Borderline Personality Disorder and Self-Mutilation

Borderline Personality Disorder and Self-Mutilation BPD Print Self-Mutilation and Borderline Personality Disorder By Kristalyn Salters-Pedneault, PhD Kristalyn Salters-Pedneault, PhD, is a clinical psychologist and associate professor of psychology at Eastern Connecticut State University. Learn about our editorial policy Kristalyn Salters-Pedneault, PhD Medically reviewed by Medically reviewed by Daniel B. Block, MD on November 25, 2019 twitter linkedin Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Daniel B. Block, MD Updated on February 19, 2020 Petar Chernaev/Getty Images More in BPD Diagnosis Treatment Living With BPD Related Conditions Warning: The content of this article may be very triggering if you engage in self-mutilation. Please consider this carefully before reading on. Self-mutilation is very difficult to understand if you have never experienced the urge to engage in this behavior yourself. If you have a friend or family member with borderline personality disorder (BPD) who self-mutilates, it can be scary, confusing, and frustrating. By understanding why self-mutilation occurs, you can help your loved one cope with these urges and act as a support network for her. What Is Self-Mutilation? Self-mutilation involves the direct and deliberate destruction or alteration of the body. Examples of these behaviors include cutting, burning, sticking oneself with needles, and severe scratching. The research frequently uses the term nonsuicidal  self-injury (NSSI). Self-mutilation is usually very different than other self-harming behaviors.  Research has shown that individuals who engage in self-harm are usually not trying to kill themselves when they engage in the behavior, although some may report that they have mixed feelings about the intent of the act. This is not to say that people who engage in self-mutilation are not suicidal; many people who self-mutilate also have suicidal thoughts or even make suicide attempts. In addition, in cases of very severe self-mutilation, people have died from their injuries. Why People Engage in Self-Mutilation Many believe that people engage in self-mutilation to get attention. This is a myth. Most people who self-harm do it in private and make sure that the marks or scars are hidden. They often will wear long sleeves to cover these signs. They are often ashamed of the behavior and keep it a secret. Particularly for those with BPD who have rejection sensitivity, they worry continuously about people finding out about their secrets. Research has shown that most people self-mutilate in order to help regulate internal experiences such as intense emotions, thoughts, memories, and physical sensations.?? Who Engages in Self-Mutilation? Unfortunately, self-mutilation is a common behavior, particularly among those with BPD. One study found that, among college students (not necessarily with BPD),?? attachment issues (insecure attachment, childhood separation, and emotional neglect) along with sexual abuse and dissociation, were significant risk factors for self-injury, and that the risk factors were gender-specific. Evidence suggests that significant gender differences exist in prevalence, method, and where on the body the self-harm is inflicted.?? Females reported higher numbers of the behavior overall, more cutting and scratching, and more damage to arms and legs than males. Males reported more burning and self-hitting, and more damage to the chest, face, or genitals. In another study of youth in the third, sixth, and ninth grades in one community,?? ninth-grade girls were most at risk, with a similar injury pattern of more cutting and scratching, and engaging in self-harm three times as much as boys. People who have experienced maltreatment during their childhood, such as through sexual abuse or neglect, or who were separated from a caregiver in childhood, are at greater risk for self-mutilation than the general population.?? Effects of Childhood Trauma Treatment Because self-mutilation is often an attempt to manage intense feelings,??  cognitive behavioral treatments for self-mutilation focus on helping the person find new, healthier ways of managing emotions and thoughts. For example, one cognitive-behavioral treatment for borderline personality disorder, dialectical behavior therapy, addresses unhealthy attempts at coping by helping the patient learn and practice a new set of coping skills. In some cases, a doctor may prescribe medications to help regulate emotions and feelings and decrease the urge to self-harm. Medications for Borderline Personality Disorder What to Do If a Friend or Loved One Self-Mutilates If you are going to talk to your friend or loved one about self-mutilation, its important to do it in a non-judgmental fashion. Approaching them calmly and with care can make the person feel heard and understood. Before talking with a loved one, it may be a good idea to consult with a therapist who specializes in treating BPD and self-mutilation. He can give you professional advice on the best way to approach the situation without frightening or upsetting your loved one. Getting Treatment for Self-Mutilation If you or someone you know is struggling with self-mutilation, there are a variety of treatment resources available including finding a therapist to talk to.   Seek Help With An Online Therapy Program

How Education Has Changed My Life - 851 Words

