Osama Bin Laden Research Paper

Osama Bal Laden; the mastermind of 9/11 Christian Hanker December 21 , 2012 World History Period 1 Osama Bin Laden changed the world on September 1 1, 2012, when he orchestrated the 911 1 bombings on the world Trade center in New York City. He has also formulated many other attacks including the October 2000 attack on the US Cole, and attacks on the US embassies in Nairobi, Kenya, and Dark sees Salaam, Tanzania in 1998 (Encyclopedia of World 1).Osama Bin Laden had a negative Influence on societies, economies, and religion throughout the world because of his actions in masterminding many radical terrorist attacks, and because he created and ended al-Qaeda. Osama Bin Laden had a dramatic effect not only on the society of the United States but also worldwide. These radical attacks have resulted in changes to the way society conducts business, travel, Immigration, and most Importantly, how people view and trust each other. Simply put, it has in many ways resulted in a drastic change to m any people's behavior.The attacks of 9/1 1 resulted in increased security exponentially. After these attacks, airport security was amplified. Other security measures were Implemented such as every time someone flies they are required to undergo body scanning; they have to remove shoes and belts, and all liquids over three point four ounces must be packed in checked luggage Monsoon 13). All these measures are now enforced to ensure maximum safety and security in airports. Instead of being able to breeze through the airport and board their flight, people are required to be there two hours early. Which has become a necessary inconvenience and a time consuming practice. After the 9/11 attacks, people were very hesitant to fly because they were afraid. To help ease the anxiety of flying and perform the safety sys precautions, the Nun deed t States created the Transportation Security Administration. The TTS hired over 50,000 people to work in airports across the country and have found to date over fifty million prohibited items, 5,000 of them being firearms Monsoon 7-10). Since Osama Bin Alden's various attacks, some airlines like Canada 3000 and Swiss Air were on the verge of going bankrupt.To counteract this, the airlines crammed more seats in their airplanes, cut the complimentary food service, and reduced flights Monsoon 22). This inconveniences the passengers because there s less space and comfort on board and with less flights, not everyone may get a seat on their flight. Osama Bin Laden had a direct impact on the way we travel, has put anxiety in the minds of innocent people wanting or needing to travel on an airplane, and caused changes in the way commercial airlines conduct businesses.Osama Bin Laden has affected society worldwide through the lives lost in 9/1 1 and America's war on terrorism. Osama Bin Laden was responsible for the many deaths that occurred as a result of his terrorist attacks. In the wake of 9/1 1, approximately 3000 people died (Newspape rs 1). This not only affected the people that died, but also the people that love them, witnessed their death, their neighbors, the community around them, and also the world. An enormous amount of grief was felt throughout the world and many societies were humbled.Another way Osama Bin Laden has impacted society is the number of troops, particularly American, that have been sent to Afghanistan and Iraq to fight in the war on terrorism. Approximately 70,000 troops were sent to Iraq and Afghanistan (Encyclopedia of World 23). This affected both their own lives and also their loved ones, not knowing if they are alive, outing a great amount of fear in millions of people's lives worldwide. The cost of the war on terrorism has not only been human lives.Governments across the world have had to fund the increased deployments and make revisions in their budgets for the future. Finally, there has been a large death toll incurred by innocent Muslims living in both America and on the battlefiel d. In retaliation to the 9/11 bombings, many Americans discriminated against Muslim Americans and many cases resulted in violence. Muslim lives have been lost fighting for AY-Qaeda and innocent civilians eave died, being caught in the middle of this war. Osama Bin Laden is responsible for changing society and the lives of many Americans, troops and his own followers.Osama Bin Laden left his mark on society by his role in inflicting terror into the hearts and minds of people worldwide. What is so frightening about terrorism is that it could happen anywhere and anytime. Bin Laden used this advantage of mystery to plant the seed of fear into people's minds worldwide. In October 2001, according to a Gallup poll, forty six percent of Americans said terrorism was America's biggest problem (Grief 47). This shows that Osama Bin Laden has had an enormous and lasting influence on the way Americans think and why they may do certain things.Osama Bin Laden had such a great influence on Americans and their minds that the CIA released a bounty worth $25 million for Bin Laden. New York City authorities put posters up around New York City showing again how much the capture of Osama Bin Laden was worth to America and how much he had affected society. This is evidenced in figure one, showing that officials want Bin Laden dead or alive. Osama Bin Laden destroyed billions of people's peace of mind worldwide. The 9/1 1 attacks were carried out in conditions of everyday life, which was in essence using the element to surprise as a weapon.What is more terrifying is that he managed to install his people into our communities. These terrorists lived amongst us until Osama Bin Laden gave his orders. This effectively created a feeling of mistrust and paranoia after the 9/1 1 attacks. It certainly had a great impact on the state of mind of many Americans. Osama Bin Laden impacted society by influencing the modification of the security systems, being responsible for killing thousands of peo ple, and outing terror in millions of people's minds worldwide.While Osama Bin Laden had an extraordinary influence on how people around the world feel and behave he also had a negative impact on America's economy. One way Bin Laden left his mark on the United States economy is that his actions caused the United States to spend billions of dollars for the military, defense, and security sectors. In the years of 2006-2008, military spending increased by $540 million to supply weapons and transportation to fight the war on terror and to deploy troops into Pakistan and Afghanistan to find Bin Laden (Griffin 17).This huge expense would not have been incurred if Bin Laden had not executed the attack on the World Trade Centre. These funds could have been spent on other things, like paying off the national debt or providing better education and healthcare for American citizens. Not only did Bin Laden cause the United States spend unnecessary money on finding him, but he also affected socie ty by redistributing $540 million of potential funding which could have been used in improvements in society. This money was spent on defense and the security sectors.All three of these divisions boosted the United States debt to $14. Trillion (Burger 8). Osama Bin Laden cost the United States lots of resources, money, and time in the search for their peace of mind. Osama Bin Alden's actions have caused friction amongst Middle Eastern and western countries, raising the prices of odds from these nations, in particular oil. After the 9/1 1 attacks, the unhealthy relationship between Islamic countries and America made Muslims reluctant to trade, resulting in an increase in the oil price. Before 9/1 1, oil prices were $1. 3, per gallon but they have increased to a current price of $3. 65 per gallon (Mille 16). Obviously, with the price of gas skyrocketing by over $2 after 9/1 1, resources have become very expensive to obtain and has put many Americans in difficulties financially because it is a huge increase that has to be accounted for. Other resources such as gold have experienced price increases. At the time of the 9/1 1 bombings, gold was priced at $271. 5 per ounce however it is now very expensive, rising to $1821 per ounce (Mille 13-14).The price of gold after 9/11 has risen over 600%, while the American dollar has lost one third of its value. Since the 9/1 1 attacks, he increased price of many plentiful goods within the Middle East has made it more difficult for people to pay for them. Another way Bin Laden affected The United State's economy is due to his role in planning the destruction caused which resulted in the reparations the insurance companies owed, and the time and money spent cleaning the devastation.Firstly, in the attacks that killed over 3,000 people, it cost an estimated $1. 5 billion to clear the devastation where the World Trade Centre stood (Gaffing 13). This cost in clearing the remains, moving it and disposing of it was a large expense w hich otherwise would have been used on other necessary expenditure such as education or roads. These funds were spent on an event that could not have been predicted or budgeted for. The cost to America can also be accounted in for the time to thousands to workers and the tort to volunteers.Another way this incident affected the economy is in the insurance claims that were owed to millions of people. These insurance claims include life insurance, auto insurance, and property insurance. The combination of lives lost and damage of properties led to and estimated $40 billion price tag in insurance claims (Gaffing 7). This huge toll on insurance companies made many companies bankrupt, and if not bankrupt, premiums became very expensive for people wanting to purchase insurance.The cost of disposing and clearing the site where the World Trade Centre stood and the insurance claims incurred after the attack crippled the economy, especially that of New York City. After the attacks of 9/1 1, m any other struggles within the United States economy arose. One example of this is that the unemployment rate in the United States almost doubled. Prior to 9/1 1, the unemployment rate was four point nine percent but soon after, the unemployment rate rose to nine point one percent Mille 7-8).As a result of the terrorist attacks over 600,000 Jobs were lost, 226,000 of them in the travel industry (Mille 7-8). This huge cut of workers left many people struggling to survive, becoming homeless, and relying on welfare or other sorts of government aide to survive. With a large demand for supplies to aid homeless people, this increased the United States debt even further, setting the debt deeper by the millions. Thousands of small businesses were destroyed by the wreckage in New York City, from the collapse of the World Trade Centre and financially.Approximately 18,000 small businesses in lower Manhattan, particularly around the site of World Trade Centre, were either physically destroyed b y flying debris or financially crushed without income to offset the costs to repair their shops (Gaffing 8). These small businesses were particularly hurt because they did not have large cash reserves or other stores to make sure they were earning money. Instead, they were out of business for six weeks while repairs were being made in lower Manhattan.This lead to the large amount of unemployment that occurred and also left many people bankrupt. The attacks of 9/1 1 that Osama Bin Laden formulated had a demoralizing toll on America's economy by increasing unemployment, destroying small businesses, skyrocketing the prices of goods and forcing America to pay hundreds of thousands of dollars to ensure safety and to find the man behind all the chaos and devastation. Osama Bin Laden was a very influential person and he used his power to change his religion for the worse.One way that he did this is that he encouraged a violent form of Islam called Salamis. With his extreme wealth, inheriti ng $300 million at age thirteen when his father died (Encyclopedia of World 4), ND power, he has influenced millions of Muslims to adopt his ideas and beliefs that encouraged violence. In Osama Bin Laden â€Å"Jihad against Jews and Crusaders†, Osama Bin Laden encourages Muslims worldwide that it is their duty religiously to kill all Americans and their allies whenever possible (bin laden, Osama).Bin Laden promoted a very extremist form of Islam and was able to spread it throughout the Muslim world. He proposed to kill other people because they were of a different religion and belief, even though they may be innocent of any religious hate crimes. He executed these attacks in many different ways, including bombings, assassinations, and cyber attacks (AY Qaeda 2). This added to his repertoire as being very dangerous and helped his followers strive for their mission of the Jihad.He was very intolerant to other religions and wanted others to tallow in his pate Laden changed views about religion and religious tolerance worldwide by increasing the stereotypes towards Middle Eastern or Islamic people being terrorists. Many forms of violence against Muslims or people with dark skin and dark hair occurred after 9/1 1 in retaliation for the attack. Osama Bin Laden therefore negatively affected religion, because innocent Muslims are being discriminated against because of Bin Laden attacks. Osama Bin Laden had a huge negative influence on religion, the economy, and society worldwide.

