Medicine and Pharmacology Essay Example | Topics and Well Written Essays - 4750 words

Medicine and Pharmacology - Essay Example Mefloquine HCl is available as 250-mg tablets (equivalent to 228.0 mg of the free base). The presence of food significantly enhances the rate and extent of absorption. About 98% of the drug binds to protein. Mefloquine is excreted mainly in the bile and feces; therefore, no dose adjustment is needed in persons with renal insufficiency. The drug and its main metabolite are not appreciably removed by hemodialysis. No special chemoprophylactic dosage adjustments are indicated for dialysis patients to achieve plasma concentrations similar to those in healthy persons. Pharmacokinetic differences have been detected between various ethnic populations. In practice, however, these are of minor importance compared with host immune status and parasite sensitivity. In patients with impaired liver function, the elimination of mefloquine may be prolonged, leading to higher plasma levels (U.S.A Food and Drug Administration Guide for Larium 2003). Mefloquine should be used with caution in individuals participating in activities requiring alertness and fine-motor coordination e.g., driving, piloting aircraft, operating machinery, and deep-sea diving. If the drug is to be administered for a prolonged period, periodic evaluations are recommended, including liver function tests and ophthalmic examinations. Sleep abnormalities such as insomnia, abnormal dreams have occasionally been reported. Psychosis and seizures occur rarely; mefloquine should not be prescribed to patients with neuropsychiatric conditions, including depression, generalized anxiety disorder, psychosis, schizophrenia, and seizure disorder. If acute anxiety, depression, restlessness, or confusion develops during prophylaxis, these psychiatric symptoms may be considered prodromal to a more serious event, and the drug should be discontinued (Weinke et al., 1991) Importance of the drug and relevance to the topic Mefloquine given 250 mg of salt weekly in an adult dose has been the antimalarial prophylactic agent of choice for much of the tropics because it is usually effective against multidrug-resistant falciparum malaria and is reasonably well tolerated. Mild nausea, dizziness, fuzzy thinking, disturbed sleep patterns, vivid dreams, and malaise are relatively common. Although rare, due to its potential increased use, the occurrences of neuropsychiatric side effects have come into attention. Approximately 1 in every 10,000 recipients develops an acute reversible neuropsychiatric reaction manifested by confusion, psychosis, convulsions, or encephalopathy. Therefore questions arise whether this should be used. This is a debatable issue, and it would be worthwhile to find out research evidence on this topic (Steffen et al., 1993). Review of Literature Mefloquine is the most effective medicine in the prophylaxis and treatment of malaria. However, neuropsychiatric side-effects can more often be seen with the use of mefloquine compared to other anti-malaria drugs. Murai et al. (2005) studied the neuropsychiatric symptoms caused by mefloquine on report from several cases. After analysis of the data the authors assume, that besides the

Business Plan Essay Example | Topics and Well Written Essays - 750 words

Business Plan - Essay Example 5. Increase charity from 0.5 of total profits to 5% in 4 years. SWOT Analysis: Strengths 1. Company attends to its corporate social responsibility by doing charity work. 2. PPQ is in par with the industry’s average profit margin for the last 3 years. Weaknesses 1. High employee turnover rate. 2. The market share of 5% is just fair. Opportunities 1. Japan’s increasing need for auto parts industry companies after the tragedy last March 2011. 2. More females are using SUV cars and market share of SUV type is increasing. 3. One of Japan’s road to recovery is to boost employment. Threats 1. There are low cost countries such as India, China, and even Korea that are already competing in this industry that could possibly be one of the leading players in SUV cars in the future. 2. Costs for new facilities that will be built when entering a new location. Alternative Courses of Action/Analysis of PROs and CONs 1. Build new facility in Japan and continue with its operations in US. Advantages: The latest tsunami tragedy that happened in Japan made other existing companies close out and this is an opportunity for PPQ to lead the industry in Japan. Since PPQ attends to its corporate social responsibility, opening a facility in Japan would be an opportunity to provide jobs to families there. PPQ will be able to gain revenue while also helping people have jobs. Japanese employees are most likely to be more cohesive as compared to their existing employees since they are recovering from their recent tragedy encounter. Disadvantages: The industry in Japan is starting up again and so competing globally may somehow be difficult. Continuous operations in US would mean that PPQ has to work on building their loyalty from their employees so as to increase employee turnover. 2. Build new facility in one of the following countries: India, China or Korea where industry is already growing and continue its operations in US. Advantages: There are more buyers in the said c ountries especially that the SUV industry is heating up in China. Disadvantages: PPQ has to cope up with the existing companies established in any of the said countries. The SUV industry which is growing could also mean that there are several competitors already. Continuous operations in US would mean that PPQ has to work on building their loyalty from their employees so as to increase employee turnover. 3. Focus on opening new facilities in different locations and close its US location since there is very high employee turnover rate already. Advantages: PPQ would no longer need to invest on time, effort and costs on winning their employee loyalty in US region if they will be giving up the said location. Disadvantages: Possible risk will be encountered since PPQ will be investing in a very new location which it has not made operations yet. It will not have another location as a backup or to exchange parts with just in case there is a shortage in the new location. Recommendation It i s recommended that PPQ take ACA#1 which is to invest in Japan to pursue on entering the SUV industry of the said country and work on making it grow there. It should also continue with its current location in US right now and decrease its employee turnover rate. The US location has always been PPQ’s home headquarters and so the company knows the business in the region, the market share and average revenue of PPQ in US is