Education has been a part of my life ever since I was born. My mother is a teacher, and I have always been in her classroom, and seeing her teaching kids is something I feel I knew I wanted to do ever since I was little. As I grew older, I had a rough time in school. I was identified with a learning disability in the fourth grade which helped me become successful and also made school difficult too. The impact education has had on my life is why I want to become a teacher. My mother has been a teacher for over 25 years, and is still going. When I was little, around the ages of three-four, I would go into her classroom to ‘visit’ her class. Even as time progressed I would go and watch her in the classroom, and eventually went to the same school she taught at. My mother would bring books home that she did not need anymore and other classroom supplies for me to play school. I would play school with my imaginary students, pretending I was the teacher and they were my ‘perfect classroom of students’. My ‘classroom’ eventually grew into friends who would be my students, or my teachers. Talking with individuals who had my mother as a teacher opened my eyes to understanding what an impact a teacher has on their student. Growing up, school was a blur to me until about grade three. About first grade, until I was in fifth, I would go into a small reading group with other students my age. I did not think much of it, but I did not like missing out on classroom instruction. ExpressingShow MoreRelatedHow Education Has Changed My Life Essay1183 Words   |  5 Pages These past four years have really been a life changing experience. From a childish freshmen not only at school but at home too, to a still sometimes childish senior, one who knows when and how to control himself. This school and its teachers have taught me so many lessons that will not be forgotten any time soon. You can probably imagine how nervous and maybe even a little timorous I was, my first day at Barstow High. It was not very simple to get accustomed to, coming from Hinkley School, whichRead MoreI Am A Great Writer892 Words   |  4 Pages1.) How has this class allowed you to think more openly? This class has allowed me to think more openly because I feel that my classmates and professor allowed me to express my opinion regardless of the opinions of others. This has helped me be more involved in discussions because I felt that I could express myself without others being judgmental and it has helped me become more of an optimistic person. I surprised myself at times because I am usually a quite person and rarely express my opinionRead MoreThe Influence Of The Internet On Society901 Words   |  4 Pagessociety has benefited from the advancement in technology. For example the wheel made it easier to travel long distances with heavy items and the invention of antibiotics saved millions of lives from infections. Today, technology is used on a regular basis, from the cars that we use to drive to work, to the electricity that powers our tv, radio, and lights. By looking at what we have accomplished, technology has greatly influenced society. If you were to ask me what piece of t echnology has greatlyRead MoreRichard Rodriguez : The Son Of Mexican Immigrants977 Words   |  4 Pageslives incompatible to each other – his life at home and school. Rodriguez revered his teachers and aspired to be like them, mimicking many of their opinions and physical gestures. At an early age, Rodriguez realized there was a separation between his school life and home life. There were certain things that could only be shared at home or at school. When Rodriguez read The Uses of Literacy by Richard Hoggart, he encountered a term that described his way of life – the scholarship boy. Rodriguez wasRead MorePersonal Experience on Culture and Gender Issues748 Words   |  3 Pagesback and looking what I have learned throughout this class I truly enjoyed three topics throughout this course. Topics such as culture, sex and gender, and education are part of my everyday life. By learning about these different ideas and beliefs, I have absorbed many different opinions abou t culture, sex and gender, and a huge part in education. Culture is a delicate word. If I told you what was the definition of culture was at the beginning of the semester, I believed that it revolved around similarityRead MoreFormal And Informal Educational Experiences1596 Words   |  7 PagesUniversity â€Æ' Learning Autobiography (LAB # 1) In this paper you will learn my insights into my life. I will touch on my formal and informal education. I will reflect on the four Breadth areas of Ottawa University’s program of liberal arts studies. Future goals, philosophy, values, and obstacles will be discussed. This will include significant people and events that have happened in my life. Formal Educational Experiences My formal educational experiences start’s with Field School, Field School isRead MoreAn Event That Changed An Individual Life848 Words   |  4 PagesAt some point in life there will be an event that changed an individual life forever. When that event changes the point of view about the education, then that event has become a big thing. Those changes could be good a thing or bad. The event that change my education view is when I move to the United State. I have been in America for about 8 years. The first couple years are hard because I don’t speak English so there is no way to communicate with others. With all the thing we hear about AmericaRead MoreDifferent Sides Of Education : An Important Part Of One s Life1606 Words   |  7 PagesSides of Education Education is vital, in fact the most important part of one’s life. Getting a higher education is very important in order to live in this world. Nelson Mandela, a politician, said â€Å"Education is the most powerful weapon which you can use to change the world† (BrainyQuote). When it comes to living a successful life, I live by this quote. I believe experience is something that will change one’s life. Throughout out our school career, we have experienced something that changed our livesRead MoreThe Chemical And Physiological Effects Drugs Had On The Human Body1358 Words   |  6 Pageswas interested in the biochemical and physiological effects drugs had on the human body. It was fascination to me how something as simple as taking Advil could relieve a bad headache or taking Nyquil could ease the symptoms of a cold. I was unaware that I wanted to become a pharmacist and have patient interactions until I started shadowing a pharmacist. The first day I volunteered at my local pharmacy an older gentleman walked in after having had a check-up with his physician. I noticed that he lookedRead MoreThe Cycle Of Illiteracy And Illiteracy984 Words   |  4 PagesIlliteracy Illiteracy has always been a problem in society in various ways that I believe, can only be frowned upon. Events in the past and present days emphasize the importance of basic education focusing in literacy as an essential part of our society. An experience as simple as a parent being illiterate can have a ripple effect on their children. Such as, my grandfather, who was raised in Mexico and was taught that labor to provide for his family was of higher importance than education and literacy

