Johannes Brahms symphony no. 4

Johannes Brahms symphony no. 4, opus 98, is a masterpiece that stays in the annals of history of music and the history of symphony. Completed in the 19-th century, it had such glorious predecessors as Beethoven’s symphonies. Therefore, in the times of Brahms, the symphony was considered the proper of great Beethoven and anybody who had courage to compose in this genre would inevitably face the possibility to be compared with Beethoven.Johannes Brahms worried that he was not worthy of the musical tradition set by Haydn, Mozart, and Beethoven. One of the most unfortunate effects of his lack of confidence was expressed in an unwillingness to compose a symphony because he was afraid of being compared unfavourably to those masters, waiting until he was 43 years old to complete his First Symphony. However, once he had completed that initial symphony, he quickly adapted to the form, producing his remaining three symphonies in the space of only nine years.Each seemed to be more succes sful than its predecessors were; each introduced more depth and innovation from the most complex of the 19-th century composers. Just as Brahms's First and Second symphonies appeared in rapid succession as a contrasting pair, so did the Third and Fourth. The Third was finished in the summer of 1883 and the Fourth was begun the following summer. The first mention of the Fourth Symphony is in a letter dated 19 August 1884 from Brahms to his publisher, Fritz Simrock; the work was completed about a year later at Miirzzuschlag in Styria.In October 1885 Brahms and Ignaz Briill gave a two-piano reading of it for a small group of friends including the critic Eduard Hanslick, the surgeon Theodor Billroth, and the historian and Haydn scholar C. F. Pohl. Brahms conducted the first orchestral performance at Meiningen on 25 October 1885 . It is very interesting to observe Brahms's progress as a symphonist. He lived in the time of romanticism in music, when considerations of form gave place to su bjective expression. F.Liszt was then creating his symphonic poems and R. Wagner produced his amazing music dramas – all works strongly colored by literary and poetic ideas, and by a very personal attitude on the part of the composer. Brahms, in his First symphony, if not an outright romanticist, is yet â€Å"romantic† in his attitude, just as Beethoven in his Fifth symphony. Later we see Brahms's progression backward – from the â€Å"romantic† to the â€Å"classic† stress. The Fourth symphony is a pure classic masterpiece.However, the symphony is not only a work of design; it has a subjective undercurrent behind itself. It is perhaps significant that Brahms, ordinarily certain of himself and his work, had misgivings and questionings about this symphony. Some find the symphony an expression of pessimism. They say that it is bitter, that it drips melancholy like the yew tree, that its thoughts are of death. In fact, by that time Brahms had lost his mother who died of a heart attack. He devoted this symphony to the memory of his mother. But pessimism is not despair.At the time when Brahms wrote this symphony, his thoughts were turning towards his own end which was near, and death must have appeared as it should appear to all of us, as a tender friend and a supreme consoler. Brahms's symphonic work embraces all that is tragic and glorious in his music. There is tragedy even in the most wonderful of these movements, where we hear yearning for things gone beyond recall, but more especially in those where he strives to renew the traditions of the classics and proves splendidly that inherited forms may be filled with new matter .Nevertheless, one may safely predict that those portions of his work which show a master's discipline and noble intention as perhaps the most impressive marks of his character, will not be held in so great and lasting an affection as those where he is wholly himself, and where only his pure and great heart, so full of riches and yet so closely guarded, is heard to beat. He deliberately took a path that led him away from the land of romance to seek the land of Bach and Beethoven with all the ardor of his soul.But the spell of the blue flower was stronger. He fancied that he had eschewed the enchantment, but this was a delusion, for he remained a romantic all his life, a dreamy enthusiast, a deep feeling recluse, who clothed in new magical sounds the voices of rustling woodlands, the radiant eyes of virginal queens, the scattered tones of lost love-songs–all this, and his own life, blessed by sorrows and raptures. It is there that he is irresistible and unforgettable.Where he played the part of â€Å"heir† he had too little to squander, though he won and consolidated precious treasure enough. Only as the eternal youth, as one wrestling and longing and drinking from abundant wellsprings, as one of the beloved fairy-tale princes of music who ever and again awaken to deliver s leeping princesses, did he in truth find the land of Bach and of Beethoven. To many listeners, the Third Symphony might have seemed like the natural goal of Brahms's development as a symphonist because it combined the simple characters of folksong and romantic.It added an intense instrumental idiom and deep sense of coherence and overall structure, resolving its tensions at the close in a manner increasingly characteristic of the expression of his most profound songs. Yet any such impression would soon have been dispelled by the symphony, which followed shortly after in 1885, for here he recalls the wealth of ideas, which characterize the Second Symphony and the earnestness, and sense of structural culmination of the First Symphony. Yet here the drama is of a different kind.It is not the classic nineteenth-century struggle from minor to major, in Brahms's case full of romantic symbols in its final stages, but rather an abstract drama, which reaches its climax through the sheer intel lectual rigor and energy of its finale rather than through any conventional symbols. It ends securely in the key in which it began, E minor. And if the Third Symphony had gained something of the personal quality of its opening from the memories of Schubert and Schumann, this goes back to memories of Beethoven and Bach.For, not only does the finale take Bach as its starting point, but the first movement takes Beethoven. As has been noted, the first subject clearly draws on the slow movement of the ‘Hammerklavier' Sonata (bars 78-86) where an identical outline appears as a consequence of the evolving influence of the interval of the third. Yet it comes through an entirely Brahms’ mediation. The setting is very close to the somber opening in which he was soon to place the first of the Motets op.110, the same key and broad shape expressing the text ‘Ich aber bin elend' – ‘But Lord, I am wretched'. Yet the symphony's is a more animated, complex type of exp ression whose distinctive two-note phrasing actually finds its closest parallel in a piece in total stylistic contrast to the motet -the Waltz in D minor, op. 39 no. 9. From this very personal stylistic chemistry, Brahms builds a movement and a work whose lofty style is closest to the Tragic Overture, a greater example of the ‘sublime style' noted in the great choral works with orchestra.And from them it takes much of its orchestral character, especially the fullness of Brahms' scoring, and the telling use of the flute, especially at bar 128 of the finale – surely a Grecian symbol. While Brahms has long since parted company with the storm and stress of the First symphony, the accents of the Fourth are in the highest degree charged with the resignation and the profound understanding that his own earnest nature and the passage of the years had brought him, and the nobility that existed under his crusty exterior.In viewing the work as a whole, its background again provides a key to its special nature and sense of direction. Indeed, it may well reveal the reverse case to that of the First Symphony, for even if it seems clear that it was the resolution of the first movement's implications that provided the compositional problem of the earlier work, it appears likely that the finale was here the starting point and thus determinant of the work's structural nature. And even if other ideas existed at this earlier stage, the special nature of the finale provided the dominant focus for their working and shape.Much of the Fourth symphony is melancholy and lamentful, but it is relieved by the consolatory beatitude of the andante and the elevating stateliness of the conclusion. The austerity with which the composer has been reproached—in many instances unjustly—is here pronounced. The solidity of the structure may be admired, but the structure itself is granitic and unrelieved. The symphony has not the epic grandeur of the first, the geniality of the second, the wealth of varied beauty that distinguishes the third.Although the precise date is not known, Brahms had shown interest in the chaconne bass of the finale of Bach's Cantata No. 150 â€Å"Nach Dir, Herr Verlanget mich† some time before the symphony's appearance. The conductor Siegfried Ochs recalls him demonstrating to Hans von Bulow the structure of the Bach movement, to which von Bulow responded coolly, arguing that it needed more than voices. Brahms agreed, commenting: â€Å"What would you say to a symphonic movement written on this theme one day? But it is too lumpish, too straightforward. It would have to be chromatically altered in some way.† Just how the alteration was effected is clear from the work, where Brahms extends the model from its five-bar length to eight bars, substituting equal dotted minims for its minim-crotchet pattern and creating a climax in the chromatic alteration of A sharp. Now it appears as leading note to the dominant, B. But how the work as a whole stood in his mind at this earlier stage is not clear. Brahms was aware of the possibility that a variation finale can be assumed from the model of Beethoven, and the St Antoni Variations had already presented a basso ostinato variation finale.Yet the precise nature of a finale, which reflected both stimuli – that of a symphonic design in a harmonically restricted form – must have occupied him for long before a solution became clear. In considering the problems, Brahms drew on a considerable knowledge of the form of the chaconne and passacaglia, as has earlier been shown. In the actual period of the work's completion, he acknowledged special interest in the Organ Passacaglia in G minor by Georg Muffat, describing it to Elizabeth von Herzogenberg in 1883 as very fine and acknowledging possession of a copy.His work on the Couperin Edition for Chrysander also gave him an acquaintance with an example from the very different tradition of the French c lavecinists through the form of the Rondeau Passacaille. But the movement for which he had the deepest feeling was the Bach Chaconne for unaccompanied violin. He wrote to Clara Schumann, to whom the arrangement for the piano, left hand, was dedicated, in the following terms: For me the Chaconne is one of the most incredible pieces of music. Using a single system for a little instrument, the man writes a whole world of the deepest and most powerful expression.If I ask myself if I had written this piece – been able to conceive it – I know for certain the emotions excited would have driven me mad. If one does not have a great violinist at hand, the most exquisite of joys is surely simply to let the Chaconne ring in one's mind. But the piece certainly entices one to occupy oneself with it somehow. From this, he concludes that the only comparable experience is to play it with the parallel restrictions of left hand alone. It seems interesting that in referring to the other w ays of imagining the work recreated he mentions the orchestra.It is not difficult to see the manner and structure of this Chaconne, which he knew so intimately, mixing with his transformation of the Bach cantata bass to provide the foundations of a movement through which both vocal and instrumental limitations are transcended in his most powerful variation structure. Heinrich Reimann gives a short description of the symphony: â€Å"A theme of the second movement constantly returns in varied form, from which the chief theme, the staccato figure given to the wind, and the melodious song of the violoncellos are derived.The third movement, allegro giocoso, sports with old-fashioned harmonies, which should not be taken too seriously† . Seen against the background of Brahms's earlier