Tuesday, December 31, 2019

Cross Cultural Managers

Sample details Pages: 17 Words: 5222 Downloads: 2 Date added: 2017/06/26 Category Statistics Essay Did you like this example? Cross Cultural Awareness Task 1 Don’t waste time! Our writers will create an original "Cross Cultural Managers | Management Dissertations" essay for you Create order The FIVE most important competencies for managing internationally in my country, Hong Kong, for these three American managers of TDS are: Interpersonal Skills If this is not the most important skill of all, it is the crucial one. This skill helps the expatriate managers to establish relationships, coordinate with others, satisfying the needs for friendship and intimacy when they are abroad. It also helps in building trust and form relationships with the people around them. The expatriate managers are often experiencing uncertainties and getting stressed when dealing things with work and personal life in a new environment. So with good interpersonal skills will be able to reduce the stress coming from every angle. Referring to a recent book (Schneider Barsoux, 2003, 190-1), the primary selection of many companies for the expatriate managers in practice is their track records on reaching their targets or getting their jobs done. Companies also would like to send those that are eager to climb further on their career ladders or those with technical or conceptual abilities instead of those with interpersonal skills abroad. These expatriates are often too focused on their personal agenda to make things happen and ignore the pressure that are given to the local staffs which would create tension at work. Moreover, feelings of mistrust and resentment of the local staffs towards the head office will also be exacerbated. Therefore, interpersonal skills should be taken into account when the American managers are being chosen to manage in a foreign country like Hong Kong. Motivation to live abroad It is a key factor for the expatriate managers and their families to adapt into the local culture successfully (Schneider Barsoux, 2003, 192). Basically they should have real interests in the country they will live in, in order to have the curiosity to get to know it better and experience it well. It is the desire that makes them easier to understand the culture with ease. Patience and respect Different countries have different cultures so it is necessary that the international managers have the patience and respect when dealing with the new culture. It takes time to cope and learn the differences between the culture at home and the culture of the new place so the international managers should be patient (Schneider Barsoux, 2003, 193). They also need to have respect for the local of how the things happen in some ways when dealing with different circumstances in any aspects. Cultural empathy This is a not skill that can be easily acquired because it is deeply rooted in someones character to have the mentality of empathy for others with cultural differences (Schneider Barsoux, 2003, 193). It is required in order to respect the local staffs by the international managers to be a good listener to focus on what they have to say. Being non-judgmental is also important for those managers to be able to understand others points of views. The psychological development of a human being allows narcissism to be evolved to a point that interfere the capacity for empathy (Kets de Vries, M. and Mead, C. 1992). Managers that are narcissistic usually are self- centred and think that others are paltry or just the extensions of their own. They make the values of others hard to be recognized, let alone appreciate, because they see others as objects or tools for them to get what they want in order to achieve their goals and they also think of others as the mirrors to reflect their own glory. This type of managers would use all their efforts to prove their worth instead of considering the needs and the existing values of the other staffs. Flexibility, tolerance for uncertainty and ambiguity These managers also need to have the flexibility, tolerance for uncertainty and ambiguity. Changing circumstances that are unexpected makes the managers face with thread of uncertainty and ambiguity because the reactions and the behaviors of the local staffs may be unpredictable. Managers are intended to reinforce greater controls and restrict on the information flow when they face this kind of tread especially during an international assignment (Schneider Barsoux, 2003, 192-3). It often results in a stereotypical response and not well adapted to the situation on hands. Although it is difficult for the managers that are usually awarded by being in charged and staying on top of things, expatriates need to go with the flow and let go of control. Everyone doesnt always need to go by the book because actions are often taken base on insufficient, unreliable or/ and conflicting information. Task 2 Controlling model and Adapting model are the names and characteristics of two specific models of strategy related to cultural assumptions and approaches in adapting to external environment as discussed in the literature. The differences between controlling and adapting approaches are described below: Controlling model is based on active search that is focused and systematic. The planning system of the controlling approach is formalized and centralized using expert consultants to assist in devising strategy. The information being used by the controlling method is objective, quantitative and impersonal also interpreting information relies on formal models and methods like strategic forecasting with scenario planning. The people involve in this model are those from the top management or the experts of the particular area. The decisions for the controlling approach would be made by the top management and pass down to be implemented. The strategic goals and action plans are clearly defined, articulated and it would be explicitly measured and rewarded in this controlling method. As it assumes that the environment is known to reduce environmental uncertainty. This approach is usually sequential and short term (Schneider Barsoux, 2003, 124). Adapting model is broad, sporadic, decentralized and mostly based on monitoring. It is the opposite from the controlling model, informal and decentralized. The adapting approach is personal, subjective and qualitative; the information would be interpreted by some informal methods with discussions and debate. It would have the employees involved from all across the ranks. The decisions for the adapting approach would be made by the front lines staffs, neither the people from top management nor the experts. The strategic goals tend to emerge and action plans are broad, implicit and vaguely monitored. Also it assumes that the environment cannot be readily known or controlled. This approach is long term and simultaneous (Schneider Barsoux, 2003, 124). The model of adapting approach is more appropriate in this situation with TDS because TDS is new to town and not quite familiar with the culture and environment in Hong Kong. Also the environment cannot be controlled or readily known, it would be wise to have the responsibilities to be diffused throughout the organization to make all the staffs from different ranks to get involved. Strategic direction tends to emerge when different people come with different perspective on the business point of view. The implementation should be locally determined to keep it within this strategic frame. Strategy can be refined on an ongoing basis and the adjustments can be made to any unexpected circumstances. TDS should be flexible in order to deal with any sort of unforeseen events or sudden change in any situation. A broad scan is needed in case of any subtle change in the environment and also accountability should be assigned to the collective too because everyone is involved to contribute to make things happen. Task 3 The Five methods of discovery that I would recommend to the three American managers transferring into my country, Hong Kong, are: Architecture and design According to a recent book (Schneider Barsoux, 2003, 24-6) the most obvious artifact is the architecture and design of the building when you enter the organization. In the United States, most of the office design would be opened space with partitioned off by half walls with each individual cubicles personalized by personal interested items such as photos, plants or aphorisms. By not being able to see each other directly allows a sense of privacy to be established. Also opened doors are usually signaled as accessible and available while closed doors are indicated as a sign of privacy desire in the United States. To the contrary, Japanese prefer to have some of the walls knocked off so informal communication would not be inhibited. On the other hand, Germans experience difficulty to work in an open-plan office due they feel it is lack of privacy. Although Hong Kong has a majority of 95 percent Chinese people according to a website (The American Chamber of Commerce in Hong Kong, 2008), and was also a British colony for over 150 years, the main business partner of its own is still the United States as shown by the figures provided from the Business Expectation Statistics Section, Census and Statistics Department, (2007a) (2007b). Therefore, most of the office design in Hong Kong is followed to the same style as those in the United States. Greeting rituals In the United States, the greeting rituals are tended to be paid less attention according to a recent book (Schneider Barsoux, 2003, 26-7). But for the other countries, the protocol is taken quite seriously. There are different forms of way in greetings such as showing respect by exchanging and inspecting business cards in Japan, greeting individual by name, shaking hands and making eye contact by French. The degree of body contact expected in greeting creates a fair amount of confusion in another part of the rituals too. In the United States, people might greet others with a hug even when the acquaintanceship is ordinary. In some countries like France, kissing hello and goodbye are common while people from countries like Hong Kong might feel uncomfortable and uneasy about it. According to a website (The Economist Newspaper Limited, 2008), handshaking followed by an immediate swapping of business cards is the most common form of greeting in Hong Kong. Dress Codes It is another cultural artifact varies from the degree of formality. Schneider Barsoux (2003, 29) pointed out that Anglo and Asian managers do not want to get too much attention or stand out by the way they dress while the Latin managers really care about their personal style. Moreover, corporate dress seems to be color coded in some countries. For example in the United Kingdom, some women are advised not to wear suits and dresses in bright color to work such as red and some bankers of a Dutch bank even avoid to wear suits in brown. It also signals task orientation. In the United States, rolled up shirt sleeves is considered as a signal of hard working while in France means relaxing on the job. Not to mention that some US companies have designated days to encourage people to appear in casual clothes at work such as Fridays. According to a website (World Business Culture, 2008), dress codes differ base on the size of company and industry sector in Hong Kong. Men mostly wear dark suits, shirts and ties while women wear conservative suits and dresses. Trousers and causal wear are tended to be worn only on informal occasions or designated days. Written versus verbal contracts In different parts of the world people have different definitions toward the sealed business agreements as mentioned in a recent book (Schneider Barsoux, 2003, 30). In some places, ones word means more than a legal document while others need to put down all the details on a paper in black and white. Problems would appear when the contracts are expected by the head office to be signed, sealed and delivered from a place where ones reputation and honor are way more valuable than some legal documents. Figures from Schneider Barsoux (2003, 30) for the estimated numbers of lawyers per capita of some countries like United States, United Kingdom, Germany, France and Japan reflect the differences on expectations. American managers will bring it to the legal department to retrieve whenever a business deal has been fell through while some other countries would sort things out through the relationship. Since Hong Kong is a Common Law Jurisdiction like most of the United Kingdom, Ireland and the United States (Wikimedia Foundation, Inc. 2008a), people most likely to expect to have a written contract over a business deal. Criteria for success It depends on the importance of stakeholders whether it is the benefit of the shareholders, the customers or the employees. Beliefs and values differ when there are different stakeholders; there are different criteria for success. Schneider Barsoux (2003, 31) claimed that American companies only exist for the benefit of the shareholders. This might be disagreed in Japan or even shock the Japanese as they believe customers have the divine rights. Some countries in Europe such as Germany or Sweden believe that the employees have the divine rights instead. Although all these factors are crucial to the business success, you still need to have a closer look to the cultural preferences in different countries like Hong Kong. Task 4 In my opinion, the key functions for managing people and human resource management are recruitment and selection, compensation and rewards, employee relations, and career development. Recruitment and selection This can be the most challenging and important function for managing people and human resource management. It is because finding the right people for the right job is essential. It is often a challenge as well especially when the nature of the local labor market or the available human resources is not familiar. The company needs to understand how to access the local labor pool in order to get the equivalent people to work for the company. So finding those candidates who have the abilities and requirements to finish the task and get the job done is also hard and essential, not to mention to get those who seem to likely match with the existing corporate culture. Moreover, the standard profile of one country might be very different from another in terms of representation and the differences in education systems also play a part to make the selection difficult in selecting which person fits the profile for the job (Schneider Barsoux, 2003, 151). Compensation and rewards The cultural differences play a role when it comes to determine the terms of reward and who gets it. Different cultures have different type of value in relations to the reward and vary to the extent in the belief that reward should be collective or individual. Pay for performance is assumed to be based on contribution or equity instead of the belonging to the group or equality (Eretz and Early, 1993). In the contractual view of employment, the notions of equity, you get what you deserve, are embedded while the notions of equality, you deserve what you get, correspond to the social view (Pennings, 1993). According to Susan Barsoux (2003, 165), the current trend of linking salary payment to working performances is especially suspect to be cultural related. It has been discovered that in some countries like France, it would be shocked for the French executives to have clearly stated quantifiable objective relating increased performances to increased bonus. It is because the French executives found that discussion about money and finance is such a turned off. It also provoked outcries when the merit pay was attempted to be introduced in Japan. It created uproar as the Japanese executives were scared that it would ruin the harmony of the group and might also encourage short term thinking especially when the employees only focus on the performance in order to get the bonus. On the other hand, the dominant influence in American managerial thinking is the principle of equity that each one should be rewarded based on the solely contribution by that