Thursday, October 31, 2019
HR - Final Essay Example | Topics and Well Written Essays - 3500 words
HR - Final - Essay Example The role of HR is changing fast with leapfrogging technological and marketplace advancements. The HR departmentââ¬â¢s primitive objectives were to ensure a smooth personnel management system, administration, hiring process etc. It was considered as a administrative overhead. The present day HR role is more strategic. It is directly connected to business success, revenues and opportunities being seized for organisational benefits and accomplishment of long terms and short term goals. (PWC, 2012, p. 1) As the industrial revolution began, it took the entire world in its grasp, changing and transforming work, its definition and the way people approached them. New roles got created starting from financial accountants, lawyers, executives, sales personnel, managers, administrators etc. Divisions such as Finance, Sales, Marketing, Legal, Accounts etc got created, roles got assigned to such departments and several designations like specialists, senior specialist, intern, contractor, proba tioner, part timer, summer worker etc got created. Human Resource Management in the 1800s or earlier involved clearly defined tasks such as recruitment, appointment with roles and responsibilities, observation during probation period, confirmation, appraisals, compensation and promotion. The scope of the Human Resource Management was limited and there was nothing as Strategic human Resource Management, as strategy was not required. What was important during the pre-industrial revolution and the pre-20th century period was finding the people with necessary qualification to do a particular job. Monopoly existed, competition was unimaginably less, organisation processes were simpler, goals were easier to comprehend and tangible. Therefore the Human Resources Arm either did not exist as a specific department or even if it did exist, it had limited scope and function. Work mainly had to do with a lot of physical exertion and there were very few main stream disciplines like: teaching, des igning, building, carpentry, plumbing, construction, electrical work, research, practising medicine, surgery, law, policing, agriculture, army and civic operations. As a result of the limited scope of work, Human Resource Management had limited things to deal with and was relatively underdeveloped. The real shift came into the picture form the 1900s when the very definition of work and profession started changing. After the industrial revolution, thinkers, entrepreneurs and leaders around the globe identified a tremendous potential for their respective businesses to flourish. The scope for growth given the industrial boom and technological leap was found to be immense. This needed information management. Thus the gradual change in the nature of work, its perception and treatment started. Work changed from the simple paper and pen based design, hand tooling of machines, laborious exercises of packaging, unpacking, in short Assembly Line work to knowledge work. A change in the Human M anagement Strategy followed. Fundamentals were changes. How work is defined and how people fit in to their roles, how organisations create and handle work, how businesses are run with the help of knowledge forever changed the system of the Human Resource Management System. With time HR departments became important entities in organisations, its effectiveness affecting the organisationââ¬â¢s performance, general perception, market value and reputation to a great extent. (Rai, 2012, p. 1) As organisations
Tuesday, October 29, 2019
International Monetary Fund Essay Example for Free
International Monetary Fund Essay The International Monetary Fund (IMF) is a central organization in the world whose mandate of establishment in 1945 revolves around world economic and monetary cooperation (imf. org, 2006). By following microeconomic policies of the member countries, this intergovernmental organization manages or oversees the global financial system. In this organization, almost all the countries in the world work together in cooperation for the common good. The primary purpose of IMF is to propagate and stabilize international monetary system which is key in ensuring and maintaining stable international payments and exchange rates that are critical in promoting trade between countries. In its efforts to ensure stability of the international monetary system, IMF has the responsibility of reviewing the financial developments in the national, regional, and global arena. The major purpose for which International Monetary Fund was established can be explained in three points. First is to promote stable exchange rates while at the same time ensuring that order is maintained in the exchange arrangements between its member countries and to prevent competitive exchange from depreciating. Secondly, IMF was established to enhance the expansion of international trade in a balanced manner so that all the member countries can benefit from increased levels of employment and real income in addition to better development and utilization of economic resources of these member countries. Thirdly, IMF has the mandate to contribute in the establishment of a new system of payment which is multilateral in nature and which functions to eliminate the many restrictions imposed by foreign exchange and which impedes the blossoming of world trade (munfw. org, n. d). The 184 member countries are required to adopt policies which protect them from financial and economic crises, promote economic stability and policies which have the capacity to raise the living standards of the citizens (imf. rg, 2006). In any given organization, the mission and the set goals are very important since they form the basis for the strategies and management of different affairs in the organization including the critical area of decision making which determines whether the goals will be achieved or not. It is therefore the objective of this paper to describe the mission and the goals of International Monetary Fund and also analyse the process of decision making in the orgaization so as to achieve these goals. One of the mission of IMF is to offer financial assistance to various countries which have faced crises of