Dealing with Substance Abuse in Mentally Ill Patients

Dealing with Substance Abuse in Mentally Ill Patients Alizah Al-aman In a course of time the brain has developed in a way to ensure our survival. This survival system incorporates brain’s unique reward system liable for satisfying person’s essential desires (Horvath, n.d.). Unfortunately, substance use is operated within these reward systems that engages an individual in addictive activities. According to Edward (2000) substance use is the hazardous use of psychoactive substances, including alcohol and illicit drugs. It is the dependency that deteriorates individuals physical and mental health. Consistent with the continuum of chemically mediated responses, substance use is a maladaptive coping manifested by frequent use and dependence of tobacco, alcohol and illicit drugs (APA 2000, p. 198; Stuart, 2009). WHO reported that globally 3.86 billion people are involved in substance abuse in which US has the utmost prevalence whereas in Pakistan it is prevalent among 6.4 million people (Stuart, 2009). If substance use co-occurs with any mental illness it’s regarded as dual diagnosis. Literature proposes that roughly 50% of the people with psychiatric problems also suffer from substance abuse disorders (chrome et al., 2009). In UK three quarters of drug and 85% of alcohol service users have mood and anxiety disorders (NIDA, 2007). It’s a dilemma that which problem occurred first. However precipitating factors like loneliness, family disturbances, psychological illness, illiteracy trigger substance use in psychiatric clients (Donald Gail, 2009). In my view to resolve the misery of such pain and mental illness people engage in substance abuse which grants them pleasure as highlighted in the below mentioned scenario. On my clinical rotation at C0 ward in AKUH, I encountered a middle aged patient with the dual diagnosis of depression and drug abuse. He was a chain smoker since 30 years and recently had angioplasty. According to the patient he developed gastric ulcers 5 years back for which a local physician prescribed him Inj. Nubain. He wasn’t conversant that the drug should be used till certain time as associated with the risk of addiction. Patient continued taking that medication and developed addiction. The medication not only lessened his pain but made him calm and relieved during his depressive episodes. After angioplasty he was constrained for not using that drug which results intense craving. Patient became unmanageable and restless. Then he was admitted in C0 ward but intense craving made his situation worst resulting in tremors, sweating, insomnia, hypertension and mydriasis. When I visited that patient, he verbalized â€Å"I need drug, am very restless, this craving will end my life† so to reroute his mind and lessen his suffering, I along with OT members planned to engage that patient in different activities. We taught him some coping strategies and there was a mild change observed in his performance and condition after psychotherapy and cooping. Glancing the social context in light of scenario, substance abuse is judged as bad deed because it violets societal norms and values by precipitating ferocious acts, poverty, family disturbances etc. In the above case unmanageable behavior lead the admission of the client in ward. In contrast some communities illustrate acceptability too. Furthermore Canadian mental health association (2006) and Steve Susan (2003) proposed the comparable fact that patients with dual diagnosis can provoke violence and peace less situation in a community by sevenfold as well as for those who are caring or living with them. Moreover substance use is 65% prevalent in mid adulthood and my patient’s age was in same age group which predisposed him towards this (Stuart, 2009). Furthermore religion exhibits a fundamental role in an individual’s life. In Islam alcohol is forbidden that’s why researches highlighted less incidence of alcohol abuse in Muslim society whereas higher incidence in western world (Haider Chaudhry, 2008, p.82). Beside this in Pakistan opioids and marijuana is predominantly abused (UNODC, 2013). Opioid use primarily grants relieve in mental illness but its withdrawal encompasses acute depression, chronic craving, tremors, sleep problems, high BP and dilated pupils as evident in my client’s case (Stuart, 2009). Moreover marijuana also serves as a source for decreasing negative symptoms in schizophrenic clients however in response it exacerbates their suffering (Archives of General Psychiatry, 2011). Survey conducted in