Cooper Pharmaceuticals Case Analysis Essay

On the surface, the issue of Bob Marsh’s firing from Cooper Pharmaceuticals appears to be an open and shut case; he did not adhere to the repeated warnings by management to alter his performance and selling style, therefore he was fired. However, other considerations are in play when you analyze this case further. Bob was an employee of Cooper for twelve years at the time of his termination, and had seemingly improved his performance when prompted to do so. Bob was also exceptionally well received by physicians, office receptionists, and hospital personnel, which is a vital attribute when being a â€Å"detailer.† His persistent downside, though, was his lack of organization, planning, and follow-up, and a tendency to question some of the company’s major promotion programs. The central question to this case is, â€Å"how could this happen to someone like Bob Marsh in a company like Copper?† In my opinion, while Cooper Pharmaceuticals was not entirely withou t fault, Bob’s termination was primarily the result of his own actions, or lack thereof. Cooper Pharmaceuticals was a major manufacturer of prescription drugs for the medical and dental professions and had a reputation throughout the industry for having â€Å"excellent† management practices. The company fielded a sales force of over 500 detailers whose job was to persuade medical personnel to use and prescribe Cooper Pharmaceuticals’ drugs. Initially, Bob fit the mold of what was desired by Cooper in prospective employees. He was rated highly in his sincerity, aggressiveness, attitude, enthusiasm, learning ability, judgment, character, affability, and appearance; Bob seemed like the perfect fit. He was hired about a month after his initial interview and, much to his delight, was assigned to a territory in his hometown, Toledo. From there, Bob was seemingly ready to start his training and begin a long and prosperous career with Cooper. An effective sales training program is vital to the success of a company’s sales force. A training program should have a finite set of objectives: increased sales productivity, lower turnover, higher morale and sense of purpose, improved communication, improved customer relations, and improved self-management. It is also impor tant that companies provide a method for systematically reinforcing their training programs. Otherwise, salespeople are unlikely to change their behavior. The training at Cooper Pharmaceuticals, in principle, should have worked quite well. Employees,  including Bob, showed signs of increased sales performance on a year-to-year basis, and in 1989 sales exceed $1 billion. Turnover was low for their industry, around 8%. Also, 60% of detailers had ten or more years with the company, and 25% had fewer than five years. Each employee received a company car, generous benefits, and reimbursement for normal business expenses. Bob, while maintaining the same position as detailer, went from a starting salary of $35,000 in year one to a salary over $60,000 in his twelfth year. Bob received a month’s training in product characteristics and selling, or detailing, skills at Cooper’s headquarters. Aside from this training, both new and experienced detailers received regular training from the 35 district managers. This reinforcement was done so to ensure that all detailers mai ntained the level of expertise and professionalism requisite of a Cooper Pharmaceuticals detailer. From these facts, it becomes more apparent that the necessary skills to be successful were properly trained, informed, and reinforced in Bob by Cooper. Even from his initial interview with Cooper, there was one glaring fault Bob possessed: his seeming indifference to organization. His first district manager, John Meredith, felt that Bob gave little advanced thought to the physicians he hoped to see. Then, upon seeing the physicians, he had no definite plan or approach once in the physician’s office. From the beginning of this class, we learned that pre-approach is vital to the selling process. In this stage, information is gathered about the prospect to decipher the specific needs they have. As noted in the beginning of the case, Bob had many references from physicians and medical personnel. I believe that these relationships caused Bob to become lazy in his pre-approach and approach, and ultimately served as a crutch on which he began to rely. In addition to his lack of organization, Bob displayed more interest in developing his own promotional programs than in following the plans outlined at district meetings, and he would also second-guess promotions by deciding, on his own, which products to promote. This should have been a huge red flag for John Meredith. What would happen if a baseball player blatantly disregarded a sign and decided to swing when his coach told him not to swing? That player would find himself on the bench. If that player continually disobeyed his coach’s instructions he would find himself looking for a new team. In this instance, though, Bob was not benched. He was instead given a list of suggestions on how he could improve in certain  areas, including: * Should overcome the tendency to prejudge customers and promotion programs * Should be more responsive to management directives * Should give more attention to planning and organization As becomes evident as Bob’s tenure at Cooper Pharmaceuticals continued, he failed to adopt this initial list of suggestions, yet his employment perpetuated. After John Meredith, there was Bill Couch, then Jim Rathburn, followed by Vince Reed, Antonia Wilkens, and ultimately Ted Franklin. Six supervisors in a twelve year span is a high number. Then, when you consider the fact that many of them were young, motivated, and driven, it becomes clearer why Bob was able to keep his job. His sales numbers were constantly at quota, and there were no issues in terms of customer relations. By the time his deficiencies were noted, a new district manager was in already in place. It seems that Bob was aware of this trend and used it to his advantage. So long as he hit his sales quotas and kept customers happy, all would be well. The case states that every Cooper Pharmaceutical detailer was evaluated in terms of both sales volume and improvement in his or her relationships with customers. From this statement one could conclude that Bob should have retained his job. His sales volumes were constant yearly, sometimes increasing. He also, evident from the multiple inquiries from current customers upon his termination, maintained wonderful working relationships with his customers. The evaluation process at Cooper Pharmaceuticals is what perpetuated Bob’s employment with the company. While looking at just the sales numbers, Bob appeared to be a great employee. However, there are other factors to consider when evaluating employees. Most managers or supervisors would likely agree that they wished their employees follow their instructions when prompted to do so. To ensure that a case similar to Bob’s does not become the norm at Cooper Pharmaceuticals there are three steps that management should take. One, they should maintain a better record keeping process of employment evaluations. It is possible that because this example occurred during the 1980s, record keepi ng was maintained on paper rather than computers. However, that does not excuse an employee who repeatedly makes the same mistakes to be retained. Two, there should be a  more streamlined transition process for an outgoing district manager to pass on files/documentation to the new district manager. For example, Bob was placed on probation by Vince Reed that required him to improve performance to an acceptable level within 90 days. However, upon Vince Reed’s subsequent transfer, no one followed up on Bob’s performance. Bob’s probationary status had â€Å"evaporated.† Three, they should enact a three-strike policy. One could receive a strike for failing to reach sales quotas, not following management’s instructions, or falling customer relations. An employee would be fired following strike three. Doing this step would make the threat of termination a tangible thought, employees would be fully aware that constant missteps and mess-ups will not be tolerated. The thought of Bob Marsh being reinstated or there being any legal ramifications for Cooper Pharmaceuticals is laughable. Bob was given the chance to improve his faults on multiple occasions, yet he failed to do so for any extended period of time. He took advantage of the fact that each new district manager gave him the chance to improve. Then, his performance would slip little by little, but by this time a new district manager would be in place and the process would repeat itself. Not until Ted Franklin took over did the process change course. Ted looked over all of Bob’s previous deficiencies and realized that his record was not good and Bob would have to follow an outline given to him and complete weekly reading assignments. Not only did Bob fail to follow this agreement, he accepted his subsequent termination with little resistance or comment. The fact that Bob would call Cooper Pharmaceuticals and say he was treated unfairly is preposterous. He should be thankful for his twelve years of employment at the company and that none of his previous district managers were as competent or paid as close attention to detail as Ted Franklin. Yes, Bob appears to have maintained great relationships with his customers, and as we learned in class 80% of sales tends to come from 20% of the customers. So it is, realistically, a possibility that some business would be lost from the decision to terminate Bob. However, a company with the reputation of Cooper Pharmaceuticals should not keep an employee simply because a few clients from one sales region want him to be retained. Certain offers, such as incentives or promotions could be provided to these customers in attempt to ensure their repeated business and prove that not just Bob can provide great service and keep them happy customers. In addition, Cooper  Pharmaceuticals should, while not being defamatory or slanderous, fully outline the faults Bob possessed as an employee and effectively relay these as the reasons of his termination to Bob’s accounts. So, to answer this case’s central question, this termination happened to Bob Marsh because of Bob Marsh.

