Abdominal Aortic Aneurysm Health And Social Care Essay

This instance survey is about an 80 old ages old male with symptomless abdominal aortal aneurism who presented to his GP with other symptoms unrelated to abdominal aortal aneurism. The writer will analyze the diagnosing of his aneurism, the mode used, the intervention and direction. Diagnosis and intervention tracts shall be followed ; analysis and comparing to other tracts shall be done to see which is the most effectual and accurate in the diagnosing and intervention of abdominal aortal aneurism. Patient confidential information shall be maintained throughout this essay, therefore in line with the codification of professional behavior, Nursing and Midwifery Council ( 2008 ) . Case study 80 old ages old, Mr X, of height 5 pess 8 tall who weighted 50 kilograms presented to his GP on the 6th of February 2010 with 6 yearss history of irregularity. During physical scrutiny a throbing mass was noted in his venters. The patient had no symptoms related to aneurysm, such us back or abdominal hurting. The GP discovered during conversation with Mr X that his brother died from rupture AAA a twelvemonth ago. Mr X smokes 3 battalions of coffin nails daily. His past medical records showed that, he had chronic clogging pneumonic disease, high blood pressure, ischemic bosom disease which he had a beltway surgery 15 old ages ago. He besides had an MI 2 old ages ago holding had transdermal conary intercession ( PCI ) to circumflex and right coronary arterias. The GP suspected that Mr X had an AAA and referred him for ultrasound scan to govern out the size of AAA. The ultrasound scan was conducted two hebdomads after seeing the GP. The scan revealed an aortal aneurism below the degree of the nephritic arterias mensurating 5.99 cm A-P diameter. Mr X was referred to a vascular sawbones who recommended a CT scan to look into the extent and anatomical construction of the aneurism to see Mr X ‘s suitableness for endovascular repai Computer Tomography Angiogram aorta was performed a hebdomad after the ultrasound scans. CT angiogram with contrast showed a big infra-renal abdominal aortic aneurism which measures maximally 6 centimeter in diameter. It besides demonstrated good infra-renal cervix. Ultrasound of the venters showing an infrarenal aortal aneurism steps 5.99 centimeter. ( Local NHS Trust 2010 ) Axial CTA with contrast of the venters demoing infrarenal aortal aneurism mensurating 6 centimeter ( pointers ) with partial calcified integral wall ( Local NHS Trust 2009 ) The sawbones so referred Mr X for an elected vascular surgery because his aneurism was big and carried a high hazard of rupture and decease. One hebdomad before his surgery, Mr X had a chest X ray, blood trial and EKG which were all normal. On the twenty-four hours of admittance, his pulsation was 68BP/min and regular with a blood force per unit area of 140/80 mmHg. The below tabular array shows pre-assessment blood probes done. Blood Test Mr X ‘s consequence Normal Laboratory Test Values Entire white blood cell count 6.56 M/mcL 3.8 M/mcL to 5.6 M/mcL hemoglobin 14 g/dL 11 g/dL to 18 g/dL Platelet count 160 150-400 Red blood cell count 5 M/mcL 3.8 M/mcL to 5.6 M/mcL Bureau of intelligence and research 1.1 0.9-1.2 Blood urea N 6.86 mg/dL 6 mg/dL to 23 mg/dL Creatinine 98 mg/dL 0.6 mg/dL to 15 ng/dL ( Tinkham 2009 ) Preoperative appraisal was done to give Mr X ‘s sawbones a image of his overall wellness position. A complete blood count was performed to look into for the presence of infection, ensured an equal ruddy blood cell volume and regulation out serious haematological abnormalcy. Electrocardiography ( ECG ) was performed to measure cardiac arrhythmias and diagnose cardiac upsets such as myocardial infarction. Chest X ray was done to measure the presence of infection, bosom failure, emphysema and other status that may act upon surgical result. Creatinine and urea were performed to place job with nephritic clearance preoperatively.INR trial was done to guarantee coagulating ability before surgery. The International Normalized Ratio ( INR ) was done to guarantee blood coagulating ability before surgery On the 30/ 4/2010, Mr X underwent an endovascular aortal fix and was transferred to intensive attention unit while proctor his status for 3 yearss. He was discharged and had a wholly recovery after a month. Mr X had a follow up postoperative ultrasound and field movie x beam of venters. X beam and ultrasound was conducted at 1and 6 months to look into the place of the stent transplant and endoleaks. However, the scan and ten beam showed no grounds of any complication. Plain skiagraphy of venters at 1 month the unity and migration of Zenith stent transplant Raad ( 2010 ) Discussion AAA is a comparatively common and potentially dangerous status associated with old age. The bulk of abdominal aortal aneurisms do non do any symptoms and hence diagnostic is frequently missed. In many instances, the exact cause of aneurism is still ill-defined. However, harmonizing to Baker ( 2009 ) , the primary cause of aortal aneurism is atherosclerosis and other factors for case, male over 65 old ages, smoke, a positive household history, COPD and high blood pressure contribute to the hazard. An probe of Mr X ‘s AAA was done during a physical scrutiny of the venters which was conducted for other grounds. Approximately 75 % of abdominal aortal aneurisms are symptomless and are found by the way during abdominal physical scrutiny or radiographic probes ordered for other conditions, ( Anderson et al 2001 ) . Aneurysm tactual exploration on physical scrutiny has merely been shown to be sensitive in thin patients and those with abdominal aortal aneurism & A ; gt ; 5 centimeter with an overall sensitiveness and specificity of 68 % and 75 % , severally for sensing of AAA, ( Fink et al 2000 ) . The primary mode used to corroborate Mr X ‘s aneurysm size was made by ultrasound. Ultrasound is a standard image mode for an probe of suspected symptomless and surveillance of abdominal aortal aneurism. Ultrasound is safe, non-invasive, comparatively cheap, widely available and does non expose patient to radiation. It is the best option for observing and mensurating the size of aneurism. However, harmonizing to Sparks et Al ( 2002 ) ultrasound can non accurately specify the extent of the aneurism as it can be altered by intestine gasses, and hence is unequal for preoperative planning of endovascular fix. Computerized Tomography Angiogram ( CTA ) of the venters was the 2nd mode to be used to look into the extent of Mr X ‘s abdominal aortal aneurism and the aneurysmal cervix for preoperative planning. CTA is going the diagnostic imagination mode of pick in the preoperative appraisal of patients with an abdominal aortal aneurism. However it has some disadvantages for case, it uses high doses of radiation, cost effectual and requires endovenous contrast but it is faster and extremely accurate in finding the size and extent of the aneurism, and its relation to the nephritic arterias. ( Hafez 2009 ) . The other mode that could hold been used for preoperative planning for Mr X ‘s abdominal aortal aneurism is magnetic resonance angiogram ( MRA ) . Harmonizing to Aburahma ( 2007 ) , MRA is merely used for surgical planning fix when CTA contradicts with patients with contrast allergic and nephritic failure. However, both computerized imaging and magnetic resonance imagination are effectual for preoperative planning fix. CTA and MRA imaging provide high-resolution imagination of the aorta and find proximal and distal boundaries of the aneurism, says ( Upchurch 2009 ) . MRI scan is comparatively clip devouring, really expensive and may be distorted by gesture artifact, extended calcified plaque and metallic surgical stents Upchurch ( 2009 ) . Hence, MRA is non used for preoperative appraisal of endovascular fix. Mr X ‘s preoperative mode was good as he did non hold any contraindication such as contrast allergic reaction or nephritic failure for him to undergo a magnetic resonance angiogram scan. With magnetic Resonance Angiogram, endovenous dye is non required and it does non expose the patient to radiation as compared to Computer Tomography Angiogram, ( Truijers 2009 ) The primary end of intervention depends on the size of the aneurism, the possibility of rupture and the patient ‘s status. The purpose of surgical intervention is to forestall aneurism from rupture for patients with symptoms such as back hurting, or symptomless aneurism greater than 5.5 centimeter in diameter, ( Hakaim 2006 ) . When sing intervention of abdominal aortal aneurism there are two types of fix ; unfastened fix and endovascular aneurism fix. Endovascular aortal fix ( EVAR ) was recommended as the most appropriate intervention for Mr X taking into history short and long term hazards and the benefits of both processs in relation to his age and co-morbidity every bit good as anatomical suitableness. This Endovascular aortal fix is a safe process and can be efficaciously performed in a patient with the suited anatomy for illustration, a individual with infrarenal aortal diameter no larger than 26 millimeters and aortal cervix length at least 15-20mm without inordinate angulations, ( Hallett 2009 ) . However, in such patients with a suited anatomy and surgical expertness, increasing the usage of endovascular aortal fix is likely justified based on its better preoperative result informations ( Hallett 2009 ) . EVAR relies to a great extent on nomadic C-arm image intensive. This enables the sawbones to utilize x-ray images to visualize the interpolation of stent transplant through the femoral arteria up to the site of the aneurism while being imaged. However, this it exposes patient to radiation during the process and in subsequent follow up EVAR is a less invasive process with a potentially reduced morbidity, mortality of 1.6 % , intensive attention, entire infirmary stay and a rapid recovery clip comparison to open fix with morality of 4.6 % , ( Tinkham 2009 ) . In the prospective randomized controlled tests, EVAR has been shown to hold a signifi ­cantly better preoperative result, ( Tinkham 2009 ) . In contrast to EVAR, unfastened fix requires a surgical exposure of the aorta clamping. Open fix was non recommended for Mr X because of hapless province of wellness due to his medical co-morbidities which limit his day-to-day activities. Harmonizing to Anderson ( 2009 ) , unfastened fix is non suited for patients with co-morbidity including terrible chronic clogging pneumonic disease or myocardial misdemeanor which places at high hazard. EVAR carries a higher hazard of complications which would necessitate farther surgery to rectify. This requires postoperative long-run follow-up imagination as the long term lastingness of the stent transplant remains unsure, ( Liaw et al 2009 ) . Mr X underwent a postoperative follow up obviously abdominal x beam and ultrasound at 1 month to look into the stent transplant unity and migration. Plain skiagraphy is easy to obtain and widely available. It still plays a utile function in measuring the metallic unity of the stent transplant but the truth of endoleaks is limited. However, the field movie can be used in concurrence with ultrasound as a method of follow up, ( Mattes et al 2011 ; Ginter et al 2009 ) . Duplex ultrasound imaging is non-invasive compared to CT. Studies show that duplex ultrasound had a sensitiveness of 90 % while CT had of 58 % in sensings of endoleaks, ( Badri et al 2010 ) Contrast-enhanced CT is another imaging mode that could hold been used for Mr X ‘s postoperative endovascular aortal fix. This image mode is expensive, less accurate in sensing of little endoleaks and it exposes patients to radiation and is. However, the major concern sing the frequent usage of contrast-enhance CT including additions cost and cumulative radiation doses which leads to lifetime malignant neoplastic disease hazard to patients have shift toward color semidetached house ultrasound, ( Mattes et al 2011 ) . MRA is alternate mode could hold been used for postoperative rating of Mr X ‘s stent transplant fix. Mr X can non undergo MRA as his aneurism was treated with Zenith stent transplant which may be distorted by gesture artifact in the magnetic field. Harmonizing to Liaw et Al ( 2009 ) , MRA is every bit accurate as CTA for sensing of endoleaks but is really expensive and can non be usage to image ferromagnetic stent transplants such as Zenith. Hence, MRA is non utile for postoperative rating of patients with stent transplants Decision I think the tract taken to name Mr X ‘s abdominal aortal aneurism was right and besides the most current pattern taken in many infirmaries. Endovascular aortal fix is a less invasive process with a potentially decreased morbidity and mortality. Endovascular aortal fix has been widely performed and it is an effectual option to open fix, peculiarly for patients with medical comorbidities. However, the mandatary follow up after is a disadvantage of this technique. Despite the disadvantages, CT remains the most widely used mode in preoperative planning for abdominal aortal aneurism and postoperative surveillance after endovascular aortal fix. In contrast to computing machine imaging, ultrasound is the simplest, cheapest, mode used for suspected and surveillance of AAA. It is a standard mode used in concurrence with field movie in some infirmaries for follow up after endovascular aortal fix. Overall, imaging provides an spread outing aggregation of tools, leting progressively accurate probe of AAAs and patient choice for endovascular aortal fix. Surgeons and radiotherapists in this field should be cognizant of the technological betterments in each imagination mode, to do the right picks before, during and after endovascular aortal fix

