Terrorism Definition Essay Example for Free

Terrorism Definition Essay Terrorism is just a word in English, but it is a hazard for mankind. Terrorism is the use of fear and acts of violence in order to intimidate societies or governments. People who do terrorism are called terrorists. Terrorism is a world-wide problem. By now, the governments throughout the world are realizing that terrorism is a serious threat to dealt with. Every terrorist acts usually takes days and even months of preparation. Terrorist are usually young, but the brain behind them are old, seasoned politicians. Terrorists mostly recruit younger people in their group as it is easy to brainwash them. Few of the terrorist attacks the world would never forget are the mid air bombings of Pan Am flight 103, the 9/11 attacks in which 2 civilian planes were hijacked and then later crashed into the famous World Trade towers in Manhattan, New York, the 2001 attack on the Indian Parliament, the 26/11 in which terrorist attacked the Taj Mahal and the Oberoi Trident hotels of Mumbai and left the world in shock. Many people lose their lives in such attacks. Around 3000 innocent people lost their lives in the 9/11 attacks. Many of you might not know that World Trade Centre was a centre of attraction for all these terrorist attacks. Well before 9/11 incident the World Trade Centre already got a choke through bomb blasts in 1993. This was said to be a failure one as they aimed for twin tower attacks and missed their task. These terrorist activities are carried out by professional terrorist groups with the Al Qaeda being the most famous one. If you have been reading the newspaper you would have noticed the ongoing terror activities in Syria and Iraq. This militant act is being carried out by another terror group called the Islamic State of Iraq and Syria or simply known as ISIS. Most of the government across the globe have special intelligence branches to counter such attacks. A few famous intelligence boards are the Central Bureau of Investigation of the Government of India and the Federal Bureau of Investigation of the United States Government. But there are evidences that the government of Pakistan had been sponsoring jihadist groups and other groups like the Al Qaeda and the Taliban to fight against its enemies like India and the United States. Many international organizations like the United Nations are continuously working to prevent such activities and also to give aid to countries which have been a victim of terror attacks Pesticides are designed to kill and because their mode of action is not specific to one species,  they often kill or harm organisms other than pests, including humans. The Organization estimates that there are 3 million cases of pesticide poisoning each year and up to 220,000 deaths, primarily in developing countries. The application of pesticides is often not very precise, and unintended exposures occur to other organisms in the general area where pesticides are applied. Children, and indeed any young and developing organisms, are particularly vulnerable to the harmful effects of pesticides. Even very low levels of exposure during development may have adverse health effects. Pesticide exposure can cause a range of neurological health effects such as memory loss, reduced speed of response to stimuli and reduced visual ability. Many studies have examined the effects of pesticide exposure on the risk of cancer. People can be exposed to pesticides by a number of different routes including: occupation, in the home, at school and in their food. There are concerns that pesticides used to control pests on food crops are dangerous to people who consume those foods. These concerns are one reason for the organic food movement. Many food crops, including fruits and vegetables, contain residues after being washed or peeled. The United Nations through the media is spreading the awareness of the need for organic farming through media channels, radios etc.

Franklin and Eleanor Roosevelt

Franklin and Eleanor Roosevelt Ally Brouwere Franklin and Eleanor Roosevelt were no regular couple. They dependably have had eyes on them particularly being the president and the principal woman of the United States. But when bits of gossip about the president becoming personally involved with his security began to turn out there were more eyes on them than any time before. Who even is Franklin and Eleanor Roosevelt? Franklin Roosevelt was thirty second president of the united states. Franklin Roosevelt was born in 1882. His dad had been married beforehand and was at that point was 54 years of age with a 28 year old child already. So, Franklin became very close with his mom, Sara. He spent the most of his childhood by his moms side, to the point that when he went to life experience school, some of his peers named him a mommys boy. As a young child, he became involved with his second cousin Eleanor Roosevelt. Franklin D. Roosevelt was the main U.S. president to be chosen four terms. He was the leader of the United States through the Great Depression and World War II. Franklin Roosevelt was leader of the United States from March 4, 1933 April 12, 1945. He was serving presidency during World War II and additionally the immense misery. He had a lot of troubled times being president but his relationship made it even harder with his wife Eleanor Roosevelt. Who is Eleanor Roosevelt? Eleanor was born on October 11 1884 in New York City. In 1905 she married her second cousin Franklin Roosevelt. Franklin found out that he had polio in 1921, after Franklin discovered he had Polio Eleanor made a decision to help him from that point forward to help him with his political profession. From that point, LeHand turned into FDRs private secretary. She remained next to him for the following two decades, noting his mail, nursing him through sick wellbeing, applauding his fantasy of a wellbeing resort in provincial Georgia (cox). Marguerite Leonard was born on september 13 in 1898. Leonard was born in a town called potsdam new york. Franklin Delano Roosevelts secretary, nurture, team promoter, counselor and conceivably partner. Missy, as franklins kids nicknamed her, she was so important to franklins life and career that he split the salary of his home equally amongst her and his significant other, Eleanor (cox). Marguerite was Roosevelts security for a long time and reputed to be a lesbian. , LeHand so awed Eleanor that after the Democrats marvelous misfortune, she requested that the young lady work at the familys Hyde Park, N.Y., home (cox) The dowager was Lucy Mercer Missy LeHand In 1920, Marguerite Missy LeHand had come to act as Franklins secretary. Throughout the years, they built up a cozy relationship, with Missy filling in as one of Franklins principle companions and partners. She lived in the White House amid his administration, and when she endured a stroke, Franklin made it so that his will to had included her. Eleanor and every one of the children were very welcoming towards Missy saw herself as part of the Roosevelt family. Franklins child Elliott later uncovered that his dad and Missy had a different relationship then everyone thought, and it appears to be likely that the family knew at the time. , who had been Roosevelts special lady almost 30 years earlier(truth about fdr). When bits of gossip about the undertaking began to fly around, Eleanor wanted a divorce . In a few regards, FDR and Eleanor had a fizzled marriage, however they likewise had a profound bond and regard for one another (richard). FDR and Eleanor had a confused marriage, yet they cherished each other to the end. Mercer was a set up by the Roosevelts daughter , Anna. Franklin was kept to a wheelchair and couldnt do anything because of the polio, so Anna talked individuals for him. Nobody knows when Lucy and Franklin started their issue, however it was in advance when Roosevelt cruised to france in 1918 tin assess maritime powers battling to the germans in world war one.