particular person. Nowadays in the view towards team management that demands group cooperation instead of competition among individuals finds the merit-based pay in the United States demotivating (Susan Barsoux, 2003, 167). The preference between financial or non financial incentives is also related to the culture. The motivating potential of money, status, vacation time is also affected and changed across countries. Swedish would prefer to have some time off rather than a bonus because they are more concerned with the quality of life and monetary rewards are less motivating while giving time off might seem to have not much point in Japan when most of the employees only take half of their holiday entitlement (Susan Barsoux, 2003, 167). So the internationally operated companies should learn to appreciate the different values and evaluate the potential impact as well because the remuneration package is a very strong indicator of the culture and the behavior expected and also can be used in order to encourage cooperation or competition, risk taking or conservatism, and information sharing or information hoarding. The remuneration package is also a very important signal when it comes to aspiring recruits. When the company wants to attract local elite, it can choose to align itself with the local norms or the alien one when the preference of the company changes to attract the less mainstream or adventurous or those that are frustrated with the local practices and looking to be rewarded for their efforts and success (Susan Barsoux, 2003, 168). Employee relations It is important to have a good relations and mutual understanding between the management and the staffs of the company. Any staff grievances of the company should be dealt with and well listened to in order to promote a harmony environment. An open dialogue is needed to be promoted between the management and the unions of the company to eliminate any conflicts or fictions that may occur between the staffs and the management specially when there is a new implementation of company policies. Also the employees political standing should be respected and well listened to especially when it is toward the company policy and issues. Good employee relations help increasing the engagement of the employees to the company so as their commitment and involvement as well. It also helps with the staff retention which is necessary for a company setting up in a new country like TDS (CIPD, 2008). Career development National culture has an impact on career development and the natures of the managerial tasks on what management should do or be are depended on assumptions of being versus doing. The determinants for success varies across cultures when some places have it based on achieving results like the United States while in the United Kingdom having good interpersonal skills and personal connections are the keys for success at the career front. Favored career paths also differ culturally and it is bound up with cultural assumptions regarding the importance of the individual versus loyalty to the company, doing versus being, and tolerance for uncertainty. So a multinational company should make sure that the perceptions of what it takes to get to the top and the patterns of career development would include people with different skills, abilities, knowledge and perspectives (Susan Barsoux, 2003, 168 -70). With the references to managing people and HRM, I feel the four department managers, two from the United States and two from Hong Kong, should focus on during their first three months is selection because it is vital to get the right people for the right job in any organization (Schneider Barsoux, 2003, 151). Local talent may have different types of abilities, skills, knowledge and strength owing to the national values differences placed on the education so it is also a challenge to get the right people who fit the requirement for the particular job and also fit with the company culture. The managers should consider the differences in attitude towards the hiring practices in Hong Kong and also the cultural differences will influence on how to recruit as well. So getting access to the local labor pool to get the people that match with the job criteria is important too. Therefore, selection should be focused by four department managers for the first three months to get the right people in place and help them to adjust and fit into a new culture and way of life in order to make the launch of TDS in Hong Kong a success. The trade unions in the United Kingdom has a culture as a collective bargaining tool with management while the one in the United States has more of a hire and fire culture. In Hong Kong, there are four trade unions and the largest one among them is the Hong Kong Federation of Trade Unions and their main slogans are patriotism, solidarity, right, welfare and participation (Wikimedia Foundation, Inc. 2008b). Although the unions in Hong Kong are focused on the rights and welfares of the workers as much as those in the United Kingdom and the United States but they are still at the stage of establishing as the largest unions in Hong Kong was founded in 1948 while those in United Kingdom have been existed for over 100 years like the General Federation of Trade Unions (UK) (Wikimedia Foundation, Inc. 2008c) and so as those in the United States like the American Federation of Labor and Congress of Industrial Organizations was founded in 1886 (Wikimedia Foundation, Inc. 2008d). Since the United States is the biggest trade business partners of Hong Kong, most of the companies would contain the culture of the United States to remain individual. Task 5 The benefits of creating and working within the context of a multicultural team are given the larger complexity and speed of change in the international business environment. It seems obvious that bringing people together from different cultures enhance the quality of decisions taken. These multinational cultures contribute a greater range of perspectives and options with even more successful marketing strategies and ideas to attract different types of customers. It can also provide a different or new way of looking at the old or existing problems and help to promote the chances for greater innovation and creativity with the cultural differences as well (Schneider Barsoux, 2003, 218). Combining people from different cultural backgrounds also benefits the organization integration and learning so as the managerial development. It improves lateral networks for the communication and information flow. Also when bringing the people with the different cultural backgrounds together, it can be a solution to help minimize the risk of uniformity and pressures for conformity which can appear in the company when there are too many like minded people working at the same company together at the same time (Janis, 1971). Also teams that are composed by members with different profiles are far more effective than teams that are made by the best and the brightest performers or with the members who are having the similar profiles. Teams that have included a mixture of members with profiles of different areas performed better as they have the balance of roles. Different cultures have different assumptions toward the business issues and also have different ideas about the reasons of teams. So that to share information and discuss about any problem at work with people from different cultural background would often generate greater results in a dynamic way. Furthermore to the benefit of the combination with people from different cultures background would enhance the productivity for the organization. The challenges of creating and working within the context of a multicultural team are that bringing people together from different cultures is given more ambiguity and uncertainty in decision making. Also it would be much more complex in the organization from the procession to implementation due to the cultural differences in assumptions. People with different cultural backgrounds work together might create interpersonal conflict and communication problems at work. Also it would create greater potential for frustration and dissatisfactions that might lead to higher turnover of team members within the group (Schneider Barsoux, 2003, 231). The choice of language using within the multicultural team might also creates friction and misunderstanding especially when the native language for the three American managers is English while the native language for the local managers is Chinese, there is a huge scope for misunderstandings that could hamper the cohesion and effectiveness of the team no matter how fluent the local managers could speak in English (I-change, 2008). According to the personal upbringing and values, technical background and training, and also the national backgrounds can distort and filter the messages in many layers of meaning within a multicultural team that can lead to further misunderstanding and frustrations. Barriers would also be created for the multicultural team due to the direct versus indirect communication; trouble with accents and fluency; differing attitudes toward hierarchy and authority and so as the conflicting norms for decision making (Brett, Behfar Kern, 2006). Direct versus indirect communication is that in western cultures, the communication is typically direct and explicit. The listener does not need to know much about the speaker in order to interpret the context because the context of the meaning of the conversation is on the surface while the meaning of the conversation is embedded in the way the message is presented in many other cultures. Although the language of international business is English, the trouble with accents and fluency may lead to deep frustration and misunderstanding because of nonnative speakers accents, problems with translation or usage and lack of fluency would also influence the perceptions of status and competence. A challenge inherent in multicultural team with differing attitudes toward hierarchy and authority is that by design, teams have a rather flat structure. But team members from some cultures that people are treated differently according to their status in an organization probably are uncomfortable on flat teams. If they defer to higher status team members then their behavior will be seen as appropriate when most of the team members are came from a hierarchical culture; but they may damage their stature and credibility and even face humiliation if most of the team members are came from an egalitarian culture. Cultures differ enormously when it comes to decision making due to the conflicting norms for decision making particularly on how much analysis is required beforehand and how quickly the decisions should be made. American managers like to make decisions very quickly and with little analysis relatively when compared to the managers from other countries that may also be the challenge too. Task 6 Management Approach The four profiles are Village Market Well oiled machine Family or tribe Pyramid of people Ethical considerations: Managers and companies need to access how different spheres of cultural influence contribute to ethnical behavior. Ethical considerations could include such things as harsh capitalism which could include laying off workers, breakdown of psychological contract, corruption, codes of conduct, and the Sullivan Principles. Common rationalizations in explaining unethical behavior can be: It is not really illegal or immoral It serves the best interest of the individual or company It is safe because it will never be found out or publicized The activity helps the company and therefore it will be condoned and protected References: Brett J., Behfar K. Kern M.C. (2006) Harvard Business Review[online]. Available from:https://web.gsm.uci.edu/~kbehfar/Behfar-HBR%202006.pdf [Accessed 27 July 2008] Business Expectation Statistics Section, Census and Statistics Department. (2007a). Hong Kong Statistics Statistical Tables [online]. The Government of the Hong Kong Special Administrative Region. Available from: https://www.censtatd.gov.hk/hong_kong_statistics/statistical_tables/index.jsp?htmlTableID=133excelID=134chartID=tableID=133ID=subjectID=5 [Accessed 29 June 2008] Business Expectation Statistics Section, Census and Statistics Department. (2007b). Hong Kong Statistics Statistical Tables [online]. The Government of the Hong Kong Special Administrative Region. Available from: https://www.censtatd.gov.hk/hong_kong_statistics/statistical_tables/index.jsp?htmlTableID=134excelID=chartID=tableID=134ID=subjectID=5 CIPD. (2008) Employee Relations: an overview [online]. Available from: https://www.cipd.co.uk/subjects/empreltns/general/emprelsovr.htm [Accessed 13 July 2008] Eretz, M. and Early, P.C. (1993) Culture, Self-identity, and Work, New York: Oxford University Press. I-Change. (2008) Multicultural teamwork Communication[online]. Available from: (https://www.i-change.biz/multiculturalteamworkcommunication.php [Accessed 27 July 2008] Janis, I.L. (1971) Victims of Groupthink, Boston, MA: Houghton Mifflin. Kets de Vries, M. and Mead, C. (1992) Development of the global leader, in V. Pucik, N. Ticy and C.Barnett (eds) Globalizing Management, New York: John Wiley, pp.194-205 Pennings, J.M. (1993) Executive reward systems: A cross national comparison,, Journal of Management Studies, 30(2), pp.261-80, p.264. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, pp.24-6, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, pp.26-7, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.29, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.30, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.31, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.124, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.151, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.165, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.167, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.168, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, pp.168-70, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, pp.190-1, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.192, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, pp.192-3, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.193, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.218, Prentice Hall. Schneider, S.C. and Barsoux, J.L. (2003), Managing Across Cultures 2nd edition, p.231, Prentice Hall. The American Chamber of Commerce in Hong Kong. (2008). Living in Hong Kong [online]. Available from: https://www.amcham.org.hk/hongkong/lhk/lhk2008/CH01-p06-Ppl_Customs.pdf [Accessed 28 June 2008] The Economist Newspaper Limited. (2008). Cities Guide Hong Kong [online]. Available from: https://www.economist.com/cities/displayobject.cfm?obj_id=10316488 [Accessed 28 June 2008] Wikimedia Foundation, Inc. (2008a) Legal System of the World [online]. Available from: https://en.wikipedia.org/wiki/Legal_systems_of_the_world#Common_lawWorld [Accessed 29 June 2008] Wikimedia Foundation, Inc. (2008b) List of trade unions [online]. Available from: https://en.wikipedia.org/wiki/List_of_trade_unions [Accessed 13 July 2008] Wikimedia Foundation, Inc. (2008c) General Federation of Trade Unions (UK) [online]. Available from: https://en.wikipedia.org/wiki/General_Federation_of_Trade_Unions_%28UK%29 [Accessed 13 July 2008] Wikimedia Foundation, Inc. (2008d) AFL-CLO [online]. Available from: https://en.wikipedia.org/wiki/AFL-CIO [Accessed 13 July 2008] World Business Culture. (2008). Hong Kong Dress Code [online]. Available from: https://www.worldbusinessculture.com/Hong-Kong-Business-Dress-Style.html [Accessed 29 June 2008] Bibliography: CIA. (2008) The World Factbook Hong Kong [online]. Available from: https://www.cia.gov/library/publications/the-world-factbook/print/hk.html [Accessed 28 June 2008]. Hmieleski, K. (2006). Research: Empowering leadership style doesnt work in start-up companies [online]. TCU The Neely School of Business. Available from: https://www.neeley.tcu.edu/default.asp?nodeid=1361 [Accessed 5 July 2008] The New York Times. (1997) The New York Times: Hong Kong [online]. 1997. Available from: https://www.nytimes.com/specials/hongkong/ [Accessed 28June 2008]

