Serial Position Effect

Serial Position Effect Introduction Serial Position Effect describes a situation where the ability to recall items in a list varies as the position of an item on the list changes. It states that items at the start of the list and at the end have a higher chance of been remembered as opposed to items in the middle. Primacy Effect is the tendency to remember an item in the beginning of serialized items.Advertising We will write a custom essay sample on Serial Position Effect specifically for you for only $16.05 $11/page Learn More On the other hand, the ability to recall items at the end of a list is called Recency Effect. Reasons have been developed to explain this phenomenon. However, the earliest reason for Primacy Effect is long In real life, Serial Position Effect is quite possible. It is easier to remember items in the beginning and end of a list. However, this may be because of the emphasis that individuals place on these two places. In games, in school and all competitions, persons at the beginning of a list are lauded and those in the end perceived weakly (Neely LeCompte, 1999). In the English Premier League, it is always quite easy to remember the first teams. Additionally, it is easier to recall teams at the end. While teams that win this competition win the English Premier League trophy, teams that eventually finish at the tail end are punished by relegations.Advertising We will write a custom essay sample on Serial Position Effect specifically for you for only $16.05 $11/page Learn More Hence, it is actually a real life thing to engage those two places in a list. The majority of the teams that lie in the middle do not get any limelight. This is because their position is perceivably irrelevant according to Neely LeCompte (1999). Reference Neely, C.B. LeCompte, C.D. (1999). The Importance of Semantic Similarity to Irrelevant Speech Effect. Memory and Cognition, 27(1): 37-44. Available at https://link.springer.com/article /10.3758%2FBF03201211#page-2

Definition Essay on Racism

Definition Essay on Racism Definition Essay on Racism When writing an essay on racism, you will be expected to share your special understanding about the issue of racism in more than just a sentence. With this type of essay, you should not rely on common definitions from dictionaries or encyclopedias, but you should base your essay on a deeper level of understanding. Tolerance is of foremost importance when you one sets to composing an essay concerning racism or similar topics. Select the words and expressions very carefully not to insult someones feelings or beliefs, as – you know – sometimes the words may hurt really in a severe way. The first thing you should do is select the topic of your paper. Make sure you select an abstract word or phrase with a complex meaning so that you will have the opportunity to tackle it from many perspectives. It will also be easier for you to create the content to complete this type of essay paper. If you select an easy topic, chances are you will be done with the essay definition in a sentence of two, and the other sentences will be what you intentionally include for the purpose of completing the content. However, if the word or phrase you define is straight-forward and simple, it may be challenging to make the essay paper interesting, but if the topic is a disputable one such as racism, then you will have many opportunities to play around with the words and end up with an interesting essay paper. Racism is something that means different things to different people and this gives you the chance to explore several meanings of the word. Then, you could even state which definition you think is best out of the many available. Just be sure that, with a definition, you analyze words to come up with a unique definition. If the definition you end up writing in your essay paper is one the reader is likely to have, then the reader is likely to perceive the essay as one that lacks depth. This is something you never want your reader to perceive about your writing. Even as you search for a complex word or phrase to define, you should always choose something very familiar. Racism is a great word to base your definition essay on, because it is a word that has been defined many times by different texts. This allows you the opportunity to read the many available definitions and come up with your own definition in reference to what you have read. This topic has already been defined and explored by many writers, so you will have the opportunity to define it in a unique and stand out from the others. At writing service you can buy a custom definition essay on any related topic. Your essay will be written by one of professional writers hired by our company.

Threats and Opportunities of Social Media Marketing in the Framework Essay

Threats and Opportunities of Social Media Marketing in the Framework of Contemporary Advertising Strategy - Essay Example This essay stresses that social media marketing is something that must always remain supreme within any advertising strategy which is geared to meet the eye of the young audiences. This has been proven with the passage of time that the young ones appreciate the presence of marketing on social media platforms like Twitter, Facebook, Google, YouTube, Instant Messengers and so on. As the paper declares the contemporary advertising strategy is such that it derives its basis from a number of different sectors, most significant of which remain the aspects of reaching out to the relevant target audiences and thus finding ways and means through which newer markets could be tapped in a corrective fashion. It would also manifest for growth and development under the already established clientele, which is indeed the target audience which is proving to be a major success for the brands and campaigns working under the aegis of these organizations. The modern day advertising strategy is such that it will bring instant results if devised in line with the needs, wishes and desires of the target audience. Within the framework of the social media avenues, it is always pertinent to discern the basis of success within the making up of such advertising strategies and plans which would eventually give the intended mileage to the brands and campaigns that are run on these platfor ms. The social media trends and changes are happening so quickly that it is very difficult to follow up what exactly is taking place within the relevant ranks. This calls for an understanding of how properly the advertising strategies are devised, planned and later on implemented within the related settings (Sigala, 2011). What is most significant here is an understanding that much sanity can prevail within these discussions if everyone knows his role well and then goes about aligning and delegating people for their respective chores and tasks. After all, it must be remembered here that the social media marketing elements are always given the go ahead when the brands and campaigns within the aegis of organizations understand their use and believe in its effectiveness and efficiency without any issues that will ultimately come to the reckoning. An opportunity that can be discussed here is of these social media platforms working to best affects for the sake of the consumers and users alike. These people want to be updated about the latest products, services and trends that belong to their own age where they spend most of their time, i.e. the social media avenues. It excites the young audiences as they want to connect with it and thus know about the different worldly affairs (Nolan, 2011). It just is a very significant part of who they are and what they want to seek from life. Psychological entities have proven that the social media enterprises and platforms excite the teenagers more than the

Artwork Analysis Research Paper Example | Topics and Well Written Essays - 1000 words

Artwork Analysis - Research Paper Example This research paper not only describes Impressionism as a direction in French painting art, but also compares the artwork of two painting artists, which were Henri Rousseau and Camille Pissarro, who had contributed their skills and paintings in this period. Paintings, that are entitled Exotic Landscape and Landscape with Flock of Sheep were analyzed in details by researcher of the paper. First of the paintings of Henri Rousseau is entitled â€Å"Exotic Landscape† which was painted in the year 1910. Some visual elements of this work are duscussed, such as it's colors, horizontal lines, diagonal lines, straight lines and vertical lines, that were used to represent the plants and leaves. The meanings of the shapes and colors used by the artist are also discussed by the researcher. Second painting analyzed was by Camille Pissarro, and is entitled Landscape with Flock of Sheep. In visual elements of this painting, it is obvious that he didn’t used lines like Henri Rousseau but used colors in dots or patches. In the conclusion of the essay, the differences between the paintings are given. First, it is the way the two artist used their brushstrokes. For Pissarro, it can be perceived that his brushstroke was used in a quickly manner while in the work of Rousseau we can perceived that he uses his brushstroke in a smoothly manner. The colors of the two paintings are also very different. To sum up, the painting of Rousseau is more on imaginary tropical landscape but for Pissarro, it is more on the real image of the rural life of French.

