is what it intends to do. Assessing the impact of support and education for carers upon the sufferers of personality disorder themselves proved more challenging than, for example, assessing the impact of treatment on sufferers, for which there is abundant literature. Still, the impact of psycho-educational and support programmes on consumers has been assessed and outcomes observed. Additionally, the evidence for the improvement of the lives of carers and the quality of care they give their charges is strong, and this fact bolsters the hypothesis that improved care for carers improves the mental health of those for whom they care. These conclusions are definitely linked, especially given the statistics that show that improvement for personality disorder takes place over a long period of time and is facilitated by positive interpersonal relationships with people who are equipped to deal with the symptoms that people with personality disorder exhibit. The presence of positive relationships with carers who are tr ained, educated and supported will assuredly improve the ‘treatment conditions for those with personality disorder. In narrowing the scope of the literature to be included in the study, several factors had to be noted. Some of the literature was so grounded in certain programmes for certain countries that many sections were not transferable to this review. For example, the results of the Network for Carers (2004) report were based upon specific programmes offered in Australia, so some information had to be excluded. However, this document was very helpful in establishing general facts about the needs of carers and the impact of programmes upon their ability to care for sufferers. It was also a thorough exposition of the opinions of carers,through which their voice was clearly heard. There were also other limitations regarding the particular demographic studied. The NHS National Programme on Forensic Mental Health Research and Development Expert Paper on Personality Disorders primarily assessed offenders with personality disorder and not merely members of the wider public suffering from the disorde r. Because of this, significant sections of the material had to be ignored. Still, this paper was useful in understanding the complexities of treatment and diagnosis of personality disorder, and provided definitions for contextualisation. In evaluating the quality of the data, the analytical tool Critical Appraisal Skills Programme (CASP) was used to assist in making sense of the evidence. This tool is advantageous to those who are strangers to qualitative research, assessing the merits of a source with regard to rigour, credibility and relevance.CASP initially asks two screening questions, the first addressing research aims and significance. The second screening question considers whether the research interprets subjective experiences of participants.Answering these two questions with a ‘yes then leads to eight more questions covering issues such as recruitment strategies, collection of data and ethical issues. In a literature review there are several ethical issues that must be considered, especially when dealing with a vulnerable population such as sufferers of mental illness. For each study used in the review it was necessary to consider whether ethical standards were maintained throughout the study, includi ng the manner in which consent was obtained and the way that confidentiality was upheld. Another ethical consideration is the handling of the outcomes of the study with the participants after the study.9 In the data observed here, it is not always explicit that consent was obtained but is often implied. Eliciting feedback from carers carries implied consent even if consent was not explicit, for obviously no individual would be forced to comment against his or her will. Confidentiality is maintained through omitting names and keeping the results impersonal. Yet the information given for studies is in its final and often abbreviated form, and the background work is not always documented comprehensively enough to ascertain whether all ethical considerations have been taken into account. One ethical consideration that is not always considered is the treatment of ethnic minorities in research projects, especially those for whom English is not their first language. The wording of questions and the criteria by which outcomes are judged is often tainted by cultural bias for those being assessed outside their native surroundings. It is practically impossible to remedy this, because part of the methodological rigour of the study depends upon all participants being treated and assessed in the same way. Differentiation on the basis of cultural differences would compromise the consistency of the study, but the impact of cultural factors is most certainly felt by those of foreign origin. Discussion of Findings Traits The traits exhibited by sufferers of personality disorder differ immensely because of the wide scope of the disorder. Examples of traits range from anxiety, narcissism and compulsivity to defiance, abnormal attachments and avoidance of social situations. Sufferers may demonstrate an arrogant interpersonal style, or may show extreme submissiveness. Personality disorders are linked with negative results in the wider population such as marital breakdown, criminal actions and professional difficulties.The anomalies of personality disorder are apparent in the thought patters, expressions and levels of self-control of sufferers. The patient will display abnormalities in the way that he or she interacts with others which will appear in a range of circumstances. There are various types of personality disorders, and each has its own banners of dysfunction. It has been recognised that the kinds of personality disorders covered in DSM and ICD are a small cluster when contrasted with the array o f personality impairments that can be identified in large configurations of people.11 Personality disorders can