Barista vs Caffe Coffe Day Essay

MILAN – The following article is a summary extract from the dissertation projects of the MBA and BBA students of Skyline College. Skyline, situated in Delhi and Gurgaon (NCR) is a premier institute providing management education specialising in MBA and BBA degrees and specialist courses for travel and tourism as well as mass communication. For further information on the article content or on the institute please clickhttp://www.skylinecollege.com/ to visit the official college website. This dissertation was completed by Saroj Shahbaz Naiyar (2007 – 2009) on the topic Barista Vs Cafà © Coffee Day a Comparative Study. Summary The objective of the thesis is â€Å"To compare and study Barista & Cafà © Coffee Day, identify areas of excellence and areas needing improvement; and provide suggestions for such improvement†. The aim of this Thesis is to successfully compare two prominent service sector companies on a common platform, analyze their working and performance, and highlight what they are doing well, while providing suggestions and recommendations for improvement. Barista and Cafà © Coffee Day were chosen because of their identical pattern of functioning and growth. They are the only two major players in the national coffee cafà © industry, and their customers consider both as interchangeable brands. This is why it is important to study how these brands differentiate themselves from each other, and attempt to improve brand loyalty amongst their customers. For the purpose of this study, I prepared a questionnaire, to find out the relevant primary data pertaining to the functioning and working of both Barista and Cafà © Coffee Day. The data was collected based on information provided by: 1. The management of the organization. 2. Customers visiting Barista and Cafà © Coffee Day outlets. Besides the primary data collected with the help of the questionnaire, I have also collected the relevant secondary data from various sources like magazines, books and Internet and newspapers. Based on the relevant primary and secondary data, a comparative analysis has been done so as to find out the areas of excellence and areas of improvement of both organizations. The areas of excellence and improvement have been identified based on factual information, in light of which recommendations and suggestions have been provided for the overall improvement of the organizations in the future. This Thesis is conducted in Gurgaon, India; so the information is relative to this city. The main objectives could be: 1. To understand market performance of Barista & Cafà © Coffee Day. 2. To do a SWOT analysis. 3. To understand consumer perception. 4. To analyze there target consumer& marketing mix(7P’s). Conclusion: Areas of Excellence Both cafà ©s have certain areas where they have been consistently performing well. These are essentially the strengths of the brand, and Barista & Cafà © Coffee Day need to capitalize on these strengths to increase their market share and brand loyalty. The main areas of excellence, based on the Case Studies & Market Survey, have been identified as follows: Barista 1. Strong Brand Image: Barista has a strong and clear brand image. Their customers can easily identify and relate to the Barista brand. This helps increase and maintain brand loyalty. 2. Excellent Human Resource: According to the survey, Barista received an excellent rating for the service and behavior of their staff. This is a huge advantage, especially in a service organization. Barista must strive to keep this advantage. 3. Ambience & Dà ©cor: Another significant area of excellence is the kind of ambience and dà ©cor Barista cafà ©s have. Respondents to the survey, including whose who chose Cafà © Coffee Day as their choice of cafà © gave Barista a near perfect rating for their Ambience & Dà ©cor. 4. Strong base for expansion & growth: Barista have worked hard on heir brand image and human resources, and have a strong base for future expansion and growth- whether nationally or internationally. Cafà © Coffee Day 1. Highly rated Taste & Quality of products: Cafà © Coffee Day got a high rating in the market survey, for the Taste & Quality of their products. If they work on this aspect, there is huge potential for them to attract customers, just based on the taste and quality of products. This is also helped by the fact that they grow their own coffee beans, and this provides an important base for future expansion and growth. Cafà © Coffee Day even won the â€Å"Barista Coffee- Making Championship† for the Best Coffee. 2. Value for money proposition: Cafà © Coffee Day is projected as an â€Å"affordable† brand. This strategy has worked extremely well so far, and Cafà © Coffee Day got a high rating, both for their prices and for their value for money, in the market survey. 3. Strong youth orientation: The Cafà © Coffee Day brand is, and always has been, extremely youth- oriented. In a country where over 40% of the population is under the age of 20, there is huge potential for Cafà © Coffee Day to become one of the country’s largest youth brands. The untapped market share and potential for growth is enormous. Areas Needing Improvement Both Barista and Cafà © Coffee Day have under performed or not lived up to potential in certain areas. The areas are weaknesses, which need to be improved upon, as that both can eliminate any disadvantage that may have, and improve customer satisfaction. The mail areas needing improvement, based on the Case Studies & Market Survey, have been identified as follows: Barista 1. Average taste & quality of products: According to the market survey, other than their Dessert, Barista got only an average rating for the taste & quality of their products. Considering their strong brand image of being the coffee- lover’s traditional cafà ©, they have not performed up to expectations in this area. 2. Perceived as an expensive brand: Customer perceptions of Barista’s prices and value for money are quite negative. Even though the prices of Barista and Cafà © Coffee Day are almost identical, Barista is still perceived as the more expensive brand. 3. Inconvenient delivery process: On a smaller note, Barista’s self- service delivery process received almost unanimous complaints from respondents of the market survey. They found it inconvenient to go back to the counter just to receive their order. Cafà © Coffee Day 1. Weak brand image: The Cafà © Coffee Day brand, although clearly a youth- oriented brand, lacks the power and strength expected to maintain brand loyalty. The brand doesn’t project a clear image to customers about what Cafà © Coffee Day is all about. This could prove as a deterrent during future national and international expansion. 2. Inefficient human resources: According to the market survey, Cafà © Coffee Day’s staff received only an average rating for their behavior and service. Cafà © Coffee Day needs to work hard at this aspect, especially considering they are a service sector organization that is looking at large expansion. 3. Ambience & Dà ©cor: The Ambience & Dà ©cor of Cafà © Coffee Day outlets received a below- average rating from respondents of the market survey. A lot of respondents did not like the fact that Cafà © Coffee Day outlets and literature served as prime space for a lot of advertising and promotions. They felt as if the cafà ©Ã¢â‚¬â„¢s had been hijacked just for advertising. Recommendation & Suggestions Barista †¢ Barista has an extremely strong brand image, but they need to work hard on improving their customer perception of being and expensive brand. Barista and Cafà © Coffee Day have almost identical pricing, but Barista is still perceived as the more expensive brand. †¢ That’s why my first recommendation for Barista is, to carry out a promotion campaign to ensure that their target market is well aware of their current low prices. This would help change customer perception and turn Barista into an affordable brand. †¢ Another backlash of having such a strong traditional cafà © brand image is that customers have very high expectations of the taste & quality of products. Barista needs to work hard at this aspect, especially for coffee and eatables products. †¢ My second recommendation is for Barista to look at its coffee beans suppliers and coffee brewing process to ensure that it is the best it can be. †¢ This is especially important considering the international expansion Barista is undertaking. Barista should also look at the Taj, their national suppliers for eatables and desserts, and either improve the taste & quality of eatable, or look at another supplier- because as of now, they are not living up to expectations, and losing customers to Cafà © Coffee Day. †¢ On a smaller note: the Barista delivery process should change, so that a cafà © attendant delivers the coffee to the table. This may seem insignificant, but it can go a long way in improving customer satisfaction. Cafà © Coffee Day †¢ Cafà © Coffee Day has done extremely well so far to project itself as an affordable youth- oriented brand. But there are still certain areas where their brand needs to be much stronger. †¢ With regard to the physical evidence associated with the brand, Cafà © Coffee Day needs to do a lot of work if they hope to catch up with Barista. My first recommendation for Cafà © Coffee Day is to clean up the dà ©cor at every outlet, wherever unnecessary advertising is taking place. †¢ Although it might be an important source of revenue, long-term customer perception of the brand isn’t very positive. †¢ Cafà © Coffee Day would do better to provide promotional space for its partners with the use of clever collaborations, and not printed advertisements and posters everywhere. †¢ My second recommendation is that Cafà © Coffee Day looks at its current recruitment, selection and most importantly, its current training policies. †¢ Customers are not happy with the behavior and service of the staff, and Cafà © Coffee Day is lagging far behind Barista is this aspect. *The above article was extracted from dissertations in Marketing, Finance, Human Resources, Strategy, Information Systems by the students from Skyline College. Skyline College is amongst the top MBA and BBA institutes in Delhi, Gurgaon (NCR). Introduction to ccd The First Cafà © Coffee Day logo a bright red cube with a green stroke above ‘e’ in ‘Cafà © Coffee Day’. The word ‘Cafà ©Ã¢â‚¬â„¢ was made to appear dominant to indicate Cafà © Coffee Day’s introduction of ‘Cafà © culture’ in India. The font used for ‘Cafà ©Ã¢â‚¬â„¢ is called SLURRY – the font looks as though the letters have congealed or coagulated out of liquid. The current logo includes a dialogue box which highlights the connection between ‘coffee’ and ‘conversations.’ This logo also reflects their current tag line, â€Å"A lot can happen over coffee.† The logo of CCD has been changed recently, this has been done in line with the increased competition and also for the proper conveying of the message that Cafà © Coffee Day desires to tell to its customer. The famous Cafà © Coffee Day squared logo has got a fresh new avatar – a ‘Dialogue Box’ – with the words Cafà © Coffee Day written in a distinct, specially created font. The new trendy ‘dialogue’ logo symbolizes the essence of what a Cafà © Coffee Day cafà © is all really all about – a perfect place to ‘relax and dialogue.’ And as we all know, a lot does happen over coffee! Vertical integration The company is known for being vertically integrated to cut costs: from owning the plantations,[2] growing the coffee,[2] making the coffee machines[3] to making the furniture for the outlets.[2] The machines cost them [pic]1.2 lakh each, which they say is half the cost of an imported coffee machine.[3] The maintenance cost of CCD’s machines is also less than foreign machines.[3] Outlets The first CCD outlet was set up on July 11, 1996, at Brigade Road, Bangalore, Karnataka.[4] Following this, CCD crossed over 1000 cafà ©s throughout the nation by 2011. They currently have (as of August 2012) 1319 outlets spread across 28 states of India.[5] The number increases almost every week. A ‘meter’ on their official website (Cafecoffeeday.com) keeps continuous track of the number.