Monday, December 23, 2019

Wilms Tumor A Type Of Cancer Essay - 1284 Words

Wilms tumor also called nephroblastoma is a type of cancer that causes tumors in the cells of one or both kidneys in children. According to the American Cancer Society, Wilms tumor occur in about 9 to 10 cancers in children with 5% to 10% children having one tumor in one kidney, and about 5% of children having tumors in both kidneys. This cancer begins in the kidneys and can develop in other organs in the body, if the tumor is not caught early. There are two classifications of this type of kidney cancer that determines the outcome of the treatment for the patient. By examining the tumor under a microscope the histology can be favorable where 9 to 10 Wilms tumors have a good chance of being cured, or can be unfavorable where the cells look abnormal. The abnormal cells are quite large and distorted which is called anaplasia making it more difficult to cure (American Cancer Society, 2016). Wilms tumor is a childhood cancer affecting children ages 3-4 years old occurring more in females than males. African-American children are at a higher risk than white children, with Asian-American children having the lowest risk of developing this type of kidney cancer. There is also a 1% to 2% risk to children through family members who have had this cancer. The other risks include about 1 in 10 children developing this cancer that have birth defects, and 30% to 50% of children that have WGAR syndrome may develop Wilms tumor (American Cancer Society, 2016). Wilms tumor was discovered inShow MoreRelatedSymptoms And Symptoms Of Wilms Tumor Essay1105 Words   |  5 PagesIntroduction. Wilms’ Tumor is a rapidly growing malignant tumor found in the kidney, that is typically diagnosed between ages two and five. It is a disease that develops only in very young children. It is found in one in ten thousand children. 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It was found that 23%, N=814Read MoreKidney Cancer Essay2558 Words   |  11 PagesPathophysiology: Your kidneys are two bean-shaped organs, each about the size of your fist. Theyre located behind your abdominal organs, one on each side of your spine. Like other major organs in the body, the kidneys can sometimes develop cancer. Your kidneys are part of the urinary system, which removes waste and excess fluid and electrolytes from your blood, controls the production of red blood cells, and regulates your blood pressure. Inside each kidney are more than a million small filteringRead MoreTransformation Related Protein 53 : A Tumor Suppressor Gene1300 Words   |  6 PagesTransformation-Related Protein 53, also known as TP53, is a tumor suppressor gene. It is named after its molecular mass. The gene was discovered by Arnold Levine, David Lane, and William Old in 1979 and was voted molecule of the year by science magazine in 1993. Although, it was not until 1989 that it was revealed to be a tumor suppressor gene. It was previously thought of as an oncogene. TP53 encodes for a pro tein, called p53 protein, that helps to regulate the cell cycle and inhibits mutationsRead MoreSeneca Valley Virus : Past Perspectives And Future Directions Essay1970 Words   |  8 PagesSeneca Valley Virus: past perspectives and future directions This article covers the Seneca Valley Virus (SVV-001) as a hopeful for an oncolytic treatment of certain cancer types. More specifically those with neuroendocrine properties such as rhabdomyosarcoma, Wilms tumor, glioblastoma, neuroblastoma, and adult small-cell lung cancer. Each of which effect smooth/skeletal muscle cells, kidneys/adrenal glands (mainly in children), astrocytes of the brain, nerve cells of a fetus, and lung cells in adults

Sunday, December 15, 2019

United States Bill of Rights and American Sporting Tradition Free Essays

Gun Control Gun control would not help crime or murder rates because instead it disarms the law abiding citizens, therefore putting them at a disadvantage in defending there selves against criminals. The second amendment states that citizens have the right to bear arms. Guns have also been an American sporting tradition for years, and have saved many lives from rapist, murders and innocent civilians from the hands of criminals. We will write a custom essay sample on United States Bill of Rights and American Sporting Tradition or any similar topic only for you Order Now The second amendment is part of the constitution and is something that should never be taken away, and can’t be taken away. The amendment says that â€Å"A well-regulated Militia, being necessary to the security of a free state, the right of the people to keep and bear Arms, shall not be infringed. † The first 10 amendments to our Constitution protect our most basic rights from being stripped away by an overly zealous government, including rights that all Americans hold dear. The United States Bill of Rights plays a central role in American law and government, and remains a fundamental symbol of the freedoms and culture of the nation. One of the original fourteen copies of the U. S. Bill of Rights is on public display at the National Archives in Washington, D. C. This amendment and right give us the citizens a chance to defend ourselves from danger from not only criminals but also a foreign attack. A shooting sport is a competitive sport involving tests of proficiency (accuracy and speed) using various types of guns such as firearms and air guns. Hunting is also a shooting sport, and indeed shooting live pigeons was an Olympic event only once, in 1900. The shooting sports are categorized by the type of firearm, target and distances at which targets are shot at. Shooting sports have been a part of the Games since Baron Pierre de Coubertin brought us the first modern Olympiad in 1896. It was one of the first nine events held at the first Olympic Games along with track and field, Cycling, Fencing, Gymnastics, Swimming, Tennis, Weightlifting, and Wrestling. Guns have been a huge part of American history since the Olympics started in 1896. Guns have been used for many years not only to defend our country but also defend ourselves in the event of being attacked by a criminal. If the availability of guns is the major reason for the murder of people, why isn’t it that when the rate of gun sales go up the murder rate doesn’t go up as well? The answer is simple guns don’t kill people, people kill people. Imagine if the 10,000+ victims had guns of their own. That statistic could have shockingly stayed the same, just with different victims: the criminals. Americans tend to believe that guns are easily obtained, when in reality federals laws already passed make it impossible for criminals to legally obtain a weapon. Gun sales have gone through the roof since president Obama took office yet in terms of violent crime, the United States is safer today than it was 20 years ago. Violent crimes will continue to exist with or without stricter gun control. Guns will always be obtained by criminals if they want to get their hands on one, and making stricter gun control laws will only make civilians defenseless against these criminals. Taking the right to bear arms away will not save lives it will only cause more violence and since criminals don’t follow the laws in the first place more laws would only hinder law abiding people not the criminals; they will still get any type of gun they want because the all mighty dollar is king. Even if we outlawed all guns criminals would still have them smuggled into the country just like drugs. The only thing that would accomplish would be law abiding people would be defenseless and the criminals would rule. How to cite United States Bill of Rights and American Sporting Tradition, Papers