balance-of-payments as a result of domestic policies. The governments of such countries do not have a choice other than to borrow from the IMF so as to propagate various economic activities in their countries. On the part of IMF, it has to safeguard the interest of the shareholders and therefore it requires that the countries borrowing the funds put in place stringent policy adjustments which will facilitate repayment. Another mission of the IMF is to function as a reserve pool for global economies. This is in light of the fact that various countries especially in the developed world have accumulated colosal amounts of resources and money which act to insure them against shocks. On the other hand, many countries especially in the developing world lack the capacity to accumulate resources for insurance purposes but rather would use them for consumption and investments. The IMF therefore in this case acts as reserve pool which can manage these reserves so that even poor countries can access financial assistance in times of economic crises (Eichengreen, 2009). The third mission of the IMF is to act as a supervisor with regard to macroeconomic activities and trends. This means that it has to be very prudent in keeping an eye on the prevaling financial conditions or trends in the whole globe and in case of any signs of financial instability, provide warnings on the same so that appropriate actions can be taken. However, it has only played a supporting role since most of these activities have been undertaken by the Financial Stability Board (FSB) following the suggestions by the G-20. The goals of the International Monetary Fund are in line with the goals set by the international community in 2000 popularly known as the UN Millennium Development Goals. These goals focus on fundamental aspects of human existence and are geared toward ensuring improved living standards by curbing poverty and improving the health of world populations. The time frame for the achievement of these goals is set to be by the year 2015 and therefore decision making and actions taken are done systematically and resources managed carefully to meet the set deadline. The areas of focus of the first seven goals are on eradication of extreme hunger and poverty, ensuring that primary education is accessible by all children, empowerment of women and promotion of gender equality, improvement of maternal health and reduction of child mortality. The sixth goal is with regard to HIV/AIDS, malaria and other diseases which have been wrecking havoc in many developing countries. The seventh goal focus on issues of environment in that IMF intends to achieve environmental sustainability by the year 2015 (imf. org, 2010). The last goal requires that a global partnership for development be formed to address issues of debt relief, aid and trade. Decisions made by the IMF are meant to ensure that the resources available are managed carefully so that the organization can meet its goals without having problems caused by lack good management of available resources in many organizations. From the goals described, it is clear that IMF targets to offer assistance to poor countries in order to overcome some of the most common challenges facing them such as disease, poverty and illiteracy. However, the organization is not a development institution like the World Bank and regional development banks. This implies that it has no mandate to provide funds for building physical infrastructure in the poor countries rather it only offers loans to the low-income countries on concessional terms in an effort to ease the pain which these countries have to endure when making critical adjustments in terms of their spending (imf. org, 2006). The purpose for making these adjustments is to bring the levels of spending to the right levels which are commensurate with their income. Consequently, this promotes important reforms which enhance much stronger and sustainable economic growth which results in poverty eradication in the affected. In addition, following streamlining of a countryââ¬â¢s economic policies, the IMF loan given to a particular country may attract other donors who are encouraged to provide more financial support. Therefore, this organization has well elucidated approaches which are used to fight poverty and achieve the rest of the goals which it has set to accomplish by the year 2015. Decision making at the IMF revolves around two major aspects one of them being on membership of countries which may want to join the organization and on the other hand on the internal operations of the organization. Both of these areas are quite important in ensuring the sustainability of the operations within IMF. For instance, bearing in mind that the major source of money of the organization is the quotas which are contributed by different countries upon joining the organization, decision making at this stage is critical since it impacts directly on the financial stability of this organization. Quotas are basically a reflection of the size of the economies of the member countries so that a country with a broad economy in terms of variability of trade, national income, monetary reserves and output is required to deposit more into the IMF kit than a country whose size of the economy is small and whose trade variability is not great. The decisions made on the amount of quota a particular country is required to deposit also affect the voting power of that country as a member of the IMF. This means that, the larger the quota of a member country, the more decision making power or voting power it possesses. For instance, the US contributes the largest quota into the IMF kit and therefore has the highest decision-making power at nearly 18%. On the other hand the whole African continent due to its small quota in the IMF possesses only a 5% decision-making power (munfw. org, n. d). The Board of Governors can review these quotas periodically and increase them when deemed necessary. The IMF staff and management comprise of different bodies which govern and manage the affairs of the organization to facilitate the realization of the laid down goals by 2015. These include the Board of Governors, International monetary and financial committee, the Executive board, and the standing committees. However, the important decisions