Product of My Environment

Xavier Rodriguez Expos 101 Assignment # 3 F. D. Professor: Debra Keates 10/22/12 â€Å"What Means the World to You† What is important to someone varies from person to person. These things can be displayed in different forms and approached in various ways. This is seen within O’Brien, Stout and Fraser’s essays. O’Brien understands what inspires human connection and he manipulates the truth of his story in order to capture the attention and respect of others. He justifies his decision to distort his story based on the impact it has on the reader.For every author, O’Brien argues that the aim is to get one’s point(s) across; to bring attention to what matters the most to them. Regardless the category, this is done by expressing one’s objective with feeling and a sense of importance. In Caroline Fraser’s, â€Å"Rewilding North America,† she uses convincing evidence to prove to the reader that reserves and corridors promote the well-being of wildlife and humans alike. Similarly, Martha Stout has a biased opinion.Stout sets out to demonstrate to readers in â€Å"When I Woke Up on Tuesday Morning, It Was Friday† that counseling is important for clients who have experienced trauma by sharing individual client stories. The way people define truth and the information they provide can determine how others will evaluate the story. There are different ways to connect to a reader. The writer’s objective and the audience both influence these decisions. O’Brien’s storytelling method may involve embellishments that bend the truth rather than adhere to it.Had he authored either Fraser or Stout’s essays, the objective may have been the same, but the style would likely have been quite different. Within their respective essays, Fraser and Stout’s definitions of truth can be observed and interpreted. Both authors cite massive research projects, specific cases and general statistic s to communicate their theory. It would appear, that unlike O’Brien, both Fraser and Stout are more concerned with providing support for their story and/or objective. O’Brien did not bother with ensuring that his facts were correct, but rather that the message was clear.Facts and evidence, however, are very important components of Fraser and Stout’s â€Å"truths†. Fraser relies on scientific evidence to gain attention from her audience. While O’Brien may not disapprove of this method, he may see it as unnecessary. As she writes â€Å"In the United States, for example, deer-vehicle collisions alone occur up to one and a half million times each year, costing some two hundred lives and $8. 8billion annually; collisions also imperil the survival of twenty-one endangered and threatened species†(123).Another example of Fraser’s tendency to provide explicit scientific evidence is when she describes Fraser writes about the Banff Project scien tists and their impact on the concept of Rewilding as they collected â€Å"footage from cameras mounted on the underpasses [which show] bears and mountain lions approaching the wire cautiously, sniffing, and peering around† (123). The animals questioned the underpass at first, just as any creature would do when coming upon something unfamiliar. Shortly thereafter, â€Å"most of them burst over or under the wires, galloping off† (123).O’Brien would say that Fraser’s method of getting attention to her theory would be a great approach, however, if all that evidence is needed then his way to get through to people would not be relatable because to his own because he believes in simplicities and getting through to people with tantalizing and basic approaches such as emotions to capture the attention of people and his ability to tell a story and his way of articulating the facts or details. Regarding O’Brien’s argument that a piece of writing or a story should create an emotional connection, Fraser’s writing falls short.Fraser does make some attempts to build a feeling of empathy for the animals whose lives are positively impacted, as she writes â€Å"in 1993, Pluie lost her collar, which was found with a bullet hole in it. The wolf herself was shot dead two years later, along with her mate and several pups† (112). Even still as she integrates statistics and hard facts when she wrote â€Å"in the last 15 years or so, 27-percent of the known wolf deaths have been from the railway, and 60-percent were on the highway. Just 5-percent were natural†¦ The Bow Valley used to have three packs.Now it has one. In 1996, three of the four pups born to this pack were lost to the highway. The next year, none of the five pups born survived, and we know at least one was hit on the railway. During 1998, the pack had no pups and was down to three members† (112). In this segment, Fraser uses a specific story to draw in the reader and build a connection. However, these moments are too few and far between, as Fraser spends a good deal of the essay providing long descriptions of scientific theory and jargon relevant to her field.For example, Fraser spends five pages outlining the development of the term â€Å"ecosystem†, â€Å"equilibrium theory† and the consequent theory supporting the use of corridors and reserves, which she is generally supporting throughout her essay. Further she has a tendency to provide irrelevant and ridiculous amounts of detail, which loses the reader’s interest. For example, Fraser writes, â€Å"Conservation biology is a small world:† and she elaborates, â€Å"Michael Soule sat on the committee at the University of Michigan that supervised Newmark’s dissertation. The study percolated in Soule’s mind as went to his next job, at UC Santa Cruz.Sitting in his kitchen one day, Soule was talking to his friend Arne Naess, the Norwegian phi losopher who founded ‘deep ecology’†¦ † While these details may be an attempt to grab the reader’s attention, they have the opposite effect. O’Brien might describe Fraser’s approach as dry and fruitless. The author’s have various styles they attempt to use to get across to their audience, as is their technique. When compared to Fraser, Stout’s approach would be more favorable to O’Brien because there is less technicality used, less use of attempt to convince the reader that her topic of dissociation is fact and is somewhat curable.She uses interconnections to demonstrate her therapist to client bond. The method that she uses is relaxed and simple yet effective by exposing the way dissociation is triggered, and how it happens to everyone whether or not the individual realizes it or not. â€Å"Sometimes dissociation can occur when we are simply confused or frustrated or nervous, whether we recognize it or not† (S tout 384). After her clients get an understanding they begin to feel and get a better sense of the things that matter to them and are more important them by working to get a grasp on the things which are simpler to connect with.Stout convinces people that her evidence is true by walking through alongside her patients in defining lost memories and times and situations and fills in the gaps necessary in order to help her clients feel closure, happy( satisfaction) and free. Allowing them to function with a more clear mind. She sees the way people are deeper than what is seen on the surface and have the ability to do the same things as anyone else can. Stout says, â€Å"All human beings have the capacity to dissociate psychologically, though most of us are unaware of this, and consider â€Å"out of body† episodes to be far beyond the boundaries of our normal experience.In fact, dissociative experiences happen to everyone and most of these events are quite ordinary† (388). Due to dissociation being an occurrence that is not identified with ease, the majority of society does not recognize that we all in fact dissociate. When it comes to straightforwardness, a person can be sincere but not report the truth due to naivety or in order to try to get a deeper meaning. O’Brien states, â€Å"In any war story but especially a true one, it’s difficult to separate what happened from what seemed to happen† (71). The truth is not out in the open and is hidden. This in turn plays on the accuracy of an experience.When retelling an experience, the sequence of events has to be objective or have an unbiased view. Often unbiased or objective views can be lost. O’Brien uses the statement â€Å"true war story† throughout his essay. The use of the word â€Å"true† causes the essay to have a biased view Stout’s ability tot be effective and connect with the reader is kept at a strong tempo when she gives strong interesting and powersfl insights How effective is Stout at connecting with the reader? If she is effective, find an example of a time in which she is. In Stout’s essay, she writes how â€Å"we can go somewhere else.The part of consciousness that we nearly always conceive as the ‘self’ cannot be there for a few moments, for a few hours and in heinous circumstances for much longer† (p 388). Everyone has moments where they go somewhere else in their own heads to cope or protect themselves from a situation, being distracted by something, mentally escaping into a film at a movie theater, or getting lost in a day dream are all little examples of how ordinary and everyday individuals dissociate. Add something about use of language. How does O’Brien use language? How about Fraser? Stout? What might O’Brien think of their uses of language? Examples: O’Brien use metaphors? artsy, elaborate descriptions? Fraser: scientific language? dry at times? Stout: person al anecdotes? also vivid descriptions? † Both authors illustrate the problems that animals and humans face and the ways they go about coming to conclusions and solving situations and problems. The role that language plays in determining truth to O’Brien, is the studies and usage of the manmade effects have on animals and what gets into the minds of humans. Fraser and Stouts style of writing differ from O’Brien’s by one (Stout) using counseling and the other (Fraser) using convincing evidence.Stout uses counseling as a means to support her assessments of her clients individual case. As Fraser uses convincing evidence in order to support her promotion of resources and corridors as being beneficial to both animal and humas. Fraser motivates people to act In â€Å"Rewilding North America,† by writing about the development of the concept of rewilding, a conservation method designed to save species from extinction by restoring â€Å"connectivity† i n nature, â€Å"holding out the hope and promise that [through this project] humanity could heal the environmental damage that had already been done† (119).Her evidence is adequate proposed solution to a problem must be tangible and realistic. Rewilding encompasses both aspects exactly. Another reason why rewilding has a better chance for success is the fact that it is natural. The combination of these three aspects makes rewilding the favorable and more effective solution to eliminating animal suffering Animals roamed planet Earth for nearly 600 million years prior to the appearance of the genus Homo. During all that time, many creatures and species came and went. By and large they evolved, disappeared and became extinct all due to nature, geography, environment and natural events.Animal extinction is a natural process, but nonetheless the rate has heightened because of mans’ interaction with animals. Humans tend to cause our wild animal neighbors much more trouble th an they do to us, as each day we invade thousands of acres of their territories while destroying their homes. These crises occurring in nature beg for humans to do something to eliminate or lessen the foreseen calamities. Caroline Fraser, in the essay â€Å"Rewilding North America† provides what can be appreciated as a balance between the latter two potential solutions.She explains the concept of rewilding, a large-scale conservation method aimed to restore and provide connectivity between animals and humans. The idea of rewilding is a marriage between synthetic biology and interspecies empathy