Saturday, December 7, 2019

Ethics and Mental Health for Mental Disorder- myassignmenthelp

Question: Discuss about theEthics and Mental Health for Mental Disorder. Answer: Introduction Deinstitutionalizing began in the1960s when the people diagnosed with a developmental disability or mental disorder were placed in communities with mental health services rather than psychiatric hospitals [20,21,24]. Leon Eisenberg a renowned psychiatrist has said that deinstitutionalization has been beneficial for the mentally ill. This can be supported by a recent study done by Steven P. Segal,M.S.W., Ph.D.,Stephania L. Hayes,M.A., O.T.R.,Lachlan Rimes,B.A. under the title The Utility of Outpatient Commitment 2. Mortality risk and protecting Health, Safety, and Quality of life. In this study, Steven P. Segal along with his colleagues assessed the outpatient communities in Australia. They found out that there was a notable low mortality risk and the quality of life was enhanced in the case of the mentally ill in comparison to the psychiatric hospitals. As through this government policy, the mentally ill were able to move out of the insane asylums run by the government and were able to live in community health care centers. So according to the definition of deinstitutionalization, it is not the reduction of the hospital censuses but it is the extension of the alternate services beyond a hospital setting. Although the closing of the psychiatric hospitals is the main part of this process it is only a part of the process. It is not all that deinstitutionalization stands for. Therefore this statement Since the closure of mental institutions, the community has been over-run with dangerous people who do not get the care they need. Like it or not, they need to be kept separately from the rest of the community for everybodys good is neither completely false nor it is completely true in nature. Deinstitutionalization has had three components firstly it is the release of the mentally ill from psychiatric hospitals to communities with alternative facilities, secondly ensuring that new admissions are not made to these alternative facilities and thirdly provision of the car e that these noninstitutionalized mentally ill need in these communities. Through these components, we can see that the last one is the most important. The altered life circumstances for these mentally ill will need new changes and configurations in the health services that they need. Therefore the statement made by the member of the parliament shows how he is fearful that our community is over-run by the mentally ill. But what it is pointing out clearly is that these mentally ill are not getting the care they deserve in these alternate services. It is showing how the government has failed to provide the care that these people need in a community care setting. [11] Body Throughout the world, the process of deinstitutionalization has been given mixed reviews. In order to understand deinstitutionalization, we need to see what scientific and societal changes led to this process [17].Firstly the scientific discoveries of many psychiatric drugs helped to treat the mentally ill. Secondly, which is quietly debatable even now, the society understood that the mentally ill do not need to be locked but should be treated for their illness. Thirdly federal funding with programs like Medicare and Medicaid were sourced for community health centers for the mentally ill rather than psychiatric hospitals. It must be understood that the first and the second component of deinstitutionalization which are release of the mentally ill from psychiatric hospitals to communities with alternative facilities, secondly it is ensuring that new admissions are not made to these alternative facilities did rapidly proceeded than the third component which is provision of the care that these noninstitutionalized mentally ill need in these communities. The President of the American Psychiatric Association Dr. John A. Talbott who states how the psychiatrists that were involved in the formation of the policies related to deinstitutionalization, oversold the certainty of the community treatment which at present is hurting the credibility of this process. The widespread scientific discoveries in the 50s and 60s including penicillin to treat psychosis led to the leaders in being prodded to take action in believing that mental illness is far more prevalent in the society than it was first thought. This is completely true that mental illness is prevalent in our society in far more numbers than it was believed earlier. But the degree and symptoms of each mental illness vary greatly. While depression and anxiety are also termed as mental illness PTSD or Post Traumatic stress disorder is also a form of mental illness that may have violent episodes. The growing political and economic liability that the legislators were facing due to the taxes being used to support the mental institutions was a final push for deinstitutionalization. The extravagant claims that were made by the psychiatrists for the community health care centers for the mentally ill, only added to the urgency to create it. The scientific professional community has had made a mistake of being overly optimistic and the political community was all about saving money. The statement Tranquilizers became Panacea for the mentally ill is quite apt for this change. The rationale to pursue deinstitutionalization had elements of pragmatism and idealism that reflect the concern for the wellbeing of the mentally challenged and ill. Many assumptions were made for the community based mental health care as for how this will be more humane than the psychiatric hospital care. This has proved to be quite true as studies such as The Utility of Outpatient Commitment 2. Mortality risk and protecting Health, Safety, and Quality of life conducted by Steven P. Segal,M.S.W., Ph.D.,Stephania L. Hayes,M.A., O.T.R.,Lachlan Rimes,B.A show [18]. But these assumptions had to be empirically tested as they cannot be realized until the severally mentally ill are included in the data pool. How will we realize whether they are being given the adequate and mandatory resources that are needed to implement these services? Secondly, it was assumed that the community-based health care centers will prove to be cost-effective in comparison to the psychiatric hospitals. Now has b een seen that there are numerous hidden costs associated with these community-based health centers that were firstly ignored. It is crucial that not all of the psychiatric hospitals are closed as it is important to acknowledge that these alternative services require a structural overhaul to ensure that they are providing comprehensive and intensive care in a setting that is not like a psychiatric hospital. When the three components of deinstitutionalization are concurrently implemented it can result in being beneficial for the mentally ill. As the quality of care for these people is improved substantially and they experience a greater satisfaction in their everyday life. They obtain a certain normality in their life even after suffering from these illnesses. They are able to live independently to a certain degree and are numerous times are employed in the society thus making them productive to the society. But these positive developments cannot be applied to all mentally ill individ uals. The severely mentally ill these new long-term community dwellings could be extremely challenging to sustain on their own. Numerous individuals will get easy access to drugs and alcohol which can make the conditions worse for their recovery and symptoms. There are concerns about the severely mentally ill who would have access to the community and society after living for many years in the psychiatric hospitals. Lets take the example of people who suffer from bipolar disorder, major depression, schizophrenia and schizophrenia disorder. These people have been in hospitals for long and are passive to a point where they are used to following orders. In a community setting these people have sufficient structure and support to tend and cater to their needs. They have their sanctuary.[22] It is not always that these mentally ill people are rehabilitated peacefully in the community. That is where the problem arises and the statement like these Since the closure of mental institutions, the community has been over-run with dangerous people who do not get the care they need. Like it or not, they need to be kept separately from the rest of the community for everybodys good is made [4,6]. Many of these individuals pose new challenges to the clinicians and planners as they suffer from side effects of psychoactive drugs such as denial, and fear of tardive dyskinesia [14]. In a state of denial, a mental patient is skeptical about his or her treatment. Mentally ill are also admitted to the criminal justice system but due to deinstitutionalization number of these people are in the society. So when these circumstances along with a shortage of resources are mixed it results in shunting of the mentally ill. The society already has a low tolerance for the mentally ill as we have see n cases where even minor offence by mentally ill have resulted in arrest and incarceration. Many of these offence are often the results of manifestations of their illness. Through deinstitutionalization, we have developed a heightened awareness for the mentally ill. We want to be more humane and understanding towards them. Mental illness varies in a great degree and so is their ability to handle unpredictability and stress. Therefore the kind of programs that would help them varies according to their needs. These needs could range from either living alone, needing psychiatric interventions, would be better in living in a residential setting or less invasive care. Whether they would be able to work also depend on the degree of their illness. [19] The service planners have grouped the mentally ill as a one, asking a single question What should be done for the mentally ill?. The focus is on individual need and rehabilitation or should we rephrase this question as what should be done for this person who is suffering from a mental illness?. It is crucial to understand that some of the mentally ill need the hospital care and deinstitutionalization is not a replacement for the care some need. Deinstitutionalization was introduced to eliminate the countertherapeutic practices that were being followed in the psychiatric hospitals but we do not need to eliminate these hospitals altogether. Unfortunately, the initial planning and implementation of these community centers were based on the assumption that we would no longer need any extensive resources for these mentally ill who need inpatient care. But experience has clearly shown that severely mentally ill need the hospital care for long periods of time and sometimes it could last the ir lifetime. The number of patients admitted to these hospitals precisely depends on the alternative services given in these facilities. So if these facilities have an array of integrated community based services and excellent infrastructure to support it tradeoffs are possible. Where the patients that are recovering well from their symptoms can be shifted to these facilities from the hospitals. For the success of deinstitutionalization we need to know that hospitals and these alternative services have to go hand in hand. Mental health professionals have an ethical obligation to respond to the stigma and discrimination that the mentally ill face in our society [16]. If a member of the parliament will make statements like these the people would feel that mentally ill are dangerous for the society and should be locked. This mistreatment for the mentally ill strips them of the expectation and hope they need to recover from their illness [13]. In this essay, we have studied how deinstitutionalization is helping the mentally ill by giving them a better quality of life and giving them a certain degree of independence. Some are even working and adding as a productive member of the society. We even learned how all mentally ill cannot be grouped as one group. Therefore it is necessary that the mental health professionals educate the people and community about this. They need to educate people that a mentally ill person has equal rights for getting treated and to be treated with respect in the society. In a rep ort by the NIMHE or the National Institute of Mental Health in England, it was stated that recovery for the mentally ill depends on many factors. Factors such as family support, community involvement, minimization of the stigma associated with their illness, clinical care, any meaningful activity or work and peer support. Many of these factors are community-based. These interventions need the support of the community. Counselors and educators are needed in the community to minimize the discrimination that the mentally ill face [3]. Approaches to the assertive community treatment where a team of multidisciplinary professionals work in a community setting for the recovery of a severely mentally ill (SMI) are needed [7]. Through these approaches and models, we can ensure that the mentally ill will be treated fairly in the community and would have lower chances of going homeless or be involved in a crime. Other models such as peer support model and supportive employment model are also f ound effective in many studies. These models are also helpful as the cost of providing care for a mentally ill decreases if he or she has recovered well enough to work. The health workers working in these community settings need specific training to work with SMI population. The movement of care from a hospital setting to a community settings needs specific training that these individuals should go through and ensure that the community around them supports the recovery process of a SMI. [10] Many of the mental health professionals are obliged to learn about the cultural aspect of the care a SMI needs. The services have to be culturally relevant. These services should be planned according to both the rural and urban community settings. This is not only needed because of the variations in the community settings in these areas but also on the fact that the social support varies in these areas. Mental health professionals should aim to involved an SMI in their recovery process [23]. Each and every individual has a set of values and goals it is necessary that a health professionals realize this and be informed about these individuals personal goals. The phrase Ask the Patient works well here. Consulting their family and friends is an extension for this care. Conclusion Mental health issues are often co-occurring with chronic physical problems. Therefore it Is needed that mental health care is integrated into community and primary based care. Through this essay, we have learned that community mental health is more therapeutic and humane than a hospital setting. But its full potential can only be realized when certain preconditions and factors are met. Due to these unmet factors, people fear the mentally ill. Which in turn encourages them to make statements like the one the member of the parliament made. That statement highlighted the fact that there are shortcomings in the care for the mentally ill in community settings on the part of the government and planners. There is too little knowledge in the community about the SMI. There are disjunctions in the following of the three factors or components of deinstitutionalization that are depopulation from the hospitals, diverting new admissions in the alternative services and development of the community- based services. We need to realize that the central problem is not locking the severe mentally ill in psychiatric wards but the central problem is provided adequate treatment and care to these individuals in a community-based setting. With the help of the psychosocial treatments and antipsychotic drugs, we can treat these individuals in an open community setting like apartments, halfway houses and care homes [8]. Nevertheless we do need to realize that there are a minority of some severely and chronically mentally ill persons that need the structured care of a psychiatric hospital. These people have to have a twenty-four hour specialized structured care and therefore we cannot eliminate mental health institutions from our society. We must aim for a continuity of support and care in the community [9]. Where the continuity of care is most important and these individuals need to be tended to in early years of deinstitutionalization. This is also the time where they can be monitored and seen whether they are fitting in the community setting or not. The lack of funding in training the health professionals have led to the failure of denationalization to a great level. Therefore additional funding along with educating the society about the mentally ill will help in achieving the success we need with deinstitutionalization. We have to highlight the plight of these victimized and isolated percentage of our population. They need the support and care of the community that can give them a life of satisfaction [2]. They should not be fear as dangerous and should not be subjected to harassment and stigma. When the mentally ill are unsupported only then they are at high risk to others and first and foremost to themselves. They should not be given a choice to trade the isolation they face in a hospital ward to the life of isolation they would face in an apartment or care house. References Bedaso A, Yeneabat T, Yohannis Z, Bedasso K, Feyera F. Community Attitude and Associated Factors towards People with Mental Illness among Residents of Worabe Town, Silte Zone, Southern Nations Nationalities and Peoples Region, Ethiopia. PLOS ONE. 2016;11(3):e0149429. doi: 10.1371/journal.pone.0149429. Cleary M, Jackson D, Hungerford C. Mental Health Nursing in Australia: Resilience as a Means of Sustaining the Specialty. Issues in Mental Health Nursing. 2013;35(1):33-40. doi: 10.3109/01612840.2013.836261. Chow W, Priebe S. Understanding psychiatric institutionalization: a conceptual review. BMC Psychiatry. 2013;13(1). doi: 10.1186/1471-244X-13-169. Fuller Torrey E. Deinstitutionalization and the rise of violence. CNS Spectrums. 2015;20(03):207-214. doi: 10.1017/S1092852914000753. Jose A. Attitude of the Adults towards Mentally Ill. International Journal of Psychiatric Nursing. 2016;2(2):1. doi: 10.1016/j.apnu.2016.09.003 Kunitoh N. From hospital to the community: The influence of deinstitutionalization on discharged long-stay psychiatric patients. Psychiatry and Clinical Neurosciences. 2013;67(6):384-396. doi: 10.1111/pcn.12071. Lee C, Liem S, Leung J, Young V, Wu K, Wong Kenny K et al. From deinstitutionalization to recovery-oriented assertive community treatment in Hong Kong: What we have achieved. Psychiatry Research. 2015;228(3):243-250. doi: 10.1016/j.psychres. Marginean R, Marginean O. P.The psychosocial rehabilitation of people with severe mental illness: a study of the impact of an assertive community treatment program. European Neuropsychopharmacology. 2013;23:S491. McCall R. Review: The consequences of early institutionalization: can institutions be improved? - should they?. Child and Adolescent Mental Health. 2013;18(4):56. doi: 10.1111/camh.12025. Mezzina R. Community Mental Health Care in Trieste and Beyond. The Journal of Nervous and Mental Disease. 2014;202(6):440-445. doi: 10.1097/NMD.0000000000000142. Moxham L. Where you live and who you live with matters: Housing and mental health. Journal of Prevention Intervention in the Community. 2016;44(4):247-257. DOI:10.1080/10852352.2016.1197720 Pescosolido B. The Public Stigma of Mental Illness. Journal of Health and Social Behavior. 2013;54(1):1-21. doi: 10.1177/0022146512471197. Reed N, Josephsson S, Alsaker S. Community mental health work: Negotiating support of users' recovery. International Journal of Mental Health Nursing. 2017;1(1):98. doi: 10.1111/inm.12368 Reta Y, Tesfaye M, Girma E, Dehning S, Adorjan K. Public Stigma against People with Mental Illness in Jimma Town, Southwest Ethiopia. PLOS ONE. 2016;11(11):e0163103. doi: 10.1371/journal.pone.0163103. Santos J, Barros S, Santos I. Stigma. Global Qualitative Nursing Research. 2016;3(1):233339361667044. doi: 10.1177/2333393616670442. Schnyder N, Panczak R, Groth N, Schultze-Lutter F. Association between mental health-related stigma and active help-seeking: systematic review and meta-analysis. The British Journal of Psychiatry. 2017;210(4):261-268. doi: 10.1192/bjp.bp.116.189464. Shen G, Snowden L. Institutionalization of deinstitutionalization: a cross-national analysis of mental health system reform. International Journal of Mental Health Systems. 2014;8(1):47. 10.1186/1752-4458-8-47 Segal S, Hayes S, Rimes L. The Utility of Outpatient Commitment: II. Mortality Risk and Protecting Health, Safety, and Quality of Life. Psychiatric Services. 2017;:appi.ps.2016001. 10.1176/appi.ps.201600164 Spaulding W, Sullivan M. Treatment of Cognition in the Schizophrenia Spectrum: The Context of Psychiatric Rehabilitation. Schizophrenia Bulletin. 2016;42(suppl 1):S53-S61. doi: 10.1093/schbul/sbv163. Taylor Salisbury T, Killaspy H, King M. The relationship between deinstitutionalization and quality of care in longer-term psychiatric and social care facilities in Europe: A cross-sectional study. European Psychiatry. 2017;42:95-102. doi: 10.1016/j.eurpsy.2016.11.011 Taylor Salisbury T, Killaspy H, King M. An international comparison of the deinstitutionalisation of mental health care: Development and findings of the Mental Health Services Deinstitutionalisation Measure (MENDit). BMC Psychiatry. 2016;16(1). doi: 10.1186/s12888-016-0762-4. Thoits P. Im Not Mentally Ill. Journal of Health and Social Behavior. 2016;57(2):135-151. doi: 10.1177/0022146516641164. Winters S, Magalhaes L, Kinsella E. Interprofessional collaboration in mental health crisis response systems: a scoping review. Disability and Rehabilitation. 2015;37(23):2212-2224. doi: 10.3109/09638288.2014 Yohanna D.Deinstitutionalization of People with Mental Illness: Causes and Consequences. Virtual Mentor. 2013;15(10):886-891. doi: 10.1001/virtualmentor.2013.15.10.mhst1-1310

