Social Phobia

Social Anxiety Disorder: Social Phobia The Diagnostic and Statistical Manual of Mental Disorders defines social anxiety disorder as a marked and persistent fear of social or performance situations in which embarrassment may occur (DSM). Exposure to these situations provokes an immediate anxiety response such as a panic attack (DSM). In order to be diagnosed, fear or avoidance of these situations must interfere significantly with the person’s normal routines, occupational or academic functioning, social activities or relationships, or a person must experience marked distress about having the phobia (DSM). In 400 B. C. , Hippocrates described a young man that displayed the symptoms of a social anxiety disorder. â€Å"He dare not come in company for fear he should be misused, disgraced, overshoot himself in gesture or speeches, or be sick; he thinks every man observes him† (Burton 2009). Throughout the 20th century, psychiatrists described extremely shy patients as having social phobia and social neurosis. British psychiatrists Isaac Marks and Michael Gelder proposed that social phobias be considered a distinct category separate from other simple phobias (Hope, Heimberg, Juster, & Turk 2005). In 1980, the third edition of the Diagnostic and Statistical Manual of Mental Disorders introduced social phobia as an official psychiatric diagnosis. Social phobia was described as a fear of performance situations, but did not include fears of informal situations such as casual conversations or social situations. Patients with broad fears were likely to be diagnosed with avoidant personality disorder, which could not be diagnosed in conjunction with social phobia (Weiner, Freedheim, Freedheim, Reynolds, Miller, Gallagher, Nelson, Gallagher, Nelson, Gallagher, & Nelson 2003). In 1985, psychiatrist Michael Liebowitz and psychologist Richard Heimberg initiated a call to action for research on social phobia (Weiner, Freedheim, Freedheim, Reynolds, Miller, Gallagher, Nelson, Gallagher, Nelson, Gallagher, & Nelson 2003). Due to the lack of research on social anxiety disorder, the disorder came to be known by many as the â€Å"neglected anxiety disorder† (Weiner, Freedheim, Freedheim, Reynolds, Miller, Gallagher, Nelson, Gallagher, Nelson, Gallagher, & Nelson 2003). In 1987, the DSM-III-R introduces changes in some of the diagnostic criteria. To diagnosis social anxiety disorder the symptoms must cause â€Å"interference or marked distress† rather than simply â€Å"significant distress. † It also became possible to diagnose social phobia and avoidant personality disorder in the same patient (Weiner, Freedheim, Freedheim, Reynolds, Miller, Gallagher, Nelson, Gallagher, Nelson, Gallagher, & Nelson 2003). In 1994, the DSM-IV was released, and the disorder was defined as a â€Å"marked and persistent fear of one or more social or performance situations in which the person is exposed to unfamiliar people or possible scrutiny by others† (Weiner, Freedheim, Freedheim, Reynolds, Miller, Gallagher, Nelson, Gallagher, Nelson, Gallagher, & Nelson 2003). The etiology of social anxiety disorder is largely attributed to genetics, and environmental factors. Family studies of individuals with social anxiety disorder show a higher incidence of the disorder than that found in the general population, and a twin study found a concordance rate of 15. % in dizygotes and a 24. 4% concordance in monozygotes (Kedler, Neale, Kessler, Heath & Eaves 1992. ). Of course, there is very little evidence that the genetic factors attributed to social anxiety disorder extend beyond the link between environmental factors since there is very little evidence of neurobiological factors. Other than the fact that se lective serotonin reuptake inhibitors (SSRIs) are effective treatments for social anxiety disorder, there is little evidence to implicate dysfunction of the serotonergic system (Jefferson 2001. . The lack of empirical data identifying neurobiological factors in causing the onset of social anxiety disorder is best stated in a quote by Dr. Murray B. Stein, a Professor of Psychiatry and Family & Preventive Medicine at the University of California San Diego, â€Å"It is clear that we have a long way to go before we can speak with authority about the ‘neurobiology of social phobia’† (Stein 1998. ) Therefore, environmental factors remain the most referred to etiological agent in the onset of social anxiety disorder. Parenting traits such as over control, lack of warmth or rejection, and overprotection are known to be associated with the etiology of social anxiety disorder (Brooks, & Schmidt 2008). Some individuals with social anxiety disorder associate its onset with a specific social event or interaction that was particularly embarrassing or humiliating. Such a circumstance could be considered an adverse conditioning stimulus (Jefferson 2001). There is further evidence that poor results from quality of life assessments can be attributed to social anxiety disorder. Individuals with major depressive disorder, obsessive-compulsive disorder (OCD), panic disorder, and social anxiety disorder have substantially poorer quality of life than community comparison cohorts. In many cases, the quality-of-life impairments associated with these anxiety disorders are equal to or greater than those seen with other chronic medical disorders (Rapaport, Clary, Fayyad, & Endicott 2005). Social anxiety disorder is a common disorder. The lifetime prevalence of SAD is somewhere between 7% and 13% in Western countries (Furmark 2002). Furthermore, epidemiological studies have demonstrated that social anxiety disorder is the most widespread of all the anxiety disorders, and the third most common psychiatric disorder after major depression and alcohol abuse (Brooks, & Schmidt 2008). Therapy and medication are the most common treatments for social anxiety disorder. Cognitive behavioral therapy is the most utilized form of psychotherapy, and has been found to be successful in seventy-five percent of patients (â€Å"Social anxiety disorder,† 2009). This type of therapy focuses on reminding the patient that it is their own thoughts, not other people or situations, that determine how they behave or react (â€Å"Social anxiety disorder,† 2009). In therapy, the patient is taught how to recognize and change the negative thoughts they have about themselves (â€Å"Social anxiety disorder,† 2009). Exposure therapy is also a common form of treatment for social anxiety disorder. In this type of therapy, the patient is gradually exposed to situations that they fear most (â€Å"Social anxiety disorder,† 2009). Exposure therapy enables the patient to learn coping techniques, and develop the courage to face them (â€Å"Social anxiety disorder,† 2009). The patient is also exposed to role-playing with emphasis on developing the skills to cope with different social situations in a â€Å"safe† environment (â€Å"Social anxiety disorder,† 2009). There are several medications used to treat social anxiety disorder. These medications are typically serotonin reuptake inhibitors including Paxil, Zoloft, and Prozac (â€Å"Social anxiety disorder,† 2009). A serotonin norepinephrine reuptake inhibitor (SNRI) drug such as Venlafaxine may also be used as a first-line therapy for social anxiety disorder (â€Å"Social anxiety disorder,† 2009). Typically, the patient begins with a low dosage, and is gradually increased to a full dosage, to minimize side effects (â€Å"Social anxiety disorder,† 2009). It may take up to three months of treatment before the patient begins to have noticeable improvement of symptoms (â€Å"Social anxiety disorder,† 2009). Social anxiety disorder remains a largely misunderstood, and under researched, disorder. Momentum through increased clinical research, in depth understanding through treatment, and stricter guidelines for proper diagnosis are positive indications that Psychology has recognized the debilitating effects of social anxiety disorder on patients. In time, clinicians will be better prepared to treat patients suffering from this disorder, and will improve the lives of patients. References Brooks, C. A. , & Schmidt, L. A. (2008). Social anxiety disorder: a review of environmental risk factors. Neuropsychiatr Disease and Treatment, 4(1), Retrieved from http://www. ncbi. nlm. ih. gov/pmc/articles/PMC2515922/ Burton, Robert. (2009). The Anatomy of melancholy. Charlottesville, VA: The University of Virginia. Furmark T. (2002). Social phobia: overview of community surveys, Acta Psychiatrica Scandinavica, 105, Retrieved from http://www. ncbi. nlm. nih. gov/pubmed/11939957 Hope, Debra, Heimberg, Richard, Juster, Harlan, & Turk, Cynthia. (2005). Managing social anxiety. New York, NY: Oxf ord Univ Pr. Jefferson, J. W. (2001). Physicians postgraduate press, inc.. Primary Care Companion to the Journal of Clinical Psychiatry, 3(1), Retrieved from http://www. cbi. nlm. nih. gov/pmc/articles/PMC181152/ Kedler, K. S. , Neale, M. C. , Kessler, R. C. , Heath, A. C. , and Eaves, L. J. (1992) The genetic epidemiology of phobias in women: the interrelationship of agoraphobia, social phobia, situational phobia, and simple phobia. Arch. Gen. Psychiatry. Rapaport, M. H. , Clary, C, Fayyad, R, & Endicott, J. (2005). Quality-of-life impairment in depressive and anxiety disorders. American Journal of Psychiatry, 162(6), Retrieved from http://www. ncbi. nlm. nih. gov/pubmed/9861470 Social anxiety disorder (social phobia). (2009). Mayoclinic. com. Retrieved (2010, April 25), Retrieved from http://www. mayoclinic. com/health/social-anxiety-disorder/DS00595/DSECTION=treatments%2Dand%2Ddrugs Stein, M. B. (1998). Neurobiological perspectives on social phobia: from affiliation to zoology. Biological Psychiatry, 44(12), Retrieved from http://www. ncbi. nlm. nih. gov/pubmed/9861470 Weiner, Irving, Freedheim, Donald, Freedheim, Donald, Reynolds, William, Miller, Gloria, Gallagher, Michela, Nelson, Randy, Gallagher, Michela, Nelson, Randy, Gallagher, Michela, & Nelson, Randy. (2003). Handbook of psychology. Hoboken, NJ: John Wiley & Sons Inc.

