Portfolios And Standardized Tests - Pros And Cons Essays

Portfolios And Standardized Tests - Pros And Cons Portfolios and standardized tests are two types of ways teachers can assess their students. There are many advantages and disadvantages to both assessments. Right now, whether teachers agree with standardized tests or not, all teachers have to give them to their students. Portfolios on the other hand, are not required in a classroom, because it is not a required assessment for all teachers to use. Portfolios are folders that hold students works in any or all subjects that teachers choose to use them for. They hold all different types of work a student creates. It has A work to work that needs more improvement on inside the folders. The students choose what goes in their portfolio, not the teacher. Standardized tests are tests administered to each student at the same time. They have a time limit to them and their test scores are based on the norm. Much of school-based assessment does actually prevent students from becoming thoughtful respondents to, and to be able to judge their own work. Portfolios help students learn to assess their own progress as learners, and teachers gain new views of their accomplishments in teaching. They also give students responsibility for taking the lead in evaluating their own work, enlarging the view of what is learned, a place for process and a developmental point of view. Some important things that matter when dealing with portfolios is a student's performance on the kind of skills that appear on tests, that first-draft work is good enough and achievement matters to the exclusion of development. There are centrally two aims that teachers have for student portfolios. The first is to design ways of evaluating student learning that, will be essentially providing information to teachers and school systems, it will also model personal responsibility in questioning and reflecting on one's own work. The second is to find ways of capturing growth over time so that students can become informed and thoughtful assessors of their own histories as learners. What teachers have students do is at the end of the school year, is let the student go back inside their portfolio and reflect on their own work. The students return to their portfolios or collections of work, and see what has changed from the beginning of the school year or what still remains to be done or worked on. This gives students a responsibility, because they are responsible for evaluating their own work. Authentic or performance assessments do provide opportunities for students and teachers to learn, often together, about the standards of good work with respect to more valued outcomes. Each student is often incorporated in as an active agent in the evaluative process, not as an object to be evaluated. The portfolio activity is a process of production, perception, selection, and reflection that is exercised by each student over his or her collections of school work. Portfolios even provide a school district with a level of achievement. Portfolios are profoundly important to children. All children have a natural ability and desire to tell a story through the contents of the portfolio. Student portfolios tell a story. The real contents of a portfolio are the child's thoughts and his or her reasons for selecting a particular entry. That selection process reflects the interests and the metacognitive maturity of a child and the inspiration and influence offered by the teachers. Portfolios serve as a metaphor for our continued belief in the idea that children can play a major role in the assessment scene of their own learning. Using an authentic assessment tool could provide a more realistic picture of each student's individual subject achievement and progress by demonstrating growth and development over a period of time, involving students in assessing their own growth and reflecting many aspects of students area of knowledge and understanding. Portfolios provide teachers with information about students' progress, thought processes, achievements and needs. They should accommodate teachers' and students' individual needs, while allowing students to take an active role in assessing their work and encouraging them to take responsibility for their own learning. Students should begin to set goals for themselves and check their progress toward reaching these goals. This will help promote self-esteem. Students and teachers

The Democratic System essays

The Democratic System essays The democratic political system has proved to be one of the best systems of government of all time. In a democratic system of government the majority rule is how decisions are reached. Usually with a vote from a group of people whether it be the elected officials in office, or the lower ranking registered voters. Special interest groups are constantly approaching the democratic political system. These groups consist of people that share the same views on a certain issue. They try to push their cause and convince elected government officials to support them. The United States is considered to be a highly organized technological society. Thanks to the massive amount of industry it has. The United States is very diverse with cultural, economic, educational, ethnic, and religious backgrounds of people. Since there is so much diversity special interest groups tend to form because of this. It is said that the United States is often a pluralist democracy according to theorists at David Trumans school. So many special interest groups are protesting their views, but wont be heard because of the large number of groups. So the government policy is the result of competition among the groups, which represent the varied interests of the people. The middle or upper class dominates these rival pressure groups, and group activities are dominated by people with business-related interests. What about the lower class? The middle and upper class rule the interest groups and the lower class have relatively little voice. The lower class is more likely to la sh out explosively rather than organizing peacefully. So much grievances have built up in the lower class that a reasonable approach is out of the question. Do special interest groups obstruct the principle of majority rule in a democratic political system? It is safe to say that interest groups do have pull in how decisions are made in government. They voice their opinion an...

Psychological and Social Factors in Informed Consent for Patients with Case Study

Psychological and Social Factors in Informed Consent for Patients with Autism - Case Study Example (2011) examined the levels of understanding and perceptions on the need to conduct randomized controlled trials among professionals, users and care givers concerned with provision of intellectual care, including care for autism cases. There was poor understanding of the principles attributable to randomized controlled trials among care givers and users, but understanding was higher among professionals. The authors noted that lack of understanding has negative implications on social validity of random controlled trials. Chen, Xu, Huang and Dhar (2013) conducted research into the levels of awareness, attitudes and experiences among a sample that comprised parents of children who were undergoing genetic testing owing to their condition. More participants were in support of genetic testing research, mainly citing early intervention and motivation, identification of the causes of the condition, and family planning as their motivations. Competence of medical staff handling the tests was highlighted as a major concern among participating parents. Minority groups in the sampled population appeared to have lesser understanding of the importance of the procedure. At the psychological level, researchers are encouraged to learn the needs of such individuals to encourage their participation. Chen, L., Xu, L., Huang, T. & Dhar, S. U. (2013). Autism genetic testing: A qualitative study of awareness, attitudes, and experiences among parents of children with autism spectrum disorder. Genetics in Medicine. 15(4): 274-281. Robotham, D., King, M., Canagasabey, A., Inchley-Mort, S. & Hassiotis, A. (2011). Social validity of randomized controlled trials in health services research and intellectual disabilities: A qualitative exploration of stakeholder views. Trials. 12:

