Discipline in the Public Schools Essay Example | Topics and Well Written Essays - 1250 words

Discipline in the Public Schools - Essay Example Tinker vs Des Moines Independent School District (1969): It was in 1965 when John tinker his sister Mary Tinker and a friend Chris Eckhardt wore black armbands on their sleeve in protest of the Vietnam War. The school faculty told them to remove those armbands, but they refused. As a consequence, John, Mary Tinker and Chris Eckhardt were suspended. (TINKER vs DES MOINES DISTRICT SCHOOL) The Tinker family protested and the sued the school district saying that they had violated the students right of Freedom of speech (Jacobs). The case was tried at Supreme Court, and the Tinker family won the case. The Supreme Court gave the ruling that the school official do not "shed their constitutional rights to freedom of speech or expression at the schoolhouse gate" (TINKER vs DES MOINES DISTRICT SCHOOL). However, the court further added that the right of freedom of choice must be maintained within the limits. It should not in any way disturb class activity or invade rights of others. The impact of this case had been huge for the next years and many times the Tinker reference was used in courts. One such instance was when Mathew Fraser of Bethel High School was suspended by the school for giving a speech containing sexual innuendos. The court, however, favored the school and the suspension was upheld a speech containing sexual innuendos. The court remarked that it was fair of the school to suspend the student for using vulgar language within school boundaries. (Jacobs) The Tinker case edges on the boundary of what is right and what is not. It depends on the situation and the way people use their rights given to them by the constitution. The Tinker family wore black armbands in dispute of the war against Vietnam, but it was not invasion of school guidelines that are handed to students. War is means of destruction, no matter for whatever reasons it is fought. It takes lives of innocent people. It has been seen today that even football players wear black armbands to condemn racism. In 2002, people went out on the streets to condemn attacks on Afghanistan, but it was only a movement in which people took part (Pinto). Nothing violent took place. Same was the case with Tinker family they just wore armbands in protest of the war and possibly to side more students with them and show the State that the youth is not supporting the cause. It was not any act of violence. There was huge unrest among the American public in response to the Vietnam War, in genera l. (Hodbod'ova'). So, the Tinker family stood right in the case. If the case was tried in 2012, the decision would have stayed the same. In the twenty first century, people have much more freedom of choice and speech. We have seen many times people coming out on the street and not supporting the cause, such as the War against Terror in Afghanistan (Pinto). Goss vs Lopez: Administrators of Colombus, Ohio, Public School System-CPSS, appealed against the ruling of three-judge federal court that was in favor of high school temporarily suspended students of CPSS, on the grounds that Fourteen Amendment was violated for a chance of hearing was not afforded to them. The ruling directed that reference to suspensions to be removed from the record of the students. (GOSS ET AL. v. LOPEZ ET AL.) The judgment had evoked Section 3313.66 of Ohio State (that provides free education to children of 5-21) which states that the Principal of a public school can, either suspend a pupil for up to 10 days o r expel him/her. In case of

Case studies about Sara Lee & APPLE Study Example | Topics and Well Written Essays - 3500 words

Studies about Sara Lee & APPLE - Case Study Example The company retains its customers by coming up with innovative products frequently with features that customers are looking for. A prime example of this can be seen when Apple launched its iPhone (Smartphone) in 2007. iPhone has been considered as the â€Å"invention of 2007† by time magazine. It was unique mobile communication device with most innovative features. The success of first generation of iPhone did not stop Apple to strive for the best. Therefore in 2009, the company came up with iPhone 3GS with more new and innovative features to gain attraction of iPhone lovers and other consumers. Then after a year in 2010, Apple launched iPhone 4, and the latest iPhone 5 in Sep 2012. Moreover, Apple has launched iPad which is a Tablet Computer in 2010. Apple also launched the first Graphical User Interface Computer (GUI) computer called Macintosh (Mac) computers but it was unsuccessful in comparison to PCs made by IBM. However, in spite of the failure, Apple kept bringing innov ative products and re-launched its Macintosh computers. This time it proved vital and greatly accepted by people. Apple Wants Result One of the most important aspects of the company is that Apple wants result oriented people. When the first Macintosh computer that Apple launched became unsuccessful, the company hired new CEO and President, John Sculley. But after some time due to his weak performance, company fired him and hired another CEO, Micheal Spindler. After three years company asked Spindler to resign and then Gil Amelio was given this position. But in 1997, when company recorded additional losses, Apple’s board of directors named the founder of the company, Steve Jobs as CEO. Steve Job turned fortune of Apple and improved its performance significantly. Extensive Research Apple always conducted research carefully to find out what consumers want. The company relies a lot on conducting research in order to find the current and future need of consumers