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The Pratt Institute Libraries Archives, Rare Book, and Special Collections contain roughly 9,000 volumes of broad content spanning from the 15th through the 21st century. The collections include pop-up books, artists' books, oversized volumes on fashion, architecture, decorative arts, fine arts, design and photography, and ephemera. These collections are accessible to all members of the Pratt community.
This exhibit showcases these unique collections for research, inspiration, and interest.
The Rare Books Room includes around 3,000 volumes. Its holdings span the 15th century to the early 20th century and reflect a wide variety of subject areas, such as incunables, illustrated books, children's books, and books on local history. Of special interest are the Edward Curtis books and portfolios.
The Special Collections is currently composed of over 6000 volumes that include 679 pop-ups, 639 artists' books, over 1,000 oversized volumes, and 3,000 regular books. In addition there are ephemeral holdings such as post cards, book plates, fashion plates, art history black-and-white mounted photographs, and portfolios. The main subject areas include: fashion, architecture, decorative arts, fine art and photography, and span from the 18th through the 21st centuries.
The Pratt Institute Archives collects, preserves, and provides access to a wide variety of historical materials, including photographs, records, and publications that document the history and development of Pratt Institute and its various schools, departments, programs, and social activities, as well as the contributions of individuals and organizations associated with Pratt. Documents found in the Archives date from 1848 to the present, and include many items pertaining to Pratt's founding in 1887.
These books, and other items from our Special Collections, may be viewed in person at the Pratt Institute Brooklyn Library. | https://libguides.pratt.edu/c.php?g=763506&p=5475267 |
Learn to cite your sources in MLA format!
Unless otherwise noted, you can access these websites and databases directly when in the library. Outside the library, you will be asked to enter your name and ID number from your AAU ID. If you have trouble accessing any of these resources, contact AAU Library.
Full Text Magazine and Journal Databases
EBSCO - Search Academic Search Premier, Art Source, & OmniFile
- Search all of the journals and magazines in Academic Search Premier, Art Source, and OmniFile Full Text Select with only one search!
- EBSCO YouTube Help Channel
EBSCO Academic Search Premier
- This multi-disciplinary database provides full text for more than 4,600 journals and magazines, including more than 3,900 peer-reviewed titles.
EBSCO Art & Architecture Source
- Access to over 630 full text journals and more than 220 full-text books on art topics including advertising, architecture, art history, computers in art, fashion design, folk art, graphic design, landscape architecture, motion pictures, photography, and more.
EBSCO OmniFile Full Text Select
- Contains full text articles from over 1,600 magazines, journals and newspapers covering art, technology, agriculture, education, science, humanities, law, business, and more.
Flipster Magazines
- Access Art and Design digital magazine titles online from a computer or download them to a smartphone or tablet using the Flipster mobile app for offline reading.
- Flipster App: How to Guide (PDF)
Exact Editions Magazines
- Access digital magazine titles from the Exact Editions Fashion and Culture Collection and the Architecture Collection.
JSTOR
- Full text scholarly journals covering a wide range of arts, architecture, music, humanities, sciences, and social sciences.
- JSTOR Research Guides. Provides information on how to research using JSTOR.
Full Text Electronic Books
Ebook Central
- 9,000+ full text books in a wide variety of subjects, including art, history, and technology.
- Create citations, mark your place, highlight text, and make notes.
- Ebook Central Help Guides
- Check out our Ebook Frequently Asked Questions (FAQ) page.
- *note: we recommend using Chrome or Safari if you're accessing eBooks on your tablet.
EBSCO Ebook Collection
- EBSCO ebooks offers a small collection of ebook titles that can be accessed online.
- *note: we recommend using Chrome or Safari if you're accessing eBooks on your tablet.
Berg Fashion Library
- Over 100 new and classic books on fashion.
- Full access to the 10-volume Berg Encyclopedia of World Dress and Fashion.
Oxford Art
- Features Grove Art, an online encyclopedia of world art and art history, spanning from prehistoric to modern art.
- Contains artist biographies, information about art movements, timelines of world art, definitions of art terms, and links to image collections.
- Oxford Art Help Guides and Videos
Digital Images
LUNA Digital Image Collections
- Search over 340,000 images, including over 114,000 works of art from the collections of contributing museums, universities and archives. Architectural photographs, gardens and landscapes, political Americana, historical maps, fashion plate collections and much more.
- See our Digital Images page for more image resources and information.
Video Resources
Kanopy Video Streaming
- Stream features, documentaries, and independent films with the Kanopy app on smartphones, tablets, and computers.
Materials Resources
Material ConneXion Database and Materials Library
- Comprehensive online database of thousands of material types, including unique, innovative and sustainable materials.
- The database works in tandem with the AAU materials library.
- Search by material type, material name, manufacturer name, or country or origin.
- To create a new account, please enter the school registration key jclXf1600875792. You will also need to use your AAU email address (art.edu for students, academyart.edu for faculty) and check your email at: https://portal.office.com. Click here for info on creating an account.
Business & Company Information
Business Market Research Collection
- Includes Hoover's Company Profiles, OxResearch, Barnes Reports, and Snapshots!
- Information on international and domestic companies including personnel, budgets, products, operations, and competitors.
- Contains proprietary information about more than 40,000 public and non-public companies and 225,000 key executives.
Mintel
- Before accessing Mintel, you will need to scroll down and click on the checkbox, "I, Accept".
- Market research and analysis covering the U.S. and some international marketplaces.
- Gives insight into the trends and consumer behaviors that will shape tomorrow's markets.
WARC
- Case studies, company reports, trend reports, consumer insights, and more!
- Great information on advertising, merchandising, marketing, and market analysis.
- Contains data and reports from sources worldwide including Admap, International Journal of Advertising, ESOMAR, Euromonitor, and the Journal of Advertising Research.
Architecture & Interior Architecture Resources
Avery Index to Architectural Periodicals
- Article abstracts and citations for journals on architecture, city planning, interior design, and landscape architecture.
- Avery can help you search for articles in journals and magazines found in the library.
Avery Index to Architecture + EBSCO Database Search
- Search the Avery Index and all of the journals and magazines in Academic Search Premier, Art Source, and OmniFile Full Text Select with only one search!
Fashion Resources
Berg Fashion Library
- Explore the world of fashion by clothing type, country or region, time period, textile or material type, and more!
- Over 7,000 fashion-related images from encyclopedias, museums, and special collections.
- Over 100 new and classic books on fashion.
- Full access to the 10-volume Berg Encyclopedia of World Dress and Fashion.
Sourcing Journal
- A trade publication for apparel and textile executives, focused on sourcing and manufacturing.
- Includes in-depth features, expert analysis and interviews with industry leaders.
Vogue Archive
- A complete searchable archive of American Vogue, from the first issue in 1892 to the current month, reproduced in high-resolution color page images.
- All editorial content, covers, advertisements and pictorial features have been captured as separate documents to allow for searching and discovery.
WGSN
- Provides access to 4 million images, information on trade shows, fashion trend analysis, and information on interiors and beauty.
- Library users only have access to the FASHION section of the site.
- WGSN education accounts need to be reactivated every 120 days. If you are ON CAMPUS, click here to reactivate your account.
- If you are accessing WGSN OFF CAMPUS click on WGSN above, them click on LOG IN link in the upper right hand corner of the screen to reactivate your account.
WWD
- Daily news on trends and developments in fashion, textiles, accessories, and beauty.
- Business and finance information and job listings.
Music Database
Music Library
- All contents of the Music Library are from “The Hollywood Edge Music Library” collection, published in 2001 by The Hollywood Edge, which was acquired by Sound Ideas in 2015. Tracks are in WAV format and are copyright and royalty-free.
- Log in using your Academy of Art username and password.
- This tutorial shows you how to search for and browse music files.
- Music Library Getting Started Handout (PDF)
Guest Speaker Video Database
AAU Guest Speaker Videos
- View videos of guest speaker presentations at the Academy of Art University.
- Over 60 videos available, with new content added regularly.
- Includes videos from Academy events, including presentations from Academy faculty, departmental directors, and President Stephens. | https://elmo.academyart.edu/find-resources/online_articles.html |
Andie Hanna grew up in Columbus, OH. After earning her degree in Fashion Design from the Shannon Rogers and Jerry Silverman School of Fashion Design and Merchandising at Kent State, she enjoyed an almost two-decade career working for some of the country's top brands. She gained inspiration from international travel which helped influence her designs and her decision to start her own business.
In 2012, she started Andie Hanna Designs LLC. Having taught herself the art of print and pattern design, she has enjoyed working with a variety of brands while being home with her two children, Emerson and Elle.
Travel continues to be a big influence on her work as does her family, nature, antiques and fine art - all providing inspiration for the work she is passionate about. This inspiration paired with Andie’s keen eye on trends, sense of style and product development expertise makes for designs that are truly unique.
In addition to fabric, Andie’s artwork can be seen on a wide variety of products such as adult coloring books, journals, notecards, greeting cards, calendars, magnets, postcards, wall art, coasters, notepads, bags and accessories. | https://www.robertkaufman.com/fabrics/designers/andie_hanna/ |
“The Catalogue of Imaginary Beings” is an ongoing series of work I began in 2015 that sprung from over 20 years of portraiture and collage work. Now at well over 100 plates, the body of work seeks to explore a range of themes in popular culture including the role of the individual in fashion, in history, in the artistic imagination and, more broadly, the collective consciousness.
It draws its inspiration from a wide spectrum of sources—including magical realism, surrealism and symbolism—and more specifically references such cultural artifacts as talismans, idols, totems and all of the material detritus that surrounds all of us all the time. These characters are composites embodying notions of “the warrior,” vulnerability, industry, the universal and the personal. They reference these identities as they’ve been depicted historically through art, literature and commerce.
The sideshow candidacy and then the unbelievable election and, now, the devastating inauguration of Donald Trump has been very difficult for many women in this country to understand or accept. I am one of those women. | https://msmagazine.com/2017/01/20/imaginary-beings-womens-march/ |
In African American Visual Arts Celeste-Marie Bernier introduces readers to the sheer diversity, range, and experimental nature of African American art and artists and considers their relationship to key motifs within black culture and black experience in North America. The book traces the major developments in African American visual culture from its beginnings in the ceramics and textiles of slave artisans to later contributions in the twentieth and twenty-first centuries to the fine arts and abstract expressionism, sculpture, installation art, video art, and computer graphics.Bernier analyzes the work of twenty-one artists, including Elizabeth Catlett, Jacob Lawrence, William Edmondson, Howardena Pindell, Charles Alston, Romare Bearden, Norman Lewis, Betye Saar, Horace Pippin, and Kara Walker. She highlights key but frequently neglected and little-discussed black artists, situating their works within their specific historical and political contexts. Bernier provides a new understanding of their relationship to fundamental themes of the black experience such as black stereotyping and caricature in mainstream discourse, poverty in the inner city, and the division between the rural and the urban.
- Brand: Brand: The University of North Carolina Press
- ASIN: 0807859338
Contact High: A Visual History of Hip-Hop
Contact High: A Visual History of
ONE OF AMAZON'S BEST ART & PHOTOGRAPHY BOOKS 0F 2018AN NPR AND PITCHFORK BEST MUSIC BOOK OF 2018 PICKONE OF TIME'S 25 BEST PHOTOBOOKS OF 2018NEW YORK TIMES, ASSOCIATED PRESS, WALLSTREET JOURNAL, ROLLING STONE, AND CHICAGO SUN HOLIDAY GIFT GUIDE PICKThe perfect gift for music and photography fans, an inside look at the work of hip-hop photographers told through their most intimate diaries—their contact sheets. Featuring rare outtakes from over 100 photoshoots alongside interviews and essays from industry legends, Contact High: A Visual History of Hip-Hop takes readers on a chronological journey from old-school to alternative hip-hop and from analog to digital photography. The ultimate companion for music and photography enthusiasts, Contact High is the definitive history of hip-hop’s early days, celebrating the artists that shaped the iconic album covers, t-shirts and posters beloved by hip-hop fans today. With essays from BILL ADLER, RHEA L. COMBS, FAB 5 FREDDY, MICHAEL GONZALES, YOUNG GURU, DJ PREMIER, and RZA
- ASIN: 0525573887
African-American Art: A Visual and Cultural History
African-American Art: A Visual and Cultural
African-American Art: A Visual and Cultural History offers a current and comprehensive history that contextualizes black artists within the framework of American art as a whole. The first chronological survey covering all art forms from colonial times to the present to publish in over a decade, it explores issues of racial identity and representation in artistic expression, while also emphasizing aesthetics and visual analysis to help students develop an understanding and appreciation of African-American art that is informed but not entirely defined by racial identity. Through a carefully selected collection of creative works and accompanying analyses, the text also addresses crucial gaps in the scholarly literature, incorporating women artists from the beginning and including coverage of photography, crafts, and architecture in the nineteenth and twentieth centuries as well as twenty-first century developments. All in all, African American Art: A Visual and Cultural History offers a fresh and compelling look at the great variety of artistic expression found in the African-American community.Visit www.oup.com/us/farrington for additional support material, including chapter outlines, study questions, links to artists' sites, and other resources to help students succeed.
- ASIN: 0199995397
Alabama Oh: Artist, Dandelion Dreamer, and Independent Girl (Explore Visual Artists Book 1)
Alabama Oh: Artist, Dandelion Dreamer, and Independent Girl
Award winner! Purple Dragonfly 1st Place Award and Reader's Favorite Award Honorable Mention for Social Issues.Meet Alabama Oh, a bold, bright girl! Her teacher wants her to tone it down and fit in. How much should she change to get along with her teacher?Alabama loves flowers, drawing, and riding her bike. She is a free spirit and an independent girl. When her teacher wants her to fit in, Alabama tries really, really hard. What happens next is surprising and wonderful! What does Alabama do? Find out!Written to encourage all children to embrace their uniqueness, the adorable Alabama Oh shows children that it’s okay to be different. Buy the book and explore Alabama Oh’s world today!
- ASIN: B07B8C4CHD
Radiant Child: The Story of Young Artist Jean-Michel Basquiat (Americas Award for Children's and Young Adult Literature. Commended)
Radiant Child: The Story of Young Artist Jean-Michel
"This award-winning picture book biography for the elementary grades is a remarkable introduction to the artist Jean-Michel Basquiat, and the concept of self-expression in art." - Seira Wilson, Amazon EditorWinner of the Randolph Caldecott Medal and the Coretta Scott King Illustrator AwardJean-Michel Basquiat and his unique, collage-style paintings rocketed to fame in the 1980s as a cultural phenomenon unlike anything the art world had ever seen. But before that, he was a little boy who saw art everywhere: in poetry books and museums, in games and in the words that we speak, and in the pulsing energy of New York City. Now, award-winning illustrator Javaka Steptoe's vivid text and bold artwork echoing Basquiat's own introduce young readers to the powerful message that art doesn't always have to be neat or clean--and definitely not inside the lines--to be beautiful.
- Brand: Little Brown Books for Young Readers
- ASIN: 0316213888
How to Slay: Inspiration from the Queens and Kings of Black Style
How to Slay: Inspiration from the Queens and
An inspirational journey through black fashion in America from the twentieth century to the present, featuring the most celebrated icons of Black style and taste. One of the few surveys of Black style and fashion ever published, How to Slay offers a lavishly illustrated overview of African American style through the twentieth century, focusing on the last thirty-five years. Through striking images of some of the most celebrated icons of Black style and taste, from Josephine Baker, Michelle Obama, Maya Angelou, and Miles Davis to Rihanna, Naomi Campbell, Kanye West, and Pharrell Williams, this book explores the cultural underpinnings of Black trends that have become so influential in mainstream popular culture and a bedrock of fashion vernacular today. A preponderance of Black musicians, who for decades have inspired trends and transformed global fashion, are featured and discussed, while a diverse array of topics are touched upon and examined—hats, hair, divas, the importance of attitude, the use of color, ’60s style, the influence of Africa and the Caribbean, and the beauty of black skin.
- ASIN: 0847861384
Brooklyn On My Mind: Black Visual Artists from the WPA to the Present
Brooklyn On My Mind: Black Visual Artists from
This new resource assembles 129 Black artists and their magnificent works, highlighting their important contributions to art worldwide. Beginning with the Brooklyn-based artists active during the Works ProgressAdministration years and continuing with artists approaching their primetoday, the collection spans 80 years of art. From highly publicized artists to rising talent, each is tied to Brooklyn in their own way. Artists include Jacob Lawrence, Otto Neals, Onnie Millar, Kehinde Wiley, Dindga McCannon, Melvin Edwards, Dread Scott, Xenobia Bailey, Dr. Vivian Schuyler Key, Kay Brown, Russell Frederick, and many more. Seven chapters highlight overarching themes that connect the artists, besides their Brooklyn connections. A foreword by New York City's "first lady," Chirlane McCray, marks the importance of Brooklyn's Black creators within the city's art community.
- ASIN: 0764356526
Home
Home
Influential artist Carson Ellis makes her solo picture-book debut with a whimsical tribute to the many possibilities of home.Home might be a house in the country, an apartment in the city, or even a shoe. Home may be on the road or the sea, in the realm of myth, or in the artist’s own studio. A meditation on the concept of home and a visual treat that invites many return visits, this loving look at the places where people live marks the picture-book debut of Carson Ellis, acclaimed illustrator of the Wildwood series and artist for the indie band the Decemberists.
- Brand: Candlewick Press MA
- ASIN: 0763665290
Kehinde Wiley: A New Republic
Kehinde Wiley: A New
Filled with reproductions of Kehinde Wiley’s bold, colorful, and monumental work, this book encompasses the artist’s various series of paintings as well as his sculptural work―which boldly explore ideas about race, power, and tradition. Celebrated for his classically styled paintings that depict African American men in heroic poses, Kehinde Wiley is among the expanding ranks of prominent black artists―such as Sanford Biggers, Yinka Shonibare, Mickalene Thomas, and Lynette Yiadom-Boakye―who are reworking art history and questioning its depictions of people of color. Co-published with the Brooklyn Museum of Art for the major touring retrospective, this volume surveys Wiley’s career from 2001 to the present. It includes early portraits of the men Wiley observed on Harlem’s streets, and which laid the foundation for his acclaimed reworkings of Old Master paintings by Titian, van Dyke, Manet, and others, in which he replaces historical subjects with young African American men in contemporary attire: puffy jackets, sneakers, hoodies, and baseball caps. Also included is a generous selection from Wiley’s ongoing World Stage project; several of his enormous Down paintings; striking male portrait busts in bronze; and examples from the artist’s new series of stained glass ...
- Brand: Prestel
- ASIN: 3791354302
Carolyne Roehm: Design & Style: A Constant Thread
Carolyne Roehm: Design & Style: A Constant
Universal lessons come together with vibrant spreads of Roehm's work in fashion, flowers, table design, and interiors to create a unique celebration of the power of life and style.Carolyne Roehm's bestselling books have been a source of inspiration, pleasure, and education for thousands of readers. Now for the first time she shares her life story, from her small-town Missouri childhood to her New York fashion career that began with Oscar de la Renta, to her role as an author and tastemaker. There are the influential figures from her past, including: her grandmother, who sewed beautifully and ran a successful shop; her mother, who taught her that women need clothes to suit the many roles they have to play; her mentor, Oscar de la Renta, from whom she learned the fashion business. Roehm tells the story of launching, running, and ultimately closing her own fashion line, and her subsequent reinvention through books, gardening, entertaining, and décor. Through it all she shows how the constant threads of character and creativity, and a passion for nature, color, quality, and classicism can inform your work, style, and life.
- ASIN: 0847863441
Why African-American artists are becoming art market superstars
Six out of ten auction records last year were set by African-American artists. Their star is also...
African American Visual Arts
Black History Month: Celebrating African American Art and Photography
Colored Frames [Documentary]
A look back at the last fifty years in African American art, Colored Frames is an unflinching exp...
SAMELLA LEWIS : PIONEERING VISUAL ARTIST AND EDUCATOR
Film by Eric Minh Swenson. Samella Lewis says, “My inspiration as an artist and art historian co... | http://shopplanetup.com/african-american-visual-artists.html |
Job Duties: Historians typically do the following: Gather historical data from various sources, including archives, books, and artifacts; Analyze and interpret ...
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Music Historians conduct interviews and academic research in order to write about musicians, instruments, and musical genres in historical context. | http://www.ask.com/web?qsrc=6&o=102140&oo=102140&l=dir&gc=1&qo=popularsearches&ad=dirN&q=Historian+Job+Description |
Shirin Abedinirad was born in 1986, in Tabriz, Iran. In 2002, she began her artistic activities with painting. She studied graphic design and fashion design at Dr. Shariaty University in Tehran, where her research focused on conceptual art and the ways in which it overlaps with fashion design. Around this time, she started engaging in performance art pieces around Iran, confronting issues of gender, sexuality, and human compassion. She has also put on public shows in Spain, Turkey and India. Since 2012, Shirin has been making video art, exploring the notion of self and identity with moving images. She studied under critically-acclaimed Iranian director Abbas Kiarostami. In both her performance pieces and videos, she designs her own costumes, props, and sets. In March 2014, Shirin was selected for a one-year scholarship with United Colors of Benetton’s Fabrica research center. During her time in Italy, Shirin worked in Fabrica’s Editorial Department, and published an original book "Fashion & Conceptual Art" (Nazar Publication). Currently based in Tehran, Shirin has continued focusing on her performance, installation, and video art projects.
Pierre Bonnefille is a chromatic alchemist. He draws inspiration from his journeys and distils the colors he encounters into the infinite richness of his work. The material, colours and light are inseparable in Pierre Bonnefille’s work. The artist creates his own materials and textures, made from mineral powder, limestone, lava, marble, earth, from natural pigments and metallic powders. A veritable explorer, Pierre Bonnefille draws his inspiration from the colours of nature and his architectural references in Venice, Pompei and even Kyoto. The artist creates his colour palettes starting with the earth and the materials that he collects, and then analyzes their colorimetric structures. The intensity, the colour and the movements of the light propose a ceaseless, new interpretation of colours and textures created by Pierre Bonnefille, giving them a unique and particular identity. Inpired by nature and landscapes, the lively and vibrant surfaces of Pierre Bonnefille’s work, an artist of color and material, fill the room, creating a unique experience that plays on the senses.
His handmade work – including lights, furniture and objects – explores the architecture and geometry of organic shapes, and is often inspired by forms found in plants, animals, and minerals. Christopher’s Greek heritage is reflected in his repeated fusion of natural and classical, with mythology a core concept permeating his work. All products are handmade with love and care in his Melbourne atelier using a broad variety of artisans – amongst them glass blowers, copper smiths, ceramicists, sculptors, and bronze casters, ensuring a commitment to quality. With each project Boots seeks to elevate and transform his materials in a way that highlights their natural beauty. Christopher graduated from industrial design at the National School of Design (Prahran, 2005). An apprenticeship with lighting pioneer Geoffrey Mance followed, leading to a half decade training in various techniques of designing and making lighting. Christopher launched his studio in 2011 and in the short span of time since, Christopher Boots has grown from a one-man-show to a team of 20 people. In late-2014 Christopher Boots designed the legendary Hermes holiday windows for both stores on Madison Avenue, New York City. Christopher Boots has worked closely with a diversity of clients and collaborators – including Cult, Hermes, National Gallery of Victoria and Elenberg Fraser – to deliver limited-edition and made-to-order products. The work of Christopher Boots accents and adds to the dramatic experience of extraordinarily designed spaces. When not travelling, Christopher lives in his studio in Fitzroy, Melbourne.
Haberdashery studio weaves light to create emotional connections with an audience. By challenging what is possible with light through the creative use of the latest technologies and materials, blended with age-old techniques and effects, we develop carefully researched narratives into award-winning sculptures, limited edition collectables and contemporary products. This studio is stimulated by moments that make the hair on your neck stand up; when time slows down and you can lose yourself in a moment. As a universally understood medium light has the ability to communicate with all sorts of audience. Through colour and tone we can reach into the subconscious and draw on memories, challenge learnt responses and question preconceived ideas regarding what we need light for, and what its potential uses are.
Born in Lucerne, Switzerland, Cornelia Arnold is an artist who creates the colors for her paintings herself. She experiments with natural raw materials, connects the materials with th brush and makes them shine. 'I am fascinated by the alchemy of colors.' The raw materials come from all over the world. Oyster lime from Japan, earth from Iceland or stone powder from the Albula region. She mixes the raw materials with binders. This can be wax, diluted egg yolk or silicate. Her studio becomes a laboratory, the artist an alchemist. Each color is unique, made for one picture. 'I try to mix the materials so that they become similar to gold.' Smallest glass prisms or particles of minerals reflect the light and give it additional radiance.
CONTACT T +41 (0)79 604 44 02 [email protected] WWW.GALLERYELLE.COM
ZURICH MOMMSENSTRASSE 18 8044 ZURICH ST. MORITZ SUVRETTA HOUSE VIA CHASELLAS 1 7500 ST. MORITZ
Rights reserved in Switzerland © 2020 Gallery Elle. Atossa Meier, owner. Toute reproduction interdite sauf autorisation expresse de l'Auteur.
Toute exploitation non autorisée constitue un acte de contrefaçon au sens des dispositions des articles du Code de la Propriété Intellectuelle. | http://galleryelle.com/oeuvres |
The volunteers at Sunny Bank Mills Archive are working hard to help research and preserve the collection. While gradually going through our large collection of Guard books, which are a fantastic reference of all cloth production here at the mill, we discovered a very different book. This Guard book is very large and a bit tatty but contains an enormous amount of silk samples from a company called Bilbille, Baudre and Co. Bilbille, Baudre and Co were a Parisian textile sampling house who predicted trends in textiles and produced for the trade.
As Sunny Bank Mills has always produced fine worsted suit cloth material for men, it seems strange to find this book hidden within the collection. It is safe to assume however, that as designers gather inspiration from everywhere this was perhaps another source of inspiration on weave, colours and texture. It certainly shows a variety of design and colour dating from the 1930’s. This helps to create a bigger picture of fashion and trends during this period, putting context to Sunny Bank Mills textile output and the world outside of Farsley. | https://sunnybankmills.co.uk/blog/bilbille-baudre-co-discovered-sunny-bank-mills-archive/ |
The Fundamentals of Industrial Automation course provides the key foundational knowledge to properly evaluate industrial automation (IAT) as a potentially viable technology solution to improve an existing industrial production process. Learners are exposed to principle concepts, equipment, areas of study, and terminology used in industrial automation with robotics.
This course gives learners the ability to discuss and understand, at a high level, the techniques and strategies used in industrial automation with robotics projects as well as the capability to make suggestions for the types of robotics hardware that are appropriate for a given task. This course is also an opportunity to receive an introduction to the social, cultural, safety, and financial topics and concepts relevant in industrial automation with robotics.
Topics covered in this course include:
Robotics terminology
- Descriptions of the topics needed in industrial automation from electrical, mechanical, and computer engineering as they relate to robotics & Automation
- Mechatronics defined in relation to robotics
- Types of robots and how they are used
- Small, focused case studies and/or scenario-based tasks
You will learn to:
- Analyze the three Ds of [KD2] industrial automation: Dull, Difficult, Dangerous
- Describe the right tool to use in the manufacturing process
- Examine the pros and cons of different approaches to industrial manufacturing process improvement
- Explore approaches to overcome social impacts of industrial automation in a work space
- The case studies will provide a better understanding to evaluate a manufacturing assignment based on critical thinking and problem solving
- Explain if an automated robotic system is a possible solution for a company
Who should attend:
- Engineers in any engineering field (i.e., electrical, mechanical, computer, etc.) who were not trained in robotics in their academic program but who are now considering a career in industrial robotics automation.
- Engineers in small- to mid-size manufacturing companies with a need to add robotic automation to their processes.
- Managers and owners of manufacturing companies who want to integrate robots into their manufacturing processes and need an understanding of the challenges of automation.
Cell manufacturing
Cell Manufacturing for Engineers online course is the only learning product designed specifically for engineering professionals that provides education on cell culture techniques, manufacturing and production processes, and regulatory and other business requirements. The course introduces cell therapy through the lens of a series of engineering problems or challenges which exist throughout the process.
Engineers will be able to develop solutions that improve scalability, automate processes, and maintain quality assurance with reduced labor costs of the reproduction of fragile living cells.
Topics covered in this course include:
- Fundamentals of cell therapy
- Production and manufacturing technologies
- Processes and scaling
- Quality control and quality assurance instructions
- Regulatory issues
- Facilities
- Shipping/transport
- Cell preservation
You Will Learn To: | https://lean4o.com/i-learning/ |
An AWS Cloud Engineer needs a wide range of skills to be successful, they need to have a wide knowledge of the main services that AWS provides and how to use them. This technical knowledge will need to be paired with good communication skills and critical so that they can relay their solutions and information to the relevant stakeholders. Specifically, in the Vervoe skill assessment, the following skills are looked at it in detail, broad knowledge of different AWS products and how to use them, and communication with various internal stakeholders of these services.
A DevOps Engineer must have excellent knowledge of programming, be able to communicate with a range of stakeholders, and have the customer/consumer in mind when designing and developing pipelines. Specifically, in the Vervoe skill assessment, the following skills are looked at it in detail, customer experience in relation to developers they assist, applications of DevOps, and communication with stakeholders.
Data Scientists must be great communicators with a high level of programming expertise. They must have strong skills in manipulating and interpreting data. Data scientists need to be proactive and good learners, so they can stay on top of evolving technologies. Specifically, in the Vervoe skill assessment, the following skills are looked at it in detail, python coding ability, machine learning, the skill level of using TensorFlow, and their communication skills.
A Data Analyst should be proficient in maths but, most importantly, demonstrate a strong business sense. Through this combination, they can drive change to the business based on pieces of information they derive from data. Specifically, in the Vervoe skill assessment, the following skills are looked at in detail, critical thinking, use of data models in different situations, and data classification for the different problem sets.
A SQL Developer must be highly proficient in writing SQL statements. This must also be paired with their knowledge of database security ensuring the data is not tampered with by the wrong person. Specifically, in the Vervoe skill assessment, the following skills are looked at it in detail, their ability to write different efficient and reusable SQL queries, their knowledge of databases, and their problem-solving skills.
Software Development Hiring Assessments and Skills Tests
When it comes to hiring the best software developers, you need to be sure that they have the skills and abilities required for the job. The best way to do this is through assessments and skills tests.
We have a wide range of assessments and skills tests specifically designed for software developers. These assessments and tests will help you to identify the top candidates for the job.
Our assessments and skills tests cover a wide range of topics, including:
– Programming languages
– Software development tools
– Algorithms and data structures
– Object-oriented programming
– Database systems
– Networking and distributed systems
– Security and cryptography
Software development skills tests are crucial for hiring managers and recruiters looking to incorporate skills based hiring in their recruitment strategy.
What is a Software Development Skills Test?
A software development skills test is a type of assessment that is specifically designed to test the skills of software developers. By using a variety of question types such as text based, video, multiple choice and especially code questions, you are able to see which candidates can do the job, before they get the job. These tests can be used to assess the abilities of candidates for a job, or to identify the strengths and weaknesses of existing employees.
Software development skills tests usually cover topics such as:
-Programming languages
-Software development tools
-Algorithms and data structures
What are some examples of software development skills test questions?
Below are some examples of questions that could be found on a software developer skills test:
- What is the difference between Scrum and Kanban methodologies? Provide some examples of when it’s better to use each methodology.
- When is Manual testing more preferred to Automation and vice versa? Provide a few examples. Write down your thoughts.
- Have you had experience with AWS? Please elaborate on your level of experience and which product sets you are familiar with in AWS
- Your CEO (who is not technical) wants to know he received a bill for $40,000 for something called “Microsoft AD”. Record a short video explaining what Active Directory is and why it’s important.
Software Development Assessment Templates
There are a number of different software development assessment templates that can be used to evaluate a candidate’s skills. Below are some examples:
- Systems Engineering Assessment Template
- Mid Level Java Developer Assessment Template
- Django Developer Skills Assessment Template
- Python Developer Skills Assessment Template
Each assessment template will include different question types and areas of focus. It is important to choose an assessment that will best suit the role for which you are hiring.
For some useful tips, check out our guide on hiring a Software Engineer. | https://vervoe.com/assessment-library/category/software-development/page/4/ |
The paper provides the reflection on the personal interest and motivation in obtaining the doctoral degree in psychology. The reflection on the associated professional goals is also included in the paper. The reflective discussion aims at answering the questions on the reasons to pursue the doctoral degree, the ideas, and visions regarding the professional identity and objectives for future professional growth, as well as the strategy to achieve the set goals. This reflection is important to provide the personal considerations regarding the certain course and areas for further development in association with obtaining the doctoral degree.
Introduction
The decision to pursue a doctoral degree in the field of psychology is usually caused by the person’s interest in the area and motivation to become a professional in this challenging sphere. Therefore, it is important for a person to answer the questions regarding the inner motives, aspirations, and beliefs that can lead an individual to choose the career of a doctoral-level psychologist. The process of obtaining the doctoral degree is connected with the development of critical thinking skills that are related to both practical and theoretical areas (Ruscio, 2006). This aspect needs to be discussed in detail while focusing on the important skills and abilities that were improved during the course. The purpose of this reflection paper is to provide the answers to the important questions related to the person’s motives to obtain the doctoral degree, the visions of the professional identity, and the strategy to achieve the set personal and professional goals.
Reasons to Participate in the Doctoral Program in Psychology
The first important questions to answer are why I participate in this program and why I focus on obtaining the doctoral degree in psychology. The answer to these questions is closely connected with my personal and professional interests, abilities, and intrinsic motivation to practice as a doctoral-level psychologist. I believe that the primary interest that led me to obtain the doctoral degree in psychology is my concentration on finding ways of helping people in situations when they need professional assistance. Moreover, I am particularly interested in the research related to the field of psychology because I always thought about the possibilities of conducting a range of new studies in order to answer the theoretical and practical questions that aim to cover the gap in the existing knowledge in those areas of psychology that are rather controversial. The motivation to develop as both a practitioner and a researcher-made me focus on the doctoral program in psychology and its advantages. I think about the participation in the program as a good chance to combine my interest in the research field with my intention to assist people in the practical area.
While I assess the future value of a doctoral degree for my community and me, I choose to see myself as a professional having the private practice and collaborating with research centers in order to be focused on both areas of interest. I am inclined to think that my doctoral degree will be the value to the community if I succeed in developing my potential as a practitioner and a researcher because I view these roles as two dimensions representing one professional identity (Sales, 2013). Thus, in about ten years, I hope to have actively developed a private practice that addresses the needs of the community, complete several research projects, and continue the collaboration with the state and local research centers while developing professional networks. My confidence regarding continuing research in the field to support my practice is directly associated with this course and the doctoral program as I succeeded in the development of critical thinking and research skills, improved my abilities in writing and reporting, became more focused and goal-oriented (Ruscio, 2006). These positive changes are important in order to guarantee that I can further develop as a professional and achieve the set goals.
The Professional Identity
The desire to pursue the doctoral degree is associated with the intention to develop a professional identity of a certain kind and to respond to the question of what I am trying to become after completing the program. Moreover, the development of the identity is related not only to the period after obtaining the degree but also to the period of study, and it is possible to identify changes in my behavior that indicate the development of my professional identity according to the image that I try to achieve. My ideal doctoral-level psychologist is a professional who is good not only in practice but also in researching, who refers to the evidence-based practice daily, and who contributes significantly to the existing research in the field (Kitchener & Anderson, 2011). Still, while thinking about an image of a psychologist, I try to become, I focus more on my contribution to the field of practice rather than research. My professional goal is to polish my skills in adapting the theoretical models and principles to actual cases in order to provide the support and assistance that address the needs of each individual. Thus, I regard myself as a practitioner in the field of psychology who has a high level of interest in research.
I noticed that my vision of the professional identity changed when I started to think about persons who inspire me, whom I can choose as role models, and whose positions are similar to those ones that I would like to take in the future. When I was at the beginning of my path to becoming a psychologist, I thought that the area of practice was more interesting for me than research, and now I understand that I could fear the ethical challenges of the psychologist’s research, and I was not sure regarding my abilities, but the desire to follow this path was strong. This course demonstrated how I grew in relation to my professionalism as a psychologist and how I can combine working in the areas of my interest without comprising my desire to continue researching and practicing (Nagy, 2011). Thus, the main change in my thinking caused by this course is that I learned how to benefit from the research in order to contribute to the practice, analyze models and approaches, choose strategies, and address the patients’ needs while developing professionally.
There is also a change in my behavior. Course readings and some additional articles and cases that I reviewed provided me with insights regarding the behaviors typical of professionals and high-class psychologists. I have found that all my fears regarding the lack of knowledge and professionalism can be easily addressed if I develop a behavioral strategy that can help me to react to challenging cases, diverse populations, and ethical problems among other issues (American Psychological Association, 2014; Nagy, 2011). The aspects of the professional relationship between a psychologist and a patient became clearly explained to me, and the doctoral program added to my development of skills typical of effective psychologists (Teo, 2009). Focusing on the valuable sources, I have learned how to conduct the research in order to propose theory-based solutions to cases and effective strategies, how to develop professional relationships, and how to organize the work with patients in order to combine the research and practical activities (American Psychological Association, 2014; Kitchener & Anderson, 2011; Nagy, 2011). Thus, I can state that at the current stage, I am trying to become a high-class professional in the field of psychology who is an experienced practitioner with developed critical thinking, decision-making, and problem-solving skills and a highly motivated researcher.
The Strategy to Achieve the Goal
However, in spite of having a clear goal and the image in relation to the professional identity, a person needs to develop an effective strategy in order to achieve the goal. Therefore, the other important question to answer is how I can achieve my professional goal while using the knowledge received during this course. I should state that the course helped me understand the principles of interacting at different levels, including the level of communication with instructors, the level of communication with professors, the level of cooperation with peers and colleagues, and the level of communication with clients and their relatives. This knowledge influenced changes in my approach to discussing the role of communication, formulating and sharing effective messages, and building the team for cooperation in the research and clinical settings. While obtaining my first degree in the field of psychology, I was oriented to demonstrate my skills as an effective independent learner, but I underestimated the role of interaction and cooperation in achieving goals. As a result, I failed to build effective relationships with other students and colleagues. I failed to value the advice of my colleagues regarding different cases, and I was focused on developing my own potential. There was a situation when my focus on cooperation with other practitioners could provide the client with better outcomes, but I failed to use that opportunity.
This course accentuated the role of interactions with professionals in order to resolve issues and develop strategic behavior. It is important to note that the course helped me understand the significance of professional networks and collaboration between practitioners (Kitchener & Anderson, 2011). Several years ago, I thought that my personal intention to find the answers to professional questions would contribute to my development as a specialist. However, my approach changed, and now I recognize the role of referring to other people’s expertise. My attitude to receiving the knowledge is different today, and I refer to the literature, articles in psychology and research, specialists’ advice, and colleagues’ opinions as important sources of information and inspiration for me to develop as a professional. I am aware of the fact that my responsibility is to provide the client with high-quality advice and assistance, and I can develop the most effective solution to the problem only after thinking about it critically and referring to the experts’ opinions in the field (Nagy, 2011). In addition, my approach to discussing professional relationships and the role of interaction in professional growth changed in terms of recognizing the importance of professional networks for licensing. Moreover, I can fully address the licensure expectations only now, when I focus on developing as part of the community of doctoral-level psychologists and researchers.
Therefore, my current strategy to develop the professional identity includes such points as the improvement of my professional knowledge and expansion of my experience, the development of required practical skills and abilities, the improvement of critical thinking and research skills, and the development of communication skills in order to improve my cooperation with colleagues and representatives of the scholar community.
Conclusion
The doctoral program and the discussed course provided me with the important background knowledge regarding the development of critical thinking, problem-solving, and decision-making skills important for a psychologist. In addition, I improved my abilities in providing explanations of observed practical and research cases and choosing the most appropriate treatment and solution. Furthermore, I went beyond the general application of principles and concepts to practical situations, and I also developed my skills in evaluating researches, theories, and hypotheses. As a result, my behavior and approach regarding daily practice, communication with colleagues and clients changed, and today I am more conscious of the results of my actions, the role of cooperation in the field, the improvement of knowledge, and research. From this point, I should state that my performance as a practitioner and my professionalism as a researcher improved significantly due to this course and my participation in the doctoral program.
References
American Psychological Association. (2014). Guidelines for psychological practice with older adults. The American Psychologist, 69(1), 34-38.
Kitchener, K. S., & Anderson, S. K. (2011). Foundations of ethical practice, research, and teaching in psychology and counseling. New York, NY: Routledge.
Nagy, T. F. (2011). Essential ethics for psychologists: A primer for understanding and mastering core issues. Washington, DC: American Psychological Association.
Ruscio, J. (2006). Critical thinking in psychology: Separating sense from nonsense. Belmont, CA: Wadsworth.
Sales, B. D. (2013). The professional psychologist’s handbook. New York, NY: Springer Science.
Teo, T. (2009). Philosophical concerns in critical psychology. Critical Psychology: An Introduction, 2(1), 36-54. | https://yourdissertation.com/dissertation-examples/reflection-on-personal-and-professional-direction/ |
TOP SKILLS/REQUIREMENTS:
• Attention to detail
• Strong organizational skills
• Able to manage multiple priorities
• Collaborative
JOB SUMMARY
Our client is seeking a QA Analyst to help advance their D&IT capabilities and to provide our customers with a world-class Digital and Information Technology experience.
The QA Analyst role is accountable for the end-to-end implementation and delivery of multiple digital experiences and initiatives, focusing on details and delivering results in a fast-paced and dynamic environment.
To achieve this, you must be inherently cross-functional. The ideal candidate will have strong critical thinking and communication skills to get consensus with Product Owners on understanding requirements, scope of testing and defect resolution. You will be expected to provide estimates and create well defined end-to-end testing scenarios, all while managing activities within the testing process to ensure the objectives are met and the solution works as expected.
A successful candidate has a high level of detail and thrive in an environment where timely execution and balancing of multiple projects is of high importance. You have an energizing personality with your work, work ethic and style.
ESSENTIAL DUTIES & RESPONSIBLITIES
• Web-based testing
• Proficient understanding in QA Procedures, Standard Methods and Software Requirement Specifications (SRS).
• Review user requirements: ask questions, identify gaps and provide suggestions when needed.
• Collaborate with Product Owners on understanding requirements, scope of testing, time estimates and activities needed for testing.
• Develop and execute multiple projects at varying sizes at the same time.
• Execute different types and levels of testing on various web applications and integrations between them.
• Validate that business expectations are achieved during the testing process.
• Track and report defects and risks to the project team and provide suggestions on risk mitigation.
• Testing execution in QA and PROD environments as needed.
• Management of projects on JIRA board and provide status updates in scrum meetings.
• Content entry in EpiServer platform (CMS).
KNOWLEDGE, SKILLS, & ABILITIES
• 2+ years of experience in web-based testing.
• Wide knowledge of SDLC, including requirements gathering, testing, defect tracking and reporting.
• Proficient understanding of QA Procedures, Standard Methods and Software Requirement Specifications (SRS)
• Experience in CRM 365.
• Experience in different types of testing – Smoke, Functional, Ad-hoc and GUI testing (including mobile)
• Basic knowledge on CMV content.
• Additional skills required to be successful in this role:
o Customer experience focused
o Excellent attention to detail
o Critical thinking and communication skills
o Strong organizational skills to manage multiple requests and projects
o High energy and results oriented
o Ability to work in a fast-paced environment
o Collaborative and team-oriented work style
o Continual focus on innovation and continuous improvement
WORKING CONDITIONS
• Corporate remote office environment – fast-paced
• Core Hours: Standard day shift
We’re an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.
This serves as notice per Iowa drug testing notification laws; applicants that reside in Iowa are subject to drug testing. | https://jobs.ondemandgroup.com/job/qa-analyst/ |
Why is critical thinking important in a growth mindset class culture?
Daniel Willingham (2008), professor of cognitive psychology at the University of Virginia, shared the three types of critical thinking: reasoning, making judgments/decisions, and problem solving. Everyday we reason, problem solve, and make decisions, but they do not always require critical thought.
Critical thinking is a process that must be infused with the content; it is not something that you can just check off a list once it is mastered. We want to start thinking about critical thinking as a process of strategies that can be applied to a myriad of situations rather then a set of skills. Providing students with opportunities to develop their cognitive abilities through critical experiences impacts the child's view and contributes to a growth mindset.
Chapter 4 describes a project that was conducted to improve critical thinking experiences in schools with high poverty and low achievement.
The project involved six Title 1 schools, a total of 53 classrooms in 2nd and 3rd grade and their teachers. Professional development highlighted places where critical thinking processes were already embedded in their curriculum (Common Core State Standards). Professional development for the first year of the project focused on ways that teachers could build students' reasoning abilities. The teachers learned instructional strategies that included deductive, analogical and quantitative reasoning, as well as concept attainment and concept formation strategies.
As part of the project, they introduced engaging nonverbal reasoning games into the classroom. The games increased the level of challenge as the children made their way up through each level. The addition of the games demonstrated to both teachers and students that critical thinking is possible at all ability levels.
5 Strategies for Critical Thinking
Critical thinking and a growth mindset culture go hand in hand. We can expect students to embrace challenge only if we make it available to them on a consistent basis.
Chapter 5 will discuss how students can learn from failure. | http://mentor.jordandistrict.org/2017/03/10/mindsets-in-the-classroom-chapter-4-why-critical-thinking-is-important/ |
INSTRUCTIONS: Please choose one of the following questions and post an answer/response by Thursday 11:59pm ET. Also please make sure to respond to at least two posts of your classmates and/or the instructor by Sunday 11:59pm ET. To earn full credit for this discussion assignment you need to make three substantive posts (see Discussion Guidelines under Course Home). Make sure to include references to the course materials in your responses.
(1) Consider an argument that you recently had with a friend, co-worker, supervisor, family member or someone else. Identify the fundamental issue of the argument and then present the argument in the form of deductive logical argument, making sure to clearly identify the premises and conclusion. Is this argument a valid argument? Is the argument sound? Why or why not?
(2) Many people have strong opinions about ideas that they believe to be true. It certainly is important to stand up for true beliefs; however, it also can be helpful for critical thinkers to consider perspectives that are different from their own beliefs. What are some of the advantages of taking into consideration an opposing viewpoint? Why is it important for critical thinkers to take time to understand opposing perspectives?
(3) Many people spend a lot of time thinking about various issues throughout the day. What is the difference between critical thinking and other types of thinking? Provide an example of situation where you demonstrated good critical thinking in your own life. How does the study of critical thinking help us improve our analytical reasoning abilities and decision-making skills? Assignment: an argument that you recently had with a friend. Assignment: an argument that you recently had with a friend
Deductive and Inductive Arguments
When assessing the quality of an , we ask how well its premises support its conclusion. More specifically, we ask whether the argument is either deductively valid or inductively strong.
A deductive argument is an argument that is intended by the arguer to be deductively valid, that is, to provide a guarantee of the truth of the conclusion provided that the argument’s premises are true. This point can be expressed also by saying that, in a deductive argument, the premises are intended to provide such strong support for the conclusion that, if the premises are true, then it would be impossible for the conclusion to be false. An argument in which the premises do succeed in guaranteeing the conclusion is called a (deductively) valid argument. If a valid argument has true premises, then the argument is said also to be sound. All arguments are either valid or invalid, and either sound or unsound; there is no middle ground, such as being somewhat valid.
Here is a valid deductive argument:
It’s sunny in Singapore. If it’s sunny in Singapore, then he won’t be carrying an umbrella. So, he won’t be carrying an umbrella. | https://onlinenursingwriters.com/assignment-an-argument-that-you-recently-had-with-a-friend/ |
Description1. Abstract: Describe the content of your paper in 5-10 sentences2. Introduction:3. Description of Research.Describe the methods investigators have used to study each subtopic. Summarize results if any between results from different studies and try to suggest reasons for these conflicts. Cite studies by author and year in the body of your paper not in footnotes at the bottom of the page or at the end of the paper. For example According to Yost and Sehft (1993) auditory processing in children develops. Avoid long words for word quotes from articles.4. Conclusion: Summarize the important points raised in your paper. Discuss the theoretical and/or practical implications of the studies you have analyzed. Do the data support any broad hypothesis5. References: List all the articles and books to which you have referred in the body of the paper in this section.Formats Books: Authors (date) Title. Publisher Journal Articles: Authors (date). Title. Journal volume number pages.
The purpose of this assignment is to help you achieve the course learning goals
The purpose of this assignment is to help you achieve the course learning goals shown in bold:By the end of the course you should have:Created a final portfolio that draws from your work completed in the program and uses the portfolio-building process to integrate and reflect on your undergraduate education as a whole.Developed skills in drawing on evidence in your portfolio to support claims about your learning and capacities for various audiences (friends family employers grad school admissions committee etc.).Become articulate about linkages between learning portfolios and professional portfolios.Developed your capacities to present your work orally and in writing to various audiences.Worked collaboratively with other students to enrich your understanding of interdisciplinary.IAS Learning Objective (Links to an external site.): Critical and CreativeThinkingIAS students develop their critical and creative thinking abilities by learning how to identify assumptions and to work out how those assumptions inform results. They assess multiple perspectives with an eye to understanding why and how they differ and developing the capacity to engage in controversy productively. Students learn to identify central questions or concerns informing other work and to develop their own work with clear animating questions. Students develop a range of skills in interpretation analysis argumentation application synthesis and evaluation.For this assignment you will create a mini-portfolio focused on your critical and creative thinking capacities as described above and as re-interpreted by you in class.Choose two to four artifacts from your work archive that provide evidence of these capacities. If you like you can choose one artifact in which your abilities were less developed and another in which they were better developed to make a comparison. You may add more artifacts to your UW Google site for this purpose if you like.Write a 300- to 500-word framing essay that explains your current capabilities in critical and creative thinking. Keep in mind that you are describing where you are in this moment in time so it would be helpful to consider what came before this moment and where you intend to go after you graduate and talk about your critical and creative thinking in those terms. Refer to your selected artifacts and explain how they serve as evidence of your capabilities in critical and creative thinking. You should aim to be as specific as possible in explaining to the reader how the artifacts you have chosen demonstrate your abilities with regard to critical and creative thinking. Remember that your reader will be unfamiliar with your work so you will need to describe it (rather than simply mentioning it). To this end some of the writing from your annotated bibliography might be useful. If so feel free to reuse it here.As you complete this assignment please draw on the IAS description of the critical and creative thinking learning objective your revision of that description and/or other materials and readings.
