Revival of the Irish Culture Essay -- Essays Papers

Recovery of the Irish Culture Individuals of Irish not too bad offer a pride in their national legacy maybe not at all like some other culture today. Numerous Irish homes are adorned with clovers, banners, and other Gaelic images even today. This energy for Irish culture has not generally been near. Indeed, this wellspring of pride can be followed back to one social restoration development in Ireland during the 1800’s. During this time, the individuals of Ireland shaped the Gaelic League to bind together their nation, and to give themselves a national character of where they originated from. Because of the oppression of the Catholic Church, the Great Potato Famine, and numerous types of abuse from the British, Ireland required a memorable approach their rich social history. Numerous variables go into causing a nation to change into a country. Eoin MacNeill, the main leader of the Gaelic League, had confidence in this full heartedly. He accepted that it took substantially more then just political power to bind together a nation into a country (Hachey and Hernon Jr. furthermore, McCaffrey 140). MacNeill realized that with the goal for Ireland to bind together, they were going to need to have a rich social history. His answer for this absence of culture was the Gaelic League. MacNeill asked the individuals of Ireland to be glad for their language, however their specialty, writing, sports, and move. Very quickly the individuals of Ireland took to this new feeling of social patriotism. The Irish started to accept that their language was not just an approach to impart, yet a method of social qualities and a lifestyle (Hachey and Hernon Jr. what's more, McCaffrey 140). Individuals from the urban white collar class, who recently remained unaware of the Gaelic h istory, started joining the association in huge measures of numbers. Before long, many... ...nal legacy. Albeit many contend that no other Irish social developments prevailing during this timespan, the Gaelic League maybe did what's necessary for every one of them. Today Irish are glad for what their identity was, and what they have become. Works Cited Mansion, Gregory. Innovation and the Celtic Revival. Cambridge: Cambridge UP, 2001. Hachey, Thamas E., Joseph M. Hernon Jr., and Lawrence J. McCaffrey. The Irish Experience. Englewood Cliffs: Prentice-Hall Inc., 1989. Hepburn, A.C.. â€Å"Language, Religion and National Identity in Ireland since 1880.† Perspectives on European Politics and Society 02.2 (2001) <http://search.epnet.com/direct.asp?an=9846113&db=aph> Academic Search Premier Mill operator, David W. â€Å"Irish Catholicism and the Great Famine.† Journal of Social History 09.1 (Fall 1975) <http://search.epnet.com/direct.asp?an=5498310&db=aph> Academic Search Premier.

Business Level Strategy Analysis of Different Training Tool

Question: Clarify the dynamic procedure the board uses to create suitable strategies to an assortment of the board circumstance? Answer: Presentation The examination will finish up about the advancement procedure of a qualities discoverer trial of an association. The job of the worker is vital in the administrative plans and methodology. There are various types of objectives and exercises, which each organization creates in the tasks. The job of the workers is a lot of urgent towards the accomplishment of those objectives and exercises. The idea of inspiration is one of the significant ideas that should be joined towards expanding the exhibition of the workers. In the event that the workers are propelled and fulfilled in an appropriate way, it will consequently build the proficiency level in the administration. There are sure territories in which the director needs to center so as to build up a solid and an appropriate instructional course, contingent on the destinations of the associations. The instructional course should be created in such a way, through which the workers of the organization are profited in various manners. Examination of various preparing apparatus There are various points of interest towards the improvement procedure of a legitimate judgment making exercises. Efficiency, improving spirit support, web assets, and collaboration are the various types of points of interest, which are deduced in the judgment making procedure of the administration. At the point when workers are engaged with the general dynamic procedure of the administration it causes the administration to build up a solid and a legitimate correspondence framework in the venture. Be that as it may, it likewise builds up an ethical help for the workers in the endeavor, which support the presentation level of the representatives in the whole venture. At long last, the idea of cooperation is another extra element, which is remembered for the general activities. Cooperation of representatives, in the general judgment-production procedure of the administration, permits all the workers to hear chance to voice their point of view, it builds the effectiveness level. As it, permit expansion of thoughts. In this specific examination, there are various types of solidarity, which are distinguished in the general operational procedure to decide the general quality of the representatives. A portion of the significant quality discoverers are introducing a legitimate checking framework. The subsequent point, which should be created in the quality discoverers process are bending workers, relationship building, and vital reasoning. There are sure focal points of building up a legitimate checking framework. Checking framework is a piece of a controlling framework. With the assistance of a legitimate controlling framework in the endeavor, the administrator in the association will have the option to coordinate the first execution with the arranged presentation. It will go about as a directing framework in the association and will at the same time help both the representatives and the organization to coordinate the first execution with the arranged presentation of the association. On the off cha nce that there is any deviation occurred in the operational plans and strategy, the administration will have the option to bring back all the digressed things in the groove again. Notwithstanding, there are distinctive extra things, which are remembered for the advancement procedure of an appropriate quality in the endeavor. A definitive target of any supervisor is to build up an appropriate system, which will permit the administration to get the ideal objectives and exercises done by the person. Be that as it may, the other two preparing devices are on field preparing and off field preparing. It will permit the representatives to lean from the field exercises. It is one of the most troublesome occupations for the chiefs to complete the work the ideal individuals. By applying these specific instruments in the operational procedure, the administrator will be profited in various manners. In the hour of globalization there various workers joins from various social foundations in the administration. The method of conveying and the method of working varies from one another. The quality and shortcoming of various workers contrasts from one another. This is one of the most significant focuses which greater part of the supervisors needs to perform. Portion of occupations by coordinating the nature of the workers with the assistance of the constrained assets is a definitive targets of each mentor and directors. End The finishing up some portion of the investigation will sum up all the variables, which will close about the quality and shortcoming of the representatives. So as to facilitate all the representatives appropriate way it will guarantee the administration to build the whole proficiency level in the endeavor. There are sure methodologies, which will goes about as quality discoverers in the administration. Other quality discoverers exercises, for example, collaboration, curving representatives, relationship building and key reasoning are the significant quality discoverers. Most of the mentors follow towards the improvement of workers in the dynamic procedure of the administration, which is one of the imperative procedure.

