Racial Diversity in Society Worksheet Essay

African Americans are more involved in the American political process than other minority groups in the United States, because, as indicated by the highest level of voter registration and participation in elections among these groups in 2004. African Americans have achieved higher levels of education than immigrants to the United States. African Americans also have the highest level of Congressional representation of any minority group in the United States. A large majority of African Americans also support the Democratic Party. In the 2004 Presidential Election, Democrat John Kerry received 88 percent of the African American voters compared to 11 percent for Republican George W. Bush. Historically, the African Americans who supported the Republican Party only votes were because of the Republican President Abraham Lincoln due to him helping grant freedom to American slaves. At the time, the Republicans and Democrats represented the sectional interests of the North and South, respectively, rather than any specific beliefs, and both Republicans and Democratic were represented equally in both parties. The African American trend of voting for Democrats can be traced all the way back to the 1930’s during the Great Depression. When Franklin D. Roosevelt’s New Deal program provided economic relief to African Americans; Roosevelt’s New Deal coalition turned the Democratic Party into an organization of the working class and their liberal allies, regardless of region. The African American voters became even more exclusively Democratic, when Democratic presidents John F. Kennedy and Lyndon B. Johnson pushed for the civil rights legislation during the 1960s. After over 50 years, the marriage rates for all Americans began to decrease while the divorce rates and out-of-wedlock births have increased. These changes have been the greatest amongst the African Americans.

Core Indian Values – an Advertising Perspective

INDIAN CONSUMER: CORE VALUES We are all consumers. Everyday, we consume goods and services as individuals, families, groups and organizations. With every passing year, the consumer has not only become smarter but also choosier with his purchase. On top of that, the fact that the competition and the variety of products available in the market only add to the marketers’ woes. To succeed in this dynamic and increasingly complex marketing environment marketers have an urgent need to learn and anticipate whatever they can about consumers.The better they know and understand consumers the more advantageous it would prove when accomplishing their organizational objectives. In a diverse country like India, which is slowly shedding its conservative nature and is opening up to new possibilities on the marketorial front, it becomes even more difficult for an advertiser to understand his consumer’s behaviour. The Indian mentality is more complex and layered than our western counterp arts. The culture of this country is very different from most others for it is home to various religions, languages, customs and values.This amalgamation has led to the Indian consumer having various layers of reasoning behind every action. There are certain values that play a very important role while purchasing a product from the point of the view of the Indian consumer. An advertiser should keep these values in mind while targeting their Indian audience. 1. Family The Indian society is a family oriented one. Elder members of the family are considered to be the head of the family. Though joint families have now disintegrated into nuclear ones, the bond and importance of family remains the same.Family is by far the most important reference group. The family is a major influence on the consumption behaviour of its members and generally the target market for most products. The consumption patterns of family members are seldom independent from those of other family members. There is a n interdependent relationship between the members of the family. An advertiser selling family oriented products must target it for the benefit of every member of the family. Eg. Tata Ventura ad. 2. Peace Peace  is a state of harmony characterized by the lack of violent conflict.It also represents cosmic harmony. An individual seeks peace when he wishes to establish a personal relationship with the cosmos. India is country where different sects coming together causes chaos and conflict. Hence, peace is highly sought after both personally and internationally. An advertiser while selling a product, depending on its nature, must keep in mind the fact that his product must not invoke chaos in any form. He must try as much as possible to maintain decorum while advocating a product. Eg. Taj holidays. 3. Health India is slowly growing to be a very health conscious nation.Indian food offers a diversity of dishes that are very tasty and each provide a different delight. But at the same time . Some of them can be very heavy and unhealthy with continuous consumption. In the fast paced of today’s times, health has become of utmost importance. Various fitness centers are being set up everywhere and maintaining a healthy lifestyle has become very important to the average Indian consumer. Advertisers target this aspect of the Indian consumer while promoting various health related products. Eg. Saffola ads. D cold total ads 4. Time Time is of utmost importance in the Indian society. Natural time regulates ctivities with a â€Å"now† orientation. Indians have always factored in on time before starting or ending any event, both metaphysically and metaphorically. Time is considered to be an auspicious and important aspect for Indians. While making major purchases, time is factored in majorly. An advertiser can either portray the time factor majorly in his advertisement or he can portray it subtlely with respect to the product. Time also reflects the era the people live in and its dynamic nature. Eg. Hindustan times â€Å"It is time† campaign. 5. Will power. Will power is the strength to achieve the impossible or the difficult.Indians consider will power to be a treasurable value as it may lead to various achievements. If one gets over their fears and has the will power to achieve what many consider to be impossible then that person is highly respected. Without will power, one cannot alter events or restore it to the original post. India’s history has been witness to the importance of will power among the Indian public. Advertisers can theme their ads on the basis of will power thereby promoting their product and also gain popular vote for encouraging strength. Eg. Mountain Dew Darr Ke Aage jeet hai ads 6. SecurityA sense of security is very important in both a family and a community. Usually, the male member of the family is considered to be responsible for the security of the female counterparts in India. Females are especially protected in this society. But along with physical security, financial security has also become important for the modern Indian family. Many make investments so that the family is always financially secure. Protection of community is also a very important aspect as Indians are very community bound. Members of the same community usually have a sense of belonging and protection towards their other members.Eg. LIC jeevan bima policy ad. 7. Age Since time old, age has played a very important role in the Indian society. A person’s age has been synonymous with the amount of respect given to them. Even today, older people are treated with utmost respect and obedience is expected of the younger ones. Wisdom and experience of a person is calculated in terms of his age. In today’s times, the youth are very instrumental to the decision making process while purchasing a product. On the basis of the product, the advertiser must carefully target his age group and center the ad arou nd the mentality of the age group selected.Eg. Raymond teacher ad. 8. Care Since the familial values are very strong in the Indian system, love and affection play an important role. Love and care for others is considered to be an important value especially with the members of family and friends. Unlike their western counterparts, Indian children live with their parents even after reaching adulthood and are duty bound to serve their parents in their old age as a token of their affection. Parents fuss over their children and take care of them protectively from a tender age and even beyond adulthood.This feeling of care and affection is largely targeted by marketers to sell their products for they hit a soft spot among the Indian audiences with this value. Eg. Vicks ads. 9. Prestiege There is nothing more important to an Indian household than the family’s honour and prestiege. Indians bank a lot on social approval and the sense of prestiege they gain from it. That sense of prest iege even comes from indulging in luxury and living a high life. A lot of luxury related products target this aspect of the Indian audience and cater to their value of prestiege. Eg. Reid and Taylor Amitabh Bacchan ad. 10. OwnershipEver since the olden days, a personal home has been of epitome importance to the average Indian household. It is a matter of protection and pride to own a home. In this tight spaced urban world, it has become even more difficult to own a home. But nevertheless, Indians continue to strive for ownership of a home for both themselves and their loved ones. It ione of the most important consumer values. A lot of options are considered and a lot of research is conducted before a home purchase. A bevy of home loans have also eased the process of a purchase of a home. Marketers also target this aspect while advertising their product.They arouse temptation to own a home which coincides with the consumer’s desire of the same. Eg. Asian paints Bird ad 11. Ada ptability In spite of being from a conservative background, Indians have changed their behaviour with the changing times. People have adapted to the different languages in the country and different lifestyles with ease. This reflects the dynamic nature of the Indian population along with their ability to adapt to the changing times and the environment. This value is considered to be a sign of progress. Many advertisers wish to promote this value through their ads and encourage this aspect among the Indian public.The ads based on adaptability have proved instrumental in shaping the minds of the Indian audience as a whole. Eg. Aircel ad. Idea cellular Language ad 12. Religion This is by far the most important consumer value among Indians. Religion plays a very important role in India. There are people of numerous faiths and religions residing in this country. It is one the sure shot ways to get attention from the Indian audience through advertisements. But is also important to not off end the sentiments of the Indian audience as they are very sensitive when it comes to their religion.One has to be very careful while welding advertisements with religion. the Indian public adheres to their traditions and customs and is very dedicated towards maintaining their culture. Festivals are considered to be the best time for promotion of products in a religious theme. Eg. Tanishq ads (wedding) Aisanpaints pngal ad 13. Pleasure Pleasure relates to being happy and cheerful towards oneself and their surroundings. Everyone likes to indulge in pleasure after strenuous work. Indians especially like to please themselves with various pleasurable activities and believe in balancing work with play.The idea of pleasure, according to most Indians, is to spend time with their loved ones and engage in leisurely activities. While targeting this value of the Indian consumer, the advertiser has to keep in mind the mentality of the consumer and