variations, this movement is unique in its observation of a clear A B A – Coda form. The contrast is provided by changes in dynamics, frequently in mode, and partly in meter. The return of the o pening introduces variation both thematically and in the scope of harmonic movement within the tight restriction of the model, taken even further in the coda.All the previous variations are continuous, though the contrast of mode to major is established from the Variation on an Original Theme. The Bach Chaconne therefore assumes great interest in its adoption of a ternary outline through contrast of mode, in its variation of harmony at the reprise (though the theme is not recalled) and in its length – both movements building to thirty variations from an eight-bar model. The form of the Chaconne is also crucial to understanding Brahms's harmonic methods.Although elements of passacaglia are used in this movement – that is of a repeated ground bass ostinato – the chief spirit of the movement is that of harmonic retention, from which the composer can dramatically move for effect. The model is compounded of Bach's bass in modified form as upper part with a Brahmsâ₠¬â„¢ bass in which descending thirds are prominent. This provides the model for the first four variations and the background to the reprise, with its increasingly free harmonic working until Brahms breaks completely away from the previous patterns in the coda, loosening the original phrasing.The intervening harmony is built either on the ground (variations 4-11, 14-16), or on pedal variants, as in the central part, variations 12-13. Thus, as in earlier variation movements, there are two harmonic models with other freer types, though it is the first, with the theme in the upper part, which has the role of articulating the large structure. This represents, therefore, a considerably more complex form than its immediate predecessor, the ostinato variations of the St Antoni Variations.In fact, Brahms brings to fulfillment the inherent influence of the chaconne, noted as early as the variations of the B flat Sextet though with the added aspect of the passacaglia reflected in the Second Se renade and the St Antoni Variations, together with the outline of sonata form. It is the latter aspect that creates the variation of the reprise, since development cannot be used in the subdued central section. Clearly, such a distinctive structure could not have provided the symphonic climax without intimate relations with the other movements.The observation of the contrapuntal connection between the descending thirds of variation 30 and the first subject of the first movement is only one of many which could be made, for this work is perhaps more subtly and comprehensively integrated than any other. Not only are thirds omnipresent in the work's thematic material – as in the bass of the model – but many other links exist, including the anticipation of the ground in the first subject (bars 9-15). Most impressive, however, is the special harmonic language of the work, which is drawn from the harmony of the model.Both plagal and Phrygian progressions contribute further to the deeply archaic quality of much of the music. For example, the first subject is built on plagal progressions and the movement ends with a very impressive plagal cadence enhanced by pedal. The harmonic language of the second movement is even more special in its modal associations, as will be shown. All these features serve to support the more obvious surface function of variation. For the principle of successive variation, which dominates the finale also, soaks the work as a whole.The links are clearest in the first movement for two principal reasons: the structure of the movement as a whole and, directly related to it, the nature of the first subject. Brahms's tendency to recall the opening material after the recapitulation where no repeat is incorporated finds a particularly plain expression in this movement, which brings an approach associated with finales – those of the First and Third Symphonies and of the Piano Quintet into the context of a symphonic first movement.Y et the method is here different, for this is no conflated development/recapitulation structure, but rather a modification of the conventional scheme, since the recapitulation follows the third tonic statement of the idea at bar 246. The special form arises from the special nature of the main subject itself, a lyric paragraph whose essential sixteen bar structure is extended by internal variation to create a sectional impression – the sense of a model which demands repetition in a way quite unlike the main subjects of the other symphonies. Thus, the movement assumes a variation-aspect at two levels.Viewed most broadly, it falls into three sections, closely related by their presentation of the same passage. Although the third statement is made more elusive by the recall of its opening phrases in augmentation, linked by figuration in the strings, the overall effect is clear when the theme resumes at bar 246. As far as the sections themselves are concerned, they also appear stron gly variational through the immediate repetition of the first theme, that of the development offering an alternative to that of the exposition, bars 145-152 comparing with bars 1-7.Thus, Brahms draws on his earlier tendency to construct the transition by variation of the first subject (compare with the Second Symphony) into a much broader context. In the sections of passing variation, which have become so characteristic, although never with the clarity and deep thematicism of, for example, bars 80-6 or 95-8, the development draws so often on variation that it directly recalls the finale.Thus, after the varied repeat of the opening of the development, bars 169-84 present another section of clear variational identity, here through motive variation of the preceding bars treated in a stretto which quickly removes the sense of accentual identity, offering yet a further example of how Brahms learned from Beethoven the art of displacing the beat through the relentless repetition of a simpl e figure. This passage is complemented at bar 192 by a more direct variation of the opening subject, the section again alternating with the marcato figure of the transition, which serves to direct and articulate the music's progress.At bar 119, the finale is even more clearly foreshadowed, mediating between the variation and the work's first subject, which it clearly outlines, drawing particularly on the original flute parts to ensure connection. In turn, the following passage from bar 237 varies the following bars, focusing on a one-bar figure, whilst recalling the color-contrast of the variations, which lead to the reprise of the finale. It is inherent in such a structure that radical alterations of the recapitulation would have disturbed the variational relationship of the first three parts.Rather, as in the finale, it is the coda, which exhibits the development quality with the most rapid modulations and intense treatment of ideas. Yet variation remains the chief model. The powe rful statement of the first subject at bar 394 is remarkable in its transformation. The theme appears in canon between the outer parts, actually retaining its identity for far longer than the ear might suggest (14 bars in all) before a bridge to an intense treatment of the transition idea of bar 414.This remarkable intensity is achieved through a use of stretto, in which Brahms seems to press to extremes the possible relationship between the harmonies permissible in his style and the logic of the contrapuntal movement, a quality that he shared to a remarkable degree with Mozart. In a period, which includes some of Brahms's most powerful first-movement codas, this is surely the most impressive in its nature and its structural function. Of the impressive central movements with which Brahms completes his overall scheme, the second relates most clearly to the principles outlined.Indeed, its leisurely first section from bar 5 parallels that of the first in its relation to earlier works. An eight-bar theme of the simplest phrasing returns after a nine-bar digression to complete an exposition in simple A B A form. The following transition proceeds again by simple variation to establish, through ideas, which relate to the parallel part of the first movement. The dominant of B for the second subject, after which there is a further variation of the first theme with descending wind figures reflects the first subject of the work and strings employ pizzicato.Bar 74 initiates an imitative development very much in the spirit of that of the finale of op. 18, after which the second subject completes the conflated scheme: 1 – tr 2 – 1 – dev – 2 – coda. Yet its straightforwardness comes into a completely different perspective when set in its harmonic context. It can be seen as perhaps the boldest and most far-reaching of Brahms's experiments with modal effects. For, the opening partly suggests a tonic C despite the preceding cadence, one interp rets the unison opening as rooted in the lower mediant of E minor.Yet at the end of the phrase, Brahms turns the closing E into the tonic of a modified sonata movement, which makes a conventional contrast (though now unusual for Brahms) with the dominant, B, for its second subject. Such an opening must have a consequence in a Brahms’ movement and the key of C returns in the closing bars as an alternate harmonization of the opening theme in succession to the chromatic harmonization of the theme in E. Thus, Brahms juxtaposes the keys of E and C through a common theme.The ‘framing' effect of the C tonality and its final resolution is evident. Whilst this passage can be seen as simply one of effect, the suggestion of a Phrygian tonality, it may also be seen in more far-reaching terms. For, unlike the other authentic modes, the dominant of the Phrygian is not on B, but on C, since it cannot form a perfect fifth from B to F sharp. Thus, though Brahms may well begin with a mer e ‘effect', the harmonic implications are readily grasped and he, though very briefly, actually contrives to close with a Phrygian aspect.The Austrian theorist Heinrich Schenker once stated that the capacity to write in the modes lay even beyond a genius like Beethoven, that the Lydian movement of op. 132 simply used modern tonality to suggest a mode through the omission of any B flat and other means. Is it not possible that Brahms's deep interest in the issue led him to go a little further in the attempt to unite modern tonality and the principles of modality in one movement? After such tonal stress, the key of the third movement appears inevitable.Yet in its manner, the movement stands in strong contrast to the parallel movements of the later works. As is often pointed out, Brahms avoids the scherzo-substitutes of his maturity for a scherzo of an individual nature -not a 6/8, but a driving 2/4 movement. Yet its character is surely not without precedent. Just as Brahms had dr awn on the ‘Hammerklavier' Sonata as the starting point for a reinterpretation of a powerful idea, so the deep historical background to this work leads him to draw on the second movement of the late Piano Sonata in A flat op.110 whose thematic outline complements its metrical character in providing his basis. Yet in no other sense does the form relate to tradition, for Brahms constructs a continuous movement, sustained by variation in which the Trio contrast is limited to a very brief passage from bar 178 to bar 198, which simply transforms the character of the opening, to play a part in the broader scheme. And now we are going to make a profound emotional analysis of the symphony.Let us take take the opening. The violins play a melody that starts as a series of two-note sighs, each sigh consisting either of a descending third (for example, B to G) or of the same interval inverted into an ascending sixth (for example, E to C, but going up to the next-highest C rather than down ). Woodwinds echo these figures, but as chords, with the two notes played simultaneously.It is hard for us to think of a lovelier, more inviting opening to a symphony – of course, its familiarity help. Something preparatory, even if it were only two measures of unison B, would help listeners find their way in. This opening is immediately followed by a second statement of the melody, this time in broken octaves and in dialogue between first and second violins, with elaborate decorative material in violas and cellos. This was thought exceedingly difficult to unravel.

