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Wednesday, August 26, 2020
Acceptance and Commitment Therapy
Acknowledgment and Commitment Therapy An as of late embraced type of psychotherapy known as Acceptance and Commitment Therapy has gotten exceptionally well known. It was made during the 90s by Steven Hayes and is a type of social and psychological treatment. These treatment strategies have for some time been utilized to treat social issues like tension, worry because of awful circumstances, and sadness. Intellectual conduct treatment instructs patients to take a negative idea and assess all the reasons why it is bogus. In any case, Acceptance and Commitment Therapy (ACT) will permit the patient to acknowledge that idea immediately. Those musings may even be permitted to proceed or rehash until the power of them is normally decreased. These undesirable musings are not promptly discharged however rather are acknowledged. Proficient specialists who utilize the ACT procedure have contended that this technique increasingly fruitful in a shorter measure of time. It permits an individual to comprehend that they can in any case make a move with changing or special stepped area your emotions in any capacity. You can understand that you are having these unsettling sentiments yet at the same time can follow up on the inverse. ACT focuses on the possibility of Mindfulness, which is an act of being available in musings and day by day living. You will likewise be educated to distinguish your own arrangement of qualities and picked practices and activities that concur with your qualities. Information has demonstrated that from 1996 to the present, that there has been a high adequacy rate in an assortment of circumstances. Author and supporters of this treatment technique accept that a more elevated level of satisfaction is accomplished when we can conquer considerations and sentiments that are negative. Patients are instructed to decide to make positive move occasion when dangerous circumstances emerge. Indeed, even this therapys abbreviation suggests that at long last you have to act to make in any positive change. Acknowledgment and Commitment Therapy is an incredible instrument for individuals managing substance misuse, physical or psychological mistreatment, just as patients with OCD, fears, and bi-polar scatters. Couples and families have likewise had the option to profit by this technique and develop nearer and progressively personal with one another. Grown-up A.D.D. Grown-up A.D.D or Adult Attention Deficit Disorder is the place individuals experience issues centering for a specific measure of time or on each thing in turn. Numerous individuals with differing kinds of Attention Deficit Disorders feel that others effectively misconstrue them. They don't see the world similarly as others. Analysis of this issue is underrepresented in grown-ups and conceivably over analyzed in youngsters. Actually, grown-ups frequently dont acknowledge what the indications that they are A.D.D until their youngsters get determined to have it. Grown-ups who experience the ill effects of this condition have issues with proceeding with an errand, being sorted out, or completing things on schedule. Furthermore, those managing this have issues with having long haul connections and controlling emotional episodes. The test used to help analyze a grown-up is generally equivalent to youngsters, however rather than word like school, the grown-up will utilize work. So in the event that you score with the scope of having this condition, what do you do straightaway? You should have a specialist wipe out other potential explanations behind your manifestations like, OCD, bi-polar, melancholy, tension, or hormonal awkward nature. Early menopause and pre-menopause can likewise make ladies display comparable indications of consideration shortfall. From the start, your PCP may give you antidepressants since sorrow is basic in grown-ups with this issue. In the event that these dont work, at that point they may advance to an energizer sedate on the off chance that you dont have a background marked by tranquilize maltreatment as this medicine can be irresistible. Consequently, individuals with this issue feel that the treatment is more regrettable then the condition. There are approaches to adapt to Adult A.D.D normally. Changing your way of life with a legitimate eating regimen and exercise can assist you with managing the confusion without clinical reactions. Normal exercise causes you to soothe pressure and can even decrease sadness. Sustenance is significant when we have to center. Cerebrum boosting nourishments with amino and unsaturated fats are critical to helping you diminish consideration shortfall side effects. In conclusion, make records. Records can assist you with remaining focused. Spot obligations of the most elevated significance first and work on going all together. You will feel pleased with yourself every night when the entirety of your undertakings have been finished. Gloom Quiz Gloom is considerably more than negligible misery. It is characterized as enthusiastic downfall and withdrawal. We frequently state that we are discouraged on the grounds that something appalling occurred during our day or we couldnt get our direction. Nonetheless, genuine gloom is a clinically analyzed condition that regularly needs treatment and additionally prescription to calm. There is an approach to see whether you have a propensity toward this condition. It is known as a downturn test. This test encourages you decide if you are giving indications of being discouraged by the side effects you express. This test wont show consequences of how profoundly this condition is felt, yet it is useful toward getting an analysis and deciding your perspective. Indicating your primary care physician this test will support that person to learn the degree of your condition and what steps should be taken. This test is equipped towards making you mindful of the general signs and side effects of this condition yet giving significant and applicable realities. The test contains a lot of inquiries that will decide whether your condition is gentle to extreme, intense to incessant. You can adequately make a rundown of the indications that you are experiencing or encountering at whatever point you answer yes to any of the inquiries. At least three yes answers can be proof of an intense type of melancholy. An incidentally discouraged individual will see these manifestations decrease as the issues that caused them likewise blur. In any case, side effects that stay over a time of a month or more can be proof of an increasingly genuine condition. For this situation, you should contact a clinical expert. These side effects comprise of weariness, sleep deprivation, crabbiness, and considerations of self destruction. On the off chance that you feel any of these side effects or only an inclination that things arent right, at that point you should take a downturn test. It would be ideal if you know that his test isn't a replacement for a clinical determination. It ought to be utilized as an approach to decide your perspective and make you mindful of the manifestations one can look with this condition. Demonstrate your outcomes to your primary care physician to decide the following stage toward emotional well-being. Crystal gazing Matching Marriage these days is a mind boggling try. Finding your ideal perfect partner has become a bet that numerous couples are losing each year. Numerous single guys and lone rangeresses stress that they may always be unable to locate the correct individual to develop old with. Individuals everywhere throughout the world have looked for different assets in discover an accomplice. There are such huge numbers of match making sites and organizations that it is difficult to get rid of the counterfeit ones. In any case, there is one strategy that is an antiquated method of discover Mr. or on the other hand Mrs. Right; its soothsaying coordinating. This training utilizes a people star signs to figure out what kind of mate would be the best for them. Utilizing this kind of similarity scale you can discover somebody to impart your life to. Celestial prophets assemble data by utilizing stars, planets and the sun. They accept that these components frequently impact our conduct and increment the likelihood of finding an accomplice. In certain societies, guardians counsel celestial prophets to assist them with finding a reasonable spouse or wife for their youngsters. The data gave by the crystal gazer will impact the choice to concur with the marriage. These readings wont reveal to you the exact future, however it can tell you what trademark you have to search for in a mate. These qualities will be the most perfect to your own or parity out your shortcomings. For