The clinical efficacy of salvia officinalis

The clinical efficacy of salvia officinalis An evaluation of the clinical efficacy of Salvia officinalis, Salvia lavandulaefolia and Melissa officinalis for the prophylaxis, management and amelioration of cognitive dysfunction: with particular reference to Alzheimers disease and non-Alzheimer-type senile dementias. 1. Introduction Dementia is a collection of symptoms caused by a chronic, global deterioration of cognitive function. It can occur at any age but is most prevalent in the elderly and increases with age (Beers et al. 2006: 1811). Around 5% of people over 65, 25% over 80 and 45% over 85 have some form of dementia (Knapp et al. 2007: 10; Collins 1997: 185). The population is aging and whereas today there is an estimated 700,000 people in the UK suffering from dementia, this number is set to increase to more than a million by 2025. The huge impact dementia has on society, devastating families and costing around  £17-18 million annually cannot be overstated (Knapp et al. 11). Early identification and safe, effective, intervention is therefore important. Dementia may be classified as Alzheimers or non-Alzheimer-types (Beers et al. 2006: 1811). The most common dementia is Alzheimers disease (AD) (Grossman et al. 2006: 985), affecting around 20 million people worldwide (Akhondzadeh et al. 2003: 53) and accounting for around 62% of dementias (Knapp et al. 2007: 11). Non-Alzheimer-type dementias typically affecting those over 60 include vascular dementia (27%), Lewy body dementia and fronto-temporal dementia (Knapp et al. 29). Cognitive disorders are treated allopathically with drugs that have yet to show real benefits and have a number of side-effects and contraindications. The need for safer, more effective treatments has led to increasing interest in the use of herbs for their management (Akhondzadeh and Abbasi 2006: 117). A variety of herbs, for example Salvia officinalis, Rosmarinus officinalis, Mellissa officinalis, Ginkgo biloba (Heinrich et al 2004: 234), Withania somnifera (Howes et al. 2003: 12), Centella asiatica (Chevallier 1996: 78) and Panax ginseng (Mantle et al. 2000: 207) have long-standing traditional use as memory-enhancing herbs. Consequently a number of clinical studies have been conducted to assess the efficacy of some of these herbs, most notably Ginkgo biloba, Salvia spp. and Mellissa officinalis, in the treatment of cognitive disorders. Of these, only clinical trials of Gingko biloba have been extensively reviewed (Birks and Grimley Evans 2002; Ernst et al. 1999; Oken et al. 1998). This present review aims to fill this gap by providing up-to-date information on whether clinical studies of Salvia spp. and Mellissa officinalis support their traditional use as cognition enhancers. To inform herbal practice it will evaluate clinical studies to assess whether the results have determined safe, effective herbal strategies and prescription for prophylaxis, management and amelioration of cognitive decline. 2. The literature review 2.1. Background: clinical presentation and pathology Although much scientific progress has been made since 1907 when Alois Alzheimer first described a case of dementia with â€Å"peculiar patches† disseminated throughout the cerebral cortex (Collins 1997: 185), there is still much to learn about the aetiology and pathogenesis of Alzheimers disease and other dementias (Knapp et al. 2007: 11). The onset of dementia is insidious, often beginning as mild cognitive impairment (MCI) and progressing to severe dementia over time (Loveman et al. 2006: 4). In the early stages, episodes of mild forgetfulness or misplacing possessions are often attributed to normal aging. Patients commonly suffer from anomic aplasia and agnosia but retain language comprehension (Collins 1997: 186). Dementia becomes more apparent when sufferers are unable to learn new information, to register the content of a conversation, or to recall recent events or the names of family members. Unlike those with benign forgetfulness, dementia patients are unaware of their amnesia. Frequently, there are mood changes, depression and other psychologic disturbances. Language comprehension fails (aphasia) and eventually patients may simply repeat what they hear or be unable to speak at all. Visuospacial deficits usually occur at a late stage (Collins 1997: 186). Those affected have difficulty in copy drawing simple obj ects. Differential diagnosis between MCI subtypes of various and complex aetiologies is challenging (Kidd 1999: 145). As some MCI subtypes are reversible (Levey et al. 2006: 992) prophylaxis for dementia could potentially encompass a range of varied or unknown aetiologies and risk factors. Knowledge of these and an awareness of differing clinical presentations are therefore important (Levey et al: 991). Additionally, an understanding of current orthodox treatment strategies and key neurochemical impairments in dementia can inform herbal practice of the most likely therapeutic actions of herbs. 2.1.1. Alzheimers disease As clinical studies have indicated that mild to moderate Alzheimers disease (AD) responds better to allopathic drugs than severe AD (Levey et al: 2006: 993), to prevent transition of MCI to AD early diagnosis is important. Evidence suggests that MCI associated with memory loss most commonly leads to AD (Levey et al. 991) and results of a clinicopathologic study of 80 subjects with MCI through to autopsy suggest that depression is one of the first features of AD (Galvin et al. 2005: 763). Formation of diffuse neuritic senile plaques in the brain is characteristic of AD but as these can only be determined from biopsy (Collins 1997: 186) probable diagnosis is made by clinical neuropsychological testing (Grossman et al. 2006: 986) such as the Mini Mental state Examination (MMSE) (Alzheimers Society 2002: 436), while magnetic resonance imaging can corroborate diagnosis by identifying areas of temporal neuronal loss (Vandenberghe and Tournay 2004: 347). Progression of AD is unremitting for around 5-10 years until death ensues. In the final stages sufferers may develop apraxia, with difficulty in performing familiar tasks. A common cause of death is pneumonia when patients eventual difficulty with eating results in aspiration pneumonia (Collins 1997: 186). The loss of faculties has been ascribed to both structural and neurochemical abnormalities (Perry et al. 1996: 1063). Senile plaques in the brains of AD patients contain amyloid and tau protein (microtubule associated protein) (Collins 1997: 188). Since isolation of b-amyloid peptide from cerebral vessels in AD patients (Wong et al. 1984: 8729), the accepted hypothesis for the pathogenesis of AD has been the ‘amyloid hypothesis, which proposes that AD is due to excessive formation of extracellular b-amyloid (Ab?) from amyloid precursor protein (APP), a membrane protein in neurons (Grossman et al. 2006: 986). It is thought that Ab molecules initiate a toxic cascade long before plaque forms by causing an inflammatory reaction, disrupting synaptic function and causing neurons to degenerate (Grossman et al. 986) with a loss of cholinergic fibres in the basal forebrain. In vitro results suggest that Ab enters mitochondria and induces free radical damage (Reddy 2006: 9). Intracellular neurofibrillary tangles are believed to be formed by abnormal phosphorylation of tau proteins (Tanzi and Bertram 200 5: 545), particularly in the hippocampus and neocortex, areas of the brain involved in memory (Mantle et al. 2000: 202). To date, thirteen genes have been implicated in AD (Bertram et al. 2007: 17). Of sporadic late onset Alzheimers up to 40% of cases may be due to a faulty gene on chromosome 21, ApoE4, an isoform of the ApoE gene that encodes for apolipoprotein, an astrocytic protein that may play a role in the reparative process in the brain. ApoE4s pathogenetic mechanism may be to enhance amyloid deposits within tissue by accelerating cleavage of b-peptide (Collins 1997: 189). Possession of a gene implicated in AD does not necessarily result in its development, the likelihood of which is further complicated by the potential role of environmental factors such as viruses and toxins in combination with genetic factors (Bird 2005: 864). 