How to write a book report without reading the book

Proved Way That Guides You to Writing an Essay on a Book You Haven’t Read Are you the one who is always confused when it comes to writing a book report? This task requires a tangible piece of time. Two in one – book reading and essay writing – sounds dreadfully? This is when you surely open the search line in your browser and look for the most effective answer and a proved tip on How to write essay on book I didnt read. If you are some sort of a procrastinator – that as sure as fate doubles your challenge. Probably there is a little time left for this not-as-simple-as-you-desire task.  We will spill some proved tips gathered in one place to help you write an essay on a book you haven’t read within several hours and get the best possible result. So here you are. Lets take four or five hours to read all the necessary stuff. This amount of time should be enough. Mind that it, of course, depends on the lengths of the book you need to study and your own speed of reading. So be conscious, take all your passion in your hand, wake up the inspiration deep within and go ahead. But first, lets think over. Is it a good idea to look for the similar works one the web As they say, if you do not know what to do – ask your pocket library, namely search engine. It is more than 50% likely that other people have already written their essays on the same or a similar topic. But be conscious. Do not give in to temptation of a plagiarism! Instead, follow the  others’ examples and use them only for the inspiration. However, it’s up to you anyway. So lets get to the point and check out our tips on how to write a book report yourself, quickly, and at your best. The count has started. Go through the book briefly, but scrupulously You probably want to make the things easier and read the first and the final chapter to get some sense of a story? To understand the whole idea, you need to take a look at more pages. We recommend that you read the first paragraphs of each chapter of your book. Depending on paragraphs lengths, it can take you from two hours to learn all the chapters briefly. This is the crucial rule you have to follow for writing an essay on a book you didnt read, which is much shorter and faster than reading the whole book. Lets assume, the approximate number of pages is 300 (plus-minus several dozens of pages) with 15 chapters, relatively. Reading the first and the last pages of it may require from an hour and a half to two-three hours, which is dependent on a speed of your reading. Read with a pen in your hands Use a proved rule of thumb – make notes while reading. It will help you with the very first draft of your future essay. You can forget something important afterwards, especially when you see the blank paper in front of you. Arm yourself with the most important information at once. It can take your time in the process, but it will save a good piece of it in the end. In order to avoid making notes blindfold, reread and check out the requirements of your essay and find out what information to look for. This will increase your effectiveness. Make notes in the most handy way for you – write out, underline or use stickers, etc. Two or three hours left and more than a half of the path is gone. You have two or more hours to write a book report and summarize everything on paper. Make your first draft Once you are done with so-called generalized reading, you can move on to finishing your first draft. Namely finishing, because youve almost done it in the process, written down the most important information and ideas for the relevant sections of your report. Dont forget to keep your eye to the required formatting. Spend the time left for improving your first draft and make it clear according to the requirements. Does it match to the words and pages count. How about the style and the content? Are you satisfied yourself? 60-90 remained minutes should be enough to finish it and start revising mistakes, misprints or rewriting the parts you find not appealing. Once youve read this studenthacking instruction, close it and start working on your task. Try to focus only on the present moment and do what you should do. Otherwise, interfering with different issues will take much more of your time and reduce your effectiveness. So do it. Or Write your report about any book with us! We hope that you have found our tips useful and they will help you write a very good report in the short term. We put all our experience in one place to give a comprehensive answer on your question How to write essay on a book I didnt read, but still these recommendations do not guarantee you success, especially when you are running out of time and the task itself is not the easiest for you. Counting on Google also makes not much sense, because of some evident reasons. Theres no one to prove that the given results will respond to your needs while surfing on the Internet, especially when your task is related to writing character analysis essays. Besides, a risk to find the works of poor quality or with incomplete information is what adds to this problem. Writing an essay on a book from scratch is a decision that can save the situation. Feeling not enough passion for doing it itself, you can always count on our help and write your report with us. We will find an experienced writer, who is not only familiar with the book, but also competent at the task. This means that you will receive a profound essay, written in accordance with all the requirements. Once ordered, our pros will save you from bad essays and meet the specified deadline. So dont bother and apply for professional help today.