Good Will Hunting Character Analysis

Introduction Social- Cognitive theory believes that humans are individuals who are capable of proactively making things happen to assist in their own development (Parajes, 2002). In Good Will Hunting, Will Hunting did not believe that he was able to make a positive change in his life. Will is a prodigy, particularly in mathematics, who did not recognize his gift. He was born and raised in the slums, where he is now comfortable. He was abandoned by his parents and in and out of numerous foster homes. He experienced abuse and neglect in these homes. He was not only physically abused but also mentally and psychologically.His ability to solve complicated mathematical equations caught the eye of a professor at the university where Will was employed. These equations had taken geniuses years to solve. The professor immediately took a liking to Will and desired to help him see his worth. He wanted Will to move forward in life. Will was not interested. His past failures influenced his decisio ns (Pajares, 2002). After seeing that Will was not at all interested, the professor seeked the help of his friend, a therapist. The therapist used empathy to assists Will. Wills view on life was negative. He does not feel he deserves a better life.His therapist helped him develop ways to change his behavioral pattern (Glanz, Rimer & Lewis, 2005). †¢Section 1: Character Personality Matrix †¢Theory †¢Major Components Structure Process Growth and Development Psychopathology Change 1. Social-Cognitive Theory In Social-Cognitive theory the mind contains schemas. Schemas are â€Å"preexisting ideas in the mind† (Pervin, Cervone & Oliver, 2005). We use schemas to make sense of the chaos around us (Pervin et. al, 2005). In Good Will Hunting, Will Hunting was abused and endured a hard life. His knowledge kept him and helped him make sense of his crazy world.He secretly answers difficult math problems at MIT, where he works as a janitor. He demonstrates many different sc hemas. Will Hunting has a negative self-schema. He believes he is worthless and deserves nothing better than the â€Å"southie† life he has. He is extremely intelligent, which could take him to greater places in life, but he doesn't feel he deserves it. He is scared of change and feels more comfortable in the world he grew up in. Will meets a girl who he falls in love with but will not allow himself to show her how he feels. He didn't want to accept her love for him because he felt he did not deserve it.Self-discrepancies have to be resolved to avoid conflict in one's self (Higgins, 1999). Growth and development occurs through observing and direct experience. Will was in need of therapy. He met with many therapists who were not able to connect with him. The choice of therapy used by these therapists was not effective. Will's issues stemmed from â€Å"distorted, incorrect and maladaptive cognitions concerning the self, others and events in the world† (Pervin et. al, p. 322, 2005). The one therapist that was able to eventually connect with Will was able to help him replace his maladaptive cognitions with realistic thoughts.This therapy is called Rational emotive-therapy (RET). Will was asked how he felt about different situations and what he said to himself. Cognitive Therapy was also used. Will's therapist told him about his relationship with his wife and the positive outcome of letting go and falling in love. This was something that Will was not accustomed to. Will was able to make changes in his life with the help of his therapy. He finally realized that he did not have to remain in the situation he was in. He finally accepted the fact that the negative things that affected his life were not his fault.In the end he accepted the love of a woman by leaving his hometown and following her to an unfamiliar place. He also now had the confidence to take on whatever employment or career that would come his way. 2. Rogers' Theory Rogers' phenomenological theory states that an individual tries to behave in the way that is consistent with their own structure (Pervin et. al, 2005). Will sees himself as a â€Å"southie†, a loser. To maintain congruence between his self-view and his experiences his acts out. He starts fights and stays in trouble. He doesn't seek anything better for himself.In Rogers' theory an individual strives for self-actualization. Will is brilliant and has knowledge about many topics. He reads a lot to keep himself knowledgeable. He answers difficult math problems that are put on a board at MIT, where he works as a janitor. In trying to maintain congruence between his self-view and his experiences he does not trust anyone. When someone tries to get close and help him he denies needing help. Will is defensive towards everyone he comes in contact with. He experiences incongruence with his cockiness of being smarter than most but he doesn't feel he deserves better than living as a nobody.Will's ability to push all his therapists and his girlfriend away shows his defensiveness. He keeps this tough boy attitude to make others not want to care about him because no one ever has. Rogers' pathology includes defensive maintenance of self (Pervin et al. , 2005). Will's therapist was concerned about Will and took an â€Å"active role in understanding the experiences of the client† (Pervin et al, p. 198, 2005). This therapy is called Client-Centered Therapy. The therapist doesn't try to change Will but accepts him as he is. Will eventually changes by embracing his new found relationship with his girlfriend and realizes his potential. Section 2: Application of Personality Theory †¢Theory Description and Rationale Social-Cognitive Theory (SCT) is the theory that describes hoe behavior is learned. SCT helps to determine how and why an individual behaves and thinks a certain way. The main idea of social-cognitive theory is that everyone develops their own schemas based on their experiences in life. â€Å"Schemas are knowledge structures that guide and organize the processing of information† (Capuzzi & Gross, 2005). When an individual hears a song on the radio that they have never heard before, it makes sense to the individual.The individual has developed schemas has to how the music is supposed to sound (Pervin, Cervone & John, 2005). We use schemas to make sense of our chaotic environment. In Good Will Hunting, the character Will Hunting came from a difficult and harsh environment. He lived his life based on these experiences. †¢Character Description Will Hunting is a young man who grew up in the slums of Boston. He went from foster home to foster home. In these homes he was abused and mistreated. He hung out with his closest friends, who are all trouble makers, below average knuckleheads. Yet, they were true and loyal to each other.Will, on the other hand, was a genius, a prodigy of math. He was determined not to let this side of him show. He stayed in a nd out of trouble with the law. He had no faith in himself. He possessed low self-efficacy, â€Å"a construct that reflects optimistic self- beliefs† (Lippke, Wiedemann, Ziegelman, Reuter & Schwarzer, 2009, p. 522). He believed that the deprived life he lived was all he was worthy of. He purposely destroyed his relationship with his girlfriend once he felt her love for him. He thought himself to be unworthy of it. He developed a negative self- schema. †¢Character Analysis †¢StructureIn Social-Cognitive theory the mind contains schemas. Schemas are â€Å"preexisting ideas in the mind† (Pervin, Cervone & Oliver, 2005). We use schemas to make sense of the chaos around us (Pervin et. al, 2005). In Good Will Hunting, Will Hunting was abused and endured a hard life. His knowledge kept him and helped him make sense of his crazy world. He secretly answers difficult math problems at MIT, where he works as a janitor. He demonstrates many different schemas. †¢Proce ss Will Hunting has a negative self-schema. He believes he is worthless and deserves nothing better than the â€Å"southie† life he has.He is extremely intelligent, which could take him to greater places in life, but he doesn't feel he deserves it. He is scared of change and feels more comfortable in the world he grew up in. Will meets a girl who he falls in love with but will not allow himself to show her how he feels. He didn't want to accept her love for him because he felt he did not deserve it. Self-discrepancies have to be resolved to avoid conflict in one's self (Higgins, 1999). †¢Growth and Development Growth and development occurs through observing and direct experience. Examining how an individual views life will assist in the development.Determining why an individual behaves a certain way is necessary. The causes of events are called attributions, which involve a casual factor responsible for an observed event (Pervin et al. , 2005). Will constantly heard what a failure he was. It's no surprise that he would believe that to be true. Will's therapist tries to reverse the misconception. He constantly told Will how bright he was and how much he could achieve. Will could either change his thoughts of himself based on this new or continue to believe what he's been told all his life. †¢Psychopathology Will was in need of therapy.He met with many therapists who were not able to connect with him. The choice of therapy used by these therapists was not effective. Will's issues stemmed from â€Å"distorted, incorrect and maladaptive cognitions concerning the self, others and events in the world† (Pervin et. al, p. 322, 2005). The one therapist that was able to eventually connect with Will was able to help him replace his maladaptive cognitions with realistic thoughts (Corey & Corey, 2007). This therapy is called rational emotive-therapy (RET). Will was asked how he felt about different situations and what he said to himself.Cognitive Th erapy was also used. Will's therapist told him about his relationship with his wife and the positive outcome of letting go and falling in love. This was something that Will was not accustomed to. †¢Change Will was able to make changes in his life with the help of his therapy. He finally realized that he did not have to remain in the situation he was in. He finally accepted the fact that the negative things that affected his life were not his fault. In the end he accepted the love of a woman by leaving his hometown and following her to an unfamiliar place.He also now had the confidence to take on whatever employment or career that would come his way. His expectations for himself were now higher. He was able to move forward and make positive changes in his life. †¢Internal and External Factors Internal and external factors shaped Will's personality. He felt unwanted, unloved and abandoned due to not being raised by his own family. He went from foster home to foster home bein g abused in each one. He did not know how to love or how to receive it because love was never shown to him. These factors made him the young man he was. Will did not recognize his potential.According to Bandura (1997) people base their actions and level of motivation on what they tend to believe and not on what is true. The positive feedback and encouragement from Will's therapist helped Will make a positive change. He constantly expressed to Will that he was worthy of having a good life and being loved. His best friend even tells him that he better not still be a â€Å"southie† fifty years from now. He let Will know that he saw the potential in him. Eventually Will made a break through after being told that everything negative that happened in his life was not his fault.He was able to embrace the positive things that were waiting for him. †¢Conclusion Use the BodyText Double style to type text in the conclusion. †¢Reference List Bandura, A. (1997). Self-efficacy: t he exercise of control. New York: W. H. Freeman Pervin, L. A. , Cervone, D. , & John, O. (2005). CST5214: Theories of personality (Custom). NY: Wiley. Pajares (2002). Overview of social cognitive theory and of self-efficacy. Retreived December 13, 2010, from http://www. emory. edu/EDUCATION/mfp/eff. html Glanz, K. , Rimer, B. K. & Lewis, F. M. (2002). Health Behavior and Health Education. Theory, Research and Practice.San Francisco: Wiley & Sons. Lippke, S. , Wiedemann, A. , Ziegelmann, J. , Reuter, T. & Schwarzer, R. (2009). Self-Efficacy Moderates the mediation of intentions into behavior via plans. Ameriacn Journal of Health Behavior, 33(5), 521-529. Higgins, E. T. (1999). Persons or situations: Unique explanatory principles or variability in general principles? In D. Cervone & Y. Shoda (Eds. ), the coherence of personality: Social-cognitive bases of consistency, variability, and organization (pp. 61-93). New York, NY, US: The Guilford Press Corey, M. & Corey, G. (2007). Becoming a Helper 5th ed. Belmont, CA: Brooks/Cole.