2.1.2. Vascular dementia Vascular dementia (VaD) is any type of dementia caused by cerebral blood vessel disease (Micieli 2006: S37). Onset of VaD is usually abrupt. Imaging may reveal areas of multiple infarcts (Collins 1997: 191) but their presence does not necessarily imply dementia (Grossman 2006: 987). According to Looi and Sachdev (1999) it is not possible to differentiate between AD and VaD with neuropsychological testing. Speech and language difficulties associated with vascular dementia may be mild or there may be a more pronounced aphasia as in multi-infarct VaD (Collins 1997: 191). 2.1.3. Frontal lobe dementia Frontal lobe dementia or Picks disease is uncommon and is characterised by neuronal loss and gliosis. Rarely, there are fibrillary inclusion bodies in the neurons. Presentation of frontal lobe dementia differs from AD in that the first symptoms are a change in personality rather than memory loss (Collins 1997: 193). 2.1.4. Lewy body dementias Dementia with Lewy bodies may differ to AD in its presentation in that patients suffer from marked visual hallucinations. Additionally, cognition tends to fluctuate between normality and confusion. Parkinsonian features such as shuffling gait, tremor, bradykinesia and rigidity are prevalent. Sleep behaviour disorder, such as acting out attacking themes, may appear years before other signs of the disease (Grossman et al. 2006: 989). 2.2. Risk factors Factors believed to pose a risk for developing dementia include cardiovascular disease, being female, a family history of dementia, Downs syndrome, older age, head trauma, diabetes and lower educational standards (Collins 1997: 186, 188; Lebson et al. 1997: 301). 2.2.1. Cardiovascular disease: Patients may have more than one type of dementia concurrently (Beers et al. 2006: 1811). This is compounded by results of a number of epidemiological studies suggesting that cardiovascular disease increases the risk of developing AD (Stampfer 2006: 12). Using transcranial Doppler ultrasonography Sun et al. (2007: 152) demonstrated diminished cerebral blood flow velocities in MCI patients who also carried the ApoeE4 allele. Risk factors for VaD are believed to include artherogenic factors such as hypertension, hyperlipidaemia, diabetes, and cigarette smoking (Micieli 2006: S38). Conversely, there are indications from clinical trials that nicotine has a protective effect for AD (Breteler et al. 1992: 71). Results of a randomised, double-blind, multicentred trial in which subjects with hypertension were treated with antihypertensives or placebo suggest that hypertension is a risk factor for developing both AD and VaD. Antihypertensives reduced risk by 55%. The results were significant as subjects had similar characteristics, the sample size was large (3228) and equally divided into placebo and treatment groups. Median follow-up was 3.9 years (Forette et al. 2002: 2047). 2.2.2. Head trauma: A meta-analysis by Fleminger et al. (2003: 858) replicated earlier findings by Mortimer et al. (1991) that head injuries pose a risk for AD but only in males, thought to be due to an early protective effect of oestrogens in females (Fleminger et al. 860). Bias may have been introduced into both studies as informants recalled the injuries. 2.2.3. Diabetes mellitus: Given that diabetes mellitus (DM) is a known risk factor for vascular disease it is not surprising that most studies on the development of vascular dementia in DM patients have shown a positive association (Biessels 2004: 10). Studies on DM as a risk factor for AD, however, have yielded conflicting results, possibly due to study limitations such as small sample sizes and selection bias (Leibson et al. 1997: 301). Large longitudinal studies may be more reliable. A population-based historical cohort study of 1,455 cases followed over 9,981 person years found a statistically significant positive association (Leibson et al. 304). According to results from the Framlingham Study, diabetes may not be an independent risk factor for developing AD but risk is strongly associated with possession of the ApoE4 genotype (Akomlafe et al. 2006: 1551). 2.2.4. Hormones: Women are twice more likely than men to suffer from AD. Although this may be partly due to women having a longer life expectancy (Beers et al. 2006: 1814) there is evidence to suggest that a decline in endogenous oestrogen in later life plays a role in its pathogenesis. Oestrogen is believed to stimulate cholinergic activity, reduce oxidative stress related cell damage, reduce vascular risks, reduce Ab formation and promote synaptic activity (Zandi et al. 2002: 2123; Hoskin et al. 2004: 141). Evidence from studies to determine whether oestrogen-containing hormone replacement therapy (HRT) in women has a protective effect on the brain, however, is conflicting (Colucci et al. 2006: 1376) but this may be due to differences in methodology and confounding factors (Resnick and Henderson 2002: 2171). For example, in one large prospective study that found a positive correlation between HRT use and a significant reduction in AD development, patients with dementia were asked q uestions regarding previous use of HRT (Zandi et al. 2124) yet accurate recall in a dementia sufferer cannot be guaranteed. Results of a retrospective case-control study suggesting the likelihood of women developing AD increases with number of pregnancies (Colucci et al. 2006: 1375) could be of little value. Cases with previous head injuries, low educational standards, both considered risk factors for AD (Collins 1997: 186; Fleminger et al. 2003: 858), and those who had used HRT, were not excluded from the study. There is evidence to suggest testosterone may delay AD onset in men. Men over 32 years of age who were free from AD at baseline (n = 574) were followed for a mean of nineteen years (Moffat et al. 2004: 188). Long-term free testosterone levels were significantly lower in men who developed AD. Due to conflicting results and confounding factors in the research the clinical evidence for risk factors for dementia is inconclusive. However, although more research is needed the results can assist in informing herbal practice. 2.3. Orthodox treatment strategies As cholinergic neurotransmitters are believed to have a role in memory function (Grossman et al. 2006: 985) symptomatic treatment for subtypes of dementia is similar and focuses on acetylcholinesterase (AChE) inhibition with drugs such as donepezil, rivastigmine and galantamine (Loveman et al. 2006: 8). According to Delagarza (2003: 1366) loss of cholinergic neurons causes a decrease in acetylcholine and subsequent drop in AChE with a compensatory rise in butylcholinesterase (BChE). Nicotinic receptors also decrease. Rivastigmine also inhibits BChE; galantamine also acts on nicotinic receptors. Depression in dementia is treated with non-anticholinergic antidepressants as anticholinergic drugs exacerbate symptoms (Beers et al. 2006: 1814). Another drug, memantine, a N-methyl-D-aspartic acid (NMDA) receptor antagonist (Grossman et al. 987), licensed to treat moderate to severe AD, acts by modulating the action of the neurotransmitter glutamate, which is believed to be associated with c holinergic damage and neurodegeneration when secreted in excess (Loveman et al. 2006: 8). Dizziness, diarrhoea, headaches, nausea and vomiting were found by a meta-analysis of dementia drugs to be common adverse events with anti-cholinesterases and memantine (Loveman et al. 2006: 49). Furthermore, their long-term benefits are inconclusive (Loveman et al. 145). Similarly, their use for vascular or Lewy body dementia is controversial as a review of clinical trials data deems there is insufficient evidence for their efficacy. Trials were of generally poor quality and with inconsistent findings (Maggini et al. 2006: 457). Other potential drugs for AD include 70 new compounds formulated to interfere with the toxic amyloid cascade or to target inflammation, oxidation or apoptosis (Grossman et al 2006: 987). As g-aminobutyric acid (GABA) agonists can impair memory GABA antagonists are also being developed (Association of the British Pharmaceutical Industry). 