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However erectile dysfunction klonopin 50 mg viagra professional, the only apparent difference is the small size of each treatment group constipation causes erectile dysfunction viagra professional 100mg with amex, i erectile dysfunction protocol pdf order 50mg viagra professional overnight delivery. Possible heterogeneity and publication bias were still present among the remaining eight articles 2 (I =70 how young can erectile dysfunction start viagra professional 50mg with amex. Also, the two higher quality studies, Arguedas (1996) and Dunne (2003), both individually had insignificant results that could establish neither the advantage of 70, 119 one antibiotic over the other nor their equivalence. The ages of the children included in these trials ranged from 6 months to 13 years. The outcome assessed in these three articles was treatment success rate at days 10-14; the definition of treatment success varied among the studies (bacteriologic cure; a composite score; complete resolution of all clinical and o to scopic findings; disappearance or improvement in signs and symp to ms). However, we concluded that the definitions were sufficiently clinically similar to justify pooling. The Jadad quality score for the article in the 2001 report was 2 out of 5 and those of the two newer articles were 2 and 3. The random effects pooled rate difference for clinical success by day 14 between cefaclor and azithromycin was estimated at -0. The quality of evidence for this conclusion is considered high, meaning further high quality research is very unlikely to change our confidence in the estimate of effect. Wait-and-See/Prescription to Hold One relevant meta-analysis was identified that compared the use of any antibiotics to that of the wait-and-see approach or the similar approach of prescribing antibiotics if needed. A meta­ analysis by Spurling (2007) identified three studies that compared delayed vs. In all four studies, the majority of patients in the immediate antibiotic group complied with use of the prescribed antibiotic (range of 83% to 99%), and many of those in the wait-and-see and prescription- to -hold groups ultimately used prescribed antibiotics, as well 3, 87 (range of 1% to 38%). We conclude that in both studies, immediate amoxicillin therapy has a higher success rate than the fino immediate treatmentfi approaches, even though 34% in the McCormick (2005) and 24% in the Little (2001) wait-and-see and prescription- to -hold groups, respectively were on antibiotics later in the course of the disease. The Spiro (2006) article reported the difference between the antibiotic and prescription- to -hold approaches (91% of the prescription- to -hold group and 93% of the standard prescription group received prescriptions for amoxicillin; the remainder received prescriptions for other antibiotics) on health services utilization (filling prescriptions on day 4-6) as the primary outcome measure and 94 presence of otalgia and fever at day 4-6 and 11-14 as the secondary outcomes. The Neumark 2007 article compared phenoxymethylpenicillin with the wait-and-see approach. It can be observed from the 95% confidence intervals of these outcome measures that no conclusion can be established with respect to the effectiveness of either treatment option in the pairs in terms of success rates. Although, the Spiro 2006 article established that those given prescriptions for immediate antibiotics filled the prescription more often than those who were given prescriptions fi to hold,fi no differences were seen in absence of otalgia or fever between 94 groups at either follow-up point. The quality of evidence for these conclusions is moderate, meaning that further high quality research is likely to have an important impact on our confidence in the estimate of the effect and may change the estimate. Thanaviratananich (2008) reported that the available evidence was biased, so no definitive 59 conclusions could be drawn. A review by Foxlee (2006) concluded that the existing evidence was 55 insufficient to make definitive conclusions on the effectiveness of to pical analgesia. Little (2001) and McCormick (2005) individually demonstrated higher clinical success rates as perceived by the parent for amoxicillin than for prescription- to -hold at day 3 and wait and-see at day 12 options, respectively; however, these results are tempered by Spiro‘s comparison of immediate antibiotic therapy to the prescription- to -hold option (2006) and Neumark‘s comparison of immediate antibiotic therapy to the wait-and-see option (2007), which had inconclusive results. In addition, single studies of comparisons (that could not be pooled) produced strong results. Equivalent clinical success rates were also demonstrated in individual studies of amoxicillin vs. The 21 comparisons are listed in Tables 20 and 21 to gether with a description of the characteristics of the study populations and interventions and the main findings. A screen of a sample of these titles revealed very few actually relevant to the to pic. We therefore did not pursue this search strategy, which would have added mostly older (pre-2001) articles. Summary of Findings from Eight Studies on Effectiveness of Treatment of Acute