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[Essay] Technology in our lives ~please correct my essay
SAT / ACT Prep Online Guides and Tips. About Technology In Life? One of the best ways to prepare for the DBQ (the “document-based question” on the AP European History, AP US History, and AP World History exams) is to look over sample questions and example essays. This will help you to get a sense of what makes a good (and what makes a bad) DBQ response. That said, not all DBQ essay examples are created equal. I’ll briefly cover what makes a good DBQ example, then provide a list of example essays by level history essay structure course.
Lastly, I’ve provided some tips as how to best use sample essays in your own preparation process. Without a doubt, the best sample resources come from the College Board. This is in life because they are the ones who design and administer the legal, AP exams. This means that: Any DBQ essay example that they provide will include a real DBQ prompt. All samples are real student responses from previous years, so you know that they were written under the same conditions you will be working under when you write your DBQ. Essay About In Life? In other words, they're authentic!
They not only do the contest have scores, they have explanations of each essay's score according to the terms of the rubric. Essay Technology? Each prompt includes several sample essays with a variety of scores. However, there are some examples outside those available from the thing essay contest 2009, College Board that may be worth looking at, particularly if they highlight how a particular essay could be improved. But in general, a superior example will: Include the prompt and in life, documents. It will be much easier for you to write thing essay contest see how the information from the about in life, documents is writing legal integrated into the essay if you can actually look at the documents.
Have a score. Seems simple, but you'd be surprised how many DBQ examples out there in the uncharted internet don't have one. Without a real, official score, it's hard to gauge how trustworthy a sample actually is. With that in about mind, I have below compiled lists by exam of high-quality example DBQs. Don't spend all your study time sharpening your pencil. Every DBQ Example Essay You Could Ever Need, by Exam. Here are your example essays! We'll start with AP US History, then move to AP European History, and finally wrap up with AP World History. Do The Essay Contest? AP US History: Official College Board Examples.
Because of the recent test redesign, the College Board has only posted sample responses from 2016 and 2015. This means there are only two official College Board set of sample essays that use the current rubric. Look here for essay technology the free-response questions from jackson, 2015 and the ones from 2016 with no analysis (so you can look at the question separately from the scoring guidelines). When you're ready for the sample responses, here are the DBQ samples from 2015 and the samples from 2016. In Life? If you want to see additional sample sets, you can also look at older College Board US History DBQ example response sets , all the frederick jackson fronteir, way back to 2003. Essay About Technology? To look at these questions, click “Free-Response Questions” for write essay 2009 a given year. For the corresponding DBQ examples and scoring guidelines, click “Sample Responses Q1.” Note that these use the old rubric (which is integrated into the Scoring Guidelines for a given free-response section). General comments about the quality of the essay, outside information, and document analysis still apply, but the score is on a nine-point scale instead of the about technology, new seven-point scale, and some of the particulars will be different.
Older DBQs had up to 12 documents, while the new format will have six-seven documents. If you do look at writing assistance legal older DBQ examples, I recommend using the technology in life, new rubric to “re-grade” the essays in the sample according to the new seven-scale score. I'll also give more advice on how to use all of these samples in ocr a level essay your prep later on. Mr. Bald Eagle is an AP US History DBQ Grader in his spare time. AP European History: Official College Board Examples. Unfortunately, sample resources for the AP Euro DBQ are a little sparse than for the other essays, because this past year (2016) was the essay, first year the test was administered in the new format.
This means that there is only one set of application for teaching school official samples graded with the current seven-point rubric. The rest of the existing available samples were graded in about technology in life the old, nine-point format instead of the seven-point format implemented this past year. Thing 2009? In the old format there were six “core” points and then three additional points possible. The old rubric is integrated with the sample responses for essay about technology each question, but I’ll highlight some key differences between the old and new formats: In the old format, you are given a brief “historical background” section before the documents. Do The Essay Contest? There are more documents—up to twelve. The new format will have 6-7. There is an emphasis on about technology in life, “grouping” the brilliant solution essays, documents that is technology not present in do the write thing contest the new rubric. There is also an explicit emphasis on correctly interpreting the documents that is not found in the new rubric. The essential components of the DBQ are still the same between the two formats, although you should definitely look at the new rubric if you look at any of the about technology in life, old AP European History samples. You may actually find it useful to look at letter job in secondary the old essays and score them according to the new rubric.
Samples by year: You can get samples in the old format all the way back to 2003 from the essay about in life, College Board . (Click “Free-Response Questions” for the questions and “Sample Responses Q1” for letter job in secondary the samples.) If you want to check out some additional DBQ sample responses that were graded by the College Board with the new rubric, look at the 2015 AP US History samples and the 2016 AP US history samples . The content will of course be different, but the structure and essay, scoring are the same as they will be for the AP Euro 2016 test. Std Know-how Essay? AP European History: Unofficial Samples. Because of the rubric revision, other European History-specific samples are also in the old format. This means there’s not much to be gained by looking outside the College Board’s extensive archives. However, the New York State Regents exam also has a DBQ on it. The format is not identical and it is scored out of essay about in life 5 under a different rubric, but I do like this European-History themed example from Regents Prep because it has highlighted sections that show where the documents are used versus where outside information is referenced. This will give you a good visual of how you might integrate outside information with the analysis of your documents. Consider how you might integrate this castle into the DBQ that is dissertation writing assistance your life.
AP World History: Official College Board Examples. The World History AP exam has just been transitioned to a new format to more resemble AP US History and AP European History for the 2017 test. Essay In Life? This means that all currently available samples were graded in the old, nine-point format instead of the seven-point format to ocr a history be implemented this year. In the old format there were seven “core” points and then two additional points possible. The old rubric is essay technology integrated with the sample responses for each question, but I’ll highlight some key differences between the old and new formats: There are more documents—up to ten. The new format will have 6-7. There is an emphasis on “grouping” the frederick jackson fronteir, documents on the old rubric that is not present in the new rubric. There is also an explicit emphasis on correctly interpreting the about, documents that is not found in the new rubric. In the old rubric, you need to identify one additional document that would aid in write contest 2009 your analysis. The new rubric does not have this requirement.
The essential components of the DBQ are still the in life, same between the application letter school, two formats, although you should definitely look at the new rubric if you look at any of the essay about in life, old AP World History samples. You may actually find it useful to application letter for teaching look at the old essays and score them according to the new rubric. For whatever reason the questions and the samples with scoring notes are completely separate documents for World History, so you’ll need to click separate links to get the question and technology in life, documents and ocr a level history, then the responses. If you want to take a look at some DBQs that have been graded with the new rubric, you could check out the 2015 and 2016 samples from AP US History and the 2016 samples from AP European History. The historical content is different, but this will give you an essay technology in life idea of how the new rubric is implemented. Don't worry, the old format isn't as old as this guy right here. How Should I Use DBQ Examples to Prepare? So, now that you have all of these examples, what should you do with them? I'll go over some tips as to how you can use example DBQs in brilliant solution your own studying, including when to start using them and how many you should plan to review.
College Board sample essay sets are a great way to test how well you understand the rubric . This is essay in life why I recommend that you grade a sample set early on in your study process—maybe even before you've written a practice DBQ. Then, when you compare the scores you gave to legal the scores and technology, scoring notes for the samples, you'll have a good idea of what parts of the rubric you don't really understand . If there are points that you are consistently awarding differently than the graders, you’ll know those are skills to work on. Keep giving points for the thesis and then finding out the sample didn't get those points? You'll know that you need to work on your thesis skills. Not giving points for historical context and then finding out the AP Grader gave full credit? You need to work on do the thing contest, recognizing what constitutes historical context according to the AP. You can check out about in life, my tips on building specific rubric-based skills in my article on how to write a DBQ. Once you've worked on some of those rubric skills that you are weaker on, like evaluating a good thesis or identifying document groups, grade another sample set. This way you can see how your ability to writing assistance grade the essays like an about AP grader improves over std know-how essay, time! Obviously, grading sample exams is a much more difficult proposition when you are looking at examples in essay technology in life an old format (e.g.
AP European History or AP World History samples). The old scores as awarded by the College Board will be helpful in establishing a ballpark—obviously a 9 is still going to be a good essay under the 7-point scale—but there may be some modest differences in grades between the two scales. Std Know-how? (Maybe that perfect 9 is now a 6 out of 7 due to essay about technology in life rubric changes.) For practice grading with old samples, you might want to pull out two copies of the new rubric, recruit a trusted study buddy or academic advisor (or even two study buddies!), and std know-how and prevention essay, each re-grade the samples. Then, you can discuss any major differences in the grades you awarded. Having multiple sets of eyes will help you see if the scores you are giving are reasonable, since you won’t have an official seven-point College Board score for comparison. How Many Example DBQs Should I Be Using? The answer to essay this question depends on your study plans! If it's six months before the exam and ocr a level structure, you plan on transforming yourself into a hard diamond of DBQ excellence, you might complete some practice grading on a sample set every few weeks to about technology a month to check in on brilliant, your progress towards thinking like an AP grader. In this case you would probably use six to nine College Board sample sets. Essay About In Life? If, on for teaching secondary school, the other hand, the exam is in about a month and you are just trying to get in some skill-polishing, you might do a sample set every week to writing legal 10 days.
It makes sense to check in on technology, your skills more often when you have less time to application job in school study, because you want to be extra-sure that you are focusing your time on essay, the skills that need the most work. So for a short time frame, expect to use somewhere in the range of three to four range College Board sample sets. Either way, you should be integrating your sample essay grading with skills practice, and letter for teaching job in secondary school, doing some practice DBQ writing of your own . Towards the essay about technology in life, end of your study time you could even integrate DBQ writing practice with sample grading. Read and complete a timed prompt, then grade the sample set for that prompt, including yours! The other essays will help give you a sense of what score your essay might have gotten that year and any areas you may have overlooked. There's no one-size-fits-all approach to using sample sets, but in general they are a useful tool for making sure you have a good idea what the frederick turner thesis, DBQ graders will be looking for when you write your DBQ. Hey, where can we find a good DBQ around here? Example DBQ essays are a valuable resource in your arsenal of study strategies for the AP History exams. Grading samples carefully will help you get a sense of your own blind spots so you know what skills to focus on essay technology, in your own prep. That said, sample essays are most useful when integrated with your own targeted skills preparation.
Grading a hundred sample essays won't help you if you aren't practicing your skills; you will just keep making the ocr a level structure, same mistakes over and over about technology, again. And make sure you aren't using sample essays to brilliant avoid actually writing practice DBQs--you'll want to essay about in life do at least a couple even if you only have a month to practice. There you have it, folks. With this list of for teaching DBQ examples and tips on technology in life, how to use them, you are all prepared to integrate samples into your study strategy! Still not sure what a DBQ is? Check out my explanation of the DBQ. Want tips on std know-how essay, how to really dig in essay about technology in life and study? I have a complete how-to guide on preparing and writing the DBQ (coming soon). If you're still studying for AP World History, check out our Best AP World History Study Guide or get more practice tests from our complete list. Want more material for AP US History? Look into this article on the best notes to use for and prevention essay studying from one of our experts.
Also check out her review of the best AP US History textbooks! Want to improve your SAT score by 160 points or your ACT score by essay about in life 4 points? We've written a guide for each test about the top 5 strategies you must be using to have a shot at dissertation assistance legal improving your score. Download it for free now: Have friends who also need help with test prep? Share this article! Ellen has extensive education mentorship experience and is deeply committed to helping students succeed in all areas of life. She received a BA from Harvard in Folklore and Mythology and essay about technology in life, is currently pursuing graduate studies at Columbia University.
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The Importance Of Technology Is Growing In Our Daily Life | My Essay
panic attack essay A Comprehensive Overview. This essay summarizes current information about essay in life, varieties of panic disorder and their treatment. It is based almost entirely on publicly available information gathered during the years 1998 through 2000 from sources (not specifically cited) that include published research papers (most available through MedScape or MedLine), published textbooks and trade books authored by qualified mental health professionals, articles in WebMD and the New York Times, the opinions of clinicians specialized or experienced in the treatment of panic disorders, and the experiences of some hundreds of individuals (patients, health care professionals, and peer counselors) who have shown up in various Internet-based support communities focused on panic disorders or other anxiety disorders. The intent is to introduce the reader to essay, the wide body of knowledge that exists today and to integrate and disseminate a variety of essay in life, emerging insights often omitted from the narrow classical view of these disorders.
This essay should not take the place of medical and letter secondary psychological treatment. Individuals who believe they may have panic disorder should be evaluated by a physician familiar with the complexities of panic disorders and the conditions that mimic or accompany them (some of which are discussed herein) and should receive an appropriate combination of pharmaceutical and psychological treatment from about in life qualified caregivers specialized in this family of conditions. For further background and do the contest 2009 a more detailed disclaimer, please refer to technology, the end of this document. The online source for this essay resides at brilliant essays, http://www.panic411.org/ This essay may be linked to or printed for limited noncommercial distribution by individuals.
Any other form of dissemination or republication must be authorized in essay technology, writing. Panic Disorder is a broad-brush label currently applied to a variety of conditions having clearly distinct etiologies, prognoses, and appropriate treatment strategies. Reasonably distinct causes of panic disorder include: Phobic sensitization to symptoms of panic or anxiety #150; fear of the fear Prolonged stress Anxious or obsessive patterns of history essay, thinking Poor breathing habits, whether rooted in anxiety or other causes Emotional or existential turmoil (whether conscious or unconscious), often deriving from conflicting expectations, needs, desires, or external requirements and resulting in about, a subjective perception of and prevention essay, helplessnes or paralysis. These first causes are the best known and, together with one or two concepts such as false suffocation alarm and separation anxiety, are considered the classic causes. However, they may in fact explain a minority of cases.
Other causes include: A hereditary defect in the metabolism of cholecystokinins (CCK), endocrine substances involved with regulating both digestion and stress endorphins. People with this form of panic disorder have likely exhibited escalating gastrointestinal symptomatology, often Gastro-Esophageal Reflux Disease or Irritable Bowel Syndrome, for years or decades before the essay about technology in life emergence of panic attacks. Norepinephrine and secondarily epinephrine GABA Serotonin. Each of the causes of panic disorder listed above is supported by a body of published research, except as noted in the last point, where the relevance to brilliant essays, panic disorder is about technology in life, more speculative and is not suggested by the researchers but is suggested by the well-documented statistical association of panic disorder with schizophrenic families. Ongoing advancement in brilliant essays, the scientific understanding of panic disorder may reveal etiological overlap among these factors beyond the overlap already suggested or it may lead to further differentiation. In addition, there are a number of distinct medical conditions, some commonly recognized and others not, that mimic panic disorder or exacerbate sub-acute cases into about, an acute phase. Beyond the universally recognized but very rare pheochromocytoma, some of the more commonly encountered conditions are: Hypothyroidism. Screening for TSH levels is widely regarded among first-line clinicians as sufficient screening for thyroid abnormalities; however, such limited screening consistently fails to identify a number of hypothyroid conditions that lead to panic attacks and other serious and sometimes life-threatening pathology. Once the condition has advanced to std know-how essay, the stage of panic disorder, correcting the underlying imbalance may not be sufficient to technology, bring about frederick, remission, as damage to the nervous system can already have occurred at this point. Strictly speaking, it can be argued that panic disorder is about in life, a misdiagnosis when it is secondary to any of these conditions. In the real world, however, medicine most often fails to diagnose the underlying condition if the job in secondary school presenting symptoms have an anxious presentation to them.
As a result, the panic disorder population #150; on which all research is conducted, from which the understanding of panic disorder derives, on which treatments are tested, and to which the resulting diagnostic and essay about technology in life therapeutic protocols are applied #150; is exactly this mixed bag of patients and causes. A diagnosis of panic disorder carries with it a substantial likelihood that one (or more than one) of writing assistance, these factors is present. Studies over long periods have established that thought patterns once thought to be causative in panic disorder, such as hypervigilance, catastrophic thinking or catastrophic interpretation of sensations, among others, emerge in many patients as a result of the condition and cannot in fact be considered preexisting causative factors in those patients #150; that, for instance, the tendency toward catastrophic interpretation of relatively normal physical sensations typically emerges (if at about in life, all) as a gradual consequence of the normal interpretation of catastrophic physical sensations lying outside non-afflicted individuals' realm of experience. It is also critical to understand that individuals with panic disorder do not necessarily worry more, feel more stressed, or internalize or somatize more than non-afflicted individuals. Solution. They can certainly develop such traits as a result of the about in life condition (or possess them from writing legal birth), but the distinguishing factor is that the neurochemistry of an individual with panic disorder reacts differently from that of a non-afflicted individual even to low or normal levels of stress #150; or to other, idiopathic factors not necessarily related to situational stress or worry.
This difference manifests itself in a variety of ways, some of which are well understood and essay technology in life some of letter for teaching job in, which are not. Absolute elimination of panic attacks should be one goal of treatment, because of their kindling effect. With each panic attack, the nervous system becomes more prone to experience the next one. This is essay about technology, not only a psychological process, but a neurological one as well. Absolute elimination of panic attacks is not a sufficient goal of treatment, much as elimination of sugar from the urine of a diabetic is letter for teaching job in school, not a sufficient goal of treatment for diabetes. Essay About. The insufficiencies, imbalances, and application letter school processes leading up to the panic attacks, both neurological and psychological, are far from essay about technology in life benign. Because of the variety of causes and essays processes at work in panic disorder, there are few generalizations one can make that would apply to as much as 75% of the panic population. However, subgroups and regularities do clearly exist, so there are many generalizations one can make that apply to various groups of as much as 30-40% of the population.
The American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV™) describes a panic attack as follows: The essential feature of a Panic Attack is a discrete period of intense fear or discomfort that is accompanied by at least 4 of 13 somatic or cognitive symptoms. The attack has a sudden onset and essay in life builds to a peak rapidly (usually in 10 minutes or less) and is often accompanied by a sense of imminent danger or impending doom and an urge to escape. The 13 somatic or cognitive symptoms are palpitations, sweating, trembling or shaking, discomfort, nausea or abdominal distress, dizziness or lightheadedness, derealization or depersonalization, fear of losing control or going crazy, fear of dying, paresthesias, and chills or hot flashes. Attacks that meet all other criteria but that have fewer than 4 somatic or cognitive symptoms are referred to as limited-symptom attacks. This is probably as good a rudimentary operational description as any, although it is only a committee consensus not based on any consideration of essential underlying mechanisms. (The idea of peaking within 10 minutes is solution, now generally agreed in essay, the panic disorder community to apply to a minority of cases. Full status panicus can persist for hours or even days. Presence of the 10-minute observation in DSM-IV is probably a legacy from the time when panic disorder was thought to be synonymous with hyperventilation syndrome.) It is ocr a history, important to note that anxiety or fear, although typical, is not a requirement.
Intense discomfort, whether existential or physiological, is equally a qualifying factor. Technology. In fact, the write essay terms panic disorder and panic attack may do as much to obscure the true face of the disorder from clinicians and patients as they do to make it understandable to the general public. Much additional insight can be gained from one of the pioneers in treating panic disorder before there was much medical understanding of the condition, Dr. Essay About In Life. Claire Weekes. She wrote of a panic attack as consisting of assistance legal, a first fear and a second fear. The first fear is some cluster of sensations, often untriggered, of which the patient suddenly becomes aware. These would be sensations like those broadly categorized in the DSM-IV definition (and treated in somewhat more detail under later headings in this essay). We know today that the term arousal or dysautonomia is more appropriate than fear to many patients and clusters of sensations, but Dr. Essay In Life. Weekes' early insight is still remarkable for her time, crucial to brilliant solution, understanding the about in life anatomy of a panic attack, and letter secondary school therapeutically useful today.
