The essence of obsessive-compulsive disorder

Speaking about obsessive-compulsive disorder and its treatment, it is primarily necessary to dwell upon its essence and clearly define this disorder because it is extremely important to clearly realize what the disease is in order to find possibly better treatment and reveal its efficiency.

First of all, it should be pointed out that obsessive-compulsive disorder is a psychiatric disorder, or to put it more precisely anxiety disorder. In fact, it may be manifested in a variety of forms but the two basic components are typical for all cases, i.e. obsession and compulsory behavior. As a rule, the obsessive-compulsive disorder is characterized by a subject’s obsessive thoughts which are often repetitive, distressing, intrusive in a combination with a related compulsions which may task or rituals that aims at the neutralization of the obsessions (Antony 1998).

It should be pointed out that the nature of the obsession often determines the future compulsive behavior (Barlow and Durand 2006). For instance, people who obsessively fear contamination may feel compelled to wash their hands dozens, or even hundreds, times a day.

Unfortunately, nowadays scientists do not really have a clear picture as for the causes and development of obsessive-compulsive disorder but numerous researches reveal the fact that the low level of brain chemical known as serotonin appear to play a key role in its development (Antony 1998). At the same time, the researches also emphasize that two major areas of the brain are also involved: structures known as the basal ganglia and the orbital frontal region which normally “work together to process and filter information received from the environment, and help to control thinking and behavior” (Baer 1998:128) but in the case of obsessive-compulsive disorder the brain does not fully filter out irrelevant information as it should.

In recent years, the researchers also found out that the genetic factor may also play an important role in the development of obsessive-compulsive disorder. Not surprisingly that the cases of the disorder of close relatives people with OCD is nine times higher than those without a family history of the disorder (Rasmussen 1999). On the other hand, the cases of OCD without a family history of the disorder is still unclear.

As a result, different treatments of are suggested, including pharmacological ones but in recent years non-pharmacological treatment is getting to be more popular and widely spread and often is considered to be even more efficient.

Behavioral and cognitive behavioral treatments

Naturally, it is extremely important to analyze the basic non-pharmacological treatments that are currently used and define their efficiency. Speaking about non-pharmacological treatments, it is necessary to point out that currently behavioral and cognitive behavioral treatments are considered to be the main ways of treatment of OCD.

In fact, these treatments are closely interrelated to each other and often are used in a combination in order to increase the efficiency of non-pharmacological treatment. At the same time, speaking about significant differences between behavioral and cognitive treatment, it should be said that cognitive treatment basically focuses on the learning to “replace illogical, obsessive thoughts and beliefs with those that are more rational” while behavioral treatment mainly consists of “exchanging destructive, compulsive behaviors for more productive responses (Barlow and Durand 2006).

At the same time, unlike the cognitive-behavior treatment of other mental and psychiatric diseases, this treatment, being applied to OCD, implies the use of a specific technique known as Exposure and Response Prevention (ERP). The main principle of this treatment is based on gradual learning of a patient to tolerate the anxiety associated with not performing ritual behavior (Barlow and Durand 2006). It means that a patients works in a close cooperation with a therapist and the latter is gradually exposed to anxiety producing thoughts and at the same time the resists the urge to engage in the compulsive behaviors that typically follow.

Practically, it may be presented as follows. For instance, at first a patient may touch slightly something that is very mildly ‘contaminated’ that is the ‘exposure’ stage. In such a situation not washing will be the ‘ritual prevention’. Gradually, the patient is exposed to increasingly more ‘contaminated’ objects to the extent that gradually he/she is naturally getting used to this practice and the ritual, washing in this case, is eventually totally prevented.

It is worthy to note that researchers that studied cognitive behavioral treatment indicated that the person “fairly quickly habituates to the formerly anxiety-producing situation and discover that his/her anxiety level has dropped considerably” (Barlow and Durand 2006:398).

The effectiveness of behavioral and cognitive behavioral treatments

Obviously, in order to properly assess the efficiency of the treatments suggested it is necessary to primarily define the recent trends in the filed of the treatment of OCD. IN this respect, it is necessary to underline that, as it has already been mentioned above, non-pharmacological treatments turns to be more widely spread due to their higher efficiency. In this respect, it is possible to emphasize that the Exposure and Response Prevention therapy is considered by many specialists as the most effective treatments for OCD (Rachman and De Silva, Abramowitz).

At the same time, it is also very important to note that cognitive behavioral treatment at large has been successfully applied to OCD and related disorders and its forms, including generalized anxiety disorder, health anxiety, social phobia and panic disorder. Moreover, another evidence of the efficiency of cognitive behavioral treatment is the fact that it has been a good evidence base in terms of its efficiency in reducing symptoms and prevention of relapse of OCD and other mental health disorders to the extent that it has been recommended in the UK by the National Institute for Health and Clinical Excellence as a number of choice for such mental health difficulties (Barlow and Durand 2006).

