According to Crowther (2010), stakeholders are players in an organization who have a pegged stake, claim or interest in the outfit they subscribe to. The carder falls into two categories namely internal and external stakeholders. Examples of stakeholders in an organization are shareholders, customers, suppliers, investors and employees.

Stakeholders affiliated to any organization must have concern and a burning interest in the ethical management of the organization (Phillips, 2003). Different categories of stakeholders be it customers, employees or shareholders recognize the fact that the particular organization they are affiliated to serves them and failure to display concern in its ethical management would amount to jeopardy. Kaler (2011) gives a perfect example that shareholders who are the owners of an organization receive benefits in terms of dividends from the particular organization they subscribe to. The carder comprehends that unethical management of the organization would most likely result to deterioration in performance. The outcome of such a scenario would be a decline in profits realized and consequently reduced dividends. The stakeholder’s would therefore reap less for lack of showing interest in ethical management of the organization (Kaler, 2011). Overlooking on the way an organization is management would affect the stakeholders claim, stake and interest in the particular organization.

The size of the divided or the success realized is not all that matters to stakeholders. The stakeholders harbour other concerns such as the organization’s posterity. The group lives to ensure that despite how successful an organization is, the future of the outfit is guaranteed, to ensure sustained benefits over years (McLean, 2006). The stakeholders want to ensure presence of ethical management to guarantee existence of the organization for many years.


Crowther, D. (2010). Stakeholders. International Encyclopedia of Organization Studies. doi:10.4135/9781412956246.n500

Kaler, J. H. (2011). Who are an organization’s stakeholders and to what extent should an organization have regard to their interests? London: Henry Stewart Talks.

McLean, G. N. (2006). Organization development: Principles, processes, performance. San Francisco: Berrett-Koehler Publishers.

Phillips, R. (2003). Stakeholder theory and organizational ethics. San Francisco: Berrett-Koehler.

The Therapeutic Alliance

The Therapeutic Alliance

According to Michel, Jobes and American Psychological Association (2011), therapeutic alliance denotes the relationship between a healthcare practitioner and a patient. The helping alliance describes the engagement between the two parties and the beneficial change that a patient reaps. The working alliance forms the most fundamental part when kick starting a psychotherapy serssion. In light of previous studies, the interaction and trust between the client and therapist best predicts treatment outcome.

Question 2

I subscribe to the fact that engagement between a clinician and a therapist entirely contributes the outcome efficiency. Numerous studies prove that a purposeful collaborative alliance between a clinician and a patient is directly linked to positive therapeutic progress and outcome. Michel, Jobes and American Psychological Association (2011) argue that therapists should focus on alliance cultivation for better results. The power of the working alliance has a direct relationship with end results. Previous research on the topic shows that therapeutic alliances start right when a patient makes a call to book the first session with a physician. The interaction through communication creates a first impression that lasts until the end of therapeutic engagement (Muran & Barbe, 2010). The effect and outcome is merely not reliant on skills and competence of a physician. A positive outcome require understanding and empathy from the therapist. Displaying a high degree of warmness during interactions builds a friendly alliance ultimately realizing positive results. Contrary, rigid therapists who fail to give a listening ear, experience strained relationship with a client leading to negative results (Muran & Barbe, 2010). Inappropriate self-disclosure and insensitivity characterize weak and unhelpful client-clinician relationships. A client having a therapeutic session with a clinician who insensitively hold silence, is overly structured and exercises intense interpretation creates a hostile environment resulting to an undesirable outcome.


As Muran and Barbe (2010) argue a continuous and authentic working alliance amounts to a successful therapy. The effectiveness of any alliance depends on the prevailing atmosphere between a client and the clinician. Relationships characterized by empathy, genuineness and positive unconditional client regard instils satisfaction to a client and makes a patient yearn to have similar repeat sessions. A clinician who fails to understand a client feelings imparts a negative impression within the patient consequently scoring a low outcome (Safran & Muran, 2000). Prosperous relationships calls for openness and honesty from the therapist. Physicians must show positive regard and avoid enacting any conditions of worth. Disregard of a patients’ values puts an ongoing therapeutic alliance in jeopardy. The behavior demonstrated by a clinician is critical to the outcome of the therapy. The relationship nature is the most fundamental art of any therapy. The effectiveness of all therapies exudes from aspects such as focusing on emotions and a patient’s feelings (Safran & Muran, 2000).

Failure to hold a patient as an equal partner during interactions is a show of demeaning the client resulting to negative transference. For an individual to trust the physician, the clinician must examine incidences of mistrust and review client goals and ultimate expectations. A clinician must inculcate a high condition of worth to make a patient feel valued unconditionally. During interactions a physician must work to dispense feelings of anger and hurt to realize a fruitful working alliance (Safran & Muran, 2000). A clinician-client relationship where a physician displays warmth, acceptance, empathy and ability to comprehend a client feelings achieves a therapy’s set goals achieving mutual satisfaction. The outcome of a therapeutic alliance depends on trust and emotional closeness between involved parties. The client and the therapist must formulate expectations regarding change of behavior. The two should reach a concurrence on methods to employ to realize set goals.


As Safran and Muran (2000) argue a strong bond in the relationship is a necessity to realize set targets. A fruitful therapeutic alliance is mutually founded between the two party’s shared goals, tasks and cultivated bond. Realizing a rewarding outcome require therapist to increase rapport with clients by displaying interest, showing active engagement and embracing the patients intentions. Quality of a therapeutic alliance is directly related to the outcome of the engagement. An efficacious connection between a therapist and a patient strengthens the alliance facilitating realizations of stipulated expectations. Current research on topic explains that therapists and clients must prioritize on building the relationship to foster good results (Safran & Muran, 2000). An amiable therapist client engagement is a core foundation for a profitable therapy. To foster a safe and a trustworthy relationship parties must honestly and openly discuss issues.

A collaborative relationship requires a positive perception for both clinician and the patient. As Safran and Muran (2000) observe the two must work as a team. Parties must take active roles for a fruitful outcome. A good rapport in a therapeutic relationship supports feedback system for both parties to make informed choices and decisions.

Cooperation during sessions in a therapeutic alliance accomplishes productive results. Prevailing relationship is powerful and acts as an agent of behavior change. Exploring negatives in a therapeutic relationship creates a sour environment and may contribute to premature termination of a session (Safran & Muran, 2000). Quality of prevailing relationship is an ingredient that determines outcome of an engagement.


Collaborative client relationships has myriad characteristics. The elements are core to success of the engagement. The features form the foundation of the relationship.


Therapist-client genuineness

Previous studies emphasize on importance of the clinician and the patient expressing concern authentically to foster cooperative relationship. As Muran and Barber (2010) expound, genuineness cultivates value of honesty and trustworthiness strengthening therapeutic relationships. Expression of real thoughts, feelings and problems in a working client relationship interaction calls for both parties to be true to one another. Collaboration is cultivated through trust and positive altitude enhanced by authenticity of both parties.

According to Safran and Muran (2000), genuiness serve as the heart of every true client relationships. The virtue is expressed through openness. A comfortable environment created by the element enable patients express feelings freely. Clients become comfortable in sharing with a therapist, ultimately deepening relationship. The feature prompts a fearsome and fearless exchange between parties in a therapeutic relationship.


Manifestation of empathy in client relationships nurtures collaboration consequently reducing level of potential conflict in an alliance (Safran & Muran, 2000). The element is essential in improving relationships and eliminating feelings of racism, sexism and other forms of sensitive aspects. Furthermore, the feature cultivates cooperation by making parties in a working alliance more open-minded about pertinent issues.  Empathetic client interactions build relationships, stimulate self-exploration, provide support and help clinicians focus attention on the client. The virtue enhances manifestation of respect and ultimately tight working relationship. Empathy enable clinicians recognize and relate to patients feelings. Clients is such engagements experience satisfying relationships. Empathetic physicians easily identify with a client experience and understand raised problems effectively. As Safran and Muran (2000) note, empathy is a key element in establishing collaborative client relationships. Clinicians exercising the feature understand issues from a client perspective facilitating accurate crafting of solutions. The cooperation creates an environment that propels the therapy in a productive direction (Safran & Muran, 2000). Clients in such a relationship comply more because of the feeling that a physician is sensitive about needs.

Trust and confidentiality

The elements enable clients have the willingness to share problems, concerns and issues considered private. The element gives clients assurance of safety in disclosing secret problems.  A therapeutic alliance lacking trust makes clients reluctant in giving information. The aspect provide reassurance and make the individual comfortable during therapies (Safran & Muran, 2000).

Positive regard

According to Muran and Barber (2010), different clients have different needs therefore demanding positive regard from a therapist. The phenomenon creates awareness and enable clinicians effectively monitor needs ultimately cultivating a collaborative atmosphere. It is an important aspect in providing support and encouragement in client relationships. Moreover, the established environment enhances improvement of a patient’s condition. Positive regard is important in preventing termination of therapy sessions and fostering effectiveness of results. Developing the perception helps get rid of barriers to successful therapeutic outcome. The coordination promotes creation of shared goals and counters possible resistance and separation during sessions.
            The element is essential for creation of cooperative client relationships. Humour in alliances stimulates a client’s mood and state of mind. It serves as a therapeutic experience and allows a patient feel more in control of the prevailing situation. The amusement impacts a client feelings and thoughts, biochemistry and behavior (Muran & Barber, 2010).


Michel, K., Jobes, D. A., & American Psychological Association. (2011). Building a therapeutic alliance with the suicidal patient. Washington, DC: American Psychological Association.

Muran, J. C., & Barber, J. P. (2010). The therapeutic alliance: An evidence-based guide to practice. New York: Guilford Press.

Safran, J. D., & Muran, J. C. (2000). Negotiating the therapeutic alliance: A relational treatment guide. New York: Guilford Press.


