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O O O O O O O O B O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O B O O O O O O O O B O O O O B O O O B O O O O O O O O O O O O O B O O O O O O O O O B O O O O O O O O O O B O O O O O O O B O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O B O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O B O O O O O O O O O O O O O O B O O O O O O O O O O O O O O B O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O


Swiss made acoustic fidelity read more about us INTRODUCTION Since its foundation in the early 1980s Schertler SA has launched a programme of passionate research that aims to achieve the highest levels of accuracy in the reproduction of acoustic stringed instrument sound Led by bassist and founder Stephan Schertler the research and development company initially began to focus on producing high quality tools and innovative technology to replace the technology and imperfections of piezo pickups Over the years Schertlers original approach to harnessing acoustic vibrations has resulted in a number of fundamental innovations some of which have gained international patents such as the STAT Series of contact microphones In 2003 Schertler launched an original series of compact amplifiers the Classic Series Since then the 3channel UNICO and 2channel DAVID have provided musicians with high quality portable solutions for stringed instrument amplification Suited to virtually any live performance situation these amplifiers have received unanimous feedback from users around the world helping to build the reputation that Schertler has gained in the field of acoustic amplification The latest note from THE DIARY Stampen En Dagen rely on Unico and Digit Two Belgian band Stampen En Dagen perform a mix of country skiffle and folk with Dutch dialectical lyrics which they call Boogie Folk The sixpiece band comprising violin banjo guitarvocals keysvocals bassvocals and drums has combined Schertler Unico amps with an SR Digit System to ensure top quality sound for both the performers and the audience Singerguitarist Rudy Van den Nest explains About two years ago we bought the SR Digit Two PA System That was a revelation to us a truly pure fantastic sound for the semiacoustic thing that we do So we decided to add 6 Unico amps one wwwstampenendagenbe infostampenendagenbe

O O B O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O


Home Medium Voltage Distribution and Grid Automation Medium Voltage Switchgear Secondary Gas Insulated Switchgear RM6 RM6 MV Compact Switchboard Ring Main Unit up to 24 kV Hireliable Gas Insulated ring main unit for underground secondary distribution applications up to 24 kV Presentation Documents Downloads Features Compact selfcontained totally insulated switchgear comprises 1 to 4 integrated low dimension functional units choice of transformer feeder protection circuit breaker with selfpowered protectionunit or switch disconnector combination combined with fuses Option on site extensibility for network enhancement electrical command for telecontrol monitoring and alarms of events Benefits Taking advantage of the reference RM6 is protecting people and goods all over the world with 1000000 installed functions in MV secondary underground distribution applications RM6 is a functional unit designed to meet the operating and enhancement requirements of power distribution networks Safety of supply continuity of service and insensitivity to the environment RM6 is the choice for hireliability Applications Can be adapted to meet all medium voltage power distribution needs up to 24 kV connection supply and protection of transformers on an open ring or radial network equipment of MV network points and enhancement of electrical power dependability Additional links Discover RM6ATS offer Heart of RM6 Users Manuals Installation User manuals Gallery

O O O O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O


All Products Low Voltage Products and Systems Safety Switches Disconnect Switches Heavy Duty Safety Switches Heavy Duty Safety Switches Roll over image to zoom in Heavy Duty Safety Switches Heavy Duty Safety Switches H325NR Heavy Duty Safety Switches SWITCH FUSIBLE HD 240V 400A 3P NEMA 3R Show more characteristics Product availability Stock Normally stocked in distribution facility Price 432200 USD Where to Buy Sales support Add to My Products Product Datasheet Instruction Sheet Catalog Characteristics Documents and Downloads Technical FAQs Main product or component type Single Throw Safety Switch Line Rated Current 400 A product certifications UL listed NEMA degree of protection NEMA 3R galvannealed steel device composition Neutral factory installed disconnector device type Fusible disconnect shortcircuit current 10 kA H or K 200 kA R J or L device mounting Surface number of poles 3 electrical connection Lugs series name Heavy duty System Voltage 240 V AC 250 V DC AWG gauge AWG 10750 kcmil copper or aluminium Ordering and shipping details Category 00054 HHU SWNEMA3R4001200A Discount Schedule DE1 GTIN 00785901451440 Nbr of units in pkg 1 Package weightLbs 183 Returnability Y Country of origin US Offer Sustainability Sustainable offer status Green Premium product RoHS date code YYWW Schneider Electric declaration of conformity REACh Reference not containing SVHC above the threshold Product environmental profile Available Product end of life instructions Need no specific recycling operations California proposition 65 WARNING This product can expose you to chemicals including Substance 1 Lead and lead compounds which is known to the State of California to cause cancer and birth defects or other reproductive harm More information For more information go to wwwp65warningscagov Contractual warranty Warranty period 18 months Documents and Downloads English Catalog Date Size Add to My Documents Enclosed Safety Switches Catalog pdf 121118 55 MB Digest 177 Sec 03 Safety Switches pdf 111318 9699 KB CAD 2D CAD Heavy Duty Safety Switches 400A Series E5 Enclosure NEMA Type 3R Rainproof Suffix R Seismic 2D CAD Heavy Duty Safety Switches 400A Series E5 Enclosure NEMA Type 3R Rainproof Suffix R Seismic DWF 41318 376 KB 2D CAD Heavy Duty Safety Switches 400A Series E5 Enclosure NEMA Type 3R Rainproof Suffix R Seismic dwg 41318 3055 KB 2D CAD Heavy Duty Safety Switches 400A Series E5 Enclosure NEMA Type 3R Rainproof Suffix R Seismic dxf 41318 9444 KB 2D CAD Heavy Duty Safety Switches 400A Series E5 Enclosure NEMA Type 3R Rainproof Suffix R Seismic pdf 41318 663 KB Brochure Square D Safety Switches Brochure pdf 12917 5527 KB Certificate UL Certificate Heavy duty safety switch 400A and 600A pdf 111517 15 MB Instruction Sheet Neutral Assembley Replacement Instructions for F Series Safety Switches pdf 121118 5514 KB 301200 A Safety Switches pdf 121118 6589 KB 800 and 1200 A Heavy Duty Safety Switches pdf 121118 6566 KB REACh Declaration SWITCH FUSIBLE HD 240V 400A 3P NEMA 3R pdf 102418 0 EU RoHS Declaration SWITCH FUSIBLE HD 240V 400A 3P NEMA 3R pdf 102418 0 Technical FAQs What Class R Fuse Kit is used with the H325N H325NR H325NDS or H325NAWK Series E1 E2 E4 OR E5 safety switch Product Line Heavy Duty Safety Switches What are the repair parts for a H325NR Series E2 E4 and E5 Heavy Duty Safety Switch Product Line HD Safety Switch What Class of fuse does the H325 H325N H325R H325NR H325DS H325NDS H325AWK and H325NAWK heavy duty safety switches accept DO NOT USE RENEWABLE LINK FUSES IN SQUARE D SAFETY SWITCHES What Class of fuse do ALL the 400amp Heavy Duty Safety Switches accept like the H225 H225DS H365R and H365AWK Fusible Safety Switches class of fuse HDSS Heavy Duty H225 H225R H225DS H325DS H325AWK H325N H325NR H325NDS What is the Terminal Lug Data for ALL of the 400amp Heavy Duty Safety Switches For example HU365RB H365 H365AWK and H365DS 400amp switch terminal lug data heavy duty switch wire range Not Fusible Safety Switches H225 H325N H325NR H325NDS See all FAQs