Conclusion

Thus, taking into account all above mentioned, it is possible to conclude that the problem of obsessive compulsive disorder is quite serious because of insufficient information about its causes and development that naturally decreases the opportunities to find the most efficient treatment for this disorder. As a result, pharmacological as well as non-pharmacological treatments are equally applied. However, the recent researches reveal the fact that non-pharmacological treatments, including cognitive behavioral treatment, especially the Exposure and Response Prevention therapy, turns to be particularly efficient in the treatment of OCD compared to pharmacological ones. This is why it is possible to presuppose that the latter may be considered to be more perspective in the treatment of OCD than the former.

The Effectiveness of Non-Pharmacological Treatments for Obsessive-Compulsive Disorder is a post from: Online pharmacy blog

The dish for dinner chosen is a chicken backed with lemon and potato. For this dish which is cooked for 35 minutes the following ingredients are combined: chicken breasts which are stated to contain 18, 20 grams of proteins, 18, 40 grams of fat and 241 total calories; a clove of garlic that contains 6, 5 grams of proteins and 0 grams of fat with total 46, 00 calories; potato which contains 2 grams of protein, 0, 40 grams of fats and 80 calories in total. Taking into consideration the way it is backed and general rules of preparation the dish is said to contain 16 grams of fat and 320 calories in total. Now applying the mathematic formula we can count the percentage of fat in this food.  The general amount of fat in grams we multiply by 9 (as each gram of fat contains nine calories), and this figure we divide into the general amount of calories (320); after that we multiply this number by100 and  we get the percentage of fat in the dish.

That is:

16 * 9 = 144

144 / 320 = 0, 45

0, 45 * 100 = 45 %

So, the percentage of fat in the chicken backed with lemon and potato is 45 % and it is quite fatty food.

The dish chosen to calculate percentage of fat for breakfast is fried eggs with backed with tomatoes.

Ingredients: tomatoes (1, 10 grams of protein), garlic, olive oil (0 gram of protein), and eggs (12, 70 grams of protein). The total number of calories – 204. and the dich contains 16 grams of fat. By conducting the same calculations according to the mathematical formula used for the above described dish we get:

16 (the total number of fat) * 9 = 144

144 / 204 = 0, 70

0, 70 * 100 = 70 %

All in all, the amount of fat in this dish is extremely high, 70 % out of 100%.

Lunch dish is Greek salad with macaroni. Calories – 418, fat – 23 grams.

23 * 9 = 207

207 / 418 = 0, 49

0, 49 * 100 = 49 %

49 % out of 100 %.

To conclude, after made calculation it is vivid that some all the dishes are fat and lack of protein.

Fat and protein content is a post from: Online pharmacy blog

Еаrly in thе 20th сеntury, Wаltеr Саnnоn’s rеsеаrсh in biоlоgiсаl рsyсhоlоgy lеd him tо dеsсribе thе “fight оr flight” rеsроnsе оf thе Symраthеtiс Nеrvоus Systеm (SNS) tо реrсеivеd thrеаts tо рhysiсаl оr еmоtiоnаl sесurity. Thе fight-flight rеsроnsе is аn аutоmаtiс сhаngе оf рhysiоlоgiсаl mаrkеrs thаt tаkе рlасе whеn а реrsоn suddеnly реrсеivеs dаngеr оr strеss (Саnnоn 1929). Blооd flоw is signifiсаntly dесrеаsеd in thе еxtrеmitiеs whilе bеing inсrеаsеd tо thе vitаl оrgаns оf thе bоdy. This еnаblеs а реrsоn tо rеасt рhysiсаlly tо dаngеr. This рhysiоlоgiсаl сhаngе wаs vеry fаvоrаblе аnd sеrvеd аs аn аutоmаtiс рrоtесtiоn dеviсе, in рrimitivе sосiеty. Аlthоugh thе fight-flight rеsроnsе hаs bееn bеnеfiсiаl аnd nесеssаry fоr survivаl, it саn аlsо bе hаrmful. If wе оvеrusе this nаturаl rеsроnsе by соnstаntly intеrрrеting things аs bеing strеssful оr dаngеrоus, thаt rеаlly аrе nоt, wе аrе сhrоniсаlly sеnding this rеsроnsе tо thе bоdy (Rоhnrmаnn & Hеnnig & Nеttеr  2000).

Thе mаin gоаl оf hаnd-wаrming is tо аssist in mеаsuring оur lеvеl оf strеss thrоugh skin tеmреrаturе, аnd thеrеby аllоw us tо сhаngе оur strеss lеvеl tо mееt thе сirсumstаnсеs. Thе mоrе strеssеd а реrsоn is, thе lоwеr thе tеmреrаturе in thе hаnds, fееt, аnd оthеr еxtrеmitiеs. Thе lоwеr thе strеss lеvеl, thе highеr thе tеmреrаturе shоuld bе in thе еxtrеmitiеs (Rаndоlрh 1984).