The second fear is essay technology in life, a reaction to jackson, the appearance and sensations of the first fear. Competing descriptions have emerged for why this second fear comes about essay technology in life, #150; premonition of death, fear of suffocation, resonance with primal separation trauma, catastrophic thinking, etc. Ocr A Level Essay. #150; but basically, Weekes' premise is that the second fear is fear of the first fear. Essay In Life. It is a rapidly escalating, possibly eruptive panic reaction that feeds back into the manifestations of the first fear or triggers new manifestations. It is Weekes' second fear that is addressed by most attempts to treat panic disorder. Patients are taught not to fear the brilliant solution essays primary sensations of the episode. This is an essay, extremely useful concept in Cognitive-Behavioral Therapy for panic attacks. In the days before any such phenomena were recognized, patients either learned to do this on letter job in secondary their own or medicated themselves with alcohol or with medications prescribed for nerves. (Or in the worst cases, they were committed to psychiatric hospitals.) The aim of such CBT is to learn and internalize the idea that the primary manifestations are benign and to essay about in life, learn not to compound them with a panic reaction. Antidepressant medications also primarily treat this second fear, even as some of them may exacerbate the primary manifestations of do the write 2009, panic disorder. Nonetheless, the fact remains that the primary manifestations of about in life, a panic attack, the frederick turner thesis first fear, can be intensely unpleasant. Even without any second fear, the primary manifestations of a panic attack can have a distinctly paroxysmal quality of about in life, their own, akin to legal, vomiting or a slow-motion sneeze or a slow-motion shudder or an orgasm.
They have differing causes in different cases. Various theories compete to provide an explanation. Some neurologists hypothesize neuroelectrical chaos. Some make an analogy to essay about technology, a sort of epilepsy outside the brain, while others dispute the appropriateness or desirability of such an frederick jackson turner fronteir, analogy. Others find deficiencies of parasympathethic neurotransmitters.
In some patients, blood oxygen saturation drops by 25% or more, sometimes in response to circulatory disturbances and other times in response to underbreathing. It is likely that a relatively large number of transitory endocrinological and neurological manifestations exist but are difficult to about in life, observe in progress. And then there are patients in whom the primary manifestations are non-paroxysmal. Such patients may simply shake randomly and uncontrollably, or feel intense generalized abdominal distress, or experience a variety of alien internal sensations. Do The Write Thing 2009. These sensations can be frustratingly difficult to describe, since they often lie outside of shared experience, the language lacks any directly descriptive terms for essay them, and the non-afflicted can only try to and prevention essay, interpret such descriptions in terms of personal experience. A further complication is essay in life, that even medical doctors versed in panic disorder do not always know what is happening biologically or how to observe or measure it in other than superficial terms. The experience usually looks like fear and it most often, though not always, feels like fear as well, albeit sometimes a strange fear. These manifestations may continue for hours or even days in thing 2009, the absence of medical intervention (despite the DSM-IV's specification of 10 minutes as a norm), and not all patients experiencing these symptoms experience the escalating or eruptive second fear to which Weekes refers. Technology In Life. It is possible to learn not to compound one's reaction when blood oxygen saturation falls substantially, or when a drop in jackson fronteir thesis, the availability of the neurotransmitter acetylcholine below a certain threshold causes muscles to go into random spasms, or when any of a host of other manifestations appear, but absence of a compounding second fear by essay about no means implies that one is well or feels well. For Teaching Job In Secondary School. One might well say of some cases #150; and such cases are not rare #150; that over essay technology in life time the panic disappears but the brilliant essays disorder remains. On one level, that is a facetious statement, but on another level, it captures an important truth.
So while practicing psychologists and psychiatrists largely focus (wittingly or unwittingly) on treating Weekes' second fear and associated complications (primarily inter-attack anticipatory anxiety, agoraphobia, or phobic avoidance), researchers and neurologists work at expanding our understanding of the first fear, or the primary manifestations of panic attacks. The belief that most panic disorder patients are simply overreacting to normal sensations that others ignore is rapidly being relegated to history. The primary manifestations of panic attacks are often anything other than normal sensations. Researchers in whom such sensations have been induced artificially have described them as harrowing. One described them as comparable in degree of trauma to wartime experiences. Hyperarousal and the Mind-Body Duality. The conditions commonly called anxiety disorders #150; Generalized Anxiety Disorder, Panic Disorder, Social Anxiety Disorder, Obsessive-Compulsive Disorder, and other less commonly diagnosed conditions #150; are all essentially disorders of hyperarousal.
In the case of panic disorder, particularly of the familial variety, the hyperarousal tends to be essential (having no single, clearly identifiable cause, much like essential high blood pressure) and, at least in the early years, autonomic (expressing itself primarily or initially in physical symptoms not under conscious control). There has been a tendency in technology, the conceptualization of essays, these disorders (at least the technology first three) to thesis, think in terms of hyperarousal specifically of the fear, alarm, and watchfulness circuits of the essay in life brain, but in truth the level essay structure hyperarousal tends to be more generalized in nature. In Life. It may even lack an intuitively anxious presentation. Because typically anxious arousal is letter secondary school, more likely to be noticed, clinicians' unawareness of the generalized nature of the essay about hyperarousal involved can lead to underdiagnosis of hyperarousal disorders or to too narrow a focus on treatment of specific symptoms. Mental arousal comprises thoughts and feelings, both conscious and unconscious. Letter Job In School. It may express itself in many ways, some of them subjectively negative (such as worry or non-specific agitation), some of them subjectively positive (such as anticipation), some of them constructive (such as productive focus on essay technology a project), some of them destructive (such as constant worry about improbable what-if scenarios). Mental arousal resides in the higher levels of the brain, those responsible for solution essays conscious and unconscious thoughts and feelings. Autonomic arousal consists of many bodily functions that are not under volitional control, such as heartbeat, sweating, digestion, and others; and about in life some bodily functions that are partially under volitional control, such as breathing and excretion, so that they self-regulate in normal circumstances but are subject to conscious or unconscious intervention from higher levels of the write 2009 brain.
Autonomic arousal resides nearly everywhere in the body outside the higher levels of the essay technology in life brain, including the nervous, endocrinological, and immune systems and the most primitive parts of the brain that regulate autonomic function. It is an axiom of psychosomatic medicine that where the mind goes, the body will follow. There is, however, an equally true but often neglected corollary to that maxim, namely that where the body goes, the mind will follow. Each type of arousal disorder and each individual case has its characteristic mixture of mental and autonomic arousal and ocr a essay its own characteristic relationship between the about in life two. It turns out to make little difference in and prevention essay, panic disorder whether arousal is subjectively perceived as negative or positive, as anxiety or as pleasurable excitement. It is the fact of in life, arousal in itself that primes the body to experience panic attacks and then triggers the attacks. This is true whether the arousal stems from external stimulation or from internal factors, whether from primarily mental influences or primarily autonomic ones such as reactions to medication, food, heat, or panicogenic inhalants (including certain common air pollutants). The classical view of anxiety disorders is that mental hyperarousal is the impetus behind autonomic hyperarousal. This is an understandable oversimplification, because it describes what is true much of the std know-how and prevention time in normally functional individuals. It ignores the essay about key point, however, that these are precisely disorders of arousal, and that there are various forms of these disorders. An arousal disorder may be driven by intrinsic hyperarousal of the mind, by intrinsic hyperarousal of the autonomic nervous system, or by jackson turner an aberration in essay about technology, the way either one influences the secondary other.
And whatever the primary impetus of the disorder, secondary effects nearly always emerge to complicate the condition and confuse its characterization #150; effects seen in the mental and autonomic domains and in the way that the two domains influence each other. Yes, the mind can arouse the body and it can calm the body. It can even make the body ill, as one sees in about in life, the traditional view of stress and psychosomatic medicine; and level history structure it can heal the body, as one sees in the response of such conditions as cancer to the influence of psychotherapy #150; although thankfully, one does not see anyone advocating treatment of the mind as the essay about technology in life primary care for cancer patients. Std Know-how And Prevention. (One hopes that the average treatment of panic disorder will some day be so enlightened…) However, the reverse is equally true: the body can arouse the mind and it can calm the mind; and it can even make the mind ill or heal the mind. One sees one obvious example in the relaxing (or in some cases invigorating) effects of massage #150; indeed the about technology in life ability of massage therapy to influence the course of do the write thing essay 2009, mental and essay in life even physical illness. Another example is found in the mental illnesses #150; depression, obsession, anxiety #150; that frequently develop as secondary consequences of frederick jackson turner fronteir, chronic organic illness.
Food reactions distinct to about technology, certain genetic groups constitute another example, as do arousal reactions to certain antibiotics and anticholinergic medications that do not act directly on higher levels of the brain. The spectrum connecting mental and autonomic arousal could be compared to a pushme-pullyou, the brilliant fictional creature from Dr. Dolittle with two front ends and two brains. The beast is particularly unpredictable in individuals with anxiety/arousal disorders. The mind can be driving the disorder with the technology in life body mostly along for the ride. Or the do the body can be driving the disorder, with the mind doing its best to resist. Treatment of the mind can accomplish surprising effects on essay technology in life biology, but this is compensation, and do the thing contest 2009 it does have its limits. If this were not so, then psychotherapy would be the essay about technology primary treatment against for instance epilepsy, a condition with certain similarities to some forms of panic disorder and write thing essay a condition that is sometimes partially responsive to psychotherapy. So a good understanding of the mind-body connection in essay about in life, panic disorder generally and in any specific patient is frederick fronteir, essential to intelligent diagnosis and effective treatment. Notwithstanding the mind-body overlap, the essence of each case is usually to essay about technology, be found in some intrinsic factor on one side or the do the thing essay 2009 other. The reader should know that the technology in life medical community currently applies the brilliant solution essays term dysautonomia to an abnormality in the self-regulation of autonomic arousal and applies the term anxiety to an abnormality in the level of mental arousal, including any manifestations of autonomic arousal presumed correctly or incorrectly to derive from technology in life conscious or unconscious thoughts or feelings.
This conceptual bias tends to hobble treatment, but it is important for the reader to std know-how and prevention essay, understand the doctor's likely perspective at about technology, the outset of the ocr a level essay structure relationship. Most of the clinical progress currently taking place in the medical treatment of panic disorder occurs through the process of patients exposing their doctors to the body of about technology in life, research relevant to their own variant of ocr a level history, panic disorder. Dysautonomia and its Paroxysms. The panic attacks in panic disorders are usually just the tip of the iceberg. Just as significant as panic attacks per se is the chronic dysautonomia present in panic disorder. Essay About. A number of expressions of dysautonomia are often present for write contest 2009 extended periods in panic disorder patients, even in the absence of frank panic attacks. Indeed panic attacks could in most cases be called dysautonomic paroxysms, and the disorder could reasonably be called paroxysmal dysautonomia. The following is a reasonably comprehensive but certainly not exhaustive list of mostly dysautonomic symptoms associated with panic disorder. (Not all of these are strictly speaking dysautonomic, though most are, but this is a convenient place to gather symptoms frequently associated with panic disorder.) Any given person is likely to essay about technology in life, experience only a handful of these symptoms, though they may be frequent and intense. The point of such an extensive list is to provide reassurance to someone diagnosed with panic disorder who is experiencing any of these very diverse symptoms that they can indeed be merely symptomatic of panic disorder and do the contest 2009 not necessarily a sign that some other medical or biological condition is present.
Heart-and circulation-related: Rapid, irregular, or forceful, loud heartbeat. Technology. Sensation of dissertation assistance, skipped heartbeats. Chest pain. Low or high blood pressure, often with remarkably wide swings. Panic disorder patients are sometimes diagnosed with atypical mitral valve prolapse or mitral valve prolapse syndrome.
It is characteristic of panic disorder that symptoms from several of the in life groups above occur together. (panic disorder is a polysystemic condition, which is one factor leading to letter job in secondary, poor recognition, diagnosis, and essay technology treatment.) It is also normal for dissertation writing legal some varying level of these symptoms to be present much or most of the time for uncontrolled patients, but for the symptoms periodically to about in life, escalate to the point of paroxysm followed by relief of thesis, varying duration. It is essay in life, common for panic attacks to occur during sleep, especially in patients with the ocr a level essay gene for cholecystokinin-related bile reflux panic disorder. In many respects, these dysautonomic symptoms ought to be of more concern to clinicians than the panic attacks themselves, except that patients experiencing panic attacks are at a strikingly elevated risk of suicide. Normal research subjects who have had panic attacks induced by the administration of GABA antagonists have described the essay in life experience as completely unbearable and frederick jackson the worst experience of their lives. Essay About Technology. (It is conceptually interesting that although synthetic panic attacks can be created with some degree of success under laboratory conditions using serotonin depleters, serotonin reuptake inhibitors, cholecystokinin, sodium lactate, and norepinephrine, no class of substances but perhaps cholecystokinin comes anywhere close to the panicogenic effect of a GABA antagonist. This suggests that the old GABA-based conceptualization of panic disorder in the wild was more correct than newer serotonin-based conceptualizations.) In a significant number of for teaching school, patients, dysautonomic symptoms and panic attacks emerge not during periods of long-term or short-term stress, but after the cessation of such stress or during its period of abatement. This is probably true in technology, particular of the patients with cholecystokinin abnormalities.
In a significant number of patients, mental/emotional anxiety waxes and wanes, and the dysautonomia waxes and wanes, but there is level history, no identifiable pattern of correlation. It is in these patients that the neurological dimension of the disorder is the most obvious. There is an about in life, interesting minority of patients who experience severe dysautonomia, even to the point of physical incapacitation, without experiencing what they themselves would call a panic attack. This is not too difficult for many sufferers of panic disorder to understand, particularly after therapy or years of experience with the std know-how and prevention essay condition have desensitized (to varying degrees) the technology fear response that can be aroused by the dysautonomia. One experiences all of the escalating dysautonomic arousal without the paroxysmal culmination that provides temporary relief. People who have not experienced a panic attack can perhaps understand this distinction by thinking of sexual arousal and orgasm as an analogy. It is possible to write thing 2009, be highly aroused without experiencing orgasm. Similarly, these non-paroxysmal dysautonomic states can be very intense #150; indeed they can be more intense than the states that would induce paroxysmal panic in technology in life, other panic disorder patients or in normal individuals. Current thinking distinguishes between Generalized Anxiety Disorder (GAD) and jackson turner fronteir thesis panic disorder largely (though not entirely) on the basis of absence or presence of panic attacks.
But in some respects, these conditions appear much of the time to be differing degrees of the same biological disorder, and if it is useful to distinguish at all, it might be more diagnostically and therapeutically useful to apply a distinction at right angles to the current one, recognizing one disorder that is primarily somatic/dysautonomic and another that is primarily cognitive/emotional. In Life. Granted there is overlap, but there does appear often to be an etiological distinction in reality. It is common practice to consider panic disorder controlled when panic attacks are eliminated. However, the application for teaching school goals of treatment should actually include elimination of most or all of the associated dysautonomia, as the technology in life dysautonomia is symptomatic of uncontrolled underlying pathology and in some cases exacerbates the underlying pathology (just as uncontrolled panic attacks escalate through neurological as well as psychological mechanisms). Panic disorder of biological genesis is chronic and mildly progressive. Although some clinicians claim encouraging cure rates, usually in carefully selected groups, studies have shown that when one looks at patients over periods of time four years or longer, a preponderance of patients experience relapse in the absence of do the write thing essay 2009, ongoing pharmaceutical treatment. Essay. This is not always evident to treating clinicians (who have been known to claim cure rates as high as a thoroughly suspicious 100%), because patients frequently change doctors if they perceive that their treatment was unsympathetic or ineffective; and relapse is readily perceived as a sign that treatment was ineffective if the std know-how and prevention essay treating physician has created unrealistic expectations of essay about in life, a permanent cure or has exerted subtle pressure to recover or to tough out minor episodes. It is often stated that panic attacks do not lead to heart attacks. This is true as far as it goes; however, sufferers of uncontrolled panic disorder are at a quadrupled risk for eventually experiencing a serious cardiac event. For instance, QT prolongation (a type of solution, subtle heart arrhythmia) is present in a disproportionate number of undertreated panic disorder patients.
In fact, a variety of arrhythmias are observed with disproportionate frequency in panic disorder patients, though many of them are only observable during an essay about, episode or during the lead-in to an episode. The paroxysm of the attack itself may serve to correct the arrhythmia. One of the greatest health risks for sufferers of panic disorder as they grow older is ocr a level, unrecognized serious illness that would be diagnosed earlier in other patients. If it is true that a certain proportion of in life, panic disorder patients tend toward hypervigilance and hypochondria, particularly in the years just prior to write thing essay contest, and following correct diagnosis with panic disorder, yet it is also documented that primary care physicians and many specialists tend to about in life, dismiss the complaints of brilliant, patients bearing a diagnosis of panic disorder (or generalized anxiety disorder) without sufficient foundation for doing so. Panic disorder patients get organic illness just as often as other patients. They just don't get it diagnosed as often. In fact, it has been clearly shown that patients with anxiety disorders go longer before diagnosis of serious conditions than do patients without these stigmatizing diagnoses, and physicians have cause to about in life, be more concerned with the potential for medical error and dissertation writing assistance legal liability. Particularly problematic is the practice in some emergency rooms of shunting panic disorder or GAD patients presenting with chest pain or other possible cardiac symptomatology into psychiatric observation without sufficient examination. There are documented instances of fatalities resulting from essay such systematized negligence. On the other side of the same coin, emergency rooms also represent frequently missed opportunities to identify potential cases of panic disorder.
Many ER doctors are poorly trained to recognize panic disorder, particularly in ocr a level essay, its pre-emergent guise of essay about, non-paroxysmal dysautonomia. Do The Write Thing Essay Contest. This is not surprising given the diagnostic criteria in use today. Pre-emergent panic disorder often does not look much like GAD, as it is is likely to be primarily somatic until the first string of panic attacks initiates the cycle of fear or worry and cognitive-emotional-behavioral disturbance. Unfortunately, even when ER doctors do recognize panic disorder, they are still as likely as not to dismiss it as neurosis unworthy of serious attention and counseling or referral. Patients are still likely to be told to breathe into a paper bag next time, although this is in fact more likely to trigger than to stave off a panic attack for a sufferer of technology, biologically rooted panic disorder. In fact, panic disorder patients are often told (not asked) that they are claustrophobic, or anxious travelers, when in fact their bodies are reacting in predictable and well-understood ways to std know-how and prevention essay, the elevated levels of CO2 present in poorly ventilated spaces full of breathing bodies. This ties in with the false suffocation alarm interpretation of panic disorder, although this theory has become less prominent in in life, the field as other mechanisms have become better documented.
This is dissertation writing assistance, not to say that the interpretation will prove to about in life, be wrong, merely that it is not universal. Std Know-how Essay. And in point of fact, it has not as yet been proven to be anything; hypotheses and assertions relating to panic disorder must be subjected to the same standard of proof as other, non-psychology-related, statements of medical doctrine. One finds that clinicians who demonstrate admirable scientific rigor in making non-psychiatric diagnoses are given to about in life, comically whimsical leaps of faith in attributing patients' symptoms to psychosomatic processes. (Hence the derisive terms psycho-so-magic and psycho-so-magical that one sometimes encounters in patient discussions.) Note: There is ocr a level essay structure, ample research around the false suffocation alarm to indicate that elevated CO2 levels do in fact provoke hyperarousal and essay technology panic attacks in a subset of the panic disorder population. At issue is the and prevention essay histrionic labeling of essay about technology in life, this reaction on the assumption that all individuals ought to experience identical toxic reactions to CO2 at identical concentrations. One might just as easily label hypoglycemic states as false starvation alarm reactions. It is not the alarm per se that is false, it is merely its characterization as one of life-threatening suffocation or starvation that is false #150; and that is not the patient's error of interpretation, as the term implies, but the diagnostician's. Do The Thing Essay. (And when this model was extended to a population with anxiety from pulmonary disease, the alarm sadly turned out essay technology in life not to be so false.) There are a number of conditions frequently associated with panic disorder. Job In School. Some of about, them may be cause or effect of the disorder, while others are merely associated. Writing Assistance Legal. It is important for physicians to recognize the associations, because sometimes it is difficult to treat the associated condition if the underlying or associated panic disorder is left untreated.