Nashville urban plan Essay Example | Topics and Well Written Essays - 1500 words

Nashville urban plan - Essay Example For this to happen, Nashville must be planned in a manner that ensures that there are enough infrastructural facilities such as roads, enough housing, electricity, stadium, water and sewerage facilities. In addition, there must be enough social facilities in the city such as hospitals, schools, and religious places, as well as recreational facilities. It is only in so doing that Nashville will be able to restore its former glory and be competitive with the rest of the cities in the world. After having conducted a feasibility study in Nashville, it became apparent that Nashville lugs behind because of poor planning. For instance, Prestige Worldwide found out that the road network is a big problem in Nashville. This is because there are few roads that link the city to the rest of the country. This inconveniences communities as they take long on the roads as noted by Parfect, Power, and Ldr International (62). Furthermore, the few roads available are very narrow thereby causing traffic jams to build up very fast. As a result, people spent too long on roads either to or from Nashville. Therefore, as city planners, we have proposed the construction of bypasses to help ease congestions and reduce the traffic jams. At the same time, we have also come up with a strategy to expand the size of the roads leading into the city from its current single lane to eight dual carriages. At the same time, we shall ensure that all roundabouts causing a buildup of traffic jams to and from the city during rush hours are replaced with flyovers, which will see some cars pass from above. Certainly, this will help reduce the traffic menace currently being witnessed in Nashville. A feasibility study conducted by Prestige Worldwide also found out that public transport is a big problem in Nashville. This is because the city has a high number of people commuting from the city outskirts to the town center while there are few available means of public transport (Parfect, Power, and Ldr Interna tional 68). As a result, we intend to solve this problem by establishing both a subway and railway system. As such, we strongly believe that trains will help sort the problem of public transport in the city. The trains will be electric powered and will have a terminus at different locations where commuters will be picked at dropped. Smith and Zepp (16) reveal that Nashville is among the fastest growing cities in the U.S. with its population having doubled over the last century. In spite of the population growth, Nashville has not had enough housing structures to accommodate the growing population. This has resulted in the development of ghettos in the city. However, as the planners of the city, we have proposed the demolition of shanties build in the city, which will then be replaced with modern housing structures. We intend to oversee the construction of as many houses as possible so as to reduce the housing problem being experienced in Nashville. A feasibility study conducted with in the cities central business district also showed a lack of proper planning cause’s congestion in the city. This is because there is no pedestrian system connecting important destinations as noted by Faragher (13). As a result, we propose the construction of pedestrian lanes between houses within the central business

Leadership Analysis Paper (Ray Kroc,Mcdonalds Founder) Essay

Leadership Analysis Paper (Ray Kroc,Mcdonalds Founder) - Essay Example He ensured the growth and consistency of production in the company. Notably, McDonalds is the world's largest chain of restaurants based in San Bernardino, California with its first restaurant starting in 1955. The company continued to open other restaurants all over the world where it sells the same brand and quality of the world’s favorite foods, which include Fries and Chicken, Big Mac sandwich, and Nuggets. Today, McDonalds is the world’s leading foodservice retailer. The leadership case of Ray Kroc relates to me since I also worked for McDonalds and I could use his leadership style in my position. Abstract Leadership is one of the dominant aspects in modern life. There are different forms and levels of leadership and thus it is not easy to define leadership. However, leadership involves the ability to establish a long-term policy and influencing others towards the realization of that policy (Bennis, 2009, p.1-8). Leadership requires leadership skills which are eith er taught or acquired and may have formal powers to exercise their mandate. Notably, leadership is very subtle in any organization and the leaders have unique responsibilities over their followers (Bennis, 2009, 147-149). This paper will analyze the leadership practices of Ray Kroc who was the founder of the McDonalds. In doing this, the paper will rely on theories covered in this course. Chapter 1: Introduction Ray Kroc was an American entrepreneur whose name is very dominant in the restaurants industry because he was synonymous in propelling McDonald’s to international success where it is now the world's largest chain of restaurants. Ray Kroc was born in Oak Park, Illinois, on October 5, 1902 (Mattern, 2011). Ray Kroc grew and spent the greater part of his life in Oak Park, Illinois. He dropped out of school at an early age 15 years to become a Red Cross ambulance driver in World War I after lying about his age to become an ambulance driver at 15 (Mattern, 2011). After the World War 1, Kroc tried various career options, which included selling paper cups, plying piano, and being a DJ on a local Oak Park radio station (Mattern, 2011). At 20 years of age, Kroc got married. He started selling cups during the day for Tulip Cup Company in 1922 and plays the piano on the radio at night. He worked as a sales representative for 17 years where he rose to become the Tulip’s Midwest sales manager (Mattern, 2011). In this position, Kroc acquired the exclusive rights to a new milkshake machine that could make five milkshakes at once and promoted it across the United States (Mattern, 2011). He got big orders for the new milkshake machine and because of the savings he got from the sales, Kroc approached the McDonald brothers to start a number of restaurants. As a result, he opened two restaurants in Illinois when he was fifty-two years old (Mattern, 2011). He consequently bought the McDonald’

Standardization of Accounting Regulations Essay

Standardization of Accounting Regulations - Essay Example As a result of this, the effect of standardization of accounting must be regarded beyond capital market settings; therefore, these effects should also be examined on other areas, including flows of information, policies and people. Although the way standardization of accounting affects accounting information more especially on the internet is rather vague, these transfers are relatively unstructured and unregulated in current accounting practices. "However, technologies in accounting are legitimizing certain sets of information, and give attention to certain voices in the quest for global attention." (Graham & Neu, 2003) Such a body is the Organization for Economic Co-operation and Development (OECD), it assist the international governments handle tackle the economic, social, and governance challenges of a global economy. They scrutinize government and help examine such performance indicators as laundering, transportation, and pension. Also, they help to review process performance measurements both to observe and to direct government performance. The funding of internet information is provided largely by the U.S Department of Defense in the 1970s and 1980s, for the purpose of developing advance communications networks linking the U.S. militaries and universities, this is shaped by standardized accounting in the development of informational technical infrastructure. "Some other agencies that have helped fund Internet communication, like (The National Science Foundation and the Advanced Research Projects Agency) have also relied on accounting technologies to balance technical and economic goals." (Graham & Neu, 2003) Flow of policy Standardization of accounting has also helped to regulate foreign policies; accounting practices are most times imposed on distant sites. By and through the terms of lending conditionality, the receiving counties are coerced, albeit co-operatively, to adopt and accept mainstream neo-liberal financial policies. This scenario is evident in most third world where they are made to abide by the conditions of the lending countries. And I such cases financial assistance is given by IMF. Accounting technologies make visible certain problems, offer certain solutions, and make these solutions operational. In most cases, practices from international sources are thus mixed with resident financial practices of the country in concern so that the problem could be solved. Ultimately, this flow of policies will produced economic survival. Flow of people The standardization of Accounting has helped to keep track of people as they move from area to area. Movement of people are monitored and analyzed as they cross borders, and accounting is deemed to be a major player in the immigration policies and practices of many countries. For instance, an accounting system which manages loans to immigrants is in operation Canada. Citizenship and Immigration Canada (CIC) makes loans to immigrants in order to assist them in various ways, and such includes transportation, proving admissibility, and general assistance (Government of Canada, 2003, as cited in Graham & Neu, 2003). Thus, the movement of people into Canada are enabled and enhanced by accounting technologies. More also, these people are monito

