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Work related stress in healthcare Setting

Work related stress in healthcare Setting

Work related stress in healthcare Setting

Stress may be defined as the physical and emotional response to excessive levels of mental or emotional pressure, which may arise from issues in both the working and personal life. Stress may cause emotional symptoms such as anxiety, depression, irritability or low self-esteem, or even manifest as physical symptoms including insomnia, headaches, loss of appetite and difficulties concentrating. Individuals experiencing high levels of stress may experience difficulty in controlling emotions such as anger, and may be more likely to experience illness or consume increased quantities of alcohol (NHS Choices, 2015). In the UK a survey undertaken by the Health and Safety Executive (HSE) has estimated that in the year 2013-2014, 487,000 of work related illnesses (39%) could be attributed to work-related stress, anxiety or depression (HSE, 2014). Additionally the survey found that as many as 11.3 million working days were lost in the year 2013-2014 as the direct result of work-related stress (HSE, 2014).

Work related stress in healthcare SettingStudies have shown that healthcare professionals, particularly nurses and paramedics, are at an increased risk of work-related stress compared with other professionals (Sharma et al., 2014). This is likely to be due to the innate long hours and high pressure of maintaining quality care standards in the job, as well as pressures caused by staff shortages, high levels of patient demand, a lack of adequate managerial support as well as the risk of aggression or violence towards nurses from patients, relatives or even other staff (Royal College of Nursing (RCN), 2009). Indeed, a 2014 survey of nursing staff by the RCN showed that up to 71% of staff surveyed worked up to 4 hours more than their contracted hours a week, 80% felt that work-related stress lowered morale, and that 72% reported that understaffing occurred frequently in their workplace. As a result of these issues, 66% of respondents in the survey considered leaving the NHS or the nursing profession altogether (RCN, 2014b). A separate report by the RCN suggested that over 30% of absence due to illness was due to stress, which was estimated to cost the NHS up to £400 million every year (RCN, 2014a).

In addition to the physical and emotional symptoms of stress previously discussed, studies in this area have shown that nurses experiencing high levels of work-related stress were more likely to be obese and have low levels of physical exercise, factors which increased the likelihood of non-communicable diseases and co-morbidities such as hypertension and type 2 diabetes (Phiri et al., 2014).

Stress and staff absence

Chronic stress has been linked to “burnout”(Khamisa et al., 2015; Dalmolin et al., 2014), or a state of emotional exhaustion under extreme stress related to reduced professional fulfilment (Dalmolin et al., 2014) and “compassion fatigue”, where staff have experienced so many upsetting situations that they find it difficult to continue empathising with their patients (Wilkinson, 2014). As previously discussed, reducing staffing levels contribute to stress in nursing staff, and in this way chronic stress within the workplace launches a self-perpetuating cycle of understaffing; increased stress leads to increased illness, more staff absence and increased understaffing. In turn, these negative emotions also reduce job satisfaction and prompt many staff to consider leaving the nursing profession, further reducing staffing availability for services (Fitzpatrick and Wallace, 2011).

Studies amongst nursing staff have also reported stress occurring as the result of poor and unsupportive management, poor communication skills amongst team members, institutional and organisational issues (e.g. outdated or restrictive hospital policies) or bullying and harassment (RCN, 2009). Even seemingly minor issues have been reported as exacerbating stress amongst nursing staff, for example a lack of common areas to take breaks in, changing shift patterns, and even difficulty and expense of car parking (Happell et al., 2013).

Work related stress can particularly affect student or newly qualified nurses, who often report higher expectations of job satisfaction from working in the profession, they have worked hard and aspired to join, and are therefore particularly prone to experiencing disappointment on discovering that they do not experience the job satisfaction that they presumed they would do whilst training. Student and newly qualified nurses may also have clear ideas from their recent training on how healthcare organisations should be run and how teams should be managed, and may then be disillusioned when they discover that the reality is that many departments could in fact benefit from improvements and further training for more experienced staff in these areas (Wojtowicz et al., 2014; Stanley and Matchett, 2014). Nursing staff are also likely to, on occasion, find themselves in a clinical situation that they feel unprepared for, or do not have the necessary knowledge to provide the best possible care for patients, and this may cause stress and anxiety (RCN, 2009). They may also be exposed to upsetting and traumatic situations, particularly in fields such as emergency or intensive care medicine (Wilkinson, 2014).

Work related stressMoral distress can also cause strong feelings of stress amongst healthcare professionals. This psychological state occurs when a discrepancy occurs between the action that an individual takes, and the action that an individual feels they should have taken (Fitzpatrick and Wallace, 2011). This may occur if a nurse feels that a patient should receive an intervention in order to experience best possible care, but is unable to deliver it, for example due to organisational policy constraints, or a lack of support from other members of staff (Wojtowicz et al., 2014). For example, a nurse may be providing end of life care to a patient who has recently had an unplanned admission onto a general ward but is expected to die shortly. The nurse may feel that this patient would benefit from having a member of staff sitting with them until they died. However, due to a lack of available staffing this does not happen as the nurse must attend to other patients in urgent need of care. If the patient dies without someone with them, the nurse may experiences stress, anger, guilt and unhappiness over the situation as they made the moral judgement that the dying patient “should” have had a member of staff with them, but were unable to provide this without risking compromising the safety of other patients on the ward (Stanley and Matchett, 2014). One large scale questionnaire based study in the USA on moral distress amongst healthcare professionals has shown that moral distress is more common amongst nurses than other staff such as physicians or healthcare assistants. The authors suggested that this may be due to a discrepancy between the level of autonomy that a nurse has in making care decisions, (especially following disagreement with a doctor, who has a high level of autonomy), while experiencing a higher sense of responsibility for patient wellbeing than healthcare assistants, who were more likely to consider themselves to be following the instructions of the nurses than personally responsible for patient outcomes (Whitehead et al., 2015).

It is acknowledged that many individuals find that being asked to perform tasks that they have not been adequately trained or prepared for can be very stressful. As such management teams should also try to ensure as far as possible that individuals are only assigned roles for which they have adequate training and abilities, and support employees with training to improve skills where necessary (RCN, 2009).

Surveys have frequently reported that organisational issues such as a lack of intuitive work patterns, overloading of workloads and an unpleasant working environment can all contribute to work related stress. Organisations can reduce the impact of these by developing programmes of working hours with working staff and adhering to them, making any necessary improvements to the environment (e.g. ensuring that malfunctioning air conditioning is fixed), and that incidents of understaffing are reduced as much as possible (RCN, 2009). Issues such as insomnia and difficulty in adapting to changing shift patterns can also be assisted by occupational health, for example by encouraging healthy eating and exercise (Blau, 2011; RCN, 2005). For example, in 2005 the RCN published an information booklet for nursing staff explaining the symptoms of stress, ways in which it can be managed e.g. relaxation through exercise or alternative therapies, and when help for dealing with stress should be sought (RCN, 2005). More recently, internet based resources are available from the NHS to help staff identify if they need assistance, and how and why it is important to access it (NHS Employers, 2015).

Witnessing or experiencing traumatic or upsetting events is an unavoidable aspect of nursing, and can even result in post-traumatic stress disorder (PTSD). However, there are ways in which staff can be encouraged by their management teams and organisations to deal with the emotions that these circumstances produce, limiting the negative and stressful consequences of these events. This may include measures such as counselling or even peer support programmes through the occupational health departments (Wilkinson, 2014). Staff should also be encouraged to use personal support networks e.g. family, as this can be an important and effective source of support, however studies have shown that support within the work place is most beneficial, particularly if this can be combined with a culture where healthcare professionals are encouraged to express their feelings (Lowery and Stokes, 2005).