GERD, IBS. Probably the conditions most universally present in panic disorder are Gastro-Esophageal Reflux Disease and Irritable Bowel Syndrome. In approximately 40% of essay about, panic disorder patients, both are caused primarily though not entirely by the excessive and irregular secretion of bile so characteristic of hereditary panic disorder. In some patients the effects are mostly upward in the GI tract, resulting in letter for teaching job in secondary, excessive stomach acid secreted to neutralize the bile and leading to in life, GERD #150; sometimes with associated asthma or sinusitis that is not recognized as related to essay, panic disorder or GERD. (Gastric swelling and consequent pressure on the diaphragm or a nerve center has been proposed as one possible cause of essay technology, abnormal breathing in panic disorder; such a suggestion is supported by the fact that subjective difficulty in breathing related to panic disorder can be alleviated in some individuals by application letter job in pressing fingertips downward into essay about technology, the abdomen not far below the sternum.) Often patients will have had GERD or IBS for years or decades, frequently even since childhood, before the emergence of panic disorder diagnosable by current DSM-IV criteria. Even panic disorder patients who do not show overt symptoms of GERD or IBS often exhibit the characteristic abnormalities of bile secretion. The combination of brilliant, Xanax and Carafate has been found to technology, be remarkably effective in treating these conditions in panic disorder patients; indeed therapeutic response of GERD or IBS to do the thing contest, this combination can almost be regarded as a diagnostic criterion. (It is not known why Carafate is often so much more effective in the panic disorder population than newer drugs like acid blockers and proton pump inhibitors, but the phenomenon is about technology, distinct.) As one follows any group of panic disorder patients over a period of turner fronteir, years, half or more do apparently keep the diagnosis of essential panic disorder. However, every year a certain percentage are found to have an organic condition the diagnosis and treatment of which resolves the panic disorder. Essay. Obviously the organic condition, or at contest, least a tendency to it, was present years before it became overt enough to trigger normal diagnostic flags. A panic disorder patient should be prepared to believe and to accept the benign diagnosis of about technology, panic disorder for the rest of their life. But clinicians and patients alike should be alert to changes and dissertation writing assistance should recognize that for instance normal ranges on laboratory tests apply to a statistical abstraction and not necessarily to every individual.
Often individuals experience well-being only within a narrower range of values than the about technology stated range (which varies from lab to lab in any case), and on some types of tests, even the optimal center point may be different for different individuals. Panic disorders, the comorbid conditions mentioned above, and the possible reasons for comorbidity offer much fertile and largely unturned ground for research in thesis, the coming years. There are quite a few chicken-and-egg questions raised by just the associations discussed above, not to mention associations that will emerge with more research. One thing that is clear even now, though, is that with or without statistical documentation, most of the associations discussed above are widely recognized in the panic disorder community. On Medicine As Biology. Those of us without a medical education tend to think of our doctor as a kind of master detective biologist. It's a natural assumption but it reflects an about in life, important misunderstanding of do the thing 2009, medicine as art or science. A doctor is only a master biologist in the loose sense that an architect or a structural engineer would be a master physicist. After a few notoriously rigorous courses in essay, certain traditional elements of human biology, a medical education branches rather quickly into the study of frederick jackson fronteir, established medical protocols for diagnosis and treatment of well-recognized conditions. When a doctor examines and diagnoses us, he is not, as we might easily imagine, unraveling the mysteries of our biological individuality. Rather he is comparing our presentation to technology, a multitude of checklists that would match us to one of the standard diagnoses and treatments he has (in the best case) mastered.
American medicine in and prevention essay, particular prides itself in being based on statistical models of disease. The European medical tradition recognizes the statistical perspective and about technology and the case-based or anecdotal perspective as complementary halves of a complete picture, halves that are roughly analogous to macroeconomics and microeconomics. But the brilliant essays case-based perspective interests American medicine only insofar as cases reflect what is typical of the statistical perspective on a patient's illness. Doctors are explicitly trained to gloss over essay about in life and filter out the idiosyncrasies that conflict with the accepted model of the condition. Thus many will persist with a favored class of medication despite a patient's obvious adverse effects or lack of response. It is revealing that the frederick jackson fronteir thesis doctor's impatience will be with the patient, not with the medication. They will ignore patients' reports of unusual symptoms as irrelevant when in fact they could be highly relevant to unraveling the individual mystery and finding a treatment that is effective for the individual patient. Essay. In such cases, the doctor is not treating the patient, he is treating the statistical model of the patient's diagnosis (a diagnosis which may or may not be correct) . Nowhere does this approach to medicine fail more spectacularly than in a condition like panic disorder, where it is so difficult to define what is typical. But it fails in other contexts as well.
The author of this document himself was evaluated by dissertation writing assistance 14 doctors over a span of essay in life, more than 10 years before aldosteronism was finally noticed, proven, and identified as the root cause of history essay structure, all the symptoms that had received such a variety of diagnoses and misdiagnoses (including panic disorder) over about that time. Mumblings about and prevention essay, anxious patient and about technology in life panic attacks were always somewhere in the background. In the end, he himself had to suggest the diagnosis that proved to be correct and argue vigorously for the definitive test that clinched the dissertation writing diagnosis. Unfortunately, the author's experience is not at all unusual. About Technology. Such outcomes are commonplace in do the, panic disorder support groups.
They may even be more the rule than the exception. The overlooked diagnoses vary, but the in life experience is the same. Patients go years and even decades getting hurried, substandard and frequently condescending care from doctors (often at premier practices or medical facilities) who jump to hasty conclusions and rush to try out the latest psychotrophic medication. Often the solution final and correct diagnosis is a condition thought to be rare, such as celiac disease, aldosteronism, or thyroid dysfunction, but which appears to be strikingly common in the panic disorder population. Sometimes these failures of diagnosis occur because a doctor who might recognize a single unmistakable result on a routine test or some other unmistakable clinical indicator is not good at about technology, recognizing a constellation of ocr a level, borderline results or suggestive indicators that must be considered in combination before they add up, as in the author's case, to a clear picture. More often such failures of diagnosis reflect a simple failure to be meticulous. So patients suffer years of adverse medication reactions, stigma, and other woes that often include lost jobs, lost mobility, lost careers, lost marriages, and lost financial security.
Then a single meticulous doctor provides a correct diagnosis and correct treatment, and the neurotic symptoms magically evaporate. One truth is abundantly clear in all of this: the extent to which our presentation is atypical is almost precisely the about extent to which our doctors will fail to correctly diagnose and treat us. They are trained to ignore the atypical, not to seek an explanation or accommodation for it. And there are virtually no typical cases in panic disorder or the conditions that mimic it. Write Thing Contest. There are only typical treatments. There have been studies showing that doctors almost universally overstate their treatment successes and understate their patients' adverse reactions. Essay In Life. Some studies have even explored psychological reasons for the disconnect from reality. Dissertation Legal. But it is also easy to explain by natural selection. There are many doctors who treat panic disorder ineffectively and who fail to diagnose medical conditions masquerading as panic disorder.
There are only a few who routinely do well at it. It is well documented that most panic patients see multiple doctors (averaging ten or more) before finally receiving effective treatment or correct diagnosis. Almost every one of those earlier doctors assumes that treatment has been successful, or at about technology, the very least fails to receive any feedback on the negative outcome or misdiagnosis. Thus there will inevitably be a large majority of doctors who think they are doing much better than they actually are. One could well object, in cases of jackson turner fronteir, delayed diagnosis, that then it's not panic disorder. Essay Technology In Life. But if all the patients who have had this experience or will have it in the future could omnisciently be removed from the population that forms the core of the panic disorder industry, it's not clear that there would be many left. Certainly much that the medical community now thinks it knows about the condition would no longer be valid in such an omnisciently sifted patient population, because most of the current knowledge (such as it is) has been derived from this heterogeneous population.
Unfortunately, all of this talk about undiagnosed and misdiagnosed conditions feeds into the worst and most common fear in the panic disorder community, namely that some terrible condition has gone unnoticed, one that will kill us before it is discovered. The bad news is that undiagnosed medical conditions are very common in the panic disorder population. But the good news it that they are almost never fatal conditions. Letter For Teaching Secondary School. The fatal conditions do get diagnosed quickly. In fact, finding things that will kill you is the essay about technology one thing that modern American medicine does better than anything else. By the writing assistance legal time a panic disorder patient has undergone EKGs, MRIs, and all of the other routine technological marvels requiring little initiative or detective work from a doctor, the essay technology patient can be confident there is no undetected brain tumor, no undetected adrenal tumor, no potentially fatal heart arrhythmia, and ocr a history essay structure no other killer lurking unseen in the background. The conditions that commonly mimic panic disorder are almost never fatal. But it is inarguably difficult to get adequate testing.
Out of every 30-60 Americans with celiac disease (a common mimic of panic disorder), only one will be diagnosed during his or her lifetime. Countless celiac patients have written in online panic support groups about the long battle for testing that they had to wage before getting the definitive tests and a correct diagnosis. Essay About Technology. For aldosteronism, the figure would be around one out of about 10-30 who ever receives the correct diagnosis. For autoimmune hypothyroidism, the prospect of diagnosis is presumably brighter, but many people write of frederick jackson turner thesis, waging long battles before the diagnosis was made. Panic disorder or the syndrome of its symptoms, even when caused by technology some other condition makes it hard for the patient to practice acceptance. Yet it is vital to do so. Brilliant Solution. We should recognize and accept that if we had a fatal condition, it would be noticed. We should recognize and accept that there may very well be some non-fatal condition causing our symptoms that has not yet been noticed #150; and that is essay, not a catastrophe . We should recognize and accept that in the doctor corps, as in every other walk of life, there is a small percentage (maybe 5%?) of people who do their work really well, a somewhat larger minority who are adequate for garden-variety patients (which we are not), and letter school a full 50% who are below average (not to mention inadequate). We must be our own detectives and advocates, but we should do so methodically, patiently, and without rancor. We should ignore the condescension and hostility of doctors threatened by technology our persistence or our discontent.
People can only be as good as they are, and it is futile to hold anyone's mediocrity against brilliant them. We should never remain locked in conflict with an unresponsive doctor, but should undramatically find another. We should remember that statistically, it will probably be the tenth or eleventh doctor who turns out to essay, understand our condition and its treatment. Every new doctor is essay structure, a step toward the right one. We should not be ashamed of looking for the right doctor, not be intimidated by charges of doctor shopping. If there is a treatable and unnoticed medical condition underlying our case, it will be our own initiative and nobody else's that leads to a doctor who can diagnose it. But in many cases, maybe half or more, no such underlying medical condition will ever be found, and we should accept that probability as well. The fact that panic is essay about technology, so hereditary (and genetically linked to a variety of other conditions) makes it clear that biology is a strong factor, but not every biological problem has found its way into the protocols of medicine. We should accept that as well. It is very possible to live a good life with panic disorder if only we find a doctor who can practice appropriate and ocr a history structure individualized treatment. We should seek a therapist as well, one who can teach us to use the mind to compensate for failings of the body.
The first resolution must be to live as well as possible within the parameters of the condition. Often correct medication and competent therapy can lead to essay technology, virtual normality. The search for application letter for teaching explanations should never become more important than making the most of the function and essay technology in life possibilities we have. The search for another explanation is like prospecting for ocr a level history gold: it is a long-term quest, one in which we must pace ourselves wisely and one in which there may never be a payoff. On Treatment Options. The most commonly used treatments for panic disorder, in no particular order, are Cognitive-Behavioral Therapy (or a special variant known as Panic Control Therapy), various meditation or progressive relaxation practices, medication with tricyclic antidepressants, medication with SSRIs (selective serotonin reuptake inhibitors, another class of antidepressant agent), medication with benzodiazepines (a form of minor tranquilizer), medication with anti-epileptic agents other than benzodiazepines, and occasionally hypnosis or medication with one or another class of monoamine oxidase inhibitors (MAOIs or RIMAs) or antipsychotic agents. Hypnosis is relatively uncommon because it is seldom effective for non-phobic panic and can easily worsen the situation. Attempts to unearth and treat the underlying trauma are usually misguided because if the initial diagnosis of panic disorder has been rigorous, it appears that there is seldom an underlying trauma to unearth. Medication with MAOIs is essay about technology, relatively uncommon because of the dietary restrictions involved and the danger of ocr a level essay structure, hypertensive crisis.
Some clinicians are working with reversible monoamine oxidase inhibitors, but so far there appears to be little data on success. In listening to essay technology in life, patients, it becomes apparent that there are patients who respond well to each of the therapies in common use, either alone or in combination. It appears somewhat common and highly advisable, for example, to supplement medication with CBT or PCT, but one also sees combinations of medications. Reactions to medications appear to be highly variable in panic disorder #150; less consistent, for instance, than reactions to anti-hypertensive medications in the treatment of hypertension. One sees that some patients respond negatively to several medications or classes of essays, medications, only to respond well to another. Essay About. Some patients report that SSRI medications foster a return to spontaneity and dissertation assistance legal exuberance, but others report a range of essay about technology, negative outcomes ranging from a dulling out of emotions or even physical sensations (resulting in serious accidental burns or cuts) at one extreme to unbearable agitation at the other. Similarly, some patients report a normalizing effect from benzodiazepines, but others experience negative outcomes ranging from stupefaction or emotional dulling at one extreme to dissertation assistance, awkward or even dangerous disinhibition at the other. It seems quite clear in talking to in life, patients that reactions are highly individual, and essay it seems probable that this is about technology in life, due to differences in respective patients' underlying biochemical disturbances. (A number of essay, studies have pointed out that generally speaking, antidepressants seem to work well when the primary manifestations are of technology, a psychological character, while benzodiazepines seem to job in secondary school, work better when the primary manifestations are of a somatic character. Here again we see evidence that there are separate etiologies underlying such a systematic difference in efficacy #150; that indeed distinct conditions are probably involved: a sort of GAD plus panic attacks and a dysautonomia with paroxysms and sometimes secondary worry.) It appears that few psychiatrists are aware of the distinct varieties of panic disorder outlined in the beginning of this essay, although the research documenting them is readily available in research journals and correct identification of the variety of panic disorder is critical to the correct choice of treatment.
Moreover, it appears that few cases of about in life, panic disorder are even referred for psychiatric evaluation in the first place. Instead, primary care physicians tend to feel competent to diagnose and treat the for teaching secondary school condition. A typical PCP is even less aware of the complexities of panic disorder than a psychiatrist, and will almost certainly regard the condition as invariably a serotonin deficiency (which term is itself a considerable oversimplification of one of several serotonin-related pathologies sometimes present in depression, panic disorder, anxiety disorders generally, and some other conditions not relevant to this discussion). So while it is essay in life, quite apparent that reactions to panic disorder medications and the correct choice of medication vary by essays individual and by about technology in life subtype of panic disorder, it also becomes apparent in listening to patients that many if not most physicians prescribe not according to structure, what should or does work for individual patients, but according to what works for the individual doctor. One doctor treats virtually all cases of panic disorder with SSRI medications; another treats virtually all cases with tricyclic antidepressants; another treats virtually all cases with benzodiazepines. Patients who respond poorly to technology, that class of medication typically suffer through several trials of four to six weeks each before changing doctors. It is not uncommon for a panic disorder patient to have gone through a number of physicians (with considerable personal suffering and sometimes loss of employment) before responding well to frederick jackson fronteir thesis, treatment. Essay Technology. Oddly, it is the patient rather than the physician who is labeled non-responsive when one size does not fit all.
(Patients also tend to be unaware of the large proportion of frederick turner fronteir thesis, doctors who have conflicts of interest in the form of subtle and sometimes not-so-subtle financial incentives to prescribe particular medications. In this respect, the ethical canons in medicine appear, at least based on essay actual practice, to essay, be remarkably lax in comparison to those of other licensed professions.) It is unfortunate that individual response is typically ignored in prescribing for panic disorder, because the essay about technology more one examines the evidence, the more it becomes apparent that any given individual is likely to respond really well to ocr a history essay structure, a benzodiazepine or to essay about, an antidepressant, but not interchangeably. Response to one of these classes of drugs is essay structure, likely to be optimal, while response to the other will be marginal at best. A small minority of patients seem to need both, but it can also happen that the two types of meds antagonize each other instead of complementing each other. This is contrary to the prevailing treatment practice, but at technology, present, practice appears to be based more on agenda (or sometimes on contest 2009 tradition, lore, or peer pressure) than on objective evidence. Indeed most non-specialists appear to be wholly unfamiliar with the actual evidence, which is often at essay technology in life, odds with the claims of the do the write contest salespeople (most of whose education is in sales,marketing, or communication) on whose counsel they rely.
The first rule of treatment in panic disorder should be: If it's currently working, don't even think about changing it! It is utterly appalling to see the in life numbers of patients who have been controlled and highly functional with one strategy of management over the course of years, only to move to a new state or change employer (and thus change insurance company) or have their doctor retire, and then have complete havoc wrought in their medical condition, their emotional state, their marriage, and even their employment and financial status, all because an inept and overly self-assured doctor sought to dissertation legal, adhere to one or another of the continually emerging vogues in prescribing. One need only search MedLine to see the about in life course of these successive vogues over the last two decades, and it is clear that what is in std know-how, today will be out a few years from now. There are choices to make in treating any newly emergent case of about technology, panic disorder, and humane, flexible, patient-responsive experimentation may be necessary. But experimentation with patients who are functional and satisfied is unconscionable, should be regarded as malpractice, and has indeed been grounds for successful malpractice litigation. Undermedication of chronic anxiety or dysautonomia is just as irresponsible and assistance legal just as ripe for judicial redress as undermedication of chronic pain. On Cognitive-Behavioral Therapy.
(and Panic Control Therapy) A large proportion of patients undergoing CBT or PCT report that they have experienced significant benefits from such therapy, particularly in the area of coping with their symptoms, reducing the essay about severity of their panic attacks, and job in secondary school improving their overall well-being. However, very few report that CBT or PCT alone is technology, sufficient to eliminate or even necessarily to reduce the number of their panic attacks. Although there have been reports in the past of very high success rates with CBT alone, a recent study revisited some of the results and came to quite different conclusions. David Barlow, Ph.D., one of the leading figures in secondary, psychological treatment of anxiety, commented on this study with the essay about in life laudable observation that The one thing that we've learned . now that more data are in, is that we're not really as good as we thought we were. Assistance Legal. This was refreshing candor and integrity in a field where professional pride has often taken priority over a dispassionate and monetarily disinterested look at the relative merits of about technology, various approaches to treatment. One would expect the best results of CBT or PCT to be achieved when the condition is std know-how and prevention essay, rooted in anxious or obsessive patterns of thought. However, it is not always easy to distinguish such cases. Certainly it seems incumbent to treat such thinking whenever it is present, whether it is a preexisting causative factor or merely a result of the essay in life disorder. Further investigation is needed into ocr a level history essay structure, the effects of CBT and PCT on about the dysautonomia associated with panic disorder.
Although a patient is likely to be very grateful (and at a sharply reduced risk for suicide) after learning to experience less severe panic attacks in the face of prolonged dysautonomia or dysautonomic paroxysm, little has been gained from a medical perspective if the patient nonetheless experiences prolonged and frequent dysautonomic episodes. There is a certain value in turner thesis, teaching patients to cope with the about technology symptoms of medically uncontrolled essential dysautonomia (especially if such treatment may reduce actual symptoms), just as there is value in writing, teaching patients to cope with the symptoms of other chronic medical conditions. Nonetheless, such therapy should not be substituted in whole for treatment of the medical condition itself. Meditation and about technology in life progressive relaxation techniques are helpful for some people. Meditation techniques need to be undertaken with the understanding that dissociative states like those it may promote are not always desirable in panic disorder patients #150; that indeed they can trigger panic attacks in themselves or simply be more difficult to terminate for individuals with anxiety disorders. (There is a fair amount of controversy around meditation in panic disorder, with strong opinions for and against.) And individuals undertaking either meditation or progressive relaxation need to understand that even when the practices are beneficial, a panic attack is writing, most likely to occur during the transition from a state of high arousal to one of lower arousal.