O O O O O O O B I O O B I B I B I B I O O O O O O B I B I B I B I O B I B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O B I O O O O O O O B I B I O O O O O O O O O O O O O B I B I O O O O O O O O O O O O O O O O O B I B I O O O O O O O O O O O O O O O O O B I B I O O O O O O O O O O O O O O O O O B I B I O O O O O O O O O O O O O O O O O O B I O O O O O O O O B I O O O O O O O O O O O O O O O O O O B I O O O O O O B I O O O O O O O O B I B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I B I O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O B I B I O O O O O O O O O O B I O O O O O O O O B I B I O O O O O O O O O B I O O O O B I O O O O O O O O O O O O O O O O O O O B I B I O O O O O O O O O O O O B I O O O O O B I O O O O O O O


Scholastic Book Clubs has corralled together a fabulous collection for October called Thrills and Chills The title alone gave me the itch for a classroom project and that is how my Halloweenthemed STEMWriting lesson was born Read on to find everything you need to implement this lesson during Halloween week Begin by reading your favorite monster story Here are a few of my favorite options How to Catch a Monster by Adam Wallace I Need My Monster by Amanda Noll Monster Trouble by Lane Fredrickson The Writing Component Before beginning the lesson I draw a picture of a monster from my own imagination I do not share this picture with the students I begin the lesson by reading aloud one or all of the books above I then hold a class discussion with the kids about having a monster of their own If they had a monster what would it look like I give them time to draw their monster inside their writers notebooks I then ask the question What if it disappeared How would you give an example of what it looks like This prompt prepares my students for fleshing out the characteristics of their monster on paper as well as setting up the STEM part of the lesson which involves catching the monster Next I ask students to open to another page in their notebooks I explain that I will describe to them a monster and I want them to draw a picture of what I describe to them I proceed with a description of my monster and have students draw while I share After I am finished I show students the picture I made earlier of my monster and ask them to compare what they drew from my verbal description to the monster I have drawn We compare the drawings and then discuss the words I used to describe my monster Students then give me feedback on ways that I could have been more descriptive We talk about types of adjectives that would have been helpful I make a list on chart paper of words that we could use to describe attributes of the monster more accurately At this point students are ready to move on to the writing step They are prompted to take the words we listed along with their monster drawing and write a monster description This will be the first draft of After students have written their first drafts I have them pair up with someone backtoback and take turns reading their descriptions to their partners As they read their partner will draw the readers monster and then the roles are reversed Both students will compare partner drawings to the original monster drawing and then discuss how each other could revise their writing After changes have been made final drafts can be placed on the WANTED paper The Science Component The final activity comes when students are then asked to devise a plan to catch their monster We are learning about simple machines so the expectation is that students will devise a trap with the inclusion of at least one simple machine If youd like to give your kids a quick simple machines tutorial before they begin Scholastic Teachables has a neat Simple Machines Interactive Science Wheel that would work well The planning starts with the following brainstorm questions What do you know about your monster What would make it hard to catch What are your plans for how to catch it Students are then giving the following pages to bring their project to life The Monster Trap Simple Machines Project Letter This is a letter outlining the project and the expectations It serves to keep students parents and teachers all on the same page The Monster Fact Sheet This is your starting place for planning Students fill out everything they need to know about their monster and draw a sketch of their monster trap The Monster Wanted Poster This poster template is for students to draw their final draft and write their final description of their monster The Monster Project Rubric Template and Reflection Questions This is an outline of the template we will use I make this template with my students so that we are all on the same page when it comes to giving them a grade for their final project The final Monster Traps will be displayed on Halloween Students will grade themselves using our studentmade rubric They will also be asked to respond to the reflection questions by celebrating their successes and commenting on their challenges and ways they plan to make changes for our next building project What great projects to you have in store for Halloween Id love to hear how you integrate STEM in your classroom Thank you for reading Smiles Kriscia Kriscia Cabral Grades 35 See all posts

O O O O O O O O O O O O B I I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O


Out of Stock dr martens black hurston boots Were really sorry it appears that this product is currently out of stock Why not check out some of the similar styles below Dont forget we have a 365 day returns policy on unsuitable items view all womens view all boots view all dr martens Try Something Similar Dr Martens LEONORE FUR LINED CHELSEA 140 Dr Martens SERENA 8 EYE II 135 Dr Martens PASCAL 8 EYE GLITTER 115 Dr Martens VEGAN 1460 8 EYE 130 Cookies on schuhcouk We use cookies to give you the best service If youre happy with this keep on browsing or find out how to manage your cookies

O O O B I B I I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O B I O O O O O B I O O O O O B I O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O


