Factors Can Affect Validity Reliability Of Systematic Review Nursing Essay

Factors Can Affect Validity Reliability Of Systematic Review Nursing Essay Systematic review with meta-analysis are considered more objective than other types of reviews such as traditional reviews because it involve the application of scientific strategies in ways that limit the bias but the interpretation of the systematic process like any other type of research is subject to bias and this articles will illustrate the sources of bias in every step of conducting a systematic review and what is its types and ways. Keywords: Systematic review, Bias, Meta-analysis Introduction A systematic review is an overview of many studies that used clear and reproducible methods while a meta-analysis is a mathematical synthesis of the results of two or more primary studies that address the same hypothesis in the same way. Systematic reviews are very popular so about 2500 new English language systematic reviews are indexed in Medline annually (Mother D, Tetzlaff J, Tricco a, et al). While the number is impressive ,the quality of their reporting is not always ideal which lead to some kind of biased results and thus shrink their usefulness. Although meta-analysis can increase the precision of a result, it is important to ensure that the methods used for the review were valid and reliable. (Greenhangh. 1997) Speaking generally,there are two sources -at least- can generate bias in systematic reviews: the risk of bias in the included studies which it can exaggerate the results of a treatments effectiveness by 18% (Pidal J, Hrobjartsson A, Jorgensen KJ, et al) and the review itself as it has a little control over the reporting of RTCs but it can apply considrable control over conducting and reporting the review, thereby minimizing the bias of review itself. In this article we will try to spot the sources of bias in every step of conducting a systematic review and what is its types and ways and after that we will talk in details about each factor might cause a bias including publication bias, time lag bias, citation bias, the influence of external funding on the validity of systematic review and outcome reporting bias. Assessing the Quality of a Systematic Review General Tips (step-by-step) Fundamentally, the quality of a systematic review and the reliability of its result are contingent on both the quality of the included studies and the quality of the methodology used to produce the systematic review. The first most important step in conducting systematic review is proposing a clear, specific,focused and concise question which will guide the review process after. Searching for articles to be included can be retrieved by electronic databases, searching by hands through appropriate journals and by contacting researchers in the area of interest. To avoid the bias in the retrieval of articles the search strategy specified in the protocol must include as much details as possible. In most cases this amounts of to a list of keywords and how they will be combined for use in electronic search engines. Some knowledge of the capability of each subject specific database is important at this point, as some databases operate a thesaurus search system and others operate on the basis of keywords only. Next step, selective inclusion studies may bias the results of systematic reviews if selected based on report characteristics which called Biased inclusion criteria and low methodological quality of studies included in a systematic review is another important source of bias (Strerne JAC, Egger M, Smith GD 2001) and inclusion of data from sources other than randomized trials reduces the reliability of the conclusions of a systematic review on issues of prevention and treatment, so they should be thoroughly considered and properly defined to avoid ambiguity and to inform the validity of the review. As protocol availability may decrease the biased post-hoc changes to methods and selective outcome reporting, this information should be included in the review protocol to minimize this bias. Even if the study has high internal validity, it may not to be generalizable(high external validity). There is often a trad-off between internal and external validity. To decide about the generalizability of the study is to explore whether the study population appears to be representative of the population to which you wish to apply the results and even in similar populations, differences in the settings and in culture or other contextual factors, should also be considered.(Petticrew M, Robert, H 2008) Reviewing the results of a number of studies of course itself provides a est of generalizability, if the results have been replicated in several settings with different population, then this gives an indication of whether the results are transferable. If the number of studies is large enough, it can suggest the range of effect sizes to be expected in different settings. Generalizability is not often assessed separately in systematic reviews, though consideration of the issue is included in some critical appraisal checklists. (Deeks J, Dinnes J, DAmico R, Sowden A, Sakarovitch C. 2003) The risk of bias of a particular study is a key component in the assessment of studies that affect the validity of the results of a systematic review. Therefore, reducing the risk of bias assessment can be completed by using scales, checklists and every individual component should be reported for each study.(Sandrson S, Tatt ID, Higgins JP 2007). As the protocol developing, all the outcomes derived from the included studies should be considered and the outcome of primary importance should be differentiated from the secondary outcomes as recent surveys have showed that the outcomes selectively reported in final reports were significantly more likely to be statistically significant than those omitted (Chan AW, Hrobjartsson A, Haahr MT, et al 2004). Therefore, if a review does not identify important variables clearly, the review risks being subject to bias. So, the reviewer might select statistically significant variables and ignore the ones were initially important by the reviewer. When it comes to analysing data, the analysing method is determined by the review question and the type of data collected and it should include a narrative synthesis for describing the results and risk of bias. The next step is usually determining if statistical synthesis is appropriate to apply or not. Indeed, such forced analysis might in the axiom garbage in garbage out, providing useless results which it will discussed Later. When the results of the analysis are ready, there are many different way to represent them but sufficient details should be presented to dtermine the potential threats to validity. As conclusion in the review, the reviewer should discuss the risk of bias, strength, limitation, weakness and applicability of the evidence for each main outcome to ensure that clinicians have all the information to interpret the results. A table outlining the users guides to the Medical Literature highlight critical appraisal questions for systematic reviews and meta-analyses may help to reduce the bias in every step when conducting a systematic review.