Cause and Effect Essay Essay

As a child my mom always taught me to be proud of who I am; to disregard all the negativity that was sure to come my way. As a constant reminder she bought books like Black Beautiful Me and Strong and Black to keep up my self-esteem. It was a good reminder, but because of all the negativity that surrounded me I started to feel bad about who I am. I never thought that I would have been a victim of discrimination moving to such an isolated place, but it comes to show that you will never be rid of the negativity in the world. Moving to a small town where African Americans are hard to find; a lot of racism was always targeted towards my sisters and I. Attending School was the hardest part; I always saw myself as being beautiful, but walking down the hall being called â€Å"that ugly black girl† started to take its toll on my self-esteem. Everywhere I went I ran into discrimination and stereotypes; I was constantly asked if I wanted fried chicken or watermelon, I would have guys tell me â€Å"I would date you if you had lighter skin,† or walking in the store and have the word â€Å"nigger† shouted and not know where it originated from. I didn’t understand why I wasn’t liked or given the chance to prove myself, but I felt unwanted, like I didn’t belong. When I had read â€Å"The Myth of a Latin Woman† I found it quite relatable to my situation when I had first moved to Cortez. Cofer talks about how she was stereotyped when she moved to America; how she wanted to fit in, but found it difficult because of her traditions and culture. She stresses the fact that nobody really understood her, that movies about Latin and Puerto Ricans were the closest understanding people got to her culture. Cofer then states that all the hard times that she had growing up made her stronger, and more successful. She tells the reader to take all the negative experiences and turned them positive so that nothing is stopping one from being successful. The negativity was a struggle for me, I wanted to quit public school and start homeschooling. But, I began to learn how to ignore people and not care how or what anybody thought of me. With that idea I became more at peace with myself. I started to look up when walking down the hallways, I learned  to just smile and at the negativity. Instead of the hurtful words putting me down I used it as fuel to my flame, motivation in other words, to do better and be successful.

Paris description

Like any other day, the sun rose In Paris. It as the beginning of May, when spring blew Its last breezes and the heat of summer started to spread around. The weather could not get any better. The sky was crystal clear and It wasn't too sunny. The sun made the whole city looked Like It was covered with a thin, light and golden layer of apple dust. I could tell the weather was perfect since I could open the windows and Just leave It there. It was probably the best time In pans for traveling, when the freezing cold and the depressing rain were all gone.Like any Parisian, my morning started with a crunchy exterior and soft Interior resistant, some slices of crispy honey coated French toasts but my breakfast was definitely incomplete without a creamy cup of cappuccino. Sitting by the windows, those flowery balconies, the cobblestone road, those old black poles on the sidewalk, those classy street lamps had never seemed so real. Along the pavement, plenty of cars were parked in an organizi ng order even though the parking spaces looked a little bit too small. Excitement took over my whole body.I could not wait to jump out of the window and go on my Paris adventure but those soft noises along with such denude silence in the early morning kept pulling me back to the chair. That peaceful atmosphere absolutely gave me the definition of Zen. It was a typical Parisian Monday. Walking down the street, everyone seemed so busy. The street was crowded with people walking, bicycling, and driving their ways to work. Some stopped along the way to grab a cup of coffee. All of sudden the smell of everyday coffee wasn't the same.The warm and bittersweet aroma of roasted coffee combined with the buttery and yeasty smell of fresh baked pastries filled the air. At the corner, people walked UT of the billionaires with bags baguette and pastries on their hands. Then, an earthy scent of fresh-from-the-garden flower and a faintly sweet smell of blooming flowers gently spread around. Flower stalls with radiant and vibrant colors glowing under the early morning sun caught my eyes. Even the homeless on the street woke up and got ready for a new day. So I Joined In the flow of people and continued living my dream in Paris. Paris is oozing with art and culture.Artists were almost everywhere and love was In the air. It's not difficult to spot a Parisian cafe © on the street. The word â€Å"cafe ©Ã¢â‚¬  said It all. It's so original that there Is so equivalent for Its name In the English language. The cafe © was so adorable with round tables and flimsy chairs on a shady pavement terrace. There were dancing people on the street. People played music with accordions, cellos or even trumpets for money. A man with a beret hat would probably paint a portrait of you In no time. Souvenir stores were filled with tiny Eiffel towers, postcards and â€Å"I heart Paris† t-shirts. The crowds of people were inside the metro station.Graffiti and paintings were all over the wa ll. Unlike others unique beauty. For centuries, this city has been the laboratory for new ideas of architects and artists, which explains why Paris has bits of everything. Seeing all the historic and majestic buildings would give you a definite aspect of European architecture. Furthermore, a large number of monumental churches were built in Paris. During the French revolution, many churches were burnt down and destroyed but fortunately some of them survived and renovated. To be specific, the Notre Dame looked like a massive masterpiece. I took a closer look from the outside of the cathedral.Every detail of the carvings was so sophisticate and amazing that it left me speechless. The interior was wonderfully classy with all the colorful stained glass, the painted ceilings and everything else in that gothic treasure. If there were a medal for the best-preserved city, Paris would probably win the first place. Along the Seine River, key locks were easily found on bridges, it's considered as a symbol of love. Lovebirds were holding hands and the music were playing. The scenery would brighten your day right away. And French people were lovely as they spoke softly and the elegant gesture they made.The laughter and conversations mingled with the music melody, created a euphonious chorus of life. The highlight of the day didn't happen until sunset. It was summer so the sun didn't go down until nine. Standing from Pont Alexander Ill, the bridge that spans the Seine River, I got the perfect spot to watch twilight in Paris. As the sun began to set, a celestial glow appeared in the sky. As it went darker, the sky turned yellow, orange with a little shades of coral and magenta and the clouds looked like giant marshmallows floating in a gigantic punch bowl with layers of colors. The Eiffel tower was all lit up.The lights started to blink like the stars were playing hide and seek. Just a few moments, the city of lights was in front of me. The attractive golden lights from the Eiffel, the yellow lights from the street, everything was exquisitely amazing. Then, those shimmering lights drew itself onto the Seine River. The reflection started to vibrate like it was trying to send a message as the river flow slowly moved. I Just stood there and did nothing but stared at every centimeter of that stunning scenery. Rambling through the streets, the Paris during the day transformed itself into the Paris that took my breath away.Every corner, every avenue was Just pure magic. On the other hand, not everything about Paris is lovable. This city can get a bit touristy and crowded during summer. If you were too busy enjoying the view, you might be the victim of a pickpocket in Just a blink of an eye. Since this city attracts so many people, the lines in most places were too long and it would probably waste your time. The queue at an ice cream cart on the street took me thirty minutes but it was all worth it. I had a strawberry sorbet. It was a blast of freshness. The sorbet tasted really Juicy and deliciously tangy.It instantly melted in my mouth then a cool smooth liquid flowed down my throat as it cleared away all my feebleness in that boiling afternoon. So, as long as you are careful with your belongings and enjoy Paris to the fullest, the pickpockets and the lengthy lines would be no problems. There goes every beautiful piece of Paris that etched into my memory. As I wandered through the street of this city, splendid works of art were gently unfolding in front of me. The whole experience was priceless. I could throw in more adjectives to describe how surreal Paris was but this city would always be more than that.