Beer Withdrawal Symptoms From Mild to Severe

Beer Withdrawal Symptoms From Mild to Severe December 01, 2019 More in Addiction Alcohol Use Binge Drinking Withdrawal and Relapse Children of Alcoholics Drunk Driving Addictive Behaviors Drug Use Nicotine Use Coping and Recovery Can beer drinkers have withdrawal symptoms? There is a misconception among some drinkers that if they stick to beer it is somehow better for them than drinking the harder stuff. Of course, it is true that you can get more intoxicated faster by drinking whiskey, simply because you have less fluid to swallow. You can down a 1.5 ounce of liquor a lot faster than you can a 12-ounce beer. But when it comes down to it, there is just as much alcohol in a can of beer as there is in a standard mixed drink or a 5-ounce glass of wine.?? Each represents  a standard drink  when determining whether you are drinking at a safe level or at a high-risk level. Alcohol withdrawal symptoms can occur when someone stops drinking alcohol.?? Those symptoms can range from mild, moderate or severe, but the severity of the symptoms has nothing to do with the type of alcohol the person stopped drinking. Beer drinkers who stop drinking cold turkey can experience the same level of alcohol withdrawal symptoms as those drinkers who consume liquor or wine. How Much Beer Is Too Much? The  recommended guidelines for beer consumption  are the same as they are for any other alcoholic beverages: 2 or fewer beers a day for men and less than 14 beers a week. For women, its 1 or fewer beers a day and no more than 7 beers a week.?? How Much Alcohol Is Safe to Drink Per Day? Any beer consumption above those levels is considered  high-risk drinking: it puts you at increased risk for developing alcohol use disorders and for developing negative health consequences.?? How much, how often, and how long you consumed alcohol play a role in  how severe the withdrawal symptoms might be. If you drank only one beer a day, your withdrawal symptoms (if you have symptoms at all) are going to be a lot less severe than if you drank a six-pack.If you drank only three times a week, chances are your withdrawal symptoms will be less severe than if you were a daily drinker.And, if you drank a case a week for 30 years, your withdrawal symptoms will probably be more severe than if you decided to quit after two years of that level of alcohol consumption. Other risk factors are more personal: your size, gender, genetics, and even race can have an impact on your reaction to alcohol consumption and withdrawal. Are Your Withdrawal Symptoms Mild, Moderate, or Severe? Do you have withdrawal symptoms when you try to stop drinking beer? Answering these 10 questions will give you an idea of your alcohol withdrawal symptoms are mild, moderate or severe. Severe symptoms, which usually occur about two days after withdrawal, can be life-threatening, so it is important to consult a doctor if you have concerns. The test is completely confidential and anonymous; your results are not recorded and are available only to you. You are not asked for any personally identifying information. This quiz is not intended as a substitute for a professional medical evaluation. It should only be used as a guide to determining if your alcohol withdrawal symptoms are such that you should seek medical attention before you attempt to quit drinking.? Common Alcohol Withdrawal Symptoms

The Myers Briggs Type Indicator - 1413 Words

Introduction The Myers-Briggs Type Indicator (MBTI) â€Å"is an introspective self-report questionnaire designed to indicate psychological preferences in how people perceive the world and make decisions† (13). It is one of several personality assessments that is popular among modern mental health experts throughout the world. Currently, it is estimated that the MBTI is â€Å"taken by more than two million people per year and is translated into 16 languages (10). â€Å"The purpose of the Myers-Briggs Type Indicator personality inventory is to make the theory of psychological types described by C. G. Jung understandable and useful in people s lives† (4). The MBTI is utilized in variety of ways throughout our society. In particular, it is used†¦show more content†¦So together, over the next several years, the mother daughter team, using much of Jung’s work as a foundation, tinkered and toyed, until they fit Jung’s theories into a practical questionnaire that could be utilized in such a way as to determine a person’s individual psychological â€Å"type†. Over the years that questionnaire has been continually updated, modified, and refined. Today, it is largely considered the most trusted personality assessment available. What is the MBTI? The MBTI differs from the more traditional testing and measuring traits, such as intelligence quotient (IQ) testing, in that the MBTI assesses individuals, and then classifies them into specific â€Å"types†. Although originally published by the Educational Testing Service, the MBTI protocol is currently controlled and published by the Consulting Psychology Press (CPP). To keep up with changing social standards and norms, CPP continually seeks to improve the MBTI, and as such the assessment is constantly in flux. In years past, there was only one set of official assessment questions. That has changed over time, and at present there are four unique versions of the assessment. Theory The theory behind the MBTI purports that while we are each born with particularly unique traits and â€Å"types†, each of our individual traits can be affected and amended by habit and repetitiveness over time, while, in general,Show MoreRelatedThe Myers Briggs Type Indicator996 Words   |  4 PagesThe purpose of the Myers-Briggs Type Indicator (MBTI) â€Å"is to make the theory of psychological types understandable and useful in people’s lives. The essence of the theory is most people do have consistent behavioral patterns† (The Myers Briggs Foundation, 2015). The theory was introduced in the 1920’s by Carl G. Jung and the MBTI tool was developed in the 1940’s by Isabel Briggs Myers and her mother Katharine Briggs. In the first phase, our team was to take the MBTI assessment. Based on our findingsRead MoreThe Myer-Briggs Type Indicator665 Words   |  3 Pageshasn’t stopped us from attempting something similar. Developed in the 1940’s and 1950’s, the Myers-Briggs Type Indicator has been tested hundreds upon hundreds of times, with accurate results. Research is ongoing, and millions of people have taken the instrument since it’s conception. The Myers- Briggs Type Indicator (MBTI) is composed of four parts, each one with two options, making it a total of 16 types. Further explanation for the parts of the instrument can be found below. The first sectionRead MoreThe Myers Briggs Type Indicator1502 Words   |  7 PagesThe Myers-Briggs Type Indicator (MBTI) test was developed by Katherine Briggs and her daughter Isabel Myers in the early 20th century. Their dedication to developing this test was inspired by the work of Swiss psychiatrist Carl Jung who introduced the theory of psychological types. The personality test taken, identified me as an ISTJ with the temperament of SJ. The results of this test will be explained by analyzing to some degree what makes me preferential to some type traits over others andRead MoreThe Myers Briggs Type Indicator915 Words   |  4 PagesContemporary Organization behavior Course Code: HRPD_702 Section: 005 Instructors Name: Preiti Momaya Date Submitted: 10/08/15 â€Æ' MINI- â€Å" MYERS-BRIGGS† TEST The Myers–Briggs Type Indicator (MBTI) is a self-report poll which is fundamentally intended to demonstrate mental inclinations and how individuals communicate once a day with the world and take choices. It likewise demonstrates the identity the person’s natureRead MoreThe Myers Briggs Type Indicator Essay2255 Words   |  10 PagesThe Myers-Briggs Type Indicator (MBTI) is a self-report personality assessment developed by Katharine Cook Briggs and Isabel Briggs Myers based on the typological personality theory of Carl Jung. The MBTI is comprised of four dichotomous nominal scales: Introversion/Extroversion, Sensing/Intuition, Thinking/Feeling, Judgment/Perception. These four scales assign individuals one of sixteen personality types. While the measures of the MBTI themselves are taxonomies, the assigned personality type is aRead MoreThe Myers Briggs Type Indicator1567 Words   |  7 Pagesconcepts of the Myers-Briggs Type Indicator and explore notions about its reliab ility as well as my personal reflection about the test result. In the first part of the report I introduce the Psychological Types of Jung and the Myers-Briggs Type Indicator. The second part regards critical notions about the readability of the MBTI. The third part of the report consists in my reflection about the MBTI and the conclusion. The Myers-Briggs Type Indicator (MBTI) was developed by Katherine Briggs and IsabelRead MoreThe Myers Briggs Type Indicator1471 Words   |  6 PagesSeminar November 10, 2015 MBTI: The Leadership Style of ISTJ Introduction The Myers-Briggs Type Indicator (MBTI) is a personality assessment that was originally developed by the mother-daughter duo, Katharine Cook Briggs and her daughter Isabel Briggs Myers. After meeting her daughter’s future husband for the first time, Clarence Myers, Katharine got inspired to start researching personality types after she noticed that although Clarence was a good match for her daughter, he seemed toRead MoreThe Myers Briggs Type Indicator1534 Words   |  7 PagesThough the Myers-Briggs Type Indicator (MBTI) Personality Test endures constant scrutiny from the field of Psychology, I believe that the test, while not always getting everything correct, does a good job at pinpointing certain aspects of one’s personality and tendencies. Upon taking the test in class, I was classified as ENTP, meaning Extroverted, Intuitive, Prospecting, and Turbulent; this personality type is nicknamed â€Å"The Debater.† While the site’s description of the categor y as a whole doesRead MoreThe Myers Briggs Type Indicator2448 Words   |  10 Pagesthe Myers-Briggs Type Indicator or the MBTI. The core idea of this assessment when being created was to help individuals gain more insight into their personalities. In the words of the creators, Katherine and Isabel Briggs Myers, this assessment was created to enable individuals to grow through an understanding and appreciation of individual differences in healthy personality and to enhance harmony and productivity among diverse groups† (History, reliability and validity of the myers-briggs typeRead MoreThe Myers Briggs Type Indicator1235 Words   |  5 PagesIn this section of my leadership development plan, I am asked to examine my personality using the Myers-Briggs Type Indicator, which was developed as a job placement tool during the 1930s and 1940s by Katherine Briggs and her daughter, Isabel Briggs-Myers, using the theories of personality presented by Carl Jung a decade earlier (Quenk, 2009). According to the theory, each person tends to fall on one of four sides of opposing scales. The scales are Introversion (I)/Extraversion (E), Sensing (S)/Intuition

Essay on Right Mindfulness in Buddhism - 1089 Words

Right Mindfulness in Buddhism Buddhists emphasize having ‘Right Mindfulness’ as a vital part of meditation as well as one of the most important steps in the eight-fold path to enlightenment. Having mindfulness is being completely aware of what happens to us and in us and only focusing on these things. Right mindfulness, defined as â€Å"the clear and single-minded awareness of what actually happens to us and in us, at the successive moments of perception,† holds an essential role in the practice of Buddhist meditation (Klostermaier, Buddhism, Pg. 132). This same concept can be beneficial to people that do not even practice Buddhism. Living life in a state of mindfulness promotes relaxation, awareness, efficiency and control. All of†¦show more content†¦This is just one of many simple example of how living a mindful life can be beneficial because we learn to devote due attention to the people and causes that are most important to us. There are many â€Å"miracles† that inte grate into our lives when practicing mindfulness. The first two miracles are the ability to be aware of the present and to make whatever is present truly present in our minds. In other words, we learn to concentrate on the ‘now’ rather than the past or the future, by which most people tend to become distracted. For example, when we eat, we may be thinking of a wide range of things from what has happened already in the day to what we plan to be doing tomorrow. By being distracted in this manner, we never really get the opportunity to enjoy our meal. Concentrating on the meal that we are eating in the present time makes it present in our actions as well as in our mind. This awareness of our current actions results in the unique chance to enjoy the act of eating a meal. One may think that we must always be aware of the present, but there are many examples of when we are not. When we drive home after work, we do not concentrate on driving home, we think about what we will prepare for dinner and all of the tasks that we must complete before going to bed. Likewise, when we eat, we are constantly preparing for the next bite of food before we have enjoyedShow MoreRelatedBuddhism : The Philosophy And Religion1426 Words   |  6 PagesBuddhism originated 2,500 years ago in India and today – is the prevailing world religion in the East. There are more than 360 million followers of Buddhism, including one million American followers. Buddhism has branched into a diverse selection of forms throughout its long history, however, all methods of Buddhism share an admiration for the teachings of Buddha with the ultimate focus on ending suffering (Religionfacts.com, 2015). In the 6th century BC, Siddhartha or Gautama Buddha was born inRead MoreThe Religion Of Islam And Buddhism1476 Words   |  6 Pages Islam and Buddhism are two of the biggest religion in the world. Around 1.5 billion of population is occupied by Islam and nearly half billio n of population is occupied by Buddhism ( http://www.worldometers.info/world-population/). These two religion has different faith, belief, culture and tradition. Knowing that the use of alcohol is common in most parts of the world among different communities and tradition, it would be a great interest of knowledge to understand the facts how these two-religionRead MoreBuddhism : Buddhism And Buddhism982 Words   |  4 PagesBuddhism is a philosophy that is often viewed as a religion and dates back to approximately 6th century B.C.E. Buddhism originated in the Indian subcontinent by a man known as Siddhartha Gautama. The original language of Buddhism is often debated as some scholars believe that it was first practiced in Pali while other believe it was first spoken in Sanskrit. The practice of Buddhism first spread to China in the 2nd century A.C.E and was translated to Mandarin in 3rd century A.C.E. Today, there areRead MoreWhat Does Eastern Religions Mean For Americans?1397 Words   |  6 PagesReligions mean to Americans?