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  • Director of Diagnostic Dermatopathology, Department of Dermato-Histopathology, St John's Institute of Dermatology, St Thomas' Hospital, London, UK

He first selected a sample of 60 mice and then divided them into a control group and an experimental group asthma 6 year old buy serevent 25mcg free shipping. Charlotte asthma treatment guidelines medscape order serevent 25 mcg amex, a nursery school student asthma treatment equipment buy serevent 25mcg with amex, hypothesizes that boys have fights with the finger paints more than girls do asthma treatment crossword clue generic serevent 25mcg with mastercard. She tests her hypothesis by casually watching the finger-painting table for three days of nursery school. The hallmarks of an experiment are the ability to manipulate the independent variable, randomly assign subjects to conditions, and eliminate (control for) differences between the conditions. When these steps are taken, disparities between the experimental and control groups can be attributed to the independent variable, the only thing that differed between the groups. No other research method allows for the control necessary to make such an attribution. Since it would be impossible to match participants on every possible dimension, many psychologists use random assignment. By taking advantage of the laws of probability, random assignment makes it likely that participants in the different conditions of an experiment will be equivalent. Random assignment does not relate to sampling or validity and has no impact on the need for statistics. In all likelihood, they need to operationalize their dependent variable more clearly. Validity refers to the accuracy of a measure, which in this case is whether they are actually measuring friendliness. If we tried to recruit parents to be in our experiment and told them that half would be assigned to divorce and the other half to stay married, it is unlikely that any would consent to participate. If you wanted to compare children whose parents had divorced with children from intact families, you could conduct a quasi-experiment. In a quasi-experiment, the researcher is unable to manipulate the independent variable but tries to control as many other factors as possible. The other four examples are relatively easy to study experimentally as the independent variables (color, exercise, exposure to violent television, and studying) are not difficult to manipulate. There is no indication that Professor Ma coerced the participants or deceived them in any way. Confounding variables are a concern for the validity of the study but not an ethical consideration. Researchers must keep suffering to a minimum, so "any amount" is not an appropriate response (choice D). Animal subjects must be chosen carefully (from accredited commercial sources) and their environment must follow strict guidelines, so choices C and E are also incorrect. Z scores measure the distance of a score from the mean in units of standard deviation. Since the distribution has an even number of scores, there is no middle score and you must average the two middle scores, 4 and 6. Since it is a high score in a distribution of low scores, the distribution will be positively skewed. Jose would certainly be interested in descriptive statistics as well, but he would not know whether or not his hypothesis had been supported until he used inferential statistics. Once sampling has been completed, one might assign the participants to conditions as described in I. Finally, approaching 50 students during a lunch period does not constitute random sampling even if the person who picks the people tries to do so randomly. Remember that the word random has a very specific meaning in the context of research. Random sampling means that all members of the population had an equal chance of being selected, and people are unable to be so scrupulously unbiased. How fast and frightened the mice are at the onset of the experiment are potential participant-relevant confounding variables. When and where the experiment takes place are possible situation-relevant confounding variables.