Learning and Favorite Academic Subject Free Essays

Speaking section Many iBT speaking questions ask you to talk about things that you enjoy, things that you value, or things that you are good at. Practice with the following topics. Be sure to support your response with specific reasons and details. We will write a custom essay sample on Learning and Favorite Academic Subject or any similar topic only for you Order Now You have 15 seconds to prepare and 45 seconds to speak. 1. What is your favorite hobby? 2. Describe a talent you have 3. What is a good book that you would recommend? 4. What is your favorite season of the year? 5. Explain about an object that is very special in your life. 6. Describe a holiday you enjoy celebrating 7. What is a possession you value highly? 8. What is your favorite method of transportation? 9. Where is your favorite park or public space? 10. What famous person would you most like to meet1. Describe an interesting trip you’ve taken. 2. What is a difficult problem you’ve had to overcome? 3. What is your favorite memory of childhood? 4. Explain an important lesson you’ve learned in life. 5. Describe a special opportunity that was given to you. 6. Describe a place that you liked to go when you were young. 7. What is something you regret? 8. Explain about a time when you felt very happy. . What was the most enjoyable day of your life? 10. Describe an event that has changed you in some way. TALKING ABOUT THE PLACE YOU LIVE 1. Describe your hometown. 2. What is something about your country that makes you proud? 3. If a visitor came to your country, where would you take them? 4. If you could give a gift to your friend that is symbolic of your country, what would you gi ve them? 5. Introduce a game from your country, and explain why you like to play it. 6. Where is a place in your hometown that you go to relax? 7. If you could visit any country, where would you go? 8. What is the most important room in your house? 9. Explain why your hometown is or isn’t a good place to live. 10. If a friend came to your country to visit, what meal would you prepare1. Describe an interesting class you’ve taken. 2. Describe some qualities of a good teacher. 3. What are some good ways to learn English? 4. What is your favorite academic subject? 5. Should cell phones be banned from classrooms? 6. Should non-academic classes like art and music they be removed from the curriculum? 7. Besides teaching the basic subjects, what are some ways that school shapes children? 8. Explain about the best teacher you ever had. 9. What is something useful that you learned in school? 10. If you take any class on any subject, what would you study and why What is your idea of the perfect job? 2. Describe a skill you want to learn. 3. How will your life be different in 5 years? 4. Describe your ideal marriage partner. 5. What is a job you admire, but don’t necessarily want to do? 6. What is a skill needed for future success? 7. Describe a trip you are planning to take. 8. Explain what you want to accomplish in the future. 9. In what type of climate would you like to live, and why? 0. What are some things people can do to stay healthy? 1. Explain about a person who has influenced you in some way 2. Describe some qualities of a good friend. 3. What is the best way for parents to discipline their children? 4. What kind of people do you like to meet? 5. Describe a person you admire, and explain why you admire this person. 6. What are some characteristics of a good neighbor? 7. Should children help with the housework? 8. Which parent do you take after the most? 9. Describe someone you enjoy talking with. 10. What is something important that your parents taught you1. If you could solve any problem in the world, what would it be? 2. What are some ways that you can help reduce pollution? 3. Should cars be banned from city centers? 4. How should people who send spam (computer junk mail) be punished? 5. Should people be allowed to clone their pets? 6. Describe how transportation will be different in the future. 7. Describe some ways in which homelessness could be fought. 8. What do you feel is one of mankind’s greatest inventions? 9. Should genetically modified food be sold in supermarkets? 10. What is the most serious problem in the world these days How to cite Learning and Favorite Academic Subject, Essay examples

Finding Nemo Symbols free essay sample

Nemo is a small clownfish, who is very adventurous and playful. While his father thought that he was too young to go to school, Nemo brims with the excitement. And it was his inexperience and childish that led to his unexpected abduction. Nemo is a typical symbol for the youth who has curiosity, enthusiasm, bravery and also ebullience. He dares to risk and yearns for adventure especially when he has motivity. Sometimes it is nothing but his immature makes him get into troubles. When every difficulty was overcome, Nemo really grows up and his adventure is exactly the same as people’s life adventure to reach adulthood. Another main symbol of the film is Nemo’s father Marlin. He is an over-protective father because Nemo was the only surviving child he had after the death of his wife and other offsprings. He is always afraid of the ocean and rarely trusts anyone a typical symbol of someone who knew the feeling of lost. We will write a custom essay sample on Finding Nemo Symbols or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page It is the reason why his son- Nemo- does not believe that it could be his father traveling hundreds miles, fighting against shark, jellyfish.. to look for him. Marlin is also a typical of parents who does not believe in the children. He always thinks that Nemo is not mature enough even when he found Nemo. After all the adventure, Marlin learns that he has to believe in his son and himself either. The adventure brings Marlin and his companion face-to-face with sharks, deep-sea anglers, fields of poisonous jellyfish, sea turtles, pelicans, and much more. After all, Marlin rises above his neuroses and learns to take risks. The whole adventure is a symbol