Epidural Catheterization In Cardiac Surgery Health And Social Care Essay

Introduction: Risk-benefit-ratio rating of extradural haematomas due to catheter arrangement in patients undergoing cardiac surgery is still controversial. The intent of this survey is to update to 2012 the per centum of catheter-related extradural haematoma hazard in cardiac surgery. Methods: Bracco and Hemmerling 2007 hazard appraisal was updated by seeking all reported instances of extradural arrangement for cardiac surgery, in web and in literature, from April 2007 to September 2012. Hazards of other medical and non-medical activities were retrieved from recent reappraisals or national statistic studies. Consequences: Hazard of catheter-related extradural haematoma is 1/5,493, with a 95 % CI of 1/970 to 1/31,114. It is similar to the hazard in the general surgery population of 1/6,628 ( 95 % CI 1/1,170 to 1/37,552 ) . Decisions: Hazard of catheter-related extradural haematoma should be considered acceptable, since it is comparable to the hazard of deceasing in a auto accident, which is a jeopardy widely accepted. Its usage should be encouraged, because extradural improves recovery in patients undergoing cardiac surgery.IntroductionIn cardiac surgery, the extradural anesthesia/analgesia technique has been performed for many old ages [ 1 ] ; however, its usage is frequently limited by the fright of increased hazard of extradural haematoma associated with anticoagulation therapy. The risk-benefit ratio of medical processs needs to be known in order to do the best pick in routinely clinical pattern. In peculiar, it is of import to better look into the hazard benefit-ratio of extradural catheter in cardiac surgery, since it is a controversial and strongly debated pattern. In a recent reappraisal [ 2 ] , Royse showed the benefits and hazards related to high pectoral extradural anaesthesia, and he concludes that & amp ; acirc ; ˆ?epidural usage in cardiac surgery is no more unsafe than in non cardiac surgery & A ; acirc ; ˆA? . Previously, Bracco and Hemmerling estimated hazard of catheter-related extradural haematoma, seeking databases from 1966 to March 2007 [ 3 ] . The deliberate hazard was 1 extradural haematoma out of 12,000 extradural catheterisation reported in literature. The purpose of this survey is to update to 2012 the per centum of catheter-related extradural haematoma hazard in cardiac surgery.MethodMedline, SciSearch Embase, Google and Google Scholar were searched to choose publications showing patients undergoing cardiac surgery who received extradural anesthesia/analgesia. The hunt standards were ( ( ( ( extradural anaesthesia ) OR extradural catheter ) OR locoregional anaesthesia ) OR extradural ) AND ( ( ( ( cardiac surgery ) OR coronary arteria beltway grafting ) OR aortal valve surgery ) OR mitral valve surgery ) . Databases were explored from April 2007 to September 2012. The compiled publication list includes: conference abstracts, randomized control tests, retrospective and prospective surveies, and meta-analysis. The figure of patients undergoing cardiac surgery who received extradural catheterisation was retrieved ; attending was paid to non number patients twice. After that, the entire figure of instances ( denominator ) was calcula ted summing instances from April 2007 to September 2012 with instances from 1966 to March 2007 ; the latters were already included in the appraisal hazard done by Bracco and Hemmerling [ 3 ] . The numerator was calculated adding instances of extradural haematoma after extradural catheterisation in cardiac surgery, occurred from 1966 to 2012. The hazard of catheter-related extradural haematoma was compared with several different hazards, such as: the hazard of catheter-related extradural haematoma in non cardiac surgery, the hazard of chest or prostate malignant neoplastic disease, and the hazard of route traffic hurt. The per centums of hazard used for comparing were extrapolated from big tests, meta-analysis or national statistics studies. As already done by Bracco and Hemmerling, the Wilson method [ 4 ] was used to cipher 95 % reversible assurance interval ( CI ) of a individual proportion. The comparing between 2 proportions was done utilizing the same method [ 5 ] .ConsequenceIn 2012, the hazard of catheter-related extradural haematoma in cardiac surgery is 3 instances out of 16,477 patients, or 1/5,493, with a 95 % CI of 1/970 to 1/31,114. From April 2007 to 2012, around 4,477 patients having merely extradural or extradural plus GA and undergoing cardiac surgery were found. This population besides includes some paediatric patients. Kind of surgery and figure of patients are shown in table 1. We summed our consequences with the one estimated by Bracco and Hemmerling ; hence, the denominator is 16,477 ( 12,000 + 4,477 ) . Merely two instances of catheter-related extradural haematoma are described in literature from April 2007 to 2012. The first one occurred in 2010 and is reported by the UK Medical Protection Society [ 6 ] . A 70-year-old adult female had to undergo alteration surgery after 6 old ages since she received a ternary coronary arteria beltway. The twenty-four hours of surgery extradural catheter was placed without incident, and so GA was induced. The twenty-four hours after surgery, in the forenoon, the patient showed initial neurological symptoms, noticed by a nurse. However, her spinal column was examined through a CT scan merely hours subsequently, after neurological scrutiny revealed an intense motor and centripetal bilaterally block at the T6 degree. A big haematoma in the extradural infinite was clearly seeable ; hence, an exigency laminectomy and emptying of haematoma were performed. This patient remained paraplegic. The 2nd instance of catheter-related extradural haematoma happened in 2011 [ 7 ] . On the twenty-four hours of surgery, after GA initiation an extradural catheter was placed. The patient was a 55-year-old adult male scheduled for mitral valve replacing and tricuspid annulate plasty, who had stopped warfarin 7 yearss earlier surgery. Preoperative blood test revealed a normal curdling profile and normal thrombocyte count. A flaccid paraplegia appeared 16 hours after the terminal of surgery ; at that clip his curdling profile was altered and he had besides thrombocytopenia. An exigency magnetic resonance imagination showed an extradural haematoma at the T5-T6 degree, hence a laminectomy, within 6 hours since symptoms onset, was instantly performed to take the haematoma. This patient had a good overall recovery, and presented merely a little dysuria 6 months after laminectomy. Bracco and Hemmerling identified merely one instance of catheter-related extradural haematoma occurred in 1995 and subsequently reported in 2004 [ 8 ] ; hence, this instance adds up to the 2 antecedently described, so the numerator for the hazard assessment up to 2012 is represented by 3 instances. Several instances of neurological complications happening in patients with an extradural catheter placed for cardiac surgery are described in literature. Arora et Al. reported a instance of pneumocephalus after extradural anaesthesia [ 9 ] . The patient was a 68-year-old hypertensive, diabetic and corpulent male admitted for a coronary arteria beltway surgery ( CABG ) . He had a moderate clogging pneumonic disease, so extradural anaesthesia was proposed, obtaining informed consent. After uneventful extradural catheter interpolation, the trial dosage was administered ( 2ml of 2 % Lidocaine ) . Immediately, the patient reported a terrible concern, and so generalized tonic clonic ictuss developed. The patient gained consciousness 10 proceedingss subsequently, after ictuss were controlled. The magnetic resonance imagination showed air in the basal cisterns and subarachnoid infinites. The patient got a full recovery and underwent surgery 2 yearss subsequently. Writers concluded that the c omplications were due to the puncture of the dura mater. The hazard of catheter-related extradural haematoma in cardiac surgery is comparable to the hazard of extradural haematoma after regional techniques for general surgery [ 10, 11 ] . Volk et Al. estimated an incidence of spinal haematoma of 1: 6,628 in general surgical population, in Germany, from 2008 to 2009. We calculated a comparative hazard decrease of 17 % prefering general surgery ( non important ) . The US mortality for bosom disease ( deaths per population ) [ 12 ] is 10 times higher the hazard of extradural haematoma after extradural anesthesia/analgesia for cardiac surgery. The hazard of catheter-related extradural haematoma in cardiac surgery is 100 times lower than both the incidence of acute nephritic failure after CABG [ 13 ] , and the incidence of sternal lesion infection after CABG [ 14 ] . The hazard of catheter-related extradural haematoma in cardiac surgery is besides a 1,000 times lower than the frequence of ordering mistakes in infirmaries ( errors/admissions ) [ 15 ] . Patients undergoing cardiac surgery with an extradural catheter in topographic point have a hazard to develop an extradural haematoma comparable to the hazard of developing chest malignant neoplastic disease ( women/year ) or prostatic malignant neoplastic disease ( men/year ) [ 16 ] , and to the hazard of deceasing by accident ( deaths/population ) [ 17 ] [ Fig.1 ] .DiscussionKnowing the hazard per centum related to medical processs is really of import in clinical pattern ; it permits to correctly measure the risk-benefit ratio and to explicate patients all is needed, in order to obtain an informed consent before executing processs. Two recent meta-analysis have shown, one time once more, that the usage of epidural over general anaesthesia in patients undergoing cardiac surgery improves recovery by diminishing: the incidence of acute nephritic failure, the incidence of postoperative supraventricular arrhythmias, the clip on mechanical airing and respiratory complications [ 18, 19 ] . Therefore, extradural anaesthesia is an of import intercession in the multimodal scheme that anesthesiologists actuate in order to vouch the best quality attention. Furthermore, wake up cardiac surgery is a new minimally invasive anaesthesia technique, and it is a cherished option for bad patients with terrible COPD ; because avoiding cannulation and mechanical airing is necessary to cut down the hazard of decease [ 20-25 ] . This survey demonstrates that the hazard of catheter related extradural haematoma in cardiac surgery is non zero, but it is a hazard that we consider to be acceptable, since it is comparable to the hazard of deceasing in a auto accident [ 26 ] , which is an jeopardy normally accepted [ Fig. 1 ] . Restrictions of the current hazard analysis are related to our determination of non sing differences among the surveies we used as beginning. Different times of catheter arrangement, different perioperative heparinization protocols and different puncture degrees are non taken into history. The increased hazard, compared to the 2007 appraisal by Bracco and Hemmerling, we believe is due to a lessening in the figure of instances we used to find the denominator, and non to a existent addition in instances of catheter-related extradural haematoma. We used as denominator the figure of patients who received an extradural catheterisation to undergo cardiac surgery. It is our sentiment, that the instances reported in literature in recent old ages are merely a little proportion of the figure of extradural catheter arrangement really performed. Furthermore, the attending paid to epidural-related jobs has increased over clip, and accordingly, the demand to describe incorrect events increased. In literature, instances of self-generated extradural haematoma without an extradural catheter after cardiac surgery are besides described. For case, Hayashi et Al. [ 27 ] reported about a 71-year-old adult females, who underwent mitral valve plasty with CPB. The surgery lasted around 4 hours uneventfully, and she was non antecedently treated with anticoagulant therapy neither with extradural. One hr after surgery, paraplegia was apparent, an extradural haematoma compacting spinal cord at the C7-T4 degree was revealed through magnetic resonance imagination. A conservative attack was chosen because the paraplegia was non progressive. The writers stated that the extradural haematoma etiology was non apparent. The adult female had good overall result. In decision, measuring the risk-benefit ratio of utilizing pectoral extradural anaesthesia in cardiac surgery should be easier, thank to this update hazard appraisal.