and then come up w ith products to meet these needs. All this process plays a crucial role in satisfying more customers. All these elements help to bring competitive strategy. Apple does not compromise result and always want result oriented people. This is the reason which makes the company able to provide innovative products. Question #2 Apple’s strategy in computers When the competitors of Apple increase their market shares, the company introduced its first notebook computer called iMac in 1999. After launching iMac, the Apple increased its profits and the share price increased considerably.. However Apple was unable to capture sufficient market share after iMac. Therefore the company started focusing on other product lines. This was a great strategy for Apple. Apple launched iPod which successfully captured the demand of consumers. The consumer interest in iPod helped in increasing personal computer’s market share. The level of trust of people increased on the products of Apple and se veral consumers also purchased to Apple computers. Eventually Apple personal computer’s market share increased to 4 percent. When customer started showing interest in Apple computers, they started producing more innovative computer notebook such as MacBook Pro. This notebook was targeted to education users. The company also introduced MacBook Air and this product was designed for the users who want portability and power. However Apple

Study On The First And Second Congo War History Essay

Study On The First And Second Congo War History Essay Congo has faced many small struggles. The major wars of the Congo are termed as Ist Congo War and Second Congo War. These wars resulted in huge loss and casualty. The First Congo War (November 1996 to May 1997) ended when Zairean President Mobutu Sà ©sà © Seko was overthrown by rebel forces backed by neighboring Uganda and Rwanda. Rebel leader Laurent-Dà ©sirà © Kabila declared himself president and changed the name of the nation back to Democratic Republic of the Congo. The war set the foundation for, and was quickly followed by, the Second Congo War, also named the African World War, which began on August 2, 1998. The Second Congo War, also known as Africas World War and the Great War of Africa, began in August 1998 in the Democratic Republic of the Congo (formerly called Zaire), and officially ended in July 2003 when the Transitional Government of the Democratic Republic of the Congo took power (though hostilities continue to this day). The largest war in modern African history, it directly involved eight African nations, as well as about 25  armed groups. By 2008 the war and its aftermath had killed 5.4  million people, mostly from disease and starvation, making the Second Congo War the deadliest conflict worldwide since World War II. Millions more were displaced from their homes or sought asylum in neighboring countries. Despite a formal end to the war in July 2003 and an agreement by the former belligerents to create a government of national unity, 1,000  people died daily in 2004 from easily preventable cases of malnutrition and disease. The war and the conflicts afterwards are, amo ng other things, driven by the trade of conflict minerals. First Congo War Origin Mobutu had ruled Zaà ¯re since 1965 with backing from the United States, which viewed him as a bulwark against the Communist MPLA in Angola, ZANU in Zimbabwe, and ANC in South Africa. A wave of democratization swept through Africa in the early 1990s, following the collapse of the Soviet Union. There was substantial internal and external pressure for a democratic transition in Zaà ¯re and Mobutu promised reform. He officially ended the one-party system he had maintained since 1967, but ultimately was unwilling to implement broad reform, alienating allies both at home and abroad. There had long been considerable internal resistance to Mobutus rule. Opposition included leftists who had supported Patrice Lumumba as well as ethnic and regional minorities opposed to the dominance of the Kinshasa region. Kabila, an ethnic Katangese, had been fighting the Mobutu government for decades. In what became known as the Great Lakes refugee crisis, 2 million Hutu refugees fled from Rwanda, fearing retaliatory genocide, after the Rwandan Patriotic Front took over the country in July 1994, ending the Rwandan Genocide. Among the refugees were members of the Interahamwe, militia groups linked to political parties who took part in the genocide earlier that year. They set up camps in eastern Zaire from which they attacked both Rwandan Tutsis and Banyamulenge, Zairian Tutsis. Mobutu, whose control of the country was beginning to weaken, supported the Hutu extremists for political reasons and did nothing to stop the ongoing violence. Course of the war When the vice-governor of South Kivu Province issued an order in November 1996 ordering the Banyamulenge to leave Zaire on penalty of death, they erupted in rebellion. The anti-Mobutu forces combined to form the Alliance of Democratic Forces for the Liberation of Zaire (AFDL). The AFDL received the support of the leaders of African Great Lakes states, particularly Paul Kagame of Rwanda and Yoweri Mucseveni of Uganda. Lacking foreign military assistance, many elements of the Zairian Army joined Laurent-Dà ©sirà © Kabila as they marched from eastern Congo on Kinshasa. With active support from Rwanda, Uganda and Angola, Kabilas forces moved methodically down the Congo river, encountering only light resistance from the crumbling regime based in Kinshasa. The bulk of his fighters were Tutsis and many were veterans from conflicts in the Great Lakes region of Africa. Kabila himself had credibility because he had been a longtime political opponent of Mobutu, and was a follower of Patrice Lumumba, the first Prime Minister of the independent Congo who was murdered and overthrown from power by a combination of internal and external forces, to be replaced by the then Lt.