Otitis Media in Recurrent Otitis Media or Persistent Acute Otitis Media Comp Comparison Author, Patient Intervention Findings Conclusion # Year Population 1 Amoxicillin Saez­ 0. Turik, 3months-12 Cefaclor (40mg/kg/d, bid, Success rate on day 10: Not enough 125 cefuroxime 1998 years 10d) Cefaclor: 93. Summary of Findings from Seven Articles on Effectiveness of Prevention of Acute Otitis Media in Recurrent Otitis Media Comp Comparison Author, Patient Intervention Findings Conclusion # Year Population 1 Amoxicillin vs. Another review, by Wall (2009), complied with only two of 11 quality criteria, so the 138 results are not reported here. None of the studies demonstrated significant 121-125 advantage for any particular treatment. Saez-Llorens (2005) examined the success rate on day 3-10 while Sher (2005) examined the success rate on day 10. The advantage of either treatment over the other or their equivalence cannot be established based on the current evidence. It compared the treatment success rates among children 6 months to 5 years of age in 6 different countries on day 2-5 of treatment (Jadad quality score 3 of 5). We cannot determine the advantage of either treatment or their equivalence based on the current evidence. We cannot draw any conclusion regarding the superiority of either treatment or their equivalence from the existing evidence. The overall quality of evidence for these comparisons is considered low, meaning that further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Ciprofloxacin-dexamethasone otic drops had a higher success rate than amoxicillin-clavulanate in these children with tympanos to my tubes for indications not specified by the investiga to rs. We cannot draw any conclusion regarding the superiority of either treatment or their equivalence from the existing evidence in these children with tympanos to my tubes for indications not specified by the investiga to rs. Ciprofloxacin-dexamethasone otic drops had a higher success rate than ofloxacin otic drops for clinical success at day 3, for clinical cure at days 18-21, and for o to rrhea absence at days 3, 11, and 18 in these children with tympanos to my tubes for indications not specified by the investiga to rs. Findings on Prevention of Acute Otitis Media in Children with Recurrent Otitis Media Previous systematic reviews. Table 22 summarizes the references found in these five systematic reviews and the controls, interventions, and outcomes utilized in each of the relevant studies from these systematic reviews. Of the articles identified for this report, only Teele (2000) was included in one of the previous systematic reviews (Leach, 2006), although the study by Koivunen (2004) was listed as 129, 130, 142 pending assessment in that same review. Because the 2006 review by Leach included all studies utilized by the earlier reviews by Bonati (1992) and Williams (1993), we will report only the main findings 139, 140, 142 from Leach (2006). Perhaps more relevant to the current review, the Leach review (2006) did sub-group analysis of otitis prone vs. These studies include five not identified by or pertinent to previous systematic reviews, one excluded by a previous systematic review, and one included in a previous review 129 for which we provide greater detail. None of the studies demonstrated a long-term advantage for any particular antibiotic or non-surgical treatment. No conclusion can be derived from the existing evidence regarding the superiority of one or the other agent or their equivalence. No conclusion of antibiotic advantage or equivalence can be derived from the existing evidence. The overall quality of evidence for this comparison is considered low, meaning that further high quality research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. No conclusion can be derived from the existing evidence regarding the efficacy of sulfisoxazole/sulfafurazole for either outcome. The overall quality of evidence for this comparison is considered low, meaning that further high quality research is very likely to 125 have an important impact on our confidence in the estimate of effect and is likely to change the estimate. The study included 178 children, ages 6 months to 8 years, and defined treatment success as no recurrence. Treatment success was measured at two different time points: at day 14 and at day 40. The long-term effectiveness of the ceftibuten 10-day treatment option cannot be established at this point. No conclusion of treatment advantage or equivalence can be derived from the existing evidence for either outcome. The overall quality of evidence for this comparison is considered low, meaning that further research is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. Propolis is fia natural 133 product collected by bees from the exudates of plantsfi (Marchisio, 2010). None of the comparisons demonstrated a significant advantage for any particular surgical or non-surgical treatment. Koivunen (2004) also reported a comparison between 130 sulfafurazole and adenoidec to my. Thus, no conclusion of advantage or equivalence can be derived for either treatment from the existing evidence for either outcome. This study compared 140 children ranging in 26 age from 3 to 15 years and had a Jadad quality score of 2.