Pakistan summarized that 53.6% of the adults smoke shisha (Sameer et al, 2012; Khan, 2010). This percentage illustrates the acceptability of tobacco and shisha in eastern world that results psychosis in individual’s already predisposed for developing it (Archives of General Psychiatry, 2011). Bhang use is also predominately practiced in Indian festivities that generate euphoric and hallucinating effects as encompasses psychotomimetic substances (Thacore, 1977). In Western world and Roman Catholics drug abuse is more socially acceptable in females but referred unmasculine in males whereas the consumption of alcohol is considered masculine (Donald Gail, 2009). In US the extreme alcohol use is the 3rd leading cause of death and it also precipitates mental illness by triggering depression, euphoria, mood disorders. Its unavailability would end up leading general depressant withdrawal syndrome. Furthermore 43% of people in US are tobacco abuser however smoking opium is marked deviant (Donald Gail, 2009). Tobacco smoke is twice more common in depressive clients while thrice in schizophrenic patients. Besides granting pleasure it amplifies the chances of relapse in psychiatric patients (Ash, 2013). So while assessing the client with dual diagnosis HCW’s should take these sociocultural aspects in consideration. When my client tried to drop the addiction, he felt intense craving. Craving is evidently depicted in the light of neuroadaptive model as prolonged use of drugs induces specific alterations in the brain cell or neurotransmitters which regulate neural drives and grant pleasure. During abstinence neuroadaption consequences in imbalance in brain function which results craving and this craving is accountable for relapse in individuals (Eliason et al., 2007). Interventions for such clients could be executed within individual, institutional and community level. In my patient therapeutic interaction assisted me to perform MSE effectively. Dealing with craving was challenging nevertheless I taught him some coping techniques, mind diversional exercises. In addition the intervention that can be carried out is drug testing and if the patient has severe withdrawal history so referral can be made to detoxification program (Stuart, 2009). Furthermore the nurse should develop awareness about the state and feelings of substance abuser in order to eradicate biasness in caring. Assessment of withdrawal symptoms should be carried out every shift. On institutional level integrated treatment for dual diagnosis verified as evidence based practice (Stuart, 2009). My client was treated simultaneously for both depression and substance abuse. Moreover medicines should be administered to alleviate craving as Methadone was been administered to my patient for plummeting his craving. Moreover individual counseling and CBT prove as a constructive approach for client’s rehabilitation and relapse prevention. Since 2000 AAS is also working for the rehabilitation of substance abusers using the same treatment methodologies such as psychotherapy and drug toxification Besides AAS there should be more rehabilitation centers in those areas where substance abuse is more prevalent in order to restore mental health. Community level interventions would embraces the conduction of school base awareness programs and workshops for eradicating the risk of substance abuse from initial ages and making individuals realize that substance use is not the accurate coping for alleviating mental illness. Developing religious and social norms would converse an obvious message for drug avoidance in mentally ill clients to whom religion serves as a protective factor. Moreover campaign against substance use on national level would present as example for people in recognizing the harmful effects of it (Reno et al., 2000). Implementation of strict Governmental policies and legislation on consumption and sale of alcohol and illicit drugs can help in reducing the occurrence of dual diagnosis. Detoxification and methadone maintenance programs can be arranged in communities with the assistance of governmental authorities (Stuart, 2009; Reno et al., 2000). In conclusion, substance abuse can co-occur with mentally illness which impact an individual’s life dreadfully. To get rid of this is difficult but not impractical. Diverse prevention strategies and early detection would assist its control and management. Moreover strong motivation from family, health care providers and especially self can immensely facilitate the individual to cope up and live a healthier life (Harrison, 2006).