Health information manager in a hospital setting Case Study

Health information manager in a hospital setting - Case Study Example As I health manager, I find it hard to deploy the EHR system because of two conflicting forces, namely: technology and law. According to McWay (2010), the law that we have cannot go with the same pace as the advances made in technology (147) which would always make the implementation of EHR system so complicated. The EHR system will make the delivery of care efficient, up to date, and accessible and will benefit both the patient and the institution. However, it is what is inside the EHR and its accessibility that are being protected by the federal regulations, accrediting and institutional standards, and professional guidelines. Therefore, as a health manager, I believe that it would be unethical to my profession and illegal to implement something in a rush that has not been approved or incompliance with applicable federal and security standards. As a health manager, we have to study the different regulations and the EHR implementing guidelines of the institution before we proceed on the project. According to Sittig & Singh (2011), a number of ethical issues are being linked to the adoption of EHR in the health care setting, among of which include: ownership of protected health information, potential for privacy breaches, and appropriateness of current methods to address these breaches (1044). In general, we should consider the harm that it may cause the patients when information are leaked to unconcerned individuals. The main question to ask is, â€Å"Are we willing to take the risks of exposing our patients’ identities or health information for the sake of efficiency and accessibility†? or â€Å"Are we equipped enough with the right people, enough resources, and appropriate technology to protect their privacy and be inclined with federal laws†? Decisions cannot be made on a â€Å"click† of a finger; thus, requires thorough planning and careful evaluation that weigh out circumstances. We cannot make law creation or amendments go

Qualitative Research Designs Paper Example | Topics and Well Written Essays - 500 words

Qualitative Designs - Research Paper Example As a way of seeking to provide an example of just such a piece, this brief analysis will consider the given article, analyze it for its utilization of quantitative techniques, and seek to detail the type and manner of the content which was portrayed therein. The research question itself clearly has to do with the level of linkages that may be illustrated between the use of antidepression medication and an increased likelihood of suicide; something that has gained widespread media attention in the past several years. With reference to the way that the research itself was actually set up and carried out, the authors of the piece sought to set up a series of test which sought to measure the epidemiological affect that antidepressants had on the patient; up to and including what the researchers deemed as â€Å"suicidabiliy†. Controls and test groups were established, antidepressant medication administered and trials concentric upon interviews and close monitoring in the form of diary and journal approaches to the frames of mind that the patients expressed during the period were employed. In terms of what was hypothesized, the researchers believed that there would be a small, perhaps unrecognizable increase, of suicidal thoughts withi n the adult patients and a larger, but still statistically small increase in suicidal thoughts within the adolescent test subjects. The study ran a series of 26 different trials of no less than 15 individuals participating in each trial. For further purposes of the study, adults were identified as over the age of 18 with children being represented from the age of 9-18. As the researchers expected, the rise in suicidal thoughts and motivations within the patients that fell into the category of â€Å"adult† were no different than that of the control group. In other words, no noticeable rise in suicidal thoughts or intentions was determined from those patients that were over the age of 18 that participated within