Art and the Emergence of Darwinism Essay Example | Topics and Well Written Essays - 250 words

Art and the Emergence of Darwinism - Essay Example Although the ideas of Darwinism were brought up in a deeply religious environment, it came to coexist side by side with the religious community. In fact, Darwinism might have been the reason behind the increase in European missionary activities not only in Africa but in Asia, because it may have given rise to the belief that since the Europeans were superior, then their religion must also be superior (Rose 297). The idea of European supremacy took hold in Europe and it emerged in the literature that was written in that period where Europeans featured as heroes while members of other races were perceived to be the villains or inferior in both physique and intellect (Day 59). Such writings continued to have an influence on the perceptions of not only the Europeans themselves, but also on the members of the other racial groups. Therefore, it can be said that Darwin’s theory came to influence the society of the nineteenth century and has continued to do so even

Public health Essay Example | Topics and Well Written Essays - 2500 words

Public health - Essay Example As such, they must also be addressed on a regional level and it appropriately becomes the function of the government to take adequate measures to control the outbreak of infectious diseases. The utility of such integrated approached have been demonstrated many time before. The reduction of typhoid incidences in nineteenth century France have been attributed to improved sanitation facilities (Woods, 2003), and the prolonged vector breeding and parasite transmission reduction programs have been responsible for the remarkable reduction of malaria in South America, Central America and many Asian countries. Johansson and Mosk (1997) have detailed the impact of public health interventions on adult mortality rates in Japan. The choice of India for the evaluation of it’s communicate disease and emergency control facilities is justified both by the size of her population as well as the emerging role that she is destined to play in the socio political activities of the future. India is endowed with immense resources – mineral, natural, cultural as well as in terms of trained and untrained manpower. The administrative capacity of Indian Government is considerable. Within a span of fifty years from her Independence, the nation has exponentiated its agricultural production, dampened surging growth rates and successfully withstood massive famines. The reach of the bureaucracy spans the entire subcontinent from where it effectively collects revenues, conducts the largest democratic elections in the world and through periodic census creates an immense pool of statistical data. Indian pharmacology, medicine and information processing skills have already attracted the attention of the world. . Its b asic public health infrastructure (laboratories, clinics etc) has been successful at carrying out complicated development programs requiring a high level of coordination and outreach-such as increasing agricultural production