One commonly cited reason for work related stress amongst nurses is the incompetence or unethical behaviours of colleagues, and a lack of opportunity to report dangerous or unethical practice without fear of reprisal. Therefore it is important that institutions and management teams ensure that there is an adequate care quality monitoring programme in place, and a culture where concerns can be reported for further investigation without fear of reprisal, particularly with respect to senior staff or doctors (Stanley and Matchett, 2014).

It has been reported that in the year 2012-2013, 1,458 assaults were reported against NHS staff (NHS Business Service Authority, 2013). Violence and abusive behaviour towards nursing staff is an acknowledged cause of stress and even PTSD, and staff have a right to provide care without fear (Nursing Standard News, 2015; Itzhaki et al., 2015). Institutions therefore have a responsibility towards their staff to provide security measures such as security staff, workplace design (e.g. locations of automatically locking doors) and policies for the treatment of potentially violent patients e.g. those with a history of violence or substance abuse issues (Gillespie et al., 2013).

As previously discussed, nurses are more likely than other healthcare professionals to experience moral distress as the result of a discrepancy between the actions they believe are correct and the actions they are able to perform (Whitehead et al., 2015). However there are policies that can be introduced into healthcare organisations to reduce its occurrence, and the severity with which it can affect nursing staff. Studies have shown that nurses who were encouraged to acknowledge and explore feelings of moral distress were able to process and overcome these in a less damaging manner than those who did not (Matzo and Sherman, 2009; Deady and McCarthy, 2010). Additionally, it is thought that moral distress is less frequent in institutions and teams that encourage staff to discuss ethical issues with a positive attitude (Whitehead et al., 2015). For example, institutions could employ a designated contact person for staff to discuss stressful ethical issues with, or set up the facility for informal and anonymous group discussion, for example on a restricted access internet-based discussion board (Matzo and Sherman, 2009)

Conclusion

Work related stress is responsible for significant costs to the NHS in terms of staffing availability and financial loss from staff absence from stress itself or co-morbidities that can be exacerbated by stress (RCN, 2009), for example hypertension and diabetes (Phiri et al., 2014; RCN, 2009, 2014a). The loss of valuable and qualified staff from the profession is also a significant cost to health services, and of course exacerbates the situation by increasing understaffing further, which in turn increases stress for the remaining staff (Hyrkas and Morton, 2013). It can also exert a significant cost to healthcare professionals who experience it, in terms of their ability to work, their personal health, effects on personal relationships (Augusto Landa et al., 2008) and job satisfaction (Fitzpatrick and Wallace, 2011). However, organisations can implement recommendations to reduce work related stress, for example by encouraging a positive and supportive culture for staff by offering interventions such as counselling (Wilkinson, 2014; RCN, 2005). Furthermore, interventions such as encouraging the reporting of unsafe or unethical practice – a commonly cited source of stress amongst nurses (RCN, 2009; Stanley and Matchett, 2014) – may also contribute to improving the quality of patient care.

References

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Should Animal Experimentation Continue

Animal experimentations have been extensively used in medical researches and products testing since the early 1980s. However, the use of animals for scientific researches and products testing has only concerned with human benefits. How about the animal rights? Does human benefits always make it legal for us to intervene the animal rights? The issue whether it is ethical and necessary to use animals for sciences and products testing has been vigorously debated for a period of time. While Animal Rights Activist perceived vivisections has ethically intruded animal rights, Laboratory Animal Research of the United States National Academy of Sciences believed animal researches is essential in many areas. Europeans for Medical Progress which also opposing this issue reveals animal experimentations as inefficient and unreliable. This essay will outline and examine their views in order to come up with the writer’s own stand over dilemma of animal experimentations.

Laboratory Animal Research of the U.S. National Academy of Sciences argues that there are needs for animal researches to be continued to protect humans from diseases and dangerous products. They were saying that modern technologies such as sophisticated computers are still scarce to represent the interactions between molecules, cells, tissues, organs and organisms like vivisection does. Researchers claimed the experimentations were carried out based on ethical procedures outlined by law and thus deny the issue of cruelty and animals’ abuse involved during the researches. They also declare that most research does not involve pain and if so, the pain is alleviated with analgesic or anesthetic drugs. Scientists also argue about the similarities of animals and humans biology which has allowed them to develop new drugs, vaccines and help them to learn more about our bodies and how its function. According to American Association for Laboratory Animal Science, the data gathered are not only useful in understanding humans, its does also helpful in understanding our pets, wildlife and other animals too (Use of Animals in Biomedical Research: Understanding the Issues. n.d. p1).

Even though this issue has been vigorously debated for a long time, the solution to stop it seems still too far and complex. As the perception on ethics, animal rights, and animals’ welfare develops over the years, animals continues being used in research but perhaps conducted within scientific, humanely appropriate, and ethical principles. This improvement was evolved as a result from the introductions of Guide for the Care and Use of Laboratory Animals by the National Research Council (NRC) of the United States. This guide that concerned with animal rights provides the institutions with brief outlines to carry out the research within scientific, humane, and ethical principles. As an example, the introduction of three Rs method – replacement, refinement, and reduction – were designed as the core guideline towards humanely animal research studies (National Research Council, 2010).

In the 1950s, researches which involved separating infant monkeys from their mothers at birth has been carried out as a means to examine on maternal deprivation. However, most psychologists have strongly criticized this action because it is ethically wrong to experiment human psychological problems that concern familial, social and cultural factors onto nonhuman models. As there are evidences that proved animals also experienced the same range of emotions as humans, psychological animal experiments that cause to animals suffering can be considered as inhumane. Meanwhile, Animal Rights Activists believed animals deserves their right to be treated as humans. This includes the right to be protected from any form of soreness. In other words, animals should be regarded as humans being rather than property. Switzerland and German has taken some steps in correspond to this issue. In 1992, Switzerland has perceived animals as being instead of things or property (Kayasse, E, S, n.d), while German added animals’ protection under the constitution in 2002.

While Animal Rights Activists opposed animal experimentations with concern about animal rights, Europeans for Medical Progress has its own stand to disapprove the use of animals in scientific researches. As the technologies develop, there are increasing numbers of clinicians and scientists started to argue on the reliability of using animals in medicals and scientific researches. The survey conducted on 2004 has demonstrated the evidences that vivisection is inefficient and unreliable. Advancement in technologies nowadays has made dependency on animals for research can be considered as impractical anymore. Moreover, newly developed methodologies that is economical has provides compelling results compared to animal studies.

Mice have been used greatly in the laboratory as the most reliable creatures to do the research on. However, it was reported in the Lab Animal magazine that mice is actually a poor models in understanding the mechanism of infection and a means of treatments for common human cancers. It was proven that the differences between humans and other animals in crucial genetic, molecular, immunologic and cellular has unlikely provide effective result in seeking for the cancer treatments. Moreover, the effective treatment tested on animals has at worst reflected poor efficacy and excessive side effects when it is applied to humans. Since 1987, U.S. National Institute of Allergy and Infectious Diseases have funded more than 100 HIV vaccine clinical trials in humans. Even though more than 50 preventive vaccines and 30 therapeutic vaccines have reflected positive results against HIV/AIDS in animals, the clinical trials has failed to react in humans.

