Great Abortion Topics for an Essay and Questions

Abortion is no doubt one of the most controversial and debatable subject in the modern society. So contentious is the decades-long issue that no group of people can come to a consensus on whether to legalize or abolish it altogether. As such, it’s always recommended that you demonstrate sensitivity and objectivity when analyzing such a topic. For years, students have been tasked with assignments to explore the controversial issue and give their opinions on the subject. Students writing such papers are supposed to look at abortion in different perspectives to explain whether there are any moral, ethical, legal, philosophical, religious or medical concerns. The topic you choose will also be dependent on the type of essay you are writing. An argumentative essay may require a topic that may not fit well in a persuasive, analytical or expository essays. Irrespective of the subject, you have to carry out extensive research to collect the required information that will make your paper stand out Proven Approach on How to Select the Best Abortion Essay Topic? Considering how contentious aborting is, we have contrasting views developed by experts in different backgrounds. Scholars have researched the subject for years, and you can expect to find various topics. One of the ways to explore for a good topic is by examining a broad theme and then narrowing down of a single subject matter. Without in-depth research on the topic under study, your paper won’t have the desired impression on your instructor. The topic is used to formulate your thesis statement and will guide you on the arguments and opinions to include in the essay. Picking a suitable topic for your paper is essential. Students should consider the audience when writing the essay. Besides, a topic should be exciting to entice the reader to continue reading. You will have to explain why you desire to focus on the particular subject and why it is crucial in the study. The best way to do this is by referring to the personal accounts of individuals who have experienced the issue. Since you will have to state your personal views on the topic or subject, ensure you select a topic that you can comfortably argue for or against. Your abortion topic should fall in either the pro-life or pro-choice category. When you have successfully found a good topic, decide on the aspect of the study that may include, religious stance, and health concern, legal or human right issue. List of Abortion Essay Topics- Best Pro-Life and Pro-Choice Ideas To get you started on an abortion essay, we have compiled a list of useful topics that you can borrow to design an outstanding paper. Feel free to explore them to get inspired in tackling the paper. Safety in the operations Contraceptives failures Abortion in an area of choice Religion Financial background Follow up procedures Reliability Medical vs. surgical abortion Gestation period Laws Reasons for abortion Rape or incest Birth control; Gender selection Mental health Abortion Essay Topics Questions: Examples That Can Develop the Discussion The essay will require that you provide answers to a precise question by supporting your claims with factual information. Be sure to remain focused on addressing the problem you seek to highlight in your paper. We have prepared abortion questions as listed below to help you further in crafting your essay. What are the circumstances that would compel a government to order a woman to have an abortion? Where do we draw the line when a mother aborts without consent from the father? Should abortion clinics be allowed to make a profit out of the pregnancy termination? Does making abortion illegal contribute to unsafe backstreet abortion? Should we limit the number of abortion on a woman in their lifetime? Is adoption a viable alternative to abortion? What are the views of abortion in society? What are the side effects of abortion? Should abortion be allowed to rape victims? Do we allow aborting to young school girls? Abortion Essay Topics Ideas: Get Tips and Expert Assistance The polarizing topic of abortion calls upon you express thoughts or views and state whether the subject is a matter of personal freedom or social norms. Note that any opinions on the topic should be backed up supporting information from reliable sources in your paper. When necessary, give evidence or testimonials from recognized authorities to reinforce your arguments. Define your topic carefully to make the reader understand your position on the subject. If you have gone through our topics and questions, but still feel you can’t write an essay on abortion, consider hiring our assistance. 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A Definition of Environmental Science

A Definition of Environmental Science Environmental science is the study of the interactions between the physical, chemical, and biological components of nature. As such, it is a multidisciplinary science: it involves a number of disciplines like geology, hydrology, soil sciences, plant physiology, and ecology. Environmental scientists may have training in more than one discipline; for example, a geochemist has expertise in both geology and chemistry. Most often, the multidisciplinary nature of environmental scientists’ work comes from collaborations they foster with other scientists from complementary research fields. A Problem-Solving Science Environmental scientists rarely just study natural systems, but instead usually work towards solving problems stemming from our interactions with the environment. Normally the basic approach taken by environmental scientists first involves using data to detect a problem and evaluate its extent. Solutions to the issue are then designed and implemented. Finally, monitoring is done to determine whether the problem was fixed. Some examples of the types of projects environmental scientists may be involved with include: Coordinating cleanup efforts at an abandoned oil refinery labeled as a Superfund site, determining the extent of the pollution problem and putting together a restoration plan.Forecasting the effects of global climate change and sea level rise on a coastal bay system, and assisting with finding solutions to limit damages on coastal wetlands, shoreline property, and public infrastructure.Consulting with a construction team to help them with minimizing sediment pollution coming from the site of a future grocery store.Assisting the managers of a state government’s fleet of vehicles with taking steps to reducing carbon dioxide and other greenhouse gas emissions.Designing a restoration plan to bring acreage of oak savanna in the proper ecological state to host the endangered Karner blue butterfly and its host plant, the blue lupine. A Quantitative Science To evaluate the condition of a field site, the health of an animal population, or the quality of a stream most scientific approaches require extensive data collection. That data then needs to be summarized with a suite of descriptive statistics, then used to verify if a particular hypothesis is supported or not. This type of hypothesis testing requires complex statistical tools. Trained statisticians are often part of large research teams to assist with complicated statistical models. Other types of models are often used by environmental scientists. For example, hydrological models help understand groundwater flow and the spread of spilled pollutants, and spatial models implemented in a geographical information system (GIS) will help track deforestation and habitat fragmentation in remote areas. An Education in Environmental Science Whether it is a Bachelor of Arts (BA) or Bachelor of Science (BS), a university degree in environmental science can lead to a wide range of professional roles. Classes typically include earth science and biology courses, statistics, and core courses teaching sampling and analytical techniques specific to the environmental field. Students generally complete outdoor sampling exercises as well as inside laboratory work. Elective courses are usually available to provide students with the appropriate context surrounding environmental issues, including politics, economics, social sciences, and history. Adequate university preparation for a career in environmental science can also take different paths. For example, a degree in chemistry, geology, or biology can provide a solid educational basis, followed by graduate studies in environmental science. Good grades in the basic sciences, some experience as an intern or summer technician, and positive letters of recommendation should allow motivated students to get into a Master’s program. Environmental Science as a Career Environmental science is practiced by people in a wide variety of sub-fields. Engineering firms employ environmental scientists to evaluate the condition of future project sites. Consulting companies can assist with remediation, a process where previously polluted soil or groundwater is cleaned up and restored to acceptable conditions. In industrial settings, environmental engineers use science to find solutions to limit the amount of polluting emissions and effluents. There are state and federal employees who monitor air, water, and soil quality to preserve human health. The U.S. Bureau of Labor Statistics predicts an 11% growth in environmental science positions between the years 2016 and 2026. The median salary was $69,400 in 2017.