the nature of the product and blend both of the m. It could be themed around pleasure with intensity or pleasure with lightheartedness. Eg. Scooty pep+ ads Cadbury’s life ka swaad ads 14. Work Since the urbanization of Indian society, there has been an evermore increase in the job opportunities especially for the youth. The youth of the country have become very ambitious and aim high.The education levels have gone up and the literacy rate has also shot up. Having a high paying job has become very important to the average Indian consumer as his salary corresponds with his buying prowess. Advertisers should start aiming at this progressive value of the Indian audience and design their ads to suit this aspect as well as promote their products. Encouraging progress in terms of education and work has become a very important aspect in current Indian society and especially among the youth. Eg. The Sikkim Manipal University distance education ads. Bibliography Core Indian Values – an Advertising Perspective INDIAN CONSUMER: CORE VALUES We are all consumers. Everyday, we consume goods and services as individuals, families, groups and organizations. With every passing year, the consumer has not only become smarter but also choosier with his purchase. On top of that, the fact that the competition and the variety of products available in the market only add to the marketers’ woes. To succeed in this dynamic and increasingly complex marketing environment marketers have an urgent need to learn and anticipate whatever they can about consumers.The better they know and understand consumers the more advantageous it would prove when accomplishing their organizational objectives. In a diverse country like India, which is slowly shedding its conservative nature and is opening up to new possibilities on the marketorial front, it becomes even more difficult for an advertiser to understand his consumer’s behaviour. The Indian mentality is more complex and layered than our western counterp arts. The culture of this country is very different from most others for it is home to various religions, languages, customs and values.This amalgamation has led to the Indian consumer having various layers of reasoning behind every action. There are certain values that play a very important role while purchasing a product from the point of the view of the Indian consumer. An advertiser should keep these values in mind while targeting their Indian audience. 1. Family The Indian society is a family oriented one. Elder members of the family are considered to be the head of the family. Though joint families have now disintegrated into nuclear ones, the bond and importance of family remains the same.Family is by far the most important reference group. The family is a major influence on the consumption behaviour of its members and generally the target market for most products. The consumption patterns of family members are seldom independent from those of other family members. There is a n interdependent relationship between the members of the family. An advertiser selling family oriented products must target it for the benefit of every member of the family. Eg. Tata Ventura ad. 2. Peace Peace  is a state of harmony characterized by the lack of violent conflict.It also represents cosmic harmony. An individual seeks peace when he wishes to establish a personal relationship with the cosmos. India is country where different sects coming together causes chaos and conflict. Hence, peace is highly sought after both personally and internationally. An advertiser while selling a product, depending on its nature, must keep in mind the fact that his product must not invoke chaos in any form. He must try as much as possible to maintain decorum while advocating a product. Eg. Taj holidays. 3. Health India is slowly growing to be a very health conscious nation.Indian food offers a diversity of dishes that are very tasty and each provide a different delight. But at the same time . Some of them can be very heavy and unhealthy with continuous consumption. In the fast paced of today’s times, health has become of utmost importance. Various fitness centers are being set up everywhere and maintaining a healthy lifestyle has become very important to the average Indian consumer. Advertisers target this aspect of the Indian consumer while promoting various health related products. Eg. Saffola ads. D cold total ads 4. Time Time is of utmost importance in the Indian society. Natural time regulates ctivities with a â€Å"now† orientation. Indians have always factored in on time before starting or ending any event, both metaphysically and metaphorically. Time is considered to be an auspicious and important aspect for Indians. While making major purchases, time is factored in majorly. An advertiser can either portray the time factor majorly in his advertisement or he can portray it subtlely with respect to the product. Time also reflects the era the people live in and its dynamic nature. Eg. Hindustan times â€Å"It is time† campaign. 5. Will power. Will power is the strength to achieve the impossible or the difficult.Indians consider will power to be a treasurable value as it may lead to various achievements. If one gets over their fears and has the will power to achieve what many consider to be impossible then that person is highly respected. Without will power, one cannot alter events or restore it to the original post. India’s history has been witness to the importance of will power among the Indian public. Advertisers can theme their ads on the basis of will power thereby promoting their product and also gain popular vote for encouraging strength. Eg. Mountain Dew Darr Ke Aage jeet hai ads 6. SecurityA sense of security is very important in both a family and a community. Usually, the male member of the family is considered to be responsible for the security of the female counterparts in India. Females are especially protected in this society. But along with physical security, financial security has also become important for the modern Indian family. Many make investments so that the family is always financially secure. Protection of community is also a very important aspect as Indians are very community bound. Members of the same community usually have a sense of belonging and protection towards their other members.Eg. LIC jeevan bima policy ad. 7. Age Since time old, age has played a very important role in the Indian society. A person’s age has been synonymous with the amount of respect given to them. Even today, older people are treated with utmost respect and obedience is expected of the younger ones. Wisdom and experience of a person is calculated in terms of his age. In today’s times, the youth are very instrumental to the decision making process while purchasing a product. On the basis of the product, the advertiser must carefully target his age group and center the ad arou nd the mentality of the age group selected.Eg. Raymond teacher ad. 8. Care Since the familial values are very strong in the Indian system, love and affection play an important role. Love and care for others is considered to be an important value especially with the members of family and friends. Unlike their western counterparts, Indian children live with their parents even after reaching adulthood and are duty bound to serve their parents in their old age as a token of their affection. Parents fuss over their children and take care of them protectively from a tender age and even beyond adulthood.This feeling of care and affection is largely targeted by marketers to sell their products for they hit a soft spot among the Indian audiences with this value. Eg. Vicks ads. 9. Prestiege There is nothing more important to an Indian household than the family’s honour and prestiege. Indians bank a lot on social approval and the sense of prestiege they gain from it. That sense of prest iege even comes from indulging in luxury and living a high life. A lot of luxury related products target this aspect of the Indian audience and cater to their value of prestiege. Eg. Reid and Taylor Amitabh Bacchan ad. 10. OwnershipEver since the olden days, a personal home has been of epitome importance to the average Indian household. It is a matter of protection and pride to own a home. In this tight spaced urban world, it has become even more difficult to own a home. But nevertheless, Indians continue to strive for ownership of a home for both themselves and their loved ones. It ione of the most important consumer values. A lot of options are considered and a lot of research is conducted before a home purchase. A bevy of home loans have also eased the process of a purchase of a home. Marketers also target this aspect while advertising their product.They arouse temptation to own a home which coincides with the consumer’s desire of the same. Eg. Asian paints Bird ad 11. Ada ptability In spite of being from a conservative background, Indians have changed their behaviour with the changing times. People have adapted to the different languages in the country and different lifestyles with ease. This reflects the dynamic nature of the Indian population along with their ability to adapt to the changing times and the environment. This value is considered to be a sign of progress. Many advertisers wish to promote this value through their ads and encourage this aspect among the Indian public.The ads based on adaptability have proved instrumental in shaping the minds of the Indian audience as a whole. Eg. Aircel ad. Idea cellular Language ad 12. Religion This is by far the most important consumer value among Indians. Religion plays a very important role in India. There are people of numerous faiths and religions residing in this country. It is one the sure shot ways to get attention from the Indian audience through advertisements. But is also important to not off end the sentiments of the Indian audience as they are very sensitive when it comes to their religion.One has to be very careful while welding advertisements with religion. the Indian public adheres to their traditions and customs and is very dedicated towards maintaining their culture. Festivals are considered to be the best time for promotion of products in a religious theme. Eg. Tanishq ads (wedding) Aisanpaints pngal ad 13. Pleasure Pleasure relates to being happy and cheerful towards oneself and their surroundings. Everyone likes to indulge in pleasure after strenuous work. Indians especially like to please themselves with various pleasurable activities and believe in balancing work with play.The idea of pleasure, according to most Indians, is to spend time with their loved ones and engage in leisurely activities. While targeting this value of the Indian consumer, the advertiser has to keep in mind the mentality of the consumer and the nature of the product and blend both of the m. It could be themed around pleasure with intensity or pleasure with lightheartedness. Eg. Scooty pep+ ads Cadbury’s life ka swaad ads 14. Work Since the urbanization of Indian society, there has been an evermore increase in the job opportunities especially for the youth. The youth of the country have become very ambitious and aim high.The education levels have gone up and the literacy rate has also shot up. Having a high paying job has become very important to the average Indian consumer as his salary corresponds with his buying prowess. Advertisers should start aiming at this progressive value of the Indian audience and design their ads to suit this aspect as well as promote their products. Encouraging progress in terms of education and work has become a very important aspect in current Indian society and especially among the youth. Eg. The Sikkim Manipal University distance education ads. Bibliography