Electroconvulsive Therapy for Severe Depression: Evaluation

Electroconvulsive Therapy for Severe Depression: Evaluation Can electroconvulsive therapy make a meaningful contribution in the treatment of Severe depressive illness? The work of mental health nurses. Contents Abstract Introduction Methodology of the review Critical Review of the literature The place of electroconvulsive therapy in the therapeutic armamentarium The place of electroconvulsive therapy in relapse prevention Mechanism of action Preference of site of stimulation Side effects of treatment Discussion Conclusions Appendix References Abstract This dissertation seeks to explore the evidence base for electroconvulsive therapy. It does so by considering the historical background to the procedure and its evolution to the present. It considers the professional and legislative guidelines which govern its use and contrasts the regulations in the UK with those in other cultures, notably the USA. In order to assist the exploration, the literature review is subdivided into five sections, each exploring a different area of interest. Electroconvulsive therapy is placed within a therapeutic spectrum of treatment for patients with major depressive illness and psychosis and is compared with other modalities of treatment. Its use in both acute treatment and its role in disease prevention and relapse is discussed. Current hypotheses of its possible mode of action are explored, and conclusions drawn about the strength of the evidence base in this area. There appears to be considerable discussion about the site of optimal stimulation for electroconvulsive therapy. This area is discussed in depth with a critical analysis of the studies which inform the evidence base in this area. The literature review concludes with an examination of the various side effects of the treatment. There is an element of discussion of the evidence and conclusions are drawn from the evidence extrapolated and presented. The whole dissertation is fully referenced. Introduction Electroconvulsive therapy was introduced into clinical practice in the late 1930s and rapidly gained a place in the standard treatment of major depressive illness. It was originated by the Hungarian, Dr Meduna, who mistakenly believed that schizophrenia and epilepsy were mutually exclusive conditions. He argued that epilepsy was never seen in schitzophrenic patients and therefore artificially inducing fits (epilepsy) in patients would cure schizophrenia. (Mowbray R M 1959). The effects on schitzophrenia were soon recognised to be minor and the most marked effect appeared to be in the patients with major depressive illness. The advent of effective classes of antidepressant, antipsychotic and mood stabilising drugs has seen a marked decline in the use of electroconvulsive therapy, but recent figures suggest that it is still used in over 10,000 cases per year in the UK (ECT Survey 2003). Currently the main use of electroconvulsive therapy is in major depressive illness although it also is considered still to have a place in the treatment of schizophrenia and some other mood disorders (UK ECT 2003), psychosis (Corrible E et al. 2004), and overt suicidal intent (Kellner C H et al. 2005). The Mental Health Act of 1983 allowed Psychiatrists to give electroconvulsive therapy to inpatients without consent if they were sectioned. This should be contrasted to the situation after the 1959 Mental Health Act, where psychiatrists had no clear guidance and a number of litigation cases forced a change in legislation. (Duffett R et al. 1998) The procedure itself involves anaesthetising the patient with a general anaesthetic and a muscle relaxant and the a small, brief pulse current (typically about 800 milliamperes) is passed between two electrodes applied directly to the scalp. This generates a seizure and there are a number of demonstrable biochemical changes in the brain after the event. (Nobler M S et al. 2001) Electroconvulsive therapy is usually given as a course over several weeks. The evidence base for length of time of treatment is not strong and appears to vary considerably between authorities. (Lisanby S H 2007) In 2003 NICE investigated the evidence base for electroconvulsive therapy and issued guidelines which suggested that it should only be used only to achieve rapid and short-term improvement of severe symptoms after an adequate trial of treatment options has proven ineffective and/or when the condition is considered to be potentially life-threatening in individuals with severe depressive illness, catatonia or a prolonged manic episode. (NICE 2003) One of the most extensive recent reviews on electroconvulsive therapy concluded that it had been demonstrated to be effective short term treatment for depressive illness in otherwise healthy adults. Many studies were cited and had shown it to have a greater effect than drug treatment. The authors noted shortcomings in many of the trials cited, especially in areas such as drug resistant depressive illness where electroconvulsive therapy is believed to be particularly helpful. (UK ECT Review Group 2003) One of the major side effects of electroconvulsive therapy is short and long term memory loss cited in many trials and studies (viz Gupta N 2001) Methodology of the review Cormack suggests that â€Å"Ultimately all good research is guided by and founded on a critical review of all of the relevant literature published on the subject.† (Cormack, D. 2000). It is therefore important not only to define what is currently believed about a subject, but also to place this in a historical context. This is particularly important in the field of electroconvulsive therapy, as the introduction to this dissertation has suggested, with great fluctuations in both understanding and application of this type of therapy over the years. One of the prime reasons for conducting a literature review is to establish the current evidence base for a particular subject. A critical review of the literature must be preceded by a careful literature search. It is often believed that searching the literature is a linear or â€Å"single episode† process. Current thinking suggests that this is seldom an optimal strategy. Bowling advises that a good literature review is â€Å"primarily a cyclical recursive process that mirrors the thinking and research process, where the discovery of new information results in new ideas, new knowledge and possibly new understanding. Once an overview, or initial opinion has been formed, it then becomes possible to revisit the initial reviews from a more informed perspective which, in turn, allows for a more perceptive interpretation of the data. (Bowling A 2002). The methodology used in this particular review was to allow for an initial period of reflection on the subject matter and to consult a small number of reference books to achieve an overview of the area. (Taylor, E. 2000). References were noted and some followed up in order to ascertain the main themes of the review. Once these were established, then methodical searches of a number of databases were carried out utilising the facilities of the local University library, the Post-graduate library (Client to personalise here) and a number of on-line search engines and literary sources including Cochrane, Cinhal, Ovid, BMJ and Lancet archives, Royal College of Psychiatrists archive and various NICE publications. Papers were accessed in both hard back and electronic forms. (Fink A 1998) Search terms included electroconvulsive therapy; evidence base; evolution; history; schizophrenia; psychosis; major depressive illness; mental health nurse; antidepressant drugs; Mental Health Act; psychiatrist. These terms were used in various combinations to sift papers with varying degrees of relevance to the topic under consideration. (Carr LT 1994) Inclusion criteria were papers less than 10 years old (unless there were specific reasons for older paper inclusion). UK sources were preferred to other ones. It should be noted that a substantial proportion of the body of literature on the subject of electroconvulsive therapy is American based. A number of authorities have suggested that this may be because the USA currently uses electroconvulsive therapy more frequently than the UK and therefore has a greater experience with it. Papers were only considered from peer reviewed sources unless making a historical point. (Bell J 1999). Each paper considered was then ranked according to its evidential value (See Appendix 1) and the highest value paper was presented for each point to be made. Critical Review of the literature The place of electroconvulsive therapy in the therapeutic armamentarium A good place to start this literature review is with the Olfsen paper. (Olfson M et al. 1998). This is an authoritative overview of the place of electroconvulsive therapy in the treatment spectrum. It has to be noted that this paper is already 10 years old and reflects clinical patterns of usage in the USA. The reason that this paper is selected for discussion is primarily on the vast size of its study cohort, which is 6.5 million patient contacts (249,600 with a diagnosis of depressive illness) spread over mainland USA. Critical analysis of the paper suggests that the authors reveal their viewpoint in the first few sentences of the paper and therefore the opinion part of the review must be understood on the basis that the authors consider electroconvulsive therapy a â€Å"safe and effective treatment for patients with all subtypes of major depression† citing the authority of the APA for this statement (APA 1997) The paper suggests that there is a strong evidence base to confirm that electroconvulsive therapy is at least as effective as antidepressant drugs pharmaceuticals for the treatment of major depressive illness. (Weiner R D 2004) The authors make the point that despite this general belief, electroconvulsive therapy is not as widely used as it should be due to three major misconceptions namely public concern about the safety of the procedure, reactive regulations and guidelines and the belief that it is not cost-effective. They then set about addressing each of these concerns Rather worryingly, the authors cite evidence of safety with the unqualified comment that â€Å"None of the depressed patients who received ECT died during