A Game of Thrones Chapter Thirty-six

Daenerys The Horse Gate of Vaes Dothrak was made of two gigantic bronze stallions, rearing, their hooves meeting a hundred feet above the roadway to form a pointed arch. Dany could not have said why the city needed a gate when it had no walls . . . and no buildings that she could see. Yet there it stood, immense and beautiful, the great horses framing the distant purple mountain beyond. The bronze stallions threw long shadows across the waving grasses as Khal Drogo led the khalasar under their hooves and down the godsway, his bloodriders beside him. Dany followed on her silver, escorted by Ser Jorah Mormont and her brother Viserys, mounted once more. After the day in the grass when she had left him to walk back to the khalasar, the Dothraki had laughingly called him Khal Rhae Mhar, the Sorefoot King. Khal Drogo had offered him a place in a cart the next day, and Viserys had accepted. In his stubborn ignorance, he had not even known he was being mocked; the carts were for eunuchs, cripples, women giving birth, the very young and the very old. That won him yet another name: Khal Rhaggat, the Cart King. Her brother had thought it was the khal's way of apologizing for the wrong Dany had done him. She had begged Ser Jorah not to tell him the truth, lest he be shamed. The knight had replied that the king could well do with a bit of shame . . . yet he had done as she bid. It had taken much pleading, and all the pillow tricks Doreah had taught her, before Dany had been able to make Drogo relent and allow Viserys to rejoin them at the he ad of the column. â€Å"Where is the city?† she asked as they passed beneath the bronze arch. There were no buildings to be seen, no people, only the grass and the road, lined with ancient monuments from all the lands the Dothraki had sacked over the centuries. â€Å"Ahead,† Ser Jorah answered. â€Å"Under the mountain.† Beyond the horse gate, plundered gods and stolen heroes loomed to either side of them. The forgotten deities of dead cities brandished their broken thunderbolts at the sky as Dany rode her silver past their feet. Stone kings looked down on her from their thrones, their faces chipped and stained, even their names lost in the mists of time. Lithe young maidens danced on marble plinths, draped only in flowers, or poured air from shattered jars. Monsters stood in the grass beside the road; black iron dragons with jewels for eyes, roaring griffins, manticores with their barbed tails poised to strike, and other beasts she could not name. Some of the statues were so lovely they took her breath away, others so misshapen and terrible that Dany could scarcely bear to look at them. Those, Ser Jorah said, had likely come from the Shadow Lands beyond Asshai. â€Å"So many,† she said as her silver stepped slowly onward, â€Å"and from so many lands.† Viserys was less impressed. â€Å"The trash of dead cities,† he sneered. He was careful to speak in the Common Tongue, which few Dothraki could understand, yet even so Dany found herself glancing back at the men of her khas, to make certain he had not been overheard. He went on blithely. â€Å"All these savages know how to do is steal the things better men have built . . . and kill.† He laughed. â€Å"They do know how to kill. Otherwise I'd have no use for them at all.† â€Å"They are my people now,† Dany said. â€Å"You should not call them savages, brother.† â€Å"The dragon speaks as he likes,† Viserys said . . . in the Common Tongue. He glanced over his shoulder at Aggo and Rakharo, riding behind them, and favored them with a mocking smile. â€Å"See, the savages lack the wit to understand the speech of civilized men.† A moss-eaten stone monolith loomed over the road, fifty feet tall. Viserys gazed at it with boredom in his eyes. â€Å"How long must we linger amidst these ruins before Drogo gives me my army? I grow tired of waiting.† â€Å"The princess must be presented to the dosh khaleen . . . â€Å" â€Å"The crones, yes,† her brother interrupted, â€Å"and there's to be some mummer's show of a prophecy for the whelp in her belly, you told me. What is that to me? I'm tired of eating horsemeat and I'm sick of the stink of these savages.† He sniffed at the wide, floppy sleeve of his tunic, where it was his custom to keep a sachet. It could not have helped much. The tunic was filthy. All the silk and heavy wools that Viserys had worn out of Pentos were stained by hard travel and rotted from sweat. Ser Jorah Mormont said, â€Å"The Western Market will have food more to your taste, Your Grace. The traders from the Free Cities come there to sell their wares. The khal will honor his promise in his own time.† â€Å"He had better,† Viserys said grimly. â€Å"I was promised a crown, and I mean to have it. The dragon is not mocked.† Spying an obscene likeness of a woman with six breasts and a ferret's head, he rode off to inspect it more closely. Dany was relieved, yet no less anxious. â€Å"I pray that my sun-and-stars will not keep him waiting too long,† she told Ser Jorah when her brother was out of earshot. The knight looked after Viserys doubtfully. â€Å"Your brother should have bided his time in Pentos. There is no place for him in a khalasar. Illyrio tried to warn him.† â€Å"He will go as soon as he has his ten thousand. My lord husband promised a golden crown.† Ser Jorah grunted. â€Å"Yes, Khaleesi, but . . . the Dothraki look on these things differently than we do in the west. I have told him as much, as Illyrio told him, but your brother does not listen. The horselords are no traders. Viserys thinks he sold you, and now he wants his price. Yet Khal Drogo would say he had you as a gift. He will give Viserys a gift in return, yes . . . in his own time. You do not demand a gift, not of a khal. You do not demand anything of a khal.† â€Å"It is not right to make him wait.† Dany did not know why she was defending her brother, yet she was. â€Å"Viserys says he could sweep the Seven Kingdoms with ten thousand Dothraki screamers.† Ser Jorah snorted. â€Å"Viserys could not sweep a stable with ten thousand brooms.† Dany could not pretend to surprise at the disdain in his tone. â€Å"What . . . what if it were not Viserys?† she asked. â€Å"If it were someone else who led them? Someone stronger? Could the Dothraki truly conquer the Seven Kingdoms?† Ser Jorah's face grew thoughtful as their horses trod together down the godsway. â€Å"When I first went into exile, I looked at the Dothraki and saw half-naked barbarians, as wild as their horses. If you had asked me then, Princess, I should have told you that a thousand good knights would have no trouble putting to flight a hundred times as many Dothraki.† â€Å"But if I asked you now?† â€Å"Now,† the knight said, â€Å"I am less certain. They are better riders than any knight, utterly fearless, and their bows outrange ours. In the Seven Kingdoms, most archers fight on foot, from behind a shieldwall or a barricade of sharpened stakes. The Dothraki fire from horseback, charging or retreating, it makes no matter, they are full as deadly . . . and there are so many of them, my lady. Your lord husband alone counts forty thousand mounted warriors in his khalasar.† â€Å"Is that truly so many?† â€Å"Your brother Rhaegar brought as many men to the Trident,† Ser Jorah admitted, â€Å"but of that number, no more than a tenth were knights. The rest were archers, freeriders, and foot soldiers armed with spears and pikes. When Rhaegar fell, many threw down their weapons and fled the field. How long do you imagine such a rabble would stand against the charge of forty thousand screamers howling for blood? How well would boiled leather jerkins and mailed shirts protect them when the arrows fall like rain?† â€Å"Not long,† she said, â€Å"not well.† He nodded. â€Å"Mind you, Princess, if the lords of the Seven Kingdoms have the wit the gods gave a goose, it will never come to that. The riders have no taste for siegecraft. I doubt they could take even the weakest castle in the Seven Kingdoms, but if Robert Baratheon were fool enough to give them battle . . . â€Å" â€Å"Is he?† Dany asked. â€Å"A fool, I mean?† Ser Jorah considered that for a moment. â€Å"Robert should have been born Dothraki,† he said at last. â€Å"Your khal would tell you that only a coward hides behind stone walls instead of facing his enemy with a blade in hand. The Usurper would agree. He is a strong man, brave . . . and rash enough to meet a Dothraki horde in the open field. But the men around him, well, their pipers play a different tune. His brother Stannis, Lord Tywin Lannister, Eddard Stark . . . † He spat. â€Å"You hate this Lord Stark,† Dany said. â€Å"He took from me all I loved, for the sake of a few lice-ridden poachers and his precious honor,† Ser Jorah said bitterly. From his tone, she could tell the loss still pained him. He changed the subject quickly. â€Å"There,† he announced, pointing. â€Å"Vaes Dothrak. The city of the horselords.† Khal Drogo and his bloodriders led them through the great bazaar of the Western Market, down the broad ways beyond. Dany followed close on her silver, staring at the strangeness about her. Vaes Dothrak was at once the largest city and the smallest that she had ever known. She thought it must be ten times as large as Pentos, a vastness without walls or limits, its broad windswept streets paved in grass and mud and carpeted with wildflowers. In the Free Cities of the west, towers and manses and hovels and bridges and shops and halls all crowded in on one another, but Vaes Dothrak sprawled languorously, baking in the warm sun, ancient, arrogant, and empty. Even the buildings were so queer to her eyes. She saw carved stone pavilions, manses of woven grass as large as castles, rickety wooden towers, stepped pyramids faced with marble, log halls open to the sky. In place of walls, some palaces were surrounded by thorny hedges. â€Å"None of them are alike,† she said. â€Å"Your brother had part of the truth,† Ser Jorah admitted. â€Å"The Dothraki do not build. A thousand years ago, to make a house, they would dig a hole in the earth and cover it with a woven grass roof. The buildings you see were made by slaves brought here from lands they've plundered, and they built each after the fashion of their own peoples.† Most of the halls, even the largest, seemed deserted. â€Å"Where are the people who live here?