Sunday, June 9, 2019
Communication class Assignment Example | Topics and Well Written Essays - 500 words
Communication class - Assignment ExampleIn the long run, such office staff produces dysfunctional behavior. The film The lion King is replete with scenes that exhibit the use of coercive power. This is evident in the way Simba forcefully grabs the throne of Pride Lands and uses coercive power in his rule. succeeding(a) the stopping point of Musafa, Scar takes over the throne of Pride Lands. Under his leadership, he exhibits a high degree of coercive power. For instance, Zazu is confined to a bone chicken coop singing while Scar lazily lies about chewing on bones (Internet Movie Database).when Zazu complains of his predicament and mentions that he never experienced the like under Mufasa, Scar scolds him and reminds him that the law requires them never to mention Mufasas name. Meanwhile, as Shenzi, Banzai and Ed complain about scarcity of food and water as swell up as the refusal of lionesses to hunt, Scar solution to them is to eat Zulu. Thus, it is evident that coercive power re sults in an atmosphere of insecurity and fear.When Scar confronts and asks Sarabi why the lionesses had refused to hunt, Sarabi answers that the herds had opted to leave Pride Rock. She therefore compares him to Mufasa. This angers Scar, who cruelly hits Sarabi. This typifies the fact that coercive power reduces peoples satisfaction with their jobs and therefore leads to lack of commitment and general withdrawal.Another instance where coercive power is manifested in the movie is the scene of Simbas arrives in the Pride Land to take his rightful throne. On his arrival, Simba confronts Scar, and demands that he steps down from the throne or fight. The use of the threat of violence clearly depicts the use of coercive power. Even so, Scar retreats back by prompting Simba to confess who was responsible for Mufasas death (Internet Movie Database). In this regard, Simba confessed that he was responsible for Mufasas death, though it was accidental.This prompts Mufasa to use coercive power so as to maintain the throne. Thus, he accuses
Saturday, June 8, 2019
Pfizer Pharmaceuticals Research Paper Example | Topics and Well Written Essays - 750 words
Pfizer Pharmaceuticals - Research Paper Example(MIOTTI, 2009). It thumps a few for the most part acknowledged plans on the head, for example, the cost of standardization. In excess of 66% of the organizations questioned expressed that standardization helps the era of benefits, demonstrating that it has a positive effect on an organizations worth. (MIOTTI, 2009).An alternate for the most part acknowledged thought is cleared aside by this speculate it is not only the substantial organizations, prepared to do assembling impressive assets in the standardization process, which consider voluntary standards valuable for their exercises (MIOTTI, 2009) littler structures, for example, SMEs with 250 representatives or less likewise discovered them helpful. Accordingly, 69.3% of organizations consider standardization to have a positive effect on their action. Given the current state of the budgetary markets, this study gives an opportune showing to backing French organizations getting more inc luded in voluntary standards work. (MIOTTI, 2009).Improved working edges and Strong money stream offset fuelling expanded money comes back to shareholders through expanded profit pay-out proportions and offer repurchase projects. (Stirling, 2011)Pharmaceutical organizations are liable to far reaching regulation by national, state and neighborhood offices in the nations in which they work together. Of specific vitality is the FDA in the U.s. (Cvetkovs, 2011) It has purview over our human pharmaceutical business and oversees prerequisites coating the testing, security, adequacy, assembling, naming, showcasing, promoting and post-advertising musing of our pharmaceutical items. The FDA additionally directs our creature wellbeing items, alongside the U.S. Division of Agriculture and the U.S. Ecological Protection Agency. (Cvetkovs, 2011)Whats more, large portions of our exercises are liable to the ward of different
Friday, June 7, 2019
Department Stores Essay Example for Free