Irish Immigration Essay

Running head: IRISH IMMIGRATION IN 1850’S 1 Irish Immigration in 1850’s Dorothy Mathews Eth/125 March 7, 2010 Henry Williams IRISH IMMIGRATION IN 1850’S 2 Irish Immigration in 1850’s The line of ancestry that I came from is the Irish and English and Dutch. I am not certain about the dates, but I am pretty sure that they emigrated around the years 1850 to 1870. The Irish left the island of Ireland because of the potato famine that overtook their country. Even though undefined, Irish emigrants faced persecution from other foreigners because they were under educated and some were Irish Catholics, and also from little knowledge of what industrialization was. The greatest number of emigrants was from around 1850 through the late 1870’s. The Irish had learned to farm potatoes, because of the productivity and market prices. Towards the end of 1845 the potato crops caught a fungus which destroyed the crops in the ground and also in the storage bins. This turned them into a blackened putrid mass. (Immigration and Immigrants, 2000). By the year 1846 the entire crop was destroyed. In the interim, more than a million people died from famine and poverty. This began the greatest influx of emigrants from Ireland. After reaching the United States by sea, the Irish stayed mostly in a city environment because the majority of them knew nothing but farming and the land. They did not have the finances or the ease of buying land to farm. They stayed in the cities and most of them ended up living in the slums with some Chinese and African Americans. They could not get jobs because of their education and because they knew nothing of factories and actually living in cities. Most were used to living on farms and farming the land. IRISH IMMIGRATION IN 1850’S 3 Most of the Irish immigrants faced many prejudices and segregation. The nativists and the other immigrants were afraid of them because of their religion and beliefs. They were forced to live in slums and in poverty because they could not find jobs. The only work they could find was in servitude and menial labor jobs. They were under educated and poor. The Irish were thought to be stupid and ignorant, so they stayed to themselves. The Irish emigrants entered a land with new social and cultural differences. At this time the African Americans and Asian Americans were involved in disputes, along with the European Americans. Add to this the disruptions between the Catholics and Protestants and there was not much peace in the neighborhoods. During this time, they developed political partisanships which brought into line a group called the Know Nothing Party and later the American Protective Association (APA). Neither of these parties lasted for long, but the Irish were later associated with the new Democratic Party. Also during this time, Irish immigrant soldiers played a big part in the Civil War during the battles of Antietam, Fredericksburg, and Gettysburg (Immigration and Immigrants, 2000). Irish Americans also were involved in disturbances against the Chinese on the west coast which eventually led to Chinese American banishment from America. During this time when the Irish immigrated to America, they suffered from many discriminations, including segregation, racism, and redlining. They were stopped from buying properties, because no one wanted to sell to them. They did not want them in their neighborhoods, or shopping where they shop. They were thought to be ignorant, and beneath the mainstream of people and only good for menial positions. IRISH IMMIGRATION IN 1850’S 4 By the end of the 19th century, because of all the negativity that they had experienced by coming to America, the Irish had solidified their communities and turned back to the Church. The catholic churches in Boston, Massachusetts grew and were able to build and renovate many churches. The Irish families had learned new jobs, and between all the members of these families, they contributed to the growth of the Church in many cities. Soon the Irish American Catholics were associated with the Democratic party. In the 1880’s and the 1890’s, the Irish Americans elected quite a few officials to different positions. Although the Irish Americans were undefined when they arrived in the United States, they assimilated into the country and eventually grew into strong and eager Americans. Most of them came from poor families, but with strong visions and many strong backs, and resolution, they formed strong bonds and strong communities. They leave a long legacy of pride and ambition. Somewhere along the line they married into other groups and other races, and from these came good Americans. I am proud to be among them. In answer to your final question: I identify more with the mainstream American culture, but I celebrate St. Patrick’s Day and wear the green. I have never been to Ireland, but that is one of my fondest wishes. I am proud to be associated with the Irish in America. In my ancestry, somewhere down the line they married with someone of English descent and also someone of Dutch/German descent. This Emigration was 150 years ago, so the lineage has been mixed with a variety of races, since then. IRISH IMMIGRATION IN 1850’S 5 References Immigration and Immigrants. (2000). In Encyclopedia of the United States in the Nineteenth Century. Retrieved from http://www. credoreference. com/entry/galeus/immigration_and_ immigrants. Voters and Voting. (2000). In Encyclopedia of the United States in the Nineteenth Century. Retrieved from http://www. credoreference. com/entry/galeus/voters_and_voting.

Philosophy Essay Example | Topics and Well Written Essays - 1000 words - 7

Philosophy - Essay Example I propose to carry out an enquiry into the elements of illusion in the life that we take for real and the relevance of our willed existence in it. My contention is that the nature of reality is essentially a construct of human imagination in relation to the socio-political and cultural existence, and the extend to which one can affect or alter the reality depends on one’s willed existence. The philosophical precepts of Arthur Schopenhauer and Friedrich Nietzsche are explored in relation to this argument which hopes to deconstruct the conventional implications of the idea of reality. Life exists in this world in relation to various other forms of existence, both animate and inanimate. Human beings develop a sense of consciousness towards these myriad forms of experience through age-old conventions transmitted through generations. Even as homo sapiens claim to be the most sophisticated, complexly evolved and fit for survival species on the face of the earth, the perceived notions of the words surrounding them is the most corrupted in relation to that of the other life forms. Human beings have surpassed the necessity to follow the instinctual urges for survival by making the world a safe place for them. This has in fact led to a state where their sensibilities are formed with reference to preconceived notions, which are in most cases misrepresentations, with regard to the nature of reality that surrounds them. A child of the contemporary world comes to reality not only through the information that its parents, teachers, elders and peers transmit to it, but also with the judicious use of the myriad possibilities of information technology. Even then, the possibilities of coming to direct contact with reality are restricted to the child. IT may come to know that some animals are to be feared and some to be used, but it may never realize that these

British Versus American Cultures Essay Example | Topics and Well Written Essays - 1000 words

British Versus American Cultures - Essay Example Nicholas a few minutes early. She is welcomed by a secretary who informs her that Mr. Nicholas will be in a minute or two, but she had to wait for more that half an hour. This makes her so agitated and extremely restless. When she stands and brushes her cloth, it is a body gesture that implied that she was already impatient with being kept waiting for a long time (Scott, par10). While still on with the conversation, Mr. Nicholas tried to show courtesy to Mrs. Marybeth. He goes on to talk about the weather so as to build rapport with his guest. Mrs. Marybeth found this to be time wasting and dismisses him. This agitates Mr. Nichols but he does not show it to her; his facial expressions conveyed it all. Mrs. Marybeth was particularly shocked by the state of Mr. Nichols’ office. It was not sophisticated as hers in Los Angels. Mr. Nichols room was in a mess which is not so much common among the Americans to find in such an office. Across the different cultures, how the offices are arranged, conveys lot different things. The way books and furniture were arranged in Mr. Nichols’ office conveyed so much to the American lady which would have been a wrong perception of the situation (Scott, par 4). Mrs. Marybeth should have known about the living culture of the British who do not put so much concern on one’s appearance. Mr. Nicholas also dressed in a way, Mrs. Marybeth found not sophisticated (Scott, par 7). Unlike the Americans, the British have proved not to be a good time keepers. Had Mr. Nichol realized that his visitor was a timekeeper he would not have kept her waiting. Mrs. Marybeth should also have realized or learnt that by saying a minute or two, Mr. Nichols’ secretary was not so precise about the arrival time of her boss. Mr. Nichol and Mrs. Marybeth, should have learnt about the different culture for better communication. Mrs. Marybeth should also have leant that the British consider courtesy to be so valuable to their visitors. S he should not have dismissed Mr. Nichols way of conversing with her, but should have acknowledged it and moved on with the matter at hand. Considering the state of the office, and Mr. Nichols dressing, Mrs. Marybeth should have learned that, in the different cultures, different people do not consider outward appearance to be primary. Although Mr. Nichol dressed in a shoddy manner, he tried to convey himself in a sense of class and also sharp and intelligent. Had the cross culture leaning occurred; none of the business partners would have been offended. Thus, there is need to appreciate other peoples culture. How Technology is Stifling People’s Compassion There are different meanings of some verbal and non-verbal cues in the diverse cultures. A person can be able to decode these cues if he or she understands the culture of the person who is using it. He should also be able to understand that different cultures do decode the different cues to mean different meanings. According to Barnett para3, a person can take several minutes to trust a complete stranger only by using a face to face communication. We can be able to pay attention to inflection in another person’s speech, interpret the smallest change in facial expressions. This has been a norm in many peoples culture since the early times. Electronic evolutions in the society today, has made it to be harder to decode the expressions made by other people. The

Global marketing 'ensure' Essay Example | Topics and Well Written Essays - 1000 words

Global marketing 'ensure' - Essay Example It has concentrated in making the product available for those in the Saudi Arabian market that are lactose intolerant. The guiding principles towards ensure innovation are development of a wide range of formats and filter types that satisfy multiple requirements. Additionally, the innovative advancement in relation to ensure adopts the use of chromatography technologies and pall membrane technologies that offer micro filtered milk products that have longer shelf lives and fresher taste, functional ingredient so high value and milk concentrates. Due to the use of these technologies, the Saudi Arabian market will continue to maintain loyalty to the product and have trust in its quality. The relative advantage of ensure examines the degree to which it will be advantageous in the new Saudi Arabian market compared to the existing or competing brands. The rate to which Ensure milk product will be adopted in the Saudi Arabian market will depend on this relative advantage. The use of innovation as a product development priority is one of the things that will make the milk product gain relative advantage in the Saudi Arabian market. The Saudi Arabian market perception of the product as quality one due to application of latest technologies will help in shaking off competition. If the customers are able to see certain attributes in ensure milk that are seemingly better than in its competitors, they will embrace Ensure nutrition milk. The rate of adoption will be directly proportional to the increase in relative advantage. Additionally, the innovative aspect has a bearing on price (Latham, 2006). On one side, it helps Abbott in its competitive pricing. Increasing the prices or lengthy time taken in learning how deal with the product will affect the product’s adoption rate negatively. The Saudi Arabian market perception of the product as an innovative on is directly related to the level of compatibility