† Dany asked. The bazaar had been full of running children and men shouting, but elsewhere she had seen only a few eunuchs going about their business. â€Å"Only the crones of the dosh khaleen dwell permanently in the sacred city, them and their slaves and servants,† Ser Jorah replied, â€Å"yet Vaes Dothrak is large enough to house every man of every khalasar, should all the khals return to the Mother at once. The crones have prophesied that one day that will come to pass, and so Vaes Dothrak must be ready to embrace all its children.† Khal Drogo finally called a halt near the Eastern Market where the caravans from Yi Ti and Asshai and the Shadow Lands came to trade, with the Mother of Mountains looming overhead. Dany smiled as she recalled Magister Illyrio's slave girl and her talk of a palace with two hundred rooms and doors of solid silver. The â€Å"palace† was a cavernous wooden feasting hall, its rough-hewn timbered walls rising forty feet, its roof sewn silk, a vast billowing tent that could be raised to keep out the rare rains, or lowered to admit the endless sky. Around the hall were broad grassy horse yards fenced with high hedges, firepits, and hundreds of round earthen houses that bulged from the ground like miniature hills, covered with grass. A small army of slaves had gone ahead to prepare for Khal Drogo's arrival. As each rider swung down from his saddle, he unbelted his arakh and handed it to a waiting slave, and any other weapons he carried as well. Even Khal Drogo himself was not exempt. Ser Jorah had explained that it was forbidden to carry a blade in Vaes Dothrak, or to shed a free man's blood. Even warring khalasars put aside their feuds and shared meat and mead together when they were in sight of the Mother of Mountains. In this place, the crones of the dosh khaleen had decreed, all Dothraki were one blood, one khalasar, one herd. Cohollo came to Dany as Irri and Jhiqui were helping her down off her silver. He was the oldest of Drogo's three bloodriders, a squat bald man with a crooked nose and a mouth full of broken teeth, shattered by a mace twenty years before when he saved the young khalakka from sellswords who hoped to sell him to his father's enemies. His life had been bound to Drogo's the day her lord husband was born. Every khal had his bloodriders. At first Dany had thought of them as a kind of Dothraki Kingsguard, sworn to protect their lord, but it went further than that. Jhiqui had taught her that a bloodrider was more than a guard; they were the khal's brothers, his shadows, his fiercest friends. â€Å"Blood of my blood,† Drogo called them, and so it was; they shared a single life. The ancient traditions of the horselords demanded that when the khal died, his bloodriders died with him, to ride at his side in the night lands. If the khal died at the hands of some enemy, they lived only long enough to avenge him, and then followed him joyfully into the grave. In some khalasars, Jhiqui said, the bloodriders shared the khal's wine, his tent, and even his wives, though never his horses. A man's mount was his own. Daenerys was glad that Khal Drogo did not hold to those ancient ways. She should not have liked being shared. And while old Cohollo treated her kindly enough, the others frightened her; Haggo, huge and silent, often glowered as if he had forgotten who she was, and Qotho had cruel eyes and quick hands that liked to hurt. He left bruises on Doreah's soft white skin whenever he touched her, and sometimes made Irri sob in the night. Even his horses seemed to fear him. Yet they were bound to Drogo for life and death, so Daenerys had no choice but to accept them. And sometimes she found herself wishing her father had been protected by such men. In the songs, the white knights of the Kingsguard were ever noble, valiant, and true, and yet King Aerys had been murdered by one of them, the handsome boy they now called the Kingslayer, and a second, Ser Barristan the Bold, had gone over to the Usurper. She wondered if all men were as false in the Seven Kingdoms. When her son sat the Iron Throne, she would see that he had bloodriders of his own to protect him against treachery in his Kingsguard. â€Å"Khaleesi,† Cohollo said to her, in Dothraki. â€Å"Drogo, who is blood of my blood, commands me to tell you that he must ascend the Mother of Mountains this night, to sacrifice to the gods for his safe return.† Only men were allowed to set foot on the Mother, Dany knew. The khal's bloodriders would go with him, and return at dawn. â€Å"Tell my sun-and-stars that I dream of him, and wait anxious for his return,† she replied, thankful. Dany tired more easily as the child grew within her; in truth, a night of rest would be most welcome. Her pregnancy only seemed to have inflamed Drogo's desire for her, and of late his embraces left her exhausted. Doreah led her to the hollow hill that had been prepared for her and her khal. It was cool and dim within, like a tent made of earth. â€Å"Jhiqui, a bath, please,† she commanded, to wash the dust of travel from her skin and soak her weary bones. It was pleasant to know that they would linger here for a while, that she would not need to climb back on her silver on the morrow. The water was scalding hot, as she liked it. â€Å"I will give my brother his gifts tonight,† she decided as Jhiqui was washing her hair. â€Å"He should look a king in the sacred city. Doreah, run and find him and invite him to sup with me.† Viserys was nicer to the Lysene girl than to her Dothraki handmaids, perhaps because Magister Illyrio had let him bed her back in Pentos. â€Å"Irri, go to the bazaar and buy fruit and meat. Anything but horseflesh.† â€Å"Horse is best,† Irri said. â€Å"Horse makes a man strong.† â€Å"Viserys hates horsemeat.† â€Å"As you say, Khaleesi.† She brought back a haunch of goat and a basket of fruits and vegetables. Jhiqui roasted the meat with sweetgrass and firepods, basting it with honey as it cooked, and there were melons and pomegranates and plums and some queer eastern fruit Dany did not know. While her handmaids prepared the meal, Dany laid out the clothing she'd had made to her brother's measure: a tunic and leggings of crisp white linen, leather sandals that laced up to the knee, a bronze medallion belt, a leather vest painted with fire-breathing dragons. The Dothraki would respect him more if he looked less a beggar, she hoped, and perhaps he would forgive her for shaming him that day in the grass. He was still her king, after all, and her brother. They were both blood of the dragon. She was arranging the last of his gifts—a sandsilk cloak, green as grass, with a pale grey border that would bring out the silver in his hair—when Viserys arrived, dragging Doreah by the arm. Her eye was red where he'd hit her. â€Å"How dare you send this whore to give me commands,† he said. He shoved the handmaid roughly to the carpet. The anger took Dany utterly by surprise. â€Å"I only wanted . . . Doreah, what did you say?† â€Å"Khaleesi, pardons, forgive me. I went to him, as you bid, and told him you commanded him to join you for supper.† â€Å"No one commands the dragon,† Viserys snarled. â€Å"I am your king! I should have sent you back her head!† The Lysene girl quailed, but Dany calmed her with a touch. â€Å"Don't be afraid, he won't hurt you. Sweet brother, please, forgive her, the girl misspoke herself, I told her to ask you to sup with me, if it pleases Your Grace.† She took him by the hand and drew him across the room. â€Å"Look. These are for you.† Viserys frowned suspiciously. â€Å"What is all this?† â€Å"New raiment. I had it made for you.† Dany smiled shyly. He looked at her and sneered. â€Å"Dothraki rags. Do you presume to dress me now?† â€Å"Please . . . you'll be cooler and more comfortable, and I thought . . . maybe if you dressed like them, the Dothraki . . . † Dany did not know how to say it without waking his dragon. â€Å"Next you'll want to braid my hair.† â€Å"I'd never . . . † Why was he always so cruel? She had only wanted to help. â€Å"You have no right to a braid, you have won no victories yet.† It was the wrong thing to say. Fury shone from his lilac eyes, yet he dared not strike her, not with her handmaids watching and the warriors of her khas outside. Viserys picked up the cloak and sniffed at it. â€Å"This stinks of manure. Perhaps I shall use it as a horse blanket.† â€Å"I had Doreah sew it specially for you,† she told him, wounded. â€Å"These are garments fit for a khal.† â€Å"I am the Lord of the Seven Kingdoms, not some grass-stained savage with bells in his hair,† Viserys spat back at her. He grabbed her arm. â€Å"You forget yourself, slut. Do you think that big belly will protect you if you wake the dragon?† His fingers dug into her arm painfully and for an instant Dany felt like a child again, quailing in the face of his rage. She reached out with her other hand and grabbed the first thing she touched, the belt she'd hoped to give him, a heavy chain of ornate bronze medallions. She swung it with all her strength. It caught him full in the face. Viserys let go of her. Blood ran down his cheek where the edge of one of the medallions had sliced it open. â€Å"You are the one who forgets himself,† Dany said to him. â€Å"Didn't you learn anything that day in the grass? Leave me now, before I summon my khas to drag you out. And pray that Khal Drogo does not hear of this, or he will cut open your belly and feed you your own entrails.† Viserys scrambled back to his feet. â€Å"When I come into my kingdom, you will rue this day, slut.† He walked off, holding his torn face, leaving her gifts behind him. Drops of his blood had spattered the beautiful sandsilk cloak. Dany clutched the soft cloth to her cheek and sat cross-legged on her sleeping mats. â€Å"Your supper is ready, Khaleesi,† Jhiqui announced. â€Å"I'm not hungry,† Dany said sadly. She was suddenly very tired. â€Å"Share the food among yourselves, and send some to Ser Jorah, if you would.† After a moment she added, â€Å"Please, bring me one of the dragon's eggs.† Irri fetched the egg with the deep green shell, bronze flecks shining amid its scales as she turned it in her small hands. Dany curled up on her side, pulling the sandsilk cloak across her and cradling the egg in the hollow between her swollen belly and small, tender breasts. She liked to hold them. They were so beautiful, and sometimes just being close to them made her feel stronger, braver, as if somehow she were drawing strength from the stone dragons locked inside. She was lying there, holding the egg, when she felt the child move within her . . . as if he were reaching out, brother to brother, blood to blood. â€Å"You are the dragon,† Dany whispered to him, â€Å"the true dragon. I know it. I know it.† And she smiled, and went to sleep dreaming of home.