Reflection Essay Example | Topics and Well Written Essays - 500 words - 27

Reflection - Essay Example She was objectified and deemed only good for her physical features. A trend that has been a vice in all generations. Our music nowadays is full of explicit content. Songs describing women in a graphic and vile manner has filled our airwaves. What is even more distressiing is that women seem to enjoy this negative attention thus encouraging the men. Sara Baartman same as most Khoi-San women was well rounded with large buttocks, large breasts and an elongated labia. One can understand that the typical African woman in those days was a sight to behold but beauty should be admired and not ridiculed. We are all fearfilly and wonderfully made and in the image of God. His work should not be the subject of mockery and ridicule but we should simply marvel at it and be in complete awe. It is important to ask ourselves why men rarely are the subject of such acts of exploitation and abuse. Sara Baartman was born in South Africa and even while there she lived as a slave to a Dutch farmer in Cape Town. Sara was then promised great wealth if she moved to England Africa was by then referred to as the black continent mostly because its inhabitants were black. Even while she was living in her motherland she was still being subjected to racial discrimination as she worked as a slave, a role mainly played by Africans who were seen as the inferior race. It was unheard of that a white would be a black man’s slave. While in Europe, racial discrimination was at its peak at the time and Sara felt its full brunt. To the Europeans she was simply a weird specimen that was to be observed to staisfy their curiosity. No one amongst them ever made an attempt to learn about the Hottentot Venus a a person. Did she have a sense of humour? Was she temperamental? Was she intelligent? Very few attempts if any were made to learn more about her innerself. The curiosity was on her extraordinary physical features. But you have to wonder, because the

Future Municipal Financial Viability in Canada Essay

Future Municipal Financial Viability in Canada - Essay Example Definitely, I feel that municipal financial viability is an issue since improper tabling of policies may result to a negative business effect. For instance, the direct impact on Small, Medium, and Micro Enterprises by municipality policies on property valuation, user charge collection, and collection of levies makes businesses end up bearing not only the intended costs, which in this case are actual payment of services to a municipality, but also the unintended costs, which include effort and time required for tax administration. To add on policies pertaining to revenue, expenditure-related policies may also affect finances generated by businesses in a municipality. This, as a result, may lead to a positive or negative impact on SMMEs through regulation of supply chain management, and preferred procurement as well as credit control. Additionally, there are other challenges facing developing countries in the commonwealth in local government revenue terms. These include weak revenue ba se for local government leading to weak central government revenue base and lack of a municipal’s own revenue sources, which brings up inappropriate composition of revenues, especially balancing between grants and own revenue resources. Further, the way they interact and autonomous revenues where strong central control is posed on local government revenues is a challenge as well. Municipalities have several responsibilities. First, they have the function to ensure urban and town planning, and regulate use of land and building construction. Moreover, they must ensure economic and social development planning, fire services, ensuring supply of water for domestic, industrial and commercial purposes. A municipality relies heavily on revenues generated through taxation and user charges/fees. It too heavily depends on transfers from central government and/or contribution from donors. These factors will significantly determine the future municipal financial viability in Canada (Sanct on and Young, 2009). Some of the strategies, which should be employed to ensure proper municipal financial viability, are as follows. First, the intergovernmental fiscal transfers’ reform program should be implemented. These reforms focus on simplifying and rationalizing transfers to municipalities and introducing a period of allocation of these transfers to stabilize municipal budgeting processes by improving predictability. Second is transparency, which opens access to information about how municipal finances are managed will give a clear outlook to every citizen allowing no room for misuse. Third, the program of budget reform which greatly focuses on improving allocation of resource planning and management. Further, having accountable decision-makers who can accept responsibility for their own actions and using contestability as a competition tool to achieve money value. It is essential to come up with a municipal support program to provide technical assistance to municipa lities in financial management areas. Bringing up new, legislated and refined national policies aimed at improving the flexibility of the legal framework within a municipality resulting to improved leadership, management and accountability in municipal governments could play a key role. Still revenue enhancement program nationally coordinated and aiming at assist municipalities with revenue

Binge eating disorder Essay Example for Free