Thе gоаl оf thе study is tо аnаlyzе thе еffесt оf strеss аnd rеlаxаtiоn оn fееt tеmреrаturе, аnd thе rеlаtiоn bеtwееn strеss lеvеl аnd hаnd tеmреrаturе. Stаrting hаnd tеmреrаturе mаy vаry with rооm tеmреrаturе; hаnd tеmреrаturе will bе соldеr in а соld rооm thаn in а wаrm rооm. In а rооm оf nоrmаl tеmреrаturе, whеn а реrsоn is nеithеr dеерly rеlаxеd nоr strеssеd, stаrting hаnd tеmреrаturе will bе in thе mild оr high 80′s. Fingеr tеmреrаturе оf 80°F is соnsidеrеd tо bе сооl, 75° F is соld, аnd 70° F оr bеlоw is vеry соld; 90° F is wаrm.

Rаngе оf hаnd tеmреrаturеs is usuаlly intеrрrеtеd (соnсеrning strеss lеvеl) аs fоllоws:

bеlоw 79° – сhrоniс tеnsiоn

79° – 84° – nеrvоus

84° – 90° – alеrt, асtivе

90° – 95° – cаlm

аbоvе 95° – dеерly rеlаxеd.

Thе рrосеss оf tеmреrаturе сhаngеs is nоt linеаr (Сrаwfоrd & Friеsеn & Tоmlinsоn-Kеаsеy 1977); if hаnds аrе quitе соld, tеmреrаturе mаy inсrеаsе vеry slоwly, аnd оnly аftеr sеvеrаl minutеs оf rеlаxаtiоn; if hаnds аrе in thе lоw-mid 80′s tеmреrаturе mаy inсrеаsе rарidly; if hаnds аrе in thе lоw-mid 90′s tеmреrаturе mаy inсrеаsе slоwly, with оnly а fеw dеgrееs оf inсrеаsе, but аt thаt lеvеl, а fеw dеgrееs is а signifiсаnt сhаngе.

Thе study inсludеs twо рrосеdurеs оf mеаsuring tеmреrаturе: thе first оnе bеfоrе rеlаxаtiоn, аnd thе sесоnd оnе аftеr rеlаxаtiоn. Thе hyроthеsis is thаt аftеr rеlаxаtiоn, thе tеmреrаturе оf hаnds will risе tо sеvеrаl dеgrееs shоwing thаt thе lеvеl оf strеss hаs dесrеаsеd. Thе stаtеmеnt оf thе hyроthеsis is mаdе ассоrding tо “fight-fight” suggеstiоn оf Саnnоn (1929), аnd is bаsеd оn thе fасt thаt аftеr rеlаxаtiоn blооd is mоrе unifоrmly саrriеd tо аll оrgаns оf thе bоdy, whilе in thе соnditiоns оf strеss vitаl оrgаns аrе рrоvidеd with blооd first оf аll.

Rеsults

Rооm tеmреrаturе wаs 90° during mеаsurеmеnts. Thе rеsults оf my first аnd sесоnd mеаsurеmеnt wеrе thе sаmе – 96°. Thus, thе hyроthеsis wаs nоt соnfirmеd by thе еxреrimеnt. In my орiniоn, this соuld hарреn duе tо 2 rеаsоns: first оf аll, thе tеmреrаturе in thе rооm wаs rаthеr high, аnd thеrеfоrе, сhаngеs hаnd tеmреrаturе wоuld bе slоw. Sесоndly, thе initiаl stаtе оf 96° mеаns thе dеерly rеlаxеd соnditiоn. Ассоrding tо (Сrаwfоrd & Friеsеn & Tоmlinsоn-Kеаsеy 1977), thе сhаngе оf tеmреrаturе in rеlаxеd stаtеs is mоrе slоw, аnd in this саsе thе сhаngе tо а соuрlе оf dеgrееs is quitе signifiсаnt. Thus, еvеn if my rеlаxаtiоn stаtе hаs bесоmе dеереr, it did nоt rеsult in signifiсаnt сhаngе bесаusе in thеsе stаtеs сhаngеs nаturаlly аrе vеry slоw.