Code of Ethics Paper Essay Example for Free

Code of Ethics Paper Essay The National Institutes of Health (NIH) is a well-known government based facility that presents a web site that keeps its customer base well informed on a wide variety of topics. Providing and gathering knowledge for doctors and patients, this facility and website serve as an investigator. This ranges from heath issues to the medicine used to treat. The NIH has been a part of history ranging from advances in penicillin to machines used such as the MRI. Also, NIH has funded and researched thousands of drugs and physicians to find cures and treatment. As a team we believe that the NIH has social, ethical issues, as well as goals that are met every day as a part of their social responsibility. â€Å"NIH’s mission is to seek fundamental knowledge about the nature and behavior of living systems and the application of that knowledge to enhance health, lengthen life, and reduce illness and disability.† (USA.Gov, 2013) NIH’s goals and their ethical principles If everyone were afraid about unethical research, nobody will participate or volunteer. Without the research subjects, developing new medicine and treatments would be impossible. Because millions of selfless and generous research volunteers, the world has benefited from an array of medical advances in used today. Furthermore, Effective chemotherapy and radiation treatments have cured millions of people with cancer, such as breast, thyroid, pancreatic, and cervical cancer to name a few. Additionally, we have also benefited from numerous vaccines that protect from deadly disease, for instance, polio, measles, chicken pox, and the seasonal flu. Moreover, these medical advances have made it possible to increase awareness about nutrition and health lifestyles (NIH, 2013). The National Health Institute’s goals are to cultivate and promote â€Å"fundamental creative discoveries, innovative research strategies and their application as a basis for ultimately protecting and improving h ealth† (NIH, 2013, para. 1). In addition, their goals are also for helping support, and â€Å"renew scientific human and physical resources that will safeguard the Nation competency to prevent disease† (NIH, 2013, para. 1) Furthermore, they work tirelessly to  Ã¢â‚¬Å"expand the knowledge base in medical and sciences to enhance the Nation’s economic well-being and guarantee a continued high return on the public investment in research† (NIH, 2013, para. 1). According to the Journal of the American Medical Association (JAMA), before any research is started there are seven ethical principles the researchers must comply with. These principles help to clarify meticulously a coherent framework for assessing the ethics of any clinical research studies: (1) social value- the research or study must define how are peoples health or well-being will improve; (2) scientific validity- the research must have a hypothesis to be tested, and controlled; (3) fair subject sel ection- an abroad group of people must be selected , including age (over 18), gender, and race, not vulnerable or privileged; (4)favorable risk-benefit ratio- the research shows that the riskier the study the more ethical it is considered; (5) independent review- an external group must review the research and will approve it or denied it. This practice makes people believe the study is more ethical and unbiased. Also, this will minimize potential conflicts of interest; (6) inform consent- the subject must be mentally capable to understand the full disclosure of the research, the decision must be voluntary; (7) respect for the enrolled subject- the volunteers privacy must be protected, withdrawal from the study cannot be denied, and their health must always be monitored. The researchers have the obligation to treat everyone who volunteers in an experiment ethically and respectfully (Emanuel, Wendler, Grady, 2000; NIH Clinical Center Department of Bioethics, 2012). NIH’s culture and ethical decision making The National Institutes of Health (NIH) is one of the largest organizations in the world with regard to researching advancements in medicine and the improvement in delivery of health care. Culturally speaking, the NIH is as diverse as the population it provides services to. Therefore, the NIH encourages health care providers to become more culturally competent in order to assist them in improving the quality of services they provide. According to the NIH, (2013) â€Å"Cultural competency is critical to reducing health disparities and improving access to high-quality health care; health care that is respectful of and responsive to the needs of diverse patients† (par. 3). Possessing a better knowledge of the cultures  a health care provider delivers services to will allow him or her the ability to provide a higher quality of care and enable him or her to remain ethical when critical decisions need to be made. Currently, the NIH is collaboration with other groups and organizati ons to help health care providers become more aware of the cultures they serve, which in turn, will provide better quality of care to all Americans (NIH, 2013). End of life is an area of health care the NIH suggests is especially critical with regard to culture and making ethical decisions (NIH, 2013). There are many different cultures in the United States that do not share the same point of view when it comes to a family members’ last wishes. An article called â€Å"Diverse decisions. How culture affects ethical decision making†, written by Wright, Cohen, and Caroselli explains the importance of cultural competence and ethical decision making at the point of a patients’ end of life. This crucial aspect of health care can be especially challenging to health care providers if they are not familiar with their patient’s cultural preferences. If not treated with the sensitivity a family requires culturally, the health care provider will likely encounter probl ems in assisting the family in arriving at an ethical decision that best helps the patient. As stated by Wright, Cohen, and Caroselli, (1997) â€Å"When these difficulties are coupled with ineffective communication related to cultural insensitivity or unawareness, the effects can be devastating† (par. 1). Few moments in life present as many challenges as the end of a family members’ life. Therefore, the NIH not only challenges its organization to become more culturally competent, it also encourages and assists health care providers to do the same, especially when assisting patients and their families in making the appropriate ethical decision. NIH’s ethical values supporting our ethical values The NIH has clearly stated that â€Å"turning discovery into health† is part of their mission statement. Supporting this ethical decision in the United States alone there are many individuals with chronic diseases or health issues. Therefore, it is safe to say that because the mission of the NIH is to find cures and treatments to better our nation is in correspondence with most. According to the NIH, (2013) â€Å"Nearly half of all Americans have a chronic medical condition. NIH research makes significant strides toward  treating and preventing these long-term illnesses.† Along with promoting wellness, the NIH develops new technological tools to treat any or most ailments in the USA. They are always looking for bright and positive new recruits to help research and enlighten the NIH to provide answers to thousands of individuals who have questions. The NIH has conducted research and found that cancer, diabetes, HIV/AIDS, and cardiovascular disease is on the decline bec ause of the research they have contributed to society. Because of their code of ethics they are helping babies that are born today live to a common age of 79, a vast improvement from the last 100 years. NIH believes it â€Å"invests over $30.9* billion annually in medical research for the American people.† (USA.Gov, 2013) and posted under NIH budget they write â€Å"Research for the People†, a clear message that this company is high in ethical values. They plan on widening the research capacity of our country and foster exploration. For any individual finding treatment for loved ones or ones’ self goes hand in hand with the ethical beliefs of the NIH. Social responsibility for NIH in the community NIH has proven itself to be socially responsible for not only the community but the entire population. They have done research and contributed a vast amount of information that physician’s, staff, and patients alike use on a daily basis for personal or practice knowledge. For example, the NIH has provided hundreds of thousands of jobs to research new technology and to find cures ever the past years. In addition, â€Å"to directly supporting research, NIH funding spurs an impressive amount of spin-off economic growth in our communities, ranging from scientific equipment suppliers to biotech firms to businesses offering food and lodging.† (USA.Gov, 2013) So not only has it contributed to health of the population, but is has proved financial contributions to the population. It has contributed more than $62 billion in revenue. Because of NIH’s research it will have not only short term effects but long term ones as well. Employing over one million employees to do rese arch and development, the NIH has made a vast contribution for jobs to those who do not have one. Providing tours and other means to understand what they do to the public, they encourage public awareness. Providing funds for over 130 Nobel prize winners that have created such instruments like the MRI, NIH scientists have paved the way for many and future scientists. The  NIH expects â€Å"to expand the knowledge base in medical and associated sciences in order to enhance the Nations economic well-being and ensure a continued high return on the public investment in research.† (USA.Gov, 2013) Providing leadership for this frontier in medical research, NIH is constantly making new advancements. Keeping archives of all research done in the past 100 years, the NIH keeps these records so future generations can learn. In conclusion, the goals of the NIH are to provide medical research, for the population of the USA. Their goal is to find cure and increase the wellness of the surro unding population. Also, the NIH is made up of a culturally diverse population making it successful in finding, curing or preventing most or all ailments. Encouraging physicians to be more culturally diverse, is one of the NIH’s main goals because of the background in genetics and their diseases. Their ethical values support ours because we are all in the same country. Where thousands if not hundreds of thousands diseases are present every day, and as part of the population most would like to see research and treatments available. â€Å"Our practical wisdom must balance the shifting demands and possibilities that our changing circumstances present.† (Fremgan, 2009) Knowing our past is important as knowing our future. And the NIH has provided a sanctuary for both. As a team we believe that the NIH has social, ethical issues, as well as goals that are met every day as a part of their social responsibility. References National Institutes of Health, (2013). Frequently asked questions. Retrieved from http://www.nih.gov/about/FAQ.htm USA.Gov. (2013). National Institutes of Health. Retrieved from http://www.nih.gov/ Wright, F., Cohen, S., Caroselli, C., (1997). Diverse decisions. How culture affects ethical Decision making. Division of Nursing, New York University, New York. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9136346 Fremgan, B. (2009). Medical Law and Ethics (3rd ed.). Retrieved from The University of Phoenix eBook Collection database

Cooperative Learning: Listening To How Children Work At School :: essays research papers fc

Cooperative Learning: Listening to how children work at school   Ã‚  Ã‚  Ã‚  Ã‚  In this study the researchers were seeking to discover the content of the communication that occurred over a period of time that a project was due. The project took place over five weeks. The students were given an assignment to create a ride for a lot that use-to host the Pacific National Exhibition. Assignment: The Pacific National Exhibition (PNE) will be closing permanently at the end of the season. The exhibition has decided to relocate on a parcel of land in the Fraser Valley. The board of executives is seeking innovative ideas from the public to help plan their new facility. Your class has been selected to participate in this unique opportunity. We would like teams of students to create a new innovative ride or redesign an existing structure. Each submission should include research, detailed drawings, and a simple mechanical model of your design. Please remember that space is limited and your group will have one half of a table top to present your model. The groups were taken from 26 sixth and seventh grade students. The researchers wanted to learn about the communication in the groups and to see how all the members of each group were able to communicate with each other as well as the teacher.   Ã‚  Ã‚  Ã‚  Ã‚  The 26 students were divided into six groups trying to keep the number of sixth and seventh graders balanced as well as the sex of the students. The students were given several days to meet and come up with ideas. The following the timeline the students were given to come up with the various elements to complete the project as formally as possible. Timeline: 1.Research and Sketches (May 14)-one page of research on the mechanics of your model; a clear sketch on 8.5 x 11 paper. 2. Final Drawings (May 17)-a detailed drawing of your design on 11 x 17 paper; diagram should include a title, labels, and scale; this drawing will be used in your final presentation. 3. Models (May 28)-a simple model that demonstrates how the mechanical system works; the model should be displayed on cardboard no larger than half a table top. 4. Presentation (May 29)-each group will be required to pitch their design to an audience (2-3 minutes); each member of the group should be prepared to respond to questions from the audience related to the mechanics of their selected systems.   Ã‚  Ã‚  Ã‚  Ã‚  The 11 work secessions over the-five week study were recorded using audiotapes for each group.