Critical Thinking 1 Speech or Presentation Example | Topics and Well Written Essays - 500 words

Critical Thinking 1 - Speech or Presentation Example Economic profit is the estimate of a forgone good. In businesses, the normal profit is required business profit and not in economic profit. If at all the interest on mortgage loan deduction were reduced or removed, then the homeowners will be hurt is a fallacy. Buyers will have to pay low prices. This because home owners get a deduction in tax which a renter paying the same amount will never get. The savings are forced every month in beginning of a mortgage. Owning property such as house is the only avenue for an ordinary person to employ leverage that not only create risk but also rewards. Persons who rent outwardly think they put extra in investments but when subjected to scrutiny it is a fallacy. A house is an asset that depreciates slowly as compared to other assets. The scenario only focuses on the percentage increase in houses but do not provide an argument what return on capital is. If a sales manager happens to announce that a marketing program is being utilized to maximize sales, I would advocate for the program scaled down because the marginal revenue is equal to zero. When the sales are maximum, the marginal revenue is at zero. When now this happen, the marginal cost exceeds marginal revenue, this means that the marketing strategy is yielding too much. For the betterment of the outcome, the marginal revenue should be equal to marginal

Analyzing the Relationships between Service Quality and Special Events Essay - 1

Analyzing the Relationships between Service Quality and Special Events in the Entertainment Industry - Essay Example While examining this issue the other questions which this research seeks to answer are: Is the current SERVQUAL instrument an effective overall measure of perceived service quality for special events organizations; if the answer to the first question is â€Å"No†, can new dimensions be added to make SERVQUAL more effective for measuring customers’ perceived service quality of special events and can such an adapted and modified SERVQUAL instrument be generalized for measuring perceived service quality of special events’ offerings? Modification of the 1991 version of the SERVQUAL method would aim at the reduction of ambiguity in expectations definition and unstable dimensionality (Babakus and Boller 1992; Carman 1990; Cronin and Taylor 1992). Babakus and Waller in fact suggest (p. 265) that â€Å"it may not be fruitful to pursue the development of a standard measurement scale applicable to a wide variety of services†. In order to achieve this modification an attempt would be made to add one or two dimensions to the standard instrument so that the scale would become more contextual for situations concerning special events. To identify these additional dimensions factor analysis would be conducted on variables (factors) to identify relevant and critical factors. Respondents would be chosen from the customer base of the targeted special events company(ies). External validity would be addressed by also surveying non-customers. The sampling scheme deployed would be stratified random sampling. The company’s entire customer base would be organized according to the demographic variable of customer income. The underlying assumption would be that the ability to purchase entertainment offered by the special events company is a direct function of the income of the consumer. However, income/ability should not be deemed to be synonymous with â€Å"willingness† to pay. Customer willingness assessment, on the other hand would be the

English Legal Process Coursework Example | Topics and Well Written Essays - 2000 words