Binge eating disorder Essay Binge eating disorder (BED) is characterized by recurrent episodes of binge eating not accompanied by inappropriate compensatory behaviors. Although it is not yet officially recognized, it was included in the current Diagnostic and Statistical Manual of Mental Disorders (DSM) as a disorder to be studied, with research criteria included. It is also slated to be included in the next DSM as one of the officially recognized eating disorders. There have been several treatment modalities employed in its treatment: pharmacotherapy, psychotherapy, and a combination of the two. Being a â€Å"young† disorder, BED still needs future research to show which modality treats it best in the long run. Approaches to Treatment of Binge Eating Disorder What Is BED? How Is It Different From Bulimia Nervosa? Binge eating disorder (BED) is characterized by recurrent episodes of binge eating not accompanied by inappropriate compensatory behaviors (Sadock Sadock, 2003). Although binge eating, by itself, is more commonly associated with bulimia nervosa, binge eating disorder is recognized as a separate entity. Unlike BED, bulimia nervosa involves excessive concern with body shape and weight, and bulimics often have a â€Å"self-perception of being too fat, with an intrusive dread of fatness† (World Health Organization [WHO], 1993). Moreover, the absence of compensatory behaviors further distinguishes BED from the non-purging type of bulimia nervosa, which is defined by the Diagnostic and Statistical Manual of Mental Disorders, or DSM-IV, as when the individual â€Å"has used other inappropriate compensatory behaviors, such as fasting or excessive exercise, but has not regularly engaged in self-induced vomiting or the misuse of laxatives, diuretics, or enemas† (American Psychiatric Association [APA], 2000). Diagnosis of Binge Eating Disorder Although binge eating disorder still has to gain official recognition, the Text Revision of DSM-IV (APA, 2000) lays down the following â€Å"research criteria† for diagnosing the disorder: A. Recurrent episodes of binge eating. An episode of binge eating is characterized by both of the following: (1) eating, in a discrete period of time (e. g. , within any 2-hour period), an amount of food that is definitely larger than most people would eat in a similar period of time under similar circumstances (2) the sense of lack of control over eating during the episode (e. g. , a feeling that one cannot stop eating or control what or how much one is eating) B. Binge-eating episodes are associated with three (or more) of the following: (1) eating much more rapidly than normal (2) eating until feeling uncomfortably full (3) eating large amounts of food when not feeling physically hungry (4) eating alone because of being embarrassed by how much one is eating (5) feeling disgusted with oneself, depressed, or very guilty after overeating C. Marked distress regarding binge eating is present. D. The binge eating occurs, on average, at least 2 days a week for 6 months. E. The binge eating is not associated with the regular use of inappropriate compensatory behaviors (e. g. , purging, fasting, excessive exercise, etc. ) and does not occur exclusively during the course of anorexia nervosa or bulimia nervosa. Several issues have been raised regarding the criteria mentioned above. For example, one question raised by some experts in the field is that there is no definite way to assess just how much food constitutes â€Å"an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances. † Fulfilling these criteria would at best be a subjective process. While the DSM-IV criteria for BED is usually applied to adults, Marcus and Kalarchian (2003) have proposed a separate set of provisional research criteria for diagnosing BED in children. These are: A. Recurrent episodes of being eating. An episode of binge eating is characterized by both of the following: (1) food seeking in absence of hunger (e. g. after a full meal) (2) a sense of lack of control over eating (e. g. , endorse that ‘‘When I start to eat, I just can’t stop’’) B. Binge episodes are associated with one or more of the following: (1) food seeking in response to negative affect (e. g. , sadness, boredom, restlessness) (2) food seeking as a reward (3) sneaking or hiding food C. Symptoms persist over a period of 3 months. D. Eating is not associated with the regular use of inappropriate compensatory behaviors (e. g. , purging, fasting, excessive exercise) and does not occur exclusively during the course of anorexia nervosa or bulimia nervosa. Some of the questionnaires used to diagnose binge eating disorder are: the Binge Eating Scale (BES), the Three Factor Eating Questionnaire, the Body Shape Questionnaire, the Structured Clinical Interview for the Diagnosis of DSM Disorders (SCID), and the Eating Disorders Examination (EDE). The Treatment of Binge Eating Disorder Overview In the management of BED, the primary goal is to achieve abstinence from binge eating (Bulik, Brownley Shapiro, 2007). However, studies have shown that BED has comorbid conditions that require as much attention, such as depression, generalized anxiety disorder, panic attacks and even attempts at suicide (Grucza, Przybeck Cloninger, 2007). Furthermore, since patients diagnosed with BED do not usually engage in inappropriate compensatory behaviors, they are usually obese as well, a condition that sometimes causes more concern in professionals caring for BED patients because of its health implications. Because of the different aspects of this disorder, different treatment modalities are being used, with some experts favoring one and others favoring another. Pharmacotherapy Medications used to treat binge eating disorder include appetite suppressants, anticonvulsants, selective serotonin and norepinephrine reuptake inhibitors, and tricyclic antidepressants. These have been studied in double-blind placebo-controlled trials, and the results, though modest, have been promising (Appolinario McElroy, 2004). Appetite suppressants. According to Appolinario, Bacaltchuk, Sichieri, Claudino, Godoy-Matos, Morgan, Zanella Coutinho (2003), fenfluramine hydrochloride was the first antiobesity agent shown to be effective in treating binge eating disorder. However, this drug has been withdrawn from the market because of intolerable side effects. Currently, the anti-obesity agent that seems to be the most studied in the treatment of BED is sibutramine. Sibutramine is a drug that inhibits the reuptake of serotonin, norepinephrine, and, to some extent, dopamine. A study by Appolinario et al. (2003) showed that patients taking sibutramine, as opposed to those given a placebo pill, experienced a significant reduction in the number of days with binge episodes. Whereas those in the placebo group actually gained some weight, the patients given sibutramine lost an average of 7. 