Peter the Hermit and the First Crusade

Peter the Hermit and the First Crusade Peter the Hermit was known for preaching Crusade throughout France and Germany and instigating the movement of common folk that became known as the Crusade of the Poor People. He was also known as Cucu Peter, Little Peter or Peter of Amiens. Occupations CrusaderMonastic Places of Residence and Influence Europe and France Important Dates Born: c. 1050Disaster at Civetot: Oct. 21, 1096Died: July 8, 1115 About Peter the Hermit Peter the Hermit may have visited the Holy Land in 1093, but it wasnt until after Pope Urban II made his speech in 1095 that he began a tour of France and Germany, preaching the merits of the crusade as he went. Peters speeches appealed not only to trained knights, who usually followed their princes and kings on a crusade, but to laborers, tradesmen, and peasants. It was these untrained and disorganized folk who followed Peter the Hermit most eagerly to Constantinople in what became known as The Peoples Crusade or The Crusade of the Poor People. In spring of 1096, Peter the Hermit and his followers left Europe for Constantinople, then moved on to Nicomedia in August. But, as an inexperienced leader, Peter had trouble maintaining discipline among his unruly troops, and he returned to Constantinople to seek assistance from Byzantine Emperor Alexius. While he was gone the bulk of Peters forces was slaughtered by the Turks at Civetot. Disheartened, Peter almost returned home. Eventually, however, he made his way to Jerusalem, and just before the city was stormed he preached a sermon on the Mount of Olives. A few years after the capture of Jerusalem, Peter the Hermit returned to France, where he established an Augustinian monastery at Neufmoustier. Resources The Crusade of the Poor People Catholic Encyclopedia: Peter the Hermit  - Concise biography by Louis Brehier. Peter the Hermit and the Popular Crusade: Collected Accounts  - Collection of documents taken from August. C. Kreys 1921 publication, The First Crusade: The Accounts of Eyewitnesses and Participants. The First Crusade

Parents Sexuality Influence Essay Example | Topics and Well Written Essays - 750 words

Parents Sexuality Influence - Essay Example The discussion of the sexuality of children with their parents is least common. However, many people think that sexuality education must be taught from the parents. Neither the parents nor the children are not prepared to talk with each other on issues which are common at teenage like drinking, sex, drug usage etc. Many of the parents do care about such issues, want their children to have safe and healthy sex, but they don't get the appropriate time to discuss, thinks talking on sex is a vulgar subject, and do not feel comfortable in discussion it. This may be because of big generation gap between them. However, the daughter consults more than the sons do. Most of the teenagers prefer to consult sexuality education centers for their problems. These centers are quite useful as they keep young people aware of the consequences and risks of premature sex. Having sex at young age can be both harmful physically and psychologically. The society in which people are living also influences in parent-children relationship. Some society, which are conservative and are more under religious influence find it a bit easier to discuss than in socially affected place. However, it is the duty of the parents, at a certain age i.e. 14-18 years of their children, the parents must take their children into confidence and discuss on their sexual development. This is the age where sexuality becomes more common among teenagers. The people need to make it clear that sexuality is the part of maturity of humans. The parents need to talk with their children and discuss sexuality issues. The fathers can talk with the sons, similarly the mothers with their daughters, discuss about the consequences of sexuality and advice them on periodic basis i.e. after six months or yearly basis of the consequences of sexuality. In this way, if children face any serious problems, the parents can consult medical consultants or may require regular treatments. The parents need to show more frankness, openness, and attentiveness in their attitude when discussing sexuality with the children. The parents need to keep their tone cool and humble, and answer them seriously. The privac y of the child must be kept intact. The father can tell the sons about the usage of condoms and mothers can help daughters when they are in their sexual periods. However, children think their parents can help them in making their sexual decisions. Awareness Among Younger generation: The parents and sexuality centers need to provide awareness among the younger generation about the sexually transmitted diseases (STDs) such as HIV/AIDS etc. If not dealt properly with such diseases, improper pregnancy, inappropriate sex etc can be very deadly. In many European countries like Netherlands and Germany they have started sexuality awareness programs through electronic media, where parents come and give useful information to young masses. These sexuality communities can also help the parents in making them better sex educators. However in France, the children are send to such centers, and the parents cannot withdraw them before the age of 13. Although sexual education can be taught from other sources, but the love and care parents can give, children cannot get it from anywhere. Bibliography: Press Release TeenPregnancy.org. Teens Say Parents Most Influence Their Sexual Decisions.