Major Implication for Airpower

Major Implication for Airpower


The battlespace in the air domain will be utilized in the future with the evolving modern welfare. According to White (2014), clear conceptual issues within the operations in the land domain seem to be clear; yet combating on the same is a challenge. There is need to have air combatants while maintaining proper operations on the land with the advancement in technological aspects. According to Lamberth (2000), the air domain is described as being the atmosphere that begins from the surface of the earth and extends largely to the altitude in which the operations of the main results are negligible. The different implication may be brought about by this aspect of having the dominance over air power in the region. Countries such as China and Russia that are of high competency may regard the air domain as a single region for improving their battlegrounds. The nature of the same is deemed to cause much competitive nature on the issue of air power.

Peer Competition

One factor to consider is that the air domain is not centered on people, and thus technical solutions are affected in regards to aiding the ground individuals. Peer competitors including China and Russia have capabilities enough to contest on the matter of air domain. According to Epstein (2014), the competitors pose a large threat to the dominance of the air domain, and it is thus difficult to maintain and attain the same. In this regard, the need for cross-domain, including the land and the sea, is rising, especially because of the improved technological advancement that affects these domains.

With the rising competition for the air domain power and limited access to the land domain, the peer competitors including China and Russia pose a profound threat of ensuring that the dominance of this domain remains contested for, yet with them having the majority of the power over the same. According to Van Crefeld, (2015), the utilization of the air domain in the majority of the defensive nature will be limited to given regions depending upon the various competing agents in the given scenario. This may hence lead to increased usage of the land barriers and defense forces may be more dependent on the land as much as the same is dependent on the air.

Dependence on Land and Sea

The rising competitive nature of the peers may result in the utilization of the land and sea domains as part of the major aspects to be utilized as opposed to using the air power. According to Pape, (2014), however, the land domains are dependent on the air power since the same cannot function in a proper way that without the air power. In this regard, there increasing dependency on the land will be more pronounced especially because of the evolving technologies that may otherwise lead to proper utilization and integration with part of the air power.

In addition, the same may result in the merging of the other peer competitions in a way to combat the competitive nature of the same. According to Lamberth, (2000), the coming up with a contingency plan to ensure that the contest for dominion of the air power will be averted and hence the major planners and competitors will work together in the given aspects. In addition to the same, the competitors may thus co-involve each other with the dominion over the air power and hence improved air security in the same.

Neutral Parity

According to White (2014), there exists a difference in the levels of control of the air domain. This is primarily because of the differences in powers of the various competitive Nations including China and Russia. In this regard, the lack of one single dominance of the strength of the air domain presents a great challenge as to how the same should be maintained. However, in the future, the same may have to be controlled from a central region. The impact of this element would be positive, in that the dominion of the air region will not be contested for, but will otherwise be claimed only for utilization at given scenarios.

In addition, with the central control, the same will have proper management resulting in concrete evidence of usage and general maintenance of the same. According to White (2014), air superiority is necessary as the majority of the various activities within the air domain will be effectively controlled and maintained properly. The same implies that the security of the given air domain will hence be improved, resulting in improved efficiency in the control and air battles, which, in turn, lead to more inclusion and utilization of the land and sea domains.

Enhanced Regional Conflicts

The competitive nature of major of the superior nations such as Russia and China for the air power superiority may result in conflicts between these Countries. According to Mrozek, (2015), hunger for power is an aspect that may lead to conflicts and ultimately lead to war. This is because each of the super powers aims at having ultimate control over the air domains, disregarding the other parties in the same. Thus, this may result in feuds between these nations over the superiority in air these domains.

Alternatively, the same may enhance and catalyze the feuds that have existed between these different nations. According to Harkavy (2013), slight disagreements and disregards may cause war on various grounds for conflicts that may not have been entirely resolved between the nations. In this regard, the feuds may have to be resolved through battles and wars, owing to the fact that these firms may be competing for the air dominance. Moreover, the party with higher superiority over the given aspects may hence have enemies from regions within, thereby having to battle with them over time due to their power over the air domain.


            The air domain is important to many nations, and superiority of the same means that they may have better focus and support to the ground teams especially in battle. The air power, therefore, is an aspect contested for by the major countries such as Russia and China. However, many implications including the dependence on the alternative domains including the cyberspace, the land, and the sea may be prudent owing to competition over air domain. Enhanced battles and conflicts between these nations may arise due to the competitive nature of the same, and hence there is a need for a central control of these aspects.


Epstein, J. M. (2014). Measuring Military Power: The Soviet Air Threat to Europe. Princeton University Press.

Harkavy, R. E. (2013). Great power competition for overseas bases: The geopolitics of access diplomacy. Elsevier.

Lamberth, B. (2000). The Role of Air Power Going into the 21st Century. Emerging threats, force structures, and the role of air power in Korea, 115-141. From

Mrozek, D. J. (2015). Air Power And The Ground War In Vietnam, Ideas And Actions. Pickle Partners Publishing. From

Pape, R. A. (2014). Bombing to win: Air power and coercion in war. Cornell University Press.

Van Crefeld, M. (2015). Air Power and Maneuver Warfare. Pickle Partners Publishing.

White Jr, S. R. (2014). Futures Seminar: The United States Army in 2025 and Beyond. A Compendium of US Army War College Student Papers. Volume 1. ARMY WAR COLLEGE CARLISLE BARRACKS PA CENTER FOR STRATEGIC LEADERSHIP. From

Child Abuse and Neglect

Child Abuse and Neglect

Child abuse refers to the treatment of children in a malicious way that affects their physical, psychological, or sexual mistreatment and neglect of a child. The mistreatment might be from parents, caregivers, educators or any person who may be directly linked with the children.  According to Chen and Chan, (2016), child neglect is a form of abuse of children where the child’s needs such as medical care, clothing, housing, nutrition, and education are not met. The federal government refers to child neglect and abuse as a form of failure of child caregivers to act as responsible parents for the child, which results in emotional, physical and sexual exploration and abuse.

Risk Factors of Child Abuse

Child abuse can arise from a number of issues that contribute to the risk of abuse increasing. The factors can be grouped into three, that is, the parental, environmental and child factors.


The parent may have abused other children or was abused at their tender ages. The mother might not be supported and may lack enough education or may be isolated and therefore abuses the child. In addition, the pregnancy may not have been wanted or the parent may not be mentally fit.


Violence in the family, stress, poverty, overcrowding and lack of good nutrition in ma lead to child abuse (Houlgate, 2017). In addition, non-biological adults who may be living in the same house with the children may abuse these children.


The child may have development or physical disability, lack of attachment between the parent and the child, or constantly falling seek, being unwanted colicky can lead to child abuse. Also, if the child is as a result of an abusive relationship, then it is possible that the child may be abused by the parent (s).

Signs and Symptoms of Child Abuse

            According to LLL, the signs and symptoms of that may suggest cases of child abuse, among others, include:

  • Slower development of their skills and abilities such as socializing and talking as compared other children of the same age.
  • Failure to gain weight and height over time.
  • Unusual parent-child relationship.
  • Emotional health issues such as low self-esteem, depression, thought of suicide, and anxiety.
  • The sudden drop in grades in school.
  • Children running away from home.
  • Signs of pain, discomfort, and fear.

Prevention of Child Abuse and Neglect

According to Pasalich, Cyr, Zheng, McMahon and Spieker (2016), prevention refers to the strategies and measures that can be undertaken in reducing the probability of a risk from occurring.  Some of the best ways to ensure that child abuse and neglect is curbed include:

  • Development of prevention programs and schemes
  • Promotion of the well-being of families and child-parent relationship
  • Making sure the public is aware of child abuse and that it affects the children.
  • Advocating for Psychological treatment and counseling to parents when they bear children and to those who are parents already.

Roles of Nurses in child abuse and neglect prevention


            Within the primary prevention, nurses should aim at preventing abuse before it begins by focusing on individuals from the community through expensive based projects to bring issues to the light of the issue and offer help administrations.


            Nurses advocate for prevention through the development of programs which are aimed at minimizing the incidences of child neglect and abuse through the identification of families which are likely to abuse and neglect children and giving them supportive services to help them resolve their issues (Pasalich et al., 2016).




            Here, the nurses are expected to develop frameworks in which they can identify families where child abuse has recently occurred and design plans to help the affected children and the conflicting party to resolve their problems.

Intervention, Treatment, and Reporting

            The nurses should be ready to identify any child who is has been noted to be treated in any abusive way or with neglect. After the identification, the nurses should intervene and try to help these children in overcoming and solving the abuse issue. This process will thus lead to the treatment process, which is only necessary if there is any sexual or physical abuse or malnutrition and other neglects that may need treatment. Houlgate (2017) adds that the nurses should as well report their findings on the abuse of the child to the administration and health care services for preventive measures to be made in due time to reduce additional risks for the children. Any person should report the cases of child neglect if they notice any cases. The reporting can be done to the police stations or health care centers and thus the ones who receive the information can devise plans on solving the same (Chen & Chan, 2016). One of the referral points that is within the United States is the Prevent Child Abuse America organization, which is responsible for treatment, counseling and providing care for children who have been abused.

Differences between child abuse and child neglecting

Child Abuse Child Neglecting
Physical hurting of a child Failure to provide basic needs
Resulting effects can be treated but may cause long lasting effects. Can cause long-lasting effects on the child
Exist in three categories: physical, emotional, and sexual abuse. Exist in four categories; physical, emotional, educational, and environmental neglect.
Examples include; sexual abuse, slapping, isolation, and threats. Examples include poor nutrition and lack of education.

Reporting of the cases should be similar since the cases affect children and may result in unwanted cases. According to Briere, Runtz, Eadie, Bigras and Godbout (2017), the types of abuse cannot be defined in the same way but their reporting systems should be similar. Therefore, many resources are available for the different types of abuse, which may include non-governmental aid, hospital care and the government and the police. The community nursing changes at every level of nursing prevention depending on the type of abuse. The nurses are expected to be more concerned with the community around those children being affected by abuse cases and with parents for the cases where neglect is noted.


In conclusion, the nurses play an important role in preventing child neglect and abuse. This is because it is their responsibility and mandate to ensure children have good security, health and physical and hence the nurses must ensure that children are not abused. The nurses are expected to report any cases of neglect to the administration for proper action to be undertaken in the event of reducing the associated risks arising from child abuse and neglect. As such, it is imperative to ensure the children are protected and the parents and caregivers have the necessary information on how to reduce and prevent child abuse and neglect.