2.4. Potential herbal treatment strategies In view of the hypothesised pathological sequelae, risk factors and current orthodox treatment of dementias, efficacious herbs for these conditions could potentially have one or more of AChE-inhibiting or cholinergic, antidepressant, hypotensive, hypoglycaemic, antioxidant, anti-inflammatory, GABA modulator, nicotinic agonist, testosterogenic and oestrogenic actions. According to Kennedy and Scholey (2006: 4614) orthodox AChE inhibitors are not well tolerated by patients as they are toxic alkaloids and European plants traditionally used for cognitive enhancement may therefore provide non-alkaloid safer alternatives. To this end Salvia officinalis, Salvia lavandulaefolia and Melissa officinalis, members of the Labiatae family (Lamiaceae), have been extensively investigated in vitro. 2.4.1. Salvia spp. Salvia is the largest genus in the Labiatae family with over 700 species. The most common European species are Salvia officinalis L (garden or common sage) (Figure 1) and Salvia lavandulaefolia Vahl (Spanish sage), both of which originate on the shores of the Mediterranean (Kennedy and Scholey 2006: 4614). S. officinalis is an aromatic, evergreen shrub up to 75 cm in height with greyish-green oblong to lanceolate opposite leaves covered in a fine down. It has bluish-violet, two-lipped flowers arranged in whorls (Wildwood 1998: 202). S. lavandulaefolia has narrower leaves and a lower spreading habit (Sergei Savelevs Database). Sage was used in medieval Europe as a tisane for prolonging life and is a traditional spring tonic for strengthening weak constitutions (Lipp 1996: 63). According to Culpepper (1826: 147) ‘Sage is of excellent use to help the memory, warming and quickening the senses and an old country remedy, which indicates its efficacy for inflammation: ‘A sunburnt face is eased by washing with sage tea (Page 1978: 41). Other traditional uses are for headaches and migraine (Page: 34). The major active constituents of the leaves of both species are believed to be the volatile oils (1.0-2.8%), containing monoterpenes such as a-pinene, b-pinene, 1-8-cineole, camphor, geraniol and thujone (Kennedy and Scholey 2006: 4615). S. officinalis contains around 50% a- and b- thujone whereas only traces have been found in S. lavandulaefolia. As thujone, a terpenoid ketone, is potentially neurotoxic, S. lavandulaefolia may provide a safer alternative than S. officinalis to orthodox dementia drugs (Perry et al. 1999: 530). However, S. officinalis is toxic only at doses of over 15 g (Grainger-Bissett and Wichtl 2001: 441) but the oil should not be ingested. Both species contain polyphenolic compounds including rosmarinic acid, methyl carnosate, luteolin, luteolin-7-0-glucoside and caffeic acid (Kennedy and Scholey 4615), triterpenes eg oleanic acid and the flavonoids 5-Methoxysalvagenin (Barnes et al. 2002: 408) and hispidulin (Johnston and Beart 2004: 809). 2.4.2. Melissa officinalis M. officinalis L (balm, lemon balm) (Figure 2) originates from the eastern Mediterranean region and western Asia and is now widely cultivated in the west (Grainger Bissett and Wichtl 2001: 329). It is a bushy perennial, about 60 cm high with bright green, lemon-scented leaves in opposite pairs. Small labiate flowers grow in whorls and change colour from pale yellow to white or pale blue. Fresh leaves should be collected when young (Wildwood 1998: 175). It has been in medicinal use as a nervous system restorative for over 2000 years (Kennedy and Scholey 2006: 4617). The London Dispensary (1696 cited in Grieve 1931) states: ‘An essence of Balm, given in Canary wine every morning will renew youth, strengthen the brain John Evelyn wrote: ‘Balm is sovereign for the brain, strengthening the memory and powerfully chasing away melancholy (cited in Grieve 1931). There are no known contraindications or adverse effects (Barnes et al. 2002: 339). M. officinalis contains 0.2-0.3% essential oil (EO) consisting of over 70 components including around 60% monoterpenoid aldehydes and over 35% sesquiterpenes. The principle monoterpenes include citronellol, neral, geranial, methyl citronellate, ocimene; major sesquiterpenes include b-caryophylene and germacrene D. The herb also contains flavonoids, caffeic and chlorogenic glycosides, polyphenolic acids such as rosmarinic acid, and triterpenes (Granger Bissett and Wichtl 2001: 330). 2.5. Possible mode of action of phytochemical constituents in dementia 2.5.1. Antioxidant properties Numerous studies have been conducted on Salvia officinalis in a search for natural antioxidants to use in the food industry. Consequently, results of chemical tests on purified extracts of the herb have suggested that phenolic compounds rosmarinic acid, carnosic acid, carnosol, carnosoic acid, rosmadiol, rosmanol, epirosmanol, isorosmanol, galdosol methyl carnosate, 9-erythrosmanol and luteolin-7-0-glucopyranoside have significant antioxidant activity (Bertelsen et al 1995: 1272; Cuvelier et al. 1994: 665; Pizzale et al. 2002: 1651; Miura et al. 2002: 1848; Wang et al. 1998: 4869). S. lavandulaefolia dried leaf extracts in ethanol, chloroform and water, and various EO monoterpenes were assayed for antioxidant properties in phospholipid microsomes. The extracts and monoterpenes a-pinene, b-pinene, 1-8-cineole, camphor and geraniol and thujone all showed significant antioxidant activity (Perry et al. 2001: 1351). The extracts showed greater antioxidant activity than any individual monoterpenes, which suggested a synergistic effect (Perry et al. 1352). Ferreira et al. (2006: 35) measured the antioxidant properties of EOs, decoctions and ethanolic extracts of M. officinalis and S. officinalis relative to b-carotene. The EO and decoctions of both herbs showed significant antioxidant activity. Lima et al (2007) found methanolic and aqueous extracts of S. officinalis prevented lipid peroxidation in hepatoma cells. As there were more phenolics in the methanol extract it was thought there were other antioxidant compounds in the aqueous extract. Ethanolic EO extract from dried M. officinalis investigated for its ability to inhibit lipid peroxidation in vitro showed a dose-dependent (10-20 mg) 80-90% protection of linoleic acid from peroxyl radical attack. As no rosmarinic acid was detected in the EO the antioxidant action was attributed to squalene (Marongiu et al. 2004: 790). Considering there are potentially 70 constituents in the EO it is unlikely that this would have been the only active phytochemical but composition of the oil varies according to harvesting, origin and climate (Grainger-Bissett and Wichtl 2001: 329). Interestingly, M. officinalis prepared as a tea demonstrated significant antioxidant capacity, which corresponded to high phenolic content, when assayed with the ABTS (2,2/-azinobis 3-ethylbenzothiazoline-6-sulfonic acid) radical decolourisation assay (Ivanova et al. 2005: 147). 2.5.2. Anti-inflammatory activity Chloroform, aqueous and ethanol extracts and monoterpenes of S. lavandulaefolia, were tested for their ability to inhibit formation of pro-inflammatory eicosanoids thromboxane B2 (TXB2) and leukotriene B4 (LTB4) in leucocytes (Perry et al. 2001: 1348). The chloroform and ethanol extracts showed significant inhibition of LTB4. Alpha-pinene and geraniol showed weak selectivity for LTB4 and TXB2 respectively (Perry et al. 1351). The results support the traditional use of S. lavandulaefolia as an anti-inflammatory herb but indicate that it is the sum of the whole plant phytochemicals acting in synergy that are likely to contribute to this action. A standardised ethanolic extract containing 9.9% rosmarinic acid (RA) from the leaves of S. officinalis reduced Ab-induced neuronal cell death, Ab-induced lipid peroxidation, reactive oxygen species formation, DNA fragmentation and tau protein hyperphosphorylation in vitro (Iuvone et al. 2006: 1143). Kimura et al (1987) found rosmarinic acid (RA) had the ability to inhibit pro-inflammatory cytokines in human polymorphonuclear leucocytes (PMNs) in vitro. As both species contain RA these results suggest antioxidant, anti-inflammatory and neuroprotective properties of M. officinalis and the Salvia spp. against Ab-induced neurotoxicity. 