of the family love, friendship and also challenges in life. Nothing could be more noble than parents love, by which we might discover a bravery inside that we never knew. Parents would try all their best to save the children, no matter how many difficulties they had to face. Dory is a friendly but forgetful company of Marlin on the way finding Nemo. In contrast to Marlin, she is a naive and over- optimistic blue tang fish that is both helpful and a hindrance to him, sometimes at the same time. Dory not only becomes a symbol of optimistic people, but also a symbol of faith especially in friendship. Her optimism proves an invaluable quality to help Marlin overcome the impossible. Sometimes we should just â€Å"keep swimming† because the worry could not solve the problem. Moreover, Dory taught Marlin and also the audience that â€Å"Trust is what friends do† and in some case we have to trust to move on. Friendship in particular and love in general all needs faith. Besides the three protagonists, other antagonists also play an important role and become typical sumbols. Bruce, Anchor and Chum are sharks that Marlin and Dory met on the way. These three sharks were tormented by their natural urge to eat fish and their resulting unpopularity amongst the general ocean population. Although they made their best to give up their instinct by swearing off, but is was so hard to get out of this bad habit. They are symbolized for the people who are awared of their defects but realising it was not easy at all. In addtition to three vegetarian shark, the  150-year-old sea turtle is a symbol. This turtle was old at age but young at heart. He was the one who helped Marlin and Dory so much, and also taught Marlin a valuable lesson. In our mind, turtle was a symbol of something patient and steady. After watching the movie, now they are also a good example of parents. They totally believe in their childrens ability. They has proved that you never  really know when your children was strong and mature enough but when they know you know you know. Protection is good but we have to let them go by themselves. Finding Nemo was really  a spectacularly beautiful animated adventure for everyone not just because of  hilarious adventure to look for a curious and impressionable six-year-old fish but also the meaning that implied in the symbols. Although the film is about the marine life and sea creatures, it symbolizes the real human- being world of us.

Service quality and customer satisfaction are important to marketers Essay Example

Service quality and customer satisfaction are important to marketers Essay 1. Introduction It is the job of a marketer to realise, understand and effectively make use of how a customer can best provide the business with the profit that it strives for. As marketing in the 21st century has moved away form traditional offensive strategies and moving towards defensive strategies where pull factors become vital when attracting and maintaining customers. A customer will purchase a product or service for a number of reasons, all however, are to satisfy the customers need or want at that moment in time. If we can understand what motivates the customer to purchase we can start to understand how and why the customer becomes one of the businesses biggest asset as it is the customer who affects the bottom line measures of success, namely profits. We will write a custom essay sample on Service quality and customer satisfaction are important to marketers specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Service quality and customer satisfaction are important to marketers specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Service quality and customer satisfaction are important to marketers specifically for you FOR ONLY $16.38 $13.9/page Hire Writer In order to analyse the title statement and ascertain outcomes and conclusions this paper will examine both classical and modern day literature making reference to how the areas of service quality, satisfaction and customer retention have been focused upon in academia. This paper shall endeavor to highlight any relevance links between these areas of business whilst answering the question of the statements validity in modern-day business. Breaking down the title quote will allow us to compare and contrast past literature on the subject and how they relate to each other. 2. Service Quality Berry et al (1988) defines service quality: Service quality can often make the difference between a businesss success and failure and Quality is conformance to customer specifications; it is the customers definition of quality, not managements that counts. These quotes put in context the importance of service quality and how important it is to focus on the customer when aiming to create this quality in service. Berry et al (1988) describe service quality as being a major differentiator for businesses as well as being a powerful competitive weapon. There has been overwhelming literature on the subject of service quality on the past two decades. Gronroos (1984) explains a customers perception of service quality: it is reasonable to state that the perceived quality of a given service will be the outcome of an evaluation process, where the consumer compares his expectations with the service he perceives he has received, i.e. he puts the perceive service against the expected service. The result if this process will be perceived quality of the service. If a customer enters the market place with low expectations of the service he or she is about to experience it is likely that if the service is better than expected the perceived level of quality of service will be high. Similarly, if expectations are high it is going to be harder for the supplier to meet the customers expectations. The service quality cannot simply be determined by the organization, it must come from the customer. If the supplier can realize what the customer wants, and more importantly, what the customer expects, it can use this information when attempting to serve the customer. Gronroos (1984) goes on to describe Technical