(cox) But who was standing by them during when the affair came out? Who were they really? How did this affect them and who else would it really affect besides Elenor? It would affect the Roosevelt children but who truly are they? Anna she was born on May 3, 1906, was the oldest child of Franklin and Eleanor Roosevelt, and also was their only daughter. She later on married young man named Curtis B. Dall in 1926 they also had two children together a son and a daughter .She then divorced and remarried a young man named John Boettiger in 1935 and they had only one child together which was a son. In 1944 annas father asked if Anna would move into the White House to become his personal aide witch she ended up becoming his assistant. During her mothers abandonment she stept up as the white houses hostess Anna watched her father as his good health became a burden she would also met with people that her father was unable to see. Anna stood by him during his time. Anna was a writer and journalist. S he spent much of her later life to problems of education and to carrying on many of her mothers interests and problems. Anna died of cancer at the age of sixty nine. James Roosevelt, who was the first son of Eleanor and Franklin was born on December 23, 1907 in New York City. He went to Groton School, before moving up too Harvard University, and then after he finished Boston University to get his law degree. He had an early interest in politics, helping with his fathers 1936 reelection campaign. He also worked in the Roosevelt White House as an executive assistant. . He passed away in 1991 from complications due to a stroke.The next child they had was Elliot Roosevelt who was Born on September 23, Elliot Roosevelt was educated at Groton Academy. After finishing Groton and the Hun School in New Jersey, Elliot entered the business world, specializing in advertising and journalism, where he rose to the level of executive in several firms.Franklin Delano Roosevelt, Jr. was born on Augus t 17, 1914 on Campobello Island, New Brunswick in Canada. He was educated at the Groton School, graduated from Harvard University in 1937, and completed law school at the University of Virginia in 1940.Franklin joined the U.S. armed forces at the outbreak of the Second World War, joining the Naval Reserves. He was called to active duty in the Navy in March of 1941, serving in North Africa, Europe, and the Pacific, and was decorated for bravery in the battle of Casablanca and awarded the Purple Heart Medal and the Silver Star. After the war, Franklin Jr. practiced law and became active in politics with a combination of appointive and elective office.The youngest of the Roosevelt Children, John Roosevelt was born on March 13, 1916 in Washington, D.C. He was educated at Groton and Harvard University. During the Second World War, he served in the Navy aboard the USS Wasp, an aircraft carrier in the Pacific theater The time frame of this issue was during his presidency terms a total of seven years. This was in the 1930s She and Franklin most likely got to be got very personal in 1916, and the undertaking was found in September 1918, when Eleanor, unloading for her significant other, who had recently come back from England with influenza, found a whole bunch of love letters. Nobody truly knows when it began simply accepted it finished when franklin passed on. Which was in 1945.There was truly no closure for eleanor enlight of the fact that she didnt find solutions or any sort of conclusion. At the point when eleanor got some answers concerning the issue Eleanor offered Franklin a separation, but franklins mother sara, ventured in franklins issues and said that on the off chance that he divorced his significant other she could never converse with him and ensure he would abandon a penny. Louis Howe, Franklins put stock in counselor, said that leaving his better half would mean the finish of his po litical profession. So Franklin consented to remain in the marriage yet standards were made by Eleanor: He needed to sever with Lucy Merce as quickly as time permits and was advised he wasnt permitted to see him until kingdom come and he would never rest in his better halfs bed as some kind of discipline it appears like Franklin likewise truly needed a separation it wasnt simply elenor If Franklin truly intended to leave his wife He now stood up to his decisions, flexibility at a high cost of living in the agreeable jail of tradition. He delighted in rich living and carelessly expected it as his due. The yearly wage from Eleanors trust, $8,000, and his own $5,000 could be told as a white collar class life. If they split who would pay for the upkeep on their homes, the workers pay rates, the club memberships, the childerns school cost at the best tuition based schools? The last march that Franklin was alive he told his mother sara that he was tired of her threatening to remove him ou t of her life when she is the one who he has taken care of and she is the one who owes him money. Eventually, Eleanor came to Franklin to let him know how she truly felt and that was that was that she had no love and no fight left to be with him anymore and she wanted a divorce even after having six children she feels that he broke something and it will never be fixed and at that point she did not care how she looked to the world. Overall, with all the rumors that were involved in this scandal was missy really a lesbian?did franklin really cheat on eleanor? Was their really love letters between missy and franklin? Did eleanor really want a divorce? No One will ever really know its all really he said she said and up in the air. But when you are the most important person in america the whole world gets involved in your business

Cognitive And Dialectical Behaviour Therapy Borderline Personality Disorder Nursing Essay

Cognitive And Dialectical Behaviour Therapy Borderline Personality Disorder Nursing Essay AIM: To give a brief history of Borderline Personality Disorder and research the effectiveness of Cognitive Behavioural Therapy and Dialectical Behaviour Therapy. Method: A review of the literature and review of controlled trials and uncontrolled trials. Conclusion: In the management of Borderline Personality Disorder, there are many problems to consider, out of these problems self-harm and suicidal tendencies are considered the most important to treat. Chapter 1 Introduction 1.0 Despite the many treatment options for people with Borderline Personality Disorder (BPD), many professionals in mental health services continue to believe that personality disorders are untreatable. This essay provides evidence the effectiveness of Cognitive Behaviour Therapy (CBT) and Dialectical Behaviour Therapy (DBT) with Borderline Personality Disorder. Background To understand BPD, I will attempt to give a historical overview of BPD. Philippe Pinel in the 1800s, first described people who engage in deviant behaviour, but with no signs of thought disorder such as hallucinations or delusions as mania without delirium or in French manie sans delire (Friedel, 2004). Although the meaning of the term has changed through many writings on the subject over time, the writing of Cleckley and his use of the label psychopath in The Mask of Sanity brought the term into accepted usage (Meloy, 1998). The Mask of Sanity is a book written by Hervey Cleckley first published in 1941; he gave the most significant clinical description of psychopathy in the 20th century. An expanded edition of the book was published in 1982, when the name was changed from psychopathy to Personality Disorder. In 1972, newer editions of the book reflected a closer alliance with Kernbergss (1984) borderline level of personality organization, in particular defining the structural criteria of the psychopaths identity integration, defensive operations and re ality testing. The diagnosis borderline was introduced in the 1930s to label patients with problems that seemed to fall somewhere in between neurosis and psychosis (Stern, 