Reducing Out-Group Bias in Huntingtons Disease Patients

Reducing Out-Group Bias in Huntingtons Disease Patients Free Online Research Papers Huntington’s disease (HD) is a genetic condition, which results in a variety of physical and psychological symptoms. The disease leads to loss of neurons in the striatum, with more severe neuronal loss as the disease progresses. The present study aims to investigate how such degeneration may affect social stereotyping. Perspective taking has been used by numerous authors to try and reduce stereotypes, and bias against groups outside of one’s own. It was hypothesised that due to degeneration of brain areas thought to be key to the process of perspective taking and reducing bias, that HD patients would be unable to use a perspective taking task to reduce their in-group bias. The participants for this study were nine HD patients attending the Queen Elizabeth Psychiatric Hospital HD clinic, and fourteen control participants, matched for educational background. A number of measures were used, including a relative positivity scale andtrait overlap to measure in-group bias, and tests of prefrontal cortex function. Analysis showed no support for the hypothesis, with no significant differences found on the measures of relative positivity and trait overlap. However, a number of methodological problems are discussed, along with directions for future research. Introduction Huntington’s disease (HD) is an inherited, degenerative illness, thought to affect between four to ten individuals of Caucasian origin in every 100 000 (Reddy, Williams and Tagle, 1999). The disease results in a variety of motor and psychiatric symptoms. These symptoms usually begin around the age of 40 to 50 years. In the early stages of the disease, these symptoms include fidgeting, clumsiness, dance like movements referred to as chorea, absentmindedness, depression, apathy, irritability and psychosis. As the disease progresses, these symptoms worsen, with speech deterioration, facial grimacing and the development of an inability to swallow. There is also a decline in cognitive functions, especially spatial deficits, and executive function (Brandt, Leroi, O’Hearn, Rosenblatt and Margolis, 2004). In its juvenile form, the age of onset is much earlier, and the symptoms more severe. The disease eventually leads to death. Snowden, Gibbons, Blackshaw, Doubleday, Thompson, Crauford, Foster, Happe and Neary (2003) also reported some social cognition deficits in patients with HD. In their study, HD patients were found to have deficit compared to controls in the comprehension and understanding of humourous cartoons and story vignettes, although these deficits were more pronounced in patients with frontotemporal dementia, another disorder affecting the frontostriatal systems. HD is an autosomal dominant genetic condition. The disease has been linked to a mutation of the IT15 gene on chromosome 4 (the Huntington’s Disease Collaborative Research Group, 1993). The mutation of this gene causes the polymorphic trinucleotide repeat of the sequence CAG, which codes for the huntingtin preotein, to expand to over 36 repeats. This in turn causes the protein Huntingtin to fold abnormally (Li and Li, 2004), initiating a protective cellular response meant to prevent the build up of the Huntingtin protein. However, this response puts the endoplasmic reticulum of the mitochondria under stress (Rao and Bredesen, 2004), affecting mitochondrial homeostasis (Bezprozvanny and Hayden, 2004). This eventually leads to cell death. The number of CAG repeats is inversely proportional to the age on onset that the symptoms of the disease begin to manifest themselves (Andrew and Hayden, 1995). It has been suggested that the number of CAG repeats also correlates to psych iatric symptoms experienced by HD sufferers, however studies have failed to find any such correlation (Berrios, Wagle, Markova, Wagle, Ho, Rubinsztein, Whittaker, Ffench-Constant, Kershaw, Rosser, Bak and Hodges, 2001). Although the IT15 gene is found in many body tissues, the primary site of degeneration is the brain (Reddy at al, 1999), in particular the striatum. In the early stages of the disease, the dorsomedial striatum is affected, then as the disease progresses, there is more pronounced degeneration of striatal neurons, with damage spreading to the cerebral cortex. The localised pathological changes found in HD patients account for the symptoms it produces. The degeneration of the basal ganglia, in particular the striatum, affects all five of the frontal subcortical neural circuits, which have been summarised by Cummings (1993). These circuits begin in the frontal cortex, which then project to regions of the striatum, the globus pallidus and the thalamus (Tekin and Cummings, 2002). The disruption caused to the motor circuit accounts for the movement disorders seen in HD, the dorsolateral prefrontal circuit the executive function problems, the orbitofrontal circuit the depression, and the anterior cingulate circuit the apathy (Tekin and Cimmings, 2002). Cummings (1993) also reported HD patients with antisocial personality disorder, and suggested a link between HD and obsessive compulsive disorder, thought to be due to the degeneration of one of the frontal subcortical neural circuits. Previous work has highlighted the role of the prefrontal cortex in the capacity to attribute thoughts and feelings to others, therefor it is plausible that HD patients may have a problem in doing this. Ruby and Decety (2004) used a perspective taking task in their neuroimaging study to highlight the importance of the frontalpolar, the somatosensory cortex and inferior parietal lobe in distinguishing the self and the other. Furthermore, Ehlers and Bratt (1996) showed that patients with serious injury to the frontal lobes