Informal report Essay Example | Topics and Well Written Essays - 250 words

Informal report - Essay Example They have recorded a steady increase in revenue, gross profit, income used in operation and net income in the past four years. Currently they have standing revenue of $ 476,294 million; $ 118,225 million gross profit; $ 26,872 million operating income and; $16, 022 million net incomes (Wal-Mart). Wal-Mart has over forty senior officers led by Doug McMillon as the President and CEO Wal-Mart Stores, Inc. Its home office is found on 702Sw 8th street Bentonville, in the US. They employ over 2.2 million employees globally. Each time a new supercenter is erected, approximately 300 job opportunities are created. Most employees/ associates begin as hourly associates with between $ 50,000-170,000 as yearly income, but over time get promotion to jobs with more responsibility and higher pays (Wal-Mart). Wal-Mart is, therefore, undoubtedly the best fortune 500 company to consider in this search of a job opportunity. It is a big company that allows for diversity thus can accommodate one’s specialties in the job market along with a promising

Workplace Communication Essay Example | Topics and Well Written Essays - 500 words

Workplace Communication - Essay Example They have communicated their reservation about the O-ring’s potential for failure but as the disaster would tell, they were not able to send their message across effectively. The launch still commenced leading to the explosion of the Shuttle just seconds after the launch. It became clear that the Challenger Disaster was a communication issue as reported by the findings of Roger Commission, the body that was formed by President Ronald Reagan to investigate the explosion. The result of the investigation showed that the people in the telephone conference from Marshal Space Flight Center had different understanding of the message that the engineers were trying to convey which is why the Shuttle was still launched despite of the engineer’s reservation. The Columbia Shuttle flight 107 disaster may have a different circumstance from the Shuttle Challenger but it still ended up in disaster just like its predecessor. The common culprit is again miscommunication. Again, the engineers had expressed their reservation about the foam prior to the Columbia launch. But they were not able to communicate its message to the proper authorities effectively so the launch was still commenced ending in the same tragedy. Both the tragic stories of Space Shuttle Challenger and Columbia taught me the importance of not only communicating my message clearly and completely, but I should also consider if my messages are reaching the intended audience at a right time and opportunity. This story may be funny but sometimes working with senior citizens in the office can have humorous implications. I took a summer job before and this is where my experience happened. Our boss can already be considered as a senior citizen but he is still brisk at work. One time, I was asked to write a report for a monthly meeting which I happily obliged. I gathered all my data at the office and told my boss that I will have it done by the weekend and will send

Reading Kafka Essay Example for Free

Reading Kafka Essay Reading Kafkas The Trial, especially for the first time, we often experience a blend of precision and obscurity; words, sentences, and single events are clear in themselves, but are linked to each other in ways we cannot always grasp. The blend of precision and obscurity is one of the most remarkable aspects of the style in which The Trial is written. The device is used constantly and consistently throughout the novel, and we assume that it is used like all other stylistic devices, i. e. to throw an aspect of the novel into relief. In an attempt to determine, if possible, what this aspect is, follows a detailed analysis of two paragraphs on pages 159 to 160 that I deem to be characteristic of the blend of precision and obscurity. In the two paragraphs, detail and precision interact with each other to produce a blend. Almost all descriptions are quite in depth, such as the description of the old woman wrapped in a warm shawl, yet these detailed descriptions are not connected with anything else in the book. The old woman does not reappear anywhere else in the book, and no symbolism, hidden meaning or reference becomes apparent after having analyzed the description. In more conventional novels, almost every character that appears is in some way, whether clear or obscure, connected with the main plot or a sub plot. Not so with The Trial. The old womans importance and connection, if indeed there is one, remains open to speculation: perhaps she belongs to the court, perhaps the scrap of what looked like carpet that K sees in the same paragraph comes from her warm shawl, perhaps this enigma is simply a device used by Kafka to confuse the reader. The possibilities and perhapses stretch on into infinity until they are lost in the obscurity of the cathedral. Kafka describes an object, person, or concept in great detail, with very few omissions in order to give the described every semblance of reality, but the meaning of the described is left completely open to the reader. This is the particular blend which casts its mottled shadow on the novel. A possible interpretation of this presence of this blend would be to say that it serves to give the novel a dreamlike, surreal quality. One knows from ones own dreams that certain aspects remain crystal clear in our memory, yet one can almost never remember for sure what the aspects role in the dream was. It is the same way with the blend: an aspect may be clear, but the rest is hazy. Supporting this interpretation would be the fact that K cannot read: he opens his album and looks through the pages for a while, probably only looking at the pictures without reading the text, and eventually has to stop this futile exercise ostensibly because it is too dark. The dream interpretation would also explain the randomness of events, objects, and people. Since the subconscious is left to work unrestricted in dreams, the products can be quite random and utterly impossible to link together or make sense of using logical means. The blend could also be viewed as a method to accentuate the confusion and plunge the reader yet deeper into the obscurity. In the second paragraph, when the candles have been lit, Kafka states that the candles only made the darkness more intense. If the candles and light are taken to represent precision and the darkness obscurity, then Kafka is clearly showing why he has worked the blend in to the novel. It is impossible to judge anything unless one compares it to something else. It is by contrast that we determine what is what. If one is constantly in the dark, one will not consider it dark, because one has become accustomed. Perhaps the candles of precision are there to throw the confusion and the haziness into sharp (or hazy? ) relief. Kafka only allows in any light so that the reader can see that he is bathed in darkness and confusion, and be attracted to the light. However, when the reader reaches the light he realizes the light is hollow as well: it is only aesthetically different from the darkness. In the second paragraph Joseph K. examines an altarpiece with his electric light. K. sees a Knight and looks at it for a considerable period analyzing it in detail without really understanding what the Knight is doing, nor why he was there. However, when K. shifts his light to see the rest of the picture, he realizes that the Knight is only a small piece of a conventional treatment of Christs burial. The parallel between K. and the reader is too strong to be overlooked. The reader, while reading the book, is looking through it one page at a time, attempting to analyze details and connect events. It is as if we too are looking at disconnected close-ups of a large picture. Like a picture, the events in the book are non-linear. They can be read any which way and in any order and still retain the same meaning. Kafka is essentially telling us as readers that we ought to shift our lights as K. does so that the whole of the picture is lit. If the reader focuses solely on one precise aspect, the rest of the picture is bathed in obscurity. Kafka, through the device of precision and obscurity, is telling the reader to take a step backwards and view the novel not as a succession of events like other conventional novels, but rather like a picture, where ones eyes and thoughts may rove freely along any lines that they choose. Only then will the whole come into focus. With reference to the last paragraph, I have been guilty of doing exactly what Kafka tells us not to do: i. e. analyzing in detail a small part of the text. Thus any conclusion that I may draw from these paragraphs alone are bound to be erroneous. However, draw a conclusion I will. I believe the blend of obscurity and precision is used to immerse the reader completely into the confusion of the text while at the same time advising the reader to take a step backwards. Given Kafkas rather eccentric sense of humor, I think it is quite possible that he believed pulling the wool over the readers eyes was uproariously funny, especially when the wool has directions telling how to lift the wool sewn on the inside, where it is too dark to see.