The similarities between humans and animals biology has enable the scientists to explore about diseases and formulate treatment for human needs. Nonetheless, this statement is not applicable anymore since there is increasing research results which demonstrated animal experimentations failed to prove its reliability in seeking for the cure. Even though the limitation of vivisection was proven, for some reasons this method of research keep continues. One of the most reliable organizations in the field has revealed the reasons why animal experimentations persist until now. According to the Medical Research Modernization Committee, animal testing is very important especially in chemical and pharmaceutical industries for their own benefits (Anderegg, C. et al. 2006, p19). It functions as legal sanctuary for the companies in cases of customers’ loss and disability caused by chemical used in the products. As the products were legally prescribed tested on animals, the victims have no right to prosecute against the company. Moreover, animal testing is retaining until these days for some motives that serve the researchers’ economic, professional and political needs. Clinical research that related to humans usually involve lots of expenses and time-consuming, otherwise vivisections can easily get publish within short period of time.

Massive development in technology and medical modern innovation at the moment has enabled the creation of alternatives which able to substitute the usage of animals in scientific research. Epidemiological is the most reliable and effective studies in identifying the underlying causes of human diseases based on human population records (Anderegg, C. et al. 2006, p15). The best way to study human diseases is none other but to closely monitoring human patients. Humane Society of the United States reveals that every year more than twenty-five million animals has been used for research, testing, and education purposes. Apart from saving thousands of animals’ life, epidemiological studies are more consistent to clarify the mechanisms, effective prevention and treatment approaches.

It is not necessary to examine animals to find out the causes of some diseases. As alternatives, the innovation of modern noninvasive imaging devices such as CAT, MRI, PET and SPECT scans have revolutionized clinical investigation and thus reduce the dependency on animals for medical research (Anderegg, C. et al. 2006, p16). In addition, sophisticated computer modeling has also replaced animal experiments which normally take months or years for the results that were just within minutes and hours now. Plus, artificial skin or “Episkin” invented by L’Oreal research team perhaps may gives some hopes to thousands of various animals from undergo lab trials (Episkin: Growing Skin in the Lab. 2007).

To sum up, even though Laboratory Animal Research of the U.S. National Academy of Sciences continues to experiment on animals within ethical procedures for the sake to seek treatment and protect humans from harmful product, animal experimentations should not be kept ongoing. Both arguments from Animal Rights Activist and Europeans for Medical Progress are irrefutable and concrete to rebut the Laboratory Animal Research of the U.S. National Academy of Sciences claims. Plus, strong supports from Medical Research Modernization Committee have provides undeniable facts regarding vivisections in reality. Without any hesitation, the writer believed that animal researches should be ended since newly develop technologies will overwhelm the limitation of animal experimentations which has now obviously considered as unreasonable anymore.

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Therapy On Military Veterans With Ptsd

The modern world is characterized with undesirable events and process such as wars, earthquakes, floods and other natural disasters. This paper focuses on the deadly warfare such as Vietnam War and their impacts on the soldiers who participated in them, as well as their families and acquaintances. Apart from deadly injuries sustained by the victims of these tragedies, long lasting psychological problems such as post traumatic stress disorders are also exhibited by the actual casualties, friends and their families. In realization of the detrimental repercussions of this phenomenon several years after their occurrences, scholars have come up with ways to deal with victims of the tragedies. This paper focuses on the various articles which illustrates history, and effects of PTSD. Various approaches of dealing with the disorders have been discussed in details. The approaches include, use of equine therapy, dog service and cognitive behavioral therapy. Also included in the paper are the procedures of dealing with PTSD, expected results and a conclusive discussion of the whole process. Ample references to reinforce the arguments in the paper are also provided.

History of PTSD

Post Traumatic Stress Disorder (PTSD), is isolation and an anxiety predicament that develop in individuals sometimes after experiencing extremely traumatic occurrences such as crime, combat, a natural disaster or an accident. Traumatic event is a painful catastrophic stressor that is outside the range of the typical human experience. The peril of exposure to distress has been part and parcel of the man’s life since mankind evolved as a species. Academicians believe that (PTSD) has a long history that encompasses different fields of study. Psychiatry is one of the core fields associated with the phenomenon. Research shows that PTSD dates back to pre-Christ times, and also proves that today’s experience and effects of the disorder were also experienced in the distance past. The implication is that, since time immemorial human beings have always succumbed to fears. For instance, history has it that individuals who lived during the stone-age were mainly hunters and gatherers. The same history indicates that the individuals used to experience nightmares after a terrified day of hunting. As a matter of fact very little about PSTD has changed over the years except that human beings have emerged as more complex creatures with more complicated abilities. This complication is as a result of brain advancement which actually improves the manner in which people deal with stress and traumatic events. For the longest time ever, international psychological organs have invested a lot of time trying to come into terms with PSTD and ways to deal with it. For instance, in early 1980s American Psychiatrist Association recognized the disorder as a mental case which needs urgent attention. Though controversial in understanding of the disorder, PTSD knowledge has filled a crucial gap in psychiatric hypothesis and practices. Furthermore, PSTD is still an important phenomenon that calls for attention from psychologists and other academicians (Brian, Stanley, Sue, Katherine & Jill, 2011).

Individuals with PSTD may relive the occurrence through invasive memories, nightmares and flashbacks. Such individuals avoid anything that take them back to the trauma; and portrays restless feelings that they did not show long before the event/ occurrence. The feelings are so deep that their lives are extremely disrupted. In case of military veterans, their work experience involves a lot of traumatic events, which are inevitable throughout their work life. Some of these events involve military wars where at times they do execute criminals as part of their job. In other instances, they go through tough moments trying to safe people from disastrous areas such as in an event of bomb blast. These experiences end up challenging them psychologically long after these events takes place. Hence, they do develop psychological illness such as the PTSD. Equine therapy is one of the treatments that can be applied in dealing with PTSD. Equine therapy is a psychotherapy applied on horses, but research has shown that the same treatment can help military veterans recover from the traumatic events that they experience in their career. Consequently, various institutions have been set up in different parts of the world so as to provide these services. The effects of Equine Therapy depend on how it is applied. The analysis in the succeeding section focuses on some of the institutions that provide treatment and the effect of those services.

EAGALA Military Services

In an attempt to streamline many of equine-assisted schemes across the board, and assist active military, veterans, their families and the families of the diseased obtain the much needed therapy services, Equine Assisted Growth And Learning Organization has established EAGALA military services. The nonprofit making association was founded by Lynn Thomas, who became the executive director of the organization. The military task of the association focused on five key sections: community education, research, government relations, program development and member training. This population has been working with Equine professions and EAGALA Certified Mental Health unit, since 1999 to date. The services have always revolved around the provision of emotional treatments, behavioral and mental challenges ranging from TBI, depression, addiction to combat grief, misery and family trauma, reintegration to PTSD. Occurrence of PTSD might be as sky-scraping as 20% in military veterans of the famous Operations Iraqi as well as for the Enduring Freedom veterans. This is according to National Centre for PTSD. The centre also indicates that, PTSD among the Vietnam veterans might be as high as 30%. Despite these alarming rates of PTSD, a recent RAND report indicates that only few soldiers have sought the necessary treatment (Korinek, 2012). Consequently, more than 1000 soldiers have committed suicide.

In response to the high level of deaths out of PTSD, EAGALA has called upon all the interested stakeholders to exhibit the replica of Equine Assisted Psychotherapy (EAP). The model makes use of ground-based practices where the natural horses act as metaphors. These involve representing associations with unit members or family, fears, aspect of self or strengths. Academicians and scholars believe that horse therapy can be essentially more effective than conventional talk therapy. They also claim that horse therapy can be applied as either a short-term move for those already facing re-deployment, or as a long term approach treatment helping several in reintegration into family life and civilian (Santaquin & Utah, 2011).