† Starting in the 19th century, Buddhism began to make its way to America through the immigration of the Chinese whom brought their religious traditions with them. Buddhism continued to gain popularity in America when Buddhist texts, as well as Buddhist teachers, were brought here to share and spread their religion. It wasn’t until the late 1950’s/early 1960’s that we see the interest in Buddhism, particularly Zen Buddhism, blossom throughout the country. Through the memoir â€Å"SacredRead MoreThe Four Noble Truths Of Buddhism1642 Words   |  7 PagesMy Enlightenment Ever since I was a sophomore in high school, I have always had a particular interest in Buddhism. I have embraced the similarities that I have found within myself and the Buddhism religion. A few years ago, I was in a dark state of mind after my father had passed away. During my healing process, I felt that I was awakened in which I found my determination to search for my enlightenment. I spent a few weeks searching for what I thought was my path to end my suffering. I needed toRead MoreHow Buddhism Has Changed Essay1643 Words   |  7 PagesHow Buddhism Has Changed Albert Einstein once said, â€Å"Buddhism has the characteristics of what would be expected in a cosmic religion for the future: it transcends a personal God, avoids dogmas and theology; it covers both the natural spiritual, and it is based on a religious sense aspiring from the experience of all things, natural and spiritual, as a meaningful unity.† I though this quote was an interesting beginning into seeing how this ancient religion changed over the course of its existenceRead MoreComparing Buddhism And The Bhagavad1453 Words   |  6 PagesContrasting Early Buddhism and the Bhagavad GÄ «tÄ  Early Buddhism and the Bhagavad GÄ «tÄ  have a wide array similarities and differences. Both Buddhism and the Gita deal with an inner struggle. We see Arjuna dealing with the struggle of whether or not he should murder his family in order to obtain a kingdom. In Buddhism, we see the inner struggle as the quest to find nirvana and the pain that is the very act of living. Although there are some similarities, the differences between Buddhism and the Gita areRead MoreBuddhism, Buddhism And Buddhism1371 Words   |  6 PagesBuddhism is one of the largest religions in the world that started in India. Later spreading to China,Burma,Japan , Tibet and other parts of southeast Asia. Buddhism is a religion that Is concentrated on spiritualism than religious teachings. Established by the buddha, one must obtain their own spiritual awakening, or nirvana through meditation. There are three main branches of Buddhism Theravada Buddhism , Mahayana Buddhism and Tantric Buddhism. About 2,500 years ago, Prince SiddharthaRead MoreThe Four Noble Truths Are Good Guidelines For Life1184 Words   |  5 PagesThe Four Noble Truths Are Good Guidelines for Life Siddhartha Gautama founded Buddhism over two thousand years ago. Gautama was a Nepali prince, sheltered from the world until his late twenties. Up until the time he left home he had lived a life of luxury, married his cousin, and had a child. Once Gautama departed, he was able to see the suffering in the world. He had a sick man, and old man, and a corpse. Because Gautama was so sheltered he had never encountered aging, sickness, or death—a conceptRead MoreBuddhism : A Religion Of Peace And Non Violence1185 Words   |  5 PagesFrom the lavish beginnings in a wealthy kingdom nestled within the Himalayan foothills of Nepal, Siddhartha Gautama’s transformation into the Buddha and the start of Buddhism was based off of and due to confronting constant human suffering in everyday life. Abandoning his regal life in pursuit of spiritual insight, Siddhartha sought to understand the problem of human suffering and propose remedies, if any, to such a condition. Verses, lectures, and sutras transcribed in scriptures by Buddha’s followers

Polycystic Ovary Syndrome Free Essays

string(103) " evaluate the quality of life in women with PCOS in King Abdulaziz University Hospital in Jeddah 2018\." Introduction: Polycystic ovary syndrome (PCOS) is a common endocrinology disorder affecting 15–20% of women in reproductive age worldwide (1).   PCOS characterized by hyperandrogenism and high level of insulin resistance which leads to the dysfunction of the hypothalamic-pituitary-ovary axis, resulting in anovulation and menstrual irregularity (2-6). PCOS is considered the most common cause of anovulatory infertility. We will write a custom essay sample on Polycystic Ovary Syndrome or any similar topic only for you Order Now Around 90%–95% of an-ovulatory women visiting infertility clinics have PCOS (7). The current first-line infertility treatment in women with polycystic ovary syndrome is Clomiphene Citrate. However, it has drawbacks, including its overall poor efficacy (only a 22% rate of live birth with up to six cycles of clomiphene (8)), ovulation rate of only 46% (9) and an undesirable side-effect profile, including mood changes and hot flushes. Failure either to ovulate (clomiphene resistance), or to conceive with ovulation (clomiphene failure) often leads to the use of more expensive treatment options for infertility that associated with higher multiple pregnancy rates and an increased risk of the ovarian hyperstimulation syndrome (10). Insulin-sensitizing agents, such as metformin, have been used successfully to treat women with PCOS (11). However, metformin also has multiple undesirable gastrointestinal side effects such as nausea (61%), vomiting (30%), and diarrhea (65%). (12,13) Furthermore, many women who have PCOS are not satisfied with pharmaceutical treatment. In a survey done on women with PCOS, 99% expressed their desire for effective treatment alternatives to fertility drugs, (14) and as many as 70% of women with PCOS use complementary medicines (15-16). Herbal Medicine is still widely used from world population for approximately 75-80%; this is because that herbal medicine is considered more culturally acceptable, less dangerous and more natural form of treatment (17). In Saudi Arabia, approximately 80% of the population use herbal medicine, and one of the main reasons is the ease of use of herbs that could be taken orally without painful procedure or invasive methods (18). Cinnamon, a commonly used spice, has become a natural product of interest because it has been considered to have health benefits, such as reducing blood glucose, total cholesterol, LDL cholesterol and decreasing insulin resistance (19). Cinnamon increases insulin sensitivity likely because of its effect on intermediate metabolites acting at the cellular level (20). Several studies stated that polyphenol polymers isolated from cinnamon could increase insulin-dependent glucose metabolism. (21-23) Cinnamon usually causes no serious side effects. The reported adverse events of cinnamon include headache, heartburn and menstrual cramps (24). In general, herbal medicines are better tolerated than pharmaceutical medications as shown in a systematic review for critical evaluation of clinical efficacy and adverse events of herbal remedies (25). Cinnamon extract may offer a low cost, readily available and relatively easily implemented means of reducing insulin resistance and thereby improving ovulation in women with PCOS.2. Literature Review: A randomized, double-blinded, controlled trial investigating the effect of cinnamon on menstrual cyclicity in women with PCOS, women receiving daily 1.5 