Operations Management Essay

Carefully review the assignment scenario/case study. From the limited information in the scenario/case study, along with your answers to the unit three written assignment, identify at least three direct and specific long-term and three direct and specific short term operations changes that Albatross Anchor must make to gain a clear and sustainable competitive advantage (provide detailed information to validate and support each recommended change) Long-Term Operational Changes (01) Building Renovation: Moving the equipment around to make sure that it is better organized. Moving the foundry to where the raw products and finished products are located right now will open up the receiving and shipping. Receiving and shipping now can be one big area with the possibility of adding more equipment to the area which would bring down the delay between the two anchors. If there is a way of dividing the manufacturing area so that the area can make both anchors at the same time instead of having that 36 hour window of changing the equipment. This will cut cost down on the down time and increase the profit margins. (02)Technology: Having up to date technology added to the area will help eliminate some of the equipment that technology could do. Also up to date technology in the administrative offices is important as well so that all employees on the floor and in the offices know what is going on. Having this technology will be safer and faster production. (03)Equipment: Updating the equipment if possible that would do more in less time would help with building up the profit margins. Adding more equipment so that both anchors can be made at the same time will also bring in the profit margins. Moving the equipment around to make room for new or making the foundry and other equipment to divide the manufacturing area to have the area produce both anchors. Short-Term Operational Changes (01)Budgeting: Budgeting the funds around to help upgrade the technology and equipment. And the funds to have more employees. The cost of what will cost to do all the long time and what the company will make after everything is complete. Having a budget will help with what can be done now and what we can see if we can get help or something that will have to wait until funds are available. (02) Employees: All employees new and old know the procedures and rules of the company. What the employees need to do to make it easier of a change. Train them on the new technology and equipment and what needs to be done. Having all employees knows the two types of anchors is very important especially the administrative office when they have callers that have questions and those that are shipping out the anchors. Sending out the wrong anchors to the customers can lead to loss of money and customers. Because of the items not being right they would think that Albatross Anchor is very none organized and more to a company that looks more organized. (03) Update administrative offices: Updating the offices will have the customers that come in want to do business with Albatross Anchor. Trying to have a couple of the administrative staff are knowledgeable in the anchors will help the other administrative staff with training and be the go to for all questions that they may have. Having updated technology the administrative will be able to do a lot more to help with the business and be able to know when delivers are coming and what amount is coming. This way all employees that deal with shipping and receiving will be on the same page. Question Two From the list of ten operational issues in the Unit 6 assignment instructions select four operational issues. For each of the four operational issues explain in detail that operational issue will help Albatross Anchor improve; 1) job retention, 2) employee morale, and 3) employee dedication. Operational Issue One: Cross Training Job retention: Have cross training employees will be able to work in different areas so if an area is short on employees can move someone to the area of shortage to help and keep everything going. This will also give the employees more of an opportunity and look for work if a position opens up. Employee morale: Having employees cross train over in areas will make them feel valuable to the company, which will give positive results in the work environment and in the employees. Employee dedication: Having employees cross train and having them feel valuable will help bring employees continue to work and want to work at Albatross Anchor. Operational Issue Two: Gain sharing and profit sharing Job retention: profit sharing created the employee will benefit of the financial success of Albatross Anchor. With the growth of the company and valuable employees will help with this success. With the employees knowing that they are benefiting from the profit sharing will continue to stay and work hard. Employee Morale: Employees will feel appreciated if they receive financial rewards. Being rewarded of their hard work created positive morals for the employees and the company. Employee Dedication: Employees has personal responsibility for the profit sharing in the company success, especially when all employees benefit when the company is successful. This will create employee dedication. Operational Issue Three: Ergonomics Job retention: Having hard physical labor brings short and long term damages. Ergonomics ensures that workers operate in the most safest and productive ways. Having a company pay attention to workers health will keep employees when they know the company cares about their employees. Employee morale: Working in hard manual labor rises the risk of damage to the employees. Having the employees know that they are working for a company that cares about their well-being will bring employee morale high. Employee dedication: Employees that feel the company is invested in their employees will bring dedication from their employees. Operational Issue Four: Technology and automation: Job retention: Improving the technology and automation will help bring the company safer and a better place to work for. Having this done will bring Albatross Anchor up to date with safety procedures. Employees will feel safe knowing they are working with the latest technology and automation. Employee morale: Workers will take pride in their work when there is an up to date technology and automation. Employee dedication: Employees that work in up to date technology and automation will come to work happy and will be dedicated to the company. Conclusion If the Albatross Anchor takes these long and short term improvements. The company will be a very successful company and many customers will continue to purchase anchors from them, especially if the company are producing both anchors at the same time. Having employees that want to come will also help bring in the success of the company. No one wants to come and work for a company that doesn’t care or show their appreciation in their employees and help with rewards after the company starts getting a profit after the changing of the equipment and moving things around. As long as Albatross Anchor does the changes and upgrades that need to be done and show support and appreciation to their works Albatross Anchor will be a successful company and one that many customers and possible customers will talk about.