According to survey program carried out by Asylum Services, an EAGALA military veteran Services plan located in Texas State, past only six programs, military veterans and their partners reported around 60% progress in harshness of marital challenges comprising, financial disputes, physical abuse, verbal abuse, parenting choices and forgiveness. Couples also reported around 50% perfection in emotional closeness, conflict resolution, sex, trust, anger and respect. An officer in the study stated that the forum provide a safe environment for him to open up because without it then it could be tricky to face reality. He also said that occasionally, the horses talked for him and assisted him to cope with his family challenges (Santaquin & Utah, 2011).

Jimmy Walters, a USA veteran, indicates that EAGALA Model makes use of the horse to achieve insight into perceptions and behaviors. According to Jimmy the reaction of the horse provide real time and unbiased feedback, breaking via the barriers that a lot of military people experience in discussions with others, who might not acknowledge what the veterans who made it back feels. Jimmy also notes that EAP provides a plan for coping with trauma in a manner that shows some sense to military veteran members. Another 23 years old active duty affiliate of Special Forces also proved that Equine Therapy works even for the active military people. He said that horses could understand his feelings and accept him; a phenomenon which he found very strange. As a result, the officer claims that the therapy has not only made it possible for him to re-connect with his family and himself, but has also made him a crucial tool in the military (Santaquin & Utah, 2011).

Ladies also have something to say concerning equine therapy. Julie Giove Sardonia, a Californian therapist, claims that since many veterans dislike talk therapy, then horses as therapists are the best in serving these military veterans. She also concluded that healing occurs naturally, particularly for the military veterans. Hence, a relationship of a soldier with a horse can offer self-understanding and emotional insights. Susan T. Lisi, a Chief Steward in VA Medical Center located in New York, affirmed that they conducted several EAGALA EAP programs with their veterans emphasizing on dealing with resilience, resources and anger management. She adds that comprehensively, veteran partakers have claimed that never ever have they found an individual session or a group so life-changing and useful. She also adds that after these sessions, several of them reflect recurrently on the skills and experience learned and then applies them in their lives. Another female soldier who was identified with PTSD after serving in the military for seven years also gave her side of the story. She claimed that she had been to numerous therapists and nothing seemed to come out of it. However, when she tried horses, it worked for her. These are some of the real life stories which portray the effectiveness of equine therapy on military veterans with PSTD (Santaquin & Utah, 2011).

High Hopes Therapeutic Riding

High Hopes Therapeutic Riding is an institution that provides equine therapy services to female veterans suffering from PSTD. In this discussion, a life story of a lady by the name Katye Zwiefka and her friends provides an overview of how Equine Therapy works for the veterans. Zwiefka had served as a marine corps for years before she joined High Hopes Therapeutic Riding. After Zwiefka had ridden a horse for the first time, she cried out of joy. She compared the good feeling to the pleasure she felt as a youngster on an early Christmas morning. Katye affirms that that It had been a long ever since she had that feeling; just that thrill and that excitement, that happiness that is uncontaminated by the humanity (McDermott & Jennifer, 2012).

Zwiefka who had been struggling with PTSD for years turned to the center hopeful that she would find psychological support that she needed. She was not alone in the centre but she was accompanied by another veteran, Khaylan Widener. Khaylan also said that linking with the horse has assisted them deal with the isolation and anxiety and isolation they have experienced while serving in the military (McDermott & Jennifer, 2012).

Zwiefka, describe the military life as that of total isolation where it is completely difficult to connect with people. She says that even at the age of 30, she still find it hard to feel comfortable and at peace with the surrounding. Her life is made even worse by the nightmares that accompany her dreams. She says that the nightmares makes her extremely uncomfortable, and hence, hard to go back to sleep. It is this desperation that pushes her into seeking professional assistance. However, with the horse riding, Zwiefka feel relaxed and forget all the stress that characterizes her daily life. She says that by thinking about riding then everything falls into its place. In fact, the thought of the smell of her horse makes her feel at peace with herself and with the surrounding (McDermott & Jennifer, 2012).

Widener has the same story as her colleague Zwiefka. The two met at Norwich vet centre where they had gone for counseling. The centre is run by the United States of America Department of Veterans Affairs and is meant to assist veterans such as Widener. She too was struggling with PTSD some few years after she was involved in the Iraq issues of 2007 and 2008. In the mission, widener lost eight of her closest friends, who succumbed to attacks from their enemies. The incidence demoralized widener more so because she lacked the support that she needed at the moment. As if that was not enough, widener also experienced another scenario that left her in a delicate health condition. This happened when she fell of a truck in Iraq during an attack by a rocket-propelled grenade. The tragedy made her suffer a traumatic brain injury which really affected her health. In general, her five years service in the army was not a good experience because it was full of tragedies and inhuman experiences (McDermott & Jennifer, 2012).

It is in the year 2009 that widener officially quitted from the military work. She is now 28 years and lives in Norwich. At this age it would be expected that she would be happily married and taking care of her own family. However, widener’s life is different from that of a typical woman because she still cannot find happiness; even though she is a mother of one and a wife. Widener feels that this abnormality has a lot to do with her military life. Nevertheless, she seems to have found a solution to her challenges the moment she enrolled for the Equine Therapy. She looks at the exercise as an opportunity to work through her issues without being criticized or judged. During her initial days in the center she made it a point of interacting with the members of the institution. These are especially children with disabilities such as cerebral palsy, autism and attention deficient disorders. By interacting with these children, Widener developed her skills of socializing with people (McDermott & Jennifer, 2012).

Apart from improving on her socialization skills, widener has been able to appreciate herself. At one point she says that riding helped her to be herself. She describes riding as a practice that has the ability to reveal a positive part of her that she had even forgotten that she possessed. In fact she claims that she was a social butterfly long before she joined militarily. Conversely, everything changed drastically because when she came back from the military she was extremely withdrawn. All in all, she is now able to appreciate her ability to lead a normal free from trauma (McDermott & Jennifer, 2012).

Zwiefka and Widener act as examples of many women who have benefited from the equine therapy. All of them have been able to recover or are in the process of recovering from post traumatic stress disorder. It should be noted that psychologically, horse riding is more effective in dealing with PTSD than talks. In fact, many of the military veterans are not sociable and that could be the reason as to why horse riding works with them and not the therapy talk.

Horses for Veterans

A Pentagon Channel documentary focuses on how veterans with PTSD are finding assistance via the supremacy of horse therapy at the Flag is Up Farms. A Horse Whisper by the name Monty Robert explores the effect of Equine Therapy on military veterans with PTSD. The study involves veterans of all ages. Robert thinks that the number one thing is to work with military veterans who have already lost hope in life. Robert demonstrates this by using abused and extremely mistreated horses; a technique he refers to Joining Up method. He adapts it specifically for the self-isolating military veterans experiencing post traumatic stress. His agenda is on learning to trust humans not by force but rather by choosing to trust them. Through the use of horse’s language or the trauma of the military veteran to converse, he supplemented, his plan engenders trust. He says that when horses trust you they will move towards you rather than keeping a distance from you. Roberts refer to horses as flight animals which are afraid of anything which does not earn their trust. That behavior matches perfectly well with the behavior of a military veteran. These individuals are never comfortable with anything they do not trust or understand. He also dislikes the traditional way of handling horses and advocates for the nonviolent approach. He thinks that veterans too need this approach to deal with their trust issues (Department Of Defense, 2012).