Science

News

from

research

organizations

Psychological

Impact

Of

Child

Abuse

Date

May

Source

Mayo

Clinic

Summary

A

history

of

child

abuse

significantly

impacts

the

wide

range

of

challenges

facing

depressed

inpatients

according

to

new

research

Share

FULL

STORY

According

to

a

new

Mayo

Clinic

study

a

history

of

child

abuse

significantly

impacts

the

wide

range

of

challenges

facing

depressed

inpatients

Included

are

an

increase

in

suicide

attempts

prevalence

of

substance

use

disorder

and

a

higher

incidence

rate

of

personality

disorder

Additionally

these

victims

also

had

an

earlier

onset

of

mental

illness

and

an

increase

in

psychiatric

hospitalizations

for

psychiatric

issues

The

study

was

presented

at

the

American

Psychiatric

Association

Annual

Meeting

in

San

Francisco

The

impact

of

child

abuse

already

is

known

to

increase

the

risk

of

suicide

however

the

literature

about

other

characteristics

of

depressed

victims

of

child

abuse

is

scarce

Although

the

findings

of

the

Mayo

study

do

not

confirm

causality

the

information

stresses

the

importance

of

more

aggressive

approaches

from

the

public

health

perspective

to

prevent

child

abuse

A

history

of

child

abuse

makes

most

psychiatric

illnesses

worse

according

to

Magdalena

Romanowicz

MD

lead

author

of

the

study

We

found

that

it

significantly

impacts

the

wide

range

of

characteristics

of

depressed

inpatients

including

increased

risk

of

suicide

attempt

substance

abuse

as

Dr

Romanowicz

says

plans

are

under

way

to

further

examine

the

association

between

child

abuse

and

metal

illness

in

a

larger

study

of

patients

Other

authors

of

this

Mayo

Clinic

study

include

Gen

Shinozaki

MD

Victoria

Passov

MD

Simon

Kung

MD

Renato

Alarcon

MD

and

David

Mrazek

MD

Story

Source

Materials

provided

by

Mayo

Clinic

Note

Content

may

be

edited

for

style

and

length

Cite

This

Page

MLA

APA

Chicago

Mayo

Clinic

Psychological

Impact

Of

Child

Abuse

ScienceDaily

ScienceDaily

May

RELATED

TOPICS

Health

Medicine

Mental

Health

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Health

Education

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Health

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and

Syndromes

Psychiatry

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Disorder

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RELATED

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Child

abuse

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Environmental

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bias

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Science

News

from

research

organizations

Kidney

stone

mystery

solved

Why

some

people

are

more

prone

to

develop

kidney

stones

Date

April

Source

Washington

University

in

St

Louis

Summary

New

research

provides

evidence

to

explain

why

some

people

are

more

likely

to

develop

kidney

stones

than

others

Their

discovery

opens

the

door

to

finding

effective

drug

treatments

and

a

test

that

could

assess

a

persons

risk

of

the

condition

Share

FULL

STORY

The

CT

image

reveals

the

presence

of

kidney

stones

New

research

at

Washington

University

School

of

Medicine

in

St

Louis

provides

evidence

to

explain

why

some

people

are

more

prone

to

the

condition

than

others

Credit

Alana

Desai

MD

Washington

University

in

St

Louis

Kidney

stones

strike

an

estimated

million

Americans

each

year

and

those

who

have

experienced

the

excruciating

pain

say

it

is

among

the

worst

known

to

man

or

woman

Now

new

research

by

scientists

at

Washington

University

School

of

Medicine

in

St

Louis

provides

evidence

to

explain

why

some

people

are

more

prone

to

develop

the

condition

than

others

Their

discovery

opens

the

door

to

finding

effective

drug

treatments

and

a

test

that

could

assess

a

persons

risk

of

kidney

stones

Now

we

finally

have

a

more

complete

picture

detailing

why

some

people

develop

kidney

stones

and

others

do

not

says

senior

author

Jianghui

Hou

PhD

assistant

professor

of

medicine

With

this

information

we

can

begin

to

think

about

better

treatments

and

ways

to

determine

a

persons

risk

of

the

condition

which

typically

increases

with

age

The

research

in

mice

is

now

available

online

in

the

EMBO

Journal

published

by

the

European

Molecular

Biology

Organization

Because

kidneys

function

the

same

way

in

mice

as

in

humans

the

new

findings

can

help

scientists

understand

the

root

causes

of

kidney

stones

in

patients

The

mouse

model

used

in

the

study

can

also

serve

as

a

platform

for

the

preclinical

testing

of

novel

treatments

for

the

condition

the

researchers

say

Most

kidney

stones

form

when

the

urine

becomes

too

concentrated

allowing

minerals

like

calcium

to

crystallize

and

stick

together

Diet

plays

a

role

in

the

condition

not

drinking

enough

water

or

eating

too

much

salt

which

binds

to

calcium

also

increases

the

risk

of

stones

But

genes

are

partly

to

blame

A

common

genetic

variation

in

a

gene

called

recently

has

been

linked

to

a

substantial

increase

in

risk

roughly

percent

of

getting

kidney

stones

In

the

new

study

the

researchers

have

shown

how

alterations

in

the

genes

activity

influence

the

development

of

stones

Typically

the

gene

is

not

active

in

the

kidney

The

new

research

shows

that

its

expression

is

dampened

by

two

snippets

of

RNA

a

sister

molecule

of

DNA

that

essentially

silence

the

gene

When

is

idled

the

kidneys

filtering

system

works

like

its

supposed

to

Essential

minerals

in

the

blood

like

calcium

and

magnesium

pass

through

the

kidneys

and

are

reabsorbed

back

into

the

blood

where

they

are

transported

to

cells

to

carry

out

basic

functions

of

life

But

when

people

eat

a

diet

high

in

calcium

or

salt

and

dont

drink

enough

water

the

small

RNA

molecules

release

their

hold

on

An

increase

in

the

genes

activity

prevents

calcium

from

reentering

the

blood

the

study

shows

Hou

and

his

team

have

found

that

blocks

calcium

from

entering

passageways

called

tight

junctions

in

cells

that

line

the

kidney

and

separate

blood

from

urine

Without

a

way

back

to

the

bloodstream

excess

calcium

goes

into

the

urine

Too

much

calcium

in

the

urine

can

lead

to

stones

in

the

kidneys

or

bladder

Intense

pain

develops

when

a

large

stone

gets

stuck

in

the

bladder

ureter

or

urethra

and

blocks

the

flow

of

urine

Hous

research

supports

the

theory

that

people

with

a

common

variation

in

lose

the

ability

to

regulate

the

genes

activity

increasing

the

risk

of

kidney

stones

He

is

optimistic

however

that

drugs

could

be

developed

to

target

the

short

stretches

of

RNA

that

are

intimately

linked

to

Drugs

that

mimic

these

socalled

microRNAs

could

keep

the

activity

of

in

check

and

reduce

the

likelihood

that

stones

would

form

Also

it

may

one

day

be

possible

to

develop

a

diagnostic

test

to

measure

levels

of

the

protein

excreted

in

urine

Elevated

levels

would

indicate

an

increased

risk

of

stones

and

people

could

take

steps

to

prevent

stones

by

modifying

their

diet

Many

genes

likely

play

a

role

in

the

formation

of

kidney

stones

Hou

says

But

this

study

gives

us

a

better

idea

of

the

way

one

of

the

major

players

work

Now

that

we

understand

the

physiology

of

the

condition

we

can

start

to

think

about

better

treatments

or

even

ways

to

prevent

stones

from

developing

in

the

first

place

The

research

was

funded

in

part

by

the

National

Institutes

of

Health

NIH

and

the

American

Heart

Association

Hou

is

working

with

Washington

Universitys

Office

of

Technology

Management

on

an

invention

related

to

work

described

in

the

paper

Story

Source

Materials

provided

by

Washington

University

in

St

Louis

Note

Content

may

be

edited

for

style

and

length

Journal

Reference

Yongfeng

Gong

Vijayaram

Renigunta

Nina

Himmerkus

Jiaqi

Zhang

Aparna

Renigunta

Markus

Bleich

Jianghui

Hou

regulates

renal

Ca

transport

in

response

to

CaSR

signalling

via

a

novel

microRNA

pathway

The

EMBO

Journal

DOI

Cite

This

Page

MLA

APA

Chicago

Washington

University

in

St

Louis

Kidney

stone

mystery

solved

Why

some

people

are

more

prone

to

develop

kidney

stones

ScienceDaily

ScienceDaily

April

RELATED

TOPICS

Health

Medicine

Kidney

Disease

Urology

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Health

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Conditions

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O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O


Journal of Cereal Science Volume 20 Issue 2 September 1994 Pages 183190 Regular Article Evaluation of Flour Particle Size Distribution by Laser Diffraction Sieve Analysis and Nearinfrared Reflectance Spectroscopy GA Hareland httpsdoiorg101006jcrs19941058 Get rights and content Abstract Laser diffraction and sieve analysis were used to measure flour particle size distributions as per cent volume and per cent weight respectively among different wheat types and milling methods Nearinfrared NIR reflectance spectroscopy was used to predict the per cent volume of flour particles within selected size ranges based on laser diffraction reference values According to laser diffraction analysis 8998 of the flour particle were distributed within the size ranges 1041 μm and 41300 μm and 211 of the particles were distributed within the size range 10 μm Flour particle size distributions were different P 005 among the wheat types tested except that hard red winter and hard white wheats were not different in flour particle size 10 μm and hard red spring and hard white wheats were not different in flour particle size within 1041 μm and 41300 μm The milling method affected particle size distributions of hard wheat flours but not those of soft wheat flours A high correlation r 095 occurred between per cent volume and per cent weight of hard wheat flour particles 45 μm but the correlation decreased r 077 when soft wheat flours were included in the comparison Nearinfrared calibration equations were developed by partial leastsquares regression for predicting the per cent volume of flour particles The per cent volume of flour particles within the size ranges 10 μm 1041 μm and 41300 μm were predicted by NIR within 2 standard errors for 96 of the flours tested Copyright 1994 Academic Press All rights reserved