Not all of these family therapies have been tested with children and adolescents with substance use disorder asthma back pain 25 mcg serevent sale. Thus asthma treatment baby serevent 25mcg generic, it is important and relevant to asthma treatment list purchase 25 mcg serevent ask "what kind of family therapy" when family therapy is recommended asthma treatment breathing treatments purchase serevent 25 mcg on-line. Common elements across most family therapies include: (a) engagement of the family (versus working with the child alone); (b) focus on education about substance use and abuse; (c) emphasis on communication skills to improve family functioning; and (d) to reestablish parental influence through parent management training (Bukstein, 1998). Sessions may be held in a clinic, home, court, school, or other community locations. For the child or adolescent, the emphasis of treatment is on skill-building, and the treatment plan often incorporates developmental tasks such as decisionmaking, negotiation, problem-solving skills, vocational skills, communication, and dealing with stress (Liddle, 2009). Parallel sessions are held with family members, in which parents examine their parenting style, learn to distinguish influence from control, and learn to have a positive and developmentally appropriate influence on their child. Research supports the use of this type of therapy for adolescents with substance use disorders (Friedman, Terras & Kreisher, 1995; Schmidt et al. A method of strategic family therapy has also been tested and found effective with substance using adolescents. This form of therapy is intended to address serious antisocial behavior in children and adolescents who abuse substances. Behavioral Therapies ­ Behavioral therapies with research support include goal monitoring, contingency management, and skill-building approaches. The underlying goal of a goal monitoring approach is to allow the youth and the treatment provider to identify specific problems and areas of deficit and to work on improving these behaviors (Bukstein, 1998). In community-based care, caregivers are taught to monitor goals and/or more effectively manage contingencies. Research shows that, when consistently applied, this type of therapy helps adolescents become drug-free and increases their ability to maintain abstinence after treatment ends (Azrin et al. Skill development is also included in many cognitive-behavioral approaches to substance use (Bukstein, 1998). The general focus of treatment includes educating the youth with relapse prevention skills, substance refusal skills, resisting peer pressure, assertiveness skills, communication skills, problem-solving, anger control, and leisure time management. Whereas it is frequently incorporated in treatment plans, research supporting skillbuilding alone is not supported by research. Motivational Interviewing ­ Motivational interviewing is a brief treatment approach that aims to increase motivation for behavior change in addicted and related problematic behaviors. It is based on five core principles, including the expression of empathy, highlighting discrepancies, avoiding argumentation, rolling with resistance, and supporting self-efficacy (Evans et al. Motivational approaches are accepting of ambivalence and uncertain motivation, and work on exploring these ambivalences. There has been ample support for the efficacy of motivational interviewing in treating substance use disorders among adults (Burke, Arkowitz & Menchola, 2003). Research examining 194 motivational interviewing among youth has found support for the efficacy of motivational interviewing in reducing substance related behaviors (Monti et al. Although the effectiveness of these two forms of treatment is suggested from case reports, no controlled studies support the use of these methods in treating substance use disorders among children and adolescents (Bukstein, 1998). Pharmacological Treatments Psychopharmological medication can be used in the treatment of substance use disorders and may be used in the initial stages of treatment for detoxification purposes, as directed by a physician. When medication is utilized for the treatment of a co-occurring mental health disorder, a cautious approach, as well as an integrated treatment strategy, is crucial. Medical detoxification is a form of pharmacotherapy that is used to treat any withdrawal effects by substituting a legal drug for an illicit one during prolonged periods of abstinence (Bukstein, 1998). This approach is most frequently used for chronic abusers of highly addictive substances such as opium. Furthermore, it is important to note that substitutions, such as methadone, are infrequently used in children and adolescents and often limited by law (Bukstein). Detoxification should be reserved for only the most severely dependent adolescents who have been resistant to other forms of treatment (Bukstein). Medication may also be used to treat co-occurring mental health disorders and is often an important treatment element. A definitive assessment requires that the youth abstain from the use of substances for a specified period, typically several weeks. Research is being conducted on the effectiveness of medications in adolescents with cooccurring substance use and mental health disorders. One controlled study was conducted to ascertain the effectiveness of lithium for adolescents with bipolar disorder and co-occurring substance use disorder.