Alejandra Sanchez, a veteran, is a regular visitor to Flag is Up Farms, but recalls her foremost occasion as if it was in the recent past. She affirms that she has never been so frightened in her life; not even as it was in her Iraq experience. She recalls that her anxiety and isolation was via the roof, since she had to face the fact that she had PTSD. Since then nightmares challenged her throughout the night. In one instance, she remembers a nightmare that reminded her of how she had reached a point of desperation while in Iraq. Sanchez describes how life of a veteran is hard because of being forced to work with individuals you do not understand. This is on top of the fact that there is lack of trustworthiness between a veteran and those around them. Coming from such a difficult life, Sanchez looks at horse riding as the trickiest thing. She could not find it easy to calm herself down in order for the horses to trust her. However, she knew very well that while she was angry, anxious or violent; the horses could not corporate. That was the beginning point of her recovery from PTSD. She is now the humble character that any horse can trust. As a matter of fact, equine therapy has positively changed the life of Sanchez (Department Of Defense, 2012).

Alicia Watkins is another veteran who experienced the worst of the military life. She joined military as an outgoing and a fun loving woman but came out of it as totally different character. She says that her experiences in Afghanistan and Iraq were not the best because they left her traumatized than ever. After the noble military service, Alicia became an isolated character who was homeless and spent a year in her car because she had lost her dignity. Life was so difficult for her that she had reached a point where she felt like committing suicide. These near death experiences were averted drastically when she made it a point to attend to Roberts’s program.

Initially, it was not easy for her to deal with the horses. However, she was positive about riding and eventually she made it possible to bridge the psychological gap between her and the outer world. She can now talk to people freely without fear or distrust. She can also be able to deal with her challenges without complication. These are some of the numerous positive things that Equine Therapy brought to her life. Robert indicates that Equine Therapy does not help the veterans to forget the past but rather it help them to mask the trauma with positive behaviors. He illustrates this by use of the horses’ experiences. Roberts indicates that horses that were previously mistreated do not just forget the mistreatments, but the nonviolent treatment makes them to trust people again. That is the same way that equine therapy works for the veterans (Department Of Defense, 2012).

Therapist Using Horses in Treating PTSD

According to Bough, the author of this article, one may look hale and hearty physically, but it’s probable that, yet without either physical stress manifestations; traumatic experiences and stress can exhibit themselves in humans and horses. However, Bough looks at Equine Therapy as the only solution for the PTSD. The treatment makes it possible for the horses and human beings to interact and solve any trauma or stress (Baugh &Ben, 2009)

Suze Maze, a psychotherapist and horseman possesses a wide knowledge; essential in dealing with trauma. Veterans have Suze to trust with their disorders. For instance, she is able to assist soldiers from Fort Gordon after returning from Iraq military service. Maze learned about Equine Assisted Psychotherapist while living in Kentucky via the EAGALA model, and afterward became certified. The name of her dealing is Horse Empowerment. According to Maze, the impacts of long-term and recurring deployments can be exhibited in the workplace, however, the phenomenon also affect families of the soldiers. Maze learned these facts at a time while she was living with individuals who were struggling with alcoholism and drug addiction. As such Maze finds it extremely important to form a platform where people who had lost hope in life could find necessary help. She looks at the military occupation as one of the noble career, where individuals put their lives on danger for the sake of the society at large. She also found it crucial to devise ways to deal with challenges faced by families of the veterans (Baugh &Ben, 2009)

Maze uses her long experience to prove the fact that Equine Therapy is the best treatment for veterans and their families. She looks at the positive aspects of the horses that make them key in dealing with post traumatic stress disorders. For one, Maze notes that trust is one thing that veterans need to develop. Maze indicates that soldiers in the service are taught not to trust anybody not even their closest friend. The notion grows slowly by slowly while in the military. This notion is very healthy for them while at the military, but it turns out to be a challenge when they get out of the army. Conversely, horses need to trust people or else they flee from those they do not trust. Thus, horse riding helps soldiers to start trusting people again. Maze notes that horse riding involves doing a task, where all the five senses are involved. She also advocates for a classical therapeutic office model to be taken out of the framework and positioned in the ring with horses, permitting the patient to interrelate with the horses as well as a professional squad with at least a licensed psychological health expert and at least a horseman specialist. Maze notes that the objective of all these is to serve military people and even those civilians undertaking treatment, with a defensive safety measure. The wish is that the modality and treatment will assist service people make an easier changeover from warfare to garrison life. Eventually, Equine Therapy is able to achieve all these aspirations in the most efficient way possible. As a result, it provides the best option for military veterans experiencing post traumatic stress disorders (Baugh &Ben, 2009)

War Veterans get help from Rick Iannucci’s ‘therapeutic riding’ program

The article is authored by Reese, and emphasizes on the effectiveness of equine therapy on dealing with post traumatic stress disorder. The author makes uses a life story of Rick Iannucci, who is the current director of Cowboy Up, which is a horse equine therapy program for warfare military veterans. Rick describes horse therapy as the excellent means that help PTSD to recover within a very short period of time. He uses the words of Winston Churchill (a military man in the Boer war), who stated that there is great about the outer surface of a horse that is excellent for the in part of a man (Reese & April, 2011).

For two and a half years, a flow of Afghanistan and Iraq war-veterans have found their means to Rick. A lot of them get there carrying both psychological and physical scars of warfare. First, they learn to walk and groom the expressly skilled quarter horses, and then the veterans work out their means up to riding and mounting them around the ring. As the military veterans link with the horses, on top of learning how to understand them, they start to heal and feel related with the civilian world once more (Reese & April, 2011).

Rick affirms that Horses will only corporate with you; if you are not uptight. This is because they wheedle a certain degree of contemplation from individuals. In other words, horses demand to see veterans come into terms with the reality. As a rule, when the military veterans begin riding and associating with the horses, they instantly begin calming down. Despite the fact that the majority of the veterans arrive at cowboy up with physicals disabilities; they all recover through the use of Equine Therapy. In his study, Rick rebrands PTSD as post-traumatic spiritual disorder (PTSD). This because he tend to believe that what happens to soldiers during the warfare is a spirit’s wounding. Therefore, he thinks that their main goal is to find that wound and heal it. Iannucci and his team integrate psychological, physical and spiritual healing. Ricks describe it as having faith again in others, themselves and faith in almighty God. He advocates for horse riding as the only mechanism that can enable veterans to achieve this wonderful life requirements. The ability of Equine Therapy to deliver veterans from PTSD is emphasized by victims of the disorder such as Sterling Bucholz. He was assisted by Rick to recover from military trauma through the horse riding technique. Many other examples prove that Equine Therapy is effective in assisting veterans suffering from Post-Traumatic Stress Disorder (Reese & April, 2011).

Military Service, Post-Trauma Symptoms and Health in Older Adulthood: An Analysis of Northern Vietnamese Survivors of the Vietnam War

Vietnam war-induced anxiety influences mortality, morbidity, psychological state of affairs and value of life in the long run is understood roughly entirely as a product of psychoanalysis of the lives and healthiness of American military veterans of 20th century wars. Studies reveal that, over thirty years past hostilities, Post-Traumatic Stress Disorder (PTSD) proves to be a noteworthy predictor of every cause, cancer, cardiovascular and external root mortality amongst United States veterans involved in Vietnam War. These facts prove that the repercussions of Vietnam War were detrimental and needed attention. This papers focus on the most viable solution for the military veterans of the war (Korinek, 2012)

Procedures: The pilot study consisted of 2 phases. First, conducting structured interviews with 310 people, age 55 and above. 215 respondents of the 310 were successfully interviewed. Out of the 95 charged with attrition cases, 81 people had died by the time of this study while the remainder had moved outside the commune. Surprisingly, 75% of the decedents were not military veterans. In an attempt to meet a target sample range of 400 respondents, 196 individuals aged 55 and above were randomly chosen from existing household registration mechanism. 91 of them were successfully interviewed making up a total of 405 respondents. Included in this total is 19 proxy interviews conducted with next of kin. This was in cases where a respondent was too mentally or physically unfit to be interviewed however, Questions concerning perceptions and feelings were not responded to by the proxies. In examining the connection between military service, distress exposure and health conditions, military service was characterized using 4 categories militia nonveterans, non-militia, combat veterans and noncombat veterans. To determine exposure to war-time stress events, the study relied upon a modified report of PTSD module of the World Health Organization findings recorded by Composite International Diagnostic Interview (Korinek, 2012).