are made by the Board of governors. The whole IMF staff and the management are accountable to the managing director of this organization who is appointed by the executive board to whom he is also accountable. The supreme decision-making body of the IMF is the Board of governors which is made of one governor and one alternate governor from each member country who is appointed to represent the interests of the country at the organization. The alternate governor of each member country is usually the governor of the central bank or the minister of finance. The board of governors is bestowed with the responsibility of making decisions concerning membership and also internal operational activities of the organization such as changes that might be required to the Fundââ¬â¢s structure. Decision making process requires ample time and therefore the Board of governors usually meets twice every year to deliberate on critical issues. The Executive board has the responsibility of carrying out the day-to-day activities of the organization. The board is chaired by the managing director who is assisted by three deputy managing directors. The member countries or groups of countries elect or appoint 24 executive directors make the bulk of the board. To ease the decision making process at the board level, most member countries are grouped into constituencies but the largest shareholders that is US, Germany, Japan, UK, France are not grouped but instead each has one chair. The decision making with regard to appointment of executive directors is in some countries based on the number of votes that a particular country has so that a country with the highest number of votes appoints the executive director. Good decision making process is characterized by consensus and this is adequately embraced in the organization whereby the board relies on consensus in making decisions. The nature of this consensus is determined by the number of executive directors who agree or disagree with a certain issue. In the light of the principle that a good decision making process gives room for opinions and views from all members involved, IMF is keen to allow for a voting exercise to take place in case different opinions crop up in the initial stages of the decision making process. In this voting approach, a needed majority is established in order to give a direction on decision making. However, the percentage majority required will be determined by the nature of the decision which is being made so that a 51%, 66% or 85% majority may be required (brettonwoodsproject. rg, 2005). During this process, the managing director of the IMF who chairs the executive board is required to advice the board to consider matters arising and be patient until that time when a broad majority has made a clear decision on the issue under discussion. Decision making process is characterized by the presence of options or alternatives so that if one fails, the other alternative can be employed to see whether the anticipated results will be achieved. This is exactly what happens at IMF when the majority still fails to precipitate consensus. The alternative is to go by the simple majority of the voting power in which a decision can be quickly made through a collective agreement involving G-7 chairs and a few directors (brettonwoodsproject. org, 2005). The IMF as a firmly rooted organization is therefore a good example of an organization whose excellent management strategy is reflected by its ability to facilitate many poor countries especially in Africa overcome common challenges such as poverty and disease. The mission and the goals set by this organization go hand in hand with the Millennium Development Goals and therefore consistent management of all the resources available to the organization is critical to meet the 2015 time target. The decision making process employed by the IMF also points to one of the key reasons for successful operations since it offers alternatives, democracy and dialogue in addition to the well organized management staff.
Sunday, October 27, 2019
An Exegetical Essay On John Chapter 1 Religion Essay
An Exegetical Essay On John Chapter 1 Religion Essay INTRODUCTION Unlike the synoptic Gospels, the Gospel of John does not begin with the historical Jesus, instead, the author exalts his eternal existences over his earthly entrance into the world. The eternal existence of Jesus is perceived by the use of Word (logos) in the prologue. Thus, the author begins his gospel with the words, In the beginning was the Wordà ¢Ã¢â ¬Ã ¦ Johns Gospel stresses on the deity of Jesus, he strikes the reader straight with the Greek Word (Logos) as a replacement of Jesus until the end of the prologue. One could say that the understanding of this Gospel is centred on the Word (logos) as a key affirmation of the entire Gospel. The prologue affirms that Jesus used the eternal Word which has been translated from the Greek word (logos). In chapter (1:1-5) the author talked about the pre- existence, in (1:6-8) he elaborated on the witness of John the Baptist, in (1:9-13) he highlighted on the light coming to the worlds, in (1:14-18) he accounted on the incarnation of th e Word. This prologue is specially or specifically designed to prepare the way for the evidence of the doings of no ordinary person but Jesus Christ. This paper is an attempt to exegete the passage of (John 1:1-18). The Pre-existence Word (1:1-5) The commencement of this Gospel as stated, in the beginning was the word has something to do with (Genesis 1:1). John was trying to say that Jesus Christ was in the beginning and He was the Word which existed in the beginning before creation or before the world began and was fully God (John 1:1-3). Jesus is indeed the creator, sustainer of all belongings, our source of living and the establishment of eternal life. To understand this concept one must commence with the Father-Son relationship which is the central revelation of Johns Gospel and also the key to understand the sayings and deeds of Christ Jesus (17:5, 24). Extensively, this term (logos) which has a meaning in English as the Word was used in Greek literature or theologians and philosophers; among them were the Stoics who used the term to describe the principle of divine reason which caused the natural creature to grow.