Life Events and Psychiatric Disorders Essay Sample free essay sample

Life EventsResearch workers have long been interested in understanding how persons and environments affect each other. chiefly so as to depict and explicate age – related behavior and single differences. One focal point has been to analyze life events. A life event is declarative of or requires a important alteration in the on-going life forms of the person. Harmonizing to Settersten and Mayer ( 1997 ) . â€Å"A life event is a important happening affecting a comparatively disconnected alteration that may bring forth serious and long lasting effects† . It refers to the go oning itself and non to the passages that will happen because of the occurrences. Life events can happen in a assortment of spheres ( household. wellness. and work ) and may be age graded ( School. matrimony and retirement ) . history graded ( war and depression ) . or non-normative ( illness and divorce ) . Most of the stripling and grownup literature reflects a sociological tradition of measuring the impact of life events as passages between major functions. We will write a custom essay sample on Life Events and Psychiatric Disorders Essay Sample or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page age classs. position additions and losingss. and so forth. Turning Points A turning point is a particular life event that produces a permanent displacement in the life class flight. It must take to more than a impermanent roundabout way. As important as they are to individual’s lives. turning points normally become obvious merely as clip base on ballss ( Wheaton and Gotlib. 1997 ) . Three types of life events can function as turning points ( Rutter. 1996 ) : * Life events that either stopping point or unfastened chances. * Life events that make a permanent alteration on the person’s environment. * Life events that change a person’s self-concept. beliefs and outlooks. However. it must be remembered that the same type of life events may be a turning point for one person. household. or other collectivity. but non for another. Besides. less dramatic passages may go turning points depending upon the individual’s appraisal of its importance. Life Event StressThe Encyclopedia of emphasis defines emphasis as â€Å"real or an taken menace to physiological or psychological unity of an person that consequences in physiological and/or behavioral response. † Stress involves a procedure in which environmental demands revenue enhancement or transcend the adaptative capacity of an being ensuing in psychological and biological alterations that may put individuals at hazard for disease. Three wide traditions of measuring the function of emphasis in disease hazard may be distinguished: * The environmental tradition focuses on appraisal of environmental events or experiences that are normatively ( objectively ) associated with significant adaptative demands. * The psychological tradition focuses on individuals’ subjective ratings of their abilities to get by with the demands posed by specific events or experiences. * The biological tradition focuses on activation of specific physiological systems that have been repeatedl y shown to be modulated by both psychologically and physically demanding conditions. Life event emphasiss therefore basically follow the environmental tradition. and are concerned with situational brushs and the intending a individual may attach to such events. Nerve-racking life events are causally implicated in a assortment of unwanted effects on our public presentation and wellness ( Dohrenwend and Dohrenwend. 1997 ) . Such observation is based on two premises. First. life alterations require version on the portion of the person and are nerve-racking. Second. individuals sing pronounced life alterations in the recent yesteryear are susceptible to physical and psychiatric jobs. All life events require version. but all life events are non needfully unpleasant. Life events can either be pleasant in nature where the emphasis is called ‘Eustress’ or unpleasant in nature where the emphasis is called ‘Dystress’ ( Selye. 1974 ) . There may besides be some life events which merely move to assist keep the internal steady province or to maintain the person interested in set abouting appropriate activities. Such emphasis may be called ‘Neustress’ ( Joseph P. Auto. 1995 ) Beginning OF LIFE EVENTS RESEARCH The hypothesis that emotional struggles related to external events can precipitate mental unwellnesss was foremost officially suggested by Heinroth in 1818 in his appellation of the term ‘psychosomatic’ . Later in early portion of the twentieth century. Adolf Meyer. popularized the ‘life chart’ methodological analysis. This attack emphasized the importance of dynamic interplay among biological. psychological and societal factors such that of import life events within the person’s life became focal point of attending for analyzing wellness and disease. However. no formal graduated table or agenda for measuring life events or their impact on wellness was as yet available. In the early sixtiess. Rahe and Holmes began developing a life events agenda based upon findings over 5. 000 of Meyer’s â€Å"life charts† taken on patients at the University of Washington. Each point selected for their agenda of Recent Experience was included because it was found to hold occurred in a big figure of patients predating the oncoming of their unwellness. Holmes and Rahe ( 1967 ) besides developed the Social Readjustment Rating Scale ( SRRS ) by delegating weights for events of different judged badness from the Schedule of Recent Experience. These weights were called â€Å"life alteration units† ( LCU ) . Elevated sores on the SRRS have been associated with the oncoming of legion medical upsets ( Rahe and Arthur. 1978 ) . It has besides been used extensively in surveies of oncoming of psychiatric upsets including schizophrenic disorder. depression and self-destruction efforts. The SRRS had an tremendous impact on research on the dealingss between life events and unwellness. It besides brought frontward and strengthened the impression that the effects of stressors operate mostly though the creative activity of inordinate adaptative demands. This led users of SRRS to be more concerned with the magnitude of life alteration than with whether the alteration was positive ( e. g. . publicity ) or negative ( e. g. . or occupation loss ) . Get downing in the seventiess. a new coevals of nerve-racking life event research workers began to dispute many of the basic premises involved in the building and marking of the SRRS. Th e undermentioned new thoughts were advanced: * Persons to gauge the stressfulness of their ain experiences as a manner of bring forthing steps instead than judge’s evaluations. ( e. g. . Sarason et. Al. . 1978 ) . * Development of a life event interview in which research workers rate the importance of events while taking into history the context in which they occur. ( Brown A ; Harris. 1978 ) . * Development of newer checklists to spread out the scope of experiences evaluated. ( Dohrenwend et Al. . 1978 ) . * Development of graduated tables to measure nerve-racking life events in specific populations whose experiences might be different from those represented on the more general SRRS. These included graduated tables for kids ( e. g. . Sandler A ; Ramsay. 1980. Monaghan et Al. 1978 ) striplings ( e. g. Murrell et Al. . 1984 ) and graduated tables for different civilizations ( Singh et. Al. . 1983 ; Sanjam. 1987 ) . * Development of life event graduated tables based on a multidimensional construct of stressors that individually assessed the extent of menace. loss. danger and other facets of nerve-racking events ( Brown A ; Harris. 1978 ) . Apart from these new developments. there have been continuances of what has already been established: * A continuance of basic research to document the effects of nerve-racking events on a assortment of physical and mental wellness result s utilizing newer nerve-racking life event steps. * An involvement in analyzing the cumulative effects of sing two or more nerve-racking life events in the same short interval of clip. ( Mc Gonagle A ; Kessler. 