Friday, November 29, 2019

Hamlet Nature Essays - Characters In Hamlet, Prince Hamlet, Hamlet

Hamlet Nature The obscurity of human thought and sentiment inhibits the possibility of understanding an individual's actions. The human mind is composed of its own due process, which, in certain individuals, might disable the ability to make decisions and act. In the play Hamlet the protagonist is marked by an indecisive nature. By analyzing every aspect of a possible action, Hamlet inevitably finds a reason not to act. His actions are untimely. The often procrastination of serious acts lead to an even more complicated situation. The complexities of the events which take place in the play do not always provide Hamlet with a possible clear decision. He is constantly faced with a challenging dilemma that adds to the intricacy of his life. Hamlet is overly conscious and unable to make a decision because of the uncertainty of the consequences that might follow. There is a constant threat that reaction these consequences will not be what he expects, possibly being detrimental to his cause. This deters him from attempting to execute any of his machinations. All these factor demonstrate that Hamlet does not suffer from a failure of will, but rather of an over analytical character that impedes him from taking any significant action. By constantly questioning every aspect of a possible action, Hamlet ultimately finds a reason no to act. He is constantly contemplating on the possibility of self-slaughter. This is evident in his soliloquies and disregard towards life. Hamlet expresses his sentiments, regarding the fact that his dear mother married his uncle only two months after the death of his father, by saying these lines: "O, that this too too sullied flesh would melt, Thaw, and resolve itself into a dew! ...How weary, stale, flat, and unprofitable Seem to me all the uses of this world!" ( I ii, 129-130, 133-134) This excerpt clearly demonstrates Hamlet's belief that suicide is a possible and realistic option. His grief is so immense and his mother's actions are so repugnant the life has no meaning for him. But Hamlet does not kill himself, he finds a reason not to; "Or that the Everlasting had not fixed -- His cannon ?gainst self- slaughter!"( I ii, 131-32) he explains. Hamlet fears damnation, he will not kill himself because it is a mortal sin allowing no possibility for salvation. Hamlet also express the same feelings when he says: "...To die, to sleep ? No more ? and by a sleep to say we end ? The heartache and the thousand natural shocks ? That flesh is heir to." ( III I, 61-64) Again suicide was in his mind, and again he found an excuse no to further his thoughts. "But that the drear of something after death, - - The undiscovered country from whose bourn ? No traveler returns, puzzles the will." ( III I, 179-181) The fear of what will happen after death deters him. Hamlet also fails to take any significant action in many other occasions. He does not kill Claudius immediately after the apparition of the Ghost, in which he discovered that his father was really murdered by him. "The spirit that I have seen -- May be the devil..."( II ii, 599-600 ) Hamlet subconsciously finds a reason not to act by doubting the validity and origin of the apparition. Hamlet encounters another chance to kill Claudius. It is after a play, set up by Hamlet to verify Claudius' guilt. Claudius clearly expresses his guilt by standing up as the murder of Hamlet's father was reenacted. Now Hamlet is absolutely certain that Claudius is the perpetrator of the most foul and unusual murder. But Hamlet finds yet another reason to postpone his deed. "When he is drunk asleep, r in his rage, Or in th' incestuous pleasure of his bed, At game a-swearing, or about some act That has no relish of salvation in ?t? Then trip him, that his heels may kick at heaven, And that his soul may be as damned and black As hell, whereto it goes."( III iv, 89-95) Claudius is in a chapel, apparently praying; therefore Hamlet hesitates killing him because at this moment he believes Claudius will not go to heaven. One must also consider the fact that Hamlet cannot simply disregard his morals and values. "Thus conscience does make cowards of us all." ( III I, 84) Hamlet understands that conscience, or what society has taught individuals to believe, is an impediment. To go against what one holds as true and right is to go against one self. Hamlet realizes that his

Monday, November 25, 2019

Brain Chemicals essays

Brain Chemicals essays Has anyone ever thought about what actually separates people from one another? I believe people are controlled by chemicals that are produced in the brain called seratonin and dopamine. I once took in the idea that ethics, role models, and the government play an enormous role in who we are. We develop ethics through our family and our religion, observing the habits of those we love, and learning morals and ethics through our religion. We will later teach our ethics to our children, and hopefully in return, we will receive a large bonus check when we check out. Our role models, whether good or bad, give us an example of who to become, or even what is ordinary and creative to believe. The government controls everyone, everyday of every week. History tells us that no single community has ever survived without some sort government, because something has to control the giant masses before we devour ourselves in war, death, and plague. For the most part, this is what I believed to be true. However, this didnt answer my question. What is the difference between two best friends who share similar morals, role models, and are both ruled by the same government? I believe that every person lives in a different mind-set, and depending on how his or her chemicals are set up inside the brain, could determine whether they are mentally stable, or legally insane. Albert Einstein once said, Man tries to fashion for himself a simplified and intelligible picture of the world; he then tries to substitute this cosmos for his own world of experience. ...Each makes this cosmos and its construction the pivot of his emotional life in order to find the peace and security he cant find in the narrow whirlpool of personal experience. Albert Einstein was ahead of his time when thinking of something of this degree. Studies of perception were only beginning to take place in the late 60s. Seratonin is the chemical inside ...

Friday, November 22, 2019

Krispy Kreme Doughnuts Case Study Example | Topics and Well Written Essays - 1000 words

Krispy Kreme Doughnuts - Case Study Example Dunkin Dollars is one of the strongest donut chains worldwide enjoying the sales of forty fiver percent from the market. Tim Hortons is a Canada based company which has international operations in many countries. What Dunkin Donuts did to boost up its sales and earn customer loyalty was to focus more on selling coffee and other beverages instead of donuts. Dunkin Donuts became a strong brand in the market in less time than expected. Credit for this probably goes to their strong advertisement campaigns, attractive slogans and drive thru service. Tim Hortons, although not as popular as Dunkin Donuts and Krispy Kreme, is a top brand for donuts in Canada and New York. Apart from the direct competitors, indirect competitors such as bakeries, cafes and retailers play a vital role in challenging the profits of Krispy Kreme Doughnuts. Although the competition in the industry is growing but Krispy Kreme is fairly satisfied with the revenue it generates from its franchises by selling donut mix es, donut making equipments and royalty. The Organization Krispy Kreme owns a simple organizational structure. It relies heavily on the revenues it earns from its franchising strategy. With this strategy, the company is in a way a little relaxed because major responsibility falls on the shoulders of Krispy Kreme’s franchise owners. Moreover, the franchising option comes with a little risk and more revenue generating methods such as selling authentic donut mixes, donut manufacturing equipments, franchising fees and royalties. Brand image of Krispy Kreme was outstanding so it was never difficult to attract franchisers from various locations. The overall strategies pursued by Krispy Kreme were not really suitable in the competitive environment. This is because they focused only on the sales of donuts-a confectionary item which is sold by a number of bakeries and cafes. So the product was easy to imitate. Whenever Krispy Kreme opened up its franchise in any new area, it brought b enefits to the competitors. Donuts, being an average confectionary item have never gained so much attention among the public. With the opening of Krispy Kreme, people gained awareness on how good and light can little donuts make them feel. So indirectly, the sales of competitors rose up. In the mid of year 2004, it was announced by Krispy Kreme that they are launching an inquiry into the accounting system and later in the same year they reported some accounting errors that were expected to cause a drop the annual sales and net income from an estimated 2.7 percent to 8.6 percent.. The same year, the share price of Krispy Kreme dropped from forty dollars to the range of 10 to 13 dollars per share. This was a huge setback for Krispy Kreme. Time had come when the company’s top heads seriously need to think of ways to save the company from drowning. Marketing Strategy It must be admitted that Krispy Kreme does not have a well developed marketing department so their marketing effor ts are limited. The company only relies on its advertisement campaigns, most of which are associated with the opening of new stores. They also earn revenue from local publicity, newspapers and majorly from word of mouth. When new outlets of Krispy Kreme are opened, media does free publicity and communities associated also become a part of this event. Although Krispy Kreme was opening

Wednesday, November 20, 2019

Ethics and Moral Theories Essay Example | Topics and Well Written Essays - 1250 words

Ethics and Moral Theories - Essay Example This doctrine assumes that we cannot ask others to act in their own self interest because it can negatively affect my self interest. 2) Individual Ethical Egoism: This is the belief that every individual should work for my interest. This is also termed as egotism and goes to an extreme level of selfishness whereby we believe that not only we should act for our self interests, others in the universe shall also act for our interests. There is no practical justification of this doctrine as it borders on extraordinary levels of selfishness (Pojman & Fieser, 2011). 3) Universal Ethical Egoism: This doctrine argues that all individuals should pursue their own self interest exclusively with no regard to the interest of others or no intention to contribute towards their interest. An issue with this theory is that without appropriate knowledge of the world, it will be difficult to understand our own interest. Furthermore, there can be debate over to what constitutes self interest. Act Utilitarianism:- Act utilitarianism states that our duty on any specific occasion is to act in a way that will produce greater total good and better consequences than what any other act will produce. This rule is applied directly to a selection of particular actions under particular events. Rule Utilitarianism:- Rule utilitarianism states that it is our duty to abide by rules designed for the greater total good and produce consequences better than those produced by any other rules. This doctrine is applied to a selection of a set of rules which are then used to determine what to do in particular situations. Feminist ethics is an attempt to reformulate the traditional theories of ethics with respect to the aspects that devalue women’s moral experience. It aims to correct male biases in historical and traditional ethical theory by emphasizing relationships