à [1]à Philo of Alexander was the mastermind of this idea in his writings and maintained it as an instr ument of the world creation. There are dissimilarities between the usage of the Word by John and Philo. In the mind of Philo, he by no means consider the Word as a person and he did not maintain its pre-existence, he denied the incarnation of the Word which is known as Jesus. But in Johns mind the Word was maintained and became flesh. This points to Jesus Christ who came to save humanity and dwell among them. One could say the fifth verse of this chapter shows the compassion of the author as a beloved disciple and an eyewitness of Jesus who is trying to communicate the good news to the Jews, Greek philosophers and all kinds of people from generation to generation in his writings. Here John declares that Jesus Christ is the true light, who shines in the darkness, but the darkness which can be translated as sinful man has not understood it. The better understandings of this verse rely on (verse10-11).à [2]à Witness of John the Baptist (1:6-8) At this point, the author diverted his thought form eternity towards historical. These verses point to the identity of no other person but John the Baptist who is not the light; however Johns job is to testify that Jesus is the coming light. This testimony of John appears strongly in public in (verse 15-34).à [3]à Johns idea is that, people might believe in Jesus alone and that He is the saviour. Light Coming to the World (1:9-13) In verses 9-13, Johns emphasis has changed from witness to Jesus as the true light that gives light to every man coming into the world. He is the fulfilment of all light foreshadowed and the one who called light into existence (Genesis 1:3).à [4]à Regarding the statement of John concerning the world did not recognise him here it means something further than created world? John is referring to people who opposed or do not believe in God or those who reject Christ as the true light. The Israelites were chosen by God to prepare the rest of the world for Christs coming but they rejected Him despite the prophecies recorded in the Old Testament.à [5]à In verses 12-13, the author elaborates on how some people received the Word. Johns centre of attention is based on the covenant people of God or believers who receive the power to be children of God. This implies to the children who are not born of natural or physical human descent. This is for those who receive Jesus Christ as their personal saviour; they are spiritually born again and have received a completely new life from God through faith. Incarnation of the Word (1:14-18) This last section of the prologue explains how the divine Word points how Jesus came into the world in a human form. Apostle Paul, one of the major characters in the New Testament writings understood this concept (Colossians 2:9). The word became flesh and made his dwelling among us (John1:14). The first century church debated on how the Word who was God could become human but thats not important to John because his main concern is to explain the price that Christ paid. The bible explains how Gods presence was in the midst of the children of Israel in the tabernacle (Exodus 40:34-38), although that was on temporal basis. John also has a similar view in a sense that the Word became flesh or Jesus became like mortal human being and made his dwelling among us likewise Gods presence to the children of Israel in the tabernacle. According to Kruse, the reference to glory is also an allusion to Gods presence in the tabernacle. Moses was instructed by God to build a tabernacle and after fini shing Moses couldnt enter the Tent of meeting because it was covered by the cloud and the glory of the Lord filled the tabernacle (Exodus 40:34-35). And that same way Gods glory is been manifested in the Word made flesh. John was an eye witness to Christs earthly life and ministry and he saw His glory. He firstly saw the glory of the One and Only who came from the Father. Further more, he saw Christ as the one who comes from the Father and the fact that he is the source of grace and truth.à [6]à The evangelists intention is for people to see Christs ministry us a manifestation of Gods grace and an exposure of his truth. Christ makes it possible for people to know God better than before, for the reason that God became visible and tangible in Christ. And he is the perfect manifestation of God in human form. Moses accentuated the law of God and His justice, but Christ emphasized His mercy, forgiveness, faithfulness and love. Moses was known as law giver, however Christ is known as the fulfilment of the law (Matthew 5:17).à [7]à This last verse of the prologue is a reminder of the first verse. There was no other better means for people to know God unless the Word point to Jesus Christ the One and Only Son of the living God. Regarding the statement John made that no one has ever seen God it has something to do with the OT in a sense that Moses did not have the chance to see God face to face, although prophet Isaiah said my eyes have seen the King, the Lord Almighty (Isaiah 6:5), none of the prophets were able to see Gods essential nature. He may be seen in anthropomorphism, but Christ Jesus made it possible to His inner essence or nature. Through Jesus Christ Gods nature and will is been revealed. The more a person gets closer to Christ, the better he or she understands the will of God. In Christ people saw the clear picture of God and even touched Him.à [8]à Conclusion The major concern of John in his prologue is to portray Jesus as an eternal being who has existed from the beginning with God. Furthermore, the prologue describes the incarnation of Christ, by coming in human form so as to identify with humanity and to save them from sin. John shows us the complete deity, the divinity and the fullness of God in Christ Jesus. Christ makes it possible for people to know God better than before, for the reason that God became visible and tangible in Christ. And he is the perfect manifestation of God in human form. Moses accentuated the law of God and His justice, but Christ emphasized His mercy, forgiveness, faithfulness and love. John wrote this gospel so that we might believe that Jesus Christ is the Son of God and by believing we may have eternal life (John 20:31).