1990 ) . * An involvement in analyzing the joint effects of sing a nerve-racking event in the context of an on-going chronic stressor in the same life sphere ( Wheaton. 1990 ) . * A considerable involvement in analyzing exposure factors. i. e. . features that make people more or less susceptible to stressor induced disease. * A motion off from an earlier tradition of concentrating entirely on the acute wellness damaging effects of distinct life events towards an probe of the long term health-damaging effects of chronic stressors. A new involvement in the cumulative effects of minor day-to-day stressors on both emotional wellness ( Bolger et al. 1989 ) and physical wellness ( Stone et al. . 1987 ) . THEORETICAL ISSUES The nature of causal relationship between psychosocial emphasis and functional mental upsets has been conceptualized by assorted theories or theoretical accounts. Although these theoretical accounts have differed in their accent on the function of emphasis in the etiology of psychiatric unwellness. they have nem con taken into consideration the impact of emphasis in both physiological and psychological domains. Crisis Theory The crisis theory of emphasis was ab initio proposed by Lindemann ( 1944 ) ; and was farther elaborated by Satiating ( 1973 ) . The theory maintains that when an person is faced with a new state of affairs ( life event ) he goes into a period of disequilibrium ( crisis ) . The result of crisis may either be adaptative or maladaptive. In the latter status. it will take to physical or psychological unwellness or decreased functional capacity. The Crisis Model has been best used to explicate the experiences of healthy persons with comparatively integral personalities and comparatively abiding coherent human relationships ( Beck A ; Worthen. 1972 ) . Principle of Opticss Rahe et Al ( 1974 ) proposed that one’s past experience may change the significance of his recent life alteration and frequently defence mechanisms are employed which diffract away some of the life alteration events. Those which are non diffracted off. excite a battalion of physiological procedures. Prolonged unabsorbed psycho-physiological activities finally lead to organ system disfunction or assortment of psychological perturbations. Differential Consequence Brown and co workers ( 1973 ) have opined that the consequence of emphasis varies for each person. Stress may hold both triping and formative effects on mental unwellness. Triping and formative effects are opposite terminals of the same go oning instead than qualitatively different procedures. Triping events at the most trigger an unwellness. i. e. they may at the most convey the oncoming frontward by a short period of clip and possibly do it more disconnected. Formative events on the other manus. play a formative function and the oncoming of the unwellness may be either well advanced in clip by the event or brought about by it wholly. Brrown et Al ( 1973 ) have besides given the construct of â€Å"brought frontward time† . i. e. . the estimation of the mean clip from an oncoming produced by an event to the clip when a self-generated oncoming would hold occurred. had non the events intervened. If the brought forward clip is more ( i. vitamin E gt ; 12 months ) . the consequen ce is formative. if it is less. the consequence is triping. ( Brown et al. 1973 ) Cybernetic Model Cyberneticss is a survey of systemic regulative mechanisms that operate via feedback cringles. Kagan and Levi ( 1974 ) proposed that the combined consequence of psychosocial emphasis and psychobiological programme determines the psychological or physiological reactions which may take to precursor of an unwellness or the illness itself. Diathesis or Vulnerability Models Several exposure theoretical accounts have been proposed. but the initial one was proposed by Meehl ( 1962 ) and it was subsequently modified by Rosenthal ( 1970 ) . These theoretical accounts assume that people have changing grades of exposure to the development of a mental upset and that the likeliness to develop an unwellness is a map of both the extent of the biologically influenced exposure and the magnitude of emphasis that the person is meeting. Vulnerability attack postulated that a balance and antagonistic balance is maintained between exposure and the sum of emphasis that can be tolerated before the symptoms appear. This theoretical account is used basically to explicate schizophrenic disorder ( Zubin A ; Spring. 1977 ) . Psychodynamic Theories Harmonizing to the theories of Freud. Jung and Sullivan. psychological emphasis consequences in arrested development. This overburdens already strained get bying mechanisms. and triggers a sequence of internal alterations whose outward look is the development of psychotic symptoms. The emphasis itself may be more of drawn-out struggle than a individual disturbing experience or it may be objectively minor but have particular psychological deductions for the person or it might exercise its consequence by virtuousness of moving on an already unnatural personality construction. Although these theories lack the support of any believable scientific research. they have been widely and uncritically accepted for long. and they are utile in that they help clinician to understand and expect the impact of life events on the patient’s class of unwellness. TYPES OF LIFE EVENTS Life events have been classified in different ways. Some of the dichotomous categorizations of life events. which are utile in explicating the consequences of life events research. are described below: Personal Vs Impersonal Events Personal events are the events in which the person is an active participant and partially or to the full responsible for the event. This includes matrimonial or household struggles. broken battle or love matter. building of a house. acquiring married and so on. Whereas. in impersonal events. the person is non straight responsible for the events. Examples include decease of a friend. unwellness of household members. belongings harm. birth of a girl and so on ( Singh et al. . 1983 ) . Desirable Vs Undesirable EventsThe events which are consistent with the favor or desire of the person. such as acquiring married. going an officer. etc are desirable 1s. Contrarily. unwanted events imply the unwanted happening of events such as decease of partner. larceny or robbery. divorce. etc. ( Singh et al. . 1983 ) . Pleasant Vs Unpleasant Events Pleasant events are gratifying events such as traveling on pleasance trip. educational or occupational accomplishment. etc. The events which are experienced by the individual as noxious. aversive. or unsafe are unpleasant events. It is noted that all pleasant events may non be desirable and all the desirable events are non pleasant. Major Vs Minor Events The events over which the person attaches importance or values are major events while the events which are. harmonizing to the person. negligible or inconsiderable are minor events. Interestingly. a major event for one person may be minor for another and vice-versa. ( californium: Kamaranjan. 1996 ) Chronic Vs Acute Events Chronic events are emphasiss associated with mundane life. such as household. work. poorness. physical disablement and mental shortage. while acute events are emphasiss associated with mostly external or unusual alterations that are unforeseen. unsought. and uncontrolled. ( Mc Glashan and Hoffman. 2000 ) Severe and Non-severe Events Severe events are experiences of long-run or moderate long term menace to an person ( e. g. decease of partner ) . Non terrible events were experiences that are endangering merely in the short term. normally less than a hebdomad ( e. g. . a kid about hit by a auto ) ( Brown A ; Harris. 1978 ) . MEASUREMENT OF LIFE EVENTS It is nem con accepted today that exposure to daily or life clip stressors may hold an of import bearing on wellness and good being. Much of research in this country has had focused in the function of nerve-racking life events in the etiology of assorted psychiatric unwellness. The chief consideration among research workers on life events are: * What type of life events act upon psychological perturbation? * What is the differential influence of life events in assorted mental upsets? * How do life events affect mental wellness. straight. indirectly and interactively? Relationship between personality factors and life events has besides been studied by assorted research workers. ( Bhatti and Channabaravanna. 