Research proposal Dissertation Example | Topics and Well Written Essays - 1500 words

Research proposal - Dissertation Example In view of the same, the concept of total quality management is deemed of paramount importance to these outsourced companies. Hence, the main focus of this paper is to look into the manner by which total quality management principles are incorporated into the processes adopted by the outsourced industries. Total quality management is defined as that philosophy for management concerned with the continuous improvement of the quality of products and processes (Ahire 1997). This particular management concept is used all over the world. The functions related thereto are based on the fact that the quality of products and processes is the responsible of everyone who is engaged in the creation or consumption of the products or services that are offered by the organization. In this sense, Total quality management entails the involvement of the management, workforce, suppliers and even customers in order to ensure that the expectations of the customers are met (Ahire 1997). Hakes (1991) on the other hand, also mentioned that total quality management is essential to all successful organizations. ... Literature Review To provide a solid ground to this study, the researcher reviews extant literature with respect to outsourcing and total quality management. This literature review covers pertinent areas related to the same. To ensure an extensive discussion as regards the subject matter at hand, this section is divided into the following sub-sections: (1) Total Quality Management: An Overview and (2) The Outsourced Information Industry: The Need for Total Quality Management. Total Quality Management: An Overview. As earlier stated, the importance of total quality management as an essential part of the management philosophy is grounded on the fact that it ensures the performance of a certain firm in accordance with the expectations of the customers and at the same time, to enable it to cope with the ever changing global market places. Usually, total quality management results into two important consequences for the firms: first, increase in productivity; and second, customer satisfac tion. One of the main characteristics of Total Quality Management is related to the need to identify the root causes of quality problems and at the same time, correcting them from the source. This is basically in line with the efforts to incorporate quality in all aspects of the organizations. Thus, it usually involves all the people in the organizations such as the customers, the employees and the suppliers. According to the article entitled â€Å"Total Quality Management† (n.d.), total quality management often has the following aspects: (1) Customer Focus; (2) Continuous Improvement; (3) Employee Empowerment; (4) Use of Quality Tools; (5) Product Design; (6) Process Management; and lastly, (7) the Management of Supplier Quality. The focus of the

Organisational Behaviour Assignment Example | Topics and Well Written Essays - 2500 words

Organisational Behaviour - Assignment Example Organizational behavior theories suggest that managers have to accomplish different organizational tasks through employees. As such motivating employees is one of the key tasks to be performed by the managers to ensure that the will to deliver the work and accomplish the organizational tasks remain high. In order to achieve any level of motivation, managers therefore have to offer certain explicit and intrinsic rewards to the employees to remain motivated. It is important to understand that motivation is not necessarily being related with the rewards of monetary nature but employees can be motivated through different other aspects of overall work too. Managers therefore must have to ensure that they understand the different motivational states of their employees to design and develop appropriate motivational strategies. (Rollinson, 2008.) Motivational States From the facts provided in the case study it could be assessed that the employees of both the organizations felt demotivated an d were unable to cope with the change. The employees of the Costwise specially seem to be at odds with the proposed changes in the culture as well as change in the management of the firm. Firstly, the managers at Costwise were relatively independent in terms of setting up some of the tactical moves for the stores. Hiring, setting up prices as well as managing the overall competition at local level was in the hands of the managers. With the takeover, however, this was not the case as Orton was highly centralized in terms of controlling and setting up each and every aspect of doing the business. This move from the de-centralized culture to a highly centralized... The overall situation described in the case study suggests that takeover has resulted into strong dissatisfaction for the employees. The lack of motivation therefore might have resulted into employee performance issue which could not allow the firm to actually profit from the takeover. It is also important to understand that the overall culture of the organization was highly centralized with most of the decision making taking place at the center. This has however, not been the case with the Costwise where managers were often involved in the decision making at the store level. This change in the way decisions were made therefore has also resulted into the strong motivation issues for the organization. In order to overcome such situation, it is important that Orton must redesign its compensation system to better accommodate the employees. There is an strong resentment within ex-Costwise employees that they are being paid less thus creating dissatisfaction as well as the lack of product ivity. This paper makes a conclusion that empowering the employees is also another important strategic move which can be undertaken to ensure that the employees perform to the best of their capabilities. This could be achieved by allowing more participation from the employees and making them part of the overall decision making process undertaken at the Orton. This could allow the employees to become more responsible and accountable for their work and decision.

Natural history and phenology Assignment Example | Topics and Well Written Essays - 1000 words

Natural history and phenology - Assignment Example In essence, this laboratory experiment entailed collecting phonological data for a tree on the campus of NEIU with a view of contributing to the modern phenology network. After being provided with a tree to be used for the experiment, I found out that the tree had broad leaf, alternate, compound, and pinnate. In this case, given that, the tree had a broad leaf it was a characteristic of a deciduous hardwood. As observed, one of the leaf was on each node, and it had multiple leaflets on a common stalk and the given multiple leaflets being arranged in a pattern resembling a feather and they were all attached to a central rachis. It had a bark of distinctive lighter streaks with a corn large about ? to 3/2 inch and a shallow cap resembling a beret. Following this chronological order of the tree characteristics, it was clear that the tree was the northern red oak as observed in the appendix B. This type of tree is often found on a varied of soil but more especially on moist sandy clay an d the rocky soil. The table 1 (appendix B) shows the chronological order followed in order to arrive at the conclusion that the tree was the northern oak. ... An oak wilt is a fungal disease often known to be transmitted by insects. It is worth noting that the ork wilt disease is transmitted through the underground roots. It is characterized by the leaf discoloring, bronzing and wilting. Contrary to what was the expected phenology, in week two, there were more leaves infected by the wilt disease with one side of the tree dropping off. Leaves were on the other hand turning brown and they were falling off. In the third week, it was evident that there were more leaves that had been infected with a single leave remaining green though some section of the tree showed signs of dying. On the fourth week, it was vivid that the entire tree was infected and thus ended up drying up. On 15th of October which marked the beginning and end of week five, it was clear from observation that the tree in its totality had turned brown and crusty. When finally, the observation was made on 11th of November, it was certainly clear that there were no leaves. The ta ble 2 (appendix A) shows the procedure followed in carrying out the experiment. Work Cited Koech, EE, & Chmielewski, Claudio. Guidelines for plant Phenological Observations. Meteorologie 2007, 398: 225 – 243. APPENDIX A Table 1. Broad leaf Bark with distinct lighter streaks Acon large ? to 3/2 inch with a shallow cap which resembles a beret. Found on moist but not wet sites Alternate Compound Pinnate Table 2. Week one Leaves were 4 to 9 inches long, dark green, with a distinctive lighter streakes. Week two More leaves infected by the wilt disease with one side of the tree dropping off Third week More leaves infected with a single leave remaining green Fourth week Entire tree was 11th of November No leaves 15th of October Tree had turned brown and crusty APPENDIX B Diagram 1 : Leaf

Research Methods Coursework Example | Topics and Well Written Essays - 2000 words

Research Methods - Coursework Example Organizations have therefore continued to struggle with the challenges that impact on the performance of managers and employees, which contributes greatly to dealing with competition within the various industries. Managers and employee performance is a theory of management within organizations that takes on various perspectives and purposes with the traditional purposes being the organization having good planning systems which serve as a means of meeting up the work expectations for managers and employees. An organization should have effective ways in which they are able to monitor performance and have ways in which an organization is able to develop the capacity of employees in performance and putting in place appropriate reward systems which motivate employees, thus resulting to good performance (Baldwin, 2008). Research question My project answers and reviews the extent to which performance of employers and employees in an organization is limited by relevant factors. Aim The proje ct seeks at ascertaining the factors that limit employees and employers within an organization’s environment. Research paradigm The paper will make use of realistic research paradigm especially because of its ability to take in the aspects of positivism and constructivism. Through the realistic research paradigm, it will be possible for me to hold on the notion that real structures exist and bring in knowledge and consciousness as aspects that look at human knowledge differently. According to the realistic paradigm, social and natural science are differentiated, while social reality is reinterpreted. Use of the realistic research paradigm was chosen because of its ability to take on a wider perspective, by bringing together the assumptions of positivism paradigm and the constructivism paradigm (John, 2005). Methodology/Research strategy My project will make use of both qualitative and quantitative research methods. First-hand information method will include the use of persona l interviews and well structured questionnaires with well-organized questions, which will be administered to employers and employees within organizations in different industries. I will use secondary data sources such as books and journals that look at the limitations of employees and employers performance in organizations, through analysis of theories and previous research on performance. Literature Review Basically, organizational performance takes into account actual results of a particular organization as measured against the intended goals and expectations within a specified period of time. Performance is therefore the end result of an organization while organizational performance at large refers to the accumulated results of an organization’s work processes and activities. Organizational aspects therefore take in activities within an organization that are concerned with the activities, goals and their monitoring and adjustment, to ensure they contribute effectively towa rds an organization (Kirkpatrick, 2010). Employers and employees have been appreciated and recognized as the major aspects of organizational performance in any industry. Good managers and employees’ performance contributes to the ability of an organization to fulfill its mission and visions, which is complemented by sound management, strong governance and persistence towards the results. Employee performance also takes in perspective employee performance

Outline the key factors influencing viability of desirable development Essay

Outline the key factors influencing viability of desirable development in Croydon, and discuss how they might be effectively mediated by the local planning authority - Essay Example Lastly, are my recommendations of policies to the council and justify them. Urban planning is best defined as a form of state intervention in a development process dominated by the private sector (David, P.2). As David stated, any form of planning including bargaining, negotiation, controlling is in the purpose of producing a better urban environment for people living in the area. It is a means to achieve sustainable development including the use of scarce resources, better social inclusion, long-term economic growth, which ensures better lives for ourselves and a better environment for future generations (NPPF, 2012). Solving the existing physical and social issues by making relevant policies, planning authorities are participating into the market in the role of moderately improving the situation towards a more acceptable position. Croydon Unitary Development Plan was the development plan for the borough until the LDF comes into force in 2012. Croydon, as the largest London borough, has the highest population among all London boroughs. It has a wide variety of residential areas. The residential neighborhoods comprise distinct communities that focus on established centers. Croydon has a significant commercial city center, which is built in the purpose of regional, as well as national importance in the Vision 2020 for Croydon Metropolitan Center. It has a fully developed infrastructure including convenient traffic linking to London and efficient public transportation. UDP (2006) indicates, the development strategy takes the Croydons location, role in the economic activity, and present situation into account. The city needs to grow positively by providing a certain amount of housing to meet the market demand, a series of jobs to meet employment needs, and the implementation of the Vision 2020 for Croydon Metropolitan Centre. Meanwhile, the plan also looks for opportunities for fully development

Tourism and hospitality management Essay Example | Topics and Well Written Essays - 750 words