Friday, October 25, 2019
Ordinary People :: essays research papers
à à à à à ââ¬Å"Why does the world go on when things like this happen?â⬠, is a quote by Gerda Weissman Klein. This means that unfortunately, incidents that donââ¬â¢t always have a positive impact on our lives, can not hold us back from moving on, or the world form continuing its business. Ordinary People by Judith Guest is a fine example of when the world goes on when you experience a grief so great that you felt almost as if the world betrayed you continuing to allow the sun to rise every and the birds to sing in spite of your pain. Ordinary People deals with the hardships of one ââ¬Å"ordinaryâ⬠familyââ¬â¢s day to day life. à à à à à à à à à à Buck Jarret brother of Conrad and son of Calvin and Beth was sailing in bad conditions with his brother when their sailboat capsized. Conrad was most effected by this tragedy. Judith Guest uses characterization to reveal this pain that Conrad holds deep down inside. Conrad is so effected by this accident that he eventually attempts to commit suicide, however he is unsuccessful due to the fact that Calvin walked in on him. Conrad could not deal with the hardship of not having the brother he once had and loved. Conrad believed that the choice was his to decide whether or not he wanted to watch the sun rise or listen to the birds sing every morning . Calvin stated that there was one thing he did wrong and that was that ââ¬Å"he stayed with the boatâ⬠. à à à à à Beth Jarret can be used as more of an indirect relation to this quote. Beth awoke one night to find Calvin missing from her bedside, when she went downstairs looking for him she found him sitting at the dining table crying. Calvin was upset at the fact that Beth fails to show affection for her son Conrad. Calvin stated ââ¬Å"Its almost like you buried all of your love with Buckâ⬠. Calvin continued to explain how he has been thinking and he is not sure if he is in love with Beth anymore due to her actions. Guest uses very dramatic dialogue to develop the level of seriousness in this crucial conversation Calvin feels great pain over this situation but yet the sun rises the next morning only to bring an understanding between Conrad and Calvin.
Thursday, October 24, 2019
Highschool Stereotypes Essay
When you first enter high school, you can face many different difficulties. (exams, new friends, drama etc. ) But one of the most stressful difficulties of all are stereotypes. ââ¬ËWhat is a stereotype? Where do I fit in? Do I Have to fit in? ââ¬â¢ are just some of the things you may be worrying about. There are three main stereotypes that I have come to recognize that are in almost every single school. The preps, the nerds, and the emos. I will help you classify which is which and understand the difference so that you can determine whether you want to fit in with these groups, or go your own way. The first main stereotype is the preps. They will usually be well talked about and you will hear their names often. They dress nice in expensive clothing, are usually wealthy and are sometimes in sports like football or cheerleading. This stereotype is usually filled with good-looking people and these types of kids are known to be meaner than average. There are advantages and disadvantages to being one of the preps. Some good things about being one is that you are well known, people envy you and want to be your friend. You usually have fun because you are invited to parties and everyone wants to be around you. A few disadvantages are that youââ¬â¢re expected to dress nicely at all times, you are also supposed to act accordingly even if that means being rude to someone else. The second stereotype is the nerds. These kids are the exceptionally smart ones. These are the people in your class that get straight Aââ¬â¢s. They enjoy doing homework and extra credit and are usually known to be socially awkward. They often wear glasses or braces or breathe heavily and often get bullied. Just like every other stereotype I am talking about today, being a nerd also has itââ¬â¢s own ups and downs. Some advantages are that you get excellent grades, which makes teachers impressed, and parents proud. Also, since youââ¬â¢re academically higher you are more likely to get into a good college and get an excellent education, which will probably lead to a high paying job in the future. Some downsides are that you wonââ¬â¢t be invited anywhere fun, probably wonââ¬â¢t have many friends and might get picked on a lot by classmates or bullies. The third stereotype is the emos. This is probably the easiest stereotype to spot out. They dress in all black, very dark makeup, dyed black hair and are usually depressed and donââ¬â¢t speak to anyone outside their circle. They frown upon the normal members of society and think they are ââ¬Ëdifferentââ¬â¢. They are usually sad and their conversations revolve around how they want to die and how terrible life is. These kids despise the preppy kids and hate anything happy or cheery. They usually spend a lot of time skipping class together, and chatting online to each other. The upside to joining this stereotype is that they have an odd sense of community. They all stick together no matter what and listen to each otherââ¬â¢s problems. Some of the downsides are that you are looked down upon by most people in society, and most people do not want to approach you or get to know you. It will be hard for you to get a decent job, and people will make bad assumptions about you. Well, now you know the 3 main high school stereotypes. The preps, the nerds, and the emos. You can be mean and popular with the preps, be geeky but have good grades with the nerds, or be depressed but have a sense of community with the emos. You can weigh out the positives and negatives for each and decide if one of these groups is right for you or you can decide to just be yourself and go your own path.