1985 ) . Harmonizing to Wethington ( 2000 ) . appraisal of life events is one of four types of realistic stressor appraisals. the other three appraisals being that of emphasis assessments. chronic stressors and day-to-day events ( or fusss ) . The differences are pointed out below: * Life events: These are exposure to out-of-the-ordinary. demanding events. such as divorce. that have the capacity to alter the forms of life or elicit really unpleasant feelings. * Stress assessments: These are self studies of sensed stressfulness and assessments of menace posed by events. Measures of appraisal focal point on the grade to which an event threatens wellbeing or threatens to overpower resources to get by. Life event graduated tables may or may non include assessment as a constituent. * Chronic stressors: These are digesting or perennial troubles and strains in an country of life. Recent research on emphasis and unwellness has turned toward stressing the function of persistent. uninterrupted. or regular exposure to stressors as of import hazard factors for the development of disease. * Fusss: These are exposure to smaller. comparatively minor. cosmopolitan and usually less emotionally eliciting events whose effects disperse in a twenty-four hours or two. The fusss paradigm focuses attending of the potentially hurtful ways in which minor stressors. even those whose effects are comparatively fugitive. can hold long-run negative effects on wellness. There are two contrasting methods of mensurating life events. which have developed over clip. viz. . * Checklist Measures * Personal Interview MeasuresChecklists are easy to administrate and are utile in carry oning big sum of explorative wellness research. Checklist method was derived from an environmental position on emphasis. proposing that the footing of experient emphasis is an event that brings about a demand for societal. physical. or psychological readjustment. The earliest of these positions was the life alteration readjustment paradigm developed by Holmes and Rahe ( 1967 ) . Other theoretical paradigms on emphasis. such as those developed by Lazarus ( 1984 ) . Dohrenwend ( 1993 ) . and Brown ( 1987 ) have augmented their attack in important ways. Some checklists measure clocking and badness of checkered event. by inquiring respondent to describe day of the month of happening. by inquiring for a brief written description. or by inquiring respondent to rate the comparative stressfulness of the event. Despite their popularity. checklist steps have been criticized on their dependability and cogenc y as steps of stressor exposure. These unfavorable judgments include: * Vagueness and generalization of the inquiries. * Inclusion of events that are confounded with experiencing provinces of psychiatric unwellness. * Recency prejudices. i. e. respondents are more likely to remember events that occur in the last few months than those that occurred a twelvemonth ago. The Personal interview steps use qualitative investigations in order to stipulate more exactly the features of life events believed to bring forth the existent hazard of unwellness and timings of life events in relationship to the results. The early development of personal interview methods for measuring life events initialized a theoretical position distinct from the alteration readjustment paradigm. which informed life event checklist. The major developer of interview methods ( George W. Brown ) proposed that societal and environmental alterations ( and expectancy of those alterations ) that threaten the most strongly held emotional committednesss are footing for experienced terrible emphasis. This position besides holds that terrible stressors. instead than minor. threaten wellness. separating it from both alteration readjustment and fusss paradigms. Interview steps are non used normally. chiefly because of their greater disbursal and complexness. Research workers tend to utilize them under the undermentioned fortunes: * Where more precise badness evaluations are required. * Where the comparative timing of stressor exposure and disease oncoming is critical to a survey. * When the happening of an event. or series of events. may be related to respondent unwellness or behavior. * Promoters of interview steps claim that they are more comprehensive. dependable and valid than checklist steps. although there is considerable argument on this point. TOOLS FOR MEASURING LIFE EVENTSSocial Readjustment Rating Scale ( SRRS ) : Developed by Holmes and Rahe ( 1967 ) . this graduated table is a milepost of life events research. This graduated table has 43 events which have been taken from the Schedule of Recent Experience. and have been assigned weights in footings of their judged badness. Each point has a â€Å"life alteration unit† ( LCU ) . The more terrible the point. the greater alteration it calls for. and so the greater is its LCU. Agenda for Life Events: Developed by Paykel et Al. ( 1975 ) this covers 64 defined life events. which are once more divided into nine classs – work. instruction. finance. wellness. mourning. migration. household and societal relationship. It is administered in the signifier of a semi-structured interview. where each event is enquired for until it clearly does non use covering a period of one twelvemonth prior to the interview. Presumptive Stressful Life Events Scale ( PSLE ) : Developed by Gurmeet Singh et Al. ( 1983 ) . it was constructed and standardized for usage in the Indian population. It is a standardisation of the SRRS. It is in the signifier of an stock list of 51 points. each point holding a leaden emphasis mark. For illustration. decease of partner = 100 ; struggle over dowry = 51 ; traveling on pleasance trip = 20. The points are farther categorized as ( I ) personal or impersonal events. ( two ) desirable. unwanted. or equivocal events. It is administered in the signifier of a semi structured interview. wherein the events are assessed to be either present or absent. British Life Events Inventory for Children: Developed by Monaghan et Al ( 1978 ) . this stock list is specially designed to measure life events of kids. Life Events Inventory for Indian Children: Developed by Sanjam ( 1987 ) . this is an Indian version of the British Life Events Inventory for Children. It comprises of 50 points with appraisal of emphasis on two clip frame parametric quantities i. e. â€Å"last one year† and â€Å"ever in life prior to last one year† . Bedford College Life Events and Difficulties Schedule ( LEDS ) : Developed by Brown and Harris ( 1978 ) . this is the most widely used personal interview method. It is a semi structured study instrument. appropriate for usage in a community sample every bit good as with patients. measuring a broad assortment of stressors. The interview consists of a series of inquiries inquiring whether certain types of events had occurred over the past 12 months ( or larger ) and a set of guidelines for examining positive responses. Structured Event Probe and Narrative Rating Method ( SEPRATE ) : Developed by Dohrenwend and co-workers. et Al. ( 1993 ) . this is an alternate life events interview and evaluation system utilizing a magnitude of â€Å"life change† evaluation system. It consists of a series of yes/no inquiries sing 84 types of events or troubles that may hold occurred and been badly nerve-racking. Neurobiology OF LIFE EVENT STRESS The biological science of life events is subsumed in the biological science of emphasis. Several physiological systems have been implicated in active and inactive header with emphasis. These include the cardinal nervous system. catecholamines. immune. endorphin – enkephalin. hypothalamico–pituitary–adrenocortical and the sympatho–adrenomedulary systems ( Baum et al. . 1982 ) . The physiological emphasis responses include chiefly the activation of autonomic nervous system and hypothalamus-pituitary-adrenal axis taking to increased blood force per unit area and tissue degrees of catecholamines and glucocorticoids. Elevations of adrenaline. noradrenaline and hydrocortisone have repeatedly been found among individuals sing chronic and acutely nerve-racking events ( Hlastala and Frank. 