Change Essay Example | Topics and Well Written Essays - 1250 words

Change - Essay Example As such, hospitals have shifted their conventional approach where they were run on voluntarism basis to a more contemporary and competitive approach. This approach has seen many hospitals corporatize their services thereby adopting normal organizational management approaches and strategies like change management. It is important to note that in their pursuit of organizational strategizing many of them have closed down while others have survived the competition. Majority of those which have closed down have done so as a result of inefficient management, others have created barriers for all patients to access medical care. In the workplace there is need for change management to take place in respect to number of staff. The hospital is operating quite inefficiently as a result of having an unnecessary high number of staff. Redundancy creeps in where many workers are doing the same thing without creativity or level of innovation. Considering the number of both outpatients and inpatients the available manpower is way above the optimum which results in wastage of time. This also results in wastage of finances which could otherwise be used to improve on quality of medical care provided. In order to ensure that all employees work optimally and to reduce on cost of operations, a downsizing plan is necessary (Schulz & Johnson, 2003). When considering the Lewin’s Force Field Analysis driving forces and restraining forces have three major elements each. Downsizing strategy/ Lewin’s Force Field Analysis This is a measure that is quite sensitive in many organizations as labor unions and other restraining forces play crucial roles. It is also referred to as restructuring or reorganizing. It is complex to implement as it also requires restructuring of job designations, change in departments and their consolidations among others (Cohn & Hough, 2008). Although highly unpopular this strategy has worked for many corporate organizations like GM and IBM. Since hospital s have adopted corporate measures in management then change strategies cannot be blind to downsizing. One of the driving forces is cost saving which is the most obvious of all benefits. Due to the increased pressure for hospitals to be self reliant and increased control of care plans the hospital needs to cut down on its cost of operations (Mason, Leavitt & Chaffee, 2007). This subsequently creates an internal pool of resources which are in turn used to improve on services offered. The economic condition is not at its best with many sectors still recovering from the recent 2007-09 global economic meltdown. The other force is improved efficiency especially by targeting employees whose jobs do not contribute directly to revenues and which do not heavily affect the hospital’s core operations. The strategy will also help in weeding out poor performers and retain highly skilled employees. Efficiency is also derived when the few remaining employees focus their energy towards core d uties of the hospital. There is also shorter communication channels and improved responsiveness. This way bureaucracy is eliminated resulting to a more flat command structure. The third major force is labor mobility which benefits the hospital in an indirect way. In case many employees will be found to be non performers it will be relatively easy to hire new ones coming from inefficient or closed hospitals. On the other hand there are competing forces that

Causes of the Civil War Essay Example | Topics and Well Written Essays - 2000 words

Causes of the Civil War - Essay Example As an overview, the American Civil War lasted from 1861 to 1865 where 11 states from the South of the country secede. With this secession, the 11 states established the Confederate States of America, which was primarily done in order to legislate the presence of slavery in these states. In line with this, the American Civil War must be understood beyond the context of death, but it must be taken into account that the civil war had bore many positive changes and perspective, not only to the American society and political system, but also in the worldwide perspective. To name a few, it had caused the Constitutional amendments, which allowed a stronger relationship between citizens with citizens and citizens with the government. Essentially, the most crucial result of the American Civil War was the abolition of slavery across the country. Nonetheless, it must be noted that prior to the emergence of the American Civil War, there have been cited causes of its coming into existence (The Am erican Red Cross 3; West 2).   The cotton gin was invented by Eli Whitney, who graduated from Yale University, and was able to go to South Carolina to tutor the children of wealthy farmers. As a graduate from Yale University, the people in South Carolina were aware of the intelligence of Whitney. One of the individuals who used this information critically was Catherine Greene, who owns a large cotton plantation in Savannah Georgia. Greene invited Whitney to her farm as a guest, and there she encouraged Whitney. to invent a machine that will allow workers to remove seen from the cotton. Whitney accepted the proposal, and after 10 days, he was able to come up with the cotton gin. With the invention of Whitney, the South was able to experience a growth in the production of its cotton. In particular, it was able to produce 8 million pounds of cotton in the span of two years after the invention of the cotton gin broke out. However, his contribution did not end here because after 12 yea rs of using the cotton gin, the American South was able to produce 80 million pounds of cotton. It was inevitable that the region was already economically up scaling due to the invention of the cotton gin (Hazen 4). The demand of cotton in the international market grew high; the American South producers considered this as an opportunity. However, the American South considered this success to be dependable on the slave labor. With this in hand, the agricultural and the societal system in the American South had greatly depended in the presence of slaves and the aspect of slavery. During the year 1860, it was recorded within the slave states that there were already 3.5 million slaves. In average, there was a minimum of five slaves and a maximum of 20 for every slave owner (Griess 7). The slaveholders of the South found that the slaves were true to their work and were more efficient. However, even with these positive working attitudes of the

Diagnosing Depression In Ethnic Minority Groups Social Work Essay