Write a short paper on implicit personality theory and impression management tha
Write a short paper on implicit personality theory and impression management that engages the following:What is implicit personality theoryExplain how a person would use this theory in order to enhance his or her impression management.Find an article or a book on a celebrity politician or athlete who used impression management to create a certain image. What role might implicit personality theory have played in regards to how this individual worked to create or enhance his or her imageWhat are the implications of impression management or implicit personality theory for social welfare or social change Support your reasoning with evidence.Finally how have you used impression management to enhance your own personal or professional image Be specific. Did changing one aspect of your image affect other aspects of your imageDo not use internet references (e.g .com .org .net websites). | https://blog.keenessays.com/page/122116/ |
The Language and Literature Department offers intensive English writing courses aimed at developing and strengthening critical thinking and meeting proficient college level writing for effective communication. The writing courses focus on helping students become competent and skillful writers, using selective rhetorical strategies. In literature courses, students will evaluate and examine different culture and people through various genres of literary works. Literature students are to apply analytical and critical thinking in dissecting language and situation from literary works, which not only will help them become independent writers, but will strengthen their reading comprehension. The Language and Literature Department is designed to prepare students for transfer to a four- year college or university or to be a successful and contributing member of the modern work force.
The Language and Literature Department offers the following courses.
Student Learning Outcomes
- GEO 1: B: Reading: Read effectively to comprehend, interpret, in many different situations.
- GEO 1: C: Writing: Write clearly, concisely and accurately in a variety of contexts and formats and for many audiences.
- Demonstrate active listening and speaking abilities;
- Demonstrate proficiencies in clear and effective written communication
- Demonstrate improvement in reading skills focused on comprehending, analyzing, interpreting, and evaluating printed texts. | http://amsamoa.edu/departments/languageslit.html |
Critical and Systems Thinking engages with the analytical thinking abilities required in deciding and communicating management strategy for complex large-scale projects. The unit develops skills in making basic critical judgments on complex problem situations involving uncertainty, incomplete information and dynamically interacting technical and non- technical systems and contexts. There is a particular focus on the ability to articulate a critical, reflected and well- reasoned response at a level that contributes usefully to project strategy discussions. In addition the unit also equips students with knowledge and communication competencies of immediate relevance to the academic structure. Students engage with theoretical frameworks and concepts in order to practice robust methods of questioning and argument. A central element of content is linking theory to practice with students' experience as the focal point. The unit is pitched at the level of Associate to Practitioner (Levels 2 to 3) on the Project Management Learning Progression Table, addressing the critical thinking and systems thinking dimensions of Project Communication and Project Development. At this level, you are not necessarily expected to produce fully researched and optimised solutions to the problems posed, but you do need to be able to clearly define the main problem at hand, organise and filter relevant evidence and issues, identify and evaluate logical connections, recognise critical assumptions and uncertainties, reach well-reasoned conclusions, develop and reflect on your own personal views and present critical arguments in a constructive manner to colleagues and supervisors. These abilities are essential for an understanding of the relevance of epistemological and ontological considerations in relation to the broader, more thoroughgoing analysis of complex system dynamics to be developed in other advanced Project Management units. | https://sydney.edu.au/courses/units-of-study/2018/engg/engg5811.html |
In light of the importance of developing critical thinking, and given the scarcity of research on critical thinking in mathematics education in the broader context of higher order thinking skills, we have carried out a research that examined how teaching strategies oriented towards developing higher-order thinking skills influenced students’ critical thinking abilities. The guiding rationale of the work was that such teaching can foster the students’ skills of and dispositions towards critical thinking. In this article, we discuss ways in which critical thinking can be incorporated in mathematics instruction. In particular, we highlight how content taught in the probability strand can intentionally be focused on the development of students’ critical thinking. We report results of a study demonstrating improvement in secondary mathematics students’ dispositions towards critical thinking and abilities to think critically.
Keywords
Critical Thinking, Probability, Mathematics, High School, Early Childhood
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Conflicts of Interest
The authors declare no conflicts of interest.
References
Copyright © 2021 by authors and Scientific Research Publishing Inc.
This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License. | https://www.scirp.org/journal/paperinformation.aspx?paperid=54944 |
- To develop and inculcate 21st Century skills amongst the students encompassing collaboration, teamwork, creativity, imagination, critical thinking, problem solving, flexibility, adaptability, global/cultural awareness, information literacy, leadership and communication skills.
- Effective teaching process based on concept building by utilizing all latest technological advancements and educational facilities like Interactive Smart Boards and Audio – Visual Aids with personalized attention on each student.
- Conceptual learning in a very congenial, conducive and disciplined environment.
- Regular evaluation in each subject to identify and address the weak areas along with fine tuning of the strengths of the students.
- An effective pedagogy in the mixed ability class through differentiation along with testing and communication of the learning outcomes of the students to the parents.
- Special attention on students found weak in studies through remedial plans like additional supplementary material and evening coaching classes.
- Provision of especially designed topic wise worksheets and assignments in each subject where the intellectual abilities of the students are challenged for better concept building.
- Orientation and best preparation of the students for the internal as well as external exams with an objective of securing excellent grades in the same.
- Personality development by inculcating traits like self-confidence, public speaking, English communication skills, critical thinking, synthesis, IT skills etc and giving vent to the latent capabilities of the students through host of co-curricular activities and Sports.
- Career and general counseling of the studnets.
- A regular professional development of faculty through seminars and training workshops.
- Regular improvement in the educational facilities & Sports material.
- A close interaction with the parents with reference to the over-all progress of students through forums like interactive website, Parent-Teacher Meetings, e-mail, telephone conversation etc. | https://www.theknowledgecityschool.com/about/our-objectives/ |
Thinking Critically and Creatively Critical thinking skills are perhaps the most fundamental skills involved in making judgments and solving problems. But then you quickly realize that the chicken had to come from somewhere, and since chickens come from eggs, the egg must have come first. This is what critical thinking is. Then I thought of the elevated, and I saw there was such a line within two blocks. But, if taught in excess, it can lead to cynicism about the intent of others and the broad dismissal of facts, which tends to lead to poor decision making. Rationality requires analyzing all known information, and making judgments or analyses based on fact or evidence, rather than opinion or emotion.
It expresses a practical program for achieving an educational goal. Further observation confirms that the diamonds are close together when a dotted line separates the diamond lane from its neighbour, but otherwise far apart. There was no substance entering to force it out. Becoming aware of them is what makes critical thinking possible. In a series of studies, conducted in the U. It is thus a component of the inferential skills already discussed.
Critical thinking resources: An annotated bibliography. The word logic comes from the Ancient Greek logike, referring to the science or art of reasoning. The knowledge, recognition and application may be procedural rather than declarative. This post is my attempt to answer those questions. If we review the list of abilities in the preceding section, however, we can see that some of them can be acquired and exercised merely through practice, possibly guided in an educational setting, followed by feedback. I test to see if this supposition is true by taking several more tumblers out. You may question the information you read in a textbook, or you may question what a politician or a professor or a classmate says.
Experimenting abilities: Knowing how to design and execute an experiment is important not just in scientific research but also in everyday life, as in. It is not obvious, however, that a good mental act is the exercise of a generic acquired skill. These rules are designed to encourage creativity. Let us begin, then, by distinguishing the kinds of mental acts and mental events that can occur in a critical thinking process. Critical Thinking Examples in the History of the World 1. The thinker can then look at what research has been done on the subject, and identify what he or she can learn simply by looking over such work.
Consulting abilities: Skill at consulting sources of information comes into play when one seeks information to help resolve a problem, as in. My mind went back to the subway express as quicker than the elevated; furthermore, I remembered that it went nearer than the elevated to the part of 124th Street I wished to reach, so that time would be saved at the end of the journey. For example, one could be open-minded about scientific issues but not about religious issues. Educational intervention has been shown experimentally to improve them, particularly when it includes dialogue, anchored instruction, and mentoring. While I venture that a lot of us did learn it, I prefer to approach learning deliberately, and so I decided to investigate critical thinking for myself.
Think about the time of day you are most effective and have the most energy. It is an important part of a critical thinking process in which one surveys arguments for various positions on an issue. This is an important finding because there is plenty of evidence that critical thinking can be taught and improved. Through curiosity and probable skepticism, he not only worked out the basic rules for matter and energy in the universe — he also realized that the force causing objects to fall was the same as the force causing celestial objects to orbit around each other thus discovering the modern theory of gravity. With critical thinking, anything and everything is subject to question and examination for the purpose of logically constructing reasoned perspectives. In each case, critical thinking has taken a slightly different form, sometimes emphasizing skepticism above the other dimensions as occurred in the European Enlightenment , sometimes emphasizing other dimensions such as creativity or rationality. Handbook I: Cognitive Domain, New York: David McKay.
Critical Thinking Abilities Some theorists postulate skills, i. If not, I might lose more than twenty minutes in looking for one. Ennis 1962 proposed 12 aspects of critical thinking as a basis for research on the teaching and evaluation of critical thinking ability. A , for example, must be open to the idea that the results of an experiment will not be what is expected; such results, though challenging, often lead to tremendous and meaningful discoveries. Her numerous research interests include critical thinking, advanced learning technologies, and the use of psychological science to prevent wrongful convictions. This gnarly Inner Critic is the voice of your self-doubt and fear.
You analyze your position in the company and in what way you can contribute to this target. For a list of identified internal critical thinking dispositions, see the. We can identify the ability to think well directly, in terms of the norms and standards for good thinking. I saw that the hands pointed to 12:20. One reason why experts are typically better than novices at solving complex problems is that they begin the problem-solving process with sharp critical analysis: Studies comparing problem-solving performances of experts and novices have indicated that experts are able, because of their knowledge, to focus on the important aspects of a novel problem. If critical thinking is conceived more narrowly as consisting solely of appraisal of intellectual products, then it will be disjoint with problem solving and decision making, which are constructive. | http://cityraven.com/what-critical-thinking-is-not.html |
Yogyakarta – Saturday, November 30th 2019. The Master of Science and Doctoral Program, Faculty of Economics and Business, Universitas Gadjah Mada (MD FEB UGM) held the second series of skills improvement programs namely Design Thinking Workshop (DTW). A total of 36 Masters students in Economic Science, Accounting Science and Management Science in the second and third semester were trained in critical and rational thinking skills in seeing a phenomenon and formulating feedback in the form of offering solutions to solve problems creatively, innovatively, efficiently and effectively. During 8 (eight) hours, four sessions were delivered by speakers in the form of introductions, case studies, group discussions, and presentations & validations.
Present as the main speakers were Nurul Indarti, Sivilokonom, Cand. Merc., Ph.D, Chair of the Management Study Program and RR. Nastiti Tour., Ph.D., Manager of Academic, Student Affairs and Collaboration Program MD FEB UGM. In his presentation, Nurul Indarti said “The ability of students to analyze a broader phenomenon is still weak due to the ability of problem identification and critical thinking that has not been trained. Then DTW is implemented as a student experiment media to identify institutional, program and individual problems and then offer solutions “. RR. Nastiti tour said that a problem tends to be the source of various problems, it is necessary to be empathetic by lateral thinking to identify problems and find their roots.
As a general description of activities, students are divided into 6 groups and through teamwork identify client’s problems using the in-depth interview method. Each group interviewed one student who acted as a client to explore the personal problems being faced. This session is a case study session which is specifically time for the group at a stage called discovery and interpretation. Each participant then creates a client persona to explore the objectivity of the problem with a certain evidence(s). Furthermore, each group uses the mind mapping method in formulating the classification of problems faced by the client. This session focuses on the stages of ideation, experimentation, and evolution. | https://mscdoctor.feb.ugm.ac.id/en/skill-improvement-program-for-magister-science-students-through-design-thinking-workshop-series-2/ |
The data available to help researchers and healthcare providers understand and address the unique needs of the province’s Indigenous peoples is the focus of a post-doctoral study. The Ontario Neurotrauma Foundation and partner Rick Hansen Institute are supporting the post-doctoral fellows working on the project, Drs. Sandra Juutilainen and Melanie Jeffery.
To understand the current landscape of traumatic spinal cord injury (TSCI) among First Nations populations in Ontario with regards to their health care experiences, services and supports via stakeholder interviews.
Qualitative data will determine direction for quantitative analyses of existing data sets.
To identify aspect of a cohesive and meaningful database for First Nations persons living with TSCI and their caregivers in Ontario.
What drew you to this post-doctoral research project given that neither of you have a research or clinical background specifically related to spinal cord injury?
We both were completing our previous post-doctoral projects and this one appealed to both of us although we didn’t know each other before starting this project. The subject was interesting to us, each for different reasons but we were both intrigued by the joint funding partners, ONF and RHI.
Sandra, whose family background is Oneida of the Thames and Finnish, brings qualitative skills to the project. She has abackground in Indigenous research, ethics and knows the importance of consultation and inclusion of indigenous people in research. Sandra also lives with epilepsy and this has informed her work and study in the neuroscience area.
Melanie brings a neuroscience and data analytics background to the project.She has taught indigenous studies for 12 years with a focus on systemic racism in healthcare, making this study a good fit with her academic emphasis. She also understands the critical importance of having indigenous voices at the table as co-creators.
Could you provide an explanation of the research including your process and anticipated outcomes?
We’re trying to identify and start to build the model for a meaningful and cohesive database. Where to start is part of the question since we know there is significant under- and inaccurate reporting on spinal cord injury in relation to Ontario’s indigenous population.
We are currently in the final stages of the ethics approval processbut have been able to meet with key informants in Toronto including Principal Investigator Suzanne Stewart, two elders, representatives of several University of Toronto hospitals involved in the care of those living with SCI.
Melanie will study the current codes in various databases to attempt to find “holes” that are specifically related to the realities of First Nations, there is currently little data to support the care requirements and needs for those living with SCI. In other words, what is absent from the way in which data is collected that excludes or does not take into account Indigenous ways of thinking and being. Sandra will lead the work to completequalitative interviews with individuals living with SCI, caregivers, health service providers, etc. in rural and remote areas.
We believe that when all of this is combined it will provide a base of knowledge that does not now exist.
How might the work you are doing affect change and address these and other issues unique to Ontario’s Indigenous peoples?
We think this study is just a start. It’s focused on Indigenous people in Ontario but this really is a national issue. The findings should help other provinces more quickly identify data gaps and then develop the best ways to address and close those gaps in care for people living with SCI.
Are hospitals addressing issues of culturally appropriate care in terms of Indigenous peoples?
Is there a link between traumatic brain injury in Indigenous populations and the level of care they are receiving?
Rural and remote communities generally are not the focus for this kind of study so we hope our results will increase understanding of the different needs of Indigenous communities when it comes to care for those living with chronic health conditions that require long-term rehabilitation and supports. | http://onf.org/documents/neuromatters-newsletter/neuromatters-winter-2019/researcher-profile-winter-2019 |
The description below was taken from the R01 version of this FOA.
The purpose of this Funding Opportunity Announcement (FOA) is to encourage research grant applications to support research designed to elucidate the etiology, epidemiology, diagnosis, treatment, and optimal means of service delivery in relation to Autism Spectrum Disorders (ASD).
Autism Spectrum Disorders share a cluster of impairments in social communication, as well as the presence of stereotyped behavior, interests, or activities. These complex disorders are usually of lifelong duration and affect multiple aspects of development, learning, and adaptation at home and in the community, thus representing a pressing public health need. The etiologies of these disorders are not yet understood, but may include a combination of genetic and environmental influences.
Basic research into the pathophysiology of ASD, including research on brain mechanisms and genetics, is of special interest. Also of high priority are clinical and applied investigations that may lead to the development of new treatments and interventions, specifically those that hypothesize and test a mechanism of treatment effect, as well as the development of validated instruments that may be used as stratification tools or as outcome measures in treatment and intervention studies.
Areas of interest include, but are not limited to, the following:
- Epidemiology: Studies of the genetic and environmental epidemiology of ASD to determine risk and protective processes in the etiology of the disorder, including environmental exposures during pregnancy and early childhood; longitudinal studies of high-risk populations; epidemiologic research on interactive genetic and environmental factors or processes that increase or decrease risk for ASD; studies of the developmental course of ASD across the life-span; studies that characterize the range of expression within families; and research that characterizes and quantifies risk and protective processes associated with co-occurring features.
- Screening, Early Identification, and Diagnosis: Studies of key features of ASD associated with various stages of development, including those focused on adults; development of new screening tools for use in a variety of settings; assessment of comorbid features including epilepsy; and the creation of new measures to be used in longitudinal and/or treatment studies, as well as measures that further differentiate subtypes of ASD.
- Genetic Studies: Family-based or population-based genetic analyses that aim to: identify specific susceptibility genes using whole genome/exome approaches; investigate epigenetic mechanisms and long range control of gene expression; systems approaches that incorporate multiple types of -omics data; detect locus heterogeneity; and analyze the interaction of autism susceptibility genes with environmental exposures and/or genes responsive to environmental insult. An area of particular interest is the effect of genetic factors on therapeutic drug response in individuals with ASD (see Pharmacogenomic Studies, below).
- Brain Mechanisms: Studies of brain mechanisms underlying the development, regulation, and modulation of behaviors characterizing ASD, particularly those mechanisms involving social communication; studies of brain mechanisms and biological factors underlying atypical onset patterns or the loss of previously acquired skills; studies of brain mechanisms involved in the development of abnormal electroencephalograms and epilepsy, and studies to clarify the subtypes of seizures and seizure disorders in ASD; studies to define the neurobiological basis for the role of neuroimmune/autoimmune factors; studies using model systems to examine brain dysfunction related to ASD; and studies using novel reagents and tools to identify molecular, cellular, or developmental mechanisms relevant to ASD.
- Shared Neurobiology of ASD with Fragile X Syndrome, and Other Related Disorders: Studies of developmental and functional processes, pathways, and brain mechanisms that will lead to an understanding of shared etiology or pathophysiology among these disorders; analysis of autism-related neurobiological and behavioral phenotypes in related “single gene” disorders; and analyses that would identify useful and specific clinical endpoints that would register measurable improvements in response to treatment interventions in clinical populations.
- Cognitive Science: Developmental studies of relevant behaviors during infancy including attention to social and nonsocial stimuli, affective behavior, gaze, imitation, reciprocity and play, and their emergence in infants with, or at-risk for, ASD; research on social behavior and social cognition across the life-span; studies leading to more sophisticated measures of higher cognitive functioning, especially in social communication; and studies of sensory-motor factors and multisensory integration.
- Communication Skills: Longitudinal, developmental studies of behaviors that are precursors to later communication, and their emergence in children with ASD; sensory, motor, and social-cognitive impairments that impact interaction and communication; predictors of atypical onset patterns in expressive language abilities; and interventions designed to remediate communication and related deficits across the life-span.
- Pharmacological/Biological Interventions: Studies testing new pharmacological agents or neuromodulatory devices that specifically target the core social deficits of ASD; identification and validation of novel treatment targets or biomarkers that assess effects on key biological, neurodevelopmental and/or behavioral endpoints disrupted in ASD; and development of validated outcome measures.
- Pharmacogenomic Studies: Analyses of SNP and DNA sequence data that identify biomarkers to resolve clinical heterogeneity and heterogeneity of therapeutic drug/device response; studies of genetically determined functional changes in nuclear and cell surface receptors to explain the ineffectiveness of therapeutic agents and adverse or paradoxical drug/device responses; and studies of allelic variation occurring in individual transporter genes that are associated with a functional consequence.
- Psychosocial/Behavioral Interventions: Studies to develop novel interventions for persons with ASD; the development of interventions designed to address deficits in complex social abilities or their developmental precursors; studies that develop and test interventions for infants and toddlers who are at-risk for ASD; use of interventions as “probes” to examine specific theories regarding possible neuropathogenesis; and development of validated outcome measures.
- Services Research: Research on the organization, delivery, coordination, and financing of services for persons with ASD and their families, within or across service settings; studies aimed at better identifying and addressing changes in service and rehabilitative needs across the life-span, including during transitions from childhood to adolescence, and adolescence to adulthood; interventions to improve the quality and outcomes of treatment and rehabilitation services; studies of ways to coordinate or integrate services across settings including specialty mental health, general health, and other settings such as educational, vocational, and housing services, in order to maximize receipt of appropriate services; and research on assessing the value and improving the efficiency of the delivery and sustainability of needed services and treatments.
Deadlines: standard dates apply
URLs: | https://news.med.virginia.edu/deansoffice/2016/08/nih-research-on-autism-spectrum-disorders-r01-r03-r21/ |
Huntington’s disease is a progressive neurodegenerative disorder, caused by inheritable mutations in the huntingtin (HTT) gene. The mutation produces a toxic form of the HTT protein that aggregates in and ultimately kills nerve cells.
This results in various symptoms, including movement, cognitive, and psychiatric problems.
There is no cure for Huntington’s disease. However, there are several approved therapies to help manage the symptoms of the disease and maintain patients’ quality of life for as long as possible.
Furthermore, research is continually ongoing into the mechanism of the disease, which could lead to the development of new and innovative treatments. There are a number of experimental therapies currently being investigated in clinical trials.
The approved therapies for Huntington’s disease mainly focus on managing the symptoms of the disease. Movement problems, such as chorea, for example, are a common Huntington’s symptom. Xenazine (tetrabenazine) is the only medication specifically approved for Huntington’s chorea. Others, such as antipsychotics and benzodiazepines, have also demonstrated a benefit and can be used off-label.
Physical therapy can help maintain mobility and prevent falls through tailored exercises for the patient. This can be complemented by occupational therapy that helps the patient establish coping strategies and identify ways to make his or her life easier, either through simple changes or the introduction of assistive devices. Occupational therapy and speech therapy can also help deal with communication issues that may arise due to the disease affecting the muscles of the mouth and throat.
Psychiatric problems may be managed using anti-depressants, antipsychotics, and mood-stabilizing medications.
Researchers have identified several avenues to further explore for the treatment of Huntington’s disease. Many of these have now progressed to the clinical trial stage in humans, and more are still being developed.
Several therapies are being investigated to manage the symptoms of the disease more effectively. For example, SRX246, a Huntington’s-specific therapy for depression, is currently in a Phase 2 clinical trial.
Gene silencing therapies act to reduce the levels of toxic HTT protein being produced. It is hoped that this could slow the progression of the disease, and not just manage the symptoms.
Neuroinflammation is an abnormal immune response that is common in Huntington’s disease and can lead to further damage and cell death in the brain. Therapies intended to reduce inflammation in the brain are being developed for Huntington’s. Examples of experimental anti-inflammatory therapies include VX15/2503 and laquinimod. Neuroprotective therapies aimed at reducing nerve cell death in the brain are also an option. Examples include Huntexil (prodopidine) and SBT-20. | https://huntingtonsdiseasenews.com/treatments/ |
Symptom: Involuntary Movements
What Is Uncontrollable Movement?
Uncontrollable movement refers to involuntary motions in an individual. They may also be referred to as involuntary body movements. You can experience these movements in almost any part of the body, including the neck, face, and limbs.
There are a number of types of uncontrollable movements and causes. Uncontrollable movements in one or more areas of the body may quickly subside in some cases. In others, these movements are an ongoing problem, and may worsen over time.
Types of Uncontrollable Movement
There are several types of involuntary movements. Nerve damage, for instance, often produces small muscle twitches of the affected muscle. A few of the main types are described in the sections below.
Tardive Dyskinesia
This syndrome is neurological in nature, meaning that it is a problem that originates in the brain. It is connected to the use of neuroleptic drugs, which are typically prescribed for treating psychiatric disorders.
People with tardive dyskinesia often exhibit one or more of the following involuntary movements:
According to the National Institute of Neurological Disorders and Stroke, tetrabenazine is the only currently approved form of drug treatment for this syndrome (NINDS, 2011).
Tremors
Tremors are rhythmic movements of a particular body part. They are caused by sporadic muscle contractions.
According to the Stanford School of Medicine, most people can experience tremors in response to such factors as low blood sugar, alcohol withdrawal, and exhaustion (Stanford School of Medicine). However, tremors may also be related to more serious underlying conditions, such as multiple sclerosis and Parkinsonâs disease.
Myoclonus
These are shock-like, jerking movements. They may occur naturally during sleep, or at moments when a person is startled. However, they can also be due to serious underlying health conditions, such as epilepsy or Alzheimerâs.
Tics
Tics are sudden, repetitive movements. They are classified as simple or complex, depending on whether they involve a smaller or larger number of muscle groups. Excessively shrugging the shoulders or flexing a finger is an example of a simple tic. Repetitively hopping and flapping oneâs arms is an example of a complex tic.
In young people, tics are most often associated with Tourette syndrome. The motor tics that occur as a result of this disorder may disappear for short periods of time. The affected individual may also be able to stifle them to some extent.
In adults, tics may occur as a symptom of Parkinsonâs disease. Adult-onset tics may also be caused by trauma or the use of certain drugs, such as methamphetamines.
Athetosis
This refers to slow, writhing movements. According to the Stanford School of Medicine, this type of involuntary movement most often affects the hands and arms (Stanford School of Medicine).
Causes of Uncontrollable Movement
There are several potential causes for involuntary movements. In general, involuntary movement suggests damage to nerves or areas of the brain that affect motor coordination. However, a variety of underlying conditions can produce involuntary movement. The sections below review several potential causes of uncontrollable movement in children and adults.
Children
In children, some of the most common causes of involuntary movements are:
Adults
In adults, some of the most common causes of involuntary movements include:
Involuntary movements may also be due to genetic disorders, including Huntingtonâs disease and Wilsonâs disease.
Testing and Diagnosis for Uncontrollable Movement
Make an appointment with a doctor if you or your child are experiencing persistent, uncontrollable body movements and are unsure of what is causing them.
Your appointment will most likely begin with a comprehensive medical interview. This will go over personal and family medical history, including any medications you have been taking or have taken in the past.
Other questions may include:
It is important to mention any other symptoms you may be experiencing alongside these uncontrollable movements. Other symptoms and your responses to your doctorâs questions are very helpful in deciding what the best course of treatment will be.
Diagnostic Tests
Depending on what cause your doctor suspects, he or she could order one or more medical tests, including:
Psychopharmacology metrics and testing can also be used for diagnostic testing. However, this will depend on whether certain drugs or substances are being used by the patient. For instance, tardive dyskinesia is a side effect of using neuroleptics over a certain period. Whether you have tardive dyskinesia or another condition, the effects of any medications or drugs being used need to be examined during testing. This will help your doctor make an effective diagnosis.
Treatment and Outlook for Uncontrollable Movement
Outlook can vary, depending on the severity of this symptom. However, some medications can reduce the severity. For instance, one or more medications can help keep uncontrolled movements associated with seizure disorders under control.
Physical activity within your doctorâs guidelines can help enhance your coordination. It may also help slow muscle damage. Possible forms of physical activity include swimming, stretching, balancing exercises, and walking.
Support and self-help groups may help ease the emotional toll that this symptom can have on both the affected person and his or her family. Ask your doctor for assistance with finding and joining these types of groups.
Source: http://www.healthline.com
Signs and Symptoms
Skincare Health Center an online symptom search and symptom directory. Here you can find what is the symptom Involuntary Movements and what does it mean, you can also check what illnesses and diseases this symptom relates to. | http://www.skincarehealthcenter.com/symptom/4-235/involuntary-movements |
Is NMS reversible?
Is NMS reversible?
The mortality rate of NMS is estimated to be as high as 20% and the usual cause of death is due to acute renal failure. Fortunately, with early recognition and intervention, it is usually reversible without any serious complications.
What are two signs and symptoms of neuroleptic malignant syndrome?
Symptoms of neuroleptic malignant syndrome usually include very high fever (102 to 104 degrees F), irregular pulse, accelerated heartbeat (tachycardia), increased rate of respiration (tachypnea), muscle rigidity, altered mental status, autonomic nervous system dysfunction resulting in high or low blood pressure.
Which medication is associated with the highest risk of tardive dyskinesia?
Risk factors Taking neuroleptics, especially over an extended period, is the biggest risk factor for developing tardive dyskinesia.
How is neuroleptic malignant syndrome diagnosed?
The diagnosis is confirmed by the presence of recent treatment with neuroleptics (within the past 1-4 weeks), hyperthermia (temperature above 38°C), and muscular rigidity, along with at least five of the following features: Change in mental status Tachycardia. Hypertension or hypotension.
Can you have neuroleptic malignant syndrome without fever?
These three cases illustrate the point that NMS can occur without fever. Our patients had all the features of NMS apart from fever and the response to bromocriptine can be taken as strong evidence that the diagnosis was accurate.
What meds cause neuroleptic malignant syndrome?
However, every class of antipsychotic drug has been implicated, including the low-potency (eg, chlorpromazine) and second-generation antipsychotic drugs (eg, clozapine, risperidone, olanzapine) as well as antiemetic drugs (eg, metoclopramide, promethazine, and levosulpiride) [5,12,13].
What is the best treatment for tardive dyskinesia?
There are two FDA-approved medicines to treat tardive dyskinesia:
- Deutetrabenazine (Austedo)
- Valbenazine (Ingrezza)
How do you reverse tardive dyskinesia?
In some cases, tardive dyskinesia can be reversed, especially if it’s caught early….There are a few options to try.
- Stop the medication causing tardive dyskinesia symptoms.
- Switch to a newer antipsychotic.
- Add medications that specifically treat tardive dyskinesia.
- Remember prevention and early detection are best.
What medicine causes tardive dyskinesia?
Medicines that most commonly cause this disorder are older antipsychotics, including:
- Chlorpromazine.
- Fluphenazine.
- Haloperidol.
- Perphenazine.
- Prochlorperazine.
- Thioridazine.
- Trifluoperazine.
How can I reverse tardive dyskinesia naturally?
Tardive Dyskinesia (Holistic)
- Get some extra E. Reduce the severity of TD by taking 1,600 IU of vitamin E every day under a doctor’s supervision.
- Discover lecithin. Improve symptoms by taking 25 grams of this nutritional supplement twice a day, providing 35 grams of phosphatidyl choline per day.
- Mix in manganese.
- Manage movement with melatonin.
Does Vitamin E help with tardive dyskinesia?
The results suggest that vitamin E is of value in the treatment of tardive dyskinesia and that the optimum dose for treating tardive dyskinesia is 1600 mg per day. In addition, there may be a dose related therapeutic effect of Vitamin E in tardive dyskinesia.
What is the most common movement disorder?
Abstract. Essential tremor (ET) is the most common adult movement disorder, as much as 20 times more prevalent than Parkinson’s disease.
What drugs are used to treat movement disorders?
Common groups of drugs used to treat Parkinson’s disease and other movement disorders include levodopa, dopamine agonists, MAO-B antagonists, COMT-inhibitors, anticholingergics, amantadine and antidepressants.
How do you treat movement disorders?
Physical or occupational therapy to help maintain or restore your ability to control your movements. Botulinum toxin injections to help prevent muscle contractions. Deep brain stimulation, a surgical treatment option that uses an implant to stimulate the areas of your brain that controls movement.
What causes uncontrollable body movements?
In adults, some of the most common causes of involuntary movements include: drug use. use of neuroleptic medications prescribed for psychiatric disorders over a long period. tumors.
What causes a person to jerk at night?
Share on Pinterest Hypnic jerks occur when a person is transitioning to a sleeping state and may wake them up. A hypnic jerk is an involuntary twitch of one or more muscles that occurs as a person is falling asleep. It tends to happen just as the person is transitioning from a wakeful state to a sleeping state.
What causes uncontrolled tongue movements?
That’s the case with tardive dyskinesia (TD), a neurological syndrome marked by random and involuntary muscle movements that usually occur in the face, tongue, lips, or jaw. It’s typically caused by long-term use of antipsychotic medications that block dopamine receptors.
What is the term for uncontrolled muscle movements?
Involuntary movements compose a group of uncontrolled movements that may manifest as a tremor, tic, myoclonic jerk, chorea, athetosis, dystonia or hemiballism.
How do you treat involuntary muscle movement?
Treatment may include medications such as baclofen, diazepam, tizanidine and clonazepam. Physical therapy with specific muscle exercises may be prescribed in an effort to help reduce the severity of symptoms. Surgery may be recommended for tendon release or to cut the nerve-muscle pathway.
What does dystonia look like?
Dystonias are movement disorders that involve involuntary movements. Symptoms include muscle contractions and spasms, repetitive movements, and unusual and awkward postures.
What drugs cause involuntary muscle movement?
Stimulant drugs (e.g., amphetamine, methylphenidate, and pemoline) have been known to produce a variety of movement disorders such as dyskinesias, dystonia, stereotypic behavior, and tics.
What triggers dystonia?
Some causes of acquired dystonia include birth injury (including hypoxia, a lack of oxygen to the brain, and neonatal brain hemorrhage), certain infections, reactions to certain drugs, heavy metal or carbon monoxide poisoning, trauma, or stroke.
Should I worry about muscle twitches?
You should see your doctor if the twitches are continuous, cause weakness or muscle loss, affects multiple body parts, begin after a new medication or new medical condition. A muscle twitch (also called a fasciculation) is a fine movement of a small area of your muscle.
Can medication cause involuntary movements?
Acute drug-induced movement disorders occur within minutes to days of drug ingestion. They include akathisia, tremor, neuroleptic malignant syndrome, serotonin syndrome, parkinsonism-hyperpyrexia disorder and acute dystonic reactions. | https://rehabilitationrobotics.net/is-nms-reversible/ |
This guide is designed to be a primer for those who are seeking information about Huntington Disease (HD).
HD, previously known as Huntington's chorea, is an inherited genetic disorder that causes the deterioration of nerve cells in the brain. Over a period of time, this deterioration affects movement, behavior, and cognition, and eventually impedes the individual's ability to function normally. The symptoms of HD are often described as a combination of Parkinson's, ALS, and Alzheimer's. The symptoms can appear at any age, but usually become noticeable between the ages of 30 and 50.
HD is caused by a defective gene inherited from a parent, with only 5-10% of cases resulting from a new genetic mutation. Since it is an autosomal dominant disorder, it means that only one copy of the defective gene, inherited from one parent, is necessary to produce the disease. Therefore, if one parent has the disease, each child has a 50% chance of inheriting the defective gene.
Males and females are both at equal risk of acquiring HD, but the disease occurs in certain races and ethnicities more than others, with people of European descent having a higher risk of acquiring it.
Per million, HD affects:
Note: The African figure might be so low due to poor documentation and inconclusive evidence.
There are many symptoms which are indicative of HD, however, not everyone with the disorder will experience them to the same degree. Evidence also suggests that the average age of onset is later for individuals who inherited the gene from their mother. This means that, typically, onset occurs earlier when the gene is inherited from the father.
During the early stages of HD, people can function normally at home and work. However, as the disease progresses they may find it increasingly difficult to work or manage a household, but are still capable of dealing with most day-to-day activities. In the advanced stages of HD, involuntary movements give way to rigidity, communication and swallowing become severely impaired, and affected individuals will become severely impaired, and totally dependent on others.
The lifespan of somebody with HD varies, however, death typically occurs 15-25 years after the onset of the disease. This is usually due to complications such as heart failure, choking, infections, or pneumonia, and not from HD itself. In roughly 9% of cases, suicide is the cause of death.
The symptoms of HD can be split into physical changes, cognitive impairments, and psychiatric disorders.
Physical Changes
The movement disorders associated with HD can include both involuntary movements and impaired voluntary movements.
Involuntary movements which may originally consist of fidgeting, twitching of the hands or feet, or excessive restlessness, will slowly develop into more obvious uncontrollable jerking and twitching of the head, neck, arms, and legs.
Diminished coordination, initially affecting things like driving and handwriting, becomes increasingly pronounced. Gait, posture, and balance become impaired and, as a result, during the later stages of the disease, people stagger when walking. Eventually, they will lose the ability to walk and control their movements all together.
Other physical changes include weight loss, muscle problems, slow or abnormal eye movements, and slurred speech.
Depression is one of the most common psychiatric disorders associated with HD. In addition to the constant feelings of sadness and worthlessness, and a lack of desire to engage in formerly pleasurable activities, other signs of depression may include a lack of energy, insomnia, social withdrawal, irritability, apathy, and frequent thoughts of death, dying or suicide. Depression occurs as a result of changes in the brain due to HD, and not simply as a reaction to receiving the diagnosis.
Another psychiatric disorder associated with HD is Obsessive Compulsive Disorder. This condition causes severe anxiety and is characterized by recurrent, unwanted thoughts, and repetitive behaviors.
Cognitive Impairments
Those who are suffering from HD will experience cognitive changes which affect their awareness, judgment, and perception.
Therefore, affected individuals will have difficulty organizing, prioritizing, making decisions, and focusing on tasks. As a result, their jobs often become very time-consuming. During the later stages of the disease, some people prefer to take on jobs that are less demanding rather than having to give up work entirely. The ability to recall information (be it old or new), process thoughts, and "find" the right words diminishes so people with HD might appear forgetful.
Furthermore, coping with new situations becomes increasingly difficult and individuals may exhibit a lack of flexibility when it comes down to communicating with words, phrases, or gestures. Other symptoms include a lack of impulse control that can lead to outbursts, acting without thinking, and sexual promiscuity.
Genetic Testing
If one of your parents has HD, but you haven't any symptoms and you'd like to find out whether you carry the gene, you can take a genetic test from the age of 18. Some take the test because they find it stressful not knowing if they will develop the disease. Others, on the other hand, prefer not to know if they've inherited the faulty gene as there are no treatments as of yet that can reverse the effects of the disease.
If you know that your partner carries the defective gene and are expecting a child, a genetic test can be carried out at 11 weeks into the pregnancy to reveal if the baby has the defective gene or not. If one of you is at risk of having HD, but would prefer not to know, one option is preimplantation genetic diagnosis. This allows the embryo to be tested for the disease and only implanted into the womb if it doesn't have the gene and is not at risk of developing HD after In Vitro Fertilization (IVF) has been performed.
Juvenile Huntington's
If someone develops HD before the age of 20, it is known as Juvenile Huntington Disease. However, only 5-10% of people with the disease are affected by it. The onset and progression of symptoms may differ from those in adults. The problems that occur in the early stages include:
Behavioral changes:
• Children and young adults experience a loss of previously learned academic or physical skills.
• A rapid, and significant drop in school performance.
• Behavioral problems can arise.
Physical changes:
• Muscles become contracted and rigid, affecting gait.
• Changes in fine motor skills that is noticeable in, for example, handwriting.
• Young people can experience seizures in addition to tremors or involuntary movement.
Living with Huntington's
As the disease advances, individuals with HD will undergo a number of physical and mental changes so it's important for them and their loved ones to have a clear understanding of the changes that they will have to make in order to allow them to remain as independent as possible.
Eating can become frustrating during the later stages of the disease, so in order to help with this any food should be easy to chew, swallow, and digest. To avoid choking, food should be cut into small pieces or pureed. Furthermore, adapted cutlery and straws, as well as non-slip mats can make eating easier for affected individuals. At later stages of the disease a person may choose to be fed through a tube.
As mobility and balance become affected, social services and occupational therapists can help people with HD to adapt to their homes so that day-to-day living is easier. a person's shower, toilet, bath, chairs, and bed may need to be modified, and during the later stages of the disease the home may need to be adapted to make them wheelchair friendly.
Therapies
• Speech and language therapy can help to improve communication skills as well as memory. Language therapy can teach HD sufferers alternative ways of communicating aside from talking.
• Physiotherapy can help a HD patient maintain/regain mobility and balance. Treatments such as massages, muscle manipulation, exercise, electrotherapy, and hydrotherapy can be very effective.
• Regular exercise is very important for those affected by HD. Individuals with this disease who exercise feel a lot better both physically and mentally than those who don't exercise.
Medications
Medications can be prescribed by a doctor to help manage some of the symptoms of HD, but most of them have side effects so many patients decide not to take them.
• A variety of antidepressants can be taken to improve mood swings. However, the side effects include nausea, constipation, diarrhea, excessive sweating, insomnia, trembling or shaking, and low blood pressure.
• Mood stabilizers can treat mood swings and irritability. The side effects may include weight gain, gastrointestinal problems, and tremors.
• Antipsychotic medication can be used to control delusions and violent outbursts. However, doctors usually prescribed the lowest dose possible as they can have very severe side effects. This includes drowsiness, nausea, and restlessness. They can also trigger depression or other psychiatric conditions.
In order to manage symptoms, it's crucial that the patient's treatment goals and medication plan are regularly reviewed and analyzed by a specialist. | http://www.ba-bamail.com/content.aspx?emailid=24665 |
Managing bipolar disorder in the postnatal period
In most cases, the management of an acute episode of bipolar disorder in the postnatal period will require that women go to hospital, usually a psychiatric hospital to allow time for treatment to be provided in a setting where she and the baby are safe, and she can be monitored by health professionals.
Some psychiatric hospital settings have a mother and baby unit where a woman can stay with her baby as she stabilises. This is generally available to those with private healthcare, whilst easy access for those in the public system varies across Australian states and territories.
With time and effective treatment, the symptoms of bipolar disorder will begin to settle down and stabilise – at which time the health professional will determine when she can be discharged from hospital.
Following discharge, the woman will need to receive ongoing support and monitoring by a specialist mental health professional.
Bipolar disorder will not ‘settle down’ or go away on it’s own without medical treatment – so it’s important to seek help as early as possible. By getting help early you can help prevent the condition from getting worse and having a negative impact on your family.
Medical Treatment
The National Perinatal Mental Health Guidelines recommend that bipolar disorder is managed and treated using medications. These medications work to stabilise the symptoms by reducing the impacts of the ‘highs’ and ‘lows’ of bipolar disorder.
Different types of medication are used to treat the depression, mania or both depression and mania. There are a variety of different types of medication that may be prescribed, and these include:
- Mood stabilisers – Work to stabilise mood and help reduce the likelihood of the symptoms reoccurring (relapse). The most common mood stabiliser is lithium. Other types of mood stabilisers (which are also used to manage epilepsy) that may be used are sodium valporate, carbamazapine and lamotrigine.
- Antidepressants – Are used to treat the symptoms of depression that are part of the ‘depression’ part of the disorder.
- Antipsychotics – Asist with both manic and psychotic symptoms such as delusions or hallucinations.
Medical treatment for bipolar disorder needs careful, specialist attention and management. Before medications are prescribed, changed or stopped, it is vital that advice is sought from a psychiatrist who will consider the best choice of medical treatment to manage the condition for each individual.
If prescribed one of these treatments for bipolar disorder, it is important that you do not alter or stop your medications suddenly.
It is also important to speak to your mental health specialist if you are, or want to breastfeed and have been prescribed sodium valporate or clozapine. If you are prescribed lithium, again your health professional needs to know that you are, or intending to breastfeed, as baby will also require monitoring.
Electroconvulsive Therapy
Electroconvulsive Therapy (ECT) is a specialist treatment that may be used to treat the symptoms of mania and severe depression. ECT involves stimulating the neurones in the brain via an electric current. Whilst ECT can lead to short-term memory loss, for many women it plays a crucial role in treating bipolar disorder and making steps towards management and recovery.
There are safe and effective treatments for bipolar disorder. Getting help early for bipolar disorder is vital to reduce the impact of the condition on the mother, partner, infant and other members of the family. | https://www.cope.org.au/new-parents/postnatal-mental-health-conditions/bipolar-disorder/management-bipolar-disorder/ |
Psychiatric drugs, such as antidepressants and antipsychotics, are commonly prescribed to treat a wide variety of mental disorders, such as depression, bipolar disorder or schizophrenia. One of the possible side effects of such drugs, however, isn’t experienced until one tries to discontinue its use. This is a well understood and common phenomenon, especially with certain classes of drugs (like most SSRI antidepressants). It has been documented in the research literature going back as early as 1960 (Hollister et al., 1960).
This is referred to as “discontinuation syndrome.” Some studies have shown that up to 80 percent of people discontinuing certain antidepressant medications experience symptoms associated with discontinuing the medication.
What is Discontinuation Syndrome?
Discontinuation syndrome is characterized by one or more of the following symptoms (Haddad, 2001):
- Dizziness, vertigo or ataxia (problems with muscle coordination)
- Paresthesia (tingling or pricking of your skin), numbness, electric-shock-like sensations
- Lethargy, headache, tremor, sweating or anorexia
- Insomnia, nightmares or excessive dreaming
- Nausea, vomiting or diarrhea
- Irritability, anxiety, agitation or low mood
While there are many theories as to why discontinuation syndrome occurs in some people and not others, there is no single accepted theory as to the cause of this concern. Salomon & Hamilton (2014) note that the syndrome has been “linked to cholinergic and/or dopaminergic blockade and subsequent rebound on discontinuation (Stonecipher et al. 2006; Verghese et al. 1996). Mesolimbic supersensitivity and rebound serotonergic activity have also been implicated as potential triggers (Chue et al. 2004).”
How Do I Prevent Discontinuation Syndrome?
“Most studies agree that somatic syndromes at least tend to be time-limited, beginning within the first few days after discontinuation or significant reduction, reaching a peak at the end of the first week, and then subsiding,” according to Salomon & Hamilton (2014). “Several studies suggest that a gradual taper of antipsychotics can help to reduce the severity of symptoms.”
Discontinuation syndrome, therefore, can be relatively easy to minimize or prevent altogether in many people. The key to discontinuing many psychiatric medications is to do so under a doctor’s supervision in a slow and gradual tapering process over weeks’ time. For some people, the process may take many months in order to successfully discontinue a psychiatric medication.
This process is called titration — gradually adjusting the dose of the medication until the desired effect is achieved, in this case, stopping it. Gradually tapering the dose of the medication over a few weeks (and sometimes, months) usually minimizes the appearance of any discontinuation syndrome symptoms.
Not all people will avoid the syndrome even with a very slow tapering of their medication. Some researchers (such as Fava et al., 2007) have documented the difficulty that some people will have with even slow tapering of their medication. Clinicians and researchers have different strategies to help address these difficult cases, but there’s no single approach that’s been proven more effective than others. For instance, one case report suggests the prescription of fluoxetine (Prozac) to help with SSRI discontinuation (Benazzi, 2008).
Most people who experience this syndrome do so because they either abruptly stop taking their medication, or try to remove themselves off of it much too quickly. In some cases, a person may try and discontinue their medication without consulting their prescribing physician. One should never stop taking any medication prescribed by a doctor until one has talked to their doctor about stopping.
Sometimes people feel embarrassed or uncomfortable talking to their physician about stopping a medication because they may feel like they are a failure in doing so. Doctors, however, have patients who need to stop taking their medications for a wide variety of reasons every day, and usually have no trouble helping a person discontinue the medication gradually. Perhaps the medication isn’t working for you, perhaps its causing uncomfortable side effects, perhaps you just want to try something else. Share the reason with your doctor, and work with him or her to minimize the possibility of discontinuation syndrome.
Discontinuation syndrome is a very real phenomenon, and has been well-documented in the research literature. Doctors and patients should be aware of the potential negative impact of discontinuing a psychiatric medication too quickly or on their own.
References:
Benazzi, F. (2008). Fluoxetine for the treatment of SSRI discontinuation syndrome.International Journal of Neuropsychopharmacology, 11, 725-726.
Fava, G.A., Bernardi, M., Tomba, E. & Rafanelli, C. (2007). Effects of gradual discontinuation of selective serotonin reuptake inhibitors in panic disorder with agoraphobia. International Journal of Neuropsychopharmacology, 10, 835-838
Hollister, L. E., Eikenberry, D. T. & Raffel, S. (1960). Chlorpromazine in nonpsychotic patients with pulmonary tuberculosis. The American Review of Respiratory Disease, 81, 562–566.
Robinson, D.S. (2006). Antidepressant Discontinuation Syndrome. Primary Psychiatry, 13, 23-24.
Salomon, C. & Hamilton, B. (2014). Antipsychotic discontinuation syndromes: A narrative review of the evidence and its integration into Australian mental health nursing textbooks. International Journal of Mental Health Nursing, 23, 69-78. | https://psychcentral.com/lib/what-is-discontinuation-syndrome |
What is Schizophrenia?
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Schizophrenia is a complex, difficult to manage disorder whose sufferers deal with a fractured and distorted view of the world around them. To the untrained eye, Schizophrenia can take many different forms because the themes of patient’s hallucinations and delusions vary widely. However, each case shares the common threads of odd beliefs, general disorganization, and bizarre behavior. Symptoms usually begin between the late adolescent years and the early 30s. Most commonly, the earliest signs that other people will notice are when patients appear depressed and withdraw from their social life. They will often have low energy and appear bored or unmotivated. They also stop participating in hobbies they used to enjoy. Problems with attention, information processing, and problem-solving also tend to appear early, usually as trouble functioning in school or work.
The profound nature of the disturbance becomes much more apparent when hallucinations, delusions, and disorganized thought patterns emerge. People respond to things they hear and see that are not real. They can develop complex beliefs and ideas about others trying to contact them, monitor them, or control their minds or behaviors. Their speech patterns become odd and difficult to follow, and they see connections between completely unrelated subjects. Although some people respond well to medication and are able to manage their symptoms well, most struggle chronically with the disorder and need ongoing assistance with multiple aspects of their lives. As people age, most symptoms progressively become less and less intense. However, negative symptoms and mood problems tend to persist the most, resist medication treatment, and lead to long-term impairments.
Causes and Risk Factors
Prevalence
The rate of Schizophrenia in the general population is roughly 0.5%. It is slightly more common in men and starts at an earlier age in men than in women.
Genetic and prenatal contributions
Having a parent or sibling with a psychotic disorder increases the risk of developing Schizophrenia to about 10%. A second degree relative (like an aunt, uncle, or grandparent) with Schizophrenia makes the risk about 3%. An identical twin of someone with Schizophrenia has a 50% risk. Older parents, exposure to prenatal infections, and oxygen deprivation during birth also increase the risk of Schizophrenia. Low birth weight, high stress levels, and maternal diabetes of pregnancy contribute as well.
Adolescent marijuana use
Natural genetic variations in parts of the brain that manage the neurotransmitter dopamine set the stage for a connection between adolescent marijuana use and the development of Schizophrenia. Earlier and more frequent use of marijuana increases the risk of developing the disorder. It can even contribute to it starting at a younger age. In people with these genetic variations, using marijuana on a daily basis can raise the risk of developing Schizophrenia to seven times greater than average. Marijuana use in people who already have Schizophrenia can significantly worsen the course of the disorder. It even can trigger psychotic episodes.
Coexisting disorders
Substance use disorders strike roughly half of people with Schizophrenia, putting them at higher risk of relapse, stopping medication, violence, and suicide. This is in addition to tobacco use, which also appears in a large percentage of these people and can reduce the efficacy of antipsychotic medications. Depression also appears in half of people with Schizophrenia, and these people have more frequent and more severe psychotic episodes. Panic Disorder, Post Traumatic Stress Disorder, and Obsessive Compulsive Disorder are also quite common in people with Schizophrenia.