O O O O O O O O O O O O O O O O B I I I O B I B I O O O O O O O O O O O O B I O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O

flour particle size distribution
sieve analysis
laser diffraction


Journal of Taibah University Medical Sciences Volume 11 Issue 2 April 2016 Pages 110114 open access Original Article Effects of different complete dentures base materials and tooth types on shortterm phonetics Khalid A Arafa PhD httpsdoiorg101016jjtumed201511003 Get rights and content Under a Creative Commons license Abstract Objective This study aimed to identify the effect of various types of complete dentures base materials and teeth types on patients shortterm phonetics Methods A quasiparallel study was conducted at the dental clinic Faculty of Dentistry at AlAzhar UniversityAssiut Branch in Egypt Fifty healthy participants with complete dentures were enrolled in the study The enrolled patients were grouped into two main batches three groups in batch one and two groups in batch two The three groups in the first batch received three different denture base materials flexible acrylic resin heat cure acrylic resin and chrome cobalt metallic base The two groups in batch two received different types of teeth acrylic and porcelain teeth The five groups completed a questionnaire composed of items pertaining to demographic characteristics and the researcher obtained data about phonetics Results The sound level was significantly higher in the group of dentures constructed of chrome cobalt metallic base in comparison to the other materials Additionally the sound level in porcelain teeth was significantly higher than that in acrylic teeth The material used to construct teeth was one of the major determinants influencing phonetics Conclusion Phonetics is affected by the material used to construct the base of complete dentures and the teeth type Complete dentures with a chrome cobalt metallic base and porcelain teeth are considered to be superior for improving phonetics Keywords Complete dentures Edentulous patients Phonetics Porcelain Tooth type Introduction Complete dentures affect speech sounds by altering the dimensions and morphology of the oral cavity Upper incisors and the different thicknesses in different areas of the dentures palatal plate were reported as influencing the dimensions of the oral cavity 1 The impact of these factors on sounds the virtual period of distinct sounds in a word and the phonetic variation in patients with dentures was examined 2 Speech making has a major influence on patients overall satisfaction with dentures Patients contentment correlates with the acceptance of dentures 3 The insertion of complete dentures often leads to speech alteration Although many of the alterations are temporary they are a source of worry for patients For dentists there is a lack of guidelines for designing dentures with the best phonetic success 4 During the production of speech sounds the tongue contacts various portions of the teeth the alveolar ridge and the hard and soft palates 5 When these structures are covered or replaced by a denture proprioceptive feedback may be changed Therefore phonetics may be affected by the presence of dentures Most of the prosthodontics literature on phonetics has been concerned with the positioning of artificial teeth and the vertical dimension of occlusion 6 Few scientific studies have related the speech changes to the palatal contour of complete dentures 5 In addition there are conflicting data on how denture wearers achieve speech improvement 6 Negligence about phonetics in the construction of complete dentures may be attributed to edentulous patients tending to return to their normal speech patterns a few weeks after the insertion of dentures 7 Previous studies which investigated factors influencing speech sound in patients with complete dentures have mainly been limited to clinical case reports In addition more recent clinical studies on the phonetic system were limited because of the absence of control groups blind assessment and a poor description of standards for assessing mastication affected by a phonetic system that has shown increases in the occlusal vertical dimension 8 During the pronunciation of sibilants z s and ch teeth come close together but do not touch Silvermans closest speaking space is used for determining the proper vertical dimension 9 Few studies have been conducted concerning the effects of both denture material and teeth on the sound level Identification of the best type of teeth to maintain the sound level is essential to dentistry This study seeks the best material for dentures and teeth types Thus this study aimed to analyse the effect of different types of materials used to construct complete dentures bases and the types of teeth on shortterm phonetics via a computerized speech lab spectrogram Materials and Methods A quasiparallel design experimental study was conducted Fifty healthy participants with complete dentures were enrolled in the study at the Dental Clinic Faculty of Dentistry at AlAzhar UniversityAssiut Branch in Egypt during a 10week period between January and April 2015 The patients enrolled in this study were male aged 55 3 years completely edentulous with normal occlusion class one and free from disabilities or chronic conditions such as diabetes All dentures with different materials had the same thickness Thus diabetic patients as well as those who were partially edentulous or had neglected oral hygiene were excluded from this study The patients enrolled in the study n 50 were divided into two main batches three groups in batch one and two groups in batch two and distributed randomly as ten patients in each group The three groups in the first batch received three different denture base materials flexible acrylic resin group 1 heat cure acrylic resin group 2 and chrome cobalt metallic base group 3 for the constructed palatal plate and rouge area of the complete dentures Another batch twenty patients divided into two groups received different types of teeth acrylic teeth group 1 and porcelain teeth group 2 The flow chart of the study Download fullsize image The five groups completed a questionnaire composed of items pertaining to demographic characteristics while the researcher measured speech quality The evaluation of speech quality was made by measuring patients phonetics The patients were connected to a spectrogram and were asked to verbalize Arabic pronunciation letters ص ض عغ The mean of the sound levels was calculated for each patient and subsequently tabulated and analysed The evaluation was made immediately following denture insertion at three weeks and at ten weeks following the insertion of dentures at a computerized speech lab spectrogram This measurement protocol was implemented for two batches The level of sound in patients was assessed via a spectrogram with complete dentures made from different base materials or from different teeth The collected data were then analysed by SPSS version 20 The chisquare test was used to test differences in the demographic characteristics of the two groups The independent ttest was employed to identify differences between the two groups All values were tabulated as the average mean with standard deviation SD whereby p values less than 005 were considered statistically significant Results The fifty patients were homogenous with respect to the demographic characteristics in the two batches While some differences in the variables such as in age and education level were noted they were not statistically significant p 005 Table 1 Table 1 Characteristics of the patients batch 1 and batch 2 that took part in the study Batches Variable Types of material p value Heat cure acrylic resin n Flexible acrylic resin n Chrome cobalt metallic base n Batch 1 Education level Illiterate 4 40 3 30 5 50 045 Primary 6 60 7 70 5 50 Age mean SD 56 2 years 58 3 years 59 2 years 023 Variable Types of material p value Acrylic teeth n Porcelain teeth n Batch 2 Education level Illiterate 5 50 4 40 Primary 5 50 6 60 026 Age mean SD 57 3years 58 4 years 038 Statistically significant The effects of the constructed palatal plate and rouge area of the complete dentures on patients sounds were measured in relation to all types of material used at three points at insertion at three weeks and at ten weeks postinsertion The sound was significantly higher in the group of dentures constructed from chrome cobalt metallic base than in