Communication Barrier

Communication Barrier between Local and International Student in Malaysia. The increasing number of international student in Malaysia brings many benefits to the country as well to the local students. However, there are many problems that faced by these international students in this country. One of them is communication barrier between the local students. Communication barrier always bring difficulty to them when interacting with the local students in the campus. This includes both verbal and non-verbal communication. These are the barriers:- * Limited interactionThere are limited interactions between the local and international students. The international students or the local students only communicate with each other when there are group discussions in the class or a meeting on a group assignment. They like to be with their own group of friends that are similar nationality, race and culture with them. These bring them to have less communication with the other group of students. If this thing keeps continuing then the international students cannot learn the host country culture, tradition and beliefs. They also will have less knowledge about the host country.Later on, this will bring difficulty to the international students when they enter in the work field at the host country. * Poor language The local and the international students also have problems with the language. In Malaysia, there are only two languages that are used widely not only in the university but in the whole country, which is Bahasa Malaysia and English Language. The international students or the local students only use English Language when communicating with each other because the international students don’t know the local language which is Bahasa Malaysia.The international students that not from English spoken country like students from China, Turkey, Arab and Japan, always have problem to speak in English with the local students. Some of the local students or the Malaysian studen ts also have the same problems when speaking English with the international students. These problems occur due to poor language skills. This make them to communicate non-verbally more than verbal. * Few close friends The international students in Malaysia have few close friends. They like to be friend with people that make them comfortable.They also make less new friends. This make them always think in the box and not out of the box. Most of the international students don’t like to be friend with the local students. Same goes with the local students. These things occur due to some thought of similarity between them. They make these things more important than the other rest like to make friends to learn new thing and to gain knowledge. * Slang Slang is colloquial language, where words mean something other than their formal meanings, or where words are used that is not actual English words.Sometimes slang or vernacular words will become dictionary words through use and custom. Slang also one of the biggest communication barriers between the local and international students. The international student’s slang or accent also brings difficulty to the local students when talking with them. They hard to understand what the international students try to tell them and sometimes, these will also bring misunderstanding between them. Due to these problems, they communicate less with each other. Reference 1.Hasri Hassan, Zulaikha Nurain Mudzar, Lucien Low, (2013), Corporate Communication, Pearson, Kuala Lumpur. 2. http://blogs. nottingham. ac. uk/chinapolicyinstitute/2013/01/28/integration-of-chinese-internationals-students-with-the-local-community-issues-arising-from-the-sccs-community-building-forum/ 3. http://english. peopledaily. com. cn/90001/90782/90872/7233749. html 4. http://www. awej. org/? article=20 5. http://www. purdueexponent. org/campus/article_f0ea98bd-10f3-5507-b699-b85e32fb1955. html 6. http://www. ijbssnet. com/journals/Vol. _2_No. _7;_Speci al_Issue_April_2011/5. pdf

“A Child Called It” by Dave Pelzer

The book â€Å"A Child Called It† by author Dave Pelzer quickly became my favorite book for many reasons but the most important was because it taught me that sometimes people don’t appreciate the wonderful things they have in life, until it’s too late.Reading is a huge part of my everyday life and has given me many hours of enjoyment. I read to gain information, for relaxation and entertainment, like reading the daily newspaper allows me to find out what is happening around the world, in other countries and in our local area, allows me to relax and offers a few laughs.I love finding new and interesting books to read, so one day when I asked my sister for suggestions in finding a book to read, she told me to read â€Å"A Child Called ‘It’† by author, David Pelzer.I read in this book, about one of the worst cases of child abuse, ever reported in the state of California, which has been documented by the child, in this book.David Pelzer provides a very detailed outline of his terrible life after growing up as a son of an alcoholic mother and a father, who stood by and watched the abuse.The story takes a circular trip around the many years of abuse of the boy. He begins by telling us what ended the torment and pain, and continues through the pages, telling us about the haunting years that followed.In one section of the book, Pelzer speaks of the unthinkable horror his mother put him through by explaining that when he was younger, Dave and his family were considered the â€Å"perfect† family but one day his mother and father began drinking and developed problems in their relationship.Dave began experiencing the worst treatment, imaginable. His mother quickly began   treating him as a nobody or an â€Å"It†. His dad wouldn’t address the problems that reeked havoc in his life, which caused Dave to hate him.Dave’s mother did many horrible things to him that he will never forget. He was singled out fo r abuse by his mother, since he had two brothers that never received their mother’s harsh beatings and cruelty.David’s mother would starve him for weeks at a time, without giving him even a morsel of food, so he had to steal food from stores and the school, in order to survive.    One day he stole hot dogs from the school cafeteria and someone caught him. When he got home his mother made him puke it up and then eat it, again. She was so cruel that she almost went to the extent of making David eat his baby brother’s feces.Another incident occurred   when David was cleaning the kitchen floor for his mother. She suddenly stormed into the kitchen and started yelling at him, â€Å"You’ve made my life a living hell! Now it’s time I show you what hell is like!†She took him by the arm, turned on the gas stove, and burned the flesh right off his arm. She proceeded to make him take off his clothes and lay on top of the flames.She tortured him for no other reason, other than her own sick pleasure. She also made him drink ammonia, wear tattered clothes and sleep in the garage. She even had the nerve to stab David and never took him in for medical help.Not only was David banned from the family, but from the public, as well. Pelzer was granted only one change of clothing a year, which he wore daily, to school.He was unable to bathe and was often viewed   as a disgrace, by neighbors and school officials. This touching story ended with David reciting the â€Å"Lord’s Prayer† and praying for God to save him from his life of abuse.Finally, a caring policeman shows up and frees David from the prison he has endured for too many years.The sequel to this book is called â€Å"The Lost Boy.† This story offers detailed claims of the horrible abuse that David’s mother had inflicted upon him but nothing can help you to understand why someone could cause such terrible pain for their own child, especially when the other two brothers are treated with respect.We learn in this book about the struggle for survival, after David’s mother tries to turn everyone against him. She became successful at convincing everyone around David and since they believe that she is a good mother, no one believes him when he cries for help and each attempt at receiving help, he fails.It’s really sad to know that David’s dad never tried to help him and to watch as his dad is terribly controlled by the woman, who abuses him.This intense child abuse seems unbearable, especially for a young child. David’s story about survival, brings a queasy feeling to one’s stomach and stabs at the heart. Pelzer dedicated his life to pleasing his mother, fearing death that come to him, at any moment. His never ending hope kept gave him just enough strength to recover from the last painful fight.Pelzer had lived in, what looked like from the outside world, an average American family, who took vacation s, ate dinner as a family and spent the holidays together, with the one exception of `The Boy` that was continually beaten down, both mentally and physically.

Managing Profitable Customer Relationships

Hardly Davidson has massive engines for motorbikes and has been known to have a friendly relationship with its customers. The company sponsors different motorbike events during which they are able to display modern bikes and their accessories. The brand name has a great reputation and has brought together riders and have welfare benefits for its members. The company has enhanced their rapport through regular communication through the internet. The riders have formed an international network attachment as well as local dealership to enhance their services. The company motivates its customers or riders by giving them pinstops which identify them with the company and so doing create pride of membership. Performance related programs on mileage for those enrolled leads to an advantage in terms of priority in accessing the best accessories for one’s bike. Harley company has been accepted in different countries and its members can rent and ride in countries such as Canada, Australia and the United States. The company has built a good reputation and has a great bond with its numerous customer needs. 1.   What are the key elements of Harley-Davidson’s efforts to build relationship with its customers? The key elements in Harley-Davidson are the involvement of customers in not being just customers but also being dealers. There is customer participation in events sponsored by the company. Membership creates a sense of belonging and enhances the attachment to the company while good communication through the internet connects the company to its customers. Presence of welfare schemes such as sponsorship to events and insurance services motivates the customers. 2.   Can you think of other companies that create such strong relationships with their customers? How do they do that? NASCAR which is the National Association for Stock Car Auto Racing has created a lasting customer relationship through a careful blend of live racing events, compelling web sites with information and entertainment, ensures ample security and organizes parties, cook outs and camps with family members. This creates a friendly environment that enriches the company-to-customer relationship. The Unilever company has created a good relationship through high standards of corporate behavior towards the employees, customers and the society. It is involved in community development activities and this extension of their services to the society attracts more customers. The company has also offered voluntary counseling and testing programs in support of the community. It has also set goals to evaluates the HIV/AIDS roadmap with strategic approaches to reaching out to its customers. A follow up plan for comprehensive care and treatment is organized so that customers are convinced that the company’s objective is to render them the service and the good gesture goes along way in maintaining a good relationship. Offering of medicines at subsidized rates has led to the growth of the company and the humanitarian activities have extended to the provision of health insurance covers. 3.   How else can Harley-Davidson build or deepen its relationships with its customers? Harley Davidson can deepen its relationship by offering medical checkups for the riders before and after an event, a welfare scheme for the member’s next of kin to participate   for future customers as well as training facilities for those aspiring to be good riders. Recommendation To enhance profitable customer relationships, it is important that there is customer involvement and participation in the activities of the company. A good rapport is enhanced through welfare schemes for members to cater for important services such as medical and insurance covers. Good communication between the two parties gives feedbacks and this helps the company in providing the best quality of service. Reference: Paul G.R. Up Close and Personal?: Customer relationship. Don Peppers, Martha Rogers. Managing Customer Relationship. Stanley A.B Customer Relationship Management   