Results: Focusing on relationship between military service and trauma risk, the sample splits along gender lines. From the study, more than half of the males are armed military veterans, and virtually one third worked in combatant sections. On the other hand, less than half of the sample consisted of women, either as armed officers or in other military roles. The difference explains why 87 percent suffered from trauma while only 13% of women were dealing with PTSD and related disorders. In general, this populace of older generation had extremely prevalent exposure to stressful events throughout their life course (Korinek, 2012).

Statistically, a considerable association of war traumas with undesirable health among men is evident. The study also proves that long lasting effects of warfare on health and chronic illness several decades past the war are more perceptible amongst men who experienced combat exposure than in women. In addition, the war had disruptive effects on certain groups of people that are not may not be well expressed in a population-based sample. Such groups include: those orphaned at a tender age and those who sustained serious injuries in bombing campaigns or in other combat events (Korinek, 2012).

Conclusion: As a matter of facts, Post Traumatic Stress Disorders diagnosis and label is not easily transported linguistically and culturally. The cultural lens via which sadness, dreams and other mental and psychological conditions are interpreted will influence stress experienced and the tendencies to remember and disclose them. It can also be concluded that lasting physical and psychological pains of war can have culturally discrete roots. Therefore, it is important to perceive physical and psychological aspects linked to war from a Vietnamese spiritual lens and cultural perspective. Lastly, it is no doubt that this research has implications that extend clear of the Vietnamese context hence, it can address more challenges than just the few outlined therein (Korinek, 2012).

The Effects of Animal-Assisted Therapy on Anxiety Ratings of Hospitalized Psychiatric Patients

According to the authors of this article Barker and Dawson, Animal-assisted therapy comprise association between a trained animal and patients, along with the animal’s human handler or owner, with an objective of enhancing patients’ progress on the road to therapeutic objectives. This study scrutinized whether a program of animal-assisted therapy lowered the anxiety or nervous intensity of hospitalized psychiatric patients, as well as whether any disparities in declines in anxiety were correlating with patients’ diagnoses.

Procedures: The study subjects used were two hundred and thirty patients referred for therapeutic exercise sessions. A pre-treatment and post-treatment intersect study design was applied to compare the results of a particular animal-assisted therapy program with those of a solitary frequently scheduled therapeutic exercise program. Before and after partaking in the 2 types of programs, subjects completed the condition degree of the State-Trait Anxiety Inventory, which is a self-report examination of anxiety presently felt. Blended-models repeated-measures psychoanalysis was applied to test discrepancies in scores from prior to and past the two categories of sessions.

Results: Statistically considerable declines in anxiety scores were established subsequent to the animal-assisted therapy program for patients with mood disorders, psychotic disorders and other forms of disorders, and following the therapeutic recreation program for patients suffering from mood disorders. On the other hand, no statistically significant discrepancies in decline of anxiety were established between the 2 types of sessions.

Conclusions: Animal-assisted therapy was linked to reduced condition anxiety intensities for hospitalized patients suffering from a range of psychiatric diagnoses, whereas a routine therapeutic exercise session was related to reduced intensity, only for patients suffering from mood disorders (Barker, Dawson, 2011).

This study scrutinized 2 Tele-health interventions to deal with symptoms of combat-associated posttraumatic stress disorder (PTSD) in military veterans. Thirty-three men combat veterans were at random allocated to one of two Tele-health treatment situations: mindfulness or psycho-education. In the two conditions, partakers completed eight weeks of Tele-health treatment, which is, two sessions individually followed by six programs over the telephone. The eight weeks treatment was followed by three evaluations, which include pretreatment, post-treatment and finally a 6-week follow-up. The mindfulness healing was founded on the tenets of mindfulness-based anxiety reduction while the psycho-education guide was based on regularly applied psycho-education tools for Post Traumatic Stress Disorder.

For the 24 partakers who completed all evaluations showed that: (a) Tele-health appears to be a viable mode for relief of Post Traumatic Stress Disorders treatment for veterans; (b) Veterans suffering from PTSD have the capacity to bear and report high fulfillment with a concise mindfulness involvement; (c) partaking in the mindfulness involvement is associated with an impermanent decline in PTSD symptoms (d) A concise mindfulness treatment cannot be of sufficient intensity to cause effects on PTSD symptoms (Niles, Klunk-Gillis, Ryngala, Silberbogen, Paysnick, & Wolf, 2012).

The Physical and Mental Health of Australian Vietnam Veterans 3 Decades after the War and Its Relation to Military Service, Combat, and Post-Traumatic Stress Disorder

The long-term health repercussions of warfare service remain unclear, despite escalating scientific interest to reveal the underlying facts. A study of a random model of Australian Vietnam militarily veterans was planned to assess military veterans’ postwar mental and physical and health more than36 years past the war and to scrutinize its connection to combat, Army service and Post-Traumatic Stress Disorder evaluated 14 years earlier. Prevalence’s in 450 veterans were contrasted to those in the Australian broad population. Military Veterans’ Army service and information from the first evaluation were assessed using complex logistic regression projection modeling. Servicemen’s health and some health hazard factors were inferior and medical talk rates were superior to Australian populace expectations. Out of 67 long-term cases, the prevalence of 47 was superior and the occurrence of four was lower when contrasted to inhabitants expectations. Nearly half of all military veterans used medication for mental comfort. The occurrence of psychiatric diagnoses surpassed Australian people expectations. War service and Military characteristics as well as age were the mainly common predictors of physical health terminals, whereas PTSD was mainly heavily linked to psychiatric cases. In comparison Draftees had superior physical healthiness than habitual enlistees although no better mental fitness. War-related PTSD and Army service are associated with danger of ill health in later life amongst Australian Vietnam war veterans (Brian, Stanley, Sue, Katherine & Jill, 2011).

Service Dog Training Program for Treatment of Posttraumatic Stress in Service Members

As a matter of facts, only two uses of dogs are widely recognized, which include a dog as a pet and use of the animal by police officers to track law offenders and locating victims of disasters. However, it has been realized that dogs can deal with challenges faced by traumatized individuals such as war veterans. This article focuses on how dogs are used to provide treatment to service men with PTSD and other related disorders (Patricia, 2012).

According to National Education for Assistance Dog Service, a fully trained dog can help veterans with mental or physical problems both during rehabilitation and after they return to civilian life. This dogs provide physical and emotional support, hence, restore the serviceman’s self-confidence and dignity; necessary to move into next chapter of life. On the other hand, The Worrier Canine Connection plays the role of training service members with PTSD, how to train service dogs to serve as source of help to physically handicapped soldiers. The secret behind use of the dogs in treatment of mental problems lies in the fact that dogs are lively pets. This makes them good to interact with veterans, essential because service men are denied that opportunity to socialize during wars. In the interaction process veterans regain their lost confidence and lead a normal life (Patricia, 2012).