This appears to be true of all or most panic disorder patients, but it is especially noticeable among those who have the aberrant CCK gene. Obviously it is desirable to essay technology in life, make the transition from high to low arousal, but most people would prefer to std know-how essay, do so without triggering panic attacks in the process. Learning effective relaxation may thus be more complicated for essay about the panic disorder patient than for other individuals. On Tricyclic Treatment. A growing number of clinicians now treat panic disorder using tricyclic medications, often after having used SSRI treatment for a number of letter secondary school, years and then reverted to the use of tricyclics based on essay about technology the number of adverse patient experiences. Tricyclics seem to work well for a minority of panic disorder patients. Statistically, some tricyclics are the and prevention most successful type of antidepressant for technology in life treating panic disorder, and those statistics were compiled in solution, an era of less brazen manipulation of clinical trial data than we see today.
However, due to essay about, the parasympathetic insufficiency so frequently present in frederick turner fronteir thesis, the disorder, a certain subset of essay technology, panic disorder patients seem particularly prone to excessive cardiac stimulation from this class of medications, which increase the availability of norepinephrine. Tricyclics are also inherently less safe than most modern antidepressants, with substantially lower margins for dosage error or deliberate misuse. Tricyclic medications also reduce the availability of acetylcholine, and std know-how and prevention essay reduced availability of acetylcholine is believed to technology in life, be implicated in the mechanism of brilliant solution essays, panic disorder. Essay About Technology. Their overall effect is to std know-how essay, increase autonomic arousal, so like the SSRIs, they seem to work best where the panic disorder is of psychological origin or has highly prounounced psychological manifestations. On SSRI Treatment. Among clinicians new to essay about, treating panic disorder or new to using SSRI-type medications, these medications are often regarded as the turner thesis treatment of choice or even a panacea. This point of view appears to be in about, retreat among more experienced clinicians, although it is still heavily promoted by pharmaceutical companies, whose representatives still grossly understate the side effect and withdrawal profiles while greatly overstating the success rates of frederick jackson fronteir, these medications in treating panic disorders. However, the side effect profile for SSRI medications is much worse than initially published studies revealed, the effectiveness is highly unpredictable in treating panic disorder, and there is high risk for precipitating iatrogenic crisis when using this class of medications to essay about technology, treat panic disorder (especially during the beginning of treatment). An alarming percentage of patients in the Internet support communities for panic disorder had never experienced or even heard of ocr a structure, a panic attack before they were treated for depression with an essay about technology, SSRI, but experienced panic attacks leading to an ultimate diagnosis of std know-how essay, panic disorder within their first week or even the first day of treatment and have not been able to rid themselves of the disorder after discontinuation of the SSRI.
Now they have depression and panic disorder, or sometimes panic disorder that persists beyond recovery from depression. Primary care physicians on the whole, and a sizable minority of psychiatrists, are unfamiliar with the true side effect profiles of essay in life, various SSRI medications, are unaware of the tolerance that develops to brilliant solution essays, these medications when they are used to treat panic disorder, and essay about are unaware of the ocr a structure withdrawal syndromes, despite the about technology fact that all of these have been well documented in and prevention, such sources as the British Medical Journal and the Journal of Clinical Psychiatry, among others. (And yes, it is called withdrawal and not discontinuation or discontinuation syndrome everywhere except in the United States.) A disturbing number of patients are not informed of the potential long-term risks of their medications, including the significant weight gain and sexual dysfunction, both of which can persist long after discontinuation of SSRI medications. When patients report some of the side effects of essay about technology in life, usage or discontinuation that are typical in panic disorder, such as visual lag and frederick jackson turner thesis sensations of random electric shock, their physicians incorrectly state that these are not recognized as attributable to SSRI medications, even though they are well documented in the psychiatric literature. Additionally, almost every recent, independent study that has looked at suicidality with SSRIs has concluded that although these medications are indeed safer in overdose than tricyclic antidepressants, a significantly greater proportion of SSRI users than tricyclic users actually attempt suicide. These people are not uninformed, either #150; they know that their SSRI is not lethal, so they tend to use acetaminophen, gunshot, or hanging instead. Both anecdotal reports and systematic surveys of clinical practice reveal that a majority of physicians prescribing SSRIs do not know how to correctly taper the beginning and end of treatment with these medications, nor what reduced dosages to technology in life, use in treating panic disorder, nor what protocol to follow in switching from one SSRI to another #150; usually a direct switch is writing assistance, advisable, but some physicians prescribe a washout period that is both uncomfortable (if not debilitating) and essay dangerous to the patient #150; nor how to switch between an SSRI and another class of antidepressant. One does see a large minority of panic disorder patients whose condition responds well to SSRI medications, even though these patients are no more exempt from the usual side effects than other patients. (Some find that the addition of Serzone [now banned], or less often Wellbutrin, can restore sexual function lost to the primary SSRI and/or reverse the fronteir thesis perversely treatment-resistant weight gain experienced by a majority of long-term SSRI users; however, neither of technology in life, these medications appears to frederick turner thesis, be useful alone in the treatment of about technology, panic disorder.) Not all of the patients who respond to SSRI treatment are the ones in whom the condition seems attributable to anxious or obsessive thought patterns, so it appears likely that there is and prevention, some set of patients for whom these medications correctly target some underlying abnormality or imbalance.
However, many physicians seem unaware that a significant number of panic disorder patients react very badly and essay technology in life sometimes very suddenly to the anticholinergic effects of SSRI medications, a reaction that should not be surprising given the parasympathetic insufficiency posited to be so often present or even causative in panic disorder. Most long-term panic disorder patients who show up in the Internet support communities have been on a progression of different SSRI medications, often with a progression of different doctors, before being stabilized long-term on a regimen of Xanax, Ativan, or Klonopin. A small number end up on thing Valium, Tranxene or other benzodiazepines. [Update: A study presented in Atlanta at the 2001 annual conference of the Anxiety Disorders Association of America made a similar observation regarding the panic disorder population as a whole.] A significant number of other panic disorder patients who show up in the Internet support communities began treatment on both an SSRI and a benzodiazepine, but were forced to discontinue the SSRI due to unacceptable side effects, and then found that they were well controlled on the benzodiazepine alone. One of the disturbing characteristics of SSRI medications is that once a particular SSRI has ceased to in life, be effective in controlling panic disorder, it usually cannot be used effectively again in the future, not even years later #150; the cessation of legal, effect is persistent and perhaps permanent. This raises some troubling questions about the mechanisms behind the technology well-known poop out phenomenon distinctive to std know-how, SSRIs and about other reuptake-inhibiting medications.
Current research hypotheses with some degree of experimental foundation include depletion of dopamine (though it is unclear why that would be so persistent), an excess of the otherwise therapeutic effect of history essay, desensitizing serotonin receptors (but why so persistent?), and physiological damage to or destruction of essay in life, serotonin receptors (in which case it is doubtful but unproven whether they can be regenerated). SSRI medications reduce the availability of nitric oxide, and reduced availability of nitric oxide is suspected as a factor in the mechanism of panic disorder. They also increase production of secondary, prolactin, which may be a factor in essay about technology in life, the high incidence of sexual dysfunction, and for teaching secondary school alter the function of the hypothalamus, which is one of the essay about technology in life mechanisms being studied as a possible factor in the strangely treatment-resistant weight gain associated with SSRI usage. (It is a shame that the dramatic differences in reactions to SSRI treatment are so often minimized, trivialized, or dismissed outright instead of being acknowledged and school studied more closely. It is a shame because the differences probably provide, in their sheer starkness, some of the best clues currently available to the varieties of biochemical mechanisms underlying panic disorders #150; and to the various mechanisms underlying depression and obsessive-compulsive disorder too, for that matter. About In Life. Groups of letter job in secondary, people with similar reactions to one class of drugs, particularly drugs as selective and powerful as SSRIs, probably represent de facto classifications of about in life, people with similar variants of panic disorder or depression. It is possible that failure to follow up such an obvious line of essay, investigation is due to commercial agendas. Technology In Life. But it is also possible that it is simply easier, with current research technology, to plan and study interactions between drugs and neurons in the laboratory than it is to look inside a living human being and observe the individual's true neurochemical processes or status at a given moment #150; that our ability to create drugs that act at the neuronal level has far outpaced our ability to observe in thorough and objective ways their actual effects on living creatures' neurochemistry. And so we rely on a priori speculation, we rely on subjective reporting of sensations and feelings far removed from the biochemical processes that cause them, and we conjecture as to their meaning.
Typically this takes place in trials where the protocol assures minimization or even outright dismissal of reactions that are not universal or at least common to a large proportion of subjects. So when something goes wrong for a minority of patients, we conjecture around variations on the presumed and intended workings of the drug at the biochemical level; but we do not know, and we have few tools to do the thing essay contest 2009, uncover, the in life subtleties that explain the full range of unintended effects.) There is an old saw that antidepressants cure panic disorder, whereas tranquilizers merely control it. Never mind that such a belief erroneously regards panic disorder as a single monolithic disorder. Even overlooking that point, when one looks beyond the short-term perspective of do the, typical clinical trials, it becomes apparent that antidepressants do not cure panic disorder, other than in rare cases #150; the condition is chronic and often mildly progressive.
Follow-up studies show similar relapse rates in the long term, and about technology in life it is dishonest and writing legal irresponsible to tell patients anything else. With CBT or PCT, one can sometimes reduce the essay about technology incidence of outright attacks by reducing sensitivity to triggers, but the underlying dysautonomia persists #150; and it is the dysautonomia, not its paroxysms, that represents the most insidious threat to health and longevity. In any case, the cure/control distinction is at letter for teaching, best misleading because very few pharmaceutical treatments cure anything. Control of symptoms is an admirable ambition and one that is deemed fully sufficient in many other medical contexts. There is no call to discriminate against the panic disorder population with a specious and condescending distinction between cure and bandaid. The fixation on SSRIs as the one-size-fits-all treatment of about, choice for panic disorders is largely attributable to a marketing campaign targeting primary care physicians and their patients that was conducted for SmithKline Beecham (as the makers of Paxil were known at the time) by the Ruder Finn agency.
As Ruder Finn trumpeted until recently on a World-Wide Web site intended for ocr a essay structure advertising industry insiders, the Paxil for Panic Disorder program was one of the most spectacular successes of pharmaceutical blitzmarketing in the history of the industry. To quote from the Web site: The Paxil for essay about technology Panic Disorder program leveraged a new indication of an existing antidepressant for job in secondary a relatively obscure anxiety disorder to generate unprecedented product sales growth. Seven months after the panic disorder launch, The Wall Street Journal referred to panic attacks as the hot new malady that is quickly replacing depression as the mental illness du jour.. The objectives of the Paxil for Panic Disorder campaign are: Increase sales and overall market noise [sic] about Paxil by generating widespread awareness of FDA clearance of the medication's new indication as a treatment for panic disorder. Urge undiagnosed sufferers to see their physicians for a diagnosis and ask for Paxil.
Take advantage of seasonal and other opportunities. The launch phase of the program was also supported with a Morning Drive-Time Radio Tour in 18 cities across the country. Essay Technology In Life. A satellite media tour was considered [but dropped]. Tie in to the stressful nature of the holiday season. Sales growth of Paxil since May, which SmithKline Beecham describes as unprecedented, has been attributed by the company to the sales and std know-how and prevention essay public relations launch of the panic disorder indication. SmithKline Beecham saw its share of the total SSRI market share grow by about technology 8.7% and its share of new prescriptions grow 7.7% between April and November.
Note that by Ruder Finn's published report, SKB itself attributed the success of Paxil not to scientific or medical documentation but to its savvy sales and public relations launch. Dissertation. The clinical trials submitted as the about in life basis of the FDA approval and ensuing media blitz were three, and in them the drug was successful in eliminating or reducing panic attacks in do the write essay 2009, 25% (misstated as 76%*), in 51%, and in 33% of trial subjects on in life Paxil, versus 44%, 32%, and 14% of subjects on placebo. To specialists in the treatment of panic disorder, these numbers are anything but impressive #150; indeed if the writing assistance drug had been promoted on numbers like these rather than the sweeping generalizations primary care physicians hear from pharmaceutical salespeople, it is unlikely that much enthusiasm would ever have developed in the first place. Additionally, grave questions have since been raised about the integrity of the about technology in life research itself. * The company did not cite a figure for all subjects in essay, the first study, but instead counted only the one-third of subjects who responded best #150; and who were on a dosage intolerable to many patients. Thus the 76% for best-responders actually represents 25% for the study as a whole. (3/4 x 1/3 = 1/4) This little white lie is among the least of the essay about technology irregularities that have emerged in court cases involving the clinical trials of Paxil. The Ruder Finn campaign aimed to broadcast the cleaner side effect profile of Paxil, although the sad truth is that clinicians are largely in agreement today, about three years later, that of all the dissertation assistance commonly prescribed SSRIs, Paxil seems to have the dirtiest long-term side effect profile and the most problematic withdrawal. (The World Health Organization's statistics on about technology in life complaints about withdrawal put Paxil in a very clear #1 position.) Based on the difficult-to-ignore evidence of their own clinical experiences, primary care physicians are spontaneously moving away from Paxil in favor of milder or supposedly cleaner SSRIs. The plaintiffs in a California class-action lawsuit against assistance legal the makers of Paxil (seeking changes to labeling, release of embargoed data, and only modest monetary damages) intend to essay technology, introduce documentary and testimonial evidence: that Paxil performed significantly, indeed markedly, worse than placebo in its early trials, before statistical spin doctors were brought in to fix the problem; that when dozens of trials did not yield positive results, statisticians manipulated the numbers to produce hypothetical trials in which one single patient who endured or thrived on Paxil for 365 days would completely offset 365 patients who could not endure the medication for more than one day; that the makers changed numerous reports (adding up to tens of percents) complaining explicitly of withdrawal, as distinct from relapse, to instances of relapse instead; that the company suppressed evidence of a 0.77% incidence of suicidality (considered quite high for such a serious side effect, and later demonstrated to be even higher); that a certain identified FDA official illegally coached the makers of Paxil in clandestine conversations on how to avoid scrutiny on the suicidality issue; that the company suppressed information on jackson thesis a 20-25% dropout rate in early trials; that the company deliberately claimed on the record in an FDA hearing that it had studied withdrawal issues and found none, when in fact it had not studied withdrawal issues but had inadvertently become aware of frequent and severe withdrawal experiences; and that the company has systematically promoted the impression that the only people who become dependent on essay technology in life Paxil are multi-drug abusers, even though the company has abundant evidence (which it suppresses) that dependence and a pronounced neurological withdrawal syndrome are common. Frederick Jackson. As internal company documents have come to light in other civil and criminal trials regarding Paxil in the United States and other countries, it has become clear that the drug's makers possessed far more documentation of the drug's potential for adverse effects than they ever disclosed to the FDA, to the public, or to the scientific community.
There is obviously a place for the discriminating use of SSRI medications in the treatment of about technology in life, panic disorder. They are irreplaceable, indeed life-saving for many people. However, they have been prescribed indiscriminately and even recklessly in recent years. The appropriateness of their use has been greatly exaggerated and the long-term risks and brilliant essays sometimes severe dependence and withdrawal effects (which bear no resemblance at all to technology in life, the condition being treated) have been swept under the carpet for std know-how as long as humanly possible. The question is not whether there is a place for SSRIs in the treatment of essay about technology in life, panic disorder. Letter For Teaching Job In School. The question is what is the proper role of an advertising agency in in life, shaping medical opinion and practice in the treatment of neuropsychiatric disorders. On Benzodiazepine Treatment. By far the largest group of functional, well-controlled panic disorder patients who show up in the Internet support communities are those on a regimen of long-acting or short-acting benzodiazepines (or both). Write Essay Contest 2009. This parallels the technology conclusions of recent long-term reports following up on earlier studies and in some cases coming to do the thing contest, new conclusions.
The most common regimen among such patients is a long-acting benzodiazepine taken on essay a regular schedule, with a short-acting benzodiazepine to be taken for breakthrough symptoms. However, significant numbers do well on a regimen of short-acting or long-acting benzodiazepines alone. A substantial proportion of these patients take only brilliant solution essays enough medication to manage their autonomic arousal, thus breaking the autonomic link in the arousal-anxiety-arousal-panic cycle, and normally rely on techniques learned in Cognitive-Behavioral Therapy to manage the technology cognitive-emotional aspects of the do the thing essay 2009 condition. Many clinicians are reluctant to prescribe benzodiazepines long-term for panic disorder, despite abundant evidence that panic disorder patients respond better to this class of medication than any other group of patients and that panic disorder patients are the least likely to abuse these or any other medications. Essay In Life. The typical pattern is that panic disorder patients require some adjustment of dosage in the beginning of their treatment #150; either up or down #150; and then remain at or below that dosage for years. When considering research on benzodiazepines, there is every reason to look at research specifically into their use in panic disorder, because the patterns that emerge are quite different from dissertation writing assistance legal those that emerge when this class of medication is used to treat GAD or situational conditions. It is common for panic disorder patients spontaneously to reduce their medication after six months to a year, and to remain satisfactorily controlled at the lower maintenance dosage.
It is common for technology panic disorder patients to try to std know-how and prevention, eliminate their medication after a considerable period free of essay technology, symptoms, only to find that they must go back on their original level of medication. There may be a medication-free period of level history essay, success lasting months or occasionally years, but the condition eventually returns #150; sometimes with an intensity requiring more medication than before. Essay About In Life. Panic disorder, at dissertation legal, least in its biologically-rooted forms, is a chronic condition. Where normal individuals report a dulling of sensation from benzodiazepine treatment, panic disorder patients typically report that they feel normal again for the first time in years. Technology. This subjective assessment is often supported by an increased level of performance at work or in school. Such an dissertation writing assistance, assessment might even be regarded as a useful diagnostic factor. The baseline levels of autonomic arousal and of parasympathetic nervous system activity tend to be different in panic disorder patients from those found in essay, normal individuals, and that helps explain why benzodiazepine treatment can be not merely therapeutic but normalizing in the panic disorder patient, with a lower incidence of side effects than those experienced by the general population and an incidence of abuse so low as to be almost nil. Optimal cognitive and motor function require the nervous sytem to brilliant solution essays, be within a certain functional range of essay about technology in life, arousal. If you have just woken up from a deep sleep or you have just hopped off a treadmill after ten minutes of essays, running your fastest, your cognitive ability in particular but also your motor ability to deal with demanding tasks are both going to be well below adequate.
Your nervous system is outside its functional range of arousal. States of about technology in life, depression and application letter job in states of autonomic anxiety like those seen in essay about technology in life, panic disorder are analogous. Both may fall outside the optimal range of application letter for teaching school, autonomic arousal, or even outside the functional range. This explains why people with panic disorder often demonstrate improved cognitive or motor function when taking benzodiazepines. Learning is a particularly demanding task, and the brain is in life, biochemically inhibited from learning well when there are high levels of arousal-inducing hormones or neurotransmitters. Thus patients with panic disorder or a condition that mimics it may be unable to learn in an academic setting and unable to benefit from Cognitive-Behavioral Therapy (which teaches the brain new patterns of thought and new reflexive behaviors) until an appropriate dose of a benzodiazepine is std know-how, taken. Essay Technology In Life. The dose must be large enough to lower nervous arousal into the optimal range without being so large as to push it from over-arousal to assistance legal, a state of under-arousal.
Much of the early research on the use of technology in life, benzodiazepines in anxiety and panic was conducted with dosages that today appear stunningly high. Std Know-how And Prevention. It is strange indeed to read of studies using 6-10 mg of Xanax for panic disorder when today we know that the great majority of patients function optimally on 1-4 mg spread across 24 hours. Some patients require as much as 6 mg per day, but that is so rare that even the most benzodiazepine-friendly physician would almost certainly question the diagnosis or consider a different type of technology, medication. At present Xanax is the best-known benzodiazepine used against panic disorder (and the one that is FDA-approved for the condition), but perusal of early research into the use of Klonopin and other benzodiazepines against frederick jackson turner fronteir thesis panic disorder shows the same thing: the dosages tested tended to be far higher #150; 2x, 3x, or even 4x #150; than the dosages commonly used and known to be effective today. It is of course important to taper the cessation of about, benzodiazepines carefully. Papers on this subject report that a three-month taper is a reasonable standard, but that six months or a year is legal, not unreasonable for high dosages or long-term use.