Social Work Practice Essay Example | Topics and Well Written Essays - 1250 words

Social Work Practice - Essay Example Ethical practices on the other hand are values that offer a community organization directives for action gotten from the desired outcomes (Dolgoff, et al, 2008). Ethical practices most often are activities that pertain to clinical work with individuals. It is however important to regards ethical practices as helpful to a community organization in it struggle for social justice. Looked at carefully, there is no doubt that there exist an ethical dilemma regarding the silence among the workers on the best intervention to solve the escalating problem of homeless in the community. In this regard, I am referring to the community indifference on the problem of homeless, a situation that should not persist in the first place because there is already a community organization operating in the area. It is particularly disgusting that community members have decided to look the other way to a community problem instead of confronting it head-on as is supposed to be the case. In looking at this ethical dilemma, I have decided to first identify the ethical principle defining the dilemma I am faced with using the Loewenberg and Dolgoff’s ethical principle screen. In doing so, I have identified two ethical principles in the Loewenberg and Dolgoff’s ethical principle screen namely; ethical principles of the protection of life, equality and inequality, and a dec ent quality of life. From the case there is no doubt that a problem of exclusivity exists in this organization. This exclusivity has taken the shape of racism that in all intent and purposes in dangerous to the organization, especially bearing in mind that this organization serves people of different races. There is no doubt that I am new in the organization and not even fully and permanently employed and therefore my ideas and suggestion might be b e taken with a degree of contempt. It is also not in doubt that the workforce as is currently constituted is unlikely to appreciate and accommodate some

Did Prohibition Succeed Research Paper Example | Topics and Well Written Essays - 2000 words

Did Prohibition Succeed - Research Paper Example This was shown already in the states that were already dry – some of the states issued permits for people to bring alcohol from one state to another, and there were 34,000 of these permits issued in Washington state, a state where there was, at the time, only 44,000 registered voters. Before the ratification of the amendment, Michigan was a dry state, and Ohio was a wet one, and the highway between Michigan and Ohio was so convenient for the smugglers that the highway became known as the â€Å"Avenue de Booze† (Okrent, 2010, p. 102). This meant that there would be an underground avenue for people getting booze, long after Prohibition was enacted, and this is exactly what happened. Part of the problem is that, as Sinclair Lewis brilliantly noted, during this time there was an overall change in the American landscape. The people were coming from more of a prairie lifestyle into one that was becoming more and more industrialized, and, with this came both disillusionment an d rebellion (Lewis, 1922, p. 56). This was the overall wrong time to try to outlaw booze. The generation had just came from war, or at least seen it or known people who have been in it, and they were coming into a period of increasing change. Alcohol becoming forbidden would be a way to rebel, if the people of the twenties engaged in it, while, at the same time, alcohol could be seen as a way to soothe the nerves of the people who are undergoing this powerful change. So, in this way, Prohibition could not have come at a worse time. In the years that followed the ratification and enaction of the 18th Amendment, there was considerable evidence that the Prohibition Amendment was nothing but a sham. For instance, in February of 1920, which was the year that the Prohibition Amendment actually took effect, Leo J. Grove seized three barrels of homemade wine from the basement of an Italian grocery store, and this was only one of many examples of people who still supplied alcohol to the mass es (Okrent, 2010, p. 120). In that first year, there were 900,000 cases of liquor that came from Canada and made its way to the United States – and this was just in the first seven months of 1920, which was considered to be a â€Å"dry-but-wet year† (Okrent, 2010, p. 124). In New England, the alcohol came from ships that were anchored beyond the three mile limit, and these were ferried to shore. These were the more professional endeavors, but there were also countless moonshiners that would make the alcohol, some of them in their bathtubs, and would distribute them (Okrent, 2010, p. 125). Worse, Prohibition led to crime on a wide scale. The first alliances were between the gangsters, such as Capone, Torrio and Lansky, and these alliances were the first signs of a crime syndicate that had gone across the United States. Moreover, these mobsters had respectability. They took part in anti-Ku Klux Klan campaigns, and they were considered to be glamorous. Longy Zwillman was dating actress Jean Harlow, and there were many mobsters who owned popular nightclubs. Another gangster had an affair with actress Mae West. Al Capone was involved in charities for the poor (Okrent, 2010, p. 274). The reason why there was so much crime, and that these mobsters and others were seen as glamorous was because there was so much money in selling alcohol underground. There were some annual sales of $3.6 billion nationally by 1926 –

Criminology Movie Review Example | Topics and Well Written Essays - 500 words - 1

Criminology - Movie Review Example New Year’s Eve celebration was launched by the gangs in the name of a military operation whereby each character take a specific role. For instance, Josh Howard (Davis) was to drive a garbage truck while the rest were to steal from various casinos. Sam Harmon. Charges were made on replacing the electrical transmission tower and in each casino electrical systems to give a backup are rewired. At midnight when everyone is celebrating and singing in all the casino the tower was placed down and darkness that was inevitable sets occurs. Funny enough the cashier cages containing money are opened instantly by the backup electrical systems contrary to putting on the emergency lights. In no waste of time, they moved into the cashier cages and stole the money. They removed money from bags and dump the bags in the garbage bin. Creatively they went back and joined the crowd pretending they were among them. Immediately lights were back, the thieves left the casinos. Josh drove the garbage truck and collects the bags passing through the blockade of the police with absence of people notice. Coincidentally Tony Bergdorf (Conte) who was an electrician got a heart attack and dropped dead in the middle of Las Vegas strip. This death caused a lot of concern as police wondered whether there was any connection with the robbery. Duke Santos (Romeo) gets reformed and decided to get back the casino bosses’ money for a return. In this scenario, he learns of Ocean and is connected to Foster, the son of Duke’s fiancà ©e (chase). Person contemplates about that before the return of Bergdorf’s body at mortuary. Santos talked to the robberies asking for half of the money. Nevertheless $10000 was set for the widow (Jean Willies) of the electrician and the rest hidden in the coffin. Creatively the group had planned to take the money in no return to Santos after coffin is taken to Francisco. However, the

Increasing Female Participation in XYZ Sports Club Research Paper

Increasing Female Participation in XYZ Sports Club - Research Paper Example The social system tends to relate all benefits associated with sports to men. This setting has discouraged many women from engaging in sportive activities especially in male dominated societies. However, the recent trend indicates that women are increasingly participating in sports even those that were solely preserved for men. With this new promise, the purpose of this paper is to present the barriers preventing women from participating in sports and recommend the best ways reduce them in order to increase their participation in XYZ club activities. Barriers to women participating in sports Essentially, women are barred from participating in sports due to practical barriers such as lack of enough time, money, transport, as well as personal safety, funding, and access to facilities. Women have less time for leisure than men due to the greater burden of family roles such as housework and childcare. In fact, many American women are trying to balance family and worker roles, and thus ha ve no space for leisure time (Klein, 2004). Many women argue that the lack of money is a barrier to sport activities as they earn less than men. Sport is often seen as a luxury, or reward for paid work. Although many women are paid workers, the perception that men deserve such reward is still evident. Nonetheless, poor families may be unable to afford to pay sporting attire or equipment as well as investing in cub membership. Transport is also a major problem especially for mothers with children and women living in rural areas. These individuals rely on public transport which is sometimes unsafe, inconvenient, unreliable, and expensive. Safety within the sports venues is also a barrier to women as they fear sexual harassment as well as unwanted attention. Accessibility to sports is also a practical barrier for women to engage in sports as the system prioritize male sports and women cannot access the facility at their preferred times. Women also find it difficult to engage in sports due to individual or personal barriers such as body image, lack of confidence, clothing and equipment. According to Lynn (2002) the issue of body image affects all features of the society and research indicates that women report greater dissatisfaction in their body image than men. It is also noted that women are more self-conscious when participating in sports than men. Therefore, the more self-conscious the women feel about their body image, the lower the chances of participating in sports. While some sports equipment might be quite expensive, some sports clothing are pretty revealing to the disadvantage of the body image. There is enough evidence that women have less self-confidence when compared to men (Birch, 2005, p. 245). Societal expectations are for the man to show confidence while confidence in a woman would be seen as a deviation from the normal. Finally are discouraged from sportive activities due to social and cultural barriers such as the male-dominated culture of spor t, sexual abuse and harassment, as well attitudes and prejudices about sexuality, disability, and ethnicity. Male domination in sports has been a factor that turns women off sports as it feels strange with being feminine. The same domination has made sports women to be associated with uncouthly acts such as lesbianism refraining others from certain sports. Disabled women

The Impact of using New Technology in Art Exhibitions Essay

The Impact of using New Technology in Art Exhibitions - Essay Example This is followed by a thorough analysis of the various expert viewpoints regarding several issues, such as whether online exhibition seems likely to replace traditional exhibition completely. These viewpoints are extracted from different literatures. For the artistic viewpoint, the research has used ‘Ways of Seeing’ and ‘Management and the Arts’, whereas, management books help elaborate the business viewpoint. 1. Traditional Exhibition: Scientific and technological advancement has dynamically altered the traditional exhibition industry, bringing in innovative technology into performance art, as is present in the London Design Museum. This has enhanced the ability of artistic techniques to express and generate emotion, and has also made the use of network form more efficient. Experts also write about how technological changes have affected the viewership and appreciation of the relevant art forms and their exhibitions. Technology has enabled a whole new segme nt of visitors to visit these art exhibitions and museums to appreciate the work. These audiences are those present worldwide, who can now appreciate the art by visiting online galleries of these museums (Camp, MacFadden and Mercer, 2000). Thus, the visitors are no longer limited to physical visits to the institutions. Their visits are no longer contingent on their geographical location, but simply on their passion and interest in art. Furthermore, technology has made it possible to sort out and cater to each of these virtual visitors individually, based on their educational backgrounds, ages and interests. This helps museums further achieve their goals of educating the public with the various lessons that art has to offer, and expanding their minds to further enable them to understand the depths of each piece of art. Thus, with this technological aide, museums are able to enrich the experience they provide to their visitors (Perlin 1998). Another relevant insight that the available literatures had to offer was about the â€Å"Contaminated Cultural Materials in Museum Collections† workshop that the Arizona State Museum at the University of Arizona in Tuscon held. The planning and implementation was sponsored by a NAPGRA grant, and the event took place from March 16th to 18th in 2000 (Odegaard & Sadongei, 2005). The workshop was held for representatives of the twenty one American Indian tribes in Arizona, aiming to discuss the features and quantity of chemical contamination present on tribal cultural material that the museum possesses. Following this, it aimed to explain the need for using such poisons on the materials. This was accompanied by a brief overview of the health risks, which are potentially attached with preserving and restoring a functional object in order to display to a community. Finally, the workshop aimed to circulate the clearinghouse information pertaining to medical referrals as well as toxicologists, chemical hygienists and other su ch health experts (Odegaard and Sadongei, p xi, 2005). Conclusion The workshop highlighted some important facts that need attention when museums and tribes plan to collaborate in the restoration of objects before sending them back to their place of origin. It shed light on the importance of communication in this ordeal. It is the museums responsibility to actively communicate all issue during consultations, and to keep the tribes informed during the whole process. The chances of uncovering a serious health issue of