The Devil in Disguise: Comparing and Contrasting the Devil Figure

The Devil in Disguise â€Å"Even before he reached me, I recognized the aroma baking up from the skin under the suit–the smell of burned matches. The smell of sulfur. The man in the black suit was the Devil. † (King) A common theme among depictions of The Devil is that of unusual physical attributes. The Devil is depicted in three different stories (Joyce Carol Oates’ ‘Where Are You Going, Where Have You Been? ’, Nathaniel Hawthorne’s ‘Young Goodman Brown’, and Steven King’s ‘The Man In The Black Suit’) in three different ways, yet each description bares remarkable similarities in some aspects to the next.Themes common to the devil are that of his physical appearance or how he presents himself, his apparent supernatural powers or attributes, and his victimology. In ‘The Man in the Black Suit’ the most striking thing, at first glance, about the man is that his eyes were â€Å"an orange that shifted and flickered. † (King). He is dressed in an all black suit, a solemn, dark, ominous color, and he was pale. He smelled like sulfur. Similarly, the Devil figure in ‘Young Goodman Brown’ appears to Goodman Brown as a traveler, â€Å"dressed in grave and decent attire. (Hawthorne) Note the connotation of the word grave (solemn). Adversely, in ‘Where Are You Going, Where Have You Been? ’ (Oates) the devil takes the shape of Arnold Friend, a typical, or so it seems, teenage boy. The supernatural attributes of the devil vary, for the most part, from story to story. In the ‘Man in the Black Suit’ he can kill by clapping his hands, and his very shadow causes â€Å"the grass beneath it to turn yellow and die. (King) The Devil in ’Young Goodman Brown’ has a magical staff, â€Å"which bore the likeness of a great black snake, so curiously wrought, that it might almost be seen to twist and wriggle itself like a living serpent. â₠¬  (Hawthorne) However there is one supernatural ability that holds universal for all three stories. In each the devil figure has a certain omniscient air. â€Å"And yet, though the elder person was as simply clad as the younger, and as simple in manner too, he had an indescribable air of one who knew the world, and would not have felt abashed at the governor's dinner-table, or in King William's court†¦ (Hawthorne) â€Å"’But I know what it is. I know your name and all about you, lots of things,† Arnold Friend said. He had not moved yet but stood still leaning back against the side of his jalopy. â€Å"I took a special interest in you, such a pretty girl, and found out all about you—like I know your parents and sister are gone somewheres and I know where and how long they’re going to be gone, and I know who you were with last night, and your best girl friend’s name is Betty. Right? † (Oates) This quote shows that he knows everything a bout Connie. In ‘The Man in the Black Suit’ The Devil knows all about Gary and his family. He knows how Gary’s brother died. He knows why he died. Another thing that is universal in these depictions is the Devil’s victimology. In each story, his victim is young, naive, and inexperienced. Gary is only nine years old. A nine-year-old is very gullible and easy to take advantage of. Young Goodman Brown is also naive at least in his belief that all men and women are what they appear to be.Connie is a young, inexperienced, teenage girl. The devil can appear in any shape or form. He has been personified throughout history in literary works such as in Joyce Carol Oates’ ‘Where Are You Going, Where Have You Been? ’, Nathaniel Hawthorne’s ‘Young Goodman Brown’, and Steven King’s ‘The Man In The Black Suit’. In each he has been portrayed differently, yet similarly in several key points: his appearance, his s upernatural abilities, and his victimology.

A Child Study Essay Example | Topics and Well Written Essays - 500 words

A Child Study - Essay Example However, Ahmed’s verbal skills are limited since English is not his first language and the use of Arabic at home has limited Ahmed’s verbal development of the English language. In order to administer Piaget’s test for understanding other’s points of view, I observed Ahmed during his play time. At the start of my observations, Ahmed was reclusive and was not open to the idea of sharing with other children. This was evidenced by Ahmed’s habit of taking toys and retreating to a corner to play on his own without showing any concern for other children. Over time, as Ahmed was exposed to the other children through his daily interactions with them, Ahmed started becoming more and more open to other children. Initially, Ahmed was only willing to accept his own self and would tend to walk away with his toys if some other child came close by. Over time, Ahmed developed enough tolerance to allow other children to come close by and sit while Ahmed played on his own. Ahmed only allowed other children to play with him when he realised that he would have to consistently interact with these children for a period longer than that in the nursery. Essentially, this signifies that Ahmed began to realise that other children had a point of view of playing with the toys that Ahmed had. It could be surmised that this indicates a development in that the child is more willing to accept other children’s points of views as evidenced by Piaget’s research (Rogoff, 2003).

Class log Essay Example | Topics and Well Written Essays - 500 words

Class log - Essay Example uld involve making a decision against one or more employees without giving due consideration to their performing abilities and other morally legitimate qualifications and experiences. Secondly, the decision may originate solely on the basis of racial or sexual prejudice and other types of morally unjustifiable notions. Thirdly, the decisions could have harmful effects on employee morale and their interests which may include hiring for employment, promotion and work assignments of the employees. In addition to the above, the text also delves into wage differences among employees based on their race and gender. According to the book the comparison of the average incomes for men and women reveals that women earn much lesser compared to men. The various media reports published further substantiates this claim. This is considered to be one of the reasons for discrimination of women employees in the workplace. Such discriminations result in the violation of the person`s basic moral rights. Reading the content in the text, reminds me of a similar situation faced by my brother when he applied for a financial analyst position in a company in China. One of his female friends had also applied to the same position along with him. Their educational qualifications, work experiences and personal qualities were similar in many aspects. However, in the end my brother was appointed for the position and his friend was not considered as the company simply assumed that women were more likely to quit jobs after they get married or have children. Thus despite similar qualifications and experiences employers prefer to hire men in most cases. Such discrimination of women based on gender is morally unjust and such attributes is mostly based on stereotypes which consider women to be emotional and

Pill Bug Lab Report Example | Topics and Well Written Essays - 3250 words

Pill Bug - Lab Report Example In this case, most of the pill bugs moved towards the moist chambers. The results were in line with the concept that the body structure of pill bugs is responsible for their response to environmental stimulus. Pill bugs breathe through gills, which make them to rely on moisture for survival; otherwise they have to rely on their crevices. Generally, the purpose of the lab was to study behavior of pill bugs in their environment. Animals exhibit orienting behavior by using compass directions to move in a specific direction to a given point when it reaches its desired destination. Intuitively, the direction in which they travel is a subject to features presented by their environment. This forms the basis for taxis and kinesis, in animals, given that an environment stimulus influences the direction of movement. Orienting behavior is of particular significance to animals in that it allows them to reach their desired destination (for food or escaping dangerous conditions). The case is best illustrated by pill bugs, which exhibit orienting behavior, when they escape from dry conditions to moist conditions. This happens because pill bugs have gills which make them prefer moist environments; otherwise, in dry conditions, they would be deprived. Further, the barely waxy outer shell of a pill bug diminishes its ability to prevent desiccation. Further, the barely waxy outer shell of a pill bug diminishes its ability t o prevent desiccation. Pill bug is in the family of woodlice and the order is isopoda. This identification is what gives pill bugs their ability to coil up into a ball hence their name roly polies. The case explains why when a pill bug is moved to a drier region it will start finding its way to underneath a log; otherwise, it will end up coiling and ultimately dying. Pill bug also prefers dark places, where there is no sunlight, to avoid drying out. Besides their gills, pill bugs also

Discussion for online Healthcare HRM Essay Example | Topics and Well Written Essays - 250 words

Discussion for online Healthcare HRM - Essay Example Human resource in the healthcare setting interacts with a group of people who are highly sensitive to the environment around them due to their respective health complications. On the same note, all the stakeholders in the health care setting work towards promoting patient welfare, and so should the attitude and perception exhibited in this setting. In this respect, the realized performance outcomes rely on the basis of interaction between healthcare practitioners and the patients, thus making attitude and perception direct influential variables on performance. The integration of attitude and perception into an evaluation process should account for the links and relations between the human resource and all the other parties present in the healthcare setting, especially the patients. While this would be a positive move, the legal aspect of the matter could be highly bureaucratic, thereby slowing down the integration process and challenging the basis of operation of the evaluation system. On the same note, the likelihood of discrimination issues against human resource arising could be relatively high (Flynn, Mathis, Jackson & Langan, 2007). Moreover, the need to set measurement variables for the purpose of undertaking the evaluation becomes

Position Research Paper Essay Example | Topics and Well Written Essays - 1750 words

Position Research Paper - Essay Example Schools can help children facing substantial obstacles of poverty and discrimination to learn to read, write, compute, solve and become the good contribution citizens? Karen Chenoweth and Kati Haycock try to answer this question in their book Its Being Done; Academic Success in Unexpected (2007). Looking at the history of the American education system the answer whether schools have the potential to deliver the pearls of wisdom and knowledge to the poor kids is ‘yes’. The schools have the potential to deliver. It is and not a mathematical question of judging the resources against the population. It is the undertaking of faith and commitment. Quality education does not only mean that one should put together a bunch of students from all races and ethnicities in the same class. It defeats the purpose because the competition will eradicate the less privileged students. Increased competition improves student performance (Marlow, 2000); however, the competition should be at the same level. The educators and the teachers need to design the courses and teaching methodologies according to the students’ needs. Does the Californian public schools have this acumen and the vision? The authors write in the book that standard suburban schools paint the perfect picture of this unjust education competition where wealthy white girls excel in education and the poor African-American and Latino children barely survive. The solution is not only confined to giving due attention. Interestingly, ethnic and racial discrimination also plagues the education system. It is a common observation that there are schools where all the kids are whites or from the upper middle class. Such segregation or accumulation of ethnicities reflects the test scores of the students. The elementary schools show high average state test scores and high schools show above average SAT scores. These schools also feel proud in sending dozens of kids to Ivy League colleges. But