Marketing. Unique home dcor items Essay Example | Topics and Well Written Essays - 750 words

Marketing. Unique home dcor items - Essay Example Unique home decor items are a decoration company that specializes in all kinds of home furnishings. Marketing is fundamental to growth of any business venture and we as a company have decided to venture into search engine marketing as one of the platforms we belief will enable us reach majority of our customers and by extension foster our upcoming company. Specifically we have decided to use search engine optimization, search advertising and other directories marketing in our search engine marketing. Jupiter communications consumer survey data observes that 81 % of people who are regular internet users locate websites through the use of search engines. The article further indicates that 54% of online shoppers who are experienced in shopping through the internet mainly rely on search engines when locating for a product to purchase on the internet. IMT strategies further assert that online search engines have provided more awareness for websites than other advertisement platforms such as television, radio or newspapers. 80 % of online search program users locate whatever they are looking for as soon as the third page. Sale leads which are made from main phrases and words searches are always the best qualified and also they have the highest buying probability. Regular search engine advertising is therefore fundamental in increasing a company’s chases of improving sales of products and services considering the importance of search engines to internet users. Any successive online advertising campaign must begin with firm search engine advertising. ... This is fundamental especially for upcoming companies that want to grow business at a faster rate it’s on this premise that we have chosen search engine marketing as an ideal platform for advertising our products. Search engine optimization For us to be able to attract customers, we need to foster the interaction of our website with users and search engines such as yahoo, Google, dogpile and many others. Search engine optimization involves building small modifications to key areas of our website. Whilst viewed in isolation, the modifications may appear like incremental improvements, however, when put together, they many have ideal impact on our websites customer understanding and performance. For us to be able to have a competitive advantage over our main rivals, we must identify what’s important for the clients of our website. These are the key consumers of our products and search engines should be able to display products of interest to our customers. For us to optimi ze our website, we need to do a variety of tasks such as creating accurate page titles, improvement of uniform resource locators structure, giving quality content to our customers, making good use of robots.txt and making use of free webmaster tools. Page titles are fundamental and for us to remain competitive we must make them unique. Key details of our company such as the name of our business, physical location, and physical address will be put on our home page. An important consideration that we as a company will make is to ensure that titles are brief, descriptive, simple language that visitors can understand and free of ambiguity. We will also use meta tags for giving summary of what is contained in each page of our website.

Article sypnosis Essay Example | Topics and Well Written Essays - 250 words

Article sypnosis - Essay Example From the item, it is evident that the company provides quality improvement. This is because the Baldor Electric Company considers product quality the same way as it considers quantity of product. The new quality plan by the company include the improvement of measurement and gauge accuracy, reduce of the cycle times of production, cost lowering of scrap and making of quick and accurate inspections (Manufacturing Business Technology). The article further states that the means used by Baldor Electric Company to provide quality improvement is the use of InfinityQS Real-Time SPC Software in data analysis and making of decisions. For instance, the company implemented this method in the inner-ring and outer-ring grinding, inner-ring machining, face grinding cells and the ring roller. This are done with plans to enlarge the purpose to heat treating induction, heat treating that is convectional and housing machine involving cast iron. Moreover, the Baldor Electric Company has formed an enterprise-wide for the intention of dealing with the task of data analysis. Another quality improvement made by the company is the evaluated gauging with the inclusion of making of updates throughout the production facilities on the shop floor (Manufacturing Business Technology). In conclusion, it is clear that the article tries to give full information about the Baldor Electric Company. For instance, it shows the facilities it produces. The article also indicates the means used in the provision of a quality improvement and also examples of the quality improvements. "Using Statistical Process Control To Improve Quality | Articles | Manufacturing Business Technology." Manufacturing Business Technology |. N.p., n.d. Web. 17 Apr. 2012.

Immigrant Employee Impact on Native Essay Example | Topics and Well Written Essays - 1500 words

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Duchenne Muscular Dystrophy Research Paper Example | Topics and Well Written Essays - 750 words

Duchenne Muscular Dystrophy - Research Paper Example The author of this research paper provides the reader with the description of a condition called Duchenne muscular dystrophy that is named after French neurologist Guillaume Benjamin Amand Duchenne who is known for his description of the disease in fine detail. This research paper focuses on discussing of the various aspects of the Duchenne muscular dystrophy, such as it's basic definition, description, epidemiology, pathogenicty, symptoms and diagnosis, treatment and on-going research. This desiase is common in boys between ages 3 and 5 and progresses very fast with most patients completely unable to walk by age 12. However, the disease can be detected with about 95% accuracy by conducting genetic studies during pregnancy. Currently, several possible treatments are being investigated in trials globally in hospitals, laboratories, independent researchers, research institutions and higher learning institutions such as universities with the major focus placed on pursuance cure from ste m cells and gene therapy. The researcher explains current treatment methods that basically aim at merely controlling symptoms and improving quality of life. It is concluded that duchenne muscular dystrophy remains one of the greatest health concerns amongst young children and especially boys today. It is prudent that expectant mothers who are carriers of the disease get help from doctors during their pregnancy so that steps can be taken to minimize effects of the ailment on their children as treatment is still researched.