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The existence of such investigative powers alone does not in itself oblige service providers to asthma definition 18th buy cheap serevent 25mcg online collect or retain information they would not otherwise so process asthma xopenex buy serevent 25mcg fast delivery. This can be important where multiple service providers are involved in processing computer data or electronic communications asthma symptoms gerd discount serevent 25mcg on-line. In addition to asthma symptoms 3-4 purchase 25mcg serevent fast delivery the influence of Cyberspecific powers international and regional Subscriber data (n=49) General powers cybercrime instruments, this Both may also reflect a common Neither need for this type of data, Content data (n=50) and a requirement on behalf of service providers for clear legal powers and 0% 20% 40% 60% 80% 100% procedures in requesting Source: Study cybercrime questionnaire. This is supported by comments from Order for traffic data: National example from responding countries. One country in the Americas, a country in Oceania for example, stated that, although providers often Disclosure of traffic data cooperate with law enforcement agencies voluntarily, Where a magistrate is satisfied on the basis of an application by any police officer that specified the application of existing general procedural data stored in a computer system is reasonably provisions to orders for supply of data was too required for the purpose of a criminal onerous and impractical. The country had therefore investigation or criminal proceedings, the magistrate may order that a person in control of initiated the process of adopting a cyber-specific the computer system disclose sufficient traffic provision for subscriber data orders. One country in South-Eastern was transmitted Asia, for instance, highlighted the possibility of extension of a general investigative power to order `any document or other thing. Later sections of this Chapter examine the use of powers in practice, as well as challenges faced by, and good practice used by, law enforcement in obtaining data from service providers. Real-time collection of data Orders for data represent an investigative measure for obtaining stored computer data. Crucial electronic evidence may also, however, never be stored at all (existing only in transient communications), or Figure 5. Accordingly, six international or regional Both Realtime content cybercrime instruments data Neither (n=51) include provisions on realtime collection of computer data. In doing so, 0% 20% 40% 60% 80% 100% instruments typically make a distinction between realSource: Study cybercrime questionnaire. In this respect, one international instrument, the Council of Europe Cybercrime Convention explicitly refers to interception of content data in relation `to a range of serious offences to be determined by domestic law. At the national level, around 40 per cent of responding countries reported that a general investigative power was used to authorize real-time interception of traffic and content data. If there is a probable cause that a person commits a crime though a computer system, a prosecutor is authorized to file a motion with a court responding countries reported having jurisdiction over the investigation place, to issue an order the existence of a legal power requesting real-time collection of traffic data, thereby a service provider is obliged to cooperate with and assist an investigative body in real-time for real-time collection of collection or recording of traffic data which are associated with specified data ­ either through a communications made and transmitted by means of a computer system general or cyber-specific within the territory. Some countries technical capability for real-time collection and recording of traffic data of highlighted the application of the service provider. The term for real time collection and recording of traffic data shall not exceed the term necessary for collecting evidence in safeguards to such powers, criminal case. Motions provided by paragraph 1 and 2 of this Article, shall be real-time collection of content considered by the court in accordance with the procedure established by Article <. National legislation in one country in Western Europe, for example, specifies that interception of computer data carried by public providers shall be intercepted with the cooperation of the service provider, unless such cooperation is not possible or is contrary to the interests of the investigation. Tools such as key-loggers and remoteadministration software, when placed on the device of a suspect, can remotely supply information 58 59 60 61 62 See Walden, I. Addressing the Data Problem: the Legal Framework Governing Forensics in an Online Environment. It must be demonstrated, for example, that the operations performed by the examiner did not themselves alter the state of the system under investigation. Only one (non-binding) international or regional instrument refers to the use of remote forensic tools as an investigative measure. More generally, the Council of Europe Child Protection Convention (Art 30(5)) also refers to the obligation to take necessary legislative and other measures in order to allow, where appropriate, for the possibility of `covert operations. For the other half of Cyberspecific powers respondents that indicated such General powers powers were included in legislation, the majority referred Both to a general power, rather than a 8% Neither cyber-specific power. As discussed in Chapter Seven (International cooperation), traditional formal means of international cooperation may not be sufficiently timely to ensure access to extraterritorial volatile 63 64 65 66 See, for example, Gartner. Of those 13% that did, slightly more than half 33% Cyberspecific powers indicated that such a power existed. Countries interpreted the term General powers widely, however, to also include the Both situation where consent to the Neither 44% measure is obtained from the 10% authorities of the country in which the measure is implemented. Chapter Seven (International cooperation) examines issues of direct law enforcement access to extraterritorial data in greater depth ­ including with reference to police use of such measures in practice. Discussion Examination of the legal basis for investigative powers used in cybercrime (and, indeed, for any crime involving electronic evidence) reveals considerable diversity in approach at national level.

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Assessment Any attempt to asthma 5 month old buy serevent 25mcg amex define problematic anxiety in youth must clearly define what constitutes normal anxiety asthma symptoms 7 discount 25mcg serevent amex. The information discussed in the following paragraphs is obtained from a personal communication with Michael Southam-Gerow and Shannon E asthma symptoms middle age purchase 25 mcg serevent with amex. Anxiety and fear are defined as a complex combination of three types of reactions to asthma treatment 4 lung serevent 25 mcg for sale a perceived threat: 1. Another important consideration in assessing anxiety disorders in youth is development. Thus, assessing anxiety in children requires knowledge of normal child development. Because anxiety is a natural and normal human experience, assessment of anxiety in youth requires attention to the level of impairment that a youth experiences because of anxiety. Accordingly, intense levels of anxiety do not constitute anxiety disorders without the presence of impairment. The provider must also identify those symptoms especially pertinent to children and adolescents. Structured diagnostic interviews can be extremely useful in assessing youth, particularly when administered independently to the youth and the parent. A thorough assessment is critical since there are numerous anxiety-related problems and because anxiety is often comorbid with other disorders. Comorbidity Youth diagnosed with an anxiety disorder may also have other mental health disorders. Substance use disorder may also co-occur with anxiety disorders (Compton, Burns & Egger, 2002; Grant et al. Some research has found that older youth may use alcohol and other substances to reduce the symptoms of anxiety (Jellinek, Patel & Froehle, 2002). Use of substances can ultimately worsen symptoms and certain substances may actually generate symptoms of anxiety. Evidence-based Treatments the treatment of anxiety disorders in youth is usually multimodal in nature. For this review, evidence-based treatments are divided into three groups: What Works, What Seems to Work, Not Adequately Tested. Psychological Treatments the many psychological treatments available to treat youth with anxiety disorders are described in the paragraphs which follow. These approaches, though diverse, typically include what is called exposure therapy. Exposure treatment involves exposing youth to the non-dangerous situations that they fear, with a focus on having them learn that their anxiety will decrease over time. As an example, youth afraid of talking to peers would practice conversations numerous times until they felt less anxious about doing so. Often, exposure therapy involves using a hierarchy, or fear ladder, such that youth may be exposed to moderately stressful situations and work towards more difficult ones. This approach allows these youth to experience mastery and increases their selfconfidence. Psychoeducation entails teaching older youth and parents about the effects of anxiety, how to distinguish between problematic and non-problematic anxiety, and how to overcome problematic anxiety. Psychoeducation also teaches youth and parents to monitor levels of anxiety across a variety of situations. Relaxation entails teaching youth how to relax through breathing exercises or by alternating muscle tension and release. Cognitive skills involve teaching youth how to observe and change their thinking so they can change how they feel and reduce their feelings of anxiety. In these approaches, parents learn the same skills as their children so that they can help them outside the therapy session. They have also been delivered with good effects in schools, clinics, hospitals, daycare centers, and homes. Other Therapies with Research Support There are several other treatments with modest levels of support. For example, educational support treatment, which involves providing support and education about anxiety to parents and youth with anxiety problems, has shown some promise in a several studies.