Briere, J., Runtz, M., Eadie, E., Bigras, N., & Godbout, N. (2017). Disengaged parenting: structural equation modeling with child abuse, insecure attachment, and adult symptomatology. Child Abuse & Neglect67, 260-270.

Chen, M., & Chan, K. L. (2016). Parental absence, child victimization, and psychological well-being in rural China. Child Abuse & Neglect59, 45-54.

Houlgate, L. D. (2017). Child Abuse and Neglect. In Philosophy, Law and the Family (pp. 127-141). Springer International Publishing.

Pasalich, D. S., Cyr, M., Zheng, Y., McMahon, R. J., & Spieker, S. J. (2016). Child abuse history in teen mothers and parent–child risk processes for offspring externalizing problems. Child abuse & neglect56, 89-98.

Waste Management

Waste Management

Incident description and its Environmental Impact

Mount Polley Mine Spill comprises breach of the tailing pond that drains its contaminated water into the Quesnel Lake and the Cariboo River. Consistently, Quesnel Lake was among the largest lakes in the world with clean and deep water. However, after testing the purity of water in the lake, the results revealed that increased levels of arsenic, selenium among other metallic wastes had contaminated the water. Contaminated water from the tailing pond consisted a slurry of toxic components that contaminates the lake waters as well as addition of mud in the lake. Pollutants spilled in the lake are among the biggest environmental disasters encountered in the Canadian history. Test results indicated that 326 tonnes of nickel, 18, 000 tonnes of copper, 176 tonnes of lead and over 350 tonnes of Arsenic were present in the contaminated water. Notably, the said hard metals have a great environmental impact that affect both human, plants and water creatures negatively.

Extreme selenium level observed in fish after sampling indicated that its impact exceeds safety threshold for human consumption. Toxic pollutants including vanadium, iron and manganese are health hazard and threaten lives of people and the population of fish. Also, the toxic level of the lake makes its water less susceptible to consumption due to high level of MCLGs in the water as stated by the Safe Drinking Water Act. Additionally, the impact of the pollutants extends to the land and pollutes the soil due to toxic spills. In addition, adverse spills with high level of liquid strength erodes the soil causation soil sediments to the lake, which adds mud to the water body.

 Physical and Chemical characteristics of the Waste

Common waste pollutants comprises of copper, iron, vanadium, lead, selenium and silver. The wastes are heavy metals and have adverse impact when consumed due to their extreme health implications. Also, chemical reactions such as oxidation worsens the situation by making metal soluble to water which in turn enhances their impact when they are dissolved in water. For instance, when such chemicals are consumed they initiate blood level poisoning in children as well as lowering their intelligent quotient. Adverse occasions may lead to impairment related to neurobehavioral development in human when their intake is high. Prolonged exposure to hard metals impacts the brain and triggers gastrointestinal disease. However, not all metallic components are soluble in water, their deposits corrodes water reservoirs hindering water preservation. Moreover, the said toxic metals ionizes water in the lake raising its pH, which further impacts the life of water creatures as well as plants.

Which of these do you think could have contributed the
most? Take a position and defend it, using at least one outside resource

Pollution of water in the lake is attributed by poor regulation and compromised management of the site that deters its conservancy. Specifically, management, construction and maintenance of mining corporations is regulated by rules and regulations that ensure standards are met to uphold both human and environmental safety. Mount Polley Mine Corporation violates the stipulated regulations that governs the standards of operation of its activities. It’s tailing dam collapsed during its construction compromising the underlying earth layer of glacial till that is unaccounted to date. It is a requirement that the company engineering team investigates the structure and the composition of the underlying geology alongside evaluating its strengths. Since there is no sufficient evidence demonstrating that the dam collapsed out of pressure from within, caution has to be taken to ensure that high standards are observed to prevent chances of risk.

Factor contributing to the Accident

Absence of an outlet for the tailing dam maybe be the main factor that contributed to its flooding for over four square kilometers. Closed dams without outlets builds up pressure due to too much weight of water. Based on the tailing dam case, the dam was constructed without the consideration of the structures holding capacity that contributed to its collapse and flooding due to inability to withstand vast water capacity. The flooding led to loss of people’s lives alongside animals and their habitats references. In addition, the disaster impacted the environment negatively through soil erosion and contamination. Additionally, loss of biodiversity and ecological imbalances comprise the impacts that are observable until today. Therefore, the flooding incident is linked to irresponsible construction and tailing pond’s substandard infrastructure



Tony Hsieh at Zappos: Structure, Culture, and Change


Zappos is commonly known as an online market for clothing, shoes, boots, dresses and athletic shoes. It was started in 1999 and has been under the leadership of Tony Hsieh as the CEO and a number of people among them Swinmurn and Hsieh. The profit was little and therefore more effort was needed to ensure company prosperity (Menipaz & Menipaz, 2011).

Would you want to work at a place like Zappos before the transition to Holacracy? How about after? Why/why not?

According to Menipaz and Menipaz (2011), opulence is obtained if holacracy exists in most of the companies and institutions. Upon emergence of Zappos, working together was unrecognized. Therefore, every employee worked as instructed by seniors to ensure high sales and good delivery of products. Tony Hsieh wanted to change the employee-to-employee relationship as well as employee to client relationship to ensure higher profits. Hsieh approved self-management rather than hierarchy management. In addition, he believed that self-management would increase transparency, obligations and organizational agility resulting to higher chances of maximizing profits. As a result, every employee was free to make decisions and the authority were employee based (Hanson, Kenney & Rourke, 2012).

Working in a place like Zappos before transitioning from hierarchy management to self-management seems to impose more pressure on the employee. Therefore, poor services are rendered to the customer. Online services involve both the client and the seller if an agreement is made (Hanson et al., 2012). The seller is therefore free to deliver the goods and services. By contrast, if the employee must consult the manager or the seniors to inquire whether that is right, it wastes time and the client may fail to continue following up with the conversation because of the delay. The scenario makes the employee give up and exit the labor force (Hanson et al., 2012). Simultaneously, if after embracing holacracy by the company, working with Zappos would be quite easy since every employee is permitted to make decisions, which are favorable to the company. In doing so, the employees feel free and are willing to work together for the prosperity of the company at large.

Why do you think Tony Hsieh is making this change? Why is he doing it now?

Checking the company progress proves that Hsieh is determined to maximize the profits. He says that free interaction with the client is pivotal since it attracts more customers. The office bureaucracy disassembles the employees rather than keeping them together for quality work.  Some years back, Zappos was comfortable with its position after making $1.2 billion to the Amazon. The undertaking put the company in a static state (Pelletier & Mujtaba, 2015). The firm hired employees from the nearest college to distribute goods to the customers. In 2012, Hsieh had a conversation with Brian Robertson. That is where he got the idea of holacracy. He started campaigning for change in their company. According to wall street journal, it is clear that the environment of Zappos was playful and this had to be transformed into a serious business (Pelletier & Mujtaba, 2015). It was arduous for Hsieh to make all the decisions and follow every employee in the company. The scenario triggered his mind to transform the structure and culture of the company where authority was handed over to the employees (Pelletier & Mujtaba, 2015). Upon implementation of the undertaking, Hsieh had to send a memo to every employee informing them of the same. Not all the employees were conversant with his decision. Therefore, they exited the job. Ironically, the Holarctic management was supposed to eliminate bureaucracy but it followed that employees continued to attend formal meetings with a procedural formality (Gerrick, 2015). Although many problems emerged, this was done for the betterment of the company.

What do you make of the fact that 14% of the employees took Hsieh up on his offer?

In the Hsieh memo, it was clear to every worker that he was advocating for the change of the company structure. The undertaking was painful and slow since workers were not ready to embrace the change (Gerrick, 2015). According to the research done, an employee who has worked with Zappos for the last ten years told the “Times” that only 14% of the employees responded to the move. Most of the employees gave up on Zappos and ceaseless meetings, which were part of holacracy acquaintance (Menipaz & Menipaz, 2011). Later on, Hsieh was convinced by the Zipponians who worked in outsourcing information in technology infrastructure in Amazon to adjust the deadline to 4th January 2016. Ultimately, Hsieh agreed and upon the deadline in January 2016. The employees who were acquainted were about 18%. The scenario indicated that quite a large number hesitated to change and therefore took the severance package. On a recent trip made by the Hsieh to the Zappos headquarters in Las Vegas, he was interviewed regarding his decisions. He said that it is the right decision since he wanted to ensure that the employees are not there just for a paycheck but believe that it is the right place for the workers. He added and said that he has gone through transition for a number of times to make the company a giant (Menipaz & Menipaz, 2011). For instance, in 2004 he offered new employment for $2000 to exit after undergoing the training practices if the staff decided that the company is too harsh or if it is not the right place.

What do you think this process feels like as an employee?

Before isomerization, every worker was used to their norms and way of doing things. Imposition of new rules to the company was not in employees favor. According to Pelletier and Mujtaba (2015), the company transition was painful. Employees were unprepared for any change enacted. Initially, the staff used to follow traditional management. Therefore, everything was done following the orders from their seniors. Courtesy of the holacracy management, it implied that every employee must be responsible and active in the office (Menipaz & Menipaz, 2011). Everybody’s decision is considered and every employee is responsible for his or her actions in the office. Only 18% employee accepted the transition. The scenario showed that most of the workers were not pleased and therefore the opted to quit the work. As a result, the company suffered a shortage of employee. More employees were therefore needed in the company (Menipaz & Menipaz, 2011). Although the transition did not favor employees, the company flourished to higher levels and the profits augmented.

How would you assess Tony Hsieh as a leader? As a boss?

Hsieh is a good example of a leader or a boss (Menipaz & Menipaz, 2011). Despite the high turnover of the employees, Hsieh is unmindful as long as there was a number of employees who embraced the change. He is determined on improving the company’s condition rather than focusing on individual interests such as just getting a paycheck (Robertson, 2015). Some of the employees who worked for money stepped down since the workers could not persevere the changes in the company. Hsieh focused and worked closely with the 18% of the employees and showed the staff importance of being proud of the company they are working with (Menipaz & Menipaz, 2011). According to the research, after Hsieh was interviewed, he boldly answered the questions relating to the reasons why he decided to implement self-management mechanism. Hsieh outlined that the clients’ need to be convinced to purchase their shoes and clothes online (Pelletier & Mujtaba, 2015). Also, he said that it is prudent if the customer can communicate to the employer through a phone call for clarity of the available goods.