2000 ) . Stressors besides activate serotonergic systems in the encephalon as evidenced by increased serotonic bend over ( Kaplan and Sadock. 2000 ) . Amino acid and peptidergic neurotransmitters are besides found to be elaborately involved in the emphasis response. Surveies have shown that adrenocorticotropic hormone let go ofing factor ( CRF ) . Glutamate. and Gamma aminobutyric acid ( GABA ) – all play of import functions in the coevals of the emphasis response or in transition of other stress antiphonal systems such as dopaminergic and noradrenergic encephalon circuits ( Kaplan and Sadock. 2000 ) . The symptho – adrenomedullary system ( SAS ) is activated during active header ( fight or flight ) . which by and large. but non ever. involves physical effort. This system increases metabolic activity in response to nerve-racking state of affairss. Measures of noradrenaline and adrenaline are typically used to bespeak the activity of the SAS. There are two of import characteristics of physiological emphasis response. The first involves turning it on in sum that are equal to the challenge. The 2nd is turning off the response when it is no longer needed. Physiological mediations of the emphasis response. viz. the catecholamines and the glucocorticoids from the adrenal cerebral mantle. originate cellular events that promote adaptative alterations in cells and tissues throughout the organic structure. which in bend protect the being and promote endurance. However. excessively much emphasis or inefficient operations of the acute responses to emphasize can do wear and tear and exacerbate disease procedure. There are nevertheless. tremendous single differences in construing and reacting to what is nerve-racking. every bit good as single differences in susceptibleness to diseases. in which emphasis may play a function. LIFE EVENTS AND PSYCHIATRIC ILLNESS Extensive empirical research on life events and unwellnesss has demonstrated that life events emphasis may ensue in jobs in both physical andor mental wellness ( Cohen. 1980 ) . There is turning organic structure of literature on the function of life events in bring forthing assortment of mental upsets. However. bulk of persons undergoing serious life events do non develop psychological damage. Hence. the focal point of current life events research has been to understand the conditions under which life events produce psychological disfunction and to place those individuals who are at hazard. The impressions of ‘vulnerability’ and ‘ diathesis’ are of peculiar importance in understanding the impact of life events on mental wellness. ‘Diathesis’ as described by Meehl ( 1962 ) refers chiefly to familial predispositional factors. and ‘vulnerability’ has been expanded to include predispositional environmental factors ( Zubin and Spring. 1977 ; Spring A ; Coons. 1982 ) . An single with a high sensitivity is at high hazard of developing unwellness symptoms. in the face of nerve-racking life events. Again. perceptual experience of emphasis is a subjective phenomenon. as the same life event may be nerve-racking to one person but non to another. Individual’s personality make-up influences his perceptual experience and assessment of the state of affairs and this in bend determines his reaction to the same ( Sejwal. 1984 ) . Life Events and Schizophrenia The influence of life events on the etiology and class of schizophrenic disorder has been a controversial issue. Research analyzing the relationship between life events and the oncoming of schizophrenic episodes can be divided into three groups: Type I: Some surveies have found a important addition in â€Å"independent† life events predating the oncoming of psychotic symptoms proposing that they may play a major triping function for episodes. â€Å"Independent events† are those events which are non influenced or caused by patient’s ain behavior ( e. g. decease of loved one ) . Bleuler ( 1911 ) considered life state of affairss and emotional struggles as causal factors in the oncoming of at least some instances of schizophrenic disorder. Valliant ( 1964 ) observed that 60 % of their schizophrenic patients had life events 3 hebdomads prior to onset of unwellness. Lukoff et Al. ( 1984 ) and Brown A ; Birley ( 1968 ) had besides found an addition in the frequence of life events 3 hebdomads before the oncoming of schizophrenic disorder. Type II: Other surveies have found an addition in life events before oncoming. but the happening of the life events was non independent of the influence of the patient’s behavior. Non-independent life events such as being fired from a occupation. divorce. neglecting in an test. may reflect the prodromic period of the unwellness or an on-going schizophrenic procedure. Zubin and Spring ( 1977 ) have labeled the procedures by which schizophrenic patients frequently bring an surplus of life events upon themselves as â€Å"stress prone forms of living† . Although both onset every bit good as backsliding in schizophrenic disorder has been associated with an increased study of life events. these events are largely of the non-independent types. This increases an already hyperbolic emphasis degree and so influences the timing if non chance of illness oncoming ( Rabkin. 1980 ) . Beck and Worthen ( 1972 ) had besides reported that seemingly fiddling events are idiosyncratically interpreted by these patients so that they are subjectively but non objectively nerve-racking. A survey by Serban ( 1975 ) found that chronic schizophrenics experienced maximal emphasis. wh ile acute schizophrenics experienced medium emphasis. compared to the normal population. Das et Al. ( 1997 ) had reported higher figure of life events in the one twelvemonth predating backsliding in relapsed schizophrenics as compared to stable schizophrenics. The latter two surveies are therefore. once more declarative of the function of a schizophrenic procedure in the patients’ experience of nerve-racking life events. Ventura et Al. ( 1989 ) reviewed the surveies on life events and concluded that both exposure and emphasis factors. and non merely the latter. contribute to the oncoming and class of schizophrenic disorder. Type Three: The 3rd set of surveies in the literature study no relationship between life events and the oncoming of schizophrenic episodes. ( e. g. Leff et Al. . 1973 ; Leff A ; Vaughan. 1980 ) . Comparative surveies of schizophrenic patients with other groups of psychiatric patients reveal that unwanted life events were more common in depression than in schizophrenic disorder ( Beck and Worthen. 1972 ; Jacobs et Al. . 1974 ; Martin et Al. . 1 995 ) Life Events and Mania Meynert ( 1890 ) and Westphal ( 1911 ) had ab initio suggested that exogenic factors ( romantic and psycho-reactive factors ) can play a portion in precipitation of passion. Ambelas ( 1979 ) found 28 % of patients sing life events before a frenzied episode. which was 5 times more than in control group. Similarly. Leff et Al. ( 1976 ) reported that independent events occurred shortly before an onslaught in 28 % of their instances. Singhal et Al. ( 1984 ) reported 60 % of frenzied patients as sing nerve-racking life events of assorted sorts. compared to merely 13 % of the controls. Lakhera et Al. ( 1995 ) reported life events in 54 % of their frenzied patients in the month predating their frenzied episodes. Kennedy et Al. ( 1983 ) used frenzied patients as their ain controls and observed a far higher frequence of life events in a period prior to the manic episode than during an equal subsequent period of clip. With respects to the type of life events that precede the frenzied episode. the more normally reported 1s are work A ; interpersonal troubles ( Patrick et al. . 1978 ; Dunner et Al. . 1979 ; Joseph P. Auto. 1995 ) ; decease of first degree relation. economic crises. failure in accomplishment ( Singhal et al. . 1984 ) ; and fiscal jobs. big loans. matrimonial and household struggles. harm to belongings or harvests ( Lakhera et Al. . 