Terrorism and Immigration Legal Report

As the world's population grew, so did political and economic instability, as well as major international conflicts. Tensions between countries and cultures tightened, and eventually and inevitably, one of them attacked. This terrorist act brought with it the panic and chaos fuelled haze that was post-911 Australia, and similar to many situations in the past, the fear and vulnerability associated with the community allowed the government quite a substantial amount of political power. This atmosphere of fear and ignorance lead to several incomplete and somewhat extreme pieces of Anti terrorist legislation to be passed by the Howard government, in order to ensure the safety of all Australians, or so they said. Dr Mohammed Haneef a doctor working in Queensland on a skilled migrant visa, soon found himself a victim of these laws. When two Indian men attempted to bomb an airport in Glasgow, UK, Mohammed Haneef became a suspect in the eyes of the Australian Federal Police, and was arrested shortly. Several blunders and misinterpretations by the AFP lead to the wrongful detention and charging of Dr Haneef, a man who spent a total of 12 days in detention without being charged and had his visa unfairly revoked during his trial. Haneef was eventually released and all charges were dropped against him, when the Public Prosecutor determined that there was no legitimate trial against him. However, the course of events that Dr Haneef experienced brought to light the glaring dilemmas associated with Australia's radical Anti Terrorist laws and corresponding government agencies. The Clarke inquiry and concurrent recommendations As a result of the badly handled Mohammed Haneef case, the labour party ordered a full inquiry be conducted into the legal case, in order to identify the key faults and inefficiencies in government agencies and legislation that related to the Haneef Case. This Inquiry was called the Clarke inquiry, conducted by John Clarke, a Supreme Court judge. Despite the inquiry lacking several crucial powers, it worked well to suggest a number of key findings and recommendations. Some very key recommendations that worked toward rectifying mistakes made in the Haneef case were as follows: That the government consider establishing legislation or necessary arrangements that would consequently apply to other inquiries and reviews that involve national security. That parliament review part 1c of the Crimes act 1914, the part that relates to terrorism offences. That the Australian government appoint an independent reviewer of the Australian counter terrorism laws. That the Minister for immigration and citizenship be included in the list for security intelligence notifications and reports produced by ASIO, in order to prevent miscommunication in the future. All of these recommendations and more were implemented and thoroughly elaborated on by the Australian government. Anti-Terrorism laws reformed due to the Haneef case. Following the Haneef case and the Clarke inquiry, the government decided that necessary reforms were in order and announced its intentions to amend and alter several Anti-terrorism laws in order for them to correlate with conventional, sophisticated standards, standards that find a fair balance between national security and civil liberties. The Labour government took a major step in deciding to abolish the sedition terms within anti terror legislation while focusing more on rebellious acts that insight violence. The previous laws were deemed restricting of academic liberty and free speech. Some of the other significant changes listed in a newspaper article include the advancement of individual review of the Australian federal police, the government's decision to broaden powers assigned to the Inspector general of intelligence and security which allows inquiries to extend across all National security agencies, and the in-statement of an independent reviewer of Australia's counter terrorism laws, to be named the National security Legislation Monitor. These reforms are a strong representation in the government's effectiveness in update obsolete or otherwise procedurally dangerous Anti-Terror laws. These changes are the first of many steps in order to find the balance between human rights and National security. Claims for compensation by Mohammed Haneef After the ill handled arrest and charge against Mohammed Haneef and the distasteful cancellation of his Visa, Haneef has finally returned to Australia to claim compensation against the federal government on the basis on his trauma, loss of wages and career, defamation. Despite having an almost iron hard case against the federal government, Haneef opted to first try his best to resolve the manner through a mediation process. A News article reported that Mohammed Haneef's lawyers were able to reach an agreement with the federal government and rested his claims for compensation, a substantial claim, though the actual amount is undisclosed. It can be seen as a victory for the Mohammed Haneef and the Australian government, whose reputation will be partially restored over the matter. The government chose to make a good decision and provide Haneef with legitimate compensation through very discreet and uncontroversial means, casting little to no negative association to the government. Formal apology from the Federal government Almost immediately following Dr Haneef's success in claiming compensation, as reported in a relevant media article, the federal government released a document in the form of a formal apology on behalf of the AFP's several blunders and misinterpretations, which lead to the prolonged detention and charge of Mohammed Haneef. Haneef's lawyer congratulated the Government for recognising the need for such measures in a formal declaration of innocence, that would help clear Haneef's name of any wrong doing . The AFP also participated in the assist of Dr Haneef's claim for compensation, and were eager to rectify its previous hastily made mistakes. The Federal government's formal apology not only allowed Haneef's professional reputation be cleansed, but also publicly rid them of any negative association with the controversial court case. Conclusion The politically fueled implementation of Anti-terrorism legislation by the Howard government was a rushed and ineffective endeavor, and despite Mohammed Haneef becoming the victim of such broad laws, his Case, as well as the efforts of the labour government, allowed these radical laws to be reformed to concur with Australia's legal and utilitarian standards.