had a general lack of empathy and inability to see situations from a perspective other than their own. The ability to see the perspective of others and the reduction of stereotypes has long been discussed in social psychology. Dasgupta and Asgari (2004) cite the early writings of Allport in 1935 and his opinion that attitudes are ‘rigid’, and unlikely to be changed or modified unless ‘under the provocation of serious affective disorganisation’. However, recent theories have taken the view that attitudes are more fluid and subject to change (Dasgupta and Asgari, 2004). Being able to take the perspective of another (perspective taking) is essential for avoiding the over use of social stereotypes. Galinsky and Moskowitz (2000) investigated perspective taking in normal subjects. They found that perspective taking was an effective strategy for reducing bias against members of a social group outside of the participants’ own. Research using caregivers of cancer patients has also shown that perspective taking ‘helped to prompt adjustments down from a self orientated viewpoint’ (Lobchuk and Voruer, 2003). Davis, Conklin, Smith and Luce (1996) have also looked at perspective taking in normal participants. In their study, it was found that the use of perspective taking resulted in the participants attributing traits to novel targets that they had previously used to describe themselves. In the second part of their study, the participants were given a memory task as a distracter while completing the original perspective taking task. In this condition, it was found that there was a reduced overlap between traits assigned to self and the novel group. This would imply that persepctive taking is only effective if the perspective taking task is remembered clearly. Memory is an executive function. Using the assumption of executive function being controlled by the dorsolateral prefrontal circuit as proposed by Cummings and Tekin (2002), is it possible that damage to the dorsolateral prefrontal circuit, such as that caused by HD, could cause some patients to also have a reduced overlap in t raits assigned to a novel group and the self? Galinsky (2002) suggests that bias between out-groups and the self may be due to internal psychological processes, in particular categorisation and egocentrism. Work conducted by Filoteo, Maddox and Dais (2001) has shown that patients with HD perform poorly on categorisation tasks, such as simple line stimuli categorisation into one of two groups, leading them to conclude that HD causes deficits in learning categorisation rules. Furthermore, a neuropsychological theory of categorisation published by Ashby, Alfonso-Reese, Turken and Waldron in 1998 highlights the role of caudate nucleus, anterior cingulate and prefrontal cortices in category learning. . A similar category learning deficit has also been found in patients with Parkinson’s disease (Ashby, Noble, Filoteo, Waldron and Ell, 2003), which has similar pathology to HD, affecting the brain areas involved in frontal subcortical circuits. The above evidence has illustrated a number of deficits and potential deficits in HD patients, linked to the degeneration of the striatum and frontal subcortical circuits. Given this evidence, the present study aims to investigate the potential deficits in ingroup bias and the effect of perspective taking to reduce in group bias in patients with HD. It is hypothesised that due to the degeneration of the striatum and associated prefrontal dysfunction caused by HD, and the loss of psychological functions associated with the damaged frontal subcortical circuits, HD sufferers will be unable to use a perspective taking exercise, similar to that used by Galinsky and Moskowitz (2000), to reduce their ingroup bias. This hypothesis will be tested using asylum seekers as an out group, as it is unlikely any of the participants will have had any direct contact with members of this group. Trait lists containing positive and negative items will be used to measure any bias. Method Participants Information packs about the study were sent to all patients attending the Huntington’s Disease clinic at the Queen Elizabeth Psychiatric Hospital, whom the Clinic Consultant deemed able to participate in the study (a copy of this pack can be found in Appendix A). All of these patients had a confirmed diagnosis of Huntington’s disease, via genetic testing. Of these, eleven patients volunteered to participate in the study. Two patients’ data was excluded from the data analysis due to failure to complete the experimental protocol. The remaining nine participants were four males and five females, with a mean age of 52.4. These participants were at various stages of the disease, however, due to time constraints, no formal measure of the severity of the disease could be taken. Control participants were recruited by opportunity sampling. A total of fifteen control participants were tested, of which one participants’ data was discarded due to a large number of outliers in their performance across all tasks in the experimental protocol. These participants had no diagnosis of Huntington’s disease, nor any family history of the disease. The fourteen control participants whose data was used were seven males and seven females, with a mean age of 59.4. Procedure Patients were tested either in their homes or at the Huntington’s Disease Clinic at the Queen Elizabeth Psychiatric Hospital, in accordance with their preference. Patients were permitted to bring one friend or relative into the testing room if they desired. The control patients were tested in their homes. At the beginning of each testing session, all participants were asked to sign a consent form, and complete a short questionnaire regarding demographic information, including age, gender and educational background (a copy of this questionnaire can be found in Appendix B). Participants were then asked to complete each task from the experimental protocol (a copy of the protocol can be found in Appendix B). The testing session was recorded using a Dictaphone recording device in all sessions. After analysis, these recordings were destroyed. If any participant was unable to complete the pen and paper elements of the protocol due to reading difficulties or difficulties associated to their movement disorder, these sections were read to the participant and recorded by the experimenter. At the end of the testing session, each participant was debriefed, and given a debriefing letter to take away with him or her (a copy of this debriefing letter can be found in Appendix A). Measures FAS The FAS Word Fluency Test was used as a general measure of prefrontal cortex functioning. In this test, participants were asked to generate as many words as they could in one minute which began with the letter F, then repeat the task with the letters A and S. This test was used to assess if there was any significant difference in prefrontal cortex functioning between the patient and control groups. Emotional Stroop The Emotional Stroop tests were used to evaluate prefrontal functioning, and to measure reduction of in-group bias. This task was repeated before and after the perspective taking task. Three conditions were used; an XXXX condition, in which rows of XXXX were presented to serve as a control for the word conditions, neutral words, and words seeded with words salient to the out-group (asylum seekers). The words salient with the out group were gained via a pilot study. Initially, an opportunity sample of students from the University of Birmingham were interviewed and asked to generate words they felt were most frequently associated with asylum seekers. The words collected from this pilot study were then compiled into a questionnaire used in a second pilot study. Again, an opportunity sample of students from the University of Birmingham were used, and asked to tick the ten words from the list they felt were most frequently associated with asylum seekers. The ten highest scoring wo rds from this pilot study were then used in the stroop test. Words for the neutral and seeded conditions were matched for word frequency and word length. Perspective Taking Task A perspective taking task was used in order to try and reduce in-group bias. The participant was given a picture of a mythical asylum seeker, with a number of prompting words printed under the picture, and asked to ‘Adopt the perspective of an asylum seeker and imagine the day in their life as if you were that person, looking at the world through his/her eyes and walking in their shoes’, and describe a typical day in that persons’ life. The prompting words can be found in the experimental protocol, in Appendix B. Trait Lists Trait questionnaires were used to assess in-group bias before and after the perspective taking task. The trait list contained ten positive and ten negative traits, and the order of the words on the trait lists was randomised as such that the traits listed were not in the same order for the second presentation. Analysis Relative Positivity A measure of relative positivity was obtained. This was achieved by first subtracting the number of negative traits from the number of positive ones for each pair of trait lists (self on first presentation, out-group at first presentation, self at second presentation, outgroup at second presentation). This created a measure of positivity. The numbers generated from this exercise were then used in a second calculation. The positivity of the out-group before perspective taking was subtracted from the positivity of self before perspective taking. This was repeated for the after perspective taking results. Trait Overlap In order to gain the data for the trait overlap analysis, traits assigned to both the self and the out-group for each repetition of the task (before / after perspective taking) was measured. Where a trait was shared, a score of 1 was recorded, and where a trait was not shared, a score of 0 was allocated. Results FAS Word Fluency Test Table 1.1 Mean number of words generated in the FAS test. Group Mean number of words generated Standard deviation Patients 25.00 17.62 Controls 53.50 17.99 Participants in the patient condition generated fewer words (mean score = 25, SD = 17.62) than the control condition (mean score = 53, SD = 17.99). The 95% confidence interval for the estimated general population is between –12.64 and –44.36. An independent t-test showed that if there was no significant difference between the scores of patients and controls, this result would be highly unlikely (t = -3.737, DF =21, p

Tundra Land Biome Description and Characteristics

Tundra Land Biome Description and Characteristics Biomes are the worlds major habitats. These habitats are identified by the vegetation and animals that populate them. The location of each biome is determined by the regional climate. The tundra biome is characterized by extremely cold temperatures and treeless, frozen landscapes. There are two types of tundra, the arctic tundra and the alpine tundra. Key Takeaways: Tundra Biome The two types of tundra, arctic and alpine, have distinct differencesArctic tundra regions are located between coniferous forests and the north pole, while alpine tundra regions can be anywhere in the worlds high elevationsArctic tundra vegetation is mostly limited due to a number of inhospitable conditions.Tropical alpine tundra vegetation consists of a variety of short shrubs, grasses, ​and perennialsAnimals that live in tundra regions are uniquely suited to endure the harsh conditions Tundra The arctic tundra is located between the north pole and the coniferous forests or