Monday, November 18, 2019

Desert Flora Essay Example | Topics and Well Written Essays - 250 words

Desert Flora - Essay Example Olive trees are in abundance in the Mediterranean desert toward the north of the Sahara desert. Plants found in the desert of Utah include mesquite (Prosopis), Cacti, and Yucca. Perennials, unlike, annuals, survive in the Utah desert all the time. Some perennials have deep root systems to reach the subterranean water. For example, Yucca’s roots exist 40 feet below the ground surface whereas the roots of mesquite (Prosopis) can penetrate up to 100 feet below the surface (Andersen, 1996, p. 5). The desert of Utah has an open nature with shrubs spaced widely apart. This speaks of the low content of moisture and is suggestive of extensive underground roots’ pattern. The main factor the limits the plants’ survival in the desert of Utah is water. Plants have different structural mechanisms to deal with this problem. Waxy coatings on the plants’ stems serve to reflect heat and reduce evaporation e.g. the leaves of Incienso covered with dense fine hairs serve the very

Saturday, November 16, 2019

The power of music

The power of music The Power of Music Music surrounds us in our everyday lives. We hear it when we are in the car, at work, when we are shopping, at restaurants, at doctors offices, and many more places. The music serves a purpose other than entertainment at many of these places.   Music has the power to influence mood and behavior in people and it is no secret that it is used at every available opportunity. We are introduced to music in our mothers womb even before we are born. It is used to sooth, to hype up, to educate, for entertainment, as a medium to remember information, for medical purposes, and so much more. Music is used in many ways to improve and enhance the lives of people. It is meant to be consumed, whether it is by the listener, performer, or composer. It is a way to translate feelings and desires that are sometimes difficult to express using language. The style of music has changed dramatically throughout the ages. For instance, there are six main eras in music history. The Middle Ages, Renaissance, Baroque, Classical, Romantic, and Twentieth Century. The music in these eras reflects the time period. Music has been and always will be a popular form of entertainment for many. The dictionary defines music as an art of sound in time that expresses ideas and emotions in significant forms through the elements of rhythm, melody, harmony, and color(Dictionary). Music has the ability and power to influence human thoughts and behaviors. Employers and retail stores use the power of music to produce a desired behavior from their employees and customers. For example, according to The Journal of Marketing, background music is thought to improve the stores image, make employees happier, reduce employee turnover rate, and to stimulate customer purchasing (Milliman). Does music actually influence mood and behavior? What is it about music that affects mood? According to an article in the Music Educators Journal, volume, tempo, consonance, dissonance, tone color and form all may have an effect on a persons mood (Gaston). It is not just the music itself that has an effect on people; the lyrics of a song can also have an effect. Many people are concerned that music with violent or derogatory lyrics may have a negative effect on youth and provoke violent behavior. Many researchers have examined the effects of how music provokes violent behavior. In a study conducted at Western Connecticut State University researchers examined whether or not watching a violent music video would provoke the participants to answer questions with violent responses. There were thirty-three participants, eleven in each of three groups; one group watched violent music videos, another group watched non-violent music videos, and the last group did not watch any videos. Afterw ard, the participants were given a questionnaire. The study found that the violent music videos did provoke participants to react more violently when answering questions about hypothetical scenarios (Tropeano). People are introduced to music even before they are born. According to an article in Pregnancy Today, by the fifth month of pregnancy the babys hearing is completely developed and they are able to hear noises that are outside the womb. Prenatal stimulation through music may provide some babies with a sense of confidence and relaxation when they are born (Lacey). In 1993 a study was conducted in Irvine, California by Dr. Francis Raucher, Dr. Gordon L. Shaw, and their colleagues on a group of thirty-six undergraduate college students it was found that they improved their spatial-temporal intelligence (the ability to mentally manipulate objects in three-dimensional space) after listening to 10 minutes of a Mozart sonata. The results of the study showed that student IQ scores improved by 8-9 points and lasted for 10-15 minutes. This study was coined the Mozart effect (Jones). Music is sometimes used to relax and soothe people. After a stressful event, listening to calming or classical music relaxes the body and mind. Music can also induce a more positive state of mind. It has long been believed that music can also act as an aphrodisiac (an element, either natural or chemical, that stimulates a sexual desire). Human senses are powerful and can trigger emotion. The type of music depends on the person. Music triggers different emotions in different people. What one person enjoys and is stimulated by could disgust and upset someone else. Many people use music as a way to get pumped up. Gyms usually play music with a faster tempo to increase speed and motivation. According to a study on musical tempo an increased tempo increased the speed in which people preformed simple tasks. It also affected the participants in the study by acting as a stressor and increasing their heart rate. When the tempo of the music was reduced the heart rate decreased (Mayfield). Music with a fast tempo and stimulates and demands physical activity. Music therapy is growing in the field of medicine. Its calming effects can help reduce anxiety and ward off the negative effects of stress (Stress and the Environment). This can help by reducing the negative effect t the stress response has on the body and mind. Music is used for medical purposes such as lowering blood pressure and autism. In an Italian study twenty-eight peoples blood pressure was monitored for twenty-four hours. They were then given a CD of classical, Celtic, or Indian music to listen to for thirty minutes per day for one month. After the month the patients blood pressure was monitored once again. The patients blood pressure did in fact drop. Their average systolic blood pressure (the first number in a blood pressure reading) had dropped three points, and their average diastolic blood pressure (the second number in a blood pressure reading) had dropped four points. There were twenty other patients who did not listen to music and after monitoring their blood pressu re, there was no change (Hitti). Children who have been diagnosed with autism receive many benefits from music therapy. Depending on where children are placed on the autism spectrum music can assist with communication and provide structural regularity that the children need (downey). We have seen that music is used for healing but what about as a weapon of war? In 1989, music used as a weapon to torture first came into light. U.S. Troops blared loud music in an effort to induce the surrender of Manual Norriega, the Panamanian president. According to an article written by Suzanne G. Cusick this form of torture, called acoustic bombardment went mainstream after the cold war and is a common practice on the battlefields of Iraq and Afghanistan in Operation Enduring Freedom (Cusick). The US also used this acoustic bombardment during interrogations in Guantanamo (Rapp). What is it about music that has such a profound effect on the human mind and body? Research has shown that music with a strong beat can stimulate brain waves to sync with the beat. The fast beat encourages sharper thinking and better concentration whereas the slower beat creates a relaxed almost meditative state. Music can also stimulate the brain to change gears easier. It effects remain evident even when you are done listening (Saarman). Using music to advertise is a good way to for a company to get the attention of a potential client or customer and for them to purchase the product or service that they are offering. Jingles are often easier for people to remember than just plain information. Many companies use popular artists or songs as a medium to advertise their products. One such company is Dr. Pepper. Their advertisements feature popular songs in hopes of getting the attention and marketing to the specific demographic associated with the song. By using music in advertising the company wants the listener to associate the song or tune with the product or service so when they hear the song they will think of the product or service. This is a great way for people to remember what they are selling. Religion uses music as a means to express ones faith and devotion. Johann Sebastian Bach, one of the worlds most famous and influential composers, wrote most of his music for the Lutheran church. Modern Christian songs are derived from popular music tunes and uses religious lyrics. According to an article written by Lorenzo Candelaria who is an assistant music professor at the University of Texas at Austin, Sacred music and art allow us to touch the face of God, through our perception of the world around us.' He believes that music is a way for people to understand their faith and spirituality and is a direct way for people to try to make sense of life and the afterlife (Moini). Music is sometimes used solely for entertainment purposes and accompanies many group and individual activities. Must is played in places such as dance clubs and skating rinks and produces a feeling of power. Faster music will control the speed at which you skate or dance or put you in the mood to do any of these activities.   Music is almost always used in movies. It can used to produce the feeling of suspense or excitement. It is used in tear-jerkers to solicit an emotional response of empathy. As you can see music has been and will always be woven into the fabric of our society. There are many uses for music and it has many hidden meaning and uses. Who knew that music was such a powerful tool and could have so many effects on the human body and mind? Its power spans from entertainment and fun to the ability to heal, reducing stress, creating a desired atmosphere for shoppers and employees, and so much more. What does the future of music hold for us?

Wednesday, November 13, 2019

What is an expert? Essay -- essays research papers

Currently the most prevalent is that an expert is a person who has some skill or knowledge in some domain that is matched by only a few other people. These people are thus extraordinary in some way. Anders Ericsson, probably the best known of the researchers on expertise defines expertise as Relatively stable outstanding performance.Experts are often labeled as such. People called exceptional, superior, gifted, talented, specialist, expert, etc. tend to belong to the set of experts. There is no doubt that there are large differences in the quality of performance of different people on different tasks or in different domains. We can think of this difference as a scale of expertise. Novices are those who do not perform very well, and we can move through different levels of expertise until we find some individuals that we might say are skilled or knowledgeable beyond that of almost everyone else in the world, or world class. What is the nature of this dimension? What are the categories within which this level of expertise motif applies? Becoming an expert in any domain requires experience and effort. Don Norman introduced the notion that an someone requires 10,000 hours of experience and practice for reasonably complex domains to have the possibility of being an expert. Most people seem to agree with that assessment. In order for someone to become an expert in physics, music, chess, psychology, mathematics, baseball, etc. takes many hours, even years, of hard work and practice. ***Keith Ericsson in viewing the development of expertise argued that the most important factor, perhaps even necessary and sufficient for developing expertise is deliberative practice. Deliberative practice has four properties: (1) it is at an appropriate level of difficulty, (2) the participant receives informative feedback, (3) the participant has many opportunities for repetition, and (4) the participant has th opportunity to correct for errors (from Ericsson (1996; found in Sternberg & Ben-Zeev (2001). If we focus on the process of becoming an expert rather than the claim that only a few become expert, we may come to a position I first heard from Micki Chi. Children are universal novices. They have not developed very many of the component skills needed for any domain. Decalage is the order of the day; many of the skills needed are relatively domain specific. The topics in t... ...wa workshops; Miss America candidates from Texas; Prodigies of all sorts. Winton Marsalis view on becoming an expert: commitment, listening, training, practice, confidence, independence. Component skills and knowledges. Must borrow many of them, learn to apply them in the right places, and integrate them to the new task. Some knowledge and skill must be learned from scratch. Many skills need to be developed more highly. It is possible that all of the component skills can be decomposed into simple enough parts that they are known a priori; however, expertise still requires integrating and restructuring them into usable schemata. What is the state of novice performance? Inchoate states, random trial and error, frustration, backward chaining, small units, surface form, separate nonintegrated components, bottom-up Expert performance--focused, much forward chaining, top-down, coherent and integrated, abstract organization, large units, proceduralization, integrated sequences, skillful, selective. Ericsson, K. A. (1996). The road to excellence. Mahwah, NJ: Erlbaum Sternberg, R. J. & Ben-Zeev, T. (2001) Complex Cognition: The psychology of human thought. New York: Oxford.