Limb Loss A Major Event Health And Social Care Essay

Amputation could be described as the remotion of a organic structure appendage or portion by surgery or injury. If taken as a surgical step, it is used to command hurting or disease procedure in the affected portion or limb. A individual with an amputation may experience mutilated, empty and vulnerable. Traumatic amputation is a ruinous hurt and frequently a major cause of disablement ( Wald 2004 ) . Furthermore, reduced self-pride, societal isolation, organic structure image jobs, and sense of stigmatisation have besides been associated with limb loss ( William et al. 2004 ) . In some state of affairss, amputation are ineluctable. Irrespective of the cause, amputation is a mutilating surgery and it decidedly affects the lives of these patients ( De Godoy et Al. 2002 ) . Amputation of limb is a common thing in this present society. The loss of a limb distorts the persons organic structure image taking to the idea of non being a complete human being. The loss of the maps performed with that limb renders him helpless for sometime.Apart from loss of physical maps, the amputee besides loses hopes and aspirations for the hereafter ; his programs and aspirations get shattered. Therefore, he loses non merely a limb but besides a portion of his universe and hereafter. A considerable figure of them remain disquieted and dying about their interpersonal relationship in the societal, vocational, familial and matrimonial surroundings. Those few who have an open mental dislocation will necessitate active psychiatric intervention. In others in whom the mental symptoms are non so obvious, a careful psychiatric interview is necessary to convey to the bow the interior convulsion whichmay need aid of a head-shrinker. Limb loss is a major event that can badly impact the psychological wellness of the person concerned. Surveies show that 20-60 % of the amputees go toing follow up clinics are assessed to be clinically depressed. Persons with traumatic amputation irrespective of the age are likely to endure subsequent troubles with respect to their organic structure image, but these are bit more dramatic in the younger age groups. The psychological reactions to amputation are clearly diverse runing from terrible disablement at one extreme ; and a finding to efficaciously restart a full and active life at other terminal. In grownups the age at which an person receives the amputation is an of import factor. Surveies by Bradway JK et Al 1984 [ 15 ] , Kohl SJ Et Al 1984 [ 30 ] , Livneh H 1999 [ 9 ] , on the psycho-social version to amputation has led to a overplus of clinical and empirical findings. Kingdon D et Al 1982 equated amputation with loss of one ‘s perceptual experience of wholenessA while Parkes CM 1976 [ 10 ] with loss of partner andA Block WE et al 1963 [ 16 ] , Goldberg RT et Al 1984 with symbolic emasculation & A ; even death.A The person ‘s response to a traumatic event is influenced by personality traits, pre-morbid psychological province, gender, peri-traumatic dissociation, drawn-out disablement of traumatic events, deficiency of societal support and unequal header schemes. The old researches on amputation has focused chiefly on demographic variables, get bying mechanisms, and outcome steps ; with there being a scarceness of literature on prevalence of assorted specific psychiatric upsets in the post-amputation period. Most patients with a limb loss irrespective of whether due to traumatic or surgical processs go through a series of complex psychological responses ( Cansever et al 2003 [ 6 ] ) . Most people try to get by with it, those who do n't win develop psychiatric symptoms ( Frank et al 1984 [ 7,8 ] ) .A Shukla et Al ( 1982 ) [ 4 ] A andA Frierson and Lippmann ( 1987 ) A note that psychological intercession in some signifier is needed in approximately 50 % of all amputees, andA Shulka and co-workers ( 1982 ) [ 4 ] A study depression to be the most common psychological reaction following amputation. The three major jobs faced by many amputees are anxiousness, depression and physical disablement ( Green 2007 ) Horgan & A ; MacLachlan ( 2004 ) found Anxiety to be associated with depression, low ego regard, poorer sensed quality of life and higher degree of general anxiousness. With increasing age both anxiousness and depressive symptoms are associated with greater physical disablement ( Brenes et al. 2008 ) . Body image may be defined as the combination of an person ‘s psychosocial accommodation, experiences, feelings and attitudes that relate to the signifier, map, visual aspects and desirableness of one ‘s ain organic structure which is influenced by single and environmental factors ( Horgan & A ; MacLachlan 2004 ) . Each individual holds an idealised image of the organic structure, which he uses to mensurate the percepts and constructs of his or her ain organic structure ( Fishman, 1959 ) . From another position, Flannery & A ; Faria ( 1999 ) see body image in a individual as a dynamic changing phenomenon, it is formed by feelings and perceptual experiences about a individual ‘s organic structure that are invariably altering. Harmonizing to Newell ( 1991 ) , attractive people post amputation will probably have less support from others ensuing in a lessening in self-esteem and a lessening in positive self-image. Jacobsen et Al ( 1997 ) survey supports this stating that amputation consequences in disfiguration which may take to a negative organic structure image and possible loss of societal credence. The relationship between disablement experience and stigma are interwoven and inter-dependent. The ground for the amputees subjective perceptual experience of being unfit for the society is likely that organic structure image non merely provides a sense of †self ‘ ‘but besides affects how we think, act and relate to others ( Wald 2004 ) . Harmonizing to Kolb ( 1975 ) , an change in an person ‘s organic structure image sets up a series of emotional, perceptual and psychological reactions. Fishman ( 1959 ) states a individual â€Å" must larn to populate with his perceptual experiences of his disablement † instead than â€Å" with his disablement. † Successful accommodation for the amputee appears to be in the incorporation of the prosthetic device into his or her organic structure image and his or her focal point on the hereafter and non on the portion lost ( Malone JM, Moore, WS, Goldston J, A et Al, 1979 and, Bradway JK [ 15 ] , Malone JM, Racy J, A et al 1984 ) . The psychiatric facets of amputation has received light involvement in our state, inspite of inadvertent hurts being common ( Shukla et al. , 1982 [ 4 ] ) . The commonest psychiatric upset seen in amputees is major depression. Randall et Al. ( 1945 ) have reported an incidence of 61 % in non-battle casualties, while Shukla et Al. ( 1982 ) [ 4 ] found depressive neuroticism ( 40 % ) and psychiatric depression ( 22 % ) as taking psychiatric upsets in amputees ; merely 35 % of the entire sample in the later survey had nil psychiatric upsets. The dearth of literature in this field has prompted us to analyze of amputation and its carbon monoxide morbid psychiatric conditions so that we may be after care & amp ; direction for these patients. The present survey was undertaken with the purpose of analyzing the psychiatric jobs particularly anxiety, depression and organic structure dysmorphic syndrome which may be associated with disablement or changed life fortunes in the immediate post-ampu tation period. A comparing was made with Stroke patients as these patients excessively frequently experience similar physical and societal disabilities to amputees. Depression is the most common temper upset to follow shot ( Starkstein & A ; Robinson, 1989 ) , with major depression impacting around one one-fourth to one tierce of patients ( Beekman et al. , 1998 ; Ebrahim, Barer, & A ; Nouri, 1987 ; Hackett, Yapa, Parag, & A ; Anderson, 2005 ; Pohjasvaara et al. , 1998 ) . Depression has an inauspicious consequence on cognitive map, functional recovery, and endurance. Diagnostic and statistical manual ( DSM ) IV categorizes station shot depression as â€Å" temper upset due to general medical status ( i.e. shot ) † with the specific depressive characteristics, major depressive-like episodes, frenzied characteristics or assorted features.Two types of depressive upset associated with intellectual ischaemias have been described from surveies done with patient informations from acute infirmary admittance, community studies, or out patient clinics. Major depression occurs in up to 25 % of patients ; and minor depression occurs in 30 % of patient. Prevalence clearly varies over clip with an evident extremum 3months after the shot and later worsen in prevalence at 1 twelvemonth. Robinson and co-workers surveies showed a self-generated remittal in the natural class of major depression happening station shot in the first to 2nd twelvemonth following shot . However in few instances depression may go chronic and persist for a longer period. While some propose that station shot depression is due to stroke impacting the nervous circuits concerned with temper ordinance therby back uping a primary biological mechanism, others in the scientific community claim it to be due to the resulting societal and psychological stressors happening as a consequence of shot. Though an incorporate bio- psycho- societal theoretical account is warranted, most surveies clearly suggest the biological mechanism to hold the upper manus in the ulterior station stroke period than in the immediate stage. In the same manner Anxiety was about every bit common as depression and extra patients became dying at each clip point. Around 20 per cent of people will develop an anxiousness upset, most normally in the first three to four months after the shot. While the literature on PSA remains in its babyhood, the literature has begun to analyze its relationship to similar demographic, hurt, cognitive, and physical features as those examined for PSD. In footings of hurt features, PSA correlates significantly with right hemisphere lesions, while co-morbid PSA and PSD are linked to go forth hemisphere lesions ( Astrom,1996 ) .A Castillo etal. ( 1993 ) A foundA anxietyA more prevailing in association with posterior right hemisphere lesions, whereas worry withoutA anxietydisorderA was associated with anterior lesions. ThoseA studiesA that have found relationships between PSA and age and gender study that adult females ( Morrison, Johnston, & A ; Walter, 2000 ; A Schultz, Castillo, Kosier, & A ; Robinson, 1997 ) and younger patients ( & lt ; 59 old ages ) are more susceptible to PSA ( Schultz et al. , 1997 ) , while others report no important relationship ( Dennis et al. , 2000 ) .Review literature:Amputation: Sociodemographic factors: Several surveies revealed that major depressive upsets and greater depressive symptomatology were more prevailing at lower degrees of socioeconomic position [ Bruce L et Al 1994, Stansfeld et al 1992 ] . However, income degrees of people with an amputa-tion were non related to depressive symptoms [ Behel J M et Al 2004 ] . Dunn used a 10-page questionnaire to determine a assortment of personal features such as matrimonial position, faith, instruction, and etiology, etc. about each of 138 topics recruited from the Eastern Amputee Golf Association.13 With a scope of points, the survey focused on those â€Å" related to the effects of positive significance, optimism, and perceived control on depression and self-pride. â€Å" 13 Depression was measured utilizing the CES-D while self-pride was assessed by the Rosenberg Self-Esteem Scale ( RSE ) . Sing physical factors, Dunn found that younger amputees were significantly more at hazard to develop depression than older amputees ( P & lt ; .05 ) . Mentioning Williamson and Schulz every bit good as Frank [ 7,8 ] et Al, the writer suggests that both activity restriction-perhaps more usual, accepted by older persons than young-and visual aspect anxiousness may account for the determination. Wald et al supported Dunn ‘s findings with a mention to Fisher & A ; Hanspal and Livneh ‘s articles that suggests immature individuals, with amputations secondary to trauma, are more likely to develop depression than older individuals with amputations secondary to disease.3 Wald et Al besides cites Cheung et al as demoing that individuals with upper appendage amputations had higher rates of depression than lower appendage amputees. Darnall et Al ‘s telephone cross-sectional study revealed some interesting physical hazard factors for depression. The survey found that comorbidities were a important hazard factor ( for one comorbidity, p=.007 ; for two comorbidities, pa†°Ã‚ ¤.001 ) . Anyone with terrible apparition hurting was 2.92 times more likely to develop depression than those without annoying pain.8 Other types of hurting such as residuary limb or back hurting were besides found to increase the opportunity of developing depressive symptoms. Hanley et al took 70 topics, 1 month post-amputation of the lower appendage, and asked inquiries about map, apparition limb hurting, header, etc. The patients were assessed once more at 12 and 24 months after the amputation.14 Phantom limb hurting was measured utilizing points adapted from the Graded Chronic Pain Scale ( GCPS ) and pain intervention was measured by portion of the Brief Pain Inventory ( BPI ) . Later, multiple arrested development analyses were used to find what factors at the initial appraisal may hold predicted the development of depression. Ultimately, the survey found the most certain physical factor to increase the hazard of depression was the presence along with the badness of apparition limb hurting. Using HADS with 105 topics at an amputation rehabilitation ward, Singh et al found none of the following to be risk factors for depression or anxiousness: age, gender, clip since amputation, degree or prosthetic bringing events.10 There was, nevertheless, a important correlativity between the presence of comorbidities and depression ( p & lt ; .01 ) every bit good as between life in isolation and anxiousness ( p & lt ; .05 ) . The writers offer small account for their findings. Dunn found ab initio that none of the following appeared to be risk factors for depression: gender, degree of amputation, matrimonial position, race, income degree, instruction, employment, or spiritual affiliation.13 Ultimately, nevertheless, the survey did find-as Wald et Al subsequently reported-that beyond young person as a physical hazard factor for depression, there were several emotional/psychological hazard factors.3 Subjects who were less optimistic-not needfully pessimistic-about their state of affairs were more likely to develop depression, as were those who could non happen significance in their amputation experience and anyone who felt they had small control over their intervention and position. It was the participants who reported missing a positive mentality, who could believe merely of the negative effects, and who felt out of control or unimportant that tended to show down symptoms as clip progressed. Wald et al went farther to mention Breakey and Rybarczyk et Al with findings proposing that missing a societal support system, holding issues with visual aspect, and uncomfortableness in society due to personal perceptual experiences about societal interactions all increased the likeliness of developing depression.3 This construct of hurt and depression issue from the amputee keeping certain beliefs about visual aspect and being sensitive to public uneasiness was echoed in the findings of Atherton et al.11 That survey explained the findings by proposing that individuals with high public uneasiness were by and large the type of individual to care a batch about societal contact and what is considered â€Å" normal † ; these individuals would be acutely cognizant of how they might now be perceived to be â€Å" different † and accordingly experience hard-pressed. Lack of societal support after an amputation was found to be a hazard factor in several of the reviewed surveies, including Darnall et al.8 The survey discovered that those topics who were, at the clip of or shortly after the amputation, either divorced or separated from a important other were more likely to develop depressive symptoms. Besides likely to increase depression rates was populating near the poorness degree ; depression, nevertheless, was buffered by the topic holding a higher instruction. Populating near the poorness degree and holding a higher instruction, although both are imaginable particularly sing the emphasis poorness topographic points upon individuals with medical conditions, was non confirmed in any of the other literature reviewed here. Previous depressive episodes and abnormal psychology was found to be a hazard factor for later depression in both Meyer and Ehde et al.5,9 Meyer ‘s survey suggested that pre-injury personality disfunction had the greatest influence on the prevalence of depression after an amputation, in this instance of the manus. Ehde et al discovered old depressive episodes-since the amputation but earlier in the survey of 24 months-to be more declarative, instead than pre-injury mental province. The survey besides suggests gender and societal support to be of import factors in the development of depression. Interestingly, Ehde et Al claims that pain catastrophizing by the topic while in the infirmary puting leads to modern-day and later increased rates of depression.9 Commenting on its