because it constructively encompasses aspects from both approaches. Rewilding is a feasible solution to eliminate animal suffering that is not only natural but also is a tangible and realistic one, in comparison to the ideas of stout and o’brien. Rewilding is an appropriate solution to the problem of species extinction because it is primarily a natural process.Rewilding, like mo st natural processes, does not affect animal’s lives in any significant negative way. Fraser writes about Banff Project scientists and their impact on the concept of Rewilding. They collected â€Å"footage from cameras mounted on the underpasses [which show] bears and mountain lions approaching the wire cautiously, sniffing, and peering around† (123). The animals questioned the underpass at first, just as any creature would do when coming upon something unfamiliar. Shortly thereafter, â€Å"most of them burst over or under the wires, galloping off† (123).O’Brien would say that Fraser’s method of getting attention to her theory would be a great approach, however, if all that evidence is needed then his way to get through to people would not be relateable because to his own because he believes in simplisties and getting through to people with tantalizing and basic approaches such as emotions to capture the attention of people and his ability to tell a story and his way of articulating the facts or details. One patient in particular, named Julia, is a successful producer of documentary films.As a child, Julia underwent child abuse and was skillfully able to remove herself from the horrific situations. The trauma Julia experienced as a child causes her to dissociate now as an adult yet, she carries her life as anyone else would. â€Å"I met her when I she was thirty-two, and an intellectual force to be reckoned with. A conversation with her reminds me of the New York Review of Books, except that she is funnier, and also a living breathing human being who wears amethyst jewelry to contrast with her electric auburn hair† (Stout 385).From the description given by Stout in her essay, Julia does not fit into the category that society has placed her in. She overrides the stereotypes and labels because she is not any different from what society perceives as â€Å"normal. † She is intelligent and successful; everything soci ety wants her to be but for some reason she is perceived otherwise. Patients like Julia commonly experience dissociation more severely because of the traumatic experiences they have been through. Why should someone who dissociates, and receives therapeutic assistance to confront their issues, be perceived in society as being different from someone who does not?Dissociation should not negatively categorize its victims, but rather serve as a common ground between people because all people dissociate. â€Å"We can go somewhere else. The part of consciousness that we nearly always conceive as the ‘self’ can not be there for a few moments, for a few hours, and in heinous circumstances, for much longer† (Stout 388). Everyone has moments where they go somewhere else in their own head to cope or protect themselves from a situation. Being distracted by something, mentally escaping into a film at a theatre, or getting lost in a day dream are all minuet examples of how ordi nary, everyday individuals dissociate.Dissociation is an obstacle that Stout’s patients encounter on a day to day basis, and, unfortunately, classifies them in society to be â€Å"abnormal. † Society has a picture of what â€Å"normal† is supposed to be; but what makes one individual more â€Å"normal† than the next? While Stout’s patients are looked upon negatively as being strange because they dissociate; they are no different from a man who enjoys a film at a theatre. â€Å"This perfectly ordinary man is dissociated from reality. Effectively, he is in a trance.We might label his perceptions as psychotic, except for the fact that when the movie is over, he will return to his usual mental status almost instantly. He will see the credits. He will notice that he has spilled some popcorn, although he will not remember doing so† (Stout 388). Someone who society would categorize as a â€Å"normal man,† experiences an example of what Stout ’s patients bear regularly. The film watcher is in no contrast with Julia, or any of Stout’s other patients; therefore, society has misinterpreted what is considered the norm.Stouts essay would be evaluated using o† brien’s definition of truth by agreeing in the wyas that there are many times that people allow their minds to drift and take over. Imagination is what O’Brien uses and the imagination of these characters are what allow them to face and deal with their traumatic experiences and allows them totake stances in their places that may or may not be realistic. She uses language by its literal form in human communication with her clients, talking and assessing what they lack and how they is a solution through language and rehearsal processes assist in one having an ability to adapt to normalisity.This is like o’briens as he is most effective with speaking and using language and mind as his tools to paint pictures to the stories he makes. These two are more natural and effective and simplistic yet powerful. When frasers compared to the authors approaches she takes more of a scientific stance as to where she provides evidence and actual facts from her discoveries. Stout says, â€Å"I believe that most of us cannot know what we would do, trapped in a situation that required such a seemingly no-win decision† (382).Stout’s patients are wrongfully perceived as â€Å"insane†, yet no one has bothered to put themselves in their position. Dissociation experienced at the caliber that Stout’s patients do, is normal to them. What society perceives as â€Å"normal,† and what Stout’s patients perceive as normal, is identical because Stout’s patients see themselves that way. Dissociative episodes are what they have been experiencing for most of their lives; therefore, it is what they see as the norm and society should not reprimand them for that. â€Å"A True war story is never mora l.It does not instruct, nor encourage virtue, nor suggest models of proper human behavior, nor restrain men from doing the things they have always done. If a story seems moral, do not believe it† (347). In short, it gives you a view of how to take in the war story. It differs from the usual happy and uplifting war story and gives a realist and somber approach to reading a war story. The following will explain the importance of this passage and how it relates to the short story. Reason why he wouldn’t agree with fraser. â€Å"True war stories do not generalise. They do not indulge in abstraction or analysis;.For example: war is hell. As a moral declaration the old truism seems perfectly true, and yet because it abstracts, because it generalizes, i can’t believe it with my stomach. Nothing turns inside. It comes down to gut instinct. A true war story, if told truly, makes the stomach believe† (O’Brien, p. 274). * In â€Å"Rewilding North America†, Fraser mentions a man named Harvey Locke, and how he said â€Å"I choose those words, ‘Yellowstone to Yukon,’ because they’re deep symbols in peoples brains. If I say those words in Stuggart, Germany, in Toronto, in new York, or in Tokyo, everybody knows what I’m talking about† (Fraser 121).He was talking about the title of his catch phrase because it would grab the attention of people who shared a common interest. He knew that there were people who would be interested in â€Å"Y2Y† because they shared a common concern that mattered to them when it involved rewilding animals. Similarly, in her essay, Martha Stout writes about a conversation she was having with a woman named â€Å"Julia† and how she had asked, â€Å"do other people remember those things, about their teachers, and going to their graduation, and learning to drive and so on? (Stout 387). Meaning the way other people think about situations that have occurred in their p asts. Things that were at some point so important, things that mattered to them, at least in those years of age and time. The process that pertains to what matters comes in all forms. In Fraser’s excerpt she was talking about the sciences and how the topic of concern would have the ability to bring awareness to her idea of restoration.There are other ways like in Stouts, she being the psychologist who works with clients, discusses and rehearses situations alongside her clients in order to recover what was supposed to be significant and have some level of importance at one stage in her client’s life. In these cases the process of restoration. There are unlimited topics of discussions which coincide with interpersonal relationships like the ones that Tim O’Brien attempts to establish by using war as the main topic, something that has long time been a concern of people.Something that he knows will draw people in and make them invest their time and feelings into wha t matters to him. However, each individual designs their stories from past and present experiences differently. There is a diverse level of severity and truth. Things that really happened and things that could have happened and how story tellers fill in those gaps, is completely up to their discretion. In â€Å"how to tell a true war story,† O’Brien writes, â€Å" you can tell a true war story by the questions you ask.Somebody tells a story, let’s say, and afterward you ask, ‘is it true? ’ and if the answer matters, then you’ve got your answer† (p276). In O’Brien’s story he writes a letter to his fallen friends relative. In it he goes into great detail that is both deep and disturbing. He mentions both the ways â€Å"Lemon† was a person he has deep love for and the gruesome ways his life ended. The truth came out towards the end after what mattered to him was not reciprocated by Lemons sister, which left a gap, a p lace of question to the person who leaves the questioner questioning.This then makes him give up in a sense, as if he were to break down which ironically is done mainly by his own accord because there was never a simple response to his letter of make believe. There are many things that happen in all our lives both good and bad and these things contribute to who we are, the ways we communicate and how we communicate, how we present ourselves and go about every day life. These things make us aim to make what matters to us a factor and a reality when it comes to achieving.What matters in each individuals life of course varies. There are times when what matters becomes something that is shared by many, creating a movement, like in Fraser’s Rewilding how there was a problem she assisted in shining light into the problem and successfully there was others who began to share the importance of restoring wildlife. In Marta Stout’s story creating an ability to connect the missing parts of her clients’ lives contributed to a better life. What mattered to her was helping her patients get a grip on their mental stabilities.Then there are some who some, when thought about can seem selfish because what matters to them is how they feel on account of others and in the process if others get left in question to fulfill what matters. In all the stories there was something of importance to the writer, something that mattered at some point enough to write about it. Sometimes those things are not relevant or seem to be when first thought about, but then many stories are designed to the knowledge of the person whose captivated your attention and sometimes afterward you might ask, ‘is it true? and if the answer matters, then you’ve got your answer† so O’Brien says. As long as the things that are being exchanged consist with a level of importance it does not matter how real or how fake it may be. What matters is the lessons learned, the com munication and the processes that go into exchanging. As long as you know what you believe and know, truth will always be left for your decision to what is and is not true.