(Table 1) Table 1. Questions should be considered in determining if the results of systematic review are valid. ( adapted from Crowther, MA. Cook, DJ 2007) Did the overview address a focused clinical question? Were the criteria used to select articles for inclusion both defined and appropriate? What is the likelihood that relevant studies were missed? Was the validity of the included studies assessed? Were the assessment reproducible? How precise were the results of the overview? In assessing the value the review, it is important to consider the following question: Can the results be applied to my patients, and will the results help me care for my patients? Are the benefits worth the harms and costs? Garbage in garbage out? The quality of component trails is important as an example if the raw material is not that quality, then the findings of reviews may also be the same. So what we put in exactly what we get out. Clearly, the studies included in systematic reviews should ideally be of high methodological quality and free of bias as possible. The biases that threaten the validity of clinical trials are relate to systematic differences in the patients characteristics at baseline (selection bias), unequal provision of care apart from the treatment under evaluation (performance bias), biased assessment of outcomes (detection bias) , and bias due to exclusion of patients after they have been allocated to treatment groups (attrition bias).(Altman 1991) Some reviews produced discordant results precisely because the authors chose to ignore the quality of component trails. The same reviewers were considerably more thorough in their attempt to identify all-relevant trails,Independent of publication statue or language of publication. Although the quality of component trails happened to be more important in this particular situation, the dissemination of findings from clinical trials is known to be biased, and a comprehensive literature search is an essential intergradient of high-quality reviews. (Eddger,M. Dickersin, K. Smith,G, S 2001) Putting the light on dissemination of research findings, Scherer et al. showed that only about half of abstracts presented at conferences are later published in full. The fact that sustainable proportion of studies remains unpublished after the study had been completed must be a concern as a large information remains hidden from reviewers. Making things worse, the dissemination of research findings is not a random process, rather it is strongly influenced by the nature and direction of results. (Eddger,M. Dickersin, K. Smith,G, S 2001) Type of reporting bias Definition Publication bias The publication or non-puplication of research findings, depending on the nature and direction of results Time lag bias The rapid or delayed publication of research findings, depending on the nature and direction of results Duplicate publication bias The multiple or singular publication of research findings, depending on the nature and direction of results Citation bias The citation or non-citation of research findings, depending on the nature and direction of results Language bias The publication of research findings in particular language, depending on the nature and direction of results Outcome reporting bias The selecting reporting of some outcomes but not others, depending on the nature and direction of results Figure 1.2 (Adapted from Eddger,M. Dickersin, K. Smith,G, S 2001) Publication Bias In a 1979 article on the file drawer problem and tolerance for null results Rosenthal said, where the journals are filled with the 5 per cent of the studies that show type I errors, while the file drawers back at the lab are filled with the 95 per cent of the studies that show non significant results. (Rosenthal R. 1979). The file drawer problem has long been recognized in the social sciences: as a review of psychology journals found that of 294 studies published in 1970s, 97% rejected the null hypothesis at the 5% level.(Sterling TD.1980) It is thus possible that studies which suggest a beneficial treatment effect are published, while an equal mass of data pointing the other way remains unpublished. In this situation, a systematic review of the published trails could identify a spurious beneficial treatment effect, or miss an important adverse effect of a treatment. In the field of cancer chemotherapy such publication has been demonstrated by comparing the result from studies identified in a literature search with those contained in an international trials registry (see figure 1.2). (Simes RJ. 1986) Time lag bias Published studies continued to appear many years after approval by the ethic committee. Among proposals submitted to the Royal Prince Alfred Hospital Ethics Committee in Sydney, 85% of studies with significant results as compared to 65% of studies with null results had been published after 10 years (Stern JM, Simes RJ. 1997). The average time to publication was 4.8 years for studies with significant results comparing to 8.0 years for studies with null results. In fact, the time lag was attributable to differences in the time from completion to publication.(Eddger,M. Dickersin, K. Smith,G, S 2001) 0.7 1.0 1.3 Published 16 (1908) Registered 13 (2491) Survival ratio (95% confidence interval) Figure 1.2 (adapted from Simes) These findings indicate that time lag bias may be introduced in systematic reviews even when most or all trails will eventually be published. Trails with positive results will dominate the literature and introduce bias for several years until the negative results finally appear. The influence of external funding and commercial interests Many systematic reviews are funded by organizations such as pharmaceutical companies. As in the design of randomized trials, the design of systematic reviews can be influenced (particularly through manipulation of inclusion and exclusion criteria) to select a particular set of studies. As a result, such systematic reviews may present a biased viewpoint. Careful assessment of the quality of the systematic review should reveal the flaws in their design. Another way in which bias can be introduced is through biased interpretation of the results of a systematic review funded by industry or authored by investigators who are influenced by industry.