instance, in the event that you are modest, you might need to look for somebody somewhat more friendly. On the off chance that you have a temper, you should search for somebody progressively gentle tempered. These things can help keep your relationship fascinating and less difficult. Knowing how that specific sign acts, thinks, and feels will give you a favorable position while looking for a mate. In any event, when you do discover an individual with a good horoscope it isnt ensured that it will last. There are numerous factors to celestial coordinating that you need to consider. This strategy should just be utilized as an instrument to limit your pursuit. You might be good with a wide range of horoscopes, however on the off chance that you are not perfect with Virgos for instance, you could know about that. You will even now need to work at any relationship. You should bring the best pieces of your character out to show possible admirers. Leo Astrology Symbol Person who are brought into the world under the Leo crystal gazing image or sign are those conceived between July 23rd and August 22nd. Leo is administered by the Sun and their component is fire. This is viewed as an exceptionally autonomous sign. Leo is the fifth mysterious sign and is from the group of stars of Leo which speaks to the lions tail. Men brought into the world under this sign are warm and cheerful and inclined to activity. He wants to be the focal point of consideration. He is profoundly social and his eagerness spreads to every one of his companions. He isnt only a pleasant time companion, yet you can likewise rely upon him when times are hard. Leos are incredible, normal conceived pioneers with quality initiative aptitudes. They are straightforward, faithful and positive and like to lead out front. They can identify with individuals from various ways of life and are exceptionally strategic. Despite the fact that they are incredible at designating assignments to other people, they dont effectively acknowledge them. Leos are dont like to acknowledge disappointment and are resolved to succeed. Leos love sentiment with candlelit meals and neighborliness. They lean toward extravagance and living truly agreeable. You need to stroke the Leos sense of self as they love acclaim and adoration when they have accomplished something. They are normally touchy animals. Leos are solid willed and predominant, so two together can be a major issue. For the most part Leos are liberal, warm, lo
Saturday, August 22, 2020
Vera Drake Movie Review Example | Topics and Well Written Essays - 1000 words
Vera Drake - Movie Review Example The truly stunning component with Vera is that she is acquainted as totally devoted with her family and her obligations as spouse and mother. Staying quiet from her family and being undisturbed for a long time, for her this was an ordinary visit to somebody's home and getting them out of the circumstance. At the time single ladies specifically would be socially and monetarily denounced in the event that they got an ill-conceived kid. So as to keep away from the cataclysmic circumstance, ladies would effectively spare their social appearance and picture. What the film attempts to suggest to the crowd is that the courageous woman follows up on the bases of her own standards and she is guided by her positive attitude to spare the ladies and enable them with the option to choose for themselves what is best for them. What we don't anticipate from the film is that such a sort and pleasing, spouse and mother could ever thought of performing unlawful premature births when social standards and limitations don't legitimize it. Vera has the inward quality and endurance to do these techniques and she is continually alleviating the setback ladies indicating profound comprehension and backing for their circumstance. The executive cautiously investigates and assumes with the jobs that Vera satisfies - spouse, mother and criminal. In spite of the fact that we are acquainted with Vera's family, companions and social encompassing we are never given the contention what made Vera into rehearsing the then illicit premature births. So we can just accept that she is doing it because of her cooperative attitude and conviction that she is making a difference. She is bolstered by her reaction when the monitor comes into her home. Truth be told, they never ask her what she is doing, she gives her in by conceding that she knows as of now why they are here. What's more, she answers: I help young ladies out. Using this code word persuades that her longing is to help the young ladies. Vera's activity can be best portrayed as getting young ladies in the clear. Another proof of her cooperative attitude is that she isn't taking cash. Rather she is brought food or milk or different fixings. At the point when gotten some information about that she is spurned. It appears that her clarification is unmistakably more entangled than just increasing additional money. Vera's watchful administrations and house to house visits part with that she is negligent about exploiting ladies' circumstances and rather chances everything - her family and her great name so as to help the ladies in their longing to make premature birth. The crowd is additionally given different viewpoints after Vera's capture. We have Reg's conclusion (Vera's little girl potential spouse) - It ain't reasonable. Me mum raised six of us in two rooms. On the off chance that you can't take care of them, you can't cherish them, presently can you His point shows understanding about the job that ladies play as moms, homemakers and care suppliers. Vera has extremely tender bond with her better half - Stan. His opinion of her capture is that Whatever she done, she done it because of the decency of her heart! Since the watchers need to depend on signs that different characters part with, Stan and Reg give us potential clarifications why Vera started her activities. The explanation behind Vera's capture is a perilous incident that transpired of her clients a little girl of a rich bourgeoisie family for whom Vera cleans. Susan's urgency is as serious as Vera's
Wednesday, August 19, 2020
Transformation of Gregor Samsa from Metamorphosis by Kafka
Transformation of Gregor Samsa from Metamorphosis by Kafka Diagnosing Gregor Samsa from Metamorphosis Oct 30, 2018 in Literature Characteristic of Metamorphosis by Franz Kafka The novella The Metamorphosis written by Franz Kafka narrates the case of the protagonists physical and mental transformation. At the beginning of the story, the author writers, As Gregor Samsa woke one morning from uneasy dreams, her found himself transformed into some kind of monstrous vermin (Kafka 29). The author describes in detail how this transformed creature attempts to survive. Its transformation can be of psychotic nature because of detached and dreamlike reality. Gregor delineates himself from the external social environment, family, and work. He has problems with speech and severe deviations in outlook on the real world. In general, psychosis has been related with the loss of identity, accompanied with a range of visual, hallucinations, auditory, and somatic disorders. In this respect, in Kafkas The Metamorphosis, the current interpretation of Gregors diagnosis is closely associated with psychosis followed by the loss of identity, and the recognition of fatal disease, whi ch could be compared with AIDS. Gregor Samsa and His Transformation in the Novella While comparing the main character with other people who have disorders and psychological problems, it can be stated that Gregor was treated like a strange sick person especially by family members and society. In order to understand Gregors psychological state, the attention should also be paid to his personal background. As a result of his metamorphosis, it has been evident that the heros adhesion of his physical state makes his further actions logical, concrete, and predictable. Therefore, his reminiscence of a person who has AIDS explains some of the actions described in the story. Kafka recognizes that Gregors family members and family background in general is really complicated and is full of conflicting and controversial situations, followed by hatred and fights. Therefore, the protagonists detachment and desire to stay in the room shows his reluctance to communicate with the outside world, including his family. Gregor is depicted as a social outcast who is rejected by society. The presence of illusions and hallucinations is also revealed through the description of Gregors psychological state because the novella is regarded as a fusion between realism and surrealism, an allegoric representation of psychotic protection. In order to understand whether Gregor Samsa really suffered from psychosis, the analysis of symptoms should be conducted.