be divided into three clusters, A-C. In the first cluster disorders relating to paranoia and schizophrenia are found. Cluster B includes antisocial and narcissistic disorders, and Cluster C focuses on avoidant, dependent and obsessive-compulsive disorders. Prevalence It is estimated that between 6% and 15% of the population have one or more personality disorders of some kind—different studies produce different results.13 The goal of one study was to estimate the prevalence of personality disorders in a local sample and discern the most common demographic groups therein. The frequency of the DSM and ICD personality disorders and the interactions between disorder clusters and demographic qualities was assessed in a local sample of 742 participants between the ages of 34 and 94 over two years.14 The results showed that the overall prevalence of DSM-IV personality disorders was approximately 9%. Among the disorders, antisocial personality disorder was the most common and appeared in almost 5% of those assessed. Dependent personality disorder and narcissistic personality disorders were rare. The prevalence of many of the individual disorders was only 1% to 2%. For ICD-10 disorders, the overall presence in the surveyed group was 7%. Again, the prevalence for individual disorders was 1% to 2%. The most common disorder in for the ICD disorders was dissocial personality disorder at 3%. Dependent personality disorder was, again, very rare. Who is affected? Studies dedicated to uncovering the risk factors for personality disorder produced a variety of results. Prominent factors that may lead to a personality disorder include having a parent who is involved in or has been convicted of a crime, having a parent with deficient parenting abilities and being part of a large family. Factors such as low intelligence also feature in the list of risk factors. However, this study and studies that are similar raise certain issues about the nature of judging which factors should be included as risk factors for personality disorder. These sorts of factors could be criticised for having prejudicial antecedent assumptions regarding what it means to be a functioning human being. It is likely that people from lower socio-economic classes will have a tendency to fit these categories more than their middle- or upper class counterparts.Care should be taken in describing risk factors to ensure the language used is not biased by class. In the study mentioned above, several demographic characteristics were assessed with regard to prevalence of personality disorder. The outcomes demonstrated that Cluster A disorders were more common in males than in females. Cluster A disorders were also more prevalent in participants who were divorced or separated than those who were married or widowed. Subjects who had never been married were the most susceptible sub-group of all. In the Cluster B category, men were again more prone to having a personality disorder than women. Cluster B disorders were most common in the youngest age range surveyed and least common in the oldest range. Further, this cluster was most prevalent in participants who lacked a high school diploma and was least prevalent in participants who graduated from high school and continued their education afterwards. The odds of having one of these disorders decreased approximately 6% for each year an individual aged. One possible explanation for the increase of prevalence of disorder with age could be that people of more mature generations are less likely to have, know about or report symptoms of personality disorder. The prevalence of Cluster C disorders was most closely related to marital status, again showing that participants who had never been married were most likely to have one of these disorders. The likelihood of having a Cluster C disorder was almost 7 times greater in those never married when contrasted with those who were married or widowed. The results of this study broadly match a number of previous studies whose results showed the prevalence of personality disorders in the general population to be 9-13%. However, there were some differences between previous studies on prevalence and this study. The present study found a notably higher prevalence of antisocial personality disorder and a much lower prevalence of histrionic and dependent personality disorders than previous studies. These differences could have been caused by methodological variants and the diagnostic criteria used such as which version of the DSM was utilised. The differences could also be a result of participant source, form of assessment, assessors experience and data collection methods. Notable strengths of the study were that the participants were obtained through a community sample and personally interviewed by psychologists who have a significant amount of experience in cross-examination. The limitations included the fact that not all subjects coul d be interviewed and that the sample size was not really large enough to pick up on very rare disorders. The results of other studies have been less conclusive. An American study examined the theory that personality traits stop transforming by the time an individual reaches the age of 30. One of the major strengths of this study was the sample size of 132,515. The subjects, aged 21-60, participated in a web-based Big Five personality measurement. The results of this study showed that qualities such as being agreeable and conscientious increased during adulthood up through middle age. The quality of being neurotic diminished for women but remained static for men.20 Both men and women decreased in openness after the age of 30, and while men increased in extraversion from 31 to 60, the same quality diminished in women in the same age range.21 While the sample size of this study was certainly impressive, one concern was that conducting the study over the internet might bias it toward younger subjects. Another concern was the cohort effect, since people of