Tuesday, October 22, 2019
A New Intervention to Reduce Anhedonia in Schizophrenia
Meta-analyses of cognitive behavioral therapy for positive symptoms of schizophrenia have demonstrated its effectiveness in reducing hallucinations or delusions. In schizophrenia ââ¬Å"negative symptomsââ¬â¢ refer to a reduction of normal functioning, and it encompasses apathy, anhedonia, flat effect, avolition, social withdrawal, and, sometimes, psychomotor retardation. The purpose of this study is the idea that Anhedonia is a challenging symptom of schizophrenia and remains largely recalcitrant to current pharmacological treatments. The goal of this exploratory pilot study was to assess if a cognitive-sensory intervention could improve anticipatory pleasure. Results show that the patients improved on the anticipatory scale of the Temporal Experience of Pleasure Scale. Daily activities of the patients were also increased. In nursing research, it has been shown that the sense of mastery is negatively correlated with negative symptoms or even with the fact of being left alone. Two research questions were addressed in a sample of five participants. Does cognitive-sensory training in anticipatory pleasure in persons with schizophrenia? Does cognitive-sensory training in anticipatory pleasure lead to an increase in the number and complexity of daily activities performed by persons with schizophrenia? They did not expect that anticipatory pleasure cognitive skills training would directly improve consummatory pleasure. If persons with schizophrenia show a deficit in their ability to anticipate pleasure rather than consummatory pleasure, then it becomes possible to consider cognitive training might help these individuals anticipate pleasure from foreseeable, future activities. I feel the author did a good job using literature to support their predictions and I was convinced by their argument. The author used well supporting concepts to prove their points as they discussed theories about Anticipatory Pleasure Skills Training: A New Intervention to Reduce Anhedonia in Schizophrenia. I particularly liked the idea that they did a two year comprehensive program including assertive community treatment, social skills training, and multifamily therapy groups that led to significantly less positive and negative symptoms, less comorbid substance buse, and significantly greater satisfaction with treatment. The author thought a more specific and symptom-centered approach because they felt it might lead to specific improvement in a shorter period of time. This symptom-specific strategy has been used in other studies for positive symptoms, allowing the development of successful specific therapeutic techniques. The case studies presented in this article highlight the use of this specific symptom approach for Anhedonia. Anhedonia has been defined as a reduction in the ability to experience pleasure. It has been regarded as a core clinical feature of schizophrenia. Research has produced a paradoxical set of findings, raising questions about its nature. Individuals with schizophrenia typically report experiencing lower levels of pleasure in their daily lives than non-patients on self-report measures of trait social and physical Anhedonia. Anticipatory pleasure is linked to motivational processes that promote goal-directed behaviors; consummatory pleasure is associated with satiety. The Temporal Experience of Pleasure Scale is a trait measure of pleasure that distinguishes between ââ¬Å"momentary pleasureâ⬠and ââ¬Å"anticipation of future pleasure activities. The illumination of a new way of conceptualizing Anhedonia in schizophrenia permits redefinition and calibration of the symptom complex as a target for treatment. If persons with schizophrenia show a deficit in their ability to anticipate pleasure rather than consummatory pleasure, then it becomes possible to consider that cognitive training might help these individuals anticipate pl easure from foreseeable, future activities. Greater ability to anticipate pleasure would lead to a meaningful increase in spontaneous daily activities performed. Five participants were included in this pilot study. The participants were recruited from the regular clinical practices of the authors. The first and second authors were working in a mobile team of a community psychiatry outpatient service. The different members of this team worked as clinical case managers and were specialized in engaging difficult-to-reach patients in a comprehensive recovery program including therapeutic, occupational, and vocational services. The third author was working in a nursing home for psychiatric patients. The intervention was proposed to the patient when Anhedonia was reported as a challenging behavior impeding improvement in the care of the patient. To be included, participants had to be on a moderate dose of maintenance antipsychotic medication, with stable dosage for at least the past 3 months, and not be suffering from a major depression (score less than 12 on the Calgary Depression Scale for Schizophrenia [CDSS]). As the intervention was delivered in the routine care, signed informed consent to use the gathered data was obtained retrospectively for patients 1, 2, and 3. The internal review board of the nursing home approved the study, and patients 4 and 5 signed the informed consent form before their participation in the study. The participants were four men and one woman. All participants met the Diagnostic and Statistical Manual of Mental Disorders (4th edition, Text Revision) criteria for schizophrenia (American Psychiatric Association, 2000). Diagnosis was obtained at the referral time with discussion with the referring psychiatrist. Participant 1 left school by the age of 16 and had no further education or training. He had been housebound for 3 years except during acute somatic or psychiatric care. Participants 2 and 3 were working part time in competitive employment. Participants 1 and 2 lived at home with their parents; participant 3 lived alone in her own apartment. Participants 4 and 5 had been institutionalized in a nursing home for 14 years and 30 years, respectively, and did not work. Participants 1, 4, and 5 had a history of alcohol abuse. Participant 1 used cannabis when friends visited him at home. The intervention is a cognitive-sensory intervention that aims at increasing anticipatory pleasure. Participants are trained in state of relaxation to anticipate pleasure from potential enjoyable activities and to get the sensation of the pleasure in their bodies. The different steps of the program are described below. 