Film Essay Example | Topics and Well Written Essays - 250 words - 5

Film - Essay Example iewiczs and was an ingenious way of attacking Hearst the newspaper mogul through an evolution character Foster Kane, and focuses on a fierce duel to expose dirty under deals of a society that was suffering from social morals and integrity among many leaders and business executives. The film satires and portrays the rise of the penny press, the power of political heavy weights, rise of fascism, support for a Spanish –American war, and the growth in space for celebrity journalism. The film aims at revealing the burial truth about Kane (Rudolf Hearst), a highly regarded lord and ruler of San Simeon against a young brilliant and ambitious boy who is determined to take Hearst down by exposing his dirty deals involving Hollywood and newspaper publications. Consequently, Hearst with all his power and might goes ahead to shut the film down, and even teams up with the some Hollywood executives under the leadership of Mayor B. Louis who at a any cost attempted to buy Citizen Kane from Welles to destroy it and protect Hearst’s reputation, characteristic of any respected leader in the American society. The story thus pitted two proud, destructive, and gifted geniuses against each other, leading to destruction of each other to what the Producer Lennon Thomas remarked, "The fight that ruined them both was thoroughly in character with how theyd lived their lives"Â  (WBGH, 2009). The war between the two daring old wealthy and respected newspaper magnate Hearst and a 24 year old yet ambitious and determined news reporter ended destroying each other. However, Welles drove the point home after a long freeze of the film by Hollywood; Hearst incidentally built his vast empire selling papers with highly entertaining stories, which were scandalous to others, and sometimes were pure fiction. The ruthless, skillful and open contempt for Hollywood thus led to the success of Welles, and in 1942, the film though named for seven categories lost all but the best screenplay after which the

Othello Essay Example | Topics and Well Written Essays - 750 words - 5

Othello - Essay Example The heart of Othello is opened for Desdemona, but his mind remains closed. We can see that love is different with different characters of the play. The main hero Othello understands that trust is very important thing in marriage and it can’t be built in one day. However, his foes acted too rapidly and did not give him a time to build trust. The deep feeling of Othello and Desdemona appeared instantly and was built mostly on passion, but Desdemona managed to turn it into strong attachment not realized by Othello: "It cannot be true that she really loves me†¦if she loves me, then there must be something wrong with her" (Shakespeare). Desdemona succeeded to protect her marriage in the face of her family. She protected her choice before Brabantio and Gratiano, praising her husband’s best qualities. Othello was clever and purposeful. He proved to be a successful leader and commanded deep respect his people. Within the play, Desdemona’s character transforms gradua lly. Having married Othello, Desdemona acted against her father’s will and in the teeth of the Renaissance public opinion. She is â€Å"a woman who combines spiritual and physical love for Othello and who is courageous and independent in her judgments, often stubbornly so† (Hall, 1999: 67). Firstly, she had fully relied on her father, but in her married life, she had to submit to her husband. On Cyprus, she supported him in career making and dealt with household with pleasure. Othello really loved his wife, their marriage was concluded due to deep love and passion. However, this passion was too strong and he could not control its power. It captured him so deeply that he did not want to see the truth. Jealousy is the power that appeared to kill Othello. It was Iago who helped this destructive feeling occupy the soul of the mail hero of the play. Stupid Iago thought that he knows everything about jealousy but he did not take into

The History of the Management in Business Essay

The History of the Management in Business - Essay Example Porter’s Five Force model is a set of analytic techniques to develop a strategy by looking at five competitive forces to position an organization and its activities so that its product or service is different and cannot be imitated by rivals or potential rivals. Of these, three forces are acting on Kao’s failure to grow its Western markets: bargaining power of buyers (Kao’s cheap image and reputation as a novice), threat of substitutes, and intensity of rivalry (competitors better at marketing high-end/high priced products). Porter then recommends that an organization choose one of three generic strategies – over-all cost leadership, differentiation, or focus – so it can compete and achieve sustainable profitability. How can we explain Kao’s success in cost leadership and differentiation? An explanation is its value chain, a framework introduced by Porter to analyze an organization’s internal capability to support and reinforce a chose n generic strategy. Kao’s internal capabilities and competencies (as we shall next see) helped it succeed in two generic strategies, although its failure to make buyers want its product means that it needs to make adjustments. Kao can satisfy the buyer’s bargaining power by improving its image through advertising and marketing, minimise the threat of substitutes by introducing quality but lower-priced products using its cost leadership and product differentiation advantages, and match the intensity of the rivalry.... buyers (Kao's cheap image and reputation as a novice), threat of substitutes (similar products familiar to the market), and intensity of rivalry (competitors better at marketing high-end/high priced products). Porter then recommends that an organisation choose one of three generic strategies - over-all cost leadership, differentiation, or focus - so it can compete and achieve sustainable profitability. How can we explain Kao's success in cost leadership and differentiation An explanation is its value chain, a framework introduced by Porter5 to analyse an organisation's internal capability to support and reinforce a chosen generic strategy. Kao's internal capabilities and competences (as we shall next see) helped it succeed in two generic strategies, although its failure to make buyers want its product means that it needs to make adjustments. Kao can satisfy the buyer's bargaining power by improving its image through advertising and marketing, minimise threat of substitutes by introdu cing quality but lower-priced products using its cost leadership and product differentiation advantages, and match the intensity of rivalry by deploying trained managers who know the culture to market products in the west. Using the so-called RBV (resource-based view) of strategy, which proposes that competitive advantage can stem from firm-specific skills and resources6, we see Kao as a collection7 of productive resources8 (brand name, quality products, employee loyalty), capabilities9 (unique combination of cross-functional business processes, Hansha information system, the way its workers interact, and how its management leads by example), and competences10 (intuitive learning environment and long-term focus). Kao must use these resources, capabilities, and competences in developing