1995 ) . Joseph P. Auto ( 1995 ) studied life events in schizophrenics. depressives and manics and concluded that life events predating passion were more related in clip. Life Events and Depression In an early survey. Arieti ( 1959 ) concluded that typical precipitating emphasiss in terrible depressive reactions fall into three general classs –decease of loved one. failure in an of import interpersonal relationship ( normally with one’s partner ) and a terrible set back or letdown in the work or other ends to which an person has been devoted. A big organic structure of research has documented an addition in happening of life emphasis before the oncoming of major depression. ( Paykel et al. . 1969. 1994 ; Rao and Nammalvar. 1976 ; Brown and Harris. 1978. 1989 ; Chatterjee et Al. . 1981 ; Rao. 1986 ; Monroe and Depne 1991 ; Miller et Al. 1989 ; Paykel and Cooper. 1992 ; Bebbington et Al. . 1993 ; Mazure. 1998 ) . Many research workers have documented that mourning has a function in the causing of depression. Loss of partner has been reported as a important life event that precipitates depressive unwellness. ( Parkes 1964 ; Clayton et. Al. . 1968 ) . Parkes ( 1964 ) observed that the figure of patients whose unwellness followed the loss of partner was six times greater than expected. Events affecting ‘loss’ . ‘separation’ or ‘hazard’ ( Beck et. Al. . 1972 ) issues and interpersonal statements ( Jacobs et. Al. . 1974 ) have been found to predate depressive unwellness. Rao and Nammalvar ( 1976 ) identified mourning as a critical precursor of depression. Benjaminson ( 1981 ) reported that multiple events were more common in non endogenous depression compared to endogenous depression. Leff et Al. . ( 1970 ) and Thomson A ; Henrie ( 1972 ) did non happen any difference between endogenous and neurotic depression in relation to life events. Satija et Al. . ( 1982 ) reported that recent life events were found to be more responsible than chronic history of life events for the oncoming of a depressive episode. Williamson et Al. . ( 1995 ) found that down striplings had significantly more independent nerve-racking life events during the old twelvemonth than did the normal controls. Similar association between nerve-racking life events and degree of depression had been found in University pupils by O’Niel et Al ( 1986 ) . Mundt et Al. ( 2000 ) reconfirmed the function of life events for the timing of depressive episodes in a two twelvemonth prospecti ve follow up survey. Life Events and Anxiety Disorders The effects of life events either on the etiology or precipitation of neurotic upsets are ill-defined. Previous surveies of life events or specific stressors related to phobic behaviour suggest that such events may trip neurotic upset but merely in few of the patients studied ( Myers et Al. . 1971 ; Cooper and Sylph. 1973 ) . A important relationship between nerve-racking events and oncoming of anxiousness symptoms was reported by Ram and Sharma ( 1988 ) . Similarly. Takeuchi et Al. . ( 1986 ) has reported life events as playing an of import function in the origin of anxiousness upset in 118 patients with the upset. Servant and Parquet ( 1994b ) found that early and recent life events. particularly loss and separation may be a hazard factor for secondary depression in anxiousness upset. Sharma and Ram ( 1986 ) observed academic failure in scrutiny and looking for interview to be significantly more in anxiousness mental cases than in controls. during the 6 months prior to the oncoming of unwellness. Recently. Sharma and Ram ( 1987 ) investigated the relationship between life events. societal and household support. and magnitude of unwellness in 87 patients of anxiousness neuroticism and 47 controls. In comparing to controls. anxiousness mental cases had less societal and household support. One survey found a important relationship between life events and panic upset ( Fravelli et al. 1989 ) . Epidemiologic and clinical informations are consistent with the position that panic upset is significantly and strongly associated with both parental decease and separation in childhood ( Servant and Parquet. 1994b ) . In an probe of 157 patients with panic upset. Servant and Parquet ( 1994a ) found that 53 patients ( 33. 7 % ) had experienced a major loss or separation before the age of 15 old ages. and it was besides noticed that the panic group with early life events showed a significantly higher life clip prevalence of major depression than panic group who did non see early life events. Savoia and Bernik ( 2004 ) reported that the type of event and the header accomplishments used in response to them. more than the happening of nerve-racking events itself. may be associated with the onco ming of panic upset. Loss of societal support was a more common life event in panic patients compared to normal. and they tended to utilize get bying accomplishments judged as ineffective. Friedman et Al. . ( 2002 ) found in their group of panic upset patients. that a history of childhood physical or sexual maltreatment was positively correlated to clinical badness. Khanna et Al. . ( 1988 ) reported an surplus of life events in the predating to months in the OCD sample. They identified these events to be more independent. to hold significantly higher negative impact and to be more uncontrolled. Both Khanna et Al. ( 1988 ) and Mc Keon et Al. . ( 1984 ) reported a hold between peak clip of happening of events and the oncoming of OCD. Mc Keon et Al. ( 1984 ) took this delayed impact of life events to connote that a certain degree of emotional rousing is necessary before compulsions intervene. De Loof et Al. ( 1989 ) compared the life events of patients with obsessional compulsive upset and terror upsets and found that the former group did non differ from the latter in footings of figure of life events they experience during the one twelvemonth prior to the oncoming of the ir upset. However. over the entire life class. panic upset patients see more life events than obsessional compulsive upset patients. Newman and Bland ( 1994 ) compared the life events experienced by the patients with major depression. anxiousness upset and terror upsets and reported important associations between nerve-racking events and these upsets. Apart from all these surveies importance has been given to life events in ICD-10 and DSM – IV in the etiology of bulk of mental unwellnesss. for e. g. Acute and transeunt psychotic upset. Brief reactive psychosis. PTSD. Dissociative upsets. Adjustment upset etc. Drawn-out exposure to life endangering fortunes have been found to convey about digesting personality alterations. Particular accent has been given to life events for sing it as a precipitating factor in the oncoming of these mental unwellnesss. GENDER DIFFERENCES IN THE RATES OF EXPOSURE TO STRESSFUL LIFE EVENTS Three forms of association between gender and life event exposure are most normally seen in the literature: * Womans have a loosely higher hazard for most or all classs of nerve-racking life events. * Womans are at greater hazard for a subset of events ( e. g. Network. Interpersonal ) . * No major differences are seen between the genders in event exposure. Previous surveies have besides produced a scope of fin dings about gender differences in sensitiveness to nerve-racking life events. Most. but non all of these surveies have employed self study steps of â€Å"depression† or â€Å"distress† instead than syndromal diagnosings of major depression. DecisionLife events research has therefore been an country of huge involvement since the sixtiess. The jobs defined and the hypotheses generated are so varied in this country. that there is really small range of exhaustion. Although literature suggests that life events play an of import function in the precipitation and backsliding of psychiatric upsets. the relationship is non all that consecutive frontward. The relationship between emphasis and unwellnessvaries with pre bing exposure factors. That is. differences in societal support system. accomplishments. attitudes. beliefs. and personality features render some individuals comparatively immune to emphasize induced unwellness A ; other comparatively susceptible. Hence. future research should concentrate on placing these step ining variables and understanding their consequence on emphasis – unwellness relationship.