Perhaps half of us are gay erectile dysfunction causes and solutions buy 50 mg viagra professional visa, a much higher percentage than would be expected by chance erectile dysfunction doctors in memphis tn purchase 100mg viagra professional amex. I found no support for Dorner’s theory that men become gay due to erectile dysfunction venous leak treatment buy generic viagra professional 50 mg on line prenatal stress erectile dysfunction shots buy 50 mg viagra professional with amex. Mothers of gay and straight men reported similar memories of stress during their pregnancies. However, I had asked subjects about their relatives’ orientations, and here I did find something. Gay men said that about 20 percent of their brothers were also gay, and straight men said that about 1 percent were. These numbers were similar to those that had recently been obtained by Richard Pillard, a Bos to n University psychiatrist. Because I had always been interested in genetics, I was excited by the prospect of studying the genetics of homosexuality. To decide which is more important, we have to do more sophisticated kinds of studies, including studies of twins. Identical (also called “monozygotic,” meaning “one egg”) twins are genetically identical, and they provide the most direct test of the power of genes. If we could separate identical twins at birth and raise them separately, in different environments, we could see how similarly they developed. We know that separated identical twins nearly always have the same eye color, because eye color is virtually completely Copyright © National Academy of Sciences. We know that separated twins can be somewhat different in their personality, although they are far more similar than unrelated people would be. Two pairs of separated male identical twins have been written about in which at least one of the twins was gay. In one of these pairs, the other twin considered himself bisexual and had had sexual rela tionships with men, although he was currently involved with a woman. If gay men are correct in their skepticism that male bisexual ity exists, this second twin is probably gay. Although identical twins reared apart provide the ideal genetic experiment, they are quite rare, and gay identical twins reared apart are rarer still. Unfortunately, mothers of twins are insufficiently dedicated to scientific progress to routinely give up at least one twin for adop tion. This means that we will probably never have a large enough sample of separated identical twins from which to draw firm conclu sions. Another kind of twin study, called the classical twin design, relies on the fact that there are two kinds of twins. Fraternal twins (“dizygotic”—“two eggs”) are not genetically identical, but are only as similar genetically as ordinary brothers. The logic of the classical twin study is this: If gay genes exist, then identical twins should be more similar than fraternal twins in their sexual orientations. Gay men’s identical twins should have a higher rate of homosexuality than their fraternal twins should. In 1990, just after I arrived at Northwestern University, I advertised in gay publications across the country, from Bos to n to Los Angeles: Copyright © National Academy of Sciences. If you are a gay or bisexual man, and you have a male twin (either identical or non-identical); or if you have an adoptive or genetically unrelated brother, we would like to talk to you about participating in a national study of the development of sexual orientation. For example, if a family that already had a son had adopted me, he and I would be adoptive brothers. Adoptive brothers are an interesting comparison group, because they share no genes, only a rearing environment. Some we conducted on the phone, and some I conducted in person on a whirlwind to ur through several states. Louis a professor’s office, in Kansas City and Dallas friends’ apartments, and in Bos to n a psychiatrist’s office. It was a grueling month-long trip, but it was also a fascinating one, because of my subjects, whom I remember vividly. Usually, I met only one twin per pair, although there were exceptions, such as the Kansas City identical pair who entertained me with s to ries of their childhood aversion to sports and the Dallas pair who convinc ingly denied childhood interest in dolls but rather had played baseball. There was the haunted Hous to nite so ashamed of his homosexuality that he could tell no one, but who suspected that his heterosexually-married identical twin was also gay. A couple of heterosexually married subjects did reveal that they were “bisexual” without their wives knowing. These subjects were especially happy to be telling their s to ries—they shared my belief that the study was a worthy goal. If something genetic is going on, then identical twins should have the highest rate of also being gay, followed by fraternal twins, with adoptive brothers bringing up the rear. This is exactly what I found: 52 percent of identical twins, 24 percent of fraternal twins, and 11 percent of adoptive brothers were also gay. Could I say anything more about genes for homosexuality, other than that they existfi I had measured twins’ femininity/masculinity retrospectively, as childhood memories. I wondered whether femi nine gay men might be the products of “nature” and masculine gay men the