Diagnosing Depression In Ethnic Minority Groups Social Work Essay The essay title is curious and could be interpreted in a number of ways. Firstly, it invites me to decide whether the essay should be from the perspective of a client, or the therapist, or both. I have chosen to present the essay from the point of view that it is the client who is a member of an ethnic minority group. Perhaps what drew me to this title over the others is of personal significance, being from a multicultural family and having lived and worked in countries in the Far East and West Africa where culture and society is vastly different to that of the UK. Essentially, I have experienced being an ethnic minority member in the opposite context and hence was eager to explore the essay from a clients perspective in the UK. I chose to focus on depression rather than psychosis, as I was less aware of current research linking ethnicity to depression and felt this would balance out my motivations and be beneficial for my development as a trainee. As for the content, I will begin with a discussion on what is meant by an ethnic minority group and by the term depression. I will then present my view of how ethnicity affects the diagnostic process, initiated with a brief health warning about the implications of racial stereotyping. Following this I will focus on presentation of symptoms and the formulation process of depression. The second half of the essay will be about the treatment process, looking closely at the influence of ethnicity on help-seeking behaviour and psychological treatments. Finally I will end the essay with a reflective account containing my thoughts about finishing the essay and a conclusion. What is an ethnic minority group? When translated literally, the term ethnicity means people or nation (i.e. ethnos; Franklin, 1983). Senior Bhopal (1994) highlight that is now used as a variable to describe health data. On closer inspection, the concept of ethnicity is not simple or easy to understand. Firstly, ethnic minority status does not account for changes over time and context. There are also many different terms used for groups. McKenzie Crowcroft (1996) highlight a good example of this: à ¢Ã¢â€š ¬Ã‚ ¦a Black Baptist born in the UK whose parents were born in Jamaica might be called Afro-Caribbean, black British, of Caribbean origin UK born, West Indian, and of course, Jamaican. Furthermore, ethnic categorization does not inform us of whether the individual is of first or second generation descent, not to mention the migrant status of the individual. Given our multicultural climate, the meaning of ethnicity is a source of continuing debate and is also likely to change with national trends and politics. For example, the Irish have only recently be recognized as an ethnic minority in the UK. Although the National Institute for Mental Health (NIMH, 2003) has advised that ethnicity should be self-identified, this does not always happen in the process of research. McKenzie Crowcroft (1996) point out that this leaves many researchers in the position of assigning membership of an ethnic minority group on an informal basis in order to have comparable data. Indeed, defining an ethnic minority group is problematic due to the lack of consensus. Despite these issues it was necessary for me to attach myself to a concrete definition for the purpose of this essay. Furthermore, I have selected a particular ethnic minority group (African-Caribbeans) when specific examples are needed. The definition I am following regarding an ethnic minority group is: Those with a cultural heritage distinct from the majority population (Manthorpe Hettiaratchy, 1993). What is Depression? Depression is a term used both clinically and in everyday discourse (Valente, 1994) to describe a host of unpleasant feelings which people experience, ranging from a low mood to describing a situational feeling (Keller Nesse, 2005). When depression is considered clinically significant is it quite different from the common experiences just narrated. A person may be diagnosed with clinical depression if they are experiencing depressed mood or loss of interest and pleasure plus at least five other adverse feelings during a two-week period or longer (DSM-IV-TR; American Psychological Association, 2000). When depression is at its worst, it can make people withdraw from ordinary pleasures and concentration may become very poor. Some people with depression report a sense of hopelessness and can experience suicidal feelings or ideations as a result (APA, 2000). Clinical depression can occur alongside different disorders and be multifaceted in its presentation (e.g. Akiskal et al., 2005). It is probably fair to say depression does not occur in every country across the world in the way we view it in the West. Other cultures may label it as something different. For example, Kleinman (1980, as cited in Bentall, 2003) found Western depression and a Chinese condition called Neurasthenia to be the same thing, although expressed in different ways. Given this, I question how useful our depression label is. This essay is however, directed by the title and the focus of this essay will therefore follow the DSM-IV-TR definition of depression. According to the Office for National Statistics clinical depression is experienced by 10% of the British Population at any one time. Depression is a diagnosis of increasing popularity, and was once referred to as the common cold of psychiatry (Seligman, 1975 as cited in Hawton et al., 2000). It is estimated that there are over 6 million people in England alone who are designated as from minority ethnic groups (Department of Health (DoH), 2003). Much of our current knowledge of depression in UK African-Caribbean people relies on limited research showing inconsistent results. I feel such statistics often lead to misdiagnosis, as clinicians are informed by research and policy. In order to avoid statistical discrimination I have therefore not included any data displaying suggested prevalence rates of depression in this population. Chakraborty McKenzie (2002) points out that early studies were criticized for methodological problems, but argues that more recent studies have attempted to advocate more rigorous methodology. More recent studies tend to suggest a high prevalence of depression in African-Caribbean populations (e.g. Nazroo, 1997 as cited in Chakraborty McKenzie, 2002). Interestingly, it is also thought that depression is underecognised and undertreated in African- Caribbeans, especially in primary care (Ahmed Bhugra, 2006). To what extent is membership of an ethnic minority group influential in the process of diagnosis of people experiencing depression? In the recent Inside Outside UK national initiative (Department of Health, 2003) a well-established link between health care disparities and ethnicity is claimed and structures are recommended which target this. I question the wider implications of producing such documents as it appears to suggest people should be viewed differently according to their ethnic status. As Lewis-Fernandez Diaz (2002) rightly point out, even people who share the same ethnic minority status can differ, as ethnic groups are culturally heterogeneous. As noted above, membership of an ethnic group is not a static thing and there are vast differences within an ethnic group as well as outside of it. I can relate to this as I often have difficulties when completing the ethnic status box on equal opportunities forms. Although I would class myself as white-British my father is Italian-American and my mother is Swiss, hence I have four passports. I normally choose to categorize myself as British however this someti mes changes to white-other or white-American depending on where I have been living. In my experience, I feel the desire to categorize people in society outweighs the usefulness of doing so. Given the increasingly multicultural climate of the UK it may not always be accurate to state that white people are of the dominant origin however statistically that is currently the case. This means