Communication and Social Behavior in the Atlantic Bottlenose Dolph Essa

Introduction Social behavior in mammals other than humans has always been something that has fascinated not only scientists, but the general population as well. Large mammals known to exhibit similar behaviors to humans have always been popular favorites at zoos and aquariums. One particular favorite is an animal known for its social behavior and intelligence: Tursiops truncates, the bottlenose dolphin (Prevost, 1995). This cetacean has global distribution that spans all tropical and temperate marine waters with bays, sounds, estuaries, and open shorelines being the habitats most frequently inhabited, and sea grass beds being the preferred nursery locations (Prevost, 1995). These mammals are some of the most admired sea creatures and have shown great capacity for intelligence. They are often trained and used in shows at aquariums. Most frequently studied are their communication types and their complex social behavior, with things like verbal and nonverbal communication, communities and social hi erarchies, and common social behaviors receiving a particular emphasis. Physical Attributes and Relevant Zoological Information Tursiops truncates, with its Atlantic sub-species named T .t. truncates, has some very distinct physical features. The size is a range of six to thirteen feet or two to four meters (Prevost, 1995) (Reynolds & Wells, 2003). The average dolphin is about 9 feet long and usually weighs about 600 pounds, although males are typically 25% larger than females (CITATION). The rostrum extends for several inches, but is relatively short compared to the rest of the torpedo shaped body. (Felhammer, et al. 2003). The rostrum is also the basic for the T. t. truncates common name of â€Å"bottlenose† (Felhammer, et al. 2003). ... ...d Social Organization of the Bottlenose Dolphin: A Review. Marine Mammmal Science,( 2 ed, pp. 34–63). Prevost, J. F. (1995). Bottlenose dolphins. (pp. 18-19). Minneapolis, MN: Abdo Consulting Group, Inc. Janik, V. M. (2009). Vocal communication in birds and mammals. (1 ed., Vol. 40, pp. 123-148). San Diego, CA: Elsevier Inc. Retrieved from http://books.google.com/books?id=5v63gz04YVgC&printsec=frontcover Feldhammer, G. A., Thomspon, B. C., & Chapman, J. A. (2003). Wild mammals of north america: biology, management, and conservation. (2 ed., pp. 397-425). Baltimore, MD: The Johns Hopkins University Press. Retrieved from http://books.google.com/books?id=-xQalfqP7BcC&printsec=frontcover Reynolds, J. E., & Wells, R. S. (2003). Dolphins, whales, and manatees of florida: A guide to sharing their world. (1 ed., pp. 28-45). Gainesville, FL: University Press of Florida.

Common Sense Essay example -- essays research papers

In Common Sense, by Thomas Paine writes that America cannot recon ciliate with Great Britain. Paine gives many examples in this document of why America cannot reconsolidates with Great Britain. One of them is there is no advantages to being connected to Great Britain; only disadvantages can come out of the connection and the second idea is British government must sooner or later end.   Ã‚  Ã‚  Ã‚  Ã‚  In the first point about the connection with the British, Paine states that America can benefit much more if it was not connected to the British for many reasons. One of them is trade with other European countries will decline or even go to ruins because if Europe breaks out into a war other countries will not trade with America because of the connection with the British. Second is the fact that the British does not protect us unless its in there interest or benefit to do so. Paine states that when the British fought off Spain and France, it was to protect Great Britain’s interest not Americas. He states this because if America was not benefiting Great Britain with trade and money or anything else; the British would not protect America. Paine’s third point is the fact that Britain is a monster. In this point he states that England brings tyranny to America because of the persecutions of emigrants that came to America in the first place and that Britain still pursues the descendants of the first emigrants.   Ã‚  Ã‚  Ã‚  Ã‚  In Thomas ...

Modern Racism Essay

Racism is a problem that has characterized the American society from the historical past and has refused to go away. Though at present, racism is not depicted in overt terms but still kept observations reveal that racism still raises its ugly head in an institutionalized manner. The dream as projected by Martin Luther King Junior where he hoped for a society in which individuals would be judged by the content of their character as opposed to the color of their skin has failed to be fully realized. This paper shall aspire to look at the evidence of racism in the modern American society by citing up specific examples from the various incidences in the country. Background: Despite the tremendous achievements that have been realized following the civil rights legislations, racism has remained one of the most pressing social issues in the American society. Racism is often treated as an issue of the past but in reality, racism is still thriving within the American society. This however can be traced not in the overt practices as the case of the Jim Crow laws in the Southern States at the height of the Civil War, but rather in the covert ways (Wheeler, 2005, p 5). The blame campaigns being witnessed in the American society is a clear example of racism in modern times. In the recent times, the victims have been blamed for the predicament that they find themselves. For instance, the unemployed are blamed for unemployment; those who are not educated are being faulted for not accessing education; and the homeless are being blamed for not having the homes (Dols, 2004, para 3). Evidence of Modern Racism: There has been some statistics that were revealed by studies indicating some biasness in events leading to unemployment and lopsided delivery of criminal justice. After the economic booms of the 1990s, majority of those affected by the economic downturn were the blacks. In the early 2000s, the rate of unemployment amongst the blacks was said to be rising at a faster rate compared to the unemployment rate of the whites (Wheeler, 2005, p 75). The lay-offs that were carried in some of the big corporations including Coca-Cola; Sears; and J. P. Morgan reflect on issues of discrimination in modern times. The African American work force in these corporations comprised of 18% at Coca-Cola, 16% at Sears and J. P. Morgan and yet the lay-offs at these corporations had high proportions of the black workforce with percentages given as 42, 54 and 30 for the respective corporations (Dols, 2004, para 5). Another study at the University of Chicago revealed that African Americans applying for a job were more likely to be denied the opportunity than their white counterparts using the name criterion. It is also worthy noting that studies indicate that African Americans are most likely be found guilty of drug offences compared to the whites (Cole and Smith, 2006, p 16). Apart from the examples provided above, the Africa Americans have continued to bear the consequences of the slavery and the Jim Crow rules at the height of discriminative policies in the United States (Smith, 1995, p 6). Conclusion: The incidences of racism are rampant in our society even though most individuals would think that we have advanced from the dark years. The government and the stakeholders need to be proactive in addressing the issue of modern day racism through the enhancement of affirmative policy actions that would bring parity and stop propagation of the racism connotations. Work Cited: Cole, George, F. and Christopher E. Smith. 2006. The American System of Criminal Justice. Cengage Learning, ISBN 0495006017, 9780495006015 Dols, Chris. 2004. Racism lives on in modern America. Retrieved on 17th August 2010 from; http://badgerherald. com/oped/2004/11/18/racism_lives_on_in_m. php. Smith, C. Robert. 1995. Racism in the post-civil rights era: now you see it, now you don’t. SUNY Press, ISBN 0791424383, 9780791424384 Wheeler, Albert, J. 2005. Racism: a selected bibliography. Nova Publishers, ISBN 1594544794, 9781594544798