Advantages Choose to Continue with Education in the Countries Essay

Many student wish they can get goods education in their life. Not all students can get goods education especially for student low income families. So, universities in Malaysia have advantages can give goods education for students. The advantages choose to continue with education in the countries is cheap and affordable cost, the courses offered by Higher Education Institution is equivalent to the other countries and many Malaysia Higher Education Institution may be choose for learning. Firstly is the advantage of learning in our country is cheap and affordable costs are as low priority fees to local students. This is due to many students choose universities that offer low fees because they can not afford to fund the study. This is shown by Malaysia because Malaysia is not experiencing a seasonal climate and this will add value in terms of financial savings to students because they do not need different clothes according to the season at home in Malaysia. (Professor Badaruddin Mohamed , 2009). It also is in Malaysia, the government has allocated a total of RM232.8 billion for the implementation of all development and welfare of the people. (Prime Minister Dato ‘Sri Mohd Najib Tun Abdul Razak, 2008). Then ,low – income families is the vast majority of low-income parents today are working but still struggling to make ends meet: struggling to find and keep a toehold in a changing labor market, to keep up with their bills, to pay the spiraling costs of essentials like health care and housing, and to raise children with a chance of future success. These families have much in common with other American families as they seek to balance work and family life, yet parents and children in low-income families are more financially vulnerable than those in higher-income families.( Annie E. Casey,2005). Secondly is the the other advantages in that the courses offered by Malaysia Higher Education Institution is equivalent to other countries are as there are more than 50000 international students pursuing tertiary courses ranging in Malaysia. This is many parts of the world attending international schools and pursuing tertiary courses ranging from diploma to degrees to PhD in private higher educational institutions and public universities in Malaysia.(Hamidon Zaini,2007) and Malaysia is acknowledged as one of the pioneers in this region in the development and promotion of transnational Bachelor’s degree programmes, starting way back in the early 1980s, collaborating with reputable universities from countries like the United Kingdom, USA, France, New Zealand, Germany, Australia, etc. (Hamidon Zaini,2007).Then is University in Malaysia collaborating with reputable university from another countries.Further,universities in Malaysia to work with reputable universities from other countries such as 1980s, university in Malaysia collaborating with university from United Kingdom, USA, France, New Zealand, Germany, Australia , etc.(Razali Awang,2008) and Malaysia private university established has many in other countries. Third is the last advantage of many Malaysian Higher Education Institutions can be selected for learning as studying in the country better than overseas. This is a study in local universities can save the cost compared to studying in universities abroad, students have to pay not only for our study but also for our living cost.(Salina,2011). This also is students who study abroad are exposed to culture shock and they will have communication barrier. In addition, you will miss your friends and family, feel homesick, at times lost or alienated.(Salina,2011). Then is local universities provide job opportunities such as if want to stay in higher education locally, draw a radius around your current institution and decide how far you can reasonably travel for another position.(Salina,2011). This is finding a job in higher education is part effort and part opportunity.(Salina,2011). In conclusion, we must take cognizance of the case studies appropriate to study whether abroad or studying locally. It is important for the learning process as a place that will change a soul either in choosing the place or abroad.

Scanning the Environment

Evaluating the relative positions of competitors allows business firms to discover threats and opportunities relative to organizational strengths and weaknesses together with an understanding of the political, economic, socio-demographic and technical forces shaping the competitive environment (Saloner, Shepard & Podolny, 2000). Insights from environmental scanning support sound strategies as shown in the succeeding discussion. Demographics and Socio-Cultural Trends and Choice of Strategy Demographics and socio-cultural trends reflect changes in consumption so that the firm that can match the pace of consumer behavior would likely achieve an edge in the market (Porter, 1998). Amazon Grocery is responding to the growing adoption, by the niche market of non-price sensitive consumers, of the health conscious lifestyle resulting to an increase in demand, for fresh and healthy food products, especially with media buzz on diet and weight-loss regimen by applying the niche strategy. Aldi’s targets a different trend, which is the growth in the middle to low income group leading to the rise in price-conscious consumers seeking low priced products but of high quality. Effect of Advertising on Strategy The audience reached by television and online advertising explains the strong impact of advertising on business strategy (David, 2007). Amazon Grocery likely engages extensively in advertising through both television and online advertising focused on reaching its targeted niche market. Advertising in the timeslot of food and lifestyle shows and creating websites or forums on healthy food suggestions are means of reaching the niche audience. Aldi’s also engages in television and online advertising with a broader perspective because it is targeting a wider market and it has a wide range of options from airing during the timeslot of children’s shows and soap operas together with company website and forums. Relative Positions of Competitors. Collated information on demographics and socio-cultural trends and advertising strategies appears to support Aldi’s better position. Aldi’s targets a wide range of consumers, which means leeway for expansion and growth when compared to the easily saturated niche market of Amazon Grocery. Aldi’s has two value offerings, which are quality and low-price allowing the firm to gain a bigger market share while Amazon Grocery only offers the value of quality healthy and organic foods. Recommended Strategy for the Grocery Store Chain. Based on recent trends and changes in the market, the effective strategy for the grocery store chain is to develop a one-stop store chain providing a section on high quality but low-priced (if not the lowest priced) healthy and organic foods and a section for high quality and low priced (if not the lowest priced) other food items. The grocery could also consider establishing a ready-to-eat and non-food sections both adopting the quality and low price value combination. This would allow the grocery food chain to tap into both the markets of its competitors and reach untapped segments giving it an edge. Strategies and Improving Image as Corporate Citizen in the Community Strategies can enhance the image of firms as contributing members of the community by providing products and serviced that improve the wellbeing of fellow community members (David, 2007). Amazon Grocery supports the health of community members, Aldi’s empathize with the limits of the purchasing power of residents, and the grocery store chain provides every possible need of the community. Conclusion Knowing one’s competitive position and that of close competitors supports the development of effective strategies that create an edge for firms.