the hospitalisation. In contrast, 30 (0.14%) of the depressed patients who did not receive ECT died in the hospital. (Schulz K F et al. 1995) Although this may well be the case, it is entirely possible that patients who were ill with other comorbidities (and therefore at greater risk of death) were not offered electroconvulsive therapy, as it required a general anaesthetic. One cannot jump to the implied conclusion that these figures suggest that electroconvulsive therapy is therefore intrinsically safe. (Mohammed, D et al. 2003) The authors draw a number of conclusions, perhaps the most significant of which is that current practice tends to reserve electroconvulsive therapy for the elderly, and those with comorbidities such as schizophrenia, dementia, and general medical (nonpsychiatric) disorders. They also comment that prompt use of electroconvulsive therapy is associated with shorter in patient stays and, by definition, more rapid resolution of the depressive state. Despite these findings, there is a large body of literature documenting the fact that many patients with major depressive illness remain largely unresponsive to therapeutic intervention. With this in mind one should consider the contribution of the Spanish research group under Gonzalez-Pinto who published a trial of a small group of patients (13) who had proved resistant to both venlafaxine and electroconvulsive therapy separately but who responded to both measures when used in a combined fashion. (Gonzalez-Pinto A et al. 2002). This was a non-randomised non-controlled trial and therefore constitutes evidence value at level III. Curiously the response was not proportional to the dose of venlafaxine used. The authors however, report the rather worrying side effect of asystole in 3 of the 13 patients immediately after the electroconvulsive therapy. A number of authorities suggest that there is a definite place for electroconvulsive therapy in the severely depressed patient who is a suicidal risk. The Kellner paper addresses this suggestion directly. (Kellner C H et al. 2005). Suicide remains one of the major associations of major depressive illness and carries a 15% lifetime risk for any patient who has been hospitalised with the same. (Bostwick J M et al. 2000) with symptoms such as profound hopelessness, hypochondriacal ruminations or delusions, and thoughts of suicide or self-harm during depression predict future suicide. (Schneider B et al. 2001). The Kellner study was a randomised crossover comparative follow-up trial making it evidence value of level 1b. There are a great many result strands from this study, but if one specifically considers the suicidal elements, then one can state that the study showed that of the 444 patients enrolled in the trial as having major depressive illness, 26% had suicidal ideation at a level of 3 or greater on the Hamilton rating scale (the measurement tool used in the trial) and 3% achieving a score of 4 (actual suicidal attempt). This group had a reduction of their scores to 0 in over 80% within the two week course of the electroconvulsive therapy. It was also reported that in the group who scored 4, 100% dropped to 0 by the end of the treatment. Despite there impressive figures for short term remission, one would have to note that the trial did not have any significant long term follow-up and there is no information on the rate of relapse after the initial treatment. (Rosenthal R. 1994). The authors state that they were aware of two successful suicide attempts which occurred whilst the trial was running (but after these patients had completed their treatment. The authors suggest that electroconvulsive therapy should be used early in the treatment regime once a diagnosis of suicidal risk has been made. To provide a balanced argument on the place of electroconvulsive therapy in the spectrum of treatment, one can consider the recent paper by Eranti (Eranti S et al. 2007) who tested out the hypothesis that has recently been published, that Repetitive transcranial magnetic stimulation (rTMS) is as effective as electroconvulsive therapy but does not have the same side effect profile that restricts the use of electroconvulsive therapy in some patients. (viz. Gershon A A et al. 2003 and Loo C K et al. 2005) This trial was a randomised, blinded comparative trial with a substantial entry cohort (260 patients) being followed up for 6 months after treatment giving it a level 1b significance. (Clifford C 1997). There were a number of possible outcome measures studied but, of relevance to our considerations in this dissertation, one can state that the authors found that Repetitive transcranial magnetic stimulation (rTMS) was not as effective as electroconvulsive therapy in the treatment of depressive illness both at the end of the treatment period and at the end of the 6 month study. The authors were able to comment however, that the rTMS was virtually free of demonstrable side effects. The place of electroconvulsive therapy in relapse prevention It is fair to comment that a brief examination of the literature shows virtually no good quality published material on this topic with the studies that have been done comprising individual case reports (viz Kramer B A 1990), naturalistic studies and small studies of retrospective cases (viz. Schwarz T et al. 1995), none of which have any control element and all of which are evidence level IV at best. A notable exception is Keller et al. who made a large UK based study of relapse prevention in major depressive illness with a randomised controlled trial over a seven year period involving over 500 patients. (Kellner C H et al. 2006). The trial is a level 1b evidence level trial and is of a particularly robust structure with great efforts made to achieve standardisation. (Denscombe, M 2002). The structure is a direct comparison between electroconvulsive therapy and a standard pharmacological regime (lithium carbonate plus nortriptyline hydrochloride). Both were given as a therapeutic course (the medication over a six month period) and the patients were followed up with DSM-IV assessments to determine their degree of relapse The analysis is long and complex but, in essence, the study clearly demonstrated that both groups had better results than a placebo control with similar percentages (about 33%) suffering a relapse and about 46% remaining disease free. The trial suffered from having a large group (about 20%) failing to complete the trial protocol. (Rosenthal R. 1994). This study does however, provide firm evidence that electroconvulsive therapy is at least as effective as pharmacological measures in reducing the likelihood of clinical relapse. Further evidence for longer term efficacy comes from the Gagnà © study (Gagnà © G G et al. 2000), which starts by acknowledging the fact that depressive illness tends to be a long term disability with long term pharmacological intervention a comparatively normal treatment strategy. The authors make a subtle distinction between continuance therapy (which is starting a new course of treatment after initial resolution and then relapse) and maintenance therapy which extends beyond the continuation therapy stage and is aimed at preventing relapse. This paper is noteworthy because, as the authors point out, there is general acceptance by healthcare professionals that long term maintenance therapy with pharmaceuticals is both rational and indicated in patients with a high likelihood of relapse of depressive illness. Treatment with continuation electroconvulsive therapy has failed to gain general acceptance. The authors argue that such an approach is particularly rational, at least in a group of patients who have demonstrated their ability to respond to electroconvulsive therapy in the past, are at high risk of relapse and who may be refractory to pharmacological intervention. The Gagnà © study is a retrospective case-controlled comparative study comparing the long term course of electroconvulsive therapy plus pharmacological maintenance therapy with long-term antidepressant treatment alone in a demographically matched group. The two groups comprised 60 patients. The maintainence electroconvulsive therapy group received the electroconvulsive therapy as a single treatment monthly after the normal intensive treatment course for the acute episode. It has to be noted that this regime is comparatively arbitrary as there appears to be no preceding published evidence base to support it. The results from this study are nonetheless quite impressive. Both groups are reported to have responded to treatment, but the group who were also maintained with follow up electroconvulsive therapy did markedly better in terms of resistance to relapse being almost doubled at two years (93% vs. 52%), and quadrupled at five years (73% vs. 18%). This result could also be expressed as a doubling of the mean time to relapse in the electroconvulsive therapy group (6.9 years versus 2.7 years for the antidepressant-alone group). A major criticism of this study would have to be a lack of standardisation of treatment in the electroconvulsive therapy group with some patients receiving univocal and others bipolar electroconvulsive therapy. The number and duration of each was left â€Å"to the clinical judgement† of the responsible clinician. This does not reduce the impact of the overall finding, but does make for difficulties in comparison with any other trials which might follow. (Berlin J A et al. 1999) A critical analysis of the study would also have to conclude that the study suffered from a comparatively small number of patients with assignments to the comparison groups not being random. More importantly, the trial assessor was not blinded to the patients group assignment. These factors make it difficult to confidently assign an evidence level to this trial. (Denzin, N K et al. 2000) The authors conclude their study with the comment that a larger, prospective study on the subject is currently underway. One should perhaps regard the results of this study as interesting, but not proven. In assessing the validity of this paper, one should note comments that it has generated in the peer reviewed press. Gupta makes a number of valid points of criticism (Gupta N. 2001), arguably the most important of which is that the study did not make any measurement