taiga region. It is characterized by extremely cold temperatures and land that remains frozen year-round. Arctic tundra occurs in frigid mountaintop regions at very high elevations. Alpine tundra can be found in high elevations anywhere in the world, even in tropic regions. Although the land is not frozen year-round as in arctic tundra regions, these lands are typically covered in snow for most of the year. This image shows permafrost melting in the arctic region of Svalbard, Norway. Jeff Vanuga/Corbis/Getty Images Climate The arctic tundra is located in the extreme northern hemisphere around the north pole. This area experiences low amounts of precipitation and extremely cold temperatures for most of the year. The arctic tundra typically receives less than 10 inches of precipitation per year (mostly in the form of snow) with temperatures averaging below minus 30 degrees Fahrenheit in winter. In summer, the sun remains in the sky during the day and night. Summer temperatures average between 35-55 degrees Fahrenheit. The alpine tundra biome is also a cold climate region with temperatures averaging below freezing at night. This area receives more precipitation throughout the year than the arctic tundra. The average annual precipitation is around 20 inches. Most of this precipitation is in the form of snow. The alpine tundra is also a very windy area. Strong winds blow at speeds exceeding 100 miles per hour. Location Some locations of arctic and alpine tundra include: Arctic Tundra North America - Northern Alaska, Canada, GreenlandNorthern Europe - ScandinaviaNorthern Asia - Siberia Alpine Tundra North America - Alaska, Canada, U.S.A., and MexicoNorthern Europe - Finland, Norway, Russia, and SwedenAsia - Southern Asia (Himalayan Mountains), and Japan (Mt. Fuji)Africa - Mt. KilimanjaroSouth America - Andes Mountains Vegetation Alaska Cottongrass. NCTC Image Library/USFWSÂ   Due to dry conditions, poor soil quality, extremely cold temperatures, and permafrost, vegetation in arctic tundra regions is limited. Arctic tundra plants must adapt to the cold, dark conditions of the tundra as the sun does not rise during the winter months. These plants experience brief periods of growth in the summer when temperatures are warm enough for vegetation to grow. The vegetation consists of short shrubs and grasses. The frozen ground prevents plants with deep roots, like trees, from growing. Tropical alpine tundra areas are treeless plains located on mountains at extremely high altitudes. Unlike in the arctic tundra, the sun remains in the sky for about the same amount of time throughout the year. This enables the vegetation to grow at an almost constant rate. The vegetation consists of short shrubs, grasses, ​and rosette perennials. Examples of tundra vegetation include: lichens, mosses, sedges, perennial forbs, rosette, and dwarfed shrubs. Wildlife A moose in the tundra. Chase Dekker Wild-Life Images/Moment/Getty Images Animals of the arctic and alpine tundra biomes must adapt to cold and harsh conditions. Large mammals of the arctic, like musk ox and caribou, are heavily insulated against the cold and migrate to warmer areas in the winter. Smaller mammals, like the arctic ground squirrel, survive by burrowing and hibernating during the winter. Other arctic tundra animals include snowy owls, reindeer, polar bears, white foxes, lemmings, arctic hares, wolverines, caribou, migrating birds, mosquitoes, and black flies. Animals in the alpine tundra migrate to lower elevations in winter to escape the cold and find food. Animals here include marmots, mountain goats, bighorn sheep, elk, grizzly bears, springtails, beetles, grasshoppers, and butterflies.

Database Systems Concepts Essay Example | Topics and Well Written Essays - 750 words - 2

Database Systems Concepts - Essay Example In addition, RAM is usually much smaller in size, about two to three orders of magnitude being frequent. (A rig that I know of has 8 Gigs of RAM and 2 terabytes of hard drive space, and the owner has room to expand to over 5 terabytes, which is roughly a three order of magnitude difference). Scheduling is almost entirely unnecessary. There is a need to compare the RAM disk and the main memory disk-cache, but this doesn't affect the choice of a scheduling algorithm for the hard drive because they are totally different systems and because scheduling on the RAM disk is only looking for buffer cache misses not main memory requests. Hard-disk scheduling considerations are totally different. Hard disks are much larger and they are not read constantly, and the head positioning must jump in order to handle different reads. The file system does store recently used blocks in a buffer cache in main memory, but this is only a partial time-saving maneuver. Caches have finite sizes and need to be purged constantly; in any respect, no one sticks to only a few things in cache. They are constantly opening up new pages, documents and programs, which requires accessing different parts of the disk. This means that scheduling for hard-disk use is at a premium: Indeed, one of the main slowing forces in Moore's Law exponentiation is the relatively anemic growth of hard-drive scanning speeds versus the memory size of hard drives. Different hard disk scheduling regimes have different benefits. When designing a scheduling algorithm, it is important to bear in mind parameters of functionality. These include power consumption, throughput, response time, flexibility for the end-user, and other factors. Again, the cache can only do so much in mitigating these problems, so the choice of how to approach hard disk scheduling has many inherent tradeoffs. One approach is FCFS, or First Come First Served. In this algorithm, operations are conducted in the order requested. This is very simple and elegant in many