g of cinnamon treatment showed significant improvements in menstrual cyclicity, whereas patients receiving placebo did not. Sampling from different patients in the study showed the luteal phase serum progesterone (progesterone level 3 ng/mL), sonographic visualization of corpora lutea, and pregnancy which all support that the bleeding has resulted from ovulatory cycles, rather than merely changes in menstrual flow (24). That suggests that cinnamon supplement may have an effect on ovulation induction in women with PCOS. Regarding the effect of cinnamon on insulin resistance, a study conducted in 2017 involving 66 women with PCOS in a randomized, double?blind placebo?controlled clinical trial. The women in the first group treated by cinnamon capsules 1.5 g/day for three months and the second group by placebo capsules. The homeostatic model assessment for insulin resistance (p = .014) reduced after the three months in the cinnamon group compared with the placebo (26). Another randomized control study concluded that oral administration of 1g of cinnamon extract daily for eight weeks was well tolerated and improved insulin sensitivity in nondiabetic women with PCOS (27). A double-blind randomized control study, comparing the effect of cinnamon and metformin on insulin resistance in 112 women with PCOS taking 1g of cinnamon versus 1g of metformin daily, shows that both significantly decreasing the insulin resistance (28). A study in non-PCOS patients with elevated serum glucose, 173 patients were enrolled and given 500mg of cinnamon daily for two months, showed a significant reduction on fasting insulin, glucose, total cholesterol, and LDL cholesterol and enhanced insulin sensitivity (29). There are many studies conducted on metformin as insulin-sensitizing agent on ovulation in PCOS women. In a systematic review, forty-four trials (3992 women) were included for analysis, 38 of them using metformin and involving 3495 women, clinical pregnancy rates were improved for metformin versus placebo (pooled OR 2.31, 95% CI 1.52 to 3.51, 8 trials, 707 women) and for metformin and clomiphene versus clomiphene alone (pooled OR 1.51, 95% CI 1.17 to 1.96, 11 trials, 1208 women) (30). Since the cinnamon have been suggested to improve the insulin resistance in previous studies and taking into account the side effects of metformin, a cinnamon supplement may offer a good and natural alternative to metformin as an insulin-sensitizing agent and thereby improve the ovulation in women with PCOS.3. Rational:The rarely and non-serious reported side effects of cinnamon along with the cost-effectiveness and availability lead to the need of exploring the effectiveness of cinnamon supplement as a complementary medicine for ovulation induction in women with PCOS.4.1 Aim:To determine the effectiveness of cinnamon supplement and clomiphene citrate (CC) combination on ovulation in women with PCOS.4.2 Objectives:Primary Objective: To compare the effectiveness of cinnamon supplement in combination with clomiphene citrate versus clomiphene citrate alone on ovulation in women with PCOS, in King Abdulaziz University Hospital in Jeddah 2018. Secondary Objectives: To measure the difference in insulin resistance after three months of cinnamon supplementation in women with PCOS in King Abdulaziz University Hospital in Jeddah 2018. To determine the effect of cinnamon and CC combination on menstrual cyclicity, approximated by menstrual frequency, during the study period, in women with PCOS in King Abdulaziz University Hospital in Jeddah 2018. To measure the pregnancy rate in women with PCOS in King Abdulaziz University Hospital in Jeddah 2018. To evaluate the quality of life in women with PCOS in King Abdulaziz University Hospital in Jeddah 2018. You read "Polycystic Ovary Syndrome" in category "Papers" Materials and Methods Place of study:The study will be carried out in King Abdulaziz University Hospital, Obstetrics and gynecology clinics, in Jeddah 2018. Exclusion criteria: Current pregnancy or lactation. Current use of treatment of infertility. Established diagnosis of diabetes mellitus. Use of Insulin-sensitizing treatment within the past three months Hormonal treatment involving estrogen or progesterone within the past three months. Known hypersensitivity to cinnamon. Use of statin medication. Any other supplements that contain cinnamon within the past month. BMI 35. Sample Size:To detect a clinically significant difference of 30% between the previously reported systematic review of ovulation rate (~46%) (9) with a one-sided 5% significance level and power of 80%, a sample size of 82 participants (41 per arm) is required. (Fleiss, Statistical Methods for Rates and Proportions, formulas 3.18 3.19). Randomization:The participants will be randomized in 1:1 fashion using a computer program by trained assistance. Allocation concealment will be ensured using similar bottles labeled by letters A and B to receive either the combination of cinnamon supplement and clomiphene citrate or clomiphene citrate with placebo. The intervention allocation will be blind for both investigators and participants.5.6 Intervention:The Cinnamomum cassia  (C. aromaticum) capsules will be purchase from Spring Valley company (distributed by Wal-Mart Stores, Inc. USA) by the investigator. Placebo capsules will be prepared by Batterjee Pharma Company and will contain 450 mg of starch and 50 mg of cinnamon powder (to improve blindness regarding taste and odor). Shape, size, and color of placebo capsules will be completely similar to the cinnamon capsules.Cinnamon and placebo capsules will be provided to both groups monthly for 12 weeks. Participants will be required to consume two capsules twice per day after meals (2g/day). The last packages of capsules will be checked at the end of the month, and the number of remaining capsules will be counted; after that, new packages will be delivered to patients. All capsules will be given simultaneously with the clomiphene citrate medication. Participants will be asked to keep their normal lifestyle including daily food and physical activity level.The 2g dose of cinnamon is chosen based on published clinical trials in patients with PCOS (8,15,16,17). All participants in both groups will be followed for three months or until pregnancy confirmed. The three month-period has chosen based on a systematic review that showed the effect of cinnamon could be as early as 4 weeks and up to 18 weeks (31).5.7 Adherence:Compliance with diet and medications and interval progress will be monitored with monthly visits with the investigator or his trained assistances along with SMS reminder or WhatsApp messages. Also, participants will be asked to return all study packs (including empty bottles) at every monthly visit.5.8 Patient safety:Patients will be monitored monthly during the study period, and any occurrence of adverse events will be recorded.5.9 Study Outcomes:Primary outcome: Progesterone level 3ng/mL (ovulation confirmation) or pregnancy confirmed.Secondary outcomes: Changes in insulin resistance, menstrual cyclicity, pregnancy rate and fertility quality of life at the end of the study in comparison with the baseline values. Procedure:The study will be initiated after obtaining approval from the Unit of Biomedical Ethics in King Abdulaziz University and approval from Saudi Food and Drug Authority. All patients will be explained the procedure and risks involved in common, understandable languages and a written informed consent will be obtained. First visit: Patients meeting inclusion