Leadership Essay Example | Topics and Well Written Essays - 250 words - 63

Leadership - Essay Example ccording to Zenger and Folkman, the plan action method works when our leadership performances are not encouraging, hence we ought to apply the action plan method to the issue and try to improve our performances. The approach to change the plans suggested by Zenger and Folkman is also known as the Linear Development Model. This model gives the current performance which determines the performance we desire in the future. The future performance gives our customers and those we lead the confidence in our profession and organizations. (Zenger and Folkman, 2009, p. 196) Secondly, we are educated on how we can approach development. The plans used in this case are the linear plans. The book focuses on helping leaders to change from poor performance to better one. The linear plan is a unique perspective that helps us to change and develop our leadership skills for better performance in the organization. However, Zenger and Folkman hit a warning to us trying to apply exceptional changes on explicit competences. This might hinder our leadership improvement as they say (Zenger and Folkman, 2009, p.217). In conclusion, the above plans suggested by Zenger and Folkman, might be effective and useful perspectives in improving our leadership skills. If well applied, the linear plan and the action plan new insights and approaches to better leadership skills which definitely improve the performance of the

Business Analysis of Yoplait in Mauritius

Business Analysis of Yoplait in Mauritius What is yogurt? Yogurt is a dairy product formed by the fermentation of milk from the action of two live bacteria; lactobacillus bulgaricus and streptococcus thermophilus. These are micro-organisms which transform the milk into the yogurt through a process by which they convert the lactose present in the milk into lactic acid, making the product digestible for people who are cannot ‘tolerate milk and maintaining the balance in the intestinal flora. The yogurt should contain 10 millions of lactic ferments per gram and must be alive to be designated as ‘yogurt. Yogurts are thus fresh products which should be kept frozen at most at 6à ¢Ã¢â‚¬Å¾Ã†â€™ up to its expiry date in order to conserve all its nutritional benefits. History of Yoplait Yoplait was established in 1965 and was recognised as the first complete range of fresh daily products. Furthermore, Yoplait showed innovation as it was the first brand ever to offer refrigerated products to its customers in ‘throw-away packages whereas other products were still sold in jars. In 1967, Yoplait came with the concept of fruit yogurt and established itself on the French market before conquering the world. From its huge success, new products were consecutively launched; diet dairy products in 1972, the first drinking yogurt, Yop, in 1974, yogurt specially for kids in 1985, the fromage frais, Cà ¢lin, in 1987, a range of milk-based desserts in 1992 and Perle de Lait in 1996 (to cite the most famous ones). Yoplait also differentiates itself from other yogurt brands as it constantly shows originality by launching new products, improving them and working strongly on promotion around the world. Today, Yoplait is so successful that it is present in almost 50 countries through subsidiaries, joint ventures and franchisees. It is the number two worldwide (after Danone) and latest statistics show that more than 15,000 cartons of Yoplait are eaten every minute around the world. As the Chairman of Yoplait states, â€Å"We are determined to ensure that the little flower continues its growth and blossoms all over the world.† Yoplait in Mauritius The Yoplait brand established itself in Mauritius in 1976 through a franchise with Maurilait Productions Ltà ©e, a subsidiary of the Food and Allied Group of companies, established in 1966. Maurilait Productions Ltà ©e is today the producer of Yoplait, Candia and Miko products through franchise, technical partnerships and international branding. Marketing mix of Yoplait in Mauritius Product The presence of Yoplait in Mauritius is not only concerned with yogurts, but with a variety of other products. However, for the purpose of the study, it should be noted that the emphasis will be entirely made on yogurts. In this sense, Maurilait has segmented its yogurts into different categories; 1. Firm yogurts; comprising of Nature Sucrà ©, Nature, Silhouette Nature, and Ti-Yoplait. 2. Mixed yogurts; 3. Drinks It should also be noted there also exists different conditionings and groupings for Yoplaits yogurts, namely, tubs of 100g, 115g, 125g, 150g and 1kg. Price Different Yoplait goods have different production costs and therefore have different market prices. When these products are freshly manufactured at Maurilait Productions Ltà ©e, they have a lower price than when they are distributed by Panagora Marketing Ltd. This is so, because Panagora also has to gain a profit from their transactions. However in Mauritius, the outlets show differences in price of Yoplait yogurt products over the whole island. Since, there is no law pertaining that the manufacturer or distributor can impose a fix price for their products, retailers have the right to put their own prices irrespective of whether it is exaggerated or not. Thus, Maurilait and Panagora can only recommend prices for the products. (see Appendix) Place (Distribution) It is Panagora Marketing Ltd, another subsidiary of the Food and Allied Group of Companies, which is in charge of the distribution of all products manufactured at Maurilait Productions Ltà ©e. It ensures that all Yoplait products are accessible to everyone within the island. To do so, it was established that the distribution will be carried out according to three distinct groups: 1. CDP, that is, Commerce De Proximità ©. This category englobes all cornershops, cafetarias and other little businesses around the island. 2. GMS, that is, Grandes et Moyennes Surfaces. For this group, Panagora ensures that the distribution is adequately made to all supermarkets and hypermarkets in the country. 3. Food service, comprising the sale and distribution of Yoplait products in bulk, namely to hotels and restaurants. It should be noted that this system is in fact used for all products distributed by Panagora Marketing Ltd, in order to ensure that the specific needs and requirements of the different categories are met. Promotion All advertisements of Yoplait in Mauritius are designed and disseminated by one of the most famous advertising agencies in Mauritius, namely, Circus Advertising Company Ltd, which is again a member of the Food and Allied Group of Companies. Regarding sales promotion, feasibility studies are conducted by Maurilait Productions Ltà ©e in collaboration with Panagora Marketing Ltd. If the studies reveal that such promotion will be profitable for both organisations, it is again Circus which will be in charge of promoting the new offers. Literature Review Introduction This section will mainly investigate how customer satisfaction, retention and loyalty affect an organisation. But before going into the subject, an essential point should be considered; customer relationship. As will be demonstrated in details below, satisfaction is more likely to induce loyalty and hence profitability if relationships between customers and firms are effectively managed. Customer Relationship Management (CRM) deals with the management philosophy that enables a business to identify, attract and retain the most ‘profitable customers and at the same time build and manage strong relationships with them by delivering superior value and satisfaction. The different stages related to the creation of those relationships are illustrated below: The courtship stage is the one in which the