PDP - Personal Development Portfolio Assignment

PDP - Personal Development Portfolio - Assignment Example Weaknesses 1. Reduced ability to analyze the concepts and the ideas in implementation of lecture information and data. 2. Experience with poor paper work due to poor personal organization, 3. Easily got bored with education –lecture and seminar as well as other routine work 4. Poor comprehensive planning skills – preferred to use lesson plans rather than class notes 5. Poor skills needed in comprehension of text provided during classroom lectures and orientation seminars Opportunities 1. There was a new path direction in the career 2. New and imitating challenge also grew bigger 3. Gained a lot of experience in different environments as well as gaining less restraints 4. There is no firm career progression as well as better earnings prospects existed. 5. Existed more autonomy in the career prospects Threats 1. There was not training qualifications 2. The experience in management lacked 3. Unaccustomed to work in different working environment 4. Lacked commercial experie nce to compete extensively 5. Many trainers were aiming the job market SKILLS, ABILITIES AND COMPETENCIES Interest in technology and science Working to polish a career I require a first-class academic locale and attention in scientific acquaintance. It is also vital to keep posted and examination for once familiarity against knowledge (Brennan, 2003). Good communication A good communication skill is needed in order to be able to communicate with the career team and also to direct and encourage client. Comfort in using complex equipment Career seekers work with modern equipments and technology. Careful concentration to detail Good powers of surveillance are needed and must pay nearby awareness to produce and detail exceedingly precise work even when underneath pressure. Noble interpersonal skills Direct connection with team members; i must be responsible, kind and have a sociable and proficient stance towards work and other members. Contented to labor as a team Functioning as chunk o f a team whose shared focus is the meeting goals and objectives. i require to identify how all these dissimilar populace intertwine and get pleasure from functioning as a team. PROGRESS MADE Get a learning company. I got a job at a company well-known in its business for raising its people. When I work for this kind of company, I am registered in a constant expansion program that goes past the scientific skills needed for your present role. This creates a great base for a triumphant career (Gordon, 2006). Remain tech-savvy- I forced myself to keep mechanical skills existing, even if fresh developments don't appear openly associated to my career job. WHAT ELSE DO I NEED TO DO Thinking global- In several industries; physical barriers to business are receiving less relevance. Co-worker, customers and stakeholders at the present and upcoming can be from everywhere in the world. I require obtaining the skill to work inside the global marketplace. Maintain a accomplishment journal. The mom ent to begin assessment concerning actions and skills should not be at the time one searching for a new-fangled job (Brockbank, 1998). Edifice and uphold expert network. One should be raising associations with people both outside and within organization. This populace will be helpful as the view of work alters. IMPORTANT THINGS NEEDED IN OBTAINING A JOB Assess and assert your strengths on a recurrent basis. Build up sensible and attainable

Emotional development Essay Example | Topics and Well Written Essays - 2500 words

Emotional development - Essay Example A multi-agency team, consisting of a play worker, a nursery nurse, and a teaching assistant, worked with Rose to help her come out of her emotional trauma. Fun tools available to the kids and the types of play activities were observed, along with special consideration given to the team’s supervision and other adults’ direct or indirect contribution in play activities. The team saw positive outcomes. 2. Importance of Attachment and Its Effects on Brain The importance of attachment of infants and toddlers with the parents or caregivers cannot be denied in terms of healthy mental development. â€Å"The impact of attachment disruptions on children’s lives can be devastating and far-reaching†, state Kaduson and Schaefer (2006: 148). When the child enjoys vigorous attachment with the caregiver, he will learn how to offer and maintain a devoted and compassionate relationship that benefits the child in both the short and long run. He will learn to rely on others. The long term outcome will be a contented, independent, and confident personality. On the other hand, when the child does not have an attachment bonding with the caregiver, he will learn to fear, to feel guilty, and to feel the world as a place which is not safe and where his needs are not going to be met. The long term outcome is a timid personality suffering from inferiority complex. Hence, we see that the attachment between the infant/toddler and the caregiver has significant importance in terms of personality developmental outcomes. 3. Components of Healthy Attachment According to Kaduson and Schaefer (2006: 267), â€Å"a healthy attachment allows for a balance between the toddler’s developmentally appropriate exploratory drive and need for emotional reassurance and support.† A healthy attachment between an infant and the caregiver has two components. the infant’s needs that he wants the caregiver to fulfill the timely response of the caregiver The attachmen t occurs when the infant has a sure feeling that the parent or the caregiver will always be there to fulfill his needs of hunger, thirst, clothing, cleaning, and the like. When the caregiver gives a timely response to the infant, this gives rise to trust. The infant forms trust on the caregivers when his needs are fulfilled and forms an attachment with them. When the infant feels otherwise, he learns to mistrust others. Attachment also includes such efforts by the infant with which he tries to remain in physical contact with the caregiver, for example, holding a finger tight, clinging to the bosom, sticking to the lap, and etcetera. 4. Parenting Styles and Attachment Parents and caregivers can play very important role in developing and maintaining healthy bonds of attachment with the children (Maccoby 1992). When the caregivers give the children the chance to share their problems and express their needs to them, they are actually ensuring them that they can always depend upon them f or a solution. Parents use many approaches while parenting, most common of which are authoritarian, authoritative, permissive, and uninvolved styles. Attachment occurs when the child feels secure with his parent’s parenting style (Strage & Brandt 1999). Authoritarian parents leave no room for reasoning and communication. Authoritative parents leave room for objections. They listen to their child’s ideas and reason with them due to which the child

The ethics of select business related social issues Research Paper

The ethics of select business related social issues - Research Paper Example Recent studies have proved that methane hydrate accounts for more than thirty times more than carbon dioxide in global warming. It is also known by the name of fire ice, which is found in the form of ice crystals where natural methane gas is locked and is mainly formed due to high pressure and low temperature. They are mainly found at the edges of continental shelves and are mainly responsible for underwater earthquake. Even though, it has been identified that in methane hydrate, there is more energy than coal, gas or oil, but using the gas as a source of energy independence is unethical for the country due to its negative consequences. In this context, a research program is conducted by the US government since 1982 that is related to the American energy independence. However, considering from the economic point of view of the US, the use of methane hydrate as a source of energy may lead to the American Energy Independence and may help the country not to be depended on other countrie s for fuel. Hence, it can provide the US with the advantage of being a major fuel exporter to different countries. Moreover, it can compete with the petroleum producing countries like Iraq, Iran, Venezuela, Kuwait, Russia and Saudi Arabia. If the world switches from petroleum as well as coal to gas, then the revenue of the petroleum producing countries will reduce, whereas America can take this competitive advantage by using methane hydrate as their source of revenue. With the help of American Energy Independence, billions of dollars of revenue can be generated, which will help in the economic development of the economy and generate job opportunities. This can only be possible when the whole world will adopt this non-petroleum form of resource from America as an alternative of petroleum and coal (Americanenergyindependence, â€Å"Journey to Energy Independence†; BBC, â€Å"Methane Hydrate: Dirty Fuel or Energy Savior?†; Bloomberg L.P., â€Å"Americans Gaining Energy I ndependence

Bioremediation Procedures of Crude Oil Impacted Soil Essay

Bioremediation Procedures of Crude Oil Impacted Soil - Essay Example Some features of the spill location show the characteristics usually associated with a priority spill of toxic substance; a spill that seeps down through the subsurface strata and then comes into contact and interaction with the groundwater.   The entire description of the ecosystem and environment where the spill occurred is a rather complex question. Map inferences and a consultation of the USGS Ground Water Atlas infer that the contamination would, because of the largely rural character, spread more readily through the food chain and have a greater impact than when such a spill would occur in predominantly non-rural locations. This is by reason of the greater saturation possible where a rural area presents less paved and therefore sealed off superficial surface runoff, situations.   First, the groundwater flow direction is determined by drilling two or more wells. A non-toxic stain is made to suggest the velocity of groundwater flow, and the testing reveals the contaminant character and concentration. This site today has well upwards of 75 wells that all have data that is constantly changing. Concentrations that are available for wells 604b (years: 1987, 90, 92, 93 and 95); 532c (1986, 87, 88, 90, 92, 93, 95), would be fairly good indicators of both groundwater flow direction and extent of contamination spread because they are separated by a reasonable distance and lie   in the line of predominant groundwater flow. The contaminants recorded are: benzene, toluene; m, p-Xylene; o-Xylene; isopropylbenzene; and Dissolved oxygen, and are parameters which can suggest the effectiveness of the bioremediation. The idea is that aerobic rather than anaerobic processes are predominant. The rationale for this is that where the contaminant concentrations go to zero the Dissolved oxygen concentration increases.

Personal Selling and Sales Promotion MBA Marketing (Masters Level) Essay

Personal Selling and Sales Promotion MBA Marketing (Masters Level) - Essay Example Ingraining is a process by which people at work develop norms and beliefs (Kerin et al 2005). Certain ways of thinking and doing become taken for granted even though they have not been explicitly stated. In the main aspect of value communication, direct two-way information transfer between customer and firm, service businesses enjoy an edge, because the customer is in the system. Their needs are therefore not remote and to be inferred but right here and given expression to. The likelihood of a firm being able to match customer needs exactly is correspondingly higher, provided the firm can customize its services (Kerin et al 2005). An interactive relationship with customers often develops in many service arenas while the service is being rendered. The customer could explain his/her needs, air travel routing with stopover, variations on a dinner order, advice from a securities analyst--and often receive service in real time. Again feedback could also be instant, resulting in high commu nicated value, provided responsiveness, flexibility, and learning ability are incorporated into the system. These strategies make the assumption that the company intends to persist in a concentration mode, that is, limit its horizons to a single product/service or achieve a predominant portion of its sales in one industry. Few large or medium size firms confine their product horizons (Kerin et al 2005). Following Kotler and Armstrong (2008) customer relationship management has a great impact on sales and value creation. "Winning and keeping accounts requires more than making good products and sales. It requires listening to customers, understanding their needs and coordinating the company's efforts to create a customer value" (p. 468). Typically it is small businesses that start with such a focus. With success and growth generally comes a desire to reduce dependence on any one product/market. Diversified firms have more stable sales and earnings. Risk reduction unquestionably helps enhance shareholder value. For instance, in such companies as DuPont or McDonald's this emphasizes the high priority that must be attached to cohesiveness and unity in the high-value organization, not just as a means to an end but intrinsically and for its own sake (Kerin et al 2005). The strengthening of linkages within and among the value creation demands a cooperative endeavor as does the need to brid ge hierarchic gaps. A main value that seems critical to the value-seeking firm is a mutuality of respect. The relevance and importance of others to the aims and purposes of the firm have to be acknowledged. Mutual respect strikes to the very heart of the issue of the dignity of the individual and the absolute conviction that the success of the enterprise depends upon each one's contribution. This applies not only to employees but to every other stakeholder, particularly customers and suppliers. In spite of complexity and global nature of business, such giants as Wal-Mart and Toyota strive toward meeting the needs of customers, which is a pervasive, ever-present consciousness of the centrality of value to a firm's mission. In addition to customer value is an ideal to strive for in the relationship among employees, customers, suppliers and other stakeholders.