Week Five Exercise Assignment Essay Example for Free

Week Five Exercise Assignment Essay Liquidity ratios. Edison, Stagg, and Thornton have the following financial information at the close of business on July 10: Edison Stagg Thornton Cash $6,000 $5,000 $4,000 Short-term investments 3,000 2,500 2,000 Accounts receivable 2,000 2,500 3,000 Inventory 1,000 2,500 4,000 Prepaid expenses 800 800 800 Accounts payable 200 200 200 Notes payable: short-term 3,100 3,100 3,100 Accrued payables 300 300 300 Long-term liabilities 3,800 3,800 3,800 a. Compute the current and quick ratios for each of the three companies. (Round calculations to two decimal places.) Which firm is the most liquid? Why? Account Edison Stagg Thornton Cash 6,000.00 5,000.00 4,000.00 Short term investments 3,000.00 2,500.00 2,000.00 Accounts receivable 2,000.00 2,500.00 3,000.00 Inventory 1,000.00 2,500.00 4,000.00 Prepaid Expense 800.00 800.00 800.00 Total Current Assets: 12,800.00 13,300.00 13,800.00 Account Edison Stagg Thornton Accounts payable 200.00 200.00 200.00 Notes payable 3,100.00 3,100.00 3,100.00 Accrued payables 300.00 300.00 300.00 Total Current Liabilities: 3,600.00 3,600.00 3,600.00 Edison: Current ratio 12,800.00 / 3,600.00 = 3.56 Quick ratio (6,000 + 3,000 + 2,000) =3.06 Stagg: Current ratio 13,300.00 / 3,600.00 =3.69 Quick ratio (5,000.00 + 2,500.00 + 2,500.00)/ 3,600.00 = 2.78 Thornton: Current ratio 13,800.00 / 3,600.00 = 3.83 Quick ratio (4,000.00 + 2,000.00 + 3,000.00) / 3,600 =2.5 The most liquid company is Edison because they have the most access if necessary. 2. Computation and evaluation of activity ratios. The following data relate to Alaska Products, Inc: 20X5 20X4 Net credit sales $832,000 $760,000 Cost of goods sold 530,000 400,000 Cash, Dec. 31 125,000 110,000 Average Accounts receivable 205,000 156,000 Average Inventory 70,000 50,000 Accounts payable, Dec. 31 115,000 108,000 Instructions a. Compute the accounts receivable and inventory turnover ratios for 20X5. Alaska rounds all calculations to two decimal places. Accounts Receivable Ratio = Net Credit Sales / Average Accounts Receivable $832,000 / 205,000 = 4.10 Inventory Turnover Ratio = Net Credit Sales / Average Accounts Receivable $530,000 / 70,000 =7.60 (205,000 + 156,000) / 2 = 180,500 (70,000 + 50,000) / 2 =60,000 3. Profitability ratios, trading on the equity. Digital Relay has both preferred and common stock outstanding. The com ­pany reported the following information for 20X7: Net sales $1,750,000 Interest expense 120,000 Income tax expense 80,000 Preferred dividends 25,000 Net income 130,000 Average assets 1,200,000 Average common stockholders equity 500,000 a. Compute the profit margin on sales ratio, the return on equity and the return on assets, rounding calculations to two decimal places. b. Does the firm have positive or negative financial leverage? Briefly ex ­plain. Profit Margin = 130,000/1,7500,00 =7.43% Return on equity = 130,000/5,000=26% Return on assets = 130,000/1,200,000=10.83% (120,000 + 80,000 + 130,000) / (80,000 + 130,000) =1.57 It has a positive financial leverage of around 1.57 times. The net profit ratio states Digital Relay made a 9% profit off its sales. 4. Horizontal analysis. Mary Lynn Corporation has been operating for several years. Selected data from the 20X1 and 20X2 financial statements follow. 20X2 20X1 Current Assets $86,000 $80,000 Property, Plant, and Equipment (net) 99,000 90,000 Intangibles 25,000 50,000 Current Liabilities 40,800 48,000 Long-Term Liabilities 153,000 160,000 Stockholders’ Equity 16,200 12,000 Net Sales 500,000 500,000 Cost of Goods Sold 322,500 350,000 Operating Expenses 93,500 85,000 a. Prepare a horizontal analysis for 20X1 and 20X2. Briefly comment on the results of your work. Horizontal Analysis 202 201 Difference %Change Current Assets 86,000.00 80,000.00 -4,000.00 -5.00% Property, Plant, and Equipment (net) 99,000.00 90,000.00 9,000.00 10.00% Intangiables 25,000.00 50,000.00 -25,000.00 -50.00% Total Assets 200,000.00 220,000.00 20,000.00 -9.09% Current Liabilities 40,800.00 48,000.00 -7,200.00 -15.00% Long Term Liabilities 143,000.00 160,000.00 -17,000.00 -10.63% Total Liabilities 183,800.00 208,000.00 -24,200.00 -11.63% Stockholders Equity 16,200.00 12,000.00 4,200.00 35.00% Total Liabilities and Stockholders Equity 200,000.00 220,000.00 -20,000.00 -9.09% Net Sales 500,000.00 500,000.00 0.00 0.00% Cost of Goods Sold 332,500.00 350,000.00 -17,500.00 -5.00% Gross Profit 167,500.00 150,000.00 17,500.00 11.67% Operating Expense 935,000.00 85,000.00 8,500.00 10.00% Net Income 74,000.00 65,000.00 9,000.00 13.85% (4,000) / 80,000 =-5% The company decreased its liabilities which is good but also decreased its assets and costs of goods sold. The operating expenses increased and kept the same amount of net sales. Their Stockholders’ Equity increased so they were able to purchase additional equipment, property, and plant. 5.Vertical analysis. Mary Lynn Corporation has been operating for several years. Selected data from the 20X1 and 20X2 financial statements follow. 20X2 20X1 Current Assets $86,000 $80,000 Property, Plant, and Equipment (net) 99,000 80,000 Intangibles 25,000 50,000 Current Liabilities 40,800 48,000 Long-Term Liabilities 153,000 150,000 Stockholders’ Equity 16,200 12,000 Net Sales 500,000 500,000 Cost of Goods Sold 322,500 350,000 Operating Expenses 93,500 85,000 a. Prepare a vertical analysis for 20X1 and 20X2. Briefly comment on the results of your work. Current Assets 15.20% 16.00% Property, Plant, and Equipment 19.80% 18.00% Intangibles 5.00% 10.00% Current Liabilities 8.16% 9.60% Long term Liabilities 28.60% 32.00% Stockholders Equity 3.24% 2.40% Net Sales 100.00% 100.00% Cost of Goods Sold 66.50% 70.00% Operating Expenses 18.70% 17.00% It seems as if the findings were the same as in the horizontal analysis. There is a difference, which is, seeing the sections changed based upon the previous. There is a 35% increase in the Stockholders’ Equity which is great for the company. 6. Ratio computation. The financial statements of the Lone Pine Company follow. LONE PINE COMPANY Comparative Balance Sheets December 31, 20X2 and 20X1 ($000 Omitted) 20X2 20X1 Assets Current Assets Cash and Short-Term Investments $400 $600 Accounts Receivable (net) 3,000 2,400 Inventories 3,000 2,300 Total Current Assets $6,400 $5,300 Property, Plant, and Equipment Land $1,700 $500 Buildings and Equipment (net) 1,500 1,000 Total Property, Plant, and Equipment $3,200 $1,500 Total Assets $9,600 $6,800 Liabilities and Stockholders’ Equity Current Liabilities Accounts Payable $2,800 $1,700 Notes Payable 1,100 1,900 Total Current Liabilities $3,900 $3,600 Long-Term Liabilities Bonds Payable 4,100 2,100 Total Liabilities $8,000 $5,700 Stockholders’ Equity Common Stock $200 $200 Retained Earnings 1,400 900 Total Stockholders’ Equity $1,600 $1,100 Total Liabilities and Stockholders’ Equity $9,600 $6,800 LONE PINE COMPANY Statement of Income and Retained Earnings For the Year Ending December 31,20X2 ($000 Omitted) Net Sales* $36,000 Less: Cost of Goods Sold $20,000 Selling Expense 6,000 Administrative Expense 4,000 Interest Expense 400 Income Tax Expense 2,000 32,400 Net Income $3,600 Retained Earnings, Jan. 1 900 Ending Retained Earnings $4,500 Cash Dividends Declared and Paid 3,100 Retained Earnings, Dec. 31 $1,400 *All sales are on account. Instructions Compute the following items for Lone Pine Company for 20X2, rounding all calcu ­lations to two decimal places when necessary: a. Quick ratio 1.17 b. Current ratio 1.86 c. Inventory-turnover ratio 10 d. Accounts-receivable-turnover ratio 13.33 e. Return-on-assets ratio 0.51 f. Net-profit-margin ratio 0.1 g. Return-on-common-stockholders’ equity 2.67 h. Debt-to-total assets 0.81 i. Number of times that interest is earned 15