Cognitive Behavioral Therapy

Post-Traumatic Stress Disorder is a problem that affects the majority of the member of the society. As such, several psychologists have devised different mechanisms for dealing with it. Any mechanism used has its advantages as well as its drawbacks. In case of the equine therapy, it is effective in the long run and is mostly advocated for the personality portrayed by the majority of the veterans. However, Equine Therapy is an expensive means, which may not be afforded by the majority of the world veterans. In addition to the high cost, the practice works well with veterans who have enough free time to attend the riding sessions. This is a limitation because even after retirement, many of the soldiers still engage in other forms of employment to earn an extra coin. To solve these challenges other forms of treatment might be of help (Robert & Howard, 2012).

Cognitive-Behavioral Treatment is one of the most applied therapies globally. The treatment is based on the suggestion that, psychological tribulations crop up on account of the manner in which individuals evaluate or interpret situations, feelings, thoughts and our behaviors. The method is based on the fact that, due to their tendency to generalize things, human beings end up traumatized. For instance, individuals who have ever been bit by a spider may end up concluding that all spiders are equally dangerous. Such people exhibit a lot of fear and anxiety whenever they come across a spider of whichever type. These individuals may opt to avoid spiders completely in order to lead a normal life free of anxiety and fear. However, in some cases this might not be possible because it might be hard to avoid all the traumatizing events throughout someone’s life time. For instance, when military veterans experience inhuman acts during wars, it might not be easy to forget whatever happened especially where people had to lose their lives. For the veterans, whether they avoid the same scenes or not, they cannot avoid the trauma and the stress that goes with the experiences. Sometimes even the contemplation of the traumatizing events leads to anxiety and isolation (Monson, Fredman, Adair, Stevens, Resick, Schnurr, MacDonald & Macdonald, 2011). Eventually, the victims of such trauma develop Post Traumatic Stress Disorder which is not easy to heal. Cognitive behavioral treatment uses three different techniques to deal with PTSD. The analysis in the succeeding section focuses on these techniques (Robert & Howard, 2012).

Self-Monitoring

The therapists concerned might first and foremost request the veteran patient to track their feelings and thoughts. The psychologist may then ask the patient to put down the thoughts and their feelings in response to definite circumstances, particularly those that give rise to anxiety or any other disturbing feeling. This assist the patient acknowledge how they assess their incidents and the end results of these assessments, such as anxiety.

Cognitive Restructuring

Once these assessments are acknowledged, the specialized may then assist the patient collect proof for and against the assessments. This is the cognitive restructuring process. Through the process, veterans may appreciate that their assessments or interpretations of circumstances are not exclusively perfect. They may as well comprehend that, even though thoughts often appear factual, they are hardly ever based on facts. These realities help veterans overcome PTSD with a lot of ease.

Behavioral Experiments

In this final stage, the therapist will request the veteran to participate in behavioral experimentations. This encompasses asking the patient to try these new methods of perceiving the humanity. This might be possible by getting into circumstances where they might come into contact with something that they once feared. Once they manage to go through this stage successfully, then they might have managed to overcome PTSD.

Further Analysis of PTSD

Clinical understanding suggests that reported youth adversity, adult experiences of hostility, and post-traumatic stress disorder (PTSD) are widespread among people suffering from borderline personality disorder (BPD) (Zanarini, Hörz, Frankenburg, Reich & Fitzmaurice, 2011). While several research findings support the connection between babyhood and adult adversity and BPD, only seven studies have evaluated the commonness of PTSD in models of criteria-defined patients suffering from BPD (3-9). Generally, the researchers recognized that PTSD was fairly regular, with a range of 20-54.9% and a center commonness of around 46%. In addition, only 2 longitudinal researches have evaluated the path of PTSD in a model of well-defined patients suffering from BPD (Niles, Klunk-Gillis, Ryngala, Silberbogen, Paysnick, & Wolf,  2012). In the foremost of these studies the Collaborative Longitudinal Personality Disorders Study o CLPS- it was concluded that BPD dispatched more swiftly over 2 years of potential follow-up in individuals with PTSD than those with unqualified PTSD. In the second phase of these researches – the McLean Study of Adult Development (MSAD) – it was established that the occurrence of PTSD reduces extensively over six years of prospective transcribe but remained considerably higher among people with BPD than amongst axis II comparison theme (Barker, Dawson 2011). It was also established that the lack of PTSD at baseline was a noteworthy predictor of a quicker period to-remission of BPD.

The recent study, which is an annex of the McLean research of Adult Development research mentioned earlier, is the first longitudinal research to evaluate the prevalence of post-traumatic stress disorder, over and above 10 years of probable follow-up in a huge and well-defined model of patients with borderline traits disorder and axis II comparison subject matters (Zanarini, Hörz, Frankenburg, Weingeroff, Reich, Fitzmaurice 2011). It is also the very first research to evaluate time-to-recurrence, time-to-recurrence, and time-to new inception of post-traumatic stress disorder in individuals with borderline traits disorder tracked prospectively for a 10 years (Zanarini, Hörz, Frankenburg, Reich & Fitzmaurice, 2011). In addition, it is the very first research to evaluate the connection between sex adversity in childhood and maturity and the possibility of remission and reappearance of post-traumatic stress disorder amongst borderline patients meeting standards for this co-occurring mental challenge at research entry. Material and techniques the current research is section of the MSAD, a comprehensive longitudinal research of the units of BPD. All subjects were originally in-patients at the great McLean Hospital in Belmont, Massachusetts. every patient was first and foremost screened to establish that he/she: (i) was between the ages of 18-35; ii) had a known IQ of 71 or above (iii) was fluent in English (iv) had no history/current symptoms of schizoaffective disorder, bipolar I disorder, schizophrenia or an organic status that could result to psychiatric symptoms. After the research procedures were clarified, written informed approval was acquired. Each patient then convened with a master-level interviewer who was blind to the patient’s diagnoses for a meticulous diagnostic evaluation (Zanarini, Hörz, Frankenburg, Reich, & Fitzmaurice, 2011). Three semi prearranged diagnostic interviews were executed. These diagnostic consultations were: I) the ordered Clinical consultation for DSM-III-R Axis I (SCID I) (12), ii) the modified Diagnostic consultation for Borderlines (DIB-R) (13) and iii) the Diagnostic consultation for DSM-III-R Personality Disorders. The test-retest and inter-rater dependability of all 3 of these procedures have been established to be excellent. At each of 5 follow-up waves, disconnected by twenty four months, axis I and II psychopathology was re-evaluated through interview techniques comparable to the baseline measures by clinically qualified MA-level or BA-level staff affiliates blind to basic diagnoses. After informed approval was found, diagnostic battery was re administered.

Remission as any 2-year phase (any follow-up phase) in which the standards for PTSD were no longer obtained. For this study 2 years is appropriate at the beginning of the research to mirror meanings of remission of BPD and its essential symptoms (18). In addition, a reappearance or new inception could be defined as any 1-month epoch in which the standards for PTSD were achieved after a 2-year remission. Therefore it can be concluded that youth adversity, adult experiences of hostility, and post-traumatic stress disorder (PTSD) are widespread among people suffering from borderline personality disorder (BPD).

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A Hands-on Guide on How to Analyze a Case Study

A case study analysis must not merely summarize the case. It should identify key issues and problems, outline and assess alternative courses of action, and draw appropriate conclusions. The case study analysis can be broken down into the following steps:

  1. Identify the most important facts surrounding the case.
  2. Identify the key issue or issues.
  3. Specify alternative courses of action.
  4. Evaluate each course of action.
  5. Recommend the best course of action.