Amanda Todd Story Essay Example for Free

Amanda Todd Story Essay Ive decided to tell you about my never ending story. In 7th grade i would go with friends on web cam meet and talk to new people. then got called stunning,beautiful,perfect,etc. then wanted me to flash. so i did 1 year later. i got a message on facebook. from him don’t know how he knew me. it said.. if you don’t put on a show for me i will send your nudes. he knew my address,school,relatives,friends,family names, Christmas break knock at my door at 4am. it was the police. my photo was sent to everyone. i then got really sick and got anxiety, major depression and panic disorder. i then moved and got into drugs and alcohol. my anxiety got worse couldn’t go out. a year past and the guy came back with my new list of friends and school. but made a facebook page. my nudes were his profile pic. cried every night, lost all my friends and respect people had me for me again.. then nobody liked me. name calling, judged i can never get that photo back. its out there forever i started cutting i promised myself never again didn’t have any friends and i sat at lunch alone. so i moved schools again everything was better even thought i sat still alone. at lunch in the library everyday. after a month later i started talking to an old guy friend. we back and fourth texted and he started to say he liked me.. led me on.. he had a girlfriend.. then he said come over my girlfriend ,is on vacation. So i did.. huge mistake.. he hooked up with me i thought he liked me 1 week later i get a text get out of your school. his girlfriend and 15 others come including himself. the girl and 2 others just said look around nobody likes you. in front of my new school 50 people. a guy than yelled just punch her already. so she did.. she threw me to the ground and punched me several times. kids filmed it. i was all alone and left on the ground. i felt like a joke in this world.. i thought nobody deserves this. i was alone .. i lied and said it was my fault and my idea. i didn’t want him getting hurt, i thought he really liked me. but he just wanted the sex.. someone yelled punch her already. teachers ran over but i just went and layed in a ditch and my dad found me. i wanted to die so bad when he brought me home i drank bleach.. it killed me inside and i thought i was gonna actually die. Ambulance came and brought me to the hospital and flushed me. After i got home all i saw was on face book. She deserved it, did you wash the mud out of your hair? i hope shes dead. nobody cared.. i moved away to another city to my moms. Another school.. i didn’t  wanna press charges because i wanted to move on. 6 months has gone by people are posting pics of bleach, clorex and ditches. tagging me .. i was dang a lot better too they said.. she should try a different bleach. i hope she dies this time and isn’t so stupid. they said i hope she sees this and kills herself.. Why do i get this? i messed up but why follow me.. i left your guys city.. im constantly crying now..everyday i think why am i still here? My anxiety is horrible now.. never went out this summer. All from my pastlife’s never getting better.. cant go to school. Meet or be with people constantly cutting. Im really depressed. Im on anti depressants now. and counselling and a month ago this summer. i overdosed in hospital for 2 days..Im stuck.. whats left of me now.. nothing stops. i have nobody.. i need someone. my name is Amanda Todd. Summarize What kind of person would bully a kid online? What kind of person ridicules a child’s memory even after she took her own life. after 3 years of hell. began with a 12 year old and a web cam. Her name was Amanda Todd. After 3 years of hell, dealing with negative/rude comments telling her to kill herself, she decided it was time. Before she killed herself, she attempted to kill herself two other times, the one time she tryed to drink bleach thinking that it’ll kill her instantly, but it didnt, the other time she started cutting herself and overdosing on drugs. Then a month before she committed suicide she posted a youtube video of what she was going through. After reading most of the rude comments on the video, she thought that why am i still here in this world? Im not wanted. Im worthless, nobody wants me here. After reading all the rude comments she finally committed suicide after 3 long years of hell. On Wednesday October 10th 2012 Amanda Todd was found dead! She finally gave up on life and finally committed suicide.