company starts to ‘know the customer and so loyalty is very weak and nearly inexistent. The relationship phase is where the feeling of commitment towards the organisation starts to grow. A strong attachment to the firm is created and the customer is no more likely to switch to competitors. Finally the marriage stage is when a long lasting relationship is created. At this stage, the degree of loyalty is very high and the customers even get personally involved in the organisation. It should be noted that the customers should somehow not be taken for granted. The marriage stage is not an eternal one, and if ever the customer gets disappointed by the company repeatedly or if the relationship is not effectively managed, he may stop any contact with the company, that is, dissolute the relationship. From now on, this section of the study will focus on how these relationships are linked to the satisfaction rate of the customer and how it affects the whole organisation. Customer satisfaction In earlier decades, Hunt (1977) already identified customer satisfaction as the degree to which the customer is pleased by a product and how far he feels his needs and wants being met. More recently, Schiffman, et al. (2008) defined customer satisfaction as being ones perception of the performance of a product or service relative to ones expectations. As can be noticed, the dimensions of customer satisfaction have evolved and they are no longer restricted to simple terms like pleasure and needs fulfilment. Instead, thorough investigation was conducted to come with the essence of the customer satisfaction state; expectations and perceptions about the products and services offered. Kotler et al. (2005) also argued in the same sense, saying that â€Å"customer satisfaction depends on the products perceived performance relative to the buyers expectations.† Both definitions show that if the performance of a product is below the level of expectations, the customer will eventually be dissatisfied and if ever the expectations level matches that of the product performance, satisfaction occurs. Hoyer and MacInnis (2001) illustrated this theory by using the confirmation and disconfirmation paradigm; This model conceptualises the occurrence of satisfaction and dissatisfaction states. For instance, consumers have expectations about the performance of a product. For example, a consumer has certain expectations before tasting a yogurt. If the level of expectations matches that of the performance, in this case the taste of the yogurt, there is confirmation of expectations and the customer is neither satisfied nor dissatisfied. On the other hand, if the performance of the product goes beyond customers expectations, there is positive disconfirmation and the customer is satisfied. If ever the performance of the product is below the level of expectations, there will be negative disconfirmation and thus, dissatisfaction. Furthermore, it is also claimed that a customer is highly satisfied and even delighted if the performance experienced from the product exceeds the expectations level, meaning that both satisfaction and delight may occur from the positive disconfirmation stage. To come forward with this argument, Lovelock and Wirtz (2004) adapted a diagram of how factors influence the customers expectations based form Zeithaml et al. (1993) work. However, there is no ‘absolute definition of the term ‘customer satisfaction and over the past years, many authors tried to illustrate it but we can observe that the different definitions converge to the same broad ideas on the relationship between how the product performs and what the buyers expect from the good itself. During the last decades, organisations came to understand the growing importance of customer satisfaction and from there, the need for delivering value to customers and building relationships came into existence. Importance of customer satisfaction Even with the growing importance of customer satisfaction, some companies still underestimate its value. In the article Surveys value is underestimated (Anon, 2005) it was consequently argued that measuring customers satisfaction also involves the measurement of their dissatisfaction. The author firmly believed that the dissatisfied customers, together with prospects, hold valuable information contributing to the success of the company. Arussy, L (2005) even consolidates this argument by saying that customers and companies both demonstrate distinct ways of thinking, operating and decision-making. Companies fail to satisfy their customers as they assert that they understand them when in fact, they are just following their own rules. Behaving in such a manner ends up in creating the efficient relationship paradox, as illustrated below. In simple terms, the efficient relationship paradox relates to the way in which customers are taken for granted. Before the creation of any relationship with customers, that is, at the courtship stage, companies invest huge amounts of money in promotion and other marketing tools to attract them. When the customer enters in the relationship phase, that is, he starts to demonstrate financial and emotional interests, the firm drops the level of investment in order to maximise profits. In so doing, the customer does not feel valued and automatically defects, thus having the opposite result of firms prior expectations. This is illustrated as the gap in the above diagram, showing that there is a complete misunderstanding between the customers anticipations and the companys actions. Consequently, organisations must be able to understand that customers should not be treated as â€Å"one time acquisitions†. They should essentially be oriented towards valuing their customers and fulfilling their expectations in order to provide them with what they are waiting for and so, giving them satisfaction. Sà ¶derlund (1998) also points out that customer satisfaction generates a powerful tool of colossal importance for organisations; the word of mouth. As described by the cited author, it is â€Å"the extent to which the customer informs friends, relatives and colleagues about an event that has created a certain level of satisfaction†. Hart et al. (1990) went into more details by claiming that the level of the satisfaction may either positively or negatively affect the word of mouth. For instance, satisfying the customer creates positive word of mouth, that is, talking ‘good about the company, and dissatisfying the customer leads to negative word of mouth, that is, talking ‘bad about the firm. He added that â€Å"customers who have had bad experiences tell approximately 11 people about it; those with good experiences tell just 6†. This demonstrates that companies should be extremely careful in delivering value to their customers as failing to do so, may cost them a lot in terms of their reputation. Bad comments may be spread nearly twice faster than it would have been with positive comments. Subsequently, organisations should focus on providing satisfaction to their customers so as to enhance the building of a good reputation. To return on the efficient relationship paradox subject, firms should be conscious that maintaining such an unwise strategy will create a pool of frustrated and dissatisfied customers who will not hesitate to ‘bad-mouth† them and degrade their reputation, which would evidently imply extensive costs for the organisation to overcome this dilemma. Factors affecting customer satisfaction Many drivers of customer satisfaction have been identified through the numerous research conducted during the past decades. However, for the purpose of this study, factors influencing customer satisfaction in the service industry will not be considered since it will not be relevant with the actual research being performed. Consequently, some of