and exclusion criteria will be evaluated during the early follicular phase (day 3-7) after a spontaneous or induced menses (medroxyprogesterone acetate 10 mg twice?daily for 5 days) for: Baseline blood work:o (Hormone profile: FSH, LH and testosterone levels).o In day 21 (luteal phase) patients will be tested for progesterone level.o Insulin resistance using homeostasis model of insulin resistance [HOMA-IR] and Quantitative Insulin Sensitivity Check Index [QUICK-I].? QUICK= 1 / (log(fasting insulin  µU/mL) + log(fasting glucose mg/dl))? HOMA-IR= (FPI(mU/l) Ãâ€" FPG (mmol/l))/22.5 Height and weight will be measured and recorded for body mass index (BMI). Diagnosis of oligo-/anovulation will be based on a menstrual pattern of oligo/amenorrhoea (cycle 35 days) and/or a low mid-luteal serum progesterone concentration. Hyperandrogenaemia will be diagnosed either clinically (acne/hirsutism) or biochemically (testosterone ?2.5 nmol/l).Last Visit: At the end of three months, all subjects will be re-evaluated during the early follicular phase (day 3-7) after a spontaneous or induced menses for: Baseline blood work: (Hormone profile: FSH, LH, testosterone levels).o In day 21 patients will be tested for progesterone level. Insulin resistance using homeostasis model of insulin resistance [HOMA-IR] and Quantitative Insulin Sensitivity Check Index [QUICK-I]. Height and weight for body mass index (BMI). Menstrual cyclicity, approximated by menstrual frequency, (number menses/number months observed). Pregnancy rate using positive urinary hCG and ultrasound detection of the gestational sac. Assessment of dietary intake: To assess participants’ dietary intake, a 24-h food recall will be collected three times during the study (at baseline, middle and end of study). Patients will complete food descriptions including food and drinks (brand names), food preparation (ingredients) in detail as much as possible in the last day. Pictures of food commonly consumed in Saudi Arabia, together with a set of common household measurement tools (glass, cup, soup bowls, plates, teaspoon and tablespoon) will be provided to assist subjects in estimating the portion sizes of the food. Assessment of physical activity levels: IPAQ will be applied to assess the physical activity level of participants. The IPAQ form comprises walking, moderate- intensity and vigorous-intensity activity and will be expressed as metabolic equivalents per minute (MET-min) per week. The levels of physical activity will be categorized into low, moderate and high, based on the IPAQ criteria. Statistical Analysis:Statistical analysis will be performed using SPSS 25. Data will be expressed as mean  ± SD for continuous variables and percentage for non-continuous variables. Normality tests will be assessed through Shapiro-Wilk tests carried out on each parameter before analysis. Intention-to-treat (ITT) analysis will include all randomized subjects, regardless of whether or not they received the study treatments. Per protocol (PP) analysis will include all randomized subjects who received the study drug and were not lost to follow-up. Participants who lost to follow-up will be assumed neither to be pregnant nor to have ovulation in the ITT analysis.Relative risk, relative risk reduction, Number Needed to Treat and Number Needed to Harm will be calculated at 95% confidence interval. Study variables:VariableOperational definitioni.e., indicatorScale of measurementOvulationProgesterone level in capillary bloodContinuous:Progesterone level ;3ng/mLInsulin resistanceHOMA-IR and QUICK-IOrdinal:HOMA-IR Healthy Range: 1.0 (0.5–1.4)?Less than 1.0 means insulin-sensitive which is optimal.?Above 1.9 indicates early insulin resistance.?Above 2.9 indicates significant insulin resistance.QUICK-I range between 0.45 in healthy individuals and 0.30 in diabetics.Lower values reflect greater resistance with values below 0.339 indicating insulin resistance. Menstrual cyclicityMenstrual frequencyContinuous:(No. of menses/ No. of month)Pregnancy rateNo. of pregnancies including live births, induced abortions, and fetal deaths per 1,000Continuous:(Number of pregnancies including live births, induced abortions, and fetal deaths / Number of women aged 15 – 44 years) Ãâ€" 1,000Quality of lifeInfertility quality of life questionnaire Ordinal Ethical considerations: Approval from the Unit of Biomedical Ethics in King Abdulaziz University will be obtained before the start of the study. Informed consent of the participants will be considered an essential prerequisite for enrollment in the study. This study will be registered in Saudi Food and Drug Administration (SFDA) and at Clinicaltrial.gov website. Confidentiality of the response of the participants will be ensured by keeping the collected data secured and used only for the study purpose. Study duration: The recruitment period will be three months; each arm group will be followed for three months, the total study duration with data analysis and writing the thesis will be ten months.Table1: study time frame How to cite Polycystic Ovary Syndrome, Papers

Post Traumatic Stress Disorder

Question: Discuss about the Post Traumatic Stress Disorder. Answer: Introduction Post traumatic stress disorder is a kind of anxiety disorder. It is a chronic illness which consists of a set of reactions that occur when an individual has gone through a traumatic event of shock. There many factors associated with development of this mental disorder. Trauma is the main reasons, which means a situation where people are trapped and could not find a way to rescue (National Institute for Clinical Excellence, 2005). Such traumatic events lead to Post traumatic stress disorder. Aetiology Post-Traumatic Stress Disorder is a kind of anxiety disorder. The people, who have directly witnessed any kind of traumatic event, and experience repeated and severe exposure to the aversive details of the traumatic event, may suffer from Post-Traumatic Stress Disorder. When an individual goes through a life threatening event such as natural disaster, physical or sexual assault in childhood or adult, serious accident etc. such people can develop PSTD due to the stress reaction (National Institute for Clinical Excellence, 2005). PSTD can also occur, when an individual suffer from the death of loved one then he may develop symptoms of PSTD, not immediately, but even after many years. The scientists are trying to study that why some people develop PSTD and other does not. The studies are also focusing on the genes that lead to creation of fearful memories and some others are involving studies of brain (Ursano et al, 2010). Incidence The incidence of Post Traumatic Stress Disorder are very sever and dangerous. Researchers have explained that most incidences of PTSD appear in vulnerable people, who have gone through some kind of dangerous of severe traumatic event. The prevalence of PTSD is also seen in the victims of rape, assault, physical abuse, and war. Such people are more vulnerable and more likely to develop the symptoms of PTSD. The stage of this anxiety disorder can be set by the genes and specific difference in the brain (Forbes et al, 2007). History of mental illness, head injury or childhood trauma and many other environmental factors can increase the risk of PTSD and hinders the growth of the brain. The prevalence and incidence of Post traumatic stress disorder also depends on the cognitive skills and personality of the individual. The level of optimism and coping skills can have positive and negative impact on the