Operating Performance and Aggressive Trade Credit Management Policies

Question: Talk about the Operating Performance and Aggressive Trade Credit Policies. Answer: The money related part keeps on showing the most grounded hunger for Trade Credit, essentially for its likely capacities for data the board. Developing models could, with some refinement, in the long run apply to flexibly chain. A few flexibly chain capacities are prime possibility for Trade Credit, which could end up being a feasible answer for use cases around exchange fund, recognizability and reviews, item genuineness and savvy contracts. By and by, you can't accepting bundled Trade Credit answers for flexibly chain utilizes cases. There keeps on being a great deal of promotion, with few even in part conveyed and extremely constrained models. Just associations that are particularly chance open minded and that are early adopters of innovations ought to consider SCM Trade Credit activities throughout the following two to five years. Less hazard lenient associations ought to incidentally take an interest in exchange consortiums or instructive gatherings to study explicit Trade Credit use cases, with the objective to learn as the innovation develops. There are some recognizable early focuses for Trade Credit in flexibly chain. In any case, like the advancement of the web where unanticipated arrangements rose as the innovation developed, new and unforeseen gracefully chain use cases could rise as the innovation develops. Flexibly chain use cases may include: Tradefinance Bills of replenishing/letters of credit, exchange installments, and so forth. Multienterprise/party item recognizability e.g., track and follow, resource provenance (counting validness and following. Brilliant agreements Where contracts, or authoritative terms, between parties are put away on a Trade Credit or, in further developed use cases, legally binding code sits on the Trade Credit that independently executes under specific conditions. Brilliant agreements may help with empowering a portion of these utilization cases by means of progressively proficient/new types of agreements and agreement the board. Nonetheless, notwithstanding the innovation being an obstruction to reception, so too will be the test of getting different gatherings to receive better approaches for working together. Tradefinance is probably going to be the momentary victor for a few reasons: it is a surely known procedure (e.g., supplant letters of credit) and banks are putting intensely in Trade Credit innovation and are as of now vigorously associated with pilots. The size of exchange account terms of all out quantities of every day exchanges (not dollars) is with the end goal that it may moderate a portion of the versatility issues and worries in different territories. For instance, in worldwide exchange, upwards of 20 to 25 gatherings can contact a request from starting source to definite goal, including banks, protection, government, providers, clients, conveys, forwarders and 3PLs. Each has a job, and there are both mutual and individual guidelines that oversee their duties at different strides all the while. Today there is no successful common and changeless approach to foundationally arrange and deal with these kinds of complex multiparty understandings, yet Trade Credit can possibly do as such. In any case, the difficulties of multilateral savvy contract enablement have not been 100% sifted through, both in fact and from a negotiating prudence. Adding work process and rules to Trade Credit will be important to associate different exchanging accomplices. Each assumes its job while consenting to the overseeing rules and each revising the chain as exchanges progress. For instance, merchandise got up production line in China and taken to a port won't be stacked on a boat until specific conditions, such as having an in-power letter of credit, are met. Today, worldwide coordinations process steps are not fundamentally associated across parties. Subsequently, the bank is unconscious that the products are prepared for stacking. Along these lines, they are late in producing the letter of credit and they don't respond until somebody physically calls the bank. References: Carb?Valverde, S., Rodrguez?Fernndez, F., Udell, G. F. (2016). Exchange credit, the monetary emergency, and SME access to finance.Journal of Money, Credit and Banking,48(1), 113-143 Breza, E., Liberman, A. (2017). Monetary contracting and authoritative structure: Evidence from the guideline of exchange credit.The Journal of Finance,72(1), 291-324 Box, T., Davis, R. L., Hill, M. D., Lawrey, C. M. (2016). Working Performance and Aggressive Trade Credit Policies

Suppose Nottingham City Council imposes rent contr Essays - Economy

Assume Nottingham City Council forces lease contr Essays - Economy Assume Nottingham City Council forces lease control on all convenience leased by understudies. Utilize the market model to direct a monetary examination of the arrangement. There are three sorts of market frameworks. An order or arranged economy, a market economy and a blended economy . An order economy is one in which all asset allotment choices are taken by the administration. The legislature decid es what to deliver, how to create and for whom to deliver (A wreck 2017) . A market economy exclusively utilizes the value instrument : the powers of interest and flexibly to assign assets and a blended economy is a mix of both an order and market economy. Forcing rent control is a case of government intercession and this must be done in a blended economy where the administration steps in to address the free market. So as to force lease control on understudy convenience , Nottingham County Council should put a value roof on lease costs . A value roof is a greatest value level that must be set beneath the free market balance cost so as to be compelling. Landowners offering understudy settlement must not raise their costs over this value roof. As found in the chart, the value roof P max has been put underneath the free market harmony . The law of interest expresses that as cost expands amount requested declines and the other way around, ceteris paribus. The law of flexibly expresses that as cost builds amount provided increments and the other way around, ceteris paribus (Amess 2017) . Considerably, the value roof will bring about another and higher amount requested Q d as a more noteworthy number of understudies will currently be willing and ready to lease understudy settlement. Notwithstanding, the amount provided will tumble to Q s in light of the fact that less landowners will be willing and ready to offer their properties for lease. This will prompt a lack of understudy settlement in Nottingham which diagrammatically is the level separation between Q d and Q s . At first under free economic situations, the balance value Pe and yield Qe are Pareto effective. Pareto Efficiency happens when it is difficult to improve anybody off without exacerbating another person off (Sloman, Wride and Garratt 2015). This can be shown utilizing the Production Possibility Curve (PPC). The PPC is a portrayal of all the potential blends of two merchandise that an economy can create inside a predefined timespan with every one of its assets completely and effectively utilized (Sloman, Wride and Garratt 2015). Delivering anytime on the PPC (focuses A, B, C and D) is pareto effective in light of the fact that the entirety of the economies' current assets are in effect completely misused, creating the most extreme potential yields of both understudy settlement and buyer products. Delivering at a point underneath the PPC (point E) isn't pareto effective on the grounds that the economies' current assets are not being completely used as more prominent amounts of both buyer merchandise and understudy settlement can be created. Creation can't happen at a point past the PPC bend in light of the fact that the economy doesn't have adequate assets to deliver the ideal amounts of both understudy settlement and purchaser products. Nottingham County Council endeavors to accomplish point F, a point past the PPC, by forcing rent control which might be alluring yet is as of now unachievable. Every single other occupant of Nottingham must be aggravated off so as to improve understudies off in light of the f act that assets should be reallocated by creating less purchaser products and more understudy facilities for the new interest to be met. Accordingly, the yield cost and amount after government intercession isn't pareto productive. The short run is a timeframe in which at any rate one factor of creation is fixed. The gracefully of understudy convenience in the short run will be cost inelastic with a versatility of flexibly esteem under 1. This can be spoken to in the market model by drawing an exceptionally steep flexibly bend. Value flexibility of gracefully (PES) is a proportion of the responsiveness of interest to an adjustment in the cost of the great or administration. PES rises to the rate change in amount provided separated by the rate change in the cost of the item (Amess