1938). Adolph Stern a psychoanalyst described the symptoms, which are now considered to be the criteria of BPD. He suggested the possible causes and what he thought the most successful psychotherapy treatments were. He renamed the disorder, by referring to patients with symptoms as the borderline group (Friedel, 2004). In 1940, the psychoanalyst Robert Knight introduced his explanation theory of borderline disorder. Ego or sense of self psychology deals with mental function, which allows us to effectively combine our thoughts and to develop helpful responses to our life around us. He stated that people with BPD have impairments in a lot of of these functions, and he referred to them as borderline states (Friedel 2004). The next important input was made by the psychoanalyst Otto Kernberg (1967); he introduced the term borderline personality organisation. He proposed that mental disorders were determined by three distinctive personality organisations: psychotic, neurotic and borderline personality. Kernberg has been a strong promoter of modified psychoanalytic therapy for patients with borderline disorder (Friedel 2004). The first research on BPD was published by Roy Grinker in 1968, which he called Borderline Syndrome (Friedel 2004). The next major article was published in 1975 by Gunderson and Singer. They defined the major characteristics of BPD. Gunderson then went on to publish a research instrument to enable an accurate diagnosis. Internationally researchers were then able to verify the validity and integrity of BPD (Friedel, 2004). This followed with BPD becoming a genuine psychiatric diagnosis and appeared in the DSM-111 in 1980. Personality disorder categories are not firmly grounded in theory, nor are they empirically based (Livesley, 1998). Some critics say that personality disorder categories are so flawed that the best option is to abolish them and start afresh, but most pragmatists recognise that so much has been invested in them that they are very likely here to stay (Blackburn 2000a; Livesley, 1998). The Nice Guidelines for Personality Disorder (2009) state that borderline personality disorder is associated with significant impairment, especially in relation to the capacity to sustain stable relationships as a result of personal and emotional instability (NICE 2009). The severity of the symptoms, are related to the severity of the individuals personal/social situations. Stone (1993) argues that some people with BPD can still function at high levels in their lives and careers. Paris (1994) stated that about one-third of patients with BPD reported severe abuse involving an incestuous perpetrator; about one-third reported milder forms of abuse; and about one-third do not report abuse. Personality disorders are common conditions; studies indicate prevalence of 10-13% of the adult population in the community and are more common among younger age groups (24-44 yrs) and equally distributed between males and females. However, the sex ratio for specific types of personality disorder is variable e.g. antisocial personality disorder is more common among males, and borderline personality disorder more common amongst females (DOH 2003). Cognitive Behaviour Therapy (CBT) can be seen as an umbrella term for many different therapies that share some common elements. The earliest form of Cognitive Behavior Therapy was developed by Albert Ellis in the early 1950s. Aaron T.Beck independently developed another CBT approach, called Cognitive Therapy, in the 1960s. Cognitive Therapy rapidly became a favorite intervention to study in psychotherapy research in academic settings. In initial studies, it was often contrasted with behavioral treatments to see which was most effective. However, in recent years, cognitive and behavioral techniques have often been combined into cognitive behavioral treatment. This is arguably the primary type of psychological treatment being studied in research today. One specific form of cognitive-behavioural therapy is dialectical behaviour therapy (DBT), a broad-based, cognitive-behavioural programme developed specifically to reduce self-harm in women with borderline personality disorders (Linehan, 1993a; Linehan 1993b). Recent research has shown that dialectical behaviour therapy (DBT) is one of the first therapies that have demonstrated to be effective for treating borderline personality disorder as well as being effective in treating people who display varied symptoms and behaviours associated with mood disorders, including self-harm. DBT combines standard cognitive-behavioural techniques for emotion regulation and reality-testing with concepts of mindful-awareness, distress tolerance, and acceptance. 1.2 Rationale As a mental health nurse coming from a forensic background, I have experience of working with clients with personality disorder. I feel that by getting more of an understanding of CBT interventions, it will make a huge difference to my future practice in the future. McKenna et al (1999) state that it is unacceptable for health care not to be based on sound evidence of its effectiveness, and back up their practice with research-based evidence (NMC, 2008) to ensure effective clinical practice. Often nurses find it frustrating working with disorders of personality. These clients can be manipulative, socially inappropriate and difficult, for these reasons, such clients need all the patience and skills nurses have to offer. But despite this service in the NHS, services have been varied and inconsistent (DoH, 2003). Besides functional impairment and emotional distress, borderline personality disorder is also associated with significant financial costs to the healthcare system, social servi ces and the wider society (NICE 2009). 1.3 Aims and objectives The aims and objectives of this project are to review the evidence on the efficacy of Cognitive Behavioural Therapy and Dialectical Behaviour Therapy with people who have Borderline Personality. 1.4 Methodology and parameters This literature review was conducted using the following resources Electronic databases: Cochrane library, CINHAL, Medline, Psychinfo, Psychology and Behavioural Sciences and Academic Search Premier Key journals were hand searched: British Journal of Psychiatry, Journal of Personality Disorders, Mental Health Practice, Journal of Personality and Mental Health University and Trust libraries Google Google scholar The following types of literature were sought and reviewed where available Randomised control trials Systematic and structured review Quantitative and Qualitative research studies Position statements/guidelines from professional bodies Government policies (NICE (2009), NSF (1999) Text Books Inclusion and exclusion criteria Eligibility for this review was determined by the following criteria: à ¢-  Participants: adults with BPD (diagnosed according to DSM-III/DSM-III-R, DSM-IV, DSM-IV-TR or ICD-10 criteria for BPD), with or without co-morbidity. à ¢-  Intervention: psychological therapies, including CBT, DBT à ¢-  Comparators: CBT/DBT or treatment as usual à ¢-  Outcomes: self-harm, suicide, interpersonal and social functioning à ¢-  Study type: published papers were assessed according to the accepted hierarchy of evidence, whereby systematic reviews of RCTs are taken to be the most authoritative forms of evidence, with uncontrolled observational studies the least authoritative. à ¢-  Exclusion criteria: papers on personality disorder without separate BPD subgroup analyses. The studies were obtained through a number of sources, as above. Searches were performed by entering the key words Borderline Personality Disorder, Cognitive behaviour therapy into several databases, which yielded many secondary references of current best evidence. Search filters developed consisted of a combination of subject headings. The topic-specific filters were combined with appropriate research design filters developed for systematic reviews, RCTs and other appropriate research designs. These articles were selected