Sunday, May 24, 2020
How Does Nitrogen Oxide Pollution Affect the Environment
NOx pollution occurs when nitrogen oxides are released as a gas into the atmosphere during the high-temperature combustion of fossil fuels. These nitrogen oxides consist mainly of two molecules, nitric oxide (NO) and nitrogen dioxide (NO2); there are other nitrogen-based molecules considered to be NOx, but they occur in much lower concentrations. A closely related molecule, nitrous oxide (N2O), is a significant greenhouse gas that plays a role in global climate change. Where Does NOx Pollution Come From? Nitrogen oxides form when oxygen and nitrogen from the air interact during a high-temperature combustion event. These conditions occur in car engines and fossil fuel-powered electricity plants. Diesel engines, in particular, produce large amounts of nitrogen oxides. This is due to the combustion features characteristic of this type of engine, including their high operating pressures and temperatures, especially when compared to gasoline engines. In addition, diesel engines allow excess oxygen to exit the cylinders, diminishing the effectiveness of catalytic converters which prevent the release of most NOx gases in gasoline engines. What Are the Environmental Concerns Associated With NOx? NOx gases play an important role in the formation of smog, producing the brown haze often observed over cities, particularly during the summer. When exposed to the UV rays in sunlight, NOx molecules break apart and form ozone (O3). The problem is made worse by the presence of volatile organic compounds (VOC) in the atmosphere, which also interact with NOx to form dangerous molecules. Ozone at the ground level is a serious pollutant, unlike the protective ozone layer much higher up in the stratosphere. In the presence of rain, nitrogen oxides form nitric acid, contributing to the problem of acid rain. Additionally, NOx deposition in the oceans provides phytoplankton with nutrients, worsening the issue of red tides and other harmful algae blooms. What Are the Health Concerns Associated With NOx? Nitrogen oxides, nitric acid, and ozone can all readily enter the lungs, where they create serious damage to delicate lung tissue. Even short-term exposure can irritate the lungs of healthy people. For those with medical conditions like asthma, just a short time spent breathing these pollutants has been shown to increase the risks of an emergency room visit or hospital stay. Approximately 16% of houses and apartments in the United States are within 300 feet of a major road, increasing exposure to hazardous NOx and their derivatives. For these residentsââ¬âespecially the very young and elderlyââ¬âthis air pollution can lead to respiratory diseases such as emphysema and bronchitis. NOx pollution can also worsen asthma and heart disease and is tied to elevated risks of premature death. What Role Does NOx Pollution Play in the Volkswagen Diesel Scandal? For a long time, Volkswagen has marketed diesel engines for most vehicles in their fleet. These small diesel engines provide ample power and impressive fuel economy. There were concerns over the cars nitrogen oxide emissions, but those were appeased as the little Volkswagen diesel engines met the stringent requirements policed by the U.S. Environmental Protection Agency and the California Air Resources Board. Somehow, few other car companies seemed to be able to design and produce their own powerful but thrifty and clean diesel engines. It became clear why in September 2015, when the EPA revealed that VW had been cheating the emissions tests. The automaker had programmed its engines to recognize testing conditions and react by automatically operating under parameters that produce very low amounts of nitrogen oxides. When normally driven, however, these cars produce 10 to 40 times the maximum allowable limit. Sources EPA. Nitrogen Dioxide ââ¬â HealthEPA. Nitrogen Dioxide (NOx) ââ¬â Why and How They Are Controlled This article was written with assistance from Geoffrey Bowers, Professor of Chemistry at Alfred University, and author of the book Understanding Chemistry Through Cars (CRC Press).
Wednesday, May 13, 2020
Marketing Mix Example - 1838 Words
1. Read following paragraph and explain the process this firm might go through to reach this specific marketing strategy - how and why this company reach to use this decision. Also explain results this firm may get from using this specific marketing strategy. In addition, recommend any modification of strategy based on SWOT analysis. Bakery chain Tous Les Jours introduces two varieties of Kim Yu-na bread,à ¢Ãâ¬Ã named after the popular Korean figure skater. The flavors, chosen by Kim herself, are the sweet potato and cream bread, and the kaya bun. The company said that the proceeds will go to various charities selected by Kim. The bread will be sold nationwide. à ¢Ãâ" how this company reach to use this decision they must go through thisâ⬠¦show more contentâ⬠¦tous les jours also can increase in sales and proceeds. moreover another sort of breads that they carry make sales more as a synergy effect because the customers who visited dont purchase just one bread. Ãâ à ¢Ãâ" recommend any modification of strategy based on SWOT analysis. in this case, the objective of marketing strategy is to build good image by SO strategy. I think it is good. but I want to recommend one thing with threat component of SWOT. nowadays most of food industry is forced to open food additives in order to reveal whether some food is good to eat or not. but bread is not mandatory to open their information. I think thats big problem in relation to trend. to remove risk about food problem, to notify this companys food is good and nice hygienically and also to prevent some problems, tous les jours had better choose things which deprive of threat, food-polluted problem. 2. Today we live in an environment of global warming and high oil prices, which demands energy efficiency. Choose any firm which is currently operating in a market, and develop marketing strategy which is applicable to that specific firm in relation with above statement.Ãâ a. first step : market situation evaluation the customers need is changing into environment-friendly product. that means the customer forces the producer produce cost(energy)-efficient items because the globe grow warmer and warmer and the people are threatened by green houseShow MoreRelatedExamples Of Decisions ( Marketing Mix )870 Words à |à 4 PagesExamples of Decisions (Marketing Mix) The main component of the marketing mix is the product. It consists of the services, along with the physical product itself. The company imaging, packaging, and the brand name are all included in this concept. An example of product decision in this particular case study is the variety of cookies that are provided: The Girl Scouts will also be asking certain troops to reduce their cookie lineups to six varieties. The top six selling cookies--Thin Mints, Do-si-dosRead MoreMarketing Mix Essay examples1043 Words à |à 5 PagesMarketing Mix MKT 421 Tyson Foods promotes several different types of food in the food chain industry. They are ranked 96 in the Fortune 500 in Americaââ¬â¢s largest corporations. Tysonââ¬â¢s produced poultry, beef, and pork, as well as providing the previous to several chain stores to use products. From McDonald nuggets to the Subway sandwich, Tyson is one of the largest poultry processing plants in the country. Tyson