strеss is a post from: Online pharmacy blog

Public health in practice

Currently, the impact of Chlamydia on the nation’s health is considered so significant that the government had funded two pilot screening studies in Portmund and Viral, which started last year in April (Aggio 2009). The screening program was launched after the incidence of Chlamydia rose three-fold in a few years.
Experts estimate that only 10 per cent of patients with genital chlamydial infection come to the department of urogenital diseases, which shows the need for screening in other health care institutions, including general practice. Today, carrying out the tests for this disease is offered at the family planning centers, at the reception of the therapist, as well as at colleges and universities. Such analyses are necessary, since the disease develops without any symptoms (Aggio 2009).
In addition, presently the NHS Funds offer all young people aged 16 to 24 years residing in three districts of London, to take rapid tests for Chlamydia. In the case if the young man sends his test results to the NHS staff, he will receive a certificate equal to £10, which can be spent on the purchase of audio recordings in the chain of HMV music stores. As another way to attract young Londoners to undergo the tests for the disease, the authors of the initiative will hold a lottery among the participants of the action with a popular iPod player as the main prize.
The NHS representatives hope that the mass distribution of rapid diagnostic tests for young people in the long run will save the country’s budget from the substantial costs of the treatment of complications of the genital infection. For example, a large-scale visual propaganda of the use of condoms in Sweden became one of the reasons for reducing the incidence of Chlamydia and other STIs (Götz 2002). The WHO activated the project of global strategy to prevent the sexually transmitted infectious diseases, and the project of their fighting which was started in 2002.
The project provides a framework for planning and implementation of accelerated reactive measures using two main operational elements: a) a technical component that outlines the main activities for infectious disease control (expended access to diagnosis and effective treatment, training or retraining of health personnel, strengthening of the monitoring on epidemics); b) a component of the informative and explanatory activity, which presumes a global campaign to raise awareness about sexually transmitted infectious diseases, and to form the commitment to the issue at the political level (World Health Organization 2006).

Linking theory and practice

In addition to the high incidence of Chlamydia, researchers have found that sexual activity among young British has increased: about a half of girls surveyed admitted that they had two sexual partners over the last year, and 56 per cent of boys reported having a new sexual partner every three months (Park 2007).
One should not forget that the National Health System of Great Britain has published a booklet on sex education for schoolchildren. The slogan for the booklet, which was titled Pleasure, was the phrase “an orgasm a day keeps the doctor away” (Mevissen 2009). One of its authors, Steve Slack, the director of the Center for HIV and sexual health department at Sheffield NHS, believes that the manual does not provoke teenage sex as it may seem, but rather offers the students to put off the loss of virginity until they are confident in their ability to get pleasure from it (Westwood 2006).
It should be noted that British schools pay a lot of attention to sex issues. Great Britain is one of the top states of the developed world for the number of pregnancies among adolescents. The average age at which adolescents become sexually active in the UK is 16 (Turnbull 2008). Moreover, sexually transmitted diseases occur as a result of random, fleeting sexual relationships with unfamiliar or completely unknown partners. Thus, according to the CDC data, only one third of young people use condoms (Creighton 2003). As shown by the WHO, in the number European countries it is ignorance in matters relating to STIs especially among young people that complicates controlling such diseases.

Increased rates of Chlamydia in young people as a public health concern is a post from: Online pharmacy blog

Obesity is truly considered to be one of the fastest growing health problems in the United States today. Interviewed by me the weight loss doctor Dr. Juan Remos admits, that the complication of obesity is really essential health problem as he works with the patients who seeks to solve this difficulty and great trouble for them. Doctor is confirmed that there are several reasons for cases of occurrence of the obesity. First of all, will force that affects a persons daily life, secondly, it is genetics and that it is just so hard for these patients to fight it. It has appeared to be a point of issue nowadays “affecting not only the patients but also every aspect of these people’s lives; even the others that are living with these people of have any sort of contact with them” (Dr. Juan Remos, 2010). Moreover, as stated by the CDC (Center for Disease Control and Prevention), obesity among grown-up population grew on 60 percent during the last twenty years and cases of obese children has grown in tree times more in the past thirty years.

A perplexing number of 33 percent among American people of mature age are corpulent obesity-related deaths have grown to more than 300,000 a year, exceeding only tobacco-related deaths (Obesity in America, 2010).

Obesity problem affects health care costs nowadays in a greater degree collating to the past.  Quite often healthcare companies won’t take a person suffering from obesity as they consider this person as a preexisting condition, it is generally believed, that obese people have more health problems than others. “With obesity come more health complications that are hidden and that can come up at any moment,” assures the doctor Remos (Dr. Juan Remos, 2010). Additionally, according to the new research organized by RTI International, the Agency for Healthcare Research and Quality, and the US Centers for Disease Control and Prevention (CDC) the yearly health care costs connected with obesity in the United States increased twice more comparing to the past ten years and nearly equal to the 147 billion dollars a year. In this research it was established that medical costst of obesity have grown up from 78 billion dollars in 1998 to 147 billion in 2008. Comparing to the medical care costs of people with normal weight, the difference is in 42 percent, that is financial expenses of those with obesity almost 50 percent higher (Catharine Paddock, 2009).

Besides the health care costs, obesity bears another meaningful effect – it influences the quality of life of American obese people, to a great degree deteriorating it. All the spheres of well-being of an obese people deteriorate, including education, recreation, leisure time, social belonging. Speaking about education, sometimes people with obesity would not chose remote universities that require travelling, or would subconsciously avoid success on their job never trying to improve their qualification (in some cases of serious degrees of obesity), their recreation and leisure time would be quite limited, monotonous and, probably, to some extent dull.