English Legal Process - Coursework Example Failure to comply with Section 24 of PACE and the Code of Practice will render an arrest unlawful.2 Together the Code of Practice and Section 24 of PACE inform that two elements must be present otherwise an arrest is unlawful. First the person arrested must be involved or suspected to have been involved in or attempted to be involved in committing a criminal offence. Secondly, there must be reasonable grounds that arrest is necessary. Section 24(5) of PACE sets forth a number of grounds upon which an arrest is necessary to prevent the person under arrest absconding.3 As soon as Ray was approached by the officers and informed that he was under arrest he attempted to escape and therefore whether or not the police had reasonable grounds to believe that Ray’s arrest was necessary when they initially attempted to arrest him, they had reasonable grounds to believe that his arrest was necessary the moment he attempted to escape. ... ect a lawful arrest.7 Ray attempted to escape the police upon learning that he was under arrest and the police merely wrestled him to the ground and in doing so used only the force that was necessary to carry out the arrest. The only questionable act on the part of the police is whether or not the police properly informed Ray of the reasons for his arrest. Section 28 (3) of PACE instructs that an arrest is unlawful â€Å"unless the person arrested is informed of the ground for the arrest at the time of, or as soon as is practicable after, the arrest.8 Obviously, it was impractical to inform Ray of the reasons for his arrest when he attempted to escape, but he could have been informed at any time after he was placed in handcuffs. However, the police did not inform Ray of the reasons for his arrest despite several opportunities to do so. He was in the police car win an officer while the police stopped at an unrelated crime scene. This raises the question of whether or not the police c omplied with their duty to take the detainee to the police station as soon as practical after the arrest.9 The stop was brief however, and given police duties to protect the public, it may be concluded that the stop was not an unnecessary intrusion and thus may not compromise Section 30 which requires the detainee be taken to the police station as soon as practical after the arrest. Although the detainee may not be questioned until after he has been cautioned, and after he is at the police station, Ray offered information while waiting in the car at the police stop. He had been cautioned and had volunteered the information and the police officer receiving the information did not encourage Ray and did not engage in discussions about it. Thus the police did not act improperly. Police are required

Choose an environmental topic, analyse the message about the issue Essay

Choose an environmental topic, analyse the message about the issue that is being constructed in the media source you have selected - Essay Example Such a broadened understanding in turn helps in effective policy formulation and resolve issues in an amicable manner. The depiction of environmental issues by the media has increased significantly, over the last couple of decades. Various environmental groups as well as government departments have been relying on the media heavily, for promotion of their self-interests as well as for raising awareness regarding the depletion of sources and encouraging the public to support their cause. Such an alliance of the media and the environmental groups / and or other groups endorsing environmental issues; often raises significant issues related to government policy formulation, risk to public life, etc. among others. This paper aims to study and analyze the issue of â€Å"oil sands pollution† in Canadian waterways as represented by the Canadian print media – especially the newspapers. For this purpose articles from some select newspapers such as The Globe and Mail, Edmonton Journal, The Gazette, and The Vancouver Sun are chosen for analysis. Dryzek has identified several discourses associated with environmental problems such as - Survivalism, Environmental problem solving, Sustainability, Green radicalism, Administrative rationalism, Democratic pragmatism, Economic rationalism and Sustainable development. The articles discussed below, will seek to identify and analyze some such discourses and assess their relevance and impact, generated by the print media. In this article the writer has discussed about the rising level of pollution around the Athabasca River and its tributaries on account of emissions from oil sands. In order to lend credibility to the arguments presented in the article the writer has included a research paper presenting contradictory views of the energy industry and the Alberta government regarding the underlying causes of this issue. The writer has directed

VIVA examination Essay Example | Topics and Well Written Essays - 2500 words

VIVA examination - Essay Example In his statement, the defendant states that he is married and operates a business that employs two individuals. According to the witness statements document 3 and 4 the defendant did not resist arrest and complied with the arresting officers when he was arrested. When the defendant was granted the pre-charge bail, he did not abscond and willingly returned to the police station to be interviewed on the second occasion. From his antecedents it is also evident that the defendant was born in Lymeshire and has a permanent address. The defendant does not have any outstanding bail commitment and has not made attempt to return to The Void. The Bail Act 1976 provides that the court should presume that the defendant should be granted bail unless there are circumstances to justify refusal of bail. Part II of the act provides circumstances when the defendant need not be granted bail. These circumstances include where it is apparent to the court that the defendant failed to surrender to custody in accordance to bail conditions in a previous bail commitment. The court can also refuse to grant bail if it believes that the defendant was on bail when the offence was committed. Additionally, the court need not grant bail if it is satisfied that there are reasons to believe that the defendant would commit a crime while on bail, refuse to commit to custody, interfere with witness or obstruct justice. Furthermore, the court should not grant bail to the defendant if it is satisfied that the defendant should remain in custody for his own protection (Loveless, 2008). From the defendants statement of proof it is apparent that the defendant did not fail to surrender to custody in accordance to the conditions of the pre-charge bail. The defendant was not on bail when the alleged crime was committed. There is no evidence on record or reason to believe that the defendant would commit a crime while on bail. The defendant does not intend to refuse to commit to

Robotic Surgery Technology Dissertation Example | Topics and Well Written Essays - 15500 words

Robotic Surgery Technology - Dissertation Example I have read the University regulations concerning plagiarism. I am willing to allow The University of Leicester School of Management to use my dissertation as a sample for future students. Signed †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ Date †¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦Ã¢â‚¬ ¦ Executive Summary This dissertation presents an examination of management perspectives for training, international medical licensing and regulatory requirements for robotic surgery technology using a predominantly qualitative approach involving a review of literature and semi-structured interviews of expert surgeons. A literature review elicits important themes from latest research to illustrate the utility of robot surgery technology, training requirements for robot surgery and regulative approaches. Semi-structured interviews seek expert opinion from minimally invasive robot surgeons, healthcare managers and those qua lified surgeons who are training to acquire skills in robot surgery on matters of interest related to robot surgery technology. Results of the investigations involving a combination of themes from the review of literature and expert insights suggest that a need exists for trying to do more to assist with the training of surgeons wanting to acquire skills in robot surgery. Robot surgery technology presents definite benefits to patients and surgeons. Thus, it is likely that robot surgery equipment will be an integral part of all modern operation theatres of the future. However, those wanting to upgrade their skills to include minimally invasive surgery using robots can face problems because they need practical training. In addition, it makes sense to lend... This dissertation presents an examination of management perspectives for training, international medical licensing and regulatory requirements for robotic surgery technology using a predominantly qualitative approach involving a review of literature and semi-structured interviews of expert surgeons. A literature review elicits important themes from latest research to illustrate the utility of robot surgery technology, training requirements for robot surgery and regulative approaches. Semi-structured interviews seek expert opinion from minimally invasive robot surgeons, healthcare managers and those qualified surgeons who are training to acquire skills in robot surgery on matters of interest related to robot surgery technology. Results of the investigations involving a combination of themes from the review of literature and expert insights suggest that a need exists for trying to do more to assist with the training of surgeons wanting to acquire skills in robot surgery. Robot surgery technology presents definite benefits to patients and surgeons. Thus, it is likely that robot surgery equipment will be an integral part of all modern operation theatres of the future. However, those wanting to upgrade their skills to include minimally invasive surgery using robots can face problems because they need practical training. In addition, it makes sense to lend support to harmonisation of regulation of medical devices so that patients benefit from timely availability of these devices cheaply.