In the essay about technology in life case of essay, panic disorder, there should not be undue pressure to get off of any class of medication, and about in life during cessation it is often difficult to distinguish withdrawal symptoms from symptoms of the underlying panic disorder (except in the case of application for teaching secondary school, discontinuing SSRIs, where the most dramatic withdrawal symptoms are clearly neurological and bear no resemblance to panic disorder or depression). A number of papers report that panic disorder patients are frequently withdrawn successfully from essay in life their medication only to have to go back on it at the same or a higher level half a year or a year or two later. These papers suggest that it is letter for teaching job in secondary school, probably healthier to essay about in life, maintain panic disorder patients at a constant level of medication, if no problems emerge, than to subject them to do the, this cycle of essay about, cessation and do the recommencement of medication #150; regardless of the class of medication in question. There are occasional patients who taper cessation of benzodiazepines over two weeks or less without difficulty. This is essay in life, definitely the exception, however, and should not represent an expectation. Such a rapid taper can be dangerous and even life-threatening. One sees a small number of panic disorder patients who do not tolerate benzodiazepines well.
It is widely regarded as canonical that benzodiazepines cannot be used in write thing, the treatment of patients with a history of alcohol abuse. However, with proper supervision, this is essay in life, not necessarily true. In fact, it turns out that benzodiazepine treatment for panic disorder can be a key to preventing alcoholic relapse. Abusers of alcohol who experience panic attacks may have been self-medicating for their panic disorder, and some even lose the desire to drink at all once the underlying state of arousal is controlled. This seems particularly true in the case of measured drinkers, those who drink regular amounts at dissertation writing, regular times of about technology, day. Both anecdotal reports and thesis published research emphasize that the technology in life definition and manifestations of tolerance, dependence, and addiction are commonly misunderstood among physicians and even among a surprising number of level essay structure, psychiatrists. In Life. Experts in the use of benzodiazepines report that tolerance normally develops to their sedative, cognitive, emotional, and do the essay contest 2009 motor effects, but not to the autonomically anxiolytic effects, i.e. not to their ability to interrupt the neurological panic circuit. Thus a patient may report drowsiness in the early days of treatment, but the drowsiness wears off. Once an effective dosage is found in in life, the first weeks of frederick jackson turner fronteir, treatment, this dosage (or, after a while, a lower one) will eliminate panic attacks and most dysautonomia for years and essay technology decades. Application. Patients on such a maintenance dosage should be regarded as medically dependent, just as many patients are dependent on glucophage or insulin or anti-hypertensive medications that exhibit a rebound effect on cessation #150; or on Paxil, for that matter #150; but should not be regarded as addicted in essay, the absence of all the other criteria that characterize addiction. The matter of dependence is letter for teaching job in secondary school, also put into a new light by the appearance of essay about, more and application letter secondary more studies (particularly, it would seem, in Britain) stressing the point of view that antidepressants also promote physical dependence in anxiety disorders.
A World Health Organization report goes so far as to state plainly that SSRI withdrawal is technology in life, a more difficult problem today than Valium withdrawal was in its time. Reports such as these call into question whether it is well-advised after all to promote antidepressants over benzodiazepines in the belief that ADs do not cause dependence. Application Letter For Teaching Job In Secondary. It is after all widely recognized that benzodiazepines are often more effective and technology in life work more quickly. It is the consensus within the panic disorder community that every medication that is actually effective in treating panic disorder has the potential to create dependence. Dr. Robert DuPont, a former director of the [United States] National Institute On Drug Abuse, has stated that the concept of using the application letter for teaching job in secondary lowest possible dose of a benzodiazepine for the shortest period of time is inconsistent with sound clinical practice. This concept needs to include the essay in life important qualification that our goal is to maximize the patient's ability to level history essay, function well and to essay about in life, enjoy life. Benzodiazepines are among the do the write thing essay contest 2009 safest and most effective treatments in all of medicine , including their role in the treatment of essay in life, panic disorder. He is joined in letter for teaching job in secondary, his opinion by many experts of comparable stature and by a World Health Organization report entitled Rational Use of essay in life, Benzodiazepines , WHO/PSA/96.11. (This consensus document from the WHO is distinct from the 1994 document Guidelines For The Rational Use Of Benzodiazepines authored by Dr.
Heather Ashton.) These medications are not a panacea and they are not without their potential drawbacks. However, they have been the subject of such a fierce backlash from their extravagant misuse and overprescription in the 1970s (similar to but exceeded by the SSRI bonanza of today), and have been the do the thing essay contest 2009 target of essay technology, such unscrupulous propaganda from the promoters of std know-how and prevention, other drugs which still, unlike most benzodiazepines, enjoy the profitability of patent protection, that most doctors are unfamiliar with the actual evidence that should govern their prescribing. The evidence clearly shows that at about technology in life, present there is no other class of medication that works nearly as well, in frederick turner thesis, nearly as large a proportion of the panic disorder population, as benzodiazepines; it shows that dependence is essay technology in life, real but is not unique to benzodiazepines and job in secondary thus not a major differentiating factor; and it shows that there is no other population less prone to addiction or abuse of benzodiazepines prescribed as part of a comprehensive management strategy. No discussion of benzodiazepine treatment would be complete without a brief mention of at least two quasi-cult-like self-help networks of individuals who claim that use of even very low doses of benzodiazepines for brief periods caused them permanent neurological damage and years or decades of anxiety and panic attacks a thousand times worse than anything they experienced before. (One wonders what they were experiencing before that could stand 1000-fold amplification.) With a vehemence and personally directed vitriol strongly suggestive of fanaticism, they reject any suggestion that they might instead be suffering from untreated anxiety or panic disorders, since the symptoms they describe when one pins them down to essay about technology in life, specifics sound very much like the symptoms of uncontrolled, advanced panic disorder. If this were all there were to the story, it would not be worth dignifying with mention here. However, this group cruises the Internet panic disorder support communities looking for std know-how essay newcomers and then bombards them with email offering self-help cures for prices that begin in the thousands of dollars and gradually decline, and terrorizing these vulnerable individuals with dreadful anecdotes that sound perfectly outlandish to about in life, pharmacologists and clinicians alike. Identifiable individuals who speak up against this group are deluged with organized hate mail, some of it threatening in nature. In this age when many patients research their conditions using the Internet (as well they should), physicians should know something about this bizarre phenomenon so that they can offer knowledgeable and brilliant solution convincing support to essay in life, patients who fall prey to these groups' terroristic tactics. On Treatment With Other Classes of Drugs.
Other classes of drugs are sometimes used in treatment of panic disorder but do not represent first-line choices. Other drugs used clinically or in research include anti-psychotics, beta blockers, CCK antagonists, alpha2-adrenergic agonists, and anti-epileptics. Although the std know-how and prevention essay author lacks statistical data, there are a notable number of reports from patients experiencing good results with Effexor XR (which seems for unknown reasons to behave very differently from its non-extended-release version Effexor), often after having bad results with SSRIs or simply having run the gamut of the major SSRIs, only to about, have each one in turn poop out (if the reader will excuse the scientific jargon) after a period that typically begins at a number of years but tends to shorten with each successive replacement drug. Some patients are also reporting good results with the RIMA moclobemide, and a few are reporting doing well with beta blockers. Reports of success with alpha2-adrenergic agonists are not common but do occur. This class of medication can be helpful in conjunction with other treatments. The same observations apply to beta blockers.
There is a small but growing trend to treat panic disorder with anti-epileptic medications. Success is mixed, but these medications are successful for an indeterminate proportion of panic disorder patients. There has been a puzzling surge of reports over the last year of letter job in secondary, doctors resorting to antipsychotic medications in the treatment of panic disorder, often before even trying all of the mainstay classes of medications, and often with unfortunate consequences. However, there are a few patients who do respond better to these medications and about need to use them despite their extensive side effects. A small number of patients have reported success with the opiate blocker naltrexone, which at ocr a, least theoretically could be of help to people whose symptoms are caused by stimulation from the opioid peptides in gluten or casein.. By patient accounts, the essay about least effective drugs commonly misprescribed for the treatment of panic disorder (although there are always exceptions), are BuSpar, Wellbutrin, and Serzone. Serzone has the particular complication, of which an alarming number of prescribing physicians seem unaware, of substantially inhibiting the metabolism of other psychotropic drugs, thus making it difficult to calibrate effective dosages. This is not to say that there are no panic disorder patients who benefit from these drugs, but they are a small percentage. There is a trend toward polypharmacy in the treatment of panic disorder, with drugs added to 2009, treat the side effects of drugs added to about technology in life, treat other side effects. Often drugs are piled on in an attempt to avoid or make acceptable the obvious but in some circles politically incorrect choice of benzodiazepines, or in blind adherence to the doctrine that SSRI medications simply must work for all.
The author has not encountered much anecdotal or published evidence that a polypharmaceutical approach works better than (or even as well as) the mainstay treatments, except for rare complex cases; and complex cases should absolutely be referred to a specialist in panic disorder. Complications of panic disorder can occasionally be severe and even life-threatening. Pharmaceutical industry insiders report that the next big push in anxiolytics will be the CCK antagonists. Already marketed successfully outside the United States for this purpose (as well as for treatment of GERD and IBS), these are reportedly intended for an aggressive push into the American market when a favorable point is reached in the product life cycle of the SSRI medications. (It is possible that this CCK-antagonist generation of anti-anxiety medications may yet be leapfrogged by a newer class of medications under development to target GABA receptors even more finely than existing drugs do, but new patent filings for CCK antagonists quietly continue to accumulate.) For the time being, the SSRIs are still among the most profitable of pharmaceutical products in the United States and brilliant are among the least vulnerable to competition. Their makers aggressively seek new areas of application for these flagship profit-makers.
But factors already at essay about, work to shift the market equilibrium include recently published major studies identifying the chromosomal locus and the importance in panic disorder, GERD, and IBS of defects in CCK metabolism, increasingly general awareness of SSRI complications, and the proliferation of thing 2009, lawsuits alleging improprieties in the conduct of clinical trials for SSRIs and the withholding of unfavorable research data. Essay About Technology. It is simply a matter of time before we see the next shift in focus. On Reported Effectiveness and Side Effects. It is write thing essay, evident to essay about in life, the author that at school, least in the case of newer psychotropic drugs, one should trust postmarketing research and the reports of experienced clinicians over the published results of Food and Drug Administration -supervised clinical trials for approval of new drugs. For instance, in the case of one popular medication, approval trials reported an incidence of sexual dysfunction well under 5%. Yet today experienced clinicians are in agreement that over the same length of time covered by the original trials, the true incidence of sexual dysfunction is at essay in life, least 60%. Some claim up to an 85% incidence in their practices. And such numbers have been substantiated in postmarketing research. How does one explain such discrepancies in the light of FDA oversight? Looking at clinical trials generally, without examining specifics of this particular medication, sources of such misrepresentation can lie along a spectrum ranging from poor research protocol to outright fraud.
In the fronteir area of essay about, protocol, test subjects for the medication above were not asked about sexual dysfunction and felt reluctant to bring it up, especially given the relatively short duration of the frederick turner fronteir thesis trial. And while randomization may have been scrupulous within the trial, it has come to light that all candidates for the study, whether they ended up on essay in life placebo or the jackson turner experimental drug, were carefully hand-picked for previously demonstrated tolerance of that drug's side effects. (As an essay about in life, aside, it is interesting to note that physicians participating in clinical trials state that the do the contest concept of double-blind placebo control is little more than a convenient fiction in the testing of psychotropic medications, and essay a somewhat ridiculous fiction at that. They say that in ocr a essay structure, most cases, the about in life high incidence of dramatic side effects with psychotropics makes it perfectly obvious to the health care personnel, if not indeed to the patients, who is taking the medication and who is taking the placebo. Dissertation Writing Legal. For this reason, drug-against-drug trials are often more useful.)
Looking again at the general case, there is also the question of fraud. Can this actually be a significant factor in American pharmaceutical testing? Doesn't the FDA ensure the validity and integrity of such testing? The General Accounting Office seems to think otherwise. The New York Times, in a 1999 series of articles on fraud in essay, drug approval trials, cited a GAO report criticizing the frederick jackson turner FDA for repeatedly failing to investigate whistle-blower reports of fraud and for colluding in some cases to cover up evidence of essay technology, its commission. According to the NYT, this GAO report concluded that the FDA was oriented toward overseeing methodological correctness and toward screening for scientific error, but was essentially helpless and disinclined to take action in the face of deliberate deception. As the NYT series documented, there are clinics that make a cottage industry out of manufacturing patients, complete with interview results and std know-how and prevention bogus specimens to go along. Whistle-blowers have faced disbelief, systematic discrediting, and retribution comparable to any found in defense industries.
Far from ferreting out and assuring prosecution of such fraud, certain FDA employees and about technology in life their supervisors seem to have facilitated its commission and dissertation writing cover-up, according to the GAO. This may be one reason that American pharmaceutical testing is viewed with skepticism in for instance Germany and technology Finland, two of the thirty-odd countries consistently recognized by the World Health Organization (and other international observers) as practicing higher standards of health care and governmental oversight than the United States. The FDA is just another government agency. While it is held in peculiar veneration by the medical community, there is no reason to expect it to be any more competent or any more scrupulous in its regulatory and inspection/examination activities than other agencies such as the Internal Revenue Service, the Department of Energy, or the Department of Agriculture. (Nor is there reason to expect it to be worse, although that is faint reassurance.) All of these agencies have many competent, dedicated, high-minded people trying to accomplish good things, but there is only so much that individuals can do in the face of entrenched bureaucratic culture. All of these agencies, including the FDA, experience periodic scandals around competence and integrity.
The FDA comes under blistering criticism from European medical authorities (not to mention domestic sources) for its pattern of write thing contest, approving medications for which pre-approval research demonstrated serious problems, only to end up withdrawing approval under pressure from consumer organizations after unacceptable levels of fatality or injury appear. It is naive to exaggerate the competence or integrity of the United States' drug approval and oversight compared to taxpayer service, oversight of the nuclear energy and weapons industries, or inspection of meat and essay about technology agricultural products. Many who work in subordinate roles in pharmaceutical testing claim that data and conclusions are routinely and unethically manipulated under the very noses of the frederick jackson fronteir thesis FDA. Diet and Supplementation. The mainstream view in the panic disorder community is about in life, that neither diet nor dietary supplementation is sufficient for the management of panic disorder, but that both can make substantial contributions.
There is a sizable minority, though, who find that it is legal, possible to manage their own panic disorder primarily or entirely with diet and essay about technology supplementation. The four most dramatic examples of dietary management are elimination of caffeine-like stimulants, adoption of a gluten-free/casein-free diet, supplementation with the amino acid taurine, and jackson turner adoption of a ketogenic diet. Each of these measures is helpful only to a subset of the panic-disorder population, a subset consisting of people with unusual sensitivities. Elimination of caffeine-like stimulants. Some people are exceptionally sensitive to the stimulants known collectively as xanthines, principally caffeine, theophylline, and theobromine, found in various combinations in coffee, most colas, tea (even green tea), and about technology in life chocolate. Write Contest. The panic disorder population appears to include a greater proportion of about technology in life, these people than the std know-how general population. People who are not caffeine-sensitive have a hard time appreciating the extent to technology in life, which the substance affects sensitive individuals. For some people, a single 12-ounce diet cola per ocr a day, the equivalent of about half a cup of American-brewed coffee, is technology in life, enough to keep symptoms of panic disorder active. Jackson. Quite a few people have reported that a single cup of about, decaffeinated green tea daily was the jackson fronteir thesis difference between experiencing heart palpitations and not experiencing them. Caffeine must be discontinued carefully. People seem to have the best success by essay technology in life tapering gradually #150; ounce by ounce at the end, if necessary #150; before completely quitting.
Many people take an NSAID like ibuprofen or aspirin for a few days starting the writing assistance legal day before complete elimination in order to avoid the in life ferocious caffeine-withdrawal headaches that can otherwise result. It takes 3-8 weeks for a caffeine-sensitive individual to ocr a history essay, return to essay about technology in life, true baseline functionality and write thing contest sensation after completely quitting caffeine-like stimulants. Prominent symptoms during the withdrawal phase are likely to include headache, depression, loss of energy and initiative, muscular stiffness, constipation, temporary changes in vision, reduction in essay, coordination, minor edema, sleeping several hours longer than usual, and markedly reduced athletic, physical, and mental performance. Because of the way caffeine affects biochemical production of energy to power muscle cells and brain cells, one is frederick turner, quite literally not as strong and not as smart during caffeine withdrawal, but full function does return after withdrawal is complete. At some point there may be a day or two of unaccustomed heart palpitations as the body moves minerals around, establishing a new balance of electrolytes. Essay About Technology. But when the withdrawal phase is over, there is normally improvement over pre-withdrawal function in brilliant solution essays, most of these areas. Many caffeine-sensitive people who complete withdrawal find that they are able to reduce or in some cases even eliminate their psychotropic medication. But this should not be an expectation; the reason to essay about technology in life, try caffeine-elimination and persist until withdrawal symptoms disappear is simply to feel better, function better, and quite likely lessen some of the dysautonomia. Gluten-free casein-free (GF-CF) diet. For Teaching Job In. It has been known for years that some patients' panic disorder (or GAD) improves with elimination of gluten sources and milk products. Only recently has a strong theoretical foundation for such observations emerged from research abroad and at a few major American medical centers.
It also turns out that truly aggressive dietary restriction, using the same vigilance a celiac patient must practice in avoiding even minimal, hidden amounts of gluten, benefits more people than was previously apparent with avoidance of only obvious, major sources. Technology In Life. Unfortunately there is std know-how and prevention essay, no quantification available yet, but it is an technology in life, inviting area for research. Patients who suspect gluten intolerance should have an inexpensive screening for IgG anti-gliadin antibodies before commencing the GF diet. With strict avoidance, the antibodies disappear in 3-12 months. However, one is still intolerant to gluten. It may be important to know one's status in that respect, since gluten intolerance is such a strong predictor or risk factor for other serious conditions including various forms of gastrointestinal cancer and a variety of autoimmune conditions. If celiac disease (one particular autoimmune consequence of gluten intolerance) is suspected, additional screening should be undertaken before commencing the GF-CF diet. Do The Write Thing Contest. A large proportion of people with very high levels of technology in life, anti-gliadin antibodies also have very high levels of antibodies to frederick jackson turner fronteir, casein. Even without such high antibody levels, the gluten-intolerant patient is likely to experience psychotropic effects from essay about casein, although the application letter for teaching job in secondary top American experts in celiac disease note that some patients recover the ability to tolerate milk products as their digestive tract regenerates itself. The amino acid glutamine is particularly helpful to patients with celiac disease, non-celiac gluten intolerance, or other GI problems that respond favorably to in life, dietary elimination. Do The Write. The digestive tract is one of the fastest-rebuilding parts of the human body and one of essay about in life, its principal building blocks is glutamine.
Even though glutamine sounds a little like gluten, it does not contain gluten. When pure it is a safe nutrient and actually an writing assistance, important nutrient for gluten-intolerant individuals. Taurine supplementation. Essay. Taurine was first tried in the treatment of panic disorder because it was known to be effective in the treatment of epilepsy. There are patients who control their panic disorder with nothing more than aggressive taurine supplementation. A number of other panic disorder patients find that they can reduce their medication with the help of taurine supplementation. Ketogenic diet. The overall healthfulness of a ketogenic diet is certainly debatable. However, it is clear that some panic disorder patients are able to control their panic disorder without medication by following a ketogenic diet, or more often a diet that is borderline ketogenic.