1. Building the rationale for the intervention. The rationale is built by asking questions to participants in order to elicit the importance of being able to anticipate pleasure from future activities, and the links between desire and motivation. Examples of these questions are: How do you prompt yourself to engage in activities? What makes an activity more or less attractive? What are your criteria to assess if the effort to engage in an activity is worthwhile? 2. List of pleasant activities. The therapist and the patient will list past enjoyable activities that the person would like to resume, actual activities that the person would like to increase, and novel activities associated with new roles that the person would like to assume. For example, a participant who wants to be closer to his/her sister could engage in the activity of preparing a dinner for his/her sister and her boyfriend. . Classifying activities according to their difficulty. These listed activities are then classified according to the difficulty and complexity of the task. The classification is done from easy-to-do to difficult-to-do. Examples of simple activities are (a) going to the corner of the street and having a kebab, (b) taking a walk with a good friend, (c) taking a shower, etc. Complex activities related to social or professional roles are split in smaller reachable units before engaging in a more challenging activity. For example, going to the stadium to support one's favorite hockey team could be split in a more achievable goal such as inviting a friend to watch one's team on TV if going to a crowded sports arena is an obstacle to engaging in the activity. 4. Anticipating pleasure. During the first sessions, the therapist uses standardized material to teach the anticipatory skills. The material is composed of attractive picture-viewing activities such as biting an appetizing apple, drinking a frothy coffee presented in a lovely cup, or walking in a beautiful park. In subsequent sessions, the training focuses on the activities listed with the patient. At the beginning of each session, as patients may be ââ¬Å"contaminatedâ⬠by co-occurring unpleasant emotions (Horan, Green, Kring, & Nuechterlein, 2006), the therapist will start with a mindfulness or relaxation exercise to help the patient be in a comfortable, pleasant emotional state. Then, the patient is asked to imagine doing the chosen activity. The therapist guides the patient to imagine the sensations linked to the activity through the senses involved (sight, hearing, touch, smell, and taste). The patient is invited to remember past positive experiences of the activity (e. g. , Imagine that you are smelling the odor of the best kebab you have ever eaten . . . Feel the smell of the grilled meat in your nose . . . Concentrate on this odor . . . Try to feel it as vividly as possible). The patient is asked to anticipate pleasant emotions (e. g. , Feel the sensations associated with the joy of being with your friend . . . You told me that this friend is funny . . . Imagine the sensations that go with laughing. Scan your body and remember how it is to laugh . . . ). According to the anticipated activity, the patient may be guided to anticipate the feeling of accomplishment (e. g. , Feel the contentment of getting out of the shower. . . How is it to feel clean and fresh? Try to get this feeling fully . . . Anticipate the sensation of reward. . . How is it? ). If the patient shows difficulty in imagining sensations and feelings, pictures can be presented. Patients have to assess their desire to perform the activity on a 5-point scale before and after each exercise. 5. Prescribing homework exercises. As participants develop anticipatory pleasure skills, the therapist prescribes homework exercises. After participants accomplish single activities in daily living, more difficult activities are trained. Participant 1 received 10 hours of training at home, aimed at giving him the desire to go outside. Participants 2 and 3 received, respectively, 25 hours and 20 hours of training at the therapist's office. Participants 4 and 5 received 11 sessions of 1. 5 hours of training each in a weekly group session. Instruments: The therapists have administrated the instruments as clinical tools to assess anticipatory and consummatory pleasure, time budget, negative symptoms, and depression. The TEPS. The TEPS measures momentary pleasure and pleasure in anticipation of future activities. It is an 18-item self-report measure of trait, and anticipatory (10 items) and consummatory (8 items) pleasure (Gard et al. , 2006). The validation of the French version of the TEPS shows psychometric characteristics similar to the original version (Favrod et al. , 2009) with a satisfactory internal and external validity. The mean theoretical range of the two scales goes from 1 to 6; higher scores indicate more pleasure. The scale was administrated in pretests and posttests. The Time Budget Measure: The measure developed by Jolley et al. (2005, 2006) takes the form of a weekly diary completed retrospectively during a structured interview with the participant. In completing the measure, interviewers probe for activities, degree of independence in activities, and number and nature of social contacts. They also check that the week is a typical or average week, and, if not, complete the time budget on a different occasion to assess an average week. Each day is divided into four time blocks (morning, lunchtime, afternoon, evening). Each time period or block is then rated from 0 to 4 as below: 0 = nothing ââ¬â lying, thinking, sleeping, sitting, etc. , 1 = predominantly passive activity (e. g. , watching TV, listening to the radio), 2 = an independent activity requiring some planning and motivation, but relatively simple or brief (e. g. , a walk to the local shops to get cigarettes, tidying room, washing up, preparing a simple meal for oneself), 3 = several two-rated activities completely filling a time period, sounding ââ¬Ëbusy', or a more complex and demanding, but unvaried or shorter activity (e. g. a visit involving public transport, prolonged social contact with others), and 4 = time period filled with a variety of demanding independent activities requiring significant motivation and planning, and with some variation in tasks (e. g. , work, a course of study, a trip out requiring organization). When more than one activity is present, the highest scoring activity is rated. There are 28 time blocks for the week, and the total possible score ranges from 0 to 112. The time budget was not used for the patients in the