Canadian Real Estate Vertical Go to Market Plans and Strategy Term Paper - 1

Canadian Real Estate Vertical Go to Market Plans and Strategy - Term Paper Example The paper utilizes suitable illustrations to support the relevant details. The paper terminates in suitable conclusion that emanates from prior discussions of the paper and illustration provided. CREV endeavours to succeed in the Canadian real estate market. However, realization of the above requires the firm to enact an ambitious advertisement plan that will expand the firm’s clientele base. Such an undertaking will require an appositely coined strategy. The strategy should adequately appraise the nature of the market. This write-up will seek to institute an opposite promotional approach that will culminate in the success of the above real estate entity. Evidently, the above strategy will be critical since the real estate sector has encountered key upheaval due to the economic crisis. The market base is dwindling. Consequently, CREV requires to repositioning itself ensuring it maintains and boosts its clientele base. This strategy will enlist certain data and relevant illustration to support it assertions. The assertion will relate to strategy that the entity should adopt. This strategy has identified communication as an integral element in this industry. Therefore, advertising has sizeable implications on the fortune of real estate firms (Vertical news). Rogers is promotional firm enlisted to undertake the above task. The marketing strategy aims at enacting appropriate measures that will ensure that it has sizeable share of the market. This plan will enlist of information from credible informer that have undertaken through research. Evidently, the Canadian real estate sector is overly competitive (Canadian real estate association). Consequently, marketing will serve as an integral tool of boosting the clientele base. However, the realization of the benefits of marketing will demand utilization of shrewd advertising campaign. Therefore, CREV will require enlisting

Hebrew Scriptures Research Paper Essay Example | Topics and Well Written Essays - 1500 words

Hebrew Scriptures Research Paper - Essay Example Judaism, Christianity and Islam. The Holy Scriptures of these religions emphatically affirm Satan as the transgressor and Gods nemesis, which refused to comply with the commands of the Creator—Almighty God the Omnipotent. Satan, according to these sources, is one among the jinn; a creature has been made by the Lord out of flame of the fire. He became the enemy of Adam and Eve at the time of their birth and caused their expulsion from the Eden Garden because of his jealousy with the new creature. Satan had challenged God that he would try his utmost to seduce the children of Adam and Eve to prove their superiority as a wrong thing. Hence, God Almighty sent His angels to His apostles including Adam, Enoch, Noah, Eber, Shelah and others to preach the humanity the noble message of God, so that they could manage to regain their permanent dwellings in the Eden Garden lost due to non-compliance of their first parents in respect of tasting the fruit of the forbidden tree because of th e satanic seduction and temptations. Satan maintained grudge and enmity for the whole mankind and intended to entice Adam, Eve and their children forever and ever till the Day of Resurrection out of sheer malice for the human beings. According to the Torah, Satan does not challenge Almighty’s powers; rather, he challenges God to examine the sincerity and compliance of Adam, Eve and their generations. â€Å"However†, Scheib argues, â€Å"Satan remains inferior to God and is incapable of taking action on mortals without God’s permission. In the Talmud and Midrash, Satan appears as the force in the world, responsible for all sins.†(2004) Almighty God has divided the humanity into two categories: one who those are transgressors and breakers of the covenant of God, and imitate the path of Satan; and the other ones are those who sincerely comply with all the terms of the sacred covenant. The individuals, tribes, clans and

Approachability as a new supervisor Essay Example | Topics and Well Written Essays - 1250 words

Approachability as a new supervisor - Essay Example Approachability: The authentic magnetization of two people based on friendliness and common grounds [1] A very simple and beautiful definition of approachability is given by Scott Ginsberg is; "The word approachability derives from the Latin verb appropriare, which means "to come nearer to." Interesting. It doesn't say anything about the approach-er or the approach-ee. Just "to come nearer to." Approachability is a two way street. It's both you stepping onto someone else's front porch; and you inviting someone to step onto your front porch."[2] A Supervisor in an ideal situation works toward maintaining good and healthy communication between him/her and the rest of the staff in every permutation or combination possible. By ensuring that employees exchange opinions and work related problems, a good supervisor is always in the driving seat to make excellent work group. By dealing with communication as a two way process, a culture based on free opinions and free from conflicts is established. supervisor has many different roles (e.g., organizer, leader, evaluator, director, planner, developer, and resource manager). Supervisor's position allows him/her to combine the talents of employees under supervision to accomplish the objectives of the company. This work group helps to meet two of the most significant challenges - to accomplish the task effectively and efficiently, and to provide fulfilling work experiences that develop employee capabilities and potential. Supervisor works toward identifying common goals of the employees and makes sure that they are occupied in completing those goals. A supervisor has to take entire work force together to achieve professional goals and also inspire the new employees to follow present work culture. He/she should hold an open hand attitude toward others while keeping a strict eye on the workings. Another key personality trait is approachability. This quality is related to your human dimension and to how comfortable that people feel around you. Remember, approachability can be crucial in many situations. Consider scenarios when employees have problems in their work lives or personal lives, when they make mistakes on the job, when they want to discuss their salary and when they want to express concerns about you. Employees also want to approach you with positive feedback and new ideas that can help the organization to improve. If you are not approachable, employees often feel too much distance and discomfort. What is approachability It is a trust between two people that each will be available for the other when needed. Always being open to discuss/help and interact with each other is the central theme of approachability. As one may say, it is a measure of whether the person in question is approachable How easy is the conversation flow with him/her It is how your personality attracts and keeps people wanting to talk to you. In achieving this stage, most important attribute is your attitude and the way you carry yourself among a group. Every person is fond of interesting conversation, and also likes to increase ones knowledge base

South west region cuisine (Arizona, Utah, Texas etc) Essay

South west region cuisine (Arizona, Utah, Texas etc) - Essay Example The American historical regional cuisine is still very much alive today, and it is what differentiates different regions. The South West region is characterized by rustic cooking, comprising of a fusion of various ingredients and diets that could have been eaten by the native Mexicans and the colonial settlers from Spain (Olver, 2014). Therefore, the characteristic cuisine of the South west region is the Mexican food, mainly characterized by the use of large chunks of meats, with beans as the accompaniments and chili pepper as the main spice (White, 1993). Thus, the combination of the large chunks of meat, beans and chili pepper making a thick soup, serves as a characteristic South west region cuisine, which is very popular even nationally and abroad. Nevertheless, even within the South west region, the preferred cuisines do vary, with the regions of Utah, New Mexico and Colorado being popular for the New Mexican cuisine, which is basically the Chili soup, while Texas has a fusion of the New Mexican cuisine with its own ingredients, to form the cuisine referred to as Tex-Mex while Arizona has its own p opular cuisine referred as Sonoran (Olver, 2014). The Tex-Mex is unique, notably because of the use of Sour cream, which is a basic ingredient used both as an ingredient in cooking and as a cooling garnish. Therefore, the Tex-Mex cuisine comprises of the large amount of meat, cumin, cheese and the characteristic sour cream (Detterick-Pineda, 2004). The Tex-Mex is a fusion cuisine from different regions, which has combined the characteristic large chunks of meat with cheese and the sour cream being a German influence, to deliver a unique cuisine to the State, which continues to evolve even to date. On the other hand, the Cali-Mex is a cuisine popular in the South west region coastal State of California (White, 1993). The state is one bordering Mexico, and