2.5.3. Oestrogenic activity A range of concentrations of EO, ethanolic, chloroform and aqueous extracts and isolated monoterpenes of S. lavandulaefolia were assayed in yeast culture for oestrogen-binding properties. The EO showed weak oestrogenic activity at low concentrations. The aqueous and ethanolic fractions and geraniol showed significant oestrogenic activity (Perry et al. 2001: 1352). The results of this experiment support S. lavandulaefolias use as an oestrogenic herb. The effects of S. officinalis in combination with Medicago sativa were assessed on menopausal symptoms related to oestrogen deprivation. Hot flushes and night sweats were completely eliminated in 20 out of 30 women (De Leo et al. 1998: 207). These effects were attributed to dopaminergic actions but it is not clear for which herb. S. officinalis does, however, contain geraniol found to be oestrogenic in vitro (Perry et al. 2001: 1352). 2.5.4. Acetylcholinesterase inhibitory activity M. officinalis EO demonstrated strong AChE inhibition in homogenised human brain tissue but ethanolic extract of the dried leaf had no effect. Ethanolic fresh leaf extract showed a weak effect (Perry et al. 1996: 1064). Conversely, when EOs and ethanolic extracts of M. officinalis were assayed in solution with AChE negligible results were obtained for its inhibition by EO and significant results for its ethanolic extract (Ferreira et al. 2006: 34). Dried, reconstituted ethanolic, ethyl acetate or aqueous extracts of M. officinalis, yielding 10mg/ml, demonstrated weak AChE inhibitory activity when assayed in a chemical system using thin layer chromatography (Salah and Jà ¤ger 2005: 146). The herbs were purchased from local suppliers in the Lebanon so their quality is unknown. S. officinalis EO and ethanolic extract assayed in solution with AChE showed moderate AChE inhibitory activity (Ferreira et al. 2006: 34). Moderate (dose-dependent) AChE and weak BChE inhibition was demonstrated by ethanolic extracts of fresh and dried S. officinalis and S. lavandulaefolia in human brain homogenates. The EOs had significant effects but not the individual constituents (camphor, thujone, cineole, caffeic acid and borneol) (Perry et al. 1996: 1066). The findings suggest a major synergistic effect of the constituents (Perry et al. 2000: 895), which was later confirmed by Savelev et al. (2003: 667). The results for camphor conflict with another experiment in which S. lavandulaefolia EO and isolated monoterpenes a-pinene, 1-8-cineole and camphor demonstrated AChE inhibitory activity in human erythrocytes. Ethanolic extracts of dried S. officinalis, S. lavandulaefolia and M. officinalis were assayed for acetylcholine (ACh) receptor activity in human brain homogenate. All plants demonstrated ACh receptor activity and M. officinalis had the highest nicotinic displacement value (Wake et al. 2000: 108). 2.5.5. GABA modulation Methanol extract from S officinalis leaves revealed the flavonoids apigenin, hispidulin and cirsimaritin functioning as benzodiazepine receptor-active components (Kavvadias et al. 2003: 113), suggesting a potential calming effect for the herb, which may be relevant to AD. 2.6. Evaluation of in vitro studies According to the results all three herbs may have AChE inhibitory, anti-inflammatory and antioxidant properties, and S. lavandulaefolia and S. officinalis may have and oestrogenic properties (Appendix I, Table 1, page 36) and a sedative effect for S. officinalis. Although these results are interesting in vitro systems cannot be extrapolated to humans and clinical evidence is necessary to support findings. For example, they cannot determine effective human dosage or mode of administration. They largely do not account for potential synergistic effects of the herbs nor do they provide an indication of in vivo physiological, pathological and genetic, or environmental, influences. Furthermore, the extent to which phytochemicals in herbs are effective in dementia may depend upon their bioavailability in the brain (Anekonda and Reddy 2005: 371). It is worth noting, however, that as terpenoids tend to be lipophilic they are able to cross the blood brain barrier (Houghton and Howes 2005: 12). Some results are conflicting but they may depend on methodological quality and design. The experiments cited above vary widely in their approach with regard to extraction methods and assay methods. Savelev (2003: 667) has demonstrated how two different methods used for exploring interactions between the same agents may give different results when applied to the same set of data. Consistency of results may also be affected by differences in harvesting times and quality of herbs. Results for M. officinalis are particularly inconsistent but, according to Perry et al. (1996: 1068) most commercial sources of the EO are adulterated. Additionally, variation in media composition is known to affect the outcome of in vitro tests (Maurer and Kuschinsky 2006: 73). Consequently, in vitro experiments can only provide an indication of the clinical efficacy of therapeutic interventions. However, despite the inherent difficulties of in vitro research with herbs, there is considerable consistency with their potential value in dementia prophylaxis and management (Appendix I, Table I, page 36). Promising results in vitro of constituents of plants traditionally used to enhance memory, and subsequent interest in their potential actions in the brains of human patients, has generated clinical trials of M. officinalis and Salvia spp. for dementia. These will be reviewed. 3. Method A computerised literature search was conducted on the Allied and Complementary Medicine Database (AMED) including CINAHL Database, EMBASE, Pascal Biomed, Biological Abstracts, RCN Journals Database and IPA (International Pharmaceutical Abstracts); PubMed, the Cochrane Collaboration, Bandolier, the NHS Centre for Reviews, The National Research Register, ADEAR (Alzheimers Disease Education and Referral Centre database), PLoS (Public Library of Science), Herbalgram and Alt HealthWatch as well as hand-searching in books and journals. Literature searches dated back to 1985 and the final search was in April 2007. Key words in medical subject headings (MeSH) for an initial search in various Boolean combinations were: memory, cognitive dysfunction, dementia, Alzheimers, herbal, botanicals, phytotherapy, complementary and alternative. Also, in a second search these MeSh terms were entered with key herbs: Salvia, sage, Melissa and lemon balm. Inclusion criteria Controlled clinical trials, observational studies and case reports. Herbs for which there are at least two clinical studies in relation to cognitive enhancement. Exclusion criteria Due to the limitations and ethical considerations of animal experiments the review is restricted to human trials. Trials with combined preparations are excluded. Due to time constraints and a restriction to papers in the English language a complete systematic review is not viable at this time. To eliminate

Exemplary Leadership