What, if anything, should Tony do now?

Tony is a CEO of a big company, which is not in its comfort level (Pelletier & Mujtaba, 2015). Zappos is still developing and more profit is needed. Zappos was developing at a slower rate and the shareholders were forced to sell their property. For example, swinmurn sold his property to invest in Zappos when the profit was low and wanted the firm to progress (Hanson et al., 2012). As a result, Hsieh looked for an initiative, which helped the organization to maximize profit. Currently, the company is doing well though it needs more workers to enhance quality of services to the clients. The firm should hire more workers to mitigate the employee’s workload. The undertaking would enable the company rise to higher levels. Also, Zappos will be of great help to the society since it offers goods, as well as employment thereby eradicating poverty.

Conclusively, Tony Hsieh has played a tremendous role in transforming Zappos to a better level. Self-management is imperative and surpasses traditional management since the element encourages Zappo’s rapid growth.


Robertson, B. J. (2015). Holacracy: The new management system for a rapidly changing world.

Hanson, A., Kenney, K., & O’Rourke, J. S. (2012)., Inc.: The Zappos Data Crisis. doi:10.4135/9781526403049

Menipaz, E., & Menipaz, A. (2011). Zappos – “Powered by Service”. doi:10.4135/9781473928060

Pelletier, R. A., & Mujtaba, B. G. (2015). Maximizing Employee Happiness and Well-being: An Examination of Value Creation and Competitive Advantage at Zappos. Advances in Social Sciences Research Journal, 2(4). doi:10.14738/assrj.24.1164

Qa-zappos-and-holacracy. (n.d.). SAGE Business Researcher. doi:10.1177/2374556814565102

Gerrick, H., (2015). Zappos: “Your Culture is Your Brand”. Branded!, 77-95. doi:10.1002/981119200567.ch5

Alzheimer Diseases and Dementia

Alzheimer Diseases and Dementia

Dementia and Alzheimer’s disease are not similar. Dementia is a terminology used to outlay signs and symptoms that affect individuals mind, operations from day to day duties. Alzheimer’s usually becomes worse with time and impact memory, thought and language. The risk of developing Dementia or Alzheimer’s increases as an individual gets older although even the younger people are at a risk of developing the conditions (Jiska 32). Despite symptoms similarities between the Alzheimer’s disease and Dementia, it is necessary to distinguish them to ensure effective management and treatment.


Dementia is a collection of symptoms which interferes with mental functions which deal with tasks such a memory and reasoning. It occurs due to various conditions such as Alzheimer’s disease (Kim & Hyun 86). People may also be affected by mixed Dementia which is more than one type of Dementia. Such people have many factors which may lead to Dementia.

Symptoms of Dementia

Early symptoms of Dementia are hardly noticeable as they often start from simple incidents of forgetting material things or other individuals for instance. People with Dementia tend to behave in abnormal ways such as losing their way in known places. Most observed signs of Dementia are repetitious questions, poor decision making and inadequate hygiene. As time progresses, people with Dementia tend to have no ability to take care of themselves and they struggle a lot in their day to day activities (Mace, Nancy & Peter 78). The conduct of this people also continues to change and they can become depressed and aggressive.

Cause of Dementia

People become more susceptible to Dementia as they grow old. Usually, it happens once particular brain cells have been destroyed. Factors that may lead to Dementia are degenerating diseases like Alzheimer’s (Mielke, Michelle, Vemuni & Walter 37). Every cause of Dementia destroys a varying group of brains.

Alzheimer’s disease

Alzheimer’s disease is a continuous ailment of the brain which slowly leads to deterioration in an individual’s ability to remember and part of the mental function that deals with logic. The fact of its cause is not yet discovered and it has no cure. Even though young people do suffer from Alzheimer’s the symptoms start after the age of sixty. Younger people suffering from Alzheimer’s disease are more likely to live for many more years compared to older people.

Effects of Alzheimer’s on the brain

Harm to the brain starts years before the symptoms start to show. The bonds within the cells are broken, hence they die. In progressive incidences, brains demonstrate a major loss whereby, individuals begin to think less than they used to. While a person is alive it’s impossible to diagnose Alzheimer’s correctly. The diagnosis may only be accurate if the brain is carefully observed under a microscope.

Differences between Dementia and Alzheimer’s

Differences based on symptoms

Alzheimer’s and Dementia symptoms can overlap but there can still be some differences. Alzheimer’s symptoms are; difficulty in remembering events or conversations that happened a short while ago, apathy, depression, impaired judgement, disorientation, and confusion. The initial symptoms of the people suffering from Dementia are visual hallucinations, difficulty in balance and sleep disturbances (Takeda, Shuko, Sato & Morishita 40). They are also likely to experience involuntary movement because of Parkinson’s or Huntington’s disease.

Differences based on treatment

In Dementia, the type and the cause of Dementia will play an important role in determining its treatment. In a few incidences, administering medication on the factors that lead to Dementia can be helpful. The factors that are more likely to react to medication are drugs, hypoglycaemia, tumours and metabolic disorders (Taylor, David, Carol & Kapur 76). Many forms of Dementia are treatable, with proper medication it can be managed while in Alzheimer’s no cure is available yet but there are options that are helpful in managing the symptoms of this disease and they include administration of medicine for memory loss which include cholinesterase inhibitors donepezil, rivastigmine and memantine, other alternative treatments for boosting brain function can be administered,  and also administering medicines for behavioural changes and also depression.

Differences based on outlook for people with Dementia versus people with Alzheimer’s

The outlook for people with Dementia relies fully on the direct cause of Dementia. Medication is available to make Dementia symptoms manageable but currently, there is no way to stop or slow down related dementia. A few types of dementia are reversible but almost all types of dementia are irreversible and will cause a lot of impairment over time. While in the case of Alzheimer’s it is a fatal illness and it has got no cure it has three stages and the length of time in each stage varies people diagnosed with Alzheimer’s has a lifespan of approximately four to eight years although a few people can for up to twenty years after diagnosis.

Consequences of Dementia and Alzheimer’s for the patient

Consequences of Dementia on patient

  • Patients have retarded memory which makes it difficult for them to remember things such as their telephone numbers.
  • They are in most cases confused and are not organised which leads to poor performance.
  • They also have poor concentration, attention and they are easily distracted.
  • Dementia patients are also not able to think clearly or solving problems.
  • They also face a lot of difficulty in completing day to day tasks of self-standing living.
  • They also face challenges following social cues, and they lack social skills.
  • Dementia patients also face difficulty in handling and managing money.
  • They also face challenges in learning new things.
  • Knowing what to do next most especially when it is out of routine is also a challenge.
  • They also face changes in personality, depression and loss of motivation.

Consequences of Alzheimer’s in patients

  • Alzheimer’s patients are incapable to undertake or complete tasks without help.
  • They also face severe changes in personality and have a tendency to become irritable.
  • They also face challenges from deterioration from language and generally in communication.
  • They also face withdrawal from their family members and loved ones.
  • They may also suffer from permanent memory loss.
  • They also suffer from confusion and forgetfulness to people and places that were once familiar.


In concussion dementia and Alzheimer’s have a lot of similarities and can cause a lot of confusion when it comes to effective treatment and management. Specialists should be careful to avoid administering the wrong medication to patients as a result of confusion derived from the patient’s symptoms. People should also see a doctor in case they feel that they suffer from the symptoms of Dementia and Alzheimer’s as early treatment can help them manage the situation easily which in return may enable them to have a long lifespan. Healthcare providers should carry out new research in regard to Alzheimer’s disease and dementia to ensure that they have adequate knowledge. Enough information will enable specialists to offer quality services to their patients.

Work Cited

Alzheimer’s, Association. “2015 Alzheimer’s disease facts and figures.” Alzheimer’s & dementia: the journal of the Alzheimer’s Association 11.3 (2015): 332.

Cohen-Mansfield, Jiska. “Behavioral and psychological symptoms of dementia.” (2015): 32.

Kim, Hyun. “Behavioral and psychological symptoms of dementia.” Ann Psychiatry Ment Health 4.7 (2016): 1086.

Mace, Nancy L., and Peter V. Rabins. The 36-Hour Day: A Family Guide to Caring for People Who Have Alzheimer Disease, Other Dementias, and Memory Loss. JHU Press, (2017): 778

Mielke, Michelle M., Prashanthi Vemuri, and Walter A. Rocca. “Clinical epidemiology of Alzheimer’s disease: assessing sex and gender differences.” Clinical epidemiology 6 (2014): 37.

Takeda, Shuko, Naoyuki Sato, and Ryuichi Morishita. “Systemic inflammation, blood-brain barrier vulnerability and cognitive/non-cognitive symptoms in Alzheimer disease: relevance to pathogenesis and therapy.” Frontiers in ageing neuroscience 6 (2014): 404

Taylor, David, Carol Paton, and Shitij Kapur. The Maudsley prescribing guidelines in psychiatry. John Wiley & Sons, 2015: 976


Legal Issues in Clinical Psychology

Legal Issues in Clinical Psychology

Privacy and Confidentiality

A psychologist is under legal obligation to uphold top most confidentiality of any information obtained by him from the client or through diagnosis of such client in the course of his treatment (Harrower, 2011). Moreover, the professionals are under legal requirement to protect any record generated during psychological undertakings in a safe and secure place where any unauthorized persons cannot access them (Linton, 2015). Privacy build trust and an interactive practitioner-client relationship.

Informed Consent and Refusal

Kaufman (2015) claims that it is a legal requirement that prior to initiating counseling and treatment clients by psychologists; they must be authorized to do so. In the event the patient is under-aged or of unsound mind, the parent or guardian is required to issue an authorization. A psychologist is also entitled to communicate any relevant information of treatment to the patient so that the ailing can comprehend their conditions and make a decision on whether to be treated or not. An example of a legal but unethical scenario is where a judge may order a practitioner to disclose information about a particular client without his consent.