Apple Case Study Essay Example for Free

Apple Case Study Essay Apple Inc. (previously Apple Computer, Inc. ) is an American multinational corporation that designs and markets consumer electronics, computer software and personal computers. Apple currently has 246 retail stores located in 44 states that employs over 27,000 retail employees. Apple also employs over 304,000 U. S. individuals from development to transportations. As of September 11, 2012, Apple is the largest publicly traded company ever. Apple has established a unique reputation in the consumer electronics industry. This includes a customer base that is devoted to the company and its brand, particularly in the United States. Fortune magazine named Apple the most admired company in the United States in 2008 and in the world in 2008, 2009, 2010 and2011. This case study will not only highlight Apple’s strengths, it will also discuss its weaknesses and past failures that have laid the foundation to become one the most powerful companies in the world. As the story famously goes, â€Å"two Steves† started one of the biggest computer companies ever in a garage after quitting their day jobs. Steve Jobs worked at Atari, a computer and gaming company and Steve â€Å"Woz† Wozniak worked at Hewlett-Packard. A friend introduced the two seeing their mutual interest in electronics. Woz had built a computer in his spare time as a hobby. According to Charles Hill and Gareth Jones (2012), authors of Essentials of Strategic Management, â€Å"That is what people did in 1976,† (p. C13). Jobs realized that people might want to buy such a machine and persuaded Woz to set up a company to make and market it. Headquarters: Jobs’ garage in California. Thus Apple Computers was born. A total of 200 units were sold at a price of $666 each; the product rolled out on April Fool’s Day in 1976 at a local electronics store. The company went on to see great successes and some failures, and the two Steves are heralded as revolutionizing the personal computer industry. After improving on the garage computer, named Apple I, with better graphics, more data storage and a simpler looking machine, Apple introduced the Apple II in 1977. This personal computer that was user friendly to non-computer using consumers soon made the two twenty somethings into millionaires. Throughout the years, subsequent models that improved on the speed and design of the Apple II were released. With these improvements came additional products: software, external drives and printers, to name a few. By 1983, the Apple IIe was introduced, which would become Apple’s most popular and best-selling of all models. In the ‘80s and ‘90s, Apple computers became computing standard for elementary schools. By the time the Apple II line became defunct, more than 2 million Apple IIs had been sold and home computers were gaining popularity. Apple Computers also changed its name simply to Apple to reflect its diversity of products. During this general timeframe, Woz was piloting a plane that stalled and crashed; he suffered some memory loss. He returned to Apple sporadically throughout the ensuing years but formally ended his full-time association with the company in 1987. Two new engineers were brought on board for two new project ideas: Jeff Raskin for the Macintosh computer model and Bill Atkinson for the more business-oriented Lisa computer. The Macintosh became a success; the Lisa did not. In 1991 Apple continued to build on its founders’ guiding principle—that the individual, not the mainframe, should be at the center of the computing universe (â€Å"Silicon Valley,† 2012). The company introduced a portable Mac, which was the predecessor of the modern laptop. In 1993 it launched the Newton, a personal digital assistant which let consumers compute without sitting at a desk. The end of the 1990s brought yet another breakthrough Apple computer—the iMac, which touted power, ease of use and esthetics. The iPod, a digital music player and the iPhone, a phone with Internet capabilities, are two of Apple’s newest immensely popular products. Steve Jobs died of cancer in October of 2011 after working and leading on and off at Apple throughout the years; Woz is 62 and currently spends his time as a writer, speaker, researcher and philanthropist. Tim Cook is the current CEO of Apple. On August 20, Apple officially became the most valuable company in history in terms of market capitalization (â€Å"Forbes,† 2012). Heading into the final hour of trading on the NASDAQ, the stock had risen more than two percent, giving the company a market cap of over $620 billion with shared trading over $662 apiece. The reason—speculation over its newest product release—the iPhone 5. Identification of the company’s internal strengths and weaknesses Strengths: †¢Product development. Doesnt invent the market, but its products set high standards for the market †¢Design and utility. Sleek, not clunky. For instance, the desktop computer is part of the screen, not a separate box with wires; the iPhone has very few buttons and feels nice in the hand. Products are easy to use, almost intuitive †¢Marketing. Clever and takes advantages of peoples frustrations with other hardware †¢Brand name †¢ Globally recognized †¢Rapid growth and high profits †¢ Pioneer of innovative and high-tech quality products such as iPod, iPhone and iPad †¢Strong Research Development department (9% of sales devoted to RD) †¢ Having the control of both its own hardware and software †¢ Having had a visionary, charismatic and innovative CEO like Steve Jobs †¢ Apple retail store experience allowing customers to use and experience Apple’s products †¢ Having a large segment of loyal customers †¢Sales of add-on products Highlighting of its products as the world’s greenest line-up of notebooks Weaknesses: †¢Very proprietary and controlling. Wont open the operating system to outsiders to develop hardware to work with the products, keeping hardware sales to itself. While this keeps design control inside and up to standards, it has hurt wide adaptation of its hardware, especially computers, where it has a relatively small market share. Apple has veto power over Apps sold †¢ The death of Steve Jobs and the absence of his leadership will be a weakness for Apple as they find ways to match his innovation †¢Not shareholder-friendly. Has abused option granting in the past and refuses to pay a dividend despite a huge (and growing) cash level, no debt, and plentiful free cash flow †¢The battery life of the products are seen as weak †¢ Failure of two products; First Apple TV launch and Mac Mini †¢ Decision to restrict the iPhone to a single network †¢ The lack of QWERTY keyboard in products like iPad and iPhone †¢ Low market share in comparison with HP, Dell, Acer, Lenova and Toshiba †¢ Apple products are highly priced, so it is hard to suit their target market Opportunities: †¢Loyal customer base which has expanded beyond the Mac-heads of the 1990s with the iPod and the iPhone. The iPad has had a very successful launch. This seems to be leading to more sales of computers. †¢Has a well-deserved reputation for high-quality products that work smoothly. New products are generally well-received and have a built in purchasing base. †¢Move into other computer or media product spaces that are not served well. Can continue to design the standard-setter for those spaces. †¢A new version of Apple TV could take advantage of todays more highly developed Web. Threats: †¢Big ideas are easy to copy. Microsoft copied the graphical user interface, and even Linux has a version. The touchscreen interface is being used in other phones (e. g. Android). Apps are being developed for other smart phones and devices. †¢High-priced products. Apple priced itself out of the personal computer market, and that remains a problem. Other smartphones that look and behave similarly to the iPhone are less expensive. †¢Google is moving into Apples smartphone space by giving away the operating system, and it has announced that it will also be moving into the TV space. Both companies are well-funded, so any battle between the two could be long and ugly. Nature of external environment surrounding the company The industry grows and changes at an alarming pace. Every day there are new products that flood the market. New technology changes cell phones, laptops and new products are advertised every week. The major companies in the industry are Apple, Acer, Dell, and ‘Hewlett Packard’. In order for new companies to break into this market, they need to have a high entry barrier as well as a differentiated strategy from the existing companies. There is also a high learning curve with the customers getting accustomed to the new products. The existing brand names make the entry barrier very difficult to break into. Apple seems to be financially stable and healthy with weaknesses and threats that Apple has overcome and conquered in its past. The strengths show Apple’s foundation built upon a long line of unique products and branding, powerful research and development along with commanding marketing gurus that make Apple the powerhouse it has become today. Financially, the financial papers seem to be responsible and accountable with much thought put into Apple’s strategy. According to YCharts (June 30, 2012), Apple’s current ratio is 1. 71, which is slightly above book value. When you have a current ratio of 1, it means that your current assets are exactly the same as your current liabilities. â€Å"The current ratio measures a companys ability to pay short-term debts and other current liabilities by comparing current assets to current liabilities† (YCharts, 2007-2012, para. 1). Apple’s gross profit margin (sales-cost of goods sold/revenue) is 42. 