The reasons for the benefit of this diet are not known, although it is do the write thing contest 2009, well established that a ketogenic diet can also reduce or eliminate the technology incidence of seizure in epileptic patients. Many panic disorder patients report doing better on job in secondary reduced-carbohydrate diets that do not, however, go as far in this regard as many of the currently popular low-carbohydrate or high-protein weight-loss diets. Technology In Life. There is thing contest 2009, considerable research to suggest that this might be due to the fact that the insulin-glucagon axis influences a host of other hormonal and enzymatic systems. However, there has been little direct study of carbohydrate restriction in the treatment of essay about technology, panic disorder, and and prevention the only connection that seems obvious and likely to about in life, be uncontroversial is the adrenaline response that can be provoked by falling blood sugar levels. Further study will probably show this to be a highly simplistic interpretation. Magnesium supplementation. Some people find that supplementation with a small amount of magnesium reduces their symptoms, particular symptoms like heart sensations, muscle tics, and annoying nerve sensations. Ocr A Level Structure. Too much magnesium will cause diarrhea and exacerbate the body's imbalance of minerals, but just enough can noticeably improve nervous function in people who have a deficiency of magnesium in about technology in life, nerve cells. (The relationship between magnesium in blood serum and magnesium in nerve cells is a bit complicated and should be interpreted by a physician who can consider the full picture, including medications that may influence where your body stores the magnesium it has available.) Fat restriction, supplementation with essential fatty acids.
In cases of defective cholecystokinin metabolism, fat restriction is an important but insufficient measure for the prevention of panic attacks. On the other hand, in cases of panic disorder in families where schizophrenia is brilliant essays, present, it seems prudent to essay technology in life, follow a diet that is sufficient in application school, fat. There are anecdotal reports of panic disorder apparently being precipitated in such families, even relatively late in life, by adherence to the ultra-low-fat diets so recently popular, and there is solid evidence that schizophrenics do better on high-fat diets than on about in life fat-restricted diets. Jackson Fronteir Thesis. While the essay about in life author has uncovered no proof that a diet relevant to the care of do the write essay, schizophrenia is also relevant to the care of panic disorder in families where schizophrenia is present, it seems prudent, at this point in the understanding of such panic disorder and of schizophrenia, for panic disorder patients from schizophrenic families to about in life, follow the dietary measures that should be followed in schizophrenia. These include strict avoidance of casein (a milk protein) and jackson fronteir gluten and gliadin (a family of proteins found in wheat, oats, barley, rye, and about technology in life some exotic grains), and the inclusion of sufficient amounts of fat, perhaps above-average amounts of fat. Brilliant Essays. This has obvious implications for weight control but is documented as beneficial to essay in life, schizophrenics. Some mainstream medical sources also warn against supplementation of the schizophrenic diet with sources rich in the fatty acid GLA (gamma linolenic acid), principally evening primrose oil and borage oil. However, where the author has observed such warnings, they have occurred in contexts attempting to debunk the purported benefits of these supplements, and therefore the standard of proof was probably lower than if the authorities in question had been asserting a benefit rather than a danger. (In other words, there is in medicine, as opposed to the body of science proper, one standard of proof applied to a claim like substance X may cause hair to grow back on your balding scalp, but quite a lower standard of proof applied to a scare-claim like not only will substance X not cause hair to grow back on application for teaching a balding scalp, but furthermore, substance X may cause the hair you still have to fall out, and maybe your teeth, too .) Nonetheless, prudence should prevail. About Technology In Life. There is solid evidence that GLA is contraindicated in patients with seizure disorders, and it may be wise for the panic disorder patient from a schizophrenic family (or an epileptic one) to avoid GLA-rich supplements. Other dietary measures.
It is beyond the scope of frederick turner, this document to treat the full complement of dietary supplements being used in the treatment of panic disorder or investigated for such use. There are simply too many to discuss, and the results are too individual to essay about in life, each patient. It is frederick thesis, clear, however, that while different individuals respond to essay technology, different supplements, there are beneficial effects that go beyond what can responsibly or scientifically be attributed to brilliant, a placebo effect. The supplements that prove effective are not the technology in life obvious choices #150; for instance, only jackson thesis a very small number of people report significant benefits from the essay technology in life well-known anti-anxiety supplements like Kava kava or Passionflower. Of those supplements, patients typically report no effect whatsoever or a reduction in anxiety without a corresponding reduction in solution, dysautonomia. This poses an interesting conundrum for researchers who consider the dysautonomia of panic disorder to be caused by anxiety, and supports those patients (and some clinicians) who claim that it seems the anxiety is in life, actually caused by the dysautonomia. Nor does the antidepressant supplement St. John's Wort have very wide support among those who favor dietary supplementation.
One more often hears complaints of exacerbation of anxiety and letter job in secondary dysautonomia, or complaints of sleep disturbance with no effect on anxiety or dysautonomia. These are similar to, but much milder than, the complaints one hears from many (by no means all) panic disorder patients treated with antidepressants. Valerian fares somewhat better, but when used in doses sufficient to exert a beneficial effect, it is reported to cause more drowsiness than its pharmacological cousins the benzodiazepines. The currently popular 5-HTP has been variously described as either useful in the control of panic disorder or directly panicogenic. (Of course the same observation applies to 5-HTP's very distant cousins, the about in life SSRI medications.) 5-HTP administered without restriction of vitamin B6 has been linked to dissertation, heart fibrosis. Very recent double-blind, placebo-controlled research suggests that Gotu Kola is somewhat effective against the variant of panic disorder arising from the genetic aberration in essay about technology in life, cholecystokinin metabolism. This fits theoretical predictions, because Gotu Kola and a small number of other far eastern herbs have been demonstrated to compete with cholecystokinin at CCK receptors in the body.
So far there is assistance, little experience or consensus in the panic disorder community. Supplements more commonly reported to be mildly beneficial are those that support parasympathetic nervous system function (B-vitamins, alpha-lipoic acid, precursors or cofactors for the synthesis of in life, acetylcholine and nitric oxide), supplements promoting cardiac stability (Q10, carnitine), supplements soothing the write thing contest digestive tract (chamomile, bismuth, glutamine, MSM, occasionally peppermint - although the last can also be counterproductive)… It is simply not possible to do more than scratch the surface lightly in this discussion. There is no clear consensus and there are almost no formal studies of the effects of special diets or supplementation on technology in life panic disorder. However, clinicians and patients alike report that certain measures have an do the thing essay contest 2009, obvious effect for essay about certain individuals. One might suppose that panic disorder patients would be more susceptible than most to a placebo effect; but in ocr a level essay structure, fact, panic disorder is so difficult to control without medication, and about technology in life panic disorder patients are so reluctant to resign themselves to a lifetime of medication, that they often try many dietary supplements in a systematic fashion, generally rejecting the preponderance of them as ineffective.
For a panic disorder patient to report that a supplement is beneficial, even if it is not sufficient to fully control the condition, is an exceptional event that should usually be taken seriously #150; especially if it makes possible a lighter use of medication. One cannot easily feign control of panic disorder or delude oneself about essays, doing so, and about technology there is little incentive to try. Panic disorders are a family of disorders the understanding of essay, which is still in essay in life, its infancy. Much of what we thought we knew only a few years ago has been proven false. (In some cases the earlier understanding directly confused cause and effect.) There is structure, far more that is about in life, not known about panic disorder than there is that is known; however, a nascent body of research in several new directions is revealing some of the secrets. Panic disorder is not a monolithic condition. Few generalities apply to a majority of the application job in school panic population, but many generalities apply to sizable minorities within the population. Some cases of panic disorder fit the classical (since 1981, that is) psychiatric interpretation. Another set, quite possibly larger, does not, although this set has distinct subtypes for which it would be possible to develop a widely applicable diagnostic protocol. Nonetheless, by the time these disorders are diagnosed, they have almost invariably progressed to psychiatric dimensions. The disorders are polysystemic and usually require multi-modal diagnosis and treatment. Parasympathetic insufficiency, often hereditary, is emerging as a new and promising direction of investigation and treatment.
Problems in CCK metabolism have been linked to panic disorder by multiple independent researchers for some time now, but 1999 saw publication of a major study that claims to essay technology in life, have identified the level history structure genetic defect in question. The biological basis of panic disorder and the long prelude of non-paroxysmal dysautonomia that typically precedes it are only about in life beginning to receive the attention they require. It will be a tremendous step forward when there is application for teaching job in school, general recognition that treatment of panic disorder must aim not only at total elimination of panic attacks (or dysautonomic paroxysms) but at in life, elimination of the associated chronic dysautonomia as well. Beyond this, the goal should be much earlier recognition of chronic dysautonomia so that it can be treated well before it reaches a paroxysmal stage and the psychiatric complications that ensue. Structure. It is about, possible that focusing on the condition as chronic dysautonomia and its advanced stages as paroxysmal dysautonomia might facilitate such recognition and a shift in perception and attitude. It seems inevitable that subtypes of panic disorder will eventually receive individual recognition, naming, and treatment protocols.
Primarily for commercial reasons, funding for job in secondary school panic disorder research has lately been focused far too narrowly on the role and the promise of essay about, SSRI medications in treating panic disorder. This shift in focus to follow the letter school availability of about technology, research funding interrupted a number of other fruitful areas of earlier research. Dissertation. Nonetheless, the biological understanding of this set of disorders has reached a stage where researchers have claimed for some time now that this reigning emperor in the pharmaceutical realm is at best scantily clad. Apparently the essay about in life emperor's successor, in do the write thing, the form of CCK antagonists, has already been designated and is awaiting coronation, but only essay technology time and experience will tell whether the next panacea is more universally effective than the dissertation writing current one. The author is extremely doubtful that any panacea will ever be found for what we know today as panic disorder #150; it is too clear that distinct and distinguishable disorders are being carelessly lumped together as one. There is a wide open field of research investigating panic disorder and essay its comorbid conditions.
There is much yet to be discovered, and some of it will revolutionize our understanding of psychosomatic medicine and somatic anxiety in particular. Panic disorder of biological origin (which probably includes all or nearly all hereditary forms of the condition) is lifelong in nature. It does not begin when panic attacks begin, but most probably began years or decades before reaching that point. Remissions may occur, but relapse should be expected. This is true regardless of the method used in treating the essays condition #150; it is a myth that antidepressants provide a cure, except in a limited subset of cases where panic disorder is secondary to another condition. Untreated or under-treated panic disorder should be considered a serious and sometimes degenerative condition. It puts significant strain on a number of body systems, and about in life the goal of treatment should be not merely the elimination of panic attacks but the elimination of the underlying or associated autonomic hyperarousal as well. Cognitive-Behavioral Therapy or Panic Control Therapy is an important component of the treatment plan, even for panic disorder of biological origin. However, it should be recognized that such therapy is sufficient in for teaching job in secondary school, itself only in those cases that are primarily cognitive-behavioral in nature.
Now that biological bases for panic disorder have been identified and tools are emerging for their quantification, more research is needed to determine what proportion of panic disorder cases are in fact of biological vs. psychological origin. It may prove to be difficult to draw a clear distinction, since each type spills over into the other, but it is already evident that such a distinction is real and meaningful. It is high time to reopen the essay technology non-specialist community's mind about panic disorders and to do the write, move them from the exclusive province of psychiatry and psychology into about technology, the domains of neurology, endocrinology, genetic analysis, and probably other disciplines that will become apparent with further research. This is exactly what growing numbers of researchers and practitioners are doing. This document summarizes observations about brilliant, panic disorders and their treatment gathered during the years 1998 through 2000 from research papers, recent textbooks, mental health clinicians, patients, and essay about support groups. It is not intended to provide medical advice. Nor is it intended to advocate original points of view in and prevention, the scientific or medical arenas. In Life. Rather it is intended to integrate and disseminate a variety of emerging insights often omitted from the narrow classical view of these disorders. As the dissertation 2000's roll in, the understanding and treatment of this family of about technology in life, disorders (and they are multiple) is in clear and dramatic transition. Ongoing research about modalities of diagnosis and treatment is level history, beginning to bear fruit that will profoundly influence both the medical and psychological perspectives on these conditions.
The viewpoints advanced in this paper are for the most part not of the author's own invention #150; they represent viewpoints that have arisen and about technology show growing support in the researcher, clinician, and patient communities. In one sense, they represent a consensus; but in another sense, the term consensus is letter job in, misleading because the essay technology in life field is dissertation, still in turmoil, with different schools of thought pursuing different avenues of research and fighting to advance different agendas. This paper represents the essay about technology author's good-faith efforts to gather the points of ocr a essay, view that appear, in his lay judgment as a hardheaded observer and a patient himself, to essay technology in life, have the best foundation and std know-how and prevention most correspondence to the reality that he and countless other patients live every day. Essay About In Life. Sources, which are not cited, include published research papers (most available through MedScape or MedLine), published textbooks and trade books, articles in WebMD and the New York Times, the opinions of ocr a history essay structure, clinicians specialized or experienced in the treatment of in life, panic disorders, and the experiences of some hundreds of individuals who have shown up in various Internet-based support communities focused on panic disorders or other anxiety disorders. Citing of sources, which were not recorded during the author's odyssey through what was then unfamiliar territory, and many of which were reviewed long before the idea of writing this document was conceived, would have multiplied the complexity of compiling the document, greatly lengthening and delaying it as well. Such a format might also have given the appearance of advocacy in the scientific arena when the author's intent is write 2009, instead to provide a coherent overview of the about technology in life points of view advocated by professional scientists and clinicians specialized in panic disorders. Readers wishing to look up further information on one angle or another should not find it too difficult to do so through the resources above and through discriminating use of Internet search engines. Somewhat contrary to established practice, the author has chosen to brilliant, give considerable weight and exposure to consensus within the patient community. It is this community that lives the day-to-day reality of panic disorders, this community that feels the effects and the side effects of medications and therapies every day and technology knows the reality and nuance of our experience. Our doctors and application letter job in secondary therapists can (and certainly do!) try to tell us what we are and are not experiencing based on the most interesting presentation they attended at a recent conference, or on essay about technology in life the glowing reports of dissertation writing, a new medication (this one miraculously free of essay technology, all the side effects that have come to write thing contest 2009, be associated with each of essay about in life, its predecessors), or on the doctrines that have brought recognition and prestige to their alma maters; but we as patients have only legal one agenda, which is essay in life, a return to well-being and normality; and we have only one truth, which is the experience within our own bodies that most of our doctors and therapists will never (to their great good fortune) be able to do more than imagine.
(Note: It is true that individuals showing up in Internet support communities represent in some sense a self-selecting sample. However, the same observation could be made with equal or greater validity about the individuals who choose to remain in ocr a essay structure, treatment with a particular clinician or about those who choose not to drop out of controlled clinical trials. Indeed even a telephone book represents a self-selecting sample. Essay. Internet support communities in the aggregate do represent one of the broadest and most diverse sources of real-world information available and include a wide variety of experiences. Write Thing Essay Contest 2009. In the case of panic disorder, these groups include individuals who are well-controlled and those who are not; those who claim to be cured or in about, remission without ongoing treatment and those who do not; those who favor one class of treatment and those who favor another; those who agree with their doctors' assessment of successful or unsuccessful treatment and turner thesis those who make a different assessment.
Absent evidence of technology, systematic bias, the author considers Internet support communities to be a valuable source of solution, perspective among others.) Understanding of panic disorders is still in its infancy. The whole family of essay technology, disorders was more or less stumbled upon because of writing assistance, their severe manifestations in about technology, the psychiatric domain. But the more researchers investigate panic disorders, the legal more it becomes apparent that the psychiatric dimensions are merely the tip of a very complex iceberg. Technology. There is much disagreement within the researcher, clinician, and patient communities. The two or three orthodoxies that exist seem on std know-how and prevention essay closer examination to be illusory and shifting, and, unfortunately, are sometimes based on narrow samples or populations and essay in life are sometimes colored by and prevention commercial interests or professional vesting in certain doctrines.
Ultimately the viewpoints and conclusions presented here, which are meant to about technology, represent some diversity of opinion, are of the ocr a essay structure author's own selection and are not necessarily endorsed by any other individuals or institutions except where specifically attributed. So in essay about in life, one sense this essay is merely one person's collection of opinions. But this collection has been reviewed by researchers, clinicians, and patients alike; and while no essay could please all readers, and most especially not those who are vested in one particular point of view to the exclusion of others, the author feels reasonably justified in stating that in another sense, this document is job in secondary school, not only built largely on published research and teaching materials, but also does meet with general approval and endorsement from at least a substantial segment of the essay in life researcher, clinician, and patient communities. The online source for this document resides at http://www.panic411.org/ This document may be linked to or printed for limited noncommercial distribution by individuals.
Any other form of frederick turner fronteir, dissemination or republication must be authorized in writing.
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Importance of technology - UK Essays
ajax java resume My resume as PDF: I have been in constant contact with computer technology since 1983. In 1996 i made software development my profession and had the opportunity to get in touch with various technologies and methodologies in the IT and financial industry. About! I founded the assistance legal, enterprise Topincs GmbH in 2015 to technology, market my 4GL online database software. Dissertation Writing Legal! I am CEO of the Topincs GmbH, an enterprise for 4GL online databases located in Germany. I am freelancing as a software developer focusing on Internet, Java and semantic technologies. Deutscher Investment Trust , Financial industry. I was responsible for document and chart generation for a software supporting the work of essay technology in life financial advisors. My activities covered all stages of the development cycle. Credit Suisse Financial Planning Solutions , Financial industry.
I was responsible for do the thing essay contest, software development in the area of document and chart generation within a web application for financial consultants. Fields of activity were architecture, specification and implementation. Apollo Media Management , IT industry. I had responsibilities in development and customizing of a web application for media management. Other activities covered evaluation of new technologies and maintenance of production environments. I completed many development projects for essay about in life, Internet, database, and multimedia applications for various companies. Activities were database administration, programming and design, planning and developing client software, and consulting in questions regarding information technology. Statistics Formal logic Item response theory Design Technical writing.
German native speaker Fluent in English. Description: A software system for rapid development of web databases based on ocr a level, the semantic technology Topic Maps. Responsibility: Idea, conception, development, design, quality control, documentation, and marketing of the product. Solution of the following technical problems: automatic schema-driven form generation, integration of computational processes to support data viewing and recording. Description: A JSON data format for easy browser integration of the semantic technology Topic Maps. Responsibility: Coordination of the changes and technology, writing of the std know-how, technical specification of the new version. Adaptation of the existing validator. About Technology! Publication in the Internet. Description: A JSON data format for easy browser integration of the semantic technology Topic Maps.
Responsibility: Idea, conception and dissertation writing, development of the library. About! Description: A web based document management system for supporting the business processes in a direct bank. Responsibility: Concept adaptation and development of a solution for transforming existing VisualBasic forms to HTML. New development of two search masks based on existing concept. Bug fixing in various front end components and in structure, the NTLM Authentication. Advisor Insight Software documentation. Description: A Software to support the work of about financial consultants. Responsibility: Writing of the usage instructions of the software libraries for generating PDFs and diagrams and for completing PDF forms. Advisor Insight continuous development.
Description: A Software to support the work of financial consultants. Responsibility: Conception and continuous development of libraries for generation of charts, documents, and forms. Description: Online bookmark solution. Responsibility: Idea, conception, development, and marketing of the product. Description: A workbench for derivation of theorems of propositional logic. The calculus was developed by Charles S. Perice in the 19th century and application letter job in secondary, uses a graphical notation. Responsibility: Idea, conception and development. Description: A Software to support the essay about technology, work of history structure financial consultants. Responsibility: Development and conception of in life software solutions for generating PDF documents presenting results of analysis and projection and for displaying interactive charts in a Swing application.
Description: System for generating multilingual resumes in HTML and PDF. Responsibility: Conception and development of the solution. Application Letter For Teaching Secondary! PDF generation in financial planning software. Description: A software to essay technology in life, support the work of financial consultants. Responsibility: Conception and frederick turner, development of a software solution for generating PDF documents containing results of the analysis and projection. Description: A web application for a one step financial analysis. Responsibility: Architecture and development of the web application. Description: A web-based system for media search. Technology! Responsibility: Conception and development of a solution for importing media over the web. Description: A content management system for the online catalog of a home improvement chain. Responsibility: Conception, development and design of the content management system and of the online catalog.
Requirement analysis with the customer. Description: A media management system. Responsibility: Conception and development of a software component for ordering pictures online. Write Thing Contest! Print document generation in intranet application. Technology In Life! Description: Solution for generating reports of various kinds, e.g. certificates, participant lists, invoices. Responsibility: Conception and development of do the essay a software solution for generation of document based on manually adapted templates and a database. Description: An image browser application for Windows NT and essay technology, Mac OS with ordering functions. Responsibility: Continuous development of the application.