Conduction deafness occurs when something goes wrong with the system of conducting the sound to asthma symptoms wont go away 25 mcg serevent fast delivery the cochlea (in the ear canal asthma what is it purchase serevent 25 mcg on-line, eardrum asthma treatment in khewra discount serevent 25 mcg with mastercard, hammer/anvil/stirrup asthma kod djece discount serevent 25 mcg on-line, or oval window). For example, my mother-in-law has a medical condition that is causing her stirrup to deteriorate slowly. Nerve (or sensorineural) deafness occurs when the hair cells in the cochlea are damaged, usually by loud noise. If you have ever been to a concert, football game, or other event loud enough to leave your ears ringing, chances are you came close to or did cause permanent damage to your hearing. Prolonged exposure to noise that loud can permanently damage the hair cells in your cochlea, and these hair cells do not regenerate. Nerve deafness is much more difficult to treat since no method has been found that will encourage the hair cells to regenerate. Touch When our skin is indented, pierced, or experiences a change in temperature, our sense of touch is activated by this energy. We have many different types of nerve endings in every patch of skin, and the exact relationship between these different types of nerve endings and the sense of touch is not completely understood. We do know that our brain interprets the amount of indentation (or temperature change) as the intensity of the touch, from a light touch to a hard blow. We also sense placement of the touch by the place on our body where the nerve endings fire. If we want to feel something, we usually use our fingertip, an area of high nerve concentration, rather than the back of our elbow, an area of low nerve concentration. If touch or temperature receptors are stimulated sharply, a different kind of nerve ending called pain receptors will also fire. Gate-control theory explains that some pain messages have a higher priority than others. When a higher priority message is sent, the gate swings open for it and swings shut for a low priority message, which we will not feel. Of course, this gate is not a physical gate swinging in the nerve, it is just a convenient way to understand how pain messages are sent. When you scratch an itch, the gate swings open for your highintensity scratching and shut for the low-intensity itching, and you stop the itching for a short period of time (but do not worry, the itching usually starts again soon! Natural endorphins in the brain, which are chemically similar to opiates like morphine, control pain. Chemicals from the food we eat (or whatever else we stick into our mouths) are absorbed by taste buds on our tongue (see. Taste buds are located on papillae, which are the bumps you can see on your tongue. Taste buds are located all over the tongue and some parts of the inside of the cheeks and roof of the mouth. Humans sense five different types of tastes: sweet, salty, sour, bitter, and umami ("savory" or "meaty" taste). Some taste buds respond more intensely to a specific taste and more weakly to others. The more densely packed the taste buds, the more chemicals are absorbed, and the more intensely the food is tasted. You can get an idea of how densely packed taste buds are by looking at the papillae on your tongue. What we think of as the flavor of food is actually a combination of taste and smell. Smell (or Olfaction) Our sense of smell also depends on chemicals emitted by substances. The molecules settle in a mucous membrane at the top of each nostril and are absorbed by receptor cells located there. The exact types of these receptor cells are not yet known, as they are for taste buds. Some researchers estimate that as many as 100 different types of smell receptors may exist. Interestingly, the nerve fibers from the olfactory bulb connect to the brain at the amygdala and then to the hippocampus, which make up the limbic system- responsible for emotional impulses and memory. The impulses from all the other senses go through the thalamus first before being sent to the appopriate cortices. This direct connection to the limbic system may explain why smell is such a powerful trigger for memories.

Additional information:

References:

  • https://www.dos.pa.gov/ProfessionalLicensing/BoardsCommissions/PhysicalTherapy/Documents/Applications%20and%20Forms/Non-Application%20Documents/PTM%20-%20CE%20Course%20List%20(ABC).pdf
  • http://course.sdu.edu.cn/G2S/eWebEditor/uploadfile/20130605221813905.pdf
  • https://www.nyee.edu/files/Education/Ophthalmology%20Resident%20Training%20Program/OKAP%20and%20Board%20Review/shields.pdf