-Gen. Mobutu. Kabila had declared himself a Marxist and an admirer of Mao Zedong. He had been waging armed rebellion in eastern Zaire for nearly two decades, although according to Che Guevaras account of the conflict, he was an uncommitted and uninspiring leader. Kabilas army began a slow movement westward in December 1996 near the end of the Great Lakes refugee crisis, taking control of border towns and mines and solidifying control. There were reports of massacres and brutal repression by the rebel army. A UN human rights investigator published statements from witnesses claiming that the AFDL engaged in massacres, and that as many as 60,000 civilians were killed by the advancing army, a claim strenuously denied by the AFDL. Roberto Garreton stated that his investigation in Goma turned up allegations of disappearances, torture and killings. He quoted Moese Nyarugabo, an aide to Mobutu, as saying that killings and disappearances should be expected in wartime. In March 1997, Kabilas forces launched an offensive and demanded the government surrender. The rebels took Kasenga on March 27. These reports were dismissed by the government which would begin a long pattern of disinformation from the Defense Minister as to the progress and conduct of the war. Talks were proposed in late March. Etienne Tshisekedi, a long time rival of Mobutu, became Prime Minister on April 2. Kabila, by this point in control of roughly 25% of the country, dismissed the coalition government as irrelevant and warned Tshisekedi that he would have no part in a new government if he accepted the post. Throughout the month of April the AFDL made consistent progress down the river, and by May were on the outskirts of Kinshasa. On May 16, 1997, the multinational army headed by Kabila battled to secure Lubumbashi airport in the southeast of the country after peace talks broke down and Mobutu fled the country. He died on September 7, 1997 in Morocco. Laurent-Dà ©sirà © Kabila proclaimed himself president on the same day and immediately ordered a violent crackdown to restore order. He then began an attempt at reorganization of the nation as the Democratic Republic of the Congo. However, once Kabila was in power, the situation changed dramatically. He quickly became suspected of corruption and authoritarianism comparable to Mobutu. Many pro-democratic groups abandoned him. He began a vigorous centralization campaign, bringing renewed conflict with minority groups in the east who demanded autonomy. Kabila began to turn against his former Rwandan allies when they showed little sign of withdrawing from his territory. He accused them and their allies of trying to capture the regions mineral resources. His reliance on the Rwandan government for political and military aid contributed to the perception that he was a puppet of the Rwandan government. In August 1998, Kabila dismissed all ethnic Tutsis from the government and ordered all Rwandan and Ugandan officials to leave the DRC. The two countries then turned against their former client, sending troops to aid rebels attempting to overthrow Kabila. This paved the way for the beginning of the Second Congo War. Second Congo War The second Congo war was a consequence of first war Congo war. The First Congo War began in 1996 as Rwanda grew increasingly concerned that members of Rassemblement Dà ©mocratique pour le Rwanda militias, who were carrying out cross-border raids from Zaire (currently known as the Democratic Republic of Congo), were planning an invasion. The new Tutsi-dominated government of Rwanda protested this violation of their territorial integrity and began to give arms to the ethnically Tutsi Banyamulenge of eastern Zaire. This intervention was vigorously denounced by the Mobutu govrernment of Zaire, but he did not have any military capability to oppose, and little political capital to spend. With active support from Rwanda, Uganda and Angola, Laurent-Dà ©sirà © Kabilas rebel forces moved methodically down the Congo River, encountering only light resistance from Morbutus crumbling regime based in Kinshasa. The bulk of Kabilas fighters were Tutsis and many were veterans from conflicts in the Great Luakes region of Africa. Kabila himself had credibility because he had been a longtime political opponent of Mobutu, and had been a follower of Patrice Lumumba, the first Prime Minister of the independent Congo who was murdered and overthrown from power by a combination of internal and external forces, to be replaced by the then-Lieutenant General Mobutu in 1965. Kabila had declared himself a Marxist and an admirer of Mao Zedong. He had been waging armed rebellion in eastern Zaire for more than three decades, though, according to Che Guevaras account of the early years of the conflict, he was an uncommitted and uninspirational leader. Kabilas army began a slow movement westward in December 1996 near the end of the Great Lakes refugee crisis, taking control of border towns and mines and solidifying control. There were reports of massacres and brutal repression by the rebel army. A UN human rights investigator published statements from witnesses claiming that Kabilas ADrFLC engaged in massacres, and that as many as 60,000  civilians were killed by the advancing army (a claim strenuously denied by the ADFLC). Roberto Garreton stated that his investigation in Goma turned up allegations of disappearances, torture and killings. He quoted Moese Nyarugabo, an aide to Mobutu, as saying that killings and disappearances should be