Elderly Suicide Strategies with Nurse Based Intervention

Elderly Suicide Strategies with Nurse Based Intervention Investigation into nurse strategies to prevent or minimise attempted suicide in patients over 65 This dissertation considers the rationale for positive nurse-based intervention in consideration of issues relating to suicide in the elderly. The introduction sets the context, including the historical context, of the issues and discusses the negative effects of ageism on issues relating to suicide in the elderly. The literature review considers selected texts which have been chosen for their specific relevance to the issue and particularly those that espouse the view that ageism is counterproductive to a satisfactory quality of life outcome for the elderly person. Conclusions are drawn and discussed with specific emphasis on those measures that are of particular relevance to the nursing profession whether it is in a secondary care facility, a residential home setting or in the primary healthcare team and the community. Introduction We can observe, from a recent paper (O’Connell H et al. 2004), the comments that, although there is no doubt that the elderly present higher risk of completed suicide than any other age group, this fact receives comparatively little attention with factors such as media interest, medical research and public health measures being disproportionately focused on the younger age groups (Uncap her H et al.2000). Perhaps we should not be surprised at the fact that both suicidal feelings and thoughts of hopelessness have been considered part of the social context of growing old and becoming progressively less capable. This is not a phenomenon that is just confined to our society. We know that the Ancient Greeks tolerated these feelings in their society and actively condoned the option of assisted suicide if the person involved had come to the conclusion that they had no more useful role to play in society (Carrick P 2000). Society largely took the view that once an individual had reached old age they no longer had a purpose in life and would be better off dead. In a more modern context, we note the writings of Sigmund Freud who observed (while he was suffering from an incurable malignancy of the palate: It may be that the gods are merciful when they make our lives more unpleasant as we grow old. In the end, death seems less intolerable than the many burdens we have to bear. (cited in McClain et al. 2003) We would suggest that one of the explanations of this apparent phenomenon of comparative indifference to the plight of the elderly in this regard is due to the fact that the social burden of suicide is often referred to in purely economic terms, specifically relating tools of social contribution and loss of productivity. (Breeching A et al.2000). This purely economic assessment would have to observe that the young are much more likely to be in employment and less likely to be a burden on the economic status of the country whereas with the elderly exactly the converse is likely to be true. This results in economic prominence being given to the death of a younger person in many reviews. (Adcock P,2003). There is also the fact that, despite the fact that we have already highlighted the increase in relative frequency of suicide in the elderly, because of the demographic distributions of the population in the UK, the absolute numbers of both attempted suicides and actual suicides are greater in the younger age ranges and therefore more readily apparent and obvious. The elderly are a particularly vulnerable group from the risk of suicide. In the industrialised world males over the age of 75 represent the single largest demographic group in terms of suicide attempts. Interestingly (and for reasons that we shall shortly discuss) although there is a general trend of increasing suicide rate with age the excess rates associated with the elderly are slowly declining in the recent past (Castell 2000). We can quantify this statement by considering the statistics. If we consider the period 1983 to 1995 in the UK then we can show that: The suicide rates for men reduced by between 30% and 40% in the age groups 55–64, 65–74 and 75–84 The rates for the most elderly men (males over 85 years) remained fairly static, this group still having the highest rates of any group By way of contrast, the 25- to 34-year-old male group exhibited a 30%increase in suicide rate during the same period, this group are becoming the group with the second highest rate, while the 15- to24-year-old male group demonstrated a 55% increase in suicide rates.(WHO 2001) Female suicide rates have shown a similar overall decrease, reducing by between 45 and 60% in the 45–84 age group. Elderly women, however, retain the highest rates throughout the life span (Castell 2000) The ratio of male to female elderly suicide deaths remains approximately 3:1 (Fischer L R et al. 2003) We can suggest that these trends in reduction of suicide, particularly in the elderly are likely to be due, amongst other things, to: The improved detection of those at risk together with the advent of aggressive treatment policies relating to mental illness in the elderly. (Warn M et al. 2003) One of the main reasons, we would suggest, for this obviously changing pattern and the discrepancies in the suicide rates between the age ranges, is the fact that, in direct consideration of the context of our topic, the elderly are more likely to be both amenable to professional help and also, by virtue that a higher proportion are likely to be in direct contact with healthcare professionals either through failing health or nursing homes and hospitals, (Soutine K teal. 2003), have the warning signs of impending suicide recognised and acted upon more promptly than the younger, arguably more independent age group. In specific consideration of the elderly group we should also note that attempted suicide is more likely to be a failed suicide attempt rather than a Para suicide. (Rubenowitz E et al. 2001). There is considerable evidence that the incidence of depression is increased in the presence of a concurrent physical illness (Conwell Yet al. 2002) and clearly this is going to be more likely in the elderly age group. Some sources have cited association rates of between 60-70%of major depression with physical illness in the over 70yr olds.(Conwell Y et al. 2000). Another significant factor is that it is commonly accepted that an attempted suicide is a strong independent risk factor in the aetiology of further suicide attempts. (Conwell Y et al. 1996) This trend is much more marked in the elderly group with a ratio of about 4:1 which compares very badly with the ratios in the younger age groups of between 8:1 and 200:1 (depending on age range, definition and study).(Hippie J et al. 1997) Aims and objectives In this dissertation it is intended to gain evidence based knowledge of the scope and significance of the phenomenon of attempted suicide in the elderly. In addition it is intended to gain evidence based knowledge in the use of strategies to ameliorate attempted suicide in the elderly to highlight gaps in the literature available and to suggest recommendations for change in nursing practice It is hoped tube able to suggest areas for research into the phenomenon of attempted suicide in the elderly. Methodology The initial strategy was to undertake a library search at the local post graduate library and the local university library (Client: you might like to personalise this) on the key words â€Å"suicide, elderly, prevention strategies, industrialised societies†. This presented a great many papers. About 40 were selected and read to provide an overview of the literature in this area. During this phase, references were noted and followed up and key literary works were assimilated. The bulk of the papers accessed and read were published within the last decade, however a number of significant older references were also accessed if they had a specific bearing on a particular issue. The most significant references were accessed and digested. The dissertation was written referencing a selected sub-set of these works. Rationale for proposal To increase nurses knowledge and understanding of attempted suicide in the older age group and to highlight through the literature review, evidence based strategies that can be employed to ameliorate attempted suicide amongst the elderly. Literature review Before commencing the literature review, it is acknowledged that the literature on this subject is huge. The parameters of the initial search have been defined above. In addition it should be noted that there is a considerable literature on the subject of assisted suicide which has been specifically excluded from these considerations The literature base for suicide in the elderly is quite extensive and provides a good evidence base for understanding, appropriate action and treatment. (Berwick D 2005) One of the landmark papers in this area is by Hippie and Quinton(Hippie J et al. 1997) which provided a benchmark, not only on the aetiology of the subject, but also in the long term outcomes, which, in terms of potential nursing care input, is extremely important. The paper points to the fact that there is a good understanding of the absolute risk factors for suicide in the elderly but a comparative lack of good quality follow up studies in the area. It set out to identify100 cases of attempted suicide in the elderly and then follow them up over a period of years. The study was a retrospective examination of100 consecutive cases of attempted suicide that were referred to the psychiatric services over a four year period. The authors were able to make a detailed investigation (including an interview of many of the survivors), about four years later. Their findings have been widely quoted in the literature. Of particular relevance to our considerations here we note that they found that of the 100 cases identified, 42 were dead at the time of follow up. Of these, 12 were suspected suicides and five more had died as a result of complications of their initial attempt. There were 17further attempts at suicide in the remaining group. Significantly, the twelve women in the group all made non-lethal attempts whereas all five of the men made successful attempts. The authors were able to establish that the risk of further attempts at suicide (having made one attempt)was in excess of 5% per year and the â€Å"success† rate was 1.5% per year in this group. From this study we can also conclude that the risk of successful repeat attempted suicide is very much greater if the subjects male. The authors were also able to establish that, because of their initial attempt, those at risk of self-harm were likely to be in contact with the Psychiatric services and also suffering from persistent severe depression. We can examine the paper by Dennis (M et al. 2005) for a further insight into the risk factors that are identifiable in the at risk groups. This paper is not so detailed as the Hippie paper, but it differs in its construction as it is a control matched study which specifically considered the non-fatal self-harm scenario. The study compared two groups of age matched elderly people both groups had a history of depression but the active study group had, in addition, a history of self-harm. The significant differences highlighted by this study were that those in the self-harm group were characterised by poorly integrated social network and had a significantly more hopeless ideation. This clearly has implications for intervention as, in the context of a care home or warden assisted setting, there is scope for improving the social integration of the isolated elderly, and in the domestic setting community support can provide a number of options to remove factors that mitigate towards social isolation. This would appear to be a positive step towards reducing the risk of further self harm. The O’Connell paper (O’Connell et al. 2004) is effectively a tour divorce on the pertinent issues. It is a review paper that cherry-picks the important information from other, quite disparate, studies and combines them into a coherent whole. It is extremely well written, very detailed, quite long and extremely informative. While it is not appropriate to consider the paper in its entirety, there are a number of factors that are directly relevant to our considerations here and weshall restrict our comments to this aspect of the paper. In terms of the identification of the risk factors associated with attempted suicide in the elderly, it highlights psychiatric illnesses, most notably depression, and certain personality traits, together with physical factors which include neurological illnesses and malignancies. The social risk factors identified in the Dennis paper are expanded to include â€Å"social isolation, being divorced, widowed, or long term single†. The authors point to the fact that many of the papers referred to tend to treat the fact of suicide in reductionist terms, analysing it to its basic fundamentals. They suggest that the actual burden of suicide should also be considered in more human terms with consideration of the consequences for the family and community being understood and assessed. (Mason T et al. 2003) In terms of nursing intervention for suicide prevention, we note that the authors express the hypothesis that sociality exists along a continuum from suicidal ideation, through attempted suicide, to completed suicide. It follows from this that a nurse, picking up the possibility of suicidal ideation, should consider and act on this as significant warning sign of possible impending action on the part of the patient. The authors point to the fact that the estimation of the actual significance of the various prevalence’s of suicide varies depending on the study (and therefore the definition) (Kirby M et al. 1997). In this context we should note that the findings do not support the ageist assumptions expounded earlier, on the grounds that the prevalence of either hopelessness or suicidal ideation in the elderly is reported asap to 17% (Kirby M et al. 1997), and there was a universal association with psychiatric illness, especially depressive illness. If we consider the prevalence of suicidal feelings in those elderly people who have no evidence of mental disorder, then it is as low as4%. It therefore seems clear that hopelessness and sociality are not the natural and understandable consequences of the ageing process as Freud and others would have us believe. This has obvious repercussions as far as nursing (and other healthcare) professionals are concerned, as it appears to be clearly inappropriate to assume that sociality is, in most cases, anything other than one of many manifestations of mental illness. It also follows from this, and this again has distinct nursing implications, that suicidal ideation and intent is only the tip of the iceberg when one considers the weight of psychological, physical and social health problems for the older person. (Warn M et al. 2002) If one considers evidence from studies that involve psychological autopsies, there is further evidence that psychopathology is involved. Depressive disorders were found in 95% in one study. (Duberstein P R teal. 1994) Psychotic disorders and anxiety states were found to be poorly correlated with suicidal completion. Further evidence for this viewpoint comes from the only study to date which is a prospective cohort study in which completed suicide was the outcome measure. (Ross R K et al. 1990). This shows that the most reliable predictor of suicide was the self-rated severity of depressive symptoms. This particular study showed that those clients with the highest ratings were 23 times more likely to die as the result of suicide than those with the lowest ratings. It also noted that other independent risk factors (although not as strong), were drinking more than 