Department Stores EssayNundies a unique brand of stockings introduced to the market rowlock 2006. The item to be sold at womens boutique and specialty shops as well as 10 Neiman Marcus department neckcloths throughout 40 states. solicitude problem did not seem to be the distribution of the new item in which they shipped out 11, 383 units of Nundies to stores through December 2007 and sold 2007 units online. A unit of Nundies consisted of a package of 5 liners. Nudies is a single use disposable panty that sticks to the inseam of womans pants, leggings, athletic wear, shorts, and jeans. Management seemed to have a difficult time trying to practice out the right strategy to use in an effort to increase the overall repurchase tack together rate in order to increase the caller-up objective of gross revenue and profits for the 2008 fiscal year. As a note there are other areas that present a problem for the company as well. A.) repurchasing orders are not meeting the goals set, B .) The company also noticed that reorders were only about 10% of the total units sold, C) The online purchases were viewed as a positive, however it was not use frequent enough to measure reorder, D.) whizz big issue was the amount of panty liners per package, E) The staff at the retail strores thought that Nundies would sell themselves. This was a blank example of communication breakdown. E) To add to the communication issue the sales personnel were not trained to educate the consumer about the intersection point or to even rede trying the product. F) The other issue that seem to be of big concern was that the displays were getting lost in the stock rooms.Jones 2FactNundies generated 60% of sales from their largest customer which was Nieman Marcus however low re-order. The company first focus on its marketing concept How they were going to reelect the new product from its current product lines. The unique idea of required development capabilities into consumer based solutions primarily medical markets and the use of the item for one single use. The product comprise per item was .60, One package of panty liners was set at 5per package at $15. The cost to make the plasticcontainer was roughly 0.45 cents.In 2006 Nundies began to run ads in magazines, they distributed throughout bracing York city based retail buyers, and promotions with gift bags for women for celebrity events. In 2007 the distribution coverage among customers in boutiques and showrooms set up by manufacturer agents organization with product information. The company decided to fork up a commission to the sales people at 12% on the wholesale determine with a minimum order of 36 packages. The company spent $800,000 on media and print ads and online sales accounted for 385 units wich is roughly around $4275, and store purchases resulted in a minimum of 252 with net profit equaling 850,000. alternate(a) Courses of ActionNundies can continue to be developed for the womens wear and specialty stores. The advantage for the company is cost at 14-400 the disadvantage is there was no buy in to keep the reliance on manufacturers agent organization to recruit stores through store show rooms. A second alternative would be to pursue upscale stores accounts, by doing this the company can market via ads, point of sales display and ad plans could be presented, the ability to produce and deliver product in the right quantity and document it. Centralize 300 stores and decentralize 350 stores. The disadvantage is that all the stores would have different merchandise buying practicesJones 3as well as line fees, warehouse fees, settlement fees, catalogue fees, cooperative ad allowance ( fees are based on annual sales with estimated cost of 35k to 55k). Option 3 Mid level department stores I believe a positive would be centralized (1,793), same costs per size as the 5 upscale department stores. The disadvantage would be to lower the cost via different brand names and packaging (7 per pkg with paper packaging), different price 8 for $10. The fourth alternative positive would be to using different channels by which could be a positive if the company maintains the ability to produce and deliver product in the right quantity and documented also centralize all sales across the board.The companys target group resulted in woman from 15-60 with an averageincome of 25 or more 6% of 18 year old woman surveyed ( 18-45) 84% of woman are interested. 81% yes to products that provide hygiene and benefits of a panty 36% yes to no panty lines and hygiene, 29% will use the item 2-3 times a week, while 35% 3 to 5 times, 19% would likely use the product 6 times a week 17% occasionally. The variances were really shifty when examining where would one likely shop the Nundies of those polled the stats were 38% would shop at an upscale store 49% Mid level department store, 64% Mass department stores and 28% specialty store and 41% online. This all said I truly believe price does matter and the Nundies would likely see more re-orders if they would seek a lower price point or increase the quantity per package. The other target is that Nundies as I see it would likely work well in the fitness stores.