Database consultant for frederick jackson, a web application. Description: An online second-hand car dealer. Responsibility: Design and administration of the database and development of reports. Database administration and PL/SQL programming. Description: Solution for the storage and description of pictures. Responsibility: Realization of data migrations and programming of triggers and stored procedures in Oracle databases. Topincs: A software for rapid development of essay about in life web databases.
Connecting Topincs - Using transclusion to connect proxy spaces. Topincs Wiki - A Topic Maps Powered Wiki. Topincs - A RESTful Web Service Interface for Topic Maps. Cerny, R.: Topincs: A software for rapid development of web databases PDF. Cerny, R.: Connecting Topincs ? Using transclusion to connect proxy spaces . In Subject-centric Computing: Fourth International Conference on Topic Maps Research and Applications, TMRA 2008, Leipzig, Germany, October 16-17, 2008, Revised Selected Papers PDF. Cerny, R.: Topincs Wiki ? A Topic Maps Powered Wiki. In Scaling Topic Maps: Third International Conference on assistance legal, Topic Maps Research and Applications, TMRA 2007, Leipzig, Germany, October 11-12, 2007, Revised Selected Papers PDF. Cerny, R.: Topincs ? A RESTful Web Service Interface for Topic Maps. In Leveraging the Semantics of Topic Maps: Second International Conference on Topic Maps Research and Applications, TMRA 2006, Leipzig, Germany, October 11-12, 2006, Revised Selected Papers PDF. CEO Topincs GmbH, Germany.
Freelancer, Germany and Austria. Software Developer with Deutscher Investment Trust, Germany. Software Developer with Credit Suisse Financial Planning Solutions, Germany. Web Developer with Apollo Media Management, Austria. Erasmus Seminar for Mathematical Psychology, Austria. Applied Studies at the University of Vienna, Institute of essay about technology Psychology, Department of Statistics, Austria. Tutor for Statistics at the Technical University of Vienna, Institute of brilliant solution Statistics, Austria. Erasmus seminar for Mathematical Psychology, Netherlands. Tutor for Statistics at the University of Vienna, Institute of Psychology, Department of Statistics, Austria. Studies in about in life, Computer Science at the Technical University of Vienna, Austria.
Studies in Philosophy at the University of Vienna, Austria. Bachelor in Psychology. Studies in Psychology at the University of do the thing contest 2009 Vienna, Austria. General Qualification for University Entrance, Austria.
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The Influence of Technology on Our Lives Essay - 820 Words | Bartleby
SQL Server 2012, 2008, 2005, 2000, 7.0, 6.5; Oracle 11g, 10g, 9i, 8, 7; Teradata; Neteeza; SAP HANA; Hyperion Essbase; MySQL; MS Access; UDB; DB2; Sybase; Filemaker. SAP ECC 4.7, 6.0; Salesforce; Oracle ERP. MM, MDM, FICO, PI, PUR, COPA, CAPEX, MFG, SD, PP, QM, PM, MRP, UOM, WM, HCM, SCM, VM. Windows Server 2012/2008/2003/7/Vista/XP/2000/NT/98/95/NT; Unix/Linux; Mac OS; Mainframe. OLTP, OLAP, ODBC, ADO, RDO, OLE DB, SOAP, SSL, SAP Bank Analyzer, Forecasting, Trend Analysis, Star and essay, Snowflake Schemas, Executive Dashboards, CDC (change data capture), 3-Tier Programming, TCP / IP, FTP, HTTP, ISO, LDAP, SSO, RPC. Agile, Scrum, Waterfall, Inmon, Kimball, object oriented programming (OOD), rapid application development (RAD), Accelerated SAP (ASAP). Consumer Products, Banking, Lumber, Legal, Logistics, Health Care, Chemicals, Pharmaceuticals, Dept. of Defense, Energy, Electric, Automotive, Government, Politics, Insurance, Data Quality, Telecommunications, Building Materials, Financial Services, Commodities, Fleet Management, Furniture, Food Beverages, Mining, Coal, Debit Credit Cards, Pet Food, Animal Feed, Incentives, Marketing, Education.
Teradata Certified Professional, Teradata Certified SQL Specialist. Development of BODS objects supporting multiple change data capture styles that include thousands of mappings and over essay about, seventy SAP DSO destinations. All information sourced from and writing to SAP HANA. Created BODS specific portions of and prevention mapping documents, including CDC information. Design (modeling) and construction of SAP HANA tables, functions, procedures, and essay, views using a combination of Data Services, PowerDesigner, and do the write thing, HANA Studio. Performed modeling with HANA, using attribute, analytic, and about, calculation views. Migration of information from multiple source systems (out of essays SAP HANA) into SAP Bank Analyzer, with various data profiling and quality checks and use of a composite table to ease maintenance/LI Environment: Data Services (BODS) 4, SAP HANA, SAP Bank Analyzer, DB2, PowerDesigner, Windows 7. Creation of executive dashboard illustrating volumes, imbalances, accounting details, and customer information related to acquisition.
Improvement of existing dashboards – organization and technology in life, bug fixes. Ensured data accuracy and providing of most important and up to date details by meeting with business analysts and management in multiple locales. Writing Assistance Legal? Developed several multi-source IDT universes referencing relational databases, containing derived tables. Provided key and timely details in user-friendly dashboard to help management make informed decisions. Conversion of essay about existing dashboards from Xcelsius to Lumira, for comparison purposes.
Environment: Xcelsius 4.1, SAP Lumira, IDT, MS Access 2012, SQL Server 2012, Windows 7. Successful and rapid conversion of multiple Ab Initio processes to Data Services, implementing methodologies to increase maintainability, including simplification, logging, and inline documentation. Data analysis, modeling, and profiling using SQL Server and Data Services, to provide new and do the write 2009, improved structures and technology in life, aid in data quality checks related to conversion efforts. Cost savings through replacement of scheduler with scripting involving file watcher loops and, or database flag checks, moving files to essay staging and production folders, and emailing of results, including attachments. Technology? Executed technical leadership on the use of the technology platform and tools, mentoring in optimal use of fronteir BODS in a SQL Server, SAP, and Unix environment. Environment: Data Services (BODS) 4, SQL Server 2008, Oracle, SAP, Ab Initio, Acorn, Windows 7, Unix. Created and about in life, optimized executive summary and several linked dashboards, including hierarchical selectors, flash variables, and dynamic sales and marketing information based on live SAP BPC data. Built Crystal Reports detail reports connected to BI services pointed at Web Intelligence blocks containing BEx query details. Reports launched by history essay, and received prompts from Xcelsius dashboard. Acted as go-to for the team for technical concerns and about technology, idea development. Significant contributions to dashboard and ETL architecture and application job in secondary school, design, including best practices.
Constructed reusable templates to speed batch and real-time ETL development in BODS and provide auditing functionality. Led training sessions explaining usage of templates and about technology in life, gathering ideas for improvement. Environment: Data Services (BODS) 4, Dashboard Designer (Xcelsius), Business Objects 4 (WebI, UDT, IDT), Crystal Reports 4, SQL Server 2008, Neteeza, XML, Windows 7. Provided administrative assistance, including fixing of thing essay scheduling errors, performance tuning, permissions management, and migrating jobs between systems. Creation of new repositories and configuration of existing ones. Environment: Data Services (BODS) 4, Oracle, Windows Server 2003, Windows 7. Constructed website to create, update, and delete batches of listings to essay technology eBay through XML using the eBay API and process related responses.
Troubleshooting of reporting, universe, and ETL issues with onshore and offshore engineers. Environment: Data Services (BODS) 4, Business Objects 4 (WebI, UDT), Oracle, SAP BW and ECC, Windows 7. Acted as systems/software engineer for technology, system architecture planning, technical design, software development and test, and software, hardware, and interface integration. Installation and configuration of application letter for teaching job in secondary Business Objects Enterprise and Data Services, including Data Quality. Creation, improvement, and documentation of HR reports and related universe, including standardization and applying best practices.
Environment: Data Services XI r3.2, Business Objects XI r3.2, SQL Server 2008; Win Server 2008. Engineered conversion projects, using a self-designed standardized process, for migrating information between SAP 4.7 and 6.0. Essay? Converted information from SAP modules, including manufacturing, material master, basic data, fico, general plant, mdm, mrp, purchasing, qm, sales data, units of measure, warehouse mgmt, and work scheduling. Built and implemented validation projects to ensure quality data migration. For Teaching Secondary School? Frequent daily interaction with SAP functional analysts and business to review requirements and results. Environment: Data Services XI r3.2, Oracle 9i; SQL Server 2008; SAP ECC 4.7, 6.0; Win XP. Converted and enhanced Cognos into essay in life, WebI, Crystal, and Xcelsius reports with SAP data (HCM and SCM). Mapping of reporting requirements from frederick thesis, business terms into SAP objects.
Creation and maintenance of OLAP universes sourced from BEx queries. Writing and editing of SAP BEx queries using Query Designer. Writing of test scripts for essay in life, accuracy, formatting, and performance. Environment: Business Objects XI r3.2; SAP ECC 4.7 – HCM, SCM, SD; SQL Server 2008; Win XP. Guided and played key role in design document production, including ETL field mappings for 500+ fields in four systems (2000+ fields total), data dictionary, universe and report documents, and DDL scripts. Constructed universe and related star schema database, with focus on do the contest 2009, user-friendly configuration of classes and objects. Universe automatically updated with self-created automation tool. Essay Technology? Led report development effort, including creation of many Web Intelligence reports. Designed and implemented Business Objects architecture, including hardware and and prevention essay, software requirements, CMS information, security, and migration from XIr2 to XIr3. Championed standardization of essay field mappings, data dictionary, and universe and report documents. Coordinated offshore ETL efforts, including meetings and jackson fronteir thesis, answering of about technology daily questions.
Environment: Business Objects XI r3.2; SQL Server 2008; Designer SDK; Crystal Enterprise SDK, Win XP. Designed, created, implemented, and tested dataflows, workflows, scripts, and jobs for multiple projects. Write Thing Essay Contest? Troubleshooting and performance tuning which reduced several jobs from several hours to essay about in life less than one. Full lifecycle project focusing on surveys, including Data Services and Designer (universe) components. Migrated dataflows, workflows, scripts, and jobs between repositories. Environment: Data Services XI r3.2, Business Objects XI r3.2; SQL Server 2008; Windows Server 2008, Windows XP. Created and ran ETL jobs to load and manipulate Material Master and Vendor SAP information. Generated, put into successful production, and trained others in write essay contest data validation / testing tool, using Data Services and SQL Server procedures and functions. Administration and configuration of multiple datastores and servers.
Upgrade of essay about First Logic / Data Quality to Data Services, with data and multiple country address cleansing. Frederick? Developed, published, and scheduled batch and real-time jobs. Essay About In Life? Produced contact duplicate checking ETL project, including match transforms and adjustable parameters. Constructed dashboards to review data validation results. Environment: Data Services XI r3.1, 3.2; SQL Server 2005; SAP (extracts); Xcelsius 2008; Windows XP. Directed and coordinated organizational strategies of employees responsible for conceptualizing, designing, constructing, testing and implementing business and technical solutions for std know-how and prevention essay, telecommunications data. Partnered with software and about in life, architectural teams to writing assistance legal plan and build out new systems, understand scalability and constraints of software, and technology in life, manage disaster recovery and business continuity planning. Acted as key developer, leading a team of four (mostly remote) developers in dissertation assistance the creation of Webi reports, universes, and Xcelsius dashboards consisting of proprietary telecommunications information. Essay? Implemented ETL related to numerous systems, including creating and manipulating tables with raw SQL/SQL Server Integration Services (SSIS) and conversion of SAS into do the thing essay 2009, packages and SQL.
Guided and developed the Business Objects teams, including providing hiring recommendations, training, mentoring and monitoring staff performance to effectively adhere to essay company’s “best practice” initiatives. Environment: Business Objects XI r2 (Webi, Designer, CMS, Admin); Crystal Reports XI; Crystal Xcelsius 2008; SQL Server 2005; Teradata; SSIS; Netezza; SAS; Aqua Data Studio; Windows XP. Responsible for creating Business Objects universes and reports to provide information on clinical trials. Successfully migrated universes and reports from development to test to letter secondary school production. Essay About? Created Oracle functions and thesis, stored procedures to supply comma-delimited lists and date information. Created functional and technical documentation for all reports and universes, outlining processes to create an easily readable roadmap of all procedures for end users. Environment: BusinessObjects XI r2; Oracle 9i; ARISg; Windows XP.
Led efforts in the successful extraction and essay, transformation of information from Excel to SQL Server database, designing a database geared towards OLAP reporting and later Essbase loading. Created over two thousand transformations to alter information extracted from Excel. Developed ETL program using VB with features for brilliant solution essays, types of processes to display and run, status lists, storing metrics, HTML help, and essay about in life, options to brilliant skip process with errors to essay about in life convert text values to zero’s. Environment: SQL Server 2005; Visual Basic 6; Hyperion Essbase; Microsoft Excel 2003; OLAP; Windows XP. Responsible for gathering customer requirements, architecting prototypical solutions, acquiring customer acceptance, and managing software processes from initial design to final implementation and deployment. Primarily responsible for dissertation, migrating Sybase, Business Objects (6.x), and Oracle Sagent data warehouses to provide commodities-related financial information to client and essay in life, internal business users. Key Projects: Migrated three reporting systems to Business Objects XI and Crystal Reports XI, with Oracle 9i. Administration using Central Management Console to schedule reports, configure user and brilliant essays, group security, and manage categories, folders, universes, and licensing. About Technology? Created and tested reports and letter for teaching school, universes with information about commodities, futures, and options.
Installed, tested, and in life, maintained Business Objects XI (including Crystal) client and server software. Environment: Oracle 9i; Business Objects XI r2 (Webi, Crystal Reports, Performance Management, SDK); Sagent; Visual Basic 6; Scripting (VB, Java, batch); ASP; HTML; XML; CSS; SDLC; Cisco VPN; Windows XP. IT Consultant 1995 to 2006. Key Clients: LeasePlan, Lockheed Martin, WPAFB (Air Force), Haworth, HPFS, ATT, Travelers, CIT, Cigna, Anheuser-Busch, Peabody Group, MasterCard, Ralston Purina, Maritz, Davis Interactive Client:nbspnbsp LeasePlan -nbspAtlanta, GA,nbsp Business Objects Expert (2005 to ocr a level history structure 2006) Created a Business Objects data warehouse to provide leasing information to 100 key clients. Designed and technology in life, rolled out an innovative reporting system using Webi, including linked reports. Created conversion utility supporting improved (Excel) and brilliant solution essays, unavailable formats (Word and HTML). Client:nbspnbsp Lockheed Martin (US Navy) -nbspNew Orleans, LA,nbsp Business Objects Expert (2004 to 2005) Gained acceptance of a conversion of an Access reporting system into Business Objects. Developed, documented, and about technology in life, performance tuned thirteen reports and associated universes. Conducted qualitative and quantitative analysis to define project scopes and application letter job in, technical criteria. Created many Data Integrator jobs, workflows, and dataflows supplying source data for systems.
Collaborated with key internal and external decision makers to recommend process enhancements, including creation of technology in life conversion utility for perfecting Word and Excel files from Excel exports. Recipient of the “Lockheed Martin Outstanding Performer” Award (2004). Client:nbspnbsp WPAFB (US Air Force) -nbspDayton, OH,nbsp Business Objects Technical Support Analyst (2005 to 2006) Provided expert analysis and assistance for the Air Force Knowledge System application, supporting over 450 tickets arising from over dissertation, 300 users. Tested and troubleshot WIS and INF errors, training, and network, database and universe issues. About? Troubleshot invalid data resulting from universe and frederick jackson turner, database problems. Technology? Client:nbspnbsp Haworth -nbspHolland, MI,nbsp Data Integrator Developer (2005 to 2006) Gathered specifications and developed, tested, and rolled out transformations and brilliant, universes for AP, PO, and FA segments of Oracle Financials using Business Objects Data Integrator and Designer. About In Life? Client:nbspnbsp HPFS -nbspMurray Hill, NJ,nbsp Business Objects Expert (2003) Served as financial reporting analyst, balancing data related to a conversion of and prevention a loan system. Provided support to essay about users for report requests and maintenance, creating and testing 30 reports. Analyzed, documented, and implemented recommendations for SQL Server DTS scripts.
Client:nbspnbsp ATampT -nbspBedminster, NJ,nbsp Business Objects Expert (2003) Reporting analyst/administrator for a data warehousing project targeted to analyze and improve call center performance and processes. Responded to daily maintenance requests, streamlining processes through the installation, administration and configuration of Business Objects, including Publisher. Client:nbspnbsp Travelers -nbspHartford, CT,nbsp Business Analyst (2002 to 2003) Main point of contact in application letter for teaching job in secondary school a Focus mainframe, SAS to essay about in life client-server (Business Objects, Crystal Reports) migration and conversion of the Annuity Reporting System. Brilliant Essays? Collaborated with cross-functional teams to essay about technology in life develop 42 reports including prototype creation, testing, documentation, performance tuning, and requirements gathering and design. Conducted in-depth data analysis including data dictionary, physical data model, entity relationship diagrams, and PL/SQL queries for balancing and essays, reviewing integrity of data. About In Life? Client:nbspnbsp CIT Group -nbspLivingston, NJ,nbsp Business Objects Expert (2002) Served as lead financial reporting analyst in do the thing essay contest 2009 a Citation mainframe to technology in life client-server (ALS) Business Objects implementation of a data warehouse (Oracle, Sybase) for leasing. Partnered with end-users and level essay structure, key internal decision makers on requirements gathering.
Full life-cycle development and performance tuning of 54 flawless reports using Business Objects Reporter, Designer, Supervisor, and Broadcast Agent. Trained, mentored and monitored new and existing developers, instilling “best practices” to adhere to internal protocols and procedures. Client:nbspnbsp Cigna -nbspHartford, CT,nbsp Data Warehousing Consultant - Genio / Brio (2001 to 2002) Responsible for about in life, the enhancement and maintenance of a customized Brio data warehouse reporting application for investment data, including transforming source data (Genio). Gathered scopes and turner, specifications to test and provide daily support of Brio and Genio. About? Taught end users on the capabilities, enhancements, and limitations of Brio.
Client:nbspnbsp Anheuser-Busch, Inc. -nbspSt. Louis, MO,nbsp Senior Business Objects Developer (1999 to 2001) Implemented full lifecycle design of a 60 report data warehouse for pricing and promotions, that aided retailer sales tracking and marketing applications. Dissertation Legal? Administered Business Objects repository, security, setup, universes, and report scheduling, including an upgrade from essay, version 4 to dissertation legal 5. Constructed automated universe and report documentation with Business Objects SDK. Participated in Oracle ETL (transformation) related efforts, including creation of essay technology PL/SQL functions, packages, stored procedures, views, tables, indexes, explain plans, and types. Client:nbspnbsp Peabody Group -nbspSt. Louis, MO,nbsp Business Objects Developer (1999) Production included report creation, design, and solution, prototyping security, universe maintenance and origination, data definition and manipulation, testing and layout. Client:nbspnbsp MasterCard -nbspSt. Louis, MO,nbsp Consultant (1998 to technology in life 1999) Accountable for the conception of do the write contest financial reporting system and associated graphical user interface, generating financial reports using Crystal Reports, VB, and Oracle. Client:nbspnbsp Davis Interactive (Interchange Technologies) -nbspSt. Louis, MO,nbsp Consultant (1995 to 1999) Responsible for design and support of multimedia projects with Macromedia Director and VB. Created graphical user interfaces and database engines to interact with databases and kiosks.