Analysis Of Marketing Mix Of NAPCO Group

Discuss About The Analysis Of Digital Marketing Mix Of The NAPCO Group? Digital marketing can be used a term that collectively includes all the marketing activities that are done utilizing the technology. It uses digital channels such as social media to market its products.   Today’s organisation utilise digital marketing to achieve new heights of success. The major motive of digital marketing is to create brand awareness and engaging the customers. Social media promotions have turned out to be the most important and productive medium of digital communications. This report deeply analyses digital marketing mix of an Saudi Arabian company NAPCO group which deals in packaging. It also studies the marketing mix of its competitor firm. The report involves recommendations for the company that could be taken for the betterment of the digital marketing mix. NAPCO is one of the leading manufacturing groups in Saudi Arabia. As seen in the appendix the company has well designed , simple and   attractive logo. The company has its headquarters in Dammam, Saudi Arabia. NAPCO is a commercial organization working to maximize its profits. Today the company conducts its business around the globe and it is one of the top ranked companies of Middle East. The group owns 10 companies with over 5540 employees. It basically deals in three strategic segments consumer products, flexible packaging, and paper containers. (NAPCO 2017). From the appendix it can be seen that NAPCO’s consumer products brands range from baby care products to family care and household products. NAPCO’s brands are licensed from INDEVCO. NAPCO’s flexible packaging segment serves the Europen, GCC, Middle East in African markets. This segment consists of 7 companies situated in Dammam and Jeddah in Saudi. The paper container segments serve European, GCC and Le vant markets. This section produces a wide range of corrugated containers to serve the needs of various industries. The major competitors of the company are   FIPCO, Saudi Pack, Al Sharq Flexible Packaging Factories, Al-Ghadeer Group, Saudi Arabian Packaging Industry WLL, Noor Carton & Packaging Industry and Gulf Packaging Industries Ltd.   The customer base of the company includes both B2B and B2C companies. The company’s current digital marketing practices include responsive website design and social media presence. The company is does not have well developed digital marketing activities it is working in this field to enhance its digital marketing and grasp more opportunities. The company is a popular name in the Middle East. Middle East is on the verge of digital revolution. Digitalisation has increased with high smart phone adoption rate and increased use of social media. The Middle East companies are ready to lead digitally enhanced lives. Although businesses and government have still not exploited those opportunities (Elmasry, Benni, Patel, Jan and Moore 2016).Three opportunities presented by changes in external environment- This is the most emerging opportunity in Saudi markets. This technology will replace the old search engine optimization. The new SEO trend would provide a better way to target the potential customers (Albhaishi, Wahsheh and Alghamdi 2014). The online audience optimization will encourage the target audience participation by social media networks, innovative and creative blogs and informative online articles. This technology will help not only in advertising but also effectively integrates mobile strategy (Lee, Jalali and Dasdan 2013). This is a kind of new digital platform is an emerging opportunity for NAPCO group. It can implement this technology. This technology provides the benefits of linking to the potential clients more effectively and efficiently. The use of mobile phones has increased worldwide. More and more people now own a smart phone. This provides the businesses and opportunity to do their marketing and reach to the potential customers through smartphones. According to a report, 90 per cent of the sales of the connected device will be smartphones and tablets by 2020 (Lunden 2015). To exploit best from this opportunity the companies should provide a mobile friendly content on their websites. Also, they should approach their customers utilizing this technology. It is necessary to provide a great experience to the customers that are browsing company’s websites through mobile phones. It provides benefits of enhanced customer relation, maintaining a constant touch with the customer and gets more genuine clients than the competitors (prolines 2015). Another opportunity is available in the field of content marketing. To exploit this opportunity company must publish high quality and informative content on popular websites (Jà ¤rvinen and Taiminen 2016). For Saudi markets optimizing unique Arabic content will help the firm to attract more B2B customers. The Arabic content marketing strategies such as press releases, blog posts, articles, newsletters etc. will help to reach millions of customers. This will ultimately enhance the profitability of the firm (prolines 2015). In today’s era customer is considered as the king of the market. Today’s customer does not rely only on to a single firm. He has a variety of options available in the market. The customer does not rely only on the company website and marketing force for getting information about the products of the customer (So, King, Sparks, and Wang, 2013). The customer has various other sources such as review sites, blogs, and social media to gain information about strengths and weakness of the product.   Today’s customers have complete control over the buying process. Therefore today’s marketers need to develop effective digital marketing strategies to create an outstanding experience for its customers. The customers now are now well informed and they have various choices therefore if the company does not want to lose its customers it needs to be customer focused.   Right digital marketing strategies can only be developed if the company is customer focused. It is a lso very important to analyze customer behavior if the company uses customer behavior statistics it will be able to create hyper specific digital marketing strategies. The company’s digital marketing strategies will only be successful if it helps customers to discover the value. To make the appropriate digital marketing strategies for the customers it is required to get insights about customer behavior so that the ideal experience in terms of customers can easily be predicted. NAPCO should identify different needs of its customers both for the B2B segment and B2C segments. This will help the company to build different digital marketing strategies that will effective strive at each of the segments. Also, it needs to develop different digital marketing strategies for markets of Europe, Middle East, Africa and GCC. Consumers in every market have different characteristics and analysis of these character tics is necessary to develop effective marketing strategies.   Analyzing co nsumer behavior is more important for determining effective digital marketing activities because it gives the ideas about the trend in the market (Polizzi 2016). Example: 80% of targeted customers use smartphone they are tech savvy, will help the firm to develop digital marketing strategies taking smartphone as an important tool. Therefore, importance of being customer focused and understanding the consumer behaviour for developing effective digital marketing strategies cannot be neglected. How company uses digital marketing across marketing mix The digital marketing mix of NAPCO can be categorized into 4Ps. The digital marketing mix is simply an adoption of traditional marketing mix it is impacted the growing use of the internet. The company has expanded its product portfolio. Initially, the company just manufactured just paper products but now the company has expanded its product portfolio to consumer products, flexible packaging, and paper containers. The effective product can only be developed by using technology and conducting online surveys (Gruner, Homburg and Lukas 2014). These online surveys helped the firm to know what customers actually want and saves the time and efforts. NAPCO also does research and development using technology. Online sources have given the firms access to know how much the product actually costs and they can also really know the prices of the competitors. NAPCO does not make use of online sources to determine the prices of the products. It has adopted the value based pricing strategy and prices are quoted according to the value that it provides to the customers (Armstrong, Kotler, Harker, and Brennan 2015). Company’s products are available in the Middle East, European and African market. The company takes orders online but it does not have a well-established e-commerce website. It takes B2B orders through emails. The company does not take retails orders online. The company also do not have a proper product catalog with prices on its website. It just sends the catalog to its regular customers. The company makes an effective use of digital marketing activities for the promotion of its products. Apart from the traditional sources such as TV, Radio and print media, it is using various other sources for promotion. The company is shifting its focus from traditional promotional sources to digital marketing. It is using social media, content writing and providing a responsive website to its customers. The digital marketing mix of the company demonstrates although the company is effectively using digital media in research, development and promotional activities it is not using it effectively to determine the price. The customers of the company also expect an online e-commerce website so that it becomes easy to shop for the products but currently the company does not hold any such website. The company should make more effective use of digital marketing to stand up to the customer expectations. Gulf packaging Ltd is the competitor of the company. The digital marketing mix of Gulf packaging is given below: The firm does not have wide product portfolio. It produces all types of BOPP films (gulfpack 2015). The product portfolio of NAPCO is much wider than the Gulf packaging. The company works in its selected portfolio and does not use technology for further research and development. The firm uses the technology to fix the prices of its products. It constantly monitors the prices of its competitors and the market trends and frames its prices accordingly. It charges different prices in the different nation by drawing information about each of the nations.   This helps the firms to generate more profits. The firm sells its products in Europe, North America, and the Middle East. This firm does not accept online orders they accept the big orders from the regular customers over the phone. The company do not provide product catalog to the customers over the website it sends the quotation for different products over the email, on demand. South American Commercial premises of the company are responsible for marketing and promotional activities. The company is engaged in traditional promotional activities basically using print media. The company does not use much digital marketing activities from the promotion. But recently the company has opted for social media marketing as a promotional activity. Gulf packaging Ltd does not make effective use of digital marketing. It has used technology for deciding the process of its products and also uses social media marketing for the promotion of its products. The digital marketing mix of the company is not well developed.   The firm does not sell its products online. The digital marketing mix of the company is just in the growing phase. The digital marketing mix of the company is can be improved in various ways. It can be improved if a company the company learns few things from its competitors. The company should use technology for determining the prices of its products. It should learn from its competitors they use the same strategy to earn its profits. Also, the NAPCO is in the beginning phase of digital marketing. The company should engage in activities such as press releases, use LinkedIn profile this will help to build a network and attract more B2B customers (Hannouz 2015). The customers of the company expect an online website for buying and selling of products. The company should pay attention to this expectation and offer its products for sale online. The other measures that can help the firm to improve its digital marketing strategy are finding creative ways for customer acquisition by using digital media. The company should utilize its data efficiently to create a personalized experience for its customerâ €™s web analytics solution can help the company in collecting and analyzing the data. The firm is already engaged in social media marketing activities, the firm can make use of live streaming to develop its digital market mix. Live streaming is the recent trend in digital marketing but the content chosen in live streaming should be really brainstorming (Shoolian 2017). Another way in which firm can effectively use the ephemeral content. Now a day’s websites such as Instagram, snap chat, and Facebook provide the opportunity to upload data that automatically disappear after a set time period.   This can help the companies to upload special offers and deals. SMART objectives of the company can be defined as the goals which are specific, measurable, actionable, relevant and time bound (Bjerke and Renger 2017). The two objectives for the company to enhance online customer experience are: Achieve online 10% online revenue contribution within 2 years To increase the online revenue by 10% NAPCO needs to work very hard. First of all, it needs to set up its e-commerce website. The company needs to take feedbacks from the customers about the website and make all the possible changes required. The company needs to effectively manage the delivery time so that the orders are reached to the customers within the time range. The companies should also provide a column for customized orders from the customers. The next step is spreading awareness in the customers about the online availability of products using the digital media for advertisement. The company should also provide some offers at the initial stage when the website is launched. All this will help the company to achieve 10%online revenue contribution. To increase the brand awareness of NAPCO’s product the company needs to increase the number of followers on twitter. It needs to achieve the target of 1000 followers within a year.Twitter is a powerful business tool and could be a great help if utilized optimally (Moody 2016). There are many ways NAPCO can increase the number of followers on twitter by using tools such as Hootshoot and Sproutsocial. NAPCO can also use Twiends to find the new users whom the company can connect. Another strategy that can be adopted by the company to increase the number of followers on twitter is following more people because there is a correlation between numbers of people followed and the number of followers (Demers 2015). The above two stated are SMART objectives that should be the key targets of the company to develop the digital marketing mix. The company should lay emphasis on enhancing customer experience. Suggested digital marketing mix for NAPCO to improve its online customer experience: The company has wide product portfolio. It can enhance its portfolio by using technology for research and development. It can use integrated tool set for SEO, email and lead intelligence tools to get consumer information and design more customized product to satisfy individual customer demands. The firm operates on value based pricing strategy. To earn more profits the company should use technology to determine the appropriate prices. NAPCO should constantly obtain upgraded data by using information technology to gain information about prices of the competitors and current market trends. The company y needs to sell its products on an online platform. The company should sell its products on the online website to reach a large number of customers. The company can use online network partners to enhance the availability of products at various products (Lien, Wu, Chien, and Lee 2017). The company uses digital marketing activities such as social media marketing. The company should adopt more digital marketing promotional activities such as innovative and creative blogs, search marketing Pay-per-click advertising (PPC), Affiliate marketing and email marketing. People are the main aspect for the success of every company. The company needs to hire some specialist from the field of computers and digital marketing. It also needs to provide training to its staff about successfully implementing digital marketing processes in the organization (Parmenter 2015) There is the need to effectively manage old processes and implement some new processes needs to be implemented. The company needs to implement a new process to start the online sale of its new products. It needs to effectively manage the product delivery process to ensure that goods are delivered within the stipulated time (Stadtler 2015). The suggested changes will also help to attain the above stated two SMART objectives for the company the changes made should help to increase the number of followers and also increasing the online revenue generations these changes are directly related to the Smart objectives. These tactical activities will provide direct benefits to the consumer and thus help to improve online customer experience. The company can monitor and control the recommended marketing mix by various metrics and methods. The company can use Google analytics to monitor and control the recommended marketing mix. This tool provides a huge summary of data related to your website (Cain 2012). NAPCO can analyze this data on the weekly or monthly basis to analyze the effectiveness of the recommended marketing mix. For example data about people that visit the website will help to monitor the trend about brand awareness. Another effective method is designing a response-attribution infrastructure to support all channels. Digital marketing mix uses multiple channels, therefore, campaign hierarchy must account for each channel along with the appropriate roll-ups so that measurement aligns with business goals (Ewald and Krishnamurthy 2009). It includes developing a framework to measure each and every step is monitored individually. The company can also use automated tools for analytics and visual reporting. Nowadays there are a variety of tools available in the market that help to regularly track selected metrics. NAPCO can get access to these tools and effectively analyze its reports regarding the operations. The recommended digital marketing mix for NAPCO has suggested changes in the process by using the latest technology these changes can be effectively monitored if the company uses the automated tools. Their company can monitor and control the effects and performance of recommended marketing mix but there is no set unit of measurement for this. Although the measurement can be done on the basis of ROI and online revenues this will only provide with the estimates, not the exact figures (Holloman 2014). This is because the recommended marketing mix involves both qualitative and quantitates terms. After implementing the recommended marketing mix the company should analyse its ROI and online revenues time to time to know the effectiveness of the process. It can be concluded that NAPCO does not have a well-developed digital marketing mix. The company is in its beginning phase regarding the use of technology in marketing. It has grown tremendously but now it has come to a stagnant position. Its customers now demand online selling of products. The company only takes online orders that also through emails, but not it needs to set up its e commerce website for growing further. The company already uses social media marketing but now it needs to design and use social media marketing campaigns more creatively. The company has already adopted the path of digital marketing, now it just needs to make some recommendations efforts to achieve the corporate excellence. Albhaishi, A., Wahsheh, H. and Alghamdi, T., 2014, May. Evaluating Web Ranking Metrics for Saudi Universities. In  Zaytoonah University International Engineering Conference on Design and Innovation in Sustainability 2014  (No. 156988). Zaytoonah University, Amman, Jordan. Armstrong, G., Kotler, P., Harker, M. and Brennan, R., 2015.  Marketing: an introduction. Pearson Education. Bjerke, M.B., and Renger, R., 2017. Being smart about writing SMART objectives.  Evaluation and program planning,  61, pp.125-127. Cain, K., 2012. Measuring Marketing Effectiveness: 6 Metrics You Need to Track, viewed on 4 August 2017 from https://contentmarketinginstitute.com/2012/10/measuring-marketing-effectiveness-metrics/ Demers, J. 2015. 50 Free Ways To Increase Your Twitter Followers, viewed on 4 August 2017 from https://www.forbes.com/sites/jaysondemers/2015/06/17/50-free-ways-to-increase-your-twitter-followers/#6d92ab9525a8 Edward, B., and Krishnamurthy, R. 2009. Five Essential Strategies for Measuring Marketing Effectiveness, viewed on 4 August 2017 from https://www.marketingprofs.com/9/essential-strategies-measuring-marketing-effectiveness-krishnamurthy-ewald.asp Elmasry, T., Benni, E., Patel, J. and Moore, J.M., 2016. Digital Middle East: Transforming the region into a leading digital economy, viewed on 4 August 2017 from https://www.google.co.in/url?sa=t&rct=j&q=&esrc=s&source=web&cd=4&cad=rja&uact=8&ved=0ahUKEwj6pcDRkL3VAhVIFpQKHecwAjkQFghFMAM&url=http%3A%2F%2Fwww.mckinsey.com%2F~%2Fmedia%2Fmckinsey%2Fglobal%2520themes%2Fmiddle%2520east%2520and%2520africa%2Fdigital%2520middle%2520east%2520transforming%2520the%2520region%2520into%2520a%2520leading%2520digital%2520economy%2Fdigital-middle-east-final-updated.ashx&usg=AFQjCNHioXhFY692mS_Qwa6hkBT6UiXYVg Gruner, R.L., Homburg, C. and Lukas, B.A., 2014. Firm-hosted online brand communities and new product success.  Journal of the Academy of Marketing Science,  42(1), pp.29-48. Gulfpack, 2017. Welcome to gulf packaging industries ltd website,viewed on 5 August from https://gulfpack.com.sa/ Hannouz, M., 2015. Three Ways to Improve Your Digital Marketing Strategy, viewed on 4 August 2017 from https://blogs.adobe.com/digitalmarketing/campaign-management/three-ways-to-improve-your-digital-marketing-strategy/ Holloman, C., 2014.  The Social Media MBA Guide to Roi: How to measure and improve your return on investment. John Wiley & Sons. Jà ¤rvinen, J. and Taiminen, H., 2016. Harnessing marketing automation for B2B content marketing.  Industrial Marketing Management,  54, pp.164-175. Lee, K.C., Jalali, A. and Dasdan, A., 2013, August. Real time bid optimization with smooth budget delivery in online advertising. In  Proceedings of the Seventh International Workshop on Data Mining for Online Advertising  (p. 1). ACM. Lien, C.H., Wu, J.J., Chien, S.H. and Lee, C.Y., 2017. Anxious Attachment, Relational Embeddedness, Trust, Co-production, and Performance: An Empirical Study in Online Business-to-Business Relationships.  Telematics and Informatics. Lunden, I., 2015. 6.1 b smartphone users globally by 2020, overtaking basic fixed phone subscriptions.  Techcrunch. com. Moody, A., 2016. How To Set Digital Marketing Objectives, viewed on 4 August 2017 from https://cariadmarketing.com/digital-marketing-objectives/ NAPCO, 2017. About NAPCO group, viewed on 4 August 2017 from https://www.napcogroup.com/#works Parmenter, D., 2015.  Key performance indicators: developing, implementing, and using winning KPIs. John Wiley & Sons. Polizzi, M., 2016. Why Your Brand Needs a Customer-Focused Marketing Strategy, viewed on 4 August 2017 from https://www.brandfolder.com/blog/customer-focused-marketing-strategy/ Prolines, 2015. 8 Top Online Marketing Trends in Saudi Arabia 2015, viewed on 4 August 2017 from https://blog.prolines.sa/marketing-trends-in-saudi-arabia-2015/ Prolines, 2015. Digital Marketing Service – Boost Your Business Online in Saudi Arabia, viewed on 4 August 2017 from https://blog.prolines.sa/saudi-arabia-digital-marketing/ Shaoolian, G., 2017. 5 Digital Marketing Ideas That Could Improve Your Brand Growth in 2017. The Forbes, viewed on 4 August 2017 from https://www.forbes.com/sites/gabrielshaoolian/2017/01/11/5-digital-marketing-ideas-that-could-improve-your-brand-growth-in-2017/#686c26a92015 So, K.K.F., King, C., Sparks, B.A. and Wang, Y., 2013. The influence of customer brand identification on hotel brand evaluation and loyalty development.  International journal of hospitality management,  34, pp.31-41. Stadtler, H., 2015. Supply chain management: An overview. In  Supply chain management and advanced planning  (pp. 3-28). Springer Berlin Heidelberg.