expected in wartime. Kabilas forces launched an offensive in March 1997 and demanded the government surrender. On March 27 the rebels took Kasenga. The governments denied the rebels success, starting a long pattern of false statements from the Defense Minister as to the progress and conduct of the war. Negotiations were proposed in late March and on April 2 a new Prime Minister was installed, Etienne Tshisekedi, a long time rival of Mobutu. Kabila, by this point in rough control of one quarter of the country, dismissed this as irrelevant, and warned Tshisekedi that he would have no part in a new government if he accepted the post. Throughout the month of April the ADFLC made consistent progress down the river, and by May were on the outskirts of Kinshasa. On May 16, 1997 the multinational army headed by Kabila battled to secure Lubumbashi airport after peace talks broke down and Mobutu fled the country. He died on September 7, 1997 in Morocco. After securing victory, Kabila controlled Kinshasa. He proclaimed himself President on the same day and immediately ordered a violent crackdown to restore order. He then began an attempt at reorganization of the nation. Aftermath and legacy Areas of continuing conflict The fragility of the state has allowed continued violence and human rights abuses in the east. There are three significant centers of conflict: North and South Kivu, where a weakened FDLR continues to threaten the Rwandan border and the Banyamulenge, and where Rwanda supports RCD-Goma rebels against Kinshasa (see Kivu conflict); Ituri, where MONUC has proved unable to contain the numerous militia and groups driving the Ituri conflict; northern Katanga, where Mai-Mai created by Laurent Kabila slipped out of the control of Kinshasa. The ethnic violence between Hutu- and Tutsi-aligned forces has been a driving impetus for much of the conflict, with people on both sides fearing their annihilation as a race. The Kinshasa- and Hutu-aligned forces enjoyed close relations as their interests in expelling the armies and proxy forces of Uganda and Rwanda dovetail. While the Uganda- and Rwanda-aligned forces worked closely together to gain territory at the expense of Kinshasa, competition over access to resources created a fissure in their relationship. There were reports that Uganda permitted Kinshasa to send arms to the Hutu FDLR via territory held by Uganda-backed rebels as Uganda, Kinshasa and the Hutus are all seeking, in varying degrees, to check the influence of Rwanda and its affiliates. Possible Remedial Steps Help by Developed nations. Continued help and support by UNO and its members. Efficient government and its policy. Uplifting moral character and standard of the people by creating awareness and educating people.

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Air superiority will continue to be vital for the preservation of the U. S. Military well into future contingency operations. Airpower is one of the military’s greatest strengths providing global reach and deterrence, and will continue well into the time to come. However, the traditional air missions of air combat and bombing are being replaced by Unmanned Aerial Vehicles (UAV’s) and intelligence, surveillance, and reconnaissance (ISR) capabilities only imagined in the past. UAV’s are not only in great demand by forces deployed in Afghanistan, they are also at work in a wide range of civilian applications, from law enforcement surveillance to mundane tasks such as checking remote pipelines or monitoring livestock. 1 The demand is so high that it surpasses supply, which naturally means fast track development of new systems, to meet the needs of increasing requirements. 2 For example, Lockheed Martin is developing a football sized UAV that can fly in and out of the water. This adds to the reach of a submarine by having its own fleet of small flying UAV’s that can search a grid the ...

A Case Study of Obsessive Impulsive Disorder

A Case Study of Obsessive-Compulsive Disorder: Some Diagnostic Considerations INTROD  UCTION Prior to 1984,  obsessive-compulsive disorder (OCD)  was  considered  a  rare disorder and  one difficult  to treat (I  )  . In 1984 the  Epidemiologic Catchment  Area (ECA) initial survey results  became available for the first time, and  OC  D  prevalence figures  showed that  2. 5  %  of  the  population m  et  diagnostic  criteria  for OCD (2,3)  . Final  survey results published  in 1988  (4) confirmed these  earlier reports. In  addition, a 6-month  point prevalence of  1. 6%  was observed,  and  a  life  time  prevalence  of 3. 0% was  found.OCD is  an illness of secrecy, and  frequently the  patients  present  to physicians in  specialties other than psychiatry. An  other factor contributing to under diagnosis of  this disorder  is that  psychiatrists m  a y fail to ask screening questions  that would identify  OCD. The  following case study is  an example  of  a patient  with moderately severe OCD  who  presented  to  a  resident  psychiatry  clinic  ten years prior to being diagnosed  with OCD. The patient  was  compliant with  out patient treatment for the  entire time  period  and was treated  for  major  depressive  disorder  and border line personality disorder with medication s and  supportive  psychotherapy.The patient never discussed  her OCD symptoms  with her doctors  but in retrospect had offered many clues  that might have allowed  a  swifter  diagnosis and treatment. CASE  HISTORY Simran Ahuja was a 29 year  old,  divorced,  indian female who worked  as a file clerk. She  was followed as an  out patient  at the  same  resident  clinic since  1971. I  first saw her 2012. PAST PSYCHIATRIC HISTORY Simran had been  seen in the  resident  out pati ent  