ways. However, the problem is that not all functions are made equal: Some functions, like Ctrl-Alt-Delete on a Windows computer or dealing with security threats, need to be scanned first. FCFS therefore doesn't have the costs of reordering the work queue, but it doesn't have the benefits either. FCFS cannot have starvation: Every request is serviced. But the performance is poor: It doesn't distinguish between the importance of needs, nor does it have any smart geography. If a end user wants to run six programs from every different side of the disk, FCFS will go in order, crossing immense redundant space and thus leading to slowdown. SSTF, on the other hand, prioritizes geography of the desk. It goes to the closest location on the disk first, no matter what. Again, this has the problem that there is no discrimination for important tasks. Scan time is reduced, but starvation is possible: The head could stay in one sector of the disk for too long if too many requests co me in. Direction switches also slow things down. SCAN goes from the outside to inside then the inside to outside. This has the advantage of being a uniform pattern and reducing variance, but it does lead to a lot of unnecessary scans (though not more scan time) which can be a power consumption issue. LOOK is a bit smarter: It stops going a direction where no requests exist. C-SCAN and C-LOOK use cylinders instead of a simple directional approach. This has the adv

More Effective Communications Assignment Example | Topics and Well Written Essays - 1750 words

More Effective Communications - Assignment Example The major problem today is that many companies are wasting their precious resources on ineffective communications that cause confusion among the customers or clients and result in costly customer dissatisfaction. Business communications are not just a simple subject for management studies but it involves a whole range of pre- and post-sale communications, including welcome kits, account statements, invoices, applications, policies, manuals, customer educational materials, announcements of changes in terms and much more (Lundy 2-11). There are several models to show that business communication is one of the most important aspects and is linked to profitability. Under the Universal Business Model (UBM), communication between the three basic functions of production, marketing and accounting increase profitability. For instance, if the marketing unit has not been informed by production as to what it currently manufactures or the amount of stock, the marketing unit may face a problem. Similarly, if manufacturing is not told by accounting what products are profitable to produce, they may operate at a loss. This kind of communication between different units of the same organization also plays a vital role in business communication (Universal Accounting ® Center n.pag. 2007). The importance of business communication and its link to profitability was expressed clearly from the results of Sage Research. Through the study, it was discovered that 22 percent of the organizations polled experienced monthly communication-caused delays-and 13 percent experienced such delays weekly. As a result of communications delays, there was a disruption in the efforts to streamline business processes or adopt the emerging "best practices".

How to Use a Company’s Annual Report to Ace Your Interview :: Process Essays

How to Use a Company’s Annual Report to Ace Your Interview If you don't take the time to get know a company, you many not have a future there.   Your interviewer will ask you why are you looking for this particular position and why are you looking at ABC, Inc.   Start by telling him or her that you have read ABC's current sales record "in their annual report."   Ã‚  Ã‚  Ã‚   Company sales are important even if you are not interviewing for a sales job.   If you have reviewed several years of annual reports, you can easily see if the company's sales have gone up or down. Asking questions about the company's sales during an interview scores lots of points because it shows you have done your homework.   Ã‚  Ã‚  Ã‚   You can get ABC, Inc.'s past annual reports directly from the company, the public library or the Internet.   The annual report may not tell you how well the company fares within the industry, but it will tell you everything you need to show your interviewer how well you can fit into the company.   Ã‚  Ã‚  Ã‚   Once you obtain a company's past annual reports, review the most recent report first. At the back of the report, you will find the name of the auditor, somebody like Smith and Smith Accounting.   Reputable companies use a certified public accountant to show that the accounting methods used in the report conform to "generally accepted accounting principles."   Ã‚  Ã‚  Ã‚   Now turn to the front of the report and find the letter from the chairman of the board, whose personal style will be reflected throughout the report. The director will discuss the direction of the company, so pay attention to how he plans to run things in the future and whether he thinks the future looks positive for growth.   Ã‚  Ã‚  Ã‚   The company's financial growth is very important to both the company and to your salary requirements.   You may not want to crunch the numbers yourself, but you will want to understand the balance sheet, the status of the company's finances at a given date.   On the left are the assets, all of the organization's valuables.   Current assets are those that the company can convert quickly to cash.   On the right are the company's liabilities-what they owe.   Current liabilities are the company's debts due in one year, paid out of current assets.   Ã‚  Ã‚  Ã‚   Net working capital, is a key figure to watch only if you have several years worth of reports to compare.