Ethical Issues in Clinical Psychology

Professional Competence

It is important that a psychologist understands and acknowledges their strengths and limitations and endeavors to learn and improve on their weaknesses. Before a psychologist embarks on counseling or treatment their clients the professional must have proper training and experience to resolve the issues and understand when it is necessary to refer the patient to a more competent professional (Linton, 2005).

Professional Ability Not Being Prejudiced and Biased

A psychologist must treat all clients equally and must refrain from negative attitude that may impair his objectivity in performing counseling and treatment (Kaufman, 2015). They must not discriminate patients’ based on political class, gender, race and religion differences. Moreover, the professionals must avoid negative convictions and treat all patients competently.

A group of psychologists in a given community may agree to lower and charge the same prices of their clinical services and products so that they can be favorable and affordable to all people across economic class.

Professional Boundary, Boundary Crossing, Boundary Violations and Effect of Boundaries on Therapeutic Relationships

Professional boundary refers to an integral distance that limits practitioner-client relationship with a sole purpose of ensuring that the psychologist fully concentrates with the therapy (Kaufman, 2015). Professional Crossing can be defined as a slight deviation towards professional boundary that is supportive to the treatment (Harrower, 2011). For instance, the practitioner may favor a client at the expense of another. Boundary violation refers to an action where psychologists cross the edge defined by professional boundary to benefit themselves at the expense of the patient (Linton, 2005). For example, the doctor may get attracted and engage in sexual relationship with the client.

The professional boundaries enable practitioner-client interaction and relationship to be effective in regards to the counseling and treatment of the patient.

Cultural Limitations Associated with Assessment and Treatment

Client’s Cultural Background

A psychologist must understand the norms and values of his client cultural background before initiating counseling and treatment. This will enable them to provide a treatment that conforms to patient values (Harrower, 2011). In addition, individual tests and assessments should be distinct because language and beliefs differs from one culture to another hence difficult to generalize test.

Minority and Majority Group

A psychologist must design different approaches for minority and majority groups as they respond differently to test and assessment. Therefore the practitioner must develop a specific plan for each group that is culturally appropriate and respectable to enable them penetrate and perform the test to the client and receive a real response that will provide appropriate counseling and treatment (Harrower, 2011).


Harrower, M. (2011). The practice of clinical psychology. Springfield, IL: Thomas.

Kaufman, J. C. (2015). Intelligent Testing: Integrating Psychological Theory and Clinical Practice. Cambridge: Cambridge University Press.

Linton, S. (2005). Understanding pain for better clinical practice: A psychological perspective. Edinburgh: Elsevier.


CONTROLLED SUBSTANCES AND OPIOIDS                                                                                      2


Opioids are used extensively for chronic pain management in the United States. These substances interact with receptors on nerve cells in the body and brain. Opioid pain receptors are safer when taken in short-term as prescribed by the doctor. An opioid is said to be misused when used in larger quantities than prescribed, or when taken without a doctor’s prescription. Long-term use of this product creates a dependence that leads to overdoses that can cause death. Devastating consequences of the opioid epidemic include increased misuse and related overdoses. Measures to control the epidemics are needed to control opioid prescription by establishing regulations and creating awareness on the impacts of opioid overdose. This paper has researched state regulations guiding prescriptive practice related to education, prescribing controlled substances, and obtaining an advanced practice license. The research has been done by choosing Pennsylvania and West Virginia cities and comparing their respective regulations. The paper has defined controlled substances and opioids and highlighted how they are misused and abused. Opioid epidemic and state regulations are discussed, and a conclusion given.








Controlled Substance and Opioids

A controlled substance is an illegal drug with detrimental effects on human’s health and welfare. The state and federal governments regulate these substances, and people caught in their possession can be fined and imprisoned by local, federal, or state law enforcement. Opioids are a drug classification including heroin, synthetic opioids like fentanyl, and pain-relieving drugs that are legal by prescription. They are natural drugs derives from poppy, and help relieve pain, by altering brain response to pain. A variety of prescribed opioids are used to provide relief from toothaches, dental procedures, surgeries, chronic conditions such as cancer, and injuries. Opioids are safe to use when used correctly by following doctor’s instructions.

Opioid Misuse and Abuse

Opioid misuse is taking the substances in different ways or larger quantities than prescribed by doctors, or taking without doctors’ prescription. Regular use of opioids even with doctors’ prescriptions can lead to dependence, and when misused, these opioids pain relievers lead to overdoses that can cause death incidents. People easily misuse these substances because they produce euphoria in addition to pain relief.

The Euphoria created by opiates is unlike any naturally occurring rush of endorphin, and this propels users to use the drug repeatedly to experience the feeling. Regular use of the substance makes the brain to stop creating endorphin and dopamine, limiting individuals to experience the feelings unless they use opiates (Pinkerton & Hardy, 2017). People crave for higher doses of opiates to experience the continued pleasure that fails to occur naturally and end up being addicts. They typically abuse the production order to lessen their pain and have a continued euphoric feeling on demand.

People who become dependent on these controlled substances may experience withdrawal symptoms when they stop taking them. Dependence is coupled with tolerance, meaning users need to take more doses of the same effects. Opioid addicts may switch to heroin because it is less expensive than prescription drugs.

Long-term misuse of opiates changes normal brain functioning leading to physical and psychological reliance. Opiate withdrawal symptoms exist from mild to severe, depending on dependence although they are different between individuals. Early withdrawal symptoms include tearing up, agitation, anxiety, and fever among others. Late withdrawal symptoms include diarrhea, depression, nausea, and drug cravings. Some psychological withdrawal symptoms and craving for drugs may prolong for days. Psychological support and therapy are provided to victims by mental health professionals as part of a substance abuse program.

Opioid Epidemic

The current problem with opioids in the world is their increased misuse and relative overdoses. There are incidences of newborns experiencing withdrawal syndromes because of pregnant mothers using and misusing opioids during pregnancy. The crisis was brought by efforts to increase prescribing for the pain to get it to zero in the 1900s. Pharmaceutical companies developed stronger and long-lasting opioids, with aggressive marketing to physicians while limiting potential risks. Users realized that short-term opioids and the long-acting ones resulted in enhanced euphoria and had additive nature. Physicians used to prescribe higher doses because of lack of education and experience, and never realized the dangers that existed.

Deaths and Violence Associated with Opioids

The total number of overuse fell by 8.3% in 2017 as compared to 2016 in America, estimating the number to be 1,977 down from 2,155 (J, 2017). The number was still greater with more than 200 deaths compared to the 2015 toll. The provisional data released by the Centers for Disease Control and Prevention showed a decline in opioids overdose deaths in 14 states during the one year period that ended July 2017. The decline is a hopeful indicator that policies are working to curb death tolls.

In the year 2016, the total number of opioid overdoses accounted for more than 42,000 deaths (Ruhm, 2018). A 40% estimate of these overdose deaths resulted from a prescribed opioid. More than 115 people in America die daily because of opioid overdose. Overdose rates began to increase in 2015, with more than 33,000 American deaths because of opioid overdose, including prescribed type, illicit fentanyl, and heroine. Two million people were estimated to suffer from the substance use disorder as a result of prescribed pain relievers, and another half a million individuals suffering from heroin use disorder in 2015. Between 2000 and 2014, the rate of overdose deaths in America increased by 200%, and by 14% between 2013 and 2014 alone.

Opioid overdose is a risk to both genders, although men are at higher risks of overdose-related deaths. Toxicology reports show the increased likelihood of finding heroin males system, and higher chances of finding prescription opioids in female’s system at the time of death. Women mostly use the healthcare system, increasing risks of using multiple prescriptions for opioids which is a risk factor (Druid, 2016).

Illegal drugs epidemics are a battle to protect future generations. Opioid overdose-related deaths for all group shows the young generation is at higher risks of these deaths. Opioids resulted in more than 25% of all fatalities in the 18 to 24 age-groups in Massachusetts. More than 33% deaths were realized for 25 to 34 age groups rising to more than 40% for men in the group. Approximately two out of every three individual deaths that were related to opioids were younger than 45.

Opioid use and crime are associated and develop together amongst opioid using criminals. America’s murder cases rose tremendously in 2015, 2016, and the first half of 2017. According to Massey, (2017), arrests for sale and possession of opioids fell by 9.2% from 2010 to 2013, even as drug use rates were rising. In 2015, arrests rose by 12.5%, the latest year for which data is available (Rana, MD & Braithwaite, MD, 2016). The timing of the drug arrests coincide with the national rise in homicides, with drug-related killings accounting for

Medical Emergencies Related to Opioid Use

Visits to an emergency department for opioid overdoses provide an important marker of acute morbidity (Elixhauser, 2017). Hospitalizations related to opioid misuse and overdoses have increased dramatically, with the rate of adults under impatient program per 100,000 people rising by 200% between 2000 and 2012. The national hospital ambulatory medical care survey between 1993 and 2010 identified emergency department for opioid overdose and outcomes addressed. The outcome measures were national emergency department visit rates for the individual with opioid overdose per a 100 thousand U.S population and 100 thousand emergency department visits. There were approximately 731 thousand emergency department visits for opioid overdose between 1993 and 2010. They represented an overall rate of 14 visits per 100 thousand population and 37 visits per 100 thousand emergency department visits. 41% were for prescription opioid overdose. The national visitation rates increased from 7 to 27 per 100 thousand individuals between 1993 and 2010, and from 19 to 63 per 100 thousand visits.

The results showed an upward trend across multiple demographic groups in the U.S after a stratified analysis of the visit rates per population. The analysis of the visitation rate per a 100 thousand emergency department visits showed an increased rate significantly across several groups above 20 years. The nationally represented U.S database of emergency visits found that emergency visit rate for opioid overdose quadrupled significantly between 1993 and 2010. The finding suggested previous prevention measures were inadequate.