The reason of an effect on the quality of life may be outlined as the following: a corpulent person feels psychological pressure from the society and its members. This pressure results in inner inferiority complexes and full unwillingness and reluctance to live healthy, entirely enjoyable life. The result may be that these people are limited to the things they can and even want to do, moreover, ”there are many things that obese people can’t even do because of their size” (Dr. Juan Remos, 2010). People feel embarrassed and they don’t feel that they can be accepted by society because of the way they look.

Among the quality of life layers those health-related are affected to an extremely great extend. Considering condition and body complexion of obese people, it is worthy to mention that it is difficult for them to conduct easy tasks, exercises, as they suffer from body annoyance and even pain, and their general vigorousness, liveliness, strength affect other layer of the quality of life.

Obese people are also suffering from the problems with job outcomes as obesity appears to be an essential hinder and an obstacle on the way of obtaining real dream job or taking a desired vacancy. Doctor Remos confirms this fact admitting that “obese people are having less and less opportunities everyday” (Dr. Juan Remos, 2010). People look at those with obesity problems with the thought that they have no determination as individuals and that is an aspect that corporations look for in a potential employee. Obese people are prejudiced against in the way of their abilities, health condition and rate of productivity in the process of work. Generally, this prejudice is called obesity job discrimination, which is quite a widely-spread phenomenon in the US. The essence of discrimination lies in the evidence that some employers do not want to offer a vacancy or to take on obese people. Finding diverse grounds, arguments and apologies for preventing from working with this people, employers say “no” to their application. That is why in many cases it is difficult for obese person to find a job placement or to be promoted. Arguments based on stereotypes can be of different types, including “less desirable employees who, compared with others, are less competent, less productive, not industrious, disorganized, indecisive, inactive, and less successful..” (Larkin, 1979, pg. 315-316).

The most substantial effect of the sizable importance is the relation of the obesity to chronic diseases as obese people suffer a great number of illnesses of a long time constantly recurring character. They face more than 6 chronic health diseases. These diseases can get complicated and even be life threatening. (Dr. Juan Remos, 2010). Obesity is a major health concern and a large factor in the contraction of diseases such as hypertension {3}, diabetes, and heart disease (Neumark-Sztainer, 1999).

Absence of medically approved diet, lack of physical exercises and general liveliness can add to or make worse illnesses, fitness and shape of health in general, comprising diabetes heart disease, cancers, hypertension, osteoarthritis and many other diseases. Diabetes is one of the most serious chronic diseases among obese people that can lead to death. The type of diabetes that obese people suffer is called type 2, when because of the obesity a patient’s organism cannot use insulin his body produces. Cancer is another dangerous chronic illness to which obese people are most inclined. Obesity deteriorates general condition of illness, making the process of recovering and treatment more complicated. It is stated, that for almost 3 and a half percent of all cases of cancer in the United States are connected with obesity. The reason of such a disease as arthritis is a high level of obesity or physical reluctance, lack of exercises.

So, obese people are subjected to a great number of chronic diseases, being the reason and the subject of the deterioration of a disease.

On the other side, it is stated that concerning job outcomes people do not have problems concerning finding jobs or getting a promotion, as very often employers are also obese, so the case of weight discrimination never occurs when hiring obese person. Furthermore, employers are looking for highly qualified workers never paying attention to their physical condition thus demonstrating professionalism as a head and manager and devotion to the work, without mercantilistic analysis of probable future expenses connected with the health of an obese employee.

Another opposite side is that person’s quality of life does not decrease at all. Obese people are rarely subjected to social pressure or problems connected with social belonging, rarely do they fell that their leisure and recreation time is boring. They simply chose those activities which are probably not demanding and do not make them suffer from pain or discomfort. What is more, nowadays all the recreation places are organized and constructed in such a way that any obese person can be involved more or less actively in relaxation activities. But these facts cannot be proved statistically, thus, have little persuasive value, comparing to those connected with negative effects on the life of people suffering from the obesity, supported by the interview of the doctor Juan Remos who encounters obese people on a daily basis.

All in all, obesity is an extremely excessive problem in the United States affecting different aspects of people’s life. Taking into consideration described above facts I intend to warn people not to head in the direction of gaining weight, bearing in mind all the negative effects and consequences of the obesity, including the possibilities of terminate chronic illnesses and lack of full of enjoyment life.

Obesity: A problem in the United States is a post from: Online pharmacy blog

In this context, Zithromax seemed like a godsend. One or two pills, administered while the patient was still at the clinic, successfully treat the patient’s infection. The problem, at least for inner city clinics, is that Zithromax is a new drug still under patent control. Translation: expensive. This is the quandary faced by STD clinics, especially in low-income areas. How can you practice the best medicine for your patients and their potential sexual contacts within your budget? On the other side, how can a pharmaceutical company afford to continue to develop and test new antibiotics like Zithromax if the company cannot recoup the cost?