clinic since July of 1984. Prior  to  this she  had not be  en  in psychiatric treatment. She  had never been hospitalized  .Her initial  complaints were depression and anxiety  and she had been placed on  an phenelzine  and responded well. Her  depression  was  initially thought  to be  secondary to amphetamine withdrawal, since she  had been using  diet  pills  for 10  years. She stated  that at first  she  took them to lose weight,  but  continued for  so  long because people at work had noted that she  concentrated  better  and that her job performance had improved. In addition,  her past doctors had  all  commented on her limit  edibility to  change  and her neediness, insecurity,  low  self-esteem,  and poor boundaries. In addition,  her past doctors had noted  her promiscuity.All noted  her poor attention span and limited capacity  for insight. Neurological  testing during her ini tial  evaluation had shown the  possibility of non-dominant parietal  lobe  deficits. Testing  was repeated  in 1989 and  showed †Ã‚  problems in attention ,  recent visual and verbal memory  (with  a greater deficit  in visual memory),  abstract thought  , cognitive flexibility, use  of mathematical operations, and visual analysis. A possibility of right temporal dysfunction is  suggested. †Ã‚  IQ testing showed a  co  m bine d score of 77 on the Adult Weschler  IQ test ,  which  indicated borderline  mental  retardation  .Over the years  the patient had been maintained  on various  antidepressants  and antianxiety agents. These  included  phenelzine,  trazadone, desipramine, alprazolam, clonazapam,  and hydroxyzine. Currently  she  was on fluoxetine  20  mg  daily and clonazaparn 0. 5 mg  twice  a day and 1. 0 mg at bedtime . The antidepressants  had been effective over the years in treating her depression. She  has  never used  m  ore clonazapam than prescribed and there was no history of  abuse  of alcohol or street drugs. Also, there was no history  of discreet  manic episodes and  she  was  never treated with neurolepics.PAST MEDI CAL HISTORY She suffered from  gas  troesophageal reflux and  was maintained  symptom free on a combination  of  ranitidine  and  omeprazole. PSYCHOSOCIAL  HISTORY Simran   was  born  and  raise d in  a  large city. She had a brother who was  3 years younger. She  described  her father  as morose , withdrawn,  and recalled  that he has said, †Ã‚  I don't  like  my  children. Her  father was  physically and  verbally abusive throughout her  child  hood. She  had  always longed  for a good relationship  with him  . She  described  her mother as  the  family martyr and the  glue that  held  the  family together.She stated that  sh e  was  very  close  to her  mother;  her mother always listened  to her and was  always  available to talk with her. She  was a poor student,  had difficulty all through school , and described herself  as †Ã‚  always disrupting  the  class by talking or running  around. †Ã‚  She  had  a  best friend through grade school whom  she  stated †Ã‚  deserted† her  in high  school. She  had maintained  few close  friends since  then . She   graduated high school with much difficulty and  effort. She  dated on  group dates  but never alone. Her husband  left her  while  she was  pregnant with her  son.The husband  was a  bus driver  and had not had  a  role in their  lives  since the  divorce. Aft  e r the  divorce,  she moved  back  to her parent  s'  home  with her son  and  remained there until getting her  own apartment  3 years ago. FAMILY HISTORY Simr an’s  mother  had two  serious  suicide attempts at  age 72 and was  diagnosed with major  depressive  disorder with psychotic features  and OCD. She also had non-insulin dependent  diabetes  mellitus and irritable  bowel  syndrome. Her  brother was treated  for OCD  as an outpatient  for the  past  20 years and also has Hodgkin's Dis  ease, currently in remission.The brother's diagnosis of  OCD was kept secret from  her  and did not become  available  to her until her mother died. Her father  is  alive and well. MENTAL STATUS EXAM She  was a  thin  ,  bleached  blond woman  who appeared her  stated  age. She  was dressed in  skin  tight  ,  provocative  clothing,  costume jewelry earrings  that eclipsed her ears  and hung to her  shoulders, heavy  make-up and  elaborately  styled hair. She  had difficulty  sitting  still  and fidgeted  constantly  in  her  chair. H er body language through out  the interview  was  sexually provocative. Her speech was  rapid,  mildly pressured,  and  she  rarely finished  a sentence.She  described  her  mood  as â€Å"anxious. † Her affect appeared anxious. Her  thought  processes showed mild  circumstantiality and tangentiality. More significant  was her inability to finish a  thought  as exhibited by her in  complete  sentences. COURSE  OF TREATMENT Initial  sessions with the  patient were  spent  gathering history  and forming a working  alliance. Although  she  showed a  good  response  by  slowing  down enough to finish  sentences and focus on  conversations  ,  she  could not tolerate  the side  effects and  refused  to  continue taking the medication  . The  winter  of  1993-94  was  particularly  harsh.The  patient  missed  many sessions because of  bad weather. A pattern  began  to   emerge  of  a  consistent  increase  in the number  of phone  calls that  she  made  to the office voice  mail to  cancel  a session. When  she was questioned about her phone  messages she stated,  Ã¢â‚¬ Ã‚  I always repeat  calls to make sure my  message  is received. † Since  the  most recent cancellation generated  no less than six phone calls ,  she  was asked why a  second call wouldn't  be  enough â€Å"to be  sure . † She  laughed  nervously