Opioid Regulation in the US

Opioid use in The United States is regulated by the federal and state governments to curb the effects of controlled substances overdose. The Centers for Disease Control and Prevention are responsible for releasing guidelines related to r chronic stress opioid prescriptions. The Food and Drug Administration (FDA) is mandated to approving reliable and efficient formulations of opioids to provide immediate and long-lasting medication. The FDA can order pharmaceutical agencies to halt or stop drug manufacturing

Drug Enforcement Agency (DEA) works in collaboration with other agencies like departments of justice to enforce powers that put to prosecution pill mills for doctors who prescribe illegally. The DEA implement prescription drug use monitoring programs (PDMPs) that are provided at state levels and application of electronic prescribing for Schedule I and II medications.

State agencies conduct an important role in reducing controlled substances and deaths related to overdoses, protecting public safety, and promoting effective medical pain remedies. They assume the role of regulating practices of medicine and insurance companies within their border. The state utilizes the agencies to train physicians about the impacts of opioids and encourages their licensure depending on registration and application of PDMPs anytime they are prescribing a controlled substance. They encourage the flow of information within states and share prescriptive information that aims at improving the efficiency of controlling overdoses, and also promoting innovations that intervene in reducing impacts associated with illegal prescriptions.

Purpose of this Paper

The paper aims to research state regulations which guide prescriptive practice related to education, prescribing controlled substances, particularly opioids, and obtaining an advanced practical license. This will be done by choosing two different states (Pennsylvania and West Virginia) and comparing and/ contrasting their perspective governing regulations.

Information to providers

Healthcare providers require appropriate knowledge, skills and professional judgment to prescribe drugs. They need to know state regulations that guide prescriptive practice to improve patient safety when prescribing because the policies set out all requirements for prescribing drugs.

Prescribing of controlled substances is regulated by legislative frameworks with policies that health practitioners must put into considerations and obey rules set in prescription laws. Following the policies and having awareness of practice will help prevent history from repeating itself. The medical community was assured by pharmaceutical companies that prescriptive opiates were not addictive to pain relievers in the late 1990s. Medical practitioners prescribed the substance at greater rates subsequently leading to increased misuse and diverse use before the side effects were realized. Drug deaths have been steadily climbing every year globally since the 1990s.

The state regulations define key values of professionalism that form the basis for the expectations set out in policies. Physicians embody the values of compassion, altruism, service, and trustworthiness to act in patient’s best interests, demonstrate professional competence, and maintain their patients’ confidentialities. The practitioners must ensure maximum collaboration, communication, and should not be driven by their advantages.

The Act 124 was put in place to provide a prescription drug monitoring program. The revision of the previous Act 124 aims to amend laws by expounding some other provisions. The prescribers doubt the PDMP systems when individuals are prescribed opioid drug products. Queries are not required when patients have been admitted to licensed healthcare facilities, or in an observation status in the same facilities after initial query, provided they remain admitted or in observation.

Bodies in charge of licensing require people applying for initial licenses or certificate authorizing them to be dispensers or prescribers to submit educational documents. The submission should not be later than one year after obtaining an initial license and must show their completion of at least two hours education program in pain management, and addiction identification. They must also show completion of several hours’ education program pertaining prescription or opioid dispensing. The licensing board requires prescribers applying for license renewal to provide completion of two hours of continuing education program related to managing pain and stress, addiction identification, or practice of prescribing opioids. The education is part of the overall requirement, and do not apply to those exempted from the drug enforcement administration necessities for a registration number.

The act 124 entails prescribing opioids to minors. The subscribers are required by law to limit opioid prescription numbers to minors by ensuring a not more than a week supply unless they determine needs to stabilize the minor’s acute medical conditions. The law requires practitioners to do a thorough assessment of whether the minors have taken or they are under prescription for substance use disorder at that time before prescribing any opioids. They have to discuss with the minor’s parents or guardians the risks of addictions and overdoses that commonly occur with use of controlled substances. Prescribers are required to get written consent for prescribing opioids to minors.

The Pennsylvanian Act 126 requires a safe opioid education and patient directives. The licensing board implemented curricula that address safer prescriptions of opioids. The curriculum is provided in all medical schools and training facilities. The act also requires patient voluntary non-opioid directive. Patients are allowed to practice this form of a directive to deny the administration of controlled substance containing an opioid.

Opioid Regulation in Pennsylvania

Opioid-related overdose deaths have dramatically increased in Pennsylvania and across the nation.  Pennsylvania declared heroin and opioid addiction crisis a statewide emergency to combat overdose harm in 2016. Governor Wolf has taken significant steps to improve doctor’s prescribing practices. The Department of Drug and Alcohol Programs ensures a safe and effective prescribing task force. The task force members include a variety of state agencies, medical association representatives, provider advocates, and the community members. They collectively established and applied measures for them medical fields to safely and efficiently use controlled substances in relieving pain. The developed law significantly impact medical practitioners nationwide, because some took effect moments after they were signed.


Pennsylvania has an Act 122 that restricts opioids limits to practitioners in emergency situations. The components of the act significantly affect practitioners in situations demanding urgent care and in-hospital emergencies. The act restricts a not more than one week opioid supply. There are extensions for physicians when it comes to treating individuals with acute illness, as they require a more than one week opioid supply. Chronic cancer treatment and palliative care exempt the requirements of Act 122, but physicians have to monitor the patients closely. Under these exceptions, physicians must document patients’ medical record that a non-opioid alternative was inappropriate under the circumstances.

The act prohibits refills, providing that regardless of the amount prescribed, physicians should not in any way write prescriptions to refill controlled substances. Medical practitioners in these situations should refer patients for treatment if they exhibit signs of abusing controlled substances. Physicians are required to make queries on prescription drug monitoring program system to discover chances of these patients being under treatment with opioid drug products by other providers. Queries do not apply to medications provided to patients in need of treatments in urgent care facilities. Any medical practitioner who violates Act 122 has their license sanctioned by the state’s board. Following the law to the latter means the medical practitioner at all time act in good faith and has immunity in civil actions.

            The legislature in Pennsylvania has determined that there should be an increased role for physicians in preventing and mitigating heroine and opioid epidemic. The intentions seem noble, and the burden lies to physicians in treating patients with increased leisure sanctions and liability if they fail to comply with the regulations. They are required to familiarize themselves with the new laws and implement their requirements to curb illegal use of controlled substances (Huber, Robinson, Noe & Van Ness, 2016).

Opioid Regulation in West Virginia

            Western Virginia has the highest rate of opioid-related overdose deaths, and drug overdose is the top mortality causal for people under the age of 45 (writer, 2018). Experts and policymakers are struggling to cobalt the nationwide opioid crisis which was declared a public health emergency, with increased efforts to control their prescriptions. In West Virginia, the poster child for the epidemic new research shows that prescription drug regulations have not affected by a decrease in opioid-related hospitalizations. The nation has experienced a reduced opioid prescription dispensed since 2012 legislations authorized the use of a prescription drug monitoring program. The overall rates of opioid poisonings are relatively constant, with poisonings from heroin and illegal opioids increasing by more than 200%. Regulations on controlled substances were made under the board’s emergency authority given that state commissioner declared opioid addiction a national crisis as a public health emergency.

The bill requires health care prescribers to obey the state’s prescription drug monitoring programs, and also established the licensing and regulation of chronic pain guidelines. The guidelines provide additional regulations for opioid treatment centers and require a consisted continued education for administrators (Lund, 2017).

Studies in Western Virginia examining opioid poisoning rates from 2008 to 2015 reveal complexities of the crisis and how it is a challenge to provide a solution to the problem Smith, MD, Kirsh, Ph.D. & Passik, Ph.D., 2018). Despite having prescriptions decrease, the crisis is still rampant because people are having alternative sources of controlled substances, cheaper and more widely available in the streets.

The Western Virginia Department of Health and Human Resources established an Opioid Response Plan in 2017 through public involvement and expert input. The board of medicine was authorized to be more aggressive in disciplining overprescribing physicians. The plan emphasized the importance of having efforts addressing excessive prescribing not go too far, and develop targeted investigations to assess prescribing, and professional boards recognize the importance of individualized care and clinical judgment. The judgment should support patients with severe pain and where an inappropriate prescription is found, the care providers should support tapering of medication rather than rapid withdrawal. The patient care plan is adopted even after provider’s prescribing certification is terminated, to support appropriate treatment for patients.

Western Virginia encourages insurers to adopt evidence-based guidelines on reimbursement for opioid prescribing before filling co-prescriptions of benzodiazepines and opioids. Non-pharmaceutical coverage approaches are supported to manage pain and improve medical education on pain prescription and treating of substance use disorders. The state is considering developing cross-agency strategies for primary prevention, to include targeted economic development, and expanded use of mentoring. An evidence-based curriculum will be put in place to identify resources for youths at highest risks based on adverse childhood experiences, and expanded primary prevention through education in schools.

West Virginia addresses the issue of opioid overdose-related deaths by putting into practice legislation to be followed by all prescribers. The legislation has a code 16-47-4 that requires good Samaritans to alert the authorities of any cases of controlled substance abuse through 911. The witnesses are protected by the legislation from arrests. The state also uses the West Virginia Code 16-46-31, to allow pharmacist distribute awareness and provide education to the public on the impacts of naloxone. The HB 2195 legislation emphasizes on implementing opioid implementation strategies to prevent their impacts and create awareness into all school curricula. HB 4347 legislation has priority over substance abuse treatment for expectant women.

The West Virginia codes 16-46-31 and 16-47-4, collectively have been linked with more 911 emergency alerts on overdose and reduced deaths. The legislature is considering other bills that will effectively help fight the opioid epidemic.

West Virginia applied for a medical waiver to specifically address substance abuse disorders. The state decided to use a considerable share of its stake with opioid distributors to expand the availability of treatment for people struggling with addiction (Webster & Grabois, 2015).

Huntington has been the heart of opioid epidemic. The city’s overdose death rate is tenfold that of the national rate, prompting the city to make several changes to combat the crisis and reduce its harmful effects. The Huntington city established Office of Drug Control Policy and coordinated with; a coalition of law enforcement, public health leaders, first responders, and local groups to mitigate opioids. The city has emphasized on reducing opioid harm by opening the first needle exchange in the state, a center for weaning babies off drugs, and school programs with students and parents who have been caught in possession of drugs. The drug users are trained on how to administer naloxone to curb deaths on overdose.