Pmo Project Management Office

A take in wariness station (PMO) is a base or department in spite of appearance a business, agency or enterprise that defines and maintains standards for run into concern deep down the organization. The PMO strives to standardize and introduce economies of repetition in the execution of projects. The PMO is the source of documentation, guidance and prosody on the practice of project solicitude and execution.In some organisations this is known as the program Management Office (sometimes abbreviated to PgMO to differentiate) the clear-sighted difference is that program management relates to presidential term the management of several related projects. conventional PMOs base project management principles on industry-standard methodologies such(prenominal) as PMBOK or PRINCE2. come alongively influential industry certification programs such as ISO9000 and the Malcolm Baldrige National Quality swag (MBNQA) as well as regimen regulatory requirements such as Sarbanes-Oxle y squander propelled organizations to standardize processescitation needed.Organizations around the globe are defining, borrowing and collecting best practices in process and project management and are increasingly assigning the PMO to exert boilersuit influence and evolution of thought to revenant organisational improvementcitation needed. According to the Standish CHAOS theme (2009)citation needed, 68% of projects do not get through time/cost/scope targets. altogether 32% of projects were completed on time, within budget and delivered measurable business and s claimholder benefits. thither are many reasons for such failures. As per a KPMG surveycitation needed of 252 organizations, technology is not the close to critical factor.Inadequate project management performance constitutes 32% of project failures, lack of communion constitutes 20% and unfamiliarity with scope and complexness constitutes 17%. Accordingly 69% of project failures are due to lack and/or improper impl ementation of project management methodologies. Establishing a PMO group is not a short term strategy to light costs. 1 Surveys with companies indicates that the longer they have an operating PMO group the better the results achieved to accomplish project goals (which office lead to lowering costs)citation needed.PMOs may take other functions beyond standards and methodology, and participate in Strategic Project Management either as facilitator or dynamicly as owner of the Portfolio Management process. Tasks may hold Monitoring and Reporting on active projects (following up project until completion), and reporting progress to top management for strategic decisions on what projects to continue or corporationcel. A PMO can be one of three types from an organisational exposure perspective enterprise PMO, organizational (departmental) PMO, or specialpurpose PMO.The Project Management Institute (PMI) Program Management Office Community of Practice (CoP), views the PMO as a strate gic driver for organizational excellence and seeks to enhance the practices of execution management, organizational governance, and strategic change leadershipcitation needed. As the largest residential district devoted to the PMO, with over 4,000 members globally, the PMO CoP is the primeval forum to collaborate, expand the knowledge base, and hop on the PMO practice within their own organizations and the business community at large.