Online Game Addiction Essay Example for Free

Online Game Addiction Essay Online game addiction is no longer just a worry of an American-chubby-child’s mother, but the worry of many parents in Cambodia and other less affluent countries. Recently, more teenage Cambodians were addicted to online games, in order to satisfy their fantasy of being heroes or warriors. Cambodian teens would rather eat less or even skip meals just to save money for the online games. Other than spending money, they also wasted their time. According to Chheng Roth Donior, a Cambodian teen, he normally spends three to five hours a day in internet cafes, even under the threat of his mother. It might have sounded strange to you, since Cambodia is not a wealthy country and most of the urban teens do not have internet at home, and why would they be addicted to online games? One of the reasons is more and more internet cafes have opened up, and Web access is growing rapidly these years. Another reason would be the teenagers in fact do not know they’re addicted to the online games or its harmful effects. The consequence of online game addiction could be serious, for example, last year in South Korea, a man died after playing online games for five days straight. For sure, the teenagers would waste all their money and time on those internet cafes. They would have less incentive to work or study since the satisfaction gained from the games is far more than those they could gain in their daily lives. It would also harm the gamers’ health (e. g. with poorer eyesight and less exercise) and would lower their face to face communication skills. Later, they may not be able to distinguish between the reality and the created world. Teenagers are the future of the country, measures must be taken as soon as possible to curb the addiction. First, promotion from the government is very crucial. The teenagers may not understand the harmful effects of online game addictions, government should advertise the harmful effect and possible consequences through mass media, i. e. TV advertisements, news paper, radio etc. Posters should also posted in school, streets and especially the internet cafes, just like a warning note must also included on the package of cigarettes. For why the teenagers would addict to online games, is that they could gain a sense of satisfaction by beating down their created enemies. Therefore, the teachers and parents of the teenagers should help them build their confidence, like giving them chances to develop their talents. For example, school can provide more Extra-curriculum activities for them afterschool. They should also help the teenagers to identify their dreams and targets, assuring them that nothing is impossible and encourage them to fight for their dreams through talks and lessons. Then they would not stick to the computer screens, instead, they would work very hard on their dreams. On their ways towards their goals, parents and teachers should give supports and advice to them. Third, government should set up clinics to help the gamers overcome their internet addictions, just like what China and South Korea did. The clinics should provide counseling and information about online game addiction, this could help those people who had already addicted to online games. Lastly, education is always the last resort of most problems. Schools and parents have the responsibility in teaching the teens about the harmful effects of online game addiction. They should educate the students or their children starting from their childhood. Schools can hold more talks on the issue in order to make sure that they receive related information. If we do not cope with the problem as soon as possible, the situation would become more complicated and serious. The solutions I suggested above would definitely help dealing with the problem, and I hope the situation would be improved soon.

Cognitive And Dialectical Behaviour Therapy Borderline Personality Disorder Nursing Essay

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

The Communist Manifesto by Karl Marx and Friedrich Engels Essay

The Communist Manifesto by Karl Marx and Friedrich Engels   Ã‚  Ã‚  Ã‚  Ã‚  The Communist Manifesto was written by two world renowned philosophers, Karl Marx and Friedrich Engels. This book was produced in an era of great suffering and anguish of all workers in a socially distressed system. In a time when revolutions were spreading through Europe like wildfire, Marx organized his thoughts and views to produce the critical pamphlet â€Å"The Communist Manifesto†. Marx’s scrutiny illustrates his belief that unless change is to occur the constant outcome will repeatedly remain uniform. This is a novel that displays the differentiation between the Bourgeois and the Proletariat. Class relationships are defined by an era's means of production. Marx’s contradictions the position that capitalism is the unsurpassed system of economics. The only tactic that could create a successful change is if the proletariat takes some initiative and brings an end to the two distinct classes. Only then will the proletariat attain equality so cially, politically and economically.   Ã‚  Ã‚  Ã‚  Ã‚  In 1846 Karl Marx was exiled from Paris on account of his radical politics. He moved to Belgium where he attempted to assemble a ragtag group of exiled German artisans into an unified political organization, the German Working Men's Association. Marx, aware of the presence of similar organizations in England, called these groups together for a meeting in the winter of 1847. Under Marx's influence this assemblage of working-class parties took the name "The Communist League," discussing their grievances with capitalism and potential methods of response. While most of the delegates to this conference advocated universal brotherhood as a solution to their economic problems, Marx preached the composition of class warfare, explaining to the mesmerized workers that revolution was not only the sole answer to their difficulties but was indeed inevitable. The League, completely taken with Marx, commissioned him to write a statement of their collective principles, a statemen t which became â€Å"The Communist Manifesto.† In the book, the essential theory presented is the creation of only one class, so that there would no longer be a class struggle. It discusses how Engels and Marx argued for equality and redistribution of wealth. More than anything else, the two philosophers had a grievance with workers not having control over t... ...his class in being assimilated into the proletariat as society becomes more urbanized and reliant on industrial production. Petty-bourgeois socialism arises from this class, but holds up the standard of the proletariat, with whom the bourgeoisie are a shared enemy. I feel that the most influential quote in the book is "In place of the old bourgeois society, with its classes and class antagonisms, we shall have an association, in which the free development of each is the condition for the free development of all". This is a claim that once the proletariat achieve political power, the eventual result will be a classless society. Abolishing bourgeois modes of production undermines the continued existence of class hostility, and without class hostility, the proletariat will lose their own class character.   Ã‚  Ã‚  Ã‚  Ã‚  The communist contribution to this ongoing revolutionary discussion will be the raising of the property question, for any revolutionary movement which does not address this question cannot successfully rescue people from oppression. Eventually the inventible will occur due to the proletariat lack of outcry and social protests. A revolution will be the undeniable consequence.