4 kg. The study participants were asked to fill out the Binge Eating Scale and the Beck Depression Inventory before and after their treatment program, and the sibutramine group had significantly lower scores after treatment. The study cites dry mouth and constipation as the adverse reactions commonly encountered by those taking sibutramine. The authors concluded that sibutramine is effective and well tolerated for treating obese BED patients. Another study supporting the use of sibutramine in BED was published in the American Journal of Psychiatry in January 2008. Wilfley, Crow, Hudson, Mitchell, Berkowitz, Blakesley, Walsh, and the Sibutramine Binge Eating Disorder Research Group (2008) found that patients taking sibutramine (15 mg daily for 24 weeks) were able to significantly reduce the following measures: weekly binge frequency, weight (mean of 4. 3 kg), frequency of binge days, body mass index, and eating pathology, such as cognitive restraint, disinhibition and hunger. Moreover, these patients also experienced global improvement and had a greater percentage of abstinence from binge eating (58. 7%, compared with the 42. 8% of the placebo group). Anticonvulsants. In the February 2003 edition of the American Journal of Psychiatry, McElroy, Arnold, Shapira, Keck, Rosenthal, Karim, Kamin Hudson (2003) reported that 30 patients with binge eating disorder randomly assigned to receive a flexible dose (25 to 600 mg per day) of the anticonvulsant drug topiramate had a significantly greater rate of reduction in binge frequency, binge day frequency, weight (mean loss of 5. 9 kg), and body mass index. They also had lower scores on the Yale-Brown Obsessive Compulsive Scale, which was modified for binge eating, and on the Clinical Global Impression severity scale. However, six patients receiving topiramate were unable to continue participating in the study because of adverse events, mostly headaches and paresthesias. The researchers concluded that topiramate was useful for the short-term treatment of BED. The journal Biological Psychiatry also published a study by McElroy, Hudson, Capece, Beyers, Fisher, Rosenthal, and the Topiramate Binge Eating Disorder Research Group (2007), which showed that 195 patients taking topiramate were able to reduce binge eating days per week, binge episodes per week, weight (mean loss of 4. 5 kg), and body mass index compared with those assigned to take placebo. Thirty percent of those taking topiramate left the study, mostly due to adverse effects such as paresthesia, upper respiratory tract infection, somnolence and nausea. However, thirty percent of those taking the placebo pill also were not able to continue with the program. Despite the adverse events reported, the authors concluded that topiramate is well tolerated and was efficacious in treating BED and its features, particularly obesity. Another antiepileptic drug that was evaluated for efficacy in the treatment of binge eating disorder is zonisamide. McElroy, Kotwal, Guerdjikova, Welge, Nelson, Lake, D’Alessio, Keck Hudson (2006) reported in the Journal of Clinical Psychiatry that thirty patients given zonisamide (100 to 600 mg per day for 16 weeks) had a reduction in the frequency of their binge eating episodes, body weight, body mass index, and scores on the Yale-Brown Obsessive Compulsive Scale Modified for Binge Eating and the Clinical Global Impressions Severity Scale. Eight of the patients receiving zonisamide discontinued treatment because of accidental injury with bone fracture, psychological complaints and cognitive complaints. In conclusion, the researchers noted that zonisamide was efficacious in treatment of BED with obesity but that it was not well tolerated. Selective serotonin reuptake inhibitors (SSRIs) and norepinephrine reuptake inhibitors. Several selective serotonin reuptake inhibitors have been shown to have beneficial effects in the management of binge eating disorder. Among the earliest SSRI’s shown to be useful in BED treatment was fluvoxamine. Hudson, McElroy, Raymond, Crow, Keck, Carter, Mitchell, Strakowski, Pope, Coleman Jonas (1998) reported that forty-two patients who received a flexible dose of fluvoxamine (50 to 300 mg) for 9 weeks had a significantly greater decrease in the frequency of binges and in body mass index. Furthermore, these patients given fluvoxamine achieved a greater reduction in Clinical Global Impression severity score and a greater rate of increase in Clinical Global Impression improvement scores. However, fluvoxamine did not have a significant effect on the participants’ Hamilton depression scale scores, and the proportion of patients who dropped out of the study because of adverse effects came from the fluvoxamine group. Furthermore, another study done 5 years later on a different, smaller set of patients showed that there was a reduction in binge frequency, eating concern, shape concern and weight concern in both the group receiving fluvoxamine and the group receiving placebo (Pearlstein, Spurell, Hohlstein, Gurney, Read, Fuchs Keller, 2003). The authors say this is just an example of the â€Å"inconsistent results of antidepressant studies in binge eating disorder† (Pearlstein et al. , 2003). Another SSRI shows greater promise. McElroy, Hudson, Malhotra, Welge, Nelson Keck (2003) conducted a 6-week, double-blind, flexible-dose (20 to 60 mg per day) study on the efficacy of citalopram in reducing the frequency of binge eating episodes. They reported that the 19 patients receiving citalopram, compared with those receiving placebo, had a significantly greater rate of reduction in the frequency of binge eating episodes, frequency of binge days, weight, body mass index and severity of illness. In addition, citalopram was said to be well tolerated by the participants of the study. A head-to-head comparison of two SSRI’s – sertraline and fluoxetine – was conducted by Leombruni, Piero, Lavagnino, Brustolin, Campisi Fassino (2008) and published in the journal Progress in Neuro-psychopharmacology and Biological