Assignment 1 Essay Example | Topics and Well Written Essays - 250 words

Assignment 1 - Essay Example Experts predict that technology in the next 25 years will revolutionize the world to something never seen before. They predict that quantum technology will be possible such that the computers will be able to harness the power of the atom to help in performing computational tasks. The current computers are electronic and therefore they only store information in 1’s or 0’s but with this technology it will be possible to store both and this will increase processing capability (The Observer). Another prediction that is made is that our smart phones that we use today will have the power of a super computer at that time surpassing the capabilities of the servers that we have today. The phones will also have increased memory and the capability to connect to a high powered network that it will be easy for anyone to access massive kinds of information. It will also be possible to store all your information in a back-up cloud so that in case it is lost you only need to identify yourself and you have all your information (Gates). Another prediction is that I will be possible to speak to your computer such that there will be no need for a key board or a mouse, you will talk to the computer and tell it to perform a given operation with ease. It will be possible to use natural language on computers as they will be able to learn and recognize their errors and mistakes. For example the Watson system developed by IBM that interacts with humans is one such example of what to expect in the future (Marsan). It is also predicted that everything will be digitized and accessible over the internet from personal information to corporate information, to history and education. All these will be scanned and stored on the internet and they will be searchable. The content will also be personalized so that an individual will receive the article, books, music or even movies that march their interest. This storage on the internet will mark the death of certain kinds

Greenwich Park Article Example | Topics and Well Written Essays - 4000 words

Greenwich Park - Article Example This has naturally raised a controversy and objections against the events being held in the park are increasing day by day. The London Organizing Committee of the Olympic Games (LOCOG) and the public and other groups have conflicting opinions regarding this. The LOCOG maintains that the park will be left relatively undamaged and will be restored to its original condition as much as possible, while the public, environmental groups, residents of the village, visitors to the park and even certain sports bodies, raise the objection that irrevocable damage will be done to the part if those events are held there. This paper is a review of the park in its existing glory and the impact that the Olympic events will have on the park. In the process, published literature on the issue will be reviewed and a survey conducted among the students who enjoy facilities of the park. The views of the LOCOG will also be taken into consideration for understanding their standpoint. The final section will b e an opinion regarding the costs, impacts and benefits, if any, that will accrue if the events are held in Greenwich Park. The history of the park, the facilities available, and other relevant information regarding the park will also be reviewed here. History of Greenwich Park: The site on which the park is located has been inhabited right from the Roman periods and some remnants bearing testimony to this have been excavated from this site by archaeologists over a period of time. The land on which the park is situated was inherited by the then Duke of Gloucester, Humphrey in 1427. He enclosed the area with a fence and also built an observatory tower. After his death, his sister-in-law (wife of Henry VI) seized the land for herself. "Greenwich Park was popular with the Tudors. King Henry VII rebuilt the manor house to make the Palace of Placentia - or Greenwich Palace." (Greenwich Park - The Royal Gateway. 2009). Henry the VIII of England introduced deer on to this beautiful hillock overlooking the Thames River in 1515. Henry and also his two daughters were born in Greenwich Village which bore the name of Placentia at that time. Trees and flowering plants were planted in French Landscape Design during the 1600s and some of those trees still stand today. Quee n Anne had a house built in the park which is now called Queen's House. The iconic landmark of the park, namely the Royal Observatory was built under the orders of Charles II who was an avid lover of astronomy and science. It was built under the aegis of the Royal Society and was named Flamsteed House to honour England's first Royal astronomer. The building stands on the Greenwich or Prime Meridian which technically divides the earth into east and west. The park suffered some damage during the World War II, but was subsequently restored to its original glory. The whole of Greenwich along with Greenwich Park is now a World Heritage Site as designated by the United Nations. The size of this Royal Park is a little more than 180 acres. The place is an extremely popular spot with the locals, tourists, and students as it offers many facilities for sport, enjoyment, and leisure. Facilities at the park at present: The word present is used here since it is not very clear as to

Marketing Plan Sex Essay Example | Topics and Well Written Essays - 3750 words

Marketing Plan Sex - Essay Example 6.2 Profitability Statement for Three Years 18 6.3 Break Even Point 19 7.0 Controls 20 7.1 Implementation 20 7.2 Marketing Organization 20 7.3 Contingency Planning 21 Reference 22 MARKETING PLAN 1.0 Executive Summary: Aging boomers want all the comforts and privileges of growing old without giving up any of the pleasures of and peccadilloes of youth - including their Harleys, an icon of youthful rebellion. The mature population is even changing the way the products are paid for; Chicago based Chase Bank issues a Kiss Platinum Visa Credit card. And the market place that wants their estimated US $ 1 trillion disposable income purchasing power is eager to help them do so. Apart from this class of customers there are other people who are deprived of the worldly pleasures because of their physical conditions caused by obesity and weight problems. Obviously this class of consumers also have a considerable disposable income and they would not hesitate to spend money to increase the sexual pleasures that they derive by using any aids which prove worthy of the price. Considering these rare psychological phenomena Cupid's...Obviously this class of consumers also have a considerable disposable income and the y would not hesitate to spend money to increase the sexual pleasures that they derive by using any aids which prove worthy of the price. Considering these rare psychological phenomena Cupid's Arrow Inc have come out with their new product 'Easy Rider' which increases the sexual pleasure by an aid which adjusts the physical position of the female partner during the sexual act. This product is complementary to other personal care products that are being dealt with by Cupid's Arrow Inc. and since the company is already having its network of distributors it would well within the control of the company to introduce this product into the market in a short span of time and achieve the targeted market share of 20 percent in the estimated $ 1 billion of the sex aid products market share in the country of United States in the first year of its introduction. The company expects to achieve a turnover of $ 50 million by selling close to 1 million products to the niche market. Cupid's Arrow Inc. is known for its health care products of a world class and has earned the continued support of the elite class consumers for their wide range of products covering the aristocratic lifestyle of the consumers.

Looking for Alibrandi by Melina Marchetta Josie Essay Example for Free

Looking for Alibrandi by Melina Marchetta Josie Essay In this novel (Looking for Alibrandi) Josephine Alibrandi is seen as an illegitimate 17-year-old girl who is self-centred, ignorant and sensitive about her illegitimacy and her reputation and what people say about her behind her back. She is also described as confused because she isnt sure where she stands in life, whether she is an Australian or and Italian, and is paranoid in thinking because she is of Italian background she is constantly being victimised and society wouldnt see her for who she is as an individual instead as an Italian or an Australian. During her final year in High School, many events take place in her life that changed her attitudes towards both her self and others, those events ranged from the most life changing events like the discovering of Nonna Katias secret, the reunification of herself and her long lost biological father and the tragic suicide of her best friend John Barton to the most least important events like the incident involving one of the beautiful people Carly Bishop. Firstly, the sudden and unexpected suicide of Josephines best friend John Barton turns her life around, The day John died was a nose-dive day and I hit the ground so hard that I feel as if every part of me hurts. I remembered when we spoke about our emancipation. The horror is that he had to die to achieve his. The beauty is that Im living to achieve mine. John Barton was one of the closest people to Josephine and they shared many things in common, she later realises how lucky she is to have to choose her own path and destiny and that some people like John Barton had their life planned out by others for them and they had no freedom over their future. Although Josephine is portrayed as a confused teenager who doesnt who she really is and where she stands in society, her emancipation changes all that, even though her emancipation didnt happen like the way she expected it to Id wake up one morning and see the light. Feel liberated from everything. Maybe one particular incident would see me through it. Her emancipation began after she believed she was wrong on what she did on St. Marthas day and she had put little kids in danger, as a result of that she became more accepting in the fact that you are not always right, and just because she wore a badge saying she was school captain doesnt make her one, its whats inside her that makes her a leader. Furthermore, Josephines emancipation-in my opinion- was the main reason for her change in maturity and personality, because after she realises she is emancipated she begins to know who she really is and where she stands in life asks me what nationality I am, Ill look at them and say Im an Australian with Italian blood flowing rapidly through my veins. Ill say that with pride, because its pride that I feel. This proves that she is proud in being an Australian with an Italian heritage. Additionally, Josephine overcomes her nature in being paranoid when it comes to racism and multiculturalism, and how she is always being victimised by society because of her upbringing, her incident with Carly Bishop makes her realise that not everyone understands multiculturalism, Im not sure whether everyone in this country will ever understand multiculturalism and that saddens me, because its as much part of Australian life as football and meat-pies. Her relationship with Jacob Coote teaches her that not everyone has a problem with her been an Italian and that it is only a small minority of people who are racist, and she learns that its not because she is Italian that she and Jacob are separated. In conclusion, Josephine makes major changes in her life, which were somehow provoked by inevitable incidences, she learns to accept the fact that no matter what happens people wont stop whispering behind her back If I lived by the rules and never committed a sin, people would still talk. She learns what responsibilities really is about and learns to appreciate and cherish every minute of her life and to not take life for granted.