Abstract In order to be a successful leader, one must have specific virtues to qualify them as effective. This analysis examines how a leader utilizes organizational power, the magnitude to which the leader is constrained by contingency factors, how the leader deals with ethical issues, and the leader’s decision-making style and influence tactics in addition to other characteristics.The leader detailed in this analysis is proven to be effective based on certain qualities and the methods he employ to successfully reach the organization’s goal, and motivate the employees to efficiently meet their subdivision and complete organizational goals. Upon completion of this analysis, it is recommended that a study is done to assess if factors such as age, sex, heritage, etc. contribute to the type of leader one becomes. Introduction Leaders are an essential part of every organization. The quality of leaders determines the success of the organization.There are exemplary leaders, a nd there are leaders that can learn a thing or two. What is a leader? Colquitt, Lepine, and Wesson (2011) define leadership as the use of power and influence to direct the activities of followers toward goal achievement (p. 451). This analysis will chronicle an exemplary leader that many other leaders can learn from. The analysis will assess the leaders use of sources of organizational power, how the leader is constrained by contingency factors, how the leader makes decisions, his influence tactics, and how ethical issues are dealt with.Context My boss at the job that I currently hold is a prototypical leader and the example chosen for this analysis. While studying Management at Howard University, one subject that was constantly visited is what makes a proficient leader. I always wondered where all of my bosses learned their horrible leadership skills from until I crossed paths with my present boss. His kindheartedness, importable nature, and accommodating temperament raises the bar for leaders everywhere.The way he interacts with his staff makes them happy to work dexterously to meet organizations goals above what is expected. These are the behaviors that Colquitt et al states an effective leader achieves. Discussion and Analysis The Use of Organizational Power Power is the aptitude to guide the performance of other individuals and limit unwanted influence in return (Colquitt et al. , 2011). The authors stated that even if one posses the power to influence, it does not guarantee they can effectively influence.Power is made up of five facets – legitimate, reward, coercive, expert, and referent. My supervisor has the power to request that I perform tasks within the scope of his authority – legitimate, the power to extend specific resources I need and rewards I want – reward, the power to control consequences for adverse behaviors – coercive, the expertise that I depend on to get my job done and to grow within the organization  œ expert, and finally he is an individual that I’d like to be associated with in the organization – referent.He has all five facets of power as described by Colquitt et al. My supervisor exercises his rights to power in order to help the organization reach its overall goals and not to be seen as a coercive leader. He exercises legitimate power for reasonable requests such as asking me to come in earlier than my scheduled time to attend an important meeting that could only be scheduled at that time. Notice that he makes reasonable requests, meaning that he gives the option to decline if I cannot make reasonable accommodations.He exercises reward power by periodically making mention of how he intends to go about upcoming performance appraisals. This is actually a strategic method as he utilizes his reward power to remind me of what he can do, which in turn heightens the effectiveness of legitimate power as I am more prone to be submissive to his requests in order to rece ive greater rewards. My supervisor has been in the marketing field – the basis of our department – for over fifteen years, which makes him somewhat of an expert, giving him expert power.My supervisor is not a fan of coercive power, as he does not feel the need to intimidate because he effectively gets his employees to do what they need to do. He encourages his employees to obtain the results he desires. Overall, my supervisor has a great deal of power. He strategically applies his powers in order to achieve what is most important – the organizational goal. As mentioned earlier, he uses his reward and legitimate power concurrently, which is beneficial for him and his staff.His expert power has strength in that I try to use it to my advantage to acquire new talents to help me grow in this organization and any future organizations. He is well respected because of his choice to not use coercive power. Contingency Factors There are four contingencies of power, which Colquitt et al tells us are substitutability, centrality, discretion, and visibility. My supervisor is insignificantly constrained by substitutability, which is the extent to which people have alternatives in accessing resources. My organization strongly attempts to adhere to budgets previously set for the year. o stick to budgets and discretion is the degree to which managers have the right to make decisions on their own (p. 455). Centrality represents how important a person’s job is and how many people depend on that person to complete their task, and visibility is how aware people are of a leader’s powers and position. . He does not have sole control of rewards and resources. As a non-profit, my organization relies heavily on budgets and each higher manager must adhere to their budgets that must be agreed upon by the chief financial officer and president.So even with his reward power, there are limitations. His centrality contingency is not a restraint. He has a ver y important role in the organization as we rely on him significantly to bring money into the organization. I personally depend on him for the completion of many of my assignments, as he must approve many of my tasks before it is executed fully. The discretion contingency may serve as a restraint for my supervisor; while he is Vice President of Marketing, the CFO or president must approve many of his big decisions.They can then revise or rebut his decision if they feel it is necessary. The visibility contingency is not necessarily a constraint or helper to my boss. The resources he can provide are not necessarily organizational record but his title makes it known that he is above most employees and under just the CFO and president; this makes it so he still has relatively high influence. Influence Tactics Colquitt et al (2011) defines influence as the use of an actual behavior that causes behavioral or attitudinal changes in others (p. 56) or as Ceasar and Grant (2004) define as Infl uence tactics are specific types of proactive behavior used to exercise influence. The influence tactics that my boss uses are exchange, consultation, collaboration, and ingratiation. One of my supervisor’s favorite influence tactics is the exchange tactic, which is when an individual extends a reward or resource to the target with the intent for them to perform a request (p). This tactic is most common when my supervisor has projects with outsourced associates.If we are compensating someone for their expertise and we need them to start working prior to receiving payment, he will construct and send an email stating â€Å"your payment is on its way, in the meantime please†¦Ã¢â‚¬  Usually, when I am asked to complete an assignment, I am also asked how we should implement it and at that point he approves or change it somewhat. This is the consultation tactic, which is when the target – me – is allowed to participate in deciding how to carry out or implement a request (p. 457). He uses the collaboration tactic, which involves making the request easier to complete.He generally provides me with the necessary resources I need to complete the task as well making it simpler so that it is done efficiently and effectively on the first try. Ingratiation is his favorite tactic to use. Ingratiation is the use of favors, compliments, or friendly behavior to make the target feel better about the influencer (p. 457). He never fails to tell me how awesome I am, or on occasions he would tell me that he does not need to review my work