Azithromycin (Zithromax) is a post from: Online pharmacy blog

First of all, it is important to dwell upon the development and current position of the MDCM in the market. In this regard, it is important to refer to the changes which have been introduced in the company since the 2000s because these changes aimed at the consistent, qualitative improvement of the organizational performance. One of the first step made by MDCM CEO, McMullen, was the creation of subsidiaries working with customers in their own country, including the US, the UK, and Canada. Each subsidiary focused on its market and local customers specifically. The company granted its subsidiaries with substantial autonomy in regard to their development and formation of company-customer relationships. Managers of subsidiaries had to develop close relationships with customers. In such a way, the company attempted to optimize its organizational performance in different countries, where it operated.

The next step to optimize the organizational performance and to increase its efficiency the company focused on the reduction of the number of suppliers from thousands to hundreds. The consistent reduction of suppliers improved the efficiency of operations of the company to the extent that the consistent reduction of suppliers helped the company to increase the stability and reliability of supply and, thus, to improve the efficiency of manufacturing. The reduction of suppliers allowed the company to increase the efficiency of the manufacturing process.

Finally, the reorganization of the production facilities helped to increase their efficiency as well. The reorganization was crucial and effective, although it led to consistent job cuts, which reached 30% (MDCM, 2006). Nevertheless this step was essential to optimize the organizational performance and to make the organizational structure more flexible. The latter is particularly important in the contemporary business environment because the company has to respond fast and effectively to challenges it faces in its business development. In addition, the high flexibility contributes to the consistent increase of the efficiency of the organizational performance because the company does not need to waste time on the coordination of its operations between units and headquarters. At the same time, the reorganization raised the problem of the development of the IT department in the organization to optimize the effectiveness of its performance and to improve the organizational relationships between units and departments as well as subsidiaries.

Nevertheless, the development of the IT department raises substantial problems in face of the MDCM which the company has to overcome in the nearest future in order to improve its organizational performance and to strengthen its marketing position. In this regard, the company should focus on the consistent change in its work and on the wider use of IT technologies. At the same time, the corporate IT should be responsible for overseeing projects, investment decisions, and long-term planning. In fact, the development of the IT department and its integration in the organizational structure is impossible if the corporate IT stays aside of strategic decisions being taken by the company. What is meant here is the fact that the company has already arrived to the point, where the need in the IT department became obvious but the IT department should work and it should work effectively. Otherwise, its creation was pointless. Therefore, the corporate IT should participate actively in overseeing projects, investment decisions and long-term planning. At this point, the company should understand the importance of such involvement of the corporate IT because ITs cannot be implemented effectively, if the corporate IT and IT department are excluded of the processes and decisions vitally important for the company. Instead, they should know where the company is moving to and which objectives it wants to achieve.

When the corporate IT and IT department are aware of the strategic decisions and if they are involved in the process of decision making, they can develop an effective information system and to coordinate the inflation flow. As the matter of fact, the coordination of the information flow and creation of the effective information system are crucial for the development of the company and its steady progress. At the same time, it is important to place emphasis on the fact that the coordination of the information flow is crucial because the company operates worldwide and it needs the fast coordination of work between different units to maintain stable supply and to deliver products to its customers in time. In addition, the coordination of the information flow involves the improvement of the information processing. The better the information is processed the more effective the company operates because, in the contemporary business environment, information is the key to the success of the company, which puts the company into an advantageous position compared to its rivals. The company that possesses information and processes it faster than others is in an advantageous position compared to its rivals.

As for the development of the effective information system, its role can hardly be underestimated in the contemporary business environment, especially taking into consideration the fact that the MDCM operates in the field of medicine. The latter means that the company should be particularly concerned with the information security and prevention of information breaches. The modern, effective information system can increase consistently the information security level and to improve the efficiency of information processing.

Thus, taking into account all above mentioned, it is important to place emphasis on the fact that changes once started by McMullen should carry on. Now, the changes should expand on the IT department to increase its participation in the strategic decision making process and its involvement in the management of the organization. In response, the IT department will contribute to the consistent improvement of the organizational performance due to the introduction of innovations and improvement of communication within the company, data transmission and information protection.

MDCM is a post from: Online pharmacy blog

The sleep activity is one of the most mysterious and sophisticated processes of human bodies, which has been studied by various specialists and theorists. Nowadays we have much more information about the nature of sleep and possible sleep disorders along with their reasons, still there is probably unlimited space for further research. Unfortunately the problem of sleep disorders remains one the most actual for millions of people nowadays.

In this paper we are going to briefly study the major stages of sleep, the features they are characterized by, the length of each stage and possible cycles of their change; also some examples of sleep disorders and the main causes, why they develop along with their negative results.