Management Essay Example for Free

Management Essay Your safety is important, updates have successfully prepared the enclosed form to report identity theft to creditors. Would you mind going to our website to fill out the customer information so that your order can be processed with our new database software? We are now offering RapidAssist, a software program that provides immediate technical support through our website to your employees and customers. To provide better service, a new software named RapidAssist is now offered to provide you with immediate technical support from our website to employees and customers e. To provide you with easy access to the new parking lot, a new restriction policy has been activated for â€Å"A† vehicle permits. The credit union now prohibits the cashing of double –endorsed checks presented by our customers to make sure you don’t suffer monetary losses. Our warranty goes into effect when we have receive the product’s registration card from the purchaser to supply you guaranteed protections. To help better your systems, we will be shutting down both systems Thursday afternoon to install upgrades. Regarding your request, the items listed above (printer toner and supplies) are being sent to your Oakdale office, referring to your telephone conversation on April 1. Kindly inform the subscriber whether or not your spokesman will be making an appearance in the near future. c. It is outstanding that we still managed the contract after the customer increased his demands, however our manager responded with better transitions. By the way, we had some errors in the schedule but don’t have to erase everything and start from the beginning. To ease the confirmation of this agreement, your negotiators push that the membership respond in the favorable. Our head manager was upset because I was sick in the time of the team meeting.