results of “nurture. This should be reflected in the rates of homosexuality in their identical twins; identical twins of feminine men should have a higher rate. Among the concordant identical twin pairs—those pairs in which both twins were gay—twins from the same pair had strikingly similar memories of their own childhood behavior. In the discordant pairs—one gay and one straight twin—you can’t use the memory of one to predict the other. The most feminine gay man might have a straight identical twin who plays football for a living. Usually, in fact, straight twins recalled being much more masculine boys compared with their gay identical twins. I also looked at whether having a gay twin has any effect on one’s own sexual orientation. For example, having an identical twin come Copyright © National Academy of Sciences. I asked twins about this, and almost always, twins said that they knew about their own sexual feelings before they had any inkling about their brothers’. The study, coauthored by Richard Pillard, was published in 1991 in Archives of General Psychiatry, and it received a fair amount of media attention. I got a flood of letters, including letters of support (prima rily from gay people and their families) and hate-mail, primarily from religious people who hate homosexuality. I found these men especially admirable, for maintaining their curiosity in the face of death. Environment must also matter, but what particular environmental fac to rs make a gay manfi When most people hear “en vironment,” they au to matically think of the social environment, such as how children are raised or what kind of interpersonal experiences they have. For example, when one identical twin is born with a major brain defect such as anencephaly (lack of a cerebral cortex, or outer brain) or microcephaly (a very small cortex), the other twin is usually normal. Only environment can cause identical twins to differ, but the environmental problem in this case is biological. What kind of environmental fac to r can cause genetically identical twins reared in the same family from birth—often dressed alike and given the same to ys— to differ in their sexual orientationsfi This means that the envi ronmental fac to rs that cause the twin differences are there early on, by childhood. Based on other things we know, such as studies of chil dren with cloacal exstrophy (like Jason/Amanda from Chapter 3), I suspect that these fac to rs operate in the womb. So far, only one environmental fac to r has been related to male homosexuality: birth order. Psychologist Ray Blanchard has found that gay men tend to be later born sons in a series of brothers. In other words, gay men have greater numbers of older brothers than straight men do. Blanchard has obtained this same result in more than 10 studies, so we can have confidence in it.

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The importance of coordinating labora to erectile dysfunction jacksonville fl order viagra professional 100 mg on line ry and programmatic efforts may seem obvious but cannot be overstated impotence losartan viagra professional 100mg fast delivery. Importance of Operational Research the experience in Peru was informed by operational research bpa causes erectile dysfunction buy viagra professional 50mg with mastercard. Operational assessment of a labora to impotence solutions 50 mg viagra professional mastercard ry method or strategy is the sole means of understanding its effectiveness when considered within the larger context of how the method is used, associated complexities or challenges in its implementation, the mitigation of its effect caused by other system delays, and other fac to rs. If to ols to moni to r labora to ry performance are incorporated in to information and reporting systems at the outset, effective operational research can be conducted with minimal additional resources, coupled with ongoing feedback, to create a sustainable labora to ry system. It was evident that resolving these issues could best be accomplished in partnership with other agencies in order to upgrade 50 labora to ry capacity at minimal cost. The introduction of the assay and training of labora to ry staff to ok place in Oc to ber 2008. The smear-positive, culture-negative rate calculated as smear-positive/culture-negative divided by to tal number of cultures was low 104 (1. Secondly, ensuring the reliable supply of reagents and consumables was at times challenging, and required constant vigilance to ensure timely cus to ms clearance and sufficient lead time in ordering. The very success of the lab quickly led to high expectations and increased demand on the lab for diagnostic testing, stretching the limits of the original facility and lab personnel. The high profile of the project also resulted in frequent partner visits, and requests for hand-on, on-site training for technicians from other African countries, which at times was stressful for the staff who were busy with trying to keep up with the workload, and who missed out on some training opportunities. This made it challenging to maintain contamination rates within acceptable limits. This experience has served as a catalyst to translate policy in to practice with new diagnostic technologies. It supports global policy setting to enhance and modernize labora to ry work in developing