the dentures constructed from flexible acrylic resin or heat cure acrylic resin Using flexible acrylic resin or a chrome cobalt metallic bas significantly e improved the level of sound at the tenth week Table 2 Table 2 The effect of the constructed palatal plate and rouge area on the level of the sound of the complete dentures using three types of materials Types of materials Sound levels L k at different times p value of timeline evaluation At insertion After 3 weeks After 10 weeks Mean SD Mean SD Mean SD Heat cure acrylic resin 16 003 17 003 18 003 009 Flexible acrylic resin 2 004 21 004 23 004 003 Chrome cobalt metallic base 3 006 34 007 38 007 0012 p value 002 003 001 Statistically significant The results showed that the sound levels in porcelain teeth were significantly higher than in acrylic teeth at insertion at three weeks and at ten weeks postinsertion At insertion the sound level was 25 L k for porcelain teeth and 18 L k for acrylic teeth It was also shown that using porcelain teeth improved the sound level at the tenth week postinsertion Table 3 Table 3 The effect on the level of the sound of the different teeth types acrylic and porcelain Types of teeth Sound levels L k at different times p value of timeline evaluation At insertion After 3 weeks After 10 weeks Mean SD Mean SD Mean SD Acrylic teeth 18 003 19 0035 2 004 007 Porcelain teeth 25 005 28 0046 3 006 003 p value 004 002 001 statistically significant Discussion There are many factors that affect voice including the dimensions locations and fabrication materials of the teeth as well as plaque Sound is formed as a result of the functional relations of various formations of the voice organ The second most important component controlling sound waves is acoustic speech 10 This study assessed the effect of base materials and teeth types on the sound level The findings revealed the superiority of chrome cobalt metallic base dentures over heat cure acrylic resin and flexible acrylic resin dentures That is the study showed that the levels of sound were significantly higher among patients who received chrome cobalt metallic base dentures These results confirm those of previous studies For example a study undertaken by Hala M Abdalhameed et al concluded that with proper denture construction the palatine rugae plays an important role in speech pronunciation as there should be some anatomical landmarks which the tongue can recognize to produce particular sounds This result can be found with metallic base plates 11 It is necessary to make the base of prostheses as thin as possible to improve sound pronunciation 12 which is best achieved when using metallic base plates in denture construction The study also showed that the level of sound measured by the spectrogram was superior in patients who received porcelain teeth rather than acrylic teeth According to the results the best material was a chrome cobalt metallic base followed by flexible acrylic resin During the production of speech sounds the tongue contacts various portions of the teeth the alveolar ridge and the hard and soft palates In addition phonetics may be affected by the presence of dentures A number of sounds are affected by the tooth position flange thickness lip support and material used to construct the base of complete dentures Phonetics improved as the patients adapted to the new shape of the dentures The sound level increased at three weeks and at ten weeks after insertion of dentures as measured at a computerized speech lab spectrogram Using flexible acrylic resin chrome cobalt metallic base materials or porcelain teeth types has a positive impact on shortterm phonetics These findings are in contrast to the findings from a Turkish study phonemes after application of removable partial dentures The Turkish study showed that problems in articulation occurred postinsertion for a removable partial denture while for other study subjects a significant amelioration was observed after the insertion of a removable partial denture In general problems in articulation of evaluated phonemes were resolved after one week of partial denture use 13 The strengths of this study include comparing two techniques to improve the sound levels for complete dentures The main study limitations include a lack of randomization and controls and a limited area of recruitment Dental Clinic Faculty of Dentistry at AlAzhar UniversityAssiut Branch in Egypt Therefore the generalizability the findings of this study are limited Thus it is recommended that fully randomized and properly controlled studies conducted on a larger sample recruited from the entire country are to be undertaken in the future Other limitations of this study include using only Arabic letters and not considering linguoalveolar sound during the evaluation of the sound level Conclusion It is concluded that words spoken by edentulous patients were related to words spoken during the different stages of denture wear An analysis revealed that a number of sounds were affected by the material used to construct the base of the complete dentures and by the type of teeth Chrome cobalt metallic base and porcelain teeth are superior measures for improving the sound level However it is difficult to know if the sound level will improve as the patient adapts to the new complete dentures Authors contribution KAA is the main investigator of this work He designed drafted and prepared all of the related work Ethical approval This study was approved by the Dental Health Department of the Faculty of Applied Medical Sciences Albaha University and all participants signed consent forms prior to the study The right of the participants to withdraw at any time was explained and preserved during the study The study was registered in the International Standard Randomised Controlled Trials Number ISRCTN registry with study ID ISRCTN10251727 Conflict of interest I declare that this study is my own work and the manuscript has not been submitted to any other journal I also declare that I have no conflict of interest related to this study References 1 EG Owens CI Goodacre PL Loh G Hanke M Okamura KH Jo et al A multicenter interracial study of facial appearance Part 1 a comparison of extraoral parameters Int J Prosthodon 15 2002 pp 273 282 Google Scholar 2 A Finbarr SMC Carthy Complete dentures from planning to problem solving Quintessence Publishing Co Ltd London Berlin Chicago 2003 pp 95 96 Google Scholar 3 F Stelzle B Ugrinovic C Knipfer T Bocklet et al Automatic computerbased speech assessment on edentulous patients with and without complete dentures preliminary results J Oral Rehabilitation 37 2010 pp 209 216 Google Scholar 4 E Kelly Changes caused by a mandibular removable partial denture opposing a maxillary complete denture J Prosthet Dent 90 2003 pp 213 219 Google Scholar 5 GA Zarb CL Bolender SE Eckert RF Jacob AH Fenton R MericskeStern Prosthodontic treatment for edentulous patients 12th ed Mosby 2004 pp 379 387 Google Scholar 6 B Carr Alan P McGivney T Brown David S McCracken Removable partial prosthodontics 11th ed Mosby 2005 pp 397 426 Google Scholar 7 V Krishna VVK Reddy NP Kumar KVK Raju Dentures with phonetically contoured palate a simple technique of adding customized rugae and palatal contours to the maxillary denture J Contemp Dent Pract 13 2 2012 pp 216 218 Google Scholar 8 DL Sarandha DL Sarandha I Zakir Textbook of complete denture prosthodontics 1st ed Jaypee Brothers Publishers India 2007 Google Scholar 9 HJ Kong CA Hansen Customizing palatal contours of a denture to improve speech intelligibility J Prosthet Dent 99 3 2008 pp 243 248 Google Scholar 10 M Kawauchi Y Kawamori R Sachdeva H Nakajima H Mitani The dynamic dentopalatography system a new approach for evaluating speech J Biomed Eng 14 1992 pp 163 168 Google Scholar 11 HM Abdelhameed ME ElSayed Effect of different techniques for palatal denture base configuration on speech quality in complete denture wearers Med J Cairo Univ 82 1 2014 pp 657 664 Google Scholar 12 K Broka et al The influence of the design of removable dentures on patients voice quality Stomatologija Baltic Dent Maxillofac J 15 1 2013 Google Scholar 13 O Murat T Íbrahim O Soner O Müjgan Evaluation of articulation of Turkish phonemes after removable partial denture application Braz Dent J 14 2 2003 pp 125 131 Google Scholar Peer review under responsibility of Taibah University View Abstract Copyright 2015 The Author Production and hosting by Elsevier Ltd