severity of the disorder. Social support of the people also becomes an important factor in such incidence, as social support of an individual will display that how he or she will cope with traumatic events. According to the reports of Australian Bureau of Statistics, 1.4 million people in Australia suffer from Post traumatic stress disorder at any one time, which makes 6.4% of the total population (Hoskins et al, 2015). Many people live with the disorder and they do not even know about their real problem. Predisposing factors People from every age can suffer from PTSD. However, it has been noted that there are some factors that increase the risk of the disease. These factors are mainly the traumatic events, which involves experiencing trauma in early childhood (neglect and childhood abuse), having a job with increased level of exposure towards traumatic events, suffering from mental problems such as anxiety and depression, lack of support from family and friends, family history of mental illness, depression or PTSD (Carniaux-Moran, 2008). Thus, PTSD can be characterized by the direct exposure to the traumatic events. Here, the primacy of the trauma is more important than vulnerability of an individual. Mental State Examination A brief mental state examination is very important for the patients of PTSD and for DSM-IV mental disorders. Mental state examination is very helpful in explaining the existence of the disorder, extent and frequency of the signs and symptoms, examining that how signs and symptoms relate with social functioning and employment (Carniaux-Moran, 2008). The examination includes: Examination is conducted to identify the impairment of communication and though process. Identify any signs of hallucinations, delusions and persistence of such signs. Examination involves the interaction of the patient, eye contact and any kind of inappropriate behavior cited with an example (Carniaux-Moran, 2008). Examination involves identification of any signs, intent or plans of suicide, suicidal thoughts and homicidal thoughts (Carniaux-Moran, 2008). Examining the ability to maintain minimal hygiene and ability to carry out basic activities. Examination involves identifying signs of short or long term memory loss. Presence of any kind of obsessive and ritualistic behavior that can hinder routine activities. Examination of flow and rate of speech in context with obscure speech patterns, irrelevant or illogical speech pattern, and constant or intermittent speech (Carniaux-Moran, 2008). Examination also involves reporting of the panic attacks, their severity, frequency, duration and effect of the attacks on independent functioning of the patient. Examination involves identifying signs of depression, and anxiety. Presence of impaired impulse control in patient and effect on mood and motivation. Any kind of problem in sleeping pattern and interference with day time activities. Examination of the other symptoms and disorder that interfere with the daily activities (National Collaborating Centre for Mental Health, 2005). Three Problems associated with Patients condition and Rational: Substance use and alcoholism: The patient suffering from PTSD may start substance abuse, alcohol and nicotine in order to cope with their stress and anxiety. Such patients believe that these things can reduce their stress. Substance abuse and alcoholism also increases hallucinations and delusion (Fox et al, 2012). Depression: The traumatic situations can lead the patients towards severe depression. The patient may feel helpless and problems with concentration may also occur (Fortinash Holoday-Worret, 2008). Suicidal Thoughts: The patient suffering with deterioration condition of PTSD may have increased risk of suicide. People suffering with PTSD and other anxiety disorder are more prone to commit suicides (Pitman et al, 2012). Medication Post traumatic stress disorder comes with co-morbidities. These co morbidities include depression and anxiety. Thus, medication of PTSD must mainly focus on reducing depression and anxiety in patients. Selective Serotonin-Reuptake Inhibitors (SSRIs) is the first and most effective medication in treating patients with PTSD. This medication includes SSRIs include fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), fluvoxamine (Luvox), citalopram (Celexa), and escitalopram (Lexapro) (Andrade, 2014). This kind of medication is well known for controlling anxiety and mood disorder. In some of the individuals suffering from PTSD, it has been found that they have deficiency of amygdala serotonin. This neurotransmitter is very important for brain to control mood. Selective serotonin reuptake inhibitors (SSRIs) modulate the level of amygdala serotonin in the central nervous system as well as in the peripheral system (Andrade, 2014). This is the only medication for PTSD, which have been approved by FDA. This medication is also the only medication that has been supported by empirical evidences in randomized controlled trials (RCTs) of reducing the symptoms of PTSD (Jeffreys, 2009). This is the initial part of medication, which is preferred for all the cases of PTSD. Exceptions may occur of the medical history of the patient about any side effects, co-morbidities, response and personal preferences. The exception could also be in the cases, where the patient is suffering from PTSD as well as bipolar disorder. In bipolar disorder, antidepressant can result into mood instability. In this condition mood stabilizing medication such as lithium or an anti-epileptic medication is given to the patient before SSRIs (Laddis, 2011). Nursing Intervention: SSRIs are very important for the patient suffering from Post traumatic stress disorder. This medication facilitates better tolerability and safety for patient. Patient must be encouraged to take medication in order to improve mental health. Patient suffering from mental disorder often refuse to take medication on time. Medication is an essential therapy for such patients. Identifying any signs of the side effects of medication, such as insomnia, anxiety or agitation. This is important to known so that dosage of the medication can be controlled (Ursano et al, 2010) Antidepressant for Post Traumatic Stress Disorder Antidepressants are helpful in balancing serotonergic and noradrenergic neurotransmission. Also this kind of medication is helpful in altering serotonin neurotransmission through different mechanism are helpful in PTSD. Some of the antidepressents are Mirtazapine (Remeron), Venlafaxine (Effexor) and Nefazodone (Serzone) (Jeffreys, 2009). The major use of the antidepressant is to treat the co-morbid Major Depressive Disorder (MDD). This disorder accompanies PTSD in 50% cases. Nursing Intervention: Antidepressant can result into different kind of sexual dysfunctions, which could be very depressive for patient itself. Thus nurse requires to support patient. While administering this medication, the quantity must be controlled and should be cautiously interpreted. Without cautious control it can lead to sever sexual dysfunction, impotency in males and anorgasmia (Ursano et al, 2010). Weight gain is another side effect of this medication, which requires being managed. Patients weight should be monitored regularly (Ursano et al, 2010). Recovery Focused Practice Recovery focused practice is based on the perspective of the individual suffering from mental disorder like PTSD. Recovery refers to retain hope and gain it through good practice. It also involves understanding about the abilities and disabilities