(Crowther, MA. Cook, DJ 2007) External funding was associated with publication independently of the statistical significance of the results. Funding by government agencies was significantly associated with publication in three cohorts of proposals submitted to ethics committees whereas pharmaceutical industry sponsored studies were less likely to be published in two studies. Indeed, the pharmaceutical industry tends to discourage the publication of negative studies which it has funded. (Eddger,M. Dickersin, K. Smith,G, S 2001). Duplicate publication bias Once a list of articles is obtained, they should be reviewed by two or more individuals and compared with a list of pre-developed inclusion and exclusion criteria The production of multiple publications from single studies can lead to bias in a number of ways. Two or more systematic reviews on the same topic may arrive at different conclusion, which raise concern about validity. Studies with significant results are more likely to lead to multiple publications, which makes it more likely that they will be located and included in a meta-analysis. Moher and Johansen and Gotzsche described the difficulties caused by redundancy and the disaggregation of medical research when results from multicentre trail are presented in several publications. It may be impossible for reviewers to determine whether two papers represent duplicate publications of one trail or two separate trails, since example exist where two articals reporting the same trail do not share a single common author. (Eddger,M. Dickersin, K. Smith,G, S 2001). Citation bias The perusal of the reference lists of articles is used to identify additional articles that may be relevant. The problem with this approach is that the act of citing previous work is far from objective and retrieving literature by scanning references lists for many possible motivations such as decoration and showing up-to-dateness and knowledge may thus produce a biased sample of studies. (Eddger,M. Dickersin, K. Smith,G, S 2001) Language bias Language bias still evident in many reviews (Hearther, 2009). Reviewers are often exclusively based on trails published in English. For example, among 36 meta-analyses reported in leading English-language general medicine journals from 1991 to 1993, 26 had restricted their search to studies in English language. Reviewers in other countries will published their work in local journals as well as English language journal if their results are positive while negative results will just be published in local journals. This is demonstrated for the German language literature when comparing articles published by the same author, 63% of trails published in English had produced significant results as compared to 35% of trails published in German. Thus bias could be introduced in meta-analyses exclusively based on English-language reports.(Figure 1.3) (Eddger,M. Dickersin, K. Smith,G, S 2001) Figure 1.3 (adapted from Egger et al.) Outcome reporting bias Reporting the outcome can be influenced by the results: the outcome with the most favorable findings will generally be reported. (Eddger,M. Dickersin, K. Smith,G, S 2001). The future of unbiased, systematic reviewing Reporting biases is potentially serious problem for systematic review. While the Cochrane Collaboration has a simple aim -help people to make well informed dicisions about healthcare-, there are many challenges that must be met to achieve this aim. Ethical and social challenges include finding ways to continue to build on enthusiasm while avoiding duplication and minimizing bias, to ensure sustainability and to accommodate diversity. Logistical challenges include finding ways to identify efficiently trails and manage criticisms and updates of reviews. Methodological challenges include developing sound guidelines for deciding what types of studies to include in reviews, effective ways of communicating the results of reviews and summarizing the strength of evidence for specific effects. (Eddger,M. Dickersin, K. Smith,G, S 2001). Conclusion and Summary points In summary, There are numerous ways in which bias can be introduced in reviews and meta-analysis of controlled clinical trials. All these biases are more likely to affect small studies therefore, their results need large treatment effect to be significant. On the other side, the large studies invest more money and time that means they are more likely to be high methodological quality and published even if their results are negative. Bias in a systematic review may become evident through an association between the size of the treatment effect and study size. Reliability and validity often not established within quality assessment instrument (Heather, 2009).If the methodological quality of trials is inadequate the findings of reviews of this materials may also be compromised. Publication bias can distort findings because trials with statically significant results are more likely to be published, and without delay, than trials without significant results. Among published trails, those w ith significant results are more likely to get published in English, more likely to be cited, and more likely to be published more than once which means that they will also be more likely to identified and included in reviews. The choice of the outcome that is reported can be influenced by the results. The outcome with the most favorable findings will generally be reported, which may introduced bias. Criteria for inclusion of studies into a review may be influenced by knowledge of the results of the set of potential studies. The definition of eligibility criteria for trails to be included, a comprehensive search for such tails, and an assessment of their methodological quality are central to systematic reviews. Systematic reviews are thus more likely to avoid bias than traditional, narrative reviews.(Eddger,M. Dickersin, K. Smith,G, S 2001) Nevertheless, the systematic review is a powerful research methodology which answers question on the the basis of good evidence and provides researchers with a valuable, impartial, comprehensive and up-to-date summary of the work conducted in a specific area.