the most important drivers of satisfaction are summarised below:- Total Quality Management (TQM) In this line, Rampersad (2001) argued that to attain satisfaction of customers, everyone in the organisation should consider that constant improvement in performance is of primary importance. In order to achieve this, there are fundamental questions that the firm should take into consideration: Which products/services the company provides The product/ service should be defined as more concretely as possible; the more specific the definition is, the better the customer needs are met. Who are the customers The company should know all its customers and examine their needs attentively. It should be noted that both internal and external customers should be considered, the internal ones being the employees. What are the wants and requirements of customers At this stage communication is crucial. Customers needs and desires should be investigated together with their feedback about the current offering. Which are the processes that need to be improved From all the data collected, the company becomes aware of whether they are able to fulfil their customers expectations, needs and wants. And the firm is also now able to improve areas in which all the above steps revealed failures. However, even if everything is respected, TQM relies on the principle that there is always room for improvement. Employee Skills and Satisfaction Rampersad (2001) also stated that â€Å"All employees determine the degree of customer satisfaction. Employees from within departments should be considered as customers of each other† For a customer to be satisfied, he should obtain a good service from the employees, and for the latter to deliver such a service, they should be satisfied with their job. Regular surveys Monitoring customers expectations and perceptions via regular research is an excellent tool for maintaining the standards of an organisation. When a firm is well informed about the expectations of a customer, it can easily deliver value according to those anticipations. Furthermore, it is also essential for a firm to be aware of how customers perceive it, together with the perceptions of the product or service offerings and performance. With these precious pieces of information, organisations are able to be proactive and thus know exactly how to satisfy and even delight its clientele. Technology According to McKinsey (2001), technology can be critical in leading to critical improvements in levels of customer satisfaction if it is properly used. West (unknown) also added that companies should compulsorily be up to date with technological advances or else be confronted to irreversible consequences. Technology can provide additional features to a product, enhancing better product quality. Technology can also improve productivity and thus be easily fulfilling increasing demand. Taking Yoplait in Mauritius as example, technology succeeded in increasing the yogurts lifetime from 28 to 30 days within only a few years. Reputation and Credibility Kuusik (2007) found in his research that it is of critical importance to match the image and values both from the companys and customers perspective. Also referred as trustworthiness, the level of credibility is critical to the behaviour of the customer. If the level of trustworthiness decreases, the customers will no longer be satisfied and will eventually start to look out for other alternatives. A company should always maintain a high reputation in order to keep its customers satisfied. Sales and Post-Sales Experience It is often the case that products are more likely to be sold by distributors rather than the manufacturers themselves. Therefore, an eye should be kept on the customer experience at the point of sale, since the satisfaction level of customers is inevitably linked to the service quality obtained there. As such, customer sales experience can leave â€Å"a good or bad taste†. If a customer obtains a great sales experience, it is most probable that he will be satisfied and stay with the organisation, whereas if the sales experience is poor, he is more likely to switch to competitors. In the same line, after sales is also a critical factor. The customer should be able to obtain the desired information and assistance about the products purchased. For example, a customer must be able to ask for exchange if ever he purchased an expired product. Customer loyalty Oliver (1999) suggests that loyalty is â€Å"a deeply held commitment to rebuy or repatronise a preferred product or service consistently in the future, thereby causing repetitive same-brand or same-brand set purchasing, despite situational influences and marketing efforts having the potential to cause switching behaviours.† However, the term customer loyalty may be found to be complex to define, and for this reason, many authors tried to categorise and segment customers with the aim of understanding the nature of their loyalty and thus take the most appropriate marketing actions. Rowley (2005) tried to illustrate it by asserting that customers may show loyalty in various ways; i) they can choose to continue to do business with a particular provider, ii) they may also increase the number of purchases or the frequency of those purchases or iii) they can become advocates of the firm. However, it should be noted that the categories above may eventually be overlapping, that is, a customer may show all three behaviours, or simply one or two of them. Taylor, Celuch and Goodwin (2004), came with the following research model Taking the definition of Bowen and Chen (2001), the behavioural approach considers the repeat and consistent purchase of products and services making the customer a loyal one. However, repeated purchase does not necessarily symbolise a form commitment to the company Attitudinal approach uses the emotional and psychological attachment felt towards the firm. It states that â€Å"the attitudinal measurements are about the sense of loyalty, engagement and allegiance.† After having questioned nearly 10,000 respondents in the United States of America about the real application of these variables on loyalty, these two authors reached to the following conclusions: Behavioural loyalty is mostly concerned with brand equity and trust while affect, resistance to change and value do contribute but to a lesser proportion. Concerning satisfaction, it seems that there exists no significant statistical relationship. Again, brand equity and trust have a major relationship with attitudinal loyalty whereas affect and satisfaction have a smaller contribution. In contrast with the results obtained with behavioural loyalty, no significant statistical connection seems to be present between attitudinal loyalty and value and resistance to change. Therefore, they asserted that all the variables present in the model have a contribution to the loyalty level of customers but they can vary across different settings and situations. Bowen and Chen (2001) in addition to the behavioural and attitudinal approaches, illustrated another measurement of loyalty; the composite approach. It combines both the behavioural and attitudinal dimensions which states that loyal customers have positive attitudes towards the organisation, are committed to repeat purchase and recommend the product/service to others. Furthermore, Dick and Basu (1994) argued that loyalty is in fact the strength of the relationship between those behavioural and attitudinal behaviours (repeat patronage and relative attitude) and accordingly proposed four conditions of loyalty which are illustrated in the diagram below Rowley (2005) segments even more the loyalty dimension by suggesting four additional orientations: Captive are most of the time customers who continue to purchase and use a product or