Religion in the Medieval Europe Essay Example | Topics and Well Written Essays - 1750 words

Religion in the Medieval Europe - Essay Example These were practiced in various ways including, divination that comprised of astrology, palm reading, interpretation of dream and reading of omens. Medical magic was also part of magical practice. It involved the use of charms, medical astrology, prayers and use of medical herbs. Other forms of practicing magic included the use of protective amulets alchemy and sorcery, which was the use of magic with an intention to harm. However, it faced opposition from the Christian religion, which viewed the use of magic as idolatry. Magic can be viewed as a religion from Etic and Emic perspectives. The initial refers to its perception from outside tradition while the latter refers to perception from within the religion. Christians, on the other hand, defined magic from what it is not. The definition was magic is neither a religion nor a science. Various groups blamed each other of practicing magic due to their varied beliefs. The church distinguished magic as not being a religion by believing t hat the church was a true religion while magic was demonic. Religion was associated with god while magic was associated with demons besides; magic was viewed to be a manipulation while prayer was viewed to be supplication (Hamilton 39). The theory of magic has an evolutionary model, which described the process to begin from magic to religion, then Christian religion that was to be taken over by science. This, however, was criticised by scholars who claimed that it was outdated, unsubstantial, unscholarly and bias. Magic was practiced in the pre modern Europe across the demographic boundaries as pagans adapted to Christianity, which accommodated them. This was due to the influence of the Arabs and scientific inventions. However, the Christians viewed magic as a cult. Magic became increasingly identifiable as definite phenomena in the medieval Europe. Until the conversion period of 300CE to 1100CE, this had acculturation characteristics including paganism coming to terms with Christia nity, beliefs adapting to new religious views. In addition, at this point, the rulers of pagan societies got themselves aligned with the church (Louise, Edward & Raudvere 10). The Christians dominated the region and introduced its own view on culture to the local community. Tension arose between the locals who were pagans and the Christians who were the intruders. The church distinguished between magic and miracles. They viewed magic as an illusion that was created by demons while miracle was real actual and non-illusory. This was more evident on the Christian writings which included book IV of Isidore of Seville’s etymology, which is against divination and demonic behaviour and practices. Belief was one important thing at this time of conversion. The church believed that magic was conducted by demons and highly condemned it. It was believed by the pagans that there were women who were capable of cutting fingerprints of the foot and performs rituals with them. In addition, so me women were dedicated to killing people through devil powers. Bishop Buchan of worms (950-1025) discouraged this. St. Benedict’s and St. Gregory the great (540-604) gave a description of how St. Benedict saw through an illusion a fire that consumed the monks which he perceived that was caused by a heath idol buried under the building. Strigae was a roman term used by pagans to refer to vampire creatures and witches. The penal code in medieval condemned the belief in the Striga who were claimed to steal children. The belief that a certain woman had experienced a nocturnal flight with the pagan gods Diana who was recognised as a Striga was