also distributes bag in bag products to stores which include Samââ¬â¢s and Wal-Mart storesRead MoreMarketing Mix Essay example1473 Words à |à 6 PagesMy Marketing Mix I am now going to create a marketing mix for my chosen product using the 4 Ps, Product, Place, Price and Promotion. Product The product I will be re-launching is the Cadburys Double Decker bar with less calories than a traditional bar. This new re-launch of a chocolate bar will be a limited edition chocolate bar. The idea being limited edition is to make a substantial profit in a short period of time. Although the product will say limited edition I aim to keep theseRead MoreMarketing Mix ââ¬â Literature Review and Company Example5234 Words à |à 21 PagesDiploma in Sales Marketing - 66th Intake Module DSM 101-Marketing Principals Marketing Mix ââ¬â Literature Review and Company Example Lecturer: Thomas Lim Team Members:Christopher Mark Charlton (team leader) Gary Chow Hock Meng Andrew Peter O Lai Wohlstand Cheah Rong Jin We declare this report is XXXXX words in length 1 Table of contents Introduction to the Marketing Mix 4Ps ~ page number 3 Marketing Mix 4Ps Place Literary Review Company Example of Marketing Mix 4Ps Place ââ¬â Ritchie Bros.Read MoreMarketing Mix1491 Words à |à 6 PagesMarketing Mix MKT 421 Marketing Introduction Companies today try their best to continue to keep up with the changes of services, products and technology. Companies rely on their abilities in marketing to keep consumers interested in their products and services. 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Smart managers treat pricing as a key strategic tool for creating and capturing customer value. --As a part of company s overall value proposition, priceà plays a key roleRead MoreEssay about Marketing Mix of the Berocca1345 Words à |à 6 Pages1.0 Abstract In this report, the aim was to analyze the marketing mix of Berocca according to our groupââ¬â¢s survey and questionnaires. Marketing mix includes product, price, place and promotion. In terms of the survey and questionnaires, some results were givens and analyzed. In addition, some personal suggestion will be presented. 2.0 Introduction Berocca is a brand of effervescent drink and vitamin tables, the tables contain comprehensive vitamin B group and vitamin C. At first, Berocca wasRead MoreFlight Centre1695 Words à |à 7 Pagesfindings: 1. Wide gap in the revenue growth of high and low performing stores. Difference in revenue growth of highest to lowest performing stores in last six months showed a huge variance. 2. Inconsistent customer experience across stores. The marketing metrics provided in the case study reveals that customers are treated differently in various Flight Centre stores. The company does not have organization level guidelines for their staff for customer handling. 3. Lack of commitment towards the visionRead MoreMkt421 Marketing Mix1094 Words à |à 5 Pagesof Phoenix MKT421 - Marketing Mix The marketing mix is comprised of four basic marketing strategies. The four strategies, which include product, place, price, and promotion, involve the decisions that a business must make to succeed. The marketing mix is reliant on how clear and defined the businessââ¬â¢ target market is and how well the company directs the strategies towards its targeted market (Glenco McGraw-Hill, 3rd Edition). This paper will further define marketing mix, the four strategiesRead MoreIncreasing Competition Between Low Cost Carriers1679 Words à |à 7 PagesSingapore Airlines. Is has been a raising star in the LCC industry, thus makes me interested in analyzing their marketing strategies, find out that whether only the marketing mix contributes to their success, or there are some other factors effecting. The following paragraphs will analyze Scootsââ¬â¢ marketing mix in advance, and then move forward to some other success factors. Marketing Mix The core value customers get from taking an airplane is the service of traveling or transportation. As a traditional
Wednesday, May 6, 2020
The contribution of the Upper tribunal to the first-tier tribunalââ¬â¢s work Free Essays
string(127) " feature of the new system and, as demonstrated above, shares features with the judicial review available in the courts\[24\]\." Introduction The reform of the haphazard system of tribunals in the UK has often provided a neat symmetry with the chaos the system has been vehemently criticised for. It has taken half a century for the Tribunals, Courts and Enforcement Act 2007 to be given royal assent, which Bradley Ewing rightly suggest to be the fulfilment of the conclusions of the influential Franks Committee of 1957, constituted to provide a once-in-a-generation review of tribunals and inquiries in the UK[1]. The Franks Committee concluded that tribunals are ââ¬Å"machinery provided by Parliament for adjudication,â⬠the operation of which should be fair, open and impartial[2]. We will write a custom essay sample on The contribution of the Upper tribunal to the first-tier tribunalââ¬â¢s work or any similar topic only for you Order Now Thus at one legislative stroke the proliferation of tribunals in the last century, which moved the then Lord Justice Woolf to author a paper entitled ââ¬Å"a hotchpotch of appeals ââ¬â the need for a blenderâ⬠[3], has now been significantly curtailed by the 2007 Act which established two tiers of tribunals to simplify what was becoming unaccountable, undemocratic and in violation of ECHR treaty convention rights[4]. A review in 2001, formed under the auspices of the then Labour Government and the main catalyst for the 2007 Act, found that there were 70 different tribunals across England and Wales and that a number of them were obsolete[5]. The Governmentââ¬â¢s response in the White Paper Transforming Public Services: Complaints, Redress and Tribunals[6] laid the foundations for the unified system which now prevails. The problems of the past which plagued tribunals are of ââ¬Å"historical interestâ⬠in the words of Bradley Ewing[7]. In the context of mental health the relevant first-tier tribunal chamber is the Health, Education and Social Care Chamber and in the Upper tribunal the relevant chamber is the Administrative Appeals Chamber which can hear appeals, with leave from the first-tier tribunal, on points of law only and exercises a judicial review function[8]. The two tiers of tribunals opened for business in November of 2008[9] and the first case in the context of mental health heard by the Administrative Appeals Chamber was heard in 2009[10]. Thus there have been almost three years of cases to evaluate the effectiveness of the Upper Tribunalââ¬â¢s contribution towards enhancing the safeguarding role of the first-tier tribunal in mental health cases[11]. In total there have been 28 cases hearing appeals from the Health, Education and Social Care Chamber within this time[12]. It is very early in the life of the unified system to conclusively say whether it is enhancing the system[13] but Bradley Ewing m ake some general observations on the advantages the two-tier system is bringing which are relevant to the mental health sphere: ââ¬Å"One valuable result of the two-tier structure is to rationalise the diverging procedures that separate tribunals had used. This task has been carried out by the Tribunal Procedure Committee, Chaired by a Court of Appeal judge. The aims of the procedure rules include that of ensuring that in tribunal proceedings ââ¬Ëjustice