service because they have no other alternative. They have a positive attitude towards the brand but may easily be poached by competitors who offer alternative products and especially if the switching cost is reduced or facilitated. Convenience-seekers are routine buyers who purchase with low involvement and usually engage in repeat transactions associated with the brand. They do not show any particular attitude towards the brand and are susceptible to promotions offered by competitors which show more convenience than what they are actually having. Contented customers generally evaluate products based on their merits and attributes and the brand owner may use this opportunity to build relationship with those customers who already made transactions with the brand. They have a positive attitude towards the brand but may switch if they get better value elsewhere or if the product is lagging behind compared to others on the market Committed ones barely consider other brands and are prepared to be involved in the brand or firm. They have a positive attitude and deliver positive word of mouth comments. These customers may somehow be lost if the product fails repeatedly with no appropriate recovery and if competitors offer new products that deliver more value. Each level of the diagram can be defined as follows;  · Suspects: These include all the buyers of the product present in the marketplace who are either unaware of the product or have no intention of purchasing it  · Prospects: These are potential customers who are attracted by the businesss offerings but have not yet started any transaction.  · Customers: Buyers of the product who do not have any feeling of attachment towards the organisation.  · Clients: These are repeat customers who do have a feeling of attachment towards the company but whose contribution is more passive than active.  · Advocates: They are clients who support actively the organisation by recommending the product and service to people around them.  · Partners: This is the strongest form of customer-supplier relationship which is maintained as both parties perceive the relationship as being mutually advantageous. Relationship between customer satisfaction, customer loyalty and profitability. Many companies tend to assume that the link between satisfaction and loyalty is simple and linear, that is, the higher the satisfaction level, the higher the loyalty rate. However, many studies showed that this believed link is neither simple, nor linear. In their study, Bowen and Chen (2001) found out that â€Å"customer satisfaction does not equal customer loyalty†. The resulting table below indicates the relationship between the overall satisfaction of the respondents and their intent to return and willingness to recommend the company. Score on overall satisfaction % Stating they would recommend the hotel % Stating they would return 7 62.6 65.0 6 29.8 24.6 5 and lower 7.6 10.4 Their research, making reference to that of Oliva et al. (1992), also revealed that when satisfaction has reached a certain level, there is a considerable increase in loyalty, and similarly, when satisfaction level declines to a certain point, loyalty drops radically. As the research of Bowen and Chen shows, only extremely satisfied customers would repeat purchases and spread positive comments on the firm. The authors Hill and Alexander (2006) also gave their opinion about this relationship. Based on the research of the Royal Bank of Scotland (n.d), they pointed out that there was a very close link between satisfaction and intended loyalty and customers could only be retained at the highest levels of satisfaction. On their part, Mittal and Lassar (1998) claimed that, while a dissatisfaction state was synonymous with a switching behaviour, a satisfaction one did not guarantee loyalty. They therefore asserted that, still, there was a correlation between satisfaction and loyalty, but that this relationship was rather asymmetrical. In this sense, Bennett and Rundle-Thiele (2004) concluded that managers should not entirely rely on sole fact that satisfaction ratings of customers are high are enough to predict future purchase. Hence, companies should realise that merely satisfying customers is not enough; instead they should concentrate their efforts to extremely satisfy and delight them. As Berman (2005) stated, organisations must do more than delivering on expectations of their customers. In this sense, Gee et al. (2008) added that customer delight can provide the stable loyalty that companies look for. The Kano (1984) model cited in Berman (2005) work distinguishes three levels that explain how customer delight can be reached. i) Must be requirements It is defined as the basic requirement that the customer expects from the product. If this requirement is not matched, the customer will eventually be dissatisfied. ii) Satisfier requirements This requirement has the ability to bring about satisfaction. The more of these are fulfilled, the higher the level of satisfaction. iii) Attractive requirements These are additional requirements that the customer neither expected nor expressed. It is believed that if these requirements are met, delight will be attained. Nevertheless, Gustaffson et al. (2005) also identified two other drivers of customer loyalty, namely, calculative commitment and affective commitment. The calculative commitment is the rational and economic decisions taken by the customer regarding costs and benefits implied, together with costs of switching to other brands, whereas the affective commitment is an emotional factor based on the value and trust offered to the customer. Subsequently, as argued, loyalty is essential to retain current customers. Reichheld (2002) suggested that if customer loyalty is obtained, profits will eventually follow. In his collaborative study with Sasser (1990) and cited in Lovelock and Wirtz (2007), four reasons why loyalty contributes to a firms profitability were identified; 1) Profit is derived from increased purchases When an organisation provides high-quality products and service, individuals may wish to purchase more with them. This may be due to an increase in family size or increase in affluence. It should be somehow noted that in whatever the cause, the loyal customer will continue to purchase with a single company. 2) Profit is derived from reduced operating costs Loyal customers cost less to serve because they know the product and attached procedures and thus require less information and assistance. 3) Profit from referrals of other customers Loyal customers provide free promotion to the company by spreading positive word of mouth, implying that the firm needs less investment in this domain. 