contradiction to common cognition and other literature on this point, Hanley et al studies happening that hurting catastrophizing in patients decreased the prevalence of depression in survey subjects.14 The writers speculate that patient hurting catastrophizing, peculiarly in the ague attention puting, garnered more attending from wellness attention staff and household, with it possibly more of the psychological or physical attention they needed to retrieve. This suggests that, by being more demanding, the patients received support that other less-vocal patients did non. Last, beyond hapless hurting tolerance, both Seidel et Al and Desmond found that topics who avoided discussing or screening and were in denial about their amputation were more likely to develop depression both ab initio and long-term.6,7 Subjects who preferred to avoid admiting their new position as amputees besides tended to hold hapless credence of their prosthetic device. This became evident at the clip of prosthetic adjustments when topics frequently became progressively distressed, by and large going depressed.Depression and anxiousness:Most surveies agree that between 20 and 30 % of amputees qualify for MDD after amputation This depression is frequently associated with anxiousness and may or may non be attributable to posttraumatic emphasis upset. All surveies describing on the prevalence of depression in the amputee population found rates higher than those in the general population, peculiarly in the months and old ages instantly following the amputation. Grunert et al. , as cited in Wald et Al, found that, at the initial appraisal after manus hurt, 62.4 % of topics claimed depressive symptoms. Another reappraisal, Horgan et Al, cites Caplan et al as happening 58 % of topics to measure up for MDD at 18-months station amputation while mentioning Bodenheimer et Al ‘s findings of a 30 % depression rate. Meyer determined that the bulk of surveies on depression in amputees, on norm, found a prevalence of about 30 % , between three and six times higher than the world-wide rate. Seidel et Al found a similar rate of depression among individuals after the amputation of a lower appendage as opposed to the more socially noticeable upper appendage and custodies. In a three-part cross-sectional study administered to 75 patients seen at the Klinik und Poliklinik fur Technische Orthopade des Universitatsklinikums Munster, topics were asked inquiries and assessed harmonizing to the Hospital Anxiety and Depression Scale ( HADS ) , In this survey, 27 % and 25 % of the topics with a lower appendage amputation demonstrated increased depression or anxiousness, severally ; 18.3 % had both higher depression and anxiousness. Desmond determined that 28.3 % of the topics had tonss to bespeak possible MDD and 35.5 % qualified for clinical anxiousness. Darnall et al completed a cross-sectional study via telephone with 914 capable amputees.8 The topics were selected from a database of people who contacted the Amputee Coalition of America between 1998 and 2000 ; the sample was categorized per the topics ‘ etiologies but both upper and lower appendage amputations were included. Through informations analysis the survey found a depression prevalence of 28.7 % which the writers concluded was comparable to rates antecedently reported in surveies of depression in the amputee population. Singh et Al performed a cohort survey on 105 individuals with lower appendage amputation secondary to a assortment of etiologies who were admitted to an amputee rehabilitation ward.10 Upon admittance and discharge, each topic completed the HADS ; during the class of their stay, certain factors about each patient-such as gender, societal inside informations and found at admittance, 26.7 % of the topics were classified as down and 24.8 % as dying. Through a cross-sectional study of 67 new ( within the past five old ages ) adult lower appendage amputees who wear prosthetic devices, Atherton et al investigated the topics ‘ longer term psychological accommodation to amputation and found 13.4 % of the topics to be depressed and 29.9 % to be dying. Ziad M Hawamdeh et Al, have shown the prevalence of depressive and anxiousness symptoms to be 20 % and 37 % severally, which is consistent with several old surveies that confirmed high rates of anxiousness and depressive symptoms after amputation with prevalence up to 41 % ( Kashani et al 1983 ; Schubert et Al 1992 ; Hill et al 1995 ; Cansever et Al 2003 [ 6 ] ; Atherton and Robertson 2006 ; Seidel et Al 2006 ) . Most surveies have found no important relationship between the clip resulting amputation and psychological perturbations ( Rybarczyk et al 1992 ; Thompson et Al 1984 ) , ( Horgan and Maclachlan 2004 ) . Horgan and Maclachlan ( 2004 ) in their publication on amputations psychological accommodation concluded that depression and anxiousness seemingly are higher in the first 2 old ages post amputation and thenceforth worsen to degrees prevalent in the general population. Singh and Hunter 2007 in their recent survey concluded depression neodymium anxiousness symptoms to decide after in patient rehab for a short continuance. Gender is one of the sociodemographic factor that could be associated with result following amputation. In footings of psychological wellbeing following amputation, most surveies have found no difference in psychosocial result between work forces and adult females ( Bradway et al 1984 [ 15 ] ; Williamson 1995 ; Williamson and Walters 1996 ) . But surveies performed by Kashani and col-leagues ( 1983 ) , O'Toole and co-workers ( 1984 ) , and Pezzin and co-workers ( 2000 ) , have reported adult females to be more likely to see depression, and to execute more ill on a step that includes an appraisal of emotional adaptability. Fisher and Hanspal ( 1998 ) , Livneh and co-workers ( 1999 ) [ 9 ] suggested immature grownups with traumatic amputation to be at higher hazard of major depression in comparing to persons with surgical amputations. Other surveies analyzing the relationship between cause of amputation and psychosocial result have found no consequence of amputation on psychiatric symptoms ( Shukla et al 1982 [ 4 ] ) , anxiousness ( Weinstein 1985 ) , and depressive symptoms ( Kashani et al 1983 ; Rybarczyk et Al 1992 ; Williamson and Walters 1996 ) . Engstorm et Al ( 2001 ) , showed that the amputee ‘s current household reactions to hold a important consequence on accommodation. Williamson et Al ( 1984 ) , Thompson and Haran ( 1984 ) , Rybarczyk et Al ( 1992, 1995 ) , found depression to be more prevailing in those who are socially stray and with low sensed degrees of societal support. Harmonizing to Weinstein ( 1985 ) , although above articulatio genus amputations are associated with poorer rehabilitation results and higher activity limitation degrees, AK amputations were non found to be associated with increased degrees of anxiousness, societal uncomfortableness, general psychiatric symptoms ( Shukla et al 1982 [ 4 ] ) , depression ( Behel et al 2002 ) , or accommodation to amputation ( Tyc 1992 ) . O'Toole et Al ( 1984 ) found that persons with BK amputation to be more likely down than those with AK amputations because BK is less badly disenabling than AK in footings of operation.Body image perturbation:Few surveies have been reported in the literature in the country of research on organic structure image and the amputee. Fishman ( 1959 ) determined the amputee ‘s perceptual experience of his or her physical disablement has a greater influence on successful rehabilitation than the extent of the disablement. He states, â€Å" A figure of really specific psychological, societal and physiological homo demands are thwarted when one becomes physically handicapped as a consequence of amputation†¦ . The method of seting psychologically to an amputation is chiefly a map of the preamputation personality and psychosocial background of the individual. Each individual holds an idealised image of the organic structure, which he uses to mensurate the percepts and constructs of his or her ain organic structure ( Fishman, 1959 ) . From another position, Flannery & A ; Faria ( 1999 ) see body image in a individual as a dynamic changing phenomenon, it is formed by feelings and perceptual experiences about a individual ‘s organic structure that are invariably altering. Harmonizing to Kohl ( 1984 ) [ 30 ] , a individual who has lost a limb must see him- or herself every bit merely that ( a individual who has lost a limb ) and non burthen him- or herself with labels such as â€Å" amputee. † Kohl [ 30 ] suggests this attitude is the key to a positive accommodation to a new organic structure image after an amputation. Shontz ( 1974 ) suggests an person who is losing a limb has three organic structure images: the preamputation integral organic structure, the organic structure with limb loss and the organic structure image when have oning a prosthetic device. The weiss et Al ( 1971 ) studied 56 transfemoral amputees and 44 transtibial amputees utilizing a comprehensive battery of trials and a 50-item Amputee Behavior Rating Scale. The evaluation graduated table assessed the existent behavior of the amputees as observed by the members of the amputee clinic squad. This signifier was completed by the squad members: the doctor, healer, prosthetics and rehabilitation counselor. On about all measures the transtibial amputees obtained better tonss than the transfemoral amputees. The research workers wises et Al ( 1971 ) found â€Å" the degree of amputation was significantly related to legion facets of psychophysiological and personality working while aetiology was non. † They concluded that since transtibial amputees are less handicapped as a group, they by and large function better than transfemoral amputees. In add-on, they suggest the less-positive self-image of the transfemoral amputees besides can be attributed to a less-appealing p ace, frequently with a noticeable hitch ( wises et al 1971 ) .Post shot:Sociodemographic profile:The possible influences of socioeconomic position ( SES ) , age and gender on the development of depression following shot have all been examined, with inconsistent consequences ( Ouimet et al. 2001 ) . Although one could foretell intuitively that lower SES and increasing age are associated with the hazard for PSD, this is non needfully the instance. Andersen et Al. ( 1995 ) reported that SES had no influence on the hazard for post-stroke depression and recent surveies suggest that younger instead than older age is associated with increased hazard ( Eriksson et al. 2004 ; Carota et Al. 2005 ) . Given the well higher prevalence of depression among adult females when compared to work forces in the general population ( Wilhelm & A ; Parker 1994 ; Ouimet et Al. 2001 ; Salokangas et Al. 2002 ) , a higher prevalence of PSD among adult females might be expected. While the consequences from some surveies support the association between female sex and PSD ( Desmond et al. 2003 ; Paradiso & A ; Robinson 1998 ; Ouimet et Al. 2001, Eriksson et al. , 2004, Paolucci et Al. 2005 ) , others do non ( Ouimet et al. 2001 ; Berg et Al. 2003 ; Whyte et Al. 2004, Spalletta et Al. 2005 ) . However, there may be existent differences between work forces and adult females in footings of the comparative importance of hazard factors for PSD. Among work forces, physical damage may be a more influential hazard factor ( Paradiso & A ; Robinson 1998 ; Berg et Al. 2003 ) , while among adult females, old history of psychiatric upset may be more of import ( Paradiso & A ; Robinson 1998 ) .Depression and anxi ousness:Three possible accounts for the association between physical unwellness and depression have been sought. First, and least likely is a coinciding relationship. The 2nd is a negative temper reaction to the physical effects of the shot. The impact of the physical unwellness may exert its consequence through the losingss it causes to the person as a major negative life event ( losingss to selfesteem, independency, employment, etc. ) . The 3rd possible account is a neurotransmitter instability as a consequence of intellectual harm caused by the shot. Depression is a well-documented sequela of shot. Based on pooled informations from published prevalence surveies ( Robinson 2003 ) , the average prevalence of depression among in-patients in ague or rehabilitation scenes was 19.3 % and 18.5 % for major and minor depression severally while, among persons in community scenes, average prevalence for major and minor depression was reported to be 14.1 % and 9.1 % . Among patients included in outpatient surveies, mean reported prevalence was 23.3 % for major depression and 15 % for minor depression ( Robinson 2003 ) . Overall average prevalence ranged from 31.8 % in the community surveies to 35.5 % in the ague and rehabilitation infirmary surveies. A recent systematic reappraisal of prospective, experimental surveies of post-stroke depression ( Hackett et al. 2005 ) reported that 33 % of shot subsisters exhibit depressive symptoms at some clip following shot ( acute, medium-term or long-run followup ) . Estimates of prevalence may be affected by the clip from shot onset until appraisal. In fact, the highest rates of incident depression have been reported in the first month following shot ( Andersen et al. 1995, Aben et Al. 2003, Bhogal et Al. 2004, Morrison et Al. 2005, Aben et Al. 2006 ) . Paolucci et Al. ( 2005 ) reported that, of 1064 patients included in the DESTRO survey, 36 % developed depression of whch 80 per centum of them developed depression within the first three station stroke months ( Paolucci et al. 2005 ) . The incidence of major depression may diminish over the first 2 old ages following shot ( Astrom et al. 1993, Verdelho et Al. 2004 ) but minor depression tends to prevail or instead addition over the above mentioned clip period ( Burvill et al. 1995 ; Berg et Al. 2003, Verdelho et Al. 2004 ) . Berg et Al. ( 2003 ) reported about one-half of the persons sing depression during the acute stage station shot, to see it in the resulting one and half twelvemonth ; nevertheless, more adult females than work forces have been identified in the acute stage while there is a male predomination in the latter half period ( Berg et al. 2003 ) . The survey of temper upsets after shot has focused mostly on depression. Reported prevalence of PSD varies widely, though most surveies place prevalence between 20 and 50 % , and indicate that depression persists 3-6 months poststroke ( Fedoroff, Starkstein, Parikh, Price, & A ; Robinson, 1991 ; Hosking, Marsh, & A ; Friedman et al, 2000 ; Lyketsos, Treisman, Lipsey, Morris, & A ; Robinson, 1998 ; Parikh, Lipsey, Robinson, & A ; Price, 1988 ; Schubert, et al 1992 ; Schwartz et al. , 1993 ; Starkstein, Bryer, Berthier, & A ; Cohen, 1991 ; Starkstein & A ; Robinson, 1991a, 1991b ) . PSD has a negative impact on instance human death and rehabilitation ( Whyte & A ; Mulsant, 2002 ) , and functional results ( Herrmann, Black, Lawrence, Szekely, & A ; Szalai, 1998 ) . In contrast, PSA has merely late begun to be investigated ( Castillo, Schultz, & A ; Robinson, 1995 ; Castillo, Starkstein, Fedoroff, & A ; Price, 1993 ; Chemerinski & A ; Robinson, 2000 ; Dennis, O'Rourke, Lewis, Sharpe, & A ; Warlow, 2000 ; Robinson, 1997, 1998 ; Shimoda & A ; Robinson, 1998 ) with prevalence studies runing from 4 to 28 % ( Astrom, 1996 ; House et al. , 1991 ) . As with PSD, the class of PSA has been found to stay reasonably changeless up to 3 old ages post stroke ( Astrom, 1996 ; Robinson, 1998 ) . Co-morbidity of PSA and PSD is high, with every bit many as 85 % of people with generalized anxiousness holding co-morbid depression during the 3 old ages post stroke ( Castillo et al. , 1993, 1995 ) . Previously depression was found to be frequent in immature patients ( Neau et al. 1998 ) , while in some surveies ( Sharpe et al. 1994, kotila et Al. 1998 ) it has been related to old age. Lack or societal support and both functional and cognitive damage may increase the hazard of depressive upset in the elsderly ( Sharpe et al. 1994 ) . Robinson et Al in 1984 studied patients of shot in 2 groups in relation to onset of of depression, group of patients with acute oncoming of depression, within few hebdomads after shot and 2nd group with delayed oncoming of depression over 24 months and found no difference in clinical characteristics or class of depression in the two groups. In 1986 Lapse et al compared a group of patients with PSD with 43 platinums with functional depression that the two groups did non differ in the symptom profile of depression is the important determination in their survey. Although post-stroke depression ( PSD ) is a common effect of shot, hazard factors for the development of PSD have non been clearly delineated. In a recent systematic reappraisal, Hackett and Anderson ( 2005 ) included informations from a sum of 21 surveies ( Table 18.2 ) . Of the many different variables assessed, physical disablement, stroke badness and cognitive damage were most systematically associated with depression. In an earlier reappraisal of 9 prospective surveies analyzing post-stroke depression, the hazard factors identified most systematically as increasing an person ‘s hazard for post-stroke depression included a past history of psychiatric morbidity, societal isolation, functional damage, populating entirely and dysphasia ( Ouimet et al. 2001 ) . Since the clip of the Hackett et Al. ( 2005 ) and Ouimet et Al. ( 2001 ) reviews, more recent surveies