Beginnings essays

Beginnings essays Psychiatrists say that a child's values are pretty much locked in by the age of ten. I grew up a child of suburban Chicago in the mid 1980s. I had a nice, cold, and snowy day for my birthday since I was born on December 30, 1985 and December is the peak of winter. My values and beliefs will be very different from someone that grew up in Coldwater, Michigan. Different religions also affect this lot since my Hindu beliefs and ideals would be entirely different from a Christians beliefs and ideals even if we grew up in the same neighborhood. Family plays a large part in my life, but it has not usually had a good impact upon it. Throughout my existence, the greed of other family members has plagued me with money problems. It would appear that, to them, having material possessions more important than assuring my well-being. My mother's parents kicked her out of the family. When my mom married my dad, my grandparents refused to speak to them; as did all the others from her family because she ran away and got married. When I was born, the families were back together in a sense. My dad worked for Drisilker, one of the worlds foremost electric motor repair facilities in the world. They received motors from all over the US, Switzerland, and Germany. My mom worked at the Taco Bell down the street as the shift manager. At the time, my dads 2 younger brothers were living with us also. They worked at various fast food restaurants. Neither of them was very responsible so they could not hold employment very long. I was born IBM PC-DOS 3.2 was released. That may later work into my fixation with computers. This new DOS system also helped push IBM further ahead into the computer market helping them to set the pace for the competition. That might help to explain my attachment to computers now. On the day I was born, President Zia of Pakistan ended martial law, and restored their constitution. When I see this ...

Media Literacy Essay Example | Topics and Well Written Essays - 1000 words

Media Literacy - Essay Example The article under study is a news article taken from the Daily Star February 12, 2007 issue which is entitled â€Å"The Jet Seat that Spots Terrorists.† There are different points that can be considered essential in the analysis of the article such as the motive of the writer, the credibility of the story and the target audience from whom a reaction and empathy is expected. One of the main points that can be considered evident in the story is the importance given to the effects of the issue related to terrorism. In the title, the word â€Å"terrorists† can obviously be viewed and catch attention. Due to the use of the issue against terrorism, the article can be perceived to present propaganda on the capability of the technology being introduced and presented which is either related to the jet seat feature, the airline company or the cooperation of the airline industry in the fight for terrorism. The latter reason being related to the fact that airlines are commonly the main tool of the terrorists in posing threat to the safety of the population. Another feature of the story is the attractive description of the capabilities of the technology being applied. This can catch the interest and attention of the population since high level technology with prototype features can almost be considered as a fiction and fantasy turned reality for the members of the public. If an ordinary citizen or even a person with a high level of interest in technology would read the news, the first reaction would probably be an expression of excitement due to the continuous development of technology and even a sense of satisfaction since safety can be improved if a need for air travel is undertaken. The features of the said technology is stressed including the sensitivity to movement and sound with less limitation in terms of sensitivity in capturing possible hints of terrorism and other crimes. The exploration of the importance

Islamic Banking and Finance Essay Example | Topics and Well Written Essays - 1750 words

Islamic Banking and Finance - Essay Example From this discussion it is clear that  the UAE Islamic financial services sector represents 30% of the overall Islamic banking industry based throughout the world. This has been possible largely because of rising requirement of customers within the UAE for Islamic financial services. Islamic banks in the UAE have played a crucial role in financing multiple infrastructure projects in the region, expansion of the human capital market by training talented individuals from the region and also, financed development of housing properties for the citizens of UAE. The growth witnessed in the Islamic banking industry has been driven by the growing requirement for Islamic products and services by an augmenting count of customers. The underlying reason for this growth is the emphasis that the industry lays on ethical principles, their commitment to transparency and implementation of the principle of mutual benefits in transactions and operations. The following sections will explain the produc ts and services offered by three of the leading banks based in the UAE (National Bank of Abu Dhabi, Abu Dhabi Commercial Bank and Emirates NBD). Following that, financial performance of each of the banks will be compared and lastly, comments would be made regarding the difference in between Islamic banking system that these banks follow and the conventional banking system.  The National Bank of Abu Dhabi’s Islamic Financial System is guided by Shari’a principle and rules.  