4) Profit from price premium It often happens that new customers benefit from an introductory discounted price, whereas loyal customers are more likely to pay regular prices, and even higher ones during peak periods. Clark (1997) went in the same sense by saying that loyal customers will remain customers for a longer period, will purchase more, will be willing to pay more and will provide more business by means of referrals. However, organisations should understand that it is far better to ‘cultivate existing customers than to ‘hunt for new ones. Reichheld and Sasser (1990) even found that 5% increase in customer loyalty and retention is enough to generate a profit increase range of 25% to 125%. Still, companies should bear in mind that all their customers are profitable ones. Clark (1997) recognised that a firm should accurately choose and care for its most profitable customers and at the same time, deselecting the least profitable ones. To make the right decision, organisations can make use of Reinartz and Kumar (2002) model. Customers are segmented into four categories based on their forecasted lifetime duration and profitability. According to Noone et al. (2003) interpretation of Reinartz and Kumar (2002) work; * Butterflies are highly profitable short-term customers. They are always in search of best deals and avoid building relationships with organisations. * True friends are highly profitable long-term customers. These customers are believed to exhibit true loyalty and commitment to a single firm and efforts should be directed towards building relationships with them. * Strangers are low profitable short-term customers. It is with this kind of customers that firms should particularly avoid investing in building relationships with them. Gee et al. even states â€Å"Identify early and dont invest anything† * Barnacles are low profitable long-term customers. They are usually loyal but have a negative impact on profitability. Dear Sir/Madam, My name is Marie-Estelle Lebon and I am a student in Marketing Management Level III at the University of Mauritius. For the purpose of my final year project, I would like to have your opinions on the Yoplait yogurts specific range of products and I would be grateful if you could assist me in filling this questionnaire. Rest assured that all the information that you will provide is only for academic purposes and will rema

Consultation Skills In Relation To Non Medical Prescribing Nursing Essay

Consultation Skills In Relation To Non Medical Prescribing Nursing Essay To illustrate this I will utilise the model of reflection adapted from (Boud, Keogh and Walker 1985) as to focus on influences on prescribing, psychology of prescribing working through the consultation, decision-making and therapy, and referral. Being present in the consultation as a non-medical prescriber challenged me to ask questions about my own practice and the consultant psychiatrist, focussing on how we arrived at our decisions and occasionally resulting in contrasting views. According to (Butler et al 1998) many authorities advise that the prime skills associated with the prescribing process are: Adequate exploration of the patients worries Adequate provision of information to the patient regarding the natural processes of the disease being treated The advisability of self-medication in trivial illness The issue pertaining to poor communication has a negative impact with patient-practitioner relationship and was acknowledged in an informative paper by (Britten et al 2000). Ultimately, all of the failures of communication were linked with an absence of the patients involvement during the consultation process. There is evidence that failure to actively engage in, or even consider, the patients perspective is a common failing amongst prescribers. (Britten et al 2000). Very often there is a focus on the term compliance and it is only recently that nurses are focussing on the more apt term of concordance. The term compliance was viewed as being authority laden (Marinker 1997) where it was expected that patients complied implicitly and without question when a prescription was given. There was little acceptance that patients would actively participate in the decision making process that surrounded the generation of the prescription. (Cox et al. 2002) Objective recognition of the patients perspectives, requirements and beliefs need to be acknowledged and then the recognition of any major differences between these and the prescribers needs could be perceived when providing nursing care. It is not just the act of writing out the prescription that is important, but it is the understanding of the processes and dynamics of the interactions that are taking place between prescriber and patient that are the fundamental key to good prescribing practice (Kuhse et al 2001). The consultation I chose to focus on was carried out by a consultant psychiatrist who for the purposes of this work shall be known as DR S, with myself as an observer of the consultation. The patient to be seen was a 45 year old gentleman who will be known for the purposes of this work as Mr A, who had been referred by dermatology to the mental health out-patients clinic as a new patient. Dermatology had referred this gentleman after a 12 month history of attending their department where Mr A had complained of persistent generalised skin irritation, and despite receiving treatment with them it appeared he may have an underlying mental health issue. Dr S began the interview by thoroughly reading the referral from dermatology and establishing what had been the concern from their point of view. The patient was then seen and before Dr S had chance to ask the patient anything Mr A expressed that he was confused as to why he had been referred to the mental health department, and not dermatology, which he perceived his medical complaint to be related to. The British Medical Journal (2000) has recognised a common theme amongst studies of patients in that they have a tendency to prefer prescribers (doctors or nurses) who listen and provide time for the individual to express their concerns without feeling hurried Dr S asked Mr A why he had been attending Dermatology to which Mr A detailed a 12 month history of describing an itchy scalp, generalised skin irritation and said no treatment had so far helped him. Mr A then went on to express that he felt all of these symptoms may be due to a parasite, or a bug which was doing something to him, and described a feeling of the bug weaving something on his face which enveloped his eyes. Other symptoms he described was that this bug or parasite was all the time making him feel thirsty and taking moisture from his body, and could somehow transpose itself to other people, including his own GP and friends describing like a magnetic type effect. From this initial information it was evident that Mr A was suffering from a delusional disorder which was quite systemised and concrete and Mr A appeared not to display any other symptoms of mental health. A diagnosis of parasitosis delusional disorder was made. It was clear Mr A needed treatment but the main factor to consider was that Mr A did not believe he any form of mental disorder and therefore there was a real issue surrounding concordance with proposed treatment. Usually, it is difficult to obtain informed consent to treat patients with delusional parasitosis with antipsychotics. Therefore experienced clinicians tell their patients that the antipsychotics are effective `against the itch or the `problems with the pests in order not to have to lie. (Musalek, 1991; Driscoll et al, 1993; Winsten, 1997; Freudenmann, 2002). This is due to the patients level of insight hindering their decision to accept treatment, because they hold a non-reality based idea that it is a somatic illness. It is therefore found that the patient will normally have sought help from their G.P., dermatologists and will often be adverse to the idea of seeing a mental health professional A full medical history was taken, looking at any familial medical problems, family composition and looking at the social aspects of MR A to include areas of employment, relationships, and any drug/alcohol usage. There have been some criticisms of the education of nurse prescribing in relation to the communication skills of nurses, where it is felt that historically there has been too much of a focus on taking a history and coming to a diagnosis. It was apparent to me that Dr S had to use his skill as an experienced mental health clinician to challenge Mr As concept of his illness not being related to a problem with his mental health Dr A approached the issue of explaining Mr A symptoms, not referring to mental health or delusions, but explaining Mr As perceived   symptoms by informing him that although he believed that these experiences were real to MR A , that his brain was interpreting false signals resulting