of the well recognised effect on memory function that short term electroconvulsive therapy is known to have. (Isenberg K E et al. 2001). Gupta suggests that clinical effectiveness must be assessed only after a risk-benefit ratio has been properly determined. Certainly a valid point and one that was not addressed in the original paper. Mechanism of action A number of papers have been published reporting biochemical changes after electroconvulsive therapy. There seems to be a general agreement that depressive illness is associated with a disturbance in the monoaminergic-cholinergic balance within the cerebral cortex. (Schatzberg A F et al. 2005). A novel and significant advance was published in 1998 by Avissar (Avissar S et al. 1998) when a correlation with G-protein levels in leucocytes was found and was discovered to be significantly reduced in depressive illness. The significance of this paper was that the authors found that electroconvulsive therapy resulted in a normalisation of the G-proteins level which preceded (by about a week), and thus predicted, clinical improvement. Patients who did not respond to electroconvulsive therapy did not show a change in G-protein levels. The significance of this finding is enhanced with the knowledge that lithium is also known to alter G-protein levels (Schreiber G et al. 2000), as are some other treatments for bipolar disorder. (Young L T et al. 2003). It is also known the G-protein levels are raised in manic states thereby suggesting that it is a marker for affective mood states. (Schreiber G et al. 2001) Further evidence of altered metabolism comes from the Nobler study (Nobler M S et al. 2001). This study used Positron emission tomography (PET) to study glucose metabolism in different brain areas. It has to be noted that this was a small study of 10 patients who were assessed before and after a course of electroconvulsive therapy. This study involved highly sophisticated measurements and concluded that certain areas of the brain showed marked reduction in metabolic rate after electroconvulsive therapy and these changes were most significant in the frontal, prefrontal, and parietal cortices. The authors suggest that their results support the hypothesis that electroconvulsive therapy works by suppression of functional (non trophic) brain activity, most prominently in the prefrontal cortex. The authors comment that their findings are consistent with the earlier Drevets study which demonstrated a reduction in brain metabolism after successful treatment with antidepressant drugs. (Drevet s W C 1998) A more modern paper by Sanacora reported alterations in the GABA concentrations in plasma, and cortex after electroconvulsive therapy. (Sanacora G et al. 2003). It is known that patients with depressive illness have reduced levels of the neurotransmitter GABA. This study, again with a small entry cohort of 10 patients, assessed patients before and after electroconvulsive therapy. It was found that the levels of GABA increased with successive treatments. It was also found that the length of duration of the convulsions was proportional to the concentrations of GABA found in the cortex supporting the view that GABA decreases cortical excitability. It may also be significant that GABA concentrations have been found to increase after the use of selective serotonin reuptake inhibitor (SSRI) treatment. (Sanacora G et al. 2002). These findings suggest that enhanced GABA activity may be central to any antidepressant activity Takano et al. have recently produced a yet more sophisticated study along the lines of the Nobler investigation. (Takano H et al. 2007). This study also uses positron emission tomography (PET) and it studied patients before, during and after the application of electroconvulsive therapy. This is essentially a technical rather than a clinical study. It also has to be noted that all the data was derived from only six patients. The majority of the results are therefore not relevant to this consideration other than the fact that the authors concluded that electroconvulsive therapy exerts its effect by increasing the post treatment blood supply to the anterior cingulate and medial frontal cortex and thalamus. They refine this comment by acknowledging that it cannot be stated that this observed phenomenon is cause or effect, but simply an association with the mechanism of treatment and is associated with a resolution of symptoms. Preference of site and nature of stimulation There is a great deal of discussion in the peer reviewed literature about the optimal sites for electroconvulsive therapy application and whether univocal or bipolar stimulation gives better results. Unfortunately the vast majority of it is anecdotal and of poor evidential value. The Bailine study is a notable exception providing a randomised comparative trial with a moderate size of entry cohort (60) making it a level 1b trial. (Bailine S H et al. 2000). The authors compared the efficacy of bitemporal stimulation with bifrontal stimulation over a treatment period of 12 treatments. The study was assessor blinded. The rationale behind the trial was that bifrontal stimulation avoids direct stimulation of the temporal areas which are directly involved with cognition and memory functions. The authors reported that they found both placements to be equally effective in their ability to relieve depressive illness, but the bifrontal positioning achieved statistical significance in reducing cognitive and memory effects. Although not directly tested, the authors comment that right sided unilateral frontal placement has fewer cognitive side effects than bilateral stimulation but needs 2 5 times the current to achieve its therapeutic effect. (citing Letemendia F J J et al. 1993) One area of difficulty which, even a brief overview of the subject illuminates, is the level of stimulus that is required to achieve therapeutic results. Some studies do not specify the level of stimulus, others simply refer to a supra-threshold stimulus, a third group refer to a â€Å"titration of stimulusâ€Å". This makes direct comparison of results difficult. Some authorities have made the comment that not standardising the level of stimulus applied is similar to conducting a comparative trial of antidepressant drugs to placebo when the drugs are given at a sub-optimal dosage and therefore not achieving their maximal therapeutic effect. Krystal has attempted to tackle this problem by reviewing the regulations governing the administration of electroconvulsive therapy and also trying to achieve a generally acceptable standard of treatment. (Krystal A D et al. 2000) The USA limits (by statute) the maximum output charge for clinical applications of electroconvulsive therapy to 576 millicoulombs. The equivalent restriction in the UK is 1,200 millicoulombs for electroconvulsive therapy devices and this has been determined by the Royal College of Psychiatrists, and this limit is more than double the limit allowed in the USA. As far as the USA is concerned there is no evidence base to ensure that this limit will allow for consistently effective electroconvulsive therapy, which is something of a paradox considering that the USA considers electroconvulsive therapy more mainstream than does the UK. Krystal published a retrospective study of nearly 500 patients who had received electroconvulsive therapy. Although most of the patients reviewed had a clinically successful treatment, the authors noted that 15% of patients required the maximum stimulus intensity to trigger a seizure and 5% of the total did not have a seizure at all. The authors comment that the clinicians responsible for the patient had to use enhancing strategies to boost the therapeutic response with caffeine, ketamine, or hyperventilation. This still left a residual 5% of patients with a sub-therapeutic response at the maximum permitted output charge. Further problems can be encountered as not only can patients vary with regard to the amount of charge that they need to trigger tonic-clonic seizures, but the amount of charge can vary as the course of treatment progresses in each individual patient. (Coffey C E et al. 2005) The difficulty that therefore arises in these non-responders, is that there is no greater therapeutic response than placebo if a tonic-clonic seizure is not triggered, but the effects on cognition and memory impairment are still present. (PECT 2000). If this is added to the clinical and economic costs, it is clear that a case can be made for higher limits of initial triggering charge, at least in the USA. The other factor which may also be relevant and can be a major cause of inconsistency between studies is the pulse width with some electroconvulsive therapy machines delivering a shorter pulse width and longer stimulus duration than others. The majority deliver a pulse width between 0.5–0.75 msec. but other machines are capable of delivering pulse widths considerably beyond these limits. There has been no definitive study which has considered the possible effect of pulse width on either the therapeutic response or the likelihood of triggering a tonic-clonic seizure. The final point made in the Krystal paper is the fact that one of the reasons that the charge limit was set at the level that it is was the fact that the authorities wanted to minimise the theoretical risk of neuropathological damage. There is now evidence that the levels of stimulus charge necessary to cause such damage is far in excess of the imposed limits. (viz. Weiner R D 1994 and Devanand D P et al. 2004) The concept of stimulus titration is referred to in many of the clinically based papers reviewed. If this concept is considered in parallel with the comments by Krystal relating to the variation of charge required to produce the seizure, the situation can be clarified in an monograph by MacEwan who advises that it is an important feature of the treatment to allow sufficient time between the initial unsuccessful shock and the attempt at restimulation as the effect of the comparative refractivity after the first shock takes a little time to wear off. (MacEwan T 2002) Side effects of treatment Considering the rather gross and intrusive physical nature of the treatment, it is quite remarkable that the literature shows very few studies which have specifically explor