The Original Case Study Example | Topics and Well Written Essays - 2250 words

The Original - Case Study Example NCEMA was established on the 14th of May 2007 under the organizational structure of the Higher National Security Council of the United Arab Emirates to ensure citizens’ safety, protect all residents of the UAE and secure the country’s property. Being under the Higher National Security Council, the National Emergency Crisis and Disaster Management Authority falls under the jurisdiction of the Executive Affairs Department in the GM office, this is a government department that was established in 2010. The Authority is located in Abu Dhabi and it has about 300 employees. NCEMA plays the role of lead organization when it comes to crisis management and emergencies in the UAE. The organization’s mission is to promote the country’s capabilities in the management of crisis and emergencies. The organization’s roles involve the regulation and coordination of the entire efforts of emergency and management of crisis. By ensuring that it sets the requirements for business continuity, the Authority enables quick recovery after emergencies through joint planning. It pursues the development of a national plan designed to give a response in times of emergencies as well as coordinates communication at the national and lo cal level during emergencies. NCEMA has several departments, the Executive Affairs Department is a new department that was established in 2010 and operates under the office of the General Manager. The other departments under NCEMA include the Operations Department, Planning and Preparedness Department, Support Services Department, ICT Department, Media and Public Information Department, and the Safety and Prevention Department. The organization is known for its high performance standards. It focuses on promoting development, consolidation, maintenance of laws, policies, and procedures of emergency, and the management of all crises at the national level The first most important person in NCEMA is the organization

Theory of Constraints Essay Example for Free

Theory of Constraints Essay Executive summary   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Customers nowadays demand better services and products in terms of delivery and production. Therefore to satisfy these customer needs and expectations companies must enact changes in their processes. Competition is so intense that if a company does not improve its processes through change, then competitors will drive you out of business. Customers, employees, shareholders and other stakeholders in a company continually demand improved products, services and profitability. All these demands calls for lower cost of production and hence the management is at pains to achieve this.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   It is critical that a company initiates a process of on-going improvement, which focuses on internal process changes instead of the company undergoing reactionary changes precipitated by external changes. To achieve this change through a process of on-going improvement, the company should question its processes and this involves starting by asking the right questions to identify critical areas that need improvement. According to the Goldratt Institute some of the pertinent questions than needs to be asked include the following: What to change To what to change How to cause the change These questions must be answered effectively and in a shorter duration of time in order to achieve the process of on-going improvement (Goldratt and Cox: 1994) The purpose of this research is to explore the TOC concept and how it can be used in various functions and day to day operations in organizations. Definition   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Theory of constraints is a management philosophy developed in the 1984 and popularized by Dr. Eliyahu Goldratt. It involves the focus on resources and the identification of the constraints. The resources are then channeled to the constraints that affect the company’s bottom line. TOC starts by identifying the root causes of a constraint or problem, developing understandable chart and formulating steps that solve the root causes of the problem and constraints (Goldratt et al: 2000) It is basically identifying a goal and formulating ways of achieving that goal on a consistent basis.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   TOC is divided into two: Five focusing steps Special thinking processes How it works Special thinking processes   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The pertinent questions asked what to change, to what to change, how to cause change provides a framework and thinking process, which is an integral part of TOC process as a whole.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Solutions to problems are formulated through the adoption of strategies developed on logic of cause-and-affect. The whole concept of cause-and-effect analyzes a problem from the signs to coming up with an action plan (Scheinkopf: 1999) TOC is applied in organizations to solve problems. It is aptly described using the following questions. What to change   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Core conflict is a problem that is unavoidable, unresolved problem that hinders the organization from achieving its desired goals. This conflict can be identified through observed signs and cause-and-effect methods. Due to the nature of the core conflict; causing undesired and damaging effects, organizations are forced to formulate policies that will remedy these undesired and damaging effects caused by the core conflict. The first process is the identification of the core conflict using the three-cloud process. The core conflict to be identified is determined whether it is one that is causing all the undesirable effects. The second process of TOC in answering the ‘what to change’ question is the developing of the current reality tree which justifies the core conflict identified in process 1 above. Current reality tree explaining the cause and effects patterns and also recognizes the factors that aid the existence of undesirable effects. To what to change   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In answering this question, solution to the core conflict is developed. Questioning all the logical assumptions underlying the existence of the core conflicts does this. It is paramount that the solution developed should ‘treat’ completely all the causes and a whole range of other aspects of the undesirable effects. The solution developed is basically a strategy that will include improvements. These improvements ensure that the core conflict does not recur again.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The solution developed take into consideration the anticipated undesirable effects and therefore deters their occurrence. The third step of the TOC process under ‘to what to change’ question is the identification of the assumptions behind the core conflict and trying to eliminate them. This is done by the critical evaluation and questioning of these assumptions. The fourth step is the construction of a future reality tree that is able to formulate and develop a solution (strategy) to the core conflict and the undesirable effects.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The undesirable effects should be desirable effects after the adoption of the strategy which should be in line with the overall strategic objectives of the system. The solution must also prevent any further occurrence of undesirable effects and suggest the improvements in terms of policies, procedures or benchmarks.   It is also necessary that the strategy support the current TOC applications used to ensure the effectiveness of the new strategy in solving the core conflict (Schragenheim: 1999) How to cause change   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Since the whole concept of TOC is about on-going improvements which as seen earlier, is basically change, then the organization should develop ways of implementing the changes bearing in mind the various organization cultures.   The idea of planning for the changes is to avoid resistance because without the full cooperation of stakeholders in an organization, even the best of the strategies is doomed to fail. ‘How to cause change’ question leads to the fifth and sixth steps of a TOC process.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The fifth step involves the development of a tactical objectives map. This is usually a road map that identifies the various steps that the organization undergoes from the current state to the future state. In the future state, the strategy formulated to cope with the core conflict and undesirable effects, is fully actualized and therefore the organization is on course to achieve its goals. The process of developing the tactical objectives map should clearly explain the functions of each sub system within a certain specified duration. A prerequisite tree is used to achieve the objective (Schragenheim: 1999) The sixth and final step of the TOC process is the formulation of ways in which all the proposed actions will work together in order to reach the future state. The proposed actions relationship will be explained using transition trees.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The Five Focusing steps of TOC   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In any extensive system in an organization, there are factors that negate the attainment of the set goals. These factors are usually problematic and prevent the system from achieving the set goals. These factors are what are called constraints.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   TOC establishes that in any system, there exist constrains that affect the attainment of the objectives in a system.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Effective, earlier identification and solving of these constraints leads to better formulation of solutions which will improve the system in terms of future strategic improvements.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   TOC works on the premise that in an organization or system, there are strong and weak points. It further explains that focusing on the strong points of system or organization is an act in futility because the whole system will still be negated by the one weak point.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Therefore it is important that organizations concentrate in strengthening or eliminating that weak point in order to improve the whole system.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The five focusing steps of TOC explain the achievement of on-going improvement through the analysis of the constraints in a continuous process. The five steps are; Constraints identification Decide how to exploit the constraint in the best way Subordinate everything else to above decisions Elevate the system constraints Avoiding inertia being a constraint and if constrain is broken in step 4 go back to step 1 Constraint identification A problem cannot be fixed if it has not been identified. The same case applies to a constraint. The organization needs to identify the constraints that hinder the achievement of the set goals. The undesired effects are then assessed to establish whether they are from one constraint. All the above identification and analysis of the constraint helps the organization to formulate strategies that are used to mitigate the undesirable effects consulting from the constraint. Exploitation of the constraint Constraints are the cause of lack of the achievement of the system goals. Therefore it is necessary that an organization uses the identified constraints and turning them to desirable effects which then aids in the achievement of the system or organizational goals. The organization should ensure that it makes most of the opportunities resulting from the identified constraint. Subordinating everything else to decisions above   Any policies or requirements of a non-constraint that are outside the control of the constraint should be subordinated thus avoid limiting the constraint.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The system should also not expect the constraint to produce more than its capability because it might lead to more branches of constraints like increased lead times, inventory pile up and clash of decisions that may confuse the whole system.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The constraint subordination leads to the identification of the opportunities that be utilized in the achievement of system and organizational goals. Elevate the system constraint   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Excess and unutilized opportunities can only be realized after the isolation and analysis of the constraint through management.