Effectiveness Ultrasound Tens Osteoarthritis Knee Health And Social Care Essay

Knee degenerative arthritis is perceived as the most common and unsafe degenerative arthritis. Besides, this is referred to as the most common cause of disablement in the United States of America, ( Eustice 2008 ) . Knee degenerative arthritis is a state of affairs consequential from weakening of articular gristle. Articular gristle is the soft coating whose intent is to cover the terminal of the leg castanetss where they convene underneath the articular gristle called Subchondral bone. Research has identified that articular gristle deteriorates due to a figure of factors including but non limited to ; old articulatio genus hurt, insistent strain on the articulatio genus, breaks, ligament tear, and muscular hurt which can impact alliance and promote wear and tear. Geneticss which make some people more likely to develop articulatio genus degenerative arthritis and jobs with subchondral borne or the bone bed underneath gristle. Research besides unfolds that of articulatio genus degenerative arthritis develops bit by bit and its symptoms include ; hurting which is moderate, mild or terrible, stiffness, limited scope of gesture in the articulatio genus and localised puffiness. Most research findings indicate that articulatio genus degenerative arthritis can non be cured but that there are interventions available which can be applied to pull off cut down the symptoms. These reportedly include ; medicines with Datril, non steroidal anti-inflammatory drugs and opioid analgetic medicines availed to those who need strong stronger hurting alleviation. Scientists use X raies to name knee OA is said to be the lone particular trial required in most instances. Trans-ceutaneous nervus stimulation or curative ultrasound ( US ) has been discovered to be so reactive in advancing effectivity of exercising on hurting, map, musculus strength and quality of life for articulatio genus degenerative arthritis. Research by pupils in United States of America unfold that 40 five patients with the articulatio genus OA diagnosing were consecutive divided into three random groups. Those in the first group were exposed to trans-cutaneous electrical nervus stimulation with superficial heat and exercising ; their opposite numbers in the 2nd group reportedly received ultrasound with superficial heat and exercising ; Group three acted as controls ( ace heat and exercising ) . Research unfolds that result steps were so included as ocular parallel graduated table, a 20 metre walking trial ; lequesne index, WOMAC shops ; isokinetic musculus proving. After this, in all intervention groups, physical modes were reportedly carried out for 15 Sessionss. Treatment groups were subjected to six hebdomads of exercising plan. FOCUSED CLINICAL Question: Does trans-cutaneous electrical nervus stimulation or curative or extremist sound addition the effectivity of exercising for articulatio genus degenerative arthritis? SUMMARY OF SEARCH: ‘Best Evidence ‘ appraised, and Key Findingss: Two articles were selected to supply best grounds about the subject. The first article is by Vladimir ( 2010 ) and it describes TENS as one of the most normally used electro analgesia and that 100s of clinical studies exist refering the usage of TENS for assorted types of conditions including that of Osteoarthritis. However, the really article unfolds failings involved in utilizing TENS and these include: It should non be used in patients with a pacesetter particularly of the demand type. Should non be used during gestation because it may bring on premature labour TENS is non applicable to carotid fistulas due to hazards of acute hypotension through a vasovagal physiological reaction. It should non be placed over anterior cervix because laryngospasm due to laryngeal musculus contraction may happen The electrodes should non be placed in an country of centripetal damage like in instances of nervus lesions, neuropathies ) where possibility of Burnss exist and TENS unit should be used carefully in patients with spinal cord stimulator or an intrathecal pump The 2nd article was extracted from plants of Brims ( 2009 ) who identified that much as TENS is good in alleviating hurting, it has some inauspicious effects among which are a possibility to go addicted in that it, a patient will hold to make more of the TENS in order to acquire to the same status. As an observation made, it has been identified that TENS is one and in fact the extremely recommended no medicative hurting alleviating agent of the musculuss non merely of the OA but even in the back hurting. At the same clip, it has been identified that TENS has got short approachs which I believe are in most instances ignored by doctors though obvious to them. If the usage of TENS does merely reduces pain but does non end or retard the acceleration of hurting to the extent that the expiration of application of TENS is the recommencement to further hurting, so it would non be recommended. Alternatively, it would be easier to use other agencies like articulatio genus replacing or any other possible options besides TENS and this would enable a patient to acquire alleviation from patronizing TENS and US activities. CLINICAL BOTTOM LINE: All the research findings identified show that articulatio genus degenerative arthritis is a strong infection without any agencies of remedy. However research findings merely identify that the status of a patient with Knee degenerative arthritis can merely be improved through usage of assorted drugs including but non limited to non steroidal anti-inflammatory drugs among many other drugs and application