Psychiatry. Twenty-two participants were given 100 to 200 mg of sertraline daily, while twenty were given 40 to 80 mg of fluoxetine per day. After 8 weeks, participants from both groups had significant weight loss and their scores in the Binge Eating Scale improved. There was no significant difference found between the two drugs, and the researchers concluded that both SSRI’s are effective options in treating patients with BED. A drug that inhibits both serotonin and norepinephrine reuptake was studied by Noma, Uwatoko, Yamamoto Hayashi (2008). Although the trial did not focus exclusively on individuals with binge eating disorder but consisted of 25 binge eaters, some of whom were diagnosed with anorexia or bulimia nervosa. These patients received the drug milnacipran for 8 weeks and were found to have improved scores in relation to their drive for binge eating and regret for the same. Milnacipran was noted to be more effective in patients without purging. Venlafaxine, another medication that inhibits the reuptake of both serotonin and norepinephrine, was mentioned by Appolinario et al. (2003) as effective in BED therapy. McElroy, Guerdjikova, Kotwal, Welge, Nelson, Lake, Keck Hudson (2007) examined the effects of atomoxetine, a norepinephrine reuptake inhibitor, on BED. Twenty patients who received the drug had a significant decrease in binge-eating episode frequency, binge day frequency, weight, and body mass index. Their scores on the Clinical Global Impressions Severity of Illness scale, the Yale-Brown Obsessive Compulsive Scale Modified for Binge Eating obsession subscale, and the Three Factor Eating Questionnaire hunger subscale improved as well. However, three of the patients receiving atomoxetine asked to discontinue their treatment because of increased depressive symptoms, constipation or nervousness. Tricyclic antidepressants. Bulik, Brownley Shapiro (2007), in a review of the diagnosis and management of binge eating disorder, also mentions imipramine as one of the drugs that were shown in trials to be effective in the treatment of BED. Imipramine is a tricyclic antidepressant that is used mainly for the treatment of depression and enuresis. A drug from the same family, desipramine, was also mentioned as having beneficial effects in BED. There have indeed been many drugs explored by research for the treatment of binge eating disorder. However, while a lot of studies show that they do have a beneficial effect on patients with BED, particularly with regards to a reduction in binge frequency and weight, the results are somewhat modest. In addition, there have been no long-term studies tracking the efficacy of these drugs as yet. And then, of course, there is the concern that many of those individuals taking these drugs might give them up due to the adverse effects they cause. More importantly, the drugs do not address the underlying cause of binge eating, the psychopathology in individuals that lead them to take in large amounts of food despite the knowledge that doing so could harm them physically and socially. Thus, while many experts in the field would agree that medications help to curb the comorbidities of BED, they still encourage the use of psychotherapy. Psychotherapy Cognitive behavioral therapy. The behavioral therapeutic approach to binge eating disorder that is probably the most tested is cognitive behavioral therapy, or CBT (Bulik, Brownley Shapiro, 2007). As the name implies, the theory behind this practice is the cognitive behavioral model of binge eating, which â€Å"postulates that binge eating develops in response to restrictive food intake and occurs in the context of ongoing dietary restraint and the experience of negative emotions† (Levine Marcus, 2003). In short, inaccurate thoughts and beliefs – for example, those about body shape and weight – lead to inappropriate eating behavior. CBT helps patients identify these binge-triggering thoughts and modify them so as to accomplish binge abstinence. According to Bulik, Brownley Shapiro (2007), cognitive behavioral therapy has been reported by several studies to be effective in reducing â€Å"binge frequency, related psychological aspects of binge eating (restraint, disinhibition, and hunger), depressed mood, and ratings of illness severity in individuals with BED. † Levine Marcus (2003) note that, while cognitive behavioral therapy has been traditionally used in the management of individuals with bulimia nervosa, the technique has been modified to accommodate the differences between bulimia nervosa and binge eating disorder. For example, unlike people with bulimia nervosa, those with binge eating disorder tend to be obese, so CBT can directly target cognitions about having a large body size. They explain, â€Å"Overweight individuals with BED may be helped to accept their body size and to restructure maladaptive thoughts about the amount of weight loss they are likely to achieve. That is, although modest weight loss may relate to improvements in binge eating, for most BED patients this decrease may not correspond with their desired weight loss. It is therefore important that cognitions about acceptable body sizes be targeted during treatment. † Interpersonal psychotherapy. Another type of therapy that has found success in patients with bulimia nervosa and has since been also applied to people with binge eating disorder is interpersonal psychotherapy, or IPT. While CBT focuses on the thoughts that trigger eating binges, interpersonal psychotherapy operates on the theory that binge eating stems from the internal milieu created by specific social and interpersonal problems. Thus, it â€Å"focuses on identifying and addressing specific, problematic interpersonal patterns, in an effort to ameliorate dysfunctional eating behaviors† (Levine Marcus, 2003). As with CBT, IPT is focused, structured and time-limited. However, it does not address the patient’s beliefs about eating, weight and shape and, unlike CBT, does not directly target eating behaviors. In the Archives of General Psychiatry, Wilfley, Welch, Stein, Spurrell, Cohen, Saelens, Dounchis, Frank, Wiseman Matt (2002) report on a comparative study that