Alicia My Story, Book Summary Essay -- essays research papers

The main character in this story is a Jewish girl named Alicia. When the book starts she is ten years old, she lives in the Polish town of Buczacz with her four brothers, Moshe, Zachary, Bunio, and Herzl, and her mother and father . The holocaust experience began subtly at first when the Russians began to occupy Buczacz. When her brother Moshe was killed at a â€Å" Boys School† in Russia and her father was gathered up by German authorities, the reality of the whole situation quickly became very real. Her father was taken away shortly after the Russians had moved out and the Germans began to occupy Buczacz. Once the Germans occupied, they moved the Jewish population of Buczacz into mass ghettos. Alicia and the rest of her family had to share a house with several other families which had also been driven out of there homes. The only source of income in this situation was to sell things at the marketplace, and even there, Jews were forbidden. Alicia went anyway and sold what she could for food and money.   Ã‚  Ã‚  Ã‚  Ã‚  One day her brother Bunio disappeared from the ghetto. Alicia and her family found out later that he had been taken to a work camp, but that they could send food packages to him. Shortly after this, Alicia was taken into custody by German officials and put on a train to another work camp. Alicia managed to escape from this train by jumping through a small window. She found her way to a river which led her back to the ghetto. By this time several people in the ghetto had been feeling the effects of the impoverished conditions. Starvation, Typhoid, and other diseases, were beginning to take its toll on the people who lived in the ghetto. Then one day, Alicia found out that her brother Bunio had been killed in the work camp. A boy had escaped so they lined up all the boys and shot every fourth one .   Ã‚  Ã‚  Ã‚  Ã‚  As time progressed, Alicia began assuming more responsibility for the daily tasks of the family such as going out and trading for more food in places other than the marketplace. While this was going on, Zachary and a few other boys from the ghetto had been forming a sort of resistance. One day Alicia was informed that her brother had been hanged. After Zachary’s death, Alicia was befriended by a woman named Bella. She met many good friends in the ghetto including a future friend as well as savior, Milek  ... ...and the police wanted to find out who was buying things from her. Over a span of 8 months they were kept but finally they were released. They received a lot of money from people that had been saved by their withholding of evidence. Alicia and her friend took this money and bought a train ticket to Lodz. They were stopped in Lvov because they went to get some tea while stopped at a station, but the train took off without them and they left all of their belongings on the train. Next they boarded a train to Krakow, and parted ways there. In Krakow, Alicia was staying at a rather large house with another family. She built a sort of orphanage by gathering up homeless children from the neighborhood. She lived with this family for a long time, and during this time she learned about a way that she could go to Eretz Island, Israel where she could be safe. She left her orphanage and went on a long journey where she met many people that were like her, in that she didn’t like to see people suffer.   Ã‚  Ã‚  Ã‚  Ã‚  Alicia made it to Israel but was taken by British border patrol officers to a jail on Cypress for coming into the country illegally. She was then released from Cyprus.