Three Years of the Korean War Essay Example | Topics and Well Written Essays - 1250 words

Three Years of the Korean War - Essay Example It was the early days of the Cold War and the attentions of the Soviet Union and U.S.A. was more focused on the European theatre than on the Koreas in Far East Asia. Yet, Korea and the Korean War would turn out to be the first theatre to demonstrate the extent to which the grand alliance of Russia with the other Allied powers during the Second World War had fallen apart in the fight by the remnants of the Allied combination against communism inspired by the Soviet Union. At the end of the war there were no territorial gains or prestige for either side, except a rise in the esteem of the newly emerged communist China.1 The Korean War would not have been extended, causing more casualties and suffering, but for the unnecessary invasion of North Korea by the UN Forces led by America. The Course of the War The North Korean invasion of South Korea began on June 25th 1950 and the unprepared army of South Korea could not offer strong resistance, and North Korean troops quickly reached the Se oul the capital of South Korea. American reaction was swift. President Truman in keeping with the American policy of containment of any expansion of communism feared that the fall of South Korea would create a breach in this containment policy and rushed support to the beleaguered South Koreans. In addition, support from the United Nations was obtained, so that more nations could come to the aid of South Korea. Though the immediate result of the America intervention did not go well, the famous Inchon operation by the commander of the American force General MacArthur led to the defeat of the North Korean forces in South Korea. They retreated into North Korea. In spite of disapproval of the Truman administration General MacArthur decided to enter North Korea and inflict a total defeat of North Korea, even if it meant risking war with China. This was the fateful decision that brought China into the Korean War, extending its duration and increasing the number of casualties during the co urse of the war. 2 There is clear evidence to show that had General MacArthur not send American led UN troops into North Korea, China would have kept away from intervening in support of the defeated troops of the North Korea. The Korean War hardly invoked any interest in China. The leaders in China were more concerned with Formosa and the Nationalist forces present there. This clearly indicates that the North Korean provocative action was a decision of their own, for their interests. China woke up to reaction only when there was the threat of American led UN forces invading North Korea, bringing an unwelcome presence of these troops on its borders. Even then it issued enough warnings against such an invasion. The lack of Chinese willingness to become an active participant in the Korean War can be seen by their conveyed willingness of remaining inactive, if the invasion was carried out only by South Korean troops, and would respond only if the invasion force included elements of othe r nations. Unfortunately, buoyed by the success at Inchon, the wrong belief that China would continue not to respond, and false confidence in the might of the American led allied forces, the invasion of North Korea was led by the elements of the American forces that reached the banks of the Yalu River, forcing China to respond to this threat. But for this decision of misadventure, hindsight clearly shows that China would not have entered the Korean War that led to an extension of the war, its intensity, and

Long listening assignment Essay Example | Topics and Well Written Essays - 2000 words

Long listening assignment - Essay Example The signature line of this song involved the simultaneous playing of the tenor trumpet (Dizzy) and the alto Saxophone (Sonny) at a difference of an octave. The octave effect is pronounced all throughout the songs whenever the noted of the opening line notation is played. The opening line is played twice in the beginning of the piece and is used as a closing stanza in the performance. Another noteworthy feature of the opening lines is that when the trumpet-saxophone combination plays the notes the drums, bass and piano remain on mute, and when the trumpet-saxophone goes on mute, the drum, bass and piano repeat the same rhythm. This gives the jazz rendition a question-answer feel, as if the trumpet-saxophone combination was engaged in a conversation with the rhythm section of the jazz band. The opening line also known as the signature phrase or signature line of the jazz composition starts at 0:09 seconds of the video documentary. Dizzy Gillespie and Sonny Stitt are seen taking the cen tre front of the stage, leading the Jazz Quintet. The audience is quiet and well settled and seen enjoying the dextrous rendition of classical jazz of this Quintet. At the back row are the following artistes: pianist Lou, bassist Ray and drummer Gus lined up left to right. The composition is based on medium tempo on duple (4/4 rhythm). The first line is rendered from 0:09 to 0:35 seconds of the video. The signature line is repeated again from 0:35 to 1:05. The rhythm accompaniment begins at 1:00 on the completion of the first stanza or the opening stanza (consisting of 2 repetitions of the signature line). The first solo commences from 1:32. Dizzy Gillespie plays the first solo that sets the expectations from this musical piece. Once Dizzy starts playing the timbre, texture and original tonal quality of the trumpet can be identified. He starts playing from the higher octave. The notes played by Dizzy are clear, bold and distinct from one another. His style represents clarity and con fidence. He does well in varying the amplitude and therefore the emphasis on certain notes by controlling the air pressure through light whistles and hard blows into the trumpet pipe. Dizzy remain calm, composed and relaxed throughout the performance. He takes time from until 2:02 seconds playing with the tempo and at a slow pace. He is seen smiling at the audience and his fellow-performers, turning left to Sonny and saying something to him between 2:00 and 2:03 seconds of the video. He demonstrates stunning control over his instrument at 2:16 playing an impromptu solo, manoeuvring the trumpet keys and weaving a fantastic note progression involving chromatic note progression (i.e., playing consecutive notes to create a dissonance). From 2:35 to 2:45 Dizzy moves along with the rhythm and creates beautiful composition and at 2:46 he plays a dissonant pattern. Once again at 3:16 Dizzy pulls off an incredibly fast and tough solo putting the audience at awe. From 3:35 till 3:40 amplitude modulation is brought out in its best form by regulating the air pressure. Dizzy modulates the pitch and frequency with ease. At 3:46 he gracefully pulls of another sweep of note progression. A gradual descent in the form 4 repetitions down the higher and middle conclude his solo exactly at 4:00 of the video. At this point in time Sonny Stitt takes the centre stage with his solo on the saxophone. The