is doneââ¬â¢; that the tribunal system is ââ¬Ëaccessible and fairââ¬â¢; that proceedings are handled ââ¬Ëquickly and efficientlyââ¬â¢; and that the rules are ââ¬Ëboth simple and clearly expressedââ¬â¢Ã¢â¬ [14] The administrative advantages of a unified system[15] are perhaps obvious but the case law has revealed some potential weaknesses with the Supreme Court recently holding that the Upper Tribunal is amenable to judicial review itself[16]. This essay will critically analyse the contribution of the Upper tribunal to the first-tier tribunalââ¬â¢s work over the past three years by analysing the statutory basis of the tribunal in part 1 as well as the decided case law in the context of mental health. The essay will then, in part 2, discuss the strengths and weaknesses of the current system and conclude that the new Upper Tribunal is indeed enhancing the work of the first-tier tribunal as demonstrated by the high number of successful appeals, the innovative judicial review function and ECHR compliance under article 6. Part 1: The Upper Tribunal in mental health 1.1 The Administrative Appeals Chamber and the 2007 Act S.3(5) of the 2007 Act confers on the Upper Tribunal the status of a ââ¬Å"superior court of recordâ⬠[17]. As noted above in the introduction the Upper Tribunal is split into three Chambers with the Administrative Appeals Chamber dealing with, inter alia mental health cases, with its functions split neatly into three categories: appellate, judicial review and referral[18]. The ordinary appellate procedure on a point of law derives from article 7(a) of the First tier Tribunal and Upper Tribunal (Chambers) Order 2008 and, in the context of mental health, is able to hear an appeal ââ¬Å"against a decision made by the first-tier tribunalâ⬠[19] but only in respect of a point of law which is not an ââ¬Å"excluded decisionâ⬠under s.11(5)(a) ââ¬â (f). With respect to the novel judicial review function, what Lady Hale of Richmond called ââ¬Å"a major innovation in the 2007 Actâ⬠[20], under article 7(b) of the 2008 Order this function has been transplanted from the High Court with the Administrative Appeals Chamber able to grant the following kinds of relief: a mandatory order, a prohibiting order, a quashing order, a declaration and an injunction[21]. This function has been qualified by the Lord Chief Justice in England and Wales who issued a practice direction to the effect that the relief of judicial review will be available where there is no power of appeal to the Upper Tribunal and where the decision is not an excluded one[22]. Finally the Administrative Appeals Chamber also has a referral function where cases may be transferred from the First-Tier Tribunal to the Upper Tribunal under s.9(5) of the 2007 Act where the First-Tier Tribunal has set aside a decision. Lady Hale noted in the Supreme Court that the appellate procedure is the most important function of the Administrative Appeal Chamber[23] although her Ladyship pointed out that this right can only be exercised with the permission of either the First-tier or Upper tribunal under ss11(3) and 11(4). The judicial review function of the Upper tribunal is indeed a novel feature of the new system and, as demonstrated above, shares features with the judicial review available in the courts[24]. You read "The contribution of the Upper tribunal to the first-tier tribunalââ¬â¢s work" in category "Essay examples" A curiosity of the system arose in 2011 in the Supreme Court where it was decided that decisions of the Upper Tribunal are amenable to judicial review in the High Court, a decision which Phillip Murray suggests undermines the advances the unified system represents[25] and which will be discussed in part 2 of this essay[26]. 1.2 Case law in mental health As noted in the introduction there have been 28 cases in the three years of the 2007 Actââ¬â¢s life which relate specifically to mental health law[27]. In order to determine whether or not the Upper Tribunal is enhancing the safeguarding role of the First-Tier Tribunal, the Health, Education and Social Care chamber, it is important to analyse the case law both qualitatively and quantitatively. In quantitative terms the appellate procedure is being used in the Upper Tribunal in the majority of cases with judicial review used very sparingly. In all cases heard in 2011, 13 in total, four were successful appeals with the decision of the First-Tier tribunal set aside[28] while in just one case the decision was taken not to set aside the decision despite the successful appeal[29]. In two cases no error on a point of law was discovered by the Upper Tribunal[30] and in only one case was the appeal dismissed entirely[31]. In another case permission to appeal was refused[32] and, to emphasi se the young nature of the tribunal two cases were dedicated to in-depth discussions of tribunal procedure about the open justice principle[33] and the revocation of Community Treatment Orders (CTOââ¬â¢s)[34]. The final decision[35] deserves closer attention in light of the fact that it is the only judicial review decision of 2011[36] and but the second judicial review in all three years[37]. The facts in this case were that while P was serving a five monthsââ¬â¢ sentence for various criminal offences he was sentenced to a further nine monthsââ¬â¢ in relation to an assault. On 21st October 2008 the Secretary of State used his powers under s.47 of the Mental Health Act 1983 to have P transferred to a psychiatric hospital. P then appealed against this decision to detain him to the First Tier tribunal on 19th February 2010 which ordered his discharge. A further appeal was made within the power of the First-Tier tribunal to review and set aside its own decisions and thus Judge Foster agreed to set aside the decision under Rule 45 of the Tribunal owing to a discussed Community Treatment Order which Judge Foster felt invalidated the original decision. A further appeal was then heard by Jud ge Foster against her own decision which led to the present judicial review proceedings. In essence, Judge David Pearl reinstated the original First-tier tribunal decision of 19th February 2010 and observed: ââ¬Å"In this case, given the findings made by the First-tier Tribunal in its decision dated 19th February 2010, the tribunal was under a positive duty to direct a discharge, albeit deferred for a period of six weeks to enable after-care arrangements to be put in place. It follows therefore that Judge Fosterââ¬â¢s two decisions must be quashed. Both of those decisions are unlawful, in that they are predicated on a reading of the First-tier Tribunalââ¬â¢s decision which can in no way be justified.