because he trusts me, or explain that he gave me a task because he knew I was smart enough to handle it.Influence tactics are the medium through which managers convert power into behaviors; when managers need others to perform tasks or participate in activities, influence tactics serve as a means of facilitating individual cooperation (Ceasar & Grant, 2004). The tactics that he uses are effective and he uses them appropri ately as well. He also uses personal appeals because in his line of work, he deals with a lot of outside clients.It is beneficial for him to build relationships with people in other industries so that they are readily available to help us when we need them. All in all, the tactics my boss uses results in internalization, which involves getting the target to agree with and become committed to a request (p. 459). Ethical Issues My boss works extremely well under intense conditions and with conflicts. Just recently, we joined with a major corporation for a campaign and sought help from a board certified doctor so that the information we offered would be further validated.Prior to execution of the assignment by the doctor, he let us know that he was not satisfied with the pay and proceeded to tell the major corporation false accounts of what we told him were part of the agreement. My boss could have outright denied his claims in the same rude manner that the doctor was exemplifying. Ins tead, he apologized to the doctor for the misunderstanding and attributed his false account to miscommunication. He then asked the doctor what his normal fee was for the task he performed, and he accommodated him accordingly.He then concluded he would never use the doctor again. In this example of an ethical issue, the fault is not of my organization or my boss but that of the doctor. However, my boss handled the situation in an ethical manner when he could have very well become as unethical as the doctor. I personally respected him for his handling of the situation, as I know my initial instinct would have been to react a lot differently. Decision-Making Styles Colquitt et al talks about four decision-making styles: delegative, facilitative, consultative, and autocratic.With delegative style, a leader gives an individual employee or a group of employees the responsibility for making the decision within some set of specified boundary conditions and with facilitative style, the leade r presents the problem to a group of employees and seeks consensus on a solution, making sure his or her own opinion receives no more weight than others (p. 488). With a consultative style, the leader present the problem to an individual employees or a group, asking for their opinions and suggestions before making a decision him- or her- self and with autocratic style, the leader makes the decision alone (p. 57). My boss uses three of the four decision-making styles as he sees appropriate. For example, he would use the delegative style in a situation where he gives the staff a project. He will provide the specified conditions and then allow us to determine the way we carry out the assignment. He would use the consultative style in a situation where he may want different viewpoints about a decision he has to make to see if he explored all relevant avenues before ultimately making the decision based on his own views.He uses the autocratic style when the decision does not directly affe ct the team and he needs no further input. Transformational Vs. Transactional Leadership According to Colquitt et al (2011), transformational leadership involves inspiring followers to commit to a shared vision that provides meaning to their work while also serving as a role model who helps followers develop their own potential and view problems from new perspectives (p. 496). Transactional leadership occurs when the leader rewards or disciplines the follower depending on the adequacy of the follower’s performance (p. 98). Grant (2012) defines transformational leadership as a central purpose to articulate a vision that focuses employees’ attention on their contributions to others. He states that this form of leadership motivate employees to perform more effectively. My boss is a transformational leader. Not only is he great at inspiring his staff to commit to a shared vision, he makes sure that their work is worth their while. He continually asks if our work is suffici ent and challenging enough because he does not want us to become bored.In addition, he gives us tasks that may go beyond our duties just to develop us into more valuable professionals. He gives us leeway to execute our tasks in a manner that is most comfortable to us while giving his input when we ask or when he sees it is necessary. He does not micro-manage and puts more focus on making us better employees so we can help him with our current skills while learning new skills to be more of a help in the future. Neutralizers Vs. Substitutes Neutralizers, as Colquitt et al (2011) explains, reduce the importance of the leader but have no beneficial impact on performance (p. 05). Substitutes reduce the importance of the leader while providing a direct benefit to employee performance. My supervisor’s effectiveness is rarely affected by substitutes. Because our organization is small, outside staff is less likely able to help us because each department has its specialty. Staff could gain experience that will lessen the extent to which they need the manager’s help but could never alleviate it completely because he is the provider of the tasks. Neutralizers are also minimal. There is task stability, formalization, and spatial distance, but inflexibility is not a factor.For the most part there are tasks that are unchanging and daily and there are written instructions for many of the tasks. Also, all leaders have offices and therefore there is spatial distance. Impact My supervisor has a major impact on performance and commitment in a positive way. His personality and leadership techniques make it so he is a pleasant person to work for. He governs over his employees just enough to make sure the work is done while giving enough space for them to be creative and comfortable. His behaviors definitely influence commitment because it is rare to find a boss of this caliber.Conclusions and Reflections I have always viewed my boss as a great boss. I never had the op portunity to think of why he was such a great boss. This assignment allowed me to do just that. And from my research, I found that my boss has virtually everything that makes a boss a great one from his personality to leadership skills. I have always had the attitude that I want to work for myself because most bosses were not very nice people. While I still desire to work for myself, I would not mind working with a boss like mine and now know that all bosses are not horrible people.I desire to be the exact type of boss that my boss is because his methods are effective. After taking the initiation and consideration assessment, I found that my score for initiating was considered low and the score for consideration was considered high. That coincides with the way I think I would lead. I would care about more about input from group members and their comfort than being more autocratic as a high initiative score would indicate. I would be interested in further researching if certain chara cteristics attribute to the sort of boss a person becomes such as gender, race, age, etc.References Colquitt, J. , Lepine, J. , Wesson. M. (2011). Organizational Behavior: Improving Performance and commitment in the workplace. New York, NY: McGraw-Hill Gardner, W. L. , & Ceasar, D. (2004). Transition to Self-Directed Work Teams: Implications of transition time and self-monitoring for managers' use of influence tactics. Journal Of Organizational Behavior, 25(1), 47-65. Grant, A. M. (2012). Leading with Meaning: Beneficiary contact, prosocial impact, and the performance effects of transformational leadership. Academy Of Management Journal, 55(2), 458-476.