and  said,  Ã¢â‚¬ Ã‚  I  always repeat  things. † With careful questioning  the following  behaviors  were uncovered.The patient checked  all locks  and windows repeatedly  before  retiring. She  checked the  iron a dozen times  before leaving the house . She  checked  her door  lock  Ã¢â‚¬ Ã‚  a  hundred  times† before  she  was able to  get in her  car. The patient  washed her hands frequently. Sh e carried disposable  washcloths in  her purse †Ã‚  so I  can wash as  often  as I need too  . †Ã‚  She  said people  at work laugh  at her  for washing  so  much. But she  stated  ,  Ã¢â‚¬Å"I  can' t help it. I've been this way  since  I was  a  little girl. † When  questioned  about telling former  doctors  about this,  the  patient  stated that she  had never  talked  about it with her doctors.She  stated  that  everyone that knew  her  simply knew  that  this  was  the  way  she  was:  Ã¢â‚¬ Ã‚  It's  just  me . †Ã‚  In  fact , she  stated, †Ã‚  I didn't  think my doctors  would  care†¦ .  I've always  been this  way  so  it  Ã¢â‚¬Ëœs  not something  you can  change . † Over the next  few sessions, it became  clear  that her arguments  with her boyfriend centered  on  his annoyance with her need  to  const antly repeat  things. This was  what she  always referred to  as †Ã‚  talking too much  . †Ã‚  In  sessions it  was  observed that  her  anxiety,  neediness and poor boundaries  a  rose over issues of misplacing things in her purse and insurance forms that were incorrectly  filled  out.In  fact,  when I  attempted to correct the  insurance forms for her, I had difficulty because of her need to repeat the  instructions to me  over and over. The Introduction Obsessive compulsive disorder (OCD) is an anxiety disorder characterised by persistent obsessional thoughts and/or compulsive acts. Obsessions are recurrent ideas, images or impulses, which enter the individual's mind in a stereotyped manner and against his will. Often such thoughts are absurd, obscene or violent in nature, or else senseless. Though the patient recognises them as his own, he feels powerless over them.Similarly,compulsive acts or rituals are stereotyped behaviou rs, performed repetitively without the completion of any inherently useful task. The commonest obsession involved is fear of contamination by dirt, germs or grease, leading to compulsive cleaning rituals. Other themes of obsessions include aggression, orderliness, illness, sex, symmetry and religion. Other compulsive behaviors include checking and counting, often in a ritualistic manner, and over a â€Å"magical† number of times. About 70% of OCD patients suffer from both bsessions and compulsions; obsessions alone occur in 25%, whilst compulsions alone are rare. 1n  she spent  ten minutes checking and rechecking  the  form  against the receipts. She  became convinced that she'd  done it wrong, her anxiety would increase, and  she  would  get  the forms out  and check  them again. Her  need to include  me in this  checking  was  so great  that she  was almost physically on  top  of  my  chair. In the  following  weeks,  se ssion s  focused  on  educating the  patient about  OCD. Her  dose of fluoxetine  was increased  to 40 mg  a  day but discontinued because  of severe restlessness and insomnia.She continued to  take 20  mg of  fluoxetine a day. Starting  another medication in  addition to fluoxetine  was difficult because of the patient  Ã¢â‚¬Ëœs  obsessive  thoughts  about  weight gain, the  number  of  pills  she  was  taking, and the  possible side effects . Finally,  the  patient agreed to try adding  clomipramine to her medications. The  results were  dramatic. She  felt  Ã¢â‚¬ Ã‚  more relaxed † and had less anxiety. She  began to talk, for  the  first  time, about her  abusive  father. She said,  Ã¢â‚¬ Ã‚  His behavior was always supposed  to be the family  secret. I felt  so afraid  and  anxious I didn't  dare tell  anyone.But now  I  feel better. I don't care who  knows. It  Ã ¢â‚¬Ëœs  cost my  mother  too  much  to  stay  silent. †   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  At  this time  the  plan is to begin behavioral therapy with  the  patient  in  addition to medication s  and  supportive therapy to  deal wit  h her  difficulties with relationships. DISCUSSION This is  a complicated  case  with multiple diagnoses: borderline  mental  retardation,  attention deficit disorder,  borderline  personality  disorder,  a  history  of  major depressive disorder and  obsessive compulsive disorder. Given the  level  of  complexity of  this  case and the  patient ‘s  own silence  about her  symptoms,  it  is  not urprising  that this  patient's OCD remained  undiagnosed  for  so  long. However,  in  reviewing  the literature  and the case,  it is instructive to  look  a  t the  evidence that  might  have  led  to an earlier diagnosis. Fir st of  all,  there  was the  finding  of soft neurological deficits. The patient  Ã¢â‚¬Ëœs Neuropsychological testing suggested  problems  with  visuospacial  functioning  n visual memory,  as well as  attentional difficulties  and  a  low IQ. In the  past,  her doctors were so impressed  with her history of  cognitive difficulties  that  neuropsychological testing was  ordered  on two separate occasions.Four  studies in the  recent literature have  shown consistent findings of  right hemispheric dysfunction,  specifically  difficulties  in visuospatial  tasks, associated  with OCD  (6,7,8,9). The patient also had a history  of chronic dieting,  and  although  extremely  thin, she continue d to be  obsessed with not  gaining  a single pound. This was  a  patient who took diet  pills for 10  years and who  see earliest memories  involved  her father's disapproval of  her bod  