Psychological and cultural insights Essay Example | Topics and Well Written Essays - 3000 words

Psychological and cultural insights - Essay Example The binary nature of the ethnic perception has created two distinct cultural segments â€Å"the east and the west†. The segments are not only geographically separated by political borders but are also diversified in terms of psychographic nature of the residing people ((Luo, 2008). On a geographical perspective, the western countries include the nations like the UK, USA, France, Germany, etc and on contrary the eastern countries encompasses Mainland China, India, UAE, Thailand, etc. Although the geographic distinction is quite apparent, however, that is not the only rationale for diversity of perception. According to The Hofstede Centre (2015), the cultural practices vary largely across national borders. The people bear different psychological profile and engage in different social practices, which is a clear reflection of psychographic diversity.Eng and Bogaert, (2010) mentioned that the psychographic profile of an individual largely influences his perception of a particular stimulus. To put it simply, two individuals belonging from different cultural background is most likely to react differently to a same stimulus. This theory stands corrected in the Watson and Wright’s (2000) study of ethnocentric consumer behaviour. A consumer’s perception of a particular brand is largely influenced by his ethnicity. His country of origin and his cultural background plays a major role in deciding the perceived value of a brand. This is mostly because of the fact that an individual designs his perception based on his surroundings.

Comparing Of The Main Heroes Of Driving Miss Daisy Essay

Comparing Of The Main Heroes Of Driving Miss Daisy - Essay Example Colburn comes to the light as Daisy’s chauffeur following a driving mishap that renders her an inadmissible client to insurance companies as noted by Hoke: â€Å"The truth is, you just cost the insurance company $2,700. You're a terrible risk. Nobody's gonna issue you a policy after this† (Backrags par 6; Uhry 3). Although hesitant to get herself driven by a chauffeur, Daisy gradually accepts Boogie in his capacity as a chauffeur. The story of Daisy, her small family, and her chauffeur is punctuated with a lot of similarities and contrast in so far as the characters and their traits are concerned. The two main characters in the plot Daisy and Colburn, particularly display a lot of contrast and similarities. The paper will focus on the two characters considering the central role that they play in the development of the plot. Character Backgrounds Mrs. Daisy Werthan is presented as a retired schoolteacher â€Å"I taught some of the stupidest children God ever put on the face of this earth, and all of them could read well enough to find a name on a tombstone† (BookRags par 13). Having been a school teacher, Daisy is presented as a knowledgeable woman -someone who ought to be respectable in society. Hoke Colburn, on the other hand, comes to the scene as an African American who is illiterate deserving of a lowly life after his career as a driver for a local judge ends. After meeting Daisy, Hoke gets to learn from the old Widow how to read at the age of 60. While Daisy is an old Jewish widow as can be seen from Hoke’s statement â€Å"Yassum. Mist’ Sig’s grave mighty well tended. I believe you the best window in the state of Georgia† (Fulton Theatre 4), Hoke is of African antecedent and no so less of an old man. The story presents, therefore, two characters from different worlds in terms of cultural backgrounds although having a common point in that they are both old. Being non-whites at a time when racial segregation i s rife in the setting, the two characters witness a lot of discrimination as they go about their activities. This is practically seen at the point in the plot where highway patrolmen comment loudly referring to them as Old Jew Woman (for Daisy) and old Nigger (for Hoke) â€Å"[watching Daisy and Hoke leave after checking them out] An old nigger and an old Jew woman takin' off down the road together... that is one sorry sight!† (BookRags par 3). Perceptions In a society dominated by whites, Daisy and Hoke are presented as outsiders in the society. Hoke cannot understand why her employer is so backward as not to understand the changes that are sweeping the social setting at the time. Mrs. Daisy, on the other hand, fails to appreciate the reason why Hoke’s people are so resentful. Only when they are separated by circumstances do the two characters truly appreciate that they are pals and longtime kindred spirits. In particular, this is seen when Daisy finds herself confine d to a home for the old while Hoke retires from his work. Hoke is a person who is patient, caring, dignified and tolerant as can be seen from the way he treats his employer, Daisy. He does not fear to air out his views respectfully and in a calm way whenever he has a point to state. Furthermore, He stands for his rights whenever he feels that his rights are at stake. On the other hand, Daisy is clearly prejudicial, although this comes to change with time as she continues to interact with Hoke.

The Family dynamic has impact on child development Research Paper - 1

The Family dynamic has impact on child development - Research Paper Example It is my theory that the family dynamic does affect child development and the factors that affect the family dynamic the most are financial security of a family, birth order, family structure, parental involvement and parental employment. These factors all seem to play a major role in Child development. FINANCIAL SECURITY: The first article that will be examined is the Canadian Council on Learning (2007) Report on the State of Early Childhood Learning and pertains to family income and how it impacts the family dynamic & childhood learning. Income is not as important as is developing countries a significant discrepancy was demonstrated in this study. Firstly in a study, 19% of children from low-income families were considered to have delayed (Academic) development compared to 14% of other children. Moreover the paper also demonstrated that 28% of young learners from low-income families demonstrated delayed development in Number Knowledge Assessment as opposed to 14% of other (Non-low income) families. Although this study mainly focused on the effect of poverty on young families and what this poverty would mean for young learners probably the most important point that was excluded is the current economic climate of North America. This article was published in 2007 when the economy wa s performing much better than it is right now and ultimately one could postulate that the declining economic condition in the global economy means that more and more young learners are going to be negatively affected and ultimately we may see sliding results on number knowledge assessment and delayed (academic) development. BIRTH ORDER: The next main article that will be covered is Vercilo’s (2010) article which postulated that birth order affects the characteristics and physiological development of Children. Ultimately there are three schools of though on this mater insofar as some psychologist believe that birth order has no effect, modest effect or a great deal of effect on a

Consulting Skills Essay Example | Topics and Well Written Essays - 750 words

Consulting Skills - Essay Example The essay "Consulting Skills" talks about a change management process, organizational development, which mainly focuses on the understanding of behavioral sciences, which addresses how organizations and people function and is also concerned with how organizations and people can be made to function more efficiently. OD consultants offer their clients with a wide array of services which include change management, group solving problem, talent management, team development, customized training, business process redesign, and meeting designs and facilitation. In the first phase of OD implementation, an OD consultant needs to gain entry with the clients by meeting them in persons to inquire what they want from the consultant. The next step in this phase involves data collection by an appropriate method, which includes individual interviews, group interviews, or questionnaires. Data collected is then summarized, categorized and analyzed. The results are then communicated back to the clients , their comments are received, and a solution is made. The clients are then consulted if they wish to consider some alternatives suggested by the consultant. An OD consultant’s duty in this phase is to help the organization understand its current situation and identify opportunities that will enhance implementation of changes that will meet the organization’s business objectives. Other duties executed in this phase include deciding on an intervention and presenting a proposal to address the conflicts or issues.

Look at the pictures Essay Example | Topics and Well Written Essays - 1000 words

Look at the pictures - Essay Example Compared to the past, there are now simpler modes of communication, there are phones and computers which can utilize the vast internet system and enable people interact and communicate through messages, emails and even by web cameras where they can see each other. Technology has revolutionized the world not only positively but negative aspects that under values writing. Concern regarding writing skills has been raised every now and then; this has been mostly noted on the 21st century generation, the writing skills of most students and the general public has gone down compared to the skills of people that existed in the 18th and 19th century. This undermining of the writing skills can be attributed to the communication advancement whose roots have dug and spread deep in the modes of writing. Social media impacts on writing skills Social media is advancement during these times where different people across all continents has the need to interact and share activities in their lives, soc ial media such as Facebook and Twitter are some of the most popular social media in the world (Young, 146). These sites are known for interactions of friends who mostly use informal language and shortened words to pass their messages across. Statistics shows that social media is addictive to the youth of the current generation who have been known to spend most of their time in social media ‘chatting’. This chatting habit reciprocates to transfer of using of the chatting language to school settings which is inappropriate to the setting of formal language and writing. The negative side of social media is on how it affects the writing skills of the users, since this communication mode is cheap and available to everyone this affects growing children who engages in it at a very young age. This then becomes the way of life for these young people who don’t realize there are other ways like reading books by which people can spend their time. By reading books written by f amous people in the likes of William Shakespeare the young minds could have attained very special writing styles in form of stylistic devices and vocabulary. By use of social media, the means of communication is texting, this is by typing the words by pressing on buttons of the mobile phones and computer keyboards, this impacts negatively to the social media users as it does not allow them time to be able to improve on hand writing skills . The witting by way of pens is an activity that was very popular especially in the beginning of 18th century; this even led to the innovation and development of creative writing as the calligraphy a talent that had to be improved by constant practice by pen and paper. How education is affected by technology Positive As much as there are a lot of negative impacts of technology on writing, technology has some positive impacts on student writing. These impacts are positive in the fact that they enhance the educational value of all students who uses t he new technology (Ferris, 23). Through being able to go back and revise through the work, this is facilitated by software designed to check grammatical errors. Students find this easier compared to writing on paper which they have to go through word by word and in most cases ends up missing some mistakes (Ferris, 34). For many high and middle school students there has been a rise of the number of students who text update blogs and are constantly using the social