that the relatively recent surge in interest and attention on differences of ethnic groups in mental health is often taken from an essentialist perspective (Giles Middleton, 1999), where differences are observed from my or our perspective. Claims made in research detailing differences between ethnic groups also encourage categorizing of individuals, which simply creates an othering between groups. Othering has been explained as a way to serve and mark those thought to be different from oneself (Weis, 1995 as cited in Grove Zwi, 2005). There is a concern for me that by focusing on the differences between African-Caribbeans and whites, or any other ethnic minority simply serves to reinforce the idea of racial differences and segregation. Institutional racism is a form of discrimination, which stems from the notion that groups should be treated differently according to phenotypic difference (McKenzie, 1999). It has been suggested that it is widespread in the UK (Modood et al., 1997). It seems to me that if we are to eliminate racial disparities in mental health care; concordant with the aims of the recent Department of Health initiative (2003), we all need to look at the way we are talking and presenting our ideas around this. For the reasons just discussed I will now attempt to present a view that is balanced and allows disparities of depression in African-Caribbean people to be seen in a relational context. Whilst I will describe potential areas of difference, the aim is not to stereotype people according to their ethnicity. Presentation The bodily styles of experiencing and expressing distress may be different for some people of African-Caribbean origin living in the UK than people from other ethnic backgrounds. Some studies suggest they experience and present more somatic symptoms of depression, e.g. headaches, achy limbs (Comino et al, 2001). Comino and colleagues also contend that idioms of distress differ linguistically and can take the form of cultural metaphors. If clinicians do not recognize these symptoms as signs of distress I imagine some clients may be left feeling quite frustrated. For us, as therapists, this does make the process of diagnosis more complex. An awareness of the possibility of somatic presentations, with a view to enquiring about the clients understanding of them seems helpful. A unique approach for the assessment and understanding of somatic symptoms of depression and idioms of distress has been developed (Lewis-Fernandez Diaz, 2002). There have also been attempts at identifying the core symptoms of depression across different ethnic groups, although the last one is most probably outdated now. In their large cross-cultural study, Jablensky et al., (1981 as cited in Bhugra Ayonrinde, 2004) found nine common international symptoms of depression; sadness, joylessness, anxiety, tension, lack of energy, loss of interest, poor concentration and ideas of insufficiency, inadequacy and worthlessness. Perhaps doing more studies like this could help in us developing a more universal approach to symptom recognition. Despite the evidence, I do believe that symptom presentation of depression can vary for a number of reasons completely unrelated to an individuals ethnic minority status. Children were once considered a difficult and under diagnosed population as they often present with somatic symptoms (e.g. failure to make expected weight gains in very young children; Carson Cantwell, 1980) which makes it difficult to diagnose. Subsequently, rating scales and measures have been devised which are appropriate for different age groups and enable a conventional diagnosis to be made (Goodyer, 2001). People living with HIV may also present somatic symptoms of depression. Kalichman et al., (2000) suggest available methods for distinguishing overlapping symptoms should be utilised when assessing such individuals. It seems obvious to me that we have to adapt standard methods of recognizing depressive symptoms when dealing with the diversity that naturally occurs in human beings. Language is also thought to be a potential barrier (e.g. Unutuzer, 2002) in the diagnostic process of depression. African-Caribbean people may not always speak clear English but speak multiple local languages or with an accent. Whilst I know this happens, I could not find any research investigating the percentages of African-Caribbean people in the UK and their language abilities. This so-called barrier could therefore be perceived rather than actual; however I will briefly discuss methods to work with this in the clinical context. As stated in the aforementioned Inside Outside document (2003) mental health services now aim to be culturally capable, which includes tackling difficulties with language. There is no doubt in my mind that communication is a key element in diagnosis, and I know from personal experience that not being able to communicate in a locally understood language can cause people to feel isolated. Thus, ensuring language access for people who speak a language other t han English through appropriate interpreting/translating services is crucial. However, I do feel that this parallels a need for people who have other difficulties with language. For example, I am sure it can be difficult to identify depression in individuals who have suffered severely dehabilitating strokes or physical injuries where speech is severely impaired. My point is that there are an array of factors which influence the way people talk about their difficulties and how they are understood by clinicians. Not being able to speak the English language in a clear English accent is simply one of those factors. I feel the issue raised here is more related to how we work with diversity rather than how we work with ethnicity. Formulation As a trainee clinical psychologist involved in the diagnostic process of depression I am also concerned with the formulation process and how this is affected. The beliefs people have about the nature and causes of depression do differ between cultures. For example, Bhugra et al., (1997) identified some African and Asian cultures view depression as part of lifes ups and downs, rather than a treatable condition. From this perspective, many psychological models which aid us in understanding depression can account for the differing beliefs and experiences of people. For example, the Cognitive model of depression (Beck, 1967, 1976) suggests that peoples early experiences lead people to form beliefs or schemata about themselves and the world. These assumptions are thought to cause negative automatic thoughts which perpetuate symptoms of depression on five different levels; behavioural, motivational, affective, cognitive and somatic. Despite this model being quite flexible at face value, ho wever, the negative cognitive triad (Beck, 1976) is directed by the beliefs and experiences of the individual. This may not fit in with those from more collectivist cultures. Indeed, we know that social networks often play an important part in the belief systems of ethnic minority members (Bhugra Ayonrinde, 2004). Therefore, thinking more systemically may be particularly useful when considering individuals from ethnic minority groups. However, we do need to be cautious in making assumptions about what beliefs people from ethnic minorities have. There is a danger that in doing so, we may