Foils for Odysseus Essay

The Odyssey is the epic that has been read time and time again, by varying ages, digging its way into our hearts, becoming an instant classic. Odysseus and the adventures of his homecoming create a much different tale than Homer’s other work, the Iliad, provided. The epic is not about bloodthirsty men trying to get their hands on kleos anymore; it is about the homecoming of a man who uses his wits, not his weapon. In the Odyssey, the characters balance – Homer provides contrasting characters to show the readers the traits that Odysseus holds and how it builds his character development and even those who are foils to him. Odysseus’ own son, Trojan War companions, and wife create the man that is called Odysseus, highlighting the various facets of his personality throughout the epic. Odysseus’ son Telemachos matured since the very first book of the Odyssey, becoming more self-confident in his capabilities, more powerful in the speeches he makes, and more impo rtantly, more determined to rule the kingdom that will one day become his. The growth that Odysseus undergoes in his travels, such as growth in intellect, maturity and strength, his son goes through as well. The emotional growth in the paralleling stories of Telemachos and Odysseus holds a key part to the storylines. When Telemachos travels to Sparta he meets Menelaus, Odysseus’ friend from the Trojan War. When Menelaus mentions Odysseus, the young Telemachos first tries to stay strong and continue to hide who he is but breaks down and cries, showing he still has a lot to learn. Odysseus is known for his tricks, especially in the Odyssey where he specializes in not being who he says he is for ninety-five percent of the epic. As Telemachos tries to accomplish being a trickster like his father he shows he has potential but it is not the right time yet to be as tricky as Odysseus is. In book 21 of the Odyssey Telemachos sets up the trial of the twelve axes perfectly for the suitors, even though he was never taught how; only Odysseus knows how to set them up so flawlessly. When it came time for Telemachos to try his hand at stringing his father’s god-like bow that only he could string, he came very close. If it were not for Odysseus’ signal the boy would have strung the bow and won. He had the potential to be just like Odysseus, stringing the bow that only Odysseus could string, proving that Telemachos has matured to the point that he could almost take his fathers place. He yields the contest to the suitors, stating: ‘Shame on me. I must be then a coward and weakling, or else I am still young, and my hands have yet no confidence to defend myself against a man who has started a quarrel. Come then, you who in your strength are greater than I am, make your attempts on the bow, and let us finish the contest’ (Book 21,131-135). As the suitors witness his failure, Telemachos starts to use and perfect the use of clever responses just like his father, making the suitors feel safer than they really are, not letting them see through his ruse. After the Trojan War ended and time for the homecoming of the soldiers came about, the men who were featured in Homer’s Iliad journeyed on their merry way, back to their homes they left behind for twenty years. Ag amemnon, Nestor and Menelaos all had different homecomings, but each of them creates a nicely knit foil for Odysseus. As Agamemnon stepped inside his own home after twenty years of being away, his wife Clytemnestra and her newfound lover Aegisthus, who was Agamemnon’s cousin, greeted him with a nice bath. Before Agamemnon arrived, Clytemnestra was plotting the death of her husband due to the sacrifice of their daughter, Iphigenia. Agamemnon was stabbed to death by the vengeful tag-team. Agamemnon’s son, Orestes, unleashed vengeance upon his mother and her lover. Agamemnon’s family is a foil for Odysseus’ family life. Odysseus’ family loves him very dearly and has done no wrong as he was away. Penelope, unlike Clytemnestra, stays loyal to Odysseus and even creates an ingenious plan to keep the suitors off her back. Telemachos on the other hand has to deal with the suitors who are trying to marry his mother and have been dishonoring his father, Odysseus, eating their fill since they sat their butts on the stools they deem as weapons. Telemachos can’t even stan d up to the suitors as Agamemnon’s son took revenge on the people who killed his father. This shows how Telemachos should be as a son and will soon be as he grows up to be more like his father. Menelaos had a long homecoming due to the gods, just as Odysseus had. Menelaos angered the Egyptian gods, due to the lack of knowledge of Egyptian customs. He was able to get home with all of his crew, unlike Odysseus, who was a lone survivor. Although Menelaos had an easier homecoming than Odysseus, he did not have a  faithful wife, just like Agamemnon. Helen was the reason for the Trojan War; for Menelaos it was not easy to forgive an unfaithful wife to that degree. He cannot rejoin the present as easily due to all that was lost in Troy, destined to be full of grief for eternity. Then there is Nestor, the man whose name means â€Å"Returner†. Nestor was the one who had the easiest and most peaceful return home. His palace was full of peace, unlike Odysseus and the other two men. As the three war heroes returned back to their homes, none of them had to disguise themselves as someone else, making it obvious who they were, which was good and bad. Odysseus had to resume pretending he was someone else, generally from Crete, until he was certain that the people who caused the most threats were out of the picture. That was a smart move on Odysseus’ part. Penelope was Odysseus’ faithful, cunning and stunningly beautiful wife. Penelope, just like Odysseus, tests people until she gets enough information to her liking. For example after Odysseus reveals himself to the household and asks for Penelope, Penelope does not believe the news so quickly. She was not so gullible as to be excited about simple information; she wanted cold hard proof. Penelope shows her cleverness when she wants to see Odysseus, telling Eurykleia: ‘Dear nurse, it would be hard for you to baffle the purposes of the everlasting gods, although you are very clever. Still, I will go to see my son, so that I can look on these men who courted me lying dead, and the man who killed them’ (Book 23, 81-84). She is not willing to let anyone know she is excited to see her husband, so she plays it off cool, saying she was just going outside in order to see her son, not even mentioning Odysseus by name. Penelope constantly reconsiders and rethinks what she should do, just like Odysseus tends to do because he never wants to be caught off guard, until Penelope, as clever as she is, starts playing the same game he does. She orders Eurykleia to ‘make up a firm bed for him outside the well-fashioned chamber: that very bed that he himself built. Put the firm bed here outside for him, and cover it over with fleeces and blankets, and with shining coverlets’ (Book 23,177-180). Knowing Odysseus would get flustered with her idea, he revealed who he was by stating that the bed could not be moved due to it being made of the olive tree trunk that the house was built on. Not one person could out wit Odysseus and yet, his own wife did so easily. Penelope was just as smart as Odysseus, making them perfect foils for one another. Odysseus was a man of wit and courage, one who was unfortunate enough to anger the gods. Even with his unlucky fate of a long homecoming, he was blessed with a loyal and loving family, a family that highlights the various facets of his personality. All of these characters molded Odysseus, just as he molded them through the events of the Odyssey. They reflect his growth as a character with their own trials and tribulations. We find the best depiction of Odysseus’ growth in comparison to other characters; his wife, his comrades, and his son all bring out different elements of his personality. Without any of them, Odysseus would not be the great character we all know and love.