Huntington is implementing the measure of sending drug users to treatment care instead of taking them to jail. The city has a Recovery point, a facility with a 100 beds to provide long-term recovery program with a 68% sobriety rate for graduates after a one year program.

Pennsylvania and West Virginia

The most effective solutions applied by states are to increase utilization of advanced practices of certified and registered medical practitioners. Advanced practices ensure the safety of patients is maintained because unqualified physicians prescribe doses with side effects. The lawmakers in both states have responded well to the opioid epidemics by planning legislatures that limit how much pain medicine practitioners prescribe to their patients. Doctors in both cities are required by their legislation to counsel new patients, who pick up a prescription for opioids, about the risks of taking controlled substances. All practitioners are required to assess patients being treated for acute conditions, to prevent risks of addiction and ensure compliance with rules and regulations.

Pharmacists who fail to follow the legislation to the latter lose their certification. The departments of Justice, DEA, and local agencies have gained supporters in both cities as a result of their efforts to combat the growing crisis. The consequences of diversion use of controlled substances include societal, clinical, and economic impacts. The high profile legislative activities force pharmacists to turn away patients who exceed their monthly dispensing limits. All wholesalers are inspected to ensure appropriate dispensing and hesitancy by suppliers and other regulatory agencies in guiding address gray areas.

In response to the ongoing prescription drug overdose epidemics, the cities have put in place prescribing guidelines, continuing education, federal, state, and international measures to deal with the epidemic. All licensed practitioners are required to prescribe opioids to acute pain patients and provide them with information. They are required to apply their skills and reinforce healthy behavior, identify problematic drug and alcohol use early, and reduce substance misuse.

Physicians and health systems reduce their exposure to investigations and prosecution by adhering to best practices and standards of care. They are bound by medical and legal regulations in prescribing opioids. Substantial compliance with opioid prescribing guidelines is the accepted standards of care and satisfies adherence to the many states and federal laws (Pardo, 2017).


Abuse of controlled substances has considerable impacts on the society providing both economic and clinical burdens. Overdoses result to more than 830,000 years potentially before the age of 65, similar to years lost through road accidents. The increase in deaths is attributed to unintentional overdoses because of failure to understand the risks associated with the use of controlled substances. Organizations should work in collaboration to curb abuse and misuse of opioids and use it for intended purposes only. Drug monitoring programs should aim at providing insight into current opioid trends, and minimize fraud prescriptions and related doctor shipping. Pharmacies mostly utilized by prescribed patients should be closely monitored to reduce potential misuse, and health bodies to come up with alternative tamper resistant with multiple mechanisms to reduce the likelihood of opioid abuse.

Pharmacies should be in the forefront in making efforts that prevent and minimize opioid abuse. Policies should be put in place requiring pharmacists to contact prescribing physicians to ensure diagnosis, and previously tried and tested, and expected lengths of therapies are accurate in verifying prescriptions for opioids.

Healthcare career has a vital responsibility to help reverse the exponential curve in opioid-related morbidity and mortality rates by improving prescribing practices. Healthcare providers should work to establish community-wide approach needed to address the opioid crisis effectively. The coordinated approach at local, regional, and state level will simultaneously address multiple parts of the complexities of opioid misuse, dependence, addiction, and recovery.

Raising awareness about chronic pain and pain management will increase knowledge about opioid abuse. Physicians should routinely take SCOPE of pain, free online training where they will learn safe and responsible opioid prescription within their first years of practice. Before providing prescriptions, practitioners should first identify patients with opioid use disorder earlier and should learn various ways of recognizing substance use disorder. The greatest measure to help minimize opioid overdoses is to demonstrate the safety of advanced practice registered nurses, and ensure they have the right skills to handle prescriptions


Druid, H. (2016). Toxicological and pathological findings in opioid-related deaths. Toxicology Letters, 258,             S36.

Elixhauser, A. (2017). Opioid-Related Inpatient Stays and Emergency Department Visits by State, 2009-   2014 #219. Retrieved 3 March 2018, from    Visits-by-State.jsp

Huber, E., Robinson, R., Noe, C., & Van Ness, O. (2016). Who Benefits from Chronic Opioid Therapy? Rethinking the Question of Opioid Misuse Risk. Healthcare, 4(4), 29.

J, F. (2017). Mass. deaths by opioid overdose fell 8.3 percent last year – The Boston Globe. Retrieved 3 March 2018, from

Lund, E. (2017). Preventing, Detecting, and Addressing Opioid Overprescribing. Journal Of Nursing Regulation, 8(2), 5-9.

Massey, B. (2017). Battling the Opiate Crisis: Translating the Latest Advances in Addiction Biology into             Novel Treatment Strategies. Pharmacy & Pharmacology International Journal, 5(4).   

Pardo, B. (2017). Do more robust prescription drug monitoring programs reduce prescription opioid overdose?. Addiction, 112(10), 1773-1783.

Pinkerton, R., & Hardy, J. (2017). Opioid addiction and misuse in adult and adolescent patients with cancer. Internal Medicine Journal, 47(6), 632-636.

Rana, MD, H., & Braithwaite, MD, B. (2016). Physician conviction for prescription-related deaths: How will this affect the opioid debate?. Journal Of Opioid Management, 12(4),   241.

Ruhm, C. (2018). Corrected US opioid-involved drug poisoning deaths and mortality rates, 1999-2015.  Addiction.

Smith, MD, H., Kirsh, Ph.D., K., & Passik, Ph.D., S. (2018). Chronic opioid therapy issues associated with opioid abuse potential. Journal Of Opioid Management, 5(5), 287.

Webster, L., & Grabois, M. (2015). Current Regulations Related to Opioid Prescribing. PM&R, 7(11),     S236-S247.

Writer, E. (2018). WV lawmakers seek to limit opioid prescribing. Charleston Gazette-Mail. Retrieved 3 March 2018, from

Panathenaic Festival

Panathenaic Festival

Panathenaic Festival, observed by the ancient Greeks, was one of the most important religious celebrations for people of Athens.[1] This significant religious festival included numerous activities performed by participants from various parts of the Greek World. All Greek citizens were allowed to participate irrespective of their age and gender. Thus, all the men, women, and youths from the ancient Greece took part in various athletic activities such as foot races, discus throw, horse chariot races, wrestling, boxing, pentathlon, javelin, and long jump among others. However, unlike any other Greek public activity, women (especially virgins from noble families) played significant roles during the festivals. They carried the sacrificial meat put in a basket into the ceremony. It was only during this festival when women were allowed to mingle with men who attended the festival freely.[2]As a result, the festival earned them respect from the female members of society due to the role they played. All the citizens of Greece and adjacent parts were allowed to participate in the celebrations except slaves who were under masters’ command at the time of the festival. Free slaves were permitted to attend to a limited extent. The festival took place every four years. Since 556 BCE, the Panathenaic Festival was important in enhancing religious and political connections between various tribes and communities from different parts in the Greek World. [3]Through the participation of people from various parts of Athens and other parts of Greece, the festival was a binding activity that translated into peaceful coexistence between people.[4]At the same time, the Panathenaic Festival enabled religious activities to take place in Athens through the inclusion of the Peplos during the festival presentations. Throughout the festival period, participants honored Athena Polias and her birthday as the goddess in-charge of Athens. This festival was an excellent representation of Athens’ power as well as the commitment to its patron goddess. Through the inclusion of the participants from Athens and other parts of the Greek Empire, the festival created unity and a sense of purpose. People gathered to celebrate their religion and politics. Therefore, the ancient Greeks viewed the Panathenaic Festival as an activity that carried a significant impact in the religious events and the politics of the region.

The Panathenaic Festival and Religious Connections

In the world of the ancient Greeks, worshippers considered religion as personal, direct, as well as a way of presenting various areas of life.[5] To begin with, formal rituals including libations, animal sacrifices, and myths account for the origins of humankind. Besides, ancient Greeks gave gods individual images, built temples in the urban landscape, and participated in the festivals. All these practices indicate that religion was inherent to ancient Greek’s mind. Ancient Greeks believed that the gods were watching them and that they responded to worship and piety acts. Old Greek Empire had different gods such as Hades, Apollo, and Athena and people took part in Panathenaic Festival with the aim of pleasing these gods.

Initially, King Theseus started the Panathenaic Festival.[6] Consequently, the society viewed him as an Athenian hero. King Theseus was related to the cult of Athena. Therefore, he started the festival as a cult to observe and show respect to Athena Polias and other gods such as Erechtheus. The festival also found its roots from the early sacrifices to Erechtheus. It had two crucial stages including the procession and the sacrifice. Through the observance of these steps, with the inclusion of various activities, the Panathenaic Festival expressed its religious significance. The event, which took place every four years, evoked different spiritual connections among the citizens of the Greek Empire and tribes who participated.

Firstly, the festivals took place in the temples which were also used as places of worship because ancient Greeks believed that gods dwelled in the temple or visited it during rituals. During the Panathenaic procession, the sacrificial meat was presented to the gods by the noble virgins in the cults. The Greeks often constructed these sects on an acropolis which dominated a city or a neighboring region. Similarly, Christians conducted various religious ceremonies in an altar built in the temple. Sacrifice and pouring libations were the most common practices observed during ancient Greek era. These two occasions were used to express respect and prayers as a way of honoring their gods. Religious believers usually sacrificed sheep, pigs, goats or cows to the honored god. The sacrificial meat was either wholly burnt or cooked. Some of the meat was given to the gods while the worshippers took the rest. Therefore, the temple was an essential element of religious practices during the Panathenaic Festival.