Tourism and hospitality management - Essay Example Hospitality management is one of the key areas which can define the overall competitiveness of the firms working in the hospitality industry. Over the period of time, firms which have been able to develop better management of its resources have been successful in developing important competitive advantages over their competitors. This report has presented a complete analysis of different issues pertaining to two different services providers in the industry. The overall purpose was to check and analyse whether different aspects of hospitality management and project management are carried out in accordance with the best practices. A visit to Sheraton Hotel suggested that the hotel has good quality hygiene food, better services, safety management as well as the roles and responsibilities are adequately defined. This has allowed the hotel to develop a system under which different activities are carried out in accordance with the laid down policies and procedures. This was done in order t o get a firsthand information about the best practices adapted by the industry leading organizations. Crystal Clear Resort, our next assignment, however, showed somewhat a different scenario as the resort faced different issues such as people management, diversity, customer services as well as communication between the employees. Due to diversity of the employees, Resort is facing different challenges and as such requires complete change in the overall attitude of the management in shaping its overall competitive advantage within the industry.... ike work place diversity , reducing the conflict between the employees as well as improve communication between them requires that the Resort must develop better strategies as well as work environment in order to ensure that it can operate on the long term basis besides become more competitive in the industry. It is also critical that Resorts must be able to implement better conflict management practices in order to ensure that it can deliver better customer services to its customers. Overall the organization needs a direction- a new strategy to ensure that it has put in place important changes. This would include better management of HR resources, better operational planning as well as the adequate and effective conflict management system. Develop and Implement Operational Plans Appendix A The need for Operational Plans Operational plans are considered as the sub-set of the overall strategic framework of the organization and require meticulous compliance with the overall strategy of the firm. It not only defines the short term goals and objectives to be achieved but also outline as to how and what parts of the overall strategy of the firm needs to be operationalized. A well-developed operational plan is considered as essential for the development and approval of the operational budget of the organization. A well-developed operational plan therefore provides answers to questions like how to measure the progress and where firm intends to go. This approach therefore makes operational plans an important part of the overall strategy execution of the firm. A clear and well prepared operational plan therefore helps firms to set clear objectives, overall activities to be delivered as well as desired outcomes. Appendix B Internal and External Factors In order to better prepare

Two Cultural Practices Among The Yanomamo Essay

Two Cultural Practices Among The Yanomamo - Essay Example He describes them as a society constantly â€Å"living in a state of chronic warfare† (p. 22). The purpose of this paper is therefore to show that contrary to popular portrayal of the Yanomamo as a community dominated by senseless violence, instances of warfare are only sporadic and waged for specific purposes (Harris, 1979). In expounding on this view, the paper will look at two main cultural practices among the Yanomamo society that shapes their beliefs and practices as a people. Festivals as a cultural practice Festivals play an important role among the Yanomamo people, and are part and parcel of their culture. They are important to the Yanomamo people because they serve both social and political functions. They are held to cultivate and reaffirm friendships among the villages. Feasting among the Yanomamo involves the sharing of meals, which in a larger extent, symbolizes the sharing of goods through trade and other economic practices that are prevalent among the Yanomamo. These festivities are therefore used to form a social bond among the tribes, despite their warring nature, and to honor and appease the spirits of their ancestors. The Yanomamo people practice a lot of festivities and rituals which include hunting rituals, marriage festivals, songs and dance festivals, and the hugely shocking endocannibalist ritual, which involves the consumption of a deceased’s ashes. ... The hunting festival plays an important role among the Yanomamo culture. They practice two main hunting festivals, the â€Å"rami† which provides them with meat, and the â€Å"heniyomou† which is practiced by the whole community collectively for special guests (Micheli, 2011). The festival is carried out in the evenings and is characterized by songs and dances. Here the young men are required to compose songs amidst laughter from the older members of the society. Whereas the Yanomamo consider marriage to be an important event in their culture, they have no actual marriage ceremonies. The Yanomamo marriage is basically a handing over affair as the suitors were already predetermined by the parents of the girl when she was at a tender age (Micheli, 2011). Such marriages are usually organized as a means of creating alliances with the men and other tribes. Perhaps the most elaborate and well organized festivity/ritual among the Yanomamo is their funeral ceremonies. To the Ya nomamo, death is a great source of grief and anger, no matter the age, gender or position of the deceased, to the whole society. This is because they believe the cause of such death results from sorcery or witchcraft from the rival tribes (Fergusson, 2001). They thus mourn their dead with passion, and mark a ritual where they cremate their dead and ingest the remains of the deceased. This form of endocannibalism is a unique feature among the Yanomamo, who believe by ingesting the remains of the dead member of the society they are preserving his spirit within the society. The major significance of these festivities among the Yanomamo was that they acted as social activities where the community

Personal Statement on Philosophy of Education Research Paper

Personal Statement on Philosophy of Education - Research Paper Example From the understanding of the historical literature philosophy of education, it is worth noting that a learner or every child must be identified as a unique individual who needs to secure knowledge towards stimulating intellectual, emotional, social, and physical growth and maturity. Therefore, as an educator (Dhawan 79), it is my desire to help each student to meet his or her fullest potential in educational growth and maturity by providing for them with a safe environment that supports risk-taking and inviting sharing of ideas towards their knowledge growth and development. Notably, I believe that the three educational philosophy elements that I must apply to achieve these goals. These elements are usually conductive towards establishing proper learning and developing an environment in every learner’s education or learning process. These elements include the expectation of the teacher as the guide to any educational process; learners should be allowed to follow their natural curiosity and the same should to direct the learning process, and the last element is promoting respect among the learners. Therefore, it is understandable that it is my role as a teacher to guide and provide access to information to the students rather than being the primary source of the information to the students or learners. Hence, the learner should be in the forefront in search of knowledge such that their search of knowledge is quenched as they learn to provide an appropriate answer to their questions.... Hence, the learner should be in the forefront in search of knowledge such that their search of knowledge is quenched as they learn to provide an appropriate answer to their questions (Kilpatrick 38). Thus, the construction of knowledge needs the opportunity for discovering new practices and skills in authentic situations (Frankena 90). Therefore, as a teacher I understand that adequate access to hand on activities, as well as adequate space and time to students, is vital enable them to use the identified material to apply and reinforce acquired knowledge thereby allowing them with an individual opportunity to construct and discover knowledge. Additionally, other than providing learning materials and self-discoveries opportunities to the learners, it is vital to ensure that these materials are relevant and meaningful to the life and the interest of the learner. Achieving these targets can only be met through a constructive and thoughtful curriculum that revolves mainly around or foste rs intrinsic interests that motivate and stimulates the learner’s passion and interest (Kilpatrick 35). Therefore, curriculum is a vital tool that will help me to follow the right path towards helping the learner to achieve his or her interests and goals objectively and successfully (Elias 213). Notably, an effective curriculum can only be generated from learners’ ideas and set goals rather than creating the curriculum for educator’s self-imaginations (Frankena 132). In other words, as an educator, I will give students the opportunity to help in negating a curriculum and this will be achieved through viewing and analysing their interests. It is worth noting that when the students are taught by their own the curriculum, they will

Departments Differ from People-Oriented Departments Essay Example for Free

Departments Differ from People-Oriented Departments Essay There are a number of differences between action-oriented and people-oriented HRM departments. One of the most distinctive differences lays in the approach that each of the different methods take to the role of human resources. Its important to note that a good HRM department is both people and action-oriented. An action-oriented HRM is one that seeks to further the organization by solving problems through taking actions. These actions are typically resolved based on a set of rational actions and not on a set of strict policies and procedures. The action-oriented department is all about people and how the HRM department can work to solve the problems of those individuals. An example would be an HRM team that has a recruiting department that is focused simply on bringing in new individuals to the organization. The lack of standard record keeping doesnt mean that adequate records are not kept it simply means that the department is focused primarily on progress and not on procedures. An example of a company that falls under an action-oriented HRM is Exxon Mobile. The difference in the people-oriented HRM department is that the entire focus of the HR team is on the individual and how those individuals can benefit the organization. It takes a slightly different approach as it is more proactive than reactive. The reason is that a people-oriented HRM department focuses on the talents and skills of individuals in the organization and how those skills can best be used in the organization. By matching employees and skills to problems that must be addressed within the organization the HRM team serves to provide a strategic advantage in that HRM is leading rather than simply dealing with reactionary problems or employees who may be unhappy in their current roles. An example of people-oriented HRM is the assessment of individual skills by which assignments will be presented. A good company example of people-oriented HRM is Apple Computer. While both methods are valid they do take a different approach to how HRM is handled. The method that is used will be determined by the senior HRM director which will set the role of HRM and how it will be managed in the individual organization. Finally, it should be noted that action-oriented and people-oriented HRM are not mutually exclusive and some organizations may function better with one method over another depending on the type of business.