â⬠[38] Part 2:Discussion of the Administrative Appeals Chamber 2.1 Enhancing the first tier tribunal? (a) Weaknesses Despite the fact that the Administrative Appeals Chamber has only been in operation for a short time there are some evident weaknesses in the way case law has developed which arguably undermine rather than enhance the First-Tier tribunalââ¬â¢s role[39]. The most obvious weakness is the fact that the decisions of the Upper Tribunal are amenable to judicial review[40]. Perhaps it was wishful thinking that unappealable decisions of the Upper Tribunal would not be subject to judicial review and that the two-tier system would continue to be ââ¬Å"authoritative, efficient and self-containedâ⬠as Phillip Murray points out[41]. There was a clear intention by Parliament in the drafting of the 2007 Act that the Upper Tribunal would have the final say as to whether any appeal from the First Tier Tribunal on a point of law should be allowed and, since there is little difference between an appeal on a point of law and a judicial review[42], a judicial leak has appeared in what was, until the Supreme Courtââ¬â¢s decision[43], a very tight and secure system. The implications of allowing review of the Upper Tribunalââ¬â¢s decisions are, in Murrayââ¬â¢s opinion, grave: ââ¬Å"Judicial review is not, like appeal, concerned with settling important points of principle or practice. Rather, its concern is with vires ââ¬â that is, ensuring that decision-makers act within the four corners of their power ââ¬â as well as questions of procedural fairness. This is the primary focus of the Sivasubramaniam model, and it would have been preferable as a result. Such an approach would have maintained the orthodox constitutional basis for review, avoided flouting Parliamentââ¬â¢s express will, and ensured proportionate protection of the rule of law.â⬠[44] (b) Strengths The strengths of the administrative appeals chamber certainly outweigh the main weakness identified above in enhancing the First-Tier Tribunal. The high number of successful appeals which have, in the context of mental health and explored earlier, set aside decisions of the first-tier tribunal are obvious indicators of the Upper Tribunal enhancing the First-Tier Tribunalââ¬â¢s safeguarding role by ensuring justice is done[45]. Thus in the 28 cases it is apparent that erroneous decisions are being caught and corrected with appropriate procedures whether that is having the decision set aside or remitted back to a reconstituted First-Tier Tribunal. The use of the judicial review function is both innovative and flexible and has, in two key decisions, proved to be invaluable in reversing procedural decisions taken at first instance[46]. In the Mersey case the internal review procedure of the First Tier Tribunal was simply ineffective and it took the Upper Tribunal to step in and rectify matters under judicial review in an impartial and independent manner. The Administrative Appeals Chamber enables the First-Tier Tribunal to be compatible with article 6 of the European Convention on Human Rights both in terms of independence and also in terms of procedural fairness. Conclusion In conclusion the Administrative Appeals Chamber has, in its short lifespan, enhanced the safeguarding role of the First-Tier tribunal within the new unitary system ushered in by the Leggatt Review of 2001[47]. In the context of mental health cases there have been 28 in total in the 3 years of the 2007 Actââ¬â¢s operation which serve to validate the work of the Upper Tribunal. As can be expected the number of appeals is relatively modest but clearly the Upper Tribunal is performing a vital function in holding the First-Tier tribunal to account and, where appropriate, setting aside its decisions. In terms of the novel judicial review function this has been used only twice in the context of mental health but has demonstrated a willingness by the tribunal system to deploy it when natural justice demands it. The fact that the First-Tier Tribunal can review its own decisions is not in itself an adequate safeguard and the case of MP v Mersey Care NHS Trust[48] is a useful reminder that the first instance tribunals, just like courts, need to be supervised independently. The Upper Tribunal also ensures vital article 6 compliance. This aspect enhances the whole system which can now survive scrutiny from Strasbourg. The one main weakness, that the Upper Tribunal is susceptible to judicial review itself, is in reality a technical one and something that is unlikely to become a crippling problem. Overwhelmingly the Upper Tribunal has enhanced the First-Tier Tribunal in its short life. Bibliography 1.0 Books Bradley, AW Ewing, KD (2011) Constitutional Administrative Law Pearson: Worldwide Creyke, Robin (2008) Tribunals in the Common Law World Federation Press: Sydney Jacobs, Edward (2010) Tribunal Practice and Procedure: Tribunals under the Tribunals, Courts and Enforcement Act 2007 Legal Action Group: UK Thompson, Brian (2010) ââ¬ËCurrent Developments in the UK: System Building ââ¬â From Tribunals to Administrative Justiceââ¬â¢ in Adler, Michael (ed) Administrative Justice in Context Hart Publishing: Oregon and Portland at p.484 2.0Journals Case Comment (2011) ââ¬ËTribunal Merger may ââ¬Å"dilute rather than enhanceâ⬠expertise, Lady Hale warnsââ¬â¢ Solicitors Journal 155(25), 3 Gledhill, Kris (2009) ââ¬ËThe First Flight of the Fledgling: The Upper Tribunalââ¬â¢s Substantive Debutââ¬â¢ Journal of Mental Health Law Spring 81-93 Mitchell, Gareth (2010) ââ¬ËJudicial Review, but not as we know it: Judicial Review in the Upper Tribunalââ¬â¢ Judicial Review 15(2), pp112-117 Murray, Phillip (2011) ââ¬ËJudicial Review of the Upper Tribunal: Appeal, Review, and the Will of Parliamentââ¬â¢ in Cambridge Law Journal 70(3), pp487-489 Rutledge, Desmond (2011) ââ¬ËPractice and Procedure: Jurisdiction ââ¬â Scope for Judicial Review of Upper Tribunal Decisions by High Courtââ¬â¢ Journal of Social Security Law 18(4) pp135-137 3.0 Reports Leggatt, Andrew (2001) Tribunals for Users, One System, One Service accessed on 20/12/2011 and available from: http://webarchive.nationalarchives.gov.uk/+/http://www.tribunals-review.org.uk/leggatthtm/leg-00.htm Report of the Franks Committee, Cmnd 218, 1957, parts II and III Transforming Public Services: Complaints, Redress and Tribunals CM 6243, 2004 4.0 Statutes Tribunals, Courts and Enforcement Act 2007 European Convention on Human Rights article 6 First tier Tribunal and Upper Tribunal (Chambers) Order 2008 5.0 Cases AH v West London Mental Health Trust and another [2011] AACR 15 CM v DHNHSFT and Secretary of State (Justice) [2011] UKUT 129 (AAC) Dorset Healthcare NHS Foundation Trust v MH [2009] UKUT 4 (AAC) (UT) DN v Northumberland Tyne Wear NHS Foundation Trust [2011] UKUT 327 (AAC) JLG v Managers of Llanarth Court SOS for Justice [2011] UKUT 62 (AAC); DP v Hywel DDA Health Board [2011] UKUT 381 (AAC) KL v Somerset Partnership NHS Foundation Trust [2011] UKUT 233 (AAC) MB v BEH MH NHST SoSJ [2011] UKUT 328 (AAC) PS v Camden and Islington NHS Foundation Trust [2011] AACR 42 (on the application of Cart) v Upper Tribunal [2011] UKSC 28 (SC) R (On the application of Cart) (Appellant) v The Upper Tribunal [2011] UKSC 28 RN v Curo Care/ OE [2011] UKUT 263 (AAC) RB v Nottinghamshire Healthcare NHS Trust [2011] UKUT 73 (AAC) TR v Ludlow Street Healthcare Ltd and TR [2011] UKUT 152 (AAC) Appendix A: Decided cases of the Administrative Appeals Chamber in Mental Health From research conducted for this essay from the Governmentââ¬â¢s tribunal judiciary homepage accessed on 19/12/2011 and available from: http://www.administrativeappeals.tribunals.gov.uk/Decisions/decisions.htm Top of Form Decision DateFile No.NCNCategorySubcategoryDecision Added 28/05/2010JR 3066 20092010 UKUT 160 AACTribunal procedure and practice (including UT)other29/06/2010 23/04/2010M 837 20102010 UKUT 119 AACMental healthAll05/05/2010 08/04/2010M 1653 20092010 UKUT 102 AACMental healthAll05/05/2010 25/02/2010M 2704 20092010 UKUT 59 AACMental healthAll15/03/2010 01/10/2009M 827 20092009 UKUT 195 AACTribunal procedure and practice (including UT)tribunal jurisdiction13/10/2009 07/08/2009M 708 20092009 UKUT 157 AACMental healthAll02/09/2009 08/01/2009M 3592 20082009 