The Development of Brands and Branding Essay -- Advertising

In today’s world material goods make a big contribution to one’s image and social status. A wealthy, financially stable person could walk down a street wearing an old pair of jeans and a rugged tee shirt and be taken as a middle-to-low-class person. On the contrary, a middle-class woman could wear her only Custo Barcelona dress and carry her only Louis Vuitton handbag and be viewed as a being with excess wealth and prosperity. Brand images are significant elements of American culture, and they continue to make a statement as prominent products of graphic design. Brands are series of logos, names, slogans, designs, and/or sounds that communicate to people what the company, product, or service in question stands for. Though the main aim of a brand is to develop trust and satisfaction with customers and supporters, people develop their own idea of what this representation may include after experiencing the product for themselves. As more people experience the product and word of the product is spread through society, the brand image becomes synonymous with the product. Some brand images have become so well known that they can be displayed somewhere irrelevant to the product and still are successfully able to convey a message to viewers. A brand is of utmost importance in advertising, and it is essential to develop a brand image early in a product’s life in order to assure that the image will be known for the remainder of time the company or product is in existence. Some companies or products pay companies with previously established brand images to use for their brand image and establish their own brand image. These companies use the existing brand images because certain qualities are associated with these brands. O... ...ed through these products since the advertisement shows â€Å"a successful person† or â€Å"the good life†. They are not really fulfilling the good life or being a successful person, they are buying a brand that represents the good life or a successful person (HBS). Branding is something that will never go away as long as there are things to sell. If branding didn’t exist and people bought products on impulse, companies would find it difficult to sell their products and services. The loyalty that branding produces makes it easier and more efficient for companies to survive. Branding is essential to companies because of the way society operates, through association of ideals to products. As long as companies continue to intensify their image and relate to desirable conditions, people will continue to buy their products and services, and businesses will continue to strive. The Development of Brands and Branding Essay -- Advertising In today’s world material goods make a big contribution to one’s image and social status. A wealthy, financially stable person could walk down a street wearing an old pair of jeans and a rugged tee shirt and be taken as a middle-to-low-class person. On the contrary, a middle-class woman could wear her only Custo Barcelona dress and carry her only Louis Vuitton handbag and be viewed as a being with excess wealth and prosperity. Brand images are significant elements of American culture, and they continue to make a statement as prominent products of graphic design. Brands are series of logos, names, slogans, designs, and/or sounds that communicate to people what the company, product, or service in question stands for. Though the main aim of a brand is to develop trust and satisfaction with customers and supporters, people develop their own idea of what this representation may include after experiencing the product for themselves. As more people experience the product and word of the product is spread through society, the brand image becomes synonymous with the product. Some brand images have become so well known that they can be displayed somewhere irrelevant to the product and still are successfully able to convey a message to viewers. A brand is of utmost importance in advertising, and it is essential to develop a brand image early in a product’s life in order to assure that the image will be known for the remainder of time the company or product is in existence. Some companies or products pay companies with previously established brand images to use for their brand image and establish their own brand image. These companies use the existing brand images because certain qualities are associated with these brands. O... ...ed through these products since the advertisement shows â€Å"a successful person† or â€Å"the good life†. They are not really fulfilling the good life or being a successful person, they are buying a brand that represents the good life or a successful person (HBS). Branding is something that will never go away as long as there are things to sell. If branding didn’t exist and people bought products on impulse, companies would find it difficult to sell their products and services. The loyalty that branding produces makes it easier and more efficient for companies to survive. Branding is essential to companies because of the way society operates, through association of ideals to products. As long as companies continue to intensify their image and relate to desirable conditions, people will continue to buy their products and services, and businesses will continue to strive.