Employment Law Assignment Example | Topics and Well Written Essays - 3000 words - 1

Employment Law - Assignment Example She has all the rights to take legal action against the operation manager. These are the issues that are hurting the operation manager as well as the organization. In the first issue, UK Disability Discrimination Act 1995 can be implemented. Enid came to know that some organizational members and staffs are making fun of her problem. It can also be considered as a disability discrimination case in which she has not done any kind of mistake. According to this act, an individual within an organization cannot discriminate others based on disability issues. Therefore, in this case Enid has all the rights to take legal actions against the staffs, who are involved in wrongdoings. The legal case of Rolls Royce Ltd v Walpole 1980 can be referred as related to this case. In this particular employee was dismissed from work due to short-term absences in workplace due to disability issues and the employee was terminated (Walpole v Rolls Royce Ltd 1980). Then, the employee filed a legal complaint under the act against the organization. This issue is very much similar to the issue of Enid. She was discriminated in workplace due to her disability issues. In this case, the staffs and other engaged employees should be warned or should take apology to Enid. In the Second Issue, Sexual Discrimination Act 1975 can be considered as Barbara was sexually harassed by some male employees at the workplace. It is highly important Barbara to take legal actions against them as it is a serious concern for the organizational workplace environment. The legal case of Noeleen McAleenon v Autism Initiatives can be referred to the case in which the female employee was sexually harassed by a male co-worker and she went on to make a legal case against the organization (Noeleen McAleenon v Autism Initiatives 2013). Finally she was legally awarded with a compensation for this workplace harassment. The issue of Barbara is quite similar to the

Ethic Issues and Impact of People and Government for the Issue of Research Paper

Ethic Issues and Impact of People and Government for the Issue of Texaco and Petroequador - Research Paper Example It also left many open squander pits full of toxic slush that had carcinogenic chemicals such as chromium VI and benzene. For a frightfully long time, these holes have been leakage of toxin into waters in the ground, lands, and small rivers that people of the area have been using this water for domestic use, the people who carried the research said this area was â€Å"Amazon Chernobyl†. Scientific at experiment showed that, Texaco did not harm people or the land, but this was not true this was just trying to show that Texaco was not responsible for the harmful caused to the human beings and the land. A self-governing, court choose a specialist with the help of14 self-governing scientists to uncover the lies, the experiment showed that 60,000 substance case showed that it was enough confirmation by Jonson, the plaintiffs, and other affected with toxic prisoners to the inhabitant health. The effect was said to be of enormous money of Damages $27 billion. Texaco’s performa nce practices were usual for industry. Chevron’s activities in Ecuador destroyed industry mores and lawful norms by approximately in every possible measure. The draining of â€Å"water of configuration† is forbidden in the areas of oil-friendly state, in 1942. In 1939, Texas forbids open-air poisonous waste depths of any type Chevron constructed in Ecuador all through to 1970s and 1980s. The whole oil industry changed from the waste removal process Texaco which are used in Ecuador in the past years which was 1920s. The throwing away of poisonous â€Å"waste water† has massive harmful to human health. The U.S. administration associates hydrocarbon exposure to dangerous disease, which cost a, lot of money to be cured like the immune system impairment, cancer nervous system damage, and reproductive troubles. This are the home of many other diseases to human health one educational research shows that rates of cancer in regions that have Texaco taking place are 130% higher Ecuador’s standard, the court-selected professional in Ecuador, by means of residents and epidemiological sampling, to predict the infectivity in the area where Texaco take place during the production course of cancer death are more than 1,500. It is comprehensible from the specialist confirmation in the experiment that Texaco’s self explanation â€Å"remediation† this was not true it was just ornately choreographed deception. The court specialist showed no difference in the levels of infectivity between areas Texaco said to have remediated, also the places that are left which are not used. Five of their lawyers and four of the Ecuadorian administration servants who were there are to be prosecuted for not telling the truth about the remediation results. Ecuador assessment court had prejudiced not in favor of Chevron, because they have transferred court proceeding from U.S to Ecuador. Centralized court, Chevron provided frequent document showing that Ecuad or’s courts were as trustworthy and sufficient. Once the proofs were directed to Chevron’s responsibility, the corporation began say that the proceedings were not fair because they wanted to rule in the fever. Still Ecuador had afforded Chevron more owing process than any defendant in

No Research Paper Example | Topics and Well Written Essays - 1500 words

No - Research Paper Example These dogmatic traditional roles place women at a lower pedestal than the elevated platforms that their male counterparts proclaim so proudly. Despite all this discrimination, women have risen to overcome this uphill task through their in born strengths and power. I believe that women are strong, powerful, competitive and equal to men in all avenues of life and if provided with equal opportunities, they are bound to excel even where men have failed. The traditional traits that women are given include sensitivity, apprehension and warmth while in contrasting fashion, the men pose as emotionally stable, dominating, vigilant. These stereotyped traits are in essence transferred to their roles as women end up being viewed as having passive, caring and nurturing and subordination tendencies unlike men. Men on the other hand enjoy a stronger role that proclaims that they are strong, aggressive and dominating over women. However, these stereotyped views are not always reliable as it has been found that either gender has the ability to exhibit roles previously not associated with. As history has shown us, men can also be caring and sensitive while women have shown courage and dominance as is seen in leadership-oriented careers. However, the sexism differs in severity from one society to another as each society has its own values, systems and assigned gender roles. Since time immemorial, art has been used to represent and paint the society as it is. As forms of art, films have been used to advocate for, against or even to represent various aspects in society. Films have been used to depict the rot and evil in society, celebrate the good and righteous and also to issue warning against trends that might affect society in the future. The same principle applies to the acclimated trio of timeless classics: Metropolis, Alien and 2001: A Space Odyssey that in their own unique ways