Effective Leadership: Implementing change

Effective Leadership: Implementing change In todays volatile economy landscape, changes are inevitable and necessary. Continuous organisational developments and restructuring are vital for survival and growth. Therefore, it is important to identify growth opportunities in order to ensure the organisations sustainability and at the same time overcoming their weaknesses (Cranfield University School of Management, 2010). However, organisational change generates resistance in employees, making it challenging for successful implementation. Moreover as organisation expand, the challenges of implementing change will be greater due to diverse environment. Leaders can lead/motivate employees towards the achievement of goals in time of change. They process the quality traits which create vision and direction to motivate employees to strive harder towards goals. Also, they can facilitate employees in overcoming challenges and resistance induced by change. Leaders also have power to communicate, influence and negotiate employees away from the harmful cashes of conflicts (Robbins Judge, 2008). The objective of this report is to determine how the modern day organisation in this research can make use of effective leadership to implement and achieve successful change. It will provide more insights on how leaders can identify factors that bring about change. Discussion will be carried out on how to diagnose change factors and identify threats/opportunities. Next, the report sets to determine the impact of communication styles of the leaders on organisational cultural values. Communication plays an important role in the change process as it helps employees to see the need for change. It also highlights the importance of the affected parties role in the whole change process. The report will also examine suitable leadership style which will help with transformational change. Effective leadership translates to effective communication and overcoming resistance. Furthermore, leadership is crucial to identify, lead and manage change. Lastly, this report will set to understand how leaders overcome employees resistance within the organisation. It is of paramount importance for leaders to implement appropriate solutions in order to minimize resistance and maintain sustainability of new change. BACKGROUND OF ORGANISATION The organisation in this research is an Indonesian IT firm specialising in the importing/exporting of self-manufactured laptops. The Singapore regional office was established four years ago and has staff strength of twenty five direct employees. It has a local regional manager in-charge of running Singapores daily routine operations. Since its establishment, the regional office has been experiencing deficits in their income statements. The organisation emphasizes on a tall organisational structure, where top-down hierarchical authority is being practised. Decision-making is made by the head office in Indonesia without any effective communication with the regional office. Quarterly review meetings are held with regional manager to only report on business performance that the regional office is currently experiencing. Owing to a lack of demand for IT peripherals due to the worldwide economic meltdown in 2009, the regional office had recently carried out a retrenchment exercise as a cost-cutting measurement. Prior to the recent downsizing exercise, each of the thirteen departments was led by a supervisor. Each employee is expected to keep to his/her individual job scope and is held accountable for all his/her actions. Strict protocols for individuals are laid out and upward interactions are usually not encouraged. The decision for the recent exercise came straight from the head office without any consultation with the regional manager. The retrenchment announcement was made through email and did not state any future plans for the remaining employees. After the downsizing exercise, the remaining employees have low morale, little sense of pride in their work and are alienated from the management team. Employee absenteeism and turnover rate has been increasing. This change has lead to further deterioration of productivity and quality of the products that are offered by the regional office. RESEARCH METHODOLOGY 3.1 Sampling Schedule In order to define situation concisely and to gather comprehensive information on objectives for the study, the research design methods of interview and personal observation is carried out for this case study. Before primary research is conducted, a group of respondents from regional office is selected for an interview to obtain their opinions. For this selection, non-probability sampling (Quota Sampling) is carried out. The sample audiences (quota) are to be made up of potential leaders of the regional office. They have direct and regular interaction with head office. They are someone of a seniority level, with leadership capabilities and have the power to influence subordinates. The sample audiences are identified to be the regional manager (whom is accountable for the operations of regional office) and the human resource officer (who is responsible for the linking of employees-related policies and organisational strategies). For personal observation, it will be done by researcher of this study in her course of work as a regional sales executive (In charge of generating sales revenue). 3.2 Methods of Gathering Data (*There is limitation of the research design as it all measures information entirely from the regional offices prespective. This might result in possible biasness/prejudices from common method variance. Primary and secondary research time-frame is in Appendix B) 3.2.1 Observation Observation is done by researcher to obtain informal visual assessment of the regional office. Events associated with the objectives are monitored, accessed and recorded. Structured observations are carried out in her course of work for the visual assessment of the organisation as a whole so that the behavior is carefully documented to ensure its validity/reliability. 3.2.2 Interview For this study, direct interview is more efficient and accurate due to small staff strength of only twenty-five. An interview study is held in order of the initial development of interview questions, the conducting of interviews, followed by data analysis. Two identified interviewees whom have interactions with the head office would be interviewed. The interviews (Appendix A) are carried out in the research direction to comprehend actual work practices, procedures, structure and embedded problem/issues faced by the organisation. 3.3 Secondary Data In order to provide in depth assessment, there is also the collection of secondary data. Besides using the online search engines for obtaining information on objectives and findings; books and journal databases (existing articles on literature review and case studies) are the main sources of references. Frameworks obtained are verified using different sources in order to validate the research findings without subjecting them to any form of prejudices. The results from the interviews and personal observation are analyzed with comparisons to secondary data. 4.0 LEADERSHIP AND CHANGE 4.1 External Macro Environment As head office is unfamiliar with Singapores working environment, leaders do not have proper business strategic plan and this would bring about disastrous consequences. Decision making are based on day-to-day responses by the head office. They have no sense of urgency to develop a long term strategic planning as they lack an external consultative opinion on how to operate the business. They also do not have good leadership skills to develop effective strategies as they had only focused on the situations at-present and eventually lost sight of main objectives. Perhaps this could be due to the differences in the cultures, where Singaporeans being highly efficiency is a stark contrast with the more laid-back mindset that most Indonesians possess. The need for change encompasses within all organisations in order to cope with the rapid environmental influences. The business environment is defined as a concept whereby external forces play a major role in the successes/failures of any organisation. By paying attention to the wider environment, leaders can identify threats/opportunities to ensure effective planning and implementation of change (Brooks Weatherston, 2000; Griffin Ebert, 2006). 4.2 PEST Analysis Hayes (2007) and Robbins Judge (2008) agree that PEST analysis will allow leaders to examine the external macro environment in which a business operates and search for evidences of change. Understanding the impact and situation of external forces would help identify factors that could possibly bring about change within the organisation. Political Griffin Ebert (2006) and Hayes (2007) concur that political change will pose threats or create opportunities for any organisation. It has a huge influence upon the regulation of businesses and the possible spending power of consumers. It is important for organisations which are exposed to international risks as the political stability of different countries will affect operations and ultimately, revenues. It consists of elements like regulations set by the government on business practices, acceptable business conducts within an economy, environmental management legislations, labour law, international trade regulations, tariffs and political stability. Economic Economic factors refer to the condition of the trading state in which the business operates in. It includes exchange rates, money supply, changing consumption patterns and power and trade cycles. All these factors will impact the operation and decision making of an organisation. For example, in an economy in which the organisation is in is experiencing economic growth. The organisation would expand leading to change and leaders must establish control during the transition period. Leaders must develop a new vision, direction, new plan and to allocate resources properly to deal with the change (Hayes, 2007). Socio-Cultural Socio-cultural factor consists of having the elements of customs, moral values and demographics of the society where the organisation operates in. It affects business ethics and operations across countries so leaders must be mindful of the different customer preferences within national boundaries. For example, MacDonalds do not sell pork items in its menu in Singapore due to the differences in religious practices in the multi-racial environment; whereas in Thailand this acceptable. Change in employees attitude towards education, work and leisure which will impact on labour force and consumption demand. Leaders should produce a working environment that is conductive enough to motivate them and improve efficiency (Hayes, 2007; Griffin Ebert, 2006). Technological Technology is defines as innovations applied into society and organisations to carry out tasks. Some examples are level of investment in Research and Development (RD), availability of new materials and new production process. Technology is constantly changing and hence staying ahead of competitors has been increasingly difficult. Organisation must have the latest equipment, processes and resources to deal with technology change. Leaders must make sure that organisational structure, vision and resources align with technological aspect. Leaders must ensure that sufficient funds are allocated on RD for better technology to improve competitiveness and gain competitive advantage (Griffin Ebert, 2006; Hayes, 2007). 