Assembled software for reusable client incentive system (CIMS for Windows). Performed database administration, including backups, scheduling tasks, and setting up users and in life, groups. Thing 2009? Designed, developed, and tested reports and essay about technology in life, associated interface using Visual Basic and job in school, Crystal Reports. Produced reusable Visual Basic tools, including batch form dynamic link library, report executable creator, system administration form creator, data source creator, and SQL Server administrative software. Environment: Visual Basic 6; Crystal Reports; SQL Server 6.5; Filemaker; Windows NT.
B.S. Accounting; Minor: Business Management, December 1996. Recipient of Academic Scholarship. Tutor: General Statistics, 1995-97. Teradata Certified Professional; Teradata Certified SQL Specialist.
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Importance of technology - UK Essays
essay on essay in life, mat rempit Bagaimanapun, gejala ini mula menjadi serius apabila pengguna jalan raya yang tidak berdosa menjadi korban, seperti yang berlaku di Kelantan baru-baru ini di mana seorang kanak-kanak tiga tahun, Muhammad Aufal Khalifah Mohd Saberi, maut akibat dirempuh seorang mat rempit. Kini bukan sekadar mat rempit yang datang membawa masalah. Essay Structure! Tetapi juga golongan minah rempit turut memberi imej buruk kepada masyarakat kini. Essay Technology In Life! Minah rempit kini semakin berani meletakkan diri mereka di dalam carta ‘sampah masyarakat’ berikutan penyebaran beberapa klip video kumpulan itu di internet dalam keadaan memalukan. Jika sebelum ini banyak kumpulan mat rempit merakam aksi ‘berani mati’, kini minah rempit pula bertindak lebih dahsyat apabila secara sukarela membiarkan aksi jijik mereka dirakam dan kemudian dimuat turun di internet, termasuk laman web antarabangsa. Penyebaran klip video terbaru itu menunjukkan kumpulan rempit, termasuk minah rempit, semakin ganas dan sanggup melakukan apa saja untuk menarik perhatian masyarakat, seolah-olah perbuatan mereka sesuatu yang glamor. Aksi ganas minah rempit terbaru ialah pada 18 Ogos lalu apabila seorang remaja perempuan berusia belasan tahun menendang motosikal anggota Skuad 42 Polis Trafik Kuala Lumpur untuk menyelamatkan teman lelakinya ketika cuba ditangkap dalam operasi mencegah mat rempit di Bandar Tun Razak, di sini.
“Kanak-kanak seawal usia enam hingga tujuh tahun pun ada perasaan malu dan tidak sanggup membiarkan alat sulit mereka dilihat orang lain.“Apa yang mereka (minah rempit) lakukan memberi gambaran ada yang tidak kena dengan perkembangan kognitif (kemahiran berfikir secara rasional) mereka,” kata Naib Presiden Hal Ehwal Wanita Angkatan Belia Islam Malaysia (Abim), Dr Mastura Badzis. Dr Mastura yang terkejut dengan pendedahan itu menyifatkan pelakuan minah rempit terbabit satu petanda gejala sosial yang sangat buruk dan ketara. Katanya, pelakuan seperti itu mungkin dapat dielakkan jika ibu bapa minah rempit berkenaan mengambil berat pergerakan anak mereka.“Di mana ibu bapa mereka? Sepatutnya ibu bapa memantau pergerakan anak. Brilliant Essays! Ibu bapa perlu tahu di mana anak mereka dan dengan siapa mereka berkawan. About In Life! Sekurang-kurangnya tindakan itu mampu menghalang pelakuan seperti itu,” katanya. Azhanyzam berkata, ada kemungkinan minah rempit yang sanggup melakukan perbuatan memalukan itu di bawah pengaruh dadah.“Apabila dalam keadaan tidak sedar, mereka tidak menyedari perbuatan mereka. Letter Job In School! Suruhlah mereka berbuat apa saja, mereka akan melakukannya,” katanya.
Sejak isu mat rempit ini menjadi lebih panas dengan paparan di kaca TV tentang skill mat rempit beraksi dengan aksi berdiri, terbaring terlentang selagak superman, dan berbagai aksi skill yang merbahaya tapi mengkagumkan, isu ini mula mendapat perhatian sewajarnya. Essay Technology! Di tambah pula isu mat rempit merosakkan harta penduduk di Bangsar hanya kerana kerana di tegur supaya lebih berhemah… Remaja merempit untuk mencari keseronokan, kepuasan, kemasyhuran, wang dan perempuan. Thing Essay 2009! Kepuasan dan keseronokan untuk melepaskan diri sementara dari tekanan hidup.Mengecapi bentuk hiburan yang murah ..berbekalkan RM 4 untuk minyak dan keberanian untuk beraksi..ada yang mendapat habuan lumayan berupa wang dan perempuan. Technology In Life! Bukan semua berani mati begitu tapi wang taruhan dikumpul dikalangan mereka, menyuburkanlagi gejala ini. Kemalangan jiwa bukanlah menjadi galang untuk merempit, tidak sedikit rakan telah cedera atau maut, tapi kerana seronok, itu bukanlah menjadi masalah. Assistance Legal! Malah ada yang berbangga dengan parut dan berapa kerat tulang yang patah..Pengaruh rakan sebaya juga memainkan peranan untuk remaja terlibat sama. About Technology In Life! Kenapa tidak terpengaruh kepada rakan sebaya yang baik? Kajian oleh Dr Hassan Ali 1977 mendapati remaja mudah terpengaruh dengan gejala yang membunuh sahsiah.
Perubahan gaya hidup,ekonomi, institusi keluarga dan masyarakat adalah harga untuk sebuah kemodenan. History Essay Structure! Perubahan cara hidup dan corak asuhan mempengaruhi sikap remaja untuk bertindak. Essay About Technology In Life! Dunia yang makin hilang sempadan ini memungkinkan pelbagai unsur negative diserap ke jiwa remaja. Write Thing 2009! Kesibukan ibubapa mengejar kemodenan ada sehingga mengabaikan anak di rumah. About In Life! Kasih sayang yang hilang, jiwa yang kosong dan pelbagai godaan di luar menawan remaja untuk bertindak. Solution! Merempit salah satu alternatif yang ada untuk hilangkan kebosanan dan ketegangan di rumah.Merempit juga menjadi alat untuk mendapat perhatian ibu bapa. Amat sukar sebenarnya untuk menangani gejala mat rempit yang menjadi satu isu sosial yang membebankan. Essay About Technology In Life! Seperti isu sosial yang lain, isu mat rempit tidak harus dipandang ringan dan pendekatan mestilah dengan penuh rasa empati, mengambil pendekatan untuk mencegah dan membimbing. Essays! Memang diakui kerajaan telah melakukan pelbagai program untuk membendung masalah ini antaranya: memantapkan institusi keluarga dan komuniti dengan menerapkan nilai-nilai murni dan kesedran sivik antara programyang sedang berjalan ialah Program Khidmat Negara, Kursus bina Insan dan program rakan muda.
menggalakn amalan hidup sihat dan harmoni dari segi fizikal, mental dan rohani, antara program yang dilakukan ialh program cara hidup sihat. memperbanyakkan program komuniti yang melibatkan remaja untuk turut serta seperti Jiran muda rukun tetangga. memperkukuhkan program sukarelawan yang membutuhkan remaja untuk sama-sama melibatkan diri. In Life! Program sebegini mampu menanamkan rasa tanggungjawab dan membina sahsiah diri yang murni. penguatkuasaan undang undang, sekatan jalanaraya dan rondaan polis trafik merupakan langkah jangkapendek untuk mengurangkan gejala ini. Beban untuk mengawal masalah ini dari terus menular, bukanlah tanggungjawab pihak kerajaan semata-mata. Ocr A Level History Essay! Pihak lain seperti NGO, parti- parti politik dan ahli masyarakat, ibubapa harus berganding bahu dan patut memainkan peranan masing masing. Pada 9 Januari 2007, Menteri Belia dan Sukan, Datuk Datuk Seri Azalina Othman Said telah melancarkan program Sukan Malam bagi menangani masalah mat rempit di kalangan remaja. In Life! Azalina menyatakan bahawa kajian terkini Institut Penyelidikan Pembangunan Belia Malaysia (IPPBM) mendapati para belia amat berminat dan optimis terhadap sukan tetapi tiada kemudahan disediakan untuk mereka. Kita harus sedar ada ketikanya sesuatu perkara yang remeh atau kecil itu mempunyai rantaian kesan yang berpanjangan.
Demikian masalah mat rempit yang hangat diperkatakan sekarang. Dissertation! Isu itu menenggelamkan isu bohsia, bohjan dan lepak, walaupun ia masih wujud. About In Life! Sekarang kita boleh melihat pelbagai gejala sosial ini mempunyai pewaris tersendiri terutama golongan kanak-kanak. Frederick Turner! Mereka menggelarnya sebagai ‘rempit junior’. Essay About Technology! Saya sendiri melihat kanak-kanak berumur 10 tahun menunggang motosikal dan berlumba basikal pada waktu petang. Bagi ahli psikologi tentunya mereka memahami bahawa keadaan ini berupaya membentuk peribadi kanak-kanak liar dan tidak terkawal apabila semakin dewasa. Essay! Sebab itu kita perlu menghapuskan golongan rempit yang memaparkan contoh tidak baik kepada masyarakat. Jadi, mengapa hanya lesen digantung dan motosikal dirampas tanpa menghukum pesalah sebenar. Technology In Life! jika seseorang itu mempunyai kesedaran, walaupun memiliki motosikal dan lesen, mereka tidak akan membabitkan diri dengan lumba haram sehingga membahayakan pengguna jalan raya serta orang awam.
Ketua Polis Negara, Tan Sri Musa Hassan memberitahu, pegangan hidup kumpulan tersebut yang mementingkan kebebasan serta bergelumang dengan jenayah dikhuatiri akan meruntuhkan akhlak rakyat terutamanya remaja di negara ini kerana ia mula menjadi ikutan mat rempit. Menurut Musa, sehubungan dengan itu beliau menggesa orang ramai terutama ibu bapa supaya memandang berat perkara ini dan memantau kegiatan anak mereka supaya budaya kuning yang dibawa oleh mat rempit ini tidak menjadi ikutan anak mereka.Selain itu, Musa ketika membentangkan kertas kerjanya berkata, ketidakstabilan ekonomi di kalangan rakyat Malaysia sejak beberapa tahun kebelakangan ini dikesan antara pendorong utama kepada peningkatan kadar jenayah di negara ini. ‘‘Mereka datang ke sini untuk mencari pekerjaan tetapi bila tak dapat kerja mereka menganggur dan mula terlibat dengan jenayah seperti merompak kerana desakan hidup,'' ujarnya.Beliau berkata selain penghijrahan penduduk luar bandar, kebanjiran pendatang asing ke sini turut dilihat mendorong kepada peningkatan kadar jenayah di negara ini. ‘‘Rakyat asing yang datang ke sini juga banyak terlibat dengan jenayah rompak, duit palsu dan gaduh sesama sendiri.‘‘Ini amat membimbangkan kerana ia bukan sahaja meningkatkan kadar jenayah di negara ini tetapi turut memberi kesan negatif terhadap masyarakat,'' katanya. Tambah Musa, walaupun indeks jenayah semakin meningkat di negara ini tetapi peningkatan itu sejajar dengan pertambahan penduduk di sini. KISAH kaitan Melayu dan motosikal cukup menarik untuk dirungkai. Do The 2009! Ramai penunggang motosikal adalah orang Melayu. In Life! Meskipun orang Melayu paling ramai menggunakan motosikal, bidang penjualan, pengedaran, servis dan pembaikan motosikal tidak pula dikuasai Melayu.Kerana menggunakan motosikal juga, orang Melayu menjadi kaum yang paling ramai maut akibat kemalangan jalan raya. Orang ramai sudah lama kecewa dan marah kerana gejala mat rempit sampai tahap memudaratkan keharmonian dan keselamatan. Ocr A Level! Pelancong pula asyik tergamam, bagai tidak percaya bahawa itu juga menjadi ‘tarikan’ di sebalik slogan kelembutan, keramahan dan imej Malaysia negara Asia sebenar.
Yang hairannya gejala ini makin menjadi-jadi. Essay! Lebih membimbangkan, sebahagian mat rempit ini selalunya mengambil dadah. Application Letter For Teaching School! Tetapi pihak berkuasa masih gagal menanganinya, seolah-olah ia lebih rumit daripada menangani ancaman militan. Bukan bermakna pihak polis tidak bertindak bahkan ada anggota polis yang mati dan cedera parah ketika bertugas membanteras lumba haram. Essay About Technology! Sepatutnya ia tidak berlaku demikian apatah lagi berulang menimpa anggota polis dan ini secara tidak langsung menampakkan kelemahan pengurusan kita. Mereka sering dilabelkan sebagai kelompok tidak takut mati, tidak serik dan tidak pernah insaf. Ocr A Level History Structure! Begitulah sikap sebenar pelumba haram atau Mat Rempit yang tidak pernah puas menyusahkan kerajaan, membahayakan diri serta pengguna jalan raya lain.Lebih menyedihkan, majoriti golongan terbabit adalah generasi muda yang masih di bangku sekolah, mentah serta punya peluang membina masa depan lebih gemilang.Sayangnya, masa depan mereka dikorbankan di jalan raya atau hilang upaya pada usia muda kerana mengikut nafsu.
Kematian dan kecederaan membabitkan pelumba haram sungguh mendukacitakan semua pihak kerana golongan ini sebenarnya tenaga penggerak kepada ekonomi dan masa depan negara. Technology! Sebelum ini, pelbagai kisah hidup pelumba haram yang cedera parah dan kurang upaya dipaparkan di pelbagai media massa sebagai pengajaran, namun golongan itu tetap meneruskan aktiviti liar mereka demi kepuasan diri.Bagi mereka, berlumba haram satu kepuasan untuk menunjukkan kehebatan sedangkan jika semangat itu dimanfaatkan untuk pendidikan pasti apa jua dihajati mampu dicapai. Kes terbaru ialah kejadian malang menimpa Konstabel Meor Mohd Armi Abdul Latiff, 20, dari Cawangan Trafik Ibu Pejabat Polis Daerah (IPD) Johor Bahru Selatan yang parah dirempuh pelumba haram Januari lalu.Sikap berani tidak bertempat pelumba haram itu menunjukkan betapa mereka perlu dikenakan hukuman berat supaya insaf. Do The Thing Essay Contest! Kejadian seperti itu bukan pertama kali berlaku tetapi ia sebahagian daripada episod malang yang terpaksa ditempuhi anggota polis dalam membanteras lumba haram. Jika dibiarkan berterusan, sudah pasti aktiviti itu menjadi parasit kepada keharmonian masyarakat serta memburukkan pelbagai versi gejala sosial yang melanda remaja masa kini.Sebagai ingatan, pelumba haram yang ditangkap boleh didakwa mengikut Seksyen 42 Akta Pengangkutan Jalan 1987 (Akta 33), atas kesalahan memandu secara melulu dan membahayakan. Menteri Pengangkutan, Datuk Seri Chan Kong Choy, dalam kenyataannya sebelum ini berkata hukuman sedia ada masih dianggap terlalu ringan oleh golongan berkenaan.Berdasarkan undang-undang sedia ada, tidak ada sebarang peruntukan bagi menghukum penonton dan penganjur. Sebagai remaja, mereka memerlukan bimbingan daripada ahli keluarga sendiri untuk membina peribadi dan bukannya meniru acuan rakan lain.Jika tidak mampu membimbing atau mengawal, ibu bapa boleh menggunakan pendekatan kaunseling sebagai jalan keluar membantu anak mereka yang bermasalah. About Technology! Dalam masa yang sama juga penguatkuasaan perlu dipertingkatkan seiring dengan pindaan dilaksanakan supaya mereka terbabit dalam gejala itu tidak terlepas. Penguatkuasaan yang berterusan dilihat mampu membanteras gejala itu sehingga ke akar umbi serta memberikan kesedaran kepada mereka terbabit.Jika kerjasama serta penguatkuasaan itu seiring dengan usaha membanteras lumba haram sudah tentu ia mampu menyelamatkan ribuan anak muda daripada terjebak atau menjadi mangsa kepada keghairahan mereka sendiri.
thnx sebb wat blog nie..mudah saye nak wat esei.hehhe. tnks jgk coz lbh mmudhkan sya utk menyiapkn asgmnt. thank n congrate 4 da sebuah artikel yg padat n lengkap..yg mmdahkan saya nak wat esei.. sueaida on frederick jackson turner, January 23, 2010 at essay in life, 12:48 PM said. kan senang..acemen sye pon da nk ciap.. syukran..mtk izin copy nk wt asgnment..jazakallahi khasiran. thanx. Letter For Teaching! bagus articles ni. Technology In Life! all complete. Dissertation Writing Assistance Legal! senang nak buat assignment pendidikan agama islam. Essay About Technology In Life! padat dgn info. sHieLa on application letter job in secondary, May 15, 2010 at essay about in life, 8:05 PM said. saya tumpang copy sama. Dissertation Assistance! kena buat pasal sociomedical issue kat malaysia. Essay About! adoii.
emil on std know-how and prevention, June 2, 2010 at about in life, 12:35 AM said. lalalalala, gumbira hati ini, sbb saiment complete sbb artikle ni.. halalkan ap yg sy amik yea. Brilliant! thanks=)) tahniah kpd blogger!
Isi yg agak PADAT MEMBANTU saya dalam debate! (^.^) insan bertuah said. yahoo. Essay About Technology! mklumat ini dpt membantu sy dlm mnghadapi ppriksaan. mohon copy isinya ye. And Prevention! nak wat present. jika anda memasukkan pendapat tokoh-tokoh, ini lebih menguatkan fakta anda. Essay In Life! terima kasih, banyak pelajar dapat membuat rujukan. hehe..syukran ats maklumat ni.Padat dan lengkap. Jackson Thesis! nak minta izin amik mklumat leh x?nak siapkan assignment.hekhek.
tumpang lalu. Technology In Life! nak salin maklumat skit. ButTErwOrtH B-bOy said. aq tabik korg pnye hasil dan mmudahkan aq nk buat assignment. Application Letter Job In! tpi korang x pyah lah nk berpolitik sngat. Essay About! x yah nk salute sngt parti tu. Application Letter Job In! parti lain x ambik tindkan ke. Heaven on essay technology in life, October 6, 2010 at frederick fronteir, 1:35 PM said. nak minta izin guna maklumat yang ada untuk tambah isi dalam asignment. thanx for in life, ur idea there.. bagus smua..senang keje doh!!
puteri kemaman said. mntak izin copy. Application Job In Secondary School! tuk wat assgnment.. sya tumpang copy ye..tenkiu. tq2,,sng nop buat rncna..adios! mnta izn nak copy..nk wt assment untk current issue..hehehehe..tQ. syud syuhada on about in life, February 16, 2011 at and prevention, 9:15 PM said.
thnks. Essay About Technology In Life! memudahkan sya nak wat esei. syukran..kerana mnyediakan semua ini. Do The Thing Contest! izinkan sy copy ye. Essay About Technology! thanks. bella bear on dissertation, March 16, 2011 at essay about in life, 4:47 PM said. tanx coz g sy idea tox wt forum.. Farah Fateha on and prevention, June 10, 2011 at essay, 9:46 PM said. Thank you sbab bg saya idea untuk siapkan karangan :) tenqs . Do The Essay! . Essay About Technology In Life! mintak halal apa yg saya copy . Application Letter Job In Secondary School! . About In Life! :) tenggzzz a lott. Essay! mnta halal sy copy untk pnulisn sy. thanks! senang wat esaimen..hehe..
arap2 glongan ini brubahlah ingatlah mati. thaks,sebab dapat juga sy ciapkan asgment saya. Essay About Technology In Life! tq kpd yg bwat artikel ni. eew. Std Know-how Essay! its tooooooooo long u FUCKER BITCH SUCKING ASS BUSTed. About Technology! iDOItic Bull SHit. really help me. Assistance Legal! hehe..tq. nurul nadiah on essay about technology, April 6, 2012 at std know-how essay, 7:55 PM said.
mintak copy ye. Essay About Technology In Life! tq. thanks for std know-how and prevention, you essay!! waz really amazing and essay about filled with various facts too!!i've done my tuition homework!! thanks once again.