have confirmed the importance of badness of initial neurological shortage and physical disablement as forecasters of the development of depression after shot ( Carota et al. 2005, Christensen et Al. 2009 ) . In add-on, Storor and Byrne ( 2006 ) examined post-stroke depression in the acute stage ( within14 yearss of shot oncoming ) and identified important associations between prestrike neurosis ( OR = 3.69, 95 % CI 1.25 – 10.92 ) and a past history of mental upsets ( OR = 10.26, 95 % CI 3.02 – 34.86 ) and the presence of dep ressive symptoms.Stroke Location and Depression:There have been 2 meta-analyses analyzing this relationship ( Singh et al. 1998, Carson et Al. 2000 ) . Singh et Al. ( 1998 ) conducted a critical assessment on the importance of lesion location in post-stroke depression. The writers consistently selected 26 original articles that examined lesion location and post-stroke depression. Thirteen of the 26 articles satisfied inclusion standard ( Table 18.3 ) . Six of those surveies found no important difference in depression between right and left hemisphere lesions. Two surveies found that right-sided lesions were more likely to be associated with depression and 4 surveies found that left-sided lesions were more likely to be associated with post-stroke depression. Merely one survey matched patients with and without depression for lesion location and size to place non-lesion hazard factors. Consequently, Singh et Al. ( 1998 ) were unable to do any unequivocal decisions refering shot lesion location and the hazard for depression. Carson et Al. ( 2000 ) undertook a systematic reappraisal to see the association between post-stroke depression and lesion location. All studies on the association of poststroke depression with location of encephalon lesions were included in the reappraisal. In entire 48 studies were included for reappraisal ( Table 18.4 ) . The writers of the reappraisal identified 38 studies that found no important difference in hazard of depression between lesion sites ; 2 reported an increased hazard of poststroke depression with left-sided lesions ; 7 reported increased hazard with right-sided lesions ; and one study demonstrated an association between depression and lesions in the right parietal part or the left frontal part. Robinson & A ; Szetela ( 1981USA ) : 18 patients with left hemispheric shot were compared to 11 patients with traumatic encephalon hurt for frequence and badness of depression, More than 60 % of the shot patients had clinically important depression compared with approximately 20 % of the injury patients. Hermann et Al. ( 1995 Germany ) : 47 patients with individual demarcated one-sided lesions were selected for survey. Clinical scrutiny, CT scan scrutiny and psychiatric appraisal were performed within a 2-month period after the acute shot. No important differences in depression tonss noted between patients with left and right hemisphere lesions. Major depression was exhibited in 9 patients with left hemispheric shots all affecting the basal ganglia. None of the patients with right hemispheric shots exhibited a major depression. Morris et Al. ( 1996a Australia ) : 44 first-ever shot patients with individual lesions on CT were examined for the presence of post-stroke depression, badness of depression and its relationship to lesion location. Patients with left hemisphere prefrontal or basal ganglia constructions had a significantly higher frequence of depressive upset than other left hemispheric lesions or those with right hemispheric lesions. Based on the consequences of a meta-analysis conducted by Bhogal et Al. ( 2004 ) , there appears to be some grounds that depression following shot may be related to the anatomical site of encephalon harm, although the nature of this anatomic relationship is non wholly clear ( Bhogal et al. 2004 ; Figure 18.1 ) . The John Hopkins Group ( Lipsey et al. 1983, Robinson & A ; Szetela 1981, Robinson & A ; Price 1982, Robinson et Al. 1982, 1983, 1984, 1986, 1987 ) carried out a series of surveies researching the relationship of post-stroke depression to the location of the lesion within the encephalon itself. They found that in a selected group of shot patients, similar to those admitted to a shot rehabilitation unit, depression appeared to be more frequent in patients with left hemispheric lesions ( Robinson & A ; Szetela 1981, Robinson & A ; Price 1982, Robinson 1986, Robinson et al 1987 ) . Among these patients, the badness of depression correlated reciprocally withthe distance of the lesion from the frontal poles ( Robinson & A ; Szetela 1981, Robinson & A ; Price 1982, Robinson et Al. 1982,1983, 1984, 1986, 1987, Starkstein et al. 1987 ) . Patients with subcortical, cerebellar or brainstem lesions had much shorter-lasting depressions than patients with cortical lesions ( Starkstein et Al. 1987,1988 ) . The correlativity of major depression to the propinquity of the lesion to the frontal pole has been confirmed by Sinyor et Al. ( 1986 ) and Eastwood ( 1989 ) . Right hemispheric lesions failed to show a similar relationship with depression. Interestingly, in one survey, patients who had both an anxiousness upset and a major depression showed a significantly higher frequence of cortical lesions, while patients with major depression merely had a significantly higher frequence of subcortical ( radical ganglia ) shot ( Starkstein et al. 1987 ) . Finally, the two big systematic reappraisals by Singh et Al. ( 1998 ) and Carson et Al. ( 2000 ) referred to antecedently, failed to happen a relationship between the shot lesion site and depression. Recent studies have suggested that psychosocial hazard factors including age, sex and functional damage or old history of psychiatric perturbation are greater subscribers to the development of PSD than lesion location ( Singh et al. 2000, Berg et Al. 2003, Carota et Al. 2004, Aben et Al. 2006 ) . While the literature on PSA remains in its babyhood, the literature has begun to analyze its relationship to similar demographic, hurt, cognitive, and physical features as those examined for PSD. In footings of hurt features, PSA correlates signii ¬?cantly with right hemisphere lesions, while co-morbid PSA and PSD are linked to go forth hemisphere lesions ( Astrom, 1996 ) . Castillo et Al. ( 1993 ) found anxiousness more prevalent in association with posterior right hemisphere lesions, whereas worry without anxiousness upset was associated with anterior lesions. Those surveies that have found relationships between PSA and age and gender study that adult females ( Morrison, Johnston, & A ; Walter, 2000 ; Schultz, Castillo, Kosier, & A ; Robinson, 1997 ) and younger patients ( & lt ; 59 old ages ) are more susceptible to PSA ( Schultz et al. , 1997 ) , while others report no signii ¬?cant relationship ( Dennis et al. , 2000 ) . Most surveies that have examined cognitive map and PSA have besides assessed physical damage. Castillo et Al. ( 1993, 1995 ) study that PSA is non signii ¬?cantly correlated with physical operation, cognitive operation, or societal operation. While some writers likewise report no signii ¬?cant correlativity ( Starkstein et al. , 1990 ) , others report that anxiousness is linked to greater damage in activities of day-to-day populating both acutely and up to 3 old ages post stroke ( Schultz et al. , 1997 ) . To day of the month, few surveies have examined both depression and anxiousness station shot, or their differential relationships to these factors. Suzanne L. Barker-Collo ( 2007 ) found in his survey Prevalence rates for moderate to severe depression and anxiousness in the present sample were 22.8 and 21.1 % , severally. That left hemisphere lesion was related to increased likeliness of depression and anxiousness is consistent with the literature if one considers 3 months to be within the acute stage of recovery ( Astrom, 1996 ; Astrom et al. , 1993 ; Bhogal et al. , 2004 ) . There is a dearth of literature about Body Dysmorphic Disorder ( BDD ) in station shot person.Aim and aims:To depict psychiatric profile of the patient with amputation and comparison with station shot patient.Materials and methods:Study was carried out in outpatient and inpatient section of orthopedicss, plastic surgery, general medical specialty at Govt. Stanley Medical College.Time period of survey:From may 2012 to October 2012 ( 6months )Design of survey:Case -control surveyChoice of sample:A sum of 30 patient consecutively chosen, organize the sample for instances and back-to-back sample of 30 patient with shot constitute the control group. Patient were assessed within the period of two to six hebdomads after amputation and shot.Inclusion and Exclusion standards:Cases ( Patients with amputation )INCLUSION CRITERIA:Patients who underwent elected every bit good as exigency amputation. Age between 18 old ages to 60 old ages.Exclusion Standards:Patients with age less than 18 old ages and with age more than 60 old ages Previous history of psychiatric unwellness Patients with history of psychiatric unwellness before the amputation Patients with other medical unwellnessControlsINCLUSION CRITERIA:Patients with shot Age between 18 old ages to 60 old ages.Exclusion Standards:Patients with age less than 18 old ages and with age more than 60 old ages Previous history of psychiatric unwellness Patients with history of psychiatric unwellness before the oncoming of shot Patients with other medical unwellnessTools used:A structured interview agenda to analyze the demographics, clinical characteristics and other relevant factors in history. General Health Questionnair ( GHQ-28 ) Hospital Anxiety and Depression Scale ( HADS ) Hamilton Depression evaluation Scale ( HDRS/HAM-D ) Brief Psychiatric Rating Scale ( BPRS ) Yale Brown Obsessive Compulsive Scale for Body Dysmorphic Disorder. ( YBOCS-BDD )General Health Questionnaire ( GHQ 28 )The GHQ 28 was developed by Goldberg in 1978, Developed as a shouting tool to observe those likely to hold or to crush hazard of developing psychiatric upset. GHQ 28 is a 28 point steps of emotional depression medical scenes, through factor analysis GHQ 28 has been divided into 4 subscales. They are: Bodily symptoms ( 1-7 ) Anxiety/insomnia ( 8-14 ) Social disfunction ( 15-21 ) Severe depression ( 22-28 ) Each point is occupied by 4 possible responses non at all, no more than usual, instead more than usual and much more than usual. There are different methods to hit GHQ 28. It can be scored from 0-3 for each response with a entire possible mark on the runing from 0-84. Using this method, a entire mark of 23/24 is the threshold for the presence of hurt. Alternatively to GHQ 28 can be scored with a binary method where non at all and no more than usual mark 0, and instead more than usual and much more than usual mark 1, utilizing this method any mark above 4 indicates the presence of hurt. Numerous surveies have investigated dependability and cogency of the GHQ 28 in assorted clinical populations. Test-Retest dependability has been reported to be high ( 0.78+00.09 ) ( Robinson and monetary value ( 1982 ) and intra rater and inter rater dependability have both been shown to be first-class ( crnballi ‘s 20.9-0.95 ) . High internal consistences have besides been reported. ( Failde and Ramos 2000 ) . GHQ 28 correlatives good with the infirmary depression and anxiousness graduated table ( HADS ) ( Sakakibara 2009 ) and other steps of depression ( Robinson and monetary value 1982 ) .Hospital anxiousness and depression graduated table ( HADS )HADS was originally developed by Zigmond and snaitn ( 1983 ) , it is normally used to find the degrees of anxiousness and depression. Sum of 14 points in that 7 points for anxiousness and 7 for depression. Each point on the questionnaire is scored from 0-3 and this means that individual can hit between 0 and 21 for either anxiousne ss or depression. ( Scale used is a likes mark and the bow informations returned from the HADS is ordinal informations ) and subdivided into mild 8-10, moderate 11-15 and terrible greater or equal to 16. Internal consistence has been found to be first-class for the anxiousness ( 2-85 ) and adequate for the depression graduated table and besides has equal cogency for anxiousness HADS gave a specificity of 0.78 sensitiveness of 0.9. For depression this gave specificity of 0.78 and sensitiveness of 0.83.Hamilton Rating Scale for DepressionThe Hamilton evaluation graduated table for depression ( HAMD ) , developed by M.Hamilton is the most widely used evaluation graduated table to measure the symptoms of depression. The HAMD is a observer rated scale consisting of 17 to 21 points ( separately 2 portion points, weight and denary fluctuation ) . Rating is based on clinical interview, plus any extra variable information such as household members study. The points are rated on either 0-4 spectrum or a 0-2 spectrum. The HAM-D relies rather to a great extent on the clinical interviewing teguments and experience of rater in measuring persons with depressive unwellness. As most patients score zero on rare points in depression ( Depersonalization and compulsion and paranoiac symptoms ) , the entire mark on HAMD by and large consists of merely amount of first 17 points. The strength of the HAMD is first-class proof research base and easiness of disposal. Its usage is limited in person who have psychiatric upset other than primary depressionScoring0-7 aNormal 8-13 aMild depression 14-18 aModerate depression 19-22 asevere depression Greater than 23 aVery terrible depressionsBrief psychiatric evaluation accomplishment ( BPRS )Developed by JE overall and Dr.Gorhav in 1962 it is widely used comparatively brief graduated table that measures major psychotic and non psychotic symptoms in single with major psychiatric upset, peculiarly Scurophressia. The 18 points BPRS is possibly the most researched instrument in psychopathology. 18 points rated on 1-7. Items are divided into observed and reported points.Observed ItemsReported ItemsEmotional backdown Bodily concern Conceptual disorganisation Anxiety Tension Guilt feeling Idiosyncrasy and Posturing Depressive temper Motor deceleration Hostility Uncooperativeness Suspicion Blunted affect Hallucinatory behaviour Exhilaration Unusual tuocyn content Disorientation Strengths of the graduated table includes is brevity, easiness of disposal, broad usage and good rescanned position.Yale Brown Obsessive compulsive Scale for BDDYBOCS is a test/scale to rate the badness of OCD symptoms. Scale was designed by Dr.Wayne Goodman and his co-workers, is used extensively in research and clinical pattern. Modified YBOCS graduated table is used to mensurate to badness of symptoms of compulsion and irresistible impulse in a patient holding pre business with sensed defect in visual aspect ( BDD ) . It is a 12 point instrument consisting 5 inquiries on preoccupation and 5 inquiries on compulsive behavior, one on penetration and one on turning away. More specifically it assesses clip occupied by preoccupation with the sensed defect in visual aspect, intervention in operation, hurt, opposition and control. Similar buildings are assessed for compulsive behavior. Similar to the YBOCS for OCD, each points on the YBOCS-BDD measured on the 5 point likert graduated table with higher mark denoting progressively psycho-pathology. Mark on this 12 points ranges from 0-48 the YBOCS-BDD has been shown to hold good inter rated dependability, trial retest dependability and internal consistence. It has besides shown to be sensitive to alter. It was developed as mensurating badness of BDD symptoms instead than as a diagnostic tool. It should be noted that, scale first 3 points reflect the DSM IV diagnostic standards for BDD. The advantage or BDD-YBOCS is that it assists in comparing clients across surveies. It is based on the YBOCS and is hence curicitically bound to a theoretical account of an obsessional compulsive ghosts disorder. An of import different between YBOCS BDD and YBOCS for OCD is that the ideas about the organic structure defect combine the evaluation for both the stimulation and knowledge response. In OCD Rumination would be rated under the irresistible impulse.ProcedureA sum of 30 patients amputation consecutively chosen signifier to try for instances and a at the same time sample 30 patient with shot constitute to command group who free make full the exclusion and inclusion standards were taken for survey. A written informed concern was obtained. HAMD, BPRS, HADS, GHQ-28, YBOCS-BDD graduated tables were administered after clinically measuring as per 1CD-10 diagnostic standards.Ethical commission blessingThe survey was submitted for ethical commission blessing on at Govt. Stanley infirma ry and blessing was obtained.Statistical methodThe information collected will be entered in excel marker sheet and analysis utilizing SPSS for this different in frequence distribution and other evaluations on different steps appropriate statistical trial seen as t trial, cui square trial are employed. The socio demographical profile and HAMD, YBOCS BDD, HADS, BPRS GHQ-28 graduated tables were given in frequences with their percentage.HAMD, HADS, BPRS, GHQ-28, YBOCS BDD scores difference between instances and controls were analyzed utilizing chi- square trial. The place of the topic in instances and control were analyzed utilizing cui-square trial. The Association between socio demographic, psychiatric upset was analyzed utilizing cui-square trial. Incidence of psychiatric morbidity off amputees was given in per centum 95 % assurance interval.