after careful reading of the title and abstract to identify the most useful. I then limited my search to full articles which made my search a lot easier. The definitive text that will be used to aid my search will be NICE Clinical Guidelines for Personality disorder 78. This guideline makes recommendations for the treatment and management of borderline personality disorder in adults and young people (under the age of 18) who meet criteria for the diagnosis in prim ary, secondary and tertiary care (NICE, 2009). BPD is present in 1% of the population, and is most frequent in early adulthood. Women present to services more often than men. BPD is not often formally diagnosed before the age of 18, but the features of the disorder can be identified earlier. Its path is changeable but many people do recover (NICE 2009). This search will comprise both British and international articles. When choosing which articles were going to be relevant, I found it impossible to ignore the amount of articles I had on DBT and as DBT was evolved from CBT and made specifically for BPD, I decided to bring it into my research project. The articles are mixed quantitative and qualitative research. The qualitative means of gathering subjective data is centred on an individuals experience, beliefs, empowerment and quality of care and does not solely concentrate on clinical outcomes for the individual. One could argue that this is the most appropriate aspect of research for mental health nurses as mental illness is individual for each person involved in the process and although BPD is not a mental illness. The National Service Framework for adult mental health sets out our responsibilities to offer evidence based, effective services for all those with severe mental illness, including people with personality disorder who experience significant distress or difficulty (NIMH 2003). While these can be misconceived as an easy option form of research, qualitative research offers rich, reflective and exhaustive data that is invaluable and has a profound contribution to make to take to practice. The qualitative evidence was lim ited with regards to the treatments reviewed, with an emphasis on DBT. Quantitative research is a formal, objective, and rigorous statistical process for generating information about the world (Burns Grove 1999), whereby the researcher would gather a range of numerical data in order to answer the research question, or prove, disprove a hypothesis (Parahoo 2006). Philosophies or schools of thought in research are called paradigms (Parahoo 2006). One such paradigm is positivism. Parahoo (2006) asserts that positivism relies on observations by the human senses to create fact (empiricism), and believe in the unity of science, and the notion of cause and effect (determinism). The positivist researcher will endeavour to test a hypothesis or theory using the deductive process of a course of experiments. This paradigm utilises a quantitative approach in its research methods. For the positivists, quantitative research is believed to provide hard evidence and objective fact that can provide knowledge on which to base best practice (Parahoo 2006). Efficacy studies focus on the usefulness of a specific helping methodology for a particular kind of problem. Comparisons are made between the methodology in question and some other methodology between clients with some disorder who do receive the treatment and those who do not or between two different methodologies for treating the same disorder. These studies are carried out under controlled conditions. Many of the studies are well designed and demonstrate efficacy. In a healthcare context, efficacy indicates the capacity for beneficial change (or therapeutic effect) of a given intervention. Chapter 2 The Literature Review Having undertaken a critical review of the literature, I have come to explore a number of issues which I feel necessary to consider, key themes emerging from this literature review are the impact of CBT DBT on suicidal behaviours, the impact of CBT DBT on self-harming behaviours, and the impact of CBT DBT on engagement. This chapter sets out to explore these themes in more detail. On the whole the most suitable research design to answer this is the Randomised Controlled Trials (RCT); hence the evidence base reviewed include accessible RCTs undertaken in those with a diagnosis of BPD (NICE, 2009). The causes of BPD are complicated and remain uncertain. Contributing factors may include an inherited vulnerability, a particular temperament, early life experiences and, in subtle neurological or hormonal disturbances (NICE 2009). NICE (2009) state that the history of specific psychological interventions designed to help people with borderline personality disorder is intertwined with changing conceptions of the nature of the disorder itself. Swartz (1990) wrote that BPD is more common among drug and alcohol users. And within these dependents there will be more women diagnosed than men. Zanarini (1998) also adds that the disorder is more common in those with eating disorders, and also among people with self-harming behaviours (Linehan et al., 1991) 2.1 Defining Cognitive Behaviour Therapy and Dialectical Behaviour Therapy NICE (2009) define CBT as a structured psychological treatment that focuses on helping a person make connections between their thoughts, feelings and behaviour. Originally CBT was used as a treatment for depression which has now been modified to treat BPD. CBT focuses on altering the thoughts, emotions, and behaviours of patients by teaching them skills to challenge and modify beliefs, to engage in experimental reality testing, and to develop better coping strategies. The goals of these interventions are to reduce the delusional beliefs, and consequently their severity, and to encourage effective coping and decreasing distress. This essay will attempt to assess the contribution of CBT and the disorder by discussing reviews on effectiveness. CBT for BPD was developed with the idea that people with BPD have learned distorted beliefs and thoughts overtime. Distressing emotional responses and behaviours develop as a result. Beck Freeman (1990) outlined such beliefs, relating to dependen cy, distrust, and rigid perceptions. The distorted thoughts are modified by monitoring,  analysis and questioning.   Davidson (2000), adds that particular attention should be paid to the problems that can disrupt therapy, and so disrupt the therapeutic relationship (NICE, 2009), such as non-engagement, loss of structure, losing focus and lack of compliance. CBT for BPD attempts to create change by improving the attitude of the patient toward treatment, the enhancement of specific skills, and the reduction of hopelessness (Friedel, 2004). The therapist and patient will construct a list of problem areas. A set of tasks will be developed that will generate and reinforce new attitudes and behaviours, which will replace the old attitudes and behaviors that have caused problems in the past. Within the past 15 years, another, newer psychosocial treatment termed Dialectical Behaviour Therapy (DBT) was developed. DBT joins standard cognitive behavioural techniques with acceptance based strategies, as well as strategies designed to keep the therapy balanced between change and acceptance (dialectical strategies). Marsha M. Linehan, a psychologist from the University of Washington in Seattle, developed DBT specifically for people with BPD, especially those who engage in self-destructive and self-injurious behaviours. DBT is based on the belief that the symptoms of BPD result from organic impairments in the brain that control emotional responses. The early behavioural effects of this impairment are exaggerated, as the person with this biological risk factor interacts with people who do not validate their emotional pain and dont help them learn effective coping skills. DBT has gained significant support in the treatment of BPD because of the results it has achieved in several