Obsessive Compulsive Disorder: Analyzed, Interpreted, and Theorized Essay

Obsession is defined by preoccupying or filling the mind of (someone) continually, intrusively, and to a troubling extent (dictionary.com). A compulsion is defined as to force or drive, especially to a course of action. All of this grouped together with a psychological irregularity can describe someone going through Obsessive Compulsive Disorder. Those suffering from Obsessive Compulsive Disorder have recurring thoughts, feelings, and ideas to feel driven to accomplish a certain task, usually cleaning, counting, fixing, etc. These people feel anxiety because of their reoccurring compulsions and can only be rid of it by acting on the thought which is called thought-action fusion. Obsessive Compulsive Disorder effects maybe 1 out of 100 children in the US and a total 3% of people in the general population due to recent research completed by the WHO www.ocdeducationstation.org ). I think the prevalence of Obsessive Compulsive Disorder in children is so low because Obsessive Compulsive D isorder is a generalized biological vulnerability, meaning the child has a heritable contribution to negative effects. This means that the child has learned from outside sources; parents, teachers, friends; that a certain stimuli will bring about a certain set of feelings and therefore actions (thought action fusion). Some research studies done by the National Institute of Health have shown that Obsessive Compulsive Disorder is caused by an uncommon mutation of the human serotonin transporter gene (www.ocdeducationstation.org). Another theory explained in an article in the JAMA Network Journal by Ben J. Harrison; PHD states that those who have Obsessive Compulsive Disorder have an altered corticostriatal function in the brain. This corticostriatal function means the networks of nerves in the brain. It was shown in their research that those with Obsessive Compulsive Disorder have even higher functionality than those without Obsessive Compulsive Disorder. This does not mean a higher IQ or brain function; it only means altered networks create abnormal and reoccurring thoughts and actions. I believe Obsessive  Compulsive Disorder to be a learned or conditioned response to events taught by those responsible for early development. This hypothesis comes from an article in Psychiatry research by Francesco Catapano that shows the relationship between levels of melatonin and cortisol, the stress hormone, in those with Obsessive Compulsive Disorder compared to those who do not have Obsessive Compulsive Disorder. Their findings showed that those with Obsessive Compulsive Disorder had lower melatonin levels giving them irregular sleep patterns and abnormal circadian rhythms. Obsessive Compulsive Disorder patients were also found to have higher doses of cortisol in their blood in comparison to the healthy control group. More research was done on the subject by Xinhua Zhang; MD who claims that aft6er treating a patient with a brain tumor, the patient began to have compulsive thoughts about her children and husband living longer than her. She realized these thoughts were unnecessary and went back to the hospital. Xinhua Zhang concluded that since the tumor excavation took place in the right frontal lobe that this is where obsessions originate and the surgery caused her to behave abnormally. Upon further research I’ve found that the right frontal lobe is the perfect place for Obsessive Compulsive Disorder to spawn from because the frontal lobe is said to control our emotions and cause us to be different in personality (www.neuroskills.com ). There has been a lot of research on the treatment of Obsessive Compulsive Disorder and it almost always leads to medication. The treatment that has gotten the most recognition and funding is a drug called Clomipramine (www.psychcentral.com/medicationsforObsessive Compulsive Disorder ). Obsessive Compulsive Disorder is a chronic disorder that doesn’t really go away because of the serotonin levels in the brain of those affected. Obsessive Compulsive Disorder causes serotonin to be absorbed at an abnormal speed which accounts for constant urge to seek relief from stress. Clomipramine allows serotonin to bind to the drug and be free flowing in the synapses of the brain instead of being absorbed and shoveled off as waste. Considering Barlow’s Integrated Model of mental health. I would categorize Obsessive Compulsive Disorder as both generalized biological vulnerability  and generalized psychological vulnerability. It could be a biological abnormality because, as previously stated, there could be something wrong with the right frontal lobe causing obsession and compulsive thoughts. To me, psychological vulnerability just means a learned thought process either from parents, teachers, siblings, or other outside sources. According to a study done by J. Griffiths, a Bristol Doctorate graduate in Clinical Psychology, the data taken from those who live with parents or close relatives with Obsessive Compulsive Disorder has a serious indication on the prevalence of Obsessive Compulsive Disorder within the children of the