Thursday, June 6, 2019
A View from the Bridge Essay Example for Free
A View from the Bridge EssayPride plays a great role in the play, A View from the Bridge. The biggest victim of pride is Eddie, who loses both(prenominal) his pride and respect throughout the play. And this gradual loss heavy affects the characters behaviors. However pride does not seem to be the unaccompanied factor that dictates the progress of the play. In the beginning of the play, Eddie is full of pride. He is respected by both Marco and Rodolfo as well as the community. The quote, I want to tell you now Eddie when you say go, we will go, shows that Marco and Rodolfo respect Eddie. The quote in other words mode that Marco and Rodolfo will be doing whatever Eddie tells them to do. The fact that this is Marcos first signifi give the sackt line in the play shows how important Marco thinks of Eddie. Also the hyphen in the put of the sentence gives effect, which emphasizes the message Marco is trying to send to Eddie. The pride Marco and Rodolfo give Eddie in the family all ows Eddie to lower his guard and gives him a chance to respect Marco as well. This perspective can be seen from the following line. Eddie says, Youre welcome, Marco, we got plenty of room here. He addresses Marco, which shows that Eddie is in favor of him.Then the second part of the line, we got plenty of room here. , not only shows the Eddie is welcoming Marco, but it also shows that Eddie has given Marco his respect. A Room in their house symbolizes respect. At first, Eddie and Marco both have each others impudence and respect, giving them both pride which brings the two to a peaceful relationship. Later as the play progresses Eddie begins to lose his pride. Marco says, Here. (the chair raised like a implement over Eddies head and he transforms what might appear like a glare of warning into a smile of triumph) The simplicity of the sentence emphasizes Marcos loss of respect for Eddie.The stage direction, Over Eddies head also symbolizes how Marco has overcome Eddie. Also the g lare of warning shows that Marco no longer thinks of Eddie as soulfulness he should respect. The story continues as Eddie loses his pride. Pride is actually important to Eddie. He says Yeah Marco Eddie Carbone. Eddie Carbone. Eddie Carbone. His name symbolizes his pride and the repetition of it shows the importance of his name in Eddies heart. Also he does not just say his first name but also his last name, which also emphasizes his name his pride. The communitys reply is another event that comes from pride.(Lipari and wife exits Louis barely turns, then walks off the stage and exits down right with Mike. ) is a stage direction that shows the communitys reply to what Eddie had done to Marco and Rodolfo. Lipari and his wife, Louis, and Mike represent the community. The fact that they have walked off and exited indicates that the whole community has turned their backs on Eddie. From there, we can see that Eddie has lost his pride in his community as well as his family. Although pride is a main factor behind the progression of the play, loyalty and family relationships, also play a very important role.Family relationships play a very important role. This could be seen from Beatrices line, Eddie, listen to me. Who could give you your name? Listen to me, I love you, Im sheding to you. I love you. The short sentences make the sentence feel real and have a real impact, as if Beatrice is really trying to talk to Eddie. Furthermore, the repetition of the phrases, listen to me and I love you emphasizes how much Beatrice really cares about Eddie. Pride and family relationships play a huge rule in the progression of the play.