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buy custom America Military essay America had stayed out of World War II until the Japanese killed thousands of Americans in an attack at Pearl Harbor. It was after the attack that America joined the World War II to battle it out with the Japanese and the Germans. The Japanese controlled the war until the Americans dropped two bombs in Hiroshima and Nagasaki on 6th and 9th August 1945, respectively forcing the Japanese to surrender. There were a series of land, sea, and air attacks from the Japanese and the Americans before 1944, but this paper will focus on the American military attacks between January 1944 and August 11, 1945, which led the Japanese to surrender. Furthermore, it will discuss the land, sea, and air attacks between May 1944 and April 1945 that led to the defeat of the Nazi Germany. US military operations against the Japanese between January 1944 and August 11, 1945 February 29, 1944, marked the beginning of another series of attacks on the Japanese with a 1000 military officers attached to the Fifth Cavalry Regiment, 1st Cavalry Division, attacked the Japanese on Los Negros (Wood, 2007). The Japanese put up a tough fight, and by March 3, 1944, most American soldiers were dead or wounded leaving Sergeant Troy A. McGill and another soldier in his squad to battle it out with the Japanese until they were both killed. The brave act won the sergeant Medal of Honor award. The next move was to attack Hollandia, and MacArthur was the man in command (Garraty, Carnes, American Council of Learned Societies, 1999). He led Adachi to believe that he planned to attack the Madang-Hansa area. On April 22 the 24th and 41st Divisions, under the command of Lieutenant General Robert Eichelberger landed and attacked Hollandia. At the same time the 163d Regimental Combat Team attacked Aitape from the sea. The US saw great opportunities in coral airstrips, which were commonly used for heavy bombings (Rottman, 2007). On May 27, MacArthur and Kenney organized the 41st Division to attack the BiakIsland. The first wave was successful, but unfortunately, series of subsequent attacks missed their targets following strong currents. The US Army intensified attacks on the island, and by mid July 1944, it had captured the airfields on the island under the command of MacArthur and Krueger. The war continued all through 1944, and in January 1945, the American soldiers moved to the shores of the Lingayen Gulf before entering Manila. Once here, they fought with the Japanese until February 24, 1945. MacArthur led the liberation of Philippines, which was announced on July 5, 1945. A series of attacks and captures followed under the guidance of Major General Roy S. Geiger, who was later killed and succeeded by General Joseph Stilwell on 22 June 1945. The US captures Ryukyus giving air forces and Allied naval strategic bases, leading to intensive air attacks and naval bombardment that led to the surrender of the Japanese in August 1945. US Military Operations against Nazi Germany between May 1944 and April 1945 The US saw England as a strategic base to set up camp in order to conquer over the Nazi Germany, so the Allied set up a base in the UK in April 1942. The Allied military conducted its first attack on Germany on June 6, 1944 dubbed as the D-Day (Sylvan, Smith, Hodges, Greenwood, 2008). The US and the British troops attacked the Normandy coast in France through intense air and naval attacks. The Germans countered the D-Day attack effectively, prompting the Allied troops, led by the Americanns, to form Operation COBRA, which attacked the Germans on July 25 at the Falaise (Henry, 2002). The Americans progressed into Paris on August 25 under the leadership of General Eisenhower, then to Lyon and Besancon. The troops later captured Belgium and Luxembourg. Operation Market Garden was planned to seize the Netherlands, but once again the Germans resisted with more force (The Military Order of the World Wars, 1995). On December 16, the Germans struck the US First Army in the Ardennes, and on December 18, Eisenhower commanded Patton's Third Army to attack Germanys southern border. This move paved way for American defenders to seize some German strongholds, which destabilized the Germans. Patton and his troops continued to attack the Germans, and by the end of January, the Nazis had lost ground. In February 1945, the Allied military marched into Germany, where the US First Army seized Cologne on March 5 and the Remagen Bridge on March 7. Through airborne attacks, the US went ahead to capture the Rhine, the Rees-Wesel-Dinslaken area, and Worms. At this point, the Germans began surrendering, and Hitler committed suicide on April 30, 1945. The Germans continued relinquishing their territories in May 1945, and on May 7, the German High Command relinquished all its forces unconditionally leading to the V-E Day on May 8, 1945. In conclusion, the US joined the World War II to fight the Japanese and the Germans. Despite being a sleeping giant at the time, America faced serious challenges in outdoing its enemies and at some point resulting to collaborate with the Allied military to gain victory. The US troops employed a series of land, air, and sea attacks to win over both Japan and Germany simultaneously. The US won over Germany in May 1945 and over Japan in August 1945 albeit several of its troops were either killed or injured. Buy custom America Military essay