they conducted between CBT and IPT. Both were done in a group setting, and the participants in each group went through 20 weekly sessions of therapy. Results showed that â€Å"binge-eating recovery rates† were similar for both CBT and IPT immediately after treatment. They further conducted follow-up on each participant and noted that, while, there was a slight increase in binge eating when the treatment ended, the frequency of such binges remained significantly lower than the frequency prior to initiation of either CBT or IPT. In addition, the researchers reported significant reductions in psychiatric symptoms, and these were maintained through follow-up. They noted that, while dietary restraint decreased more quickly in patients who underwent CBT, a similar level of dietary restraint was accomplished by those who underwent IPT by the time of follow-up. The participants’ weight decreased only slightly, but significantly, and the authors then concluded that group IPT is a reasonable alternative to group CBT for dealing with overweight BED patients. Dialectical behavior therapy. Another type of therapy used for the treatment of BED is dialectical behavior therapy, or DBT. This is described by Levine Marcus (2003) as â€Å"a comprehensive treatment program based on cognitive and behavioral principles and complemented by the use of acceptance-based strategies derived primarily from Zen Buddhism. † Patients undergo a weekly individual outpatient therapy and, at the same time, a weekly group skills therapy that has the goal of increasing behavioral skills that can help them deal with binge eating. According to Bulik, Brownley Shapiro (2007), dialectical behavior therapy â€Å"fosters the development of skills in the domains of mindfulness, emotion regulation, interpersonal effectiveness, and distress tolerance. † Although it is still considered an â€Å"alternative† form of behavior therapy, there have been studies showing that DBT has led to a greater reduction in binge days, binge episodes, and concerns with weight, shape and eating. Other behavioral therapies. Aside from cognitive behavior therapy, interpersonal psychotherapy and dialectical behavior therapy, Bulik, Brownley Shapiro (2007) mention self-help, exercise and virtual reality therapy as treatment modalities that have been tried in patients with BED. Self-help interventions are delivered in various formats, and may be done with or without structure, and with out without the aid of a facilitator or a therapist. It has been shown by some studies to result in greater reductions in the mean number of binge days and in the clinical severity of BED. Abstinence and cessation rates were also reported to be improved with self-help, but weight loss was not significantly achieved. Medications and Psychotherapy: Combined and Compared Several studies have explored the option of combining pharmacotherapy with psychotherapy. Bulik, Brownley Shapiro (2007) discuss the results of these studies. For example, a trial compared fluoxetine alone with CBT alone and fluoxetine plus CBT. The authors of that trial reported that CBT plus fluoxetine, and CBT alone, were more effective than fluoxetine alone in reducing the frequency of binges, concerns with eating and body shape, disinhibition and depression. Another comparison discussed in the same paper compared desipramine alone, weight loss therapy, and CBT. Bulik, Brownley Shapiro (2007) relate: â€Å"Binge eating was significantly reduced after 12 weeks in both groups receiving CBT; however, this effect did not persist at 36 weeks of treatment. Average weight loss was greatest in the weight loss therapy group in the early stages of treatment, but over time (i. e. , at 3-month follow-up) the group receiving desipramine lost the most weight. Desipramine showed no clear advantage in reducing symptoms of depression. † Claudino, de Oliveira, Appolinario, Cordas, Duchesne, Sichieri Bacaltchuk (2007) compared topiramate alone with CBT plus topiramate and concluded that â€Å"topiramate added to CBT improved the efficacy of the later, increasing binge remission and weight loss in the short run. Topiramate was well tolerated, as shown by few adverse events during treatment. † Finally, Molinari, Baruffi, Croci, Marchi Petroni (2005) conducted a comparison of CBT alone, fluoxetine alone, and CBT plus fluoxetine. Results showed that â€Å"the two groups which underwent psychotherapy resulted in a better outcome in terms of number of bingeing episodes, maintenance of weight loss reduction from baseline and psychological well being than the group treated with pharmacological therapy alone. † The authors concluded that the results of their study highlight the importance of a multidisciplinary approach to binge eating disorder. However, as with pharmacotherapy alone and with psychotherapy alone, the long-term efficacy of a combined drugs-and-talk approach to binge eating disorder still has to be proven by future studies. Practical Advice To Tell Patients Empowering patients to take control of their disorder is also important. Smith, Barston, Segal Segal (2008) offer the following tips that concerned eating disorder professionals can give their patients: †¢ Eat breakfast. Skipping breakfast often leads to overeating later in the day, so start your day right with a healthy meal. Eating breakfast also jump starts your metabolism in the morning. Studies show that people who eat breakfast are thinner than those who don’t. †¢ Avoid temptation. You’re much more likely to overeat if you have junk food, desserts, and unhealthy snacks in the house. Remove the temptation by clearing your fridge and cupboards of your favorite binge foods. †¢ Stop dieting. The deprivation and hunger of strict dieting can trigger food cravings and the urge to overeat. Instead of dieting, focus on eating in moderation. Find nutritious foods that you enjoy and avoid labeling foods as â€Å"good† or â€Å"bad. † †¢ Exercise. Not only will exercise help you lost weight in a healthy way, but it also lifts depression, improves overall health, and reduces stress. The natural mood-boosting effects of exercise can help put a stop to emotional eating. †¢ Destress. Learn how to cope with stress in healthy ways that don’t involve food. Conclusion Binge eating disorder is still relatively â€Å"young. † With its anticipated inclusion in the next edition of the DSM, a lot of studies have turned their attention to this eating disorder that has only been recognized as an entity separate from the other eating disorder in the last decade. Hopefully, these studies, and the ones still to be conducted, will provide a sound basis for how best to approach binge eating disorder. More importantly, only future research can tell which treatment modalities really work best in the long term. In the meantime, patients with binge eating disorder need help in the here and now. References American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th ed. Text rev. ) Washington, DC: American Psychiatric Association Sadock, B. J. , Sadock, V. A. (2003). Synopsis of Psychiatry: Behavioral Sciences / Clinical Psychiatry (9th ed. ). Philadelphia, PA: Lippincott Williams Wilkins. World Health Organization. (1993). The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. Geneva: World Health Organization. Marcus, M. D. Kalarchian, M. A. (2003). Binge eating in children and adolescents. Int J Eat Disord, 34(Suppl), S47–S57. Retrieved from PubMed database. Bulik, C. M. , Brownley, K. A. , Shapiro, J. R. (2007). Diagnosis and management of binge eating disorder. World Psychiatry, 6(3), 142-148. Grucza, R. A. , Przybeck, T. R. Cloninger, C. R. (2007). Prevalence and correlates of binge eating disorder in a community sample. Comprehensive Psychiatry, 48(2), 124-131. Appolinario, J. C. McElroy, S. L. (2004). Pharmacological approaches in the treatment of binge eating disorder. Current Drug Targets, 5(3), 301-307. Appolinario, J. C. , Bacaltchuk, J. , Sichieri, R. , Claudino, A. M. , Godoy-Matos, A. , Morgan, C. , Zanella, M. T. Coutinho, W. (2003). A randomized, double-blind, placebo-controlled study of sibutramine in the treatment of binge-eating disorder. Archives of General Psychiatry, 60, 1109-1116. Wilfley, D. E. , Crow, S. J. , Hudson, J. I. , Mitchell, J. E. , Berkowitz, R. I. , Blakesley, V. , Walsh, B. T. , the Sibutramine Binge Eating Disorder Research Group. (2008). Efficacy of sibutramine for the treatment of binge eating disorder: a randomized multicenter placebo- controlled double-blind study. American Journal of Psychiatry, 165(1), 51-58. McElroy, S. L. , Arnold, L. M. , Shapira, N. A. , Keck, P. E. Jr. , Rosenthal, N. R. , Karim, M. R. , Kamin, M. Hudson, J. I. (2003). Topiramate in the treatment of binge eating disorder associated with obesity: a randomized, placebo-controlled trial. American Journal of Psychiatry, 160(2), 255-261. McElroy, S. L. , Hudson, J. I. , Capece, J. A. , Beyers, K. , Fisher, A. C. , Rosenthal, N. R. the Topiramate Binge Eating Disorder Research Group. (2007). Topiramate for the treatment of binge eating disorder associated with obesity: a placebo-controlled study. Biological Psychiatry, 61(9), 1039-1048. McElroy, S. L. , Kotwal, R. , Guerdjikova, A. I. , Welge, J. A. , Nelson, E. B. , Lake, K. A. , D’Alessio, D. A. , Keck, P. E. , Hudson, J. I. (2006). Zonisamide in the treatment of binge eating disorder with obesity: a randomized controlled trial. Journal of Clinical Psychiatry, 67(12), 1897-1906. Hudson, J. I. , McElroy, S. L. , Raymond, N. C. , Crow, S. , Keck, P. E. Jr. , Carter, W. P. , Mitchell, J. E. , Strakowski, S. M. , Pope, H. G. Jr. , Coleman, B. S. Jonas, J. M. (1998). Fluvoxamine in the treatment of binge-eating disorder: a multicenter placebo-controlled, double-blind trial. American Journal of Psychiatry, 155(12), 1756-1762. Pearlstein, T. , Spurell, E. , Hohlstein, L. A. , Gurney, V. , Read, J. , Fuchs, C. Keller, M. B. (2003). A double-blind, placebo-controlled trial of fluvoxamine in binge eating disorder: a high placebo response. Archives of Women’s Mental Health, 6(2), 147-151. McElroy, S. L. , Hudson, J. I. , Malhotra, S. , Welge, J. A. , Nelson, E. B. Keck, P. E. Jr. (2003). Citalopram in the treatment of binge-eating disorder: a placebo-controlled trial. Journal of Clinical Psychiatry, 64(7), 807-813. Leombruni, P. , Piero, A. , Lavagnino, L. , Brustolin, A. , Campisi, S. Fassino, S. (2008). A randomized, double-blind trial comparing sertraline and fluoxetine 6-month treatment in obese patients with binge eating disorder. Progress in Neuro-psychopharmacology and Biological Psychiatry, 32(6), 1599-1605. Noma, S. , Uwatoko, T. , Yamamoto, H. Hayashi, T. (2008). Effects of milnacipran on binge eating – a pilot study. Neuropsychiatric Disease and Treatment (4)1, 295-300. McElroy, S. L. , Guerdjikova, A. , Kotwal, R. , Welge, J. A. , Nelson, E. B. , Lake, K. A. , Keck, P. E. Jr. Hudson, J. I. (2007). Atomoxetine in the treatment of binge-eating disorder: a randomized placebo-controlled trial. Journal of Clinical Psychiatry, 68(3), 390-398. Levine, M. D. Marcus, M. D. (2003). Psychosocial treatment of binge eating disorder: An update. Eating Disorders Review, 14(4). Retrieved from http://www. gurze. net/site12_5_00/newsletter16. htm. Wilfley, D. E. , Welch, R. R. , Stein, R. I. , Spurrell, E. B. , Cohen, L. R. , Saelens, B. E. , Dounchis, J. Z. , Frank, M. A. , Wiseman, C. V. Matt, G. E. (2002). A randomized comparison of group cognitive-behavioral therapy and group interpersonal psychotherapy for the treatment of overweight individuals with binge-eating disorder. Archives of General Psychiatry, 59, 713-721. Claudino, A. M. , de Oliveira, I. R. , Appolinario, J. C. , Cordas, T. A. , Duchesne, M. , Sichieri, R. Bacaltchuk, J. (2007). Double-blind, randomized, placebo-controlled trial of topiramate plus cgnitive-behavior therapy in binge-eating disorder. Journal of Clinical Psychiatry, 68(9), 1324-1332. Molinari, E. , Bariffu, M. , Croci, M. , Marchi, S. Petroni, M. L (2005). Bingea eating disorder in obesity: comparison of different therapeutic strategies. Eating and Weight Disorders, 10(3), 154-161. Smith, M. , Barston, S. , Segal, R. Segal, J. (2008). Binge eating disorder: Symptoms, causes, treatment, and help. Retrieved from http://www. helpguide. org/mental/binge_eating_disorder. htm.