O O B I I I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O


Procedia Social and Behavioral Sciences Volume 224 15 June 2016 Pages 554561 open access Emergence of Sustainability Based Approaches in Healthcare Expanding Research and Practice Malliga Marimuthu a Hanna Paulose b httpsdoiorg101016jsbspro201605437 Get rights and content Under a Creative Commons license Abstract The study explores the scope of sustainability practices in healthcare by systematically examining studies conducted on healthcare related issues within the context of sustainability The review is focused on three main conceptual aspects dimensions of sustainability practices in healthcare drivers of sustainable practices within the industry and strategies to implement sustainability effectively in healthcare Relevant literature on sustainability in healthcare is referred to address the developed research question Based on the identified expanding dimensions of sustainability research and practices future research insights are proposed as conceptual models that reflect the scope of sustainability practices in healthcare This could enhance understanding Keywords healthcare sustainability environment customer employee community Peerreview under responsibility of the Universiti Teknologi MARA Sarawak 2016 The Authors Published by Elsevier Ltd

O O O O O O O O O O O O O O O O B O O O B O O O O O O O O O O O O O O O O O O O O O O O O O O O B O O B O O O O O O B O O O O O O B O O O O O O O O O O O B O O B O O O O O O O O O O O B O O B O O O B O B O O O O O O O O O O O O O O O B O O O O O O O O O O O O O O O O B O O B O O O O O B B O O O O O O O O O O O O O O O O O O O O


Exercise Therapy Therapeutic exercise is the systematic implementation of planned physical movements postures or activities designed to 1 remediate or prevent impairments From Current Therapy in Pain 2009 Learn more about Exercise Therapy Therapeutic Exercises Joel D Sebag DPT in Pain Procedures in Clinical Practice Third Edition 2011 Therapeutic exercises or exercise therapy is a major component in the management of various disorders It can be defined as any prescribed and supervised exercise program in which during therapy sessions the patients are required to carry out repeated voluntary dynamic movements or static muscle contractions either whole body or region specific and either with or without external loading with the aim of relieving symptoms or improving function by controlling inflammation when present restoring range of motion ROM restoring andor improving muscular strength power and endurance and training to return to daily and recreational activities 14 Effectiveness of exercise therapy for chronic nonspecific low back pain Marienke van Middelkoop Maurits van Tulder in Spinal Control 2013 Implications for practice Exercise therapy is not effective for acute low back pain Exercise therapy is effective for chronic low back pain but there is no evidence that any type of exercise is clearly more effective than others Subgroups of patients with low back pain may respond differently to various types of exercise therapy but it is still unclear which patients benefit most from what type of exercises Adherence to exercise prescription is usually poor so supervision by a therapist is recommended If home exercises are prescribed strategies to improve adherence should be used Patients preferences and expectations should be considered when deciding which type of exercise to choose Therapeutic exercises for the shoulder region Johnson McEvoy Carel Bron in Neck and Arm Pain Syndromes 2011 Introduction Therapeutic exercise is a cornerstone of physiotherapy practice and was initially referred to as medical gymnastics The development of medical gymnastics in physical therapy has had many diverse influences including Dr Francis Fuller author of Medicina Gymnasticia 1740 Swedish gymnast Per Henrik Ling 17761839 and the Dutch physical education teacher and physician Dr Johann Georg Mezger 18381909 Barclay 1994 Terlouw 2007 More recently Kendall 2002 summed up the role of therapeutic exercise in physical therapy Central to the practice of physical therapy is the prevention of movement dysfunction and the rehabilitation through restoration and maintenance of active movement in other words therapeutic exercise in its broadest sense The focus of this chapter is to introduce general principles of therapeutic exercise for the shoulder and to stimulate clinical reasoning and rational rehabilitation The chapter will briefly discuss posture stretching and strengthening of a selection of muscles without focussing on one specific clinical population Principles of Therapeutic Exercise Design In The Physiotherapists Pocket Guide to Exercise 2009 THERAPEUTIC EXERCISE Therapeutic exercise is one of the core skills upon which the profession of physiotherapy is based By considering definitions of therapeutic exercise physical activity and exercise it is possible to see that although therapeutic exercise contains the components of both physical activity and exercise it also provides a systematic exercise programme for remediation of impairments and improvement of function Physical activity is any bodily movement produced by skeletal muscles that results in an expenditure of energy wwwcdcgovnccdphpdnpaphysicalterms Examples of physical activity could include housework walking dancing gardening or exercise Exercise is physical activity that is planned or structured It involves repetitive bodily movement done to improve or maintain one or more of the components of physical fitness cardiorespiratory endurance muscular strength muscular endurance flexibility and bodily composition wwwcdcgovnccdphpdnpaphysicalterms Therapeutic exercise is the systematic implementation of planned physical movements postures or activities designed to remediate or prevent impairments enhance function enhance fitness and wellbeing APTA 2001 Complementary and alternative therapies and naturopathic treatments Dominik Irnich in Myofascial Trigger Points 2013 2334 Motionexercise therapy Exercise therapy in the sense of naturopathic treatments includes exercises for wholebody fitness with moderate but regular stamina training and the creation of an everyday plan Physiotherapy with all its forms of application and techniques and training of body posture are other components Many of these procedures have found a use in conventional treatment but they are still used in various forms in the naturopathic context Basically any form of exercise therapy can be helpful for patients with chronic myofascial pain to overcome the pain and increases physical fitness The procedures relevant to myofascial pain are given in Ch 24 under relaxation techniques or as exercises specifically for the individual muscles see Chs 2634 26 27 28 29 30 31 32 33 34 Nonmotor Parkinsons The Hidden Face Nataliya Titova K Ray Chaudhuri 1 in International Review of Neurobiology 2017 8 Exploration of the Role of Exercise and Complementary Medicine in the Management of NMS in PD Exercise and complementary therapies have remained of anecdotal value until recently when several studies have shown the valuable role of exercise on nonmotor aspects of PD in animal models and humans The role of complementary therapies such as acupuncture and yoga are also being developed Nutrition is emerging as an important aspect for management of some NMS of PD such as constipation and probiotic use may for instance be beneficial The future should bring about a largescale gathering of evidence for the precise role of exercise and other complementary therapies including diet in PD and its role in alleviating aspects Connective tissue disorders Janet L Poole PhD OTRL FAOTA Jane S Brandenstein PT in Rheumatology 2010 AIMS AND PRINCIPLES OF MANAGEMENT Exercise Therapeutic exercises are dependent on patients symptoms and muscle enzymes at the time When in flare rest and activeassisted to active exercises are indicated As symptoms subside gentle strengthening may be incorporated into the programme Energy conservation Patients need instruction in pacing and energy conservation to decrease unnecessary muscle use especially when in flare Training may need to be repeated at periodic intervals as patients improve Modalities Moist heat may be used with careful supervision during times of flare and muscle achiness Warm shower or baths are especially helpful if morning stiffness is present Careful monitoring of the skin is imperative for any heat modalities Peripheral Artery Disease Reena L Pande Mark A Creager in Hematology Seventh Edition 2018 Exercise Therapy Supervised exercise therapy improves walking distance by as much as 100 to 150 in patients with PAD Patients are recommended to walk on a treadmill or track three to five times per week for a duration of at least 45 minutes per session for 3 to 6 months Exercise should continue until patients develop moderate to severe claudication after a rest period they should resume walking with the cycle repeated until the session is over As patients improve walking speed and treadmill grade can be increased Recent studies have shown that homebased exercise therapy is also effective when home activities are monitored and quantified 21 or when paired with periodic and facilitated group behavioral training 22 The CLEVER The Claudication Exercise Versus Endoluminal Revascularization trial showed that a 6month supervised exercise training program in patients with aortoiliac disease and claudication produced a greater improvement in walking time than optimal medical therapy alone or stenting 23 In contrast in the IRONIC Invasive Revascularization or Not in Intermittent Claudication study improvement in diseasespecific qualityoflife measures was greater for stenting than supervised exercise therapy in patients with lifelimiting claudication While prior studies had evaluated the benefits of supervised exercise therapy in comparison to revascularization the ERASE study assessed the impact of exercise therapy in addition to endovascular revascularization The study showed that combination treatment resulted in greater walking distance and quality of life at 1 year than supervised exercise therapy alone 23a It remains clear that physical activity should be recommended as a part of a multifaceted approach to improving symptoms in patients with PAD The mechanisms responsible for the benefits of exercise remain unclear Potential mechanisms include collateral blood vessel development as a consequence of upregulation of angiogenic growth factors endotheliumdependent vasodilation because of enhanced nitric oxide bioavailability more efficient walking biomechanics and improved skeletal muscle metabolism Medical management of the supported patient Priya Nair Paul Forrest in Mechanical Circulatory and Respiratory Support 2018 Exercise Capacity Exercise therapy independent of rehabilitation predischarge has been shown to improve outcomes 131 The nature of the exercise high intensity vs low intensityis actively under study at present Patients are generally encouraged to maintain regular walking and to regain strength in preparation for subsequent transplantation While measured peak oxygen utilization does not return to normal with LVAD implant the quality of life and distance walked in 6 min have been shown to improve 132 133 The disconnect between cardiopulmonary stress testing and functional outcomes is surprising although even with intermittent speed augmentation achieved exercise cardiac output with LVAD therapy or even transplantation remains only a fraction of that of the normal heart 134 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B I O O O O B I O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O B I O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O B I O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O