and Functional quality, see The Service Quality Model figure 1 below: The technical quality is the outcome of the transactional. This is what the customer attempts to find when entering the market place and seeks to satisfy the original want or need. The functional quality is how well the service does its job and is what contributes to the quality of the service. Once the technical and functional qualities are added to the image of the service the customer can start to evaluate its service quality. The image of the organization and the image of service itself can dramatically affect the way in which the customer perceives the overall service quality. Gronroos (1984) also explains that: image may be a quality dimension. If a consumer believes that he goes to a good restaurant and the meal, for instance is not perfect, or the behaviour of the waiter is irritating, he may still find the perceived service satisfactory. Zeithaml and Bitner (p.92, 2003) explain how consumers judge service quality: Over the years service researchers have suggested that consumers judge the quality of services based on their perceptions of the technical outcome provided, the process by which that outcome was delivered, and the quality of the physical surroundings where the service is delivered. The Interactions Qualities are the qualities that the organization attempts to serve the customer with, such response times and the ability to communicate clearly with the customer. Any combination of the five factors above contribute to how the customer perceives the service quality he or she receives during the interaction between them and the organization. The Physical Surroundings that the customer is aware of is another quality that contributes to service quality. This can be as simple as a comfortable chair for the customer to sit on whilst he or she is dealing with the organization the perception of a customers surroundings can influence a customers overall perception of service quality. An example of this would be Nike Town where the whole where the customer is encouraged to fully engage in the shopping experience as it becomes a day out offering customers to perceive excellent quality service. The Outcome Qualities are what gets the customers attention and what the customer wants to get out of the interaction with the organization. For example, if a customer wanted a jacket to be dry-cleaned the clean jacket would be the outcome quality. Again, the five factors listed above make up an overall perception for the customer on the outcome quality. Parasuraman, et al (1985) describe how understanding customer expectations through market research and open communication with employees contributes to the five service quality dimensions. If an organization can gain information about the market it can more effectively create superior service dimensions for the customer by identifying what the customer wants and how these wants fit into the market as a whole. Open communication with employees also allows the organization to gain first hand data on customer responses as employees often received on-the-spot feedback from customers. Parasuraman, et al (1985) also describes how management commitment to service and employee performance impact on how the service dimensions are perceived. Zeithaml Bitner (1996) describe the zone of tolerance and the two levels of service expectation, see figure 3. Figure 3 The zone of tolerance lies between a perceived adequate level of service and the desired level of service. Due to the nature of services variation can often arise from serving one customer to another. One customer may even experience different levels of service, or a lack or consistency, from one transaction to another. The zone of tolerance allows for an amount of variation where the customer still finds the service to be acceptable if the perceived level of service drops below the acceptable level the customer will become frustrated and dissatisfied. The zone of tolerance can increase or decrease for individual customers depending on factors including competition, price or importance of specific service attributes (Lovelock et al, p.127, 1999) For example, if a customer was given a complimentary holiday from a travel company they are likely to have a larger zone of tolerance than if they had paid full price. The level of service they receive may drop to below what they would usually accept but because the holiday was free they may not be dissatisfied. Just three years later Burrell and Gale (1987) show us the PIMS Principle (figure 4) and the relationship between Relative Quality and Relative Market share. This is a useful model to understand as it brings in the Return on Investment (ROI) which most models do not include. The equations are: High Market Share + High Quality = High ROI Low Market Share + Low Quality = Low ROI We must remember that service quality is rarely described as a cheap or short-term implemented part of business. Berry et al makes it clear that service quality is long term if it is to work. There are no ways to change the attitudes, habits, knowledge, and skills of human beings quickly. Service quality can add a valued differentiator to the products offered where goods in todays environment are largely undifferentiated. However, this will inevitably have an instant effect on bottom line success in that it will costing will increase. 