of trans-cutaneous electrical stimulation. On the same note, Brims ( 2009 ) identifies that taking pain medicine sums to decrease of the hurting but can be habit-forming and will construct up a tolerance in one ‘s system implying that a patient needs to take an increasing sum of the hurting medicine in order to acquire the same consequence. Pain medicine is said to extinguish hurting but is besides said to be impermanent and hence can hold negative long term effects. Cortsone trunkss can be every effectual at relieving the hurting brought approximately by terrible articulatio ge nus degenerative arthritis but it is said to merely be a impermanent hole and that the consequence will decline as conditions wear out. SEARCH STRATEGY: Footings used to steer Search Strategy: aˆ? Ultrasound which is referred to as a process that uses high frequence sound waves to see internal variety meats and produce images of a human organic structure ( Nucleus medical art 2011 ) aˆ? Trans-cutaneous electrical stimulation ; aˆ? Knee degenerative arthritis which is a status ensuing from impairment of articular gristle aˆ? The causes of articulatio genus degenerative arthritis. These can be traced from the causes of impairment in the articular gristle which include but non limited to old articulatio genus hurts and insistent articulatio genus strivings The effectivity of ultrasound and trans-cutaneous electrical stimulation in bettering articulatio genus degenerative arthritis as taken from a consideration of a randomized survey by Eyigor s. demoing how the effectivity of exercising for articulatio genus degenerative arthritis can be increased by trans-cutaneous electrical stimulation and ultrasound The difference between bettering articulatio genus degenerative arthritis hurting and bring arounding articulatio genus degenerative arthritis ; Harmonizing to research findings accessed, knee osteoarthritis hurting can be improved but non healed. The gradual procedure that is said to take to knee degenerative arthritis must be perceived as a non idiot able status in that when a simple break develops into articulatio genus degenerative arthritis, there are no opportunities of retrieving from the complication. Table 1: Databases and sites searched Search Footings Limits used Osteoarthritis of the knee-orthogate-improving orthopedic attention Eustice ( 2008 ) Knee degenerative arthritis, what you need to cognize Daniel Sims ( 2009 ) Severe knee osteoarthritis-ways to cut down the hurting Eyig, et Al. ( 2005 ) the best exercising to better conditions of patients with OA Vladimir ( 2010 ) , the significance of TENS and its penetrations Watders ( 2006 ) Immediate reactions in utilizing TENS to a patient INCLUSION and EXCLUSION CRITERIA aˆ? Inclusion: The extent to which trans-cutaneous electrical stimulation and ultrasound can be helpful in bettering the status of a patient with articulatio genus degenerative arthritis compared to other ways of cut downing hurting caused by degenerative arthritis of the articulatio genus. Other inclusions were the symptoms of articulatio genus degenerative arthritis which included hurting, swelling and stiffening of the articulatio genus among others. aˆ? Exclusion: The research ne'er considered other options of covering with knee degenerative arthritis like articulatio genus replacing because it would misdirect the research worker in pull outing the information pertaining to the design of the research RESULTS OF SEARCH There are six relevant surveies obtained for this subject: The survey was designed to research whether TENS is so effectual in bettering the articulatio genus degenerative arthritis infection. The survey was a success holding used the findings of Research by pupils in United States of America who unfold that 40 five patients with the articulatio genus OA diagnosing were consecutive divided into three random groups. Those in the first group were exposed to trans-cutaneous electrical nervus stimulation with superficial heat and exercising ; their opposite numbers in the 2nd group reportedly received ultrasound with superficial heat and exercising ; Group three acted as controls ( ace heat and exercising ) . Research unfolds that result steps were so included as ocular parallel graduated table, a 20 metre walking trial ; lequesne index, WOMAC shops ; isokinetic musculus proving. Following this, in each and every one of the intervention groups, physical modes were allegedly conducted for 15 Sessionss. Treatment groups were subjected to six hebdo mads of exercising plan. These findings were compared with findings by other research workers about TENS which had unfavorable judgments unveiling that TENS was non perfect as it hard some inauspicious long-run effects Best Evidence: The undermentioned study/papers were identified as the ‘best ‘ grounds and selected for critical assessment ; Daniel Brims ( 2009 ) , Carol Eustice ( 2008 ) and Traits & A ; Mosey ( 2008 ) . Reasons for choosing these surveies were: All the four were relevant to the research. All the four documents had intimations on the relationship between TENS and Osteoarthritis knee hurting to the extent that one of them ( for Brims ) hard a photographic position of the job that was studied One of the surveies included a instance of patients who were tested with TENS to detect its effectivity and others had information sing the pros and cons of utilizing TENS All the articles were reviewed and recommended for public usage. SUMMARY OF BEST Evidence: Table 3: Description and assessment of: 1. Daniel Sims ( 2009 ) Severe knee Osteoarthritis-Ways to cut down the hurting 2. C. Eustice ( 2008 ) Knee Osteoarthritis What you