family. The children reported feeling embarrassed by their parent and a feeling of loss of control considering boundaries and the happiness of said â€Å"sick† relative. Children who suffer from Obsessive Compulsive Disorder usually have fears of getting dirty, getting hurt, or have a feeling of need for exactness and/or symmetry. They’re both linked because of the integrative model of psychological disorders. Having a parent with Obsessive Compulsive Disorder, or any other type of mental disorder for that matter will have an effect on those in close proximity of them due to classical conditioning and learned response from an abnormal or neurotic pattern of behavior according to Etelà ¤-Savon Sairaanhoitopiiri, the writer of the article â€Å"Obsessive-compulsive disorder (OCD) in childhood† in the Duodecim journal. Many studies show that Obsessive Compulsive Disorder is more common in people who don’t follow pre- and perinatal health advice. Since prenatal childcare is the most crucial due to the formation of the brain and the natural chemicals combining in the amniotic sack, those who do not exercise greater caution in certain respects may cause their children to inherit Obsessive Compulsive Disorder later on in life. Data showed that excessive weight gain and edema of the hands, feet, and face during pregnancy lead to higher rates of people born with Obsessive Compulsive Disorder. Another huge contributor to predisposed Obsessive Compulsive Disorder is whether or not the mother took or mixed medications during the beginning stages of the pregnancy. A counter point made in â€Å"The Structure of Genetic and Environmental Risk Factors for Dimensional Representations of DSM-5 Obsessive-Compulsive Spectrum Disorders† in JAMA Psychiatry shows that there  is a strong correlation bet ween environmental factors and the onset of mental disorders. Their conclusion was that it is much more possible to get Obsessive Compulsive Disorder from traumatic experiences or living arrangements than biologically inherited. Those who suffer because of life events rather than genetics suffer to a higher degree than those of their biologically inherited symptom counterparts. This usually accounts for a higher drug dosage and a lesser ability to control and manage the symptoms of Obsessive Compulsive Disorder (Benedetta Monzani, PhD). This is supported by the lecture we did on experiential avoidance and the conditioned responses we acquire due to stress. If someone lives in such a way that any thought they encounter causes them stress, then they might pick up some behaviors that stop them from stressing out due to thinking; which is exactly what victims of Obsessive Compulsive Disorder encounter on a daily basis. It starts out as either biologically inherited or psychologically learned Obsessive Compulsive Disorder. Once they experience a str essful thought or action, they revert to their learned stress relief which is usually compulsive behavioral rituals to suppress said thoughts. In â€Å"Adverse childhood experiences and gender influence treatment seeking behaviors in obsessive–compulsive disorder†, an article in Comprehensive Psychology, it states that adverse childhood experiences (ACE) leads to higher activity in the frontal lobe of the brain; which we have deduced is where compulsive behavior originates. Different outcomes according to sex were also examined in this study and it was shown that males do a better job at rebounding after adverse or traumatic experiences than females which accounts for the higher rate of Obsessive Compulsive Disorder in females than in males. During my studies, while distinguishing adverse health outcomes due to prenatal care is easy and logical, I think that more research states that Obsessive Compulsive Disorder is more psychologically conditioned than inherited. The number of patients with Obsessive Compulsive Disorder who had traumatic or rough living environments vastly outnumber those who did not have such circumstances. I think this also shows the degree to which they are affected. Someone who is predisposed to have Obsessive Compulsive Disorder would not be as strongly influenced by their thoughts in comparison to someone who has a physical real life correlation with a traumatic experience. This is supported by the fact that the pharmaceutical treatment  for Obsessive Compulsive Disorder is the same as treatment for PTSD. Selective serotonin reuptake inhibitors (SSRIs) are both used to slow the absorption of serotonin in the brain so it is free floating in a higher dosage which leads to less stress and less abnormal behavior. The rate at which the serotonin is released and absorbed is equivalent to the time spent in less stress. Antidepressants work in these types of situations because of the high impact that Obsessive Compulsive Disorder has on the emotional state of the mind. The frontal lobe, as previously discussed, is the anatomical site for emotion and personality, so an abnormality in chemical processing or a physical abnormality not only spawns Obsessive Compulsive Disorder in subjects, but also alters their emotional state and how their outlook on life. Studies show