Monday, November 11, 2019

Thorn Queen Chapter Eighteen

The village I'd passed earlier was called Marmant, and I had to get directions from Maiwenn's guards to make sure I didn't accidentally take some twisted Otherworldly path in my attempt to return. I rode there with troubled feelings, still replaying the events with Kiyo and trying to decide if our assorted arguments today had qualified as true fights. I soothed myself a little by reaching out and manipulating the air, creating gusts and eddies and attempting to see how big a blast I could make. At one point, I made a scrubby tree bend pretty far, but it tired me out. I had to practice more to sustain true gale-force winds, and lightning still remained out of my grasp. The people of Marmant greeted me with that same mix of fear and awe I had come to expect. Word of the changes being wrought in the land was getting around, so they were grateful and allowing themselves optimism at last. Yet, my fearsome reputation always lurked on the horizon, so they spoke gingerly around me, fearful of enraging the dangerous monarch who had forced this dangerous land upon them. â€Å"How is everything?† I asked, hoping I seemed concerned and nonthreatening. Rather than a mayor, this town had a council of five that made decisions, and they'd invited me inside for a private meeting. They were ordinary-looking men and women-still with that peasant feel so common in the Otherworld-but there was an air of competence around them. â€Å"You've got water and food now?† â€Å"Yes, your majesty,† said a middle-aged woman who seemed to be the speaker of the group. â€Å"Thank you, your majesty.† â€Å"Good. I'm sorry it's been so hard on you. Things should be better now.† There was a brief silence in the group, one heavy with unspoken meaning. I looked from face to face. â€Å"What?† â€Å"We don't want to trouble your majesty†¦Ã¢â‚¬  â€Å"Trouble away. It's what I'm here for.† This got another round of exchanged looks. It was still apparently an odd concept for these people. â€Å"Well,† began the woman, â€Å"near the outskirts of our town's boundaries, there have been some attacks.† â€Å"What kind?† â€Å"Bandits, your majesty.† â€Å"Son of a bitch,† I said. We'd known the group had moved, but they'd been quiet thus far, allowing me to hope I could take Kiyo up on his offer and deal with them before they caused more trouble. â€Å"We actually have many fighters and strong magic users,† she said with some pride. â€Å"But we could not stand against their monsters.† â€Å"You mean demons.† She gave a nervous nod. â€Å"Son of a bitch,† I said again. This had to be dealt with, and at this point, I really was willing to be a bastard and hold a gun to Jasmine's head. â€Å"Don't worry. They're going to be taken care of. Soon. Very soon.† The woman looked startled at the menacing tone in my voice, but her words were grateful. â€Å"Thank you, your majesty.† â€Å"Anything else I should know about?† This time, it was a man who spoke up. â€Å"We don't want to trouble you†¦Ã¢â‚¬  I groaned. â€Å"Just tell me what it is.† â€Å"We heard your majesty has been seeking missing girls.† I straightened up. â€Å"Yes. What about it?† â€Å"One of ours disappeared two days ago. My neighbor's daughter, Markelle.† A small, wry smile crossed his lips. â€Å"She's a wild one, often wandering off where she shouldn't. But she hasn't come back†¦and she always does†¦.† I felt my fists clenching and forcibly relaxed them. I didn't need to scare these people any further. â€Å"Aside from the bandits, have you seen anyone else lurking around? Humans, maybe?† He seemed even more afraid to discuss this topic. â€Å"We see humans sometimes, your majesty.† I think he thought mentioning my own kind would anger me. â€Å"It's not uncommon. Often there are humans who†¦ah, give chase to some of the denizens of this world.† Shamans like me, he meant. â€Å"Usually, they leave us alone once they've found their quarry.† I thought back to Jasmine. â€Å"Any soldiers or warriors of the gent-shining ones?† â€Å"Occasionally. I presume they're deserters from King Aeson.† Not a bad theory, actually. â€Å"But we see none of them regularly. There's no one in particular who keeps returning.† I leaned forward, some part of me feeling like everything was about to fall together. â€Å"But there is a human you keep seeing, isn't there? Especially since the girls began disappearing?† He nodded. It was here. Everything was here. â€Å"A man, right? A man with a red snake tattoo?† â€Å"No, your majesty.† â€Å"I-what?† I froze for a moment. â€Å"Then who?† â€Å"A woman, your majesty. A woman with graying hair that she wears in a long braid.† I stared at him for several seconds, and then I laughed. This seemed to scare them all more than if I had burst into a rage. â€Å"Abigail,† I said at last, more to myself than them. â€Å"Your majesty?† I waved a hand at them. â€Å"Never mind.† Abigail. Fucking Abigail and Art. Working together to†¦what? Abduct gentry girls? But why? I'd toyed with the idea of Art as some kind of sick rapist, but where did Abigail fit in with this? Surely that would hold no interest for her. With a sigh, I pushed the questions to a small box in my mind, needing to wrap this up and get back to the human world. I needed to have that talk with Roland. â€Å"Anything else going on I need to know about? You've got copper nearby, right?† Finding water and food was naturally essential, but it was copper that was going to truly change things in the Thorn Land. It was what all our trade agreements were being based on. â€Å"How's the extraction going?† â€Å"Slowly until today, your majesty,† the woman admitted. â€Å"Our magic users are skilled in many things, but we have few who can work with metal. Much of our labor has been manual.† I frowned. â€Å"Why did things change today?† â€Å"Why,† she said in surprise, â€Å"because you sent the Oak King to us.† â€Å"The Oak-wait. You mean Dorian?† I exclaimed. â€Å"He's not here now, is he?† They were all clearly surprised at my surprise. â€Å"Yes, your majesty,† said the guy who'd spoken earlier. â€Å"He's out with the workers now. I thought you knew.† I stood up, still full of shock. â€Å"I have to see him. Excuse me.† They all murmured polite farewells and nearly knocked each other over with bows. I didn't stick around to return the formality. Instead, I headed back out into the bright afternoon sun, lightly jogging to where I'd seen the workers on the far side of the village. At first, I saw no indication of Dorian. Men and a few women were digging diligently, sweat rolling down their faces. Then, suddenly, I heard a slight rumbling, and the ground trembled. Huge chunks of rock rose from the earth, a few of them glinting in the sunlight. They lifted in a cluster and then slowly drifted off to the side of the work site, gently coming to rest on a pile of similar stones. Turning, I looked to the opposite side of the area and finally found Dorian, his hands moving in the air as he guided the ore. His clothes were simple today, but that hair burned and rippled in the sunshine like liquid fire. His face was filled with concentration as he watched the rocks, but once they'd come to a halt, he broke into a smile as he strode forward. â€Å"My lady Thorn Queen, what a delight.† I let him kiss my hand for the sake of appearances-seriously, why were the gentry so into that?-and then pulled him out of earshot of the others. â€Å"What the hell are you doing here?† I exclaimed. â€Å"Why, retrieving my copper.† â€Å"That's not what I mean!† He shrugged and wiped sweat off his brow. His devil-may-care expression aside, it was clear he was tired. I grabbed hold of his arm and led him back toward the town. â€Å"Come on, get something to drink before you get dehydrated. And start explaining.† â€Å"I heard there was some difficulty with your copper, and I decided to come help, seeing as it benefits me too. My sword is in need of replacement, you know-and that's not a metaphor. The metaphorical one is just fine. Besides, you don't honestly think I can let you take all the glory as being the most helpful monarch around, do you? You're making us all look bad.† â€Å"Dorian,† I groaned. Because there was really no other response. If people had fallen all over me when I arrived, the two of us together created quite the stir. Again, I was reminded of some celebrity tabloid couple. We returned to the council hall, at which point I used my queenly authority to get some privacy and some refreshment. It was a bit startling to see how quickly my orders were obeyed. Once we were alone and Dorian was sprawled in a chair, I truly got a good look at just how exhausted he was. â€Å"How long have you been out there doing this?† I asked, pouring him water from a pitcher. â€Å"Most of the day. And I'll take the wine, my dear.† He nodded toward a nearby decanter. â€Å"It'll dehydrate you further,† I scolded, handing him the cup of water. He scowled but drank it down eagerly. I watched him, still perplexed. â€Å"But why? You don't need the copper that badly.† â€Å"Perhaps not. But you do.† He finished the water, and I gave him a refill. â€Å"Thank you. Waited on by a queen-truly the dream of many a man.† I pulled over a chair of my own. â€Å"You didn't need to do it,† I protested. â€Å"You've practically killed yourself.† â€Å"Hardly. Give me and my stamina some credit.† â€Å"I still don't get it.† He finished this cup too and then gave me a look that was both exasperated and amused. â€Å"Eugenie, why do you keep having such a hard time believing I'd do things for you?† There was earnestness in his voice, and I realized we kept having this conversation over and over. Out of everyone in my life lately, it seemed like he was the only reliable one. â€Å"I don't know why. I'm sorry. I just run into few people who give something for nothing. Mining isn't going to get me into your bed.† â€Å"Well,† he said cheerfully, â€Å"nobody knows that for sure, but even if not? It doesn't matter. You need it. It makes you happy. End of story.† I looked away. Dorian truly was my friend. â€Å"Thank you. It does make me happy. One less thing in a sea of problems today.† He handed me the cup. â€Å"Get me wine this time, and tell me what your problems are. You can even sit on my lap.† â€Å"No thanks,† I said, but I did get him the wine. â€Å"I saw you and the kitsune pass earlier, actually. Is that part of your problem?† He answered his own question. â€Å"Yes, yes. Of course it is.† I was a bit surprised to hear myself pouring my thoughts out to him again. I didn't even have the excuse of being drunk this time. â€Å"I saw the baby today.† â€Å"Cute?† â€Å"Very. And it just made me feel†¦I don't know. Kiyo thinks it's jealousy, but it's more than that. I just can't explain it.† â€Å"Kind of a questioning of your own life and the choices-or lack thereof-before you?† I looked up, startled, and met his eyes. They were unusually serious. â€Å"Yes, exactly.† Dorian remained silent, and I found myself rambling more. â€Å"He's having a hard time getting all of it lately-the magic, the girls, the demons†¦he doesn't like me spending time over here. Neither does Roland.† I couldn't help a smile. â€Å"Hell, neither do I. But†¦I have to. I have to put things right around here.† â€Å"I know you do,† he said, face serious. â€Å"Dorian†¦what would happen if I got a crown?† This made him a smile a little. â€Å"It would make you look even more beautiful.† â€Å"No, I'm serious. Kiyo says it's a bad idea. That it would make all this real.† â€Å"It's already about as real as it's going to get, my dear.† â€Å"That's what I told him! But I don't get the big deal. You never wear a crown.† â€Å"Not often. But I have one, and I was crowned and all my people swore fealty to me. That's what a crown would lead to. You want one for ornamentation? Sure, that's easy. But put one on and walk out among your people-especially in a city like Highmore-and say, ‘This is who I am, I am your queen†¦' Well, that's what the kitsune fears. You're already queen. No crown can affect that. But you accepting one and declaring your authority is when you truly believe you're a queen. And as far as Kiyo is concerned, that's where the danger is.† â€Å"Wow,† I said, nearly as surprised to have such a thorough explanation from him as I was by the content itself. â€Å"Are you afraid of it?† He snorted. â€Å"Hardly. I don't need a crown to know you're a queen. It radiates off of you. But I would like for you to know you're a queen.† If dealing with all the crap I had on my plate didn't make me think I was a queen, then I didn't really know what else would. I let the crown issue go and instead recapped my latest intel about the bandits and Abigail. â€Å"I can't figure out her role here. You mentioned before that Art's motives would be†¦uh, understandable. But why her? Unless she's just enough of a pal to help him score some gentry action.