3 units of alcohol per day and sleeping more than 9 hours a night. One further relevant point that comes from the O’Connell paper is the fact that expression of suicidal intent should never be taken lightly in the older age group. The authors cite evidence to show that this has a completely different pattern in the elderly when compared tithe younger age groups. (Beauties A L 2002). The figures quoted show that if an elderly person undertakes a suicide attempt they are very much more likely to be successful than a younger one. The ratio of Para suicides to completed suicides in the adolescent age range is 200:1, in the general population it is between 8:1 and33:1 and in the elderly it is about 4:1. (Warn M et al. 2003). It follows that suicidal behaviour in the elderly carries a much higher degree of intent. This finding correlates with other findings of preferential methods of suicide in the elderly that have a much higher degree of lethality such as firearms and the use of hanging. (Jorum A Feet al. 1995). The paper by Cornwell (Y et al. 2001) considers preventative measures that can be put in place and suggests that independent risk factors commonly associated with suicide in the elderly can be expanded to include psychiatric and physical illnesses, functional impairment, personality traits of neuroticism and low openness to experience, and social isolation. And of these, t is affective illness that has the strongest correlation with suicide attempts. We have discussed(elsewhere) the correlation between impending suicide and contact with the primary care providers. Cornwell cites the fact that 70% of elderly suicides have seen a member of the primary healthcare team within 30days of their death and therefore proposes that the primary healthcare setting is an important venue for screening and intervention. It is suggested that mood disorders are commonplace in primary healthcare practice but, because they are comparatively common, are underdiagnosed and often inadequately treated (ageism again). The authors suggest that this fact alone points to the fact that one of the suicide prevention strategies that can be adopted by the primary healthcare team. they suggest that clinicians, whether they are medically qualified or nursing qualified, should be trained to identify this group and mobilise appropriate intervention accordingly. Obviously the community nurses can help in this regard as they are ideally placed to maximise their contact with vulnerable and high risk groups. We have identified the role of a major depressive illness in the aetiology of suicide in the elderly. Bruce (M L et al. 2002) considered the role of both reactive and idiopathic major depression in the population of the elderly in a nursing home setting. This has particular relevance to our considerations as firstly, on an intuitive level, one can possibly empathise with the reactive depressive elements of the elderly person finding themselves without independence in a residential or nursing home and secondly, this is perhaps the prime setting where the nurse is optimally placed to monitor the mood another risk factors of the patient and continual close quarters. The salient facts that we can take from this study are that there was substantial burden of major depressive symptomatology in this study group (13.5%). The majority (84%) were experiencing their first major depressive episode and therefore were at greatest risk of suicide. The depression was associated with comorbidity in the majority of cases including â€Å"medical morbidity, instrumental activities of daily living disability, reported pain, and a past history of depression but not with cognitive function or socio demographic factors.† All of these positive associations which could have been recognised as significant risk factors of suicide in the elderly. Significantly, in this study, only 22% of all of the seriously depressed patients were receiving antidepressant therapy and none were receiving any sort of psychotherapy. In addition to this the authors point to the fact that 31% of the patients who were put on antidepressants were taking a sub therapeutic dose (18% because they were purposely not complying with the dosage instructions). The conclusions that the authors were able to draw from this study were that major depression in the elderly was twice as common in the residential setting as opposed to those elderly patients still in the community. The majority of these depressed patients were effectively left untreated and therefore at significant risk of suicide. There was the obvious conclusion that a great deal more could be done for this study population in terms of relieving their social isolation and depressive illnesses. And, by extrapolation, for their risk of suicide. Ethical considerations. In consideration of the issue of suicide in the elderly we note that there are a number of ethical considerations but these are primarily in the field of assisted suicide which we have specifically excluded from this study. (Pabst Batten, M 1996) Evidence for positive nursing interventions Having established the evidence base in the literature that defines the risk factors that are known to be particularly associated with suicide in the elderly, we take it as read that this will form part of the knowledge base for the nurse to be alert to, and to identify those patients who are at particular risk of suicide. It is equally important to be aware of those factors that appear to confer a degree of protection against suicide. This will clearly also help to inform strategies of intervention for the nurse. Studies such as that by Gunnel (D et al. 1994) point to the fact that religiosity and life satisfaction were independent protective factors against suicidal ideation, and this factor was particularly noted in another study involving the terminally ill elderly where the authors noted that higher degrees of spiritual well-being and life satisfaction scores both independently predicted lower suicidal feelings. (McClain et al. 2003). The presence of a spouse or significant friend is a major protective factor against suicide. Although clearly it may not be an appropriate intervention for nursing care to facilitate the presence of a spouse(!) it may well be appropriate, particularly in residential settings, to facilitate social interactions and the setting up of possible friendships within that setting (Bertolote J M et al. 2003) Conclusions and discussion This Dissertation has considered the rationale behind the evidence base for nursing intervention and strategies to prevent or minimise suicide attempts in the elderly age group. We have outlined the literature which is directed at identification of the greatest â€Å"at risk† groups and this highlights the importance of the detection and treatment ofboth psychiatric disorders (especially major depression), and physical disorders (especially Diabetes Mellitus and gastric ulceration).(Thomas A J et al. 2004) Although we have been at pains to point out the relatively high and disproportionate incidence of suicide in the elderly, we should not lose sight of the fact that it is not a common event. One should not take the comments and evidence presented in this dissertation as being of sufficient severity to merit screening the entire elderly population. (Erlangen A et al. 2003) The thrust of the findings in this dissertation are that the screening should be entirely opportunistic. The evidence base that we have defined should be utilised to identify those who are in high risk groups, for example, those with overt depressive illnesses, significant psychological and social factors, especially those who have a history of previous attempted suicide. The healthcare professional should not necessarily expect the elderly person to volunteer such information and if the person concerned is naturally withdrawn or reserved, minor degrees of depressive symptoms may not be immediately obvious. (Callahan C M teal. 1996). In terms of direct nursing intervention, this must translate into the need to be aware of such eventualities and the need to enquire directly about them. The nurse should also be aware that the presence of suicidal feelings in a patient with any degree of depression is associated with a lower response rate to treatment and also an increase in the need for augmentation strategies. The nurse should also be aware of the fact that these factors may indicate the need for secondary referral. (Gunnel D et al. 1994). If we accept the findings of Conwell (Y et al. 1991), then the estimated population at risk from significant mood disorder and therefore the possibility of attempted suicide in the elderly, is 74%.This can be extrapolated to suggest that if mood disorders were eliminated from the population then 74% of suicides would be prevented in the elderly age group. Clearly this is a theoretical viewpoint and has to be weighed against the facts that firstly â€Å"elimination† of mood disorders (even if it were possible), would only be achieved by treatment of all existing cases as well as prevention of new cases, and the secondary prevention of sub-clinical cases. We know, from other work, that the detection and treatment of depression in all age ranges is low, and even so only 52% of cases that reach medical attention make a significant response to treatment(Bertolote J M et al. 2003). These statistics reflect findings from the whole population and the detection rates and response rates are likelyto lower in the elderly. (Wei F et al. 2003). It follows that although treatment of depressive illness is still the mainstay of treatment intervention as far as suicide prevention is concerned, preventative measures and vigilance at an individual level are also essential. Nursing interventions can include measures aimed at improving physical and emotional health together with improved social integration. Sometimes modification of lifestyle can also promote successful ageing and lead to an overall decrease in the likelihood of suicidal feelings. (Fischer L R et al. 2003) On a population level, public health measures designed to promote social contact, support where necessary, and integration into the community are likely to help reduce the incidence of suicide in the elderly, particularly if we consider the study by Cornwell (Y et al.1991) which estimated the independent risk factor for low levels of social contact in the elderly population as being 27%. Some communities have provided telephone lines and this has been associated with significant reduction in the completed suicide in the elderly (Fischer R et al. 2003) To return to specific nursing interventions, one can also suggest measures aimed at reducing access to, or availability of the means for suicide such as restricting access to over the counter medicines.(Slog I et al. 1996), Some sources (Castell H 2000) point to the possibility of introducing opportunistic screening in the primary healthcare setting. The rationale behind this suggestion is the realisation that there is high level of contact between the suicidal elderly person and their primary healthcare team in the week before suicide (20-50%) and in the month before suicide (40-70% make contact). This is particularly appropriate to our considerations here because of the progressively increasing significance of the role of the nurse within the primary healthcare team particularly at the first point of contact. (Houston, Ret al. 2002) The evidence base for this point of view is strengthened by reference to the landmark Gotland study (Ruts W et al. 1989) which examined the effect of specific training in suicide awareness and prevention in the primary healthcare team by providing extensive suicide awareness training and measures to increase the facilitation of opportunistic screening of the population. Prior to the intervention, the authors noted that, when compared to young adults, the elderly were only 6% as likely to be asked about suicide and 20% as likely to be asked if they felt depressed and 25% as likely to be referred to mental health specialist. This balance was restored almost to normality after the intervention. Suicide in the elderly is a multifaceted and complex phenomenon. It appears to be the case that the elderly tend to be treated with different guidelines from the young suicidal patient insofar as the increased risk is not met with increased assistance. (Kouras L et al.2002). We have presented evidence that the factors included in this discrepancy may include the higher overall number of young suicides, the higher economic burden that society appears to carry for each young suicide together with ageist beliefs about the factors concerning suicide in the elderly. From the point of view of nursing intervention, both in a hospital and in a community setting, there should be greater emphasis placed on measures such as screening and prevention programmes targeted at the at-risk elderly. There is equally a need for aggressive intervention if depression or suicidal feelings are overtly expressed, particularly in the relevant subgroups where additional risk factors may be active, for example those with comorbid medical conditions or social isolation or recent bereavement. (Harwood D et al. 2001), Many of the elderly spend their last years in some form of sheltered accommodation, whether this is a nursing home, a hospital, warden assisted housing or being cared for by the family. (Haut B J et al.1999) In the vast majority of cases this is associated with a loss of independence, increasing frailty and an increasing predisposition to illness that comes with increasing age. (Juurlink D N et al. 2004).This loss of independence and increasing predisposition to illness is also associated with depressive illnesses of varying degrees. (Bruce ML et al. 2002). These patients are arguably, by a large, more likely to come into contact with the nurses in the community. (Munson M L 1999)The comments that we have made elsewhere relating to the nurse’s role in being aware of the implications for the depressed elderly patient are particularly appropriate in this demographic subgroup. As a general rule, it may be easier to keep a watchful eye on patients who are exhibiting early signs of depressive illness or mood disorder in this situation by making arrangements to visit on a regular basis or on â€Å"significant anniversaries† such as the death of a spouse or a wedding anniversary. (Nagatomo I et al. 1998) when the risk factors for suicide increase dramatically (Schonberg H C et al. 1998) The literature in this area is quite extensive and covers many of the aspects of suicide in the elderly. It is noticeable however, that there is a great deal of literature on the subject of risk factors and associations of suicide together with plenty of papers which quote statistics that relate the various trends and incidences. There are, by comparison, only a few papers which emphasise and reflect on the positive aspects of nursing care. The positive steps that can be taken by the nursing profession specifically to help to minimise the burden of suicidal morbidity. There is clearly scope for studies in areas such as the impact that a dedicated community nurse might have on the levels of depression in the community if regular visits were timetabled. It is fair to observe that the community mental health nurses fulfil this role to a degree, but are severely hampered in most cases by sheer weight of numbers in the caseload. (Mason T et al. 2003) Having made these observations, we must conclude that there appears tube an overwhelming case for opportunistic screening of the at risk elderly at any point of contact with a healthcare professional. It is part of the professional remit of any nurse to disseminate their specific professional learning with others. (Yuri H et al. 1998). This can either be done on an informal professional basis in terms of mentorship or, if appropr