Walmart’s Key HR Functions Underperforming

Introduction The success of any organization depends on its strategic asset, the human capital. As pointed out by Lawler (1996), organization’s competitive advantage comes from its human capital. Efficient management of this resource can bring significant benefits to the company. It should be remembered that motivation is the epicenter of performance and an important factor ensuring the success of a company. Improving workplace productivity however remains a major challenge in most companies. In this regard, this study explores the human resource management approach at Wal-Mart. It identifies the ways in which two HR functions (employee motivation and employee performance practices) are underperforming. This includes a brief account of how the functions operate within the organization, how they are applied and what the outcomes for the business are given that they are underperforming. The paper evaluates why these particular functions are considered to be underperforming using Herzbergâ₠¬â„¢s motivator Hygiene Theory. Further the paper makes some recommendations for improvement of these HRM practices and the benefits to the company. What is human resource management? Human resource management encompasses all activities associated with management of the human capital and in ways towards achieving the corporate goal or objective. In any organization, the human resource department plays a crucial role. Not only are HR managers required to recruit and train employees, but they also have the obligation of motivating and engaging the workforce. Understanding what motivates the employee and ensuring good employee employment practices is key for talent retention and performance (Lockwood et al. 2010). Regardless of the economic environment, it is imperative for companies to create an engaged and motivated workforce. Underperformance in the workplace has recently been a major concern in Wal-Mart stores. According to a new research report by Wolfe research, an equities research firm, Wal-Mart has been underperforming over the past years. The firm lowered Wal-Mart from a â€Å"market perform† rating to an â€Å"underperform† rating (Covert, 20 14). Failure by Wal-Mart has been attributed to their poor employment practices especially low wages and lack of rewards. Whereas Wal-Mart may not be the only big store chain criticized for its poor employment practices and policies, it has come to the spotlight owing to its aggressive policies and low cost strategy which undermines the effort made by employees. Just last year, a lawsuit was filed against Wal-Mart by the international Labour Rights Fund for requiring overtime, denying minimum wage and punishing union activity (Covert 2012). This is clearly a violation of worker’s rights. Wal-Mart which was initially a corporate fortress seems to be headed to a downfall. Even its operations in the US indicate the possibility of a failure in the giant retailer. More recently, Wal-Mart warned its investors that its comparable store sales may be slightly negative after the third quarter. This is also evident in the huge layoff of 2300 workers at Sam’s club, one of its stores. The layoff was attributed to their poor performance. Whereas Wal-Mart still remains the corporate fortress in the retail sector due to its massive size, its underperformance in the US and emerging markets indicate the possibility of a failure in the near future. Walmart’s bad business practices Wal-Mart has on several accounts been criticized for poor wages. Why should employees suffer in one of the giant retail stores that make billions of profit annuallyWal-Mart is ranked among the best 100 corporations by Forbes magazine yet most of its employees take on average less than $250 a week. Full-time employees are paid between $6 and $7.50 an hour. A further a third of the employees who are part-time are limited to working up to 28 hours a week and are not eligible for benefits. Such pay scale places them and their families below the poverty line. The lack of rewards demotivates and discourages them from performing well. Perhaps Wal-Marts bad business practices are more evident with the Rana Plaza tragedy which led to the loss of over 1000 lives. The tragedy exposed some of the profound flaws in the industry. Rana Plaza produced private garments for some of the giant retailers including Wal-Mart. Evidence provided by the Bangladesh center for Worker Solidarity showed that Wal- Mart had been producing its garments in Ether Tex factory situated on the 5th floor of the building (Steven 2013). Some documents were found in the rubble detailing purchase orders for certain garments which were to be delivered to Wal-Mart. Further, at the time of the tragedy, Wal-Mart was already listed in Ether Tex’s website as one of the main customer. Although Wal-Mart denied knowledge of their operations at the factory building, it announced its plans to put in place new safety measures at some of their factories in Bangladesh. The corporate fortress, however, promised to stop production if urgent safety problems were uncovered at some of its factories. The company further assured the Bangladeshi government of their support and commitment towards improving workplace safety. But the company stopped short of committing to these improvements and distanced itself from the Rana Plaza tragedy. This is a clear example of bad business practice. Why these particular functions are considered to be underperforming Last year, Wal-Mart reported $11 billion in net income yet it has not been able to remedy some of its questionable workplace practices. Wal-Mart has been filed in over 5,000 lawsuits for poor employment practices such as inadequate health care, wage law violations, worker exploitation and their anti-union retailer stance. Wal-Mart anti-union stance can be seen in their recent threat to close one of its stores in Quebec after workers successfully unionized. Citing ‘economic reasons’; Wal-Mart announced their plans on shutting the store. However, this argument was rejected by Quebec’s labor relations and Wal-Mart’s firings found illegal. Further, the move to extend operations to overseas markets including setting up factories in emerging markets such as Bangladesh and China was driven by the desire to take advantage of cheap labour. For example, Wal-Mart pays much less its employees in China compared to those in the US and the UK. A further criticism has been the lack of employment benefits. Part-time employees are limited to working up to 28 hours a week and are not eligible for benefits. While, workers who are eligible for benefits pay way over the odds to get health insurance and other benefits. The company has often come under criticism for not providing employees with affordable access to health care and employees are overburdened. For example, in 1999, 36% of the total costs were paid by the employees. In 2001, there was a 42% rise in employee burden. The health of its employees has been deteriorating at a faster rate. According to the company’s internal memo discovered by New York Times, Wal-Mart workers were sicker compared to the national population. This begs the question: Why can’t such a giant corporation provide its workers medical retirement benefits given the huge profits that they makeThis question was once raised by one of Wal-Mart’s managers only to be fired by the CEO and reasons of disloyalty cit ed as the reason for being quitted. (Jordan 2008). As Michael Porter (1980) once pointed out that a company would rely on three basic competitive strategies to maintain their edge in the market: differentiation, cost leadership, and focus strategy. Wal-Mart has obviously taken the cost-leadership strategy by reducing the cost of recruitment, providing low pay, no rewards, requiring overtime, and cheap children labors. It currently faces a barrage of lawsuits for extensive violations of labour laws. Wal-Mart also faces law suits for extensive violations of state regulations that require time for breaks and meals. In some instances, minors are forced to work late for the performance appraising. Outcomes for business Wal-Mart may be headed for a downfall. Its customer service is already low and their low-cost strategy has led to many cut offs of employees. Since recession, Wal-Mart has been cutting down on their staff. Without enough manpower for their retail operations and with workers on site underpaid, its merchandize remains stacked on pallets in warehouses instead of the shelves where customers can reach them. What then is the value of offering lower prices if the products are not accessible to the customers? Further, the check-out lines are painfully long and there seems to be a decline in the overall customer shopping experience. Customer shopping experience has been deteriorating due to the longer checkout lines, disorganization and less staff help. Last year, the giant retailer was placed last among in the American Customer Satisfaction Index, a six year in a row in which Wal-Mart has taken the last spot (Ungar 2013). Lessons must be learnt from the experience of the other low end retail ers. McDonald’s earnings have fallen significantly due to their poor terms of employment. Similarly, Wal-Mart needs to consider the potential upside of their aggressive policies. Despite the poor employment practices, Wal-Mart still remains among the leading retail giants. Its remains ahead of its competitors such as Target and JC penny. However, Wal-Mart faces a threat from Costco, its primary competitor. Costco has been experiencing a fairly healthy 8% growth in annual sales (Ungar 2013). In fact, a significant number of customers are moving to this retailer for their shopping experience. Could this be attributed to the good employment practices at CostcoUnlike Wal-Mart, employees at Costco get a decent living and are paid in excess of the minimum wage. Given the aggressive HR policies employed by Wal-Mart, it begs the question: what then is the role of HR managers in this companySince, as HR professionals, they are required to put in place strategies oriented towards the e mployees. To some point, however, employees seem to be encouraged to think of themselves as ‘servant leaders’. For example, employees are called â€Å"associates† showing that the company values their contribution. Such kinds of HR policies are employed in most of the best performing companies. These policies and practices serve to motivate employees to increase their performance and can aid in developing good corporate culture. However, employees may not feel appreciated if they are paid less than minimum wages and denied rewards and opportunities for professional growth. There seem to be no opportunities for enhancement and professional growth. Wal-Mart does very little training and developments of its human resources and as such, opportunities for enhancement of professions especially for women are limited. In fact, several claims have been filed against Wal-Mart for discriminating against women in terms of employment positions and the lack of opportunities fo r advancement. Improving employee motivation and employment practices at Wal-Mart As HR professionals continue to seek bright, talented and highly engaged workforce, motivational theories can provide insights on how Wal-Mart can improve employee motivation and engagement. Several motivational theories have been suggested including the Expectancy Theory, Maslow’s Hierarchy of Needs theory, Herzberg’s motivator Hygiene Theory, Goal Setting Theory, and Equity theory (Lockwood et al. 2010) Herzberg’s motivator Hygiene Theory is perhaps more applicable to the case of Wal-Mart. The theory suggests that two main factors must be met for employees to become satisfied with work. These are: the hygiene factors and motivator factors. The hygiene factors include meeting the basic needs such as adequate pay, comfortable working environment, effective supervision and good relationships with the core workers. On the other hand, motivation factors include advancement and professional growth, and rewards or opportunities for recognition (lockwood et al. 2010) W al-Mart needs to consider applying the two-factor theory of motivation if they are to improve on the performance of their employees. They need to revamp their policies, increase the salary of their employees, and the safety and security of the employees. Further, they need to consider motivators that are intrinsic to the job which include providing rewards for achievement and increasing their growth opportunities. Pundits, policymakers and activists outraged by the company’s low wages have been calling for protests. According to Robert Reich, a professor at U.C. Berkeley, Walmart’s net income is estimated at $17 billion meaning that they can easily afford to give its workers a small pay-rise (Atner 2013). The Chancellor professor of public policy has in fact urged shoppers to boycott Wal-Mart since they do not want to share even a little bit of their income with their employees (Atner 2013). Conclusion In today’s highly competitive marketplace, motivation of employees and employing the best employment practices is key to success. Underperformance in the workplace has recently been a major concern in Wal-Mart stores. Several lawsuits have been filed against Wal-Mart for violation of worker’s rights including low wages, lack of employment benefits, being required to work overtime and denied to participate in union activity. Bad employment practices are clearly evident in Wal-Mart. This has affects employee productivity as it demoralizes and demotivates them. Wal-Mart needs to consider applying the two-factor theory of motivation if they are to improve on the performance of their employees. Incentives are key to maintaining a motivated workforce and ensuring business success. Appraising and offering hardworking employee with incentives will motivate them to go the extra mile of putting the company first. Employee valuations need to be implemented and growth opportunities made plenty. HR managers at walmart need to understand the benefits of employee motivation and engagement. By sharing their profit, employees will feel appreciated and more passionate about their work. Ultimately, this will result in improved performance and greater customer satisfaction Reference Ciura, B., 2014. Is Wal-Mart’s empire about to failViewed on 29th March 2014. Available from http://www.fool.com/investing/general/2014/02/01/is-wal-marts-empire-about-to-fall.aspx Covert, B., 2014. Walmart’s labor practices backfire. Viewed on 29th March 2014. Available from http://thinkprogress.org/economy/2014/02/10/3271221/walmart-downgraded-understaffing/ Gusdorf, M.L. and Reed, S.M., 2009. The role of mission and values in strategic human resource management. 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Wal-Mart pays workers poorly and sinks while Costco pays workers well and sails-proof that you get what you pay for. {Viewed on 30th March 2014} available fromhttp://www.forbes.com/sites/rickungar/2013/04/17/walmart-pays-workers-poorly-and-sinks-while-costco-pays-workers-well-and-sails-proof-that-you-get-what-you-pay-for/