nursing home because the time-budget of these patients depended on the institutional routine. The week assessed should be a typical or average week, and if not, the time budget is completed in relation to a week chosen to be more representative. Time budget has a satisfactory criterion and construct validity, and shows good inter-rater reliability and test-retest reliability (Jolley et al. , 2005, 2006). In the present study, the participants were interviewed on their time budget starting from the day before the assessment meeting until 7 days before this meeting. The time budget was assessed in pretests and posttests. The CDSS. The CDSS was used to assess depressive symptoms (Addington, Addington, Maticka-Tyndale, & Joyce, 1992). The CDSS is a largely validated interview-based measure that has been shown to assess depression rather than positive, negative, or extrapyramidal symptoms (Addington, Addington, & Maticka-Tyndale, 1993, 1994; Addington et al. , 1992). The scale is validated in French (Lan?on, Auquier, Reine, Bernard, & Toumi, 2000; Lan?on, Auquier, Reine, Toumi, & Addington, 1999). The CDSS was administrated in pretest only to assess the severity of depression. Depression defined by the Diagnostic and Statistical Manual of Mental Disorders (4th edition, Text Revision) criteria for major depressive episode corresponds to a mean score of 11. 8 (standard deviation [SD] = 3. 8) on the CDSS (Kim et al. , 2006). The Scale for the Assessment of Negative Symptoms Anhedonia/ Asociality. The Scale for the Assessment of Negative Symptoms (SANS) assesses five symptom complexes to obtain clinical ratings of negative symptoms in patients with schizophrenia. They are affective blunting, alogia (impoverished thinking), avolition/apathy, anhedonia /asociality, and disturbance of attention. The final symptom complexes seem to have less obvious relevance to negative symptoms compared with the other four complexes. Assessments are conducted on a 6-point scale (0 = not at all to 5 = severe; Andreasen, 1989). The SANS is a valid instrument (Peralta & Cuesta, 1995); however, interrater reliability is reduced when clinicians use it in comparison to highly trained research assistants (Norman, Malia, Cortese, & Diaz, 1996). In the present study, only the anhedonia /asociality scale of the SANS was administrated in the pretest to assess the severity of Anhedonia. I feel the researchers can test their predictions using these methods because of what lengths they went to in presenting their techniques. They incorporated a lot of various useful ideas when testing their participants. Many angles were used to go into full detail in what steps were taken to evaluate each participant in this study. The authors I feel gave a very detail analysis of each step that was taken as to not leave out any variables in each case scenario. A cognitive-sensory training package focusing on anticipating future pleasant feelings about performing activities appears to improve anticipatory pleasure as measured by the TEPS. The high RCI indicates that the posttest scores of the anticipatory pleasure scale are reflecting important change for the five participants. These results, although preliminary, are very interesting because Anhedonia remains a particularly challenging symptom. Our second question related to whether an increase in anticipatory pleasure would be accompanied by an increase in daily activities. Concurrently, change in anticipatory pleasure, as measured by the scale, was accompanied by an increase in activity for the three participants for whom it was possible to fulfill the time budget. Participant 4 had been ritually visiting his mother once a week for years before training. At the end of the training, the nursing home team observed that the patient had added in every week a new spontaneous activity such as going to town to do shopping, planning a little trip, or spontaneously organizing an appointment with the hairdresser outside of the nursing home. Participant 5 had been accomplishing five household chores a day for many years and did not change his program at the end of the training. The participant had been institutionalized for a great part of his life. In previous work, we found a significant negative correlation between anticipatory pleasure and the avolition/apathy of the SANS (Favrod et al. , 2009). This correlation was lower than the one with the Anhedonia/asociality scale of the SANS, indicating a weaker link between these two variables. Apathy and avolition are probably associated with anticipatory pleasure. However, several other variables may affect activity and willingness, such as planning skills, motor skills, reinforcements provided by the environment, etc. The results indicated that the training did not seem to improve consummatory pleasure as a consequence of an increase in anticipatory pleasure. The lack of follow-up assessment did not allow observation of an eventual delay for improvement in consummatory pleasure as a consequence of improvement of anticipatory pleasure and engagement in new activities. Another explanation could be that both kinds of pleasure have some independence between them. Anticipatory pleasure is linked to motivational processes and consummatory pleasure with satiety processes. I feel the researchers did a very good job in describing every detail of their research. My reaction to this article is that I think Pleasure Skills Training can really help people with schizophrenia if done properly over an extended period of time under the right conditions. I as well sense that the article does contribute something interesting and important to the field. Individuals with schizophrenia already have a hard enough time in life and to go on living without experiencing a sense of pleasure is disheartening. This study shows that people living with schizophrenia if trained with the right circumstances can eventually learn how to experience pleasure. I felt this article was presented well and easy to read with what was presented. Going through this article it was clear where each step was and what was going on. The authors used wording appropriate to this article without using too much technical jargon where it was not needed. The readability for me was quite familiar because I have had to do assignments like this before. I think when any author presents an empirical article to the world where others besides advanced Psychologists read it; they indeed try and make it easily readable so that their ideas presented get across in the best way possible.
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