Finding Self Essay -- essays papers

Finding Self I realize that the whole universe is at my fingertips, as is my willingness to manifest what is needed in my reality. Every experience of life is God teaching me. As I look in this pure state of awareness, I feel this pure energy within my whole body. From the rhythm of my breathing, I feel a quiet state of attunement — one with God. My soul incarnated into a specific form on earth for a unique purpose. My journey is now and exists at this moment, whether I want to realize it or not. Knowing my life’s purpose and acting on it will give me direction and is a necessary step in achieving true happiness. To have this deeper experience requires the ability to have conscious awareness of Soul, or Higher Self. I find my life runs much more smoothly when I let the Universe run itself without any interference from me. As a matter of fact, the less my brain does its "stuff'', the more fulfilling my life becomes...hence more enriched. This above all: to thine own self be true, and it must follow the night and day, â€Å"Thou canst not then be false to any man.† â€Å"But I tell you to love your enemies and pray for anyone who mistreats you.†(Matthew 5:44) Humans are not all alike, one will hate you and the other will love you. The difference in moods is the reason why humans are who they are. The knowledge that everyone is different in some way, will lead to one giant leap on my journey. Loving thy neighbor no matter what, as stated in the Ten Commandments, will enrich my spiritual progression. Not being familiar with my actual role in this Universe at this stage of my existence is at times very frustrating and often very far-fetched. Nothing happens by chance. We are a part of a universe that is forever giving us... ...nnection. Balance, harmony, and compassion are the natural state of my innermost self. Since spirituality is an experience, the degree to which I reflect the qualities of balance, harmony and compassion in my everyday moment-to-moment experience will support my connection to God. These problems are made visible in the two opposite notions of the loss of the self, or alternatively, the absorption with the self, both of which impoverish our sense of self. I will argue against the notion of the self as one that is constantly changing to meet the demands of the competing voices surrounding it. Rather, I will not argue that I must find a vantage point from which to view the world and create a sense of self that persists through time. I cannot be, â€Å"populated with the character of others.† Being a â€Å"self† must mean more than being an image, wearing a mask, or playing a role.