Secondly, the festivals involved priests who performed various rituals. Similarly, priests conducted religious rituals and ceremonies which include offering sacrifices, pouring libations and delivering prayers. However, the position of the priest was open to all worshippers, since the body of the priest became inviolate upon wearing the sacred headband when conducting the ceremony. Although priests served a specific god, they were not necessarily religious experts. Therefore, in case the worshippers had theological questions the priest could not answer, they were supposed to consult an exegete, who was a state official knowledgeable in religious matters. Both genders had equal chances of serving as priests and conducting religious ceremonies. However, often the priest on duty was supposed to be of the similar sex as the god they represented. However, the leaders restricted priestesses; they were to be either virgins or beyond menopause stage. On the other hand, worshippers constituted of both genders though certain restricted rituals excluded either female or male.

Thirdly, women played a significant role during Panathenaic procession. Likewise, women served as priests and preceded religious ceremonies despite them having no other public position.[7] Besides, in both cases, virgins from great family backgrounds were appointed. Consequently, the priestesses of Greek religion were accorded much respect as compared to their fellows in the society. Due to their dedication to their religious duties, they were regularly given valuable properties, paid and most importantly, accorded respect by other society members due to their contributions. Other community members viewed the priestesses of the Greek religious cults as celebrities and role models. Athena Polias marked the most significant religious function in Athens. Athena served as the patron goddess of Athens whereas Athena Polias served as the incarnation of Athens to guard the polis. Besides, the high priestess of Athena Polias represented the most senior religious position in Athens. A woman from Eteoboutadae’s noble family held the position and exerted considerable religious and political influence in the community. Besides, other females played crucial roles in both the cult and its overall activities.

Moreover, Athens celebrated the Panathenaia every year before commemorating Athena’s birthday. This festival was an excellent representation of Athens’ power as well as the commitment to its patron goddess.[8] In addition to the yearly Panathenaic celebration, they held a more significant Panathenaia celebration in every four years. This festival was more celebrated and had more significance than other common festivals. Consequently, the festival was inclusive of the Panathenaic Procession. During the preparation of the Acropolis’ procession, the believers made a new peplos for Athena’s cult statue housed on the Acropolis. Archon Basileus chose from noble families two young girls to serve as arrephoroiI.[9]They were supposed to stay with Athena’s priestesses for a specific duration to assist in weaving the new attire.[10]During the Procession which took place in the streets of Athens, the cult leaders dropped the peplos ceremonially. Meanwhile, the kanephoroi, who were young virgins of noble blood, carried sacred baskets which contained pieces of meat meant for sacrifices.[11] They presented the sacrificial animals at the altar of Athena together with the peplos.[12] These virgin females were allowed to mingle freely with Athenian men from noble families during the procession, which was very exceptional for the typical women of the Greek community.

Therefore, it is evident that women played significant roles during the Panathenaic Procession as well as in Athenian religion. As a result, these women were respected and valued by other society members, unlike ordinary Greek women. Besides, it is an indication that women contributed towards connecting the rest of the society with their religion through participating in the festivals.

Besides, feasting characterized the Panathenaic festival since it was the primary part of the ceremony. All participants from different part of the Greek empire and their neighbors participated in the festival. During the celebration, the participants feasted on animal meat which was mostly slaughtered to appease their gods. Similarly, sacrificial animal characterized other religious ceremonies. The animals were meant to please the gods and bringing people together as they shared them. Finally, all individuals were allowed to take part in the Panathenaic festival irrespective of their origin, unlike another festival which had exceptions. As a result, individuals participated in the ceremony regardless of their race, gender, ethnicity as well as their age. Likewise, people were allowed to take part in religious traditions in the society despite their diversities. Therefore, these similarities show connection between this festival and religious activities of the ancient Greeks.

The Panathenaic Festival and Political Connections

Just like with religious activities, Panathenaic festival had a close connection with political matters. That is, Panathenaic festival activities had an impact on the politics of the ancient Greek in various ways.

Firstly, all citizens from the early Greek world and the adjacent parts were involved in the event.[13]However, slaves who were under their masters’ command were not allowed to participate in the festivals. Besides, the freed slaves were allowed to attend to a limited extent. Consequently, the festival unified the entire Greek empire and their neighbors since worshippers were able to come together to observe similar religious ceremonies and rituals during the festival. Besides, the festival enhanced coexistence peacefully among the society members by bringing them together and more so through sharing the sacrificial meat. Similarly, the political goal of the political leaders was to unify the entire empire and ensure there was peaceful coexistence among the citizens and the residents of other parts surrounding them. Besides, during the festival, the leaders engaged in political propaganda discussing the issues taking place in the ancient Greek Empire. Leaders utilized the festival since all citizens were gathered together to attend the ceremony. Therefore, such celebrations and the political world of the ancient Greeks were interrelated.

Furthermore, the gods offered protection to all worshippers during the festivals. During the festival, the Greeks and citizens from their neighborhood offered sacrifice to their gods to appease them.[14]In return, the gods protected the society members from evil spirits as well as any form of attack by their enemies. Similarly, in the Greek empire, political leaders were charged with the responsibility of protecting their citizens from any attack either internal or external. This action shows the connection between the festival and political world of the Greek people during the Athens arena.

Thirdly, the festival leaders taught the civic education to the worshippers who attended the ceremony. Most residents valued the Panathenaic festival, and therefore they participated in large numbers. As a result, the festival was the best platform for the political leaders to teach citizens civic education.[15]Besides, the citizens attentively listened to teachings during the festival which implies they were likely to understand the civic education better. The collective knowledge was meant to strengthen democracy in the empire.[16]The political leaders were assigned the responsibility of teaching political education in the empire. Besides, civic education was a significant factor in the political matters of the early Greek community. Therefore, it is evident that the festival activities connected the festival with the political world of the ancient Greek.


Panathenaic festival was the most valued ceremony among the residents of the ancient Greek world. All the old Greek citizens gathered to celebrate the festival which occurred in every four years irrespective of their gender and age. Also, people from adjacent parts participated in the celebration. However, unlike other Greek public festivals, women were allowed to take an active role during the ceremony. Virgins from noble families were assigned the responsibility of carrying the sacrificial meat placed in baskets. Most importantly, festival connected the ancient Greek people to both religious and political matters. The festival took place in an altar built outside the temple similarly to religious activities. Also, the festival involved the offering of sacrifice and libation to please the gods which characterized most religious activities. Besides, just like religious activities where women served as a priest, during the festival women were directly involved. The festival included sharing of the sacrificial meat which they shared during religious ceremonies. In addition to spiritual connection, the festival had relationships with political matters of the ancient Greek community.


Cartwright, Mark. “Ancient Greek Religion.” Ancient History Encyclopedia. Last modified April 11, 2013.

Charles, Waldstein. The American Journal of Archaeology and the History of the Fine Arts

David, Wiley-Blackwell. “A Brief History of the Olympic Games.” (2004).

Fantham, Modern Greece.” (2006).Elaine. Women in the Classical World. Oxford University Press, New York, Oxford, 1994.

Feeney, Denis. Caesar’s Calendar: Ancient Time and the Beginning of History. Berkeley: University of California Press, 2007.

Haland, Evy Johanne. “Athena’s Peplos: Weaving as a Core Female Activity in Ancient and Modern Greece.” (2006).

Hugh Bowden, Mystery Cults of the Ancient World Princeton, NJ: Princeton University Press 2010.

Jennifer Neils, “The Political Process in the Public Festival: The Panathenaic Festival in Athens,” in Greek and Roman Festivals (2012), 199–215.

Parker, Robert. Polytheism and Society at Athens. Oxford: Oxford University Press, 2005

Pomeroy, Sarah. Goddesses, Whores, Wives, and Slaves: Women in Classical Antiquity. Schocken Books, New York, 1995.

See Pickard-Cambridge, The Dramatic Festivals of Athens, 1968, 40–42, for features of the festival.

Stevenson, Tom. “The Parthenon Frieze as an Idealised, Contemporary Panathenaic Festival.” (2003): 233-280.

Venetus, A. “Recapturing a Homeric Legacy.” (2009).

Vol. 1, No. 1 (Jan. 1885), pp. 10-17.

Walter Burkert, Homo Necans: The Anthropology of Ancient Greek Sacrificial Ritual and Myth (Berkeley, CA: University of California Press, 1983), 153–161.

writer873. “The Women of Athena’s Cult.” Ancient History Encyclopedia. Last modified January 18, 2012.

[1]Cartwright, Mark. “Ancient Greek Religion.” Ancient History Encyclopedia. Last modified April 11, 2013.

[2]“The Women of Athena’s Cult.” Ancient History Encyclopedia. Last modified January 18, 2012.

[3]David, Wiley-Blackwell. “A Brief History of the Olympic Games.”  (2004).

[4]. Charles, Waldstein. The American Journal of Archaeology and the History of the Fine Arts

Vol. 1, No. 1 (Jan. 1885), pp. 10-17.

[5]Cartwright, Mark. “Ancient Greek Religion.” Ancient History Encyclopedia. Last modified April 11, 2013.

[6]Feeney, Denis. Caesar’s Calendar: Ancient Time and the Beginning of History. Berkeley: University of California Press, 2007.

[7]Fantham, Elaine. Women in the Classical World. Oxford University Press, New York, Oxford, 1994.

[8]Parker, Robert. Polytheism and Society at Athens. Oxford: Oxford University Press, 2005.

[9]Pomeroy, Sarah. Goddesses, Whores, Wives, and Slaves: Women in Classical Antiquity. Schocken Books, New York, 1995.

[10]Haland, Evy Johanne. “Athena’s Peplos: Weaving as a Core Female Activity in Ancient and Modern Greece.” (2006).

[11]See Pickard-Cambridge, The Dramatic Festivals of Athens, 1968, 40–42, for features of the festival.

[12]Walter Burkert, Homo Necans: The Anthropology of Ancient Greek Sacrificial Ritual and Myth (Berkeley, CA: University of California Press, 1983), 153–161.

[13]Stevenson, Tom. “The Parthenon Frieze as an Idealised, Contemporary Panathenaic Festival.” (2003): 233-280.

[14]Hugh Bowden, Mystery Cults of the Ancient World (Princeton, NJ: Princeton University Press 2010

[15]Jennifer Neils, “The Political Process in the Public Festival: The Panathenaic Festival in Athens,” in Greek and Roman Festivals (2012), 199–215.

[16]Venetus, A. “Recapturing a Homeric Legacy.” (2009).