Reasons for and benefits of training and development

Reasons for and benefits of training and development Executive Summary Among the first elements in the company that gets the pressed budget of the company is training for employees who often end up on the cost cutting. Unfortunately, the trained employees and qualified employee are simply that an enterprise should stimulate growth and solve problems in the lean. Innovation, flexibility and dedication required to construct dynamic companies truly come well trained and supported staff. One of the best ways to encourage and support people in your staff is through the professional development and training opportunities. Sending employees to training, or bring opportunities in society, opportunities actually brings a company with new ideas and creative ways to solve old problems. Sometimes, only employees daily grind of their daily work schedule is sufficient to boost energy and to encourage employees to revalidate their employment and society. Later in this report, that well look at some training programmes run by 2 major businesses in U.A.E, those are Emir ates Islamic Bank and InterContinental Hotel Group. We will also examine opportunities, weakness and threat on the training and development. . What is training and development In the field of HRM, training and development is the organizational activities to improve the performance of individuals and groups aiming in organizational settings. It was known by several names, including staff development, developing human resources and learning and development. Training and Development includes three main activities: training, education and development of these ideas are often synonymous. But the practitioners include three separate, although interrelated, activities, as follows: Training This activity focuses on both evaluated against employment any person currently holds. Education This activity focuses on the jobs that a person may hold potentially in the future and is evaluated with these jobs. Development This activity focuses on activities that the Organization employing the individual, or that made individual part, can participate in the future and is almost impossible to assess. The stakeholders in the training and development are classified into several categories. Sponsors of the training and development are senior executives. The customer training and development are corporate planners. Line managers are responsible for guidance, resources and performance. The participants are those who actually undergo the process. The animators are specialists in human resources management. And providers are specialists in the field. Each of these groups has its own agenda and motivation, which sometimes conflict with the agendas and the motivations of others. Typical Reasons for Employee Training and Development Training and development can be initiated for various reasons for an employee or a group of employees, for example: When a performance evaluation indicates performance improvement is necessary. Compare status improvement so far in an effort to improve performance On a programme of professional development in all By planning help an employee to be eligible for a planned succession change in the role of the organization. Pilot, or test the operation of a new system of performance management To form a specific topic, as shown below Typical Topics of Employee Training Communications: Increasing todays workforce diversity offers a variety of languages and customs. Computing: Computer skills are becoming a necessity to carry out administrative and tasks from desktop. Customer service: Increased competition in todays global marketplace makes it critical that employees understand and meet the needs of customers. Diversity: Diversity training usually includes explanations on how people have different views, and perspectives and includes techniques for the value of diversity Ethics: Today company growing expectations on the social responsibility of businesses. Also, diverse workforce today brings a wide range of values and morals rather than work. Human relations: Constraints increased labor today can include misunderstandings and conflicts. Training can people get along in the workplace Quality initiatives: Initiatives such as total, quality circles, calibration, and quality management and so on, require training base on the concepts of quality, guidelines and standards of quality, etc. Security: Security training is critical where working with heavy equipment, hazardous chemicals, repetitive activities etc., but can also be useful with helpful tips to avoid aggression, etc. Sexual harassment: Sexual harassment training usually includes a thorough description of policies on sexual harassment, organization especially on what are inappropriate behaviors. General Benefits from Employee Training and Development There are many sources online training and development. Several sites suggest reasons for supervisors conduct training between employees. These reasons are: The greater job satisfaction and morale of employees Increased employee motivation Greater efficiency in the process, resulting in financial gain Increase capacity to adopt new technology and methods Innovation in products and strategies Reduced employee turnover A better image of the company, for example, ethics training (not a good reason for ethical training!) Risk, for example, training on sexual harassment, diversity training Training is one of the most important parts of overall business strategy. Before starting a specific business or consider a potential acquisition, the first question that poses if present in the organizational skills needed or not. As a general rule, all the skills necessary for effective management of the company must be available in a company; however other core businesses can be outsourced. Training need arises because of the advancement of technology, the need to improve performance or professional development. Insight on Benefits of Training Benefits of training are intangible and invest in training benefits both, organization and used for a long time. Training improves levels of worker skills. It provides the feeling of satisfaction, which is an intrinsic motivation. Training also provides multi employees skills body. Training increases an employer engagement in their jobs and their organization. Understanding reduced employment accidents. One of the benefits of training for a larger organization is that it provides expertise in organization which reduces the overall cost of operations of the company. Quality is a key functionality needed for an organization over the long term survival. TQM (total Quality Management) and other quality management techniques require the training of staff as an important necessary to its successful implementation. Customer satisfaction increases repeat business, which is a key to success. Employee training to promote good customer relations will increase customer satisfaction and service quality. Just in time philosophy is one of the main ideas in Japan.JIT stress on reducing waste and wait times in production processes. Better training reduces wastage and machine downtime. Much of the cost of quality consists of monitoring; by providing adequate training, reduced. Training increases the productivity of employees and processes. High turnover can be a serious threat to the existence of the Organization, the major advantage of the training is that it allows reducing staff turnover and help an organization to keep its staff. Better training may offer an advantage competitive organization to others in the industry. In service industries the primary source of business income is his expertise of staff and skills, acquire professional with high skills are relatively expensive than the current acquire these skills training. Training is also a major element of the new recruits; adequate training helps understand the work, its requirements and responsibilities. Training also increases understanding of organizational culture. Training programs strengthens the communication between the different levels of an organization. Any deficiencies in the processes and jobs are eliminated and those close to production processes have become involved in the management. Clearance of personnel is a recent trend management; this empowerment will be successful in the proper training is provided to persons entitled. . Organization, Trainee and Trainer An organization has a very close relationship with the trainee and the trainer because it is the first contact for both. Demand for training in the undertaking increases when the organization wants to: Hire new people training as a means of training new recruits To expand when society wants to increase its workforce. To increase number of employees (by position) by a certain date To improve the performance of employees Name of the Organization to be part of the training unit Demand for training also increases when there is a change in the nature of employment, consumer tastes, change in the methods of product development, etc. The organization goes through the following steps to transfer training field. But the problem arises when the organization outsource training process. In this situation, the Organization assumes the trainer must be aware of the type of training s needs of participants and their organization and their content meets these needs. This leads to failure of the program, which translates collusion. Therefore, it is a duty before any organization to make the trainer and their conscious organization culture, climate, the responsibilities of the Organization, etc. Developing People and Capabilities Many organizations face the challenge to develop greater confidence, initiative, solution-finding capabilities and solving problem between their peoples. Organizations need to staff at all levels, to be more self-sufficient, creative and independent. This staff allows behavior can operate at higher strategic level, which makes their organizations more productive and competitive. The efforts of the people produce greater results. This is what all organizations strive to achieve. However, then the conventional training give people new techniques and methods, it does develop their maturity, belief, or courage, which is essential for the development of managers and strategic capacity. Yet once again focus on the development of the person, not skills. Try to see things in perspective of the person (your employees). Provide learning and experiences that they would like for their own personal interest, the development and completion. Performance and capacity are ultimately dependent on the attitude and the peoples emotional maturity. Help them achieve what they want on a personal level, and it provides a platform for confidence, emotional Contracting Organization and development of skills/process/knowledge further relevant to handle the highest responsibilities, roles and teams. Participatory workshops work well in the beginning of this type of development attitude. Involve people from the outset. Focus on what they want. You can also use a questionnaire for personal development to begin to set the stage and provides examples of learning opportunities other. It starts with the person, not skills. It attitude and emotional maturity. The principles of the emotional intelligence and methodologies to adapt very well with modern approaches to popular belief, maturity and attitude development. When people develop trust, integrity, emotionally, they are automatically more proactive, focusing on solutions, reactive, etc., on a whole team, which has a cumulative effect. Johari is a useful model too. For many people to work is simply crosses the movements, acting in a consistent status, often because they feel not secured, lack of confidence to do what they think, it is fair, or are nervous about being fat, whereas daring is absolutely necessary for self-sufficiency, initiative, greater responsibility; in fact all behaviors organizations is to encourage. You cannot teach daring persons were to experience things to feel bolder, take risks and want to take risks. This means that premium must be too or people have no reason to stick their neck and not only the perspective of a financial reward. Especially responsible additional actual Herzberg type motivators and the recognition and participation in new projects successful and interesting. This is the fuel for growth and change people. Emirates Islamic Bank UAE They are located in different Emirates of UAE. Emirates Islamic Bank provides training and development of their employees as follows: Induction programs Each new employee is attend after recruitment, and is doing a familiar employee and knows the meaning and goal of putting in place the Organization and their employment business. Course Relevant courses in the fields in the Department of the Bank that the employee works, new procedures and developments. Workshops Workshops are conducted by internal staff and external people to Bank staff in their respective fields for the benefit of their performance. Training institutes Emirates Islamic Bank is associated with Emirates Bank Institute funds to train its employees. Training Center-General conditions This training Institute provides short-term and long-term courses related to banking services on a regular basis, and the duration of the course varies from 2 to 7 days each course. Certification programs: Emirates Islamic Bank has sponsored employees for certification programs CIPA Islamic public accounting certified Emirates Islamic Bank sponsors the CIPA examination cost for its talented and senior bankers, who are expensive examinations with regard to cost, and all expenses are borne by the Bank itself. MBA programs Emirates Islamic Bank facilitates its employees to obtain an MBA by providing interest free loan, partially or fully sponsored MBA costs required employees, as the base case. Talent Pool Employees of high performance for all departments (ministries) are placed together with the potential to be responsible for transmitting them with specialized or tailor made programs leadership in collaboration with leading universities. The duration is 3-4 months. Seminars and activities These seminars are specific department; furthermore they are for personal growth, such as the construction of motivation and pastimes activities Intercontinental Hotel Group In UAE and Worldwide: InterContinental Hotel Group believes that their population led to the success of their business, so that they will invest in their skills to improve their work and progress to more difficult and more responsible position. To help make this InterContinental offers a range of training programs designed to develop their potential in the moment that their employees become part of the team of the INTERCONTINENTAL. Range of INTERCONTINENTAL functional training and leadership development initiatives includes: Revenue management The INTERCONTINENTAL provides training courses on several high-impact drivers focus hospitality managers to maximize revenue: forecasting and availability, pricing and distribution, channel management controls overbooking and group management and non-traditional revenue management applications. The course explores a subject in depth, with particular emphasis on the role of effective revenue management policy and applying practical tools and techniques for hospitality. Sales and marketing InterContinental offers training to employees of the sales and marketing, service typical course covers following topics: Effective leadership skills Marketing Research Market Intelligence Key account management Finance for managers non-finance Strategic business planning Professional sales skills Housekeeping It is mandatory for all new employees in the housekeeping service to take this course to meet high standards of service. InterContinental regularly organize training as necessary existing employees. The course develops some training for equipment and products used by the hotel in the household. Maintenance and monitoring of leadership. This training is oriented to less management; this training provides the leadership skills at the personal level supervisor. Programs for employees of the INTERCONTINENTAL online training: InterContinental uses new technology and, therefore, all members of staff have access to hardware training about the role that employees and everywhere where they work, they can also take advantage of online training programs developed in partnership with the Institute home. Senior leadership programs Senior leadership program offers a structured range of develop skills in top-level management. The program offers courses and psychometric assessment content delivered by leading academics focuses on connection with nobody, business, personal and career goals. Assessment centers InterContinental are also the only group hotel offer Assessment centers around the world to help high-performing individuals in business, management and monitoring moving on and next level roles. Four promises of INTERCONTINENTAL its employees: One of the promises of four of the intercontinental to everyone who works for intercontinental is room to grow. To support employees and give them opportunities to develop and pursue rewarding careers intercontinental will be make sure: You know what success means for your role. Youll be involved in regular feedback instructions quality You will have the opportunity to develop both your current and future roles in Find out what career opportunities are available with intercontinental worldwide. Bearing in mind a comparative study of the training and development between the international markets that Japanese work environment is a good example, which is declared as follows: A good example: Japanese, work environment Many times in and outside Japan share a picture of the Japanese work environment that is based on a model of life-employment used by large enterprises as well as a reputation for working hours long and strong dedication to the society. This environment is said to take into account economic conditions began in the 1920s, when large corporations competing on the international market has begun to accumulate the same prestige was traditionally assigned to the daimyo retention of government service relationship or feudal Japan in the Meiji Restoration. In very high, the most prestigious companies would recruit and retain the best workers by offering better benefits and job security life really. In the 1960s, employment at a prestigious company had become the goal of the children of the new middle class, the prosecution which required resource mobilization family and great perseverance individual in order to achieve success in the education system of ferocious competitive. Employees are expected to work hard to demonstrate loyalty to the company, in exchange for certain benefits such as housing, grants and employment security good insurance, use of leisure facilities and premiums and pensions. Start at low wages, but age is rewarded with promotions based on a combination of age and capacity. Leadership does not rely on the assertion itself or quick decision-making, but on the ability to create a consensus, taking into account the needs of subordinates. Investigations indicate continuing preference for the bosses who are demanding but show concern for privacy of workers on the less demanding bosses interested only in performance on the job. This system reward behavior showing identification with teamwork, indicated by sing the song of the company, not take vacation days and share credit for the achievements with the working group. Pride in his work is expressed in competition with other parallel sections in the society and between the company and other similar companies in industries. Thus, people are motivated to keep wa (harmony) and participate in activities group, not only on employment but also within hours socializing (nomikai). However, the image of loyalty group may be more a matter of ideology practical, especially for people that he do not upwards. SWOT Analysis The following SWOT analysis is carried out by comparing the training and development of employees in the UAE and Japan. Strengths: UAE is a hub of business, attracting not only work, but expats, tourists, investors and ultimately employees from a very wide range of countries and cultures to come and work in the UAE. The market and environment of UAE is very quick in adapting new changes and making developments and has the skills of applying them successfully. UAE attracts workforce from all over the world. Weaknesses: The UAE needs to reconsider its law on visa regulation, as a visa of 3 years and medical checkup very frequently, for it restricts the Employer for planning on a long term plan for the training and development of the employee. The Labor laws are not flexible enough and does not enable free market concept. Equal opportunities should be available for both locals and expats in the UAE for training and development of the Employees. Language barriers of foreign training institute operating in U.A.E with foreign trainers. U.A.E losses lots of expertise and experience when expats leave the country. Opportunities Underdeveloped national workforce, hence potential for training is high. Government is determined to develop National workforce The Growth of Free zone are encouraging Bring in training institutes from Japan to make the employees of the UAE feel as their assets and plan training and developing programs accordingly. Threats UAE despite being one of the most fastly developed countries in the world, it will not be able to develop in building a reputation of attracting new recruitments and then training and developing employees in building personalities of the people who work for them, as it motivates employees to work better and give better results. Critical Analysis Despite having several training and development programs both IHG and emirates bank consider them as over head expense. Instead of building and maintain workforce they try to hire directly skilled resource from the market. As recession has taken toll also there is considerable cut in the budget of training and development. Some time employees also attend training for the sake of training; there can be variety of reasons for this like lack of motivation, lack of interest in the subject and attitude. Conclusion The UAE is one of the fastest developing economies with new ideas from its people coming in to advance its infrastructure, technology and economy. It already is playing a major role in the training and development of its employees, but revising its visa policies and collaborating further with Japanese training institutes will enhance its workforce both locals and especially expats in working better. *************************