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Isolation of the constraint may also indicate that extra opportunities in terms of e.g. capacity may be needed. Hence the acquisition or transfer of workload to other resources may be initiated (McMullen: 1998)   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   It is important that before an acquisition of excess resource capacity is undertaken; all possible options that lead to goal achievement are explored and thus save on the creation of unnecessary extra capacity which can itself become a constraint hence creating branches of constraints. If in previous steps constraints are broken go back to step 1 During the exploitation subordination or elevation of the constraint, it might be eliminated. The elimination of constraint does not mean that there will be no further constraint. Other constraints will be appear and therefore the need to revisit the whole process by going back to step 1   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   An example of how solving one constraint lends to another is when the constraint is lack of capacity. Acquiring more capacity thereby lending more rooms for production may eliminate lack of capacity. However, this may lead to overproduction so that the new constraint is the lack of market (McMullen: 1998)   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Therefore TOC involves the analysis of systems and processes in a continuous manner hence the term on-going improvement. Application of Theory of Constraints Theory of constraints principles has been applied in a wide variety of fields ranging from business, government to non-government organizations.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Utilization of TOC processes creates huge savings in costs and increase in profitability. Basically it can lead to faster realization of system goals, which is the desire of any organization.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   Some of the areas that TOC concept can be applied include the following Manufacturing operations Logistic and supply chain Finance and accounting Project management Marketing and sales Synchronous Flow manufacturing (SFM) In a manufacturing process, the factory’s resources in terms of capacity is hampered by its constraints operation, the capacity constraining resource (CCR)   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The constraint leads to inefficiencies, which may include loss of time due to e.g. idle time. The loss of this time is irrecoverable.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In a manufacturing process, the theory of constraints measures the performance based on the amount of finished goods produced, levels of inventories and operating expenses. The number of units of finished goods produced should be more while the inventory levels and operating expenses amount should be lower (Levinson: 2002).      Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In a synchronous flow manufacturing, the production information is between CCR and production starts. The CCR ensures production in form of production starts. A deficit at the CCR leads to lose of time, which cannot be recovered.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The Drum-Buffer-Rope production control is achieved in a SFM in the following way: The constraint operation controls the factory’s production speed by hindering the overall rate of production. This is same as â€Å"beating the drum† of the speed of production. The constraint is then connected with the production outputs by a rope in order to achieve the level of production speed dictated by the CCR. It is also necessary that a buffer of inventory is maintained at the or just before the constraint to avoid stoppages in pre constraint production stages. The whole process thus results in a Drum-Buffer-Rope production (Levinson: 2002). Logistics   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   TOC application in logistics involves the analysis of drum-buffer-rope scheduling, buffer management and VAT. Drum-Buffer-Rope   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   It is used to plan the flow of materials in a TOC process. As explained earlier in the SFM, the drum is the constraint and is responsible for determining the speed of the whole process. Buffer is the resource that sustains the end product. Buffer stock avoids breaks in the process therefore ensuring the optimization of the end product. The rope is a plan for introducing inputs to the production floor. It is basically a control that ensures that no more than the required resources are released into the production floor. The rope also ensures that the constraint is subordinated by the non-capacity constraints (Dettmer: 1998) Buffer Management   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   It helps in the management of the production schedule in the production floor. The buffers can be at the constraint, assembly or shipping. Buffer management ensures that there is no idle capacity, which can lead to the non-achievement of the end product or customer deadline. VAT Analysis   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   VAT analysis establishes the general flow of the production process from the beginning to the end i.e. the flow of inputs up to the end product. VAT analysis assumes that the whole production process in terms of products, raw materials and processes are intertwined. VAT analysis, therefore, establishes that the interactions result into three production structures; the V logical, A logical and T logical structures. Logical structures are the expected patterns and processes hat a product must undergo to its completion (Dettmer: 1998)   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The V logical structure starts the production process with one or a few inputs, which then result into many products as it flows through the logical structures. The end result of this production process is many end products. The A logical structure starts with many inputs which then converge as the production process progress and consequently result into a single or few finished products.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The T logical structure results into same end products produced from the same process and sub processes. The raw materials pass through a number of same processes, which then provide inputs to the several sub processes that result into similar end products. In VAT analysis, the system control points, which can be gating operations, divergent points, constraints and delivery points are identified and managed once the production flow is determined. These control points are then analyzed to establish whether buffers can be used to maximize the production and avoid stoppages (Dettmer: 1998)   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   The control points to be adopted in the management of the production process depend on the shape of the logical structure. A V structure utilizes the constraint, gating operation and divergent points. Buffers are used to ensure uninterrupted flow to the constraint with gating operation controlling the resource availability. Divergent point uses the delivery schedule thus avoiding wrong material allocation.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   A T structure uses constraint and gating operation with the output of the gating being pegged on the constraint. The constraint is managed using the five steps focusing process. In the A logical structure, the constraints, gating operation, divergent and convergent points are analyzed. Finance and Accounting   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   In a Finance department of a company, there are two types of accounting statements that are made; the Financial accounting (for shareholders, government and other external stakeholders) and Management accounting (for management). Under the management accounting, the following accounting techniques are used: Absorption costing – focuses on cost Variable costing – contribution Throughput accounting is arrived at if the concepts of absorption and variable costing are applied to management accounting. Throughput accounting is basically cash based non allocation method which is slightly different from full absorption costing in the sense that throughput accounting expenses manufacturing overhead costs in the period the product is produced while full absorption costing allocates the costs to products until sold (Youngman 2008). The measures of throughput, inventory and operating expense can be used together with the analysis of constraints to maximize profitability in a business. Decisions made are based on the knowledge of constraints within the system and where it will occur in the future. These constrains can be external or internal. Internal constraints calls for the calculation of the through put generated per unit item of the constraint while external constraints treats any through put above total variable costs or positive contribution to the system (Youngman 2008). In throughput accounting, a change of one critical aspect calls for the complete evaluation of the whole system. It is basically the effects of decision but not the product that is considered.   Despite of all the benefits of throughput accounting over marginal and absorption costing, it has been found that it is not perfect. It does not allocate fixed costs. This thus has lead to the development of Constraints Accounting concept. Constraints accounting, introduces the effects of constraints to profit and loss statement thus subordinating management accounting to the set goals of the firm. Constraints are broken as operating providing ways of achieving goal congruence in both short term and long term results (Caspari and Caspari: 2004) Project Management All types of projects in different fields have two common problems; that they are uncertain and competing resources, deadlines and project details. These problems therefore make project management an uphill task. TOC tries to address the problems associated with projects by answering the three pertinent questions of: What to change To what to change How to cause the change In answering the â€Å"What to change† question, the organization must identify and effectively solve the cause of all the problems associated with project management. (Jacob and Mc Cleland: 2001) Multiple projects may pose serious problems resulting from wrong decisions on project start times. Wrong start times may affect the resource committed to existing projects thus delaying their finish times. Single projects problems may originate form wrong assumptions made during the planning and scheduling stages (Schragenheim: 1999) Answering the â€Å"to what to change† question should adequately tackle the root causes of problems associated with project management. This is done through planning, effective scheduling, introduction of work that creates extra capacity, project control and work actions that facilitate good project performance (Newbold: 1998) Project planning involves all stakeholders and basically identifies constraints thereby avoiding reworks halfway through the projects. Important tasks, paths and resource needs are established Project scheduling considers the critical chain by evaluating task, resources and iteration dependencies. Introduction of work should not exceed the existing capacity so as to avoid creating further constraints. Buffer management helps in the control of the project by identifying areas that need buffer stock thus ensuring uninterrupted flow of work. TOC project management adopts delay runner work ethics, which enables the workers to immediately start working on the assigned tasks, and provide notification of completed works (Jacob and Mc Cleland: 2001) The last question of the project management is the â€Å"How to cause the change†. Change should be implemented at a pace that allows for the identification of necessary changes while at the same time ensuring project progress. Conclusion   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚   It is evident from the discussions above that TOC is an important concept, which revolutionizes business processes hence leading to the attainment of the set goals of organizations. The adoption of TOC concept in the various organizational functions in many industries underscores its importance. References Goldratt, E. M., and Cox J., (1994). The Goal: A process of continuous improvement, 2nd Revised Edition.   The North River Press. Goldratt, E. M., Schragenheim, E., and Ptak, C., (2000) Necessary but not sufficient.   The North River Press. Caspari, J. A., and Caspari, P., (2004) Management Dynamics: merging constraints accounting to drive improvement.   John Wiley Sons Inc. Dettmer, H. W., (1998) Breaking the constraints to world class performance.   ASQ Quality Press. Scheinkopf, L., (1999) Thinking for a change: putting the TOC thinking processes to use. St Lucie Press/APICS series on constraint management. Schragenheim, E., (1999) Management dilemmas: The Theory of Constraints approach to problem identification and solutions.   St. Lucie Press. Newbold, R. C., (1998) Project management in the fast lane: applying the theory of constraints.   St. Lucie Press, 284 pp. McMullen, T. B. C., (1998) Introduction to the Theory of Constraints (TOC) management system.   St. Lucie Press. Jacob, D., B and Mc Cleland, W., T (2001). The Theory of Constraints: Project Management. The Goldratt Institute. Retrieved on 6/3/2008 from http://www.goldratt.com/tocpmwhitepaper.pdf Youngman, K. J (2008). A guide to implementing TOC. Retrieved on 6/3/2008 from   http://www.dbrmfg.co.nz/Bottom%20Line%20Accounting%20for%20Change.htm Levinson, A. W. (2002). The theory of constraints and synchronous flow manufacturing. Levinson Productivity Systems P.C. retrieved on 6/3/2008 from http://www.ct-yankee.com/lean/toc_sfm.html