4.3 Findings: Implication of PEST and SWOT Analysis The interview findings (Appendix C) show that the organisation adopts a top down approach management style by the head office in Indonesia. PEST analysis is recommended so leaders in Indonesia will be able to improve on its decision-making process as it allows them to assess Singapores market potential, situation and business development. It encourages proactive thinking and allows them to plan ahead. With the analysis, leaders will know their present position, environment and how they can develop in the future. As they do not understand the impact and situation of external factors; they will need PEST to understand Singapores regulations, labor market, economy, customers, competition and technology. The analysis at external level helps to identify opportunities and threats of the external environment. With PEST, there will be detailed preparation and formulation of strategic plans, good leadership skills can be deployed to anticipate change and align businesss vision. The regional office will have better decision making process, productivity, competitive advantage and sense of belonging in employees. An example of the PEST analysis of the organisation is as follows: Singapores Regional Office -PEST Analysis * Data adapted from Morrisons website (2009) External Environment Factors Potential Impact: (+) / (-) Relative Importance Political Strict Government Legislation in Singapore High Opportunity Critical Labour Law (Singapore) Medium Opportunity Critical Political Instabilities in Indonesia High Threat Critical Economic Economic Downturn High Threat Critical Decrease in Consumers Demand and Investments High Threat Critical Stable Money supply Medium Opportunity Critical Social Demographic Trends Low Opportunity Unimportant Consumers Change in Preference and Attitudes High Threat Critical Attitudes towards Work and Employment High Threat Critical Technological Technology Revolution and Development High Opportunity Critical R D High Opportunity Critical New Production Processes/Ideas/Innovation High Opportunity Critical 5.0 LEADERSHIP AND COMMUNICATION 5.1 Communication Barriers The lack of communication, especially in terms of feedback from employees whom are familiar with the local demands of customers, coupled with stringent cost cutting measures could said to have contributed to poor sales performance. Many consumers are unaware of products that the regional office is offering due to lack of budget in generating brand awareness. Comparing to the bigger players whom have higher levels of economies of scale, it would definitely lose out in terms of its revenues. The regional office does not hold any weekly meeting within departments and there are no consultative approaches. Head offices quarterly meetings are only held with regional manager to obtain report solely on its current business performances. There are no established channels to voice employees feedback to the head office and it often results in a lack of information for proper accomplishment of tasks. Without proper communication structure, there is no room for improvement and employees will commit the same mistakes repeatedly. This would also mean that the head office would be unfamiliar with Singapores working environment, which would result in ineffective communications amongst the employees. Robbins Judge (2008) stated that communication is the life support for any organisation and it plays a vital role in the change process. Communication links people who believe in a common cause and unites them with a common vision to achieve goal congruence for the organisation. 5.2 Styles of Communication 5.2.1 Downward and Upward Communication Leaders would engage in top-down communication to disseminate information/goals, inform job procedures and highlight problems (Robbins Judge, 2008). Gilley et al. (2009) argued that in times of change, leaders must provide employees with abundant and value-added information with regards to change. Leaders must give justifications for rationale for change and also address employees concerns. Well-developed rationalizations are more likely to be accepted as employees acceptance and participation depend on their perception of personal benefits associated with the change. Hence, proper explanation and feedback is important for leaders to work on in areas of change to increase employees acceptance. Upward communication is used by employees to provide feedback, inform progress and issues towards goals to leaders. It is important for leaders to know about how employees feel and to allow for opportunities for growth and improvement. Upward communication has its limitation whereby leaders are overwhelmed and distracted. Employees morale would be affected as it would be time-consuming and demoralizing if it is difficult to get their leaders attention (Robbins Judge, 2008). Hayes (2007) exclaims that without proper upward/downward communication, it will lead to organisational silence which is a major barrier to change. One illustration within the cited organisation Due to Indonesias culture, leaders like to be respected and will disregard negative feedback from subordinates as a form of attack on their credibility. A culture might be cultivated whereby employees might be afraid to voice out the truth to their leaders. It is a double-edged sword when employees do not highlight issues to leaders and leaders will find it tough to get employees to accept change. In times of change, leaders must acquire a diverse set of effective communication techniques to convince employees to embrace a new breakthrough (Robbins Judge, 2008). In contrast, leadership ambivalence reduces acceptance to change and increases resistance. Communications should be regular, motivating and yet achievable. Unfulfilled vision will weaken leadership credibility leading to employees feeling a sense of injustice. Gilley et al. (2009) explain that employees whom experienced unjust treatment would be resentful towards their superiors, thus destroying commitment. Being honest and fair when things go wrong enables employees to accept an undesirable outcome. Therefore, there is a need for realistic and truthful communication that includes communicating negative aspects of change implementations when necessary. 5.2.2 Communication Strategy In every change process, communication plays a big part for leaders to ensure a smooth transition. There are five basic communication strategies (Hayes, 2007): Spray and Pray Showing all the information and hope others can understand and share the vision. The effectiveness is low as it depends on employees perspective of what is important. One major drawback is that the employees would be overloaded, thus increasing resistance. Tell and Sell Leaders would only communicate the core issues that relate to the change and pushes the idea for acceptance. This strategy is a one-way-communication process without any channels for meaningful feedbacks to express concern. Employees will tend to feel uncommitted as little input is required from them. Underscore and explore Similar to the Tell and Sell, but the sender listens to the receivers feedback to prevent misunderstanding. This is a very effective communication method as leaders would listens to employees concern to clear embedded doubts/queries. Identify and reply This is a reactive approach as leaders will listen and respond to the employees concerns which would guide employees out of complexity. One short-coming is that employees might not be aware of the critical issues currently hence, it might be time-consuming. Withhold and uphold Most of the information are withheld and employees are unaware of the real situation. Leaders who adopt this strategy are power-oriented and think that employees are not capable enough to handle core issues. This strategy will lead to dissatisfaction and mistrust amongst employees. Communication can be an effective tool in shaping organisational cultural value in motivating employees, providing feedback and reinforcement during the change. This would foster an environment with better decision making process to deal with obstacles (Gilley et al., 2009). 5.3 Findings: Implication towards Effective Communication Base on the interview findings (Appendix C), the organisation adopts the Withhold and uphold strategy to deal with the downsizing exercise. As leaders in head office are power-oriented due to Indonesias culture, they make decisions without consultation with regional office. Subordinates are expected to carry out requests of the retrenchment in exacting detail. As there are no justifications for the change and unable to express concern, employees are feeling resentful and thus causing the high turnover. There is also lack of proper downward/upward communication between the two offices. It leads to the improper sharing of information which results in inefficiency. One recent incident that happened that illustrates this effectively. The Head office had instructed the dealers to return an outstanding consignment of laptops and they had made arrangements to ship it back to Indonesia. However, this message was not communicated to the regional sales executive. She was unaware of this agreed communication, continued to send e-mails, reminding the dealers about the outstanding consignment. Such miscommunications inevitably tarnish the organisations reputation as the dealer was very unhappy and spread this among other dealers. She was made responsible for this miscommunication and feedbacks by her were rebuked. As remaining colleagues felt unjust for the sales executive, the miscommunication drove conflict between head office further and aggravated the misunderstandings and hostilities. In t he long run, with only top down communication and no feedback, it will lead to organisational silent with disastrous consequences. As the main problem lies with the internal communication of the organisation, leaders needs to resolve the problem by setting up basic structures to promote effective communications. For the head office to improve relationships with employees, internal communications must consist of the personal touch. Electronic communications cannot be a substitute for personal interactions. Going forward after the retrenchment, leaders should convey messages personally to their employees as this allow opportunities to clarify complex or sensitive issues. Leaders must foster an open environment, using underscore and explore strategy which allows feedback as communication is a two-way street in any change process. Leaders must have an open-mind to be more receptive to new ideas from employees. Regional manager should hold weekly meetings within departments to gather information and feedbacks. It would help employees to understand and follow up with the outstanding issues and for the managers to establish their authority. Constructive feedback from employees would help to identify problems which help the organisation to improve. By keeping employees informed and involved with the implementation of change programs; it would help increase the commitment levels and increase productivity. 6.0 STYLES OF LEADERSHIP 6.1 Leadership Role in Change Process The organisational structure emphasizes on top-down hierarchy authority and major decisions are made by the head office. The top-down leadership approach and strictly-defined job scopes reduces the employees into becoming merely cogs of the machines, where they would merely perform the bare minimum within their stated job scopes, with minimal dedication to what they do. As such, everyone will only specialize in what they are doing, without a clear picture of the main business objectives, which impedes innovation and quality improvements. Weak leadership is also shown by the surprise retrenchment exercise, which caught many employees in the regional office off-guard. Without proper leadership to establish/lead new direction after the retrenchment, it eventually might be a possible factor that would lead to the downfall to the organisation. Kotter (Senior Fleming, 2006) emphasise that in all change process, effective leadership is needed to establish direction (develop vision/strategy), align members (communication to gain cooperation/acceptance), motivate and inspire (leading members to overcome various barriers) and overcoming change. 6.2 Transactional Leadership Robbins Judge (2008) indicated that transactional leadership would ultimately influence employees into the direction of achieving pre-established organisational goals by being task-oriented. Transactional leaders aim to maintain the status quos by making use of contingent and monetary rewards for effort and good performances. They would state their expectations; establish rules and procedures, and emphasize a fair deal with their employees. When work is allocated to employees, the leaders would expect them to take full responsibility. If the tasks are not performed to expectations, employees would be held liable. Hence, it is important for leaders to engage in open forms of communication to bring about mutual trust between employees and themselves. Contributions should be acknowledged and rewarded by the leaders towards their employees according to the industry standards, so as to bring about job satisfaction. However, Hoogh et al. (2005) argued that stringent goals, rules and procedures due to transactional leadership would only promote stable work environment with high degrees of structures. It results in employees having little ambiguity in pursing the goals. The lack of ambiguity would help ensure fairness and set straightforward guidelines. Moreover, with stability, it would not promote inducements or opportunities for change. Employees would not be motivated to perform beyond expectations. They would not be flexible and innovative enough to response quickly and effectively to environmental change; it would be difficult for the transactional leaders to bring about change. 6.3 Transformational Leadership Kotter (Senior Fleming, 2006) Robbins Judge (2008) agree that transformation leaders goes beyond transactional leadership by inspiring members to achieve goals, paying attention to their needs and encouraging new breakthrough in goal attainments. They will make use of charisma (providing vision, direction and gaining trust), inspiration (using communication/symbols to get things done), intellectual stimulation (promoting participation and problem solving) and individualized consideration (treating individual members equally/individually) to handle change. Transformation leaders will encourage followers to be more innovative and creative to increase efficiency. Hence, Followers would push beyond boundaries to pursue ambitious goals/vision of organisation, be more committed and will pursue it with due importance. Transformation leadership is able to induce higher levels of motivation and satisfaction leading to higher performance. There will also be lower turnover, higher productivi ty and lower stress levels. Transformational leadership is critical in helping mangers to identify change, which would in turn aid them with leading and managing change by ensuring effective communications and encouraging acceptance. Transformational leadership will ensure vital planning and design assumptions to allow leaders to recognise change by paying attention to the external environment, financial resources, and company staffing. In addition, it ensures proper management of formal and informal relationships between members to increase change momentum and improve managerial change interventions. Finally, it helps to overcome employees resistances when the organisation is disturbed by initiatives to change (Karp Helgo, 2009). 