r esearch studies. It has been shown that DBT can be taught to and used by many, but not all, mental health professionals. For the time being this seriously restricts the use of this helpful treatment approach. DBT seeks to validate feelings and problems, but it balances this acceptance by gently pushing to make productive changes. DBT also deals with other opposing or dialectical tensions or conflicts that arise, such as the patients perceived need for a high level of dependence on the therapists, and the fear and guilt aroused by such extreme dependency. DBT combines both cognitive and behavioural techniques and designed specifically to treat BPD. It is a combination of individual psychotherapy and psychosocial skills training that has been shown via controlled clinical trial to be effective in treating individuals with BPD (Linehan, 1993b). One of the most limiting factors of treating and delivering therapies is that there is not enough staff in the NHS trained to a high standard ( NICE 2009). Cunningham (2004) interviewed fourteen women with BPD to discover why and how DBT is effective. The women were provided with tools to help them deal with their problems and so enabled them to to see the disorder as a controllable part of themselves rather than something that controlled them (NICE, 2009). Cunningham (2004) found that although their problems did not disappear, they became more manageable. It also seemed to have encouraging results on their relationship interactions, and, in addition DBT instilled hope and an ability to try to live independently (NICE, 2009) 2.2 Suicidal acts NICE (2009) define suicidal acts as, deliberate; life threatening; resulted in medical attention; medical assessment consistent with suicide attempt. The main problem staff face in managing BPD is suicidal behaviour (Paris Zweig-Frank, 2001). There is also an association between BPD and depression (Skodol et al., 1999; Zanarini et al, 1998), and Solof (2000) adds that the combination of the two disorders increases the number of suicide attempts. People with BPD possibly will take part in a number of negative and reckless behaviours including self-harm, eating disorders and substance misuse. Self-harming in BPD has different meanings to each individual, including relief from feelings and distress, such anger, or to reconnect with feelings after episodes of emptiness (NICE, 2009). Because of the high occurrence of self-harm, the risk of suicide is higher (Cheng et al, 1997), with 60-70% of patients with BPD making suicide attempts at some point in their lives (Oldham, 2006), however, unsuccessful attempts are far more common and the actual rate of completed suicides is estimated at between 8-10%. A specific therapy for BPD, DBT tak es a behavioural approach to self-harm and suicidal acts that include skills training in emotional regulation and validation of client experience (NICE, 2009). Cognitive-behavioural therapy along the lines of Beck, Freeman, Associates (1990) has been investigated in at least two uncontrolled trials. Brown, Newman, Charlesworth, and Chrits-Cristoph (2003) found significant decreases on suicide ideation, hopelessness, depression, number of BPD symptoms, and dysfunctional beliefs after 1 year of cognitive-behavioural therapy for suicidal or self-mutilating patients with BPD. Results were maintained at a 6 months follow-up. Effect sizes were moderate (0.22-0.55). Dropout rate was 9.4%. Arntz (1999a) found positive effects of long-lasting cognitive-behavioural therapy in a mixed sample of personality disorders, including 6 patients with BPD. Two patients with BPD dropped out prematurely, but the other four attained good results. Linehan et al (1991) conducted a randomised controlled trial using 44 chronically parasuicidal women with BPD to assess the effectiveness of DBT. Among the two groups, there was very little difference between measures of depression, hopelessness and suicidal ideation. Overall the group which received DBT had an average of 8.46 inpatient days compared to the controlled group which had 38.86 days. A naturalistic follow up review was conducted on 39 on the women one year later, to determine the effects of DBT. The women that had completed the DBT course had fewer parasuicidal episodes, but after 18-24 months there were no significant differences between the two groups, although psychiatric inpatient days were still lower for the DBT group. Rathus et al. (2002) went on to conduct a study with a group of 111 suicidal teenagers. 29 were assigned to DBT, while the other 82 had treatment as usual (TAU). It is worth mentioning that the DBT group had far more severe symptoms pre-treatment. The study therefore was not randomised. During the 12 week treatment, the DBT group had fewer inpatient hospitalisations, although the number of suicide attempts made during the treatment did not differ between the groups, but, the attendance and completion was higher in the DBT group. A smaller case study was conducted by Hengeveld et al (1996); he reported of 9 female patients who were given a 10 week course of CBT, they had all attempted suicide at least twice. Of the 9 women, four of those were diagnosed with BPD. Following up the women 10 months later, by phone or examining medical records, all four BPD patients had reports of further suicide attempts (NICE, 2009). Linehan et al. (2006) conducted a one-year randomized controlled trial with one year of post-treatment follow up. The objective was to evaluate the hypothesis that unique aspects of DBT are more efficacious compared to treatment offered by non-behavioural psychotherapy experts. The study included 101 female participants with recent suicidal and self-injurious behaviours that met DSM-IV criteria. The subjects who received DBT were half as likely to make a suicide attempt. 2.3 Self-harm NICE guidelines (2009) use the definition that self-harm is self-poisoning or self-injury, irrespective of the apparent purpose of the act. Self-harm BPD is connected with a range of diverse meanings for the individual, including release from distress and feelings, such as emptiness and anger, and to reconnect with feelings after an episode of dissociation (NICE, 2009). There have been positive attitudes from patients about DBT, as it has helped improve their ability to control their emotions, improves their relationships and significantly reduces the occurrence of self-harm (NICE, 2009). In a large sample, Tyrer et al (2003) found that CBT was equivalent to TAU for the treatment of recurrent self-harm and noted that this method was less effective for patients with BPD. In an uncontrolled study by Brown (2004), patients with BPD with self-harming tendencies received CBT over 12 months; they then stayed in contact with them by phone over the next 6 months. Therapists were on call to emergency phone calls throughout. A randomised controlled study by Verheul et al (2003) was carried out to compare DBT with TAU for patients with BPD, 58 women received treatment for a year were randomised to DBT or TAU. The results: the 12 month attrition rate (37%) for DBT was substantially lower, compared to TAU (77%); DBT treatment also resulted in a large reduction of self-harming behaviours than TAU. A follow up review of this study was carried out by Van den Bosch et al (2005), to ascertain whether the previous results were continued over the following 6 months. It was discovered that the benefits of DBT after the treatment were sustained, and levels of self-harm were lower. It must be said, however, that the definitions of self-harm were all slightly different in each of the RCTs, this can make it very difficult to compare results (NICE, 2009). Another case study series by Alper (2001), presents data on 15 women in a forensic setting, with a diagnosis of BPD. Nurses in the hospital carried out the DBT, and over 4 weeks there was a significant reduction in the occurrence of self-harm. Alper (2001) also carried out qualitative interviews with the nurses to describe how they felt about the treatment, they were all very positive. Bateman Tryer (2004) state that the extensive implementation of DBT is a acknowledgment of its founder, Marsha Linehan, with its mixture of acceptance and change, skills training, manualisation, and an opinion that is willing to embrace this comprehensive approach (NICE, 2009). The evidence strength though, is not justified, however (Tyrer, 2002b), and answers about the long-term success of this therapy as a treatment for BPD are premature. In view of the fact that the original trial, which was handicapped by many methodological limitations, there has only been one study that supports the findings clearly, which was that of Verheul et al (2003) (NICE, 2009). 