Global Crime Analysis Essay

Every single day, in every location of the world, there is crime going on. Crime does not only happen in one specific area, for that reason it is an issue all across the map. There are various major global crimes and criminal issues that have a global impact on national and international justice systems and processes that every individual should be knowledgeable about. Comparing and contrasting the various international criminal justice systems and how these major global crimes and criminal issues are addressed only helps individuals understand every justice system all around the globe. The justice system, in every country, is drastically impacted on a regular because of the many global crimes and criminal issue occurring. Drug trafficking, fraud, smuggling, extortion, terrorism, money laundering, gangs, briber, and cyber crime are just some examples of global crimes that are seen in this world. Although all global crimes are serious and cause issues the global drug trade is one that is an ongoing and is currently a multi-billion dollar industry. Every day, all around the world drugs are being made, but it is only in certain countries that large quantities of drug trades are made. Specific drugs are mainly found within only certain countries but as for Marijuana it can be produced worldwide. Marijuana is a drug that is easily produces so it comes to no surprise that it can be obtained worldwide. On the other hand individuals will find that different drugs are found in different areas of the world. For drug buyer is looking to buy opium poppies used to produce heroin, Myanmar, the Golden Triangle Burma, Thailand and Laos, Pakistan, Iran, and the Golden Crescent Afghanistan would be the places of interest for the buyer. On the other hand when it comes to the drug cocaine, South America would be the buyer’s place of interest. As can be seen these drugs all are produced within third world countries reason being the production of these drugs helps these countries economies by bring more money whether it be illegally or not. This is where a conflict comes in, with each country having different points of views on drug trade it is hard to enforce drug laws if all countries are not eye to eye. In order to improve the overall effectiveness of strategies the law enforcement’s from other countries needs to work together to try and come up with strategies and ways to take down the drug trade. The political and social structure has a major effect on the widespread of certain crime. Each country being diverse makes this vary from country to country. â€Å"For example, in middle-income and developing countries, homicide is far more prevalent compared to nations with higher incomes† (Shaw, et al, 2004). Research reveals that nations that have high rates of homicide tend to be accompanied by social and political unrest, where crime organizations tend to run the country more than the politicians† (Shaw, et al, 2004). â€Å"On the other hand, there has been a dramatic decline in the rates of robbery among nations included in North America compared to other nations of the world† (Shaw, et al, 2004). Within the criminal justice system another thing that varies from country to country is the way criminals are tried and detained. This difference seen is based on the different social and political structures that are made for each country. Research has revealed that most nations follow a civil law system, which is typically based on Roman law structures, in which a person can be punished as soon as a sufficient amount of evidence proves that a person is guilty of a crime† (O’Connor, 2011). â€Å"This varies from the common law systems, where innocence is assumed prior to proving that a person is guilty of a crime† (O’Connor, 2011). â€Å"More common in nations, such as Iraq, Afghanistan, and Iran, the Islamic law system is directly based on the Koran, which is often interpreted as a harsher law system compared to other law systems utilized by other nations† (O’Connor, 2011). In most cases the law system that is being used within the country is one that reflects on the beliefs and standards of that particular county. Overall, this helps individuals of a certain country understand what exactly would be considered a crime within his or her country. When looking at countries one by one a difference can be established. One example is â€Å"seven of the eight nations that are included in the group of Caribbean nations have been affected by colonial rule for centuries† (United Nations Programme Development, 2012). This colonial rule has caused their criminal justice system to be based on British common law, as well as national statutory laws† (United Nations Programme Development, 2012). â€Å"Their courts are also structured in a manner that is similar to British courts, where there is a magistrate court, a high court, as well as a court of appeals† (United Nations Programme Development, 2012). Although all individuals tried in court receive a fair trial, juries are normally only used in serious criminal trials. This is without a doubt different from the United States justice system, where there are few cases ever tried where a jury was not involved. Research has revealed that the rates of attrition, or the rates in which a criminal is obtained and tried for the crimes in which they are accused of committing, differ with the status of the nation† (Shaw, et al, 2004). This meaning that nations that are more developed tend to have higher rates of attrition and nations that are still developing nations have lower attritions rates. The correctional system is another part of the criminal justice system that varies from country to country. Although many countries correctional systems are somewhat similar to the one in the United States, they all vary from place to place. In Jamaica, law enforcement depends on the probation system in order to rehabilitate criminals who pass through their punitive system† (United Nations Programme Development, 2012). Within other nations that are included in Caribbean nations both probation and parole are commonly used to rehabilitate criminals (United Nations Programme Development, 2012). On the other hand research shows that nations with little crime such as Switzerland, have little crime is because there are wealth of social institutions that help to ensure that each citizen is well provided for (O’Connor, 2011). Crime is going to continue to occur every day, no matter the location of the world. The various major global crimes and criminal issues that have a global impact on national and international justice systems and processes will continue to impact each and every country unless a pact is made. No two countries are the same and for that reason no two criminal justice systems will ever be in agreement, but becoming aware of these differences will only helps individuals understand every justice system all around the globe whether it be the United States or China.