that patients with Obsessive Compulsive Disorder who have a better outlook on their treatment and acceptance of it, have a better treatment outcome than those who don’t take SSRI’s. In conclusion, Obsessive Compulsive Disorder is a rare abnormality originating in the frontal lobe. The absorption rate of serotonin in the brain strongly correlates with onset of Obsessive Compulsive Disorder. Although there are many medications to take, the most widely used is Clomipramine and SSRI’s so the emotional and physical stress can be tolerated. Obsessive Compulsive Disorder can be contracted at any time but due to recent studies, I have more confidence in the theory that traumatic life experiences and negative living arrangements have a higher rate of setting on OCD than a predisposed genetic availability to contract it because of the physical testimonies from those in that situation. Although I’m sure that prenatal care and genetics play a viable roll in mental health, I would still say that those who have a physical association with stress or trauma are more affected by it in the mind. Obsessive Compulsive Disorder affects only 3% of people in the general population, but given the fact that mental health takes a toll on family members, coworkers, and fri ends; it can be conjectured that it is affecting more than that by a â€Å"contact mental illness†. The problems people face every day should be taken into softer hearts because you never know who has been affected by this rare disorder. Works Cited Benedtti, F. (2014). Comprehensive psychiatry. Adverse childhood experiences and gender influence treatment seeking behaviors in obsessive–compulsive disorder, 55(2), 298-301. Retrieved from http://www.sciencedirect.com/science/article/pii/S0010440X13002988 Flament, M. (1988). Journal of the american academy of child & adolescent psychiatry. Obsessive Compulsive Disorder in Adolescence: An Epidemiological Study, 27(6), 764-771. Retrieved from http://www.sciencedirect.com/science/article/pii/S0890856709658615 Monzani, B. (2014). The Structure of Genetic and Environmental Risk Factors for Dimensional Representations of DSM-5 Obsessive-Compulsive Spectrum Disorders, 71(2), Retrieved from http://archpsyc.jamanetwork.com/article.aspx?articleid=1792141 Ocd education station. (2014). Retrieved from www.ocdeducationstation.org Traumatic brain injury. (2014). Retrieved from www.neuroskills.com

Foiled Again!

Foiled Again! Foiled Again! Foiled Again! By Maeve Maddox A line associated with the 19th century mustache-twirling stage villains thwarted by the hero was Curses! Foiled again! Foil as a verb meaning to frustrate the efforts of is popular with headline writers and journalists. Netanyahu makes final push to foil Swedish plan to divide Jerusalem No-shows foil Sunrise mayors payment plan for code violators Police foil plan to kill Dawoods brother The verb originated as a hunting term meaning to spoil a trace or scent by running over it, from Old French fouler, trample. It took on its modern meaning of spoiling someones plans in the 1660s. Foil as a noun meaning a thin sheet of metal, comes from a French word for leaf, modern French feuille. The sense of metallic food wrap dates from 1946. In fiction, a foil character is a secondary character used to point up certain traits in a main character. In Hamlet, for example, Laertes acts as a foil to Hamlet. Whereas Hamlet hesitates to avenge his fathers death, Laertes is quick to seek vengeance for the death of his sister. In Macbeth, the loyal, law-abiding Banquo serves as a foil to ambition-crazed Macbeth. Macbeth murders to win the crown. Banquo does nothing and becomes the father of kings. This idea of the word foil as contrast comes from the practice of backing a gem with metal foil to make it shine more brightly. Shakespeare used it in this sense in Henry IV, Part I. The future Henry V is a dissolute prince. In a soliloquy he anticipates changing his ways when he becomes king. He thinks that his subjects will appreciate his reign more because theyll have his rotten youth to compare it with: My reformation, glittering oer my fault, Shall show more goodly and attract more eyes Than that which hath no foil to set it off. This use of the noun foil to mean contrast is a favorite with political writers: Republicans make President Obama foil in state races Crist Uses His Old Party as a New Foil: He has used the Republican-led state legislature as a conservative foil to increase his appeal among centrist and Democratic voters. Ehrlich welcomes Palin as a foil: Ehrlichs camp is embracing Palins move as an opportunity to emphasize the former governors more moderate profile. Both noun and verb are used playfully here: Mans foil theft plan foiled at Home Depot: A man who tried to foil the theft detection devices at Home Depot with aluminum foil learned Saturday that his scheme would not work. Foil meaning a light fencing weapon is of uncertain origin. Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Vocabulary category, check our popular posts, or choose a related post below:"Because Of" and "Due To" When to Form a Plural with an ApostropheHow often is "bimonthly"?