y  ha bitus. Eating  disorders a  reviewed by  some  clinicians  as  a form  of  O C D. O  C D.Swedo and Rapoport (II)  also note  an increased incidence  of  eating disorders in children  and  adolescents  with  OCD. While  this was  no doubt true,  the underlying  obsessional  content pointed directly  to OCD and should have  generated a list of screening questions  for OCD. This underscores  the  need to be  vigilant for diagnostic clues and to perform one's  own diagnostic assessment when  assuming the treatment  of any  patient. While the  literature  makes  it clear that OCD  runs in families,  the  patient was unaware of the  illness  in her family  until after  her diagnosis  was mad  e.It  would have be  en  helpful to know this information  from the  beginning  as it should  immediately  raise a suspicion of OCD in a patient  presenting  with complaints  of  depression and anxiety. Finally,  her diagnosis of borderline  personality  disorder  made  it  easier to pass  off her observable  behavior  in the office as  further  evidence  of  her  character structure. The diagnosis of borderline  personality  disorder was  clear. She  used the  defense of splitting  as evidence d by her descriptions  of her fights  with her boyfriend . H  e was either  Ã¢â‚¬Å"wonderful† or a  Ã¢â‚¬Å"complete bastard. † Her  relationships were  chaotic  and unstable.She had no close friends outside  of her family. She  exhibited  affective instability, marked  disturbance of body  image  and impulsive behaviors. However, it was difficult to discern whether her  symptoms were truly  character logical  or  due  instead  to her underlying  OCD and related  anxiety. For instance,  the  in  stability  in her relationships was,  in  part,  the result  of  her OCD , since  once she  began to obsess  on  something,  she  repeated  herself so much  that  she  frequently  drove others into  a  rage. A  study by Ricciardi,  investigated  DSM-III-R Axis II diagnoses following treatment for OCD.Over  half  of  the  patients in the study  no longer met DSM-III-R  criteria for personality disorders after  behavioral  and  /  or pharmacological treatment  of  their  OCD. The  authors  conclude that  this  raises questions  about  t  he validity  of an Axis  II diagnosis  in the  face  of  OCD. One might also begin  to wonder how many  patients  with personality  disorders  have undiagnosed  O  CD? Rasmussen  and Eisen  found a very high comorbidity of  other Axis I diagnoses in patients  with OCD. Thirty-on  e  percent of patients studied  were  also diagnosed with major  depression, and  anxiety disorders accounted for twenty-four per cent.Other coexisting disorders  included eating disorders, alcohol  abuse  and dependence, and Tourette's syndrome. Baer,  investigated  the comorbidity  of Axis  II disorders  in patients  with OCD  and found that 52  percent  met  the criteria for  at least one  personality  disorder  with mixed,  dependent  and histrionic being  the  most common disorders diagnosed  . Given  the  frequency of comorbidity in patient  s  with OCD,  it would  be wise to include  screening questions  in  every  psychiatric  evaluation. These  need  not  be elaborate. Questions about  checking,  washing,  and ntrusive,  unwanted thoughts can be  simple  and direct. In  eliciting a  family history,  specific  questions about  family members  who check  repeatedly  or  wash  frequently  should  be included. Simply as  king if  any  family member  has  OCD  m  ay  not  elicit   the  information  , since  family members may  also be undiagnosed. In  summary, this  case  represents a complicated  diagnostic  puzzle. Her  past physicians  did not have the  information  we d  o  today  to unravel  the  tangled skeins  of symptoms. It  is  important to be  alert  for  the  possibility  that this  patient ‘s story is not an  uncommon one.BIBLIOGRAPHY * Psychology book (NCERT) * Identical * Suicidal notes * A psychopath test: journey through the world of madness * Disorder of impulse control by Hucker INDEX * Introduction * Case study * Course of treatment * Discussion * Bibliography ACKNOWLEDGEMENT I would like to express my special thanks and gratitude to my teacher Mrs. Girija Singh who gave me the golden opportunity to do this wonderful project on the topic ‘obsessive-compulsive disorder’, which also helped me in doing a lot of research and I came to know about so many new things.Secon dly I would also like to thank my family and my friends who helped me a lot in finishing this project. CERTIFICATE This is to certify that Jailaxmi Rathore of class 12 has successfully completed the project on psychology titled ‘obsessive-compulsive disorder’ under the guidance of Mrs. Girija Singh. Also this project project is as per cbse guidelines 2012-2013. Teacher’s signature (Mrs. Girija Singh) (Head of psychology department) 2012-2013 PSYCHOLOGY PROJECT NAME OF THE CANDIDATE: JAILAXMI RATHORE CLASS: XII ARTS B SCHOOL: MGD GIRLS’ SCHOOL

Illegal Aliens Burden Healthcare and Border Security Essay