6.4 Leaders Checklist for Leading Change Every leader can adopt a process perspective on change management on top of the above-mentioned leadership approaches by adopting a checklist to control the change process and ensure smooth transitions (Kotter, 1999). Establishing Sense of Urgency Leaders must alert employees to need for change by creating a sense of urgency. They should begin examining the organisations external environment and communicate these findings to induce aggressive cooperation of employees and motivate them to change. Forming Powerful Coalition Leaders should form a competent strong team with expertise and have sense of urgency to kick start the change process. Leaders must lead the team to assess the problems, identify opportunities and change the mind of oppositions. Creating Vision The coalition team would need to create a shared vision to clarify the possible attainable directions, thus providing a guideline about organisations future to the employees. It must be flexible to encourage involvement and develop strategies to deal with the change. Leaders must allocate ample time to develop the shared vision so that it would be ingrained as a strong set of shared values. Communicating the Vision Leaders should communicate the vision as it would establish the direction, commitment and learning within the organisation towards the structural changes. They must use every method to communicate the new vision and strategies to ensure that employees understand and make short-term personal sacrifices in order to help the organisation achieve its goals. Empowering Others to Act on Vision through Leadership Good leadership skills are needed to lead transformational change and raise demands that are consistent with overall change effort. Leaders must remove obstacles and encourage risk taking to generate more creative actions to support the vision. Leaders must make use of compensation to encourage employees acceptances of new vision. Planning and Creating Short Term Wins Leaders should plan, and create visible performance improvements and reward employees involved in the change improvements. As changes cannot take place overnight, it should be implemented in phrases, allowing time for maturity. The short-term goals in phases would act as a source of motivation in continual efforts for change. Consolidating Improvements and Producing More Changes Leaders should capitalize on early wins but should not declare victory too early should there be any possible amendments to the winning efforts; and use that as further motivation for continued and subsequent changes. Next, leaders should use increased creditability due to short term improvements to overcome the current structures that are not in alignment with the vision. Institutionalizing New Approaches Leaders need to ensure that change is consolidated by showing employees how change has produced optimal performance. Every opportunity should be taken to demonstrate the benefit Cervical Cancer: An Action Plan Cervical Cancer: An Action Plan INTRODUCTION Cervical Cancer also recognized by ‘cancer of the cervix’ occurs from the tissue of the cervix. The cervix is a component of the female reproductive system, which also encompasses the uterus, ovaries, fallopian tubes, vagina and vulva (Australian Government-Cancer Australia, 2014). The cervix is the lower part of the uterus that connects to the vagina. It is sometimes called the neck of the uterus. Cervical Cancer affects the cells of the lower part of the uterus that joins the inner end of the vagina also known as the uterine cervix (Cancer Council Victoria, 2014). In Victoria 179 women were diagnosed in 2010 with cervical cancer (Department of Health 2014). This is considered to be the twelfth most common cancer in Australia (Australian Institute of Health and Welfare Canberra, 2013) and has a much greater impact on indigenous women than non-indigenous complements. An indication of evidence shows that 59% of the women population died from this disease. According to Vic toria Health, 85% of women developed cervical cancer and either never had conducted a Pap smear test or failed to follow the recommended two yearly screening programs therefore leaded to a lack of participation in cervical screening which is one of the main risk factors for cervical cancer and is common against Indigenous women. Due to the inadequate time frame and the availability of health services such as the Bunurong Health service, Dandenong and District Aborigines Co-operative Limited to contribute in the project, the Indigenous population in the City of Greater Dandenong is the focus of this assignment. The objective of this is to reduce the occurrence of cervical cancer rates among Indigenous women in the City of Greater Dandenong over a three year plan. The strategies conversed in the project involvement plan by engaging the broader participation of indigenous people and their culture imparting a holistic approach to addressing this specific issue. Intensifying cultural awa reness and cultural safety is also a significant component. This realization plan will focus mainly on two detailed strategies: to familiarize and educate Aboriginal and Torres Strait Islander women in the City of Greater Dandenong by 50% informing about the new and easy technology use for cervical screening to reduce the pain and discomfort by 2015-2017. Another significant strategy is to ensure that the needs of Aboriginal and Torres Strait Islander women diagnosed with cervical cancer are met physically, culturally, spiritually and medically within the timeframe of three years 2015-2017. This curriculum will provide two-yearly Pap tests to women aged 18-69 for the early detection of cervical cancer. This implementation plan will initially present an action plan and next it will discuss about methods that have been used to encourage sustainability. Then methods of communication, which will be developed to connect stakeholders involved in the assignment, will be conversed along wit h the supply of resources. ACTION PLAN STRATEGY 1:To familiarize and educate Aboriginal and Torres Strait Islander women in the City of Greater Dandenong by 50% informing about the new and easy technology use for cervical screening to reduce the pain and discomfort by 2015-2017. STRATEGY 2: To ensure that the needs of Aboriginal and Torres Strait Islander women diagnosed with cervical cancer are met physically, culturally, spiritually and medically within the timeframe of three years 2015-2017. SUSTAINABLITY Attention to the sustainability in a community based cervical cancer; controlled program over a 3 year period must have extensive experience in planning implementing and evaluating a program which engage the indigenous aboriginal women, to educate women in City of Greater Dandenong. To sustain the program of prevention of cervical cancer, various steps must be put in place to maintain that the sustainability in the implementation scheme (Shediac-Rizkallah Bone, 1998, p.87-108). For instance, an entire program may be continued under its original or an alternative organizational structure, parts of the program be institutionalized as individual components, or there may be a transfer of the whole or parts to the community ownership (Shediac-Rizkallah Bone, 1998, p.87-108). In 2013 an study conducted by the Australian Institute of Health and Welfare identified the main changed that would be needed to occur and which stakeholders would be likely to be impacted. Projects with training (p rofessional and paraprofessional components are more likely to be sustained than those without: those trained can continue to provide benefits, train others and form a constituency in support of the program. As strategy 1 states that it is aimed to familiarize and educate Aboriginal and Torres Strait Islander women in the City of Greater Dandenong by 50% informing about the new and easy technology use for cervical screening to reduce the pain and discomfort. Therefore; by having general community and professional monthly and or yearly meetings and follow ups will help the project be sustained for a longer period of time and this will be evident with the use of data towards the participation of Pap screening tests for the population of Indigenous women. The results of this data in future within the 3 year time frame will help to detect whether more education and support implants are needed to be put in place culturally, physically and mentally or whether the results show an increase towards the population of Pap screening tests for cervical cancer in Indigenous women specifically. Topromote ongoing skills, development in health promotion and training/education, by allocating half a day to train the leadership skills and furthermore; being qualified to maintain their relationship with the Indigenous women for better health. It is important to train the trainers to help health services and programs to be sustained, patient-centered care, self-management support and behaviour change within their organisations therefore will be structured to be continued for the management and progress (Practice change requires staff skills development and systems implementation planning, 2013). For that reason, where the team will identify a reliable person who will be appropriate for the subject of leadership in future and have a greater understanding of the vision and management skills about health project towards the Aboriginal culture. Managing the culturally supportive environment for the Indigenous women will encourage the team to promote and achieve the sustainability and health promotion goals. COMMUNICATION To build a therapeutic relationship among indigenous women is quintessential; Health workers must gain trust and build rapport and considering their cultural background. There are various stakeholders one needs to consider while promoting health. For instance; while developing and delivering Aboriginal specific cervical screening health promotion training to health professionals, health promotion workers, aboriginal health workers and others who are working within the project. However; to establish organizational supports, such as local advisory committees, and in order for the project to develop effective relationships, within the Indigenous women committee (Gruen et al., 2008, p, 1579-89). One of the key strategies to achieve in this project is to train local clinicians to provide education and awareness about Pap screenings and cervical cancer to Aboriginal women in a form of considering their cultural background. Public is the first and prime stakeholders as the implementation of health promotion plan deals within the public domain (Hetzel, Glover, Gruszin. 2012). Apart from public, local councils and local councilors, Australian Health department and party workers were in the middle stakeholders (Gruen et al., 2008, p, 1579-89). Medical expert’s dealing in the treatment and research institute where diseases are the first lane resources, therefore; is vital to be included in any plan in prevention for cervical cancer (Anne F.Rositch, Michelle I. Silver, Patti E. Gravitt, 2014). CONCLUSION In conclusion, cultural barriers prevent Aboriginal women from seeking for their sexual and reproductive health and creative strategies are needed to encourage Aboriginal women to attend for Pap screens. For example: Information needs to be presented to the community in a format and language that is understandable to the target population. Services need to be provided in a safe and confidential environment and services need to be available on a â€Å"walk up basis† to avoid the need for appointments which can lead to a fear of loss of privacy and confidentiality. Due to cultural impediments, past research has proven that the establishment of women’s advisory committee was/is a strong scheme as a strategy to facilitate the promotion of the project within the community by engaging respect within the community and the women who are involved in the project so they could promote to the targeted group. In order to continue the momentum started by the project, community awareness of the need for cervical screening, needs to be maintained and raised contained by the Aboriginal women. This will require ongoing consultation with the community and ongoing health promotion activity which has been mentioned above. Ongoing involvement and collaboration with other community stakeholders such as Bunurong Health Services, Local Government – Victoria, Victorian Aboriginal Health Service, Cancer Council- Victoria, Royal Women’s Hospital Aboriginal Advisory Unit, Victorian Aboriginal Community Controlled Health Organisation and City of Greater Dandenong are also seen as dominant too long term success in increasing awareness and promotion of cervical screening in the City of Greater Dandenong among Aboriginal and Indigenous women.