earlier generations might not engag e with psychological instruments with the same ease as those who are younger. Overall, the multiplicity in paradigms of change did not affirm either that personality does not change after 30 or that it does. The study concludes that the traits examined are complex in nature and subject to an array of developmental influences. Historical View The onset of the de-institutionalisation of mental health establishments has produced a number of benefits. There is now less public stigma placed upon sufferers of mental illness and their traits and presence in wider society has come a long way toward normalisation. Suffers of mental illness have become less isolated and enjoy greater freedoms, including the freedom to choose from a selection of services. From a governmental point of view, deinstitutionalisation has saved them an enormous amount of money. However, the responsibility for managing and caring for mental illness sufferers has been transferred from the institution to the local community, and specifically to carers. Carers are involved in every possible aspect of the lives of their charges, even to the extent that their role could be characterised as an informal social worker. But the burden of the role combined with the lack of training, education and support often results in the damage of the psychological health of th e carer, as well as strict limitations on their life outside the caring role. The striking impact of caring on the lives of carers and other factors led to the undertaking of research on the involvement of families in managing and treating mental illness. From this came solid evidence of the benefits of such involvement, and the needs of carers began to be recognised. In recent years services have been put in place to assure that the needs of carers are met, and education for carers has been pinpointed as the most beneficial service for carers and consumers. Carers need to be educated in order to feel equipped to perform their tasks effectively. Specifically, carers named a need for â€Å"education about mental disorders† and information about treatment options† as their most salient needs. These statements are reinforced by studies from various countries where carers named the same things as most important for their success. Historically, studies examining the impact of educational programmes for carers have come from two different hypotheses. The first is that the chances of a consumer recovering from a mental illness are augmented if an educated and informed family surrounds him or her. Such a family will have deeper knowledge and sympathy for the condition of the sufferer and will be equipped to manage challenging behaviours. The second hypothesis is that because of the implications of their role, carers have an inherent right to access to adequate services. They have a right to services that will enhance their individual welfare and their effectiveness as carers. Assigning a course of treatment to personality disorder has always been an inexact science. Personality disorder is particularly complex to treat because the prime method of treatment is not always apparent after a diagnosis has been arrived at. The type of treatment which will prove most effective for the patient differs from individual to individual. Case conceptualisations can be helpful in assessing the individuals issues, identifying areas of risk and determining proper treatment goals.24 There is an abundance of research about treating personality disorder, but the studies cannot always be relied upon due to their lack of sound methodology. While some forms of treatment for personality disorder can reduce relapses and facilitate recovery, there is no simple panacea for this ailment. Cognitive treatments including cognitive-behavioural approaches have produced some pleasing results with personality disorder patients, as have psychodynamic treatments. Diagnosis Individuals who suffer from personality disorder encounter several issues with their diagnoses. They may be diagnosed through the means of an interview, a self assessment questionnaire or other means. Clinical psychiatrists often diagnose patients through interviewing them with regard to the DSM or ICD categories. This method is slightly better for detecting the existence or not of a personality disorder, but shows low accuracy for particular types of disorder. Self-report questionnaires like the Personality Diagnostic Questionnaire (PDQ-IV) and the Millon Clinical Multi-axial Inventory (MCMI) are also used to diagnose personality disorder. These questionnaires are considered imprecise because individuals tend to over-emphasise or under-emphasise the issues they are having. In addition to these methods of diagnosis, there are several semi-structured interview schedules to assist professionals. These schedules feature lists of questions that correlate to the DSM or ICD and the clinici an may then mark the patient and determine whether he or she has a disorder according to the criteria. Interview schedules have shown that they are slightly more reliable than other forms of diagnosis, but this success is only relative and the results are still much less valid than is needed. Really none of the diagnostic tools should be considered better than any of the others, for they are all faulty to the extent that they cannot be relied upon. There is a problematic absence of consensus regarding the reliability of diagnosing in general and the consistency of different diagnostic schemes. Part of the problem is that the explanations of personality disorders in the DSM and ICD feature a concoction of psychological traits and displayed behaviours, so that it becomes uncertain whether the diagnoses are attempting merely to pinpoint deviant actions or to identify traits whose presence is significant for determining personality disorder. The solidity of diagnoses for personality disorder is frequently questioned, and there are only a few disorders