Early Occupational Therapy Intervention for Schizophrenia

Early Occupational Therapy Intervention for Schizophrenia The Potential value of Early Occupational Therapy Intervention  for Adults with Schizophrenia. Introduction (approx 250 words) In this discussion, we would stress on the importance of occupational therapy in the treatment of schizophrenia and in vocational rehabilitation of schizophrenic adults. The discussions begin with examining the causes and aetiology, prognosis and diagnosis of schizophrenia, the symptoms involved and the general outlook of the treatment. We look at stress factors, genetic vulnerability, deformities in the brain, chemical imbalance in hormones and neurotransmitters in the body, faulty neural connections, increased or decreased size of brain parts, viral infections at foetal stage and pre and post natal complications that can all contribute to schizophrenia. The clinical manifestation of the disease usually shows early onset in male adults and schizophrenia is rare in children and elderly persons. Symptoms of the disease show the presence of hallucinations, delusions, disordered and bizarre thinking, social isolation and extreme suspicion. The various types of intervention programs for treatment and care of schizophrenia are then discussed and these range from pharmacological interventions to psychotherapy such as cognitive behavioural therapy and occupational therapy, family and psychosocial interventions. The different types of interventions including psychological, occupational and clinical have been suggested by the NHS and Department of Health and the role of mental health services has been stressed. The guideline issued by the National Institute for Clinical Excellence (NICE) suggests the need for care across all stages of the disease with medical attention at the initial acute stage of the disease. Treatment of acute episodes promoting reduction of symptoms and application of tranquilizers have been identified as essential and we discuss in detail the importance of occupation and the role of occupational therapists in aiming to restore a healthy life for schizophrenics. Chapter 1 (approx 1200 words). Aetiology of schizophrenia – Several Factors The cause of Schizophrenia has not yet been conclusively established and several causes have been proposed. The interplay of genetic, behavioural, social and physiological factors may be responsible for the onset of the condition. Changes or deformities in the brain have been held responsible for development of schizophrenia although genetic factors are also important. Schizophrenia seems to run in families and a child born in a family with history of schizophrenia is 10 times more likely to develop the disease than anyone in the general population. Multiple genes are involved in developing a predisposition for schizophrenia although prenatal difficulties like intrauterine starvation or viral infections, peri-natal complications, and various non-specific stressors, seem to influence the development of the condition. However the mechanism of genetic transmission of the disease has not yet been established. Identification of specific genes in the human genome is underway and the strong est evidence suggest chromosomes 13 and 6 are responsible for susceptibility to schizophrenia. Some evidence that schizophrenia is related to imbalance in chemical systems of the brain suggests that neurotransmitters dopamine and glutamate are linked to the onset of the disease. Neuro-imaging studies have found abnormalities in the brain structure of schizophrenics with decreased or increased size of brain parts. However these brain abnormalities are not just present in people with schizophrenia nor are they common for all schizophrenics suggesting that these abnormalities may not have definite links with the disease. The National Institute of Mental Health (NIMH) has categorised schizophrenia as a developmental disease resulting when neurons form inappropriate connections in the foetal stage of development. However these faulty connections can remain dormant and tend to affect only after puberty when changes in the brain seem to get adversely affected by these dormant faulty connec tions. Certain biochemical changes have been found through brain imaging techniques as preceding the onset of disease so changes in neural circuits as well as molecular changes exploring the genetic basis of brain abnormalities have all been linked as causes of schizophrenia. Recent studies have proved that schizophrenia and other mental ailments are caused by a combination of inherited genetic factors and external environmental factors and all current theories such as the chemical imbalance theory, genetic vulnerability theory, stress and vulnerability theory and complex disease theory reach similar conclusions. The two factors – genetic vulnerability and environmental vulnerability or stress and their effects on the body and brain have been found to play important role in Schizophrenia. Excessive stress, for example can trigger the release of certain hormones and result in increased levels of cortisol in the brain. Excessive cortisol in turn destroys nerve cells in the hippocampus that are responsible for memory and coordinating daily and complex tasks. The NHS emphasises that much of the available research on the aetiology of schizophrenia is consistent with a ‘stress-vulnerability‘ model of the illness (Nuechterlein Dawson, 1984 cited in NHS, 2005),a model which arguably has the greatest utility in integrating current biological,psychological and social findings. This paradigm suggests that individuals possess different levels of vulnerability to schizophrenia, which are determined by a combination of biological, social and/or psychological factors. It is proposed that vulnerability to schizophrenia will result in the development of problems only when environmental stressors are present. If the vulnerability of an individual is sufficiently high, relatively low levels of environmental stress might be sufficient to cause problems. If the vulnerability is much less, problems will develop only when higher levels of environmental stress are experienced. The model is consistent with a wide variety of putative causes of the disorder, as well as the differential relapse and readmission rates observed among people with schizophrenia (NHS report, on Schizophrenia 2005). 1.2 Clinical Presentation of Schizophrenia Early Onset. Schizophrenia is a disabling and chronic mental ailment and has been related to brain disorder. The disorder appears earlier in men and usually affects women later in life. The vulnerable age for the disease is late adolescence to early adulthood in most men and affects men of age 16 to 30 years and women in their late twenties to early thirties. The disease is marked by early onset and is rarely found in older men or children, although such cases of very early or late schizophrenic acute phases have been reported. The disease once affecting an individual can cripple him for a lifetime. People with schizophrenia can have delusions and hallucinations and can even be paranoid that leave them fearful, suspicious and withdrawn. They may be incomprehensible or disorganised in speech and actions and lead a life completely isolated and excluded from social interactions (Schretlen et al. 2000). In most conditions they lose contact with reality and their repeated, meaningless and sometimes wi thdrawn and sometimes aggressive behaviour can be frightening to other individuals. The onset of schizophrenia is marked by withdrawal and shocking changes in behaviour and is accompanied by hallucinations, delusions, paranoia and false personal beliefs and unreal experiences (WHO, 1980). Social isolation and unusual speech or thinking are found in this acute phase of the disease. Chronic schizophrenic symptoms or a continuing or recurring pattern of illness in a patient signifies the necessity for long term treatment including medication and the patient may even fail to recover normal functioning. 1% of the population has been found to have this disease and the NHS and WHO give a statistical data on schizophrenia and we will be providing here. Sometimes people with symptoms of schizophrenia may show depressive mood or bipolar disorder and in some cases individuals may be diagnosed with schizophrenia like symptoms also known as schizoaffective disorder. 1.3 Early Intervention Service Occupational Therapy (Core Skills). Comparing the effectiveness of skills training with occupational therapy, Liberman et al (1998) studied community functioning of outpatients with persistent forms of schizophrenia after the patients were treated with psychosocial and occupational therapy or given social skills training conducted by paraprofessionals. For the study 80 outpatients with persistent schizophrenia were randomly selected and received psychosocial occupational therapy or skills’ training for 12 hours every week for 6 months and this was followed by 18 months of case management in the community. Antipsychotic medication was also given by psychiatrists. The results of the study indicated that patients who received skills training showed greater independent living skills during a 2 year follow up of everyday community functioning. Liberman et al concluded that skills training can be effectively conducted by paraprofessionals with durability and generalization greater than that achieved by occupational th erapists who provide patients with psychosocial occupational therapy. Whitwell (2001) discuss early intervention as a strategy in the treatment of mental illness carried out by specialised and innovative projects and approaches. Early intervention approaches have grown rapidly in the last decade as it has been observed that schizophrenia reaches a peak of severity after 2-5 years of its onset and after this the disability remains the same or decreases , also known as the ‘plateau effect’ (McGlashen 1988). Most people remain untreated for the first 1 or 2 years of the onset of illness and when left untreated, the illness set out biological, psychological and social processes that add to the chronicity of the illness and the illness may actually become toxic triggering chemical changes in the brain. The ‘critical period’ hypothesis or the necessity to intervene and treat the condition early is essential for developing newer insights into the nature of the illness (Birchwood et al 1998).Early intervention is the strategy for trea ting psychotic illnesses during its early stages of development, involving shortening the duration of untreated psychosis and may also involve intervention even before the psychosis develops. Early intervention with flexible and assertive approach on the part of occupational therapists is important in full recovery or prevention of the disease. Chapter 2 (approx 2500 words), To evaluate the effects of schizophrenia on the individuals occupational performance 2.1 The Occupational Nature of Humans. Occupation of a human being refers to the role a person plays or an activity through which a person earns money or livelihood. With the emergence of occupational science and the realisation of health benefits of occupational engagement, there is a necessity for increased research into the occupational nature of humans. Chugg and Craik (2002) argue that engaging in occupations have a positive effect on an individual’s health and sense of well being, although in schizophrenia there is a decreased volition and reduction in occupation with lowered performance. Their study focused on the influences on occupational engagement for people with schizophrenia living in a particular community. They used semi-structured interviews and qualitative analytic approach. 4 male and 4 female participants aged 23 to 49 years described their occupational engagement and the associated influences. Content analysis along with coding was used to categorise the data and four main themes on health, rout ine, external and internal factors emerged from the study. The specific factors identified within these themes are medication, daily schedules, family, staff, work, self concept and life challenges. The role of occupational therapists to influence clients with schizophrenia to engage more successfully in occupations has been highlighted in the study. Wilcock (1999) claim that the relationship between occupation and health and well being of an individual is very complex and can be described in many ways. Wilcock claims that the definition of occupation that appear to appeal a wide range of people is a synthesis of doing, being and becoming. Wilcock reflects on a dynamic balance between doing and being which is central to healthy living and wellness and suggests that becoming what a person or a community is best suitable for is dependent on both the doing and the being. Doing is what Wilcock suggests, the synonym for occupation and it is not possible to envisage a world without occupation showing the importance and central role of the occupational nature of humans. Being is represented by notions such as nature and essence and encapsulates being true to ourselves and individual capacities in all that we do. Becoming adds to this an element or sense of future and holds in it the notions of transformation and self actualization. Wilc ock emphasises that becoming helps in actually enabling occupation with ideas on human development, growth and potential. The occupational therapists help people to transform their lives through enabling them to do and to be through the process of becoming. Philosophically, thus doing and being are integral to becoming and to occupational therapy, process and outcomes and Wilcock suggests how best to utilize these in self growth, professional practice, student teaching and learning and help individuals to influence a social and global change for healthier lifestyles. 2.2 Occupational Deficits associated with Schizophrenia Bejerholm et al (2004) suggest that schizophrenia is a complex disorder and has severe impacts in daily life. The human occupational pattern is considered as a product of person-occupation-environment interaction and the importance of exploring all these three factors have been stressed as essential to understand the daily occupational patterns among persons with schizophrenia. Bejerholm’s study used data obtained from 10 schizophrenic individuals and examined their time use reflecting on their daily occupations, social and geographical environments, emotional reactions and reflections on their occupational performance. The results of the study indicated stagnation in a participants’ occupational pattern and time use. The authors suggest that most activities by schizophrenics are not triggered by a facilitating environment but happen due to factors inherent in the person triggered by basic and immediate life needs or simply for the need of escaping reality and seeking s ocial isolation. The paper suggests that occupational therapists are capable of assisting people with schizophrenia to help reshaping the environment and help them to regain roles that involved interacting with the external environment. Breier (1998) claims that schizophrenia is characterised by cognitive deficits in several human domains and involve dysfunction in attention, information processing, memory and executive performance. These deficits are observed in family members of schizophrenics as well suggesting a heritable component in the disease. Cognitive deficits also predate the onset of schizophrenia suggesting that core components of schizophrenia are not secondary to medication side effects or to positive or negative symptoms. Cognitive abnormalities tend to predict occupational and social dysfunction is a major determinant of long term outcome. Breier points out that traditional neuroleptic drugs have been proven to be relatively infective for the deficits and atypical antipsychotic drugs may have cognitive properties. One of these antipsychotic agents, olanzapine increases norepinephrine and dopamine in prefronatal cortex and produces mediated disruption in information processing with mixed effects supp orting cognitive enhancing potential. Breier points out that that some recent trails, olanzapine, risperidone and haloperidol when used in comparative trials in early phases of schizophrenia have suggested that olanzapine demonstrates superiority for a number of cognitive domains over other antipsychotic drugs. Atypical drugs are increasingly used for the treatment of schizophrenia and may play even greater roles in the future. 2.3 The Value of Occupational Performance Occupational therapy helps in assessing and remediation of human performance deficits and closely associated with enhancing occupational performance. Occupational performance is measured as the ability to perform tasks that make it possible to carry out occupational roles in a manner appropriate to an individual’s developmental culture, stage of life, and environment. Functional performance is important to occupational therapy and is required for assessment of a person’s level of functioning and for assessing the efficacy of interventions. Occupational functioning measures can be made at various levels of complexity and occupational therapists need to measure the level at which a mentally disabled individual can work. The WHO classifies mental impairments on a functional hierarchy and provides the initial foundation according to which occupational therapists distinguish levels of functioning for various diseases. Lower levels of impairment signify dysfunction of organs and may not be accompanied by any impairment of functional ability. For example in case of diabetes or a related illness, a dysfunction of the pancreas may not involve impairments in occupational performance. Bio-mechanical and physiological aspects of motor performance are measured with the help of devices although measurements of occupational performance are a bit more complex as they involve an appraisal of abilities which can be measured, representing component parts of occupational performance. The importance of each of the component parts or abilities for measuring occupational performance can vary from one individual to another. Disability would usually refer to the inability to perform any particular physical task although m otivational issues are important as these help to overcome disabilities in a person. The highest level of impairment categorized by WHO is a handicap, in which any disability severely impairs a person from performing a social or physical role successfully. Occupational therapists seek ways in handicap patients and help them to overcome performance deficits. However handicap is more of a socially defined phenomena rather than a quantifiable impaired physical ability and not being able to fulfil a social role is a serve problem faced by mentally ill patients, especially in schizophrenia. Occupational therapists tend to restore the social and psychological involvement to an extent in schizophrenic individuals. The measurement of occupational performance needs to be understood in social and individual contexts as also in the context of individual function and development. 