Antisocial Personality Disorder (ASPD) Treatment Strategies

Antisocial Personality Disorder (ASPD) Treatment Strategies 1. TREATMENT OF ASPD BY PHARMACOLOGICAL MEANS Treatment of antisocial personality disorder by pharmacological means is notoriously difficult, mainly because of the problems with non-compliance due to the side effects of the medication at doses high enough to produce a therapeutic response. A recent paper by Walker has claimed spectacular results from Quetiapine which reduced symptoms of irritability, impulsivity, and aggressiveness together with improvements in hostility and rage reactions with minimal side effects and therefore good levels of compliance. We should note however, that this study was in adults and there is little data on the effectiveness of this regime in children. (Walker C et al. 2003) ~~~~~~~~~~~~~~~~~~ A brief overview of the literature on the subject shows that there is huge controversy surrounding the areas of treatment (both psychotherapeutic and pharmacological) of the psychopathic and antisocial personality disorders in general. They range from some (usually the older texts) which suggest that the condition is largely untreatable (viz. Cleckley, H. 1964) to others which offer varying degrees of evidence of success. Critical analysis would have to conclude however, that the different methods of treatment that have been tried have largely suffered from a lack of controlled follow-up research and that comparison of trials is rendered difficult because of the lack of consistency in both the definition and the diagnosis of the disorder. (Martens W H J 2000) There does appear to be a general acceptance in the literature that the core antisocial behaviours associated with the antisocial personality disorder are difficult to manage (Myers W C et al. 2006) and that the bulk of pharmacological treatment is aimed at the control of the associated behaviours. The main clinical dilemma which faces healthcare professionals is whether it is better to target the untreatable aspects of the condition, on the grounds that they are what usually caused to patient to come into contact with the healthcare professionals in the first instance, or to treat the associated symptoms which may be more responsive to pharmacological intervention. (Hodgins S et al. 2007) With these caveats in place, if one focuses on the treatment options most commonly employed in antisocial personality disorder, then one can observe that the options can be broadly categorised as the neuroleptics, anticonvulsants, lithium, antidepressants, psychostimulants and benzodiazepines. It should be noted that many of these medication categories will typically take a substantial time to exert optimal effect and compliance is frequently a problem rendering treatment assessment difficult. The treatment options will be considered by category Neuroleptics This group typically have a tranquillising effect of disturbed and aberrant behaviour patterns. Anger, hostility and tension levels can be reduced by low dose regimes and this drug group and are also helpful in dealing with specific psychotic episodes, but in typically higher doses. (Black, D. A. 2002) Anticonvulsants This category of medication is thought to have a number of actions on many of the neuropsychiatric syndromes, as well as the behavioural disorders, in addition to their direct anticonvuslant activity. (Hudziak J J et al. 2006) Carbamazepine has been found to be helpful in situations of angry outbursts, self-mutilation and violence. It is postulated that it may work in this respect through its activity in the limbic system. There is also EEG evidence of reduced abnormal activity in the EEG traces of the most explosively violent patients with antisocial personality disorder. (Cowdry, R et al. 1998) Lithium Lithium has also been demonstrated to reduce the incidence of emotionally unstable behaviour patterns. It does have the drawback of producing clinical sedation at the higher ends of the therapeutic spectrum and may also be associated with both tremor and lack of coordination. Constant supervision is therefore essential and this may be difficult in an uncooperative patient. (Paris J 2005) Antidepressants The antisocial personality disorder patient will often demonstrate mood disturbances which may be helped by the antidepressants. Children are not good candidates for some antidepressants, for example the MAOIs used in adult patients are not appropriate in the younger age group. Imipramine has been found useful in children who have panic attacks, mood swings and dysthymia and also in some obsessive children. The antidepressants tend to be used in clinical cases where lithium has failed. (Gunderson J G et al. 2006) Benzodiazepines These are perhaps the most effective in the anxiety states and in cases of insomnia. Because of their fast onset of action, the Benzodiazepine group are useful in the acute behavioural disturbance, particularly in aggression. Some studies have highlighted the downside of benzodiazepine treatment. This includes not only the problems of habituation, but also the possibility of dysinhibitory effects in certain patients. Alprazolam is arguably one of the most effective agents in this therapeutic area but it’s use is complicated by cases of serious dyscontrol. In some studies, episodes of drug overdoses and severe self-mutilation required the immediate withdrawal of the medication. (Frank E et al. 2002) Psychostimulants These are particularly useful in the younger patient where they are known to reduce symptoms of dysphoria and anxiety. There have been a number of well conducted trials in this area. Medications such as amphetamine and methylphenidate have proved useful in reducing behavioural disturbances children, particularly when there is an overlap between antisocial personality disorder and attention deficit syndrome. (Turgay A et al. 2002) Some studies in this area have demonstrated good responses to both the tricyclic antidepressant group and the SSRI group, with fluoxitine appearing to be particularly favourable. The best studies however, do not claim a good response rate of higher than 27% in subjects with antisocial personality disorder. One should note also that some studies also record an apparent clinical worsening of their condition, with amitriptyline and haloperidol producing increased levels of both agression and hostility in some patients who did not exhibit these symptoms before treatment. The causal linkage was given further credence when it was found that these symptoms increased with longer duration of treatment and increased dosage of medication. (Tyrer P et al. 2004) In conclusion, one can ponder the writing of Tyrer and Bateman who have written extensively on the subject of pharmacology of the personality disorders. When considering an appropriate drug choice for antisocial personality disorders and others, they note that any demonstrable neurobiochemical disorder may actually not be central to the condition, and may even be part of the peripheral syndrome (drug abuse etc,). to cite Tyrer: The best that pharmacology and physiology can offer is the justification for trying drug treatment: it cannot predict its efficacy. This argument can be followed in greater detail in the earlier writings of Cloninger: Even when a dimension is agreed (e.g. affective instability as a core feature of borderline personality disorder) its definition may vary. Some see affective instability in terms of reward dependence, whereas others consider it as disinhibition. Which view is taken is of considerable importance when considering drug treatment. The author sees novelty-seeking as being determined through genetic predisposition via the dopamine system, whereas many others consider affective disinhibition to be related to the serotonergic system. When no biological marker is linked clearly to diagnosis answers can only be speculative. (Cloninger, C. R et al. 1993) 2. TREATMENT BY CONVENTIONAL MEANS Treatment by â€Å"conventional means† could be taken to include various psychotherapeutic approaches. A landmark study by Chiesa and Fonagy compared the results of a one-stage treatment model (in-patient treatment with no after care) with a two-stage model (shorter in-patient admission followed by outreach therapy) in a large cohort of patients with antisocial personality disorder (and other psychopathies). The paper is both long and complex, but, in essence, those patients treated in the two stage model did significantly better in both global assessments of mental health as well as assessments of social; adjustment. Many papers refer to treatment regimes which, although varying in detail, tend to include elements of a socio-therapeutic programme which are generally managed primarily by the nursing staff, and a more formal psychoanalytic psychotherapy programme which tends to be delivered by medical and non-medical psychotherapists. The latter typically tends to target psychodynamic orientation and typically focuses on the interpretation of the internal conflicts of the patient, as well as on the confrontation and clarification of dysfunctional behaviour. It also will include analysis of institutional transferences as they become apparent during the treatment phase. (viz. Dolan, B et al. 2007) ~~~~~~~~~~~~~~~~~~~~~~ In very much the same way as we have observed in the context of pharmacological interventions, it would appear to be true that the literature relating to psychotherapeutic regimes suffers from difficulties inherent in maintaining follow up and comparison of ostensibly similar trials because of the variations in both diagnosis and the nature of the various treatment regimes. A number of sources place great emphasis on a holistic assessment of the patient’s full history including their cognitive and affective levels of functioning. Particular attention should also be paid to the patient’s criminal history if it is relevant (and it usually is) and to any available evidence of any previous behavioural disorder, including any associations such as attention deficit disorder. These factors will rely upon a combination of interviews, psychometric measures (including the MMPI scales, repertory grids and Hare’s Psychopathy Checklist) and file information, in which records of social, psychiatric and criminal history can usually be found. (Soyka M 2000) In addition to all of this, treatment decisions may also need to be based on factors and information which has been obtained from any number of independent sources such as family members, court records and victims. Oldham states that an important element in treatment is as assessment of the degree to which the patient feels able to exert any control over the various aspects of their behavioural dysfunction as well as their own reaction to their perception of their antisocial activity and conduct. This latter element may necessitate enquiry into a number of lifestyle factors such as â€Å"deviant behaviour, including attitudes to self and others, interpersonal style and substance abuse†. (Oldham J M 2006) All of these factors will have a bearing on the particular therapeutic approach to be adopted as well as an assessment of the patient’s own intellectual abilities. Lamberg points out that an important element in achieving any degree of success in treatment is to come to a realistic agreement with the patient as to the what both the healthcare professionals and the patient can expect as a result of the treatment programme adopted. Unrealistic attitudes or expectations on the part of either party are lily to lead to disillusionment and treatment breakdown. (Lamberg L 2006) The fine details of the various treatment options are clearly beyond the scope of this essay and therefore they will be presented in overview. Behaviour therapy This type of approach effectively uses a mixture of learning theory and experimental psychology to the various maladaptions of the patient’s behaviour. The (now largely outdated) reasoning behind this approach is that the patient is regarded as having learned abnormal behaviour patterns by inappropriate conditioning through interactions