How You Plan to Collect Data on Customers Essay Example for Free

How You Plan to Collect Data on Customers Essay How you plan to collect data on customers, competitors and the market environment and why you think this will be useful. How do you propose to use this market research to understand the behaviour of customers, competitors and the market environment? Market research is a crucial factor to do for any organisation in order to make their business successful. In the case of STUDENTAL, it is a new product from Sainsbury’s. Therefore, Sainsbury’s have to do all the market research on customers, competitors and on market environment in point of fact. For this task, I have to collect data on customers, competitors and the market environment. To collect data on customers I am going to prepare some questionnaires and ask Customers questions regarding STUDENTAL. This will help me to get the true analysis from customers straight away. This will be more accurate than information collecting from other sources like internet and magazine. I have included a variety of questions to the questionnaire and I am sure that this will help me in understanding behaviour of customers towards energy drinks. In addition, I am also going to observe customers by going in to Sainsbury’s and other supermarkets. I will observe their buying attitudes towards energy drinks. This will help me to make suggestions to the future developments of STUDENTAL. Through observing and asking questions to customers, we will be able to analyse their likes, dislikes and attitudes towards energy drinks. We will able to apply this information to the STUDENTAL. To collect data on competitors, I am going to do a research on internet. There are many competitors for STUDENTAL. This includes the bigger brands like, Lucozade, Red Bull, Boost and Power Ade. I will check for the price and product descriptions of the competing products. Through this, we will be able to understand the similarities and non-similarities of STUDENTAL and other products. Internet research will be useful to identify similar drinks sold by ASDA and Tesco. This will help Sainsbury’s to make any further changes to the product to compete effectively with other supermarkets. Another useful method of collecting information on competitors will be doing a SWOT analysis, Boston Matrix and Product Life Cycle. SWOT analysis will be able to find out STUDENTAL’s strengths, weaknesses, opportunities and threats. With the help of Boston Matrix, we will be able to understand and recognize the competing brands. To collect data on market environment, I am going to do a research on the packaging of STUDENTAL’s competitors. Using a PESTE-G will also help to find the necessary information on market environment. PESTE-G focuses on Political, Economical, Social, Technological and Green Issues. By doing a PESTE-G analysis, I will be able to understand all the external issues, which affects STUDENTAL and Sainsbury’s. The questionnaire used for collecting information from customers is attached and results obtained will be presented in the form of pie charts and bar charts as appropriate. Questionnaire STUDENTAL Please tick one box for each question. 1. Your GenderMale Female 2. Age groupUnder 16 16 19 20 – 25 20 – 25 25 – 40 40 over 3. Where did you first hear about STUDENTAL? In store From friends Advertisements On TV 4. How would you describe the taste of your favourite energy drink? Bitter Sweet Bitter Sweet Bland 5. Which of the following drink do you buy? LucozadeRed bull Powerade Other 6. From where do you buy energy drinks? Supermarkets Sports shop Gym/fitness club Other 7. What price (per litre) do you think would be right for STUDENTAL? Under  £1.00 £1.00  £1.30  £1.30 –  £2.00 £3.00 and over 8. What price do you usually pay for these. Lucozade ______Coca-cola _______ Redbull ______ Boost _______ Don’t know _______ 9. What kind of drink do you think the STUDENTAL is? Energy drink Health Drink Social drinkChildren’s drink 10. If you bought STUDENTAL, would the packaging be important to you? YesNo 11. Does it matter if the packaging is recyclable? YesNo 12. How often do you drink energy drinks? DailyTwice a week Once a weekmonthly 13. When do you drink energy drink? MorningWith Lunch When Excising When working Thank you for filling out this questionnaire Sebil To get the data on customers, I have asked customers 13 questions. To make it more effective, I asked questions to a both Males and Females. I also made sure to ask the questions to a mixture of people from different age groups. 1. Firstly, the question was about surveyed people’s gender. I asked the questions to 25 people. It included 15 Males and 10 Females. This indicates that people from both gender groups have been engaged in this survey. The above charts shows that 40% of total participants were Females and 60% of them were Males. 2. The second question was about the surveyed people’s Age Group. There was a mixture of people from different age groups. However, a large percentage of people were from the 16-19 age group. I think this will help Sainsbury’s, as STUDENTAL’s direct target market is peoples from 16-19. The above chart represents the age group of the people who participated in the survey. 16% of total participants were under 16. There were 54% of people from 16-19 age group. 22% of total participants were between 20-35 age. 8% of them were above 40 years old. This indicates that a mixture of people from all age groups participated in this survey. This will definitely help Sainsbury’s in the case of market research. 3. I asked the people about STUDENTAL after the second question. I asked them, where did you first hear about STUDENTAL? This question was to check whether they know about the product already or not. 80% of surveyed people said that they heard about the product from their friends. 20% of them said, from store. 4. How would you the taste of your favourite energy drink? This question was to understand people’s favourite taste. From the chart above, we can we clearly see that about 30% of people like bitter taste, 40% of them like sweet, 20% of them like bitter and sweet and finally, 10% of them like bland taste. Sainsbury’s may make STUDENTAL’s taste bitter or sweet as from the chart we can understand that most of the people like sweet and bitter taste 5. Which of the following drink do you buy? This question asked to find out the popular brand among the public. In addition, when STUDENTAL will be launched that popular brand will be the main competitor with STUDENTAL. The chart above represents the participators’ favourite energy drink. 30% of total participants like Red Bull Energy Drinks while 40% of th`em said that they like Lucozade. 6. From where do you buy energy drinks? This question was asked to know the place from customers buy energy drinks. About half of the people are buying their energy drinks from supermarkets. This is a very good signal for Sainsbury’s as they are going to sell STUDNTAL at their stores. 7. What price (per litre) do you think would be right for STUDENTAL? This question was asked to find out how much money people would spend on STUDENTAL when it is available in supermarkets. 40% of total participants thinks that STUDENTAL’s price will well be right if it is under  £1.00. Another 40% thinks that the price will be right if it is between  £1.00 and  £1.30. This indicates that the current price of STUDENTAL is high and there will be only very few customers who are willing to buy STUDENTAL at a cost of  £13.9/litre. 8. What price do you usually pay for energy drinks? This question will help to find out the people’s buying behaviour. The above chart shows that how much money they are spending on energy drinks. 44% of them are spending  £1.00 to  £1.50 for energy drinks. 36% of them are only prepared to spend less than  £1.00. As the chart indicates, people are not willing to buy energy drinks for higher prices. Therefore, Sainsbury’s must have to adjust the price accordingly. 9. What kind of drink do you think the STUDENTAL is? The above chart shows the answers for the question, what kind of drink do you think the STUDENTAL is? Most of the people do not know that STUDENTAL is an energy drink. I think this is due to the name STUDENTAL. It does not have the power to represent an energy drink. 10. If you bought STUDENTAL, would the packaging be important to you? This was one of the important questions asked to the participants. 90% of them said that they do care about the packaging of STUDENTAL. 11. Does it matter if the packaging is recyclable? This was another important question included in the questionnaire. 70% of participants said that they do care about the packaging and they want it to be recyclable. 12. How often do you drink energy drinks? The above chart shows that 10% of total participants consume energy drinks daily, 30% of them consume it twice in a week, 40% of them consume it weekly and 20% of them consume energy drinks monthly.