Wednesday, June 5, 2019
Hamlets Moral Nature Leads to Death Essay Example for Free
critical points Moral Nature Leads to Death Es reckonWhile rambling on to the highest degree vengeance, the senseless prince hamlet utters I, his sole son, do this same villain send to heaven. O, this is hire and salary, not revenge or about some act that has no relish of salvation int then trip him, that his heels may kick at heaven, and that his soul may be as damnd and black (3. 3. 77-95). This soliloquy is significant as it shows villages intentions when he must delay his murder purposes to a specific time frame where Claudius is performing corrupt because then the Kings soul will descend into hell. Moral relativism is also evident when the melancholic prince moans To be, or not to be that is the principal whether tis nobler in the mind to suffer To die, to sleep when contemplating life and decease (3. 1. 57-61). This unique proclamation further explains why village is incapable of murder because he is dismayed of what lies afterward death, particularly hell and purg atory. For these reasons, religion is a main virtue of Hamlets moral genius leading his incompetence in desire retri providedion on King Claudius.Another unambiguous quality in the Princes moral nature that leads to the dispose of Claudius is cunctation. While in the castle, the insane Dane Hamlet sadly proclaims Thus conscience does make cowards of us all, and thus the native hue of resolution is sicklied oer with the pale cast of thought, and enterprises of great pitch and moment with this run into their currents turn awry, and lose the name of action (3. 1. 84-88). This declamation clarifies Hamlet is troubled by hisover scrupulous conscience which prevents him from immediately avenging his fathers murder.After finishing conversation with the Captain, the wild-eyed prince Hamlet boldly states How all occasions do inform me against me, and spur my dull revenge What is manO, from this time forth, my thoughts be bloody, or be nix worth when realizing now is the time for him t o act (4. 4. 31-65). Hamlet finally recognizes that he has held out his revenge for too long and must act on it after seeing Fortinbras army sacrificing money and men to get back a worthless piece of land just for honour. In due course Hamlets procrastination eventually leads to his death in the end.If it is not for the Danish Princes moral nature of procrastination, he could have very well avoided death by acting on his deed to his father. Last, the most important moral virtue that the saddened prince portrays is indecisiveness. When deciding whether or not to fulfill his revenge for his deceased father, Hamlet confidently declares now whether it be, bestial oblivion, or some craven scruple, of thinking too precisely on th event a thought which, quarterd , hath but one part wisdom and ever three parts coward I do not know why yet I live to say this things to do ,sith I have cause , and will and strength , and meansto do. 4. 4. 39-44) This decision further describes that Hamlet is indecisive about when he must show out retribution for his forbearer. Indecisiveness relates to both religion and procrastination qualities as well. Hamlet pronounces I, his sole son, do this same villain send to heaven. O, this is hire and salary, not revenge or about some act that has no relish of salvation int then trip him, that his heels may kick at heaven, and that his soul may be as damnd and black when determining when Claudius should be slain and go to hell (3. . 77-95). Not only phantasmal virtues are apparent but also indecisive traits. Indecisiveness is evident while Hamlet needs to decide at what specific point in time to achieve his goal of retaliation. When speaking to himself in the castle, the melancholic prince sighs Thus conscience does make cowards of us all (3. 1. 84). Even though procrastination is evident in Hamlets speech, indecisiveness can be found as well. Indecisiveness is present in Hamlets speech because he is contemplating on his own life and death. For these examples, indecisiveness is in the Danish Princes moral nature that affects his ability to seek payback for his father. In conclusion, moral relativism, procrastination and indecisiveness are the three vital virtues that insane Prince carries. These traits prove the reoccurring theme that the need for revenge can consume you. Hamlets moral nature is the reason why he is unable to seek vengeance for his father immediately and if the insane Dane had taken action and fulfilled his assassination on Claudius instantly, Prince Hamlets fate would have ended better. Works Cited Shakespeare, William Hamlet.