3. Customer Satisfaction We can define customer satisfaction: Satisfaction is the consumers fulfillment response. It is a judgment that a product or service feature, or the product or service itself, provides a pleasurable level of consumption-related fulfillment. Zeithaml and Bitner (2003) quote R. L. Oliver. Satisfaction happens when the customer perceives the product or service to at least meet their expectations. The customer may experience fulfillment, contentment, pleasure, delight or relief. If the customers needs or wants are not met he or she will become dissatisfied. Zeithaml and Bitner (2003) go on to compare customer satisfaction: Although they have certain things in common, satisfaction is generally viewed as a broader concept, whereas service quality assessment focuses specifically on dimensions of service. Based on this view, perceived service quality is a component of customer satisfaction. We can see how the Customer Perceptions of Quality Customer Satisfaction model (Zeithaml and Bitner, 2003) is completed in figure 5. Figure 5 We can see that price is introduced as a contributing factor to customer satisfaction, whereas as price does not contribute to service quality. Most importantly, we can see that situational and personal factors influence customer satisfaction. These factors are beyond the control of the organization and are part of individual customers and what they bring with them to the market place. Customers emotions can also affect their perceptions of satisfaction, Positive emotions such as happiness, pleasure, elation and a sense of warm-heartednesss enhanced customers satisfaction (Zeithaml Bitner, 2003) Zeithaml are offering the notion of emotional transactions with the service delivery and if organizations factor this into the delivery it is likely to enduce a positive outcome of customer satisfaction, hence customer satisfaction is in itself an emotional state. This is important to marketers, as a customer with already positive emotions is likely to respond to the service quality with an already positive outlook when dealing with the supplier. Negative emotions will, however, have the opposite affect. negative emotions such as sadness, sorrow, regret and anger led to diminished customer satisfaction. (Zeithaml Bitner, 2003) Cronin Taylor (1992) describes the results from their study on Service Quality that they link to satisfaction and the relationship the results are as follows: (1) a performance-based measure of service quality may be an improved means of measuring the service quality construct, (2) service quality is an antecedent of consumer satisfaction, (3) consumer satisfaction has a significant effect on purchase intentions, (4) service quality has less effect on purchase intentions than does consumer satisfaction. 4. Defections Management Realising and effectively managing how and why customers decide to leave, or defect, from your company can have a positive impact on bottom line success. Companies can boost profits by almost 100% by retaining just 5% more of their customers. (Reichheld Sasser, p.105, 1990) Reichheld Sasser (1990) explain the cost of losing a customer in relation to the initial spend made by companies to gain the customer in the first place. An example of a credit card is used to demonstrate how attracting one customer can cost as much as $50 but this outlay is not recouped until year two. They explain that operating costs decrease the longer the customer stays with the company, and revenues increase year on year as the customer becomes more confident in using the service. Costs are likely to decrease as a more confident customer is expected to spend less time asking questions and more time making use of the service i.e. spending. Defections Management can also result in increased profits from referrals and price premiums. 5. Repeat Purchasing and Retention Customer repurchase intention is influenced by seven important factors service quality, equity and value, customer satisfaction, past loyalty, expected switching cost and brand preference. (Hellier et al, 2003) Past loyalty to the product is likely to influence the customer making another purchase simply due to the loyalty the customer feels towards the business. If a customer has been loyal in the past it may feel perfectly natural to carry on with a system that has worked in the past. Large organizations, for example, will often order supplies such as stationary from the same supplier because they have systems in place to make those orders due to past loyalties with the supplier. The expected switching cost can be a major contributing factor to repurchases in industries where joining fees or get-out clauses exist. Jones Sasser (1995) compare satisfaction with retention at Rank Xerox in the early 1990s (Figure 6). High levels of retention are not met until the customer is very satisfied. Just not dissatisfying the customer or even satisfying the customer is not enough to gain 50% or higher levels of retention. Rust et al (1995), however, say that scores of 5 will result in 97%, a score of 3s and 4s will result in 95% retention. We can see from this that satisfaction to retention varies from one organization to another, as well as from industry to industry. Figure 7 (Jones Sasser, 1995) displays how this relationship changes dependant on industry. A service such a telephone service provider (or most utility providers) often serve their customers because there is none or very little alternatives available. Contracts and notice to leave also result in customers staying with their service provider because it is more convenient, even if they are not especially satisfied. A motorcar supplier is shown to have the opposite affect as there is much choice in the market and customers are free to purchase how and when they like. Technological advances may also influence if and when a customer defects from one company to another, as they may desire new technology from a competitor. Robert Weisman, Boston Globe (2004) supports this notion: Some customers may feel trapped theyll continue doing business with their vendors because they have to, not because they want to. We can also explore the notion that loyal customers have a direct postive affect on bottom line business success. Much literature on loyal agrees that loyal customers will be more familiar with a companys transactional processes and therefore should find it cheaper to serve them (Reinartz et al, 2002) Reinartz et al (2002 ) do not agree fully that loyal customers have a direct positive affect on profits: Specifically, we discover little or no evidence to suggest that customers who purchase steadily from a company over time are necessarily cheaper to serve, less price sensitive, or particularly effective in bringing in new business.