Phrenology essays

Phrenology essays Phrenology Phrenology is basically the study of personality through the study of the shape of the skull. The basis of this theory is that the brain conforms to the shape of the head and its contours. This pseudoscience says that because we have isolated where different parts of personality come from we can tell how dominant this trait would be in a persons life by the size of the piece of the brain. We have since proven that this theory is not true. Franz Joseph Gall is considered to be the founder of the direct scientific link between the morphology of the skull and personality traits. Gall was one of the first scientists to consider the brain the home of all mental activities. His main work was called The Anatomy and Physiology of the Nervous System in General, and of the Brain in Particular. In this article he put forth five points that phrenology was based on in general. 1. That moral and intellectual faculties and innate. 2. That their exercise or manifestation depends on organization. 3. That the brain is an organ of all the propensities, sentiments, and faculties. 4. The brain is composed of many particular organs as there are different propensities, sentiments, and faculties which differ from one another. 5. That the form of the head or cranium represents the form of the brain, and thus represents the relative development of the brain organs. Gall linked the faculties with precise brain localizations through careful observation and expensive experimental measures. Johann Spurzheims contribution to phrenology was also great. He helped Gall in a study of brain injuries with the phrenology concept Gall had created. He also studied many cases of aphasia following victims cranial injuries in battle. In 1832, he arrived in America, which was at that time desperate for insight into human personality, and started on a lecture circuit that eventually killed him only six months into it....

Subordination of People to Systems and Organisations in the 21st Essay

Subordination of People to Systems and Organisations in the 21st Century - Essay Example Morgan further illustrated his views by studying eight organisational metaphors: Machines: Organisations can be perceived to be logical enterprises, which are created to accomplish predetermined objectives in a competent manner through the linear aspects of cause and effect. Organisms: Organisations can be viewed as being living organisms that aim to transform in such a manner that they are capable of surviving or remaining relevant in a changing environment. Brains: Organisations can be viewed as being a type of brain that is flexible, inventive, and resilient. Here, the facility for intelligence is presumed to be distributed all through the enterprise, thus allowing the entire system to self-organise and develop along with the rising challenges. Cultures: Organisations can be said to be mini-societies that have their own rituals, values, beliefs and ideologies. They can also be defined as continuing procedures of reality construction that permit people to see and appreciate particu lar actions, events, comments, objects, and situations in distinct ways. For example, most restaurants have â€Å"back of the house† as well as â€Å"front of the house† operations (Morgan, 2006). Workers at the front are usually hired to portray a certain appearance as well as personality. The employees serving in the back might not have similar dress codes as those in the front because the culture there is totally different. Political Systems: Organisations can be perceived to be structures of political activity, with outlines of conflict, competing interests, and power. Psychic Prisons: Organisations can be viewed as being systems that get caught up in their own objectives in which mind traps, obsessions, strong emotions, narcissism, anxiety, illusions of control, and defence mechanisms are at the centre of attention. Flux and Transformation: Organisations are perceived as being representations of the lengthy processes of change. Instruments of Domination: Organisat ions are perceived to be systems that take advantage of the natural environment, their workers, and the worldwide economy to accomplish their own objectives (Robertson, Wang and Trivisvavet, 2007) Managers usually oversee functions in all organisations. A manager is a person who organises, plans, controls and leads the activities as well as the employees of an organisation in an efficient way that leads to the organisation realising its objectives. Management specifically concerns the managers of a business as well as their responsibilities in that organisation. Many people believe that managers are made, not born; while others feel that managerial skills form an intrinsic quality that cannot be taught. It has been suggested that the reality is a combination of both opinions (Morgan, 2006). A manager has to have an intrinsic potential before the talent can be fine tuned into being a useful skill. The basic underlying skills are not enough to make a person become a good manager. The inborn skill to be manager has to be developed in the right environment and given

Interventions for the working Stage Essay Example | Topics and Well Written Essays - 500 words

Interventions for the working Stage - Essay Example In another proposal, work satisfaction appeared to be affected by work attributes that can be unfavorable for some workers, such as its â€Å"low decision attitude and high job demands† (Cox, 1993, p. 15). Demands on both sides, individual and organizational, generate stressful tensions when shortcomings are foreseen on both sides. Aside from personal and work expectations, a number of maladaptive cognitive and behavioral problems appeared to further hamper better functions of adults in work areas. Cognitive areas need to be constantly updated to better meet occupations demands, thus, inadequate trainings and seminars, in combination with excess workloads, can hamper cognitive development and account for stress and discontent. Behaviorally, people appear to act up when they are not recognized for excellent performance, do not receive incentives, and are plagued by unsupported colleague interactions (Davis & McKay, 2009). The work culture of negative self-talk can aggravate the stressful atmosphere, as the need for affiliated group approvals are interspersed with events of blame for the shortcomings of others, preventing the acceptance of adult newcomers in organizations (Davis, Robbins Eshelman, & McKay, 2000, pp. 107-119).