2.4 The Relevance of Occupation Occupational performance can be classified into four types according to the use of occupational performance as a generic frame of reference for national medical practice, as a frame of reference for occupational therapy curricula, as a term for the use of occupational therapists to explain practice and the use of occupational therapy to develop assessment tools. The concept of occupational performance is closely associated with therapy as performance indicated purposeful activity and consisted of areas in care, work and leisure activities. Skills in areas of performance are related life space of an individual and include the cultural, social and physical environment. Occupational performance is based on learning, developmental stages of sensory integrative functioning, social functioning, psychological functioning, cognitive functioning and motor functioning. Based on the framework for occupational performance, a consistent occupational therapy model could be developed and the Canadian Association of Occupational therapy outlined the generic conceptual framework of function for occupational therapy to be followed by clients, in work settings and in modes of practice. In general the notion of occupational performance is affirming the worth of a person as an active participant in his or her therapeutic relationship although this concept gets into difficulty for patients with severe mental ailments. The three areas of occupational performance have been described as self care, productivity and leisure activities and four performance components recognised are mental, physical, socio-cultural and spiritual. Townsend et al stated in achieving occupational performance, each individual both influences and is influenced by his or her environment (1997, p.71). 2.5 Early Intervention of Schizophrenia Department of Health objectives, NHS plan and guidelines of the Mental Health National Service Framework The NHS describes schizophrenia as a mental illness with substantial short and long term consequences for individuals, family, health and clinical services and society. One in hundred people experience schizophrenia in their lifetime with highest incidence of the disease in late teens and early 20s. People with schizophrenia suffer distress and long term disability and there is a lot of accompanied stigma and prejudice involved with the disease that can have negative effects on employment, relationships and life satisfaction. A person’s family is completely destroyed with schizophrenia and carers and family members also carry the burden of the disease and caring the person for a long time. A schizophrenic family member can be a stress to the entire family. Schizophrenia costs the NHS more than any other mental illness and consumes more than 5% of the NHS budget as it is associated with a loss of income causing serious personal, medical, social and economic problems. Stigmatiza tion, and discrimination is associated with schizophrenia and occur in wider society and diagnosis of the disease can have serious implications for a person’s career or social life. Even within the NHS, individuals with schizophrenia can receive substandard no psychiatric care as a result of professional ignorance and prejudice. However guidelines provided by the NHS are essential for improving services and provisions for schizophrenics. The NHS, DH and NICE guidelines for schizophrenia can be given as follows Schizophrenia: Core interventions in the treatment and management of schizophrenia in primary and secondary care, outlines best practice for health professionals caring for individuals with schizophrenia in a range of areas, including: Care across all stages (for example, the importance of working in partnership with service users and carers, and offering treatment in an atmosphere of hope and optimism) Initiation of treatment (for example, the development of early intervention services to provide appropriate care for people with suspected or newly diagnosed schizophrenia) Treatment of acute episodes (for example, the use of antipsychotic drugs as part of a comprehensive package of care that addresses the individuals clinical, emotional and social needs) Promoting recovery (for example, the use of psychological interventions such as cognitive behavioural therapy to prevent relapse and reduce symptoms) Rapid tranquillisation (for example, minimising factors that might increase need for rapid tranquillisation and outlining the principles health professionals should follow) The guideline has been developed by the National Collaborating Centre (NCC) for Mental Health. The recommendations in the schizophrenia guideline given by the NICE (National Institute for Clinical excellence- NHS) cover psychological treatments, treatment with medicines, and how best to organise mental health services in order to help people with schizophrenia. The guideline concentrates on services for adults of working age with schizophrenia and not on schizophrenia in childhood or schizophrenia starting in later life . The guideline also does not cover diagnosis and assessment tools in detail. It outlines the kind of treatment (medicines and psychological therapy) and services are of most help to people with schizophrenia, and whether treatment should be given as an outpatient, by a community mental health team, as an inpatient or in any other mental health service. It also outlines the role of GPs in managing and treating schizophrenia. The Specific aims of the guideline of NICE and NHS on Schizophrenia are given below: Source: NHS report on Schizophrenia treatment and Interventions guidelines Source: NHS, 2005 The NHS report points out that the treatment and management of schizophrenia took place in large asylums in earlier times although government policy initiated a programme to change this practice and this has been largely possible by the introduction of conventional antipsychotic drugs such as chlorpromazine, thioridazine, haloperidol. The NHS mentions several interventions methods such as pharmacological treatment, psychological interventions, service level interventions, primary-secondary care interface, physical health care, and skills training as effective for treatment and support for schizophrenic individuals. We would discuss these methods of intervention in the next chapter. Chapter 3. A Critical Analysis of Early Interventions used by Occupational therapists. 3.1 Psychosocial intervention Mueser and McGurk (2004) define Schizophrenia as a mental illness that is among world’s top ten causes of long term disability. The symptoms of schizophrenia include psychosis, apathy and withdrawal, cognitive impairment and these can lead to associated problems in social and occupational functioning as also problems with self-care. They also give the percentage of affected population at 1% across different countries, cultural groups and sexes. Mueser and McGurk point out that the illness develops between the ages 16 and 30 years and persists throughout the adult’s lifetime. Reiterating that the cause of schizophrenia is largely unknown, the authors claim that genetic factors, early environmental influences and obstetric complications, social factors such as poverty can contribute to the illness. Although pathophysiological differences exist in a wide range of brain structures , no biological alterations are symptomatic or pathognomic of schizophrenia. As for interventi on methods, the authors emphasize that antipsychotic medication is the mainstay for managing schizophrenia although a range of other psychosocial treatments such as family intervention, supported employment and occupational therapy, cognitive behavioural therapy for psychosis, social and skills training, teaching illness self management skills, assertive community treatment and other forms of integrated treatment for co-occurring substance abuse are equally important. In this section we would discuss several intervention methods and approaches highlighting on the three important ones including the broader category of psychosocial intervention, skills training and pharmacologic or medical treatments. Schizophrenia is a chronic disorder that can affect an individual during the early adult years or adolescent period of life. It is usually marked by acute and sometimes frequent relapses. In acute conditions, the main treatment method is controlling the symptoms and this is done with the application and administration of antipsychotic medication, psychotherapy and counselling and a variety of other methods. Antipsychotic medication prescribed by psychiatrists is the most common form of treatment and both older typical medication as well as newer anti-psychotics are used which are usually taken by the patient once in every two to four weeks. Injections given are usually thought to improve effectiveness of medication. Newer atypical anti-psychotics are generally used for acute episodes although there is very little evidence that they prevent relapses. Talking treatments and therapies involve meetings with therapists, general support and advice on illness and some deeper analysis may al so be involved. However certain types of therapies may not be effective treatments of acute symptoms although they may help in particular problems as in vocational rehabilitation or occupational therapy who are helped to learn self help skills and given vocational training or aided to get back to earlier work. Antipsychotic medication is sometimes given in combination with occupational and other types of therapy although these drugs may have many long term side effects. Typical anti psychotics were known to cause disorders in movement although the newer varieties may have other side effects such as weight gain. Talking therapies along with medication can help improve compliance with the antipsychotic medication given and increase general knowledge about the illness making patients more aware of their condition. Patients are usually treated by a team of professionals comprising of psychiatrists, occupational therapists, social workers and nurses. Community psychiatric nurses or CPNs treat outpatients and provide both therapeutic and medical help. Social workers tend to address family problems and related issues. Vocational rehabilitation is given by occupational therapists, psychiatrists give medical help and advice and clinical psychologists usually undertake psychotherapy and engage in talking cure remedial measures. Occupational therapy is skilled treatment helping affected individuals to achieve independence in all areas of life. Occupational therapy he