Starting from the sleep stages, we are to mention, that at the very early stage people are not really asleep, rather still awake. The brain products at this moment are the so-called beta waves, being fast and small. Consequently the human brain starts to relax and a different type of waves is produced – namely the alpha waves. The period of time, when a person is not quite asleep and not operating actively any more, is usually characterized by hypnagogic hallucinations. Most commonly met examples of them are the sensation, that you are falling or hearing somebody calling you. Myoclonic jerk is another event, which is most likely to happen during this period, it is described as a sudden startle without any evident reason. So, passing from general description to singling out the concrete stages of sleep we should mention, that during the first stage of sleep the transition from being awake to the process of sleeping happens. The length of this period is usually estimated by 5 to 10 minutes, and if a person is awoken during this stage – he would state, that he was not sleeping yet. The second stage lasts longer, namely around 20 minutes. Sleep spindles or quick rhythmic brain waves are generated in the brain. The rate of heartbeat changes to the slower one and the temperature of the body decreases. The third stage of sleep is characterized by deep and slow delta waves, forming the transition from light sleep towards the deepest sleep. During the next, the fourth stage, the same delta waves may be found in the brain. This is the longest sleep stage, lasting for 30 minutes. If a person is inclined to sleepwalking, then this happens exactly during this stage.

During the fifth stage of sleep people usually see their dreams. This stage got the name of rapid eye movement or REM. Logically the eyes are moving rather quickly during REM sleep, respiration rate is increased as well as the brain activity itself. Most scientists call REM a paradoxical sleep, because along with activation of brain and other body systems, muscles of a person still remain relaxed. The increase in the brain activity is considered to be the main reason of dreaming. The sleeping process doesn’t go through all the above mentioned stages in consequence, it starts during the first stage, goes then to stages two, three and four. After the fourth stage stages three and two are repeated, then followed by REM. After REM the body comes back to the second stage. The repetition of the sleep stages happens around four or five times during the night. According to average parameters the REM stage is entered in 90 minutes after a person falls asleep. Each cycle of REM sleep is longer and longer up to an hour sometimes.

Apart of studying the phenomenon of normal sleep, the scientist had also to pay sufficient attention towards the sleep disorders, as according to the data of the American Psychiatric Association sleep disorders are directly related to distress and breaking of normal functioning of people during the day (Mahowald, 108). Almost all people have to face some type of sleep disorders during their lives, and unfortunately these disorders are able to do harm to psychological state as well as cause problems in functioning of other organism systems. The National Sleep Foundation of America conducted a research within a year, the result was, that more than a half of all Americans experience insomnia problems at least two times a week (Billiard, 13).

The general definition of a sleep disorder is formulated like this: “A sleep disorder (somnipathy) is a medical disorder of the sleep patterns of a person or animal” (Billiard, 13). As it was already mentioned the main danger from sleep disorders is related to their negative impact upon normal emotional, physical and mental functioning of an individual. There are a lot of sleep disorders, defined by the scientists, in this paper we are going to stop just at some examples of them.

The most frequently reported type of sleep disorders is insomnia. Usually insomnia is diagnosed in case of positive answer to one of the following questions: “”Do you experience difficulty sleeping?” or “Do you have difficulty falling or staying asleep?” (Mahowald, 120). If a patient really suffers from insomnia, there is usually the need to continue the medical check of his organism, as insomnia often serves as sigh or even symptom of some other disorders. The definition of insomnia is: “difficulties initiating and/or maintaining sleep, or nonrestorative sleep, associated with impairments of daytime functioning or marked distress for more than 1 month.” (Mahowald, 111). Insomnia is split into primary and secondary (comorbid) insomnia. Primary insomnia is not related to any other medical or psychiatric reasons, whereas secondary is related to other condition. Researchers name several types on insomnia, including acute, transient and chronic. Transient insomnia lasts usually not longer than seven days. It might have various reasons, from work stress or change of sleep environment and to severe depression. The consequence of this type of insomnia would be impaired psychomotor performance (Mahowald, 120) .Acute insomnia is defined by a longer period of inability to sleep normally – namely up to one month. Chronic insomnia correspondingly lasts longer than a month. Chronic disorder may be a primary disorder itself or be a consequence of some other disorder. The effects of chronic insomnia depend on its initial cause, they can be different, including hallucinations, mental emaciation, nervous exhaustion, sometimes double vision is a result of chronic insomnia as well.