81%, gross profit margin represents the percentage of each dollar of a companys revenue that is available to cover fixed costs after paying for the goods or services that were sold. With Apple seizing new opportunities every day, Apple will continue to dominate its markets for a long time to come and will remain fiscally responsible while continuing to make large profits, making it a wise decision to invest in the Apple organization. SWOT analysis It cannot be debated that Apple has many strengths. They should not, however, become complacent with their success and in order to maintain its competitive advantage, the company must constantly evaluate their internal and external operations and address its weaknesses and threats, as well as assess its strengths and use them appropriately. One of Apple’s current strengths is its brand recognition and strong brand image. Apple has effectively used this strength through product development. As Apple took the market by storm and was gaining momentum, it expanded its product offering. With each new product such as the iPhone and the iPad, consumers expected the same quality and ease of use as Apple’s preceding products as they had already established that position in the consumer mind. Apple also has an enviable position in the market place and in the minds of the financial world. Apple’s robust financial performance is strength as the growth in capital allows for continued growth. While reviewing the strengths, one must also consider the weaknesses. For example, Apple’s weaknesses can be demonstrated with the release of the iPhone 4 and the concerns over the antenna on the product and how it could affect the performance of the device. Product recalls can result in a damaged image and reputation which will affect sales. Recalls also result in warranty and other expenses. It is clear that Apple views the iPhone as a major opportunity. The iPhone leads the company in percentage of sales, and with he new release of the 4s, combined with additional service providers supporting the device, will continue to do so. The expanding tablet market and demand for mobile technology also makes the iPad market a big opportunity for Apple. Expanding in international markets is also a big opportunity for Apple. Despite its strengths and opportunities, Apple faces many threats. One major threat to the company’s iPhone growth is the rising popularity of Google’s Android. Critics and users alike have stated that the Android is comparable, if not superior, to the iPhone technology. This fierce competitor is sure to affect Apple’s market share. In conclusion, an overview of Apple’s SWOT allows us to break down current strengths, as well as weaknesses, opportunities and threats. This allows us to further analyze the company as a whole and is imperative when devising a corporate strategy. The kind of corporate level strategy the company is pursuing Apple’s corporate strategy is to focus on making the industries’ best products. They are a company that focuses on innovation, and also improvements on their existing products. They use the focused differentiation strategy, by making products that are exclusive, and fairly expensive. Not everyone can afford an Apple product. They focus on aligning their business strategy and their marketing strategy with product development. This is something that they do much better than their competitors, and this is a huge advantage for them. Apples target market is people who are willing to pay more for products with better user experience, people who like to have fun with technology, music enthusiasts and people who work with media and design professionals. They have done a good job by finding out which customer needs to satisfy. They have found out that these customers want a nice, beautiful and simple design and user input, and they have focused on programs that help photograph and edit both pictures and videos, as well as good music programs to both listen to and make music. To make these programs, they have to have to focus on innovation, and have programmers and designers that can make programs like thisthat are easy to use, beautiful to look at, and do what you expect them to do. The nature of the company’s business-level strategy Apple’s fundamental business model has not changed since it first began business in the late 1980s. Apple’s organizational strategy â€Å"think different† is to control the development and design of the hardware and software for all of its products. The company is focused on providing innovative products and solutions to consumers. Apple has a simple strategy of providing customers with the best products and experiences possible. Another strategy is offering exclusiveness of their products to certain providers and companies. This not only builds a strong working relationship, but also builds a strong want by consumers for Apple products. I think the most important strategy is their branding strategy. This includes making new products that supports a â€Å"digital hub† strategy. This is a concept where the products that Apple produces will function as a hub for digital devices such digital cameras, cell phones, etc. Apple focuses on the lifestyle of the customer which includes imagination, hopes, dreams, and many more attributes. They are committed to the customer (Apples branding strategy, 2011). Mission Statement Apple mission statement is as follows, â€Å"Apple designs Macs, the best personal computers in the world, along with OS X, iLife, iWork, and professional software. Apple leads the digital music revolution with its iPods and iTunes online store. Apple reinvented the mobile phone with its revolutionary iPhone and App Store, and has recently introduced its magical iPad which is defining the future of mobile media and computing devices (Investor relations, 2011). † Steve Jobs stated that Apple’s â€Å"core value that the company believes, is people with passion can change the world for the better. † He stressed that value at its core is something that should never change despite the world changing around it. The company’s structure and control systems and how they match its strategy Apple’s first product, the Apple I, was vastly different from the Apple products of today. This first handmade computer kit was constructed by Apple co-founder Steve Wozniak. It lacked a graphic user interface (GUI), and buyers had to add their own keyboard and display. Co-founder Steve Jobs convinced Wozniak that it could be sold as a commercial product. In 1976 the Apple I was unveiled at the Home Brew Computer Club and put on sale for $666. 66. Jobs and Wozniak continued to create innovative products. Soon their new company, Apple Computer Inc. , had surpassed $1 million in sales. However, the mid-1980s saw some difficult times for Apple. In 1983 the company introduced the Apple Lisa for $10,000. The product flopped. In 1985 Steve Jobs was ousted after internal conflicts with the Apple CEO. Its computer products the Mac I and the Newton were not successful, and the company underwent several CEO changes. With declining stock prices, the future of Apple was in jeopardy. Steve Jobs returned to Apple in 1997 to try and save the struggling company. The return of Jobs introduced a new era for Apple. Jobs immediately began to change the company’s corporate culture. Before Jobs’ return, employees were more open about Apple projects. After he returned, Jobs instituted a â€Å"closed door† policy. Today Apple continues to remain vigilant in protecting its technology and ensuring that information remains proprietary. Jobs also created a more flattened organizational structure; rather than go through layers of management to address employees, he addressed them directly. Perhaps one of the most noticeable changes, however, was Apple’s expansion into new product lines within the electronics industry. In 2001 Apple launched the iPod—a portable music player that forever changed the music industry. The company also introduced iTunes, a type of â€Å"jukebox† software that allowed users to upload songs from CDs onto their Macs and then organize and manage their personalized song libraries. Two years later Apple introduced the iTunes Store, in which users could download millions of their favorite songs for $0. 99 each online. In 2007 Jobs announced that Apple Computer, Inc. would be re-named Apple Inc. This signified that Apple was no longer just a computer manufacturer but also a driver in consumer electronics. Some saw this as a shift away from computers toward consumer electronics such as Apple TV, iPods, iTunes, iPhones, and iPads. However, it may be more accurate to say that Apple is reinventing computers. With the introduction of tablet computers such as the iPad, Apple has begun to take market share away from its top competitors in the computer industry. Sales of desktops, laptops, and netbooks began to decline after tablet computers were introduced. Analysts believe that tablet computers will continue to grow at a rapid rate. Apple’s transition from a computer to a consumer electronics company is unprecedented—and hard to replicate. Although many can only speculate about why Apple succeeded so well, they tend to credit Steve Jobs’ remarkable leadership abilities, Apple’s highly skilled employees, and its strong corporate culture. Conclusion Today, Apple continues to lead the industry with their outstanding and ‘ award winning’ products and services. Apple is also credited with leading the digital media revolution with their iPod portable music and video players and iTunes online media store, creating the first sustainable music-downloading business model in history (Gershon, 2009, p. 367). The company has also entered the mobile phone industry with an altogether different business strategy known as† value innovation† with the iPhone. Value innovation focuses on making the competition irrelevant by opening up new and untapped markets, creating a leap in value for consumers. The iPhone is yet another product that has changed the way the industry defines new product standards and possibilities. With growing demand for high-quality, powerful, user-friendly, and cost effective products, Apple is undoubtedly the leader in terms of bringing these ideas to life. The company realizes that rather than publicly announcing product development plans years in advance, products are better received with an â€Å"awe† response if they are simply released when they’re finished as opposed to providing â€Å"beta† or â€Å"demo† versions to the public. This is an excellent strategy when the goal is to keep consumers eager for the latest products and asking, â€Å"What could they possibly improve next? †