exercise therapy
systematic implementation


Behavior therapy Behavior therapy is a genuine psychological treatment approach that includes a large variety of specific techniques and interventions From Comprehensive Clinical Psychology 1998 Learn more about Behavior therapy Adults Clinical Formulation Treatment Jürgen Margraf in Comprehensive Clinical Psychology 1998 Definition Behavior therapy is a genuine psychological treatment approach that includes a large variety of specific techniques and interventions In clinical applications these different methods are utilized either alone or in combination depending on the nature of the problem to be treated Behavior therapy can therefore not be understood as a single circumscribed treatment method that relies on one single theoretical model On the contrary its theoretical background is composed of a multitude of general and disorderspecific etiological theories and psychological models of change The common link is the orientation toward empirical psychology A futureoriented characterization can not limit itself to a list of present methods The definition of behavior therapy therefore has to fulfill the following requirements i the theoretical and methodological breadth of the behavioral approach needs to be included ii in spite of broad borders the specific aspects of behavior therapy have to be named explicitely and iii openess for future developments This has led me to the proposal to consider the behavioral approach as a broad basic orientation rather than as a single therapy school or group of treatment methods Margraf 1996 Margraf Lieb 1994 Modern behavior therapy can then be defined as follows Behavior therapy is a broad psychotherapeutic orientation that is based upon empirical psychology It includes disorderspecific and general treatment methods that aim at a systematic improvement of target problems on the basis of as much as possible tested knowledge of disorders and psychological principles of change Interventions have concrete and operationalized goals on the different levels of behavior and experience They are derived from the diagnosis of disorders and individual problem analysis and target the predisposing triggering and maintaining conditions of the problem Behavior therapy is continuously evolving and explicitly asserts to test its statements empirically The levels of behavior and experience can be conceptualized in different ways In behavior therapy they are typically defined according to Langs threesystems model 1971 This includes a behavioral a subjective and a physiological level of response Although this model can be criticized in some respects eg Fahrenberg 1987 a multimodal approach has become the standard in most of behavior therapy research Seidenstücker Baumann 1987 Behavior Therapy Theoretical Bases D McKay WW Tryon in Reference Module in Neuroscience and Biobehavioral Psychology 2017 OverviewIntroduction Behavior therapy also known as behavioral therapy has become a welldeveloped and integrated mental health treatment Behavior therapy has undergone three waves of significant changes that include unique terms and constructs for each Behavior therapy became more inclusive during this development by drawing from different aspects of psychology Unfortunately this did not result in theoretical integration or unification until recently The need to empirically support treatment packages has been preserved throughout this development The purpose of this article is to provide a comprehensive understanding of the field within the limits of space constraints Within each of these three waves we address the conceptualtheoretical and empirical bases of each wave and their clinical practices We end with a consideration of the role that neuroscience and computational neuropsychology plays in understanding how and why these therapies work Behavior Therapy with Children D DiLillo L Peterson in International Encyclopedia of the Social Behavioral Sciences 2001 Child behavior therapy including behavior modification and cognitive therapy consists of a group of diverse but related scientificallybased approaches to the assessment and treatment of children experiencing behavioral and emotional difficulties Although contemporary behavior therapy with children is characterized by a plurality of viewpoints techniques and theoretical rationales a distillation of these differing perspectives reveals several common features that define the essence of child behavior therapy These features include 1 principles of behavioral psychology most notably principles of learning 2 use of strategies or procedures that are methodologically sound and empirically validated and 3 application of such principles and procedures to adjustment problems of children and adolescents Ollendick 1986 Presented here is an overview of the historical roots of child behavior therapy an explication of key concepts underlying the approach and examples of classic and contemporary uses of behavior therapy with children Behavior Therapy Psychiatric Aspects LM Drummond in International Encyclopedia of the Social Behavioral Sciences 2001 Behavior Therapy refers to a range of treatments and techniques which are used to change an individuals maladaptive responses to specific situations Altering the maladaptive responses can often alleviate psychological distress and psychiatric problems The first early examination of behavior therapy examined how fears and phobias are learned and demonstrated the role of classical conditioning in their genesis The early treatments of phobic disorder used systematic desensitization This technique requires deep muscular relaxation before the patient is asked to imagine increasingly anxietyprovoking situations Systematic desensitization was superseded by exposure Exposure does not use relaxation but involves the patient in gradually facing up to the feared situation It is the treatment of choice for phobic and obsessivecompulsive disorders Modern behavior therapy can be divided into three main types of technique First there are the exposure treatments used in a range of anxiety disorders Second there are methods aimed at teaching new skills such as in social skills deficits marital disharmony and sexual dysfunction Third there are reinforcement or reward programs These are based on rewarding desired behaviors and ignoring or suppressing undesirable ones They are used most commonly in the chronic institutionalized patient Behavior therapy commonly is used in conjunction with cognitive therapy when the patients thinking patterns are also examined and unhelpful ways of thinking are challenged by the patient and therapist together Behavior therapy is also often combined with drug treatment More research is needed in this area Psychotherapy Integration Warren W Tryon in Cognitive Neuroscience and Psychotherapy 2014 Behavior Therapy Behavior therapy became widespread after Joseph Wolpe 1958 introduced a treatment that he developed in the laboratory with dogs His systematic desensitization was based on the physiological principle of reciprocal inhibition Eysenck 1964 claimed that Behaviour therapy may be defined as the attempt to alter human behaviour and emotion in a beneficial manner according to the laws of modern learning theory p 1 Wolpe and Lazarus 1966 stated that behavior therapy entailed the application of experimentally established principles of learning p 1 Wolpe 1969 defined behavior therapy as the use of experimentally established principles of learning for the purpose of changing unadaptive behavior p vii It turned out that these definitions of behavior therapy were mainly aspirational because learning theory like the rest of psychological science was in disarray at the time and only partially able to support clinical practice cf Tryon 2000a 2002c Pointedly Kazdin 1979 noted that there really was no modern learning theory upon which to base the broad array of therapeutic practices that clinical psychologists were using at the time Successful animal models of psychopathology such as the learned helplessness model of depression Overmeier Seligman 1967 Seligman Maier 1967 generated much research but little by way of specific clinical application thereby demonstrating a double dissociation between theory and practice Cognitive Behavioral Treatments for Substance Use Disorders Danielle Barry Nancy M Petry in EvidenceBased Addiction Treatment 2009 Review of Behavioral Therapy and Cognitive Therapy Behavior therapy employs interventions based on classical and operant conditioning An early example is Wolpes 1954 systematic desensitization in which patients are taught progressive relaxation techniques and then are systematically exposed to stimuli that elicit fear while in a relaxed state Because the relaxation response is incompatible with anxiety it weakens the learned association between a stimulus and an anxiety response Cognitive therapy views psychological distress as the result of an information processing problem that leads to a negative cognitive bias Beck 1963 The cognitive bias is learned and can be broken down into a number of specific cognitive distortions that perpetuate maladaptive feelings and behaviors Beck 1964 Cognitive therapy consists of identifying these cognitive distortions and helping clients learn to view the world more objectively