KNOWLEDGE, INNOVATION AND NEW PRODUCT DEVELOPMENT Assignment

KNOWLEDGE, INNOVATION AND NEW PRODUCT DEVELOPMENT - Assignment Example Such information may include those in applications, specific markets and users. Proper harnessing of these information resources, can contribute enormously to making innovation effective in the organization. Also, organizations partner with others to fulfill specific business goals and objectives. In doing so, invaluable knowledge resources can be created. If a structured approach exists for capturing and sharing these resources, it can aid the innovation process tremendously. It must be added that, a structured approach to acquiring organizational knowledge can by itself be self-financing, in that knowledge is an important source of sustainable wealth creation. It is also cost-effective to the organization in the sense that projects that are unlikely to succeed on the market can be identified on time by the structures created and abandoned. Such an approach sharpens the innovative process and thereby increases Institution of the needed structures is only part of the process of making innovation effective in an organization. In addition to that, there must be a well defined strategy and also a supportive culture for the process. It has been estimated that around 30 percent of western consumers would be aged 50 by 2009. Available reports indicate that this age group would like to maintain youthful looks (Pitman, 2006). Hair care products with anti-ageing properties should therefore be appealing to them. Financially, this category of users is more endowed than their younger counterparts and therefore spends more money on such products. Targeting this category of consumers with naturally occurring hair care products should find ready acceptance with them. Developing a natural hair product for this market would require a seven step processes to be followed. These steps are (i) new product strategy development (ii) idea generation (iii) idea screening and evaluation (iv) business analysis (v) product development (vi) market testing and (vii) commercialization. Many manufacturing companies have a clearly defined new product development strategy that defines the role a particular new product is to help fulfill its overall objectives. Such a policy sharpens the focus of the idea generated for the company. This also prevents the company from dissipating its resources on work that does not help achieve its vision and goals. The naturally occurring hair product with anti-aging properties to be developed is strategically consistent with the company's objective of being recognized as an environmentally friendly. The conception of the idea of producing a naturally occurring hair product emerged from desk research. The researcher came across articles that extolled the properties of some hair care ingredients as well as the emerging trends among male adults to maintain their youthfulness. On the strength of these pieces of information, the idea to manufacture a hair product was conceived. Subsequently, several alternative ingredients were explored. Several product ideas

The role of resilience in the work place and its relationship with Thesis

The role of resilience in the work place and its relationship with physical and emotional well-being - Thesis Example the role of organisation, both leaders and employees need to be inculpated in ensuring enough organisational flexibility to endure themselves into the future that is prone to change and the change of changing essence (Friedman, Merle, 2005). This paper reflects a relatively new concept known as Resilience that can handle this new wave of organisational change and sets a cohesive and conducive vibration within the organisation that helps maintain the spirit of the employees and the organisational productivity during the ever changing changes of ups and down. Resilience is that power which builds the strength to fight back any adverse situation. And more an employee can perform this; more mutually beneficial it is for both the employee and the organisation. It paves the way for flexibility and innovation skills that result in deep and constant renewal capacity of revolutionary thinking, totally free from any conventions and of new markets where no one sets in before (Friedman, 2005). T his is the essence of what is called Resilience. In basic sense, Resilience is an attitude, which is directly co-related with an individual’s development and well-being. When the mind and the body are strong enough to face the wicked wind of stress, downfall, impossible deadlines, unpredictable changes and the unsaid agitation of personal or organisational instability; it is rest assured that the person is conjuring the power of Resilience, the power of fighting odds thus to set a harmony. In surge of increasing the organisational bottom line most of the organisations have downsized their workforce leaving less people to do the work and following this retrenchment the core of people have been termed as the working wounded! The long-term effect of such occurring is known as the survivor syndrome; like soldiers left intact after a war and lurching guiltily on their survival. The modernization of human civilization led to innovation and adoption of improved technologies into our daily

RESEARCH PAPER Example | Topics and Well Written Essays - 1000 words

Research Paper Example Hence, it would be apt to apply a Marxist critical approach to any of the works of Shakespeare, and more so to Hamlet. The more traditional approaches towards literary criticism do coax and cajole the text to yield the innate meanings inherent in it. However, a Marxist approach towards the understanding of Hamlet, rather than delving on bringing out the hidden meanings, will rather try to approach the text as a material creation that needs to be understood in a historical context. To be able to interpret Hamlet in a Marxist context, the readers need to approach the theory wearing a Marxist lens that places a more than regular stress on as to how the characters affiliated to varied classes tend to interact with each other, particularly in the backdrop of the class oppression and the involving socio-economic inequity, and especially considering those words and dialogues emanating from any character that propose or are indicative of the rebellion against the upper classes. This is becau se form a Marxist perspective, the main element of interest will tend to be a determining base and then the determined superstructure imminent on it. In that context in the play Hamlet, the mannerisms inherent in the interactions between varied social classes, and the way the society is structured in the play indeed happens to be a strong driving force in the play (Joughin 57). In Hamlet one could indeed trace a strict representation of the avowed Marxist social classes that are the Aristocracy, represented by the royal family and the people of the court, which constitute the ruling class and make the pivotal socio-economic decisions in the play, the Bourgeoisie that are the characters that stand just below the aristocracy and earn a living by trading in the resources required by the other classes, and then the lowest class that are the Proletariat or the working class or the serfs that eke out a living by selling their labor and skills. There is no denying the fact that without muc h elaborating on the characters akin to each of the respective social class, it is amply evident in Hamlet that every character in it could be placed in one of the three Marxian social classes. The very first scene in Act I in Hamlet is replete with the indications of class struggle and thereby constitutes an ideal subject for a Marxian dissection. The scene begins by showing one of the guards on the palace walls relieving his colleague of the night duty. Now, in the times of Shakespeare, night watch was a work that was never assigned to the members of the upper class, and hence it could be concluded that the two guards, though being officers, hailed from the lower social strata. Irrespective of their mutual greeting of â€Å"Long Live the King!† which seems to evince their loyalty for the aristocracy, this loyalty seems to smack of falsehood and despair as no good member of the lower class made to perform the watch duty on a cold night will prefer to be so supportive of the upper classes who made one undergo such an ordeal. Hence, the truth that leaps forward is that perhaps Shakespeare happened to be an opportunist who simply could not help supporting and sustaining the socio-economic status quo of which he was a part of, that is, the monarchy,

Emerging ClassroomTechnology Research Paper Example | Topics and Well Written Essays - 1500 words

Emerging ClassroomTechnology - Research Paper Example One clear and concise field this has been exhibited is in the education sector where digitalization has been seen taking over the previously existing means of offering learning services in school settings. Some levels of instructions like the higher education may be slightly ahead of the others (elementary, secondary and high schools) in instilling and embracing such technology. The use of tablets in the classroom setting can be a critical and efficient technique as students pursue education. Owing to the fact that the tablets are portable, have an extensive display and easier input of data, these appliances are absolutely what people will have to look out for in the next five years especially in the high schools, targeting the adventurous teenagers (Rouse Margaret, July 2014). In the medicine-related subjects like Biology, students can conduct studies on bones just by zooming in and out the input high-quality images unlike taking a whole high school class for an unnecessary trip to a medical school. In the case of an educational field trip, the students can take pictures of some of the principal physical sources of information they would not want to forget. They can later view these images of high quality anywhere and anytime without necessarily having to travel back to the fields. The high school students too will enjoy live recording of the lectures in the next five years lest this technology is implemented. The students can watch some of the captured important steps a lecturer may be explaining, for instance, in a chemistry practical class where steps are important for scoring marks. Repeatedly watching these video clips can be more enjoyable and an easy to remember method of ideas. The tablet can also be useful when it comes to storage of books. It has enough storage space that can store a large number of written and published books alike within just an A4

Critical Thinking Essay Example | Topics and Well Written Essays - 500 words

Critical Thinking - Essay Example ver, recent years have shown the will of the two nations to come a peace agreement but political analysts have argued that the influence of outside forces is greater than their will to negotiate a peace deal. One significant external force directly linked to this conflict is the United States. The United States is perceived as a great ally of the Israeli nation. At the same time the nation is directly involved in the quest for peace in the region. In an argument by Citron (2006) the relationship between the United States and Israel is the greatest hindrance to a peace strategy between the Arab and the Israeli. The author further argues that the United States protects nuclear activities carried out by Israel but greatly condemn if any Arab nations use the same weapons. With this intervention, the quest for peace in the region has become an imagination that may never be achieved. It is also an obvious assumption that the Arab population has a significant level of hate against the United States. And their involvement in the conflict in the Gaza does not make the situation better. One could easily argue that the role of the United States in this particular conflict is to safeguard its interest and their diplomatic relationship with Israel. However, to their defense the United States government has on several occasions claimed that its involvement in the conflict is based on its responsibility to stop the use of dangerous nuclear weapons rejected across the globe. Additionally, its significance in the global political front puts the nation in a position whereby it has the obligation to act as the negotiator in this conflict. In an argument by Citron (2006) with the majority of the Arab nation against the role of the United States in the conflict, would it be better if the negotiating responsibility was given to a neutral nation? The same notion is shared by Maoz (2006) who argues that the Arab/Israeli conflict has been heightened by the constant interference of the