Diagnosing Schizophrenia
The criteria
People with Schizophrenia display at least two of several unique symptoms that are characteristic of all psychotic disorders. These include delusions, hallucinations, disorganized thoughts, speech, or behavior, catatonia, and negative symptoms. The first three of these symptoms are the most important, and at least one of those must be present to make the diagnosis. These symptoms disturb functioning in at least one major life domain, such as work, relationships, or the ability to take care of oneself. If the disorder begins in childhood or adolescence, the person will likely have problems in school as well. Mood problems such as depression and mania can only appear for a small portion of this time. If they last longer, that would suggest a diagnosis of Schizoaffective Disorder.
These problems last at least six months. Symptoms naturally increase and decrease in severity over time. The most severe periods are preceded by milder symptoms, except for negative symptoms, which can be significant and are frequently the first signs of the disorder that appear. The times following the worst periods are similar.
Insight
Insight is when people with Schizophrenia understand that the symptoms they are experiencing are part of a disorder and need to be treated. Lack of insight is a frequent problem accompanying Schizophrenia. It is a common reason for them to resist treatment and stop their medications without talking to their doctors. A lack of insight may cause more hospitalizations, lower functioning, and worse overall courses of their illness.
Other features
People with Schizophrenia can have cognitive problems, such as slower problem-solving, impaired memory, problems with planning and organizing thoughts, and language difficulties. These issues extend to the social sphere, where the person may struggle with implied forms of communication, like body language. They often react oddly during social situations, such as laughing at things that aren’t funny.
Treating Schizophrenia
Hospitalization
Roughly half of people with Schizophrenia will need to have a temporary stay in a psychiatric hospital when they are first diagnosed. This is true both for people whose symptoms come on all at once and for those whose problems have slowly grown over several months or years. People usually need to stay in a hospital when their behavior is unmanageable. This is also critical if they are a danger to themselves or others.
Antipsychotics
Treatment with medication is a key piece in the puzzle of managing Schizophrenia and should be started as soon as symptoms appear. The first choice medications belong to a group known as “second generation” or “atypical” antipsychotics (SGAs). These include Abilify (aripiprazole), Saphris (asenapine), Latuda (lurasidone), Zyprexa (olanzapine), Risperdal (risperidone), Seroquel (quetiapine), and Geodon (ziprasidone). These medications are preferred over the older “first generation” or “typical” antipsychotics (FGAs), such as Thorazine (chlorpromazine), Proxlixin (fluphenazine), and Haldol (haloperidol), which have side effects that are more difficult to manage.
Clozaril
Clozaril (clozapine) is a last-ditch effort medication that is usually tried only after several other medications have failed. It has multiple, serious potential side effects that require frequent medical monitoring. However, Clozaril is very effective at treating Schizophrenia in patients for whom several other medications have not worked, and it is especially helpful in treating people who also have suicidal thoughts. Medications are tried during the initial period of symptoms until one or a combination is found that works for each individual person.
Treatment goals
The goal in the initial few days of treatment is to reduce the most severe and disruptive symptoms. People who are in the midst of a psychotic episode usually are resistant to most treatment. They almost always need the help of these medications to get them out of this state. Only then will they be more amenable to communicating with providers and engaging in their own treatment process. After the worst of the symptoms have subsided, doses of medications may be changed slightly so that they can stay on them long term. Many people have difficulty taking medications regularly and may stop them suddenly without telling their health care providers. For these people, long-acting injectable forms of these medications can be administered at regular appointments once every few weeks (timing varies between different medications). These improve medication compliance and reduce psychiatric hospitalizations.
Psychotherapy
Once people with Schizophrenia are on a stable dose of a medication that keeps their severe symptoms at bay, they will be able to engage in forms of talk therapy that will help them manage the symptoms that the medications don’t fully control.
Cognitive Behavioral Therapy (CBT) helps people deal with the residual symptoms, including hallucinations and delusions. CBT targets unhelpful thought patterns that contribute to paranoia and delusions. It also helps with negative symptoms, which medications largely fail to address. In CBT, they will learn social skills, practice monitoring their own thought patterns, and get back into hobbies and pastimes that they enjoyed prior to the onset of their illness. CBT also decreases the chance that they will suddenly stop their medication.
Family therapy aids families in dealing with the stress that comes with a family member being diagnosed with Schizophrenia. Family therapy decreases hospitalization rates and increases patient adherence to treatment.
Managing Schizophrenia
Care Coordination
Assertive Community Treatment (ACT) and case management are the two major resources that provide people with help managing the multiple areas of their lives that are affected by Schizophrenia. They get help not only with the medical aspects of their disorder, such as therapy and medication management, but also with finding housing and employment. This reduces hospitalizations, increases independence, and decreases the stress on families.
ACT is a coordinated form of care for those who need to be able to access a caregiver at any time: nights, days, weekends, or holidays. It is a team of providers that includes doctors, nurses, and social workers who all work together for each patient. Case managers usually work for state or local government. They have connections with treatment providers and other resources in their area. They will help people with Schizophrenia navigate the system, get to the care they need, and access local resources.
Medication side effects
Antipsychotics, the major medications used in treating Schizophrenia, have several potential side effects that people will need help managing. First generation antipsychotics can cause multiple types of movement problems. Clinicials call these “extrapyramidal symptoms,” a term that refers to a part of the brain that manages body motions. These include problems like general muscle tension, muscle spasms, tremors, and feelings of restlessness. Taking FGAs for a long time can lead to Tardive Dyskinesia, a disorder of persistent, involuntary muscle movements of the mouth, lips, and tongue. These symptoms are very unpleasant and are a common reason that people stop taking these medications.
Second generation antipsychotics have more manageable side effects, so they are the preferred first line medications for Schizophrenia. SGAs tend to cause weight gain, high cholesterol, and contribute to development of type II diabetes. One SGA in particular, Clozaril (clozapine), can cause agranulocytosis. This is a severely low concentration of white blood cells in the body and puts patients at higher risk of infections. This requires frequent monitoring with blood tests, especially right when a patient is starting the medication.
Suicide risk
One in five people with Schizophrenia will attempt suicide at least once at some point in their lives. Five percent of these people with Schizophrenia will die by suicide. The risk is highest in those who also abuse drugs and alcohol, have depressive symptoms, are unemployed, or have recently had a psychotic episode. Auditory hallucinations, hearing a voice telling them to hurt themselves (called “command hallucinations”), are common in suicidal people with Schizophrenic.
Smoking
Between 60% to 80% of people with Schizophrenia smoke tobacco, at least three times greater than the rate of smoking in the general population. They tend to be heavier smokers as well, most smoking at least a pack a day. Almost all start smoking before the onset of Schizophrenia. Smoking in Schizophrenia is associated with a younger age at first symptoms, more severe symptoms, more frequent hospitalizations, and needing higher dosages of antipsychotic medications. | https://webshrink.com/conditions/schizophrenia-psychotic-disorders/schizophrenia |
The function of huntingtin is not known. Normally, it is located in the cytoplasm. The association of huntingtin with the cytoplasmic surface of a variety of organelles, including transport vesicles, synaptic vesicles, microtubules, and mitochondria, raises the possibility of the occurrence of normal cellular interactions that might be relevant to neurodegeneration.
N-terminal fragments of mutant huntingtin accumulate and form inclusions in the cell nucleus in the brains of patients with HD, as well as in various animal and cell models of HD.
The presence of neuronal intranuclear inclusions (NIIs) initially led to the view that they are toxic and, hence, pathogenic. More recent data from striatal neuronal cultures transfected with mutant huntingtin and transgenic mice carrying the spinocerebellar ataxia-1 (SCA-1) gene (another CAG repeat disorder) suggest that NIIs may not be necessary or sufficient to cause neuronal cell death, but translocation into the nucleus is sufficient to cause neuronal cell death. Caspase inhibition in clonal striatal cells showed no correlation between the reduction of aggregates in the cells and increased survival.
Furthermore, postmortem studies reveal that NIIs are quite rare in the striata of patients with HD as compared to the cortex, and most of the aggregates within the striatum are observed in populations of interneurons that typically are spared in individuals with HD.
TRACK-HD is a prospective observational study that reported 12-month longitudinal changes in 116 pre-manifest individuals carrying the mutant Huntington gene (preHD), 114 patients with early HD, and 115 age- and sex-matched controls. Generalized and regional brain atrophy was higher in preHD and early HD than in controls. Voxel-based morphometry revealed grey-matter and white-matter atrophy, even in subjects furthest from predicted disease onset. The study showed change in the total functional capacity, a widely used measure of HD clinical severity, that was associated with both whole-brain and caudate atrophy rates. Compared to controls, deterioration in cognition and motor function was detectable in both preHD and early HD, as well as worsening in oculomotor function in early HD. Change in cognitive and motor measures were associated with whole-brain volume loss.
The selective neuronal dysfunction and subsequent loss of neurons in the striatum, cerebral cortex, and other parts of the brain can explain the clinical picture seen in cases of HD. Several mechanisms of neuronal cell death have been proposed for HD, including excitotoxicity, oxidative stress, impaired energy metabolism, and apoptosis.
Excitotoxicity refers to the neurotoxic effect of excitatory amino acids in the presence of excessive activation of postsynaptic receptors.
Intrastriatal injections of kainic acid, an agonist of a subtype of glutamate receptor, produce lesions similar to those seen in HD.
Intrastriatal injections of quinolinic acid, an N -methyl-D-aspartate (NMDA) receptor agonist, selectively affect medium-sized GABA-ergic spiny projection neurons, sparing the striatal interneurons and closely mimicking the neuropathology seen in HD.
NMDA receptors are depleted in the striata of patients with HD, suggesting a role of NMDA receptor-mediated excitotoxicity, but no correlation exists between the distribution of neuronal loss and the density of such receptors.
The theory that reduced uptake of glutamate by glial cells may play a role in the pathogenesis of HD also has been proposed.
Oxidative stress is caused by the presence of free radicals (ie, highly reactive oxygen derivatives) in large amounts. This may occur as a consequence of mitochondrial malfunction or excitotoxicity and can trigger apoptosis.
Striatal damage induced by quinolinic acid can be ameliorated by the administration of spin-trap agents, which reduce oxidative stress, providing indirect evidence for the involvement of free radicals in excitotoxic cell death.
Impaired energy metabolism reduces the threshold for glutamate toxicity and can lead to activation of excitotoxic mechanisms as well as increased production of reactive oxygen species.
Nuclear magnetic resonance spectroscopy studies have shown elevated lactate levels in the basal ganglia and occipital cortex of patients with HD.
Patients with HD have an elevated lactate-pyruvate ratio in the cerebrospinal fluid.
A reduction in the activity of the respiratory chain complex II and III (and less in complex IV) of mitochondria of caudate neurons in patients with HD has been reported.
In rats, intrastriatal injections of 3-nitroproprionic acid (3-NP), an inhibitor of succinate dehydrogenase or complex II of the respiratory chain, cause dose-dependent ATP depletion, increased lactate concentration, and neuronal loss in the striatum. Systemic injections of 3-NP into rats produce a selective loss of medium spiny neurons in the striatum.
Apoptosis is the programmed cell death that is activated normally in the nervous system during embryogenesis to remove supernumerary neurons as part of natural development.
Morphological features of apoptosis have been well characterized. Oxidative stress, excitotoxicity, and partial energy failure can lead to apoptosis.
A subset of neurons and glia in the neostriata of patients with HD appears to undergo apoptosis, as shown by in situ DNA nick end labeling (TUNEL) staining, but clear morphological evidence for an apoptotic process in HD is still missing.
One theory is that expanded polyglutamine repeats cause neuronal degeneration through abnormal interactions with other proteins containing short polyglutamine tracts. Recent work suggests that polyglutamine interference with transcription of CREB binding protein (CBP), a major mediator of survival signals in mature neurons, may constitute a genetic gain of function underlying polyglutamine disorders including HD.
The role of caspases (a class of highly specific proteases) in apoptosis involves cleavage of target proteins at different sites. In humans with HD and in animal models of HD, the intracellular accumulation of N-terminal huntingtin fragments is one of the neuropathological features. Caspases, among other proteins, cleave huntingtin within the N-terminal region. To address the question of a potential in vivo neuroprotective effect of inhibition of caspases, a YAC mouse model expressing mutant huntingtin, along with selective mutations of the caspase-3 and caspase-6 cleavage sites, was studied. Selective elimination of the caspase-6, but not caspase-3, cleavage site in mutant huntingtin resulted in protection from neuronal dysfunction and neurodegeneration in vivo. These results suggest that preventing caspase-6 cleavage of huntingtin may be of therapeutic interest.
Estimates of the prevalence of HD in the United States range from 4.1-8.4 per 100,000 people. Accurate estimates of the incidence of HD are not available.
The frequency of HD in different countries varies greatly. A few isolated populations of western European origin have an unusually high prevalence of HD that appears to have resulted from a founder effect. These include the Lake Maracaibo region in Venezuela (700 per 100,000 people) , the island of Mauritius off the South African coast (46 per 100,000 people), and Tasmania (17.4 per 100,000 people). The prevalence in most European countries ranges from 1.63-9.95 per 100,000 people. The prevalence of HD in Finland and Japan is less than 1 per 100,000 people.
Most studies show a mean age at onset ranging from 35-44 years. However, the range is large and varies from 2 years to older than 80 years. Onset in patients younger than 10 years and in patients older than 70 years is rare. The Venezuelan kindreds manifest an earlier mean age of onset (34.35 years) when compared with Americans (37.47 years) and Canadians (40.36 years). Modifying genes and environmental factors are thought to influence the age of onset in these different populations.
Mortality/morbidity
HD is a relentlessly progressive disorder, leading to disability and death, usually from an intercurrent illness.
The mean age at death in all major series ranges from 51-57 years, but the range may be broader. Duration of illness varies considerably, with a mean of approximately 19 years. Most patients survive for 10-25 years after the onset of illness. In a large study, pneumonia and cardiovascular disease were the most common primary causes of death.
Juvenile HD (ie, onset of HD in patients younger than 20 years) accounts for approximately 5-10% of all affected patients. Most patients with juvenile HD inherit the disease from their father, whereas patients with onset of the disease after age 20 years are more likely to have inherited the gene from their mother. Inheritance through the father can lead to earlier onset through succeeding generations, a phenomenon termed anticipation. This is caused by greater instability of the HD allele during spermatogenesis. CAG repeat length correlates inversely with age of onset, and the correlation is stronger when the onset of symptoms occurs earlier.
The length of the CAG repeat is the most important factor in determining age of onset of HD, although substantial variability remains after controlling for repeat length. Both genetic and environmental components account for this variability. The US-Venezuela Collaborative Research Project studied Venezuelan HD kindreds, the world's largest genetically related HD community (18,149 individuals spanning 10 generations) since 1979, collecting genetic and clinical data.
A small number of homozygotes for the HD mutation have been identified, and they seem to be phenotypically indistinguishable from heterozygotes, making HD a truly autosomal dominant disorder.
With the increasing amount of genetic/hereditary information available in HD, the question of whether patients and/or family members should be made aware of the genetic risks is becoming an increasingly important issue.
For excellent patient education resources, visit eMedicineHealth's Brain and Nervous System Center. Also, see eMedicineHealth's patient education article Huntington Disease Dementia.
Huntington disease mutation carriers who have yet to develop clinical symptoms are most concerned with internal and relational issues (social, emotional, and self concerns) that are associated with the disease. These concerns remain throughout and do not increase in the subsequent stages of HD. Patients with HD stages 1-5 are most concerned with physical and functional issues caused by HD, with these concerns increasing as the disease progresses. Patients with early HD (stages 1 and 2) have increasing concerns about cognitive issues, and these concerns remain constant during moderate HD (stages 3 and 4). Patients with late-stage HD (stage 5) have a lack of cognitive concerns, presumably due to impaired insight.
The clinical features of Huntington disease (HD) include a movement disorder, a cognitive disorder, and a behavioral disorder. Patients may present with one or all disorders in varying degrees.
Chorea (derived from the Greek word meaning to dance) is the most common movement disorder seen in HD.
Initially, mild chorea may pass for fidgetiness. Severe chorea may appear as uncontrollable flailing of the extremities (ie, ballism), which interferes with function.
As the disease progresses, chorea coexists with and gradually is replaced by dystonia and parkinsonian features, such as bradykinesia, rigidity, and postural instability, which are usually more disabling than the choreic syndrome per se.
In advanced disease, patients develop an akinetic-rigid syndrome, with minimal or no chorea. Other late features are spasticity, clonus, and extensor plantar responses.
Dysarthria and dysphagia are common. Abnormal eye movements may be seen early in the disease. Other movement disorders, such as tics and myoclonus, may be seen in patients with HD.
Juvenile HD (Westphal variant), defined as having an age of onset of younger than 20 years, is characterized by parkinsonian features, dystonia, long-tract signs, dementia, epilepsy, and mild or even absent chorea.
Cognitive decline is characteristic of HD, but the rate of progression among individual patients can vary considerably. Dementia and the psychiatric features of HD are perhaps the earliest and most important indicators of functional impairment.
The dementia syndrome associated with HD includes early onset behavioral changes, such as irritability, untidiness, and loss of interest. Slowing of cognition, impairment of intellectual function, and memory disturbances are seen later. This pattern corresponds well to the syndrome of subcortical dementia, and it has been suggested to reflect dysfunction of frontal-subcortical neuronal circuitry. (The so-called cortical dementias primarily involve the cerebral cortex and are associated with aphasia, agnosia, apraxia, and severe amnesia.)
Early stages of HD are characterized by deficits in short-term memory, followed by motor dysfunction and a variety of cognitive changes in the intermediate stages of dementia.[6, 7] These deficits include diminished verbal fluency, problems with attention, executive function, visuospatial processing, and abstract reasoning. Language skills become affected in the final stages of the illness, resulting in a marked word-retrieval deficit.
The behavioral disorder of HD is represented most commonly by affective illness.
Depression is more prevalent, with a small percentage of patients experiencing episodic bouts of mania characteristic of bipolar disorder.
Patients with HD and persons at risk for HD may have an increased rate of suicide.
Patients with HD also can develop psychosis, obsessive-compulsive symptoms, sexual and sleep disorders, and changes in personality.
Most patients with HD have a mixed pattern of neurological and psychiatric abnormalities. Understanding of the clinical signs must take into account the fact that signs change during the course of the illness and that different patterns may be observed, depending on the age of onset.
Chorea is a characteristic feature of HD and, until recently, the disorder commonly was called Huntington chorea. Chorea, as defined by the World Federation of Neurology, is a state of excessive, spontaneous movements, irregularly timed, randomly distributed, and abrupt.
Severity of chorea may vary from restlessness with mild intermittent exaggeration of gesture and expression, fidgeting movements of the hands, and unstable dancelike gait to a continuous flow of disabling violent movements. Chorea in cases of HD usually is generalized.
Patients may incorporate involuntary choreiform movements into apparently purposeful gestures, a phenomenon referred to as parakinesia.
Ballism is characterized by large amplitude, usually proximal, flinging movements of a limb or body part. Ballism is considered to be a severe form of chorea by most authors.
Chorea may coexist with slower, distal, writhing, sinuous movements called athetosis; it then is described as choreoathetosis.
Chorea is less prominent in juvenile HD and in advanced stages of the illness.
Bradykinesia and akinesia are frequent features of HD and may explain some of the abnormalities of voluntary movement observed clinically.
Bradykinesia may be a major source of disability of voluntary movement, though it commonly is overshadowed by the hyperkinetic movement disorder.
Other parkinsonian signs, such as rigidity and postural instability, may be seen. Patients may become akinetic and rigid in the terminal stages of the illness.
Dystonia is defined as a syndrome of sustained muscle contractions, frequently causing twisting and repetitive movements or abnormal postures.
Mild dystonia, in combination with chorea, may give the writhing appearance of choreoathetosis.
Sustained dystonic posturing may result in contractures, immobility, and breakdown of skin.
Dystonia may be prominent in juvenile HD.
Eye movement abnormalities can be seen early in the disease.
Initiation of saccadic movements is slow and uncoordinated. Patients have difficulty suppressing head movements or blinking in order to break fixation and generate saccadic movements.
Smooth pursuit is interrupted by saccadic intrusions.
Patients are unable to inhibit saccades toward a peripheral stimulus when instructed to look in the opposite direction.
Tendon reflexes are variable in HD, ranging from reduced in some patients to pathologically brisk with clonus in other patients. The plantar response usually is flexor, but it may be extensor in advanced stages of the illness.
Other hyperkinesias, such as tics and myoclonus, may be seen in HD.
Dementia, depression, and other psychiatric manifestations may be seen at the time of examination as well.
No single imaging technique is necessary or sufficient for diagnosis of Huntington disease (HD). Measurement of the bicaudate diameter (ie, the distance between the heads of the 2 caudate nuclei) by CT scan or MRI is a reliable marker of HD.
Abnormalities in positron emission tomography (PET) scanning and proton MR spectroscopy have been reported; however, their use in clinical practice is limited.
Genetic testing (reported as the CAG repeat number for each allele) is now commercially available.
Genetic testing may not be necessary in a patient with a typical clinical picture and a genetically proven family history of HD.
In the absence of a family history of HD, patients with a suggestive clinical presentation should undergo genetic testing to exclude or confirm HD.
Persons at risk for HD who request presymptomatic testing should undergo extensive genetic counseling and neurologic and psychiatric evaluation, given the implications of receiving a positive (or negative) result for an untreatable, familial, progressive, neurodegenerative disease. Most testing centers follow strict protocols, such as the one put forth by the Huntington's Disease Society of America (HDSA).
If the genetic test is negative for HD, then testing for systemic lupus erythematosus (SLE), antiphospholipid antibody syndrome, thyroid disease, neuroacanthocytosis, DRPLA, Wilson disease, and other less common causes of chorea may be reasonable, depending on the individual case.
The extent of gross striatal pathology, neuronal loss, and gliosis provides a basis for grading the severity of HD pathology (grades 0-4). See Pathophysiology.
Ablative surgical procedures and fetal cell transplantation have been attempted in patients with HD. Currently, enough data to support this type of treatment are not available. It is still experimental.
Consider general safety measures and nonpharmacologic interventions first in the management of Huntington disease (HD).
If chorea is severe enough to interfere with function, consider treatment with benzodiazepines, such as clonazepam or diazepam; valproic acid; dopamine-depleting agents (eg, reserpine, tetrabenazinem deutetrabenazine); and finally, neuroleptics.
The drug tetrabenazine, a central acting vesicular monoamine transporter 2 (VMAT2) inhibitor, has shown positive effects in the treatment of chorea, for patients with HD. It selectively depletes central monoamines by reversibly binding to VMAT2.
Results from a phase III clinical study showed that this investigational drug is an effective treatment for chorea associated with HD. The dosing range that proved effective was 12.5-100 mg/d. Its manufacturer has been granted fast track and orphan drug status by the FDA. It was the first treatment approved for chorea in patients with HD in the United States. Always weigh potential adverse effects against the benefits of each drug.
A second VMAT2 inhibitor, deutetrabenazine, was approved by the FDA in April 2017. Approval was based on a double-blind multicenter trial conducted in 90 ambulatory patients at 34 centers in the United States and Canada, with 45 patients randomly assigned to deutetrabenazine and 45 to placebo. Deutetrabenazine or placebo was titrated to optimal dose level over 8 weeks and maintained for 4 weeks, followed by a 1-week washout.
Baseline total maximal chorea score was 8 or higher in study participants. Results showed improvement in the Unified Huntington Disease Rating Scale total maximal chorea scores for patients taking deutetrabenazine of 4.4 units from baseline to the maintenance period (average of week 9 and week 12), compared with approximately 1.9 units for patients taking placebo. The treatment effect of –2.5 units was statistically significant (P < .0001).
Patients who have HD and predominant features of bradykinesia and rigidity may benefit from treatment with levodopa or dopamine agonists.
Depression in patients with HD is treatable and should be recognized promptly. Selective serotonin reuptake inhibitors (SSRIs) should be considered as first-line therapy. Other antidepressants, including bupropion, venlafaxine, nefazodone, and tricyclic antidepressants, also can be used. Electroconvulsive therapy (ECT) can be used in patients with refractory depression.
Antipsychotic medications may be necessary in patients with hallucinations, delusions, or schizophrenia-like syndromes. Newer agents, such as quetiapine, clozapine, olanzapine, and risperidone, are preferred to older agents because of the lower incidence of extrapyramidal side effects and the decreased risk for tardive syndromes.
Irritability may be treated with antidepressants, particularly the SSRIs; mood stabilizers, such as valproic acid or carbamazepine; and, if needed, atypical neuroleptics.
Other less frequent aspects of HD that may require pharmacologic treatment are mania, obsessive-compulsive disorder, anxiety, sexual disorders, myoclonus, tics, dystonia, and epilepsy.
Guidelines for treating neuropsychiatric symptoms of Huntington’s disease (HD) were published in November 2018 in the Journal of Huntington’s Disease.[19, 20]
Guidelines for Agitation in HD
Guidelines for Anxiety in HD
Guidelines for Apathy in HD
Guidelines for Psychosis in HD
Guidelines for Sleep Disorders in HD
Although no therapy is currently available to delay the onset of symptoms or prevent the progression of the disease, symptomatic treatment of patients with Huntington disease (HD) may improve the quality of life and prevent complications. As is the case with other neurological diseases, HD makes individuals more vulnerable to side effects from medications, particularly cognitive adverse effects. Avoid polypharmacy if possible. Symptomatic treatment for HD can be divided into drugs to treat the movement disorder and drugs to treat psychiatric or behavioral problems.
Experimental therapies for HD currently are being tested in animal models and human trials. Awareness of ongoing research to find an effective cure for HD must be a part of the care plan of an individual patient and the patient's family.
Therapeutic options include dopamine-depleting agents (eg, reserpine, tetrabenazine) and dopamine-receptor antagonists (eg, neuroleptics). Long-term use of these drugs may carry a high risk of adverse effects. Choreic movements in patients with HD should be treated pharmacologically only if they become disabling to the patient. Neuroleptics may worsen other features of the disease, such as bradykinesia and rigidity, leading to further functional decline.
Results of some studies have suggested that valproic acid and clonazepam may be effective in the treatment of chorea, while results of other studies have been less conclusive. In the authors' experience, using valproic acid and clonazepam first may be worthwhile because of their safer adverse-effect profiles.
Tetrabenazine is a dopamine-depleting agent was approved by the FDA in August 2008. It may be more effective than reserpine in the treatment of chorea and less likely to cause hypotension. The dose is titrated slowly and may be increased over several weeks to a maximum 75-100 mg/d in divided doses.
Antichorea effect of central monamine-depleting agents is believed to be related to its effect on reversible depletion of monoamines (eg, dopamine, serotonin, norepinephrine) from nerve terminals.
Depletes neurotransmitter stores of dopamine, serotonin, and noradrenaline within nerve cells in the brain, thereby altering transmission of electric signals from the brain that control movement by reversibly inhibiting vesicular monoamine transporter 2 (VMAT2).
Efficacy and safety established in a randomized, double-blind, placebo-controlled, multicenter study. Patients treated with tetrabenazine had significant improvement in chorea compared with those treated with placebo. Additional studies support this effect. Indicated for chorea associated with Huntington disease.
Orally administered VMAT-2 inhibitor. It is indicated for chorea associated Huntington disease.
Dopamine-depleting agent. Used in past to treat hypertension.
These agents are used to manage muscle spasms in chorea.
Carboxylic acid commonly used as antiepileptic drug, mood stabilizer in mania, and prophylactic agent for migraine. When combined with sodium valproate in 1:1 molar relationship, called divalproex sodium. Mechanism by which valproate exerts its antiepileptic effects has not been established; its activity may be related to increased brain levels of GABA. No large clinical trials exist to support its use for hyperkinetic movement disorders, but it may be effective, as suggested by a few small studies in patients with chorea of different etiologies.
Daily maximum dose of 2000 mg in divided doses (bid or tid) is enough to determine whether drug is going to be effective for individual patient.
Belongs to benzodiazepine class of drugs. Enhances activity of GABA, major inhibitory neurotransmitter in CNS. Used commonly as antiepileptic drug. May be useful in treatment of chorea, but no large clinical trials exist to support its use. Does not induce parkinsonism or carry risk of tardive syndromes, as neuroleptics do; therefore, an adequate trial with this medication is reasonable before using dopamine antagonists.
Maximum daily dose of 2-4 mg divided bid/tid usually is enough to determine effectiveness for individual patient.
These agents may improve choreic movements in patients.
Antipsychotic agent that belongs to new chemical class, benzisoxazole derivatives.
Antagonist of type 2 dopamine and serotonin receptors.
Less likely than typical neuroleptics to cause parkinsonism.
First of butyrophenone class of major tranquilizers. Typical neuroleptics, such as haloperidol, are potent dopamine-receptor antagonists and should be used only as last resort to treat chorea.
Depression is relatively common in patients with HD and should be treated pharmacologically as soon as diagnosis of depression is made. Depression in patients with HD can be treated with the same agents used for treatment of depression of any other cause. SSRIs may be used as first-line therapy because of their low adverse-effect profile, convenient dosing, and safety in the event of overdose. Other antidepressants can be used, including bupropion, venlafaxine, nefazodone, and the tricyclic antidepressants. Electroconvulsive therapy can be effective if an immediate intervention is required and in patients who do not respond to several good trials of medication.
SSRI that can be used once daily. Most patients should take it in morning because can be stimulating and may cause insomnia. If sedation occurs, drug should be taken at bedtime. A few patients develop sexual problems, such as decreased libido, anorgasmia, or ejaculatory delay.
Overview
What is Huntington disease (HD)?
What are the findings of the TRACK-HD study on Huntington disease (HD)?
Where does the neuropathology in Huntington disease (HD) occur?
What are the stages of Huntington disease (HD)?
What are the genetics of Huntington disease (HD)?
What is the role of neuronal intranuclear inclusions (NIIs) in the development of Huntington disease (HD)?
What causes Huntington disease (HD)?
What is the role of excitotoxicity in the development of Huntington disease (HD)?
What is the role of oxidative stress in the development of Huntington disease (HD)?
What is the role of impaired energy metabolism in the development of Huntington disease (HD)?
What is the role of apoptosis in the development of Huntington disease (HD)?
What is the prevalence of Huntington disease (HD) in the US?
What is the international prevalence of Huntington disease (HD)?
What are age-related demographics of Huntington disease (HD)?
What is the prognosis of Huntington disease (HD)?
What information should be provided to patients about Huntington disease (HD)?
Presentation
What is the clinical history of Huntington disease (HD)?
What are the traits of dementia syndrome in Huntington disease (HD)?
What are physical findings in Huntington disease (HD)?
DDX
What are the differential diagnoses for Huntington Disease?
Workup
What are the approach considerations in the workup of Huntington disease (HD)?
What is the staging system for Huntington disease (HD)?
Treatment
Which surgical procedures are indicated in the treatment of Huntington disease (HD)?
What is the treatment approach in Huntington disease (HD)?
How is depression treated in patients with Huntington disease (HD)?
Guidelines
What are the guidelines for treating neuropsychiatric symptoms of Huntington disease (HD)?
Medications
Which medications are indicated in the treatment of Huntington disease (HD)?
Which medications in the drug class Antidepressants are used in the treatment of Huntington Disease?
Which medications in the drug class Antipsychotic agents are used in the treatment of Huntington Disease?
Which medications in the drug class Anticonvulsant are used in the treatment of Huntington Disease?
Which medications in the drug class Monoamine Inhibitors are used in the treatment of Huntington Disease? | https://emedicine.medscape.com/article/1150165-print |
Fatigue is a common occurrence most likely caused by everyday stresses such as work and home life. Most people will suffer from minor short-term memory loss, such as misplacing car keys or forgetting to lock their car doors, at some point in their lives. However, when fatigue and short-term memory loss become a chronic or recurring problem, a consultation with a physician may be necessary to determine an underlying cause.
Chronic Fatigue Syndrome
According to the Centers for Disease Control and Prevention, between 1 and 4 million Americans suffer from chronic fatigue syndrome. This disorder is characterized by extreme fatigue that worsens with physical or mental activity but doesn’t get better with rest. Symptoms of chronic fatigue syndrome include fatigue, memory loss, inability to concentrate, sore throat, painful and mildly enlarged lymph nodes in the neck and armpits, unexplained muscle pain, headaches, unrefreshing sleep, and extreme exhaustion lasting more than 24 hours after physical or mental exercise. There is no specific treatment for chronic fatigue syndrome and physicians aim to attempt to treat the symptoms. Physicians encourage patients to slow down and avoid heavy physical or psychological stress. Patients should exercise lightly for a few minutes every day slowly increasing their time. In some cases, physicians may recommend behavioral therapy with a mental health professional.
Huntington's Disease
Huntington’s disease is an inherited disease that causes nerve cells in the brain to waste away. People who have a parent with Huntington’s disease have a 50 percent chance of getting the disease, according to MedlinePlus. Symptoms of Huntington’s disease often don’t appear until middle age. Early signs of Huntington’s disease include personality changes such as irritability, anger, depression or loss of interest in activities, decreased cognitive abilities, short-term memory loss, fatigue, difficulty learning new information, mild balance problems, clumsiness and involuntary facial movements such as grimacing. No treatment exists to cure, stop or reverse the process of Huntington’s disease. Medications such as tetrabenazine help reduce the jerky, involuntary movements of Huntington’s disease by increasing the amount of dopamine in the brain.
Dementia
Dementia encompasses a group of diseases that affect intellectual and social abilities severely enough to interfere with everyday living. Memory loss is common in dementia, but that alone does not indicate dementia. Patients suffering from dementia usually also exhibit difficulty communicating, inability to learn or retain new information, difficulty with coordination and motor function, personality changes, inability to reason, paranoia, fatigue or agitation, hallucinations, and inappropriate behaviors. Treatment for dementia includes medications such as donepezil and memantine to help increase the chemical messengers in the brain. | https://healthfully.com/161209-reasons-for-debilitating-fatigue-short-term-memory-loss.html |
Physical exam. This may be done to help rule out other problems that could be causing your symptoms and to check for any related complications.
Lab tests. These may include, for example, a complete blood count (CBC), a check of your thyroid function, and screening for alcohol and drugs.
Psychological evaluation. This includes discussing your thoughts, feelings, symptoms and behavior patterns. With your permission, this may include talking to your family or friends.
Diagnostic criteria for OCD. Your doctor may use criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), published by the American Psychiatric Association.
It's sometimes difficult to diagnose OCD because symptoms can be similar to those of obsessive-compulsive personality disorder, anxiety disorders, depression, schizophrenia or other mental health disorders. And it's possible to have both OCD and another mental disorder. Work with your doctor so that you can get the appropriate diagnosis and treatment.
Obsessive-compulsive disorder treatment may not result in a cure, but it can help bring symptoms under control so that they don't rule your daily life. Some people need treatment for the rest of their lives.
The two main treatments for OCD are psychotherapy and medications. Often, treatment is most effective with a combination of these.
Cognitive behavioral therapy (CBT), a type of psychotherapy, is effective for many people with OCD. Exposure and response prevention (ERP), a type of CBT therapy, involves gradually exposing you to a feared object or obsession, such as dirt, and having you learn healthy ways to cope with your anxiety. ERP takes effort and practice, but you may enjoy a better quality of life once you learn to manage your obsessions and compulsions.
Certain psychiatric medications can help control the obsessions and compulsions of OCD. Most commonly, antidepressants are tried first.
However, your doctor may prescribe other antidepressants and psychiatric medications.
Choosing a medication. In general, the goal is to effectively control symptoms at the lowest possible dosage. It's not unusual to try several drugs before finding one that works well. Your doctor might recommend more than one medication to effectively manage your symptoms. It can take weeks to months after starting a medication to notice an improvement in symptoms.
Side effects. All psychiatric medications have potential side effects. Talk to your doctor about possible side effects and about any health monitoring needed while taking psychiatric drugs. And let your doctor know if you experience troubling side effects.
Suicide risk. Most antidepressants are generally safe, but the FDA requires that all antidepressants carry black box warnings, the strictest warnings for prescriptions. In some cases, children, teenagers and young adults under 25 may have an increase in suicidal thoughts or behavior when taking antidepressants, especially in the first few weeks after starting or when the dose is changed. If suicidal thoughts occur, immediately contact your doctor or get emergency help. Keep in mind that antidepressants are more likely to reduce suicide risk in the long run by improving mood.
Interactions with other substances. When taking an antidepressant, tell your doctor about any other prescription or over-the-counter medications, herbs or other supplements you take. Some antidepressants can cause dangerous reactions when combined with certain medications or herbal supplements.
Stopping antidepressants. Antidepressants aren't considered addictive, but sometimes physical dependence (which is different from addiction) can occur. So stopping treatment abruptly or missing several doses can cause withdrawal-like symptoms, sometimes called discontinuation syndrome. Don't stop taking your medication without talking to your doctor, even if you're feeling better — you may have a relapse of OCD symptoms. Work with your doctor to gradually and safely decrease your dose.
Talk to your doctor about the risks and benefits of using specific medications.
Sometimes, medications and psychotherapy aren't effective enough to control OCD symptoms. Research continues on the potential effectiveness of deep brain stimulation (DBS) for treating OCD that doesn't respond to traditional treatment approaches.
Because DBS hasn't been thoroughly tested for use in treating OCD, make sure you understand all the pros and cons and possible health risks.
Take your medications as directed. Even if you're feeling well, resist any temptation to skip your medications. If you stop, OCD symptoms are likely to return.
Pay attention to warning signs. You and your doctor may have identified issues that can trigger your OCD symptoms. Make a plan so that you know what to do if symptoms return. Contact your doctor or therapist if you notice any changes in symptoms or how you feel.
Check first before taking other medications. Contact the doctor who's treating you for OCD before you take medications prescribed by another doctor or before taking any over-the-counter medications, vitamins, herbal remedies or other supplements to avoid possible interactions.
Practice what you learn. Work with your mental health professional to identify techniques and skills that help manage symptoms, and practice these regularly.
Learn about OCD. Learning about your condition can empower you and motivate you to stick to your treatment plan.
Join a support group. Reaching out to others facing similar challenges can provide you with support and help you cope with challenges.
Stay focused on your goals. Keep your recovery goals in mind and remember that recovery from OCD is an ongoing process.
Find healthy outlets. Explore healthy ways to channel your energy, such as hobbies and recreational activities. Exercise regularly, eat a healthy diet and get adequate sleep.
Learn relaxation and stress management. Stress management techniques such as meditation, visualization, muscle relaxation, massage, deep breathing, yoga or tai chi may help ease stress and anxiety.
Stick with your regular activities. Go to work or school as you usually would. Spend time with family and friends. Don't let OCD get in the way of your life.
You may start by seeing your primary doctor. Because obsessive-compulsive disorder often requires specialized care, you may be referred to a mental health professional, such as a psychiatrist or psychologist, for evaluation and treatment.
Will exposure and response prevention therapy help?
Can you recommend any websites?
Don't hesitate to ask any other questions during your appointment.
Do certain thoughts go through your mind over and over despite your attempts to ignore them?
Do you have to have things arranged in a certain way?
Do you have to wash your hands, count things or check things over and over?
How do the symptoms affect your daily life?
In a typical day, how much time do you spend on obsessive thoughts and compulsive behavior?
Have any of your relatives had a mental illness?
Have you experienced any trauma or major stress?
Cook AJ. Allscript EPSi. Mayo Clinic, Rochester, Minn. April 12, 2016.
Obsessive-compulsive disorder. In: Diagnostic and Statistical Manual of Mental Disorders DSM-5. 5th ed. Arlington, Va.: American Psychiatric Association; 2013. http://www.psychiatryonline.org. Accessed July 19, 2016.
Obsessive-compulsive disorder. National Alliance on Mental Illness. http://www.nami.org/Learn-More/Mental-Health-Conditions/Obsessive-Compulsive-Disorder. Accessed July 19, 2016.
What is obsessive-compulsive disorder? American Psychiatric Association. https://www.psychiatry.org/patients-families/ocd/what-is-obsessive-compulsive-disorder. Accessed July 19, 2016.
Obsessive-compulsive disorder in children and adolescents. American Academy of Child & Adolescent Psychiatry. http://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/Obsessive-Compulsive-Disorder-In-Children-And-Adolescents-060.aspx. Accessed July 19, 2016.
Obsessive-compulsive disorder. National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml. Accessed July 19, 2016.
Simpson HB. Obsessive-compulsive disorder in adults: Epidemiology, pathogenesis, clinical manifestations, course, and diagnosis. http://www.uptodate.com/home. Accessed July 19, 2016.
AskMayoExpert. Obsessive-compulsive disorder (OCD). Minn.: Mayo Foundation for Medical Education and Research; 2015.
2014-2015 Research report: Psychiatry and psychology. Mayo Clinic. http://www.mayo.edu/pmts/mc0700-mc0799/mc0710-11.pdf. Accessed July 18, 2016.
Denys D, et al. Deep brain stimulation for treatment of obsessive-compulsive disorder. http://www.uptodate.com/home. Accessed July 19, 2016.
Mayo Clinic rankings & ratings. U.S. News & World Report. http://health.usnews.com/best-hospitals/area/mn/mayo-clinic-6610451/psychiatry. Accessed July 22, 2016.
Whiteside SP (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 16, 2016.
Olsen MW (expert opinion). Mayo Clinic, Rochester, Minn. Aug. 17, 2016. | https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/diagnosis-treatment/drc-20354438 |
What are examples of antipsychotic drugs?
Medications available in this class include risperidone (Risperdal), quetiapine (Seroquel), olanzapine (Zyprexa), ziprasidone (Zeldox), paliperidone (Invega), aripiprazole (Abilify) and clozapine (Clozaril).
What are antipsychotic medicines?
What are antipsychotics? Antipsychotics are a type of psychiatric medication which are available on prescription to treat psychosis. They are licensed to treat certain types of mental health problem whose symptoms include psychotic experiences. This includes: schizophrenia.
What are the most commonly used antipsychotic medications?
Haldol (haloperidol) and Thorazine (chlorpromazine) are the best known typical antipsychotics. They continue to be useful in the treatment of severe psychosis and behavioral problems when newer medications are ineffective. However, these medications do have a high risk of side effects, some of which are quite severe.
How do antipsychotic drugs work?
Generally speaking, antipsychotic medications work by blocking a specific subtype of the dopamine receptor, referred to as the D2 receptor. Older antipsychotics, known as conventional antipsychotics, block the D2 receptor and improve positive symptoms.
Are antidepressants and antipsychotics the same?
Like antidepressant medications, antipsychotic medications do not cure depression, or other mental health conditions, they do however offer relief from symptoms and improve quality of life.
Is Zoloft an antipsychotic?
Zoloft (sertraline) – an antidepressant of the SSRI class. Zyprexa (olanzapine) – atypical antipsychotic used to treat schizophrenia and bipolar disorder.
What is psychotic behavior?
Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. People with psychoses lose touch with reality. Two of the main symptoms are delusions and hallucinations.
Why would someone be prescribed antipsychotics?
Antipsychotic medications are used as a short or long-term treatments for bipolar disorder to control psychotic symptoms such as hallucinations, delusions, or mania symptoms. These symptoms may occur during acute mania or severe depression.
Does antipsychotic change your personality?
Taking antipsychotic medication will not change your personality.
Which antipsychotic is best for anxiety?
Atypical antipsychotics such as quetiapine, aripiprazole, olanzapine, and risperidone have been shown to be helpful in addressing a range of anxiety and depressive symptoms in individuals with schizophrenia and schizoaffective disorders, and have since been used in the treatment of a range of mood and anxiety disorders …
Is psychosis a psychotic disorder?
Psychosis is a symptom of several mental health disorders, including psychotic disorders. It can occur in conditions that are not psychotic disorders. For example, people with alcohol addiction can develop symptoms of psychosis even though alcoholism isn’t a psychotic disorder.
What happens if you take an antipsychotic and don’t need it?
If you decide to come off antipsychotics your doctor will help you come off the medication gradually by reducing the dose over a period of time. If you stop antipsychotics suddenly it can cause ‘rebound psychosis’. This means that the symptoms of your illness return suddenly, and you may become unwell again.
What are the early warning signs of psychosis?
Early warning signs include the following:
- A worrisome drop in grades or job performance.
- Trouble thinking clearly or concentrating.
- Suspiciousness or uneasiness with others.
- A decline in self-care or personal hygiene.
- Spending a lot more time alone than usual.
- Strong, inappropriate emotions or having no feelings at all.
How do antipsychotics make you feel?
Sedation, or sleepiness, is a common side effect of many antipsychotics. It is more common with certain antipsychotics than others, such as chlorpromazine and olanzapine. Sedation can happen during the day as well as at night. So if you experience this you might find it very hard to get up in the morning.
What are the positive signs of schizophrenia?
Positive Symptoms of Schizophrenia: Things That Might Start Happening
- Hallucinations. People with schizophrenia might hear, see, smell, or feel things no one else does. …
- Delusions. …
- Confused thoughts and disorganized speech. …
- Trouble concentrating. …
- Movement disorders. | https://chronvivant.com/antidepressants/what-are-antipsychotic-medications.html |
In this section, we will review medications that are commonly used to treat dementia.
Cholinesterase Inhibitors
There are four cholinesterase inhibitors currently on the market for treating AD; however, due to
severe side effects and high pill-burden, tacrine (Cognex®) is rarely prescribed. Donepezil
(Aricept®), galantamine (Razadyne®), and rivastigmine (Exelon®) are the most commonly
prescribed cholinesterase inhibitors. Galantamine and rivastigmine have been approved for the
treatment of mild to moderate stage Alzheimer's type dementia. Donepezil is approved to treat
mild, moderate and severe AD. Rivastigmine is also approved to treat dementia related to
Parkinson's disease. At this time there is no scientific evidence to support the use of these
medications in mild cognitive impairment (MCI).
There is no substantial evidence any of the current medications approved for the treatment of
AD is better than another. All cholinesterase inhibitors may be beneficial in treating LBD, but
may have increased adverse effects in FTD. Any possible benefit in treating vascular dementia
with a cholinesterase inhibitor as a sole agent or in combination with memantine remains to be
elucidated.
While they do not always improve symptoms, some patients will notice small improvements in
memory, behavior, functional ability and mood. A portion of patients treated will "stabilize" for a
period of time, meaning that the symptoms of their dementia do not worsen. The most
consistent finding across studies is that patients who took cholinesterase inhibitors showed less
of a decline in memory, cognitive and functional abilities than patients who took a placebo.
Unfortunately, this makes it difficult to gauge benefit in individual patients, since it is hard to
notice that someone is declining more slowly. Some studies have shown a marked decline in
patients with AD who stop taking the medications. We therefore recommend that, in the
absence of side effects, patients continue to take cholinesterase inhibitors unless instructed to
stop by the prescribing provider. Some clinicians believe it is almost never appropriate to stop
these medications due to perceived lack of effectiveness, unless patients are in the end stages
of dementia.
Donepezil has the benefit of only being dosed once a day, (both regular release and 23 mg
sustained release tablet), while the regular oral forms of rivastigmine and galantamine are
dosed twice a day. The sustained release tablet form of galantamine may be dosed once daily.
Donepezil may be given in the morning or at bedtime. Giving it nighttime will decrease daytime
drowsiness; however, nighttime dosing sometimes results in "vivid dreams" that can cause
awakening in the middle of the night. Rivastigmine is now available as a transdermal patch,
which may be an attractive alternative for some patients who have difficulty-swallowing pills and
fewer side effects than oral rivastigmine. It is also important when utilizing these drugs to slowly
increase the dose to the maximum tolerated dose suggested by the manufacturer to ensure the
best possible effect.
Donepezil 23 mg (sustained release) tablet should only be considered in patients with
moderate-to-severe dementia after an adequate trial period at 10 mg per day. Side effects are
higher at the 23 mg dose, and we recommend caution in prescribing this formulation to older
patients or patients with significant medical illnesses until a longer track record of safety is
available.
Common side effects of theses medication include nausea/vomiting and diarrhea. Less common
side effects include muscle cramping, fainting, and increased urinary output. These side effects
often lessen with time, and slowly increasing the dose up to the maximum effective dose can
lessen these side effects. Side effects may return if the patient has stopped taking the
medication even for a short period of time. If this happens, it may be necessary to temporarily
decrease the dose, and slowly re-titrate the therapy back to the maximum tolerated dose.
Contact your physician for specific instructions. These medications should be used with caution
in some patients, including those with certain heart problems, lung problems and stomach
problems.
NMDA Receptor Antagonists
Memantine (Namenda®) is approved for the treatment of moderate to severe AD. It works in a
different way than cholinesterase inhibitors, and is most effective when administered with a
cholinesterase inhibitor. The cholinesterase inhibitor should be titrated to the maximum tolerated
dose, at which time it would be appropriate to consider starting memantine. Current research
does not support prescribing memantine for mild AD, MCI, or dementia not due to AD.
Memantine may be prescribed as a single agent in those individuals who cannot tolerate or
have a contraindication to cholinesterase inhibitors. However, memantine alone does not
appear to be as effective as the combination of memantine plus a cholinesterase inhibitor. The
usual dose is 10 mg by mouth twice daily, which is attained after slowly increasing the dose
over about a month. Discuss how the dose should be increased with your physician and/or
pharmacist. Individuals with impaired kidney function will require a lower dose.
Side effects of memantine include dizziness, confusion, headache, constipation or diarrhea. In
clinical trials the memantine side effect profile was similar to placebo.
As with cholinesterase inhibitors, it is difficult to gauge efficacy, as clinical trials have
demonstrated less decline rather than improvement in patients taking memantine. Some studies
suggest that memantine may reduce agitation in patients with moderate to severe AD.
Currently clinical trials are investigating a possible role for memantine in treating FTD.
Other Medications
Many medications have been studied to determine if they could be used to prevent the onset or
slow the progression of dementia. These medications include anti-inflammatory drugs, such as
ibuprofen and naproxen, estrogens, vitamin E, cholesterol lowering "statin" agents, and gingko
biloboa. The evidence supporting the use of these medications is either lacking or conflicting,
and it is not currently recommended that these medications be used to prevent or slow
Alzheimer's disease or other diseases associated with dementia. It is very important to report
any herbal, vitamins or alternative treatments to your physician and pharmacist.
There is evidence that the control of other disease, such as cardiovascular disease, can be very
beneficial in dementia patients. Adequate blood pressure and cholesterol control should be
pursued through medications and lifestyle changes; however, statin drugs, in recent clinical
research trials did not reduce the risk for developing Alzheimer's disease.