in these unusual thoughts. Dr A went on to use the analogy of an amputee who perceives that he can still feel is amputated leg, through false interpretations of the brain. Drew et al. (2001). found that prescribers would emphasise the positive benefits of the medication far more frequently than they would discuss the risks and precautions, despite the fact that the patients perception was that such a discussion is seen as essential. Therefore looking at this, this could lead to patient confusion, with patient anxieties, and a degree of ambivalence to medication being offered to them. It is transparent that if there is a degree of empathic display between that of the patient and the prescriber, there is a greater chance of concordance. This will hopefully lead to an increased level of compliance/concordance and patient satisfaction resulting in desired clinical results Here we face the issue surrounding honesty, integrity, consent and acting in the best interest of the patients in focussing on treatment The issue of treatment was then discussed by Dr A, who said to Mr S that he believed he could help him by prescribing some medication for him that would help relive the distressing symptoms he was experiencing. Mr A initially expressed some confusion once more why he was not seeing dermatology as he perceived the problem needed treating by them This indicates that Mr S was still not displaying any insight and the questions of concordance issues were reconsidered. The National Institute for Clinical Excellence (NICE 2002) recommends that a risk assessment should be performed by the mental health clinician responsible for treatment and the multidisciplinary team regarding concordance with medication, and depot preparations should be prescribed when appropriate. Mr A questioned the proposed medication and it was explained to him that he would be given a course of Neuroleptic medication of a new medication called Aripiprazole. Dr A said that although the medication leaflet would mention the medication was used for Schizophrenia, that Mr A should not be too worried about that as that was not the reason why he would be taking it. Dr A then went on to say that the leaflet would also explain possible side-effects and that although it listed quite a few they were quite rare. The paper by (Cox et al.2000) found that it was common practice for prescribers to initiate the discussions about just what medication they were going to prescribe, rarely refer to the medicine by name and equally rarely refer to how a newly prescribed medication is perceived to differ in either action or purpose, to those previously prescribed. Patient understanding is rarely checked as it is usually assumed after the prescriber has given the prescription. Even when invited to do so, patients seldom take the opportunity to ask questions. (Cox et al 2000) I felt it was the right thing to initiate pharmacological treatment, although on reading further research surrounding the best treatment for Parisitosis I would question the choice of medication Mr A was commenced on However, after spending many clinical hours with this particular Consultant Psychiatrist, I am aware that he has high tendency of prescribing Aripiprazole for the majority of his clients. On questioning Dr A about his decision for choice of medication, Dr A commented that it is the newest and most effective of the atypical medications with lesser incidence of side effect relative to other medications in its group.   I had to question myself that there may be other factors influencing in the prescribing decision which were not based on any of the NICE guidance or that of the British Journal of Psychiatry. In fact, Dr A replied to me with medical jargon relating to molecular structures of both the brain and chemical make-up of Aripiprazole which was hard to follow due to its complexity. I was conscious that as a consultant psychiatrist of many years experience, I was not sure of the honesty or consequences if I had challenged Dr A about his continued choice of Aripiprazole against other choices of medication any further. After researching treatment for this disorder, I felt that the initiation of a typical antipsychotic should have seriously been considered due to its proven faster working efficacy. However, it is known that typical antipsychotics have an increased prevalence of side-effects. Therefore I had considered the preliminary use of typical antipsychotics to establish a degree of insight into the beneficence of taking medication, and if it was felt that further pharmacological treatment is required then switch to a typical antipsychotic as recommended by the NICE guidelines. An article in the British Journal of Psychiatry (2007) highlighted that delusional parasitosis has shown significant treatment results with the use of typical antipsychotics. (Traberts 1995) found that the introduction of typical antipsychotics has substantially improved remission rates (Frithz 1979) described another important treatment in delusional parasitosis is to consider typical anti-psychotic depot medication. This was suggested, as was earlier highlighted that one of the main stumbling blocks is a lack of insight that causes patients t be reluctant to accept oral medication. However, the administration of medication in injection form might be viewed by the patient as the answer to their somatic perception of their illness. It would be hoped that the injection would lead to a degree of insight where the patient may be more open to accept regular medication At the end of the consultation the patient Mr A agreed to take the medication as prescribed and was offered a further out-patients appointment in 2 weeks time. Ultimately, I accept a clear indication for medication, and in conjunction with this at a later stage this could be combined with some cognitive behavioural therapy should symptoms persist. Clinical Governance plays an important part in relation to prescribing., and in particular for non-medical prescribers role .(Bradley E and Nolan P 2005) state that training courses must remain up-to-date and flexible and must change in response to changes in government policy on non-medical prescribing, with nurse prescribing leads being involved in any discussion about course development.

Siddhartha and Govinda Essay -- Essays Papers

Siddhartha and Govinda Siddhartha, written by Herman Heese, is a book about a man’s journey to find his inner self beginning when he is young and ending when he is of old age. Siddhartha, while on this quest, searched for different mentors to teach him what they know, hoping to find truth and balance in and of the universe. At the end of the novel, Siddhartha reaches the enlightenment through many teachings. Govinda, Siddhartha dearest friend and confident, is often viewed as his Siddhartha’s follower, or as his shadow. In the beginning, Siddhartha goes with Gotama to hear the teachings of the Buddha, and Govinda remains with Buddha to become his disciple. Siddhartha believes that each person must find his or her own way to salvation and does not stay with Buddha. He says, â€Å"That is why I am going on my way-not to seek another and better doctrine, for I know there is none, but to leave all doctrines and all teachers and to reach my goal alone-or die. (28)† This quote is the underlying message portrayed for the rest of Siddhartha’s quest. This tells that life experience is the best teacher, which in turn is the core of Buddhism. As the two friends part to go their separate ways, Siddhartha again voices the central idea of the novel: he reminds the Buddha that the process of enlightenment which he underwent is unteachable, and that there is no way of communicati ng first-hand experience to the disciples. As the last part begins, Govinda has arrived to cross the ...