Tuesday, June 4, 2019
Pathophysiology Disease Body
Pathophysiology Disease BodyUlcerative colitis.Pathophysiology is the study of disturbance of sane mechanical, physical and biochemical functions either caused by a disease or resulting from a disease or abnormal syndrome or condition that may qualify to be called a disease. Its defined when something disrupts the normal physiology and it enters in to realm. Pathophysiology looks at the detailed malfunctioning that causes diseases. Pathophysiology deals with the how the body reacts incase of a pathogen in the digestive system. Pathophysiology of Ulcerative colitis is the most common inflammatory catgut disease affecting most people in the world and mostly in Australia. The inflammatory process of ulcerative colitis begins at the rectum area of the anal retentive canal and progresses proximally to early(a) body parts within the digestive system. After analyzing my patient, i found out some symptoms in him which are in ulcerative colitis. They included Frequent visit to the toilet w ith 7-8 visits during the night, diarrhea and the diarrhea progressed to have line of reasoning stains, loss of weight by 10 kg, loose of appetite, he was worn down because of dehydration he experienced ache in the legs and this resulted to fatigue. These are the common symptoms in ulcerative colitis and this patient happened to have the symptoms after i diagnosed him. In most people the disease is confined to the rectum and sigmoid colon. Although ulcerative is untreatable, it has long-term debilitating demos which disrupt lifestyle.Some of the common signs and symptoms of this disease fall under deuce categories that is internal manifestation and external manifestation. Some examples of the internal manifestation include include inflammation at the base of the crypt of lieberkun in the large intestine which is connected with the inflammation on the thick lining wall of the rectum it also happen to other parts of the digesting track. It is also characterized by remissions and e xacerbations involving the inflammation of the rectum and colon. Blood stained john with mucus also is another symptom for ulcerative colitis. Abdominal pain, tiredness and weight loss, mouth ulcers, malaise and malnutrition, frequent diarrhea with small passage of blood and purulent mucus, some people experience fever in the body some patients may start vomiting or have nausea other patients may experience pain in the anus while passing stool. Chronic inflammation leads to a trophy, narrowing and shortening of the colon, with loss of its normal haustra. Pseudo polyps, vocabulary like projections of bowel mucosa into of the bowel regenerates. The disease is also severe in the rectum and sigmoid colon. Loss of the absorptive mucosal surface and rapid colonic irrigation transit and this causes large volumes of watery diarrhea, anemia. Many of the external manifestation may be missed as the sign of Ulcerative colitis examples of external manifestation include joint pain oral lesions, arthritis, osteoporosis and skin manifestation e.g. Erythemanodusum. Some other external manifestation may be in the eyes and liver. otherwise signs are anorexia, fatigue and weakness in the body. Some people may have frequent visit to the toilets which can equate to 6 to 10 visits per daylight with bloody stool. All these symptoms differ with normal health because when one is healthy he or she does not visit the toilet frequently, diarrhea, has blood stool, vomit or has fatigue and weakness in the body. When the gastrointestinal is normal, digestive system is also good and the colon and rectum function properly. Chronic inflammatory is caused by abnormal gastrointestinal. GI process is definitive because it strengthens the mucosal lining of the rectum this results to better absorption of vital nutrients and thickening of the colon wall.After various medications failed, some of the visible effects of the authorized medication (cyclospororine) are mild increase in transaminases , thrombocytopenia, and pancytopenia. This suggests that the therapy with VGC is effective against CMV in organ transplant. Also the current medication had fatigue problems the body was problematic in a lot of metabolic processes and got exhausted because of that medication. This has led to general energy loss in the body as a whole. Although has negative regard to energy that is not reflected to weight has weight remained constant. The patient was not allergic to the medication and neither of his body parts responded negatively to the medication. Diarrhea has not halt so the patient still administers predisone drug because it helps in reducing diarrhea. To avoid some of those effects the patient is supposed to medication that is suitable to his body. The medication i can recommend to the patient is the current drug because although it has so effects but it is helping the patient greatly. is an immunosuppressant for the treatment of the disease. Cyclosporine acts as an inhibiting lymphocyte which is important for propagation of inflammation. Apart from other immunosuppressive agent, this medication does not suppress the activity of other hamatopoetic cellsReferences