4Mental healthAll14/01/2009 Top of Form Decision DateFile No.NCNCategorySubcategoryDecision Added 15/03/2011JR 2381 20102011 UKUT 107 AACMental healthAll30/03/2011 17/02/2011HM 84 20102011 UKUT 74 AACMental healthAll07/03/2011 11/02/2011HM 840 20102011 UKUT 73 AACMental healthAll07/03/2011 09/02/2011HMW 2881 20102011 UKUT 62 AACMental healthAll07/03/2011 20/12/2010HM 1533 20102010 UKUT 454 AACMental healthAll12/01/2011 17/12/2010HM 525 20102010 UKUT 455 AACMental healthAll12/01/2011 12/11/2010M 695 20092010 UKUT 32 AACTribunal procedure and practice (including UT)statements of reasons17/02/2010 03/09/2010HMW 134 20102010 UKUT 319 AACMental healthAll06/10/2010 29/07/2010M 84 20102010 UKUT 264 AACMental healthAll17/08/2010 02/06/2010M 1089 20092010 UKUT 185 AACMental healthAll17/06/2010 Bottom of Form Top of Form Decision DateFile No.NCNCategorySubcategoryDecision Added 21/09/2011HMW 1339 20112011 UKUT 381 AACMental healthAll06/12/2011 16/08/2011HM 226 20112011 UKUT 327 AACMental healthAll13/09/2011 12/08/2011HM 803 20112011 UKUT 328 AACMental healthAll13/09/2011 10/06/2011HM 2479 20102011 UKUT 233 AACMental healthAll29/06/2011 11/04/2011HM 2201 20102011 UKUT 263 AACMental healthAll04/07/2011 07/04/2011HMW 509 20112011 UKUT 152 AACMental healthAll27/04/2011 30/03/2011HM 487 20112011 UKUT 143 AACMental healthAll19/04/2011 29/03/2011HM 840 20102011 UKUT 135 AACMental healthAll19/04/2011 23/03/2011HM 2915 20102011 UKUT 129 AACMental healthAll19/04/2011 15/03/2011JR 2381 20102011 UKUT 107 AACMental healthAll30/03/2011 How to cite The contribution of the Upper tribunal to the first-tier tribunalââ¬â¢s work, Essay examples
Tuesday, May 5, 2020
Cardiomyopathy A Disease Of The Heat Muscle Essay Example For Students
Cardiomyopathy : A Disease Of The Heat Muscle Essay Cardiomyopathy is a disease of the heat muscle and has many different types. Dilated, Hypertrophic, and Restrictive are the three main types of cardiomyopathy. Each of these types have different causes, signs and symptoms, and treatments. In cardiomyopathy, the heart muscle can become enlarge, thick, or rigid, and in some rare incidents the muscle tissue can become replaced with scar tissue. As the condition worsens, the heart becomes weaker and less able to pump blood throughout the body. The heart will also become unable to maintain a normal electrical rhythm. Results from cardiomyopathy can lead to heart failure or irregular heartbeats called arrthymias (American Heart Association, 2016). Dilated cardiomyopathy is the most common type of cardiomyopathy, occurring in adults between the ages of 20-60. It affects more of the male population then the female population. Dilated cardiomyopathy affects the heartââ¬â¢s lower (ventricles) and upper (atria) chambers of the heart. The disease starts in the left ventricle (heartââ¬â¢s main pumping chamber). As the chamber dilates, the heart muscle doesnââ¬â¢t contract normally and canââ¬â¢t pump blood very well. The inside of the chamber enlarges and the problem often spreads to the right ventricle and then to the atria (Elliot. 2000). Signs and symptoms of dilated cardiomyopathy â⬠¢ Systemic embolism ( blood clot in arterial circulation) â⬠¢ Pulmonary congestion (excess fluid in the lungs) â⬠¢ Low cardiac output â⬠¢ Fatigue for many months or years â⬠¢ Intercurrent illness â⬠¢ Development of arrhythmias â⬠¢ Genetics â⬠¢ Sudden death (Elliot, 2000) Myocarditis an inflammation of the heart muscle is known to be a cause of dilated cardiomyopathy. A carnitine and calcium deficiency can also lead to dilated cardiomyopathy. Excessive alcohol and drug use such as Anthracyclines have been linked to the cause of dilated cardiomyopathy. Anomalous coronary arteries, a malformation of coronary vessels and arteriovenous malformations, a congenial disorder of blood vessels in the brain are some other known causes. X linked diseases such as Beckerââ¬â¢s and Ducheneââ¬â¢s muscular dystrophies are linked to dilated cardiomyopathy as well as mitochondrial mutations. Beckerââ¬â¢s muscular dystrophy is an x linked recessive inherited disorder in which the leg and pelvis muscle slowly weakens. Ducheneââ¬â¢s muscular dystrophy is a severe form that is caused by an x linked genetic defect that prevents the production of dystrophin, a normal protein found in muscles. Most cases of dilated cardiomyopathy are idiopathic (Elliot, 2000). Diagnosis for dilated cardiomyopathy starts with an assessment of the patientââ¬â¢s family history, specially paying attention to a history of muscular dystrophy, mitochondrial diseases (epilepsy), and signs/symptoms of other inherited diseases. A complete drug history is also essential, both in the administration of drugs that are toxic to the heart and the use of illegal drugs such as cocaine. An ECG in patients with dilated cardiomyopathy could be remarkably normal, but abnormalities in an isolated T wave to septal changes to Q wave can show up with patients who have extensive left ventricular fibrosis, prolonged AV conductions, and bundle branch block may be seen. 20%-30% of patients have non-sustained ventricular tachycardia and a small percent present with sustained ventricular tachycardia. Metabolic exercise testing may be able to provide diagnostic information in patients with ventricular impairment by detecting a severe state of low blood pH (Elliot, 2000). There is no specific treatment for dilated cardiomyopathy. The primary aim of treatment is to control the symptoms, prevent disease progression, and prevent complications of progressive heart failure, sudden death, and obstruction of blood vessels by a blood clot. Warfin is used to treat patients with moderate ventricular dilation. Partial left ventriculectomy is performed to reduce the left ventricular size by removing a portion of its circumference to reduce stress on the wall and to improve ventricular blood flow (Elliot, 2000). .uc96d7413db3006f94bae5df3248cf11b , .uc96d7413db3006f94bae5df3248cf11b .postImageUrl , .uc96d7413db3006f94bae5df3248cf11b .centered-text-area { min-height: 80px; position: relative; } .uc96d7413db3006f94bae5df3248cf11b , .uc96d7413db3006f94bae5df3248cf11b:hover , .uc96d7413db3006f94bae5df3248cf11b:visited , .uc96d7413db3006f94bae5df3248cf11b:active { border:0!important; } .uc96d7413db3006f94bae5df3248cf11b .clearfix:after { content: ""; display: table; clear: both; } .uc96d7413db3006f94bae5df3248cf11b { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .uc96d7413db3006f94bae5df3248cf11b:active , .uc96d7413db3006f94bae5df3248cf11b:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .uc96d7413db3006f94bae5df3248cf11b .centered-text-area { width: 100%; position: relative ; } .uc96d7413db3006f94bae5df3248cf11b .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .uc96d7413db3006f94bae5df3248cf11b .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .uc96d7413db3006f94bae5df3248cf11b .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .uc96d7413db3006f94bae5df3248cf11b:hover .ctaButton { background-color: #34495E!important; } .uc96d7413db3006f94bae5df3248cf11b .