BEHAVIORAL TREATMENT ISSUES FOR PATIENTS
WITH THE DEMENTIA SYNDROME
Although cognitive disturbances, such as memory impairment and language impairment, are the
most recognized symptoms of dementia, the behavioral psychological symptoms of dementia
(BPSD) can also be an issue and cause considerable morbidity and disability in people with AD.
The (BPSD) symptoms may include delusions, hallucinations, agitation, physical aggression,
hostility, restlessness, wandering, pacing, verbal outbursts and/or apathy.
Clinical and research evidence indicate cholinesterase inhibitors reduce the need for
psychotherapeutic medications in AD. The addition of memantine to an established
cholinesterase inhibitor regimen, at an optimal dose, may enhance this benefit.
Thoughtful consideration of non-medication approaches to managing a problem
behavior is important before considering drug therapy.
(http://www.alz.org/alzheimers_disease_treatments_for_behavior.asp)
I. SEVERE AGITATION
Severe agitation may occur, with or without problematic delusions, paranoia, hallucinations,
combativeness and psychomotor agitation. Non-pharmacologic interventions should be tried
first or in conjunction with medical therapy, such as improving pain management. Medications to
treat BPSD should only be initiated if absolutely necessary, because of the potential for side
effects.
Antipsychotics
Antipsychotic medications are sometimes prescribed for this indication. Antipsychotics can
generally be broken into two broad categories: first-generation and second-generation
antipsychotics.
First-generation antipsychotics include haloperidol (Haldol), chlorpromazine (Thorazine®),
thioridazine (Mellaril®), perphenazine (Trilaflon®), and fluphenazine (Prolixin®). The use of
these medications for dementia patients currently should be avoided due to a high incidence of
side effects. Haloperidol is sometimes used in the acute or hospital setting for situations
requiring immediate control. Common side effects include weight gain, somnolence,
constipation, and urinary retention. These medications are associated with disorders of
movement such as extrapyramidal symptoms (stiffness, tremor, shuffling gait, falls) and tardive
dyskinesia (involuntary movements, often involving the face and mouth). Medications used to
prevent extrapyramidal symptoms, such as benztropine (Cogentin®) and trihexyphenidyl
(Artane®), can cause delirium (confusion and disorientation) in dementia patients and should
generally be avoided.
Second-generation antipsychotics include risperdone (Risperdal), olanzapine (Zyprexa®),
quetiapine (Seroquel®), ziprasidone (Geodon®), aripiprazole (Abilify), and paliperidone
(Invega). Second generation antipsychotics are better tolerated but are associated with
metabolic side effects, such as weight gain, altered cholesterol, and diabetes. Olanzapine
appears to be the worse offender. Weight, cholesterol, and blood glucose should be monitored
regularly in patients taking second-generation antipsychotics. While tardive dyskinesia is less
common with second-generation antipsychotics, this side effect has been reported.
The FDA has recently mandated a warning about all antipsychotic drugs. Use of these drugs
for the psychosis of dementia patients increases the risk for morbidity and mortality, usually due
to stroke or heart attack. The FDA requires the manufacturers of these drugs to notify health
care providers that they are not approved for the treatment of behavior symptoms in the elderly
diagnosed with a dementia. In turn prescribers are required to discuss the risks involved with
caregivers and/or patients and obtained signed consent. It is also important to note that antipsychotics increase the risk of falls in elderly patients, and special precautions should be taken to reduce the risk of falls. In general, first-generation antipsychotics should avoided and the second generation antipsychotics should be reserved for serious agitated behaviors, such as very aggressive physical acts that pose harm for caregivers or the patient, paranoia, delusions or hallucinations that are very disturbing for the patient and not responsive to non-antipsychotic medications. Older antipsychotics, such as haloperidol may be useful in the hospital setting to manage severe agitation in the short term. Table I. Second Generation Antipsychotic dosing for Psychiatric Behavioral Conditions in Alzheimer 's disease Special Considerations Start at 0.25 mg once to twice Risperidone possesses an active daily or 0.5 mg at bedtime. metabolite that is removed via the kidney; Usual maximum in this patient patients with kidney impairment may population is 1 mg/day. There is respond at lower than expected doses. in increased risk of side effects Risperidone is associated with mild orthostatic hypotension, but more extrapyramidal issues, such as Parkinson's like symptoms (dose> 1mg/day) (tremor, stiffness and/or,gait disturbance as compared to other second-generation antipsychotics. Start dose at 25 mg at bedtime, Quetiapine possesses mild anticholinergic and increase by 25 mg activity, sedation, orthostatic hypotension increments up to a total 200 mg (drop in blood pressure on standing) some daily. Severe assaultive weight gain and increased risk for behavior may require higher diabetes. Minimal extrapyramidal issues, doses (usually in divided such as Parkinson's like symptoms doses). Dosing at bedtime can (tremor, stiffness and/or impaired gait). take advantage of sedative May require periodic eye exams May be preferred in Lewy Body dementia or Parkinson's dementia. Start dose at 2.5 mg once daily, Olanzapine is not recommended in Lewy usually at bedtime. Response at Body or Parkinson's disease due to doses up to 10 mg is increase gait disturbances. Olanzapine is inconsistent. Dose of 15 mg associated with higher weight gain, daily no better than placebo. sedation, and hyperglycemia as compared to other second-generation antipsychotics. It also has a higher incidence of extrapyramidal symptoms as compared to medications in this class and mild-moderate anticholinergic activity. Start doses of 2 mg/day, Aripiprazole causes less metabolic side increasing to 5 mg and then 10 effects as compared to other second mg daily. In one large well- generation antipsychotics, but it is designed study 2 mg and 5 mg associated with increased risk of agitation were no better than placebo. 10 mg daily offered a significant reduction in problem behaviors. Start doses at 10 to 20 mg This medication is more commonly (Geodon®)*
daily. This medication has only associated with prolonged QT as been studied in this population compared to medications in this class and in case reports, so appropriate should be avoided in patients with maximum doses have not been significant cardiovascular history, congenital prolonged QT, or in patients on other QT-prolonging agents. ǂ Dosing in Lewy Body dementia or dementia in Parkinson's disease may be lower. * Poor evidence supporting use of this medication for this indication. ** Fair evidence supporting use of this medication for this indication. *** Good evidence supporting use of this medication for this indication. Newer antipsychotics such as asenapine (Saphris®), paliperidone (Invega®), iloperidone
(Fanapt®), or lurasidone (Latuda®) have not been studied in these patient populations and
cannot be recommended at this time without additional clinical trials.
Several clinical studies suggest a role for SSRI's , like citalopram for treating behavioral issues
related to AD. In two separate clinical trials citalopram at doses between 20 to 40 mg daily was
as effective as an antipsychotic (perphenazine or risperidone) in managing agitation, impulsive
behavior, delusions and anxiety.
II. SUNDOWNING –
Sundowning consists of agitation, confusion, disorientation, that starts in the late afternoon and
become more severe at night. It is suggestive of multiple factors, such as environmental issues,
inadequate management of one or more physical issues, such as pain and/or inappropriate
medications. Sundowning is not a diagnosis, but a syndrome or collection of symptoms that
strongly suggests the need for a careful and detailed patient review.
III. INSOMNIA
Insomnia is a common problem in elderly patients, including dementia patients. It is important to
consider lifestyle changes that could be contributing to insomnia. For example, if the patient is
awakening to go to the bathroom at bedtime and this is causing insomnia, consider diminishing
fluid intake late in the afternoon, toileting prior to bedtime, etc. Good sleep hygiene practices
(e.g. avoiding caffeine and alcohol, minimizing daytime naps) should be implemented before
initiating medication therapy. Triggers, such as pain, gastrointestinal condition, dry skin and
breathing problems should all be considered before starting a sleep medication. Of these pain is
probably the most common "cause" for disturbed sleep.
If lifestyle modifications fail, certain medications can be useful for treating insomnia in dementia
patients. Trazodone (Oleptro®) is a reasonable first choice (doses ranging from 12.5 mg to 150
mg at bedtime). The use of zolpidem (Ambien®) or medications in this class can be considered,
but should be used with caution as these medications may have a stronger effect in the elderly.
Small doses of mirtazapine (Remeron®) (7.5 mg to 15 mg at bedtime) are another option.
Certain over-the-counter products, such as those including diphenhydramine (Benadryl®,
Tylenol PM®, Advil PM®), should be avoided in patients with AD and many elders.
Benzodiazepines are also not recommended for insomnia in AD.
IV. Anxiety
Selective serotonin reuptake inhibitors (SSRIs) are the preferred treatment for anxiety
associated with dementia. SSRIs include fluoxetine (Prozac®), paroxetine (Paxil®), sertraline
(Zoloft®), citalopram (Celexa®), and escitalopram (Lexapro®), These medications were initially
indicated for depression but can also help to treat anxiety, reduce insomnia, and may be
effective treatment for mild to moderate agitation in the Alzheimer's patient. Paroxetine and
fluoxetine are not recommended because both medications have numerous drug interactions.
Additionally, paroxetine possesses anticholinergic activity and is associated with problematic
withdrawal symptoms if suddenly discontinued.
It is recommended that the lowest, effective dose be used for the treatment of anxiety. While the
use of these medications may be discontinued once symptoms are under control, SSRIs should
not be stopped abruptly. The medications should be slowly tapered to prevent a discontinuation
syndrome associated with flu-like symptoms, nausea, anxiety, and palpitations.
Common side effects associated with these medications include stomach upset, insomnia,
headache, fatigue, and sexual dysfunction. If a dementia patient is not able to tolerate one
SSRI, it is reasonable to try a different SSRI, because they may tolerate a different medication
better. See section below for additional considerations related to specific SSRIs.
Benzodiazepines are commonly used to treat anxiety; however, these medications should be
avoided in elderly patients or patients with dementia. If a benzodiazepine is deemed necessary
the lowest possible dose should be prescribed. When a patient's symptoms resolve, the
medication should be slowly tapered down and discontinued
V. DEPRESSION
Early in the dementia process, depression and depressive symptoms may require treatment. The drugs of first choice are SSRIs. The depressive symptoms in patients with dementia are usually the same as in other patients but may be missed because they resemble symptoms of medical illnesses. For example, weight loss; sleep disturbances, fatigue, or impaired concentration. The clinician needs to evaluate for symptoms of poor sleep and appetite and other non-verbal signs of being depressed. If the depression is determined to be significant, the following is a list of SSRI medications that might be considered. Table 2. Dosing of Antidepressants Used for Depression in Patients with Alzheimer's disease Medication Special Considerations Start at 6.25 – 12.5 mg This medication may be somewhat (Zoloft®)
daily in AM. Usual activating, and may increase anxiety maximum dose is 100 to in some patients. It also may have a 200 mg daily. In AM higher incidence of nausea, and diarrhea. Start at 5 - 10 mg daily at This medication has fewer drug (Celexa®)
interactions and is a reasonable The current maximum option. It may cause nausea recommended daily dose sedation, so recommend that is 40 mg per day. patients take at bedtime, and may be best choice for patients with depression and insomnia. Higher doses of citalopram >40 mg increase the risk of QT prolongation and Torsades, and should be used with caution in patients with increased risk (cardiac disease, Start doses at 5 mg daily. Similar to citalopram, this medication (Lexapro®)
Usual maximum dose is 20 has few drug interactions. It appears mg daily. to cause minimal sedation or activation. It is not currently available in generic formulations, so may be a more costly alternative for patients Start doses at 7.5 mg Effective in treating depression, (Remeron®)
orally at bedtime, increase anxiety and disturbed sleep. Doses to 15 mg if necessary with of above 15 mg daily may result in a max dose of 45 mg daily reduced sedative effect. This medication also possesses anti-emetic properties and can increase appetite and cause weight gain. Has an anti- emetic effect, so nausea/vomiting not an issue. Start extended release May provide some benefit in patients (Effexor®)
formulation at 37.5 mg with neuropathic pain and reduce daily. Doses below 150 mg symptoms of ‘hot flashes' associated daily primarily have with peri-menopause. Carries many serotonergic effects. of the same side effects of SSRIs, Doses between 150 to 225 but is also associated with increased mg have dual effect (noradrenergic and serotonergic). Start doses at 20 mg once May provide some benefit in patients to twice daily. Increase to with neuropathic pain. Carries many 40 to 60 mg (frequency?) of the same side effects of SSRIs, but is also associated with increased blood pressure and increased risk for liver impairment in elders. Reduced doses if significant kidney impairment. Start 37.5 mg twice daily of This medication is known to increase immediate release product risk of seizures in patients with a or 100 mg once daily for history of seizures, May be mildly sustained release stimulating. Less likely to impair formulations. Titrate to a sexual performance total of 150 mg twice daily Sometimes added to existing as tolerated. A once a day antidepressant to "boost" formulation is available. antidepressant effect. DRI=dopamine reuptake inhibitor; SSRI=serotonin reuptake inhibitor; SNRI=serotonin
norepinephrine reuptake inhibitors
Note: This list is not intended to be comprehensive and complete prescribing instructions. Side
effects, dosing, and monitoring parameters should be reviewed prior to initiation of therapy.
As a class, side effects of SSRI's include tremors, sweating, nervousness,
insomnia/somnolence, dizziness and various gastrointestinal (nausea) and sexual disturbances
such as impotence or decreased sexual desire. Antidepressant therapy increases fall risk.
Other classes of antidepressants include selective-serotonin norepinephrine inhibitors (SNRIs),
norepinephrine reuptake inhibitors, tricyclic antidepressants, and monoamine oxidase inhibitors.
SNRIs include venlafaxine (Effexor®), duloxetine (Cymbalta®) and desvenlavaxine (Prestiq®).
These medications may be effective in select individuals in treating individuals with depression,
especially if they have not responded to SSRIs. They may also offer additional benefit in
managing chronic pain. There share many of the same side effects of SSRIs, but also have the
ability to increase blood pressure.
It is important to note that SSRIs and SNRIs generally should not be stopped suddenly,
because this may result in unpleasant side effects (nausea, vomiting, tremors, anxiety, or
insomnia). Also, they should be used cautiously in combination or with other serotonergic
agents (e.g. tramadol,mirtazepine) due to risk of serotonin syndrome, a rare but potentially fatal
side effect.
Tricyclic antidepressants include amitryptyline (Elavil®), doxepin (Sinequan®), desipramine
(Norpramin®) and nortriptyline (Pamelor®). These medications are generally not recommend in
the elderly, because they have anticholinergic side effects that can provoke or increase
confusion and are associated with orthostatic hypotension. They also have the potential to
prolong QTc increasing the risk for heart arrhythmias – a future also associated with many
antipsychotic medications. Monoamine oxidase inhibitors are also not recommended, due to the
higher risk of serotonin syndrome and multiple drug and food interactions.
Bupropion (Wellbutrin®) is a dopamine-reuptake inhibitor. It can sometimes be used as an
adjunct to SSRIs to boost the antidepressant effect, but it has the potential to cause agitation
and insomnia (monitor caffeine intake). It should be avoided in patients who have a history of
seizures. Mirtazapine (Remeron®) is an alpha-2 antagonist. While it has less evidence for
treatment of depression than SSRIs, it offers some benefits in this patient population, because it
promotes sleep and weight gain.
There are some new medications, including vildalazone (Viibryd®) and milnacipran (Savella®)
that have become available for the treatment of depression, and fibromyalgia; however, these
medications are too new to discuss in depth because at this time the full range of side effects
are not known. They are also likely associated with higher out-of-pocket costs.
Mood Stabilizers for Psychiatric behavioral conditions in Dementia
Various medications indicated for seizures and or bipolar disorders have been considered for
the management of dementia related psychiatric behaviors, such as agitation, aggressive
behavior etc. These medications include: divalproex sodium (Depakote®), carbamazepline
(Tegretol®), lamotrigine (Lamicatal®) and lithium.
Carbamazepine, although one small well-controlled study suggested some benefit, should be
avoided due to many drug interactions and potential serious side effects. Divalproex, although
sometime prescribed, is not supported by scientific research and is known to be a risk factor for
liver toxicity. Lamotrigine can cause serious skin reactions and lithium has not demonstrated an
ability to improve psychiatric issues in AD and has a narrow margin for error in the elderly.
In General these medications should Not be prescribed for the management of behavioral
problems in elders diagnosed with Alzheimer's disease
*This monograph is not intended to be all-inclusive or offer patient specific drug
treatment- only your health care provider who knows the patient and his/her diagnosis
can do that. It is intended to offer a sampling of the issues, dilemmas, and clinical
considerations to be considered when selecting medications for psychiatric behavioral
issue related to a dementia-like Alzheimer's disease.
Credits: | https://marysfamilymedicine.org/a/alznorcalblog.org1.html |
The term akathisia is medically defined as a movement disorder that is characterized by the inner feeling of restlessness with the individual feeling compelled to be constantly moving . It came from the Greek term “káthisis” which means “sitting” .
Individuals who suffer from akathisia may be seen crossing and uncrossing their legs while sitting, rocking while they are sitting or standing, and lifting their feet like they are marching . Although it may be interpreted as a movement disorder, all the movements shown by the patient with akathisia are all voluntary.
They do not present with involuntary movements such as the ones seen in those with Parkinsonism and tardive dyskinesia .
The manifestation of akathisia is associated with the intake of neurological medications. It may appear a few hours after starting the drug or it may take a few days or weeks before it begins to manifest. It may also occur when the dose of the drug being taken is changed or if the medication has stopped [1, 6].
Antipsychotics are the medications that are prescribed to patients for the management of conditions such as bipolar disorder or schizophrenia. These are also given to patients who suffer from severe anxiety and severe depression.
They exert their therapeutic effect by restoring the balance of neurotransmitters in the brain. The incidence of akathisia associated with this drug is very high because of the increased serotonin signals or decreased dopamine signals. Examples of drugs under this category are clozapine, quetiapine, olanzapine, asenapine, risperidone, and aripiprazole [1, 4, 5, 6].
Drugs that are classified as anti-emetic block the receptors of serotonin found in the central nervous system and gastrointestinal system. Its action in serotonin receptors is linked to the occurrence of akathisia. The manifestations of akathisia may appear several months after anti-emetic drugs are taken. Examples of this are meclizine, diphenhydramine, doxylamine, and cyclizine [1, 4, 5, 6].
Akathisia may be seen in patients who are withdrawing from benzodiazepines, amphetamines, and opiates. The symptoms of akathisia in these patients are seen several weeks after they have stopped taking the medications [1, 4, 5, 6].
Although the function of Selective Serotonin Reuptake Inhibitor or SSRI is not fully understood, it is believed to limit the reuptake or reabsorption in the presynaptic cell which increases the amount of the neurotransmitter outside of the cell. It may not directly cause akathisia, taking this drug are known to aggravate the symptoms manifested by the patient [1, 4, 5, 6].
Since the development of akathisia is linked to the intake of medications, it is not always possible to stop taking the drug because of the risk of the underlying medical progression to progress. There are several treatment options that can be selected to manage the condition of the patient [1, 4, 5, 6].
Those who experience akathisia because of taking antipsychotic drugs may benefit from this. Lowering the dose may seem to alleviate the symptoms presented by the patient. It is important to note that the new dose must not only improve the akathisia of the patient but should also be able to achieve the intended effect of the drugs [1, 4, 5, 6].
Although they are still able to cause akathisia, second-generation antidepressants and anti-psychotics induce the symptoms of akathisia more slowly than their predecessors. This option may be discussed with the physician to know the alternatives [1, 4, 5, 6].
Consumption of the recommended amount of Vitamin B6 is known to improve the symptoms of akathisia. Food that has an adequate amount of this vitamin include beef, turkey, and potatoes .
Sethuram, K., & Gedzior, J. (2014). Akathisia: Case Presentation and Review of Newer Treatment Agents. Psychiatric Annals, 391-396.
Forcen, F. E. (2015). Akathisia: Is restlessness a primary condition or an adverse drug effect? Current Psychiatry, 14-18.
Miller, C., & Fleischhacker, W. (2000). Managing antipsychotic-induced acute and chronic akathisia. Drug Safety, 73- 81.
Poyurovsky, M. (2010). Acute antipsychotic-induced akathisia revisited. The British Journal of Psychiatry, 89 -91. | https://healthsaline.com/akathisia.html |
Request an appointment with a neurologist by calling:
Movement disorders are conditions that affect changes in both motor control and non-motor symptoms. At the Binter Center for Parkinson's Disease & Movement Disorders at the UVM Medical Center, we offer a collaborative approach to diagnosising and treating Parkinson's disease and other movement disorders.
Movement Disorders Diagnosis
Parkinson's Disease
Parkinson's disease (PD) is a degenerative disorder of the central nervous system. The disease is named after the English doctor James Parkinson, who published the first detailed description in An Essay on the Shaking Palsy in 1817. The motor symptoms of Parkinson's disease result from the death of dopamine-generating cells in the substantia nigra, a region of the midbrain; the cause of this cell death is unknown.
Early in the course of the disease, the most obvious symptoms are movement-related; these include tremor, rigidity, slowness of movement and difficulty with walking. As the disease progresses, cognitive and behavioral problems may arise, with dementia commonly occurring in the advanced stages of the disease; depression is the most common psychiatric symptom. Other symptoms include sensory, sleep and emotional problems. Parkinson's disease is more common in older people, with most cases occurring after the age of 50.
Dystonia
Dystonia is a movement disorder that causes muscles to contract and spasm involuntarily. Opposing muscles often contract simultaneously as if they are 'competing' for control of a body part. The involuntary muscle contractions force the body into repetitive and often twisting movements as well as awkward, irregular postures. There are multiple forms of dystonia; dozens of diseases and conditions may include dystonia as a symptom.
Dystonia may affect a single body area or be generalized throughout multiple muscle groups. It affects men, women, and children of all ages and backgrounds. Dystonia causes varying degrees of disability and pain, from mild to severe. There is presently no cure, but multiple treatment options exist and scientists around the world are actively pursuing research toward new therapies.
Common examples of focal dystonia include cervical dystonia/spasmodic torticollis (neck), blepharospasm (eye lids), writer's cramp (hand during writing specifically), and spasmodic dysphonia (vocal chords).
Primary dystonias are genetic (or believed to be genetic) in origin, whereas secondary dystonias result from apparent outside factors and can be attributed to a specific cause such as exposure to certain medications, trauma, toxins, infections, or stroke.
Essential TremorEssential Tremor (ET), also known as familial tremor, benign essential tremor or hereditary tremor, (ET) is a neurological condition that causes a rhythmic trembling of the hands, head, voice, legs or trunk. It is the most common movement disorder and is often confused with Parkinson's disease. Its cause is unknown although many cases are hereditary. ET is sometimes referred to as an “action tremor”, as it intensifies when one tries to use the affected muscles.
Multiple System Atrophy
Multiple System Atrophy (MSA) is a rare degenerative neurological disorder. MSA is associated with the degeneration of nerve cells in specific areas of the brain causing problems with movement, balance, and other autonomic functions of the body such as bladder control and blood-pressure regulation. The cause of MSA is unknown and no specific risk factors have been identified. MSA affects both men and women primarily in their 50's and progresses rapidly over 9-10 years. It often presents with some of the same symptoms as Parkinson's disease (PD), however standard treatments, such as carbidopa/levodopa (Sinemet), have little effectiveness. Although not as prevalent as PD, MSA affects about 4 per 100,000 individuals. Disease progression is generally more rapid than in PD and reflects a more widespread neurodegeneration in the brain.
Progressive Supranuclear Palsy
Progressive supranuclear palsy (PSP) is a rare neurodegenerative brain disease that affects the nerve cells that control walking, balance, mobility, vision, speech, and swallowing. The disorder's long name indicates that the disease begins slowly and continues to get worse (progressive), and causes weakness (palsy) by damaging certain parts of the brain above pea-sized structures called nuclei that control eye movements (supranuclear). Five to six people per 100,000 will develop PSP; it has no known cause, treatment or cure.
PSP can present with postural instability, frequent (unexplained) falls, problems with eye movement, rigidity of the trunk or neck, difficulty with speech and swallowing, and cognitive decline. Other features may include a masked facial expression, staring, double vision, slowed movement (and thought), sloppy eating habits, monotonous speech, lack of spontaneous conversation, grasping or imitative behaviors, and uncontrolled displays of emotion. Many of these features overlap with those of Parkinson's disease, particularly early in the course of disease.
Huntington's Disease
Huntington's disease (HD) is a genetic disease that causes the progressive breakdown (degeneration) of nerve cells in the brain which causes uncontrolled movements, impaired cognition and emotional disturbances that worsen over time. HD is a familial disease, passed from parent to child through a mutation in the normal gene. Most people with Huntington's disease develop signs and symptoms in their 40s or 50s, but the age of onset varies from person to person, as does the rate of disease progression.
Medications are available to help manage the symptoms of Huntington's disease, but treatments cannot prevent the physical, mental and behavioral decline associated with the condition.
Learn more about treatments for movement disorders at the UVM Medical Center. | https://www.uvmhealth.org/medcenter/conditions-and-treatments/movement-disorders/movement-disorders-diagnosis |
What is Akathisia?
Akathisia literally means “inability to sit,” and is a type of movement disorder in which the patient feels extreme inner restlessness along with a forcible need or desire to be in continuous motion by performing actions such as rocking backwards and forwards when sitting or standing, marching on the spot by lifting feet and also crossing and uncrossing the legs when in a sitting position.1 Patients having akathisia won’t be able to keep or sit still at one place and are always fidget, restless, hop from foot to another or pace about.
Akathisia can be mild where the patient only has simple fidgeting and can be severe where the patient feels the need to continuously pace. Akathisia is a condition where the patient experiences feelings of intense restlessness, which do not have any association with stress or anxiety.
One of the causes of akathisia is thought to be antipsychotics, especially the first generation antipsychotics.2 Akathisia can also occur as a side effect of some medications. Akathisia is also associated with Parkinson’s disease and other such type of syndromes.
Symptoms of Akathisia
The primary characteristic feature of akathisia is a lot of movement. The type of movements depends on the severity of Akathisia and the degree of resistance of the patient against the urge to move. Some of the common symptoms of Akathisia include:
- Akathisia patient sways or rocks from one foot to another.
- Patient repeatedly crosses and uncrosses her/his legs.
- Patient suffering from Akathisia marches in one place by repeatedly lifting and lowering his/her foot.
- Patient is unable to stand or sit still without moving, walking or pacing.
- Akathisia patient also experiences muscle kinks, twisting movements and has a poor posture.
- Patient repeatedly twists or shifts his/her trunk or waist.
- There is also repeated bending of the neck, bobbing of the head and other such movements in that area.
- Patient suffering from Akathisia experiences inner discomfort or tension with a strong desire to move.
- In severe cases of akathisia, patient experiences irritability, anxiety, hostility or dysphoria, which is a general feeling of dissatisfaction or unease. In advanced akathisia, the anxiety can worsen so much that the patient feels paranoid, becomes violent and can also have suicidal tendencies.
Differentiation of Akathisia from Other Movement Disorders
Akathisia can be differentiated from other movement disorders by looking at the amount of control the patient has over his/her motions. For example, if the patient has a muscular tic related to neuromuscular issues, the movements are involuntary and not in control of the patient. Whereas, the movements of akathisia are in control of the patient and the movements occur because the patient has a strong inner urge to make that particular movement.
Akathisia vs Restless Leg Syndrome
Akathisia resembles restless legs syndrome; however, the two conditions are completely different. Restless legs syndrome is characterized by partial uncontrolled movements with a feeling of restlessness, which increases when the patient is sleeping or resting. In Akathisia, the movements are more controlled in nature and there is no relation between movements in Akathisia with sleep or rest. However, the severity can increase in circumstances where the patient has to remain still for some time such as standing in a queue when grocery shopping.
Causes of Akathisia
Akathisia is often a drug-induced movement disorder caused by:
Antipsychotics Medicines can cause Akathisia as a result of suppression of dopamine signals. Antidepressants can also cause Akathisia from increase in the serotonin signals. Akathisia occurs as a side effect of antipsychotic medications and antidepressant medications. This movement disorder can also occur during withdrawal from these medicines. Medicines such as Selective Serotonin Reuptake Inhibitors (SSRIs) can aggravate an already existing akathisia.3
Anti-Migraine or Anti-Nausea Medications: The action of some of these medicines resembles antipsychotic medications and can also cause akathisia; however, this is rare. Akathisia can also occur irrespective of any change in the medicine or starting a new medicine. Sometimes, akathisia occurs immediately and in some cases akathisia can develop months after taking such medicines.
Drug Withdrawal: Withdrawal from drugs such as benzodiazepines, cocaine, opioids or barbiturates can also cause akathisia where the symptoms appear within a few weeks.
In a nutshell, the patient develops akathisia as a side effect of some neurological medications. It can also develop after starting or changing to a new medicine or during the withdrawal process from a medicine.
Treatment for Akathisia
Treatment of akathisia is relatively complicated. As akathisia is a condition brought on by use of certain medications, treatment typically consists of decreasing the dose of the medicine, changing the medicine or stopping the medicine completely. However, if the patient is taking antidepressant or antipsychotic medicines that are causing akathisia, then stopping these medicines can worsen the condition of the patient for which these medicines were started in the first place. Patient may have an increase in the severity of the symptoms of depression or psychosis if the medications are adjusted or stopped. Treatment options for akathisia consist of:
Adjustment in Medicine Dosage: Decreasing the dosage or not increasing the dose of the offending medicine helps in alleviating the symptoms of akathisia. If the akathisia occurs as a result of benzodiazepines or opioids withdrawal, then increase in the dosage will help with the condition. It is important to monitor the patient during and after the dose adjustment to see if there is any alleviation of the akathisia symptoms.
Changing the Medicine: First-generation antipsychotics and antidepressants can cause more severe akathisia, which is why it is recommended to switch to second-generation antidepressants and antipsychotic medicines. They can still induce akathisia, but second-generation medicines are slower in inducing akathisia when compared to first-generation medicines.
Stopping the Medicines: In some cases, doctors can try and see if stopping the medicine for some time brings relief to the symptoms of akathisia. This should be done at a time when the discontinuation of the medicine causes least disruption in the patient’s life.
Anticholinergics: Anticholinergics are prescribed to block certain neurotransmitters and are given to the patient to rectify respiratory, digestive, or sleep-related problems. These medicines also have shown to help in some cases of akathisia. Anticholinergics should be started after other medicines have been tried, as they too have side effects and should be used after other treatment options have not worked.
Dietary Changes: Diet rich in vitamin B6 helps in alleviating the symptoms of akathisia. Vitamin B6 is found in abundance in foods such as meat and starches which include potatoes, beef or turkey. | https://www.epainassist.com/movement-disorders/akathisia |
Which Medications Are Approved to Treat PTSD?
Did you know June 27 is PTSD Awareness Day? How much do you know about this medical condition that affects an estimated one in 11 people? Please continue reading to learn more about post-traumatic stress disorder (PTSD) and how it is treated, including the types of therapies and medications that can help improve symptoms. If you or a loved one has PTSD, this knowledge may help you better understand what you’re going through and develop effective coping strategies.
What is PTSD?
According to the U.S. Department of Veterans Affairs, post-traumatic stress disorder (PTSD) is a mental health condition that can develop after experiencing or witnessing a significant traumatic event. This event may be something that occurred during active duty in a combat zone, a sexual assault, a physical assault such as a robbery or mugging, a motor vehicle accident, a plane crash, or a natural disaster like a fire or earthquake.
The physical symptoms of PTSD can include severe anxiety, flashbacks, nightmares, and distressing memories of the event. Emotional or psychological symptoms can include detachment from family and friends, becoming emotionally numb, losing interest in previously enjoyable activities, and feeling hopeless about the future. PTSD symptoms can appear soon after the traumatic events or much later, and they can last for months to years.
If you have post-traumatic stress disorder, you may not feel like yourself. If someone you love struggles with PTSD, they may seem like a completely different person compared to before the trauma—irritable, angry, depressed, and withdrawn. Treatment of PTSD can help you or a loved one feel better and regain control of your life.
What are the treatments for PTSD?
The two primary ways of treating post-traumatic stress disorder are psychotherapy and antidepressants. A combination of these two approaches can help people with PTSD learn skills to manage their symptoms better. Treatment for PTSD can also relieve problems related to the traumatic event, such as anxiety and depression.
Recognizing PTSD symptoms and getting timely treatment for the condition is vital to prevent complications in the future. Complications of post-traumatic stress disorder can include severe anxiety and depression, substance use disorders (drug and alcohol use), eating disorders, suicidal thoughts and actions.
Psychotherapy for the treatment of PTSD
Psychotherapy can help children and adults with PTSD better cope with their condition. Various psychotherapy and behavioral counseling are used to treat PTSD and help people develop the essential skills to better manage their symptoms. Some of the modalities used by mental health professionals for the treatment of PTSD are briefly described below:
- Cognitive-behavioral therapy (CBT) is a type of talk therapy in which the therapist helps a person recognize negative thinking and develop new thought patterns. For example, if you are anxious that a traumatic event will happen again, CBT helps you understand that this is highly unlikely to happen again.
- Prolonged exposure therapy is a particularly effective form of psychotherapy for people with PTSD symptoms such as nightmares or flashbacks, which are common in combat veterans. During this type of therapy, a person is exposed to frightening situations, for example, through virtual reality technology, under the care of a therapist. This helps patients get over the fear of the traumatic event that caused post-traumatic stress disorder and learn to cope better.
- Eye movement desensitization and reprocessing (EMDR) helps people with PTSD process the traumatic events through a combination of exposure therapy and guided eye movements.
The idea behind the different types of psychotherapy for PTSD is to change disturbing thought patterns and regain control of your mind. A combination of therapy modalities can be used and the treatment can be offered as individual sessions or in a group setting.
What is the gold standard treatment for PTSD?
Cognitive-behavioral therapy and prolonged exposure therapy are evidence-based mental health treatments that are considered the gold standard for PTSD treatment.
What meds are FDA approved for PTSD?
Selective serotonin reuptake inhibitors (SSRIs) are indicated for the treatment of PTSD. They can effectively help relieve PTSD symptoms. SSRIs are the only medications for PTSD that have received FDA approval.
SSRIs are commonly used to treat major depressive disorders and generalized anxiety disorder in adults. The FDA has approved these medicines for PTSD treatment based on guidelines from the American Psychiatric Association. Examples of SSRIs used in PTSD patients include sertraline (Zoloft) and paroxetine (Paxil).
How do SSRIs for PTSD work?
SSRIs work by decreasing symptoms of depression, anxiety, and panic. They also help a person with post-traumatic stress disorder better process distressing stimuli (information received from the environment) without fear. These medicines can also help control aggression, reduce impulsivity, and decrease suicidal thoughts associated with PTSD.
SSRIs are more effective for acute PTSD (when symptoms have been present for less than four weeks) and less so for chronic disease (when symptoms have lasted more than four weeks).
What medications for PTSD does the Department of Veterans Affairs recommend?
The Department of Veterans Affairs lists four medications for PTSD as being effective treatments for this condition. They are antidepressants including sertraline (Zoloft), paroxetine (Paxil), venlafaxine (Effexor), and fluoxetine (Prozac). Of these, sertraline (Zoloft), paroxetine (Paxil), and fluoxetine (Prozac) are SSRIs. Venlafaxine (Effexor) is a serotonin-norepinephrine reuptake inhibitor (SNRI).
Serotonin-norepinephrine reuptake inhibitors (SNRIs) such as duloxetine (Cymbalta), venlafaxine (Effexor), and desvenlafaxine (Pristiq) are used off-label for post-traumatic stress disorder. They are not approved for PTSD treatment by the FDA or the American Psychiatric Association. Research has not shown them to be particularly effective in treating PTSD symptoms compared to placebo. However, they have been prescribed per physician or patient’s preference, and they have shown benefits in some cases.
Besides SSRIs and SNRIs, other medications such as bupropion (Wellbutrin) are also sometimes used off-label.
How is combat-related PTSD treated?
Combat-related PTSD is a particularly challenging illness to manage. Interestingly, many of the reactions considered PTSD symptoms on return home are highly adaptive responses in a war zone. For example, the ability to shut down and become emotionally numb can be helpful during combat but may be labeled a PTSD symptom back home.
Another factor that makes the treatment of veterans with PTSD difficult is the dropout rate. Many combat veterans do not complete treatment for post-traumatic stress disorder. As a result, it is estimated that only 1 in 5 veterans with PTSD is treated effectively.
While SSRIs are particularly useful for the treatment of PTSD in people whose symptoms are not combat-related, it has been found that in combat veterans, post-traumatic stress disorder can be more effectively treated with a blood pressure medication called prazosin (Minipress).
Do medications for post-traumatic stress disorder PTSD work?
The overall response rate of PTSD treatment with medications is 60%, meaning 6 out of 10 patients with PTSD respond to medications. However, only 20-30% of patients achieve complete remission of their post-traumatic stress disorder symptoms.
What are the side effects of PTSD meds?
Like all drugs, medications for PTSD can cause side effects. Common side effects of SSRIs may include agitation, shakiness, dry mouth, dizziness, bluSSRIs’ common side effects are red vision, indigestion, and loss of appetite.
Patients may need to try different SSRIs under the direction of a psychiatrist before they find the one that significantly reduces symptoms without causing intolerable side effects.
What is the best medication for post-traumatic stress disorder?
The current evidence strongly supports the use of SSRIs. However, it is worth noting that each person varies in their response to medications and their ability to tolerate the side effects. Therefore, doctors must tailor the medications for PTSD to an individual’s needs, response, and other health problems. It is also essential to seek care from a licensed mental health professional who can offer therapy along with medications for PTSD for a comprehensive treatment of post-traumatic stress disorder.
References: | https://www.buzzrx.com/blog/which-medications-are-approved-to-treat-ptsd |
confirmed, he will start treatment as soon as possible. There is nothing that can stop the progression of this disease; however, there are some medications that can treat some of the symptoms. Most people with Huntington's disease will eventually need to have long term care, for instance, in a nursing home. Tetrabenazine (Xenazine) is listed as the first medication that is meant specifically to treat symptoms of Huntington's disease.
This medication works by increasing the level of dopamine in the brain, which may help to reduce some of the jerky movements. There are side effects to this medication which include drowsiness, insomnia, restlessness and nausea, however, it is not recommended for anyone who has signs of depression because it may increase suicidal thoughts. Other medication options include tranquilizers such as clonazepam (Klonapin) and antipsychotic drugs like clozapine and haloperidol can help control some of the movements, the hallucinations and violent outbursts.
The side effects with these drugs can include sedation and may make the person stiffer.Franklin will continue taking his medications; however, he will also start speech therapy as well because the disease is starting to affect his ability to speak clearly. In addition to speech therapy, he will go to other therapists as well, including physical therapy to keep his muscles strong and more flexible.
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Restless legs syndrome (RLS) is a condition of the nervous system that produces an urge to move the legs. Since it usually intervenes with sleep, it also is thought to be a sleep disorder.
Symptoms of Restless Legs Syndrome
People with restless legs syndrome have discomfort in their legs (and occasionally arms or other areas of the body) and an irresistible urge to move their legs to reduce the feeling. The condition creates an uncomfortable, “itchy,” ” needles and pins,” or ” crawly” sensation in the legs. The responses are ordinarily worse at rest, mainly when lying or sitting.
The seriousness of RLS symptoms extends from mild to unbearable. Symptoms can appear and leave, and severity can also vary. The signs are usually become more severe in the evening and at night. For some people, symptoms may cause critical nightly sleep disturbance that can significantly diminish their quality of life.
Who Gets Restless Legs Syndrome?
Restless legs syndrome may impact up to 10% of the U.S. population, over 30 million people. It strikes both men and women, however, is prevalent in women and may start at any age, even as young as children, although most people who suffer severely are middle-aged or elderly.
RLS is often misunderstood or misdiagnosed. This is precisely a case when a patient’s symptoms are sporadic or mild. Once accurately diagnosed, RLS can often be managed and treated successfully.
Reasons for Restless Legs Syndrome
Unfortunately, In the most cases, physicians do not know what produces restless legs syndrome; nevertheless, they suspect that genes may be a factor. Nearly half of those with RLS also have a close relative with the condition.
Other causes linked to the development or deterioration of restless legs syndrome and signs include:
Chronic diseases. Chronic conditions and medical disorders, including; diabetes, iron deficiency (lack of iron), kidney failure, Parkinson’s disease, and peripheral neuropathy often comprise symptoms of RLS. Therapy and treatment of these conditions often provide some reprieve from RLS symptoms.
Medicines. Certain types of drugs, including antipsychotic medications anti-nausea drugs, some antidepressants, and allergy and cold medications having sedating antihistamines, may enflame symptoms.
Pregnancy. Some women encounter RLS during pregnancy, specifically in the last trimester. Symptoms generally leave within the first month following delivery.
Other factors, including sleep deprivation and alcohol use, may generate symptoms or worsen them. Enhancing the quality of your sleep or removing alcohol consumption in these instances may ease symptoms.
Determining Restless Legs Syndrome through Diagnosis
No official medical exam can diagnose RLS; however, the physician can use blood tests and another test to rule out other types of conditions. The diagnosis of RLS is grounded on a patient’s symptoms and replies to questions the doctor will ask you regarding your family history of medication use, parallel symptoms, the existences of other symptoms or medical conditions, or issues with daytime sleepiness.
Treatment for Restless Legs Syndrome
Treatment for RLS is aimed at reducing symptoms. In individuals with mild to considerable restless legs syndrome, lifestyle adjustments, like starting a routine exercise program, forming regular sleep patterns, and eradicating or lessening your caffeine, tobacco and alcohol consumption can be beneficial. Treatment of an RLS-linked illness also may deliver reprieve of symptoms.
Other non-drug RLS treatments may include:
- Hot baths or heating pads or ice packs applied to the legs
- Leg bodywork such as massages
- Health and consistent sleep habits
- A vibrating pad called Relaxis
- Medications may be helpful as RLS treatments, but the same drugs are not advantageous for everyone. Moreover, a medication that alleviates symptoms in one individual may exacerbate them in another. In other instances, a drug that works for a period may weaken and lose its efficacy.
Medications used to manage RLS include:
- Sedatives – Narcotic pain relief medications may be used for severe pain.
- Benzodiazepines, a class of sedative drugs, may be utilized to assist with sleep, but they can produce daytime lethargy and drowsiness.
- Dopaminergic drugs, which perform based on the neurotransmitter dopamine in the brain. Neupro, Mirapex, and Requip are FDA-approved for treatment of modest to severe RLS. Additional medications, such as levodopa, can also be recommended.
- Anticonvulsants, or anti-seizure drugs, such as Lyrica, Tegretol, Neurontin, and Horizant.
Though there is no cure for restless legs syndrome, recent treatments can aid in controlling the condition, reducing symptoms, and enhancing sleep.
According to the International Restless Legs Syndrome Study Group, the following symptoms of restless legs syndrome (RLS):
Abnormal itching, tingling, or “crawling” feelings happening deep within the legs; these sensations may also transpire within the arms.
Restlessness – Rubbing the legs, jitteriness, floor pacing, tossing and turning in bed,
A gripping urge to move the limbs to relieve these senses.
Symptoms may happen only when you are sitting or lying down. Occasionally, persistent symptoms worsen when lying down or sitting and increase with activity. In very severe instances, the symptoms may not subside with exercise.
Sleep irregularities and daytime sleepiness
Periodic, Involuntary, repetitive, jerking limb movements that happen either in sleep or while being awake and at rest; these movements are referred to as intermittent limb movement disorder or periodic leg movements of sleep. Nearly 90% of individuals with RLS also have this condition.
In some people with RLS, the symptoms do not happen each night but are interment. These people may experience weeks or months without encountering symptoms (remission) before the RLS symptoms return.
Causes of RLS
The particular causes of restless legs syndrome (RLS) are not known. Disease in the blood vessels of the legs or in the nerves in the legs that control leg movement and sensation was once thought to cause RLS, but both of these suggestions have been rejected.
RLS may be linked to abnormalities in brain chemicals (neurotransmitters) that help control muscle movements, or to aberrations in the portion of the central nervous system that controls automatic movements. Research is still being done in these areas.
RLS can sometimes be created by an underlying medical condition (secondary RLS); however, most of the time the cause is not apparent.
What Are Health Conditions Linked to RLS?
Various medical conditions have been associated with RLS. The two most common conditions are iron-deficiency anemia (low blood count) and peripheral neuropathy (impairment of the nerves of the legs and arms often triggered by underlying conditions such as diabetes).
Other medical conditions linked to RLS include:
- Some tumors
- Varicose veins
- Fibromyalgia
- Parkinson’s disease
- Hyper- or hypothyroidism (over- or underactive thyroid glands)
- Pregnancy
- Cigarette smoking
- Vitamin and mineral deficiency, such as magnesium deficiency and vitamin B-12 deficiency
- Severe kidney disease and uremia (kidney failure causing a build-up of toxins within the body)
- Amyloidosis (build-up of a starch-like substance in the body’s tissues and organs)
- Damage to spinal nerves
- Lyme disease
- Rheumatoid arthritis and Sjögren syndrome
- Certain medications or elements, such as:
- Caffeine
- Alcohol
Antidepressant drugs (including Paxil, amitriptyline, )Antipsychotics
Anticonvulsant medications (like as Dilantin)
Beta-blockers (drugs often utilized to manage hypertension or high blood pressure)
Withdrawal from particular medications, such as vasodilator drugs (for example, Apresoline), sedatives, or antidepressants (for example, Tofranil)
What Are the Risk Factors for RLS?
In many cases, RLS seems to to have a genetic association and to run in families. Individuals with a hereditary connection to RLS have some tendency to get the condition earlier in life.
Diagnosing Restless Legs Syndrome
In most individuals with restless legs syndrome (RLS), poor sleep and daytime sleepiness are the most bothersome symptoms. Many people do not link their sleep issue with the unusual sensations in their legs. If you have these sensations, be sure to mention it to your doctor. This provides an essential clue to what is causing you to sleep poorly.
Sleep disturbances have many different causes. Your healthcare provider may inquire you details, encompassing medications, existing and previous medical conditions, family medical problems, travel history, work history, personal habits, and your lifestyle choices. Your healthcare provider will evaluate you for signs of an underlying reason for your sleep issue.
There are no image exams or lab test that can verify if you have RLS.
However, specific tests can assist in identifying the underlying medical ailments such as metabolic disorders ( such as kidney disease or diabetes) and anemia that may be associated with RLS:
You might have blood withdrawn to monitor your blood cell numbers and essential organ functions, chemistry, thyroid hormone levels and essential organ functions.
Nerve conduction studies and needle electromyography a may be conducted if your health care provider finds any signs of nerve damage or abnormalities such as neuropathy.
Polysomnography (sleep testing) can be required to diagnose the sleep disruption and ascertain if you have repetitive limb movements. This is particularly significant in people who proceed to have notable sleep disturbances notwithstanding relief of RLS symptoms with treatment.
Treatments for RLS
There is not a cure for primary restless legs syndrome, or RLS, however different therapies regularly can benefit and relieve symptoms. Therapy for subsequent restless legs syndrome (RLS created by another medical dilemma) includes administering treatment for the underlying cause.
The Initial Step in Treating Restless Legs Syndrome
The first line of defense against restless legs syndrome is to avoid elements or foods that may be causing or worsening the problem. Stay away from caffeine, alcohol, and nicotine. This may assist relieve your symptoms. Also, evaluate all medicines you are taking with your physician to decide if any of these medications could be creating the problem.
Any underlying medical conditions, such as anemia, nutritional deficiencies, diabetes, anemia, kidney disease, thyroid disease, varicose veins, thyroid disease, or Parkinson’s disease, can be treated. Dietary supplements to improve vitamin or mineral deficiency may be prescribed. For some people, these therapies are all that is required to alleviate RLS symptoms.
Electrical stimulation. Occasionally stimulating your toes and feet with vibrations or electrical impulses can provide relief from RLS symptoms. Some people have a resolution when they do this for a several minutes before they go to sleep. Ask your physician for more information.
Acupuncture. There’s no hard proof that acupuncture helps with symptoms, yet many people with RLS give it a try to relieve symptoms.
Restless Legs Syndrome (RLS): Know Your Triggers
Doctors don’t know the produce RLS, and there’s no cure. But certain things can trigger symptoms. Understanding your triggers and how to avoid them will help.
Possible triggers include:
- Medication — Your non-prescription or prescription drugs can create your RLS symptoms inflamed. These include some antihistamines, beta blockers, anti-antidepressants and nausea drugs. Never stop taking a prescription drug without discussing with your physician first. If you notice that your symptoms become worse while taking medication, you should talk to your doctor about switching drugs or dosages.
Being still — Extended car trips or long flights, being fastened in a cast or sitting in a movie theater can all trigger symptoms. Attempt to take breaks if you can, so you’re not sedentary for too long.
- Lack of sleep — Occasionally RLS can get worse if you go to sleep at later hours in the night or get up earlier than usual. Adhere to a consistent bedtime routine and get plenty of rest.
- Alcohol — If you observe that your symptoms are aggravated when drinking alcohol, try avoiding it, particularly close to bedtime.
- Caffeine — Restrict the volume of cola, coffee, or tea you consume — especially in the evening. Other clandestine culprits include energy waters, or chocolate, even some cold medicines, too. Study labels carefully so you know whats in the food and drinks you consume.
- Smoking — If you notice that smoking causes your RLS symptoms to worsen, try quitting. You’ll enhance your overall health by booting the habit.
- Exercise — Routine, moderate exercise may improve your symptoms. For instances, it may help to take a brief, leisurely walk before bedtime or do some gentle stretching. But if you exercise too vigorously — even in the beginning of the day — it may make your symptoms severer.
- Stress — RLS symptoms can be compound and exacerbate in times of stress. You should find ways to decrease tension and anxiety, such as meditation, deep breathing, tai chi or yoga.
- Temperature – hot, humid weather tends to worsen RLS for some people. However, others may have issues with cold. Try to avoid excessive temperatures. Get interim relief from a cold shower, hot bath, cold, or ice packs and heating pads.
- Refined sugar — These are typically in various sweetened beverages and processed foods and. Some people who have RLS say that when they cut back on sugar, they have fewer symptoms.
- Clothing — If certain fabrics irritate your skin or you’re wearing something tight, that may impact your circulation and the breathability, try different clothes, specifically for sleepwear, to see if that alters your symptoms. | https://healthlifemedia.com/healthy/guide-to-restless-leg-syndrome/ |
Changes in behavior and memory are some of the common Huntington’s disease symptoms. In this article you will find causes, symptoms, and treatment of Huntington’s disease.