need to cognize 3. Traits & A ; Mosey ( 2008 ) Effectiveness of TENS and OA. Aim/Objective of the Study/Systematic Review: 1. The purpose of this survey was to happen out whether extremist sound and trans-cutaneous electrical stimulation can better esteoarthritis articulatio genus hurting 2. The aim was to analyse the research findings about the effectivity of extremist sound and trans-cutaneous electrical stimulation in relation to betterment in degenerative arthritis articulatio genus hurting by different research workers. Study Design ( including scenes and participants ) : The survey design was a success holding used the findings of Research by pupils in United States of America who unfold that 40 five patients with the articulatio genus OA diagnosing were consecutive divided into three random groups. Those in the first group were exposed to trans-cutaneous electrical nervus stimulation with superficial heat and exercising ; their opposite numbers in the 2nd group reportedly received ultrasound with superficial heat and exercising ; Group three acted as controls ( ace heat and exercising ) . Research unfolds that result steps were so included as ocular parallel graduated table, a 20 metre walking trial ; lequesne index, WOMAC shops ; isokinetic musculus testing ; and the short signifier 36. After this, in all intervention groups, physical modes were reportedly carried out for 15 Sessionss. Treatment groups were subjected to six hebdomads of exercising plan. These findings were compared with findings by other research workers about TENS which had unfavo rable judgments unveiling that TENS was non perfect as it hard some inauspicious long-run effects Result MEASURES: 1. When TENS and US are used to better conditions ensuing from Osteoarthritis, a patient improves but does non acquire healed. Harmonizing to some findings accessed, it has been identified that there are long term inauspicious effects alongside the usage of TENS hence TENS was non recognized as a perfect non medicative application towards OA by some writers yet it was recommended by others. 2. The effectivity of TENS was measured from research findings by some pupils which involved three groups of patients upon which TENS was tested and it worked 3. On the other manus, the ineffectualness of TENS was identified holding identified the long-run inauspicious effects alongside it. Consequence: 1. Amidst the surveies the findings accessed, it is difficult to believe that TENS and US can be used to absolutely better hurting of a patient with OA due to the inauspicious effects yet it can non be recommended to reason establishing on the findings that the experiment is good. What is of import nevertheless is to sensitise patients about the pros and cons of utilizing TENS and US so that it becomes their ain enterprises to take on the right place 2. On the other manus, it would be good if the usage of other drugs is promoted AUTHORS ‘ Decision: 1. â€Å" TENS and US can work efficaciously if done addictively but at the same clip it is good to educate the patients about the pros and cons of utilizing TENS and US before their application Critical Appraisal: ( Validity ) 1. Based on the experimnt by Eustice ( 2008 ) Trans-cutaneous electrical stimulation and ultrasound are so powerful in bettering the conditions of a patient with OA hurting However harmonizing to Daniel Sims, TENS should be applied sing the side long-run inauspicious effects? INTERPRETATION OF RESULTS: Comparing Eusten ‘s and Brims ‘ assertations and findings, the usage of Trans-cutaneous electrical stimulation should be to the right people, in appropriate conditions and establishing on right determinations Execution FOR PRACTICE: The deductions of the surveies and findings indicate that TENS being a powerful no medicative hurting stand-in can be used but the usage of drugs could be the top most precedence.

Gender Roles in Macbeth - 732 Words

According to gender theory, society assigns certain roles for men and women. In Shakespeare’s Macbeth, these gender roles play an important part in violence. Both Lady Macbeth and Macbeth appeal to the role of â€Å"manhood† as violent and aggressive in order to accomplish the murders of King Duncan and Banquo. Women are portrayed as initiators of crimes and are viewed as devious.So, throughout the play, gender roles provide a means for murders and viciousness. At the beginning of the play, King Duncan awards Macbeth with the title of Thanes of Cawdor because on his heroic fighting against the rebels (I.2.65), and then, Macbeth doesn’t really want to assassinate the king. Macbeth says, â€Å"He [King Duncan] hath honoured me of late† (I.7.32).†¦show more content†¦The portrayal of a man’s nature as being violent is trivial as compared to the dark representation of women as naturally wicked and the instigators of crimes. For example, the witches and Hecate (Queen of the Witches) are casting spells and conjuring up spirits around the cauldron, thereby provoking the violent ambitions of men. Macbeth calls them â€Å"Secret, black, and midnight hags† (IV.1.63). Because Macbeth doesn’t want toShow MoreRelatedGender Roles In Macbeth1477 Words   |  6 PagesShakespearian times the woman had no powerful roles, they did not write or act in plays. The roles were strictly played by men. This was true, howe ver, in Macbeth written by William Shakespeare he portrays that both the men and the women in the play craved powerful roles, and desire ambition. Additionally, he shows how the roles of gender are flipped between Macbeth and Lady Macbeth, and displays that Lady Macbeth wants control over Macbeth. 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