† Dorian was still in his pensive mode. He'd poured himself yet another glass of wine and handed me one too that I sipped sparingly. â€Å"Let me ask you this. Why do men of the shining ones so often abduct your women?† â€Å"Easy,† I returned. â€Å"Because we're more fertile. You guys might have sex in public, but it doesn't usually result in anything. A guy who wants a kid has better luck with a human.† Dorian nodded. I had a feeling he'd already made some leap of logic and was prompting me here to figure it out myself. â€Å"And what about humans? Are you hoping for children each time you make love?† I laughed, thinking of my stock of condoms and birth control pills. â€Å"Hardly. We go to a lot of trouble not to. Too easy for us.† He leaned toward me, green eyes shrewd. â€Å"Then think about it. You understand why we would want humans. Why would humans want us?† I studied him, trying to catch up to what he'd already thought of. A few moments later, I got it. â€Å"Because you'd fulfill the opposite need. A human could have sex with a gentry girl and not worry too much about her getting pregnant. Or getting a disease.† Gentry were healthier than us in that regard. It seemed to go along with them having such long life spans- â€Å"Oh God. That would be part of it.† The more I followed his logic, the clearer and clearer it became. â€Å"You guys live longer. Gentry girls would stay young and beautiful for a long time†¦.† The horror of it was setting in. Until that moment, I had thought there were few sexual crimes worse than gentry guys consistently trying to rape me to get me pregnant. As shocking as it seemed, I was wrong. If this were true†¦if this idea that Dorian was suggesting was true†¦well. That was worse. Gentry girls taken because they were the ideal sexual partners: young, disease resistant, hard to get pregnant-even with a human. I almost laughed. It was like Tim's poem about the maiden who'd come from another world, whose beauty and youth were so great that mortal men had coveted her. The question was, how did the gentry girls feel about this role? A lot of girls wanting to get pregnant might wholeheartedly embrace human lovers-literally and figuratively. But Moria's traumatized state suggested her stint with Art hadn't been welcome†¦ I stood up and rubbed my eyes. â€Å"Oh God,† I repeated. â€Å"The stuff†¦all the stuff†¦Ã¢â‚¬  â€Å"What?† asked Dorian, understandably confused. Dropping my hands, I looked back at him. â€Å"These shamans, Abigail and Art. They live well. They have more possessions†¦nicer things than they should for the jobs they have.† Art's giant house in an upper-class neighborhood. The shiny SUV. Abigail's luxurious-albeit messy-apartment. Her extensive jewelry collection. â€Å"I don't know how, but they're making money off it. Off these girls.† I slumped against the wall. â€Å"And I don't know what to do about it.† Dorian rose and came to stand by me. â€Å"You'll stop them.† I shook my head. â€Å"It's not that simple. Art was right-there's no shaman council. I can't report them to anyone, certainly not human authorities. There's no accountability, no laws that apply here.† â€Å"They're breaking your laws,† he said, leaning toward me. â€Å"Therefore you have every right to stop them. Treat them as you would any other criminal in your land. Kill them.† â€Å"I can't!† I exclaimed. â€Å"I'd have to actually catch them here, and so far I haven't been able to. And I'm certainly not going to go to Texas and kill them there.† â€Å"Why not? If a murderer from my kingdom killed someone in yours, I wouldn't bat an eye if you came to slay him.† â€Å"It's different. They're†¦Ã¢â‚¬  â€Å"Human?† I hated to admit, but yes, there it was. I had chased Otherworldly monsters from my world back to this one and never hesitated to kill them or banish them directly to the Underworld. But somehow, the thought of intentionally tracking humans and killing them†¦ I didn't need to voice my answer for Dorian to understand. Exasperation flared on his face, this time mixed with†¦anger. â€Å"Damn it, Eugenie. You just told me you had to put things right! Which is it? Or does it only depend on what's easy at any given time? What your mood is? Who you like better that day?† â€Å"It's not that easy!† I exclaimed. â€Å"You don't understand. You can't understand. I'm caught between two worlds here, with two sets of loyalties. I've spent my entire life being human-being part of that world. You can't expect me to throw all that away and betray my own kind.† He opened his mouth to retort and was interrupted by a faint roll of thunder. Whatever words he'd been about to utter disappeared, and he laughed. â€Å"Do you hear that? That's you, Eugenie. Your anger.† I shook my head. â€Å"I can't control thunder and lightning yet.† â€Å"Not control, no. But you can summon it unconsciously. Do you think there's anything in this land that isn't tied to you?† He gestured around us. â€Å"All these people here†¦all the people in this village looking at you with adoring eyes†¦they are your own kind too. This is what I meant when I said you're the only one who doesn't seem to realize you're a queen yet! All these people are looking to you to protect them and do what's right. If you can't do that, then you might as well back off and do what the kitsune and your stepfather want you to do.† â€Å"Dorian, I can't kill in cold blood!† He gripped me by the arms, voice calm but infused with anger. â€Å"You can do whatever it is you have to do! You are a queen. Forget all this talk about Storm King's grandson. Right now, you are his heir. You are on the verge of becoming one of the most powerful rulers in this world, which means you don't have the luxury of being squeamish. You can rule with love, but you have to rule with ruthlessness too. You are going to go down in history, Eugenie, as one of the greatest monarchs we have ever seen. And it is going to start with this-this wrong that you're going to right. If you can't do it, if you can't stop those who are hurting your people, then you might as well stop the rest of this charade. Go out there and tell those people you can't do anything for them, that you can't feed them or protect them because they aren't your kind and aren't worth bloodying your hands for!† He was shouting now, breathing heavily. I stared at him, eyes wide, filled with a little of that fear I always got when his temper rose. Moments like these reminded me of just how powerful Dorian was physically and magically. His lazy, lean appearance was deceptive; I'd seen him fight. Between that and the power he wielded, I hoped there would never come a day when we were truly antagonists. Outside, I heard thunder again. It took me several seconds to muster an answer, and when I spoke, my voice was very small. â€Å"I can't,† I said. â€Å"I can't tell them that.† â€Å"I know you can't,† he whispered. And then, still gripping me, he leaned down and kissed me. More astonishingly, I kissed him back. It seemed like all the emotions that had consumed me recently-all the rage and confusion-were poured into that kiss. My teeth bit against his lips, and when he shoved me against the wall, I welcomed the brief pain. Our hands were all over each other as we kissed, mine running the length of his body while his more aggressively hiked up the dress I'd earlier regretted wearing. In a matter of seconds, it was pushed over my hips, leaving my legs bare. With one hand still holding the skirt up, his other pushed between my thighs, slipping underneath the thong I'd put on this morning in the hopes of getting intimate with Kiyo. Those clever fingers slid into me, stoking a wetness I hadn't thought could come on so fast. My small exclamation was muffled in his crushing kiss as he alternately thrust his fingers into me and pulled out to tease and dance with my clit. It was the latter he eventually settled on, circling and stroking as heat built between my legs and made all my muscles tense up. Then, the burning flood of sensation exploded, and I came with another cry that his kiss smothered, a cry that faded into a moan as my body trembled and spasmed from the shock waves of heat and electricity still shooting through me from his touch. My orgasm created no pause in the action, though. The hand that had just brought me such pleasure moved from between my legs to his pants as he began to unfasten them. His mouth finally left mine, moving on to my neck, his kisses hot and fierce. He shoved his pants down, and I felt him against me, hard and ready as he pressed his hips to mine. My hands were tangled in his hair as I tilted my head back to receive his kisses, but his hands, busy as always, were prying off my underwear. The reality of what was happening sank in. â€Å"Wait†¦Ã¢â‚¬  I murmured, lost as his mouth bit against my skin. â€Å"No, we can't†¦I can't†¦Ã¢â‚¬  â€Å"You can,† he breathed in my ear. â€Å"Let me†¦let me do it. Let me bury myself in you. Let me spread your legs and take you like I did before. We are gods in this world, Eugenie, with no other lovers who are our equals. No others who are worthy of this joining.† The thong was on the ground now, and I could feel his erection pressed against my skin, so, so close to sliding in and doing all the things he promised. He rested his hands under my thighs and hoisted me up against the wall so that my legs wrapped around his hips. â€Å"Dorian†¦Ã¢â‚¬  I gasped. â€Å"I'm with Kiyo†¦.† â€Å"So? You're a queen. Do you think you can't have as many lovers as you like?† â€Å"It's†¦it's wrong. We can't†¦Ã¢â‚¬  â€Å"We can,† he said, voice low and full of promise. â€Å"And when we do, this land will be reborn†¦.† Afterward, I would never be entirely sure if I would have let him do it. I like to think I would have stopped him. I was in love with Kiyo, after all, and loyal to him. Surely I would have said no and shoved Dorian aside. I wasn't in love with him†¦or was I? In those moments before we'd kissed, I'd felt like he truly got me and understood the things in my head. I think I'd probably loved him since around the time we'd met; I certainly never lost the attraction. Still, that didn't make cheating on Kiyo right. Whatever decision I would have made was taken from me when there was a knock at the door. I jerked away from Dorian and hastily shoved my skirt down. He more casually turned away to pull his pants back up, seeming in no particular hurry. The door opened, and the lead councilwoman stuck her head in. Even with Dorian's back to her and me dressed, it had to have been obvious what was going on-particularly with my underwear on the floor. If she found it shocking, though, she didn't show it, and I recalled how free the gentry were in public. â€Å"Your majesties,† she said politely, â€Å"there's a storm coming in, and the workers were wondering what the Oak King wanted to do.† Dorian, decent once more, turned around and gave her a laconic, charming smile. â€Å"A storm? Really? How truly unexpected. Well, tell them to bring as much of the ore as they can into storage before the rain and cover the rest up. I'll come check on it in a moment since I have a feeling the Thorn Queen is about to depart with some haste.† The woman gave a quick curtsey and shut the door once more. â€Å"You're right,† I said, jerking my thong back on. â€Å"I'm leaving.† â€Å"Yes,† he agreed, still smiling. â€Å"Because that's your normal course of action when something happens that you don't know how to process.† â€Å"That's the thing,† I growled. â€Å"Nothing happened here, okay? None of this did.† His eyebrows rose. â€Å"Really? Because I could have sworn that something happened when my hand was between your-â€Å" â€Å"No!† I would have approached him with clenched fists to drive home my threat but was afraid of what would happen if I was close to him again. â€Å"This didn't happen. This was anger and confusion and me in a weak place, okay? I appreciate what you've done here with the copper-really. And for the advice on the girls. But that's it.† I turned, not wanting to look into those green eyes or see that smirk anymore. I didn't want to admit that loving two men was just like the rest of my life, ripped into two worlds. I needed to get out of here and get back home-though I wasn't sure which home I meant. Dorian didn't try to stop me, but his voice rang out after me as I hurried out and rain began to fall outside. â€Å"Don't forget what I said, Eugenie. Crown or not, you are a queen, so don't be afraid to do what you have to do. Love and ruthlessness. Those are the keys.†