Role Of Family In Mental Health Social Work Essay

Role Of Family In Mental Health Social Work Essay As a potter molds clay to form a beautiful creation, so does the strong family support and good values does. Family bonds are a link from the beginning and guide to future. Early influences are fundamental to individual development. Everyone wants to belong and feel accepted. A sense of belonging is derived from the strong bond of family. Family is where roots take hold and grow. We are molded within a unit, which prepares one for the experiences of the world and reactions to those experiences. A close family bond is like a safe harbor where one finds refuge. From trusting that someone will pick us up when we fall, as a toddler, to someone being there for us as we experience the storms in life. Family bonds help to instill trust, hope and belief in ourselves. The other hand if family doesnt have attachment, poor relationship, insecurity and anger can lead to negative consequences like isolating, low self image, anger and pain inside them. If one isnt loved as a child, they may later seek love and acceptance in a way that brings them harm. This not only affects the emotional, physical and social well-being. The poor self-image may be with the patients throughout life, causing inability to make positive choices or be close to others. Strong family bonds help us to thrive in all aspects of life. Lack of these bonds can lead to forever seeking that something which is missing and one should not take the value of family bonds for granted. Along the farm duties, family usually faces burdens. Yip (2005) identified three types of burdens in family care giving of persons with mental illness. Objective burdens are financial burdens, time and effort in care giving of family caregivers. Subjective burdens are feelings of loss, shame, worry, anger, and hopelessness of family caregivers towards their relatives with mental illness. Finally, there are burdens in management of problem behaviors like assault, mood swing, unpredictability, and other negative symptoms due to mental illness of a family member. Along with the burdens, there are benefits when family stay with mentally ill person. Often patients listen to their family because they are close to each other and every disease needs cure and family is the major support. They can help their family member to involve in the social and family activities, by involving them in rehabilitation program, encouraging other family members and friends to invite the ill family member to join them in activities and by respecting the need of solitude. Scenario: My patient was a 17 years old female, forth among seven siblings, with the diagnosis of schizophrenia. Her pre morbid personality was that she was always a different child, quite and always thinking. She had no friends and was never interested to talk to her sisters as well. She never took part in household chores and when asked to help, she used to get angry, and never participated. She had a jealousy component in her as the mother always admired her elder sister and degraded her. Before hospitalization she even had hallucinations and delusions. While talking to the patient, she verbalized that I dont like my sisters because everyone compares them with me. Patients mother also accepted that she had always given importance to the elder sister and pointed out the client that she is the laziest person of the family. May be this could be a reason of patients anger, frustration and not having a caring attitude towards family. Significance of family support in Pakistani context: Family support is a very important part of our entire Pakistani nation. Family support is given a lot of importance in terms of family bonding, love and affection. On the other hand there are few families which do not pay attention to this important issue. The family support is important because it effects on physical, psychological and social well being of an individual. In the Pakistani context no such study is been done on familys role in ones life. According to Mansoor (2008) Family system in Pakistan states that each member of a Pakistani family has respect for the older family members. The parents feel responsible for teaching their children the basic beliefs of the chosen religion. Looking at the scenario mentioned above the family has paid less attention to the child because of huge family, house hold responsibilities and low socio-economic system. According to my understanding when a child grows in a close kit family they learn to appreciate all the members of family and nev er hesitate to accompany their elders or youngers in public. I believe that strong family bond serves as catalysis for everyones joy. This is because the family has its rules and regulations and when these rules and regulations are strictly followed it brings joy to the whole family and helps in community building. There is always the belief that good families can make a good society. Strong family bonds create an atmosphere of interference in the affairs of one another. For example a strong and united family the elders do not abandon the family, but they keep taking care of their parents and their younger ones in times of troubles. Significance of family support in western world is on appendix 1. Analysis of concept in the light of literature: During the 1950s, Murray Bowen gave family system theory. Theory affirms that the individual can change behavior if aware of the impact of current and historical family behavior. It works on family as well as on the emotional health of an individual. Bowen summarized his theory using seven interlocking concepts. First three concepts apply to overall family and other four are related to family characteristics. Differentiation of self The concept of differentiation of self measures all human functioning on a continuum from the greatest emotional fusion of self boundaries to the highest degree of differentiation or autonomy. In my patients scenario self was suppressed from the childhood in the result of that her family relationship were not strong. A lot of family criticism was there. Children were not allowed to take their own decision; instead they have to do whatever parents asked. The example is secular studies were compromised and the client was put in Madrasa to learn and recite Quran. As a result the family bonding went down. Her issue were not given importance and taken as a least important person of the family. She was never paid attention for whatever she did; the reason could be huge family, less differences between children and poverty. The continuum of differentiation of self is discussed more in detail in appendix 2. Triangles Triangle is a predictable emotional process that takes place when difficulty exists in a significant relationship, and the third entity is included. In my patients scenario, the triangle has three ends. One is father, another mother and the third is the patient. The conflicts between parents have a great impact on child and that can leave lifelong effects on ones life. In my clients scenario the parents had conflicts between them and research indicates that the longer parental conflict continue, greater the tension between the parents, the greater the likelihood that psychological difficulties will result for children such as emotional and behavior problems, anxiety, depression, sleep problems, low self-esteem, school problems and a number of other difficulties. The example of family triangle is on appendix 3. Nuclear Family Emotional System These are patterns of interaction between family members and the degree to which these patterns promote emotional fusion. In my clients picture she was always projected that she never participates in house hold chores and is the laziest person of the family. This indeed led to low self esteem and hopelessness. Most of the patients develop hopelessness because of shame and guilt of being poor. According to Patel Kleinman (2003) stated that hopelessness is a core experience: it is associated with spouse and family abuse, forced marriages, limited educational and work prospects, stigma for failing to produce a son, and the migration of husbands to urban areas for employment. The family projection process It is the projection of spouses problem onto one or more children to avoid intense emotional fusion between the spouses. This also fits into the clients scenario that because of poverty and low socio economic status parent and child were not able to create bond between them. The economic stressors such as unemployment, low income, and lack of affordable housing, are more likely to precede mental illness.