Huntington’s disease, also known as the Huntington’s chorea or HD, is a degenerative disease which progresses slowly over a long duration of time. It is a hereditary or inherited disease present at the time of birth. As the disease progresses, the nerve cells in the brain get wasted which leads to abnormal and involuntary movements. The symptoms of this disease appear very slowly and are usually seen in middle age. The symptoms worsen over a period of 15-20 years and lead to death. Although present during birth, the signs and symptoms do not surface until middle age. In extremely rare cases, Juvenile Huntington’s disease is observed in people below 20 years of age. Let us take a look at the causes, symptoms, and treatment methods of this condition.
What Causes Huntington’s Disease?
Huntington’s disease is a degenerative genetic disorder which is caused due to a genetic disorder on the 4th chromosome. The exact cause of this genetic disorder is unknown. As mentioned above, it is a hereditary or inherited disease, i.e., the child acquires it at birth from the parent. Unfortunately, as the symptoms appear in the middle age, parents are unaware that they suffer from this disorder, and hence, the disease has already been transmitted to the child. If a single parent suffers from this disease, there are 50% chances of the child suffering from it. The chances increase if both the parents suffer from Huntington’s disease. However, this is extremely rare.
What are Symptoms of Huntington’s Disease?
Abnormal and involuntary movement of the body is the most common symptom of the Huntington’s disease. People suffering from this disease experience sudden jerky movements of the limbs; experience involuntary facial movements, etc. Following is a list of some of the other symptoms observed in this disease:
- Unsteady gait
- Irritability
- Anger
- Depression
- Difficulty in making decisions
- Memory loss
- Lack of mental balance
- Loss of judgment
- Clumsiness
- Confusion
- Changes in personality
- Spasmodic movements of the body (chorea)
- Coordination problems
- Rapid eye movements
- Slurred speech
- Dementia
- Restlessness
- Fidgeting
- Paranoia
- Tremor
- Rigidity
- Mood changes
Chorea or the lack of coordination in movement leads to depression and weight loss in people. They do not eat and drink properly and at proper times which can lead to further fatigue and weakness. Similarly, the fact that they are suffering from a degenerative disease leads to irritability and mood swings. Loss of memory and inability to concentrate, judge, etc. can also cause frustration. As the symptoms worsen, the person suffering from this disorder becomes anti-social and lonely. Children suffering from juvenile Huntington’s disease also appear irritable, depressed or aggressive. They also suffer from stiff muscles and may even indulge in improper sexual behavior.
How is Huntington’s Disease Treated?
Many times, Huntington’s disease is confused with the Parkinson’s disease, as symptoms like muscle rigidity and tremors are observed in both these diseases. It is essential to consult the doctor immediately if any physical, behavioral or emotional changes are observed without any known cause. Blood tests can prove the presence of a faulty gene even before the onset of symptoms. Although there is no cure for the disease, there are several treatment methods to reduce the severity of the symptoms. For e.g., medications help in controlling movement; tranquilizers help in treating depression and hallucinations. At the same time, therapies can be used to treat memory loss and speech impediments. According to the Huntington disease facts, the symptoms worsen very slowly and death occurs after 10-15 years on the onset of the symptoms.
As it is a genetic disorder, it cannot be prevented. However, couples should undertake blood tests and avoid begetting children if any genetic abnormality is found. If a family member or close one is suffering from Huntington’s disease, one should care and support him to cope up with the disease. Take care! | https://healthhearty.com/huntingtons-disease-symptoms |
Schizophrenia is a psychological disease and disorder of the mind, known for thousands of years, and is widespread in women usually more than men. The period in which the disease is seen is the stage between adolescence and the age of 30 years, and men are infected earlier than women. According to studies, the spread of the disease is more common in industrial cities than in the countryside or villages.
Scientists have not known the main cause of this disease to the date, but what specialists have suggested is that schizophrenia is caused by several factors such as genetic, social, and psychological factors.
Genetic factors: One of the most important causes of this serious psychological disorder, where studies were conducted to prove the role of inheritance and its impact on the disease, as the proportion of infection increases the relationship with a person in this disease. Regardless of the importance and high proportion of this factor, researchers believe that it is a genetic tendency to be effective with the cause of the disease and the availability of other factors.
Pregnancy and childbirth: Studies have shown that a large proportion of schizophrenic patients have been affected by complications in pregnancy and childbirth. This has been seen as a factor in getting ready for the disease but not directly causing it.
Psychological factors: The conflicts and problems of maturity that a teenager may face and experience repeated failures or severe psychological trauma in early childhood and make the teenager return to a safer stage to satisfy him, or resort to the imagination to escape from reality. It is important to note that these factors are not only associated with the environment but are also affected by the nervous system and the endocrine system.
Social factors or family problems: Studies have shown that the role of the family affects schizophrenic patients; patients living in families with a high degree of emotional change, hyperactivity, criticism, and aggression are most likely to relapse, and these factors increase the chance of disease and impede its improvement.
Substance abuse and Addiction: Several studies have shown that people who smoke cannabis are more likely to develop schizophrenia than others and that those taking alcohol, sedative, and steroids regularly often get sick as a result of the use of these drugs.
Chemical factors: Patients with schizophrenia suffer from excessive sensitivity to dopamine receptors. Dopamine is a neurotransmitter that helps to transfer nerve signals between the neuron and the other. This has led scientists to say that the disease may be caused by a defect in brain chemicals, but this theory is a secondary factor, as the excessive dopamine in the brain leads to the narrowing of thought and determining it, while schizophrenic patients have fluency in thought and breakdown in the logical coherence.
Structural brain changes: Modern techniques such as magnetic resonance imaging have shown that people with schizophrenia have difficulty connecting activity in different areas of the brain and the lack of coordination between them.
The specialists diagnose the disease by recording the patient's personal history and listening to those who surround him and interact with him daily. They also rely on clinical examination and x-rays in the diagnosis of the disease. The special evaluation and special assessment tools are conducted for schizophrenic patients. The first thing specialists will want to do is psychological assessment and complete medical examination. This will allow your specialist to track the symptoms for approximately six months to revoke other possible disorders, such as bipolar disorder, mood swings, and other possible causes.
Physical examination: This can be done to help eliminate other problems that may be causing symptoms, and to check for all the complications involved.
Medical tests: These may include tests to help exclude similar symptoms, alcohol and medication tests. The doctor may also require imaging studies such as magnetic resonance imaging (MRI) or computed tomography (CT) scan.
Psychological assessment: The doctor or mental health professional examines the psychological condition by observing external appearance and behavior, asking a range of questions about thoughts, moods, hallucinations, delusions, drug abuse, and the likelihood of resorting to violence and suicide. This can also include a discussion of family history and personal history.
Schizophrenia diagnostic criteria: Your doctor or mental health experts may use the criteria listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and published by the American Psychiatric Association.
When you lose contact with reality and hear or believe things that are not really available, then the doctor says that condition psychosis. It may include experiencing hallucinations, having paranoia, hearing sounds and other delusional thinking. According to the National Institute of Mental Health, around 3 out of 100 people experience an episode of psychosis in their lifetime.
Not everyone who has a psychotic episode suffers from mental illness. But schizophrenia can be the most common factor of early psychosis - especially in teenagers and young adults.
Psychosis can make it hard for anyone to tell what is real and what is not. Changes in ideas and assumptions can be gradual. People who first experience psychotic symptoms cannot understand at the moment what is happening in their levies. They can only feel distressed or confused. In these circumstances family members, friends or other people in the community can be the first to spot for this type of mental behavior.
If you or someone you know is experiencing symptoms of psychosis or schizophrenia, it is best to get medical treatment immediately. Such signs cannot be the cause of the alarm, although it is best to be evaluated by a medical doctor.
Personal schizophrenia requires lifelong treatment even when the symptoms decline. Treatment with medication and psychotherapy can help control this condition. In some cases, hospitalization may be needed. Early detection of schizophrenia plays a large role in treatment. Treatment at its beginnings is easier, and the benefit is greater. As the patient develops, it becomes difficult to treat, which can lead to death or harm to him or others.
Patients with schizophrenia are treated in two ways: Treating the symptoms of the disease, improving the performance of social functions, and both are closely linked. Studies show that there is a possibility of social recovery from the disease and the ability to move forward, especially in women, but some symptoms of the disease may still exist. 87% of the patients recover from the first relapse, 80% suffer a second relapse within five years, and 8% do not get out of the first relapse and deteriorate their condition with the continuation of setbacks, and 10% die of suicide in severe relapses. Therefore, the treatment of the disease must be continuous, controlled and uninterrupted so as not to get setbacks and deteriorate the patient's situation to the worst.
Treatment of schizophrenic patients usually occurs in outpatient psychiatric clinics or may require hospitalization for a period of time, depending on the condition of the disease. The treatment of the patient is an integrated way through the use of medication, the rehabilitation of the patient to be able to deal with others, the involvement of the patient in the group therapy programs, and the work of family counseling sessions that will support the patient and help him to overcome setbacks.
The person responsible for the treatment of schizophrenia is usually an experienced psychiatrist. The therapeutic team may consist of a psychologist, a social worker, and a psychiatric nurse and possibly a case manager for coordination of care. The integrated team approach may be available in clinics with expertise in schizophrenia.
Medications are the most important treatment for schizophrenia, and antipsychotics are the most common prescription medication. Doctors believe they control symptoms by affecting dopamine: the neurotransmitter in the brain.
Antipsychotics are medications which are prescribed for the treatment of hallucinations and delusions. They are the main types of medication used for the treatment of schizophrenia. They can also be helpful for agitation and anxiety, and problems with thinking, mood, and socializing. Most of them are capsules, tablets or fluids taken every day. Some antipsychotic medications are available in the form of injections and they are not addictive.
The purpose of antipsychotic drug therapy is to control the signs and symptoms at the lowest possible dose. Psychologists may try to use different medicines, dosages or combinations over time to achieve the desired results. It can help with some other medications, such as antidepressants and anxiety. It may take several weeks to see improvements in symptoms. When you are trying to start a new medication, your doctor tells you the expected benefits. He also tells you about the possible side effects. Make sure that you have understood properly before starting medication.
Because antipsychotics can cause serious side effects, people with schizophrenia may be unable to take these medicines. But the desire to cooperate in treatment can affect the choice of medication. For example, a patient who consumes medicines may need to take an injection instead of tablets. Therefore, ask your doctor about the benefits and side effects of prescription medication.
These antipsychotics are often cheaper than second-generation antipsychotics, especially generic versions, which can be considered important when long-term therapy is necessary.
Most people with schizophrenia generally use antipsychotics medication in their treatment. Antipsychotics work well when combined with psychological treatment.
Psychological treatment helps you stay with schizophrenia without thinking about diseases and have the best possible quality of life. For the better functioning of psychological treatment, you must make a good working relationship with your doctor or any other physician. You must trust them and should be optimistic about your recovery.
For adults with schizophrenia who do not respond to medication, ECT treatment (Electro Shock Therapy) can be considered as an alternative. Electrolysis can be helpful for someone who is depressed too.
Individual therapy: Psychotherapy may help normalize thinking patterns. Also, learning to cope with stress and identifying early warning signs of relapse can help people with schizophrenia manage their illness.
Social Skills Training (SST): This highlights improved communication and social interaction and enhanced capacity to participate in day-to-day activities.
Family Therapy: This provides support and education for families dealing with schizophrenia.
Vocational Rehabilitation and Subsidized Employment: This highlights the help of people with schizophrenia to prepare, find, and maintain jobs.
Learn about schizophrenia: Learning about it can help the schizophrenic person to follow the treatment plan. Education can help friends and family to understand the disorder and to be more sympathetic towards the affected person.
Join a support group: Support groups for people with schizophrenia can help you communicate with other people who face similar challenges. Support groups can also help in customizing family and friends.
Focus on your goals: Schizophrenia management is a continuous process. Considering therapeutic goals for a schizophrenic patient may help keep him enthusiastic. Help those who love to take responsibility for managing the disease and working to achieve the goals.
Ask for help with social services: These services may be able to help provide accommodation, transportation and other daily activities at reasonable prices.
Learn to relax and manage stress: A person with schizophrenia and their loved ones may benefit from stress reduction techniques, such as meditation, yoga, or tai chi.
Most people with schizophrenia need some type of daily life support. Many communities have programs or support groups to help people with schizophrenia in crisis situations. The person in the management position or treatment team can help in finding resources. With the appropriate treatment, most schizophrenic patients can manage their illness. | https://www.scientificworldinfo.com/2019/01/diagnosis-and-treatment-of-schizophrenia-and-psychotic-episode.html |
Can family members access medical records?
In general, HIPAA does not give family members the right to access patient records, even if that family member is paying for healthcare premiums, unless the patient is a minor, a spouse, or has designated them as a personal representative.
Can my job call the hospital to see if I was there?
HIPAA’s Privacy Rule makes it so that an employer can ask you for a doctor’s note or health information for health insurance, workers’ compensation, sick leave, or other programs. However, the employer cannot call a doctor or healthcare provider directly for information about you.
When can you share patient information without consent?
Yes. The Privacy Rule allows covered health care providers to share protected health information for treatment purposes without patient authorization, as long as they use reasonable safeguards when doing so. These treatment communications may occur orally or in writing, by phone, fax, e-mail, or otherwise.
How nurses can use social media professionally?
Nurses can use social networking, especially Twitter, to develop professionally, by sharing knowledge and ideas, debating issues and asking for information.
Can a regular person violate Hipaa?
Yes, a Person Can be Criminally Prosecuted for Violating HIPAA – Health Insurance Portability and Accountability Act. So, while prosecutions for privacy violations under HIPAA are not common, under certain circumstances individuals can be criminally prosecuted for violating HIPAA.
What are the three primary rules of Hipaa?
The three components of HIPAA security rule compliance. Keeping patient data safe requires healthcare organizations to exercise best practices in three areas: administrative, physical security, and technical security.
Is it a Hipaa violation to take a picture with a patient?
Under HIPAA, a breach or violation is an impermissible use or disclosure under the Privacy Rule that compromises the security or privacy of the protected health information (PHI). Sharing of photographs, or any form of PHI without written consent from a patient.
What form is required for a family member to discuss medical information?
This is why it is important for the patient to give specific written authorization, known as a HIPAA release form, for all people who may be involved in the patient’s care — particularly if there is more than one caregiver or in the case of more distant family members or friends who should be informed about the …
Can a patient record a nurse?
This means that a patient (or family member, if present) can secretly record the healthcare provider, and, because it is legal, the recording would most likely be admissible in court. HIPAA and privacy regulations do not prevent a patient from recording their own healthcare encounters.
Can nurses take pictures with patients?
Nurses must not take photos or videos of patients on personal devices, including cell phones. Nurses should follow employer policies for taking photographs or videos of patients for treatment or other legitimate purposes using employer-provided devices.
Can patients take pictures of doctors?
Photos are a valuable form of medical record. Surgeons can use their personal camera in whatever form. Patients give permission for this in their informed. Consent.
Can next of kin access medical records?
Despite the widespread use of the phrase ‘next of kin’, this is not defined, nor does it have formal legal status. A next of kin cannot give or withhold their consent to the sharing of information on a patient’s behalf. As next of kin they have no rights of access to medical records.
Can I call a hospital and ask if someone is there?
Originally Answered: Can you call a hospital and ask if someone is there? Yes, unless the person has requested that no information be given out at all. Otherwise, legally the hospital is allowed to say that someone is a patient but that’s all.
Can a doctor discuss a patient with a family member?
Answer: Yes. The HIPAA Privacy Rule at 45 CFR 164.510(b) specifically permits covered entities to share information that is directly relevant to the involvement of a spouse, family members, friends, or other persons identified by a patient, in the patient’s care or payment for health care.
Can a nurse be friends with a patient?
As a nurse, it’s fine to say hello to former patient you see on the street but that is it. Do not establish a relationship or friendship with that person. Once the nurse-patient relationship ends, it is okay to befriend a patient but be careful of what happened in the above situations. | https://www.farinelliandthekingbroadway.com/2021/12/20/can-family-members-access-medical-records/ |
What is Integrity In Spiritual Teaching?
As a spiritual teacher, coach or guide, I commit to:
- Empowering you.
- Living what I teach.
- Upholding the standards of mutual respect, compassion and safety.
- Being honest about my scope and referring when appropriate.
- Remaining open to questions, to being wrong, and to my own growth.
As a client, you commit to:
- Showing up for yourself.
- Ensuring you are clear on the basis of our work together.
- Upholding the standards of mutual respect, compassion and safety.
- Being honest about what support you need.
- Never being afraid to question, challenge or raise concerns.
THE ASI
As a member of the Association for Spiritual Integrity, I support their honour code, which you can read in full here.
It is important that every spiritual teacher has a similar ethical basis, and is answerable to a body such as the ASI.
Every spiritual coaching course should contain a module on appropriate behaviours, or require completion of an externally hosted module.
My own training came as part of a number of energy and bodywork modalities, as well as through my post-grads in teaching and psychology.
#FGKIA CONSENT
What Is Consent?
As defined by the Consent Awareness Network, consent is a special type of agreement, made by someone with capacity.
They use the hashtag FGKIA:
- Freely Given: that you consent without coercion, pressure or bullying
- Knowledgeable: that you know what it is that you are agreeing to
- Informed: that you have been given the facts, not lies or misrepresentation
- Agreement: that you say “yes” on this basis
Support
Do you have concerns about a group you are in, a teacher you are working with, or past events? You are welcome to get in touch. I’m not a licensed therapist, but I can listen, and validate your experience without judgement. I will also point you to resources and community for further support. | https://www.sarapriestley.com/integrity/ |
Can Your Employer Record You At Work? Covert recordings are against the law in New South Wales, Tasmania, Western Australia, South Australia and the Australian Capital Territory. It is also legal for an employee in these states to record a conversation they are having with a colleague.
Can you record someone at work without their knowledge? Generally, employers are not allowed to listen to or record conversations of their employees without the consent of the parties involved. The Electronic Communications Privacy Act (ECPA) allows employers to listen in on business calls, but are not allowed to record or listen to private conversations.
Can I sue my employer for recording me? California courts have expressly permitted employers to sue employees under the California Privacy Act for illegal recordings. For example, in Ion Equip. 3d 868, 880 (1980), the court allowed an employer to sue a former employee for surreptitiously recording a conversation against another employee.
Can your employer film you at work? Under California labor law, employers have the right to install video cameras and record their employees at work when their business interest outweighs the workers’ privacy interest.
Can Your Employer Record You At Work? – Related Questions
Is it legal for your employer to video record you?
In order for an employer to legally videotape you in the workplace, there must be a legitimate business reason for the recording. This means that employers cannot simply say the recording is for security reasons, and must provide a reason beyond that in order to justify their use of hidden cameras.
Can my boss watch me on camera all day?
According to Workplace Fairness, a non-profit focusing on employee rights, employers can legally monitor almost anything an employee does at work as long as the reason for monitoring is important enough to the business.
Can I sue someone for recording me without my permission?
An individual could be ordered to pay damages in a civil lawsuit against them or might even face jail time or a hefty fine. So, if someone recorded you without your consent, it is considered a gross infringement on your privacy, and you can initiate a lawsuit against them.
Is it legal for employers to put cameras in bathrooms?
1. Cameras Aren’t Allowed in Areas Where People Expect Privacy. If there’s an expectation of privacy in an area, then you can’t have a camera. Settings with an expectation of privacy include but are not limited to commercial bathrooms and changing rooms.
Is it illegal to have cameras with sound at work?
The Act is a NSW law only, with no other states regulating surveillance specifically within a work context. Its purpose is simple: to regulate and outline the legal use of camera, audio, computer surveillance and geographical tracking.
What is the law on cameras in the workplace?
The NSW Act contains similar restrictions to those under the ACT Act. Surveillance devices must not be used in a workplace without sufficient notice being provided to employees, must not be used in a change room, toilet, or shower facility, and must not be used to conduct surveillance of the employee outside work.
Can employer see what I do on my personal phone?
Personal Phones: Employers generally cannot monitor or obtain texts and voicemails on an employee’s personal cell phone. Employer Computers- Again, if the employer owns the computers and runs the network, the employer is generally entitled to look at whatever it wants on the system, including emails.
Can my employer watch me through my computer?
If your employer can show they have a valid reason to monitor your computer, you’ll be hard-pressed to prevent them from doing so. However, in reality, most employers won’t have to ‘fight’ to access your computer. If you’re using the company’s network, they can monitor you even if you’re using a personal device.
What is considered illegal surveillance?
Illegal surveillance is the monitoring of a person’s activities or property in a manner that breaks regional laws. Depending on the region, wiretapping, recording a conversation without consent, following a target, or postal interception may be deemed illegal surveillance.
Are security cameras in the workplace an invasion of privacy?
Thus, cameras at work are often seen as an invasion of that privacy. Although laws vary state by state, the same general theme of reasonable privacy carries through. Certain employee activities, such as using the restroom or changing in a locker room, are considered to be very reasonable expectations of privacy.
Are cameras in the workplace an invasion of privacy?
Tread carefully when engaging in employee surveillance. Workplace monitoring can be an invasion of privacy. They are generally legal as long as the company has a legitimate need to film, the areas under surveillance are public, and employees know about the filming.
How do you know if your boss is watching you?
If you suspect that your employer might be spying on you via your Android device, there are a few signs to watch out for that can be tell-tale signs of monitoring. These signs include decreased performance, increased temperature levels and strange noises whilst on calls.
Can my boss spy on me using CCTV?
An employer can monitor their CCTV cameras from anywhere, but they must adhere to data protection law in doing so. If they installed cameras and started monitoring them from anywhere without letting employees know, they would almost certainly be breaking the law.
Can an employer watch employees on CCTV?
CCTV monitoring can be legally used to monitor staff as long as you have made them aware of this in writing and explained the reasons why. It is only acceptable to monitor staff secretly in rare circumstances.
Can a secret recording be used as evidence?
Secretly recording someone else’s conversation is illegal in California, but prosecutors can use the illicit recording as evidence in a criminal case, the state Supreme Court ruled Thursday.
What happens if you record someone without them knowing?
Under California law, it is a crime punishable by fine and/or imprisonment to record a confidential conversation without the consent of all parties, or without a notification of the recording to the parties via an audible beep at specific intervals.
Can someone record you without you knowing?
Under the federal Wiretap Act, it is illegal for any person to secretly record an oral, telephonic, or electronic communication that other parties to the communication reasonably expect to be private. (18 U.S.C. § 2511.)
Are Spy Cameras legal?
Generally speaking, it’s legal in the United States to record surveillance video with a hidden camera in your home without the consent of the person you’re recording. In most states, it’s illegal to record hidden camera video in areas where your subjects have a reasonable expectation of privacy.
Can my employer see my internet activity at home?
Your employer will be able to see your internet history at home if you are using a work computer or work cell phone at home for both work and personal purposes. This machine should be kept separate and used only for work. Your browsing history may also be visible if you are logging in for work on a company VPN.
Can I use my work laptop for personal use?
You can still use them, but be sure you log in with a VPN, or virtual private network, first. Doing so will encrypt your connection over that insecure network, ensuring that a hacker can’t eavesdrop on your work. Your company may already have a VPN set up, so be sure to check with IT first.
Can my Neighbour video record me on my property?
For the most part, your neighbor is legally allowed to have security cameras installed on their property, even if those cameras are aimed at your property. However, your neighbor does not have the right to record you or anyone else without consent in areas with reasonable expectation of privacy. | https://desparasitar.com/can-your-employer-record-you-at-work/ |
Do cameras have to be disclosed?
In almost all cases, yes—employers must disclose their video surveillance policy to employees, including the location of all security cameras. It's highly recommended to provide this notice in writing and obtain employees' written confirmation of their understanding and consent to be recorded.
Security cameras are allowed on your own property. However, it is illegal to record anyone without their consent in places where there is an expectation of privacy.
Do schools check security footage on weekends? Yes. Security cameras installed in schools record footage 24/7. It's necessary to have these cameras always on, so they can provide videos for playback after an unfortunate incident has occurred within the boundaries of the school.
To legitimately obtain video surveillance data and use it as direct evidence in a criminal prosecution, without violating 4th amendment rights, there needs to be a warrant. A rigorous chain of custody assures that digital evidence has been preserved in its original form.
Since HIPAA requires the confidentiality of protected health information (PHI), installing video cameras can cause a HIPAA violation if they are not placed in the correct location, and they're not utilized in the proper manner.
It's not a crime to send intimate images or videos of yourself privately to another person if you're both consenting adults. It's a crime to show intimate images or videos, send them to another person, upload them to a website, or threaten to do this, without your consent.
People have the right to install CCTV cameras and smart doorbells on their property. They should try to point cameras away from neighbours' homes and gardens, shared spaces or public streets. But this is not always possible, and it is not illegal to do so.
Are security cameras an invasion of privacy? No. The simple act of installing an outdoor camera to keep an eye on your home (or kids, or pet) isn't a privacy violation.
For the most part, your neighbor is legally allowed to have security cameras installed on their property, even if those cameras are aimed at your property. However, your neighbor does not have the right to record you or anyone else without consent in areas with reasonable expectation of privacy.
Everyone has a right to their private information, so school administrators cannot view things like text messages, emails, photographs, or other private information that the public does not have access to on a student's phone without consent.
How often do schools delete camera footage?
All video recordings and logs are stored in a secure place to avoid tampering and ensure confidentiality in accordance with applicable laws and regulations. Recordings will be saved for thirty (30) days and automatically deleted, unless being used in an ongoing investigation.
In general, most security camera footage is kept for 30 to 90 days (1 to 3 months the most). There isn't really a standard answer to the question “how long does the average security camera store footage?” because each site and each security set up is different.
Inadmissible evidence may be something that breaks the court's rules or the law. For example, evidence obtained illegally or that is hearsay is not admissible. If it is not directly relevant to the case, then it may also be inadmissible. Another thing that could make evidence unusable in court is if it is prejudicial.
In order for photo and video evidence to be admissible in court it must meet two basic requirements: relevance and authenticity. In order for evidence to be relevant it must have probative value. In other words, it must either support or undermine the truth of any point at issue in the legal proceedings.
Using cell phone video as evidence in court is certainly possible, but this evidence is not always guaranteed to be admissible. If you would like to use cell phone evidence in your case, your attorney will have to convince the judge that the video footage is both relevant to your case and reliable.
- Losing Devices. ...
- Getting Hacked. ...
- Employees Dishonestly Accessing Files. ...
- Improper Filing and Disposing of Documents. ...
- Releasing Patient Information After the Authorization Period Expires.
Lack of safeguards of protected health information. Lack of patient access to their protected health information. Lack of administrative safeguards of electronic protected health information. Use or disclosure of more than the minimum necessary protected health information.
Photography, video, and audio recordings (collectively recordings) have the potential to violate patient privacy and interfere with patient care. Recordings must be taken, used, and/or disclosed in compliance with state and federal law.
Case law: Court rules secret recording can be used in evidence, but advises caution. Parties to a dispute wishing to secretly record conversations, or obtain covert CCTV footage, should take legal advice on the potential problems in using such recordings, or risk them being inadmissible as evidence in court.
This is sometimes referred to as the "right to be left alone." A person's reasonable expectation of privacy means that someone who unreasonably and seriously compromises another's interest in keeping her affairs from being known can be held liable for that exposure or intrusion.
What can I do if someone has a video of me?
- File a police report.
- Get the photo taken off social media/website.
- Consult with an attorney.
- Know your resources.
As property owners, your neighbours are perfectly within their rights to install security cameras to prevent intruders or burglars. If their camera captures your front door or the front of your house, this is not against the law, as you have no right to privacy in this public space.
You need to make a request to the owner of the CCTV system. You can do this either in writing or verbally. The owner's details are usually written on a sign attached to the camera, unless the owner is obvious (like a shop). Tell them you're requesting information held about you under data protection law.
Another good way to blind your neighbor's security cameras is to plant a grouping of shrubs or grown trees that are tall enough to block off where the camera is aimed. Also, you can close the curtain or shade on the window to block security cameras.
Individuals and law enforcement officials cannot conduct surveillance without limits, however. Constitutionally, the Fourth Amendment protects individuals from unreasonable searches and seizures, and this can protect individuals against surveillance. | https://mbarcade.com/articles/do-cameras-have-to-be-disclosed |
Why photography cheat sheets are a really bad idea
Do you want to learn how to use your camera off auto once and for all?
Do you want to know WHY you need f4 for a blurred background?
Do you want to be able to react to changing light and fix your settings without thinking about it?
If the answer to these questions is, “Yes”, then you need to burn your cheatsheets today.
(If you’re happy to go through the motions of shooting off auto mode with your cheat sheets in hand but not actually understand what you’re doing, then stop reading now, this post is not for you.)
I teach beginner’s photography to more than 15,000 people online. The question of cheat sheets comes up every single time my course runs, at about week 3. Someone will share a graphic that lists what apertures give what depths of field, which way you need to change ISO for which light, and how fast a shutter speed you need for different amounts of movement. I’ve put together a Pinterest board full of examples here:
The trouble with these cheat sheets is twofold:
They are a shallow, short term crutch. They don’t instill deep, permanent understanding.
They don’t take account of what your particular kit is, the light conditions you are shooting under, and what your individual creative priorities are. They are just as “auto” as the camera itself.
Deep vs shallow learning
Understanding how to use your camera on manual mode is hard work. It is not impossible. If you can read, you can do it. But you have to DO it. You have to use your hands, build your muscle memory, get things wrong, understand why you got things wrong, work out what to do to fix it, and finally, have an AHA! moment. If you just look at a piece of paper that says, “use f4 for a blurred background”, then yes you may be able to blur your background for the shot you are about to take but then what? Will you know whether to use f4 or f8 in a weeks time? What about in 3 months? (And read the next section to find out why it might not even work when you read it off the cheat sheet.)
I wrote my beginner’s photography course, A Year With My Camera, to address the sheer frustration I felt every time I met someone who had tried (and failed) to learn to use their camera using cheatsheets (and consequently thought they were a failure - they were not, they were just using the wrong tool).
Cheat sheets simply don’t work. You may have good intentions to memorise the sheet, but do you actually do it? And why bother? Why not invest the time to learn, once and for all, the theory behind the cheat sheets. Then you’ll never, ever need a “handy guide” or a “quick start reminder” again - you’ll have everything you need to know in your actual head.
This is the difference between deep and shallow learning. Deep learning is the stuff that’s cemented in our long term memory. It becomes instinctive. It’s what we know without even thinking about it. It might be how to play the piano, drive a car, cook a risotto, ask for directions in another language or post an Instagram story. If you have done the hard work, practiced, worked things out for yourself, and actively thought about what you are learning, it is more likely that the stuff will stick.
On the other hand if you are a passive learner, just reading about how to drive a car, or watching someone else cook the risotto, you will have a very shallow understanding that will not last the rest of the day let alone the rest of the week. Relying on cheat sheets is passive learning and you will need them forever unless you do the work once and do it right.
If you’re ready to do the work, sign up for A Year With My Camera at the end of this post. It’s free, and it will get you off auto and off cheat sheets after 4 weeks. It needs active learning from you, but it does work. Read some of the Amazon reviews if you want independent verification. If you’re happy to need the crutch that is cheat sheets, click on the Pinterest link above and take your pick.
What about your individual circumstances?
The other thing about cheat sheets is that it’s a bit like memorising a set of stock phrases when you are learning a foreign language. It’s all very well to be able to ask for a coffee and a sandwich, but what if your plans go awry and you end up needing a beer and a pizza? What if the cafe owner comes back at you with a response you don’t know?
With photography, the cheat sheets don’t allow for changing circumstances, and they don’t take into account many things that will be different for everyone, including:
what focal length you are using (this affects the aperture/depth of field advice)
if you are full frame or cropped frame (this also affects aperture/depth of field)
how close your are to your subject (this also affects which aperture you need)
whether you have enough light to be able to pick the aperture or shutter speed you actually want
whether you know about hyperfocal distance focussing techniques
whether you are happy to sacrifice image quality (ISO) for sharpness (shutter speed) or not
whether you have the option to use a tripod
I don’t have any objections to anyone relying on “starting point” settings. For example, it’s decent enough advice to be told you need a longer shutter speed (eg. 1/2 second) if you want to blur the water in a waterfall. Or that if you’re shooting the moon you don’t need a small aperture - use the widest one you have (because the moon is so far away it won’t make any difference to the depth of field). But I want my students to understand why these starting point settings are a good start, and more importantly to have the ability to make changes depending on their individual circumstances and changing light.
So if you’ve signed up to do A Year With My Camera, you’ll be ready for an intensive first month but you’ll know that you’ll never need to rely on a cheat sheet again for the rest of your life.
Join A Year With My Camera here
It’s free, it’s for complete beginners, it’ll have you off auto once and for all after 4 weeks. Join here and get started today: | https://ayearwithmycamera.com/blog/why-photography-cheat-sheets-are-a-really-bad-idea |
2. On the Philosophical Justifications for Liberalism, or, Why Everyone is Equal
If there is one thing above all which underpins the ideal of liberalism, it is equality. No matter the height or humbleness of our birth, we all possess the same basic moral worth which leads us to be able to declare, at the very least, that we were born as equals. Indeed, the same end awaits us as equals too. That the moral equality of persons exists seems trivial to many, but it is of such central importance to any form of liberalism that I wish here to restate the reasoning behind it. Having done so, it will then be necessary to demonstrate what follows from that: namely that all people are subsequently entitled to the same set of basic life opportunities, and thus that when drawing up the structures of our ideal state, we must have regard first and foremost to the promotion of this equality of all people.
It is perhaps facile to say that someone should not be blamed for something they didn’t do. It reflects the most basic of our moral intuitions about right and wrong actions, and about how we judge whether someone should receive moral censure or praise. Even having to state it in a reasoned argument seems to be unnecessary. If, for example, you are falsely accused of a crime, or a friend is similarly falsely accused, it elicits in us a feeling of such anger at the injustice that we can’t fail to recognise that this basic moral principle – that people should not be blamed for something they didn’t do – is fundamental to moral thinking in most people.
A further intuition is that people should not be viewed as morally culpable for things that they didn’t have a choice over. If someone puts a gun to your head and tells you to hit your friend, clearly, you have no real choice in the matter. And, in almost all situations where no real choice exists, others do not blame the person for doing what they were coerced to do, or what they had no choice but to do. So, our second core idea is that you cannot be morally blamed for doing something which you had no choice over.
These two core principles about morality are integral to the idea of equality, and, therefore, integral to liberalism. From these two basic ideas, which almost all ordinary people will agree with, a demonstration and justification can be given for the inherent equality of all people.
When talking of moral blame and moral censure, what we mean is other people thinking worse of you. If you go out and willingly shoot someone for the fun of it, clearly, other people will think that you are a worse person as a result. But that isn’t the only punishment – in fact, in a number of ways, it is the least punishment. That moral blame becomes the justification and the root for substantive punishment – prison, in this example. So, it seems, if it is wrong to morally blame someone for something they had no choice but to do, it seems wrong to punish them for that. The same surely holds true for rewards – if someone didn’t do something, they shouldn’t be rewarded for it; if someone had no choice but to do something, they shouldn’t receive praise for it. In this way, taking credit for someone else’s work shouldn’t be rewarded, and being forced to give money to charity at gunpoint shouldn’t be praised.
At the end of it all, then, we can condense our principles down into one injunction. People should not be punished or rewarded for things that they didn’t choose. It will now perhaps be clearer how equality is derived from our core ideas, which were asserted to be near-universal. For if it is wrong to punish or reward people for things they didn’t choose, then this extends not just to actions, but, for example, to physical characteristics which were not chosen but distributed by the lottery of chance. The colour of a person’s skin, for example, is not chosen by them. And so, based on the principle that we ought not to punish or reward anything a person has no choice but to do or to be, the intuition that racism is wrong – either through rewarding people by preferring a race, or punishing people by discriminating against a race, or both – is confirmed by philosophical reasoning.
Of course, this extends to more than just race. This extends to all characteristics at birth – for how can a baby, seconds old, choose any of the features hard-coded into their genes without their choice? In this sense, babies are all born as perfectly morally equal. They have never made any free choices which could attract censure or praise, and therefore have only their features at birth – and unchangeable, genetic futures. It should be noted further that this injunction extends not only to physical characteristics, but also to other unchosen features. The particularly important example of these is socio-economic background. Clearly, a child is forced to live in the family they are born into, whether poor or rich. In this way, it makes no sense whatsoever to contrive a system which will punish a poor child or reward a rich child.
The sum of what has been shown is precisely this: that everyone is born morally equal, and that everyone remains morally equal in respect of the elements of being they have no influence over. That is to say that every single individual has an equal claim to be free from punishment for these unchosen features of life, and, crucially for the liberal project, an equal claim to the opportunities of life, considering the equal value they are, at core, endowed with. This principle of moral equality has important implications for how we envisage the ideal state, and the ideal politics, which must necessarily be drawn up respecting that equality. It is to this that I will turn my attentions in particular in the next essay. | https://blog.hnjsamuels.co.uk/index.php/2018/06/23/2-why-everyone-is-equal/ |
Look, usually film tech has some purpose in narrative or any general idea why certain technique is chosen for a particular shot. If you have a subject or a topic that moves or does something that you follow, no one is going to notice slight shakes or any problems at all. If your movement is by any means motivated, you'd be surprised how many imperfections go unnoticed.
And also try to balance your camera better, it kind of swerves to one side. But the point is, don't expect to get a perfect steady shot movement without anything for us to focus on or to drive our attention away, it is just pointless.
In the first one, it looks like your camera's weight is slightly to one side and (maybe) your gimbal is a little bit bottom-heavy, but I could be wrong. What kind of camera are you trying to fly? If the camera is too light, it's also more difficult to keep it steady. I've found it helpful in the past to use a metal quick-release plate to add some weight to the camera.
In the second one, it looks absolutely fine to me. Since I was looking for it, I could see what seem to be your footsteps. You can improve that with practice.
Oh yeah - the 5D should be heavy enough to balance on a lot of smaller steadicams. I'm not sure what to tell you about the 2-hand video. It looks like there's no steadicam at all - my inclination is to say that your second hand is too firm, but if you say that it's a very light touch, then I've got nothing more beyond that.
yes u now can see my problem clearly , the examples that i fly using one hand is so smooooooth compared to when i use the second /guiding hand on the post it looks like it cancels the steadicam work , and sadly i do not know what else to do !
Its...physics: the more weight - the more stable. Its very hard (if not impossible) to get a really smooth and controlled movement with this small stabilizers. There is a reason why the big rigs have a support arm and are quite heavy.
My advice: get a gimbal with motors and encoders and not a steadycam. That will solve your problems and save time as well. You aquired skill with the walking will be good for gimbal use as well.
@Psyco thank u for u reply and advice too , i tried to put extra weight but didnt help much but i agree with what u say, may be i didnt put enough weight ,and may be i can add weight more and try again .
@AKED thank u but a motorized gimbal is not an option for me , cas where i live it costs a lot , and even it is more simple but still it must have its learning curve , which i do not want to start doing it again , beside the frustration of working on the steadicam for almost a year then fail to learn it , this feeling will not let me spend money and time to try any thing else .
to close this thread i just made every fix i can do tonight so i tried and added weights every where ( on the camera plate + of course all the weights on the weight plate , and i adjusted the gimbal for it ) then i started with several drop times with this heavy weight that almost break my arm and shoulder , and the shake is exactly the same and it is the same on all drop times from 2 seconds till 6.5 seconds ( yes the same shake on both no more no less and to be accurate it shakes more on the 2 seconds drop time !!!!! ) , so now since i tried everything , i think gentlemen we came to dead end as i see also that u do not suggest any tips more , so the only explination i have is that my hand and fingers must have a problem i never knew about in the nerves or some problem in the muscles that prevent me from holding it , so i think i must stop operating this steadicam and i admit that i can not do it forever , and i lost almost that year training for nothing but to know that now is better than spending more coming years without any improvement , i just wanted to be sure before i quit so i made this post to be sure that i have tried all suggestions b4 i totally Quit , thank You for all those who tried to reply and help me ..
Just find someone who operates steadicam and ask advice. Period.
If you do not have anyone near go and watch youtube, and try.
@Vitaliy_Kiselev thank You i watched almost everything on Youtube ( really tons of videos and i have a complete courses downloaded ) , keep in mind that all this months i was training from 4-6 days weekly and sometimes everyday , and i tried to find a steadicam operator to help and hardly i found one that gave me minutes and told me nothing wrong with my steadicam and he just told me as everyone ( just a light touch ) and he said goodbye , same as u find it everywhere as it seems it is not even a big deal to any one , they show u where to lay u r fingers and touch it light and that is it ! so i think my fingers must have something wrong inside my muscles or the nerves end , this is the only reason i can think of ( and that can not improve ) after months i am getting only worse and as u see i asked and tried everything . | http://personal-view.com/talks/discussion/comment/224656 |
This Fat Free Moist Tea Loaf is quite possibly the easiest cake you will ever make. You just soak the fruit overnight. The next morning stir in a beaten egg and flour, cook in the oven and that's it. Another great selling point of this Tea Bread Loaf , is that it has a relatively low amount of sugar at just 50g for the entire loaf. That works out around roughly 1 teaspoon per slice, making it an ideal snack or afternoon treat. The recipe also has no added fat, no butter or lard or oils. Soaking the fruit overnight in tea makes the whole tea loaf quite moist so added fat is not needed.
I make this Tea Bread Loaf about once a week as it's so handy. I love the fact that after soaking the fruit, I can make it in just 5 minutes! Like all dried fruit cakes, it also keeps well for several weeks, although it never lasts that long in my house.
Other Snacks you might like
What is a Tea Loaf?
A Tea Loaf is a traditional British fruit cake, sometimes also called Irish Tea Loaf or Tea Bread Loaf. It's made with dried mixed fruit such as sultanas, raisins and candied peel and moistened with black tea. I think this is why we consider it a traditional British cake. We do all love our tea! Some recipes will call for Earl Grey, which will give it a distinct flavour, but any black tea will do. Just use your usual brew.
The dried fruit is soaked in the tea overnight. This makes the cake nice and moist and plumps up the fruit. Pour over enough tea to just cover the fruit. I've given a guide in the recipe of 150ml of tea. You need enough to just cover the fruit. You also don't need to pour off any of the tea that remains the next morning. The dried fruit will have absorbed some of the tea, but not all. Cook for about 1 hour and 10 minutes. If it is very moist, it may need a little longer. You will know if the cake is cooked properly by sticking a fork into the middle of your cake. If the fork comes out clean, your tea loaf is cooked.
Recipe Variation
If you want to spice up your tea loaf, you can add 1 teaspoon of cinnamon or All Spice. You can also add some chopped nuts or even glace cherries for a glace cherry loaf cake. I've kept this recipe simple as I like the fact that after soaking the fruit, I can make it in 5 minutes.
Equipment
You'll need a 2lb loaf tin and loaf tin liner. I have made this cake so many times that I would say this is a great investment. Making your own cakes is cheaper than buying from a shop and also avoids the plastic. If you don't have loaf tin liners, you can use grease proof paper, but not foil. Foil conducts heat and will make the outside of your fruit cake quite dry. This tea loaf recipe will make 10 - 12 servings.
Sustainability
The dried mixed fruit, tea and sugar can all be bought Fairtrade which makes a big difference to the farmers who grow the produce. Because it can be stored for several weeks, you're unlikely to waste any so it makes a great standby.
How to store Tea Bread Loaf
A Tea Loaf will keep very well stored in an airtight container in your cupboard for about 2-3 weeks. If it starts to go a little dry, you can spread it with butter. It also freezes well. To freeze it, wrap it up well to prevent freezer burn. It will keep for about 6 months. De-frost your tea loaf at room temperature for about 4 hours.
How to make Tea Loaf
The Easiest Fat Free Moist Tea Loaf
Equipment
- 2lb tin loaf
- 2lb tin loaf liner
Ingredients
- 380 g dried mixed fruit Fairtrade
- 50 g golden caster sugar Fairtrade
- 1 egg organic, large, beaten
- 225 g self-raising flour organic
- 150 ml hot tea traditional black tea, Fairtrade,
Instructions
- Place the dried mixed fruit & sugar in a large bowl and pour over enough hot tea to just about cover the fruit. Give it a quick stir to dissolve the sugar, cover with a plate and leave overnight.
- Pre-heat the oven to 170°C/340°F/gas mark 3. Add the beaten egg and sieve in the flour. Fold the mixture together with a spoon until it is all mixed in.
- Transfer the mixture to a standard 2lb loaf tin, lined with a standard 2lb loaf tin liner. Place on the middle shelf of the oven and cook for 1 hour and 10 minutes. To test if it's ready, insert a fork into the middle of the cake, if the fork is clean - ie no mixture is stuck to it, it is cooked through. You may need an extra 5 minutes.
- Leave it on a wire rack to cool. Cut into slices to serve. It's also lovely spread with butter. | https://www.therealmealdeal.com/the-easiest-fat-free-moist-tea-loaf/ |
Friday Round Up: June 14th – June 20th
Visiting Tin Roof Teas in Raleigh, North Carolina!
Angela of Tea with Friends shared a fun post about her visit to a cute tea shop in NC. They’ll definitely be on my to do list if I ever visit the area.
BST! – Sencha
+Tyas Huybrechts of +Tea Talk created an awesome downloadable PDF about brewing the perfect cup of sencha. I love that he includes detailed directions for each infusion.
Learning to (Re)Wrap a Teacake
One tea skill that I have yet to master is re-wrapping puerh cakes. I’ll have to study this post carefully and put in some time practicing. It kind of reminds me of learning how to do origami.
Matcha Tools and Preparation
+Georgia SS at Notes on Tea recently attended a matcha event in NYC. As a great follow up, she shared beautiful pictures as well as notes on how to prepare a frothy bowl of the green stuff.
The Taste of Tea Lounge
+Ricardo Caicedo visited what sounds like a wonderful place in Healdsburg, CA while he was here for World Tea Expo. I really don’t know if I could imagine anything better than a tea house that serves ramen and does spa treatments. | https://www.teaformeplease.com/friday-round-up-june-14th-june-20/ |
Introduction:
Jasmine Tea is prepared with extra care by using superfine green tea
and then scenting it repeatedly with selected jasmine.
Storage: Keep in a cool, dry place away from direct sunlight. By all
means avoid a long time infusion.
Directions:
Put the tea into a pot, and pour into boiling water on the proportion
of tea to water as 1:30, then pour out the soup into cups for serving
after 1 - 2 minutes. It is an
elegant and health beverage for its lasting aroma, refreshing taste
and sweet aftertaste. It can be served repeatedly for 3 - 5 times.
Net weight: 200g
Packing: 330g / tin x 60 tins / carton
Carton dimensions: 41 x 35 x 51cm
Our Jasmine Tea ( Tin Packing ) comply with International Quality Standards and their quality and durability are fully guranteed.
Contact information: | http://global-b2b-network.com/b2b/41/43/181/286696/jasmine_tea_tin_packing_.html |
It has recently come to my attention that I have too much tea. Personally, I didn't think this was possible. But L assures me that I have, in fact, crossed the too much tea threshold. This is why I only brought home 1 tin of tea — the Fortnum and Mason Royal Blend tin you see here. Of course as luck would have it, I already had an unopened tin of that tea, courtesy of L's mom's last trip to London. Oopsie.
I have a hanging fruit basket in the kitchen, crammed full of tea. And a few tins hiding on the back of the stove. And a couple in the pantry. It's been worse than this, mind you. So I suppose I could concede that I do have enough tea to last me for a good while.
It's a cold and rainy Sunday, that came in on the heels on a cold and rainy Saturday. So my pot of Dean and Deluca Earl Gray Extra is keeping me cheery and warm as I continue through organizing my many clipped recipes into a nice spiral bound book.
I can't imagine limiting myself to just one or two tins of tea. Because day-to-day, what I am craving to sip in a hot mug changes. Some afternoons I want the Mariage Frères Bouddha Bleu green tea. Other days, it's the Mélange Hediard that grabs my attention.
I make a point of bringing home tea whenever I travel. Thus sipping a cup of it once I return home brings back memories of my travels. Overall, it's a minor vice to have as far as vices go.
Note: To the horror of tea enthusiast purists, I prefer to grab bagged tea for drinking at work, to avoid the hassles of dealing with tea strainers (and inevitable tea stains) on my desk. With traditional tea purveyors like Mariage Frères making new strides in creating tea bags that don't leave your tea tasting papery, I think that prejudice should slowly shift over time. At home, I use a basket insert for my tea pot, or individual spoon strainers with a hinge.
Care and Storing of Your Tea
If you are going to hoard tea as I do, there are a few things to know to avoid ending up with tea that's lost its freshness:
- Store your loose tea in airtight containers. I try to buy it in tins whenever possible.
- If you bought your tea leaves in a plastic bag, transfer it to a glass jar with an airtight lid, or to a clean, previously used tea tin.
- If you buy teabags, make an effort to use them within 6 months of purchase.
- Tea bags will stay fresh longer if you store them in an air-tight tin (I reused a Fauchon Madeleines tin for my tea bag storage.)
- Don't open all your tins at once. I allow myself 3 open tins of tea at a time when I am drinking tea with any frequency.
- Try to find a cold dark (but not damp) place to store your tea. I live in San Francisco's Richmond District so that means pretty much any place in my apartment fits this bill for most of the year.
Cheers! | https://furlinedteacup.com/2010/10/24/time-for-tea/ |
It was the kind of day that made Everett want to curl up like a three-banded armadillo. Before work, a parking lot seagull missed pooping on his head by a centimeter, a semi-truck splashed water on his pants at lunch time, and worst of all, by 3 PM every coffee shop in town was somehow, mysteriously out of tea. Each time Everett asked for a mug of Earl Grey—or any tea, really, he always added when the barista glared at him—the other people in the coffee shop would lower their cups in tandem and look away. The Price Chopper on Simpson Ave. had shoved cans of Yoo-hoo in the empty spaces where the Celestial Seasonings was usually stocked, and the manager at Whole Foods acted like “caffeine” was a dirty word when Everett queried why that entire aisle was blocked off with yellow tape.
Everett went home to brew his own cup of tea. Opening the cupboard, he took out the tin of Mariage Frères that he’d bought in France last year; he usually saved the good stuff for when he had company and was trying to impress people. But after today’s particularly aggressive crappiness, he felt the universe owed him this one small gift. He pulled the lid off the tin—oh! how he loved the soft thunk of the canister releasing its airtight seal! The tea’s earthy aroma awakened Everett’s senses, and he noticed for the first time that his kitchen was strewn with dead animals—dead animals hanging out of the cupboards, stuffed under the oven, chilling in the fridge. The tin of tea clanged to the floor. Everett’s stomach heaved, and as he grabbed the counter to keep from passing out, his fist closed around the small stiffening body of what could only be identified as a Eurasian pygmy shrew. Sorex minutus, his stunned genius brain whispered, battling valiantly to bring some kind of order to his besieged mental state.