2.4 Non-engagement For effective treatment, commitment to therapy is required, and research shows that fewer people drop out of DBT than other therapies (Verheul et al 2003) Haigh (2003) interviewed service users and according to them the services could be improved if staff recognised and accepted that BPD can be treated; they felt a more positive experience at their preliminary referral would aid further engagement with services; therapeutic relationship endings were dealt with effectively; and when signs of improvement are observed, services should not be removed immediately, as this tends to raise anxiety and discourage future progression (NICE, 2009). Hodgetts et al (2007) studied five people with BPD. The participants were told that DBT was the only treatment for BPD. This raised expectations and anxieties in the service users. Some preferred the structure of DBT, but others would have preferred a more flexible treatment that is adjusted to each individuals needs. Service users each felt differently about individual therapy and group therapy. One participant dropped out of therapy as she found the challenges too much to deal with. The same lady reported that she was turned away from the crisis team as she was already involved in the DBT group; this was another reason for her departure. All of the participants in this study found that the therapeutic relationship is essential, also they appreciated the importance of collaborative working and sharing their experiences (NICE, 2009). Other studies have reported quite high drop out rates from CBT, for example up to 37% (Verheul et al, 2003). It is probable that some patients did not engage because they did not find the therapy useful, but ratings from patients who had at least five sessions of CBT suggest that both the patients and therapists view the experience of therapy to have been a positive one. Even so, some patients simply did not attend. Chapter 3 Discussion and Conclusion This research project has tried to look at research evidence on the efficacy CBT and DBT in the management of Borderline Personality Disorder. This work has been done using the NICE Guideline (2009) as the definitive text. This is because this guideline is main reference document in clinical practice. Borderline Personality Disorder is one of the most challenging entities for todays therapist; in fact, this category originated as a repository for patients who fail to improve with ordinary treatment methods and whose particular pathology is most likely to provoke a negative emotional reaction in the therapist. Comfort and effectiveness in the treatment of BPD implies mastery both of ones own emotions and of therapeutic techniques in general. It is not realistic to expect success in every case, and successful treatments are usually long and stormy. Because the BPD diagnosis have common characteristics with schizophrenia, psychoses, anxiety and depression, Gunderson (2001) believes it to be a wastebasket diagnosis, which lacks diagnostic accuracy and strength, and so would only be useful to service users that did not fall into other diagnostic types. It is thought that BPD has responded badly to the treatments, and a lot of health professionals also unfortunately, believe this to be true (Friedel 2004). It seems that overall the non-RCT outcomes suggest that individual therapies are more suitable to people with BPD. Positive outcomes were shown generally, these need to be compared to the RCTs before definite conclusions can be made (NICE, 2009). It seems that the evidence base is fairly poor for therapies of BPD, the studies are minimal, the number of patients are low and the outcomes too numerous, with very little commonalities between studies (NICE, 2009) Giesen-Bloo et al (2006) are critical of DBT, stating that it fails to reduce core symptoms related to deeper personality change. The most difficult problem is that DBT is resource-intensive and expensive. Where it is available, there are usually long waiting lists. However, DBT is the treatment of choice for individuals experiencing severe impulse and self-harming behaviours. 3.1 Strengths and limitations of the review Having never done a substantial piece of work before, I did not realise the amount of work required to achieve it. I was aware of how to narrow down a search, which was needed due to vast amount of information available, but the confusion came as I particularly wanted to look at standard CBT for BPD, which very little research has been done. There was far more research for DBT, and so I decided I would explore this t

The Life of William Shakespeare Essay examples -- Shakespeare

William Shakespeare was a very talented man known for his various works of literature. His works include poems, plays, and sonnets. His works are then broken down into tragedies, comedies, and histories. Shakespeare left this world centuries ago, but his writings continue to live throughout the world today. He has greatly impacted the world of literature and his existence will forever be remembered. In 1564, William Shakespeare was born in Stratford-upon-Avon (Hazell 32). It seems that Shakespeare’s career began around the year 1592. This was a tough time for playwrights and actors. There was an outbreak of the bubonic plague which caused concerns for those wanting to watch because of being surrounded by those potentially carrying the disease, thus making it hard for the playwrights and actors to find work (â€Å"William Shakespeare.† 653-654). Not only was disease an obstacle William Shakespeare had to overcome in his work, he was also forced to face hampering from religious aspects as well. Leaders in the Puritan community looked down upon plays, acting, and other things of that nature. These authorities thought that these activities would sway people from focusing on the importance of practicing their religion. Plays and such were not allowed to be performed while in the city of London. They were banned. Eventually, despite all the obstructions, plays and theater came to be a popular thing although still forced outside the city (â€Å"The Changing Status...†). After overcoming the troubles of becoming an actor and a playwright, William Shakespeare has become well renowned. His works reach to people all around the world despite the language barriers and different races and cultures. For centuries, the popularity of his work... ... Co., 1919. 5. Print. Ellis, Jessica. â€Å"What are Shakespeare’s Comedies?† wiseGEEK. Conjecture Corp., 2003. Web. 31 Jan. 2012. Frye, Roland Mushat. Shakespeare’s Life and Times. Princeton, NJ: Princeton University Press, 1967. 16. Print. Hazell, Rebecca. Heroes: Great Men Through the Ages. New York: Abbeville Press, N.d. 32. Print. McMillan, Eric. â€Å"Who Was the Greatest of All Writers?† The Greatest Authors of All Time. N.p. 2011. Web. 26 Jan. 2012. â€Å"Race – Introduction.† Shakespearean Criticism. eNotes.com. Gale Cengage, 2006. Web. 31 Jan. 2012. Schwartz, Debora B. â€Å"Shakespeare’s Plays: The Histories.† ENGL 339. N.p. 2002. Web. 31 Jan. 2012. â€Å"The Changing Status of Theater.† About.Com.Shakespeare. The New York Times Co., 2012. Web. 31 Jan. 2012. â€Å"William Shakespeare.† Encyclopedia Americana. Vol. 24. Danbury, CT: Grolier Inc., 1994. 652-654; 656. Print.