Reading Skills Essay Example for Free

Reading Skills Essay Reading daily, Reading deeply, Reading widely are the few important skills of reading from which we can enhance our understanding of passage, ameliorate our vocabulary, correct our grammatical mistakes, increase our thinking capacity and helps in improving or learning any part of a language. The more you read the one thing you realize the key to doing well in the examination, and the key to perform or present any task in a well equipped way. There are many techniques used in reading to get and understand whole idea or summary of the passage to improve reading. But few important skills of reading are given below to improve reading. 1. Styles of reading 2. Active reading 3. A tip for speeding up your active reading 4. Spotting authors navigation aids 5. Words and vocabulary [pic]1. Styles of reading There are three styles of reading which we use in different situations: Scanning: Scanning is what you do to find an answer to a specific question. You may run your eyes quickly down the page in a zigzag or winding S pattern. If you are looking for a name, you note capital letters. For a date, you look for numbers. Vocabulary words may be boldfaced or italicized. When you scan for information, you read only what is needed. Its useful to scan parts of texts to see if theyre going to be useful to you: †¢ the introduction or preface of a book †¢ the first or last paragraphs of chapters †¢ the concluding chapter of a book. Skimming: for getting the gist of something Skimming is covering the chapter to get some of the main ideas and a general overview of the material. It is what you do first when reading a chapter assignment. You don’t read for details at this point. Here is how you skim a chapter: . To preview a passage before you read it in detail  · Read the first paragraph of the chapter line by line.  · Next, read all the bold print headings starting at the beginning.  · Read the first sentence of every paragraph.  · Study any pictures, graphs, charts, and maps.  · Finally, read the last paragraph of the chapter. As you skim, you could write down the main ideas and develop a chapter outline. Detailed reading: for extracting information accurately Where you read every word, and work to learn from the text. In this careful reading, you may find it helpful to skim first, to get a general idea, but then go back to read in detail. Use a dictionary to make sure you understand all the words used. [pic]2. Active reading When youre reading for your course, you need to make sure youre actively involved with the text. Its a waste of your time to just passively read, the way youd read a thriller on holiday. Always make notes to keep up your concentration and understanding. Here are four tips for active reading. Underlining and highlighting Pick out what you think are the most important parts of what you are reading. Do this with your own copy of texts or on photocopies, not with borrowed books. If you are a visual learner, youll find it helpful to use different colours to highlight different aspects of what youre reading. Note key words Record the main headings as you read. Use one or two keywords for each point. When you dont want to mark the text, keep a folder of notes you make while reading. Questions Before you start reading something like an article, a chapter or a whole book, prepare for your reading by noting down questions you want the material to answer. While youre reading, note down questions which the author raises. Summaries Pause after youve read a section of text. Then: 1. put what youve read into your own words; 2. skim through the text and check how accurate your summary is and 3.fill in any gaps. [pic]3. A tip for speeding up your active reading You should learn a huge amount from your reading. If you read passively, without learning, youre wasting your time. So train your mind to learn. Try the SQ3R technique. First developed by researchers at Ohio State University, SQ3R is a useful technique for absorbing written information. It helps you to create a good mental framework of a subject, into which you can fit the right facts. It helps you to set study goals and prompts you to use the review techniques that will help you to remember. The acronym SQ3R stands for the five sequential techniques you should use to read a book: Survey, Question, Read, Recite and Review. Survey Gather the information you need to focus on the work and set goals: †¢ Read the title to help prepare for the subject †¢ Read the introduction or summary to see what the author thinks are the key points †¢ Notice the boldface headings to see what the structure is †¢ Notice any maps, graphs or charts. They are there for a purpose †¢ Notice the reading aids, italics, bold face, questions at the end of the chapter. They are all there to help you understand and remember. Question  Help your mind to engage and concentrate. Your mind is engaged in learning when it is actively looking for answers to questions. Make questions that can be answered during the reading of the material. This will give a purpose to your reading. Take a heading and turn it into a question. For example, if a heading in a chapter about Cell Division is in your biology text, make a question by turning the title around: â€Å"How does cell division occur? † or â€Å"How many steps are involved in cell division? † Read Read the first section with your questions in mind. Now you read the material trying to find answers to your questions. This is a careful reading, line by line. You may want to take notes or make flashcards. Recall As you read, look away from your book and notes and try to answer your questions. This checks your learning and helps put that information in your memory. After each section, stop and think back to your questions. See if you can answer them from memory. If not, take a look back at the text. Do this as often as you need to.. Review To check your memory, scan portions of the material or your notes to verify your answers. Review the material and note the main points under each heading. This review step helps you retain the material. The SQ3R method is just one technique that can be used to retain information you collect while reading. Students learn in different ways. Therefore they should be aware of their learning styles. Knowing whether you are an Auditory (learn by hearing), Visual (learn by seeing) or Kinesthetic (hands-on) learner helps you to understand your best learning environment. The SQ3R technique of reading can help to enhance your reading skills no matter what your style is. [pic]4. Spotting authors navigation aids Learn to recognize sequence signals, for example: Three advantages of or A number of methods are available leads you to expect several points to follow. The first sentence of a paragraph will often indicate a sequence:† One important cause of followed by Another important factor and so on, until The final cause of General points are often illustrated by particular examples, for example: General: Birds beaks are appropriately shaped for feeding. Particular: Sparrows and other seed-eating birds have short, stubby beaks; wrens and other insect eaters have thin pointed beaks; herons and other fish hunters have long, sharp beaks for spearing their prey. Whatever you are reading, be aware of the authors background. It is important to recognize the bias given to writing by a writers political, religious, social background. Learn which newspapers and journals represent a particular standpoint [pic]5. Words and vocabulary When youre a graduate people expect you to use a vocabulary which is wider than a school-leavers. To expand your vocabulary: Choose a large dictionary rather than one which is ‘compact or ‘concise. You want one which is big enough to define words clearly and helpfully (around 1,500 pages is a good size). Avoid dictionaries which send you round in circles by just giving synonyms. A pocket dictionary might suggest: ‘impetuous = rash. A more comprehensive dictionary will tell you that impetuous means ‘rushing with force and violence, while another gives ‘liable to act without consideration, and add to your understanding by giving the derivation ‘14th century, from late Latin impetuous = violent. It will tell you that rash means ‘acting without due consideration or thought, and is derived from Old High German rasc = hurried. So underlying these two similar words is the difference between violence and hurrying. There are over 600,000 words in the Oxford English Dictionary; most of them have different meanings, (only a small proportion is synonyms). Avoid dictionaries which send you round in circles by using very complicated language to define the term youre looking up, leaving you struggling to understand half a dozen new words. Keep your dictionary at hand when youre studying. Look up unfamiliar words and work to understand what they mean. Improve your vocabulary by reading widely. Reading skills in a precis form Comprehensions Reading comprehension is a basic skill that each college student must possess. Believe it or not, reading is a complex, accrued skill—not acquired overnight learning to read and comprehend takes practice. Comprehension involves obtaining information from written text. A reader who comprehends a text accurately understands what the writer intended to communicate. She understands the purpose and the main idea. Comprehension cannot be observed directly, but a reader who is able to retell, paraphrase or summarize a text demonstrates comprehension. Interpretation †¢ When a reader interprets a text, he is employing a critical thinking strategy. He uses evidence and clues from the text to draw conclusions and looks for larger or more universal principals in what he has read. Interpretation requires going beyond the initial impression of what he has read to develop a more complex and complete understanding. Analysis †¢ When a reader analyzes the text, she identifies the assumptions of the writer and examines the structure of the argument. She asks questions such as, Does the evidence support the argument? and Does it support the conclusions the writer draws? She is looking for evidence of a logical and/or consistent argument. Synthesis †¢ With synthesis, the skilled reader is able to show how a text develops or builds meaning. He sorts out and reconstructs ideas in a text to point out how they are interrelated. He compares and extends meaning from multiple sources. Evaluation †¢ Evaluation, determining the quality and effectiveness of a text, is the highest level of critical thinking associated with reading, according to Lesley Thompson, Senior Assessment and Accountability Program Associate at the Northwest Regional Education Laboratory. An effective reader evaluates the merit of the text by drawing on her own experience and knowledge and considering whether other sources provide evidence that agrees with or contradicts the writers argument.