Ethical considerations Essay Example for Free

Ethical considerations Essay Deception; the participants were not aware that they were taking part in a psychological study about memory until after the study had taken place in order to reduce the risk of bias in the experiment. Afterwards they were informed and were given the opportunity to withdraw their responses without prejudice. They were told that no names would be recorded and that confidentiality was assured of their result. Another risk would be if people then realised the experiment tested memory they could think it was to do with intelligence and worry that they would be judged as stupid if they did not remember many words. This could cause psychological distress to that person and might confirm personal fears of insecurity causing further damage. This could be controlled by warning the participant what the study was going to be about before they did it so if they felt embarrassed or worried about their result they could make a more informed decision not to take part. Results This table shows how many words were recalled by each participant. It shows that the mean average number of words recalled in Condition A was 15.08; 1.59 less than condition B at 16.67. It also allows us to see that 2/3 of the participants recalled more words with classical music playing than they did in silence.  Summary table to show the number of words recalled by each participant in condition A and. Condition B This bar chart shows condition A results in red and condition B in green. From this we can see that both the highest and lowest numbers of words recalled were in condition B. This bar chart clearly demonstrates the difference between condition A and B to vary greatly throughout the experiment.  This pie chart shows the difference between the average scores to be quite insignificant as there is only a 5 % difference which means that although most of the numbers of words recalled did increase from condition a to condition b there was not a big difference when taking into account what their scores actually were and working out the average. I also deduced the range to be 12 for condition A, the lowest/ highest values being 8 and 20, and 17 for condition B, the lowest/ highest values being 7 and 24. The median, however, for both was the same at 16.5. This means there was a wider spread list of values for condition B therefore more variation in how many words people remembered than in condition A.  However the descriptive statistics used above only describe what has been found. In order to suggest the probability of achieving the scores that we did, an inferential sign test was used. A sign test was used as the experimental design was a repeated measures design and the data collected was nominal. When we applied our raw data to the sign test analysis a sign value of 4 was achieved. As this exceeds the critical value of 2, for 12 participants, we can suggest that the raw data achieved is more than 5% due to chance factors and less than 95% due to the manipulation of the independent variable which means our original hypothesis is only partially supported. Discussion From the results obtained in this experiment, we can suggest that our one tailed experimental hypothesis of playing classical music during a memory test will increase the number of words remembered, is only partially supported, in that only 2/3 (66.67%) of participants recall improved when tested with classical music. This was not found to achieve a significant level of probability 0.05, which means that recall was not 95% or more due to the manipulation of the independent variable i.e. whether or not classical music was playing in the background. Therefore on this occasion we must accept our null hypothesis of there will be no significant relationship between whether or not music is played in the background and how many words the participants remember as there was not a high enough probability to suggest that the variation in number of words recalled was a direct effect of the manipulation of the independent variable. In our experiment we found that classical music did improve performance of memory as 2/3 of the participants recall improved. This disagrees with the findings of Cohen whose study suggested that participants who were exposed to background noise were cognitively impaired. Our experiment was similar to Cohens in that it tested the effect of environmental stimulants on recall ability. Cohen, however, tested the participants under exposure to aircraft noise which is much louder and more distracting than a relaxing piece of music such as Mozart. Our findings, therefore, may be more appropriately compared to the findings of Dr. George Lozanov. Lozanov designed a way to teach foreign languages to children in a fraction of the learning time. He did this by teaching whilst using certain 60 beats per minute Baroque music and found that his students had a retention rate of 92% and an accuracy of 85- 100% after only thirty days. The findings of which reflect our own in that he used classical music, with the typical 60 beat per minute pattern, to improve performance of memory in the recollection of vocabulary in foreign languages. However, the percentage of improvement in his experiment was 92%, whereas ours was only 66.67% and therefore shows that his experiment was more accurate than our own However, as our participants were young adults and not children, as in the above, direct and reliable comparisons may not be fully appropriate. This could be due to wider social influences upon adults in relation to children for example a young adult would understand the instructions better and therefore might feel under more pressure to perform than a child. This could have adverse effects and make their performance worse or make them try harder than a child would. Due to this ignorance on the childs behalf, an experiment involving children is often more natural. Also, differences in procedure and experimental design may have led to the difference in findings. For example Lozanov choose to teach foreign languages to children and it has been proven that children have a higher capacity than adults for learning language, as they are not as set in speaking their own language as an adult is. The differences found may have related to this factor and so had an effect upon the data that we achieved. If my experiment had been carried out on children instead I think I would have gotten more positive results due to the above reasons. Other limitations include our choice of method; an experiment is not a natural setting as participants would feel pressurised by the fact that their results were being analysed and might have not been able to concentrate on recalling the words. An improvement could have been a test administered by a normal teacher in a classroom environment, where students would be more used to getting a test and might be more relaxed. This would be unethical, however as it is deceptive. The repeated measures design used meant that the list of words in the second experiment had to be changed because the same participants had seen it in the first experiment and therefore might recall more words after looking at it for a second time. This would have meant the results were inaccurate therefore another list of words was devised. This could however have caused even more problems because, although care was taken not to use more confusing or longer words from one list to another, the experiment was not standardised and therefore direct comparisons could not be made. A matched pairs design would have allowed comparisons to be made between the lists, but not as accurately between the participants, as every participant will be different. The opportunity based sample that I used meant that there werent an equal number of males and females, therefore it wasnt representative. A better sampling technique would be to use stratified sampling, in which equal numbers of the same sex can be selected. If the target population was larger, the sample would have been more representative but we needed to use similarly aged participants, as there would have been difference in recall ability between, for example, a four and an eighteen year old. Using people from our own class could have interfered with the result because the participants knew who they were doing the experiment for and could be biased to the experimenter. Also, I think that using younger participants would have given a more natural element to the experiment, as they would not ask too many questions, worry about the results or interfere as much with the experiment by not trying their best. The participants did not seem to be confused by the standardised instructions but they might not have been clear on why they were doing the experiment, which could have had an effect on their performance. The participants were also talked through the experiment as we carried it out and everything was plainly stated to them. A better way of presentation of the words however, might have been to present them on an over head projector, so that timing could be controlled better; in our experiment, participants were in control of turning over the sheet of paper with the list on and therefore could have turned it over before the test started. The paper was only one sheet thick as well so participants might have been able to see the words even when the sheet was face down. To expand the experiment further, there are many different variables and different aspects of memory which I could test. The serial position effect, mentioned in my introduction, would be an interesting aspect of memory to test as I noticed in the lists of words there were a significant number of words from the start and the end of the actual list, included in the words the participants remembered. We could test this by setting a quota at, say, the first five and last five words and seeing what percentage of the recalled words were within one of these quotas. We could have used a recording of background noise to repeat Cohens experiment or used music with words to test the participants. A really interesting experiment would be to use children against adults in a memory test with the classical music, as I believe children would give a more positive result in relation to my hypothesis. I dont believe that there would be a significant difference between males and females, if any, but it would be worth considering. We could have tested different amounts of words see if there is a difference in capacity of recall between a list of one hundred words and thirty words; would the participants be put off by the amount of words and not remember as many for the long list as the short? There are clearly many different experiments relating to memory that could be tested.

The system development life cycle framework Essay Example for Free

The system development life cycle framework Essay The system development life cycle framework provides a sequence of activities for system designers and developers to follow. It consists of a set of steps or phrases which each phase of the SDLC uses the results of the previous one. Here are some important phases that are essential for developers, Planning, Analysis, Design, and Implementation. These SDLCs are put into place and composed of clearly defined and distinct work phases. These are used by system engineers and system developers to plan for, design, build, test and deliver information systems. The product Life Cycle, is the process for building information systems in a very deliberate, structured and methodical way, originally developed for large scale functional business systems to figure out the life cycle of a program or programs. Here are the following SDLC guidelines that are used,  Preliminary analysis: The objective of phase 1 is to conduct a preliminary analysis, propose alternative solutions, describe costs and benefits and submit a preliminary plan with recommendations. Conduct the preliminary analysis: in this step, you need to find out the organizations objectives and the nature and scope of the problem under study. Even if a problem refers only to a small segment of the organization itself then you need to find out what the objectives of the organization itself are. Then you need to see how the problem being studied fits in with them. Propose alternative solutions: In digging into the organizations objectives and specific problems, you may have already covered some solutions. Alternate proposals may come from interviewing employees, clients, suppliers, and/or consultants. You can also study what competitors are doing. With this data, you will have three choices: leave the system as is, improve it, or develop a new system. Describe the costs and benefits. Systems analysis, requirements definition: Defines project goals into defined functions and operation of the intended application. Analyzes end-user information needs. Systems design: Describes desired features and operations in detail, including screen layouts, business rules, process diagrams, pseudocode and other documentation. Development: The real code is written here. Integration and testing: Brings all the pieces together into a special testing environment, then checks for errors, bugs and interoperability. Acceptance, installation, deployment: The final stage of initial development, where the software is put into production and runs actual business. Maintenance: During the maintenance stage of the SDLC, the system is assessed to ensure it does not become obsolete. This is also where changes are made to initial software. It involves continuous evaluation of the system in terms of its performance. Evaluation: Some companies do not view this as an official stage of the SDLC, but is it an important part of the life cycle. Evaluation step is an extension of the Maintenance stage, and may be referred to in some circles as Post-implementation Review. This is where the system that was developed, as well as the entire process, is evaluated. Some of the questions that need to be answered include: does the newly implemented system meet the initial business requirements and objectives? Is the system reliable and fault-tolerant? Does the system function according to the approved functional requirements? In addition to evaluating the software that was released, it is important to assess the effectiveness of the development process. If there are any aspects of the entire process, or certain stages, that management is not satisfied with, this is the time to improve. Evaluation and assessment is a difficult issue. However, the company must reflect on the process and address weaknesses. Disposal: In this phase, plans are developed for discarding system information, hardware and software in making the transition to a new system. The purpose here is to properly move, archive, discard or destroy information, hardware and software that is being replaced, in a manner that prevents any possibility of unauthorized disclosure of sensitive data. The disposal activities ensure proper migration to a new system. Particular emphasis is given to proper preservation and archival of data processed by the previous system. All of this should be done in accordance with the organizations security requirements. All of the above is necessary for proper end user design of software. If we did not have this process then systems would become obsolete and in efficient. http://csrc.nist.gov/publications/nistbul/april2009_system-development-life-cycle.pdf