Monday, June 3, 2019
Presented With The Complaints Of Depression Psychology Essay
Presented With The Complaints Of Depression Psychology EssayThe purpose of this case study is to define the case of a patient known as Ellen Farber. Ms. Farber, an insurance company executive, arrived at a psychiatric emergency room at a university hospital with numerous complaints in regard to her overall well-being. It is apparent that Ms. Farber has been affected by her symptoms to a large degree. This case study go away discuss the complaints provided by Ms. Farber and will provide a detai direct discussion of how her symptoms fit the criteria provided in the DSM-IV-TR for several(prenominal)(prenominal) disorders such as Major Depressive disturb, individual Episode ingest bother non Otherwise Specified and Impulse-Control Disorder non Otherwise Specified. This paper will likewise discuss differential diagnoses as well as co-occurring disorders that may be present. The final portion of this paper will discuss a possible treat handst plan as well as an indication of the patients prognosis base on known information about her diagnosing.Ellen Farber is a 35 year old woman who presented with complaints of depression, the thought of driving her car off-key of a cliff, and numerous other symptoms. Upon closer evaluation of Ms. Farbers symptoms it appears that she is suffering from a Major Depressive Episode. The symptoms that she has exhibited that allow for this conclusion are a lack of energy for the past six months a lack of pleasure for the past six months increasingly persistent depressed mood for the past six months oversleeping in amounts of 15-20 hours per day over have to the extent that she has gained 20 pounds over the past few months and thoughts of suicide with a specific plan (Barlow Durand, 2012, p. 206). According to the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev. DSM-IV-TR American psychiatric Association, 2000), the presence of a single manic depressive episode in the absence of another disorder, such as schizophrenia, indicates that Ms. Farber can be diagnosed with Major Depressive Disorder, Single Episode. It is also clear that Ms. Farber has never endured a prior Major Depressive Episode indicating even further that Major Depressive Disorder, Single Episode is the proper diagnosis for her (DSM-IV-TR, 2000, p. 375). It is innate to point out that Ms. Farber is also a candidate for other diagnoses beca character she has engaged in binge eating and impulsive spending. Ms. Farber has reported that she has engaged in eating binges since she was an adolescent. During these binges she reports that she eats anything that she can find. Although she has engaged in intermittent binge eating since adolescence she has done so without using compensatory methods to rid her body of the excess calories. According to the DSM-IV-TR (2000), Ms. Farber should be diagnosed with Eating Disorder Not Otherwise Specified (Binge-Eating Disorder) because she does not engage in the compensatory behavi ors that are typically characteristic of binge-eating syndrome Nervosa (p. 595). Finally, Ms. Farber has engaged in obtain sprees that she refers to as buying binges. This excessive and impulsive spending has resulted in a large amount of debt, about $250,000, that has arisen from illegal practices such as unauthorized use of her employers credit cards and over drafting bank accounts to open new accounts, a process she calls check kiting. Since the money was used on impulsive purchases and cannot be accounted for by another disorder, such as substance dependence or a paraphilia, it appears likely that Ms. Farber is also a candidate for a diagnosis of Impulse-Control Disorder Not Otherwise Specified (DSM-IV-TR, 2000, p. 677).According to the DSM-IV-TR (2000), the adjacent diagnoses are relevant for Ellen FarberAxis I Major Depressive Disorder, Single EpisodeEating Disorder Not Otherwise Specified (Binge-Eating Disorder)Impulse-Control Disorder Not Otherwise SpecifiedAxis II Border line Personality DisorderAxis III Moderately loweringAxis IV Unemployed, financial difficultiesAxis V GAF = 35 (current)On Axis II, Ellen received a diagnosis of Borderline Personality Disorder for several reasons. First, she has reported that she has experienced lifelong feelings of emptiness, degenerative feelings of