Israel :: essays research papers

Israel The Official language for Israel is Hebrew. It is a very old language dating back over 5000 years. The version that is spoken today is different than the kinda of Hebrew written in the Old Testament. The version spoken today is commonly refered to as modern Hebrew. Since Israel is a Jewish state, naturally the main religion is going to be Judaism. There is also a lot of Muslims and Christians, but most of the people are Jewish. Many of the Jewish Holiday are also national holidays, such as Yom Kippur, Purim, and Rosh Hashanah. One of the holidays exclusive to Israel is Independence Day, where Israel celebrates it's becoming a state. Israel Produces many crops such as figs, dates, apples, pairs, oranges, and olives. They are a very self-sufficient nation and do not need to import much. Probably the most renowned person in the country is the Prime Minister. He is similar to a President. The current Prime Minister is Benjamin Netanyahu. One of his biggest problems right now is to try and negotiate a peach agreement with the arabs. Two of the biggest Ethnic groups, the Arabs and the Jews, have been fighting every since the Jews came to the land in the early 20th century. The Jews want Peace and the Arabs wanna kick the Jews out. One of the Biggest debates is over the Mosque in Jerusalem. The Mosque is located right by the Whaling Wall, which is the remnants of an ancient Jewish Temple. They are both major parts of each religion so they are fighting over who has ownership of what. In Israel they like many of the sports we do. Soccer, Basketball, Football, etc. They eat many of the same foods we do. Some of the foods native to that area of the world are: Falafel, Hummus, Techina, and Shwarma. The population of Israel is roughly 6 million. Almost on sixth of those live in a city called Tel Aviv, the nations largest city. It is also a popular city for jews because it is about 95% Jewish. It is in the north where there are hills and mountains, the opposite of the South where there is deserts and flat lands. The Dead Sea is the lowest altitude onEarth and it is located in Israel. The Government is modeled after the British. With a parlaimentary Democracy. The Prime minister is elected by the people through an indirect vote. The people vote on the party and the party with the most votes, then votes on

Promoting Communal Harmony

Promoting Communal Harmony Promoting Communal Harmony In our country people belonging to various religions live in harmony, but there are occasions when the communal fabric gets disturbed, often on trivial issues. It is the responsibility of all sections of society to ensure peace and brotherhood so that all round development of the country takes places rapidly. The police have a great role to play in promotion of communal harmony and national integration. They come in contact with the general public in the process of performing their duties far more frequently then most other bodies of civil servants of the Government.In such a situation, interaction with vision, understanding, tact, compassion and humour by the police will not only raise the public esteem of the police but will also lead to a healthy police-public relationship, and secure the desired measures of public involvement and cooperation in promotion of communal harmony. Keeping this in mind, the National Foundation for Co mmunal Harmony (NFCH) has been organizing seminars with the aim of effective sensitization of the police officers so that they become the torchbearers of communal harmony and national integration in their day to day functioning.The first such seminar was held at Haryana Police Academy, Madhuban, in August 2007 and the second one in Mumbai in October 2007. The Foundation, which is working silently for promotion of communal harmony, has also supplied reading materials on the role of police in promotion of communal harmony and national integration, constitutional and statutory provisions relating to communal harmony. These seminars have been quite successful in spreading the message of communal harmony and national integration amongst the police officers.The Foundation is an autonomous organization registered as a society under the Societies Registration Act, 1860. It functions under the aegis of the Ministry of Home Affairs and the Union Home Minister is the Chairman of the Governing Council. The principal objectives of the Foundation is to foster communal harmony, fraternity and national integration in general, and facilitate physical and psychological rehabilitation of the child victims of caste, communal, ethnic or terrorist violence, in particular.The NFCH undertakes and assists state governments, local administration, non-governmental organizations, universities, colleges and schools, social activists, scholars, researchers and students in undertaking activities and programmes aimed at promoting harmony at local, state and national levels. Though there have been some incidents of communal violence in certain States, there has been no major communal riot in any part of the country in 2007. Proactive role of the Central and State Governments prevented escalation of communal violence at Gorakhpur in Uttar Pradesh and Indore in Madhya Pradesh last year.All states are advised to keep a close watch on the situation with communal overtones and take early steps to prevent any flare up. Over the last five years the incidents of communal violence have gradually come down. The decline is attributed to the Centre closely monitoring the situation and keeping a strict vigil on the activities of individuals and organizations to ensure that the situation remains under control. The activities of all organizations having a bearing on maintenance of communal harmony in the country are under constant watch of the law enforcing agencies.The Communal Violence (Prevention, Control and Rehabilitation of Victims) Bill 2005 has been introduced in the Rajya Sabha. The Bill has been referred to the Department Related Standing Committee of Home Affairs. The report of the Standing Committee, on the basis of suggestions made by several individuals and organizations with regard to the Bill, has been received. The report and various suggestions received are being examined in the Ministry in consultation with the Ministry of Law and Justice and others for further nece ssary action.The Good Samaritan Playing the role of a Good Samaritan, the NFCH provides financial assistance to children who are orphaned or become destitute in caste, communal, ethic and terrorists violence for their care and education. Assistance is provided at the rate of Rs. 9,600 per annum per child in ‘A’ and ‘B’ class cities and Rs. 9,000 per annum per child at other places without any restriction on the number of children in a family. Additional assistance at the rate of Rs. 1,800 per annum per child is extended for undergoing vocational training.Children in the age group of 0-18 years (extended to 21 years in appropriate cases) whose families are below poverty line (Rs. 31,600 in urban areas and Rs. 22,400 in rural areas per family per annum) are eligible under the assistance provided they pursue their study after the age of five. Assistance is sanctioned for 12 months at a time coinciding with the academic session of the child and is renewed on ye ar-to-year basis. The Foundation aims at providing assistance to every single eligible child victim of violence so that such children, after receiving proper education become responsible and productive citizens.The Foundation has stepped up its liaison with State Governments for ensuring assistance to every eligible child, both in the categories of fresh cases and renewal cases. The NFCH has to necessarily depend on States and particularly District administrations for identification of orphaned or destitute children and for submission of their applications along with necessary documents. Every year awards are given by the Foundation to individual and an institution for their outstanding contribution to the cause of communal harmony and national integration.Instituted in 1997, the award has acquired an aura of its own. The Foundation is striving for greater publicity for the awards so as to ensure that cases of as many deserving cases as possible are placed before the jury for select ion. Aimed at creating awareness about communal harmony and national integration, the Foundation extends assistance to state administrations and non-governmental organizations for holding debates, seminars, workshop, painting, poster, slogan or essay writing competition, musical and cultural programmes, kavi sammelans and mushairas.The Foundation is striving to encourage and support as many organizations as possible to take up, on a significant scale activities related to promotion of communal harmony and national integration. The Foundation extends financial assistance to state/union territory administrations