(Hudson, 2005 ) Multigenerational Transmission Process This refers to the transmission of a family projection process. The nature and degree of intensity of emotional responses are passed down from generation to generation. Levels of differentiation are affected through generations based on levels of differentiation of partners as they marry. This was not exactly explored during the interaction but it could be a part of patients illness. Emotional cutoff The concept of emotional cutoff describes people managing their unresolved emotional issues with parents, siblings, and other family members by reducing or totally cutting off emotional contact with them. In my patients case she became isolated from the family. This could be because she has some concerns from the family but they were never addressed and she got emotionally cutoff from it. Siblings position There is an impact of sibling position on development and behavior. Most of the time it is practiced that older child is the leader and the youngers are the followers. My patient follows exactly in this category. She is forth among seven siblings. She never liked her mother to say that be like your elder sister and never liked to follow her elder sisters. (Stuart, 2001) See appendices 4 for the factors left. Intervention: At individual level, a mental health nurse can take time for the patient and encourage them to ventilate their feelings. Moreover, while giving teaching to the patients, nurse can discuss the coping strategies. She can provide holistic care and address the problems and concerns accordingly, as the need of the individual. The nurse can provide the most important informations to the patient that is the need for the understanding their own responsibility. Make them aware of the importance of family support which is necessary for them. The interventions done on the client includes family teaching on dealing with hallucination and delusions that was informal. Mother was given teaching on stress management and coping mechanism. Client was involved in occupational therapy example making sit upon, coloring, drawing, collage work, making bands and so on to see the concentration level and keep the patient busy and asked the family to keep patient involved. At group level family can also involved with patient, to be aware of patients condition and involve them actively in patients care. The individual can be involved in group therapies for example milieu and occupational therapy. Moreover, in Pakistan, organizations should be made which can involve families who have clients with mental illness so that they can share their concerns, ventilate their feeling and reform solutions to problems. Some organization can also work to reduce the poverty and socio-economic instability, which is one of the leading factors of mental illness. At institutional level different groups of health care professional can be train for the risk assessment, can conduct the educational session on importance and role of family in ones life. Moreover, seminars can be held for general public regarding awareness of mental illness, coping skills to reduce stress and to ventilate their feeling. Hence, I would like to recommend that health care workers should be more vigilant towards clients health. At governmental level, organizations should be made to teach skills to clients for earning and to feel them self-empower. In addition, it is role of a nurse to identify the concerns in clients, spend time with the clients for their ventilation of feelings, should not be judgmental regarding clients complains and try to resolve their issues collaboratively with clients, families and other health care providers. My own learning Reflection: Through this paper writing my horizon of thinking about family role has more broaden. I always had a thought that mental illness occurs more often with parental conflicts but it has many other dimensions to look at. Going through different researches I came to know that love and affection are the important aspects which can help a mentally ill patient to live a normal life and when one is deprived from it can end into many other issues. The misconceptions I had before about mentally ill patients were that they are harmful and attacking but now I realized that they are only looking for love and someone to listen them. Mentally ill patients are also human and they should be treated as human beings, this is their right and they should get it. Conclusion: In conclusion, low family sociability, the extent to which family members derive and seek   gratification from social interaction with others along with a lack of cohesion explicitly, the extent to which family members have bonding towards one another is important. Conflicts between family members, authoritarian family styles, the extent to which parents dominate the locus of rule making and low family sociability plays a significant role in ones life. Importance of Family lies in the fact that one can discuss matters with the other family members and search solution from discussions. At times, conflict appears in a family but enough space should be provided to their opinions and views. In modern days, we have seen that joint families have broken up into nuclear families and a nuclear family consists of a couple and their children. In western countries, nuclear families are the norm but in many eastern countries, joint families still exist. Children receive guidance from the family as to what they should do or what they should not do. The Importance of Family lies in the fact that it determines to a large extent the social roles that the children will perform. Family support and bond can help an individual to come out from stressors, mental illness and other health problems. References: Abelenda. J., Helfrich. C., A. (2003). Family resilience and mental illness: The role of occupational therapy. Occupational Therapy in Mental Health, 19 (1), pge # Edalati.A., Redzuan. M., Mansor. M., Abu Talib. M. (2010). Family values and females psychological aggression.Malaysia Journal of Social Sciences 6 (1), 8-13. Katie M., Rootes.H., Peter J., Jankowski., Steven J Sandage. (2009). Bowen family systems theory and spirituality: exploring the relationship between triangulation and religious questing. Springer science business media, LLC. Mansoor.H. Family System in Pakistan. Retrieved on April 21st, 2010 from http://EzineArticles.com/?expert=Hayi_MansoorHYPERLINK http://ezinearticles.com/?expert=Hayi_Mansoor . Marshall.T., Solomon P., Steber. S.A., M.S.S., Mannion E. (2003). Provider and family beliefs regarding the causes of severe mental illness. Psychiatric Quarterly, 74,(3). Mental illness and poverty. A fact sheet. (2007). Florida council for community mental health. Retrieved on April 10th,2010. Nichols, M. P. Schwartz, R. C. (2001). Bowen family systems therapy. In M. P. Nichols R. C. Schwartz, family therapy: Concepts and methods. 5th ed., pp. 137-171. Boston: Allyn and Bacon. Retrieved on April 15th, 2010. Patel. V., Kleinman. A. (2003). Poverty and common mental disorders in developing Countries. Bulletin of the World Health Organization, 81 (8). Retrieved on April 13th, 2010. Schizophrenia: The Journey to Recovery. (2007). A consumer and family guide to assessment and treatment. Canadian psychiatric association schizophrenia society of Canada. Retrieved on April 20th, 2010. Stuart, G. W. (2001). Principles and practice of psychiatric nursing. 7th ed. St. Louis: Mosby. Sven.D. (1998). Family ties in Western Europe: Persistent contrasts. 17 Population and Development review, 24 ( 2). Retrieved on April 18th, 2010. Time magazine teen age pregnancy. (2006). Children having children-teenage pregnancy in America. Retrived on april 22nd, 2010 from http//: teenage pregnancy single parent families society and modern ailments rape sexual assault.mht Videbeck, S. L. (2004). Psychiatric Mental Health Nursing. Philadelphia: Lippincott. Yip.K.S. (2005). Family intervention and services for persons with mental illness in the peoples Republic of China. Journal of Family Social Work, 9 (1). Appendices 1: Significance of family support in western context: According to Sven.D. 1998 There are regions where traditionally the family group has priority over the individual and others are opposite, with the individual and there values having priority over everything else. The geography of these family systems suggests that North America, center and northern Europe has been characterized having relatively weak family links. There are indications that these differences have deep historical roots. There is little to suggest that they are diminishing today in any fundamental manner. The way in which the relationship between the family group and its members manifest itself has implications for the way society itself functions. According to my thinking, in western world, families have less importance, may be because of their fantasy world, interference they dont like or freedom they are fond of. In the west, kids are allowed to leave parents at the age of 18 as they are mature and can take their own decisions and responsibility and parents dont mi nd it because its their trend, as a result single parent family comes into existence. According to Jill Francis, of the National Childrens Bureau, There are four main reasons why teen age unmarried girls in Britain become pregnant. The likelihood becoming pregnant as a teen increased if one had parents who were inattentive, unloving, or failed to instill moral values with no family bonding. Girls whose mothers were teenage mums are more likely to do the same. Here the question arises that if this situation will continue, will there be family bonding in upcoming years? It is important for the family to understand the importance of family role in order to save the generation from mental illness, as families role is one of the biggest factors contributing towards mental disorder. The concept of family is somewhere far but those who belief in family bonding are still holding their hands together. Appendix 2: High differentiation Low differentiation Fusion with others. Personal autonomy Blends thoughts and feelings. Distinguish between thoughts Emotionally reactive when stressed. and feelings. Retains objectively when stressed.