of the patient, his active engagement in life, autonomy, and purpose of life, social identity and to develop a positive sense towards life. For this approach, it is essential to understand that recovery of a patient is not a cure, while recovery refers to internal condition and external conditions (Hoskins et al, 2015). Internal conditions are the perspective of the individual about themselves, which includes hope, empowerment, healing and recovery. External conditions include the conditions, which are helpful in making recovery. External conditions are positive culture of healing, implementing human rights and providing recovery oriented service (Stuart, 2014). The participants in recovery based practice will learn to identify the multiple evidence based practice approaches, while providing the trauma therapy to the patient. This practice also facilitates the opportunity for the care providers to implement and integrate the cognitive processing therapy as well. Recovery focused practice also focuses on supportive psychotherapy that help patients to overcome their traumas (Peterson, Prout, Schwarz, 2013). The Goals of Recovery Focused Practice It focuses on recognizing the uniqueness of every individual. It considers that recovery is not just the cure, but it must also involve individuals choices and to improve quality of life. It should be accepted that recovery outcomes are different in every patient, and not same level of recovery can be expected in every patient. Patients should be supported and empowered to have trust in the care providing setting (Peterson, Prout, Schwarz, 2013). Every individual must be supported to make their own choices. Their decision about how they want to spend their life must be accepted. Individual must be supported in a way that they understand importance of their lives and take every possible responsibility of their life. Care providers must also maintain balance between duty of care and supporting individuals. The care providers focus on listening, learning and actively communicating all aspects related to the patient. The care providers are also liable to protect individuals rights, and citizenship. Individuals are also supported to maintain recreational, social, vocational and occupational activities (Peterson, Prout, Schwarz, 2013). Dignity and respect of every individual is very important. Care providers focus on being respectful, courteous and honest. They also respect the values, beliefs and culture of every individual. It also challenges any kind of prevailing discriminations. Working in partnership is another goal of this recovery focused approach. Every individual has the right over their life and recovery can be done by working in partnership with them. It further values importance of sharing relevant clinical information and promotes communication. Goals, aspirations and values of every individual are considered (Review Examination for Post-Traumatic Stress Disorder (PTSD), 2007). Evaluating recovery on different levels is another major goal of recovery focused practice. Individuals are also involved in tracking their progress. Care providers will use their personal experience to improve quality of care. It also focuses on improving employment, housing, social and family relationships, education and well-being of every individual (Peterson, Prout, Schwarz, 2013). Deficits in nursing knowledge can hinder the recovery and progress of the patient. If the nurse do not understand the identification of the co-morbidity and associated psychiatric conditions than success actions can be hindered. It is important to understand the co-morbidities associated with PTSD to improve the quality of care (Wetherell et al, 2013). There could be many clinical and environmental factors associated with PTSD, which can hinder the implementation of actions. These factors may involve ineffective nursing practice, ineffective coping skills of the individual, exposure to substance abuse and alcoholism and risk of self destruction and suicide (Wetherell et al, 2013). Methods to Overcome Barriers Evaluation of suicidal and homicidal behavior. Encourage safety of the patient Providing support and enhancing family support. Identifying ineffective coping and developing acceptance towards emotions. Conclusion Post traumatic stress disorder is the condition, which arises due to exposure to long term traumatic events or reoccurrence of traumatic events. Medication is the best therapy suggested for PTSD, as it helps to control depression and anxiety. There are many different practices to help individuals with this disorder. The paper reviewed Recovery Focused Practice and its goals to help patients suffering from PTSD. References Andrade, C. (2014). Selective serotonin reuptake inhibitor drug interactions in patients receiving statins.The Journal of clinical psychiatry,75(2), 95-99. Carniaux-Moran, C. (2008). The psychiatric nursing assessment.Psychiatric mental health nursing: An introduction to theory and practice, 41-43. Forbes, D., Creamer, M., Phelps, A., Bryant, R., McFarlane, A., Devilly, G. J., ... Newton, S. (2007). Australian guidelines for the treatment of adults with acute stress disorder and post-traumatic stress disorder.Australian and New Zealand Journal of Psychiatry,41(8), 637-648. Fox, H. C., Anderson, G. M., Tuit, K., Hansen, J., Kimmerling, A., Siedlarz, K. M., Morgan, P. T., Sinha, R. (2012). Prazosin effects on stress- and cue-induced craving and stress response in alcohol-dependent individuals: Preliminary findings. Alcoholism,Clinical and Experimental Research, 36,351-360. Fortinash, K. M., Holoday-Worret, P. A. (2008).Psychiatric mental health nursing. Mosby. Hoskins, M., Pearce, J., Bethell, A., Dankova, L., Barbui, C., Tol, W. A., Bisson, J. I. (2015). Pharmacotherapy for post-traumatic stress disorder: Systematic review and meta-analysis.The British Journal of Psychiatry : The Journal of Mental Science, 206(2), 93-100. Jeffreys, M. (2009). Clinicians guide to medications for PTSD.National Center for PTSD. US Department of Veterans Affairs. Laddis, A. (2011). Medication for complex posttraumatic stress disorders.Journal of Aggression, Maltreatment Trauma, 20,645-668 National Institute for Clinical Excellence. (2005). Post-traumatic stress disorder (PTSD): The management of PTSD in adults and children in primary and secondary care.Clinical guideline,26. National Collaborating Centre for Mental Health (UK. (2005). Post-traumatic stress disorder. Peterson, K. C., Prout, M. F., Schwarz, R. A. (2013).Post-traumatic stress disorder: A clinicians guide. Springer Science Business Media. Pitman, R. K., Rasmusson, A. M., Koenen, K. C., Shin, L. M., Orr, S. P., Gilbertson, M. W., ... Liberzon, I. (2012). Biological studies of post-traumatic stress disorder.Nature Reviews Neuroscience,13(11), 769-787. Review Examination for Post-Traumatic Stress Disorder (PTSD). (2007). Retrieved From: https://www.benefits.va.gov/predischarge/docs/disexm56.pdf Stuart, G. W. (2014).Principles and practice of psychiatric nursing. Elsevier Health Sciences. Ursano, R. J., Bell, C., Eth, S., Friedman, M., Norwood, A., Pfefferbaum, B., ... Zatzick, D. F. (2010). Treatment of Patients With Acute Stress Disorder and Posttraumatic Stress Disorder. Wetherell, J. L., Petkus, A. J., Thorp, S. R., Stein, M. B., Chavira, D. A., Campbell-Sills, L., Roy-Byrne, P. (2013). Age differences in treatment response to a collaborative care intervention for anxiety disorders.The British Journal of Psychiatry : The Journal of Mental Science, 203,65-72.