loneliness, chronic feelings of sadness, and chronic feelings of isolation. In order to satisfy her feelings of emptiness she has engaged in periodical buying binges which complete her current level of debt. Ellen has also engaged in daily episodes of binge eating without compensatory behaviors. She has also experienced chronic uncertainty with whom she wants to be friends and about what she wants to do in life. We also know that she has been in numerous brief and intense relationships with both men and women. In these relationships, Ellen exhibits a quick temper that has frequently led to arguments and physical fights. Based on a comparison of Ellens symptoms and the diagnostic criteria for Borderline Personality Disorder provided in the DSM-IV-TR it is clear that Ellen suffers from Borderline Personality Disorder (DSM-IV-TR, 2000, p. 710). Ellen has not presented with any other medical defines other than the fact that she is moderately overweight. Since this is the only condition of concern it was listed on Axis III. Axis IV includes relevant information about psychosocial and environmental problems that may be affecting Ellen. Since Ellen is unemployed and is experiencing a large amount of debt as a result of her spending binges this information is listed at a lower place Axis IV (DSM-IV-TR, 2000, p. 33). On Axis V I have included a GAF crisscross of 35. After evaluating the information provided in the DSM-IV-TR it seemed apparent that Ellen fierce within the 40-31 range on the GAF scale. She fell into this range as a result of her suicidal thoughts with a specific plan and because she is currently unemployed just now unable to work as a result of her depression. Within the scale it appeared that Ellens level of functioning was not severe enough to receive a GAF score of 31 but her functioning was not well enough to receive a GAF score of 40. Based on this scale, it seems that Ellen fits in the middle of the 40-31 scale so I assigned a GAF score of 35 (DSM-IV-TR, 2000, p. 34).According to the DSM-IV-TR (2000), there are several common differential diagnoses present for Major Depressive Disorder, Single Episode. These disorders include Bipolar I Disorder Bipolar II Disorder Mood Disorder Due To a General Medical Condition Substance-Induced Mood Disorder Dysthymic Disorder and Schizoaffective Disorder (DSM-IV-TR, 2000, p. 373). In the process of diagnosing Ellen, I made a differential diagnosis between Dysthymic Disorder and Major Depressive Disorder, Single Episode. The chief(a) way that this differential diagnosis was made was comparing the length of time that Ellen reported experiencing her symptoms and comp aring them to the length provided in the DSM-IV-TR. For Dysthymic Disorder, a period of at to the lowest degree two years must be met for depressed mood (Barlow Durand, 2012, p. 209). Symptoms for Major Depressive Disorder, Single Episode are only required to be present for a period longer than two weeks (Barlow Durand, 2012, p. 206). From the information that is known about Ellen, it only appears that Ellens symptoms have differed from her normal level of functioning for six months. Since Ellen did not meet the stripped two year requirement for depressed mood it seemed apparent that her symptoms only met the criteria for Major Depressive Disorder, Single Episode. Eating Disorder Not Otherwise Specified also presented with a differential diagnosis, Bulimia Nervosa. This was easily distinguished because Ellen did not engage in compensatory behaviors in order to control her caloric intake, and a diagnosis of Bulimia Nervosa requires that a person engage in inappropriate compensato ry methods to prevent weight gain (DSM-IV-TR, 2000, p. 589).It is not uncommon for other mental disorders to co-occur with Major Depressive Disorder, Single Episode. These common mental disorders include Substance-Related Disorders, Panic Disorder, Obsessive-Compulsive Disorder, Anorexia Nervosa, Bulimia Nervosa, and Borderline Personality Disorder. Axis II presents the personality disorders that Ellen has presented with and Borderline Personality Disorder is listed. Ellen has presented with chronic feelings of loneliness, emptiness, sadness, and isolation. She has also experienced chronic uncertainty about what she wants to do in life and with whom she wants to be friends. She has engaged in numerous intense relationships with both men and women that have often resulted in arguments and physical fights as a result of Ellens quick temper. In order to cope with her chronic symptoms she has engaged in weekly buying binges and daily episodes of binge-eating. Based on this information, as stated previously, Ellen meets the criteria for Borderline Personality Disorder (DSM-IV-TR, 2000, p. 710). There are no conditions listed in the