countries. It can be used both for ordering supplies as well as estimating the needs at the lower level to be supplied. For procurement, a cost estimate can be obtained also, provided data on current prices are part of the basic input at set-up. This has the same initial input requirements and functions as the one above for the microscopy network, but it also includes a more extensive part for correct s to ck keeping. The latter is even more essential for this type of labora to ry, in view of the large variety of items needed and the greater difficulty to estimate needs correctly, except based on past consumption. Leafcutter ants and replication of a bacterium or kills antivirals and chemicals such as it outright can be called an antibiotic. Antibiotics are a type of antimicrobial Most antibiotics used to day are designed to target bacterial infections produced in labora to ries, but they are within (or on) the body. This makes often based on compounds scientists antibiotics subtly diferent from the other have found in nature (Box 1). Some main kinds of antimicrobials widely used microbes, for example, produce to day: substances specifically to kill other nearby bacteria in order to gain an • Antiseptics are used to sterilise advantage when competing for food, surfaces of living tissue when the water or other limited resources. They are used on non the infection they are targeting is living surfaces, for example in located. Fungi and viruses can also be a danger Here, antibiotics are absorbed in to To cultivate a fungus, Leucoagaricus to humans, and they are targeted by the bloodstream or target bacteria in gongylophorus, in ‘gardens’ within antifungals and antivirals, respectively. Injections of their colonies, the ants feed the Only substances that target bacteria antibiotics directly in to the bloodstream leaves they cut to the fungus, which are called antibiotics, while the name (intravenous antibiotics) are only used in turn is the colony’s sole food antimicrobial is an umbrella term for for the most serious infections. Leafcutter ants thus form sophisticated farming societies in Definitions of some key terms symbiosis with the fungal cultivar. Today, substances used Antibacterial being invaded by a range of harmful to disinfect non-living surfaces are known as antibacterials. The ants have evolved defences Antifungal A class of drugs used to treat fungal infections. Upon returning last century or so people did not know He concluded that, according to this from a holiday in Sufolk in 1928, the infections were caused by bacteria. The Egyptians, for example, applied mouldy called arsphenamine was an efective fungus had created bacteria-free bread1 to infected wounds. The word ‘antibiotics’ very low concentrations, preventing number one cause of human death in the was first used over 30 years later by Staphylococcus growth even when developed world2,3,4. After early trials in treating human wounds, collaborations with British pharmaceutical companies ensured that the mass production of penicillin (the antibiotic chemical produced by P. By D-Day in 1944, penicillin was being widely used to treat troops for infections both in the field and in hospitals throughout Europe. Scientists in Oxford were instrumental in developing the mass production process, and Howard Florey and Ernest Chain shared the 1945 Dr Selman Waksman (left) discusses his experiments with visiting Nobel laureate Sir Alexander Fleming in 1951. Nobel Prize in Medicine with Alexander Waksman was awarded the Nobel Prize in 1952 for the discovery of strep to mycin, the first antibiotic efective Fleming for their role in creating the first against tuberculosis. The introduction of antibiotics resistant to the antibiotics previously Antibiotics are sometimes used in in to medicine revolutionised the used to treat them. It is estimated that, a limited number of patients before way infectious diseases were by 2050, the global cumulative cost surgery to ensure that patients do not treated. Without this jumped by eight years, with antibiotics In the 1950s and 1960s new precaution, the risk of blood poisoning used to treat infections that were drugs were being isolated all the would become much higher, and previously likely to kill patients. However, the rate of drug many of the more complex surgeries Today, antibiotics are one of the discovery has slowed markedly. Some are highly the public health revolution more regularly – and resistance is specialised and are only efective that antibiotics brought about was developing to them, to o. The more we these reserve antibiotics are also as broad-spectrum antibiotics, attack use them, the more resistant more to xic or have more severe a wide range of bacteria, including bacteria become. There are two main ways in all antibiotics used worldwide are If we ran out of efective which antibiotics target bacteria. Box 2: the science behind antibiotic Bacteria are quick to evolve resistance: types of resistance resistance to antibiotics. Mutations that allow bacteria to survive where others do not (Box Reduced uptake in to cell Chloramphenicol 2) are beneficial and are passed on to successive generations; antibiotic Active efux from the cell Tetracycline resistance is a prime example. Eliminated or reduced binding of fi-Lactams, erythromycin, Bacteria can also develop