Interventions Against Burnout in Mental Health Nursing

Interventions Against Burnout in Mental Health Nursing Are educational interventions effective in reducing the incidence of burnout among mental health nurses? A critical review of the literature Abstract Background There is much evidence to link burnout with mental health nursing, but limited empirical evidence that examines the impact of educational interventions on the incidence of burnout in mental health nurses. Aim The aim of this literature review was to critically evaluate the literature relating to educational interventions associated with burnout in mental health nursing using selective and comparative analysis Method The search strategy involved the use of several electronic databases, and a library search to access relevant journals. Search terms and inclusion/ exclusion criteria are identified. Evaluative criteria (Price 2003) were applied to a critical analysis of the literature. Findings There is limited empirical research in this area; some of it is predictive rather than evaluative. Conclusions Despite the paucity of information, there are some strong arguments for the use of educational interventions to reduce the incidence of burnout in mental health nurses. There are implications for further research to be carried out in this area. Background Burnout is defined as a state of emotional exhaustion, accompanied by a sense of low self- worth (Peveler et al 2000), lack of motivation and a physical as well as emotional, sense of ill- health (Malach-Pines 2005). It tends to involve an insidious process of cumulative stress (Morrisette 2002a). Burnout is most often associated with human- service (helping) professions (Ekstedt and Fagerberg 2005) and frequently, it is those who have a high level of commitment to their work, who are most at risk (van Dierendonck D et al 2005). There is much evidence within the literature that links mental health nursing with burnout ( Barling 2001; Coffey 1999; Duquette et al 1994; Edwards et al 2000; Fagin et al 1995; Happell et al 2003; Harper and Minghella 1997; Kipping 2000; Prosser et al 1999a; Onyett 1997; Wykes et al 1997). Although burnout is associated with different types of nursing (Nolan and Smojkis 2003); mental health nurses in particular, are reported to be at high risk (Nolan et al 1999; Thomsen et al 1999a). Suggested reasons for this high level of vulnerability to stress and burnout are that the profession attracts people who have a predisposition to mental health difficulties themselves (Guppy and Gutteridge 1991) and that working with people with severe mental illness is so stressful that a degree of transference can occur between the patient and health professional (particularly if the latter is inexperienced) (McLeod 1997). The stressors associated with mental health nursing are further compounded if certain factors are present, such as low self- esteem; conflicting demands of home- life, inadequate coping mechanisms (Thomsen et al 1999b) and a lack of job satisfaction, which is especially associated with hospital, rather than community nurses (Prosser et al 1999b). Many sources propose that burnout is preventable (Burnard P 1999; Figley C 2002; Jones 2003 ; Morrisette 2002b; Taormina and Law 2000). It is important therefore, to raise awareness of prevention strategies. It is possible that these could be incorporated into educational programmes and it is suggested that failure to do so can result in informally learned negative behaviours leading to maladaptive coping strategies (Thompson 2003). Aim The aim of this literature review is to critically evaluate the literature relating to educational interventions associated with burnout in mental health nursing using selective and comparative analysis. Method The search strategy involved the use of the Athens Access Management System in order to access such databases as The British Nursing Index, CINAHL, the Cochrane library, Evidence- based medicine (EBM) reviews, Embase psychiatry, internurse.com, Medline, Ovid, PsycINFO, Pubmed, ScienceDirect and TRIP database. The University library was also used in order to conduct a hand search of such relevant journals as The Journal of Psychiatric and Mental Health Nursing; The International Journal of Mental Health Nursing; Mental Health Nursing; Journal of Psychosocial Nursing and Mental Health Services, Journal of Advanced Nursing; International Journal of Nursing Studies; Nurse Researcher and Nursing Research. The search terms and keywords used were: ‘burnout’ and ‘stress’ in combination with ‘mental health nursing’; ‘mental health nurses’; ‘nurses’ ‘education’; ‘nurse education’; ‘training’ (as it was found that this word was used quite a lot within the literature) and ‘prevention’. The search process highlighted the search terms that were most effective in accessing the relevant information using trial and error; otherwise referred to as a process of screening (Fink 2005a) The inclusion criteria were: papers dating back to 1990, the rationale being that a lot of work on burnout was conducted during the 1990’s; some of it in relation to mental health nursing, which is still being cited by published authors; research articles addressing the concepts of ‘stress’ and ‘burnout’ as they relate to ‘mental health nursing’; research articles linking ‘burnout’ with ‘nursing’, ‘prevention’ and ‘education’ as there is limited specific information on educational interventions to prevent burnout in mental health nursing, therefore some transferable principles were applied. For the same reason (shortage of specific information) research articles from other countries were not excluded. Both quantitative and qualitative studies were included. Exclusion criteria were any papers published before 1990; any articles not written in the English language; any articles not specifically addressing stress and burnout and articles about stress and burnout that are not related to nursing. Evaluative criteria adapted from the framework developed by Price (2003) were broadly applied to a critical analysis of the literature. These criteria are: Do the papers address my question? Is the content accessible and comprehensible? Are the research results valid, reliable and authentic? Are there any gaps within the literature and Are there any competing perspectives/ contradictions within the literature? These criteria were supplemented by selective reference to sampling techniques used, strengths and weaknesses of the research designs, methods of data collection and analysis, ethical aspects and presentation issues (Fink 2005b). Findings A recurring theme that emerged from the literature in relation to burnout within the helping professions is the concept of emotional labour, and that education and training can help to make people more aware of this phenomenon and to develop strategies to manage it. Emotional labour is a form of dissonance when the practitioner feels under pressure not to display the emotions which are engendered by the nature of their work (Brotheridge and Grandey 2002). There are two levels of emotional labour; surface or deep acting (Ashkanasy et al 2006). Surface acting is when the practitioner adopts a behaviour that belies their true emotions whereas deep acting is when they struggle to feel the emotion that is expected of them. Mann and Cowburn (2005) conducted a study that aimed to increase understanding about the links between components of emotional labour and stress in mental health nursing. 35 mental health nurses completed questionnaires which yielded information relating to 122 nurse- patient interactions. Three different published research instruments were integrated into the questionnaire; the Emotional Labour Scale, the Emotional Labour Inventory (both of which related more directly to nurse- patient interactions) and the Daily Stress inventory which addressed more general areas of stress. The use of tried- and- tested research instruments helps to ensure validity and reliability of the findings. Published research tools have often been refined several times, with the need to have excellent reliability and validity (Giles 2002). The data was analysed by using Pearsons correlations and multiple regression techniques. The researchers concluded that emotional labour is positively correlated with both the stress that arises from interactions with patients, as well as other sources of stress; that the impact of emotional labour is dependent upon the intensity of the interaction and the range of emotions experienced throughout the interaction, and that surface acting is a more important predictor of emotional labour than deep acting. Only one psychiatric unit was involved in the study with a relatively low response rate of 29%; low response rates can introduce bias and uncertainty into a study (Smeeth 2002). What constitutes a satisfactory response rate varies according to the nature of the research, however a 60% response rate might be considered to be ‘good’, and a 50% response rate to be adequate (Sim and Wright 2000); although many researchers accept that any response rate over 40% can yield meaningful results. The authors acknowledge that generalisability of the results is limited. Interestingly it was the non- cooperation of the unit in general that adversely af fected the response rate because of a lack of flexibility regarding access to respondents which influenced the methodology, in that it was not possible to obtain qualitative data relating to the lived experiences of mental health nurses in relation to emotional labour which might have been more meaningful, and an unwillingness to allow the researchers to follow- up non- responders. There is an implication here for nurses to become more research aware and for healthcare organisations to promote and support research- mindedness. The discussion and conclusion are interesting and relevant to the link between education and burnout in relation to mental health nursing. While acknowledging the limitations of the study, the authors do however stress that the findings have important implications for nurse education in that skills training for performing emotional work should be given a higher priority; that an increased focus be placed on facilitating self- awareness skills to enable mental health nurses to become more introspective about their feelings, so that they can develop effective techniques for dealing with them. However this study does not have the scope to be able to empirically demonstrate that educational interventions are effective in preventing burnout. The value of developing new educational strategies in relation to addressing emotional labour (in addition to other issues) for student mental health nurses was more clearly demonstrated by Turner et al (2004). The purpose of the study was to evaluate a pilot client attachment scheme for student mental health nurses. The rationale for client attachment is that it enables students to form therapeutic relationships with individual clients. This type of educational experience differs from the more traditional route of progressing through different placements. The methodology involved the use of semi- structured interviews to gain the perspectives of students (12), their supervisors (22) and clients (2). Although this is a small sample, the design was qualitative and a depth of meaningful information was obtainable, particularly from the students and the supervisors. The data was organised using thematic analysis, although this was not possible with the client data as there were only two clients and although they gave very positive feedback, the amount of information was very limited. Service user involvement in mental health research is a relatively new and developing concept (Telford and Faulkner 2004). This study is relevant to the discussion because it highlighted that different educational approaches can more effectively promote reflective skills among mental health nurses, which in turn can provide a tool for dealing with emotional labour. The researcher’s literature review revealed that many mental health student nurses report sources of stress as including not feeling part of a team, and dealing with distressing incidents involving clients. These factors lead to emotional containment, causing reduced motivation and increased stress. The client attachment scheme goes some way to addressing these issues by providing more continuity and increased supervision for mental health student nurses. Although the scope and generalisability of this study is limit ed, it flags up important indicators for changes to be made to the student nurse curriculum that will provide students with the skills to recognise and deal with, emotional labour, which should impact upon more effective stress management and prevention of burnout. Another study which concludes that changes should be made to the mental health student nurse curriculum in relation to stress management was conducted by Kilfedder et al (2001). They contend that previous studies on burnout in nursing contain several methodological inadequacies, and so set out to design a more theoretical study. The study sample was drawn from nurses employed in a Scottish National Health Service (NHS) Trust which provided both acute and continuing care mental health services in both hospital and community settings. 