Yum Brands China Business Strategy Research Paper

Yum Brands China Business Strategy - Research Paper Example Yum Brands Inc. entered the Chinese market in 1987, considering the fact that during this period, the Chinese economy had rapidly grown after its liberalization. The company was one of the early players in the Chinese restaurants’ business, which has enabled it to establish its operations in the Chinese market firmly. The company’s entry into China has provided Chinese consumers with a new and unique dining experience, where they get customized and clean ambiance service. The Yum Brand Inc. business strategies have focused on menus that include both western and local consumables, with focus being directed towards offering customer preferences in each province. Business Strategies The business strategy of Yum Brand Inc. in China encompasses providing a variety of consumables, customer preferences, franchise relationships, and employing locals to key positions of the company. The company focused on strategies of employing locals in its key positions alongside delivering s ervices according to customer preferences, which vary from one province to another. The company also has established franchise relationships and built its own logistics and distributions network. Moreover, the company has been keen on its business strategy of developing new markets through establishing widespread restaurant chains in China division to increase its market share. Apparently, mainland China is Yum Brands’ leading market according to worldwide restaurant development (Enz, 2010, p.945). Internationally, the company has built a vibrant global entity by focusing on key business strategies such as establishing leading brands all over the Chinese market, driving aggressive expansion of the international market, and building franchise value and long-term shareholders for industry needs. The Company has built a unique business culture that is filled with exciting opportunities and energy for both employees and customers. According to executives, the company believes in the people, encourages ideas from all and sundry, and trusts in positive intentions of its people. Through this, the company has been able to bring about diversity in style in its business operations and consumables, considering that customer needs and preferences can be best met through diversity. In a bid to establish a huge market for base in the Chinese market, Yum Brands Inc. in Beijing sought to take over the Little Sheep Group limited, which operates a popular chain in China. This move is among the many global business growth strategies, which have seen the company penetrating and establishing its groping in the largest Chinese market. The Chinese market of casual dining was seen to grow expansively, which befits the Yum Brands move to grow beyond the chicken and Pizza market being concentrated on by Pizza Hut outlets and KFC. The company’s stake holdings in the Little Sheep limited operations have enable massive growth on foodservice operators’ growth. Mergers and take over strategies being put in place by the company have propelled its market penetration in China to greater heights, although government regulatory measures have limited its international bid. The Little Sheep Company has contributed to Yum Brand Inc’s great leap forward in winning in China market due to its widespread operations of the cuisine where patrons are able to cook meat and vegetables themselves. China’s great market embraced such kind of an idea with enthusiasm, and thus enabling Yum Brand Inc. to take root into the market. The market has since grown tremendously, with the company adding up its popularity by introducing consumables such as seafood-topped pizza and fried

Legalizing Prostitution Essay Example for Free

Legalizing Prostitution Essay â€Å"Prostitution may be the worlds oldest profession, and laws prohibiting prostitution may well be the oldest example of government regulation, government sex discrimination and overall government control. Recent research indicates that over one million women in the United States earn their living by full-time prostitution† (The Case for). Over half of the world’s population has experienced, participated or heard of prostitution. This shows that many people, buyers and sellers, are in some way a part of the prostitution profession, so for the United States government to ban prostitution for only a moral reason, and wasting hard working Americans tax dollars on fighting prostitution seems ridiculous and an overall waste of time. Since we live in a free society it makes no sense for the government to be telling people that they cannot charge a fee for harmless services. Such proof is why Prostitution should be legal. For more reasons than one, prostitution is popular in areas where the crime rates are very high, due to these police officers and courtrooms are overwhelmed with prostitution cases; which is very costly. Every other day there is a case about prostitution being brought in front of a judge and what does it do the business? , absolutely nothing. Just think about it, if prostitution were legal, police officers would have less work with trying to â€Å"eliminate† prostitution and more time protecting the community from the REAL crimes such as, murder, rape, and robbery. â€Å"It is estimated that if prostitution were legalized in the United States, the rape rate would decrease by roughly 25% for a decrease of approximately 25,000 rapes per year† (Prostitution and Sex Crimes). Other countries have already figured this out; it boggles the mind to why the U. S. just can’t get with the program. If prostitution were to become legal, it must be looked over and done in safe fashion, not just for the prostitute or employee but for the customer. Due to prostitution being illegal, it has been forced into the streets. Since most of these streets have high crime rates, this puts most of the prostitutes in danger. Prostitution thrives at night, it involves them getting into cars with strangers which is easy pickings for serial killers and other sociopaths who will cause them harm. America can look at European cities for a little bit of inspiration. In many European cities prostitution is allowed designated areas like brothels and areas called red-light districts. People who are interested in getting their â€Å"needs met† can go to one of these places where such acts are permitted. Therefore, the prostitutes can work in safer environments. Many Americans feel that allowing prostitution into society will increase the STD rates in the U. S. But in reality, it may help delete these huge statistics drastically. If prostitution was to be legalized and made a taxable business, there can be health and safety precautions made. Like mandatory STD checks and blood tests run on every single client and employee. This eliminates the fear of catching a disease slim to none. But if prostitution is still going to be illegal, then honestly the rates will continue to rise. Records show that the cities with the highest STD rates are Washington, D. C. , and New York City. â€Å"Prostitution is an institution of male domination and exploitation of women. †(Raymond) Men coming in willing to buy â€Å"favors† from these women means actually puts them on a pedestal. It shows that women still have the say so in society, in life, and in a â€Å"man’s world†. But people seem to forget the males roll in all this. â€Å"Research, programs, and legislation related to sex trafficking are often premised on the invisibility of the male buyer and the failure to address men’s role in buying and abusing women in prostitution. †(Raymond) None of this can be done without a man. But still, it seems that everyone wants to place the blame on the prostitutes who are simply just doing their job. So it’s safe to say that there is some kind of a double standard that is related to this matter. Human beings as a species always want to destroy something that they can’t really understand. The people who are trying to get rid of and/or ban prostitution do not know the person’s situation. This could be all they have left in order to supply for their family. But if the prostitute is willing to face these acts, then let them. It’s their life. A sensitive issue to some, but it’s an issue nonetheless. Prostitution is something that isn’t just going to go away. Why political leaders are trying to ban/abolish it is mind boggling. Since pretty much the beginning of time prostitution has been broadcasted to the world; it was never a secret. But the media describes it as something that is just plain wrong. But the real question is why? Many opinions are based on personal preferences and moral reasons, which shouldn’t be a deciding factor on such a broad and debatable topic. The media shows how media how prostitution is wrong, but little do they know it’s showing why it should be legalized. Prostitution is defined as the engaging in, or agreeing to engage in, sexual conduct for a fee. Women are pushed into entering prostitution for many reasons including lack of education, poverty, and personal choice. Prostitution is currently illegal, but there is much controversy surrounding this issue. â€Å"There are approximately 1. 3 million prostitutes in the United States today. However, there is only an arrest figure of about 100,000 prostitutes in 1995, and the number of arrests has been fairly consistent since then. The General consensus has shown that law enforcement has been generally ineffective in the removal of prostitution from our society. †(Prostitution Policy) There are many people involved in prostitution, seventy percent of which are female, twenty percent male, and ten percent customers. Quite a large amount of citizens are actively fighting against prostitution. On the opposed side, many are fighting to legalize it. â€Å"Legalized prostitution cannot exist alongside the true equality of women. The idea that one group of women should be available for men’s sexual access is founded on structural inequality by gender, class and race† (Argument). This is an example of something that has changed drastically. Nowadays women seek prostitution as an option to provide . Although some are forced into this lifestyle, one has to think of the â€Å"what if’s†. For example, a mother has a child that is starving and finding a legitimate job just isn’t an option for her right now; what is she to do to provide for her child. Well, it seems that the only realistic thing for her to do is to let the child starve. A bit harsh an unreasonable, but so is banning something that just isn’t going away. Different methods have been expressed to find a way to get rid of this â€Å"crime†. But desperate times call for desperate measures. Since Prostitution is single handedly the biggest slap in the face to America, how about we send every single person who knows and/or participated in prostitution to jail for life. Seems legit and fair; these people have done the unthinkable and they should be punished. Now that over a million people is in jail for sex that leaves the police to fight the real criminals. For example, murders, killer’s, thieves, and can’t forget about child molesters. We will leave these people in the streets because they just don’t compare to disgusting and vile life of a prostitute. â€Å"With the new law legalizing prostitution, it would make it easier for the government to regulate. In past centuries, it is not hard to find news about selling women to be prostitutes on the black market or minors stepping into this business before being mature enough to figure their lives out†( The Present Is). Sadly, no one could really stop the problem since all of these actions were taken underground. Setting up new laws regarding the prostitution issue, brothels would have to be licensed which would make it easier for the government to monitor and prevent forced prostitution. It may seem like a wild idea; but think about the jobs that prostitution could bring to the economy, its already booming in the underground world. An extreme alternative but a job nevertheless. That struggling mother could provide for her child or her family or he/she could do it for their own â€Å"personal† reasons, either way it’s their body. Who is America to tell them what they could do with it. It could open up more nursing positions due to the fact that a strict and mandatory STD screening will be given to each customer. It could also open up other secretarial positions because someone is going to have to keep track of who’s doing what with who. Making this a business isn’t â€Å"all† about sex; it can actually provide jobs for people who need it. For the media, prostitution never shows any pros about the matter, but always finds a way to express the cons. In figure number one, you can see a little girl with an aged face lying in a bed next to a grown man. Many would say that this is the exact reason why prostitution should stay the way it is; illegal. But think about it, if allowing prostitution to be legalized then the disgusting sex trafficking â€Å"business† would soon vanish. In figure number two, it shows an American Flag with the words, â€Å"Sex Worker Rights Are Human Rights. † This is obviously an ad that agrees with legalizing prostitution. The American Flag is displayed to show what America stands for; which is for equality for all. If a person decides to sell his/her body for money, then let them. For example, guns are allowed in America, despite what the government is trying to do right now, guns are allowed. Taking that away from users is taking away their human rights and their constitutional rights as well. Same thing with prostitution, a person may feel as if what they are doing is their personal preference which falls into human rights. In other words; let these people live. In conclusion, prostitution is an underground business that isn’t going to go away. It’s something that isn’t going to go away. The government, once again, is trying to control the way we choose to live our lives. Everyone has rights of their own and its up to them to figure out what is right and what is wrong. Prostitution goes back to the ancient times and has still been a thriving business to this day. Nothing is going to change that; nothing.