Case Study of Eruption Cysts

Case Study of Eruption Cysts Eruption cyst not uncommon: A series of three cases Abstract Aim: Presentation of three clinical cases with an eruption cyst Background:  Eruption cysts are rarely seen benign cysts most commonly encountered on the mucosa before the tooth eruption Case description: In two patients, eruption cyst occurred in the maxillary arch and in one patient it foundin the lower arch. The three eruption cysts were found with the permanent teeth. Surgical treatment was done in all three cases and tooth erupted in normal pattern Conclusion: Eruption cyst requires surgical interventionwhen patient experiences any hurt, bleeding or when they get infected and face unesthetic appearance. Surgical excision requires to relive the child from discomfort. Clinical significance: Knowledge about occurrence of eruption cyst, a rare developmental eruption disturbance is very essential to provide the correct diagnosis and treatment Key words: Benign cyst, eruption cyst, surgical excision INTRODUCTION eruption cysts are rarely encountered benign soft tissue lesions seen on the mucosa before the tooth eruption takes place. Some authors belived them as either dentigerous cysts or follicular cysts. However, they are categorized as separate lesions as they seen only in soft tissue. The pathogenesis behind the development of this cyst is not known. One author has found trauma, infection and deficient space for eruption as main etiological factors for their occurrence based on the retrospective study of their 36 cases. It appears to be to arise from the separation of the epithelium ffrom the enamel of the crown of the tooth due to an accumulation of fluid or blood in a dilated follicular space. The exact etiology of occurrence of eruption cyst is not clear. Aguilo et al.3 in their retrospective clinical study of 36 cases, found early trauma, infection and the  deficient space for eruption as possible causative factors. It seems to be toarise from the separation of the epithelium from the enamel of the crown of the tooth due to an accumulation of fluid  or blood in a dilated follicular space literature search shows low prevalence of these cysts. The reason behind low prevalence could be attributed to the fact of being them considered as dentigerous cysts by many investigators  in addition to this only few reports show the definitive diagnosis of these cysts using biopsy since they are benign lesions This may also suggest that either the eruption cyst is an unusual lesion or it is an accepted local disturbance that is associated with the eruption of many teeth. The clinicalsignificanceof low prevalence may also be due to the factthatmost often the dentist sees only symptomatic eruption cysts and the majorityresolves unnoticed CASES DISCRIPTION We hereby report three cases of eruption cyst who reported to the Out Patient Department of  Pedodontics and preventive dentistry, College of Dental sciences, Davangere, India  Case No A12-year-old  male child along with his parents reported with the  chief complaint of bluish black swelling on the gums in the front region of the upper jaw [Figure1a]. History of the case revealed lesion started appearing weeks back as translucent swelling over normal mucosa and it increased to its present size.  The color of the  lesion also slowly changed from its normal red mucosa to the present bluish black colorone week back No fluid  discharge or any other associated symptoms were associated. The general physical examination of the child showed no abnormalitiesExamination of the oral cavity revealed that the child was in the mixed dentition stage.  Soft tissue examination did not show any abnormalities except, the presence ofswelling on the buccal gingiva with respect to unerupte d 11, not extending to palatal surface. Clinically the lesion as bluish-black, circumscribed, fluctuant swelling that measured approximately 1 x 1.5 cm in diameter and was very soft inconsistency. The mucosa was smooth and no ulcerationor bleeding was present Case No An 8-year-old female patient reported with the chief complaint of non erupting upper front tooth along  with a swelling in upper anterior region Figure  1b]. Lesion started appearing 6weeks back as translucent swelling over normal mucosa and it slowly increased to  reach present size. It associated with dull aching pain on mastication.  The general physical examination of the child showed no abnormalities.  Examination of the oral cavity  showedthat the child was in the mixed dentition stage. All the permanent 1st molars had completely erupted and allcentral incisors except were erupted. Swelling measured approximately 1x 1 cm in diameter and was very soft and fluctuant and slightly bluish in color. The was smooth with no ulceration or bleeding Case No A 7- year-old boy reported with the chief complaint of swelling inlower left back tooth region [Figure 2a]. Lesion started appearing 3 weeks back translucent swelling in the region of unerupted left permanent first molarand it slowly increased to its present size.  Examination of the oral cavity revealed that the child was in the mixed dentition stage. All the permanent 1st molars had completely erupted  except mandibular left molar Swelling measured approximately 2 x 2.5 cm in diameter and was very soft and fluctuant with bluish color. In this case too, the overlying smooth with no ulceration present Radiographic examination Case 1 showed presence of 11, case 2 showed presenceof 21, case 3 showed presence of 36 in the stage of eruption and involvement or any radiolucency surrounding this tooth.Based on clinical and radiographic examination, the lesions were diagnosed as eruption cyst associated with 11, Treatment The clinical condit ion was explained to the parents and they were advised to observe the swellings for another 2 weeks as it may rupture on its and may notrequire any surgical intervention. Patients reported after 15-20 days. In all three cases, the swelling was not resolved and complained of discomfort associated with swelling while chewing food. The surgical procedure was explained to the parents and consent was obtained for the same. A blood investigation was carried out before the procedure.In first two patients,the treatment included incising the eruption cyst with BP bladeno.15 and draining the contents of the cyst. A window was cut leading to the exposureof 11 and 21. In third patient as little big with thick mucosa overlying, the superficial part present over 36 was excised completely and it was sent for histological examination. content of the cyst was drained completely. Post operative instructions were given in all patients [Figure 1c, 1d and 2b]. The case 1 and case reviewed after one month and a normal eruption pattern was observed [Figure 1e, 1f]. In addition of surgical excision of cyst in case 3, pulp for 74, cementation of modified distal shoe with intra-mucosal extension was cemented to guide the eruption of 36 [Figure 2c] and reverse crown and loop space maintainer cementation was done to prevent the mesial migration of 46. Case reviewed after 2 and 4 weeks and a of 36 was observed [Figure 2d and 3a]. After 3 month, when complete eruption of 36 was observed, distal shoe appliance was replaced and loop space maintainer [Figure 3b Microscopic examination: Haematoxylin and Eosin stained section from case No. 3 revealed, stratified squamous parakeratinized epithelium with areas of acanthosis. Connective tissue was moderately fibrous with areas of extravasated RBCs, few blood vessels and chronic inflammatory cell infiltrate of plasma cells and lymphocytes. Few inactive odontogenic rests was also seen in the connective tissue DISCUSSION on clinical examination eruption cysts appears as aelevated dome shaped swelling more commonly encountered on the mucosa of the alveolar ridge. On palpation these lesions feel soft in consistency and the surface colour usually appears as bluish, purple to black or transparent color  on clinical examination eruption cysts appears as aelevated dome shaped swe lling more commonly encountered on the mucosa of the alveolar ridge. On palpation these lesions feel soft in consistency and the surface colour usually appears as bluish, purple to black or transparent color. It  raised Clinically, eruption cyst appears as a dome shaped raised swelling in the mucosa of the alveolar ridge, which is soft to touch and the color ranges from transparent, bluish, purple to blue-black.2 Inall three presented cases here, the  color of the cyst ranged from reddish black to bluish  Eruption cyst found to appear more in the upper arch compared to lower and commonly involving anterior teeth.to be more prevalent in the maxillary archinvolving anterior teeth. Eruption cyst associated with molars and premolars is very rare. Nagaveni et al.,5 reported development of this cyst in relation to mandibular first premolar which is a rare finding on radiographic examination it is difficult to differeciate between the cystic space of eruption cyst. The reason could be the presence of both the cyst and tooth in the soft tissue. In case of dentigerous cyst we can appreciate anunilocular radiolucent region in the shape of a half moon on the crown of a non-erupted tooth. 2on h istological examination the eruption cysts shows the similar microscopic features of the dentigerous cysts which consists of connective fibrous tissue covered by a fine layer of non-keratinized cellular epithelium.  Ã‚  area It is difficult to distinguish the cystic space of eruption cyston radiographbecause both the cyst and tooth are directly in the soft tissue  in contrast to dentigerous cyst in which a well-defined  unilocular radiolucentarea is observed in the form of a half moon on the crown of a non-erupted tooth.2Histologically,the eruptioncyst presents the same microscopic characteristics as the dentigerous cyst, with connective?brous tissue covered with a fine layer of non-keratinized cellular epithelium.2 On histologic examination of tissue excised from case no. 3 showed stratified squamous parakeratinized epithelium with focal areas of acanthosis, chronic inflammatory cells and few inactive odontogenic rests in connective tissue  most of the times, the eruption c ysts do not need any treatment and they resolve on their own. 4,7 surgical treatment is required when they show bleeding, infected, hurts the patients or esthetically unpleasing. 2,8 Treatment is done to give relief from the discomfort resulting from the eruption cysts. The treatment involves simple excision or excision of the overlying tissue to expose the crown and draining the fluid is carried out in cases where the underlying tooth is not erupting or when the cyst is increasing in size. Mostly, the eruption cysts do not require treatment and majority of them disappear on their own.4,7 Surgical intervention is required when they hurt bleed, are infected, or esthetic problems arise.2,8 Treatment has to be performed in order for the childto be relived from discomfort arising lesion.Simple incision or partial excision of the overlying tissue to expose the crown anddraining the fluidis indicated when the underlying tooth is not erupting or the cyst is enlarging advanced imaging techniques like the diode laser system is an excellent equipment for the management of eruption cyst. The advantages include elimination for the need of local anesthesia in majority cases.9 As a result the occurrence of possible complications, toxicity and allergic reactions are avoided. This diode laser has bactericidalcoagulative effects. In addition to this one can appreciate mild bleeding and better visualization of the working area as compared to conventional scalpel method of treating erupti on cysts. 10 In thepresented 3 cases, we used scalpel for incising or excising the lesion as we did not have access to the laser therapy in our department. The diode laser system is an excellent toolfor management of eruption cyst,since it eliminates the need for local anesthesia in most cases Painless character of laser has been attributed to its transitory anesthetic effect due to the blocking of the  nerve conduction in Na/K pump.9 The patient is comfortable, not noticing the sensation of vibration or observing the contact of the laser handpiece with the mucosa.4As of local anesthesia is not used, the possibility of complications, toxicityand allergic reactions are eliminated. The diode laser has bactericidal coagulative effectsalso.Compared with conventional scalpel there is mild bleeding and better visibility of working areawith use of laser.10 In the presented 3 cases, we used scalpel for incising or excising the lesion as we did not have access to the laser therapy in our institution. Conclusion: Eruption cyst requires surgical intervention when they hurt, bleed, are infected, or esthetic problems arise. Treatment has to be performed in order to relive the child from discomfort. Clinical significance: Knowledge about occurrence of eruption cyst among clinicians is very essential to provide the correct diagnosis and treatment.