An increasing number of people from all over the globe are migrating into America for one reason or another. This has raised alarm to the American government as it is a great burden to the healthcare system and a threat to the national security. Migrations that are legal can be beneficial to the American government while on the other hand migrations that are illegal seem to create disorders in the society (Edwards Jr. ). Aliens are not referred as illegal because of color, race, ethnicity or even nationality, but it is immigration into a country without the qualifications to migrate in the right way. Every country has outlined guidelines that an individual or group must go through before migrating into the country. Illegal immigration has been a problem in America with illegal aliens increasingly becoming associated with the burdening of the health care system and the security of the American borders (Edwards Jr. ). The American health care system ensures that health care services offered citizens are subsidized. The American government has been trying its best to reduce the population that is not insured but the illegal aliens that storm into the borders every now and again have been increasing the numbers each time. In the year 1998, a total of 37% aliens who had been staying in the America did not have health insurance (Edwards Jr. ). This is not fair really as many aliens get free treatments with the tax of the Americans. A reduction in insurance coverage has made most of these aliens poor as compared to the natives. Additionally, in the education system, the illegal aliens have not been able to take their children to schools. This creates more problems as lack of education results to increased criminals hence threatening border and general security. The illegal aliens have been a great problem to deal with as they have really cost the health system of the Americans. It is clear that hospitals and other medical facilities cannot run well without financial aid. This financing is expected to come from the citizens who pay taxes and have got insurance on their health. On the other hand, one cannot see a dying patient and start asking if he or she is an alien or a native individual. A doctor would rather choose to give medication to that patient than ask whether he is an alien or an American citizen. This has led to exhaustion of the medical facilities in the American hospitals and led to even closure of some hospitals. For instance in California, 84 hospitals have been closed (Edwards Jr. ). It is a fact that the illegal aliens in the United States have really been a great burden to the government. Apart from Illegal aliens burdening the insurance systems in America, the illegal aliens have caused border insecurity. It is clear that at one point or another, individual can commit a mistake or even a crime. Once that has been done, an individual is expected to pay damages for that crime committed (Edwards Jr. ). Aliens that are illegal are not insured and thus they are not eligible to pay for the damages they cause. What makes it worse, most of the rude people in the society are the illegal aliens who have no clue how an offence can be punished. They go ahead and do such crimes and they walk away. This has been a burden to the insurance system of the United States of America. In terms of security, illegal aliens have really burdened the American government. To begin with, to deter more aliens from crossing the borders to gain access of the resources of the Americans, there has been a need to increase the patrol at the borders of America; this is a practice that is very costly as it includes recruiting many police security officials to watch over the people migrating into the American soil illegally. This was enhanced upon realization that some people cross the borders to gain access into the American soil. This has been a burden to the border patrol as they have to watch every time even during the night on any one crossing the border (Edwards Jr. ). Further still, in the prisons systems of the Americans, most of the inmates are aliens. This sends a clear signal that most of the crimes committed in USA are done by the illegal aliens that stay inside the borders of America. Apart from the burden the illegal aliens give to the American prison systems, they have also sent a signal of the national security threat. It is stipulated that 29% of the prisoners in the state and federal prisons are aliens (Edwards Jr. ). This implies that most of the criminals that are arrested are aliens. This is a threat to the security as they try all ways to combat crime in the USA; illegal aliens keep committing those crimes. Therefore one can conclude that illegal aliens are really costing the Americans. Law enforcement systems in America waste billions of dollars each year in the enforcing the law that is often broken by the illegal aliens. To enforce law involves the activities of the judges, lawyers and the prosecutors. These personalities demand a lot of money in one single sitting to issue a sentence to a criminal. Most of the people who need these procedures are the aliens since they do not understand the American constitution well and they end up finding themselves in the hands of criminals all the time (Edwards Jr. ). This has posed a lot of burden to the American government as it tries to control the level of crime rates in America. Generally, the illegal aliens in the American soil have led to negative impacts in the United States and even in politics, the illegal aliens have taken part in the frauds of the voting exercises either at a fee by the American politicians or even personal willingness. It is also clear that most of the terrorist attacks in the American soil are done by the aliens that are illegally in the country (Edwards Jr. ). Further still, most companies have often believed that the aliens offer cheap labor and have gone further in substituting the aliens with the American employees in their companies. This in the end has adverse effects on the American citizens. In conclusion, illegal aliens in the United States and the illegal migrants have really brought a lot of burden, not only to the American government, but also to the entire population of America. Despite the measure being put in place to deter more aliens from flocking into the country, there have still been a number of aliens who come into the American boundaries illegally.