be able to formulate quicker but may also cause considerable distress to the client. I recently attended a mental health awareness course as part of my placement where an African Caribbean service user came to talk to us about her experiences of being in the mental health system. She described her first traumatic admission to hospital after a close suicide attempt at the age of nineteen. She told us it was persistently assumed by mental health staff that she had attempted suicide because she did not understand or fit in with the predominantly white community in her area. She told us how upset and misunderstood this made her feel, as this was not the case at all. On reflection, this highlights the importance of service-user feedback in clinical practice. The question I see appearing with regards is how we as clinicians in the UK can best explore the beliefs, experiences and background of the multicultural population we are working with in order to diagnose appropriately. As Fernandez Diaz rightly point out, to do this we need a systematic method for eliciting and evaluating cultural information in the clinical encounter (Lewis-Fernandez Diaz, 2002). There is a paucity of information debating ways to take this forward and models to encapsulate these ideas are currently being developed and tested in the USA. One such model is the Cultural Formulation model (Lewis-Fernandez Diaz, 2002), which is an expansion on the depression guidelines, published in the DSM-IV-TR. This innovative model consists of five components; assessing cultural identity, cultural explanations of the illness, cultural factors related to the psychosocial environment and levels of functioning, cultural elements of the clinician-client relationship and the overall impact of culture on diagnosis and care. I find this model very inclusive as it can still elicit very useful information about culturally-based norms, values and behaviours even when there is no ethnic difference between the clinician and the client. Whilst cultural differences exist within an ethnic group, they are not necessarily ethnicity-bound. For example, they can equally be associated with an individuals age, gender, socioeconomic status, educational background, family status and wider social network (Ahmed Bhugra, 2006). If this is the case, then I would say that it is important for clinicians to have a very exploratory and curious approach when assessing and diagnosing an individual in a mental health service, whether they are from an ethnic minority or not. To what extent is membership of an ethnic minority group influential in the process of treatment of people experiencing depression? Some people with depression get better without any treatment. However, living with depression can be challenging as it impacts many areas of an individuals life including relationships, employment, and their physical health. Therefore, many people with depression do try some form of treatment. This process usually begins at primary care level and then a collaborative decision is made between the patient and the clinician as to what treatment suits them best. It has been suggested that Africa-Caribbean people are less tolerant to antidepressant medication than whites (Cooper et al., 1993). Therefore this section of this essay will focus on the process of psychological treatments of depression. Treatments vary and have altered radically with the growing use of Cognitive Behavioural Therapy (CBT), which is based on the scientist-practitioner model and routinely offers outcome data (Whitfield Whitefield, 2003). In CBT, and in the majority of other talking therapies, treatment usually involves seeing a therapist for a number of sessions on a regular basis. Seeking help There appear to be two main potential barriers when it comes to the treatment of depressed clients from ethnic minorities. Firstly, the help-seeking behaviours of African-Caribbean and other ethnic minority groups have attracted considerable attention in the research domain. Members of the African-Caribbean population are thought to be less likely to seek professional treatment for psychological distress (e.g. Bhui et al., 2003). Whilst reading a mountain of papers listing reasons why the help-seeking behaviour of people from ethnic minorities is so different, a few ideas sprung to my mind. From my own experience when people are very depressed they may struggle to get motivated and make less use of the support available to them. Moreover, I wonder whether one it is a possibility that African-Caribbeans do not approach services as much because of negative experiences of the UK mental health system. I recall seeing an elderly Jamaican gentleman for an assessment last year whilst working as an Assistant in a Clinical Health department. Following the very limited referral information I had, I elicited his ideas about what brought him to our service. He told me that he had felt unable to cope with his low mood and intrusive thoughts for some while, however he did not feel able to seek help because a family member of his had been treated unfairly by mental health staff before. Perhaps the reasons for people not acc essing treatment are simpler than we think. In their study of reasons for exclusion of African-Caribbean people in mental health services, Mclean et al., (2003) found the types of interactions between staff and patients strongly associated with disparities in treatment. They encourage positive, non-judgmental interactions as the first step on the path to social inclusion of mental health services (Mclean et al., 2003). Their study reminded me of a report I read recently on placement about the Circles of Fear (Salisbury Centre for Mental Health, 2002). Essentially, this report stipulates that people from ethnic minorities tend to have a more negative experience of the mental health system. People may then fear the consequences of becoming involved with it and avoid contact. This leads me to believe that we (the health service) are very much part of the reason why such individuals may not seek help. Geography may also be a reason for varying help-seeking behaviour. People living in rural areas are thought to be at risk of facing isolation and discrimination in mental health treatment (Barry et al., 2000). I do think there is something valuable about looking at populations which services are not reaching. However, it has just struck me that writing about the help-seeking behaviour of people can come across as quite blaming and puts the responsibility very much with the individual. Whatever the reason, if minority members are less likely to get appropriate care, I feel the focus should be on how to engage different members of society in effective care for depression. Fortunately, depressed people who fail to seek help for treatment can often be identified and treated in general medical settings (Shulberg et al., 1999). One study also suggests that the majority of people who are depressed do want help, regardless of their ethnicity (Dwight-Johnson et al., 1997). What I find particu larly interesting is that the desire for help seems to be related to the severity of the depression in precedence of their ethnic minority status. Thus it appears that ethnicity, severity of depression, geographical location, previous experiences with the mental health system and beliefs about what