How Is Being An American Related To Young Goodman Brown? :: Free Essay Writer

Young Goodman Brown and Endicott and the Red Cross and two short stories that, I believe, have many subliminal messages. The author of both, Nathanial Hawthorne, uses symbolism many a time to bring across these messages along with his personal beliefs of life, and the people of the 17th century. Religion is the basis of both stories. Both men go against religion. So what is an American? Not necessarily someone that goes against religion, but stands up for their rights, for what they want.   Ã‚  Ã‚  Ã‚  Ã‚  The biggest symbol in Young Goodman Brown is the idea of faith. Before he goes on his â€Å"errand,† he is talking to his wife, promising he will come back, but in actuality he is talking to his faith, as in religion. He subconsciously knows he is going against his faith on this errand, but will return. â€Å"My love and my Faith,† replied young Goodman Brown, â€Å"of all nights in the year, this one night must I tarry away from thee. My journey, as thou callest it, forth and back again†¦Ã¢â‚¬  When Brown says later in the story â€Å"I am losing my Faith†, he is not only about his wife, (which is shown through her pink ribbon in the tree), but more about his religion, which is flashing before his eyes. This errand was a test of Goodman Brown’s faith. When Brown hears people singing hymns in swears, it is a symbol of the corruption of the church. The name Goodman Brown I think is very ironic. Is he a good man after this errand?   Ã‚  Ã‚  Ã‚  Ã‚  The sword in Endicott and the Red Cross is a symbol of the ideas of the Puritans. When Endicott thrust his sword through the flag, he was using their new idea to get rid of those of the English. When he pointed at people with the sword when he was talking, he was referring to his beliefs. â€Å"But Endicott, in the excitement of the moment, shook his sword wrathfully at the culprit†¦Ã¢â‚¬  This is showing how he put his ideas in the face of Williams and the English. The Red Cross represents the English power and religious ideas forced upon the citizens of the colonies. When Endicott cut the red cross out of the flag, he was ridding his people of the English power. This was going against religion, a common theme among Hawthorne’s writings.   Ã‚  Ã‚  Ã‚  Ã‚  What is an American? After reading these two passages, I would have to say that we are a people that religion is not really a big thing.

Viet Nam :: essays research papers

The media has made sure that all of us are aware of the Vietnam conflict. Readers and movie goers the world over are now familiar with America's suffering in Vietnam and the problems American veterans have endured as they attempted to adjust to civilian life. Although all life is irreplaceable, the fact remains that the United States lost fewer than a million men in the Vietnam conflict and their social institutions and infrastructure remained relatively intact. The Vietnamese, however, lost two million men and their culture, society, landscape and tradition were literally obliterated. Despite this destruction, their side of this horrendous story has seldom been told. Worse yet, when it is told, they are often portrayed in the most unattractive of all light. Until only a few years ago, the Vietnamese were portrayed by the media as a faceless people with no identity; entities not worth caring about. The turning point came with the publication, in Dutch, of Duong Thu Huong's Blind Paradise in 1994. This landmark book was followed by Bao Ninh's The Sorrow of War. War novels deal, superficially, with war. But underneath all the blood and horror and carnage lie far deeper social and human issues. The best novels of war, such as Erich Maria Remarque's All Quiet on the Western Front and Ernest Hemingway's For Whom the Bell Tolls, as well as Bao Ninh's The Sorrow of War, also deal with the makeup and morality of a culture or a society gone wrong. The protagonist of these books, whether real or fictional, often endures a harrowing personal struggle through both a public and private hell and usually undergoes some sort of redemption, even if that redemption results in death. Born in 1952, Bao Ninh served in the Glorious 27th Youth Brigade during the Vietnam conflict. Of the five hundred youths who went to war with this brigade in 1969, Bao Ninh was one of its ten survivors, so it is not unusual that war should be the subject of his first book, considering the impact it has had on his life. Semi-autobiographical in nature, the protagonist of The Sorrow of War, Kien, is the lone survivor of his brigade and a ten year veteran of the war. As the book opens he is serving as part of an MIA body collection team. It is through his memories that we slowly learn how the war has devastated his youth and the youth of his countrymen.