Karl Marx And Marxism Essay examples -- essays research papers fc

Karl Marx and Marxism   Ã‚  Ã‚  Ã‚  Ã‚  Karl Marx set the wheels of modern Communism and Socialism in motion with his writings in the late nineteenth century. In collaboration with his friend, Heinrich Engels, he produced the The Communist Manifesto, written in 1848. Many failed countries' political and socio-economic structures have been based on Marx's theories, for example the USSR, East Germany etc. Many people believe that Marxism is not applicable to today's society, as Karl Marx put forward his ideas not anticipating the type of society we have today. The welfare state system has effectively nullified Marx's arguments, and made them irrelevant.   Ã‚  Ã‚  Ã‚  Ã‚  Karl Marx, born on May 5, 1818, died on March 14, 1883, was a German economist, philosopher and revolutionist whose writings form the basis of the body of ideas known as Marxism. In his youth he was deeply affected by the philosophy of G.W.F. Hegel, and joined a rebel group called the Young Hegelians, which contributed ideas towards the movement against organized religion and the Prussian Autocracy. Later on in life, he was influenced by the writings of Ludwig Feuerbach, who wrote that God was invented by humans as a projection of their own ideals, and that in creating such a 'perfect' being, in contrast to themselves, mankind lowered themselves to lowly, evil creatures who needed guidance from the church and government. He said that, in creating God in their own image, humans had 'a...

Peachtree Healthcare Essay

Peachtree Healthcare has been faced with a dilemma. There has been a major IT infrastructure problem within the company for some time now. Since technology has taken over in the healthcare field, it is imperative that Peachtree Healthcare get the technology needed so that they can be trusted and well known within the healthcare industry. Mission The mission of Peachtree Healthcare is to ensure quality, consistency, and continuity of care across the entire network – and to deliver care with the highest levels of efficiency and economy while maintaining respect for patients and staff. Objectives The hospital needs to decide on what long / short term IT infrastructure system strategies and roadmaps are needed to increase efficiency. The new system should allow sharing of patient records, ensure quality, consistency, and continuity of care across entire network of hospitals and physicians. Key Issues The IT infrastructure is not reliable; therefore, uses are unable to perform their day to day functions including clinical duties. This is impacting quality and safety of patient care. Recommendations Adopt service oriented architecture (SOA) which will enable selective standardization. CURRENT SITUATION (10) Peachtree Healthcare has major IT infrastructure problems and is struggling to find the right fix. Growth through acquisitions has led to the inheritance of many incompatible legacy systems. Current IT resources are focused on maintaining inefficient processes in order to keep the hospital running. The maintenance costs of the current IT system are so high that further innovation has become a luxury. In addition there have been recent meltdowns of clinical information systems. IT infrastructure is not reliable; therefore users are unable to perform their day to day functions, including clinical duties. This is impacting quality and safety of patient care. Furthermore there is pressure from the hospital’s board to standardize hospital procedures and practices without fully assessing the need for it. Max Berndt (CEO), Candace Markovich (CIO) and Tom Drane (CFO) are struggling to analyze the current situation subjectively in order to properly manage the pressure to follow competitors. CRITERIA (5) The hospital needs to decide on what long / short term IT infrastructure system strategies and roadmaps are needed to increase efficiency. The new system should allow sharing of patient records, ensure quality, consistency, and continuity of care across entire network of hospitals and physicians. The system should also ensure â€Å"selective† standardization of certain medical procedures across the network but allow sufficient flexibility to individual hospitals and professionals in other areas. Other criteria include: †¢ Time to value – when will the new system realize value for each business unit †¢ Flexibility – easy to modify, upgrade and customization capabilities †¢ Staff buy-in – ability to convince all staff to give this project a try ALTERNATIVES & RECOMMENDATIONS (15) Alternative 1: Monolithic System (Modular Enterprise System) A monolithic system is single set of systems and applications that will provide consistency across Peachtree’s facilities but may not give doctors enough flexibility. Other pros and cons include: Alternative 2: Service-Oriented Architecture (SOA) System A servicer-oriented architecture system is modular design that will allow Peachtree to standardize incrementally and selectively but poses certain risks as a newer technology. Recommendation: My recommendation is to crease a strategy of selective standardization using a SOA system. This means assessing and deciding on a SOA architecture standard. Reviewing individual business functions and deciding on an ideal standard for that functional unit then migrating others to it. This will allow Peachtree to standardize incrementally, which Max has wanted most in an IT infrastructure. RISK MANAGEMENT PLAN (15) Since SOA is a new technology, there are serious risks and consequences involved with this approach. The SOA technology is not mature yet and has not been tested in the long term. As a result there is a lot of unpredictability. To mitigate these risks Peachtree should gradually replace its old system with the SOA System. They should proceed with SOA in stages by piloting smaller projects to quickly provide value to business units. By gradually installing the SOA, Peachtree and its doctors would learn about how the systems worked and they could then master it in a sense as the infrastructure moved further. By gradually installing the infrastructure, Peachtree would not only minimize risk but also create flexibility and control. With the gradual learning process on the new SOA system, Peachtree and its physicians would allow IT to shift priorities along the way. Peachtree should also create case studies to get other business units and vendors support throughout roll-out process. They should also consider hiring external change management consultants to ensure minimum user disruption and smooth transition into the new system.