Let’s look at what each step involves.

1. Identify the most important facts surrounding the case.

Read the case several times to become familiar with the information it contains. Pay attention to the information in any accompanying exhibits, tables, or figures. Many case scenarios, as in real life, present a great deal of detailed information. Some of these facts are more relevant than others for problem identification. One can assume the facts and figures in the case are true, but statements, judgments, or decisions made by individuals should be questioned. Underline and then list the most important facts and figures that would help you define the central problem or issue. If key facts and numbers are not available, you can make assumptions, but these assumptions should be reasonable given the situation. The “correctness” of your conclusions may depend on the assumptions you make.

2. Identify the key issue or issues.

Use the facts provided by the case to identify the key issue or issues facing the company you are studying. Many cases present multiple issues or problems. Identify the most important and separate them from more trivial issues. State the major problem or challenge facing the company. You should be able to describe the problem or challenge in one or two sentences. You should be able to explain how this problem affects the strategy or performance of the organization. You will need to explain why the problem occurred. Does the problem or challenge facing the company comes from a changing environment, new opportunities, a declining market share, or inefficient internal or external business processes?

In the case of information systems-related problems, you need to pay special attention to the role of technology as well as the behavior of the organization and its management. Information system problems in the business world typically present a combination of management, technology, and organizational issues. When identifying the key issue or problem, ask what kind of problem it is: Is it a management problem, a technology problem, an organizational problem, or a combination of these? What management, organizational, and technology factors contributed to the problem?

o To determine if a problem stems from management factors, consider whether managers are exerting appropriate leadership over the organization and monitoring organizational performance. Consider also the nature of management decision-making: Do managers have sufficient information for performing this role, or do they fail to take advantage of the information that is available?

o To determine if a problem stems from technology factors, examine any issues arising from the organization’s information technology infrastructure: its hardware, software, networks and telecommunications infrastructure, and the management of data in databases or traditional files. Consider also whether the appropriate management and organizational assets are in place to use this technology effectively.

o To determine the role of organizational factors, examine any issues arising from the organization’s structure, culture, business processes, work groups, divisions among interest groups, relationships with other organizations, as well as the impact of changes in the organization’s external environment-changes in government regulations, economic conditions, or the actions of competitors, customers, and suppliers. You will have to decide which of these factors—or combination of factors—is most important in explaining why the problem occurred.

3. Specify alternative courses of action.

List the courses of action the company can take to solve its problem or meet the challenge it faces. For information system-related problems, do these alternatives require a new information system or the modification of an existing system? Are new technologies, business processes, organizational structures, or management behavior required? What changes to organizational processes would be required by each alternative? What management policy would be required to implement each alternative? Remember, there is a difference between what an organization “should do” and what that organization actually “can do”. Some solutions are too expensive or operationally difficult to implement, and you should avoid solutions that are beyond the organization’s resources. Identify the constraints that will limit the solutions available. Is each alternative executable given these constraints?

4. Evaluate each course of action.

Evaluate each alternative using the facts and issues you identified earlier, given the conditions and information available. Identify the costs and benefits of each alternative. Ask yourself “what would be the likely outcome of this course of action? State the risks as well as the rewards associated with each course of action. Is your recommendation feasible from a technical, operational, and financial standpoint? Be sure to state any assumptions on which you have based your decision.

5. Recommend the best course of action.

State your choice for the best course of action and provide a detailed explanation of why you made this selection. You may also want to provide an explanation of why other alternatives were not selected. Your final recommendation should flow logically from the rest of your case analysis and should clearly specify what assumptions were used to shape your conclusion. There is often no single “right” answer, and each option is likely to have risks as well as rewards.

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Should College and University Education be Free?

A group of students studying outside
A group of students studying outside

When you were young, college always seemed like this far off place where everyone had to go. There was never a time thought High School that teacher’s wouldn’t mention how great something would look on your college applications or that college’s liked it when you wrote a certain way. We have been conditioned to accept that at the end of high school you would go to college, and then, if you wanted, you would go into graduate school or another specialty school. If not, you would jump straight into your career doing whatever you loved and getting paid a lot of money for it and you would live happily ever after. What no one ever told you was how much it would cost you. There was always some understanding that college would cost you money, but in the teenage brain, no one ever believed that it meant you. According to Mark Kantrowitz, the class of 2015 was the most indebted classes that has ever graduated to date and with the increase of public college/university tuition by 50% in the past ten years, everyone can see why. A simple solution for this would be to increase the amount of money granted to students every year, but with the current reduction of the Pell Grant program, that seems very unlikely. Ultimately, the only way to save the future generations of graduates from being the new “most indebted” would be to make public college and universities free.

Attending a four year college or university and obtaining a bachelor’s degree is imperative in today’s job market. Most careers will not even consider future employee’s with a single high school diploma or a GED anymore. However, with the cost of attending a public college ranges between $9000 to over $20000 a year, being able to attend and pay can be out of reach for most students just on their own. Luckily this is why we have FAFSA, but when the amount given out is only a third of what you need to go to school, private loans become the next viable option. According to USA today, the class of 2013 graduate with an average of $30000 in debt. With doing some simple calculations,  it would cost a student on the low end of tuition $36000 for four years, adding in the average amount of loans, that student, in four years, had to find $6000 from somewhere.

college is expensive

Ultimately, $6000 does not seem like a lot to have to pay in a four year time and in comparison, it really isn’t. But even if the student had an on-campus job where they made minimum wage, paying that off still would be extremely difficult. In an optimistically perfect world, this $6000 would have been a grant or scholarship to the student, but we all know too well that this isn’t true. With most scholarships and grants being given to either extremely in-need students, extremely intelligent students, or student athletes, many students go without their choice university giving them any sort of help. If public colleges made their tuition’s free, there would be no issues with finding money to entice certain students to come to a school or to assist students who need to go to college to do so. The money given to these students now can be allocated elsewhere for research programs, campus updates, or even increasing the number of jobs on campus for students.

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The question that most pine for when discussing free college is “how much will it cost?” In legislative proposals done by Senator Bernie Sanders, he finds that the federal government will pay 67% of the total public university cost, while leave the remaining 33% to the states for their respective public universities. Of the 70 billion dollars it costs across all fifty states and their public universities, this means that each state will be responsible for a little over 450 million dollars to fund public universities. Although this may seem like a lot, for a comparison on how some states frivolously spend money, California has already spent over 180 million dollars on their lightning rail project in 2015 alone, which has yet to break ground and has been in discussion since 2011. If all the money was consolidated from pointless projects and maybe an increase in taxes, free college would be easily attainable.

As for the federal government, where is their 67% coming from. Well according to the legislation being proposed, there would be a Robin Hood Tax imposed on Wall Street. The tax would not be very much, only 0.1% in some places, but the estimated revenue will be hundreds of billions a year, which is so much more than the measly 70 billion spend on public universities a year. The “extra” money left over from the tax can be used to aid in the lowering of the United States current deficit, aid in the creation of jobs, and can be used wherever it is seen fit. This aids the proponents of the legislature in their quest of free college.

 Why college should be freeUltimately, making public colleges and universities free will aid in the education of many college age students and adults everywhere. Since there is such a great necessity for a bachelor’s degree and not easy accessibility, unless you are willing to dole out over $30000 in loans, allowing for people to attend public college’s for free allows for a great need to be filled. This not only assists in the bettering of someone’s life, but will be better off for their future. There will be no more worry about finding a career that will aid in the payment of loans, but now graduates everywhere will be able to find careers they want without worrying about their debt.

Article Credits: Samantha >>>> Making College More Affordable

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