whose diagnoses are considered reliable. The diagnosis that can be made with the most certainty is antisocial personality disorder, because this problem can be identified by external actions that can be easily observed. Those who diagnose individuals with personality disorder are not always able to be precise in identifying which personality disorder they are dealing with, therefore m ultiple personality disorder diagnoses are common. Clinicians often find themselves confronting comorbidity, and prudent professionals test for the full scope of disorders. Comorbidity is quite common, with male legal psychopaths having an average of three disorders each. Women may have four.28 There is a great amount of interaction between the descriptors of the various types of personality disorder and so it is difficult to tell them apart. When dealing with multiple diagnoses, it is advisable to keep all disorders in mind when constructing a treatment regime, even if many of the features of the respective disorders overlap. The classification of disorders is also problematic, because the categories lack the quality of homogeneity present in reliable psychological categories of other types. Categories of psychological dysfunction work best when each class is different from others and common elements are contained within one class. This is not the case with personality disorders. For example, there are literally hundreds of ways to satisfy the criteria for borderline personality disorder, and so individuals with the same diagnosis may have utterly distinct behaviours, symptoms and needs. Axis I disorders feature frequently in those who suffer from personality disorder, particularly where there is substance abuse or depression. The classifications for personality disorder tend neither to be theoretically based, nor to stem from statistical research, which is presumably part of the reason that precise diagnoses are so elusive. The categories are so unreliable that abandoning the categories altogether and composing a new classification system is often proposed. While this may be the ideal way to correct the flaws, the time and effort already invested in the use of the present system is likely to ensure its continued existence. One approach to dealing with personality disorder is the trait approach. This approach states that a minimal amount of theories can illumine the majority of human behaviour. Observing the personality traits exhibited by an individual and placing them on a continuum from truly normal to extremely dysfunctional is more faithful to the structure of t he human psyche and tells clinicians more about the true nature of the dysfunction suffered by the patient. Currently, the most extensively developed trait theory relating to personality disorder is the theory of psychopathology. Treatment Cognitive-behavioural treatments (CBT) aimed at treating personality disorders have a tendency to take a broad approach. CBTs engage an array of behaviours, thoughts, preconceptions and internal emotional mechanisms. Many treatments are residential and are conducted with a group. They frequently include tenets of other methods such as psychodynamic therapy. Therefore it is an arduous task to pick out what, if any, elements are effective in a multi-dimensional approach so that they can be improved and repeated. Dialectical behaviour therapy (DBT) is a method of CBT focusing on female patients with borderline personality disorder. The goal of the therapy is to reduce or eliminate incidents of self-harm through group skills training. Group sessions address destructive thought patterns and social skills. Individual therapy can also be used. The outcomes for one study showed that women who were treated experienced reduced anger and self-destructive or suicidal thoughts. Their social skills improved and they required less psychiatric treatment. Arnold Lodge Regional Secure Unit has produced a treatment method aimed specifically at offenders with a personality disorder. The treatment programme centres on teaching patients socially acceptable mechanisms for problem solving. The patients work individually and with others and receive regular counselling. This regime is supplemented with services that are individually tailored to the needs of the individual, such as anger management sessions or substance abuse education. This form of treatment has been shown to reduce deficiencies in social functioning and self-control.32 While the initial studies are promising, long-term analysis will confirm or refute the true effectiveness of this type of treatment. Therapeutic communities, cognitive therapies and dynamic therapies may also be used to treat personality disorder. Therapeutic communities are tailored primarily for offenders and have produced promising results in terms of reduced recidivism and improved social integration. A study into the effectiveness of therapeutic community treatment of personality disorder explored whether this type of treatment improved the health of patients to the extent that the burden on Health Services eased. Several previous studies reported reductions in the use of psychiatric services after therapeutic community treatment. The previous studies were limited by the fact that they observed participants for one year only and lacked thorough follow-up. This study sought to fill the methodological gaps of the previous studies by tracking patients for years after treatment. They assessed the impact of treatment on Health Services by counting the number of admissions to hospital before and after treatment. Th e study found that therapeutic community treatment resulted in a statistically significant drop in in-patient admissions over the 3-year period. Those who were admitted to hospital tended to be the subjects who had the briefest experience of therapeutic community treatment. Another study involving therapeutic community treatment focused on individuals with severe personality disorder. The effect of p