Compare Macbeth to a Film Adaptation Essay Example for Free

Compare Macbeth to a Film Adaptation Essay In William Shakespeare’s â€Å"Macbeth† the audience witness’s one man’s overriding ambitions to his iconic fall. Shakespeare makes a point of showing the deterioration of the Macbeth that entered the stage in Act 1 and the Macbeth that dies in act 7, showing that even the deep morality and honesty of a man like a man can worsen into a man who is willing to kill his own King – a deadly sin in Shakespeare’s 17th century. Throughout my piece I shall make unifying links between the adaptation directed by Mark Brozel and the original text wrote by none other than Shakespeare. For the period of Act 1, Scene 2, Macbeth is hailed as the very heroic and brave â€Å"Worthy gentleman!† who â€Å"carved out his passage Till he faced the slave;† this suggests two points already, the fact that Macbeth is a graceful fighter who elegantly â€Å"carved† his way through the battle which also suggests that he is as much a perfectionist in the play as he is a cook in the adaptation. The perfection we see in the play is the perfection of murder, how he kills people so wonderfully and gracefully without any shame. Whereas the adaptation shows a more remorseful Macbeth, it pains him to kill animals inhumanely and uses a less murderous way when he has to, he cooks for perfection also, and before his breakdown at his restaurant he refuses to serve the food late when it was ready at the time, saying â€Å"you can’t keep perfection under the light†, only a perfectionist would inherit such a trait. Plus, he mentions that †the first rule in the kitchen is respect†. In Act 1 Scene 3, you begin to see Macbeth’s character really emerge. In the play Macbeth is intrigued by the witches, this highlights two point, he wants to know more â€Å"Stay, you imperfect speakers, tell me more† for the reason of asking more questions, because the idea has been proposed that he shall be king and Cawdor. However Joe Macbeth laughs at the idea of being the head chef at his Duncan’s restaurant, he finds it delusional and this is the main difference between the two. The Play’s Macbeth is already showing signs of being delusional from the â€Å"aside† side notes but the Macbeth of the adaptation is calmer, more collected. Macbeth battles with himself to then only later write Lady Macbeth a letter telling her all about what has happened. This is because Macbeth in the play is very insecure Macbeth; he is so overrun by the idea that he can be king he begins to speak to himself as â€Å"aside† followed by the quote of â€Å"Gl amis, and thane of Cawdor! The greatest is behind† showing his yearning for power and how his desires, in this case the desire to even have a chance of being king, suddenly take control of his actions and this becomes his tragic flaw. It prevents him from becoming aware of when to stop and think about the consequences; alternatively the Macbeth in the film is more aware of his actions, when forced to fire his two chefs he does so but his guilt consumes him, he realises the tragic outcome of his actions and how his two employees won’t be able to follow their dreams, so he all willingly gives them a large sum of money, this is something the play scripts Macbeth would never do, because he is unaware of the outcomes of his actions. The second point is how intrigued Macbeth is in the play when he is proposed with the idea of becoming the Thane of Cawdor and the King himself; he doesn’t plan the death of Duncan because, to build on my point earlier, he doesn’t want to kill Duncan, Duncan is aware of how morally wrong it is and the guilt that will live with him. He is just interested by the idea of being the King and Duncan just happens to be in his way. His motivation is fuelled by desire and ambition, however what you see in Joe Macbeth is different – Joe, when proposed with the idea of being head chef laughs, but soon gains interest later, but the interest is because he would get to kill Duncan and this is shown by the jealous looks given at the beginning of the play, his motivation is fuelled by jealousy. Joe Macbeth even before considering the idea of being head chef starts to plan Duncan’s murder, this is evident in the scene where Duncan takes Joe Macbeth aside and Joe tells Duncan â€Å"the chance of you being run over by a bus are zero† this shows that Joe has started considering the idea of it happening even before telling Lady Macbeth about the witches prophecies or taking into account the idea of being the head chef. In the play Macbeth seems to be in awe of King Duncan, Macbeth feels any work done on the request of or for Duncan is not work at all, but duty, Macbeth admires Duncan as a King and respects him as I quote â€Å"The service and the loyalty I owe In doing it pays itself. Your highness part Is to receive our duties, and our duties Are to your throne and state children and servant† (Act 1, Scene 4) Macbeth and Duncan have a respected relationship, one where they are grateful of each other and admire one another in the first Act, this makes the murder of Duncan even harder and that’s why he chooses to murder Duncan at night. His hand can commit the murder without his eye having to witness it. Somehow this will make the guilt and betrayal less. Macbeth changes throughout as his character develops, in comparison to the relationship between Duncan and Macbeth in the film adaptation is to a certain extent, unalike. When asked about a recipe of Duncan’s Macbeth replies with a jealous voice â€Å"yes, that’s mine† the relationship between Duncan and Joe Macbeth is strained. Joe knows he is the reason the restaurant is so successful and it pains him to lose credit where credit is due .Joe is envious of Duncan, this is confirmed through the first confrontation between the two and how Joe uses only â€Å"Duncan† as a greeting, to represent his cold emotionless feelings towards Duncan.