The Effects Of Homophobic Bullying Social Work Essay

The Effects Of Homophobic Bullying Social Work Essay The stigma and prejudice attached to homosexuality encourages the perpetuation of homophobic bullying against the lesbian, gay, bisexual and Trans gender (LGBT) youth by their peers. Bullying can take the form of homophobic epithets, sexual harassment and even violence. The class room has been described by social psychologists as the most homophobic of all institutions. This paper examines the effects of homophobic bullying on the physical and mental health of the LGBT youth which is characterized by depression, suicide ideation and engaging in risky behaviors (alcohol and substance abuse). The paper also analyses the buffering effects provided by positive school climate, parental and peer support as well as personal resilience. Keywords: LGBT youth, homophobic bullying, depression, hostile school climate, suicide ideation The Effects of Homophobic Bullying on the Mental and Physical Health of LGBT Youth: The Buffering Effects of Positive School Climate and Parental Support A Review of the Literature In todays permissive society an increasing number of adolescents who are in their early and middle teens (Middle and High school students) have begun to come out of the proverbial closet. However, even in this day and age our society is largely intolerant of deviation from gender norms prescribed by the culture. This makes it especially challenging for lesbian, gay, bisexual and transgender (LGBT) youth who are struggling and trying to come to terms with their sexual identity and orientation. The stigma attached to homosexuality encourages the perpetuation of homophobic bullying against the LGBT youth by their peers. It is a matter of immense concern to the doctors, psychologists and the entire community that there is a high incidence of suicide within this sexual minority group as compared to the heterosexual youth. This literature review focuses on homophobic bullying and its effects on the LGBT youth who are at a challenging stage in life and are struggling with their feelings abo ut sexual orientation and sexual gender. The effects of homophobic bullying on gay, lesbian, bisexual and transgender youth encompass challenges to their psychosocial development, emotional distress an increase in risky behavior (substance abuse), depression and suicide ideation. However, the literature review also highlights the buffering effects of a positive school environment and positive parental relations against negative effects of homophobic bullying. Homophobic Teasing and General Peer Victimization Homophobic teasing, peer victimization and gender non-conformity attitudes are some important mental health issues faced by the LGBT youth as result of their sexual orientation. Homophobic teasing is often long-term, systematic, and perpetrated by groups of students; it places the targets at risk for greater suicide ideation, depression and isolation. Homophobic teasing includes negative beliefs, attitudes, stereotypes and behaviors towards gays, lesbians, bisexuals and transgender youth, and can take the form of verbal and/or physical abuse, and in todays advanced technological age cyber abuse. Peer victimization can take the form of verbal insults, threats of violence, physical assault, and sexual assault (Espelage, Aragon, Birkett Koenig, 2008). A 2009 survey of more than 7,000 LGBT middle and high school students aged 13-21 years found that in the past year, because of their sexual orientation: Eight of ten students had been verbally harassed at school; four of ten had been phys ically harassed at school; six of ten felt unsafe at school; and one of five had been the victim of a physical assault at school (cdc.gov). Challenges to Psycho Social Development According to Erik Eriksons theory of psychosocial development all individuals must master particular developmental tasks during the adolescent years in order to lead productive and healthy lives. These tasks include adjusting to the physical and emotional changes of puberty, forming practical social and functioning relationships with peers, accomplishing independence from primary care takers, preparing for a career, and formation of a unique identity and a set of moral values (McDermott, Roen Scourfield 2008). However, for the LGBT adolescents achieving these developmental goals is challenged by the stress of being part of a stigmatized group. These youth also have to contend with a lack or absence of a support system such as family rejection, social isolation and harassment by peers and feelings of alienation with the school as a result of consistent homophobic bullying. Emotional Distress The social climate of our nation promotes heterosexist attitudes and these views are up held by our social institutions such as families, schools, the church, and government institutions. These prejudiced attitudes result in gay related stress for the LGBT youth who experience a unique set of stressors related directly to being sexual minorities within a heterosexually oriented society. These stressors may be both external (homophobic bullying, family rejection), and internal (internalized homophobia) in nature From the time they are children the youth have been barraged by negative attitudes towards homosexuality and this can lead to the internalization of homophobic sentiments. Internalized homophobia often results in feelings of shame and disgust towards ones sexual orientation which has been reinforced by family and society and can create conflict and dissonance and lead to emotional distress (Rosario Schrimshaw 2002). School Alienation and Lack of Social Support The constant flow of negative information regarding gender non -conformity and homosexuality from figures of authority such as parents, teachers, the clergy, and government officials encourages discriminatory and prejudicial behavior towards the sexual minority group by fellow students. Their heterosexist tendencies are manifested through homophobic bullying, social isolation and violence towards the vulnerable LGBT adolescents. Peer victimization can result in creating a hostile school environment and promotes feelings of alienation from school. An on-line research conducted on 3,450 public and private students (ages13-18) in the U.S found that 88% of the students reported that homophobic remarks were used in the teachers presence and that teachers and staff failed to intervene during these incidents (Espelage 2008). These findings clearly indicate that teachers and staffs failure to intervene encourages and promotes peer victimization and homophobic teasing and creates and sustains a hostile environment for lesbians, gays, bisexuals and transgender youth. Having a strong social support system (family, peers, and teachers) is vital to maintaining mental and emotional health. It works as a buffer against stress; elevates a persons self-confidence and self-esteem; reduces feelings of loneliness and isolation to name a few. Lesbian, gay, bisexual and trans gender youth have lack or absence of a social support system by virtue of their sexual orientation that is negatively sanctioned by the heterosexual society. They face family rejection after coming out, social isolation by their peers, and many adults fear discrimination, job loss, and abuse if they openly support LGBT youth. Thus there is a lack of positive role models and support system which makes it more challenging to cope with the stress produced by stigmatization (Padilla, Crisp Rew 2011). Depression, Substance Abuse, and Suicide Ideation Suicidal ideation is defined as thoughts of engaging in suicide-related behavior. It can range from passive ideation- having the thought but not the intent to active ideation which includes intent as well as a plan to harm oneself. Suicidality has a number of risk factors as well as a number of protective factors. Among LGB individuals there is a higher incidence of risk factors and there are less protective factors in place. There is, for example, a higher incidence of important suicide risk factors such as depression and substance abuse in LGB youth compared to their heterosexual peers. These associations between mood disorders are borne out by research studies (Malley, Posner, Potter, 2008). Also, LGB individuals often experience a lack of support at home and are deprived of positive environments in their schools due to avoidance or bullying. Within the LGB cohort certain factors can affect the risk of suicidality as well-for example the younger the age at which the individual di scloses sexuality the higher the risk of suicide. According to the U.S. Department of Health and Human Services (2007), It has been widely reported that gay and lesbian youth are two to three times more likely to commit suicide than other youth and that thirty percent of all attempted or completed youth suicides are related to issues of sexual identity. The Suicide Prevention Resource Centre (2008) in the United States noted a 1.5 to 7 fold (depending on the study) increased risk of attempted suicide in LGB youth as compared to their heterosexual peers. A landmark study commissioned by the US Secretary of Health found that one third of all sexual minority youth suicides occur before the age of seventeen (Malley, Posner, Potter, 2008). Padilla, Crisp, and Rew (2010) found that in the adolescent population sexual minorities have a much higher rate of drug use with contributing factors including a greater number of psychological stressors and poor social networks. They also noted that when parents accepted the adolescents sexual orientation the impact of life stressors was decreased significantly. Buffering Effects Provided by Parental Support and Positive School Climate and Resilience As mentioned previously there is a greater prevalence of psychological problems and high risk behaviors in LGBT youth then in their heterosexual peers. These include mood disorders, suicidal thoughts and substance abuse. Espelage, Aragon, Birkett and Koenig (2008) and Poteat, Mereish, Di Giovanni Koenig(2011) highlighted the crucial role a support system plays in preventing psychiatric and other behavioral problems in LGBT youth. Two important and beneficial support networks identified were the first of which were communicative and empathic parents and the second affirming and healthy school environments. The presence of both these networks corresponded with a markedly reduced incidence of psychological problems, suicide and substance use compared to individual where there was a lack of these support systems. Parental support and acceptance also seems to foster resilience and improve coping skills. It appears from the review of relevant literature that contrary to popular perception and despite the efforts of most sections of the media as well as many social organizations, general and unconditional acceptance of LGBT individual remains the exception and not the norm. The alienation and stigmatization is achieved through both passive (social ostracization, not standing up for LGBT rights) and aggressive (violence and emotional homophobic bullying) means and is aggravated by the absence of a buffer against these assaults in the form of parental acceptance and positive school environments. These findings do not differ much from those of earlier studies or from studies of other minorities that face prejudices. We know that the problem exists and we have identified the enabling, aggravating and protective factors. What remains to be seen is whether society will show the will to follow words with actions. What may also be beneficial is to conduct larger studies with more statistical power so that the facts can be ascertained with a greater degree of confidence. Annotated Bibliography Center for Disease Control and Prevention (2011, May 19). Lesbian, gay, bisexual and transgender health. Retrieved April 3, 2012, from http://www.cdc.gov/lgbthealth/youth.htm This website provides statistics on the prevalence of homophobic bullying in the schools. Since community psychology focuses on social issues and social institutions it is of particular interest to community psychologists that our sexual minority youth are facing harassment and violence at the hands of these social institutions such as schools, church and governmental organizations. Espelage, D.M. (2008). Addressing research gaps in the intersection between homophobia and bullying. School Psychology Review, 37 (2), 155-58. Homophobic bullying is a pressing and immediate problem facing our community since it affects adolescents who are members of a sexual minority group. One of the fundamental principles of Community psychology is a respect for diversity which includes race ethnicity, gender, sexual orientation and social class. Espelage, D. L., Aragon, S. R., Birkett, M., Koenig, B. W. (2008). Homophobic teasing, psychological outcomes, and sexual orientation among high school students: What influence does parents and schools have? School Psychology Review, 37(2), 202-216. Another fundamental principle of Community Psychology is ecological perspective and multiple levels of intervention. LGBT youth face an increased risk of mental and emotional problems as a result of stigmatization of their sexual orientation. It is of interest to the community psychologist that the youths positive parental (microsystem) and school (microsystem) involvement help as a buffer to negate the effects of stigmatization. McDermott, E., Roen, K., Scourfield, J. (2008). Avoiding shame: young LGBT people, homophobia and self-destructive behaviors. Culture, Health Sexuality, 10(8), 815-829. doi:10.1080/13691050802380974 Since community psychology focuses on social issues and social institutions it is of particular interest to community psychologists that our sexual minority youth are facing harassment and violence at the hands of these social institutions such as schools, church and governmental organizations. Padilla, Y. C., Crisp, C., Rew, D. (2010). Parental acceptance and illegal drug use among gay, lesbian, and bisexual adolescents: Results from a national survey. Social Work, 55(3), 265-275. Community psychologists are interested in the effects of social support on our youth. Since social support has been shown to promote and maintain physical and mental wellbeing and also helps in the development of resiliency in youth who are at risk such as the sexual minority youth. Poteat, V., Mereish, E. H., DiGiovanni, C. D., Koenig, B. W. (2011). The effects of general and homophobic victimization on adolescents psychosocial and educational concerns: The importance of intersecting identities and parent support. Journal of Counseling Psychology, 58(4), 597-609. doi:10.1037/a0025095 Another fundamental principle of Community Psychology is ecological perspective and multiple levels of intervention. LGBT youth face an increased risk of mental and emotional problems as a result of stigmatization of their sexual orientation. It is of interest to the community psychologist that the youths positive parental (microsystem) and school (microsystem) involvement help as a buffer to negate the effects of stigmatization. Rosario, M., Schrimshaw, E. W., Hunter, J., Gwadz, M. (2002). Gay-related stress and emotional distress among gay, lesbian and bisexual youths: A longitudinal examination. Journal of Consulting and Clinical Psychology, 70(4), 967-975. doi:10.1037/0022-006X.70.4.967 Since community psychology focuses on social issues and social institutions it is of particular interest to community psychologists that our sexual minority youth are facing harassment and violence at the hands of these social institutions such as schools, church and governmental organizations. Suicide Prevention Resource Center. (2008). Suicide risk and prevention for lesbian, gay, bisexual, and transgender youth. Newton, MA: Education Development Center, Inc. Community psychology advocates the importance of context and environment because our behaviors are governed by the expectations and demands of given situations. It is vital to study the social environment of the LGBT youth to figure out what interventions can be made in order to prevent suicide within this population.