510 nurses returned questionnaires (a response rate of 48.8%). A total of 12 published measures were used, together with one purpose- designed measure which related to non- occupational stressors. The others related to such aspects as social support, occupational stress, burnout and coping strategies. As previously highlighted, the use of published measures can enhance reliability and validity. A range of statistical tests were used to analyse the data. H igh levels of emotional exhaustion, depersonalisation and burnout were reported and low levels of personal accomplishment. The researchers concluded that not only should a core part of the nursing curriculum be devoted to stress management and coping skills, but also that management training should incorporate leadership skills that facilitate stress management and that all nurses should be provided with training that equips them to develop coping mechanisms. Education is very much seen by the researchers as an essential part of a comprehensive approach to prevention, which should be emphasised more than the current tendency towards ‘picking up the pieces’ after the event. This study is quite complex which tends to affect its accessibility, however its findings have important implications for stress management in mental health nurses. Sharkey and Sharples (2003) evaluated a learning pack on risk management, developed for use with clinical mental health teams with emphasis on the impact the pack had on team members’ stress. The learning pack was made up of six sections, each one corresponding with a facilitator- led workshop. Participants were expected to carry out some reading and learning activities between workshops. Interestingly the authors identify two aspects of risk management that are potential stressors; the potential risks of the job such as dealing with violence and having to get to grips with the concept of risk management as a relatively new concept, and the systems involved. The researchers adopted a quasi- experimental approach, using pre and post measures, taken eight weeks before and after the learning intervention, in order to be able to measure any change in relation to work- related stress among the participants, as a result of following the educational programme. The researchers highlig hted difficulties with not being able to conduct a controlled experiment which might have affected the outcome, as it was not possible to be certain that any change was attributable to the educational intervention, as opposed to other factors. Sampling was self- selective which might also have affected the findings, as having volunteered; the participants indicated a level of motivation which could have impacted on the effectiveness of the learning programme. The sample (42) was drawn from two mental health locality teams, which included mental health nurses. The pre and post measures used were the Occupational Stress Indicator and the Healthcare- related Work Pressure Scale. Again, these are tried and tested published instruments, the use of which should contribute to the validity and reliability of the findings. These yield quantitative data which was analysed using descriptive statistics, the paired t -test and the Wilcoxon signed rank test. Once again, it might have been of valu e to combine qualitative with quantitative measures, in order to gain an understanding of the participants’ experience of stress; qualitative methods allow researchers to overcome the assumptions inherent in fixed- choice questionnaires, although these also have their value for example, in relation to information about prevalence (Cummings and Galambos 2004). All 42 participants completed the pre measures( although only 32 started the programme and 27 completed it) together with the post measures. It would have been interesting to identify why almost half of the original sample did not complete the programme; whether workload and/ or stress issues contributed to this level of attrition. However it was suggested that quite intensive time commitment was required to complete the programme which might have been an inhibitory factor and there could be implications for redesigning the programme so that it can be accessed more flexibly by participants. Responses were not broken down into professional groups- this also might have yielded some important differences. In relation to the Occupational Stress Indicator, comparing pre and post scores indicated that there was a general decrease in many sources of stress. Interestingly lower means at post measures were observed for the ‘job satisfaction’ subscale which indicated reduced satisfaction. The researchers suggest that this could be due to increased knowledge and expectations as a result of the learning intervention; whether this development could be a source of stress in itself is not speculated upon even though different studies have reported a relationship between stress and reduced job satisfaction (Koslowsky 1998). Scores for the Healthcare- related work pressure scale all show a lowering of item means at post measure. Overall the researchers concluded that the learning intervention brought about positive changes in relation to the work- related stress of the participants; in some cases the i mpact was significant. It is suggested that the ways in which educational interventions can bring about change is by enabling participants to gain knowledge and skills within the ‘safe’ environment of the classroom. A positive outcome of this study is that the learning pack has been modified, following feedback from the pre and post measures together with evaluations from the participants, and is now in use. Ewers et al (2002) evaluated the effect of Psychosocial Intervention Training (PSI), using a controlled experiment, in reducing burnout rates in mental health nurses working in secure units, having identified that this group is particularly at risk of developing clinical burnout syndrome. The hypothesis was that if nurses gained a better understanding of clients’ illnesses and develop more skills to be able to help clients, then they would experience lower levels of burnout within their clinical roles. A self- selecting sample of 20 volunteered to do the PSI course, but these met pre- set inclusion criteria and represented all grades of staff and all wards. 10 subjects were allocated to the experimental PSI group and 10 to the waiting list control group. Baseline measures of knowledge were taken, using a 30- item multiple choice questionnaire which had been used in previous studies; of attitudes, using a measure developed by one of the researchers and of burnout, using the Mas lach Burnout Inventory. It was not clarified whether the attitude measure had been tested for reliability and validity, whereas the other two measures are tried and tested. The experimental group received 20 days of PSI training. On completion of the course all subjects were asked to complete the measure of knowledge, attitudes and burnout. The facilitator had previously received advanced training in PSIs. The course includes both practical and theoretical assessment components and a minimum attendance of 80% was required. The data was analysed using Fisher Exact tests and t tests. The results showed that there was a significant difference in the knowledge scores for each group, with an increase in the knowledge of the experimental group. The same applied to the measurement of attitudes, which it is assumed (although not made clear by the authors) refers to an increase in positive attitudes for the experimental group. Again, the same applied to the burnout measure; this time the res ults are expressed more clearly in that the experimental group had moved in a positive direction along the subscales measured by the Maslach Burnout Inventory. The limitations of this study are that the results might not be generalisable to other units; as only one unit was involved in the study wherein specific factors might exist that contribute to the development of burnout. As with the previous study, the self- selecting nature of the participants might indicate that they were more highly motivated and more responsive to change. However, while acknowledging the methodological weaknesses, the researchers conclude that the significantly positive changes in knowledge, attitudes and burnout measures of participants within the experimental group are indicative of the value of educational interventions in reducing the incidence of burnout among mental health nurses working within secure units. Ho (2007) describes a study which explored the value and meaning of a psychodynamic work discussion for mental health nurses, which is described as a method of working, learning and development in professional practice. A work discussion group can enable psychological and emotional containment for mental health nurses which can impact upon the prevention of burnout. While the work discussion group is a means of learning in itself, education about the psychodynamic processes involved is also necessary in order to unlock the potential of the group. A qualitative design was used in order to be able to explore the feelings, experiences and perceptions of the participants, which seems highly appropriate within a study of this kind. Data was collected from a focus group of 6 mental health nurses ranging from staff nurse to ward manager level. This is quite a small sample, however this is often more acceptable within qualitative research as depth rather than breadth of information is being sought. It is generally considered that the ideal composition of a focus group is between 6-12 people, however when the nature of the subject could be emotionally charged or sensitive, it is preferable to limit the size of the group to 5 or 6 (Polit and Beck 2004). The data was analysed using Bulmer’s framework, a technique derived from grounded theory in order to define meaning through focus groups. This article is quite complex but comprehension has been facilitated by the presentation, in tables and boxes, of the categories and themes within which the discussion was structured. The purpose of the focus group (which was not immediately made clear) was not to act as a work discussion group but to explore the potential for its value with mental health nurses, and the group appeared to be generally responsive to the concept. The author concludes that mental health nurses could benefit from this approach, but would need encouragement and education and that the use of the work d iscussion group could be integrated into nurse education. The researcher acknowledges that the potential use of this approach needs to be explored further, with larger samples from a wider area. Lee (2005) evaluated the effectiveness of a stress management training intervention for care assistants working in a residential home for the elderly; many of whom had dementia, having cited research which links caring for people with dementia with work- related stress. The study took place within one residential home. The training consisted of a three- day programme that aimed to create and maintain an effective work environment by managing stress and stressful situations. The researcher provides an outline of the course content but does not state how many participants there were or how she measured the effectiveness of the programme, despite including sections headed ‘methods’ and ‘findings’. She reports that the stress management training reduced the care assistants’ levels of stress and improved their ability to cope with potentially stressful situations. She also concluded that the age or experience of the care assistants did not have an impact o n their stress levels or coping ability, which did not concur with the findings of a different study. This is a poorly written research article; the lack of detail reduces its value. However given the paucity of research related to educational interventions for mental health workers, it still adds to the existing body of knowledge. An interesting development is that the researcher subsequently contacted 21 residential homes and found that only 3 provided training interventions related to stress management. Conclusions An extensive review of the literature has revealed that there are gaps in the literature relating to educational interventions to reduce the incidence of burnout in mental health nurses; this finding is supported in a review by Edwards and Burnard (2003), who concluded that while there is evidence that stress is a problem for mental health nurses, research on interventions to address this, is insufficient. Many articles on this subject are literature reviews, drawing on broad- based research in related areas, with a definite lack of empirical studies, and these reviews have not been included here. It has been necessary to include studies which predict that educational interventions will reduce the incidence of burnout in mental health nurses as well as those which evaluate existing interventions (which are very few). There are implications for further research into this important area. However there are some interesting and valuable conclusions that can be drawn from the existing lit erature. A synthesis of this review of the literature yields the following outcomes: There is a link between emotional labour and burnout, and adopting strategies (including educational) to enable mental health nurses to recognise and deal with emotional labour (including self- awareness and reflective skills) should impact upon the prevention of burnout. Educational interventions aimed at reducing the incidence of burnout should take place both within pre registration programmes and as part of continuing professional development (CPD). Educational interventions are an important part of a comprehensive strategy to reduce the incidence of burnout among mental health nurses. As well as focussing on stress management, educational interventions can also be used to enhance knowledge and skills (relating to for example, risk management and helping skills) which in turn, positively impact upon stress levels and coping skills. A range of educational approaches should be explored in relation to stress management, allowing for innovation and flexibility, to facilitate access for mental health nurses, who may feel inhibited by such factors as shift patterns, workload or lack of resources References Ashkanasy N, Zerbe W and Hartel E. Emotions in the Work Place: Research, Theory, and Practice. Quorum/ Greenwood. 2000. p. 16 Barling J. Drowning not waving: burnout and mental health nursing. Contemporary Nurse. 11(2-3) 2001 pp. 247-59. Brotheridge C and Grandey Emotional Labour and Burnout: comparing two perspectives of ‘people work’. Journal of Vocational Behaviour. 60 pp. 17-39. Burnard P Practical counselling and helping. Routledge. 1999. p. 115 Coffey M . Stress and burnout in forensic community mental health nurses: an investigation of its causes and effects. Journal of Psychiatric and Mental Health Nursing 6(6) 1999. p. 433 Cummings S and Galambos C. Diversity and Aging in the Social Environment. Haworth press. 2004. p. 157. Duquette A, Kerouac S, Sandhu BK, Beaudet L. Factors related to nursing burnout: a review of empirical knowledge. Issues in Mental Health Nursing. 15(4) 1994 pp.337-58. Ewers P, Bradshaw T, McGovern J and Ewers B. Does training in psychosocial interventions reduce burnout rates in forensic nurses? Journal of Advanced Nursing 2002 37(5) pp. 470-476. Malach-Pines A. The Burnout Measure, Short Version. International Journal of Stress Management. Volume 12(1) 2005. pp. 78-88 Mann S and Cowburn J. Emotional labour and stress within mental health nursing. Journal of Psychiatric Mental Health Nursing. 12(2) 2000 pp.154-162, Nolan P, Dallender J, Soares J, Thomsen S and Arnetz B. Violence in mental health care: the experiences of mental health nurses and psychiatrists. Journal of Advanced Nursing 30(4) 1999. p. 934 Nolan P and Smojkis M. The mental health of Nurses in the UK. Advances in Psychiatric Treatment. 9. 2003. pp. 374-379. Prosser D, Johnson S, Kuipers E, Dunn G, Szmukler G, Reid Y, Bebbington P and Thornicroft G Mental health, burnout and job satisfaction in a longitudinal study of mental health staff. Social Psychiatry and Psychiatric Epidemiology. 34 (6). 1999. pp. 295-300. Sharkey S and Sharples A. The impact on work-related stress of mental health teams following team-based learning on clinical risk management. Journal of Psychiatric Mental Health Nursing. 2003 10(1) pp. 73-81 Sim J and Wright C. Research in Health Care: Concepts, Designs and Methods. Nelson Thornes 2000. p. 359. Smeeth L. Improving the response rates to questionnaires. BMJ 324 2002 pp. 1168-1169 Taormina R and Law C. Approaches to preventing burnout: the effects of personal stress management and organizational socialization. Journal of Nursing Management 8(2) 2000, pp. 89-99 Telford R and Faulkner A. Learning about service user involvement in mental health research. Journal of Mental Health. 13(6) pp. 549- 559. Thompson T. Handbook of health communication. Lawrence Erlbaum Associates. 2003. p. 356. Thomsen S, Soares, J, Nolan P, Dallender J and Arnetz B. Feelings of Professional Fulfilment and Exhaustion in Mental Health Personnel: The Importance of Organisational and Individual Factors. Psychotherapy and Psychosomatics 68 1999 pp.157-164 Turner L, Callaghan P, Eales S and Park A. Evaluating the introduction of a pilot clien