antibiotic to cell target lincomycin resistance by taking up genetic material containing antibiotic Enzymic cleavage or modification to fi-Lactams, aminoglycosides, resistance genes from their inactivate antibiotic molecule chloramphenicol surroundings (Box 3). Metabolic bypass of inhibited reaction Sulfonamides, trimethoprim For details on how antibiotic resistance can develop and spread, Overproduction of antibiotic target Sulfonamides, trimethoprim see Boxes 2 and 3. To reduce antibiotic resistance Antibiotic resistance often arises when an antibiotic wipes out all it is important that patients finish susceptible bacteria – resistant ones survive and pass on the resistance. Mr X has a has been an ‘evolutionary arms race’ Resistance to antibiotics is clearly sore throat. He buys some penicillin between researchers developing new as natural as antibiotics themselves and gives himself, not enough to drugs and bacteria becoming resistant (see Box 1– Leafcutter ants) and kill the [bacteria] but enough to to them. Why is it, then, that antibiotic longer than our knowledge of its He then infects his wife. Recognising this, Alexander pneumonia and is treated with become a pressing concern for Fleming summarised the dangers of penicillin. As the [bacteria] are now healthcare providers and scientists rising levels of antibiotic resistance in resistant to penicillin the treatment around the worldfi In many penicillin can be bought by anyone most antibiotics, resistant strains countries, prescription and use in the shops. Then there is the of bacteria tended to arise sooner of antibiotics is not controlled danger that the ignorant man rather than later. In fact, resistance very strictly, if at all, allowing 6 Factfle: Antibiotic resistance | In addition to reproduction, plasmids can move between against which antibiotics are individual bacterial cells in several diferent ways13: completely useless. Alternatively, • When two bacteria are near each other, genetic material can be passed poor diagnostic methods directly between cells, or via a hollow structure called a pilus, or a pore, that can mean that infections are can form between the two cells. Plasmids can use this pilus like a bridge, not recognised correctly and sending copies of themselves from one cell to the other. Resistance in animals is widespread as a result18, and it is easily transmitted to humans through the meat we consume19. It’s important to remember that antibiotics don’t ‘cause’ Artwork showing resistance. It often evolves spontaneously and can play a role in competition between microbial species, and as a result we cannot – and do not want to – s to p it completely. Much rather, the aim is to slow its advance to ensure that antibiotics drugs used if the main ones fail.

A person who feels violent impulses to impotence of organic origin meaning order 100mg viagra professional with amex ward others will not accept these feelings but rather see others as intending to erectile dysfunction treatment fort lauderdale order viagra professional 100 mg with visa harm him or her erectile dysfunction medication risks viagra professional 100 mg for sale. Projection often takes the form of inaccurate mind reading: believing that others are motivated by or thinking about certain emotionally charged ideas that are actually within the observer’s mind erectile dysfunction drugs egypt buy 50mg viagra professional mastercard. In its extreme form, projection becomes paranoia—believing that others are in a conspiracy to harm one despite a lack of plausible evidence for this belief. Displacement: the defense mechanism that redirects an unacceptable emotional response from an object that is seen as threatening or unacceptable to ward one that is less so. Misplaced anger is a classic example of displacement: kicking the cat when you are really angry with a friend. However, other emotional responses can be displaced, such as when a child who is fearful of a bully at school unconsciously develops a phobia of going to school. Bandura reviews his theoretical and research contributions, including modeling, cognitive behavior modification, the classic Bobo doll experiment, media effects on violence, self-efficacy, and his plans for the future. University Film & Video, University of Minnesota, Suite 108, 1313 Fifth Street, S. Skinner and Behavior Change: Research, Practice, and Promise (16 mm, color, 45 min. Skinner and other psychologists discuss the philosophical, ethical, and scientific questions generated by behavioral psychology. Shows three models of learning (classical, operant, and observational) applied to treatment. Childhood Aggression: A Social Learning Approach to Family Therapy (16 mm, color, 35 min. Ac to rs play Freud and his patients to show the development and power of unconscious motivations and repression. Eight films—four family interviews, all with the same family, and four brief talks with the therapists who conducted the interviews. This type of video, combined with a manual, is used in behaviorally oriented parenting classes. Chapter 2: Models of Abnormal Behavior 33 Maslow: Self-Actualization (16 mm, 60 min. Abraham Maslow discusses his theory of self-actualization by assessing case material. The four others present an analysis of the case from a psychoanalytic, behavioral, phenomenological, and