for organizing inter-community ‘milans’ (get together) on important festivals like Eid, Deepawali and Christmas subject to certain monetary ceiling. ‘Sadbhavana clubs’ have been established in educational institutions to sensitize students and motivate them to work for promoting communal harmony and national integration.The clubs aim at inculcating so cial values like fraternity, love and peace among the young generation. They strengthen bonds of unity and affinity and promote belief in the principles of non-violence in the society. The Foundation associates itself with important inter-community festivals like â€Å"Phool-Walon-Ki-Sair† in Delhi, and â€Å"Nauchandi† festival in Meerut and â€Å"Deva Mela† in Barabanki, both in Uttar Pradesh, to promote better understanding among various communities. Communal Harmony Campaign Since its inception in 1992, the Foundation has been taking active part in communal harmony campaign and has extended financial assistance of over Rs. 6 crore for rehabilitation of 8,849 children up to December 31, 2006. It also assists non-governmental organizations under the project â€Å"Cooperation† and grants fellowships for undertaking research in field situation in the communally sensitive districts. The Union Home Ministry on its part gives â€Å"Kabir Puraskar† nat ional award to those promoting communal harmony by showing physical and moral courage while saving the lives and property of members of another community during communal riots, caste conflicts or ethnic clashes.While â€Å"Sankalp Divas† is observed on October 31 every year, â€Å"Qaumi Ekta Week† is observed from November 19 to 25. The Home Ministry also encourages voluntary organizations to undertake activities for the cause of national integration and communal harmony through cultural shows, essay and painting competitions, inter-regional camps and exhibitions. It is the cumulative result of all these efforts that a sense of communal harmony prevails in the country by and large as is reflected in the Home Ministry statistics

Oprah Winfrey’s 2008 Stanford Speech

This speech was about three lessons that Oprah Winfrey has come across in her professional and personal life. She talked about striving to be yourself and not anyone else and how you can grasp failure and turn it around by embracing it and finding the solution, and lastly how happiness comes when you give back to others. Her first lesson was about striving to be your own self; she talked about in the beginning of her professional career when she had a job in Baltimore as a news anchor. She was constantly holding Barbara Walters as the image she wanted to be in her career and wanted to be like.So she was always trying to talk like Barbara, look like Barbara and act like Barbara†¦ And she kept getting it wrong. She felt the need to be spontaneous and more of herself when she would read some of the headings†¦. Especially upsetting headings with disasters involved. So she would sometimes not pre-read any of headings until she was live so it would come across more realistic. She once covered a story of a horrible fire and afterwards ran to the scene and helped the fire victims by providing blankets. She never lost her empathy.She ran into some barriers during this job that ultimately helped her find her true purpose in life. The first barrier was that her boss let her know that they did not like the way she looked, and that they wanted to give her a new name that they thought would be more â€Å"friendly† and would be remembered by the public. She refused to change her name but did try to improve her looks by getting a perm that eventually made her hair fall out. She was let go from her position as the news anchor and placed on a talk show instead. It was there on the talk show that she felt she was at home and knew she had found her purpose in her life.So here she learned that she should never try to be anyone other than herself†¦ and that when you are doing something you are supposed to do you will feel right about it. She referred to it as f eeling â€Å"at home†. Her second lesson was about embracing your failures and leaning with them instead of resisting them to find the solution. She talked about some of her failures and how she gained from them instead of being devastated. She mentioned her job loss in Baltimore†¦ at first she was upset but it turned out to be one of the best things to have ever happened to her because out of t she would up on a television show and found her place in her future HUGE professional life. She talked about how your gut can tell you a lot. When you are doing something you’re supposed to be doing your gut will let you know it. When you’re doing something you probably shouldn’t be doing, your gut will also tell you. Something just won’t feel right. That there is an inner voice inside you that you must follow and that it guides you through life. She calls is â€Å"life’s whisper†. Oprah stressed that when devastation hits you, take a ste p back and ask â€Å"what is this trying to teach me? She told the story of building a school in Africa for girls and took so much effort into making sure the building was perfect for the girls. Then she found out that one of the dorm matrons was suspected of sexually abusing the girls. She expressed how devastating this was to her and that she had to take a step back and ask herself what was the lesson here? She realized she was paying attention to all the wrong things. That she built that school from outside in, when what really mattered was the inside. She also expressed that she feels you never stop learning.She was referring to the graduates of Stanford that their education journey does not end her and that looks to the earth as a huge school never ending learning experience, and that she is still learning to this day. She went over a few quotes by her father and by BB King. Her last lesson was about giving back to others. And in order to be happy you MUST give back to others. And with that comes happiness. It gives you gratitude and makes you feel good. She also said to be a part of something bigger than yourself because life is a reciprocal exchange.She expressed that giving back is the greatest lesson of all to her. She talked about how in her career how she has given back in numerous amounts of ways and gave advice for whenever you’re in a mess, you help someone else get out of a mess†¦ whenever you are in pain, help someone else in pain, whenever you have a loss help someone else with a loss†¦. She talked about how the founders of Stanford University lost their son and how they took their pain and sorrow and channeled it into grace and started the University and helped other people with children like their son.She told the students that whatever their career may be that they use their ability to help others and pass along greatness. She ended with a Martin Luther King, Jr. quote. Speech Analysis Oprah gained the audience’s at tention right away because she is a widely known influential media leader. She is the Oprah Winfrey. She started by telling the audience she had a secret and that one of the students Kirby (Gail King’s daughter) was her god daughter and gave a quick story of how she knows Kirby and how proud she was of her god daughter for graduating.This was also part of an attention getter. Oprah used good eye contact and her voice manner was very pronounced and sure of herself. She is obviously a very experienced speaker, being Oprah. She used humor throughout her speech such as saying â€Å"Stanford† with a serious tone in her voice. She kept her speech very relatable to the graduates of Stanford by talking about her professional career and all her goals she met and would occasionally talk to them specifically and give them advice about when they go out in their career how they can help, or not to give up because of failures, etc.Oprah had good body gestures and moved her arms arou nd when talking, gave great pauses for emphasis and looked around at the audience. She did not seem to read her speech word for word, but rather just glance down at her notes and just speak freely of her own experiences. She talked a lot about her college career in the beginning of her speech which also gained attention from the graduates. O Oprah’s vocal tone was as always, inviting and I think that really kept the audience engages and very attentive towards her and what she was saying even though her speech was pretty long (30 min).Oprah was never repetitive and her examples were very witty and relatable. She gave each audience member two books from inspirational writers that she claimed helped her with her own life. She joked with the audience saying she wished she could have gotten everyone cars, but couldn’t pull it off. Oprah’s speech was very inspirational, impacting and I believe left a huge impression and impact on those 2008 graduates’ lives. I loved the speech and am happy I watched it and picked this one to analyze.