Amphoteric Definition and Examples

Amphoteric Definition and Examples An amphoteric substance is one that can act as either an acid or a base, depending on the medium. The word comes from the Greek amphoteros  or amphoteroi, meaning each or both of two and, essentially, either acid or alkaline. Amphiprotic molecules are a type of amphoteric species that either donates or accepts a proton (H), depending on the conditions. Not all amphoteric molecules are amphiprotic. For example, ZnO acts as a Lewis acid, which can accept an electron pair from OH but cannot donate a proton. Ampholytes are amphoteric molecules that exist primarily as zwitterions over a given pH range and have both acidic groups and basic groups. Here are some examples of amphoterism: Metal oxides or hydroxides are amphoteric. Whether a metal compound acts as an acid or a base depends on the oxide oxidation state.Sulfuric acid (H2SO4) is an acid in water but is amphoteric in superacids.Amphiprotic molecules, such as amino acids and proteins, are amphoteric.

Improvement in Race Relations essays

Improvement in Race Relations essays Race relations in the United States are much better now than they were when Toni Morrison wrote A Slow Walk of Trees 25 years ago. The United States prides itself in being considered the most diverse country in the planet. Living in Los Angeles, California, one of the biggest metropolitan cities in our country, I have the opportunity of seeing different races every day. Our cultural melting pot of a country has evolved so much from the mid-1970s, that interracial marriages, minority executives, celebrities and athletes are all now commonplace in our society. It is also not unheard of to see many minorities living in prominent neighborhoods.. There are still many racial stereotypes in our country. Some people, many of which are Caucasian, are still alienated when seeing a group of young African-American or Latino males. African-American and Latino minorities are still being pulled over by police officers for no particular reason, other than looking suspicious. Racial stereotypes are a result of many instances. One major cause of racial stereotypes in the African-American community is rap music. Rap artists such as Kurupt, Snoop Doggy Dogg, Nas, DMX, Master P and the late Christopher Wallace (Notorious B.I.G) often use lyrics riddled with incidents such as the dealing and use of narcotics, promiscuity, robbery and homicide. The large exposure of rap music, currently the number one selling music genre in our country, gives many people the impression that the majority of black people live that same exact dangerous lifestyle often glamorized by irresponsible rap artists. However, there are rap artists such as Talib Kweli, Mos Def, Outkast, The Roots, and Common Sense that write lyrics about the lack of racial unity in our country, oppression, and the disagreement of the rap style of the rappers who project criminal personalities. ...

Critically discuss the key concepts in Conduct that explain our agency Essay

Critically discuss the key concepts in Conduct that explain our agency in social worlds - Essay Example In these social interactions, we usually have the concept of â€Å"conduct† wherein we do activities in a manner that is acceptable to the surrounding environment where we are and these activities should be understandable considering the individuals who will be affected by the action. â€Å"Conduct† is greatly influenced by agency. In this paper, we will critically discuss the key concepts in conduct that explain our agency in social worlds. Agency, in the social sciences, refers to the capacity of individuals to act independently and to make their own free choices. For example, given a situation wherein there is a rape victim and a doctor. A decision of the doctor is needed whether the raped victim is allowed to have an abortion or not. We all know that abortion is not universally accepted because of difference in the concept of morality. We must all consider that one's agency is one's independent capability or ability to act on one's will. Although independent, this a bility is greatly influenced by the cognitive belief structure of the individual. ... Disagreement on the extent of one's agency with others and even the society often causes conflict between parties. Conduct can be defined in many ways. The Oxford English Dictionary (OED) even has considered several definitions for the word â€Å"conduct†. It can refer to the action or manner of conducting, directing, managing or carrying on any actions or activities like business, performance, process and course. It is related to the ways in which an organization, social activity or process is assembles, carried out, managed and regulated. For example, the manner in which a speech for the declaration of independence of a colonized country is done. For this social activity to be successfully done, we should consider a lot of things. First of all, the person who will do the speech should be a reliable speaker. That person should be known as an advocate of freedom, since it is an independence speech. The content of the speech should be concise yet fruitful. Every word should hav e a great impact to its audience. In relation to this, the audience should also be taken into consideration. The speech should be appropriate to the audience or else it will only produce conflicts and the message of the speech would not be efficiently conveyed. Hence, there are many considerations to look into for a certain social activity to be â€Å"conducted†. The individual’s agency should also be considered whenever â€Å"conducting† a certain social activity or process. The agency should be suitable to the objective of the conduct. The word â€Å"conduct† can also be seen in the perspective of behavior wherein it refers as the manner of conducting oneself or one’s life usually with influence of moral quality.

What can coins excavated at a roman villa tell us about the site and Essay

What can coins excavated at a roman villa tell us about the site and it's wider context - Essay Example It takes a lot of effort to divine some of these social dealings by the use of numismatics. Besides archaeologists and academicians, other groups of people are also very interested in studying these coin finds in ancient Roman sites such as social scientists, numismatists, and economists who try to impute social contexts using these Roman coins as guides for their study. However, it is often the case where there is no standard way of how to properly and scientifically catalogue these finds and moreover, and also no set standard for their coinage analysis. Be that as it may, it is still possible to know how the people in a Roman villa had lived and in relation to the surrounding communities through the study of these archaeological coins. It just takes some time and lengthy effort for archaeologists and others interested in these sites to come up with their findings and conclusions based on a careful consideration of all the artifacts in an excavation site but admittedly, there are no set standards for doing this but rather only some set patterns which may be useful to make any comparable analyses with other similar sites. This paper examines and discusses how the coin assemblage can give some useful and pertinent ideas of the wider social context in which these people lived in relation with their neighbors. A case in point of how Roman coins determined the wider context of social living in an area surrounding an ancient Roman villa is the fairly recent excavations at the San Felice Villa, which is located in the Basentello River Valley of Italy that separated the ancient vicus (Roman word for neighborhood) of Apulia from Lucania. This site is a rich archaeological dig in terms of the old architectural remains (buildings and houses), artefactual assemblage, and environmental evidence within the site itself. Preliminary evidence suggests it was a part of a larger estate; it was important in fostering local and regional connections for the villa’s