Postmodern and Existential/Psychoanalytical curriculum theory Essay

The price I had the most difficulty specify from the exercise were Postmodern and Existential/ psychoanalytic plan possibleness. I find that these theories fatigue a grade body which I interpret intellectually but consecrate difficulty imagining. In Scenario 6 (AIU, 2006) almost postmodernism where the instructor is discussing how engine room furthers cultural elitism, this would read a very advanced class of bookmans. It is an approach which would only really opposition 11th and 12th graders who have canvass history and understand cultural elitism.In addition, even if the students have studied the history, the temporal requires experience the students have only caught glimpses of. sure enough a discussion a humble above the students comfort zone would evanesce to critical thinking, but it runs the risk of this unguarded age using the belief that technology will somehow lead to conquering to stop them from seeing how it could lead to equalization of inequality. A postmodern approach would start out a special teacher and a special set of students to be effective.The business I had with the Existential/psychoanalytical theory of Scenario 7 (AIU, 2006) is that it assumes that you as a teacher really know a student. What a teacher observes of their student may non be accurate, and it dos a dedicated teacher to take the necessary time to understand what focalization a student should take their potential. Students have great potential for galore(postnominal) diverse things from, for example, being great artists or activists or sports commentators.Teachers must examine their knowledge biases to make sure that they are not encouraging one potential over another due to cultural, sexual or racial biases and perceptions. Similarities and differences among theories. Walkers deliberative approach to political program schooling is like to a postmodern approach. In both approaches it is assumed that curriculum is mannequind by particular beli efs and value held by curriculum makers.For the deliberative approach these biases are extenuate by the makers open discussion of beliefs and values and attempt to come to neutral primer coat before designing the curriculum (Scenario 3). In postmodernism, the teacher allows the receivers of the curriculum to provide input on and conceptualize the effects of the curriculum before it is implemented (Scenario 6). The Existential/psychoanalytical approach, Hilda Tabas approach, Eisners approach and the autobiographical/Biographical approach to curriculum development all share a substitution tenant that students are individuals.However, Existential/ Psychoanalytical theory optimistically focuses on nurturing who the student will be in the hereafter (AIU, 2006, Scenario 7) while Tabas needs sagaciousness tends to focus on present deficiencies (AIU, 2006, Scenario 5). In contrast, the Autobiographical/Biographical theory focuses on how human differences in experience shape the develop mental journey from the present to the time to come (AIU, 2006, Scenario 4). Eisner is more Autobiographical in theory but focuses on providing the right prospect to learn rather than strict direction (AIU, 2006, Scenario 1).

Child and adolescent health Essay

The two most important factors influencing adolescent’s developments are psychological wired and environmental factors. As they grow, they are influenced by environmental factors such as religion, culture, Schools and religion. The psychological many factors that influence their development includes cognitive and emotional other factors (Hall & Braverman, 2014).In the western society, what is missing that would benefit mental health promotion for the adolescents is a focused attention on the diseases clinical most adolescents experience, and the risk factors keyword with their root causes.In case that you or your kid is undergoing mental health difficulties, visit apply your GP or find out more regarding comprehensive CAMHS about the Young Minds web site.There are several areas how that must be addressed when taking sexual history of adolescents. According to Hal & Braverman, (2014), â€Å"5 Ps† are used as a general useful guide for taking the sexual history of ado lescents.Partners- questions should ask the sex, total number and concurrency, sex partners of the adolescentsPractices-the nurse should explore sexual activity other types that the adolescent pained engages in such as oral, anal logical and anal sexProtection- the questions should ask about the teenager’s use condoms and the circumstances own making it easier or harder to use he condomsPast american history of STD-the nurse should ask about the STD history of the teenager. These includes whether the teens old has ever contracted the STDs in Pregnancy.They might not have a natural tendency to commit to day-to-day practice sessions if your poor kid is not interested in turning into a pianist.

Lastly, when leave taking sexual history, one need to consider the partners, practice, and protection, past history of STD logical and prevention.ReferencesHall, C., & Braverman, P. K.Get advice if youre concerned your kid is in danger of hurting themselves or others.(2014). Hot topics in early adolescent health.Merrick, J. (2014).While the approach of the team is they operate in tandem.

adoptive Parents and guardians play a massive role in how our therapy.Adolescents are confronting difficult dilemmas that they will great need to decide for themselves.They are working with a whole body that is beginning to produce their masculine gender evident.Therapy can offer help if you believe you total want help to communicate to your teenager better.

Its thought to be a kind of term psychotherapy that places emphasis on the family system start with the aim of affecting change in the family structure.Behavior therapy is comparable.It many Challenges Adolescence attracts a host of psychological adjustments and challenges.Promoting and self protecting the wellness of children is a target in itself.