between their environmental past and their current environmental situations. (Gilligan J, et al. 2004). Clearly this is not referable to the various associated organic syndromes which may present as comorbidities. Behavioural therapists therefore start from the assumption that all these behavioural aberrations can be both predicted and controlled. Their goal is therefore to use externally derived stimuli to either weaken or completely eliminate any of the unwanted maladaptive behaviour patterns. In clinical situations, the therapeutic effect is sought through the mechanism of either positive or negative reinforcement techniques which can streng then or enhance the desired behaviour pattern or occasionally through punishment mechanisms which make it less likely. Robertson suggests that such techniques can be enhanced by the addition of other learning principles including â€Å"avoidance, extinction, time-out, generalisation and discrimination† (Robertson M R 2000) Aversion therapy appeared to be in vogue in the 1980s but is seldom used in current practice. Other facets of behaviour therapy include the adoption of skills training where the patient learns appropriate responses to potentially aggressive encounters, the need to control anger, and the ability to deal with authority figures. (Kerr I B et al. 2007) Cognitive approaches This appears to be a more frequently used approach in the modern literature. It involves identifying, confronting and then questioning any maladaptive or irrational thoughts that the patient may have and establishing new cognitions to replace them. (Mack A H et al. 2003) The basic concept behind this type of approach is that the clinical problems which are responsive to this type of intervention are disorders of either thought or feeling processes which modify or even dictate or behaviour patterns. It follows that modification of these maladaptive thought processes will change the maladaptive behaviour patterns. (Evenden J 1999) The commonest application of this technique is therapeutic modelling whereby treatment allows the patient to observe a competent, coping model of human behaviour, and then embarking on a cognitive dissection in the hope that this will be reflected in the patient’s future conduct. It has been successfully used in situations of response to provocation, physiological monitoring, assertiveness training, reappraisal, cognitive self-control, relaxation training and self-instruction. Cognitive approaches can be undertaken in either a group or individual basis. (Toone B 2004) Individual and group psychotherapy This approach differs from behavioural approaches (which focus primarily on externally observed behaviour patterns) insofar as it is primarily concerned with approaching the patient in an empathetic relationship which allows them to reach an understanding of what is happening in their own personal inner world Freud believed that patients could both share and explore the underlying causes of their clinical difficulties and learn to change the psychological determinants through the process of experiencing of unrecognised forces in themselves. (Brown, D et al. 1979) In broad terms, a psychodynamic approach to the treatment of antisocial personality disorder places emphasis on the â€Å"importance of personality structure and development, and is based upon the principle that antisocial behaviour is an expression of an underlying personality disturbance. Chronic antisocial behaviour is held to reflect distortions in development and most particularly, the patient’s primitive defences against trusting relationships†. (Sugden S G et al. 2006) Patients with antisocial personality disorder typically show damage to their ego strength and therefore their capacity to contain and manage various primitive anxieties and impulses. It follows therefore that a crucial part of psychotherapy is helping the patient to uncover the relevant mental states and meanings behind their behaviour patterns, and allowing them to explore and understand their feelings and maladaptive defence mechanisms. (Grossman L S et al. 1999) Therapeutic community approaches Some authorities advocate the use of the therapeutic community. This involves a more democratic engagement between healthcare professionals and patients and encourages the more active participation of patients in their own treatment in addition to giving them a greater responsibility for the day to day running of their hospital community. It is hoped that this delegation of responsibility to patients in a ‘living and learning’ environment will help to encourage a more open expression of their feelings and a greater understanding and exploration of interpersonal relationships the lack of which is a major feature in antisocial personality disorder. The organisation and atmosphere in such a community is typically low key and fairly unstructured with regular meetings between the healthcare professionals and the patients. This type of approach is occasionally referred to in the literature as ‘milieu therapy’. The therapeutic structure is that the community allows for the provision of a combination of interventions such as pharmacotherapy, psychotherapy, cognitive therapy, group therapy and behavioural therapy. All of these elements are delivered by a wide range of staff from different professional backgrounds, so that the various patients in the community can receive different treatment packages, depending on their individual needs. (Connor D F et al. 2003) 3. ASSOCIATION OF ASPD WITH SUBSTANCE ABUSE Another of the major themes apparent in the literature is the association of antisocial personality disorder with substance abuse. Part of the therapeutic regime should therefore include a direct approach to this element of the problem. It is known that the earlier the clinical manifestation of antisocial personality disorder (particularly at the age of 10 or younger) the greater is the risk of substance abuse in adolescent or adult life. (Joshi V et al. 2001) It has also been shown that the involvement with substance abuse prior to the instigation of treatment is a predictor of poor therapeutic outcome. (Myers W C et al. 2006) ~~~~~~~~~~~~~~~~~~~~~~~ Studies which have attempted to quantify the association of antisocial personality disorder with substance abuse have, almost without exception, identified the element of deceit on the part of the patients as being a major source of unreliability in their findings. Deceit is a commonly found behaviour pattern in antisocial personality disorder and the social stigma associated with substance abuse makes the apparent need for deceit on the part of the patient more understandable. Myers published a tour-de-force on the issues linking substance abuse and the adolescent with antisocial personality disorder. (Myers M G et al. 1998). A number of well constructed studies (viz. Windle M 2000) have stated that antisocial behaviour patterns diagnosed in children and adolescents are predictive of both adolescent and adult involvement in substance abuse with Robins going further and stating that conduct disorder (considered to be part of the same spectrum of conditions as antisocial personality disorder) is a strong prognostic indicator for both antisocial personality disorder and abuse of psychoactive substance in adulthood. (Robins L N et al. 2001). These observations have led a number of commentators to conclude that adult antisocial personality disorder and substance use disorders may share common aetiological pathways. This however, is rather speculative. There is some evidence that there may be a genetic link between the two but the situation should be regarded as â€Å"not proven†. The two elements are certainly linked but the nature of the linkage is unclear. The thrust of this theme can be considered further with the examination of an interesting viewpoint which is expressed by Fu (Fu. O et al. 2002) who was exploring the genetic background between antisocial personality disorder and alcohol dependence. The comments made in the Myers paper (cited above) relating to the possibility that antisocial personality disorder and substance abuse may have a common or related aetiology is given further credence by Fu’s work in which he cites evidence in studies by Kessler and others for separate increased genetic susceptibility to antisocial personality disorder, marijuana dependence and alcohol dependence. Both marijuana dependence and alcohol dependence have been found to be familial in some studies with monozygotic separated twins showing higher incidences than the normal population. (Kessler R C et al. 2006) Slutske suggests that common genetic risk factors have been suggested to account for between 76% and 71% of the genetic association between antisocial personality disorder and alcohol dependence in twin studies. (Slutske W S et al. 1998) a finding that was replicated in the True study showing the possibility of a genetic link between antisocial personality disorder, alcohol dependence and marijuana dependence. It should also be noted that the same study reported the presence of a statistically significant genetic link between antisocial personality disorder and major depression which is believed to also be linked to increased risk of alcohol dependence. (True W R et al. 1999) There is a disproportionately high prevalence of antisocial personality disorder amongst substance abusers. Those substance abusers who have antisocial personality disorder are likely to have started abusing earlier than their non-affected counterparts. (Carroll K M et al. 2003) . Other authorities demonstrate a preponderance of polysubstance abusers in substance abusers who have antisocial personality disorder with the same studies showing worse prognostic outcomes in this sub-set. (Cacciola J S et al. 2005) If one considers the problem from a developmental viewpoint, some years ago Moffitt identified two distinct sub-types of deviance in adolescence. By far the largest group were those where the problem and challenging behaviour patterns begin and end before the end of adolescence. The second, much smaller group were those where the behaviour patterns persisted into adulthood. (Moffitt T E 1993). Studies which have attempted to further define these issues have suggested that early emergence of antisocial personality disorder (or conduct disorder in the child) together with a demonstration of these deviant behaviour patterns across a wide spectrum of settings are both good prognostic indicators of likely persistence of antisocial personality disorder and substance abuse into adult life. (Loeber R et al. 2003) Moffitt (who has written extensively on this issue) proposes the concept of â€Å"snares† in which a number of features of the behaviour patterns of the antisocial personality disorder are critical in serving to limit options for the individual to escape their antisocial lifestyle. The concept that deeper commitment to drugs or alcohol may, in themselves, limit the â€Å"escape options† for pro-social behaviour or they may habituate the patient to environments which are more â€Å"risky† in terms of relapse. Both of these mechanisms unfortunately serve to perpetuate a deviant or antisocial lifestyle. This concept can be considered further with the realisation that antisocial personality disorder and substance abuse expands into most of the major life domains. The problems that all sufferers with antisocial personality disorder have in areas such as school or work, interpersonal relations, and legal difficulties, are greatly increased by the coexistence of a problem with substance abuse. All these areas are clearly important to the developing adolescent persona. This also is reflected in the fact that such â€Å"high risk† individuals increase their difficulty further by indulging in substance abuse and this, in turn, is associated with an increased persistence of antisocial personality disorder into adult life. The persistence of symptoms into adult life in this sub-group can be viewed as being associated with the presence of additional psychopathology. 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