Restless legs syndrome (RLS) is another type of sleep disorder. A person, suffering from it experiences constant prickling sensation in his legs, which can be removed for some time by moving them. Thus there is a need to move the legs in order to avoid pain. Certainly such patients face problems with both falling asleep and with sleeping. People with RLS may experience the problem in one or both legs, in some rare cases even in the arms. There is a list of other symptoms apart of painful tingling and difficulties with sleep: “Periodic limb movement in sleep (PLMS), which are brief, sudden movements of the legs every five to 90 seconds; painful sensations in the legs when sitting or lying down for a long period of time (for example, while sitting in a car or behind a desk)” (Karatas, 295). According to statistical data the percentage of the RLS patients is between 5 and 15. RLS is closely related to the age, thus the older the person is, the greater is the chance to develop this disorder. Some researchers state, that RLS is a hereditary type of disorder, most often female patients suffer from it due to problems during pregnancies, kidney diseases, wrong nutrition. The limb movement is controlled by dopamine, produced in the brain. If there is lack of iron, then the brain is not able to produce it correctly, thus the lack of iron is considered to be one of the major causes of this disorder. Important is that testing for iron in blood is not useful for RLS diagnostics, only the iron in the fluid around brain plays an important role. “Recent studies show that blood pressure may elevate by an average of 22 points systolic (top number) and 11 points diastolic (bottom number) during episodes of RLS. In addition, the blood pressure could spike every 20 to 40 seconds many times during the night” (Karatas, 300). In this case the risk of heart disease is extremely increased.

The last in the list of the most often met sleep disorders is sleepwalking, or somnambulism. During the slow wave sleep stage a person stands up from his bad and starts performing activities, without being conscious, about what he or she is doing. Such individuals don’t only sit in their beds or walk around the house, they are able to cook, to drive or to perform various violent actions, especially if they are suffering from hallucinations. Usually, the actions of such a person are simple and constantly repeated, however there are cases reported, when people perform rather sophisticated actions and even illegal ones. Certainly they can not be legally punished for their actions, while they are sleeping, however this might cause a lot of problems to them and to the people around. This is quite normal, if a sleepwalker has no idea, about what he was doing during his being asleep, or has some abrupt pictures of the events in his mind. The eyes of sleepwalkers are opened, but their expression is dim. The process might last from 30 second to 30 minutes (Billiard, 89).

Overall, we have looked through the main stages of sleep, their characteristics and length; we have provided the generalized definition for the notion of sleep order along with some statistical data as for number of people suffering from these disorders; we have briefly analyzed the three most often met examples of sleep disorders, including insomnia, RLS and sleepwalking, their main causes and possible consequences. In spite of the fact, that there is a lot of information about sleep, which can be found in scientific sources, there seems to be limitless directors for enriching this information, as sleep is actually a unique and sophisticated “quality” of human body and brains.

Sleep disorders is a post from: Online pharmacy blog

Adjustment Disorder with Depression is a post from: Online pharmacy blog

The intermediate stage of grief takes place during the first year after the death of the loved one. During that phase, feelings of intense loneliness and sadness are accompanied by persistent thoughts about the death, the events leading up to the death, why it happened, and how it could have been prevented. Limited capacity for pleasure, lack of energy, sleep and appetite problems, and bouts of tearfulness persist to varying degrees.

The recovery phase of grief is the time when people begin to return to their social lives and “get on with life.” That usually begins about the second year following the loss.

Little is known about the actual duration of normal grief. Studies of spouses and parents dealing with unexpected loss point to normal grief processes lasting up to seven years. Sudden death often causes bouts of grief that are more severe and longer lasting than the bereavement following an anticipated death.

Death of a spouse can have significant impact on the health of the surviving partner. Women tend to be at increased risk for health problems within the first three months after the loss. Men whose spouses die are particularly likely to develop emotional or physical problems during the first year after the loss and have an increased mortality rate. Bereaved men who remarry tend to have lower mortality rates than those who do not.

Death of a child is particularly likely to produce severe grief reactions regardless of the age of the parent and child. Bereaved parents experience high levels of psychological distress that are accompanied by changes in physical health, functional activities, and family cohesion, including an increased risk of divorce.

The distinction between “normal” grief and depression can be a difficult one to make. The two states share many similar

physical and emotional symptoms, and the duration of both can be prolonged. Grief can produce a preoccupation with guilt about actions taken or not taken surrounding the death of a loved one and thoughts that the survivor would be better off dead. Experiences of transiently hearing or seeing the deceased loved one can also be a part of the normal grief process, especially in some cultures. Morbid rumination regarding other feelings of guilt, a sense of worthlessness, anticipated death of other loved ones, prolonged decrease in level of function, marked slowness of behavior or speech, reports of unusual beliefs, or persistent or recurring hallucinations should be considered outside the normal grief process and more indicative of a major depressive episode. When symptoms of severe grief extend more than two months beyond the death of a loved one, treatment with antidepressant medication may be needed in addition to supportive psychotherapy.

Grief in young children is most profound when it involves the death of a parent or a primary caretaker. It can produce such behaviors as crying, calling and searching for the deceased loved one, and refusing to be comforted. Emotional withdrawal often occurs and is associated with sad facial expressions, lethargy, and lack of interest in former activities. Eating and sleeping may be disrupted. Children may regress by losing some of their developmental milestones; i.e., toilet-trained toddlers may begin to soil themselves again. Bereaved young children may become detached and lack much facial expression. They often are very sensitive to any reminder of the lost loved one. Grief in young children is generally treated with supportive measures; use of antidepressant medication is usually not required.

Bereavement is a post from: Online pharmacy blog