Description of the Minnesota Multiphasic Personality Inventory

Description of the Minnesota Multiphasic Personality Inventory The Minnesota Multiphasic Personality Inventory (MMPI) is a standardized questionnaire designed to bring forth a wide variety of self-descriptions scored to give a quantitative dimension of an individuals level of emotional adjustment and approach toward test taking. The MMPI has been known as the leading personality inventory, most psychologists who conduct assessments as part of their clinical and consulting practice utilize this test. The widespread use of this test is accredited to several features ranging from its straightforwardness in scoring and administration, a straightforward response format that is essential for research design, a large item pool, many useful purposes and functions, and many practically established correlates. Psychologists make diagnostic and treatment decisions, through MMPI, it has been employed in inpatient and outpatient mental health facilities. It has been used by psychologists in clinical setting to evaluate the existence of psychological components in physical issues and to aid in predicting responses to a variety of therapy and treatment. Starke R. Hathaway and J. Charnley McKinley developed the MMPI in 1939 at the university of Minnesota. It was developed initially because of their vision of an instrument that could assist in evaluating patients during routine psychiatric case workups and could precisely determine the severity of their disorders. Hathaway believed the MMPI might aid researchers in assessing the usefulness of new treatment interventions by allowing methodical matching and evaluation of the participants. The MMPI was constructed using the criterion keying method also known as the empirical method of inventory construction. (Archer, 1997) The criterion keying method is utilized by testing with two or more groups of participants. One group serves as the criterion group, this group has evidence of the defining trait, diagnosis or characteristic that test is intended to evaluate, and the other group/groups serve as a comparison group, where there is no evidence of the characteristics or diagnosis under evaluation. Responses of the criterion and comparison group are compared, and items are then selected for inventory membership that empirically demonstrate significant differences in response frequency. (Archer, 1997) Hathaway and McKinley began their construction of the MMPI by creating an extensive item pool from which various scales could be constructed, the item pool consisted of a variety of statements from different sources, ranging from previously established scales of personal and social attitudes, clinical reports, case histories, psychiatric interviewing manuals and personal clinical experience. (Groth-Marnat, 1997) the result of extensive exclusion and amendment were 504 statements, these statements were balanced between positive and negative wording, and were developed to tap into a broad area of an individuals life. The 504 items were divided into twenty-five content areas. These included items related to general medical and neurological symptoms, the clinical scales ranged from hypochondriasis, depression, hysteria psychopathic deviate, paranoia, schizophrenia, etc to scales to social introversion etc. An additional 55 items thought to be related to masculinity-femininity were later added, and 9 items were subsequently deleted to achieve the final pool of 550 items. (Nichols, 2001) The format of the inventory was first person declarative statements, composed of basic phrasing based on contemporary word-frequency tables. The responses were limited to true, false or cannot say. (Nichols, 2001) The population consisted of normals(Nichols) who were selected to contrast with the pathological criterion groups (N=724) ranging from the age of 16 to 65 referred also as the Minnesota normals(Groth-Marnat, 1997), the sample was closely representative of a typical group of individuals from the Minnesota population, as indicated through the 1930 census. The scales were cross-validated by selecting a different group of normals and contrasting their responses with a new group of clinical patients; so that the items and scales would be valid for differential analysis in clinical setting. Hathaway and McKinley were interested in the fact that participants amend the impression they made on the test due to different test taking positions and opinions; hence the created several scales that could identify the different types and magnitudes of various test-taking attitudes which could invalidate the clinical scales. They developed four scales: the cannot say scale (?) was simply the total number of unanswered statements; If amount of questions was high it would reduce the overall validity of the MMPI profile. The lie scale (L) was developed to indicates the examinees efforts to place himself/herself morally and culturally under an favorable light a create an favorable impression. The infrequency scale (F) is used to assess the inclination of individuals to claim highly unusual attitudes, opinions, and behaviors that are classified as an component of psychopathology. The correction scale (k) assesses the examinees degree of psychological defensiveness (Groth-Marnat, 1997) t his is considered the most important validity scale. Practical evaluation of the MMPI The MMPI can be administered to an individual who is above the age of 16, with an average sixth-grade reading level. As mentioned above an individual above the age of 16 is permitted to take the test, but adolescent norms needs to be addresses. Standard instruction are given prior to the test, test instruction are given regarding the nature and purpose of the test, and what it is designed to evaluate, and how the results will be used. Administering of the MMPI can be viewed as a relatively easy undertaking, and hence many practitioners tend to overlook vital elements that influence the participants test-taking attitude and would eventually lead to invalid results. Prior to the administration, scoring, and interpretation of results, the administrator should highlight the importance and consequences of the test in a serious manner to the test-taker, often the administrators do not high light the importance of the test to decrease performance anxiety. A clear elucidation oh how the resu lts are significant and how it is going to be used will increase cooperation. Interpretation of data is an important and vital part of the MMPI; the collected is useful in supplying information about attitudes toward assessment, cooperation, cognitive/ideation, mood and affect, conflict areas, coping styles, diagnostic consideration and treatment recommendation The interpretation of the scores was based on the principle that a participant attains a raw score on each scale based on the number of items that they identified in the scored direction. The raw scores are then later converted to T scores, with a mean of 50 and a standard deviation of 10. The interpretation of the test can be done in three ways, first using the validity indicators, this is the first step in interpreting any personality profile; which is establishing the validity to assure the subjects cooperativeness in taking the test. MMPI has been established as having the most comprehensive validity indicators (Goldstein, 2000) among all established personality inventories and assessments. Secondly interpreting results involve Configural Interpretation (code type), this is due to the intercorrelations amongst scales and also the overlap amongst the similarities of clinical syndromes, evidence has been attained indicating several MMPI scales tend to increase together, therefore, interpretations of scales should depend on the elevations of other scales in the personality profile. Third and final approach to interpreting the results is content bases interpretation. The principal followed in the content interpretation relies on the assumption that the participant when answering test items is reacting and responding with honesty and sincerity to the MMPI. Accordingly the content of the MMPI may represent a vital source of information that cannot be accessible through empirical test-interpretation. Technical evaluation The reliability analysis of the MMPI indicate that its has moderate levels of temporal stability and internal consistencyà ¢Ã¢â€š ¬Ã‚ ¦ all MMPI scales are quite reliable, with values that range from a low of .71 to a high of .84. (Groth-Marnat, 1997) many studies have reported inconsistency in some of the scales; many argue that the scales of the MMPI show instability in the test scores that are to be anticipated. This is mainly due to the psychiatric population since the effects of treatment or stabilization in a temporary crisis situation is likely to be reflected in a patients test performance. (Groth-Marnat, 1997) To cross-validate the scales, participants of the criterion and the control groups were administered the items. To qualify as cross-validated, a scale had to distinguish the criterion group from the control group at a 0.5 alpha level significance. Another issue that has surface about the MMPI is about the construction of the scales. The intercorrelations between most of the scales are relatively high, which is primarily due to the extensive amount of item overlap. Occasionally, the same item will be concurrently used for the scoring of a few other scales, and hence most of the scales have a relatively high percentage of items similar to other scales The problems associated with the reliability and scale construction have led to hurdles and speculation on the validity of the MMPI. MMPI has been commended about its strict psychometric properties that present complications, but it has been adequately compensated by its intensive validity studies Development of the MMPI-2 and MMPI-A Problems concerning the MMPI were mainly about the growing issues related to scale construction, insufficiency of a standardized sample and problems with the item pool. The original norm had inadequate representation of the minorities and hence was redundant in making conclusions about and with current test-takers. In 1982, the university of Minnesota instigated a major research in effort to revise, update, improve, and restandardize the MMPI. Its main goals were to delete the redundant, questionable, and problematic items. Maintain the efficacy of existing validity; clinical and different widely utilized scales of the test. Develop a representative sample, Develop new, revised norms for the MMPI and the development of new scales. The MMPI was updated and restandardized and the new version was released in 1989; 46 years after the original MMPI was published. The revised MMPI-2 differs from the older MMPI in various ways; the T scores that the subject obtains are usually not as deviant as those from the previous version. In addition, the T scores designed to produce the same range and distribution right through the established clinical scales. The practical result is that T scores of 65 or greater are considered to be in clinical scale range; also the percentile distributions are consistent throughout the different type of scales. The test booklet itself contains 567 items, but the pattern has been changed so that the previously established scales (the 10 clinical and 3 validity scales) can be derived from the first 370 items. The proceeding 197 items provide different content, supplementary scales. A number of new and revised scales have been included along with new, revised, adjunctive procedures of test vali dity, separate measure of masculinity and femininity and 15 other additional content scales measuring unambiguous and specific personality traits and factors. (Groth-Marnat, 1997) The MMPI-2 shares a lot of psychometric property with the original MMPI. The median split-half reliability coefficients for the MMPI and the MMPI-2 are in the .70s with some coefficients as high as .96 but others much lower. Median of the test-retest coefficients range from a low .50 to .90; when one observes the basic higher-order factor structure; the MMPI and the MMPI-2 are extremely reliable, with coefficients running as high as .90. The MMPI and the MMPI have been criticized due to the item overlap and this issue was not confronted in the revision of the original MMPI, as the goal was to retain all the original scales. Another criticism associated with the MMPI and MMPI-2 is the imbalance in the way the items are keyed(Kaplan Saccuzzo, 2009). the MMPI and the MMPI-2 strongly emphasize the importance of taking the participants demographics into account when interpreting profiles. The MMPI-A was published for the sole interest of creating an instrument for adolescents, with a normative sample depicting the broad teenage population. This occurred because MMPI produced different scale elevations for adolescence than for adults. This resulted in the construction of different sets of recommended norms for use with adolescent populations. To counter argue that the MMPI is too long, especially for adolescent, the MMPI-A contains 478 items, there by shortening the administration. (Groth-Marnat, 1997) Significant features of the MMPI include descriptive and diagnostic information about the personality profiles, flexible administration and scoring. The most important feature of the MMPI is its validity scales; and it has been translated and published into over 20 languages The most needed amendment of the MMPI apparently has been a major accomplishment; the majority of psychologist, researchers, and clinicians have supported its utility and practical value resulting in its rising popularity among them. The MMPI serves to assist in distinguishing the normal from abnormal groups; specifically the test was designed to help aid in diagnosis and evaluation of major psychiatric or psychological disorders.