thus reducing psychological distress Like behavior therapy cognitive therapy is based on a learning model Beck Weishaar 1989 although it focuses on changing underlying beliefs and thoughts whereas behavior therapy addresses overt behaviors Cognitive behavioral therapy combines behavior therapy and cognitive therapy by applying learning theory to both observable behavior and to thoughts and emotions as well CBT is based on social learning theory Bandura 1969 and the assumption that behavior including maladaptive behavior such as substance abuse is learned through a combination of classical conditioning operant conditioning and modeling Carroll 1998 When applied to substance use disorders the CBT approach suggests that individuals first learn to use drugs or alcohol by observing other people using them If their observations convince them to try a substance then operant conditioning can occur as the individual experiences pleasurable effects and uses the substance repeatedly in order to recreate those effects Anticipation of substance use can create a strong desire or craving and consequently elimination of craving by using the substance is strongly reinforcing Classical conditioning contributes to dependence when substance use is paired repeatedly with environmental cues such as certain people locations objects times Marlatt 1985 Over time these cues can trigger craving for the substance CBT models view addictive behaviors as acquired habits that are shaped by learning and these models further maintain that habits can be changed through the development of behavioral skills and cognitive strategies Marlatt 1985 Similar to behavior therapy CBT uses techniques based on classical and operant conditioning Because classical conditioning results in certain stimuli eg particular people places or situations sight or smell of substances drug use equipment being associated with substance use clients experience cravings when exposed to those stimuli To reduce risks of cravings clients are taught to recognize and avoid conditioned triggers When using operant techniques clinicians instruct clients to reward themselves for meeting goals eg engaging in an enjoyable activity or purchasing a desired item after a sustained period of abstinence As with cognitive therapy a major tenet of CBT is that behaviors and feelings are caused by thoughts about other people events and situations Beck 1963 1964 Ellis 1957 The theory and practice of CBT are based on an ABC model of human emotions and behavior People events and situations are considered determinants or antecedents A that may or may not lead to particular feelings or behaviors consequences or C depending on the intervening beliefs B Thompson Hollon 2000 Ways of thinking about the world are learned and maladaptive behavior and feelings can be changed if one learns to think in a different way Antecedents for substance use can be negative events such as job loss interpersonal conflicts or financial problems Although these events tend to be associated with stress and a range of negative emotions the particular association depends on an individuals beliefs about the situation One individual might believe This is difficult but I can deal with it while another believes This is terrible and I cant cope with it unless I have a drink Consequences are Behavioural and cognitive psychotherapies Stirling Moorey in Core Psychiatry Third Edition 2012 Recent developments in CBT Behaviour therapy was the first wave cognitive the second wave and now a resurgent form of behaviour therapy is on the scene The term third wave therapy refers to a group of therapies including dialectical behaviour therapy DBT Linehan 1993 acceptance and commitment therapy ACT Hayes et al 1999 behavioural activation BA Jacobson et al 2001 and functional analytic psychotherapy FAP Kohlenberg et al 2009 These therapies share a foundation in radical behaviourism and an interest in the function of problematic behaviours thoughts emotions and physical sensations rather than their content Hayes 2004 According to Hayes they emphasize contextual and experiential change strategies rather than direct and didactic ones Their difference from traditional second wave CBT is most obvious in their approach to cognition Rather than challenge negative thoughts patients are helped to acknowledge the thoughts without engaging with them This is done through experiential exercises ACT or mindfulness practice DBT The behavioural component of therapy may involve a functional analysis of unhelpful behaviours FAP or identifying behaviours that help you work towards your life values ACT Another feature is an emphasis on directly experiencing negative emotions without engaging in ruminations or avoidance Cuijpers et al 2006 Mindfulness based cognitive therapy MBCT Segal et al 2002 is often included in this group although it is not based on Skinnerian learning theory MBCT has been developed to treat recurrent depression It teaches mindfulness meditation a secular application of Buddhist meditation practice This develops the skill of being able to accept whatever we are experiencing in the moment without trying to fix or change it By learning to be aware of what is happening to us here and now we can make skilful choices about how we act so that we do not get caught up in depressive ruminations or unhelpful behavioural patterns MBCT is proving very popular Teasdale et al 2000 Behavior Therapy Psychological Perspectives GC Davison in International Encyclopedia of the Social Behavioral Sciences 2001 Behavior therapy has expanded from its original focus on applying the principles of classical and operant conditioning to the amelioration of psychological dysfunction and distress to an approach that encompasses cognitive processes Conditioning procedures believed to be based on classical conditioning include Wolpes systematic desensitization whereby fearful people are taught to relax during graduated exposures to imagined scenes that depict what they are needlessly anxious about Clinical outcomes from various exposurebased interventions are usually very positive Operant conditioning techniques whereby desired behavior is encouraged with rewards and undesired behavior discouraged by punishment or the withdrawal of positive reinforcers have shown their utility Foundations Graham CL Davey in Comprehensive Clinical Psychology 1998 113315 The origins of behavior therapy Behavior therapies based on conditioning principles have been shown to provide some of the most effective forms of treatment for a whole range of psychological problems cf Rachman Wilson 1980 but this begs the question of why conditioning principles were chosen to form the basis of an approach to applied human psychology In this respect it is instructive to trace the origins of behavior therapy and to pinpoint some of the events from which it developed Krasner 1971 has outlined a number of these historical factors i the early conditioning studies of J B Watson and his subsequent influence on experimental psychology ii the field of operant conditioning and in particular a seminal report by Lindsley Skinner and Solomon 1953 on conditioned barpulling in psychotics iii Wolpes development of reciprocal inhibition techniques based on the classical conditioning research of Pavlov and Hull iv the work of Eysenck and colleagues at the Maudsley Hospital UK working within a Hullian framework v Dollard and Millers 1950 attempts to interpret psychoanalysis into learning theory terms vi the development of behavioral and social learning alternatives to the traditional medical model of psychopathology and vii the failure of psychodynamic and psychoanalytic psychotherapies as indicated by internal dissatisfaction and widespread external critique In effect these historical influences can be distilled to form just three good reasons why learning theory was to provide a basis for new psychotherapies First the writings of behaviorists J B Watson and later B F Skinner 1953 were to stress a belief in the continuity of psychological mechanisms between nonhuman animals and humans If conditioning principles had been established with animals thensince humans were only quantitatively rather than qualitatively different from animals in learning abilitiesthese principles should also apply to humans Second there was a growing dissatisfaction in the late 1940s and 1950s with the medical or disease model of psychopathology This was gradually being replaced by a faulty learning account which stressed the need to treat symptoms as bona fide behavioral problems rather than mere symptoms of underlying causes Third the growing belief in the greater efficiency and usefulness of concepts derived from experimental psychology In particular that branch of experimental psychology which rested on the rubric of behaviorism was most favored primarily because the principles of behavior derived from behavioristic analyses readily suggested therapeutic action and had greater predictive power than their contemporary psychodynamic counterparts View full topic index

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O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O B I O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O O 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behavior therapy
psychological treatment