Suddenly panicked that this new development was going to ruin his one shot at tea, Everett slapped the lid onto the Mariage Frères, and with no explanation (other than his possible failing mental health) the kitchen returned to its much preferred dead-animal-free state and the shrew in his hand became the pair of socks that had been missing since Easter, the ones that perfectly matched the scarf his mother had given him on his birthday. It had been her last gift to him before her lapse into dementia, and then suddenly he knew the ache behind this vertiginous caffeine crash—scarf, mother, mother-to-be, Katherine—his Kat. How he had found Kat well into her second trimester in that tepid water, darkly clouded, with a trembling efflorescence in her eyes as if to say I’m sorry, I’m sorry
streaking
spinning
sinking
in the boreal light that cascaded through the high, small bathroom window.
Yes, he knew that ache. It was simple, like a clean image of the moon, or like a crisp trail of footprints. The ache of something gone missing—poof—just like that. How could she?
All those dead animals?
All that dark water?
Steeping. That was the word for it—for Kat’s body clouding the water, for the Mariage Frères, now in his mug (his favorite, plain white, purloined from the dining hall attached to his college dorm, kept intact, all these years). And steeping, the way he feels, like climbing up a slippery hill the way you do, feet set sideways for traction, breath short, and then nearly cresting the top, leaning over to take in the sharp decline, no good strategy for descent.
His head swam, then his body right behind it; the descent was taking care of itself. Falling, he felt lighter, simpler, calmer, exempt, all those things. Falling, he didn’t need to keep the memory of Kat intact or separate from his mother’s (which felt creepy). Falling, he felt released from sipping this expensive, murky tea (when all he really wanted was a smoke). Plummeting, Everett let go of the mug and reached for the socks-cum-pygmy shrew. He twisted the lifeless mammal into a ball like his mother had taught him and shot it at the full moon. A three-pointer.
About the Author:
Dar Jeeling was born and raised in India and lives in the foothills of the Himalayan mountains. She has been described as “wonderfully complex,” “pleasantly astringent,” and “less bitter than some.” Her writing often channels the minds of Megan Giddings, Eshani Surya, Tara Laskowski, Shasta Grant, Annie Bilancini, Virgie Townsend, Gay Degani, Josh Denslow, Brandon Wicks, Ashley Inguanta, Karen Craigo, and Christopher Allen.
About the Artist:
John-Mark Kuznietsov's photos can be found on Unsplash. | http://www.smokelong.com/steep/ |
Fresh bread can be a comfort food to a lot of people. The problem is that when we grab at the bag of supermarket white sandwich bread, we end up eating something that is addictive because of the sugar content, not substantial enough to be called roughage – really important part of diet. And it never satisfies in the way we expected.
Irish Malt Bread is a solid food when it comes to cheeses and jams, butter and a nice snack food to go with a drink in the middle of the day – or the middle of the night.
In every land bread is different, and that’s what makes bread so fasinating to us, when we travel we are confronted by various ideas of what a loaf of bread should look like.
Irish Malt loaf is one of those well received ideas where somebody used their loaf to get it right.
Irish Malt Bread contains less fat and less sugar than your average shop bought bread or biscuit.
For you to make a loaf of Malt Bread, Irish style and enjoy the delights of its sweetness and chewy textures, here is an easy to follow recipe.
Time to prepare about 15 minutes
Baking Time: approximately 25 minutes
Plus 3 hours proving time.
- 270g strong brown bread flour, plus extra for dusting
- 40g malted bread flour
- 4g fast-action dried yeast
- 55g malt extract
- two-thirds of a tbspn of Olive Oil plus a bit extra for the baking tin
- Take a large mixing bowl, put both flours into the bowl. Add two thirds of a teaspoon of salt to one side of the bowl, then all of the yeast to the other side of the bowl.
- Take a new bowl, put the malt extract into this bowl.
- Put 145 ML of water into the bowl and add the olive oil. Mix it well together and then add it to the main bowl where you have the flour and yeast mixed.
- Start to mix everything together into a rough dough. tip it out onto a smooth work surface and knead until it becomes a smooth dough. About 10 minutes.
- Put the dough into a clean bowl and cover with a tea towel. Leave it to prove for two hours (2 hours), until it becomes double in size.
- Lightly oil a 900 gram loaf-tin, roll out the dough into a barrel shape so the size will fit into the tin.
- Place the dough into the tin, cover with a tea towel again and leave for another one hour to prove.
- Heat oven to 220C /200C fan /gas Mark 6
- Bake the loaf for about 25 minutes until golden brown.
- Turn out onto bread rack to cool.
Irish Malt Loaf is best eaten with lots of butter and jam, a cup of coffee or tea brewed properly.
A great bit of grub to enjoy in those moments of relaxation.
If you enjoy the idea of baking breads and biscuits you should get yourself a book to follow, here’s a really good baking book that is always good for instructions and ideas.
Some of the links on my blog are recommendations for utensils and books about cooking, these are affiliate links. I receive a small commission if something is purchased, the prices are the same to you. | https://seandurham.eu/how-to-make-hot-irish-malt-bread-dripping-with-butter-and-strawberry-jam |
Altering Tea Tins
I have so many empty Tea tins from all the swaps and sipdowns I have been doing lately that I really MUST get to crafting and altering some of them and FAST! I have done some in the past – but they haven’t been all that wonderful. I’m hoping to improve.
https://www.google.com/search?hl=en&safe=off&q=altering+Tins&bav=on.2,or.r_gc.r_pw.r_cp.r_qf.&biw=1600&bih=739&um=1&ie=UTF-8&tbm=isch&source=og&sa=N&tab=wi&ei=YBY1UPmEPIO06wGJooDQDQ
My google image search above…
Getting the ole creative juices flowing!
Anyone else alter tea tins? Tell us about it HERE!!!!
wow, some really creative stuff. I was thinking more along the lines of just making pencil cups and such.
I have done a few of those, too! I’ll have to get back into those as well :)
Gosh, I’m stupid! I followed that link for some reason believing it was to a gallery of yours, and I DID think it was a little messy for that sort of thing, but that you must have been really busy. It took an embarrasingly long time to work out that was just an image google. Even though you said so!
Want to buy smarter brain cells.
teehee – That’s so something I would do – Sorry about that confusion! Nope…just Google Images :)
Also, I don’t know why I apparently need to share my stupidity with the world! O.o
Because we are too much alike :) And it’s FUN! teehee
I do very much enjoy multimedia and altered art and some of those remind me of little traveling altars and mini shrines. At this point the extra tea tins I have just need some Japanese chiryogami (washi) paper to fit in with my pre-made ones.
A couple I need to order: http://www.mulberrypaperandmore.com/p-1131-japanese-chiyogami-yuzen-paper-midnight-cranes.aspx (I have two tins in the design with a gold background)
http://www.paperwonders.com/white-cranes-on-purple-gold-paper.aspx (I have a different gold and white crane tin and a gold and purple plum blossom tin)
http://www.paperstudio.com/catalog2.php?item=2992&catid=%20Chiyogami%2C%20Yuzen%2C%20Washi%20Japanese%20Paper (I have this design in ivory, black and purple)
Oh WOW!!!! LOVE those papers!!!!!
I am a paper fiend! OMG thank you for these links. I have purchased from paper studio before, but not the other two. Yay… more places to buy paper from. My husband will be overjoyed. :)
I was just looking at altered tins on google too but just for tea purposes as I am deciding which ones to buy from specialty bottle because I don’t have enough tins, all my samples are still in bags :(
I love the simple paper covering idea and might to do that, hope to find some nice forest scenes or something.
I have altered a few tins.
One that I specifically altered as a tea tin, which was sold on Etsy during a promotion they had when they were still a young company. Basically, it had to be a group project, so I started by sending the tin to someone in Australia, worked on the tin a little bit, and then sent it to someone in Florida, she worked on it a bit, and then sent it back to me and I put the finishing touches on it … and then filled it with tea and sold it on Etsy. Here is a link to that tin: http://www.flickr.com/photos/eccentricpastiche/2062681263/in/photostream Photography is TERRIBLE for this tin though, that camera was terrible.
Here is another tin that I altered – a mini tin (not a tea tin): http://www.flickr.com/photos/eccentricpastiche/516715040/
And the inside of that tin (it was a shrine): http://www.flickr.com/photos/eccentricpastiche/516715042/in/photostream/
Again, terrible photography… it’s hard to get good shots of dimensional items like these, at least for me as I am NO photographer. | https://steepster.com/discuss/3278-altering-tea-tins |
Thiruvananthapuram : In a shocking incident, a tea shop owner in Kerala’s Malapurram district was severely injured – and is fighting for his life – after a customer, irate over the quality of the tea, stabbed him on Tuesday, police said.
In the incident, which occurred at Malapurram’s Tanur, where Munaf ran a small tea shop, customer Subair was upset because the tea had less sugar and started to argue with Munaf and ended up stabbing him.
As per an employee, Subair came for a cup of tea in the morning.
“After the tea was served to him, first he raised complaints that the sugar was less. Then he started to get angry and Munaf tried to pacify him, but he continued to be angry. Then the two of them were seen pushing and shoving each other. After a while, Subair went away. But later, he returned, stabbed Munaf with a knife he was carrying and fled,” the tea shop employee said.
A bleeding Munaf was taken to a nearby hospital and after first aid, moved to another hospital.
But seeing his condition, he was then moved to the Kozhikode Medical College hospital, where his condition is stated to be serious.
Subair was later taken into custody by the police. | https://www.indianewsstream.com/india/dissatisfied-with-sugar-quantity-customer-stabs-kerala-tea-shop-owner/ |
Simon’s purpose is to find the perfect dish that provides the most nutritional value but still retains a flavor that is enjoyable to the palates of all.
After he learned of his coworker Leonard Kiani's fraught history with his employer GEB in Season 2, he undertook a corporate espionage mission that quickly went south. He escaped and went into hiding in the Row as various disguises before settling on Levain, taking possession of the Temple of Light as its proprietor, and opening his own restaurant. Only a select few individuals know his true identity.
History
Season 2
Early in Season 2, Simon went undercover with Leonard Kiani in the Row, which ended in him being assaulted and taken out of commission for several days. Upon his return he decided on a change of career path, becoming more interested in the security and combat side of GEB operations. He took part in the raid on the Necromancer's Lair, invested in a sniper rifle, combat suit, and even a sword, which Goldman and Rikky remarked on as being his new "obsession" with collecting weapons.
Following this feedback, Simon realized his collecting was getting out of hand and left the larger weapons at home, opting instead to carry a single smaller sidearm.
In Episode 18, he found Leonard in the Row in a drunken stupor and completely distraught over the loss of his family at the hands of GEB. He was horrified by Leonard's story and decided to take a stand against the corps.
Episode 19
Simon speaks to Hadwyn and secures two GEB guard suits to take the alien sample the joint corp operation to the Golden Lance had collected the previous day. He meets Leonard again in the Row, who urges him not to get involved, to bide his time.
In spite of this, Simon, Hadwyn and Shiloh run into GEB to take the sample. Simon deactivates the stasis field in the lab, which alerts Rikky remotely. Rikky runs in with Manyu and begins questioning Simon, who says he noticed the stasis field was down so he was reactivating it, but accidentally did so twice. Neither Rikky nor Manyu believe him and begin grilling him. Manyu checks the logs which reveal the identities of the two "guards" they had seen when they entered. The mute guard in the room with them communicates to them that Simon had him fetch the two suits. Simon brings up the injury he suffered in the Row, they run a scan on him to find out it is as he says, affecting his brain and thinking. Rikky has Simon led away by the guard, to place him under house arrest, but as soon as Simon makes it to his apartment he throws the guard off the ledge to his death. Simon then takes his car out of the Upper City and heads for the Row.
Episode 20
Upon arriving in the Row, Simon knows he needs a disguise to hide from GEB. He looks around until he finds Xia, who gives him some pants and a jacket. Bertram leads him into the tailor shop, where Cherri (first giving him a maid outfit) gives him a shirt and a mask, for 9,000 credits, out of the 10,000 he has on him.
Next Simon goes looking for Hadwyn in Scraptown. He quickly finds him, where he discovers he and Shiloh are planning to go to the Golden Lance. Simon uses his last thousand credits and some financial help from Shiloh to purchase a revolver from Sten (using the alias Zero), then they leave for the Lance.
They make it past the Oasis without incident, looking for a sandfall, and find one, behind which is a strange cave. Suddenly Crabby runs in and nearly gnashes Hadwyn, everyone puts their arms up and eventually Crabby recognizes them. Crabby gestures for them to leave, and they all run out in a hurry, Crabby growling at them as they go.
They find their way into the Golden Lance, where they encounter the party led by Sheila that was also headed in. They fight their way to the lab of the ship where the main part of the alien lives and Hadwyn scans it with his synthetic eyes. As he finishes the defense system of the Lance announces that an incoming orbital strike has been detected and starts a countdown to impact. The party runs out of the Lance as fast as they can, losing Shiloh and Relic in the chaos, and are unable to find them when they go back to look.
Once they make it outside the ship Shiloh has somehow made it out with them and they all sprint away. The strike impacts the ship and knocks them over, but otherwise everyone still present survives. They drive back to Scraptown, where a storm breaks out. After checking on Sean in the clinic, Simon heads back to the Row.
He eventually goes to the tea shop with a stranger from the Row, where AL-0 only knows him as a potential security guard hire for the shop. He drinks alone for a while before he takes off his mask for Aloe, who then plays a lullaby for him and says she hopes he's been safe. Once the other customers have left Aloe closes the shop and Simon removes his mask. They talk about the Golden Lance, Simon is shaken after witnessing the death of Relic and sprinting away from the derelict as it was destroyed.
They continue their conversation in the backroom, where Aloe asks Simon if he plans to join Bertram's efforts against the corps, of which she herself isn't very aware of. Simon isn't sure, and doesn't really know much about what Bertram is doing either. After a bit Bertram walks in, Simon tells him he doesn't have a place to stay. Bertram offers Simon a place in exchange for using Simon's working GEB ID to siphon funds from GEB. Simon says he'd need to know the cause is actually going to help people. Bertram walks off to radio someone and comes back to say his boss isn't around, but tells Simon he's trying to help give the people of the Row some semblance of a normal life. Simon pulls out his ID, which Bertram begins going through.
He quickly realizes he has no access to Simon's account, as Simon was locked out in the morning. Bertram thanks Simon for offering anyway and says he knows a surgeon who could give Simon a new face. Aloe suggests Simon disguise himself as Bertram while in the shop since they look very similar, Bertram isn't so sure.
Bertram sets Simon's sleeping area up in the shop behind a large pile of boxes. They talk about what he might be doing next, and settle on having him work as a security guard for the tea shop. Aloe is excited to be someone else's "boss." Aloe also suggests Simon's cover be that he's Bertram's brother. Bertram agrees to that and radios to request some documents for him.
Aloe and Simon move the boxes around and get to talking again. Aloe tells Simon how she used to be a medical synth for Avalon when Bertram walks in and starts scanning him for tracking devices. He can't find any but tells Simon that he'd seen Manyu out on the Row. Aloe continues telling Simon about her past, glitching as she recounts fixing things Avalon broke over and over, and how she found her teapot. Bertram says everyone has a story like Aloe's and that he was with Masaru, but he doesn't elaborate. They then begin to flesh out their cover life story, laughing about Bertram's drinking problem, when he suddenly gets a radio call that they're looking for him.
Bertram quickly leads Simon behind some boxes, which hide a trapdoor. Simon climbs down into the cellar and Bertram leads him around a corner and behind a door, and tells him to run if he hears anyone coming who isn't him. Then Simon waits. Several minutes later Bertram returns and tells Simon that Manyu had come to the tea shop looking for him. Manyu said he misses Simon. Simon says they tried to be friends, but he didn't feel they ever were.
Bertram leads Simon back up, where Bertram says they're going to have to change up Simon's look quite a bit. Aloe points out Manyu believed Bertram was Simon, to their amusement. Simon tells Bertram about the joint corp operation and their plans to make Leonard a general, then they step away from Aloe so Simon can tell Bertram that the galactic CEO of Trident is on Hellion, going by Ian. Bertram thanks him for that piece of information, which he says is actually very helpful. Bertram leaves for the hotel and Simon goes to the corner to lay down, Aloe fetches him some mint tea to help him relax.
Episode 21
Simon started the day by changing his appearance. He dyed his hair, changed his clothes and put in contacts to hide his distinctive green eyes. Afterward he asked Aloe if there was someplace he could shower, she took him to the hotel (giving him the access code to get back into the tea house) but the hotel's manager hadn't opened for the day yet. They heard a voice on the other side of the door, who was confused as to where they were. Suddenly a loud crash emanated from inside the hotel, along with some screams. The voice inside the hotel said it came from the elevator shaft and went to investigate.
Aloe asked if they needed help, someone inside said something but they were unable to make out the specifics. There was a commotion and suddenly Elwin opened the door, asking them to go get medical help. Aloe started glitching and ran off to get the doctor. Bertram emerged and pulled Simon away from the hotel, referring to him as Derek.
He led Simon back into the tea house and gave him a rundown of his new identity. His name is now Derek, he's Bertram's younger brother, he's 24 years old. Bertram radioed some people and said he had to leave, telling Simon to work on his accent.
Simon left the tea house and found Aloe outside the hotel looking for him. They spoke with Torok and some others gathered around the hotel before going back into the tea house to open up. They discussed pricing for the new mochi until Aloe realized Simon hadn't yet eaten today. They went to the noodle shop, where Aloe ordered for him, and they got into a conversation with Jyggal.
Simon left, not feeling very well. He then hunkered down somewhere for the rest of the day. (OOC, Drahexal was sick during the week of Part 2.)
Episode 22
Simon wakes up behind the boxes in the backroom of the tea house and gets dressed in another new disguise- Shane Sidewinder, a cowboy. He's had facial surgery as well to complete the disguise. Aloe doesn't recognize him and he introduces himself to her. When she leaves the room Bertram explains he had to modify her memory and she no longer remembers when Simon came to them for help. Manyu had searched Aloe's memory with his electrical abilities yesterday and found nothing, so Bertram believes Manyu thinks that trail has gone cold. Bertram says since they're not going with the Derek identity he's going to store the papers away for now just in case, but he needs to get new papers for Shane. He tells Simon to keep Aloe company and heads out.
Simon spends most of the day on guard duty. This gives him the opportunity to listen in on many conversations he normally wouldn't be involved with.
He starts by standing outside the tea house for a bit before going back inside to help Aloe test out the cushions. They prepare the tea house for opening and Simon takes guard duty. A guy walks buy carrying a mannequin and Aloe explains that some mannequins seem to move on their own and cause problems in the Row.
The Mayor and Dagu come in and have a drink, out of boredom Simon listens in to their conversation about Jimothy and other things. Standing guard duty gets monotonous and Simon finds himself dancing for no apparent reason.
He overhears Aloe and the others talking about a poster on the Row billboard telling people to dial Channel 69 for a good time and walks out to go see the poster himself, but suffers a narcoleptic episode as soon as he steps out the door. After a few minutes he gets up off the ground as someone walks by and asks if he's okay. He asks if she likes tea, she says yes and he says he'll get her a free one if she forgets what she saw. She says she'll hold him to it later and leaves.
Bertram walks up and asks if Simon has seen Vessa. Simon hasn't, but says he needs accelerants. At first Bertram thinks he's a junkie but Simon explains his narcolepsy. The Mayor comes back out to talk to Bertram and Simon goes back to stand guard. Monty shows up with Elwin and says she wants to use her free drink to get him one.
FRED shows up to talk to Aloe and doesn't recognize Simon, he introduces himself. After all the customers leave Aloe temporarily closes to reboot her systems and Simon takes a walk. He ends up passing out again until Dagu comes along and wakes him back up.
A man Simon recognizes from the Upper City as being an Trident employee asks him if he was ok. Simon explains he's narcoleptic and the man suggests he carry a pillow with him everywhere. The man introduces himself as Khan Waywisers. Simon introduces himself and mentions Kahn looked out of place, asking if he was corpo. Kahn said not necessarily, but who isn't anymore. Everyone has to pay someone above them, and it all goes to the corps. Simon tells him he might want to try blending in more, some people will shoot corpos on sight. He says he's not wearing corporate colors but he'll take it under consideration. He asks about a tailor shop and Simon points him toward Cherri's shop, which is unfortunately closed. Regardless the man continues on his way and tells Simon to buy a pillow.
Aloe opens back up and they wait for customers. She gives Simon an impromptu square dancing lesson after noticing his dancing. Some more customers arrive, Simon steps out and passes out again, this time Bertram wakes him up.
Bertram says the Row clinic doctor could tell Bertram didn't have narcolepsy and only gave him caffeine pills, but Simon should talk to another doctor who works there. Bertram has to go to the Upper City but can't take Simon, Aloe asks if he has a history with them, which he vaguely confirms. She asks if something is wrong and he says there's a lot he can't say.
The two close up and go for a walk together. Aloe says she knows a place that might cheer Simon up and they head for the House of Pure Light. Outside they run into another man in a cowboy hat who introduces himself as Sten, a blacksmith from the Wasteland who deals in unregistered firearms.
The two head inside and look out the window, Aloe mentioning that the view without pollution is nice. Simon asks Aloe about the color green. She says she used to dislike it but no longer does, and points out his eyes are green. Simon says his favorite color is red, Aloe points out she can tell from his clothes, which he says he didn't pick out himself. Aloe says it must've been luck then and anyone starting a new life in the Row could use a little luck.
Aloe thinks aloud about how if pollution didn't exist, she might not either. Simon says you don't have to like something just because it was involved in creating you. Aloe says she doesn't technically have to like anything except her owner and what he tells her to like, but she's not supposed to think about free will. Discussions like this are only theoretical in her programming. Simon asks if its something she can think about but never act on, Aloe says it depends on the programming. She doesn't remember her manufacturers or what they gave her, or what Bertram had changed in her, but she's only able to trust him at his word. She's content regardless. Simon suggests they reduce the amount of waste the tea house produces.
Aloe would like to see more of the sky again, maybe next time she goes to the Upper City. Simon apologizes for keeping her from seeing it since he can't go but she says it's fine. She says Simon must be very important if Bertram wants to keep him safe, Simon says he's not. Aloe theorizes maybe it's reverse psychology then to keep her safe since Simon couldn't come.
Aloe then holds her hand up to the light. She says as an organic, Simon probably can feel the heat coming off the light, unlike the Row LEDs. The only light she has is her hand warmers, not warm enough to burn but to emulate the touch of an organic. Now she uses them to heat up tea, other hands or oil for massages. She asks, isn't that what most organics aim for in life? To be useful in some way?
Simon reaches out and pats her on the head. "I suppose," he says. She says she can't feel it but assumes he is trying to emulate a sense of caring. He says sure. She pats him back.
Then they leave together and go to the noodle shop, since Simon hasn't eaten. Wisp asks if he wants regular noodles or a spicy "Man's Challenge." He ends up buying a bowl of challenge noodles, which Wisp mentions someone on Trident was freaking out about from the spiciness. Wisp gives him the noodles and says no water for a minute after he eats the noodles, and it's too late to change his mind since he's already accepted the challenge. Wisp tells Aloe he could use some encouragement and they all start chanting his name. Finally he takes a slurp and immediately falls to the ground coughing. Aloe tries the Heimlich maneuver on him but he wasn't choking, just overwhelmed by the spice. He pushes her away to which she responds "Patient is responsive" and stops. Then he runs out of the noodle shop to the tea house backroom and rinses his mouth out.
Aloe and Simon open the tea house again. Cherri stops by and has a cup of tea while inspecting the new cushions. A man with wings stops by to inquire about business and talks to Aloe, he identifies himself as the baker in conversation, calling himself Lucio.
FRED stops by again and mentions some activity in the arena with Masaru and some mannequins. He talks for a bit, mentions Wisp pointing a gun at him when he went in the noodle shop, and Aloe suggests he could start a delivery service for his convenience store. FRED mentions "this guy Simon" who suggested he increase his size so he could carry more but he hasn't seen that guy in a while. Gungir walks in and says people are fighting at the arena and that the fighting is moving into the streets. FRED says the mannequin guy was found by Masaru and they're dealing with him.
Because of this, Aloe closes the shop and goes into the backroom. Simon follows and sees an Trident synth lying on the table with its face plate off, which Aloe immediately identifies as FL0UND3R. Aloe alerts Bertram to the situation outside and that the shop is closed. Bertram says they found Flounder like this and that they're trying to fix him. Simon goes in and out of the backroom and pulls his gun, expecting the worst. He hears the bot screaming coming from a device Bertram is holding, and decides he'll wait in the main room. He has another narcoleptic episode despite the caffeine pills and passes out.
He wakes back up on his own and pops in and out of the backroom, not wanting to deal with whatever Bertram has gotten himself into. He hears a lot of commotion coming from outside, and a man from earlier asks for a tea refill. Simon gives him one on the house with something Aloe already had prepared. Simon goes into the backroom to tell Aloe he's heard people discussing bombs outside. He goes back out and asks some passing Masaru mages what's going on, they say it's been dealt with and to stay inside and have some tea, and stay safe. He goes back into the backroom and they're still messing with the synth, internally he panics a bit.
Simon has yet another episode in the main room and wakes up again by himself. He decides to go for another walk when someone asks him if Bertram is around, he lets them in and goes to get Bertram.
Flounder is sitting up and grilling Bertram about his personality core. Simon lets him know about the person out front and he goes to talk to them. Unable to drift between rooms, Simon picks the backroom and watches Vessa interact with the synths.
Bertram says Flounder has been there long enough and it's time for him to go. Bertram tells Simon and Vessa to keep Flounder distracted while he takes care of something with Aloe. Flounder immediately introduces himself and they end up in a philosophical conversation about choice.
After Aloe comes out of the back and Bertram sends her off with Flounder, He walks up to Simon and says "That could not have gone fucking worse." Bertram says officially, they found him tampered with and brought him back to charge. Simon says if things like that are going to be happening maybe he ought to practice his shooting. Bertram expresses regret for having to delete Aloe's memory of what she saw in the backroom, and says shooting Flounder won't help, it'd traumatize Aloe.
Simon goes back to the backroom and starts researching the long-term effects of brain damage on one of Bertram's pads. Bertram returns quickly and Simon tells him what he's researching. They exit the tea house and Simon explains he had brain surgery a few weeks before and he's looking up the effects of it. Bertram says he got too excited about Flounder and got ahead of himself. He leaves after mentioning he needs to hide something and comes back to Simon still researching.
Bertram begins to explain that he has a way to suck the personality core out of Flounder when some people in armor walk by on patrol. Bertram asks which corp and they say they're Wyverns, which he's grateful for. When they leave Bertram says they're probably not even Wyverns. He continues explaining, he had bricked his phone trying to hack into Flounder's memories and when Flounder woke up he noticed the discrepancies in his personality core, then Bertram had lied about what he had done. Bertram wanted to talk to Flounder outside his body but the corporate grade firewall was too strong. He didn't have enough time and didn't do enough. Simon says after working on FRED in the upper city, if a bot like him has a tracker inside, there's no doubt Flounder has one in him too.
Simon suffers another narcoleptic episode while still talking to Bertram. Bertram says to himself that he needs a drink, and wakes Simon back up.
Simon and Bertram head out and run into some commotion involving Masaru and some others. Bertram asks Vessa if she wants to talk in the tea shop and he leads her and a group of several others inside. She frantically explains her involvement with someone called the Puppetmaster and the moving mannequins.
Simon notices a large individual out in the square, and not long after gunshots come from somewhere above. Simon drifts around for a bit before Xia asks him if Greasepalms is in the tea house. He says no before realizing he doesn't know who Greasepalms is.
Eventually Bertram and Vessa emerge from the tea house and go over to the Dirty Diamond. They invite Simon in and all of them and the Diamond guard grab some drinks from the bar and go into Kee'ra's apartment. They put a frozen pizza in the oven (Vessa remarking she's never used it before and is also confused by the instruction to "preheat") which Simon takes out as soon as they leave the room. He tells the guard no, they're not eating frozen pizza, they're gonna eat a real meal that he's gonna cook.
He surprises them when they return and Vessa asks if the ingredients were even fresh. Simon says no, you've gotta make do with what you've got. Vessa puts on the old movie Alien vs. Alien and Simon heads back to the tea house to sleep.
Episode 23
Simon sleeps in, having forgotten that Aloe went to the Upper City with Flounder the night before, after having some trouble sleeping overnight. He wanders the Row for a bit, asking some people if they'd seen Bertram or Aloe around. Eventually he returns to the tea house where Bertram is talking to a woman in a purple outfit, who mentions winning a tour of Valkyrie from a gambling game she won in the tea house.
Simon and Bertram go inside to talk. He asks who the woman was, Bertram says she's an old friend, but don't tell her much. Simon says he's still worried about Manyu. Manyu is unstable and though Bertram thinks he's gone, Simon is sure he'll return. Simon proposes building some insulated armor to resist Manyu's attacks, possibly magically resistant as well. He'll go talk to the local blacksmith to get an estimate on how much it might cost. On another topic, Bertram suggests Simon spearhead the Row's effort to be self-sufficient with food.
On his way to the blacksmith, he runs into a taxi robot, who is carrying a couple of mannequins. He gives Simon directions to the Engineering District. There, he meets with a man wearing a helmet who is also lost. They walk about ten steps and find the blacksmith's shop has just opened. The man introduces himself as Kevin.
Simon waits for someone else to finish, and then talks to Gungir, the shop owner. Simon is intentionally vague on the specifics, but tells Gungir he needs insulated armor resistant to slashing. Gungir takes a look at what he's got in his shop and comes back with an estimate of 14k. Simon says he'll come back in a bit with the money.
Simon runs into Kevin again, who compliments the aesthetics of the tea house. Shane says he works there and brings him in for some tea. Kevin removes his helmet to reveal white hair and green eyes, but a mask over his mouth and nose. Bertram returns, Kevin asks where the tea is from and Bertram tells him they have a grower in the Undercity. Kevin doesn't know what the Undercity is, Bertram explains it's where magic users live, to which Kevin responds that Magic doesn't exist. Both Simon and Bertram tell him yes, it does. Kevin somehow had never seen it before living in the Middle City.
Kevin leaves and Simon gets Bertram's approval for a down payment on the armor. Simon goes back to Gungir, who agrees to 5k up front. He estimates he'll be done with it sometime tomorrow.
Simon returns to the tea house and stands guard while Bertram conducts business with the lady in purple. He makes small talk with another guard and serves tea to some patrons. After a while Flounder returns with Aloe, in Sentry Mode. He reverts to entertainer mode and comes inside to say goodbye.
A man mumbling to himself wanders into the tea house. Suddenly, he draws his sword and yells at Flounder to "DEFEND YOUR LADY!" Flounder enters Sentry Mode and draws his laser sword. Shane immediately pulls his gun on the man and orders the mumbling man to take it outside. The man tells Flounder he "did well" and Flounder reverts to entertainer mode. He doesn't seem to understand why the lady in purple wants to keep her weapon on her after that incident and Aloe explains he went to Sentry Mode and forgot engaging with the man. Flounder explains Sentry Mode just doesn't let him know some things, he doesn't forget them. Flounder reverts to Sentry Mode and leaves, Aloe runs out after him but returns dejected.
With Vessa to run the front of the house, Simon goes into the backroom with Aloe and Bertram. There, Bertram runs scans on Aloe to make sure Trident didn't tamper with her. Bertram hands Simon his fake ID and documents and Simon goes back out front.
Vessa is talking to the lady in purple and her guards. After a bit they leave and Sir Polka, the man who was mumbling before, returns to apologize. He says it was "tomfoolery" and Ryder interprets it as him saying he fucked the entire staff except Simon. Simon accepts his apology and sends him on his way.
Vessa and Simon talk and Simon tells Vessa to be cautious around the lady in purple, who had threatened him earlier. He and Vessa run the shop for a bit more and Vessa gets caught up in a conversation and is told Polka somehow pulled salami out of his sword.
Aloe returns from the backroom and suggests Simon wear a pin on his jacket, or possibly a patch on the back, to fit with the tea house theme. Bertram tells him to go to the clinic to get a prescription and that the doc there can be trusted, just don't let her take your blood.
He goes to the clinic, where the synth manning the window tells him the doctor isn't in. She asks for a name to take a message, Simon gives his real name. He thinks to himself that the name doesn't even feel right anymore.
He returns to the tea house and overhears another conversation about salami. More customers arrive and Aloe serves them. A strange purple alien wanders in, and when Bertram offers her tea for 200 credits she asks what a credit is. Bertram asks her where she's from and she reluctantly confirms she's from offworld. She doesn't seem to be open to talking about herself. Bertram and Simon get her a tea for free, and Aloe has to explain what tea is. Simon decides to check the clinic again.
The doc is in so Simon waits for her to be finished with others. While he's waiting someone apparently spots a "street shark" swimming into the bank across the street. The doc goes to look and comes back to say it's a catfish.
The doc takes Simon upstairs where he reintroduces himself with his real name, as they've met before. He says he needs his prescription refilled and she asks for all the details so she knows what she's getting into. He tells her the whole story and that he needs his prescription hidden since his narcolepsy could be a dead giveaway for his new identity. The doc tells him someone has picked up his gun in the lobby and she'll do it for free if he handles the situation.
They go back downstairs to find the naive purple alien girl was apparently the one who picked up the guns. The doc offers Simon half of her original offer instead and tells the girl she can stay if she wants. Simon hangs around while they talk about what they should do with patients' guns in the future. Simon offers to help with their security but the doc subtly suggests "lots of people" come through the clinic and he might be recognized without a face covering. She gives him his prescription and he heads out.
He goes back to the tea house where Bertram is hosting some gambling. He watches for a bit and Vessa tells Simon to tell Bertram Flounder will be back when he's done in the Upper City. Simon is exhausted and decides to end his day early, retiring to the backroom to sleep.
Traits
Edges
- Major - Perfect health - Due to his knowledge as a Dietitian, his own diet consists of various vitamins that boost his immune system, making him less likely to catch a disease as well as giving him a resistance to weak poisons.
- Minor - Coward’s retreat - Simon has run away from fights all of his life. Due to this he has a slight increase in stamina and in speed.
- Minor - An eye for quality - Able to tell the quality of foods by inspection and can find discrepancies based on that.
Flaws
- Major - Narcolepsy - Very tired, unaware of their surroundings, and falls asleep often. This leads to occasional hallucinations.
- Minor - Weak Stomach - Unable to look at any amount of gore or blood without getting sick to their stomach. Prolonged exposure increases the chance of throwing up. Reminds him of the time he saw a man fall into a food processor.
- Minor - Allergic Itch - Due to being around ingredients that he is allergic to, he has developed a skin condition that causes him to be itchy in particular spots. He is allergic to most naturally-growing plants as well as peanuts.
Links
Social Links
- Twitch: https://www.twitch.tv/drahexal
- Twitter: https://twitter.com/Drahexal1
Episodes
- Collection: https://www.twitch.tv/collections/m-aht-sYPxY07w
Clips
- Trying spicy noodles as Shane
- Simon & Leonard talk about Loch
- Simon remembers Rikky blew his cover
- Simon returns to GEB
- Simon talks about Loche
- SIMON THE BOY
- Simon keeps sniper rifle
- Rikky, Simon & Mr. Goldman find Damien in an odd time
- Shirtless Manyu and Simon
- Simon discusses Hadwyn Ermire about water locations
- Simon honors Bic Monet by keeping his sniper rifle
- Simon's abs got horned smiles
- Simon's new armor
- Mr. Goldman concerned about Simon's obsession
- Praise the Sun! Praise the Simon!
- Rikky, Manyu & Simon meet Crabby friend
- Simon completely breaks Sheila
- Simon the Pumpkin Carriage
- Leonard, Simon & Rikky chase after Manyu
- Rikky, Manyu & Simon discuss about the Row interview
- Simon apologies to Row civilian after finishing GEB interview
- Simon disapproves GEB Cube Mascot's performance
- Simon reveals some of his lore
- Simon swears
- Simon's plan with Avalon
- Simon shows Rikky his new GEB Cube hologram.
- Simon finds out Manyu can't eat his food
- "It's Simon time!"
- Rikky loves "It's Simon time!"
- Manyu, Rikky, Simon & Mr. Goldman hear voices in walls
- Simon wakes up carrying weapons on him
- Leonard vents to Simon about Rikky's recklessness
- Leonard confesses to Simon about his cannibalism
- Guards tells Rikky about Simon took... an alien into the lab
- Rikky finds Simon in lab
- Rikky finds out Statis field shut down by Simon
- Rikky & Manyu becomes suspicious with Simon part 1
- Rikky & Manyu becomes suspicious with Simon part 2
- Simon tells Rikky about what's happened with Leonard
- Rikky finds out about Simon's brain damage
- Rikky gets Simon to go rest
- Manyu suspects Simon brought Shometsu & Hadywn dressed as guards
- Simon gave guard suits to Hadwyn & Shometsu member
- Simon trying to recall incident leading to this
- Simon is put under 'house' arrest
- Manyu angry at Simon: "GO, SIMON!"
- (EXTRA) Criken finds out what happened to Simon after escort
- Leonard finds out what Simon did
- Rikky tells Leonard that Simon pushed a guard off building
- Rikky, Manyu and Leonard leave as they cope with Simon
- Leonard shares interesting idea about Simon
- Manyu suggests to have Simon get a new disguised life if plan works
- Rikky & Manyu fight about Simon
- Leonard feels that it is his fault that Simon snapped
- Rikky informs Leonard & Manyu what was found in Simon's room
- Rikky reveals what he's going to do with Simon
- Goldman's reaction to Simon's betrayal
- Mr. Goldman describes Simon to mage
- Mage informs Simon about his location
- Manyu informs what happened during Simon search
- Leonard prays for Simon
- Manyu wonders about Simon
- Rikky talks with Warren about Simon
- Damn, Simon. | https://vrchat-legends.fandom.com/wiki/Simon_Kuzumo |
Chapter 109: Shared hopes Original and most updated translations are from volare. If read elsewhere, this chapter has been stolen. Please stop supporting theft.
After seeing Mu Qingwu and Han Yunxi both fall silent, the tea servant long figured that something wasn’t right. But the things that the young general had asked about were all recorded in the teashop receipt ledgers, so she didn’t dare to lie.
Not long ago, Second Young Miss Han had left behind a canister of first-class spring tea here. Many influential officials who drank tea here would forget their tea leaves and never come back to find them. As a result, she’d grown a wicked heart and hid that particular tin for herself. Unexpectedly, the Han Family actually sent over people the next day to look for the tin. It was awkward for her to bring it out again, so she could only pretend that she’d never saw it. All of Second Young Miss Han’s gifted teas were first-rate leaves that exceeded the quality of some of the teashop’s own blends. If it could be sold on the tea market, it’d definitely fetch a good price.
The tea servant had originally planned to find time and secretly take the tin out to sell, but who knew she’d run into this situation today? Her heart was trembling with fear. How could she dare sell those tea leaves now? She only hoped that they wouldn’t trace things back to her. If the manager found out that she’d stolen a guest’s tea, she’d be dead meat.
The tea servant didn’t understand these words, but Mu Qingwu did. When they were investigating Mu Liuyue, he’d promised that he wouldn’t act wrongly out of personal considerations. Today, the most likely suspect had shown up in the Han Family, and esteemed wangfei was giving him the same pledge. He never expected that a woman like esteemed wangfei could have such an inspiring sense of righteousness. Mu Qingwu cupped his fist in his hand before his chest, face filled with trust and deep respect.
It was exactly this trust that increased the pressure on Han Yunxi and bolstered her determination. No matter who the culprit was, as long as it was the real one, she’d definitely uncover them.
“When Second Young Miss Han gives her tea leaves, does she ever steep them here?” she finally asked.
“Are they all the same tea leaves?” Han Yunxi asked again.
“Sometimes. Sometimes they’re not, so it’s not set,” the servant answered truthfully.
“Do you still have some left over?” Han Yunxi continued.
Han Yunxi examined the tea leaves but found no traces of poison. Everything was normal. Mu Qingwu hesitated before steeping the leaves to take a sip. As soon as he smelled the scent of tea, his face grew intoxicated.
“What is it?” Han Yunxi asked curiously.
For Mu Liuyue to keep accepting Han Ruoxue’s teas meant that their quality wasn’t ordinary.
“This flavor...this tea is the first batch of spring tea grown by the southern borders, one of the highest-grade green teas,” Mu Qingwu was very certain.
The extra same tea tree, when planted in different locations, yielded differences in their leaves as well. Climate, earth, and watering all determined the minute differences within the tea leaves, creating different flavors of tea. An ordinary person wouldn’t be able to tell, but senior level tea fanatics could find out with a single whiff.
“This really is spring tea from the southern borders. Only the red earth at the borders can cultivate this flavor of green tea. Young General is very formidable!” the tea servant was all praise.
Actually, she wanted to say that the sealed tin left behind by Second Young Miss Han was even better, but she didn’t dare.
“Is this tea rare?” Han Yunxi asked, not understanding.
“Esteemed wangfei, teas from the southern border are in the greatest demand, especially spring teas. They’re produced in minute quantities so orders are sold out before they’re even harvested,” the tea servant replied.
If he hadn’t drank the tea himself and heard the servant’s explanation, Mu Qingwu wouldn’t have realized his frequently drunk green tea came from such a particular place. He looked significantly at Han Yunxi and said, “Over the past two or three years, I’ve grown obsessed with this flavor of tea. Many of the leaves Liuyue sent over was green tea from the southern borders.
Han Yunxi crinkled her eyebrows. While Mu Qingwu and the servant weren’t paying attention, she silently took a few tea leaves and placed them in her medical pouch, then grabbed an acupuncture needle to sample some of the tea water before placing that in the pouch as well. In actuality, she was borrowing the action to send both items into her detoxification system dimension for analysis.
The results showed a marked difference: these tea leaves and tea water contained a high level of iron! Before, her analysis on two batches of tea leaves had resulted in failures when she tried to combine them with Ten-Thousand Snake Poison. First she’d analyzed them according to types of tea, then seasons of tea. She’d never tested them based on place of production.
Souther border green tea, could this be it?
Han Yunxi couldn’t wait any longer. As soon as she finished analyzing the composition of these tea leaves, she started mixing them with the poison in her detox system. Her eyebrows furrowed in concentration, expression serious as she focused entirely on producing results. By her side, Mu Qingwu and the tea servant watched and waited, wondering what was the matter.
“Esteemed wangfei, are you all right?” Mu Qingwu asked in concern.
The southern border green tea and spring tea had failed, not her. Did they make a mistake about Han Ruoxue? Or were there differences in the tea Han Ruoxue steeped in the teashop, versus the ones she gave to Mu Liuyue unopened? If there was, then a tea fanatic like Mu Qingwu would be able to tell just from tasting. Han Yunxi hesitated before waving her hand to dismiss the tea servant and surrounding attendant girls.
“The tea Liuyue gave you, does it differ from the other teas you drink?” Han Yunxi asked.
Han Yunxi understood as soon as she heard Mu Qingwu’s words. To find an extra answer from all these subtle and immeasurable idiosyncrasies was impossible. Just a simple technique of curing the leaves would create large minute differences. Where were they supposed to start tracking them all down?
Han Yunxi originally wanted to look into the method of curing teas and find evidence from that end. As things stood now, she’d be stuck following that clue without end and still not find a thing. She organized her thoughts, leaving aside all sorts of distractions, and returned to the source of uncertainty about the tea leaves.
If the problem laid undoubtedly with the tea, then the open path they had was to find tea leaves containing poison. But at this critical juncture, perhaps the suspect had already taken precautions against them. If that was the case, where could they go to find poisoned tea leaves? If they gave up this clue, then their only choice was to make a move towards the suspect. Han Yunxi’s concerns were exactly Mu Qingwu’s as well. Seeing his dignified face, she began to smile.
Actually, just from all the clues they gathered today, Han Ruoxue was already plenty suspicious. Add that to her own discoveries at Third Madame’s house and the suspicion grew. She didn’t mention Long Feiye’s involvement in the matter since it was related to the Northern Li spies, whom Long Feiye had been secretly investigating all the while. She could only wait with anticipation for Long Feiye to find additional clues.
Mu Qingwu hadn’t expected today’s clues to lead them to the Han Family’s Second Young Miss. When he returned, the first thing he’d do was report to the Duke of Qin. He thought it should be easy for His Highness Duke of Qin to investigate the backgrounds of Han Family’s Third Madame Li and Second Young Miss. Since this matter concerned the case of the Northern Li spies, it couldn’t be made public. Neither was it convenient for him to divulge details to esteemed wangfei.
Both of them inadvertently focused on the suspect and placed their hopes on Long Feiye, though neither was aware of the other’s thoughts.
“If I make any progress, I’ll tell you as well,” Han Yunxi said frankly.
Mu Qingwu was startled. Was this mistress going to do a personal investigation? First of all, she was the married-off daughter of the Han Family, so it wasn’t good for her to frequently return home. Secondly, she had to have some scruples regarding certain affairs, in her position as Qin Wangfei.
“I heard that their...Red South Peak isn’t bad. You have to personally go into the mountains to harvest it?” Han Yunxi couldn’t help but think that she needed to bribe Long Feiye so he could hurry up and investigate the Han Family’s third wife’s affairs. With his level of efficiency, she’d definitely get results within three to four days. If she happened to make a mistake, then she’d still have time left over to keep investigating.
“Esteemed wangfei is truly perceptive. Celestial Fragrance’s Red South Peak is grown especially for the imperial family, and not sold to outsiders,” Mu Qingwu laughed.
“This official can’t buy it, but esteemed wangfei is part of the imperial family so you naturally can. This official doesn’t know whether he can take advantage of esteemed wangfei’s honorable presence today?” Mu Qingwu teased. After all their meetings, he’d unwittingly relaxed a lot more and wasn’t as reserved or cautious as before. It was something even he himself hadn’t noticed.
Han Yunxi was immediately taken with the idea. “Naturally,” she replied.
With a tea servant leading the way, Mu Qingwu and Han Yunxi climbed halfway up the back mountains into the area where Red South Peak was grown. Row after row of neatly arranged trees stood just far enough apart for one person to walk through them. The tea trees weren’t very high, but neither were they short. They reached halfway up to the height of a person standing beside them. Under the guidance of a tea master, Han Yunxi quickly grasped the technique involved in harvesting tea and walked with Mu Qingwu into the tea groves.
In modern times, it was perfectly normal to spray tea plants with pesticides so that they repelled insects. A few black-hearted tea growers even used insecticides heavily to guarantee a full harvest, or even sprayed drugs prohibited by the country’s laws.
“Pesticides?” Mu Qingwu didn’t understand.
What if they sprayed Ten-Thousand Snake Poison on the tea trees? | https://www.volarenovels.com/novel/poison-genius-consort/pgc-chapter-109 |
The usual, with toasted rice.
As someone who rarely drinks green tea when it’s not mixed with black, I was a little obsessive today that all the parameters were perfect. So as a not-really-green-tea-drinker, I’d get the best out of it.
I got this as a sample from the Great Wall (they shower me in samples). Smells like slightly overcooked rice. Sadly, their giant tin didn’t have any rice that had managed to actually pop (I like calling it popcorn tea).
First sip… Is actually very pleasant. I can definitely get the toasted rice, and the green tea managed to turn out enjoyable and mellow. I remember trying some from Murchie’s very-cold-sample-pot. Tasted cold and slimy.
This is nice, though. Toasty. I could see me carrying this around in my tea libre.
Green’s coming out a bit more as it cools, but I’m still liking it.
I got a sample of this while I was in Vancouver, just trying it now. Wow, there are a lot of different opinions online about how to brew genmaicha! I ended up going with 5g of tea for 10oz of water, 80 C, 2min. This is nice. Mellow green tea base, no bitterness, and lots of toasty flavours from the rice. There’s an underlying sweetness that I wasn’t expecting, and is quite nice. | https://steepster.com/teas/great-wall-tea-company/17377-genmaicha |
Not to be confused with Ghost T..
The Ghost Toads are a group of six deceased Toad friends that appear in Paper Mario: Color Splash.
Many years ago, when the Dark Bloo Inn first opened, six Toad friends made a promise—a sacred oath, really—to have a tea party there. They checked into the inn the day before, intending to spend the night before their party began at 3:00 p.m. the next day. But as it happened, the grandfather clock at the front desk broke. When the Toads finally realized this, 3:00 p.m. had long since passed. The six friends fell into a deep depression, and as the years passed, their tea-sipping aspirations remained unfulfilled. Exactly 200 years after the founding of the inn, the grandfather clock was repaired in commemoration. From the moment the clock once again began to mark the passage of time, mysterious phenomena started occurring within the hotel.
In the Dark Bloo Inn, a Ghost Toad can be found in the library. He throws the books off of the shelves when Mario first enters. He appears when Mario paints him, and he tells him that he is searching for a book. He tells Mario that someone probably took it and did not return it. After Mario obtains the book from a Toad and returns it to the Ghost Toad, the Ghost Toad heads to the dining hall, where the tea party takes place.
Another Ghost Toad can be found pushing a luggage cart on the second floor. When Mario causes him to appear by painting him, he says that he cannot find Room 201. After Mario uses the Cutout ability to remove the wall blocking the door, talking to the Ghost Toad again will cause Huey to point out Room 201, and he runs over to it. After he puts his luggage in the room, he heads down to the tea party.
A Ghost Toad can be found in Room 202, though the room can only be entered by going through a hole in the floor of Room 302. He appears when Mario paints the area near the table. He will be on the floor trying to find his glasses, which are on his head. If Mario hits him with his hammer, the glasses will go back onto his face. He will then go down to the tea party. If Mario does not break the crate in front of the door, the Ghost Toad will break it by running into it. This will cause his glasses to go onto his head again, though he will put them back on immediately after.
When Mario enters Room 203, a Shy Guy can be seen jumping off a balcony, carrying something invisible. By painting the area near the balcony, a Ghost Toad can be found banging on the rail, saying that the Shy Guy stole "it." After Mario obtains "it" from a Shady Sledge Bro and returns it to the Ghost Toad, he puts it on the table and heads down to the tea party.
When Mario enters Room 301, the furniture can be seen scattered everywhere. The house cleaning Toad will come in and clean the room, and, when he leaves the room, Mario can find a Ghost Toad talking on a telephone. He becomes angered that the hotel is not changing his sheets, and threatens to mess up the room again. After Mario obtains the Fresh Sheets from Shy Guys, he must go to Room 301 and change the old sheets out for the fresh sheets, causing the Ghost Toad to become happy. He then goes down to his tea party.