High Cholesterol :: Health, Dementia, Alzheimers Disease

Evidence is increasing concerning an association among vascular risk factors in midlife with an increased risk of both Alzheimer’s disease and vascular dementia decades later (citation). Diverse studies have found total cholesterol measured in midlife to be a significant predictor of subsequent dementia (Whitmer et al., 2005), mild cognitive impairment (Kalmijn et al., 2000) or cognitive decline (Kivipelto et al., 2001). Total cholesterol on midlife was also associated with Alzheimer’s disease (AD) in some studies (Kivipelto et al., 2001) and especially with concomitant hypertension (Beeri et al., 2009). Meanwhile, the exact mechanism of high blood cholesterol in dementia is not known, because cholesterol is not able to pass the blood-brain barrier (BBB) (Bojanic et al., 2010). Beyond that, observational studies have yielded mix results for lipids levels and cerebrovascular disease risk (Bowman et al., 2003). Of interest, lipid abnormalities have been also implicated in the pathogenesis of ischemic cerebrovascular disease (Demchuk et al., 1999; Goldstein, 2007). Stroke contributes to the development of cognitive disorders in nearly 20% of elderly patients (citation). Stroke related features such as multiple strokes, white matter lesions, left hemisphere infarct location, atrophy, and volume of infarcted tissue are associated with an increased risk of post-stroke dementia (Rasquin et al., 2004). Nevertheless, even though a decrease in cholesterol concentrations with statins can reduce the incidence of stroke in high-risk populations and in patients with a stroke or transient ischemic attack (Amarenco et al., 2006), serum cholesterol traditionally has been considered a poor predictor of total stroke risk (Ansell, 2000) and epidemiological evidence has failed to demonstrated a clear relationship between the risk of stroke and serum cholesterol levels (citation). Mild cognitive impairment (MCI) refers to the transitional state between the cognitive changes of normal aging and very early dementia (Petersen and Negash, 2008). MCI is defined as memory deficits with preservation of other cognitive and functional brain activities (Nestor et al., 2004). However, whether the MCI results from neuronal loss within circuit-specific pathways involved in learning and memory (Verkhratsky et al., 2004) and/or from cerebrovascular deregulation within these pathways (Iodecola et al., 2004) remain debatable. The aim of the current study was to determine whether a cognitive impairment associated with elevated plasma cholesterol levels over aging is related with structural pathology or white matter disease (vascular lesions?

Vanity Fair :: Essays Papers

Vanity Fair Vanity Fair, though it does not include the whole extent of Thackeray's genius, is the most vigorous exhibition of its leading characteristics. In freshness of feeling, elasticity of movement, and unity of aim, it is favorably distinguished from its successors, which too often give the impression of being composed of successive accumulations of incidents and persons, that drift into the story on no principle of artistic selection and combination. The style, while it has the raciness of individual peculiarity and the careless case of familiar gossip, is as clear, pure, and flexible as if its sentences had been subjected to repeated revision, and every pebble which obstructed its lucid and limpid flow had been laboriously removed. The characterization is almost perfect of its kind. Becky Sharp, the Marquis of Steyne, Sir Pitt Crawley and the whole Crawley family, Amelia, the Osbornes, Major Dobbin, not to mention others, are as well known to most cultivated people as their most intimate acquaintances in the Vanity Fair of the actual world. It has always seemed to us that Mr. Osborne, the father of George, a representation of the most hateful phase of English character, is one of the most vividly true and life-like of all the delineations in the book, and more of a typical personage than even Becky or the Marquis of Steyne. Thackeray's theory of characterization proceeds generally on the assumption that the acts of men and women are directed not by principle, but by instincts, selfish or amiable--that toleration of human weakness is possible only by lowering the standard of human capacity and obligation--and that the preliminary condition of an accurate knowledge of human character is distrust of ideals and repudiation of patterns. This view is narrow, and by no means covers all the facts of history and human life, but what relative truth it has is splendidly illustrated in Vanity Fair. There is not a person in the book who excites the reader's respect, and not one who fails to excite his interest. The morbid quickness of the author's perceptions of the selfish element, even in his few amiable characters, is a constant source of surprise. The novel not only has no hero, but implies the non-existence of heroism. Yet the fascination of the book is indisputable, and it is due to a variety of causes besides its mere exhibition of the worldly side of life.