help is available all influence help-seeking behaviour. Psychological Treatment The second claimed difficulty in the treatment of African-Caribbean people who are depressed is poor attendance rates and incompletion of treatment (Bhugra Ayonrinde, 2004). There are also claims that African-Caribbean people are more likely to experience a poorer outcome from treatment. Given that the search for a biological cause for disparities in treatment success rates has not been fruitful we must turn our focus to other explanations. For example, we now know that the relationship between the therapist and client is a key component of treatment outcome (Hovarth Greenberg, 1994). As such, I am going to focus on those explanations which link to the therapeutic alliance. There are few empirical studies which explore how ethnic differences affect the therapeutic alliance and these have consisted mostly of client preferences. Cultural unfamiliarity may act as interference to some African-Caribbean people staying in psychological treatment (Davidson, 1987). In their study of secondary school students, Uhlemann et al., (2004) looked at how being an ethnic minority therapist affected relationships in a counselling setting. They found ethnic minority counsellors were perceived more favorably than white-Caucasian counsellors. Most students believed therapists were less able to understand or empathize with them if the therapist was ethnically different. In another study Coleman et al., (1995) surveyed studies comparing ethnic minority clients preferences of therapists, being ethnically similar or ethnically dissimilar. They found that in most cases clients preferred therapists of similar ethnic background, particularly those with strong cultural attachments. I acknowledge that this may be something to be aware of as a therapist; however I do not think this in itself would put people off psychological treatment. It might be useful for us as therapists to address this issue and to do so early on in the treatment process. One way of doing this could be to address any obvious ethnic differences and explore together how it may affect the given relationship. This may also help the process of understanding which is deemed very important in strengthening the therapeutic alliance. Whilst this is something I will try and be aware of in my practice, I also feel it is important to present this discussion in a realistic and in context. From my experience as a trainee, the age and amount of experience a therapist is far more valuable and influential than the ethnic status of a therapist. One lady I saw recently had difficulty accepting me as her therapist for the simple fact that she worried about how much I would be able to help her in comparison to a qualified clinical psychologist. There was also an ethnic difference between us but this was did not cause her concern. Similarly, Coleman et al., (1995) asked clients individuals in their study to list the characteristics of a competent therapist in order of importance. Sure enough, they found that people placed ethnic similarity below that of other characteristics such as educational ability, maturity, gender, personality and attitude. I think this illuminates just how important it is for us to tailor the treatment process to the individual needs and concerns of the client. Is a more holistic approach to psychological treatment of depression the answer? I do wonder whether CBT, the current preferred model of treatment, will soon lose its popularity. The somewhat prescriptive nature of CBT for depression may mean the varying needs of people in our multicultural climate are not being met. Rather than creating new and separate treatment models or services for ethnic minority clients, perhaps we should be embracing ones which encourage clients to lead the treatment. One model I find demonstrates this is the Recovery model. Recovery from mental illness is seen as a personal journey and the unique experiences of each individual are valued and explored (Jacobson Greenley, 2001). Treatment using this model works around helping the client gain hope, a secure base, supportive relationships, empowerment, social inclusion, coping skills, and finding meaning to their experiences. Although used more with individuals experiencing major mental health problems, I think the principles are very inclusive and useful for the treatment of any mental health problem, including depression. Of course, I have only touched upon one model and there are many more which embrace individual differences. Reflective statement As a current trainee on my adult mental health placement, I cannot pretend that I am able to provide an objective nor extensively experienced view. I am also aware that I am at the beginning of my first placement, in a service which very much promotes recovery from mental illness through understanding the individual rather than categorically through their psychiatric label. Whilst this may have had an influence over my stance towards the essay topic, I have witnessed the positive effects in my clinical work of not categorizing people and feel that this has indicated some valid concerns. Upon finishing this essay it came to mind that that the buoyancy of the essay may be a reflection of the ideas and questions I have been grappling with as part of my practice on placement. However, these ideas are by no means a closed deal and I continue to work with them in an applied context. Furthermore, I acknowledge that had I chosen to present this essay assuming that it was the therapist who was a member of an ethnic minority, my essay and conclusions may be very different. How will writing this essay affect my practice as a Trainee Clinical psychologist? I do feel we are in a contentious situation. If we treat people differently according to any issue of diversity we run the risk of perpetuating institutional racism. On the other side of the coin, if we work with everybody in exactly the same way and try and fit people in to Eurocentric systems then we run the risk of ignoring important cultural differences. What I will take from this is the importance of being sensitive to peoples backgrounds and experiences and investigation of what makes them who they are. I will definitely attempt to bring more flexibility, curiosity and receptiveness to my practice and acknowledge when there is a noticeable difference between myself and the client in the therapeutic setting. Conclusion In conclusion, membership of an ethnic minority group may influence the diagnosis and treatment process in how people experience depression, present to services and possibly how they proceed with psychological treatments. If we are to diagnose and treat depression through a Euro centric lens, we should be embracing the use of models which allow for cultural diversity in the diagnosis and treatment of depression. However, as I hope I have demonstrated in my writing, no two people in a therapeutic setting will ever be exactly the same. So how useful is it to continually focus on ethnic differences when they are just one drop in the ocean of diversity? Perhaps instead we need a shift in the dominant discourses surrounding ethnic differences in mental health? The real challenge I think we face is understanding how the identity of the individual contributes to the diagnosis and treatment of depression.