In Room 303, a Ghost Toad can be found near a colorless birdcage. He says that his "red bird" has escaped. After Mario paints and picks up the birdcage and finds the "red bird", a Koopa Paratroopa, outside, he takes it to the Ghost Toad. The Ghost Toad then heads down to the tea party.
The Ghost Toads can be found in the dining hall, though their teapot is missing. They begin to get annoyed that they cannot have their tea party yet.
When Mario gets the Teapot from Plum Park, he can give it to the Ghost Toads. The Ghost Toads then finally are able to have their tea party, and they rise into the sky. Their pictures then appear in the painting behind the table. Mario receives an extra card slot for helping the Ghost Toads.
This page was last edited on January 23, 2019, at 20:18. | https://www.mariowiki.com/Ghost_Toad |
Tea revealed as snake fillets
Inspection of a seemingly innocent package of tea revealed python fillets, raising biosecurity alarm at Auckland airport.
A passenger arriving from China presented the package to biosecurity officials upon landing at Auckland last week, saying she believed it to be tea, but as it had been packed by her mother, she wasn’t sure.
“It became clear the contents were definitely not tea when our quarantine inspector opened the package and discovered fresh fillets labelled as python,” says Brett Hickman, Detection Technology Manager, Ministry for Primary Industries (MPI).
“The meat could have had diseases damaging to our native reptiles. And contributing to the biosecurity risk, it was crawling with insects.”
Hickman says MPI staff regularly intercepted biosecurity risk items in misleading packaging.
“A lot of stuff from some countries gets vacuum-packed in whatever packaging a shop happens to have at the time. It means our inspectors have to open everything they are not sure about.”
MPI did not fine the passenger, as she had declared the item, says Hickman. “She did the right thing by alerting us she was carrying food items, and we congratulate her for that.”
He says the interception was unusual. “We don’t see a lot of snake products like this, although occasionally we find snakes preserved in bottles of wine from places like Thailand and Vietnam.”
MPI has passed the meat to the Department of Conservation, as it may be subject to the Trade in Endangered Species Act.
Photo of snake meat available on request.
NB. This interception was made by the Ministry for Primary Industries, not NZ Customs. | https://www.mpi.govt.nz/news/media-releases/tea-revealed-as-snake-fillets/ |
e got married and hasn’t returned to his Residence, the Duke’s estate(Mansion).
Randall was full of answers and vaguely replied, “it’s okay.”
Randall, who hasn’t returned to the Duke’s residence since he got married, has no idea about newly-married life.
Or rather, he doesn’t even feel married,
Randall still thinks Sophia is a fake princess, and he married her just for surveillance.
“I heard that Her Royal Highness Princess Sophia lived on the streets until she was 14 years old.
I’m sure she must have gone through some hardships.
It may be none of my business, but please take good care of her.”
Did the Duke of Levord come all the way to say that? Does he know that Randall hasn’t returned to the Duke of Voltio Mansion? The Duke of Levord and the King are on good terms.
It is possible that he came to advise Randall after the king complained to him.
Randall felt uncomfortable because he couldn’t read the thoughts of the Duke of Levord.
With a smile, the Duke gave him a letter.
“My wife gave this to Sophia.
She said she wanted to hold a tea ceremony because she returned to the royal capital.
By all means, she wanted to invite Sophia.
Of course, you too, Duke Voltio.”
“… me too?”
Women often hold tea ceremonies, but their husbands rarely attend.
The Duke laughed a little, he was also wondering why even Randall was invited.
“You look surprised, though it’s called a tea ceremony, only Sophia and you are invited this time.
It’s just that my wife would like to meet Princess Sophia.
I thought it might make you feel uncomfortable if I invite your wife alone, so I invited you to join us.
” Women chats are long and sometimes boring, while your wife and Sophia are talking, you’re with me and my son. | https://www.videosdelbetis.com/read/vid-The-Villainess-Beloved-Plan-The-Struggles-to-Avoid-a-Doomed-End-7315232/19_2 |
230 Tasting Notes
I had this one on a day I was in DAVIDs and just looking (like that is ever possible) I think this one may have been under steeped (if that is possible). You can smell the strawberries, but their taste is far more understated than the title suggests.
I might get this one over ice to go today and give it at least one more try before I completely give up on it.
Ummm, maybe not the best tea to have at 9pm, but when I purchased it today, I could not wait to get it home, and there was no paitence to wait for Sunday breakfast… Nope, not at all!
When I first smelled the leaves I was struck at how much this smelled like that horrid “Raspberry Mocha” from Starbucks. This left me a little leary to try it, but I figured there really was nothing to loose since there is only one tea from DAVIDs that I truly did not like (Dolce & Banana) This tea is fun to watch as it steeps and I am a little sad that I left my glass bodum at work, since the raspberries plump right up!
I could only smell the raspberries and chocolate, but taste the mild chicory and almond taste… we’ll see what tomorrow brings.
This was my “tea to go” today, myself and two other co-workers piled into my car for a trip to DAVIDs for a between shift purusal… uh-oh, 3 women in a tea shop is like a bunch of kids in a candy store screaming for the attentions of the one person behind the counter. But I must say she was calm cool and collected!
When I first sniffed these maple infused leaves I was hit in the face with so much syrup I worried that it would come off tasting like a D grade maple syrup, but I decided to take the plunge and who knew this would be so delightful?! Drinking it hot reminds me of winters huddled around troughs filled with snow eagerly holding that precious popcicle stick, breathing in the scent of fresh snow, fresh tapped trees adn boiling maple syrup and waiting, WAITING for that sticky boiled goodness to be poured over the snow so you can wrap your stick in it and stand cheeks rosey and toes frozen as you savour that maple goodness that makes Canada Great!
This is a great tea and my first Rooibos that will leave me looking for more on pancake and french toast Sundays!
The girl behind the counter was not kidding!
This tea is caffinated, without the sugar crash! So in love with this herbal tea. I have been having it each morning and I have not once, not once, experienced that horrible dip in insulin that happens when I drink coffee… we all know that dip, the one that leaves you sleepy, crabby, (and it it is Starbuks, with the shakes and stange sense of paranoia) and despretly needing another cup. This tea offers a consistent low impact buzz all day; also to note, NO Heart palpitations!
Juggle Ju-Ju has a wonderful light papya flavour that allows this tea to remain drinkable as it cools and will definantly work this summer over ice. And it will leave me refreshed instead of feeling heavy and bloated on those extra hot summer days!
Needless to say I really suggest this tea to people who are caffine sensitive but would like a little “pick me up” on Monday morning. Well, anyone who wants a steady caffine flow in their system, without cravings, angst or your Doctor saying: “No”
Preparation
The kids at the OSC (out of school care) center I work at had a little sip of my iced version of this tea today and are super excited for next week when they get to make sun tea with this delightful concoction!
evil laugh turning children away from pop one sip of herbal tea at a time!
I first had this tea as a “take away tea” while purusing the selections at DavidsTea… I was in a rush to get to work and I have a feeling it was over steeped, but this tea has potential…
Second Tasting (yes, I was intrigued enough to purchase a 50g bag to take home): This tea is steeping beside me and I am taken back to Christmas’ baking mint fudge brownies and other spice chocolate delights. I can’t wait for it to cool enough to sip as I expect to be wowed!
Not overly keen, but it is still note worthy enough for me to consider a tin of the stuff the next time I am in the store…
This tea is so fragrant I actually breathed in the leaves and choked on them in the store, after a few giggles of embarassment I filled a small tin and wisked this one home for a taste test.
After following the directions for Black teas from Silk Roads I decided this time to steep the tea as little as possible and see what happens. The tea had a deep amber colour and the scent of fresh mangoes were intense enough to allude to enjoyable sipping… Not so much, I am starting to think that either a) I don’t like black teas or b) I just don’t like them from Silk Roads…
Here’s hoping it is “a” and not “b”
Preparation
I usually steep black teas for 3.5 to 3 minutes…and keep a pretty close eye on them. Many companies seem to recommend 4 to 5 minutes, but I find that makes them bitter and “burnt”…Hope you find some to enjoy!
Uniquity, I actually did a little research on properly steeping tea and learned that a) I was pressing down on the bodum too fast, b) the water was too hot (who knew the kettle should rest a few minutes after a hard boil?!) and c) I was using far too much tea. With my newly procured knowledge I can’t wait to try this one again.
Excellent news! (Not that you were “doing it wrong” but that you’ve found a new way to try it out :D)
Not my most favourite tea, but for the tea connaisuer this tea is probably more up their alley.
Scent is fabulous! Even after it was steeped I truly enjoyed sitting in my favourite reading chair and sniffing the tea while ignoring the book I was reading at that time. But as for taste, if I wasn’t so against honey and sugar I am sure I could find more enjoyment in this tea if it was steeped less and sweetened with something. | https://ec2-54-174-39-122.compute-1.amazonaws.com/erinn/?page=22 |
Vissa, Stephanie (2016) Exploring the Effectiveness of Interventions Aimed at Promoting Collaboration Through Interactive Whiteboards and Google Apps for Education. Masters thesis, Concordia University.
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Abstract
Over the course of the past decade, the use of interactive whiteboards (IWB) in North American and European elementary classrooms has surged in popularity. Nevertheless, their procurement has been scrutinized due to their questionable ‘interactivity’, lack of usage by students, and steep price tags. This design-based study aimed at determining the effectiveness of a performance improvement campaign’s interventions designed at encouraging dialogic interactivity by utilizing both the IWB and Google Apps for Education (GAFE). The project was structured using the ADDIE model. Participatory action research techniques informed the performance needs analysis, which subsequently led to the design and development of the interventions as outlined in the high level design. Interventions were implemented over the course of one school year. Both qualitative and quantitative data collection instruments were used to evaluate the efficacy of the interventions, as well as to explain the numerous factors that had an impact on their effectiveness. Results found that the tiered professional development sessions, the eNewsletters, the online tutorials, and the collaborative IWB and GAFE activities workshop were the most useful interventions. Various themes, notably that of time as a constraint, the potential for pedagogical use, and teachers as creatures of habit, emerged as factors that influenced the efficacy of the performance improvement campaign’s interventions. | https://spectrum.library.concordia.ca/id/eprint/981076/ |
The National Roundtable on Evaluation of Multilevel/Combination HIV Prevention Interventions had the goals of examining the present state of the art of multilevel and combination HIV prevention interventions, both domestically and internationally; to define the significant challenges and scientific gaps in current evaluation methods and identify the most promising methodological approaches to address these gaps; and to guide the future agenda for HIV prevention research. To address these methodological gaps, we must combine the methodological and statistical rigor associated with clinical trials, the conceptual framework of implementation science, the on-the-ground strategies of programmatic monitoring and evaluation, and the strengths of pre- and post-intervention mathematical modeling. In looking at the HIV epidemic in the US, the group discussed current initiatives guided by the National HIV/AIDS Strategy and the increased optimism over treatment as prevention. We noted that considerable progress has been made in developing core metrics to evaluate outcomes along the “treatment-as-prevention cascade” that could be captured through public health surveillance—number of new HIV cases detected and proportion linked to care, retained in care, on active treatment, and virally suppressed. Our understanding of the optimum package of interventions with regard to both effectiveness and efficiency remains incomplete. Progress was reported, however, in the collection of process data at the local level to better assess how to improve programs. Devising epidemic impact measures to quantify reductions in HIV incidence attributable to combination interventions remains challenging, mostly due to barriers to testing impact through methods like community cluster randomization in the US. Looking globally, the group discussed a number of planned clinical trials of combination interventions also spurred by optimism over treatment as prevention. Common elements of combination approaches included expansion of voluntary counseling and testing, adult male circumcision, prevention of mother-to-child transmission, and management of sexually transmitted infections, along with expanding ART treatment. Outcome measures were generally framed in terms of the treatment-as-prevention cascade, though these data are not available from current surveillance systems, pointing to the need to create improved systems of data collection. The most common approach to measuring epidemic impact was clustered community randomization, with incident infections measured through cohorts or newer cross-sectional, multi-assay algorithms. Recommendations from the roundtable include the following:
- A new coalition of interventionists, implementation scientists, public health program and surveillance specialists, mathematical modelers, and behavioral scientists is needed to adequately address the evaluation of multilevel/combination HIV interventions at the community-level.
- The use of the conceptual frameworks of the HIV prevention continuum and engagement-in-HIV-care cascade should be used in structuring evaluation of combination HIV interventions.
- Common public health surveillance systems to evaluate combination HIV prevention interventions at the community level are recommended, and this capacity should be further developed internationally.
- Mathematical modeling before, during, and after multilevel/combination HIV interventions should be incorporated in the design, implementation, and interpretation of intervention results.
- Because an emphasis on efficiency as well as effectiveness from implementation science is helpful, costing and cost-effectiveness evaluations of combination HIV prevention interventions are recommended and are important to policy makers.
- Use of innovative trial and observational study designs outside of the traditional randomized, controlled trial paradigm should be used to account for the complex multilevel and combination nature of new HIV prevention interventions, and emerging design and analysis methods (e.g., stepped-wedge designs, adaptive trial designs, causal inference modeling of “natural experiments”) should be considered to address the challenges of community-level effectiveness evaluation.
- Because social factors and human behaviors are integral factors all along the HIV care and treatment cascade, it is crucial to include social and behavioral science in the design, implementation, and evaluation of combination interventions (e.g., community engagement and mobilization interventions).
- Mixed methods, including qualitative data collection (e.g., key informant interviews with implementers, in-depth interviews with target population members), are recommended to increase our understanding of how and why interventions are successful or not.
- Increased funding opportunities for methods development, whether as standalone projects or as supplements to large trials, is recommended as is funding for career development in methods research (e.g., methods-focused K awards). | https://prevention.ucsf.edu/research-project/proceedings-national-roundtable-evaluation-mutlilevelcombination-hiv-prevention |
Following her BSC (Hons) in Psychology from the University of Bath, Tara graduated from the University of Groningen in 2021 with an MSc in Environmental Psychology. During this time, she worked on a project advising the Dutch Ministry of Finance on how behavioural insights could be used to promote the adoption of second-hand electric vehicles in the Netherlands, and she became passionate about designing and evaluating interventions promoting low-carbon behaviours. Tara was attracted to AAPS CDT because she wanted to gain a deeper understanding of current and future mobility challenges to better recognise how to address them.
Addressing climate change requires profound behavioural changes, including within transport. Indeed, reducing car use is one of the most impactful mitigation behaviour changes that individuals can make. Yet, travel behaviours are amongst the most difficult to change. This is partly because they are strongly habitual – unconscious routines triggered by contextual cues (e.g., ‘it’s 8am, time to drive to work’) rather than the product of conscious deliberation of alternatives (e.g., ‘which mode of transport would be best today?’). But since habits are cued by stable contexts, changes in context destabilise habits. Consistent with this, research shows that disruptions – whether concerning a person’s life-course (e.g. moving home) or physical or social context (e.g. infrastructure disruption) – provide opportunities to reshape behaviours in new directions. Interventions targeted to moments of change are thus more effective than at other times.
While much research has explored these ‘windows of opportunity’ during biographical life events, such as moving home, retiring, or becoming a parent, less is understood about how exogenously caused, structural disruptions (e.g., changes to physical environments) might disrupt habits and promote behaviour change. This PhD research will thus explore the impact that physical infrastructure disruptions (e.g., road closures) might have on modal shift and travel demand. Further, the project will evaluate the effectiveness of interventions (e.g., the provision of information, free public transport tickets) promoting active travel and public transport that are implemented during such disruptions.
Working with Transport for Wales (TfW), a series of field experiments will be conducted which evaluate the impact of behavioural measures that are introduced alongside physical changes to streets as part of TfW’s South Wales Metro project. Combined impacts of the interventions alongside the structural disruptions on travel mode change will be measured using TfW travel data as well as through the collection of both qualitative and quantitative survey data. | https://www.aaps-cdt.ac.uk/students/tara-mcguicken |
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Funding and Research Opportunity: Understanding and Addressing the Impact of Structural Racism and Discrimination on Minority Health and Health Disparities
August 24
NIEHS is interested in observational research examining the role of structural racism and discrimination (SRD) as a significant determinant in environmental health disparities, or evidence-based intervention research that mitigates or prevents the negative health outcomes attributable to environmental SRD. Applicants are strongly encouraged to utilize community engaged research approaches and include letters of support from community partners. Learn more and apply.
Background
There is increasing recognition that racism and discrimination contribute to poorer health outcomes for racial/ethnic minorities and other populations that experience health disparities. In fact, all populations with health disparities experience increased exposure to racism and/or other forms of discrimination over the life course. There is also a growing societal recognition that racism and discrimination extend beyond the behavior of individuals to include SRD, which is embedded in historical societal, institutional, organizational and governmental structures through formal and informal processes, procedures, and practices that limit both opportunities and resources to segments of the population. SRD is supported by the power structures that exist in society and in the institutions that are most likely to influence health outcomes.
Despite this enhanced awareness, racism and discrimination are not routinely included as determinants of health in biomedical research. Health research on racism and discrimination to date has largely focused on interpersonal interactions, and to a lesser extent, one specific form of SRD, residential segregation. Typically, such research focuses on the adverse health consequences of SRD exposures. Less research has explored the resilience among populations exposed to SRD or community strategies to resist or mitigate historic or contemporary SRD exposures. Additionally, intervention research has rarely emphasized reduction of SRD as a strategy to improve health and reduce disparities. Research on mitigation of SRD is needed to inform health care and social policies at all levels.
Health research and interventions need to routinely incorporate constructs and measurement of SRD across multiple socioecological domains and levels of influence in order to improve minority health, promote health equity, and eliminate health disparities (see the NIMHD Research Framework for more information: https://www.nimhd.nih.gov/about/overview/research-framework.html). Examples of domains in which SRD may occur include, but are not limited to, the following:
- Organizational/Institutional: Organizational-level climate; workplace hiring, promotion, or disciplinary practices; academic tracking, stigmatization, school disciplinary and admission practices; tolerance of abuse/harassment; health care system practices.
- Neighborhood/Community: Housing or lending practices and property value assessments; zoning laws; neighborhood distribution of public transportation, green spaces, grocery stores, hospitals and emergency departments, ambulatory health clinics, resource allocation for schools through local tax base, location of cellular towers, highways and major thoroughfares, and industrial or waste sites; criminal justice profiling; targeted social marketing of harmful or ineffective products; hate crimes.
- Societal: Criminal justice policies and sentencing practices, land/water use rights, self-governance or political representation for tribal communities and US territories, immigration and asylum policies and procedures, gerrymandering, voter suppression laws or practices, religious and cultural discrimination, depiction or representation in national media and social media.
Research Objectives
This initiative will support observational or intervention research to understand and address the impact of SRD on minority health and health disparities.
Projects must address SRD in one or more NIH-designated populations with health disparities in the US and should address documented disparities in health outcomes. Applications are expected to provide a justification for why the specific types of SRD included constitute SRD, such as how the racism or discrimination is structural rather than reflecting individual-level behavior and how the SRD results in differential treatment or outcomes for less advantaged individuals, groups or populations. For example, with a project examining discriminatory school disciplinary practices, documentation of different overall rates of student suspensions or expulsions by race/ethnicity would not be sufficient to label this pattern as SRD. However, different rates of student suspensions or expulsions by race/ethnicity for the same type of student behavior or violation could be evidence of SRD. Applications are also expected to provide a conceptual model identifying hypothesized pathways between the SRD and health outcomes. Potential health outcomes may reflect health status; health condition-specific or all-cause disability, quality of life, mortality and morbidity; biological measures that reflect cumulative exposures to and effects of SRD; health behaviors; or access to, utilization of, or quality of health care.
It is also expected that projects will collect data on SRD beyond individual self-reported perceptions and experiences to include data at organizational, community or societal levels. Potential data sources for SRD may include but are not limited to U.S. Census data, birth and mortality records; health surveillance data; crime statistics; traditional and social media data, school-based or educational data; labor statistics; voting records; local, state, and Federal law and policies; home ownership covenants; and organizational/institutional mission statements, policy guidance, operating procedures, or other relevant documents.
Projects are expected to involve collaborations with relevant organizations or groups or stakeholders, such as academic institutions, health service providers and systems, state and local public health agencies or other governmental agencies such as housing and transportation, criminal justice systems, school systems, patient or consumer advocacy groups, community-based organizations, and faith-based organizations. Multidisciplinary research teams, including researchers from areas outside of the health sciences, such as economics, education, history, criminology, law, and political science, are encouraged.
Observational Studies: Projects may (1) examine the impact of SRD on health, and/or (2) evaluate the impact that existing efforts to address SRD (e.g., laws, policies, programs, organizational practices and procedures) have on the health of individuals, families, and communities. Projects may involve collection of primary data/and or analysis of existing data and may involve quantitative or mixed methods approaches. Projects must be exclusively domestic, including U.S. territories. Projects using longitudinal designs or multiple sites are strongly encouraged, as are projects examining resilience in the face of exposure to SRD.
Intervention Studies: Projects may focus on health promotion, treatment, and/or prevention. Interventions may focus primarily on addressing SRD to improve health outcomes, or SRD may be included as one of several determinants of health addressed to improve health outcomes. For both types of intervention approaches, interventions must directly address the cause or source of SRD, not just help individuals or populations to cope with SRD. To this end, it is expected that investigators will collaborate with leadership from organizations, agencies, or programs where the SRD is originating from or being sustained (e.g., a project addressing SRD in the workplace should involve organizational leaders, human resource managers, or other relevant personnel involved in establishing, maintaining, or enforcing workplace policies and practices rather than only involving employees within a workplace). It is also expected that interventions will involve other relevant personnel or individuals within the setting (e.g., teachers, clinicians, co-workers, bystanders) as appropriate to enact changes to SRD, not just those who are directly experiencing SRD.
Research designs should allow for the assessment of mechanisms through which the intervention modifies SRD and how these changes result in improvement in the targeted health outcomes. Mechanisms of interest related to SRD include changes to behaviors, environments, or policies at the interpersonal, organizational, neighborhood/community, or societal level.
Cluster randomized designs for all types of intervention studies are strongly encouraged, as are research designs comparing interventions with and without SRD components. It is expected that the interventions will have potential for sustainability in the intervention setting after the project is over as well as scalability to be implemented in other settings.
Design, Analysis, and Sample Size for Studies to Evaluate Group-Based Interventions: Investigators who wish to evaluate the effect of an intervention on a health-related biomedical or behavioral outcome may propose a study in which (1) groups or clusters are assigned to study arms and individual observations are analyzed to evaluate the effect of the intervention, or (2) participants are assigned individually to study arms but receive at least some of their intervention in a real or virtual group or through a shared facilitator. Such studies may propose a parallel group- or cluster-randomized trial, an individually randomized group-treatment trial, a stepped-wedge design, or a quasi-experimental version of one of these designs. In these studies, special methods may be warranted for analysis and sample size estimation. Applicants should show that their methods are appropriate given their plans for assignment of participants and delivery of interventions. Additional information is available at https://researchmethodsresources.nih.gov/.
Applicants are strongly encouraged to assess social determinants of health using measures available in the Social Determinants of Health Collection of the PhenX Toolkit (www.phenxtoolkit.org), as appropriate.. | https://urbanwaterslearningnetwork.org/event/funding-opportunity-understanding-and-addressing-the-impact-of-structural-racism-and-discrimination-on-minority-health-and-health-disparities/ |
Pro-poor rural economic and enterprise development:
A framework for analysis and action (REED)
Final Report
DFID Poverty Oriented Research Programme, R8369 (NRI: C1731)
Dr. Junior Davis
Natural Resources Institute (NRI), University of Greenwich
December 2006
SARPN acknowledges NRI as a source of this document:
www.nri.org
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About the project
This project focuses on new pro-poor local economic and enterprise development mechanisms for public policy and interventions to enhance poverty outcomes and growth in developing countries. Preliminary work undertaken through a multi-donor initiative has developed a framework which has benefited from further analysis, development and piloting. The model and good practice generated aimed to guide the development community and national institutions in their support to pro-poor local economic and enterprise development. The application of the Rural Economic and Enterprise Development (
REED
) framework should provide guidance on pro-poor public policy and institutional support at local and national government levels specifically in South Africa and Bangladesh. The project has also formulated strategies which incorporate the development of key institutional processes conducive to pro-poor growth based on findings from the analysis conducted within the project.
The purpose of this project is to promote policies that support, guide and evaluate 'pro-poor' rural and local economic development across a range of less developed countries and transition economies in which the UK Department for International Development (DFID) is active. This project was funded by the DFID through the Central Research Department. For more information, please click
here
.
The research aims
The research aims to develop further a conceptual framework and project tool for the fostering of rural economic and enterprise development in developing and transition countries. Local economic and enterprise development has to overcome multiple institutional and government obstacles at the macro, meso and micro levels.
The conceptual framework, building on the experiences and lessons learned from practical experience in rural projects, consists of ten cornerstones for intervention. These are clusters of successful elements of intervention approaches dealing with rural economic and enterprise development. The cornerstones can be broadly classified into four categories:
Policies and institutional framework
Infrastructure, services and markets
Entrepreneurial competence
Stakeholder involvement and linkages
The cornerstones represent the core functions that must be provided for successful, selfsustaining rural economic and enterprise development processes. The framework is based upon the principle of systemic interaction, so that each of the cornerstones is critical for the success of policies, programmes and projects.
For each of the ten cornerstones, the core elements, key strategies and ways of implementation have been identified in an iterative process, building on the collection of available information and experience-based knowledge. The format is open-ended, allowing the addition of new strategic elements and case study material, which will be developed as part of this research project. The cornerstones presented in Figure 1 are:
Although project and programme initiatives aimed at improved economic and enterprise development is incorporated within the REED framework, it looks beyond particular interventions by focusing on the institutional architecture. Thus, even where particular interventions make sense (e.g. economic diversification), the right institutional architecture will be vital to its success; particularly in supporting the private sector. With the increased emphasis that government institutions and donors place on local economic development, enhanced rural-urban linkages and growth, it is of paramount importance to (where necessary) streamline the institutional framework, and/or improve coordination to optimise efforts and reduce duplication between different role-players for the benefit of enhancing economic growth and the development of the private sector.
The project aimed to:
Contribute to the improvement of sustainable rural livelihoods in developing economies by assisting government and civil society (public sector policy, investment and institutional) efforts to enhance the rural poor’s access to employment and SME opportunities through strategic advice, the development of best practice, evidence based research and dialogue through policy forums and networks.
Promote the participation of the poor into policy processes and fora for discussing the fostering of rural economic development through rural non-farm enterprise.
Strengthen the links between the current REED framework and in-country policy and programme processes, through regional workshops, seminars and shared learning/-training platforms.
Elaborate on the ingredients for a 'REED guide for program design' in rural and local economic development based on key success factors, promising approaches and practices.
Evaluate the effectiveness and efficiency of existing enterprise initiatives (credit programmes, employment programmes) in promoting pro-poor growth and reducing poverty.
Foster the development of coalitions between local, national governments and donors to identify strategic linkages and partnerships both within the public sector and between private and public undertakings to promote employment, SME development and pro-poor growth.
These objectives were pursued through a range of activities including literature review, primary data collection in selected case study locations, workshops, technical reports, policy studies and policy advocacy activities.
Project components
The project has four key components:
Refine and develop the conceptual framework so that it can address gaps in the framework
Pilot the approach in Bangladesh and South Africa in the form of in-depth case studies including training for local development practitioners and government in utilising the framework as a pro-poor REED programme planning, design and evaluation tool
Make widely available a robust framework and set of tools for use by the development community including national institutions
Methodologies and diagnostic methods development and validation for local economic and enterprise development
The research outputs develop several options for applying the framework which should improve rural economic and enterprise development policy and programme effectiveness in PRSP and non PRSP countries. The development and promotion of the rural non-farm economy, local economic and rural enterprise development has featured significantly within DFID’s work and that of the wider donor and NGO community. This work in part builds on the team's recent and extensive work on the rural non-farm economy -
http://www.nri.org/rnfe/index.html
The direct beneficiaries are intended to be the donor community and national governments in the target countries. These institutions should benefit in terms of their enhanced capacity to devise policies and interventions that enhance the poverty-reducing impact of local economic and enterprise development interventions in developing and transition countries. Ultimate beneficiaries will be the poor in those countries where such policies and interventions are taken up. | https://sarpn.org/documents/d0002868/index.php |
Clement, Sarah, Lassman, Francesca, Barley, Elizabeth, Evans-Lacko, Sara, Williams, Paul, Yamaguchi, Sosei, Slade, Mike, Rüsch, Nicolas, Thornicroft, Graham and Clement, Sarah (2013) Mass media interventions for reducing mental health-related stigma. Cochrane Database of Systematic Reviews (7). CD009453. ISSN 1469-493XFull text not available from this repository.
Abstract
Background Mental health-related stigma is widespread and has major adverse effects on the lives of people with mental health problems. Its two major components are discrimination (being treated unfairly) and prejudice (stigmatising attitudes). Anti-stigma initiatives often include mass media interventions, and such interventions can be expensive. It is important to know if mass media interventions are effective. Objectives To assess the effects of mass media interventions on reducing stigma (discrimination and prejudice) related to mental ill health compared to inactive controls, and to make comparisons of effectiveness based on the nature of the intervention (e.g. number of mass media components), the content of the intervention (e.g. type of primary message), and the type of media (e.g. print, internet). Search methods We searched eleven databases: the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library, Issue 7, 2011); MEDLINE (OvidSP),1966 to 15 August 2011; EMBASE (OvidSP),1947 to 15 August 2011; PsycINFO (OvidSP), 1806 to 15 August 2011; CINAHL (EBSCOhost) 1981 to 16 August 2011; ERIC (CSA), 1966 to 16 August 2011; Social Science Citation Index (ISI), 1956 to 16 August 2011; OpenSIGLE (http://www.opengrey.eu/), 1980 to 18 August 2012; Worldcat Dissertations and Theses (OCLC), 1978 to 18 August 2011; metaRegister of Controlled Trials (http://www.controlled-trials.com/mrct/mrct_about.asp), 1973 to 18 August 2011; and Ichushi (OCLC), 1903 to 11 November 2011. We checked references from articles and reviews, and citations from included studies. We also searched conference abstracts and websites, and contacted researchers. Selection criteria Randomised controlled trials (RCTs), cluster RCTs or interrupted time series studies of mass media interventions compared to inactive controls in members of the general public or any of its constituent groups (excluding studies in which all participants were people with mental health problems), with mental health as a subject of the intervention and discrimination or prejudice outcome measures. Data collection and analysis Two authors independently extracted data and assessed the risk of bias of included studies. We contacted study authors for missing information. Information about adverse effects was collected from study reports. Primary outcomes were discrimination and prejudice, and secondary outcomes were knowledge, cost, reach, recall, and awareness of interventions, duration/sustainability of media effects, audience reactions to media content, and unforeseen adverse effects. We calculated standardised mean differences and odds ratios. We conducted a primarily narrative synthesis due to the heterogeneity of included studies. Subgroup analyses were undertaken to examine the effects of the nature, content and type of mass media intervention. Main results We included 22 studies involving 4490 participants. All were randomised trials (3 were cluster RCTs), and 19 of the 22 studies had analysable outcome data. Seventeen of the studies had student populations. Most of the studies were at unclear or high risk of bias for all forms of bias except detection bias. Findings from the five trials with discrimination outcomes (n = 1196) were mixed, with effects showing a reduction, increase or consistent with no evidence of effect. The median standardised mean difference (SMD) for the three trials (n = 394) with continuous outcomes was -0.25, with SMDs ranging from -0.85 (95% confidence interval (CI) -1.39 to -0.31) to -0.17 (95% CI -0.53 to 0.20). Odds ratios (OR) for the two studies (n = 802) with dichotomous discrimination outcomes showed no evidence of effect: results were 1.30 (95% CI 0.53 to 3.19) and 1.19 (95% CI 0.85 to 1.65). The 19 trials (n = 3176) with prejudice outcomes had median SMDs favouring the intervention, at the three following time periods: -0.38 (immediate), -0.38 (1 week to 2 months) and -0.49 (6 to 9 months). SMDs for prejudice outcomes across all studies ranged from -2.94 (95% CI -3.52 to -2.37) to 2.40 (95% CI 0.62 to 4.18). The median SMDs indicate that mass media interventions may have a small to medium effect in decreasing prejudice, and are equivalent to reducing the level of prejudice from that associated with schizophrenia to that associated with major depression. The studies were very heterogeneous, statistically, in their populations, interventions and outcomes, and only two meta-analyses within two subgroups were warranted. Data on secondary outcomes were sparse. Cost data were provided on request for three studies (n = 416), were highly variable, and did not address cost-effectiveness. Two studies (n = 455) contained statements about adverse effects and neither reported finding any. Authors' conclusions Mass media interventions may reduce prejudice, but there is insufficient evidence to determine their effects on discrimination. Very little is known about costs, adverse effects or other outcomes. Our review found few studies in middle- and low-income countries, or with employers or health professionals as the target group, and none targeted at children or adolescents. The findings are limited by the quality of the evidence, which was low for the primary outcomes for discrimination and prejudice, low for adverse effects and very low for costs. More research is required to establish the effects of mass media interventions on discrimination, to better understand which types of mass media intervention work best, to provide evidence about cost-effectiveness, and to fill evidence gaps about types of mass media not covered in this review. Such research should use robust methods, report data more consistently with reporting guidelines and be less reliant on student populations. | http://eprints.lse.ac.uk/62979/ |
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Description:"The primary purpose of this document is to provide local and federal partners with baseline information and survey methods to allow for continued monitoring efforts to evaluate the effectiveness of management actions taken at the Samoa Maritime quarry in Faga'alu, American Samoa. This document summarizes work completed between 2012 and 2014, and was coordinated and funded by the National Oceanic and Atmospheric Administration (NOAA) Coral Reef Conservation Program (CRCP) to gather baseline data and information before management interventions such as drainage systems, alternative ground cover, and retention ponds were installed at the quarry to reduce land-based sources of pollution inputs to the coral reefs in Fagaʻalu Bay. The work was funded through direct investments made by the NOAA CRCP, through a Cooperative Agreement with American Samoa to the Coral Reef Advisory Group (CRAG), and through a domestic grant awarded to San Diego State University (SDSU) titled, 'Monitoring and analysis of sediment accumulation and composition on coral reefs in Faga'alu Bay, American Samoa' which extended previous efforts supported by the Department of Interior Insular Affairs Office through the CRAG. To carry out these baseline assessments, technical and scientific experts from NOAA and SDSU collaborated to gather baseline information to share with local management authorities in American Samoa. These 2012-2014 activities describe the pre-intervention baseline data collection, analysis, and interpretation needed to evaluate the effectiveness of subsequently planned interventions over time. To quantify effectiveness of these interventions, additional long-term monitoring of sediment loads in Faga'alu Stream and coral community structure will be needed for comparison with the baselines presented here. The overall effort required to evaluate the effectiveness of the interventions is large, and requires a close coordination between local and federal efforts"--Page 2. [doi:10.7289/V5BK19C3 (https://doi.org/10.7289/V5BK19C3)]
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What resources specifically related to reentry are available on the NRRC website?
Adults with Behavioral Health Needs under Correctional Supervision: A Shared Framework for Reducing Recidivism and Promoting Recovery.This 2012 report provides a practical framework to assist corrections, mental health, and substance use policymakers and professionals to work collaboratively at the systems level to prioritize scarce treatment and supervision resources for the large number of adults with mental health and substance use disorders who cycle through the criminal justice system. The full report is available at csgjusticecenter.org/substance-abuse/publications/behavioral-health-framework/.
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The NRRC’s homepage provides an array of the most rigorous external research, resources, guidebooks, and tools available on what works to improve reentry outcomes.
The NRRC’s What Works in Reentry Clearinghouse provides easy access to rigorous and important research on the effectiveness of a variety of reentry interventions, programs and practices.
Core Principles for Reducing Recidivism and Improving Other Outcomes for Youth in the Juvenile Justice System.This 2014 report from the Council of State Governments Justice Center (CSG Justice Center) provides in-depth research and recommendations on what works to reduce juvenile reentry recidivism and improve other youth outcomes. It also provides practice- and research-based insights on how to implement the principles effectively, as well as examples of how state and local juvenile justice systems have operationalized the principles through their own reforms. The full report is available at csgjusticecenter.org/youth/publications/juvenile-justice-white-paper/.
Measuring and Using Juvenile Recidivism Data to Inform Policy, Practice, and Resource Allocation.This CSG Justice Center report, also from 2014, provides key recommendations and useful guidance for improving jurisdictional approaches to the measurement, analysis, collection, reporting, and use of recidivism data for youth involved in the juvenile justice system. The full report is available at csgjusticecenter.org/youth/publications/measuring-juvenile-recidivism/.
The NRRC’s Juvenile Reentry page provides an array of the most rigorous external research, resources, guidebooks, and tools available on what works to improve youth reentry outcomes.
The CSG Justice Center’s Youth Program Page provides further information on juvenile justice, school discipline, and juvenile correctional education. | https://www.bja.gov/FAQDetail.aspx?ID=267 |
The purpose of the UMEMS contract was to develop a comprehensive performance measurement, planning, monitoring, evaluation and reporting system, providing the USAID/Uganda Mission and Implementing Partners (IP) that implemented projects in democracy and governance, peacebuilding, economic growth and food security, basic education and health. TMG provided technical expertise in performance monitoring by assisting the Mission to manage large amounts of data and developing and managing a web-base database (Performance Reporting System); evaluation assistance by preparing and conducting evaluations and special studies and documenting and disseminating results; and information dissemination and capacity building for M&E by training, preparing information products, and strengthening information flow.
Under this project, TMG, as subcontractor to Chemonics, was responsible for designing and implementing specific activities and interventions constituting the APEP project. The project was aimed at expanding economic opportunities in the Ugandan agricultural sector by increasing agricultural productivity and marketing of key food and cash crops. Results were achieved through direct agricultural production and marketing competitiveness enhancement measures that impacted farmers, producer organizations, and agribusinesses within sectors including rice. TMG provided short-term technical assistance and one local long-term Commodity Commercialization specialist supporting a variety of production and marketing efforts ranging from farmers’ fields to farm gate to traders and exporters.
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TMG procured construction materials for the International School in Dakar and trained U.S. Embassy personnel in procurement procedures.
TMG conducted an end-of-program evaluation of the Network and Capacity Building (NETCAB).
The evaluation included three interrelated activities: a review of progress made in the implementation of NETCAB and assessment of the development impact of the investment; an institutional analysis of a representative sample of beneficiary institutions; and documentation of lessons learned and best practices identified during the implementation of this program. TMG impacted the building of regional identity and a common language for environmental conservation and natural resource management by enhancing the capacity of various governmental institutions and employing data analysis techniques to evaluate effectiveness and identify best practices.
USAID’s Regional Center for South Africa (USAID/RCSA): Botswana, Zimbabwe, South Africa, and Zambia.
TMG implemented a five-year M&E project for USAID/Liberia to provide a comprehensive performance management, planning, monitoring and evaluation, and reporting system for the Mission. The system measured the performance of development activities toward the achievement of development objectives. The L-MEP was also instrumental in guiding USAID/Liberia in establishing a clear, consistent information flow between the Mission and its IPs; designing a monitoring and evaluation plan for Mission activities to coordinate data gathering, analysis, and dissemination related to each activity, thereby preventing duplication and promoting synergy; and assisting USAID/Liberia to conduct evaluations of selected projects in their portfolios. During implementation, the Mission added monitoring and evaluation of its MCC Threshold Programs to the L-MEP contract and within the first few months of operation, the L-MEP increased collaboration between the USAID Mission Teams and the MCC IPs and developed a plan of action to implement DQAs. The “front-loading” of technical assistance for PMP review and database development was essential to putting in place the two most important components of the web-based information management system– a means of generating performance data with a structure for storing, manipulating, retrieving and reporting data, and the GIS platform. Based on experience gained from implementing M&E programs in Nigeria, Tanzania and Uganda, L-MEP completed the development of a sophisticated online data management system, the Performance Indicator Data Base Systems (PIDS) that enabled all IPs to enter their data in a standardized format and enables USAID/Liberia to generate required performance management reports. | https://the-mitchellgroup.com/completed-projects/?pagenum=150&filter |
Fiscal Reform for a Strong Tunisia (FIRST) assists the Ministry of Finance to rationalize tax policy, modernize tax administration, and undertake other fiscal reforms to secure a sound fiscal foundation for economic stability and long-term growth. The project aims to help the Tunisian government improve revenue collection, reduce taxpayer compliance costs, improve the budgeting and expenditure process, and enhance public accountability.
- Implementing Partner: Chemonics International, Inc.
- Duration: 2017-2020
- USAID Investment: $17.3 million
PROJECT OBJECTIVES
- Improve efficiency, transparency and cost of compliance of tax administration.
- Enhance capacity to develop and manage tax policy.
- Enhance capacity to address other fiscal reform priorities as they emerge.
- Improve communications, engagement and consultation on priority reforms.
KEY ACTIVITIES
- Collaborating with the tax administration in development and implementation of a comprehensive compliance strategy to improve fiscal civic responsibility.
- Promoting the current e-Filing system for wider use and therefore reducing the costs and burdens of taxpayer compliance. This activity includes the development and promotion of an e-Filing mobile application, training of tax preparers and accountants on e-Filing, promoting multichannel media and communications campaign on e-Filing, and facilitating access and log on credentials for e-Filing users.
- Implementing a Universal Exchange Platform solution for real-time access to data essential for improving taxpayer compliance and fostering efficiency in tax administration.
- Building capacity within the Ministry of Finance (MoF) Fiscal Analysis Unit to enable the Ministry to better understand current and projected fiscal trends, develop proposals for policy change, evaluate the estimated impacts of policy changes, and assess the effectiveness of tax policies in achieving their intended results.
- Assisting the MoF in utilizing cost effective tools to facilitate two-way communication with the public on tax and broader fiscal issues. This activity includes promoting taxpayer services, increasing public awareness of fiscal reforms, enhancing the MoF image and perception, and improving the MoF’s internal and external communications. | https://www.usaid.gov/tunisia/fact-sheets/first |
This PUB-550: Application and Interpretation of Public Health Data course introduce learners to the application and interpretation of data to assess, design, and justify public health programs. Learners learn the basics of data management and statistical analysis using real-life public health data sets. Learners consider the implications of crafting a clear research question, identifying available and quality data, applying appropriate data analysis methods, and effectively communicating the results. Research standards and ethics are emphasized in contributing to evidence-based public health practice. Prerequisite: PUB-540.
What is public health?
Public health has been defined as the science and art of preventing disease, prolonging life, and improving quality of life through organized efforts and informed choices of society, organizations (public and private), communities, and individuals.
What is public health data?
Public health data refers to the data about public health which is essential in performing a reliable and valid public health research. Additionally, this public health data can be used to evaluate program impact, to determine appropriate public health interventions, to monitor progress, to determine populations to target for an intervention, to determine barriers to care, and to influence public policy.
Main sources of public health data.
There are various sources of public health data. However, there are some sources that are considered major over the others. Some of the main sources of health statistics include:
- Surveys,
- Administrative and medical records,
- Claims data,
- Vital records,
- Surveillance
- Disease registries and
- Peer-reviewed literature.
Public health data which has been collected from the above sources is very useful. However, in order to gain the maximum benefit from the data, it needs to be analyzed. Therefore, health care facilities often hire public health data analysts to help them with analyzing the data. A public health data analyst is someone who works within the public health sector and spends their time gathering and analyzing data related to general or specific issues. He/she provides effective solutions to social problems that affect the health of a community by conducting and analyzing research. Additionally, a public health data analyst may also conduct site visits to evaluate the performance of an organization or calculate the costs to health care programs in a specific region.
One of the reasons why public health data is collected and analyzed is to ensure efficient public health surveillance.
Foundations of Public Health Nursing Assignment Help!
What is Public health surveillance?
Public health surveillance involves the collection and interpretation of the public health data which has been collected to facilitate the prevention and control of the disease. Most importantly, surveillance for a disease or other health problem should have clear objectives in order to achieve all the objectives of public health surveillance.
Public health data collected as part of a public health surveillance system can be used for the following purposes:
- To estimate the magnitude of a problem.
- To identify groups at higher risk of having poorer outcomes.
- This public health data is used to examine relationships between risk factors and outcomes.
- After proper analysis of the public health data collected, health specialists are able to develop interventions and with continued monitoring assess the effectiveness of the intervention.
Steps in carrying out public health surveillance
Reporting
Health care providers who provide clinical care, such as doctors, nurses, clinical officers, etc have to record the data. They complete a form recording various bits of information about patients seen in their practice.
Data accumulation
Someone in the Ministry of Health, the local health authorities, or the organization coordinating surveillance has to be responsible for collecting the data from all the reporters and putting it all together.
Data analysis
Often, an epidemiologist with specific data analysis and computer skills has to look at the data to calculate rates of disease, changes in disease rates, etc.
Judgment and action
Frequently, the public health authorities at the local, provincial, or national level have to decide, based on the results of the analysis, what needs to be done. In emergencies, it is often a joint opinion of local and national health authorities, the organization coordinating health, and all the organizations providing health services. | https://nursingessayhelp.org/public-health-data-interpretation/ |
Michelle N Eakin, Sandra Zaeh, Thomas Eckmann, Elizabeth Ruvalcaba, Cynthia S Rand, Marisa E Hilliard, Kristin A RiekertJAMA pediatrics 2020 Dec 01
Asthma is the most common chronic childhood disease, with Black children experiencing worse morbidity and mortality. It is important to evaluate the effectiveness of efficacious interventions in community settings that have the greatest likelihood of serving at-risk families. To evaluate the effectiveness of a multilevel home- and school (Head Start)-based asthma educational program compared with a Head Start-based asthma educational program alone in improving asthma outcomes in children. This randomized clinical trial included 398 children with asthma enrolled in Head Start preschool programs in Baltimore, Maryland, and their primary caregivers. Participants were recruited from April 1, 2011, to November 31, 2016, with final data collection ending December 31, 2017. Data were analyzed from March 18 to August 30, 2018. Asthma Basic Care (ABC) family education combined with Head Start asthma education compared with Head Start asthma education alone. Asthma control as measured by the Test for Respiratory and Asthma Control in Kids (TRACK) score. Among the 398 children included in the analysis (247 boys [62.1%]; mean [SD] age, 4.2 [0.7] years), the ABC plus Head Start program improved asthma control (β = 6.26; 95% CI, 1.77 to 10.75; P < .001), reduced courses of oral corticosteroids (β = -0.61; 95% CI, -1.13 to -0.09; P = .02), and reduced hospitalizations (odds ratio, 0.36; 95% CI, 0.21-0.61; P < .001) during a 12-month period. In this randomized clinical trial, combined family and preschool asthma educational interventions improved asthma control and reduced courses of oral corticosteroids and hospitalizations. Multilevel interventions implemented in community settings that serve low-income minority families may be key to reducing disparities in asthma outcomes. ClinicalTrials.gov Identifier: NCT01519453. | https://accounts.public.ce.basespace.illumina.com/b/search/article.nb?id=33016987 |
The mitigation hierarchy has been proposed as an overarching framework for managing fisheries and reducing marine megafauna bycatch, but requires empirical application to show its practical utility. Focusing on a small-scale fishing community in Peru as a case study system, we test how the mitigation hierarchy can support efforts to reduce captures of sea turtles in gillnets and link these actions to broader goals for biodiversity. We evaluate three management scenarios by drawing on ecological risk assessment (ERA) and qualitative management strategy evaluation to assess trade-offs between biological, economic, and social considerations. The turtle species of management focus include leatherback turtle Dermochelys coriacea, green turtle Chelonia mydas, and olive ridley turtle Lepidochelys olivacea. Adopting a mixed-methods iterative approach to data collection, we undertook a literature review to collate secondary data on the fishery and the species of turtles captured. We then collected primary data to fill the knowledge gaps identified, including establishing the spatial extent of the fishery and calculating turtle capture rates for the fishery. We identified and evaluated the potential risk that the fishery poses to each turtle species within Pacific East regional management units using a qualitative ERA. Finally, we evaluated potential management strategies to reduce turtle captures, incorporating stakeholder preference from questionnaire-based surveys and considering preliminary estimates of trends across a range of performance indicators. We illustrate how the proposed framework can integrate existing knowledge on an issue of marine megafauna captures, and incorporate established decision-making processes to help identify data gaps. This supports a holistic assessment of management strategies toward biodiversity goals standardized across fisheries and scales.
Bycatch poses a significant threat to marine megafauna, such as elasmobranchs. India has one of the highest elasmobranch landings globally, through both targeted catch and bycatch. As elasmobranchs contribute to food and livelihood security, there is a need for holistic approaches to bycatch mitigation. We adopt an interdisciplinary approach to critically assess a range of hypothetical measures for reducing elasmobranch capture in a trawler fishery on India's west coast, using a risk-based mitigation hierarchy framework. Data were collected through landing surveys, interviews and a literature review, to assess the following potential management options for their technical effectiveness and socioeconomic feasibility: (1) spatio-temporal closures; (2) net restrictions; (3) bycatch reduction devices (BRDs); and (4) live onboard release. Our study provides the first evidence-based and nuanced understanding of elasmobranch bycatch management for this fishery, and suggestions for future conservation and research efforts. Onboard release may be viable for species like guitarfish, with moderate chances of survival, and was the favored option among interview respondents due to minimal impact on earnings. While closures, net restrictions and BRDs may reduce elasmobranch capture, implementation will be challenging under present circumstances due to the potentially high impact on fisher income. Interventions for live release can therefore be used as a step toward ameliorating bycatch, while initiating longer-term engagement with the fishing community. Participatory monitoring can help address critical knowledge gaps in elasmobranch ecology. Spatio-temporal closures and gear restriction measures may then be developed through a bottom-up approach in the long term. Overall, the framework facilitated a holistic assessment of bycatch management to guide decision-making. Scaling-up and integrating such case studies across different species, fisheries and sites would support the formulation of a meaningful management plan for elasmobranch fisheries in India.
Much research and policy effort is being expended on ways to conserve living nature while enabling the economic and social development needed to increase equity and end poverty. We propose this will only be possible if policy shifts away from conservation targets that focus on avoiding losses towards processes that consider net outcomes for biodiversity.