I am Filipino Essay

Every race around the world has different culture and beliefs and in that difference sometimes they even fight because of that contrast. One of the races known around the world is the Filipino. The Filipino people (Filipino: Mamamayang Pilipino) or Filipinos are an ethnic group native to the islands of the Philippines. According to the 2010 Census, there were 92,337,852 in the Philippines and about 10-12 million living outside the Philippines. There are around 180 languages spoken in the Philippines, most of them belonging to the Austronesian language family, with Tagalog and Cebuano having the greatest number of native speakers. The official languages of the Philippines are Filipino and English and most Filipinos are bilingual or trilingual. The Philippines was a Spanish colony for over 300 years, leaving what can now be called Filipino culture and people semi-Hispanicized. Under Spanish rule, most of the Filipino populace embraced Roman Catholicism, yet revolted many times to its hierarchy. Due to a colonial program, almost all inhabitants adopted Spanish surnames from the Catalogo alfabetico de apellidos published in 1849 by the Spanish colonial government. As neither past governments nor the modern National Statistics Office account for the racial background of an individual, the exact percentage of Filipinos with Spanish ancestry is unknown. What is being a Pinoy all about–aside from pointing with our lips and having an action star for our President? It’s our character. Filipinos are carry many qualities which set them apart as people. One of that characteristic is the strong belief of the Supreme Being or also known as Faith of God. Filipino may have different religions in different sectors of our country, but what is consistent is that we have one strong form of faith in the Supreme Being. Supreme being also known as God/Diyos for Christians or in Islamic as Allah, sometimes called as Bathala, Kabunian, Ginoo, and others. We Filipino are also known as respectful because of the great respect for our elders. Other countries call their elders by their name but here in Philippnes we used Kuya, Ate, Lola, Lolo, Tito, Tita, Mama, Papa and more. From the â€Å"mano† to saying â€Å"po† and â€Å"opo† to our elders, these words that are part of our language show how we respect people. In our culture we always respect and follow what our parents and adults advise us to do. Not talking back, and trusting the adults around us has always been a part of who we are. One of the examples of the respect is following the beliefs by our elderly. Traditional Pilipino values have clearly influenced beliefs and practices pertaining to child rearing, medical care, disability, and death and dying. Each of these areas is detailed in the following sections with respect to more traditional views. Formal studies of Pilipino child-rearing beliefs and practices have shown considerable consistency in their findings (Church, 1986). Moreover, the specific socialization patterns and training for desirable childhood traits and behaviors (particularly during infancy/toddlerhood and early childhood) are highly consistent with other Asian cultural groups. However, Pilipino child-rearing beliefs and practices are reinforced within a traditional family structure and 1 extended family system with characteristic similarities and differences relative to other Asian cultures. Filipinos are also having close family ties. We enjoy having and knowing family members are around us. From cousins, aunts, uncles and grandparents, some family’s share their homes celebrate holidays and lends a hand to a relative in times of need. The complete centrality of family life and the importance of family loyalty, obligation, and interdependence are previously described. These values are supported by a family structure and kinship ties that reflect the multicultural Pilipino heritage. Having withstood Hispanic Catholic influence, the ancient Malay tradition of equality between men and women translates into a bilateral extended kinship system. Both the mother’s and father’s lineages are of equal importance. Thus, for example, names may be inherited through the male line or both the father’s and mother’s family name; it is not unusual for the mother’s maiden name to be given as a child’s middle name. Inheritance patterns further call for equal division between daughters and sons (Aquino, 1981; UPAC, 1980). The Filipinos are a helpful people. They live the members of their family, their relatives, neighbors, friends and even strangers. If the family is poor, the members help one another and the elders sacrifice for the education of the younger ones. The bayanihan spirit makes it possible for the people to build houses, move houses, plant crops, harvest crops, build roads and other things with little expense. The people of the community help one another in doing this. Bayanihan is also an occasion for fun because it brings the people of the community together. It means getting together or helping one another in a common project or work. Many hands make light work is the idea behind the bayanihan. When we have people visit our homes, we always welcome them with smiles, conversations, and foods. This is one of the most popular qualities of Filipinos. Foreigners who have gone to the Philippines find themselves falling in love for their hospitality. It’s a different kind of values which already existed thousands of years ago. Examples of hospitality that they show not only to foreign but also to their fellow citizens. This is observed when one person has nothing and they tend to share what they have to them. When one visits a friend’s house, they greet them with a very warm welcome. They let their visitor sit down and prepare them a meal or a snack plus drinks for them. They may not want you leave the house with an empty stomach. They make sure you had a great time visiting them. They offer their guest room to their visitors if they’re going to spend the night with them. Meals offered are very special, if not, they make a way to prepare great tasting food that their visitor wanted to eat. Majority of our livelihood in the Philippines is based on agriculture. It takes a lot of back-breaking work to plant the fields. Them it takes patience to care, water and to harvest. We Filipinos are hardworking people to the fact that they are willing to work several time to almost whole day just to feed their families. That’s how Filipinos are. One example of a hardworking person is a farmer, they earn so little but still they tend to work very hard for few bucks. Filipinos always find ways to earn for a living like putting. 2 up a small business from their home wherein they sell foods or other items for the convenient of their neighbors as well. . During the times we don’t have means to accomplish something, we find ingenious ways f using what we have to solve our problems that’s why we are also known as resourceful and creative. And because we’ve been through a lot of trials in our history, Filipinos have learned not to be depress. Rather, we find jokes and have fun even during our difficulty. An Asiawide (minus Japan) consumer survey has found that Filipinos and Thais are the happiest in the region while people of Hongkong worry about their jobs, the economy and their waistlines. The survey was conducted before the outbreak of SARS in China and elsewhere. The survey report, made by the advertising group TBWA Hongkong, was based on focus groups and five major surveys over three years in seven Asian locations. There were more that 15,000 respondents with a bias towards those aged 25 to 35 who were thought to lead the culture in Asia. The report, titled â€Å"marketing Premium Brands in Asia†, said Hong Kong people scored minus 27 on the researchers’ happiness index, compared to minus six in Taiwan, minus two on the mainland, plus six in Singapore, 10 in Malaysia , 11 in Thailand and 12 in the Philippines. The index compared the number of people who classified themselves as â€Å"very happy or â€Å"happy† against those who said they were â€Å"unhappy† or â€Å"very unhappy†. Those who said they were â€Å"okay† were excluded. Filipinos were not only the happiest among those surveyed, but were also the least body-conscious. Only 18 percent regarded themselves as overweight compared with 47 percent of Hongkongers saying they were â€Å"too fat† or â€Å"a bit fat†. We also don’t like to waste anything since we don’t have a lot. We are careful of what we have, knowing that it will serve as for a long period time which also make us Filipinos thrifty and frugal. The Filipinos held their womenfolk in high regard. The women where highly respected. When walking together, men walked behind them. They were accorded equal rights to men by their customary laws, like they could own and inherit properties. They could also engage in trade and industry. The alone enjoyed the privilege of giving names to their children. When there was no male successor to become chief of barangay, a woman could become one. Filipinos are the sweetest and loving people in the world. I don’t know why, I’m not saying this because Im a Filipino but dude, you’ve got to know them well. Men are so sweet and romantic when it comes to love, they will send you flowers, bring you to a very romantic place, they text you sweet quotes and often tell you how special you are to them. Filipino women are also romantic and very caring, that makes foreigners want to marry a kind like them. Women tend to prepare dinner before their husband comes home. They are so loving that they value the relationship which make them so faithful to their husband. And they will love you for the fullest.