Guilty Betrayal in Arthur Koestlers Darkness at Noon Essay -- Europea

Guilty Betrayal in Arthur Koestler's Darkness at Noon Arthur Koestler's Darkness at Noon depicts the fallacious logic of a totalitarian regime through the experiences of Nicolas Salmanovitch Rubashov. Rubashov had fought in the revolution and was once part of the Central Committee of the Party, but he is arrested on charges of instigating attempted assassinations of No. 1, and for taking part in oppositional, counter-revolutionary activities, and is sent to a Soviet prison. Rubashov, in his idle pacing throughout his cell, recollects his past with the Party. He begins to feel impulses of guilt, most especially in those moments he was required to expel devoted revolutionaries from the Party, sending them to their death. These subconscious feelings of guilt are oftentimes represented physically in the form of toothache or through day- or night-dreams. As his thought progresses with the novel, he begins to recognize his guilt, which emerges alongside his individuality. It remains in his subconscious, and it is not until Rubashov abs olves himself through silent resignation at his public trial that he is fully conscious of guilt. By joining the Party, Rubashov allows himself to forget the questions of human nature and of his individuality. The nature of his guilt lies in this betrayal of his individuality. Early in the novel, Rubashov experiences a chronic toothache that he later associates with recollections of past events or people for which he now feels guilty, although he did not feel so at the time. The toothache appears upon recollection of Richard's and Little Loewy's expulsion from the Party, and of Rubashov's inaction towards the expulsion and execution of Arlova. It occurs on "the right eye-tooth which [is... ...duality and still be a devoted Party member. Rubashov is guilty for the expulsion of many innocent Party members, but ultimately for the sacrifice of the knowledge of his identity for the Party system. Upon his arrest, he has felt his subconscious attempt to reach him through toothache and shivers. These physical manifestations of his guilt allow him to become fully conscious of his guilt and, consequently, the fallibility of the Party's beliefs and methods. Rubashov is also subconsciously aware that he must pay for his guilt. There is no method for redemption, save for dying in silence. Rubashov's resignation to silence during his public trial is his expression of individuality, his complete divergence from Party principle in the suppression of the individual. Works Cited: Koestler, Arthur. Darkness at Noon . New York: New American Library, 1948.

Product Mix and New Product Development Strategies Essay

The Coca-Cola versus Pepsi competition is perhaps the most well known rivalry in the history of marketing. Coke has long enjoyed the home field advantage, having become entrenched as the most popular and identifiable cola throughout the world. Although it has carved itself a substantial portion of the market, Pepsi has struggled to match the sales revenue of Coca-Cola; until recently. Although Pepsi has never come close to equaling Coke cola market share, they have become more aggressive and adept than Coke in cornering the non-carbonated beverage market. It is in this market that Pepsi is seeking to obtain a sustainable competitive advantage over Coke. It their quest to acquire and develop new products, will the use of the PTSTP method help Pepsi develop new products in order to obtain a sustainable competitive advantage?A product is defined in three levels; core, actual, and augmented. The core of the product is the benefit it offers the consumer. For the example of colas, it could be refreshment, energy (sugar and caffeine), alertness, or just pleasure. The soda itself is the actual product. The augmented product for a cola could be the recognition and status gains perceived by drinking that particular brand. Or it could even be the weight loss from sticking to diet colas. For the development of new products, we first need to identify what consists of a new product. There are six categories of new products:1.New-To-The-World. This is a product that has no like product offered elsewhere. For example, when the first personal computer was offered to the public, this would be a new product. 2.New Product Lines. This is when similar products exist, possibly even under the same brand, but a new line of the product offers some tangible difference to those products already offered. For example, offering diet colas in addition to regular colas under the same brand. 3.Product Line Additions. This is the addition of a product that is directly related to one offered. For example, offering Vanilla Coke for sale alongside Coke. 4.Improvements/Revisions. This is a product which has already been offered,  but some change or revision has been made to the products properties. For example: New Coke, or anything labeled â€Å"new and improved.†5.Repositioned Products. The same product offered in a new market or directed towards a new target market. For example Pepsi bringing Sabritas chips into the US to target the Hispanic market. 6.Lower-Priced Products. This is simply reducing the price of an existing product to stimulate sales. New products affect the product mix of a company. Product mix is generally defined as â€Å"the total composite of products offered by a particular organization.† The product mix includes both individual products and product lines. A product line is a group of products which are closely related by function, customer base, distribution, or price range. To use Pepsi as an example, Pepsi’s product mix includes beverages and potato chips. The beverage product line consists of carbonated, non-carbonated, and water. Pepsi, Gatorade, and Aquafina all are individual products. PTSTP is a mnemonic for the five step process underlying Target Marketing and Positioning. The five steps are as follows:1.Identify competitive Products. 