sociocultural perspective, followed by a panel discussion of the merits of each perspective’s view of Ot to. The film covers the four subphases of the process (differentiation, practicing, rapprochement, and object constancy) over the first three years of life. The relationships among theory, research, and practice and how treatment of psychological disorders has been influenced by his to rical, cultural, and social forces. May discusses what existential psychology is and how we give meaning to experience. Covers material from nineteenth century phrenology to current use of micropho to graphy to show how neurotransmitters cross the synaptic gap. Ellis describes rational-emotive psychotherapy and illustrates by interviewing a patient. Skinner discusses behavior modification and shaping of human behavior using positive reinforcement. Rogers discusses his humanistic theories, comparing them to other established theories of the time. Problems: check validity of observations when patient is from another culture; reactivity B. Errors: information exchange blocked, anxiety in interviewee, interviewer orientation C. Projective personality tests a) Rorschach technique (inkblots) b) Thematic Apperception Test (pictures) c) Sentence-completion test d) Draw-a-person test 2. Functional magnetic resonance imaging: high resolution, noninvasive views of neural activity E. Problems: medical emphasis; usefulness; sexist (controversy over premenstrual dysphoric disorder); symp to ms more valuable than placement in categories 2. A label can predispose people to interpret all activities of the affected individual as pathological 2. A label may lead others to treat a person differently Copyright © Hough to n Mifflin Company. A label may lead those who are labeled to believe that they do indeed possess such characteristics 4. Define reliability, and differentiate among test-retest, internal, and interrater reliability. Define validity, and differentiate among predictive, criterion-related, construct, and content validity. Describe and discuss various psychological assessment techniques and their strengths and limitations, including observation of behavior, clinical interviews, and tests and inven to ries. Discuss ethical issues involved in assessment, particularly how cultural differences may influence clinical judgments. Explain the goals of classifying abnormal behaviors and review the his to ry of classification systems. Describe four problems associated with classification and labeling and the research related to these problems. Incorrectly labeling someone with a psychiatric diagnosis has a greater stigmatizing effect than mislabeling a person with a medical diagnosis. The instruc to r can illustrate this with a simplified version of signal detection theory. When the tests show nothing and the symp to ms go away, we have a false alarm; everyone is happy and relieved, and no harm has been done. Physicians are trained to be on the safe side and consider people sick even if they aren’t. Now ask the class to consider this scenario: An adult comes to a psychologist complaining of voices that say “thud” and “empty” (the same symp to ms Rosenhan’s pseudopatients used). What are the effects of assuming that the person may have schizophrenia and sending the person to a mental hospital for a psychological evaluation (the equivalent of medical tests)fi This exercise will help students see that what is “conservative” diagnostic practice in medicine can be dangerous in psychology. Instruc to rs may want to expand on the text’s treatment of reliability and validity and the relationship between the two by subdividing reliability in to internal consistency, test-retest, and interrater. You can explain the first two categories in terms of the evaluation method an instruc to r uses for teaching abnormal psychology. Ask students how they would feel if questions unrelated to course material (What is the capital of New Jerseyfi All items should contribute to the test’s to tal score; otherwise error is introduced. Suggest to students that it is a good idea for exams to evaluate them repeatedly at about the same level. For example, how much faith could they put in exams if on the first one they got an A, on the second they got a D, and on the third they got a Bfi This discussion should lead them to think about changes in study habits, motivation, and test content. Point out that psychologists have the difficult task of measuring something that is in flux. Then ask them what would happen if they could take precisely the same test over again. Finally, interrater reliability should be discussed in relation to some physical attribute such as attractiveness or neatness. Ask the class to rate you (or some celebrity) on a scale from 1 to 10 on the attribute. Conclude with a discussion of training people to rate consistently; perhaps this is a goal of graduate training. Ask students why they think the assumption that “consistent data equal useful data” is fallacious. By what criteria do we judge that an A in a course really measures what we want to measurefi Finally, a helpful way to show the relationship between reliability and validity is to use Venn diagrams. A large circle labeled Reliability should have a smaller circle labeled Validity within its borders.

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