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. In the words of Moffitt The substance abuse and emotional difficulties apparent in the group with antisocial personality disorder may well be reciprocally related in such a way that each serves to exacerbate the other. (Moffitt T E 1993) References Black, D. A. (2002) A five year follow up of male patients discharged from Broadmoor Hospital. In Abnormal Offenders, Delinquency and the Criminal Justice System (eds. J. Gunn D. P. Farrington). Chichester : Wiley Brown, D. Pedder, J. (1979) Introduction to Psychotherapy: An Outline of Psychodynamic Practice. Principles and Practice. London: Routledge Cacciola J S, Alterman A I, Rutherford M J, Snider E C : (2005) Treatment response of antisocial substance abusers. J Nerv Ment Dis 2005; 183 : 166 – 171 Carroll K M, Ball S A, Rounsaville B J : (2003) A comparison of alternate systems for diagnosing antisocial personality disorder in cocaine abusers. J Nerv Ment Dis 1993; 181 : 436 – 444 Cleckley, H. (1964) The Mask of Sanity (Forth ed.). United States : Mosby 1964 Cloninger, C. R., Svrakic, D. M. Pryzbeck, T. R. (1993) A psychobiological model of temperament and character. Archives of General Psychiatry, 50, 975 – 990. Connor D F, R. Thomas Boone, Ronald J. Steingard, Ivan D. Lopez, and Richard H. Melloni, JR (2003) Psychopharmacology and Aggression: II. A Meta-Analysis of Nonstimulant Medication Effects on Overt Aggression-Related Behaviors in Youth with SED. Journal of Emotional and Behavioral Disorders, Fall 2003; 11 : 157 168. Cowdry, R. Gardner, D. C. (1998) Pharmacotherapy of borderline personality disorder. Archives of General Psychiatry, 45, 111 119 Evenden J (1999) Impulsivity: a discussion of clinical and experimental findings J Psychopharmacol, Jun 1999; 13: 180 192. Frank E, Jill M. Cyranowski, Paola Rucci, M. Katherine Shear, Andrea Fagiolini, Michael E. Thase, Giovanni B. Cassano, Victoria J. Grochocinski, Bryan Kostelnik, and David J. Kupfer (2002) Clinical Significance of Lifetime Panic Spectrum Symptoms in the Treatment of Patients With Bipolar I Disorder. Arch Gen Psychiatry, Oct 2002; 59 : 905 911 Fu. O Heath A C, Bucholtz K K, Nelson E et al. (2002) Shared Genetic Risk of Major Depression, Alcohol Dependence, and Marijuana Dependence. Contribution of Antisocial Personality Disorder in Men. Arch Gen Psychiatry. 2002; 59 :1125 1132. Gilligan J, Lee B (2004) The Psychopharmacologic Treatment of Violent Youth. Ann. N.Y. Acad. Sci., Dec 2004; 1036 : 356 381. Grossman L S, Brian Martis, and Christopher G. Fichtner (1999) Are Sex Offenders Treatable? A Research Overview. Psychiatr Serv, Mar 1999; 50 : 349 361. Gunderson J G, Igor Weinberg, Maria T. Daversa, Karsten D. Kueppenbender, Mary C. Zanarini, M. Tracie Shea, Andrew E. Skodol, Charles A. Sanislow, Shirley Yen, Leslie C. Morey, Carlos M. Grilo, Thomas H. McGlashan, Robert L. Stout, and Ingrid Dyck (2006) Descriptive and Longitudinal Observations on the Relationship of Borderline Personality Disorder and Bipolar Disorder. Am J Psychiatry, Jul 2006; 163 : 1173 1178. Hodgins S, Alderton J, Cree A, Aboud A, Mak T (2007) Aggressive behaviour, victimisation and crime among severely mentally ill patients requiring hospitalisation. The British Journal of Psychiatry, October 1, 2007; 191(4): 343 350. Hudziak J J, TJ Boffeli, JJ Kreisman, MM Battaglia, C Stanger, SB Guze, and JJ] Kriesman JJ (2006) Clinical study of the relation of borderline personality disorder to Briquets syndrome (hysteria), somatization disorder, antisocial personality disorder, and substance abuse disorders Am J Psychiatry, Dec 1996; 153: 1598 1606. Kerr I B, Taylor D, (2007) Acute disturbed or violent behaviour: principles of treatment. J Psychopharmacol, 1997; 11: 271 277. Kessler R C, Nelson C B, McGonagle K A, Edlund M J, Frank R G, Leaf P J. (2006) The epidemiology of co-occurring addictive and mental disorders: implications for prevention and service utilization. Am J Orthopsychiatry. 2006; 66 : 17 31. Lamberg L (2006) Personality Disorder a Possibility in Problem Patients, Specialists Say. JAMA, Sep 2006; 296: 1341 1342 Loeber R, Wung P, Keenan K, Giroux B, Stouthamer-Loeber M, Van Kammen W, Maughan B: (2003) Developmental pathways in disruptive child behavior. Developmental Psychopathology 2003; 5: 103 – 133 Mack A H, Frances R J (2003) Substance-Related Disorders. Focus, Spring 2003; 1: 125 146. Martens W H J (2000) Antisocial and Psychopathic Personality Disorders: Causes, Course, and RemissionA Review Article. Int J Offender Ther Comp Criminol, August 1, 2000; 44 (4) : 406 430. Moffitt T E : (1993) Adolescence-limited and life-course persistent antisocial behavior: a developmental taxonomy. Psychol Rev 1993; 100 : 674 – 701 Myers M G, Stewart D G, Brown S A (1998) Progression From Conduct Disorder to Antisocial Personality Disorder Following Treatment for Adolescent Substance Abuse Am J Psychiatry 155 : 479 485, April 1998 Myers W C, Burket R C, Husted D S (2006) Sadistic personality disorder and comorbid mental illness in adolescent psychiatric inpatients. J Am Acad Psychiatry Law, January 1, 2006; 34 (1) : 61 71. Oldham J M (2006) Borderline Personality Disorder and Suicidality. Am J Psychiatry, Jan 2006; 163: 20 26. Paris J (2005) Borderline personality disorder. Can. Med. Assoc. J., Jun 2005; 172: 1579 1583. Robertson M R (2000) Tourette syndrome, associated conditions and the complexities of treatment. Brain, Mar 2000; 123: 425 462. Robins L N, Price R K : (2001) Adult disorders predicted by childhood conduct problems: results from the NIMH Epidemiologic Catchment Area project. Psychiatry 2001; 54 : 116 – 132 Slutske W S, Heath A C, Dinwiddie S H, Madden P A, Bucholz K K, Dunne M P, Statham D , Martin N G. (1998) Common genetic risk factors for conduct disorder and AD. J Abnorm Psychol. 1998; 107: 363 374. Soyka M (2000) Substance misuse, psychiatric disorder and violent and disturbed behaviour. The British Journal of Psychiatry, Apr 2000; 176: 345 350. Sugden S G, Kile S J, Hendren R L (2006) Neurodevelopmental Pathways to Aggression: A Model to Understand and Target Treatment in Youth. J Neuropsychiatry Clin Neurosci, Aug 2006; 18: 302 317. Toone B (2004) Attention deficit hyperactivity disorder in adulthood. J. Neurol. Neurosurg. Psychiatry, Apr 2004; 75: 523 525. Turgay A, Carin Binder, Richard Snyder, and Sandra Fisman (2002) Long-Term Safety and Efficacy of Risperidone for the Treatment of Disruptive Behavior Disorders in Children With Subaverage Iqs. Pediatrics, Sep 2002; 110 : e 34. Tyrer P and Anthony W. Bateman (2004) Drug treatment for personality disorders. Advan. Psychiatr. Treat., Sep 2004; 10: 389 398. Windle M (2000) A longitudinal study of antisocial behaviors in early adolescence as predictors of late adolescent substance use : gender and ethnic group differences. J Abnorm Psychol 2000; 99 : 86 – 91 ################################################################ 2.8.08 Word count 4,757 PDG