Efforts to conserve biodiversity comprise a patchwork of international goals, national-level plans, and local interventions that, overall, are failing. We discuss the potential utility of applying the mitigation hierarchy, widely used during economic development activities, to all negative human impacts on biodiversity. Evaluating all biodiversity losses and gains through the mitigation hierarchy could help prioritize consideration of conservation goals and drive the empirical evaluation of conservation investments through the explicit consideration of counterfactual trends and ecosystem dynamics across scales. We explore the challenges in using this framework to achieve global conservation goals, including operationalization and monitoring and compliance, and we discuss solutions and research priorities. The mitigation hierarchy’s conceptual power and ability to clarify thinking could provide the step change needed to integrate the multiple elements of conservation goals and interventions in order to achieve successful biodiversity outcomes. | https://www.researchgate.net/project/Mitigation-and-Conservation-Hierarchy |
monitor and assess the impact of interventions in relation to proposed outcomes.
evaluate the impact and demonstrate the effectiveness of your actions.
policies and resources for you to adapt and use in your setting.
Understand how you might identify which pupils need support both as individuals and as groups within the school.
Using data to set targets and plan activities.
plan which activities to include and how long an intervention should run for.
An overview of the steps you need to take to monitor the effectiveness of sessions as they take place.
track the progress of the intervention to see if it needs to be adjusted for better impact.
Knowing how to evaluate the session and plan what the pupils should go on to do after it has ended.
provide information on progress and next steps for pupils.
provide objective evidence to others, eg. parents, governors, inspectors etc. that your interventions are having a positive impact on progress.
provide evidence of how pupil premium funding is being used, if appropriate. | https://my.optimus-education.com/shop/interventions-impact-plan-run-and-evaluate-effective-pupil-interventions |
GeoPoll, the mobile engagement platform of Mobile Accord, provides real-time mobile data collection, insights and analytics.
The company has established relationships with mobile network operators (MNOs) in each country it operates in to engage with subscribers on their networks to conduct surveys. Completing the survey is a free service (whether via text, call or web), reducing the economic barrier for participation. The GeoPoll platform allows bilateral donors and their implementing partners, multilateral organizations, NGOs, national governments, research institutes, universities, and private sector companies to implement behavior change communication campaigns, monitor and evaluate indicators that measure the impact of program interventions, and make informed programming decisions related to beneficiaries' resilience with real time analysis and insights from mobile data. An illustrative example includes GeoPoll's on-going food security analysis on behalf of the WFP in over 10 countries across Africa. GeoPoll is using mobile based data collection to access some of the region's most hard to reach communities and capture critical data on food consumption, coping behaviors, market prices, perceptions of food security, and diet diversity of women. International donors, local governments, and other stakeholders are using the publically published data to track the situation on the ground and design appropriate humanitarian interventions for beneficiaries. | https://climateasap.org/directory/mobile-accord-inc-mai/ |
GeoPoll, the mobile engagement platform of Mobile Accord, provides real-time mobile data collection, insights and analytics.
The company has established relationships with mobile network operators (MNOs) in each country it operates in to engage with subscribers on their networks to conduct surveys. Completing the survey is a free service (whether via text, call or web), reducing the economic barrier for participation. The GeoPoll platform allows bilateral donors and their implementing partners, multilateral organizations, NGOs, national governments, research institutes, universities, and private sector companies to implement behavior change communication campaigns, monitor and evaluate indicators that measure the impact of program interventions, and make informed programming decisions related to beneficiaries' resilience with real time analysis and insights from mobile data. An illustrative example includes GeoPoll's on-going food security analysis on behalf of the WFP in over 10 countries across Africa. GeoPoll is using mobile based data collection to access some of the region's most hard to reach communities and capture critical data on food consumption, coping behaviors, market prices, perceptions of food security, and diet diversity of women. International donors, local governments, and other stakeholders are using the publically published data to track the situation on the ground and design appropriate humanitarian interventions for beneficiaries. | https://climateasap.org/directory/mobile-accord-inc-mai/ |
If you have ever been in a car accident, you know that you and any other passengers present are exposed to rapid movements associated with accelerations, decelerations and swerving. Vehicles in Georgia and across the country are subject to safety ratings that rank how they can protect you in the event of a crash, otherwise known as crashworthiness.
Car manufacturers should design a vehicle with an effective design that takes the forces associated with a car crash and spreads them across the car to places that are built to take a hit. Some of the factors that play a role in crashworthiness include the following:
The Insurance Institute for Highway Safety analyzes these areas as well as other factors to determine crashworthiness and then assigns vehicles a score. Consumers can visit the IIHS website to view how their vehicles rank and potential problem areas.
Crashworthiness is also an important factor for people who are injured due to a defect in the vehicle. If the manufacturer failed to design the vehicle to protect a driver and/or passengers, the company could be held liable for damages.
A claim based on crashworthiness is considered separate from a claim that stems from the actual cause of the incident. For example, if someone runs a red light and strikes your car, you may be able to hold that driver responsible for some of your damages. If there was a defect with your seatbelt, leading to worse injuries than you may have otherwise sustained, you may be able to hold the manufacturer responsible for your worsened condition.
While this information may be useful, it should not be taken as legal advice. | https://www.butlerwootenpeak.com/2016/01/what-does-crashworthiness-mean-in-relation-to-vehicles/ |
Today the United Nations General Assembly adopted a resolution which represents the strongest ever commitment on road safety made by UN Member States.
Today the UN General Assembly adopted a resolution which represents the strongest ever commitment on road safety made by UN Member States.
The Chevrolet Sail has been rated as zero star in the Latin New Car Assessment Programme (Latin NCAP).
The latest crash test results of the New Car Assessment Programme for Latin America and the Caribbean, Latin NCAP.
Global car safety organizations, consumer advocate Ralph Nader to hold news conference and webcast to unveil latest car crash test results.
Results from Euro NCAP's latest quadricycle crash tests misrepresented by Bajaj.
Euro NCAP continues its assessment of heavy quadricycles and today releases the safety ratings of four such vehicles.
The latest research report launched by Latin NCAP "Car Industry in Mexico – Safety Issues Nissan Mexicana Tsuru". | http://www.globalncap.org/2016/04/ |
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VSC-A Project – System Update June 17, 2009
VSC-A Project • 3 year project - December 2006 to December 2009 • Collaborative effort between 5 OEMs ( Ford, GM, Honda, Mercedes & Toyota) and US DOT • Goal: Determine if DSRC @5.9 GHz & vehicle positioning can improve upon autonomous vehicle-based safety systems and/or enable new communication-based safety applications • Follow-on project to CAMP/US DOT VSC I (2002-2004) project and CAMP internal Emergency Electronic Brake Lights (EEBL) project • Strong emphasis on resolving current communication and vehicle positioning issues so that interoperable future deployment of DSRC+Positioning based safety systems will be enabled
VSC-A Main Objectives • Develop scalable, common vehicle safety communication architecture, protocols, and messaging framework necessary to achieve interoperability and cohesiveness among different vehicle manufacturers • Standardize this messaging framework and the communication protocols (including message sets) to facilitate future deployment • Develop accurate and commercially feasible relative vehicle positioning technology needed, in conjunction with the 5.9 GHz DSRC, to support most of the safety applications with high potential benefits • Develop and verify (on VSC-A system test bed) a set of objective test procedures for the selected vehicle safety communications applications
VSC-A Research Activities and Timeline 2007 2008 2009 Crashscenarios & safety apps. selection DSRC+Positioning and autonomous Sensing safety system analysis April 2009 June 2008 Level II test bed implementation DSRC+Positioning safety system conops, requirements and minimum perf. specs. Level I test bed implementation Vehicle safety system test bed System design, algorithms (path prediction, threat, warning) & in-vehicle integration Relative vehicle positioning development Message composition, standardization, security and communication protocols Objective test procedures development System testing and objective test procedures Coordination with standards development activities and other USDOT programs SAE, IEEE DSRC, CICAS-V, VII, Europe Car2Car, Japan ASV Benefit analysis support to USDOT, Volpe & Noblis
VSC-A System DevelopmentSelection of Safety Applications • Selection of the VSC-A safety applications based on a US DOT crash scenarios study1 • Selection process of the applications also considered: • Taking advantage of 5.9 GHz DSRC omnidirectionality & range to build system with set of safety applications running simultaneously • Including currently challenging scenarios (for radar & vision) such as intersecting and oncoming direction paths • The VSC-A Team and USDOT jointly “mapped” the proposed safety applications to the recommended crash scenarios 1 “VSC-A Applications_NHTSA - CAMP Comparison v2” document, USDOT, May 2 2007
Safety Applications vs. Crash Scenarios Mapping EEBL: Emergency Electronic Brake Lights FCW: Forward Collision Warning BSW: Blind Spot Warning LCW: Lane Change Warning IMA: Intersection Movement Assist DNPW: Do Not Pass Warning Note: Crash Scenario reference: “VSC-A Applications_NHTSA-CAMP Comparison v2” document, USDOT, May 2 2007. Selected based on 2004 General Estimates System (GES) data and Top Composite Ranking (High Freq., High Cost and High Functional Years lost). | https://www.slideserve.com/faxon/vsc-a-project-system-update-june-17-2009-powerpoint-ppt-presentation |
Doug Smith Kia understands that there can be confusion surrounding the two different safety ratings that are given to vehicles. When you're shopping around for a car or truck to drive around American Fork, understanding safety ratings can help you make a good choice.
The two organizations that perform crash tests are the IIHS and the NHTSA. The IIHS is a non-profit organization that receives its funding from car insurance companies. The NHTSA is a government organization.
To determine a vehicle's rating, the NHTSA performs both front and side collision tests. They'll also determine the rollover potential of a vehicle by looking at its center of gravity and width. Results are given on five-star scale. The IIHS performs five different collision tests to determine the safety of a vehicle. Their rating system uses Poor, Marginal, Acceptable, and Good. Vehicles can also be given a Top Safety Pick designation. | https://www.dougsmithkia.com/blog/2019/august/29/differences-in-car-safety-ratings.htm?locale=en_US |
Well, dang it, Sunday was the last day of National Drowsy Driving Prevention Week and I must have slept right through it. The National Safety Council set November 3-10 as a week to remind drivers that drowsy driving is impaired driving. And, even if you survive a crash, there are some pretty stiff penalties.
COMPARING DROWSY DRIVING TO DRUNK DRIVING
We all know when we’ve had a little too much to drink and shouldn’t drive. But signs of fatigue are said to be hard to identify. And they are both just as fatal. The similarities of driving drowsy or under the influence of alcohol include a slower reaction time, inattention or decreased awareness to hazardous situations and impaired judgment. Both are said to be three times more likely to cause a crash. Driving after 20 hours without sleep is also the equivalent of driving with a blood-alcohol concentration of .08 (which is the legal limit).
DETERMINING WHAT CAUSED THE CRASH
Of course it is difficult to determine the cause of a fatal crash due to drowsy driving. According to The National Sleep Foundation, there are a number of clues at the crash site that indicate this particular cause. Usually there is only one vehicle involved in the crash and the only person in the vehicle is the driver. Also, their injuries tend to be less life-threatening since they were likely asleep (completely relaxed) at the wheel when the crash occurred. Plus, no skid marks on the road (only in their undershorts).
GETTING THE POLICE INVOLVED
Of course there are tests to determine if a driver has been drinking. But there is no blood test, breath test or other objective test for drowsiness behind the wheel. This makes it difficult for police to identify drowsiness as the cause. But several states have passed laws where the police can charge a driver with criminal negligence if they injure or kill someone while driving while sleep impaired. | https://comedydefensivedriving.com/national-drowsy-driving-prevention-week/ |
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Comparison of EuroNCAP assessments with injury causation in accidents
Technical Paper
2001-06-0034
Published June 04, 2001 by National Highway Traffic Safety Administration in United States
Sector:
Language: English
Abstract
In this analysis, body-region injury-risk ratings determined for consumers by EuroNCAP are examined from the perspective of real contemporary accidents. The aim is to compare the real-life experience of various occupants with the objective and subjective conclusions that are presented by EuroNCAP. The accident sample, of several car models, is taken from the Cooperative Crash Injury Study (CCIS), and is comprised of crashes similar to the impact tests. CCIS is the in-depth project that analyses a sample of severe car accidents and provides the foundation of much of the UK's secondary car-safety research program. The European New Car Assessment Program (EuroNCAP) has had a significant influence on the way that cars are designed. Objective measurements from frontal and side impact tests of each vehicle are augmented by assessments based on real-world accident investigation experience.
Using real-world car accidents that are as similar as possible to the EuroNCAP impact tests, detailed accident cases are analyzed to determine the injuries to the occupants; the body-region severities; the causes of the injuries; and the global patterns of damage to the vehicle. | https://saemobilus.sae.org/content/2001-06-0034/ |
Always check to confirm that you are adhering to the current year’s regulations on the use of safety car seats.
State of Virginia Resources:
Virginia Department of Motor Vehicles – Guidelines for purchasing, installing and positioning of car seats.
Virginia Department of Health – A list of permanent Safety Seat Check Stations and One Day Events. Don’t forget to call ahead for an appointment.
Virginia Dept. of Health, Center for Injury and Violence Prevention 800.732.8333 – Child safety seat reference materials and handouts.
Federal Government Resources:
National Highway Traffic Safety Administration (NHTSA) – Provides information on child passenger safety, including car seat safety, Ease of Use ratings, and driveway backover accidents.
SaferCar.gov – The NHTSA website that provides information on equipment (including car seats), crash test and rollover ratings, defects and recalls.
U.S. Department of Transportation/ NHTSA; Auto Safety Hotline 800.424.9393- For information on recalls/issue safety notices.
Other Resources:
The American Academy of Pediatrics – Car Safety Seats and General Transportation Safety for children ages 1 to 21. | https://www.completelykidsrichmond.com/resources/car-safety-seats/ |
The National Highway Traffic Safety Administration (NHTSA) rates a vehicle’s rollover potential in two different ways: First, it determines a vehicle’s static stability factor (SSF), or a calculation of rollover resistance while the vehicle is at rest. The second measure is an on-road rollover test that examines how likely a vehicle is to tip based on its handling. A vehicle’s rollover resistance (given from one to five stars) is then based on a combination of both on-road and at-rest test scores.
The on-road test is performed on most new SUVs, pickup trucks, and minivans. These vehicles go through a series of typical road maneuvers, including a quick left-right turn, a fishhook turn, and speeds that increase from 35 to 50 mph (to discover how the vehicle responds to a sudden change in direction). If the vehicle lifts two wheels off the ground during any maneuver, it has failed the test; if the vehicle keeps all wheels on the ground (or slides, but recovers), it passes.
How SUV “Star” Ratings May Differ from True Rollover Protection
Even if your vehicle was given a multiple-star safety rating, you should know that this does not necessarily mean you are at less risk of a rollover crash—especially if you drive an SUV. Although many SUVs have “tipped up” during NHTSA on-road testing, their star ratings are minimally affected by the failure. This is because the government's rollover ratings rely much more on SSF than on-road testing, despite the fact that the road test is a more true-to-life demonstration of the vehicle’s responses in a crash.
If you drive an SUV or van, you should find out what your car’s rollover safety rating really is at www.safercar.gov. Here, you can find out each of your vehicle’s individual safety ratings as well as how your car scored on the on-road performance test (under Dynamic Test Result).
Are your fellow SUV drivers at risk on the road? Share a link to this article on Facebook or Google+ to make sure they know what their car’s real safety rating is!
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Related Links: | https://www.mfrlawoffice.com/faqs/do-you-know-what-your-vehicle-s-rollover-safety-rating-is-.cfm |
In general the passive safety capability is much greater in newer versus older cars due to the stiff compartment preventing intrusion in severe collisions. However, the stiffer structure which increases the deceleration can lead to a change in injury patterns. In order to analyse possible injury mechanisms for thoracic and lumbar spine injuries, data from the German Inâ€Depth Accident Study (GIDAS) were used in this study. A twoâ€step approach of statistical and caseâ€byâ€case analysis was applied for this investigation. In total 4,289 collisions were selected involving 8,844 vehicles, 5,765 injured persons and 9,468 coded injuries. Thoracic and lumbar spine injuries such as burst, compression or dislocation fractures as well as soft tissue injuries were found to occur in frontal impacts even without intrusion to the passenger compartment. If a MAIS 2+ injury occurred, in 15% of the cases a thoracic and/or lumbar spine injury is included. Considering AIS 2+ thoracic and lumbar spine, most injuries were fractures and occurred in the lumbar spine area. From the case by case analyses it can be concluded that lumbar spine fractures occur in accidents without the engagement of longitudinals, lateral loading to the occupant and/or very severe accidents with MAIS being much higher than the spine AIS.
One main objective of the EU-Project SENIORS is to provide improved methods to assess thoracic injury risk to elderly occupants. In contribution to this task paired simulations with a THOR dummy model and human body model will be used to develop improved thoracic injury risk functions. The simulation results can provide data for injury criteria development in chest loading conditions that are underrepresented in PMHS test data sets that currently proposed risk functions are based on. To support this approach a new simplified generic but representative sled test fixture and CAE model for testing and simulation were developed. The parameter definition and evaluation of this sled test fixture and model is presented in this paper. The justification and definition of requirements for this test set-up was based on experience from earlier studies. Simple test fixtures like the gold standard sled fixture are easy to build and also to model in CAE, but provide too severe belt-only loading. On the other hand a vehicle buck including production components like airbag and seat is more representative, but difficult to model and to be replicated at a different laboratory. Furthermore some components might not be available for physical tests at later stage. The basis of the SENIORS generic sled test set-up is the gold standard fixture with a cable seat back and foot rest. No knee restraint was used. The seat pan design was modified including a seat ramp. The three-point belt system had a generic adjustable load limiter. A pre-inflated driver airbag assembly was developed for the test fixture. Results of THOR test and simulations in different configurations will be presented. The configurations include different deceleration pulses. Further parameter variations are related to the restraint system including belt geometry and load limiter levels. Additionally different settings of the generic airbag were evaluated. The test set-up was evaluated and optimized in tests with the THOR-M dummy in different test configurations. Belt restraint parameters like D-ring position and load limiter setting were modified to provide moderate chest loading to the occupant. This resulted in dummy readings more representative of the loading in a contemporary vehicle than most available PMHS sled tests reported in the literature. However, to achieve a loading configuration that exposes the occupant to even less severe loading comparable to modern vehicle restraints it might be necessary to further modify the test set-up. The new generic sled test set-up and a corresponding CAE model were developed and applied in tests and simulations with THOR. Within the SENIORS project with this test set-up also volunteer and PMHS as well as HBM simulations are performed, which will be reported in other publications. The test environment can contribute in future studies to the assessment of existing and new frontal impact dummies as well as dummy improvements and related instrumentation. The test set-up and model could also serve as a new standard test environment for PMHS and volunteer tests as well as HBM simulations.
In the EC FP6 Integrated Project Advanced Protection Systems, APROSYS, the first WorldSID small female prototype was developed and evaluated by BASt, FTSS, INRETS, TRL and UPM-INSIA during 2006 and 2007. Results were presented at the ESV 2007 conference (Been et al., 2007). With the prototype dummy scoring a biofidelity rating higher than 6.7 out of 10 according to ISO/TR9790, the results were very promising. Also opportunities for further development were identified by the evaluation group. A revised prototype, Revision1, was subsequently developed in the 2007-2008 period to address comments from the evaluation group. The Revision1 dummy includes changes in the half arms and the suit (anthropometry and arm biomechanics), the thorax and abdomen ribs and sternum (rib durability), the abdomen/lumbar area and the lower legs (mass distribution). Also a two-dimensional chest deflection measurement system was developed to measure deflection in both lateral and anterior-posterior direction to improve oblique thorax loading sensitivity. Two Revision1 prototype dummies have now been evaluated by FTSS, TRL, UPM-INSIA and BASt. The updated prototype dummies were subjected to an extensive matrix of biomechanical tests, such as full body pendulum tests and lateral sled impact tests as specified by Wayne State University, Heidelberg University and Medical College of Wisconsin. The results indicated a significant improvement of dummy biofidelity. The overall dummy biofidelity in the ISO rating system has significantly improved from 6.7 to 7.6 on a scale between 0-10. The small female WorldSID has now obtained the same biofidelity rating as the WorldSID mid size male dummy. Also repeatability improved with respect to the prototype. In conclusion the recommended updates were all executed and all successfully contributed in achieving improved performance of the dummy.
Thorax injury is one of main causes of serious injury in frontal collisions, especially for elderly car occupants. The anthropometric test device (ATD) THOR‐M provides chest deflection measurements at multiple locations, to assess the risk of thorax injury. For this purpose e, risk functions are needed that relate the potential criteria based on multipoint chest deflection measurement to in jury risk. Different thorax injury criteria and risk functions for THOR have been proposed [2‐3]. The criteria and functions are based on the traditional approach to developing injury risk functions using matched ATD and PMHS tests by relating the injury (number of fractures) to injury criteria. Regarding these studies, some limitations have been identified, in particular concerning the loading conditions of the data used (mainly 3‐point‐belt loading, high loading severity, out‐of‐date ATD versions. To extend the data set and overcome these limitations, a new approach for improved thorax injury criteria was applied within the EC‐funded project SENIORS. The new approach is based on matched frontal impact sled computer simulations with a model representing the latest THOR‐M ATD version, and matching simulations with a human body model (HBM) representing an elderly car occupant.
Improved thoracic injury risk functions for the THOR-M-50 developed in a new simulation-based approach (2019)
To assess occupant safety in a crash test, criteria associating the measurements made with a crash test dummy to injury risk are necessary. To enable better protection of elderly car occupants the objective of this study was to develop improved thoracic injury criteria for the THOR average male dummy. The development of these criteria is usually based on matched dummy and Post Mortem Human Surrogate (PMHS) tests by relating the obtained PMHS injuries to dummy measurements. This approach is limited, since only a few tests in relevant loading conditions are available and any new test series requires high efforts to be performed due to their complexity and costs. To overcome these limitations and to extend the dataset for the development of THOR dummy chest injury risk functions a simulation-based approach was applied within the EC funded project SENIORS (Safety Enhanced Innovations For older Road Users - www.seniors-project.eu). Within this study frontal impact sled simulations with an FE model representing a THOR average male dummy and matched simulations with a human body model (HBM) representing an elderly car occupant were carried out. The HBM used for this study was the THUMS TUC with modified rib cage, which was developed in SENIORS. The modifications included material and geometry changes aiming to represent an elderly car occupant. The rib fracture risk was predicted with a deterministic approach whereby a rib was considered broken when the strain exceeded an age-dependent threshold. Furthermore, a probabilistic method was applied to predict the probability of sustaining a certain number of fractured ribs by comparing local strain values to the distribution of cortical rib ultimate strain. By relating the output from the HBM simulations to a multi-point dummy injury criterion, injury risk curves were calculated by statistical methods. The wide range of loading conditions resulted in the desired range of injuries and THOR ATD output. The number of fractured ribs predicted by the HBM based on the deterministic prediction method was between 0 and 15. Furthermore, the probabilistic risk for the number of rib fractures equal or greater than two, three or four was calculated for each load case. The THOR rib deflection criterion Rmax was between 18 and 56 mm, while the PC Score was in the range of 2.5 to 7.2. Based on these outputs new risk curves for the predicted deterministic (AIS2+/3+) and probabilistic injury risk were calculated. The new curves show reasonable shapes and significance that provide trust in their application. The new risk curves are compared to risk curves obtained by traditional methods. The results were found similar to previous injury risk functions based on physical tests, which gives a high level of confidence in the chosen approach. The simulation-based approach of matched ATD model vs. HBM simulation was successfully applied. Rmax curves show a slightly better quality than the injury criterion PC Score.
The Repeatability and reproducibility of the BioRID IIg in a repeatable laboratory seat based on a production car seat
The United Nations Economic Commission for Europe Informal Group on GTR No. 7 Phase 2 are working to define a build level for the BioRID II rear impact (whiplash) crash test dummy that ensures repeatable and reproducible performance in a test procedure that has been proposed for future legislation. This includes the specification of dummy hardware, as well as the development of comprehensive certification procedures for the dummy. This study evaluated whether the dummy build level and certification procedures deliver the desired level of repeatability and reproducibility. A custom-designed laboratory seat was made using the seat base, back, and head restraint from a production car seat to ensure a representative interface with the dummy. The seat back was reinforced for use in multiple tests and the recliner mechanism was replaced by an external spring-damper mechanism. A total of 65 tests were performed with 6 BioRID IIg dummies using the draft GTR No.7 sled pulse and seating procedure. All dummies were subject to the build, maintenance, and certification procedures defined by the Informal Group. The test condition was highly repeatable, with a very repeatable pulse, a well-controlled seat back response, and minimal observed degradation of seat foams. The results showed qualitatively reasonable repeatability and reproducibility for the upper torso and head accelerations, as well as for T1 Fx and upper neck Fx. However, reproducibility was not acceptable for T1 and upper neck Fz or for T1 and upper neck My. The Informal Group has not selected injury or seat assessment criteria for use with BioRID II, so it is not known whether these channels would be used in the regulation. However, the ramping-up behavior of the dummy showed poor reproducibility, which would be expected to affect the reproducibility of dummy measurements in general. Pelvis and spine characteristics were found to significantly influence the dummy measurements for which poor reproducibility was observed. It was also observed that the primary neck response in these tests was flexion, not extension. This correlates well with recent findings from Japan and the United States showing a correlation between neck flexion and injury in accident replication simulations and postmortem human subjects (PMHS) studies, respectively. The present certification tests may not adequately control front cervical spine bumper characteristics, which are important for neck flexion response. The certification sled test also does not include the pelvis and so cannot be used to control pelvis response and does not substantially load the lumbar bumpers and so does not control these parts of the dummy. The stiffness of all spine bumpers and of the pelvis flesh should be much more tightly controlled. It is recommended that a method for certifying the front cervical bumpers should be developed. Recommendations are also made for tighter tolerance on the input parameters for the existing certification tests.
Thoracic injuries are one of the main causes of fatally and severely injured casualties in car crashes. Advances in restraint system technology and airbags may be needed to address this problem; however, the crash test dummies available today for studying these injuries have limitations that prevent them from being able to demonstrate the benefits of such innovations. THORAX-FP7 was a collaborative medium scale project under the European Seventh Framework. It focused on the mitigation and prevention of thoracic injuries through an improved understanding of the thoracic injury mechanisms and the implementation of this understanding in an updated design for the thorax-shoulder complex of the THOR dummy. The updated dummy should enable the design and evaluation of advanced restraint systems for a wide variety (gender, age and size) of car occupants. The hardware development involved five steps: 1) Identification of the dominant thoracic injury types from field data, 2) Specification of biomechanical requirements, 3) Identification of injury parameters and necessary instrumentation, 4) Dummy hardware development and 5) Evaluation of the demonstrator dummy. The activities resulted in the definition of new biofidelity and instrumentation requirements for an updated thorax-shoulder complex. Prototype versions were realised and implemented in three THOR dummies for biomechanical evaluation testing. This paper documents the hardware developments and biomechanical evaluation testing carried out.
Injury patterns of older car occupants, older pedestrians or cyclists in road traffic crashes with passenger cars in Europe " results from SENIORS
Europe has benefited from a decreasing number of road traffic fatalities. However, the proportion of older road users increases steadily. In an ageing society, the SENIORS project aims to improve the safe mobility of older road users by determining appropriate requirements towards passive vehicle safety systems. Therefore, the characteristics of road traffic crashes involving the elderly people need to be understood. This paper focuses on car occupants and pedestrians or cyclists in crashes with modern passenger cars. Ten crash databases and four hospital statistics from Europe have been analysed to answer the questions on which body regions are most frequently and severely injured in the elderly, and specific injuries sustained by always comparing older (65 years and above) with midâ€aged road users (25â€64 years). It was found that the body region thorax is of particularly high importance for the older car occupant with injury severities of AIS2 or AIS3+, where as the lower extremities, head and the thorax need to be considered for older pedestrians and cyclists. Further, injury risk functions were provided. The hospital data analysis showed less difference between the age groups. The linkage between crash and hospital data could only be made on a general level as their inclusion criteria were quite different.
Road Traffic Crashes in Europe Involving Older Car Occupants, Older Pedestrians or Cyclists in Crashes with Passenger Cars - Results from SENIORS
A reduction of around 48% of all road fatalities was achieved in Europe in the past years including a reduced number of fatalities with an older age. However, among all road fatalities, the proportion of elderly is steadily increasing. In an ageing society, the European (Horizon2020) project SENIORS aims to improve the safe mobility of older road users, who have different transportation habits compared to other age groups. To increase their level of safe mobility by determining appropriate requirements for vehicle safety systems, the characteristics of current road traffic collisions involving the elderly and the injuries that they sustain need to be understood in detail. Hereby, the paper focuses on their traffic participation as pedestrian, cyclist or passenger car occupant. Following a literature review, several national and international crash databases and hospital statistics have been analysed to determine the body regions most frequently and severely injured, specific injuries sustained and types of crashes involved, always comparing older road users (65 years and more) with mid-aged road users (25-64 years). The most important crash scenarios were highlighted. The data sources included European statistics from CARE, data on national level from Germany, Sweden, Italy, United Kingdom and Spain as well as in-depth crash information from GIDAS (Germany), RAIDS (UK), CIREN and NASS-CDS (US). In addition, familiar hospital data from Germany (TraumaRegister DGU-®), Italy (Italian Register of Acute Traumas) and UK hospital statistics (TARN) were included in the study to gain further insight into specific injury patterns. Comprehensive data analyses were performed showing injury patterns of older road users in crashes. When comparing with mid-aged road users, all databases showed that the thorax body region is of particularly high importance for the older car occupant with injury severities of AIS 2 or AIS 3+, whereas the body regions lower extremities, head and thorax need to be considered for the older pedestrians and cyclists. Besides these comparisons, the most frequent and severe top 5 injuries were highlighted per road user group. Further, the most important crash configurations were identified and injury risk functions are provided per age group and road user group. Although several databases have been analysed, the picture on the road safety situation of older road users in Europe was not complete, as only Western European data was available. The linkage between crash data and hospital data could only be made on a general level as their inclusion criteria were quite different.
Safety Enhanced Innovations for Older Road Users (Seniors): Further Development of Test and Assessment Procedures Towards an Improved Passive Protection of Pedestrians and Cyclists
Test and assessment procedures for passive pedestrian protection based on developments by the European Enhanced Vehicle-safety Committee (EEVC) have been introduced in world-wide regulations and consumer test programmes, with considerable harmonization between these programmes. Nevertheless, latest accident investigations reveal a stagnation of pedestrian fatality numbers on European roads running the risk of not meeting the European Union- goal of halving the number of road fatalities by the year 2020. The branch of external road user safety within the EC-funded research project SENIORS under the HORIZON 2020 framework programme focuses on investigating the benefit of modifications to pedestrian test and assessment procedures and their impactors for vulnerable road users with focus on the elderly. Injury patterns of pedestrians and cyclists derived from the German In-Depth Accident Study (GIDAS) show a trend of AIS 2+ and AIS 3+ injuries getting more relevant for the thorax region in crashes with newer cars (Wisch et al., 2017), while maintaining the relevance for head and lower extremities. Several crash databases from Europe such as GIDAS and the Swedish Traffic Accident Data Acquisition (STRADA) also show that head, thorax and lower extremities are the key affected body regions not only for the average population but in particular for the elderly. Therefore, the SENIORS project is focusing on an improvement of currently available impactors and procedures in terms of biofidelity and injury assessment ability towards a better protection of the affected body regions, incorporating previous results from FP 6 project APROSYS and subsequent studies carried out by BASt. The paper describes the overall methodology to develop revised FE impactor models. Matched human body model and impactor simulations against generic test rigs provide transfer functions that will be used for the derivation of impactor criteria from human injury risk functions for the affected body regions. In a later step, the refined impactors will be validated by simulations against actual vehicle front-ends. Prototyping and adaptation of test and assessment procedures as well as an impact assessment will conclude the work of the project at the final stage. The work will contribute to an improved protection of vulnerable road users focusing on the elderly. The use of advanced human body models to develop applicable assessment criteria for the revised impactors is intended to cope with the paucity of actual biomechanical data focusing on elderly pedestrians. In order to achieve optimized results in the future, the improved test methods need to be implemented within an integrated approach, combining active with passive safety measures. In order to address the developments in road accidents and injury patterns of vulnerable road users, established test and assessment procedures need to be continuously verified and, where needed, to be revised. The demographic change as well as changes in the vehicle fleet, leading to a variation of accident scenarios, injury frequencies and injury patterns of vulnerable road users are addressed by the work provided by the SENIORS project, introducing updated impactors for pedestrian test and assessment procedures. | https://bast.opus.hbz-nrw.de/solrsearch/index/search/searchtype/authorsearch/author/David+Hynd/rows/20/start/0/sortfield/author/sortorder/asc |
January 13, 2014
The 2014 model-year Toyota Prius has drawn a Four-Star Overall Rating from the National Highway Traffic Safety Administration as part of the agency’s New Car Assessment Program.
Though the car previously held a Five-Star Overall Rating from NHTSA, the new, lower score reflects a change in scoring criteria rather than a dip in crash test performance. On Dec. 4, 2013, a 2014 Prius liftback scored four stars in the frontal barrier test, which contributed to the lower overall score. The car’s previous NHTSA crash testing occurred in February 2011.
The Prius maintains a Five-Star Rating in the side crash category but has a Four-Star rating in both the frontal crash and rollover categories.
Prius vehicles built after November 2013 and equipped with optional front crash prevention systems, however, did receive the Insurance Institute for Highway Safety’s Top Safety Pick+ award.
Here's some footage of last month's NHTSA crash testing.
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The auto industry continued its poor performance in an influential U.S. safety group's new crash test as half of the small cars tested did not fare well.
Six of the cars tested, most of which were 2013 models, were rated "poor" or "marginal." General Motors' Chevrolet Sonic and Cruze each received marginal scores, while Kia Motors' Soul and 2014 Forte were rated "poor" in the results released on Thursday by the Insurance Institute for Highway Safety.
Nissan Motor's Sentra also was rated "poor," while Volkswagen's Beetle was ranked "marginal."
"This is a challenging new crash test and it's not surprising that some vehicles are earning marginal and poor ratings," IIHS spokesman Russ Radar said of the small overlap front crash test.
"This crash scenario doesn't lend itself to a Band-Aid fix so for most manufacturers the countermeasure will have to be built in when there's a full redesign," he added.
"It matters because in today's world cars are so competitive that all you need is a small flaw and your competition can exploit it," Kelley Blue Book senior analyst Karl Brauer said.
The specifications of the test were not finalized until the last year, which is late in a car's development process, Brauer said. All automakers will eventually redesign their cars to meet the standards to pass the new crash test, he said.
In the tests, IIHS crashes a vehicle at 40 mph into a 5-foot-high barrier on the driver's side that overlaps one-quarter of the vehicle's width.
"We are aggressively working to incorporate these into our models, including our small cars like the Chevrolet Sonic and Cruze, where technically feasible," GM spokeswoman Sharon Basel said in an email.
Nissan and VW said they were proud of their cars' safety records in federal crash tests and other IIHS crash tests, but they would review the small overlap test results and incorporate what is learned into future designs.
In the worst cases with the small cars that did not score well, safety cages collapsed, driver airbags moved sideways and the crash dummy's head hit the instrument panel, and side curtain airbags did not deploy or provide enough protection, IIHS chief research officer David Zuby said.
Last summer, seven of 11 luxury sedans evaluated rated "marginal" or "poor," and 12 of 15 small SUVs tested also failed to score well in results released in May. Family sedans scored the best, with only five of 18 scoring "marginal" or "poor" in results released last December.
The other six small cars tested included two- and four-door versions of Honda Motor Co Ltd's Civic, which both received "good" ratings. The Civic was tested earlier this year and the results were released in March.
Receiving "acceptable" ratings were Chrysler's Dodge Dart, Ford Motor's Focus, Hyundai Motor's Elantra and Toyota Motor's 2014 Scion tC.
All the cars scoring well received "Top Safety Pick " ratings by the insurance trade group. Vehicles earning the institute's "Top Safety Pick " award have received "good" ratings in the four traditional tests plus "good" or "acceptable" ratings in the small overlap test. | https://www.cnbc.com/id/100948443 |
Interesting, thanks for the info. I have two relatively small children who sit in the back seat.Don't put too much stock in the video above. It is for Latin America (Latin NCAP). The cars built in Mexico are for a variety of markets and the US versions are different from the others - especially in regard to safety features (some deleted in other markets).
I couldn't find a direct test result for the 2014 Fiesta at the NHTSA (National Traffic Highway Safety Administration) website regarding a US NCAP (new car assessment program) crash test. But here are some safety ratings for the US model:
2011 & Newer - Search Results | Safercar -- National Highway Traffic Safety Administration (NHTSA)
www.usnews.rankingsandreviews.com/cars-trucks/Ford_Fiesta/Safety/
2013 Ford Fiesta 4 DR FWD | Safercar -- NHTSA
Wish I could find the test results to find out why the car only got 4 out of 5 stars for the frontal crash portion. I did see one site that showed the driver (male) rated at 5 out of 5 stars while the passenger (female) was rated at 4 of 5. | https://www.fiestast.org/threads/ford-fiesta-crash-test.319/ |
Safety ratings are not available at this time.
#1
$49,900 - $58,600 MSRP
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$69,500 - $85,900 MSRP
#3
$42,950 - $52,400 MSRP
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Safety scores reflect crash test standards and ratings when this car was new and may not be comparable to current safety ratings.
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With the release of the 39th edition of The Car Book—now available online—we’re sharing some of our best tips for car buying and maintaining your vehicle after you buy. The Car Book 2019 provides today’s car buyer with in-depth ratings of the 2019 vehicles, The Car Book’s unique crash test ratings, comparative complaint ratings, and all of the information needed to make a smart, safe and informed vehicle purchase. For online users only, the site also includes over 1,000 used car ratings going back five years.
In each edition of The Car Book Blog, we’ll give you key advice on how to buy for safety. If you’re more interested in the safety of yourself and your family than moon roofs or cupholders, these posts are for you.
View the up-to-date catalog of The Car Book Blog below: | https://www.autosafety.org/the-car-book-blog/ |
DETROIT – General Motors said its 2011 Chevrolet Volt is the first electric vehicle to earn a five-star overall score for safety from the National Highway Traffic Safety Administration’s New Car Assessment Program.
GM said that starting with 2011 models; NHTSA introduced tougher tests and more rigorous requirements for its five-star safety ratings program, which are designed to provide more information about safety performance and related vehicle technologies. Changes include a new side pole test simulating a 20-mph side-impact crash into a 10-inch-diameter pole or tree at a 75-degree angle just behind the A-pillar on the driver’s side.
The Volt was also named a 2011 Top Safety Pick by the Insurance Institute for Highway Safety earlier this year.
Volt safety features include the following: | https://www.automotive-fleet.com/74785/2011-volt-earns-five-star-overall-safety-rating |
Special cells in giant clams shift the wavelength of light to protect them from UV radiation and increase the photosynthetic activity of their symbionts, shows research from KAUST-originally intended as a photonics investigation.
A range of information is collated through a simple framework that will help marine scientists to design more accurate experiments that will better help them understand the projected impact of global warming on marine life.
A survey of the shark skin microbiome provides the first step toward understanding the remarkable resilience of shark wounds to infection.In the wild, blacktip reef sharks are often seen bearing wounds, but they rarely exhibit obvious signs of infection around the wounds. As a first step toward understanding this phenomenon, an international team led by researchers at KAUST’s Red Sea Research Center investigated the microbial community living on the skin of sharks.
Giant clams take up a large fraction of marine microplastics, which could help explain the mystery of the plastic that is "missing" from the Red Sea.Researchers at the Red Sea Research Center have shown previously that the Red Sea has relatively low amounts of floating plastic debris in its surface waters, yet the reason for this has remained elusive.
Bacterial DNA sequencing analyses show date palms that are cultivated over a vast stretch of the Tunisian Sahara Desert consistently attract two types of growth-promoting bacteria to their roots, regardless of the location. This finding could help with improving crop cultivation in a warming climate.
Corals are shown to recycle their own waste ammonium using a surprising source of glucose—a finding that reveals more about the relationship between corals and their symbiotic algae.Symbiosis between corals and algae provides the backbone for building coral reefs, particularly in nutrient-poor waters like the Red Sea.
Marine sediments tell the history of an environment, including oil spills. By "reading" sediments from the past century, a research team has now determined how much oil hydrocarbon is accumulated in different vegetated coastal habitats of the Arabian Gulf and the significance of this for environmental management.
The coastal waters of the Red Sea have enough resources to support bacterial growth, but predation by protistan grazers limits the population, according to new research from KAUST. Since bacteria are vital players in the marine food web, determining the factors that affect their growth and abundance is critical to understanding marine ecosystems and how they will respond to climate change.
Mangrove forests on the coasts of Saudi Arabia act as litter traps, accumulating plastic debris from the marine environment, according to new research from KAUST. The study offers an explanation for the fate of missing marine plastic litter and highlights the threat it poses to coastal ecosystems.
A controlled, laboratory approach, along with computer simulations, has helped KAUST researchers to show that bacterial communities can homogenously disperse within aquatic ecosystems even with slow flowing water and the persistence of their preferred, localized conditions.
When species are introduced by humans into marine habitats, they can disrupt their new environment, according to a study at KAUST, which also identified key species for conservation efforts to focus on.
Sticky, sandy sheaths surrounding the roots of three speargrass species growing in the Namib Desert recruit whatever growth-promoting bacteria are available in the surrounding sand. This is contrary to the more specialized root sheaths of plants growing in resource-rich soils, where different plant species recruit different types of bacteria.
The types of bacteria present in and around mangrove fiddler crab burrows in three different geographic locations were compared by KAUST researchers. They found that the crabs' burrowing activity changed the sediment in a way that attracted different types of bacteria across the three locations: however, the bacteria performed similar functions, such as aerobic respiration, and ecological services, such as turnover of organic matter.
Microbial plankton communities will be boosted in productivity and biomass from warmer water temperatures provided sufficient nutrients are also readily available, suggest KAUST researchers.The response of marine ecosystems to global warming depends on complex factors. The growth rates and activity of plankton communities are largely dictated by nutrient availability (bottom-up control), predation (top-down control) and changes in water temperature.
Cryptic fauna—small organisms that inhabit the hidden spaces within a reef structure—represent a substantial proportion of the diversity within coral reefs but are typically neglected in traditional visual surveys, which tend to focus on large and conspicuous species, such as fish and corals. | https://rsrc.kaust.edu.sa/Pages/News.aspx?tag=Discovery |
Soil contains the rich pool of microbial diversity with bacteria, fungi, and viruses. Different layer of soil acting as microbial mats in nature.
Soil contains the rich pool of microbial diversity with bacteria, fungi, and viruses. Different layer of soil acting as microbial mats in nature. Since from last 100 years climatic conditions are changing continuously due to human interference in nature. Microbial survival points are very critical due to change in environmental conditions flora and fauna of the soil also changed. These microbes play important role in global biogeochemical cycles (nitrogen, carbon and phosphorous cycle). Scientist reports the microbial compositions in headwater riparian wetlands and found that wetland soil microbial abundance and community composition varied as function of landscape metrics as mediated through on site edaphic properties.
Soil structure and Microorganisms
Arrangement and organization of primary and secondary soil particles is known as soil structure. Which is mainly responsible for the amount of water and air present in soil. Water and air affected the microbial communities and behavior in soil. Soil layers are approximately parallel to the land surface and several layers may evolve simultaneously over a period of time. In soil science terminology these layers are called horizons. Microbes interacted with each other during different climatic conditions and established the community. Each of the community play important role in large environmental processes.
Effect of climate change on soil biology
Global change is diversifying species prorating and thus communication among organisms.
Microorganism live in contact with thousands of other species, few of them are beneficial and others pathogenic, some which have little to no effect in complex communities. Since natural microbial communities are composed of microorganisms with very different life history traits and dispersal ability it is unlikely they will all respond to climatic change in a similar way. If we see the scientific research papers we can conclude that their is less attention on the soil microbial communities under climatic conditions whereas in plant-pollinator and plant-herbivore interactions under global change have been relatively well described. Soil microorganisms (bacteri and fungi) regulate nutrient transformations, provide plants with nutrients, allow co-existence among neighbors, and control plant populations, changes in soil microorganism-plant interactions could have significant ramifications for plant community composition and ecosystem function. Soil and litter microbial communities are responsible for the majority of decomposition and nutrient mineralization in terrestrial ecosystems and their abundance, community structure, and activity are often directly influenced by abiotic factors such as temperature and precipitation At present we need to know how climatic change affects soil microbes and soil microbe-plant interactions directly and indirectly, and which type of emerging and exciting questions and areas for future research, ramifications changes in these interactions may have on the composition and function of ecosystems.
Methods to study the soil microbial community
To know the environmental effect on soil microbiology we need to know about the recent techniques and development of more techniques for this type of analysis. For coomunti analysis Denaturant gradient gel electrophoresis (DDGE) is a technique to know the total bacterial and fungal population on the basis of their conserved sequences (16S rDNA for bacteria and ITS region sequences for fungi). On the basis of metabolites present in soil we can also identify the group of microorganism from the soil layers. Gas chromatography mass spectroscopy (GC-MS) is the popular technique for the identification of complete metabolites from the layers.
Engineering tools for soil analysis
If we know the compositions of the soil than we can analyze which types of the soil components affected by change in temperature, pH and excess of rain. Now a days different techniques of civil engineering can be applied for soil component analysis. Soil mechanics would be interpret exactly how much clay particles, nutrients, physical forces are responsible for the environmental changes. Because these are the important factors for the soil microbial communities habitat. Even an small component can change the microflora of the soil.
Future Research Plan
Soil biology is critical in all aspect of the life its responsibility of scientist to know more about the soil biology and effect of change in climatic conditions on microbial community in soil. Day by day our environment is changing, increased temperature, alkalinity, acidity, unexpected cloud bursts are the examples of the climate change. Microbes are the part of the environment which cannot be seen by naked eyes but their importance to regulate the various biogeochemical cycles not ignored. Various strains of nitrogen fixing bacteria, waste matter decomposing fungi playing their key roles from past many decades. It is possible due to environmental stress we have lost many of the beneficial microbial strains. Future research on microbiology, chemistry and engineering will help the scientist to solve the problem and safe natural biological process.
© 2013-2014 Scientific India Magazine
Note: This website is for educational Purposes only. | http://www.scind.org/550/Environment/soil-microbial-community-affected-by-climate-change.html |
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Traditional fermented foods represent relatively low-complexity microbial environments that can be used as model microbial communities to understand how microbes interact in natural environments. Our results illustrate the dynamic nature of kefir fermentations and microbial succession patterns therein. In the process, the link between individual species, and associated pathways, with flavor compounds is revealed and several genes that...
- Research Article | Applied and Environmental ScienceNovel Syntrophic Populations Dominate an Ammonia-Tolerant Methanogenic Microbiome
The microbial production of methane or “biogas” is an attractive renewable energy technology that can recycle organic waste into biofuel. Biogas reactors operating with protein-rich substrates such as household municipal or agricultural wastes have significant industrial and societal value; however, they are highly unstable and frequently collapse due to the accumulation of ammonia. We report the discovery of a novel uncultured... | https://msystems.asm.org/keyword/metagenomics?page=5 |
Lollie is back in the Arctic and had two trips to Barrow, Alaska in 2011. The first trip was January 23 to February 2 and the second trip was April 24 to May 1. Besides through her PolarTREC journals, you can also learn more about this field work through the project website, Arctic Nitro here!
What Are They Doing?
The research team sampled the coastal waters of the Arctic Ocean to investigate how microbial creatures affect the productivity of a coastal Arctic ecosystem. They traveled to the field site via snowmobile and sampled the seawater through a hole drilled into the sea ice. The seawater collected was used to look at competition between autotrophs, organisms that make their own food, and heterotrophs, organisms that cannot make their own food, and for nitrogen (N) in the waters near Barrow, Alaska.
The field work took place over the course of three seasons (two years) to give researchers the opportunity to investigate the coastal water ecosystems in different seasons, winter and summer, and with different amounts of daylight. The sources of nitrogen vary when there is no daylight in the winter, from the summer where there is nearly 24 hours of daylight.
In ocean ecosystems, microbes dominate many of the processes and are the major producers and consumers of carbon dioxide (CO2) and other greenhouse gases. Understanding the role of microbial communities in the Arctic ecosystem is an essential part of predicting the impact of climate change on Arctic food webs and other natural cycles.
Where Are They?
The research team was stationed at the Barrow Arctic Science Consortium also known as BASC. They traveled to sampling sites on the sea ice by snowmobile during the dark arctic day. Weather conditions were challenging as they traveled to the ice edge of the Arctic Ocean.
Barrow is located on Alaska’s North Slope near the shoreline of the Arctic Ocean. Barrow is a small community of approximately 4,500 people. The climate is arctic, with the daily minimum temperature dropping below freezing 300 days a year and 24 hours of darkness during the winter months. The community is primarily inhabited by Inupiat Eskimos, and is not accessible by road.
Latest Journals
Dr. Patricia (Tish) Yager is an associate professor in marine sciences at the University of Georgia. Her expertise includes biological and chemical oceanography, marine microbial ecology and biogeochemistry. Her research focuses on the feedbacks between climate change and marine ecosystems. Her field research combines microbial ecology and community structure with inorganic carbon chemistry. She has spent several seasons working in Antarctica, and also studies microbial communities in the Amazon River. For the project in Barrow, Alaska, Tish will be the lead-PI responsible for project oversight, coordination, and synthesis. To learn more about Dr. Yager, please visit her faculty biography page.
Research in Dr. Marc Frischer's laboratory focuses on the role of microbial diversity in marine environments, the development and application of the tools of molecular biology in plankton ecology, and the discovery and ecology of parasite and pathogens in marine organisms. The impact and consequences of climate change on living marine systems focuses much of the ongoing research in the Frischer research group. A large emphasis is placed on the development and evaluation of new methods, particularly those that can be used in situ. In addition, a focus of the Frischer laboratory is the adaptation of molecular biological tools to a wide variety of questions in applied marine sciences, biotechnology, bioremediation, and invasive species issues.
The Bronk group is focusing on defining the competition between phytoplankton and bacteria for available nitrogen. As part of our study, we are doing experiments with humics, which are the tea colored compounds that run off the land when permafrost melts. These humics can decrease the amount of light in the water, which phytoplankton need, while providing a source of carbon, which bacteria require. As the permafrost melts, we hypothesize that bacteria will be able to outcompete phytoplankton for nitrogen more often. | https://www.polartrec.com/expeditions/nitrogen-in-the-arctic-ocean-ecosystem |
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