Color Purple :: essays research papers

The book called The Color Purple shows many of the topics discussed in class, but for the purpose of this paper I would like to discuss three aspects that are the most concerning and disturbing. The concept of the body, reproduction, and violence shown through the novel are the most prominent and key concerns seen in this literature selection that I would like to analyze in this expository essay. Beginning with the concept of the body, The Color Purple portrays a very graphic portrayal from the first pages. â€Å"She ugly† (Walker, 9). This gives the feel that the men have high standards of the women that are seen in this story of Black Southern Women. This also can be seen when Celie (the main character) holds on to a picture of Shug Avery (the woman she lets her husband have an affair with) because she is so beautiful. These are ideals seen in our culture as a whole. Women holding onto pictures of women in magazines and posters lead to the idea that the airbrushed picture is attainable and that is what the women of the world need to look like. The forerunner of this is visualized when this is what the men look at in their magazines. The view that men have of women is one of this sexual being waiting to be had. Celie holding onto this picture is the same as a woman today buying a magazine that appeals to her inferior parts. â€Å"I’m not as pretty or as smart†(10) is played on throughout the book as well as in our culture. Women of the world today need to be attractive to be someone, or so it seems. The same way Celie is a barefoot and pregnant housewife living her fantasy of a singer that is attractive. The epitome of the quotes that shows the sexuality associated with a women’s body is â€Å"right down there in your *censored* is a little button that gits real hot when you do you know what with somebody† (81). This allows the feeling of vulgarity in someone’s mind today, because talk of this sort is discounted. Throu gh this following quote it continues with other vulgarities that society does not accept â€Å"I kiss her back†¦Then us touch each other† (118). Mainly, because female sexuality as a whole is discounted and seen as a negative portrayal of our home lives.

Health Care Information Systems Essay

Health Care Information Systems Terms Define the following terms. Your definitions must be in your own words; do not copy them from the textbook. After you define each term, describe in 40 to 60 words the health care setting in which each term would be applied. Include at least two research sources to support your position—one from the University Library and the other from the textbook. Cite your sources in the References section consistent with APA guidelines. |Term |Definition |How It Is Used in Health Care | |Health Insurance Portability and |This is a federal law that was passed in |HIPAA is used in Health care to help keep | |Accountability Act |1996 that will protect the continuousness |patient information private and secure. | | |of health coverage when a patient changes |HIPPA ensures that all patient health | | |or loses their job which can limit the |information is being stored in a secure | | |health plan exclusions for preexisting |location and only authorized staff should | | |medical conditions that require the patient|be able to access this information. If this| | |medical information to be kept private and |information is not protected the health | | |secure. |care organization can face fines and | | | |penalties (Wager,, Lee,, Glaser,, & Burns,,| | | |2009). This term will be applied to the | | | |whole health care facility. | |Electronic medical record  |Is an electronic record of a patient’s |The electronic medic al record will be used | | |health related information which can be |in the health care setting each and every | | |created, gathered, and managed by |time the patient visits the health care | | |authorized clinicians and staff within the |organization. This is how providers are | | |health care organization. |able to keep up with the services and | | | |procedures that patients receive every time| | | |they are seen by a provider. This term will| | | |be used I billing and coding and | | | |departments as well as medical records that| | | |may need to check patient status or | | | |allergies. | |Electronic health record |Is an electronic record of health related |The electronic health record is a record | | |information on an individual that conforms |that can be seen at multiple health care | | |to nationally recognized health information|facilities at one time. When this | | |standards and that can be created, managed,|information is sent to different providers | | |and revised by authorized staff in more |it is encrypted in the event someone that | | |than one location. |is not authorized has access to it they | | | |will not get patient information that | | | |should be private. | |Personal health record |Is an electronic record of health related |Personal health record is the health  record| | |information on a patient. This information |of the patient which the patient has | | |can come from different facilities that |control over. The patient can get health | | |the patient may have been seen at. And the |information from different providers and | | |information can be managed, shared, and |share this information as they see fit. The| | |controlled by the patient. |personal health record may have some health| | | |information that the patient may feel the | | | |new provider does not need to see in order | | | |to treat them. This will be for the patient| | | |to disclose with the provider and then the | | | |provider may add this information to the | | | |patients chart. | |Computerized provider order entry system |Is a system that allows users to |This computerized provider entry system | | |electronically write orders, maintain the |lets providers monitor the patient’s | | |online medication administration record, |medication distribution. Providers and | | |and go over changes made to an order by |authorized staff are able to write | | |authorized personnel. |prescriptions for patients and track | | | |previous prescriptions. Providers will be | | | |able to see how long it’s been since they | | | |filled a p rescription for a patient. This | | |  |will be applied at the health care | | | |organization. | |Unique patient identifier |Is a system that uses information such as |The unique patient identifier lets | | |the patient’s date of birth to create a |provider’s look at patient health care | | |unique code that is reported instead of the|information without having to use patient | | |patient’s name. |personal information to identify them. This| | | |helps the organization stay in compliance | | | |since according to HIPAA all patient | | | |information must be secure and kept | | | |private. This will be used any place in the| | | |health care organization where a patient’s | | | |chart will need to pulled or looked up. | |Protected health information |Is any identifiable health information. |Protected health information is the | | |Individually identifiable health |patient’s personal information such as date| | |information is that which can be linked to |of birth social sec urity number and even | | |a particular person such as date of birth, |their address where they reside. This | | |address, and social security number. |information needs to be in a secure | | | |location at all times. The data entry | | | |person will have access to this information| | | |as well as the billers and coders in a | |  | |health care organization. | |Centers for Medicare & Medicaid Services |Is a federal agency within the United |The Centers for Medicare and Medicaid | | |States Department of Health and Human |Services set the pace on how and what other| | |Services that administers the Medicare |insurance companies will be expected to | | |program and work in Medicaid. |cover depending on the patients plan. This | | | |will be used all over the health care | | | |facility to make sure everyone is always in| | | |compliance with state and federal laws. | |Covered entities |Is three specific groups including health |With covered entities this will apply to | | |plans, health care, clearinghouses, and |anyone who is authorized to access patient | | |health care providers that transmit health |information and is sharing patient health | | |information electronically. |with other parties inside and outside of | | | |the health care organization. Is | | | |information is used inappropriately the | | | |health care organization will be | | | |responsible and could face penalties and | | | |fines. | |Health information exchange |Is the process of sharing electronic health|Health information exchange can happen when| | |information between health care |two health care organizations or facilities| | |organizations. When sharing this |need to share information about a patient | | |information staff should make sure they are|(Morrisey, 2011). Depending on how the | | |sharing in a way that will protect the |information is sent it must be encrypted so| | |confidentiality and privacy of the patient.|hackers are able to identify the | | | |information being transferred. | | | | | | | | | References Morrisey, J. (2011). Health Information Exchange. Retrieved from http://search.proquest.com.ezproxy.apollolibrary.com/docview/854861185?accountid=35 812 Wager,, K., Lee,, F.W., Glaser,, J.P., & Burns,, L.R. (2009). Health Care Information Systems. A Practical Approach for health Care Management (2nd ed.). Retrieved from .