2.Define the Target market. 3.Determine the basis for Segmentation. 4.Determine if any Target markets are underserved. 5.Develop a Product for the underserved market. By using this method, a company can identify a gap in a particular market segment. This gap may be present because there is no product to fill it, or because the current product is reaching the end of its life-cycle, thus creating an opportunity for new growth. To answer the previous question, we will contrast the PTSTP method to Coca-Cola and Pespi’s development of the non-carbonated beverage market. Pepsi has continually struggled to match Coke’s market share in colas and other carbonated beverages. Coke enjoys a 44% slice of the market compared to Pepsi’s 32%. During their 108 year rivalry, Pepsi has never come close to selling as much soda as Coke. Much of this is due to Coke’s brand recognition. Although in 2006 Pepsi, for the first time, beat Coke in beverages sold. This was due to Pepsi’s embracement of the non-carbonated beverage market, where it led the market with a 24% share over Coke’s 16%. Pepsi was able to recognize and take advantage of the growing non-carbonized market much earlier than Coca-Cola. Although cola sales have recently stagnated to less than 1% growth, non-carbonated beverages grew 8% in 2004. Much of the failure of Coke to expand into this market can be traced back to the stubbornness of Coke executives to expand beyond the soda market. Coke had an opportunity to acquire Quaker Oats in the 1990’s, but passed on the opportunity. Instead, Pepsi acquired Quaker Oats in 2001. Among Quaker Oats assets were Gatorade and Snapple, both leaders in their markets. Although these product lines were already established, they represented new products to Pepsi, as they represented Pepsi’s introduction into the non-carbonated beverage market. As a result, Pepsi owns a commanding lead in the sports drink market, with Gatorade holding an 80% share to Coke’s Powerade at 15%. Until 2001, Coca-Cola had been reluctant to embrace new products. They were not willing to extend their company and take the chance in the non-carbonated market, until they saw the success Pepsi was having. In addition to passing up on Quaker Oats, Coke lost a bidding war for the Sobe line of enhanced juices, and their bid for the Planet Java line of coffees and teas was not embraced by their independent bottlers. However, since 2000 Coke has been actively seeking new products in this market, including the acquisition of the successful Minute Maid juice line. The difference in philosophy has made the difference for Pepsi. In fact, losing the cola wars may have been the best thing for Pepsi. This forced Pepsi to look outside the soda realm in order to increase profits. As Pepsi’s CEO, Steven Reinemund believes that his company’s growth is due to their constant quest for change, that â€Å"Innovation is what consumers are  looking for, particularly in the small, routine things of their life.† Pepsi’s willingness to embrace new product lines has given them the edge over Coke for the first time in history. Their offerings of Quaker Oats’ beverages, Sobe, and Aquafina have all been firsts for a soda company. As a result, they have gained the brand recognition over Coke’s subsequent offerings, leading to an increased market share. In order for Pepsi to maintain their competitive advantage over Coke, they need to follow the advice of Reinemund, by remaining innovative. PTSTP can help them sustain this advantage. By identifying potential markets, and developing products for these markets, they can continue to capture new market shares. The beverage market is saturated with options for the consumer, with new products appearing everyday. Many of these products are variations on existing products. For example, energy drinks have become very popular in the past few years. As a result the market has become flooded with options. It will become increasingly difficult to introduce new products in this category. By using PTSTP, Pepsi can identify a new niche in this market, or a different market to exploit. Using the energy drinks as an example, the competitors range from Fuze, Red Bull, and many others. By defining the target market, they can identify that the same demographics both tend to buy sodas and energy drinks. Pepsi can then segment the market into young males (18-30). They then determine that the target market of combined soda energy drinks is underserved. They then develop a product to serve this market. Thus Pepsi Max is born. By using PTSTP, Pepsi has created a new product in soda energy drinks, Pepsi Max. It is this type of creativity and innovation that is embraced by Reinemund, and will serve to keep Pepsi with a sustained competitive advantage over Coke. Only by using a method such as PTSTP, can underserved markets be identified and exploited. References 1. http://business.enotes.com/business-finance-encyclopedia/product-mix2. Brady, Diane (). A Thousand and One Noshes: How Pepsi deftly adapts products to changing consumer tastes. Business Week. 14 Jun 20043. Foust, Dean. Things Go Better With †¦ Juice: Coke’s new CEO will have to move quickly to catch up in noncarbonated drinks. Business Week. 17 May 20044. Brooker, Katrina. How Pepsi outgunned Coke: Losing the cola wars was the best thing that ever happened to Pepsi — while Coke was celebrating, PEP took over a much larger market. FORTUNE 1 Feb 2006http://money.cnn.com/2006/02/01/news/companies/pepsi_fortune/index.htm5. http://www.marketingteacher.com/Lessons/lesson_three_levels_of_a_product.htm