Harriet Tubman :: Slavery History Biography Essays

Harriet Tubman Harriet Ross Tubman was an African American who escaped slavery and then showed runaway slaves the way to freedom in the North for longer than a decade before the American Civil War. During the war she was as a scout, spy, and nurse for the United States Army. After that she kept working for rights for blacks and women. Harriet Tubman was originally named Araminta Ross. She was one of 11 children born to Harriet Greene and Benjamin Ross on a plantation in Dorchester County, Maryland. She later took her mother's first name. Harriet was working at the age of five. She was a maid and a children's nurse before she worked in the field when she was 12. A year later, a white guy either her watcher or her master smacked her on the head with a really heavy weight. The hit was so hard it left her with permanent neurological damage. In result of the hit she had sudden blackouts during the rest of her life. In 1844 she got permission from her master to marry John Tubman, a free black man. For the next five years Harriet Tubman was a semi-slave. She was still legally a slave, but her master let her live with her husband. In 1847 her master died. Followed by the death of his recipient and young son in 1849. That made Harriet’s status uncertain. In the middle of rumors that the family's slaves were being sold to clear the estate, Harriet Tubman went to the North and freedom. Her husband stayed in Maryland. In 1849 Harriet Tubman moved to Pennsylvania. She returned to Maryland two years later hoping to get her husband to come to The North with her. John Tubman had remarried by then. Harriet did not marry again until after John Tubman died. In Pennsylvania, Harriet Tubman became an abolitionist. She worked to end slavery. She decided to become a conductor on the Underground Railroad (a network of antislavery activists who helped slaves escape from the South). On her first trip in 1850, Harriet Tubman brought her sister and her sister's two children out of slavery in Maryland. In 1851 she rescued her brother, and in 1857 Harriet Tubman returned to Maryland and brought her parents to freedom. Over a time period of ten years Harriet Tubman made an estimated 19 trips into the South and brought about 300 slaves to the North.

Jane Eyre By Charlotte Brontë :: English Literature

Jane Eyre By Charlotte Brontà « Jane Eyre by Charlotte Brontà « was published in 1848, under the name of Currer Bell. Although the novel is over 150 years old, there are still themes that we can relate to today, such as bullying, prejudice and hypocrisy. In this essay, I am going to discuss the three themes mentioned and also consider admirable characters from the novel; the authors narrative technique and the part that I found appealing. The first issue that I will discuss will be on the bullying that Jane received at Gateshead Hall: the home of her Auntie and cousins. She is bullied by not just her cousins, but her aunt as well. In Chapter one, it shows the bullying from her cousins and aunt, when she has begun reading and John Reed, her cousin, throws the book at her head, and she retaliates. But because she retaliated, John's sisters ran up to their 'mamma' and blamed the fight on Jane. She was then escorted upstairs and locked in the red room. This could be counted as a form of bullying, as she only puts her in the red room as a punishment for attacking John, but we, the readers, already know that John started all of the commotion. Verbal bullying is also used in chapter one, where John Reed calls her names for throwing a punch at him (QUOTE: CHAPTER1/LINE 16: "I don't very well know what I did with my hands, but he called me 'Rat!, rat! ') During Jane's First term at Lowood, Jane is bullied out of food, when there was very little and the older girls wanted some more food to devour. Jane Eyre is a first-person narrative, related in the voice of the protagonist, or heroine. Jane Eyre is the "I" of the story, the person whose voice we hear as we read, and everything that happens is seen from her point of view. Nowhere in the novel does the author break the flow of the narrator's voice to give us an objective view of her main character. However, she does remind us once in a while that the story is being told by Jane as a mature woman, looking back on events that happened some years earlier. The mature Jane occasionally comments on the younger Jane's reactions to those events, and sometimes she even addresses you, the Reader, directly. You'll also find occasions where her narrative includes long stories told to Jane by other characters (such as Rochester's accounts of his past), conversations that Jane overhears between other characters, and even accounts of Jane's dreams. These not only add variety to the style but give the reader a Jane Eyre By Charlotte Brontà « :: English Literature Jane Eyre By Charlotte Brontà « Jane Eyre by Charlotte Brontà « was published in 1848, under the name of Currer Bell. Although the novel is over 150 years old, there are still themes that we can relate to today, such as bullying, prejudice and hypocrisy. In this essay, I am going to discuss the three themes mentioned and also consider admirable characters from the novel; the authors narrative technique and the part that I found appealing. The first issue that I will discuss will be on the bullying that Jane received at Gateshead Hall: the home of her Auntie and cousins. She is bullied by not just her cousins, but her aunt as well. In Chapter one, it shows the bullying from her cousins and aunt, when she has begun reading and John Reed, her cousin, throws the book at her head, and she retaliates. But because she retaliated, John's sisters ran up to their 'mamma' and blamed the fight on Jane. She was then escorted upstairs and locked in the red room. This could be counted as a form of bullying, as she only puts her in the red room as a punishment for attacking John, but we, the readers, already know that John started all of the commotion. Verbal bullying is also used in chapter one, where John Reed calls her names for throwing a punch at him (QUOTE: CHAPTER1/LINE 16: "I don't very well know what I did with my hands, but he called me 'Rat!, rat! ') During Jane's First term at Lowood, Jane is bullied out of food, when there was very little and the older girls wanted some more food to devour. Jane Eyre is a first-person narrative, related in the voice of the protagonist, or heroine. Jane Eyre is the "I" of the story, the person whose voice we hear as we read, and everything that happens is seen from her point of view. Nowhere in the novel does the author break the flow of the narrator's voice to give us an objective view of her main character. However, she does remind us once in a while that the story is being told by Jane as a mature woman, looking back on events that happened some years earlier. The mature Jane occasionally comments on the younger Jane's reactions to those events, and sometimes she even addresses you, the Reader, directly. You'll also find occasions where her narrative includes long stories told to Jane by other characters (such as Rochester's accounts of his past), conversations that Jane overhears between other characters, and even accounts of Jane's dreams. These not only add variety to the style but give the reader a

Mohandas Ghandi Essay -- essays research papers

Mohandas Ghandi was the source of many changes throughout, India, Britain, and the world. With all that Ghandi has done in our world it becomes overwhelming when I think about his life. What Ghandi did in terms of opening the minds of the people of India is almost analogous to what Christ did to open the minds of the people around him. With all that can be said about Ghandi, I would like to focus upon his economic impact in Britain and India. Britain’s self-glorifying empire building was a great hindrance on the Indian economy. Britain employed the “Mother Country'; system in Indian. This is where the raw materials of the colony (i.e. India) are harvested and shipped to the Mother country (i.e. Britain.) The raw materials are manufactured into goods that are shipped b...