Mental Health Illness and Stigma Literature Review

Mental Health Illness and Stigma Literature Review 1. Introduction 1.1 Mental illness and stigma Inequalities in health services delivery and utilization for people with mental illness has been widely documented.1 Subsequently this results in poorer outcomes for this population in regard to general health, such as circulatory diseases, mortality from natural causes, and access to interventions .2-4 Several issues have been identified as contributing to these disparities in health service access and delivery, including stigma.5-6Stigma associated with mental illness has been defined as negative attitudes formed on the basis of prejudice or misinformation that are triggered by markers of illness.1-5Illness markers include atypical behaviours, the types of medication prescribed and noticeable medication related adverse effects.5-7These markers allow for the continuation of stigma concerning people with mental illness, but they also allow community pharmacists to identify patients with a broad range of what are often unaddressed health related needs.1 Behavioural and mental disorder s are estimated to account for 12% of the global burden of diseases. Mental health related medications account for >10% of all medications prescribed by general medical practitioners8, therefore, it is an inescapable fact that community pharmacists must interact with patients suffering from mental health problems.9 Mental illness is relevant to practising pharmacists who can play vital roles in the treatment of patients with mental illness.10 Throughout the latter half of the previous century, the diagnosis and pharmacological treatment of mental illness improved radically.9 1990-2000 was proclaimed the Decade of the Brain. to promote the study of disorders of the brain, including mental illnesses.11 Despite these advances, the stigma associated with mental illness remains a compelling negative feature in society.10 Unfortunately health care professionals, including pharmacists are not invulnerable to such harmful attitudes.9 Pharmacists attitudes toward mental illness and the menta lly ill are extremely important because they can affect their professional interactions and clinical decisions.12-13 In addition, they could ultimately affect the delivery of pharmaceutical care which has been defined as the pharmacist assuming the responsibility for positive patient outcomes.14 Activities like medication counselling and monitoring of therapy have been documented to improve both satisfaction and adherence to drug therapy in patients with mental illness.15 It has been pointed out that pharmacists must become more involved in such activities for patients with mental illness.9 1.2 Optimising the use of medications for mental illness Community care offers many advantages over institutional care; however, it can place extra demands on family, friends and primary health care practitioners.16 Health professionals have identified people with mental illness as the most challenging patients to manage.8 The quality and accessibility of community care for people with mental illness needs to be improved.17 The appropriate use of medicines plays an imperative role in the effective management of mental illness, nonetheless, there is evidence that psychotropic medicines are often used inappropriately.18-19 Elderly people are especially susceptible to the effects of psychotropic medicines, and may experience adverse effects such as cardio toxicity, confusion and unwanted sedation .8 Contributing factors to the high rates of non-compliance to psychotropic medicines include, psychosocial problems, the emergence of side effects, and the delayed onset of action of anti-depressant medication.20-21 Medical co-morbidity is also comm on, and polypharmacy increases the risk of medication misuse and drug-drug interactions.22 The World Health Organisation (WHO) has indicated that the inclusion of pharmacists as active members of the health care team can improve psychotropic medication use.23 The benefits of dynamically engaging mental health service users in their own management is supported by both clinical experience and research evidence.24 A systemic review of the role of pharmacists in mental health care, published in 2003, concluded that pharmacists can bring about improvements in the safe and effective use of psychiatric medicines.23 The wide range of pharmaceutical services provided by community pharmacists are potentially well suited to assisting patients and prescribers optimise the use of medications for mental illness.8 2. Method 2.1 Literature search strategy Pubmed (1965-March 2010), International Pharmaceutical Abstracts (1970-March 2010), Embase (1974-March 2010), Cinahl (1981-March 2010) and Psychinfo (1972-March 2010) were searched using text words and MeSH headings including: community pharmacist.s, pharmacist.s, pharmaceutical care, pharmaceutical services, mental illness, mental disorders, stigma and mental illness, mentally ill persons, depression, schizophrenia, bipolar disorder, psychotic disorders, psychotropic drugs, antidepressive agents, benzodiazepines, anxiety agents and antipsychotic agents. ~550 abstracts were read. Reference lists of retrieved articles were checked for any additional relevant published material. Exclusion criteria included articles not published in English, no service provided by pharmacists, not relevant to mental illness, and studies and surveys that were carried out to evaluate pharmacist.s services in hospital inpatient or acute care settings. The literature search identified 88 papers that reporte d or discussed community pharmacist.s involvement in the care of patients with mental illness. 2.2 Inclusion criteria and review procedure For section 3.1 of the discussion, studies and surveys conducted into the attitudes of community pharmacists toward mental illness and the impact of stigma were considered. The literature review procedure for section 3.2 of the discussion, which deals with optimising the use of medication for mental illness, differed from that of 3.1, as studies without control groups, results of postal surveys and qualitative interviews were excluded. Studies with a parallel control group that reported the provision of services by community pharmacists in community and residential aged care facilities were considered. This included trials specifically conducted for individuals with a mental illness, and studies of medication reviews and education initiatives to optimise the use of medication for mental illness. Papers that reported pharmacist.s interventions in nursing homes were included, because community pharmacists frequently provide services to nursing homes. Studies of pharmacist.s activities as part of multi-disciplinary teams were also included. The literature search identified 57 papers that reported or discussed community pharmacy services to optimise the use of medications for mental illness. 3. Discussion 3.1 Mental illness and stigma While the views of the public9 and of certain health care professionals25 and health care students26-28 toward mental illness have been well documented over the years, there are limited numbers of investigations accessing community pharmacists and pharmacy student.s attitudes. Crimson et al.12 examined the attitudes of 250 baccalaureate pharmacy students toward mental illness, Phokeo et al.29 studied the outlook of 283 community pharmacists toward users of psychiatric medication, Cates et al.9 detailed the attitudes of community pharmacists toward both mental illness and the provision of pharmaceutical care to patients with mental illness, and Black et al.1 studied the satisfaction that patients with mental illness have with services provided by community pharmacists. 3.1.1 Community pharmacist.s attitudes toward patients with mental illness In general, pharmacists express positive, unprejudiced attitudes toward mental illness,1, 9, 29, 30 and overall they show encouraging attitudes toward the provision of pharmaceutical care.9 Phokeo et al.29 reported that pharmacists feel uncomfortable inquiring about a patient.s use of psychiatric medication and discussing symptoms of mental illness compared to the medication and symptoms associated with cardiovascular problems. Pharmacists also monitor patients with mental disorders for compliance and adverse effects less frequently than patients with cardiovascular problems. Crimson et al.12 found an association between a personal or family history of mental illness and attitudes of pharmacists toward mental illness. Age and years in practice are also connected with attitudes toward providing pharmaceutical care to patients with mental illness. The older and more experienced pharmacists have more encouraging responses than their counterparts.9Pharmacists are of the opinion, however, that patients with mental illness do not receive adequate information about their medication from their physicians. These patients may also receive less attention from pharmacists compared to medically ill patients, which raises concerns that their drug-related needs are not being met.29 3.1.2 Patient.s attitudes toward community pharmacists Consumers of mental health services generally have a positive perception of community pharmacists and their services, however, expectations are limited to standard pharmacy services, like providing patients with information about their medication and resolving prescription issues when dispensing medications.29 The majority of patients feel at ease while discussing their psychotropic medication and related illnesses with pharmacists.31 Clinically orientated services like working collaboratively with other health care providers, making dosing or treatment recommendations, monitoring response to treatment, and addressing the individuals physical and mental health needs have been found to be unavailable to patients.32 Patients with mental health problems, expectations of community pharmacists are low, and do not match the services that they can provide.33 Although stigma has been perceived to be similar with other health care professional, Black et al.1 revealed that 25% of patients with mental illness have experienced stigma at community pharmacies. 3.1.3 Substance misuse The prevalence of coexisting substance misuse and mental illness (dual diagnosis) has increased over the past decade, and the indications are that it will continue to do so.15 A patient with both a mental illness and a substance misuse problem can face prejudice and stigma from health care professionals, who might question the capacity of dually diagnosed individuals to respond to care.34 A Canadian survey into the attitudes of community pharmacist.s toward mental illness showed that only 55% of respondents agreed that substance misuse is a mental health problem. This finding reflects the perception that addiction represents poor self control or is a self inflicted problem.29 Over recent years, the capacity to intervene pharmacologically in substance misuse has increased greatly, pharmacotherapy is now available for opiate, alcohol and nicotine misuse.19 Some psychiatric patients with comorbid substance abuse achieve stabilisation rapidly, furthermore, severe mental illness does not necessarily predict worse outcomes.35 Socio-economic and emotional aspects are the main challenges to recovery, and case management in the context of integrated community and residential services has been shown to increase medication compliance over time.36 The contribution that community pharmacists have in the management of substance abuse has been well documented.37 Most general psychiatrists are only in the position to give patients 5-10 minutes of brief advise or intervention regarding a substance misuse problem,38 whereas community pharmacist.s are easily accessible to the public and are in a central position to provide specific advice about substance misuse.37 Community pharmacists currently provide dispensing services to drug addicts,38 and they are also the first point of contact for people misusing substances who are not in touch with the substance misuse services.39 3.1.4 Overcoming the barriers created by stigma Studies have indicated that patients prefer to go to the same pharmacy for their medication and other pharmacy needs and a significant number of patients favour to interact with the same pharmacist, which suggests that the relationship they have with their pharmacist plays an imperative role in their health and well being.1 A lack of privacy from failure to use an available private counselling room in the pharmacy contributes to patients feelings of discomfort regarding talking about their medication and their illness.31 Pharmacists are trained to educate and support patients regarding psychotropic medications, including how a drug works, monitoring for treatment response and adverse effects, and guiding patients through the process of stopping treatment, however, there are inconsistencies in the provision of these services.29 The potential for discrimination and stigma in community pharmacies has been well documented and initiatives to improve exposure of pharmacists to persons with mental illnesses in practice and in training has been suggested.23, 29 Pharmacists experience an increased level of discomfort in this therapeutic area as they receive inadequate undergraduate training in mental health.9 Adequate training in mental health is needed to improve the professional interactions of community pharmacists toward users of psychiatric medication.1 3.2 Optimising the use of medications for mental illness Community pharmacists are one of the primary health care providers in the community and have the opportunity to influence patient.s perception of their mental illness. Patients are far less likely to adhere to medications for mental health problems outside the hospital setting. Community pharmacists can significantly contribute to optimising medication use in mental illness through counselling, 40-42 patient education and treatment monitoring, 43-36 medication review services, 30, 47-49 pharmacotherapy meetings with general medical practitioners, 50-54 delivering services to community mental health centres and outpatient clinics,55-57 improving the transfer of information between health care settings,58-60 and being active members of community mental health teams.61-63 3.2.1 Counselling services In the Netherlands, three studies were carried out to highlight the impact of community pharmacist.s medication counselling sessions for people commencing non-tricyclic antidepressant therapy.40, 42 Intervention patients participated in three consecutive counselling sessions which lasted between 10 and 20 minutes each. They also received a take-home video that reiterated the importance of adherence. Throughout the counselling session, pharmacists informed patients about the appropriate use of their medications, which included, providing information about the benefits of taking the medication, informing patients about potential side effects, informing patients about the onset of action for antidepressant medication and explaining the crucial importance of taking their medication on a daily basis. Medication compliance was measured using an electronic pill container that recorded the time and frequency that the cover was opened.41 At the three month follow up the intervention patients had significantly more positive attitudes compared to the controls.40 At six months greater medication compliance was observed with the intervention patients that remained in the study25 55, also apparent improvements in symptoms were noted.41 Research on adherence shows that the patient.s knowledge and beliefs about the benefits of adhering to their medication regime plays a critical role in compliance.64 Non-adherence is not an irrational act but rather a product of poor communication.65 Patient compliance to health care recommendations is more likely when communication is optimal.66 The results of these studies indicated improvements in