Case Study of clinical decision making in practice

Case Study of clinical decision making in practice This assignment was written by a Community Matron working in a Primary Care setting for a local GP surgery. Using a case study approach, it aims to illustrate a clear, logical account of clinical decision making in the practice environment, whereby the patient was fully assessed, differential diagnosis reached, and effectively treated, furthermore, through a collaborative model of consultation (Rudisill et al 2006) and working, professionals pooled knowledge and resources and carers were educated to reduce further incidences of the problem illustrating the benefits of proactive care from the Community Matron ( Boaden, Dusheiko and Gravelle 2005). The patient was chosen for this study as this was the third incidence of the presenting condition in as many months, making it obvious to the practitioner that whilst the problem had been treated on previous occasions, further investigation of the condition and a constructive, concerted approach was needed to prevent future recurrences and to maintain patient comfort. In accordance with the Nursing and Midwifery Councils Code of Conduct (NMC 2009), consent was granted by the patient prior to undertaking the study and names changed to protect identity and maintain confidentiality, for this reason the patient will be referred to as Jack Lowe and his wife as Linda. Multiple complex pathologies and socioeconomic conditions influenced the development of the patients skin condition, due to the constraints of word allowance it was not possible to elaborate on all the contributing factors; for the purpose of this assignment, the practitioner aimed to give a brief overview of pathologies and to concentrate on consultation and clinical decision making from a primary and secondary prevention perspective Jack had been registered with the Community Matron for eighteen months; he had a history of coronary heart disease having experienced a cerebrovascular accident resulting in right sided hemi paresis with reduced mobility ten years ago, and a diagnosis of type 2 diabetes two years ago. Following a history of poor diabetic control, Jack was referred to the Community Matron by his Gp in June 2008 to provide ongoing education and support for Jack and Linda in order to more effectively manage Jacks condition and minimise complications of diabetes (DoH 2001). Information, education and psychological support is the cornerstone of diabetic care (DoH 2001); the Diabetic Specialist Nurse proved an invaluable resource to the Community Matron who was subsequently able to provide dietary advice to Jack and Linda both verbally and written using a patient handbook (NICE 2002a). This approach proved successful and diabetic control improved, consequently Community Matron visits were reduced to a mont hly support and monitoring regime. However, carers recently noticed a skin problem during morning visit (see Appendix 2) and referred Jack to the Community Matron for reassessment. Systematic and sensitive assessment has been a key government policy in primary health and community care (RCN 2004); accurate medical history taking is vital as this is arguably the most important aspect of consultation (Crumbie and Walsh 2006) with 80% of diagnoses formulated on the interview alone (Epstein, Perkin, Cookson and Bono 2003). Skin problems constitute 15% of GP consultations; essential management requires a history of the complaint as well as background information, including general health and concurrent treatment (Parker 2009). Following a full explanation, reassessment (appendix 1), took into consideration the personal areas involved and the possibility that the condition was sexually transmitted; sensitive questioning of sexual history was undertaken and noted. Information was gained using a variety of methods, including open questioning of Jack, wife Linda, medical notes, hospital discharge letters and Care Agency daily records. Whilst interviewing Jack it became apparent that he was feeling depressed, further questioning confirmed that Jack had been feeling depressed for some time (Patient Health Questionaire-PHQ 9 completed and filed in Jacks notes with a copy to GP), Linda had been ill with a cold earlier in the year and had snapped at Jack, he said that he felt that he was a burden and refused to be persuaded otherwise becoming very tearful during the consultation. After further discussion, Linda agreed that she had been finding it difficult to cope and agreed to accept more help during the day; referrals were made to social services and to crossroads to provide day sitting service to allow Linda time to herself. Antidepressants were discussed for short-term relief of symptoms but both Jack and Linda felt that with extra support they would both improve. Assessment tools to aid memory and ensure relevant information is identified include mnemonics whereby an easily remembered acronym associates with list items (mnemonic). Mnemonics have been used since the second century BC (Nager and Heinrichs 2009), whilst SOCRATES is generally used by medical professionals as a pain assessment tool to gain insight into patients condition (http://en.wikipedia.org/wiki/Socrates-(pain assessment), the practitioner could find no validation of this tool, although Clayton et al (2000) use this acronym in their study, they too fail to highlight the origins of the acronym and provide no validation or references. A plethora of mnemonics can be found to assist in consultation and assessment http://www.medicalmnemonics.com/), acronyms considered, included SWIPE (starts, worse, improves, pain, episode), LOSTWAR (location, onset, severity, worsening, alleviating and radiating), nevertheless, the practitioner found SOCRATES easy to remember and relevant to Jacks condition, pertinently, she found this particular tool an invaluable resource when gaining a concise history of the presenting problem(See appendix 2). Recent blood test results reviewed (appendix 3), vital signs of blood pressure, pulse, and temperature recorded, and shown to be within normal limits, no pyrexia was noted which precluded infection, weight, BMI, waist measurements and random capillary blood glucose levels were taken and compared to previous results. Whilst there appeared little change in general observations, Jack had gained 5kg in weight with a proportional 7cm increase in girth measurements, Hba1c levels had increased from 6.3% in June 2009 to 7.8% in January 2009; also his eGFR had decreased from 49ml/min in June 2009 to 44ml/min in January 2010. Medication (appendix 1) was reviewed to assess if this may have contributed to the condition and whilst Aspirin, Bisoprolol and Xismox all have itching and rash listed as a side effect, this is indicative of an allergic reaction which occurs suddenly (BNF 2009), over the counter medication and herbal remedies were also explored and Jack confirmed that he only used prescription medication, and therefore it was perceived medication could not have initiated the problem. Jack has no documented allergies to medication which could possibly have caused a rash, and has not been receiving antibiotic therapy which may have predisposed him to fungal infections (Hilson 2002). Jacks wife confirmed that no new topical agents or laundry powders have been used recently which may have triggered a skin reaction (Parker 2009). Following history taking and full explanation, consent for examination was obtained. Whilst Jack was well known to the practitioner and a confident, professional relationship established, sensitivity was shown to the fact that he would be partially undressed during the procedure, examination was then conducted in the privacy of the bedroom with the curtains and windows closed, pertinently, a clean sheet was used to cover areas not under scrutiny to ensure only the relevant areas of Jacks body remained uncovered at one time during the procedure to maintain dignity, Linda was present throughout the examination at Jacks request. Physical examination was then undertaken using the skills of inspection and palpation, the senses of touch, listening and smell, physical findings from the examination were then integrated into the diagnostic process. According to Epstein, Perkin, Cookson and Bono (2003) there is a tendency to focus on the localised area of skin but as an organ in its own right skin should be fully examined to gain maximum information. A full examination in good light is essential to identify details necessary to formulate a differential diagnosis, these include, site, distribution, pattern, colour, heat, flat or raised surface and any ulceration (Chadha 2009 Bickley and Szilagyi). A careful inspection ruled out rash or dry skin problems elsewhere on the body, however, the skin between the groins extending onto the scrotum was intensely reddened, cracked in skin folds, covered in a moist rash with a creamy curd discharge, well defined borders and scaling on the edges, small satellite lesions outside the scaly borders and a yeast like odour was present. On palpation, the skin felt damp, heat radiated from the skin and the area was sore when touched. Nevertheless palpation of the inguinal area revealed no pain, or l ymph node enlargement, Jack was apyrexial and said that he felt well apart from the skin problem indicating no outward signs systemic infection. Clinical decision making is often fraught with uncertainties, however, expert diagnosticians maintain a degree of suspicion throughout the assessment process, consider a range of potential explanations, then generate and narrow their differential diagnosis, based on own experience, familiarity with the evidence related to various diagnoses, and understanding of their individual patient. Ultimately, diagnosis is confirmed or ruled out by combining findings from physical examination and history and comparing them to findings from diagnostic studies which closely match presentation of the problem (Goolsby and Grubbs 2006). A plethora of skin conditions exist which were initially considered including eczema (or dermatitis), the commonest inflammatory condition accounting for 30-40% of dermatology consultations (Forslind and Lindberg 2003), flexural psoriasis had some features and associated factors i.e. affecting skin folds but as no lesions elsewhere on the body and no history of psoriasis this was only fleetingly considered, whilst distribution, symptoms and appearance of incontinence dermatitis was almost identical to Jacks condition, he had in situ a fully functioning urethral catheter and no faecal or urine leakage problems which could have initiated the condition. Following reassessment, consideration of medical, social history, physical findings and clinical manifestations of the disease, only five conditions were included in the diagnostic process (appendix 4). Differential diagnosis of Intertrigo was initially included but discounted as the area had signs of skin