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .uc96d7413db3006f94bae5df3248cf11b .uc96d7413db3006f94bae5df3248cf11b-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .uc96d7413db3006f94bae5df3248cf11b:after { content: ""; display: block; clear: both; } READ: General Studies and research of Cardiology EssayHypertrophic cardiomyopathy (HCM) is a primary disease of the muscle of the heart in which a portion of the heart muscle is thickened without any obvious cause. The thickening of the heart muscle creates functional impairment and can make it harder for the heart to pump blood. This type of cardiomyopathy is the leading cause of sudden death in young athletes. HCM can often go undiagnosed because most people have few, if any symptoms and can lead normal lives with no significant problems. However, a small number of people with a thickened heat muscle may experience shortness of breath, chest discomfort, fainting, dizziness, pa lpitations, and extreme fatigue. HCM is caused by a gene mutation and appears in 50% of people of any generation. The mutated gene influences certain proteins that are part of the heart muscle (Maron, 2002). Hypertrophic cardiomyopathy is usually identified by an echocardiogram that produces ultrasound images of the thickened wall of the heart muscle. HCM is most prominent in the wall separating the left and right ventricle (ventricular septum). Echocardiograms may also show partial obstruction of blood flow from the left ventricle into the aorta, caused by forward motion of the mitral valve and whether there is abnormal leakage through the mitral valve. Atrial fibrillation occurs frequently in HCM and accounts for the high numbers of unexpected hospitalizations. A-fib in older patients can cause heart failure and stroke, so anticoagulants may be recommended (Maron, 2002). Implantable cardioverter-defibrillator (ICD) is the most reliable and effective treatment for hypertrophic cardiomyopathy patients at high-risk. ICD has the potential to alter the course of the disease by automatically sensing and terminating lethal disturbances of heart rhythm, often in young people with little to no symptoms. If blood flow obstruction is detected, then a septal myectomy operation is recommended. A surgeon removes a small amount of muscle from the upper part of the septum. Treatment options are more limited to patients who have severe symptoms and these patients may become candidates for a heart transplant. Sudden death occurs in young patients who are athletes due to vigorous exertion (Maron, 2002). Restrictive cardiomyopathy (RCM) is a rare form of heart muscle disease that is characterized by restrictive filling of the hearts ventricles. The squeezing (contractile) function of the heart and wall thickness are usually normal, but the relaxation or filling phase of the heart is very abnormal. The lower walls of the heart become abnormally rigid and lack the flexibility to expand and to fill with blood. RCM is found mostly in children ages 5-6 years old and mostly in girls. There is no known cause (Goldstein, 2014). Signs and Symptoms of RCM â⬠¢ Repeated lung infections â⬠¢ Appearance of an enlarged heart â⬠¢ Fluid in abdomen â⬠¢ Enlarged liver â⬠¢ Edema â⬠¢ Abnormal heart sound â⬠¢ Signs of heart failure â⬠¢ Fainting â⬠¢ Sudden death (Goldstein, 2014). Diagnosis for restrictive cardiomyopathy is very difficult to establish and is only made after certain symptoms become present such as decreased exercise tolerance, a gallop heart sound, syncope (fainting), or chest pain during exercise. Once suspected, certain test are performed to help confirm a diagnosis. An ECG can be most helpful by showing abnormalities of the atria. Cardiac catheterization is used to confirm a diagnosis of RCM, a catheter is slowly advanced through an artery or vein into the heart, while the doctor is watching it on a TV monitor, so the pressure in the hearts chambers can be measured. These measurements show significant elevated pressure during the relaxation period of the heart. In rare cases a cardiac biopsy may be performed to look for potential causes of RCM (Goldstein, 2014). Currently there is no ââ¬Å"cureâ⬠for restrictive cardiomyopathy. Treatment is used to improve the symptoms of RCM. Diuretics, sometimes called water pills, can be taken to reduce excess fluid in the lungs and other organs by increasing urine production. Beta-blockers can be also given to slow the heartbeat and increase relaxation time of the heart. This can allow the heart to fill better with blood before each heart beat and decrease some of the symptoms created by stiff pumping chambers. Heart transplantation is the only effective surgery offered for patients with RCM, particularly those who already have symptoms at the time of diagnosis or have reactive pulmonary hypertension (Goldstein, 2014). .uc5e0655dea8a2376166e872a8102dca2 , .uc5e0655dea8a2376166e872a8102dca2 .postImageUrl , .uc5e0655dea8a2376166e872a8102dca2 .centered-text-area { min-height: 80px; position: relative; } .uc5e0655dea8a2376166e872a8102dca2 , .uc5e0655dea8a2376166e872a8102dca2:hover , .uc5e0655dea8a2376166e872a8102dca2:visited , .uc5e0655dea8a2376166e872a8102dca2:active { border:0!important; } .uc5e0655dea8a2376166e872a8102dca2 .clearfix:after { content: ""; display: table; clear: both; } .uc5e0655dea8a2376166e872a8102dca2 { display: block; transition: background-color 250ms; webkit-transition: background-color 250ms; width: 100%; opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #95A5A6; } .uc5e0655dea8a2376166e872a8102dca2:active , .uc5e0655dea8a2376166e872a8102dca2:hover { opacity: 1; transition: opacity 250ms; webkit-transition: opacity 250ms; background-color: #2C3E50; } .uc5e0655dea8a2376166e872a8102dca2 .centered-text-area { width: 100%; position: relative ; } .uc5e0655dea8a2376166e872a8102dca2 .ctaText { border-bottom: 0 solid #fff; color: #2980B9; font-size: 16px; font-weight: bold; margin: 0; padding: 0; text-decoration: underline; } .uc5e0655dea8a2376166e872a8102dca2 .postTitle { color: #FFFFFF; font-size: 16px; font-weight: 600; margin: 0; padding: 0; width: 100%; } .uc5e0655dea8a2376166e872a8102dca2 .ctaButton { background-color: #7F8C8D!important; color: #2980B9; border: none; border-radius: 3px; box-shadow: none; font-size: 14px; font-weight: bold; line-height: 26px; moz-border-radius: 3px; text-align: center; text-decoration: none; text-shadow: none; width: 80px; min-height: 80px; background: url(https://artscolumbia.org/wp-content/plugins/intelly-related-posts/assets/images/simple-arrow.png)no-repeat; position: absolute; right: 0; top: 0; } .uc5e0655dea8a2376166e872a8102dca2:hover .ctaButton { background-color: #34495E!important; } .uc5e0655dea8a2376166e872a8102dca2 .centered-text { display: table; height: 80px; padding-left : 18px; top: 0; } .uc5e0655dea8a2376166e872a8102dca2 .uc5e0655dea8a2376166e872a8102dca2-content { display: table-cell; margin: 0; padding: 0; padding-right: 108px; position: relative; vertical-align: middle; width: 100%; } .uc5e0655dea8a2376166e872a8102dca2:after { content: ""; display: block; clear: both; } READ: Essay on Transcatheter Aortic Valve ReplacementPrognosis for cardiomyopathy is based on the different types. For dilated cardiomyopathy the prognosis is poor. 50% of patients die within 2 years of diagnosis and 25% survive longer than five years with treatment. The common cause of death for dilated cardiomyopathy is progressive heart failure and arrthymia. The overall annual mortality rate for hypertrophic cardiomyopathy is 3-5% in adult and at least 6% in children. Severity of disease and prognosis varies according to the genetic features associated with HCM. Restrictive cardiomyopathy has a very poor prognosis with patients dying within a year of the diagnosis even with treatment (Oakley, 1997).
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