Global Health Priorities

Global Health Priorities Every year the World Health Organization (WHO) collects health information from all member states. The health information is used to formulate both short term and long term goals.Advertising We will write a custom essay sample on Global Health Priorities specifically for you for only $16.05 $11/page Learn More This information is then shared with all stakeholders. Based on this information, priority areas are selected and appropriate interventions formulated. Health priorities vary from region to region but there are some that are generally considered to be universal. This paper will discuss the global health priorities. It begins with a brief overview of the health related millennium development goals (MDG). The WHO has traditionally formulated global health priorities using the millennium development goals. The millennium development goals related to health include MDG 1, 4, 5, 6, 7, and 8 (WHO, 2013). MDG 1 is concerned with childhood malnutrition especia lly reduction of underweight while MDG 4 focuses on child health and immunization. MDG 5 is concerned with maternal and reproductive health. The health aspects covered in MDG 6 include malaria, tropical diseases, tuberculosis, and HIV/AIDS. The seventh millennium development goal covers water and sanitation. Global health priorities emerge from the MDGs. Some health concerns are confined to some regions but due to huge socioeconomic burden they exert on communities, they qualify to be regarded as global health concerns. Other health priorities include universal health coverage and access to essential medicines in all countries, healthcare for people living with disabilities, and prevention and control of non communicable diseases. Reduction of childhood health problems is a universal priority. The emphasis is on childhood malnutrition and immunization. Other childhood diseases are also covered. Immunization is among the most effective ways of reducing childhood diseases and mortalit y (WHO, 2013). WHO has setup a global vaccine action plan to ensure worldwide access to immunization services. The aim of the program is to ensure that vaccines are availed to both privileged and underprivileged communities at the same time. Child underweight is associated with maternal underweight. An underweight mother is likely to give birth to an underweight infant. Therefore, WHO advocates for weight and nutritional monitoring during the antenatal period. Diligent management of other childhood conditions and illnesses like diarrhoea is necessary for future national development. Maternal mortality remains one of the greatest concerns of the WHO and member states. This is captured in MDG 6 which envisages improved maternal health and reduction of maternal mortality.Advertising Looking for essay on health medicine? Let's see if we can help you! Get your first paper with 15% OFF Learn More To achieve this, WHO requires mothers to attend antenatal clinic at least four times. It further advises that mothers should deliver in the presence of skilled birth attendants. Maternal health has a great effect on the health of an infant. Reproductive health services also contribute to improved quality of life. The World Health Organization has asked governments and other agencies concerned with maternal health to provide essential equipment and drugs to support maternal and child health. Water and sanitation is a huge health concern. At the moment, over 1.1 billion people in the world cannot access clean water (WHO, 2013). This poses a great danger to the affected communities. There are several diseases that are associated with poor sanitation and dirty water. It is the hope of the World Health Organization that all communities will access safe water and sanitation services in the near future. Malaria, tuberculosis and HIV/AIDS are among the leading causes of preventable deaths. HIV/AIDS is a manageable disease yet it still causes huge socioecono mic burdens to communities and individuals (Chipeta, Schouten, Aberle-Grasse, 2004). The WHO has prioritized programs geared towards prevention and control of these diseases. References Chipeta, J., Schouten, E., Aberle-Grasse, J. (2004). HIV Prevalence and Associated Factors. Retrieved from https://dhsprogram.com/pubs/pdf/FR175/12Chapter12.pdf. World Health Organization. (2013). The  World health statistics 2013. Web.