infection not associated with Intertrigo which is an inflammatory condition and not an infection (Parker 2009), Erythrasma, and Bacterial Intertrigo were considered as the localisation, namely skin folds fit the inclusion criteria and then discarded as images of Erythrasma and Bacterial Intertrigo were too dissimilar to Jacks rash, coupled with the fact that the yeasty smell and white areas on the skin appeared more consistent with fungal rather than bacterial infection. Tinea Cruris is commonly caused by the fungus Trichophyton rubrum and looked remarkably similar; however, this diagnosis was discounted as there was fungal rash to scrotum which was inconsistent with Tinea Cruris and no Tinea Pedis (maceration of interdigital web folds) consistent with the condition (Brannon 2009). Whilst a KOH test, performed by examining skin scrapings under a microscope, would have given an absolute diagnosis, the practitioner felt confident that as the description of Candidal Intertrigo (Brannon 2004) most closely matched the physical manifestations and characteristic distribution of Jacks skin condition, coupled with the fact that Intertrigo Candida had been previously diagnosed and treated if not eradicated, this appeared the most likely diagnosis. In order to effectively treat the skin problems one must first consider the underlying pathology of the condition. The skin is the largest organ of the body and forms a barrier between the internal organ and the external environment as people age, less efficient micro-circulation results in reduced blood flow, skin becomes drier, less elastic and more permeable, making it more susceptible to damage (Ousey 2005). Elderly people, therefore like Jack who are obese and less mobile, have increased prolonged occlusion in areas such as groins, resulting in more moisture and warmth in skin. Intertrigo occurs when two occluded, moist surfaces of skin rub together with the resulting friction setting up the inflammatory process (Parker 2009). Following activation by cells present in tissues, macrophages, dendritic cells, histiocytes, Kuppfer cells and mastocytes inflammatory mediators are released and vasodilation increases blood flow, causing itching, redness and heat, the blood vessels become more permeable resulting in oedema and the release of bradykinin increases sensitivity to pain (http://en.wikipedia.org/wiki/Inflammation). This cycle continues due to the constant chafing stimulus provided by the two skin surfaces leading to chronic inflammation and a moist warm environment where Candida can thrive (Gullo 2009). Key aims of the health professional in treating Candidal infections are identifying and encouraging the management of underlying predisposing risks as this will improve symptoms and minimise recurrence(Parker 2009). Candidal (yeast infections) are commonly caused by Candida Abicans, which is normally present on body surfaces, colonisation with the fungus (Mims et al 2001) has an increased incidence in obese, the immunosuppressed, and diabetic patients with increased prevalence in the elderly and in those with poor personal hygiene (Weller et al 2008, Parker 2009), antibiotic therapy is also known to predispose the patient to fungal infections (Hilson 2002). Interestingly, whilst it is generally accepted that diabetics are more prone to Candida Albicans infection, the practitioner could find only scant explanation for this, Hall and Hall (2009) and Laube and Farrell (2002) suggest that high blood glucose levels encourage proliferation of bacteria and attacks from microbials and fungal infections, Mims et al (2001) agree and also propose that skin sepsis is poorly controlled in diabetics probably due to defective chemotaxis and phagocytosis in polymorphs which show impaired energy metabolism, they add that in vitro, the energy of polymorphs is rapidly restored by the addition of insulin. Following diagnosis and identification of multifactoral elements and risk factors, treatment was commenced, primarily to eradicate the Candida infection and secondly through a structured programme of health promotion, and collaborative working, risk factors were reduced to minimise recurrence. Treatment options considered included therapeutic and non therapeutic options. Therapeutic treatment is aimed at secondary prevention whereby therapy is commenced to treat the condition and prevent further complication. Whilst Candida Albicans is a common infection in the elderly (Hall and Hall 2009), invasive candiadasis (candidaemia) occurs when the pathogen become systemic and is associated with significant mortality and morbidity (Gullo2009, Candiadasis http://en.wikipedia.org/wiki/Candidiasis ). Guidelines show (BNF 2009) that therapeutic interventions of Candidal Intertrigo are confined to topical treatment with an Imidazole cream with an added steroid component where inflammation is present. The decision not to treat the skin inflammation with combined antifungal and steroid cream was based on the fact that steroid therapy is contraindicated in occluded groin areas where dermal uptake of the steroid may be systemically increased, signs of infection reduced, and itching made worse (Watkins 2004, Brannon 2004). As previous infection responded to a course of antifungal treatment but recurred, advice was sought from the local pharmacist who suggested that recurrence could be partly due to stopping the treatment once condition appeared resolved, he advised that treatment with antifungal creams should be used twice daily for a minimum of two weeks after symptoms cleared. As evidence suggest(BNF 2009) that no one Imidazole more effectively treats fungal infections than the others, the choice of which to prescribe was based on nothing more than the cost of the product, past experience and availability at the small local pharmacy, therefore Clotrimazole Cream 1% 20mg was prescribed by the practitioner (NPF 2009-2011). Whilst keeping the affected area clean and dry relieves symptoms of inflammation and improves healing (Parker 2009), the practitioner could find no non-therapeutic remedies to treat the fungal infection. Here, non therapeutic treatment relates to primary prevention of the disease process, namely prevention of the disease process occurring (Katz et al 2000). This included lifestyle management to control weight, improve mobility, reduce occlusion of skin in groins, improve blood glucose control, effective skin care, and prompt identification of intertrigo (Gullo 2009, Parker 2009, Hall and hall 2009) to limit the condition and reduce the risk of infection. Carers were responsible for all Jacks hygiene needs and played a key part in primary and secondary prevention, in order to ensure effective treatment with continuity of care, written and verbal instructions were needed, consequently a care plan was devised by the practitioner in conjunction with Linda and Jack to incorporate therapeutic and non therapeutic interventions. Whilst accurate research-based information was available on the internet (http://www.library.nhs.uk/skin/SearchResults.aspx?tabID=290catID=83420), neither Jack nor Linda had access to a computer, therefore downloaded information was printed out and given to Jack to reinforce information contained in care plan. Following consultation with the Care Agency manager, a copy was then placed in Jacks file and one at the Care Agency Office. The empowerment model of health advocated by Katz (2000) suggests that the aim of the health professional is to teach people the skills to take care of their own health. Consequently, Linda and Jack were encouraged to take an active role both in treating his skin condition and in improving general health and well being. Being assertive is advocated in this model, and as Linda reported that the carers were often in a hurry to complete hygiene within allocated time limits, she was encouraged to be more assertive and to ensure that Jack had sufficient time allowed by social services for his needs, the practitioner agreed to request a reassessment if Linda considered that carer time allotted to Jack insufficient for his needs. Scrupulous cleaning is essential, however, with ph of 5.5 skin is slightly acidic (Skewes 1996, Hampson 2006) and whilst soap cleans effectively it is alkaline (ph 10-12) and if not rinsed off thoroughly, can elevate the skins natural ph, reduce antibacterial property, and encourage fungal growth; lipids naturally present on skin surface are removed making skin drier and affecting barrier function (Warner and Boissey 1999) further increasing the risk of infection. Linda was advised not to buy perfumed soaps or bubble baths as these can cause allergic reactions and skin dryness (Lievre 1996), an emollient cream was prescribed, carers were advised through the care plan to rinse and dry skin thoroughly to reduce opportunistic fungal growth (Parker 2009). Jack agreed to inform the carers if he was not dry between the groins. A management plan was included in the care plan, as early treatment can often delay or reduce the impact of the condition, carers were therefore encouraged, to closely observe groins for the first signs of the condition, and to report to Linda so that effective treatment could be implemented. Jack was subsequently referred to the physiotherapist and commenced a weekly programme of physiotherapy, he was encouraged not to use the wheelchair in the home and very slowly his mobility increased, the diabetic nurse visited to advise on diet and Linda was encouraged to participate and try to eat more healthily. About three days into treatment with the antifungal cream, Jacks skin showed marked improvement, the cream was discontinued after three weeks. Unfortunately, four weeks later, Linda reported that the condition had recurred, examination of the area showed Jacks groins only mildly affected by intertrigo with skin folds slightly reddened, no infection was noted therefore a prescription was issued by the practitioner for Actisorb Silver which she advised carers to place between groins, this served to both separate the skin folds as suggested by Practice Nurse (2009) and reduce bacterial skin count (BNF. org 2009. Whilst the practitioner could find no research based evidence to support this decision, reflection upon practice based evidence illustrated that in the past, placing this dressing on reddened groins reduced redness and prevented further exacerbation. Fungal infections can be unsightly, chronically itchy and are increasingly being recognised as a threat in critically ill adults and can be life threatening in some adults (Gullo 2009), and whilst Jack had a further recurrence of intertrigo, prompt identification of the condition and treatment reduced severity and prevented the complication of a fungal infection, however with the multifactoral elements of the condition it may recur at a later date. Hopefully, an empowered team approach will minimise risk factors and ensure that these episodes are at least reduced if not prevented.