depressive symptoms,41 more positive attitudes,40 and better compliance to their medication.42 A limitation of this method was that the same pharmacist provided counselling services to both the intervention and the control group. As the intervention studied was multifactorial, it is inconclusive whether the three face-to-face counselling sessions or the take home video were primarily responsible for changes in drug attitude, adherence and the symptom scores.40-42 3.2.2 Patient education and treatment monitoring Four studies have reported results from pharmacist conducted patient education and treatment monitoring services for people prescribed antidepressant medications in the United States.43-46 These services involved the pharmacist taking a medication history, providing information about the prescribed antidepressant medications, and conducting telephone and face-to-face follow-ups. In two of the investigations, one of which was controled43 and the other randomised controlled, 62 medication adherence was calculated by reviewing prescription dispensing data, and reported using an intention-to-treat analysis. Both studies also demonstrated that involvement of the pharmacist was associated with a decrease in the number of visits to other primary health care providers; however, statistical significance was only achieved in one of the studies. Improved adherence to antidepressant medication was reported in both studies, 43-44 although patient satisfaction was only evident in one.44 The other two studies were randomised controlled.45-46 One of the studies was conducted using a self administered health survey,45 while in the other study antidepressant adherence was measured by asking patients how many times a day they took their medication in the past month. The results obtained from these investigations45-46 showed that patients who were taking their medication at the six month follow-up exhibited better antidepressant compliance and improved symptoms. However, antidepressant adherence and depression symptoms scores were similar for both the intervention and control group.46 Given the high rates of antidepressant discontinuation during the first three months of treatment, pharmacists have a potentially crucial role in providing medicines information and conducting treatment monitoring for those patients at high risk of non-compliance. Studies need to be conducted to compare outcomes of pharmacist.s treatment monitoring of people commencing antidepressant medication and o ther health professionals monitoring.8 An investigation into the impact of nurses treatment monitoring, also demonstrated improved medication adherence.67 3.2.3 Medication management reviews Pharmacist conducted medication management reviews are crucial in identifying potential medication related problems among people taking medications for mental illness.8 Medication review services provided by pharmacists comprise of comprehensive medication history taking, patient home interviews, medication regimen reviews, and patient education.68 A randomised controlled study of pharmacist conducted domiciliary medication reviews was carried out in the United States. The patients involved in the study were individuals living independently in the community that were identified to be at high risk of medication misadventure. The results showed a significant decline in the in the overall numbers and monthly costs of medication, however, there was no major difference in cognitive or affective functioning between the intervention and control group. The majority of patients were unwilling to follow the pharmacist.s recommendations to discontinue benzodiazepines and narcotic analgesics.47 The great potential of pharmacist conducted medication reviews for people with mental illness may not be limited to optimising the use of mental health medication.8 Physical health care for people with mental illness is generally less than adequate. This is caused by the tendency among health professionals to focus solely on the management of the mental illness among people with both mental and physical illnesses. Pharmacist conducted medication reviews may be a comprehensive strategy to improve medication use for both mental and physical illness.68 3.2.4 Medication management reviews in nursing homes Older people who are cared for in nursing homes are arguably the most vulnerable patient group, and the useful contribution that pharmacists can make to the care of these patients has been documented.30 Older people are particularly sensitive to the effects of medication,69 regular use of psychotropic medication is associated with an increased risk of recurrent falls,70 and also long term usage is linked with tardive dyskinesia.71 Psychotropic medication use may also be connected with an increased rate of cognitive decline in dementia.72 The beneficial effects of psychotropic medication must be balanced against extrapyramidal and other side effects.73 In 1995 it was reported that psychotropic drug use in Australian nursing homes was 59%, although this figure has fallen in recent years.74 In Ireland, 19% of older people in nursing homes were reported to be taking phenothiazines,75 however, this figure is lower now following a tightening of the licensing indications of thiordazine. In the England, a study showed that 30% of residents in nursing homes were taking antipsychotics.76 Two studies have looked at the appropriateness of psychotropic medication prescribing in the United Kingdom. In Scotland antipsychotic medication use in nursing homes is 24%, it was found that 88% of these prescriptions were inappropriate if the United States criteria for use were applied. In England, 54% of prescriptions were found to be inappropriate according to the United States criteria.77 A study conducted in Denmark suggested that behavioural problems were a determinant for the use of antipsychotics and benzodiazepines, irrespective of the psychiatri c diagnosis of the resident.78 A randomised controlled study of pharmacist-led multidisciplinary initiative to optimise prescribing in 15 Swedish nursing homes was carried out. The study involved pharmacists participating in multidisciplinary team meetings with nurses and physicians at regular intervals within a 12 month period. A significant decline in the use of antipsychotics, benzodiazepines and antidepressants by 19%, 37% and 59%, respectively was observed in the intervention facilities.79 A follow-up investigation of the same intervention and control facilities three years later indicated that the intervention facilities maintained a significantly higher quality of drug use, with far fewer residents being prescribed more than three drugs that could lead to confusion, not-recommended hypnotics and combinations of interacting drugs.48 An additional randomised controlled study showed that pharmacist.s medication reviews in residential care facilities demonstrated significant reductions in the number and cost of medications prescribed. 10.2% fewer residents were administered psychoactive medications and 21.3% fewer hypnotic medications. The impact of medication reviews on mortality was also measured and a noteworthy reduction was observed.49 One study indicated that one hour per week of a pharmacist.s time can make a significant contribution to patient care in nursing homes. It was found that this input was well received by nursing staff and prescribers and that general medical practitioners accepted the pharmacist.s advice in 78% of cases.30 Physician.s recognition was 91% in south Manchester, where 55% of interventions resulted in treatment modifications. Community pharmacist.s in Northamptonshire analysed prescriptions of nursing home residents and provided prescribing advice to general medical practitioners. The advice was accepted in 73% of cases and it was estimated that pharmacist involvement could give a 14% reduction in the cost of prescribing.69 A randomised controlled trial in 1 4 nursing homes in England showed that a brief medication review reduced the quantity of medication overall with no detriment to the mental and physical functioning of the patients.58 A reduction in the use of primary and secondary care resources by pharmacist medication review services has also been shown.80 The recommendations provided by pharmacists included stopping and starting medicines, generic substitution, switching to another medicine, dose modification, changes in administration frequency, formulation change and requests for laboratory tests or nurse monitoring.30 Almost 50% of the recommendations were to stop medication and 66% of these were due to the fact that there was no indication for the drug prescribed. This suggested that medication regimes were not reviewed. Conversely, initiation of a new drug made up 8% of recommendations, which implied that indications were present but not always treated76. Pharmacists have an important part to play in multi-disciplinary heal th teams and they must be integrated into any proposed models of care. Nursing home residents are a vulnerable group of patients who deserve the same high-quality clinical care as people of any age living at home.30 3.2.4 Pharmacotherapy interventions to optimise prescribing Pharmacist.s educational visits to general medical practitioners have been shown to modify prescribing behaviour.54 Four studies have evaluated the impact of pharmacists educational visits to general medical practitioners to optimise the prescribing of benzodiazepines and other psychotropic medications prescribed for mental illness,50-53 two of which showed positive results.52-53 A cluster randomised controlled study carried out in the United States found that pharmacists educational visits to general medical practitioners were associated with a significant decline in the prescribing of potentially inappropriate psychotropic medications in intervention facilities.53 An Australian study of educational visits to general medical practitioners, conducted by three physicians and one pharmacist resulted in a noteworthy decline in the prescribing of benzodiazepines.52 In the Netherlands, groups of local pharmacists and general medical practitioners conduct inter-professional meetings to optimise prescribing. These pharmacotherapy meetings are undertaken as part of routine clinical practice. A cluster randomised study of pharmacotherapy meetings to discuss prescribing of antidepressant medications resulted in a 40% reduction in the prescribing of highly anticholinergic antidepressants, compared to a control group of practitioners that did not partake in these meetings39. The possible awareness of prescribing related issues generated by asking general medical practitioners to conduct a self-audit of their prescribing caused this overall reduction.52-53 Additionally, pharmacist.s initiatives to improve prescribing are most effective when both pharmacists and general medical practitioners have an opportunity to build rapport.39 3.2.5 Community mental health centres and outpatients clinics Two studies were carried out to investigate the effect of pharmacist delivered services to community mental health centres and outpatient.s clinics.56-57 In a controlled trial, pharmacists managed patient cases in a community mental health centre in the United States. Significantly better personal adjustment scores were observed from patients receiving case management from a pharmacist in comparison to those receiving it from a nurse, social worker or psychologist.56The patients also rated themselves as healthier and were considerably less likely to seek help from other health care providers. The medication service provided allowed the pharmacist to adjust medication doses and dose timing, and prescribe or discontinue medications under supervision. The cost effectiveness of incorporating a pharmacist as part of the health care team was also measured. It was estimated that a 60% cost reduction can be achieved when medication monitoring is conducted by a pharmacists instead of a clinic psychiatrist. The pharmacist also performed more medication monitoring of patients per month than the clinic psychiatrist and had more contact with each individual patient .56 In Malaysia, a study of patients discharged from hospital after admission for relapse of schizophrenia, who were identified as having poor medication adherence were allocated to receive pharmacist medication counselling or standard care.57 The importance of compliance to medication was also reinforced by the patient.s psychiatrists at follow up visits. At the 12 month follow-up, patients receiving counselling from a pharmacist and who were exposed to daily or twice daily medication treatments, had significantly fewer relapses that required hospitalisation than patients receiving standard care.57 3.2.6 Integrated mental health services The needs of people with recurrent, severe mental illness fluctuate over time and services must be coordinated, and be able to anticipate, prevent and respond to crisis. Integrated mental health services across primary and specialist services should promote early interaction and allow the provision of continuous care to meet patients needs.58 Prescribed medication is an important component in the successful management of mental illness. Accurate information should be transferred seamlessly between primary and secondary sectors to ensure the optimum care of these patients.59 The simple delivery of information to community pharmacists regarding drugs prescribed at discharge enables comparison with general medical practitioners prescriptions and any discrepancies can be followed up and resolved.82 Discrepancies that may occur can be described as any changes observed between supplies of prescribed drugs, including a wide spectrum of observed events.83 These can range from simple changes between supplies of prescribed drugs to more complex errors that might result in adverse reactions.60 This information transfer enables a cost-effective reduction in all unintentional discrepancies, including those judged to have significant adverse effects on patient care.58 An investigation that evaluated the impact of providing mental health patients with a pharmacist generated medication care plan at the time of discharge found that patients with care plans were less likely to be readmitted to hospital than those without. Information contained in the care plan included l ists of discharge medications, a summary of the patient education that was provided, and the potential adverse effects that need to be assessed. Community pharmacists who received copies of the care plan were also more likely to identify medication related problems for the discharged mental health patients than those pharmacists who were not provided with copies of the care plan, however, the results from this study are not significantly significant.57Other methods of transferring information such as electronic transfer have the potential to be of value in this patient population.84 People with mental illness have complex needs which are not recognised by organised boundaries.58When discussing discharge and after-care in the community, medication management must be prioritised.85Mentally ill patients are vulnerable and medication is a vital part of their well being. It is therefore essential that an accurate transfer of information between care settings minimises the potentially har mful discrepancies that can occur. Community pharmacist.s interaction in this area could prevent such incidents.58 3.2.7 Community mental health teams Most people with bipolar mood disorders and psychotic illnesses in the United Kingdom and Australia are managed by interdisciplinary community mental health teams (CMHTs).86 The potential benefits of greater involvement by pharmacists in CMHTs have been documented and debated for over 30 years.87-90 The majority of clinical team meetings conducted by CMHTs do not involve a pharmacist. A review of CMHTs in New South Wales found that just 1 in 5 had a designated pharmacist.91 Pharmaceutical care programs provided by phar