DSM-IV-TR that co-occur with Eating Disorder Not Otherwise Specified (Binge-Eating Disorder) or Impulse-Control Disorder Not Otherwise Specified.The manipulation of Ms. Farber is complicated by her thought of driving her car off a cliff. This indicates that she possesses suicidal desire, capability, and intent. As a result, she should be asked to agree to, or sign, a no-suicide contract. This contract is essentially a promise that she will not try out suicide without contacting the mental health professional overseeing her case first. If she declines to agree to the terms, or if there is doubt about her sincerity, hospitalization may be required (Barlow Durand, 2012, p. 251). Considering that Ms. Farber has presented with several co-occurring conditions, treatment for her Major Depressive Disorder would be most effective if she bear withes combined treatment. The first aspect of her treatment should be a medication base treatment, especially treatment with a selective-serotonin reuptake inhibitor (SSRI). This medication functions by blocking the presynaptic reuptake of serotonin causing a temporary increase in the levels of serotonin at the receptor site. All antidepressant therapies provide some form of benefit to about fifty percent of the patients who receive them (Barlow Durand, 2012, p. 236). In combination with the prescription for SSRIs, I would also recommend cognitive-behavioral therapy. A cognitive-behavioral approach, such as Lynn Rehms self-control therapy, could assist Ellen in gaining control over her moods and daily activities while incorporating cognitive therapy to assist her in identifying and correcting errors of thought, shifting her thought pattern from a depressive thinking pattern to a more realistic thinking pattern (Barlow Durand, 2012, p. 240). Ms. Farber should also undergo treatme nt for her diagnosis of Eating Disorder Not Otherwise Specified (Binge-Eating Disorder). The most appropriate treatment for Ms. Farber would be a technique that involves therapist led treatment. It seems appropriate that she should undergo guided self-help therapy in which she would meet with a therapist periodically to review a self-help manual. This approach would be the most effective for her because she presented with several diagnoses (Barlow Durand, 2012, p. 375).The prognosis for Ms. Farber appears to be relatively positive in regards to the alleviation of her Major Depressive Episode however, there are some risks within the first two years following her diagnosis of Major Depressive Disorder, Single Episode that may alter her prognosis level to fair. Approximately 67%, or two-thirds, of patients experiencing a Major Depressive Episode may experience complete remission of their symptoms. One-third, or 33% of individuals suffering from a Major Depressive Episode may only expe rience partial remission of their symptoms or may not experience any alleviation of their symptoms at all. At least 60% of individuals with Major Depressive Disorder, Single Episode will experience a back up episode and 5%-10% will subsequently develop a manic episode, meeting the criteria for Bipolar I Disorder (DSM-IV-TR, 2000, p. 372). In the first year following an episode there is a 20% risk of reoccurrence. In the second year the risk of reoccurrence increases as high as 40% which would qualify Ms. Farber for a diagnosis of Major Depressive Disorder, Recurrent (Barlow Durand, 2012, p. 208). By undergoing combined treatment for her depression her chances for remission may increase slightly over receiving medicinal treatment only if (Barlow Durand, 2012, p. 243). At this point it is impossible to determine the exact course of Ms. Farbers symptoms. At best we can expect a more positive prognosis with treatment than without any treatment at all.Ellen Farber presented with seve ral co-occurring conditions and psychosocial and environmental problems that have potentially affected the onset and severity of her symptoms. The purpose of this paper was to discuss Ms. Farbers symptoms, provide diagnoses based on the DSM-IV-TR, and discuss the appropriate means of treatment for her conditions. Ms. Farber has been affected immensely by her symptoms and requires appropriate treatment immediately in order to prevent her condition from worsening. In the end, her prognosis ranges between fair and relatively positive based on the available knowledge about her diagnosis. It appears that if Ms. Farber receives the appropriate treatment she is at a greater likelihood for remission of her symptoms and continuing treatment may reduce the risk of a reoccurrence of her symptoms. Only time can definitively show how Ms. Farber will be affected by the course of her co-occurring disorders.
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