Describe the Factors That contribute to Canada¡s Power essays

Describe the Factors That contribute to Canada ¡s Power essays There are a lot of factors that contribute to Canada ¡s power in the world. One of the major factors is Canada ¡s Natural Resources. Some of Canada ¡s Natural Resources include: Mining is a very important business in Canada, with mines all over the provinces and territories. Canada is one of the biggest mining countries in the world. Canada mines over 60 minerals and metals. In 2000 the mining industry brought in $30.4 billion dollars for the Canadian economy. Canada is one of the world top exporters of minerals. 80% of the mineral production in Canada is exported, which contributes to the Canadian economy. Canada is the worlds leader in the mining of uranium and potash. Canada is also ranked in the top five for: Nickel, Lead, Aluminum, gold, zinc, copper, gypsum, molybdenum, platinum, salt, cadmium, titanium, and asbestos. For Canada, energy is also one of their biggest, and most important resources. In 1999, Canada produced 11.3 billion barrels of crude oil. In 200, crude oil production was at 1.35 million barrels per day(BPD) of light, and 0.85 million BPD of heavy, together totaling 2.2 million BPD or 803 million barrels for the year. In 200, Canada produced 69 million tonnes of coal, and produced 600 net terawatt hours from electricity generation. The United States is accountable for 96% of all Canadian energy Exports totaling $52.2 billion. The forestry industry in Canada is very large, with $69.6 billion in shipments per year. Canada has 10% of the worlds forests, and it is the worlds largest forest products exporter. The total value for forest products exported was at $47.4 billion in 2000. Its not just the resources that contribute to Canada ¡s power. Other things like employment rates, education, manufacturing, farming, research and development of aeronautical engineering, automotive research and computer development. What makes the country grow is ...

Censorship of pornography essays

Censorship of pornography essays The censorship of pornography has been an issue under constant debate in our society. There are many arguments for and against the censorship of pornographic materials. Advocates for freedom of expression feel that increased censorship violates many basic human rights and consequently may harm our society. They believe in personal choice and that any action is lawful as long as it brings no harm to others. Supporters of an increase in censorship are rooted in the belief that such material may cause direct and/or indirect detriments to society. They believe that enabling people, primarily men, to view degrading and violent material to women, and sometimes children, will increase their likelihood of them acting out on women and children and make the world a more dangerous place for those groups to live. The purpose of this essay is to present the issues of those who are for censorship and those who are opposed to it and to present some of the arguments they put forth to support the ir position on the subject. Those groups who are opposed to censorship include Liberals and Feminists, more specifically radical libertarian feminists. Liberals oppose any abridgment of the freedom of speech through government censorship, regulation or control of communications, which includes books, magazines, movies, the internet and pornography. Liberals believe that the censorship of pornography is a violation of the liberty of expression and freedom of speech that every person is entitled to. Liberals believe that a person should be free to do whatever he or she chooses to do as long as it does not harm themselves or any other individuals. For Liberals, pornography is encompassed within this Harm Principle. They believe that those people who make pornographic videos should be able to do so as long has it is done in a lawful way and does not cause harm to others, stores should be able to rent and sell the pornographic videos without ...

Unit 1 Seminar Case managemnet Research Paper Example | Topics and Well Written Essays - 250 words

Unit 1 Seminar Case managemnet - Research Paper Example dividuals, actively manage any programs that ensure a successful service provision as well as making decisions that facilitate a smooth service provision (Metzger 30). Dual relationships mean relationships that crop up between a client and a worker in the course of their interaction. A dual relationship might occur consecutively or simultaneously during the interaction between the client and the service provider. There are various types of dual relationships. They include, social dual relationships whereby the client is also a friend, a professional dual relationship whereby the client and the service provider are professional acquaintances in other arenas and a communal dual relationship involves the client and worker living in the same area/community. Other dual relationships include sexual dual relationships whereby the two are involves in a sexual relationship and a business dual relationship whereby the client and worker are business partners as well. Client rights refer to the entitlement of a client to receive certain treatment or services. Some of clients’ rights include privacy and confidentiality, accurate and timely access to information, receipt of excellent services (Woodside, 271). Clients are also entitled to have the cultural needs respected as they get respect as well as dignity in service provision. For instance a client going to see a professional counselor over divorce or custody matters has the right to have information disclosed to the counselor private and confidentially no matter

HBS (Harvard Business Studies) IT WILL BE CASE ANALYSIS Essay

HBS (Harvard Business Studies) IT WILL BE CASE ANALYSIS - Essay Example At the present time, over 90 percent of the workforce cannot run official duties in English. The CEO has set some punitive measures for those who will fail to achieve set scores – they will face demotions. As the program is rolled out, employees struggle to learn English. There are many challenges faced including loss of productivity, insufficient time to conduct studies, and internal resistance from managers. It is very clear employees are disgusted with the new policy and are only learning English to avoid being demoted or losing their jobs. Nine months to the deadline, the employees are growing desperate as they are realizing that it is increasingly becoming clear that they are not going to meet the set scores by the deadline. This has created anxiety and generally disrupted the workplace (Tsedal, 2011). In this paper, this case study is critically analyzed by examining the key communication challenges that are evident in the case study, suggesting alternatives to these cha llenges and showing why the alternatives will work. The challenges which are likely to be encountered in implementing the alternatives will also be highlighted. CASE ANALYSIS Key communication issues in the case study Radical changes in any organization require good preparation. In the case of this case study, the radical change was the change in the official language of the organization. The biggest communication challenge which can be identified here is insufficient of it. The manner in which the change in policy was communicated was clearly not the best. It was clearly going to draw resistance. Employees were never given time to internalize the new changes which were going to take effect. Everything around them was changed overnight including the menu language at the cafeteria. Hiroshi Mikitani relegated communication in this sense to a very naive position. According to Griffin (2003), communication should not be viewed naively as just a transmission of information. He argued tha t this notion often breeds â€Å"managerialism, discursive closure, and corporate colonization† (Griffin, 2003, p. 495). It is clear that Hiroshi Mikitani did not have the patience to engage his employees and collect their opinions on what they thought of the new policy. This challenge was similarly seen in the managers – the managers were clearly complaining and not on the side of their boss. The implication is that they had no prior information about the change in policy. This is a complete communication breakdown from the side of the CEO and such breakdowns often lead to very slow and reluctant adoption of new policies especially when such policies are radical. Alternatives to the challenges There are many alternatives that Hiroshi Mikitani could have used to ensure that his communication was welcomed. 1. There was a need to involve the employees – 2. Hiroshi Mikitani did not involve his employees in deciding on the new policy Their opinions did not seem to m atter to him and therefore by assuming this he was indeed communicating other messages such as they really do not matter to him. According to Tsedal (2012), engaging employees in decision making or in change of policies creates a platform to explain the rationale of creating a new policy. 3. The policy should have been implemented at the managerial level first It could set a great precedence if the policy was