ACT Guessing Strategy The Top Mistake Students Make

ACT Guessing Strategy The Top Mistake Students Make SAT / ACT Prep Online Guides and Tips The ACT doesn't penalize guessing, so you should never leave any answer blank even if you have to take a completely blind guess. Even with this information, students still make one huge mistake. Here we expose the biggest ACT guessing strategy mistake students make, and suggest a much better approach. We've seen students improve 1-2 points immediately after applying this 5-minute strategy. The Biggest ACT Strategy Mistake ACT takers already know not to leave any questions blank – after all, the ACT doesn't penalize guessing. But many students take this to mean that they should spend substantial time on each question. These mistaken students think, "if I have to answer all questions, doesn't it make sense to spend at least 20-30 seconds looking at each?" The answer is a big, fat NO. Let me be clear: you have to give an answer for each question, but you DO NOT need to spend 20-30 seconds looking at each question. I am a strong advocate of blind guessing for many students on many types of questions. First, What Is Blind Guessing? Blind guessing is exactly what it sounds like guessing on a question without even reading it. Just filling in "C" or "G" at random. This might sound crazy, but for many students this is not a bad strategy. How and Why to Use Blind Guessing In particular, you should always blind guess when you encounter a problem way beyond your difficulty threshold. For example if you usually score a 15 on the math section, then most of the problems in the "hard" towards the end of the section will be way above your skill level. You get .20 points (in expectancy) just for blind guessing, which means you have a 1-in-5 chance of getting it right. And it takes 1 second! Now, since these are hard questions, and you usually score a 15, it may take you 2 minutes just to understand each question, and another 2 minutes to eliminate a couple of answer choices. This is a really bad use of four minutes to just get .4 extra points (in expectancy). Besides, you may not even eliminate correctly. Who Should Not Blind Guess: High Scorers High scorers, those with above a 20 on all sections, should not be using Blind Guessing. That's because, to maximize their points, they need to be spending time trying all of the questions. In such a case, since you're reading and understanding all questions anyway, you might as well make a more educated guess by eliminating some answers. When Everyone Should Not Blind Guess: Easy Questions For easy questions (those toward the beginning of the section), everyone should be trying them even if you're a low scorer, these are the questions that will give you your baseline points. On these questions, blind guessing is a big no-no. Recap As a recap, a holistic ACT guessing strategy is made up of three parts: 1. Always answer all questions, even if it means blind guessing last minute. Never leave them blank! 2. If you read a question, make an educated guess by eliminating answers you think are wrong. 3. Do not spend time on all questions: for ones that you know are much too hard for you, intend to blind guess. Read More! How is the ACT scored? Is the ACT easier than the SAT? Want to improve your ACT score by 4+ points? Download our free guide to the top 5 strategies you need in your prep to improve your ACT score dramatically.

Social Media for Small to Medium Enterprises Essay - 2

Social Media for Small to Medium Enterprises - Essay Example Small and medium-sized enterprises, SMEs play a crucial role in any national economy. They are a major source of employment and foster socio-economic expansion (Taprial & Kanwar 2012). To foster the achievement of their objectives, a majority of these SMEs leverage on IT-based tools to increase information content and creativity (Belo, Castela & Fernandes 2013; Laudon & Traver 2010). With this regard, many SMEs have incorporated social media strategy in their operations so as to realise the benefits that IT offers in their businesses. Joosten (2012) generally describes social media as technological systems that enhance collaboration and connection by creating personal and corporate profiles, sharing of opinions, activities and information and content creation. Among the many social media networks, Schwartz (2010) documents Twitter and Facebook as the most popular. SMEs have established their presence in a majority of these platforms. Anoto Group AB is an example of an SME that has embraced the use of social media in its operations. This Swedish high-tech company provides solutions for transmitting handwritten text from hard copies to digital media, intelligent camera surveillance and scanning printed text (Anoto Group AB 2013). To reach out to its customers and all other stakeholders, the company has presence on Twitter, Flickr and YouTube social media sites. With only 103 employees spread across Sweden, UK, US and Japan, the company is an example of modern SMEs that have adopted new IT features as change drivers to enable them gain sustainable competitive advantage over their rivals. Indeed, just like Anoto AB, many other SMEs have embraced the strategy of using social media to achieve their objectives. Meske and Stieglitz (2013) observe that 24% of small enterprises structurally use social media with another 20% using it informally. For medium-sized organisations, the

Child Abuse and Steps for Its Prevention Essay Example | Topics and Well Written Essays - 2000 words

Child Abuse and Steps for Its Prevention - Essay Example Baby P was admitted in hospital several times before his death in which instances the healthcare providers, who offered complete and conclusive reports on their physical examinations, noted his battered body and the bruises on his skin (Marinetto, 2011). Over the course of 8 months while his mother was living with her boyfriend (not Peter’s biological father), the child experienced physical trauma resulting in over 50 injuries. This was indicative of a trend of physical abuse from the live-in boyfriend and should have been spotted and stopped before it got to such extents.While the physical abuse was being carried out, the family interacted with agencies that could have noticed the problem over 60 times, with none of these encounters being effective in stopping the abuse. Doctors’ reports analyzed during the inquiry over his death indicated that Baby P had swallowed a tooth broken during a beating, had a broken spine and several fractured ribs. The last of these reports was dated a day before his death and according to pathological reports, should have acted as the much needed wake-up call that could have saved his life. About 9 months and then again 2 months before his death, the child was placed under the protective care of a friend of the family to ensure his well-being. The second homecoming resulted in his death and from the wealth of evidence of abuse that had been accumulated, could have been prevented by the provision of better and more adept child welfare practices by all the professionals involved. Professionals in the social fields have a very important job of putting together the pieces that indicate that an individual needs more help from them than their position affords. As a result, agencies involved in such industries operate under a model of interdependency, with practitioners forwarding the cases that another agency will pick up on. This model allows for the sharing of information and the assessment of cases that social workers would, under normal circumstances, not review. This system depends on the communication between professionals and if this is not established, a lot of cases could go under the radar, as was the case with Baby Peter. This case was repeatedly analyzed by practitioners from several departments who ended up with the conclusion that he was safe in the environment that he was in, which is clearly a fallacy. It is therefore imperative that we understand the shortcomings of the agencies and agents that handled the case to negate the possibility of such c alamities in the future. The physical aspect of child abuse manifests itself in a condition that normally requires the attention of medical practitioners. This is the first line of defense and can create awareness if the neighbors and other individuals in the child’s environment are not aware or do not respond to the child’