Study of government backed initiatives to promote female participation in Physics and Mathematics The WritePass Journal

Investigation of government sponsored activities to advance female cooperation in Physics and Mathematics Presentation Investigation of government sponsored activities to advance female cooperation in Physics and Mathematics IntroductionReferencesRelated Presentation This article expects to investigate the UK based activities intended to advance female interest inside Science, Technology, Engineering and Mathematical (STEM) disciplines concentrating predominately on Physics. The exposition will think about the diverse showing methods and styles that have been looked into and actualized so as to bid explicitly to a female crowd and their relative accomplishment as far as urging females to seek after both advanced education in STEM based trains and professions. It is perceptible inside various records and insights that ladies in STEM based subjects are under-spoken to which has lead to a nonattendance of females effectively utilized inside STEM careers.â In 2008, ladies made up just 12.3 percent of the STEM workforce. This is, be that as it may, an expansion of 2.0 rate focuses since 2003 (Kirkup, et al., 2010. Ladies and men in science, building and innovation: the UK insights manage 2010. Bradford: the UKRC) indicating that there has been some fruitful work towards empowering females towards STEM professions. This under-portrayal is not any more clear than inside the science control of Physics, which shows the relentless issue of an absence of young ladies proceeding to consider material science past the age of 16 (material science is an obligatory piece of the GCSE educational program). It has been perceived that a critical number of young ladies in reality out perform young men at Key Stage 4 inside science, yet this isn't moved into the longing to contemplate material science into Key Stage 5 (post-16). In 2005, just 14% of young ladies who were granted an A* or A for GCSE Double Award Science or material science advanced to A level material science (Hollins et al., 2006). The Institute of Physics have discharged figures showing a gradual yearly increment in the quantity of A level material science up-and-comers somewhere in the range of 2006 and 2008 yet there has been little change in the extent of young ladies that have taken the subject post-16. In 2008, just 22% of the sections for A-level Physics were female (Institute of Physics, 2008). These measurements can be seen obviously in the informative supplement where the quantity of female passages in 2008 really represents a reduction in female take-up in contrast with 2007 of - 0.3%.â what's more, enrollment to science has remained generally stable with a bigger number of females than guys being entered for A-level assessments. Science passages for both m ale and females are moderately equivalent arithmetic despite everything sees a top-overwhelming male check, albeit less drastically than material science. There has been a broad measure of examination into the potential purposes for the reliably low quantities of females inside Physics.â The advancement of standardized instruction in England depended on standards of class and sexual orientation separation (Purvis, 1981) and numerous researchers trait existing sex culture today to their recorded roots where it was the standard for working class young ladies to embrace jobs as spouses and moms of society’s favored men of their word. Subsequently, material science, with its high scientific substance and frequently conceptual thoughts, was a subject idea appropriate just to guys with young ladies concentrating on the more emotional zones of science, for example, the ethical perspectives including religion and how science can be utilized to improve household life. Many despite everything accept undertones of this mentality exist today and keeping in mind that it is essential to perceive that in spite of the fact that ‘educati onal arrangement may change, what understudies, their folks and their educators have come to comprehend as suitable ways for young ladies and young men to be, to know and to carry on, will keep on mirroring the verifiable underlying foundations of the culture’ (Murphy,P.,Whitelegg,E .,2006).â what's more, inquire about by Alison Kelly (1987) recognizes three factors that seem to represent an absence of enthusiasm by ladies in science, specifically ladies consider it to probably be troublesome, manly, and generic. Various advanced activities and explicit instructing methods have been begat to address these misguided judgments and will be investigated, with their relative achievement studied, in the rest of the body of the exposition. Numerous activities to empower female cooperation in science attempt to address the reasons for the wonders referred to in the scholarly world as the ‘leaky pipeline’. The expression has been conceived to outline what insights plainly appear, much like a defective pipeline, ladies consistently drop out of the science instructive framework, which brings understudies in optional training through to advanced education and afterward onto a vocation in STEM. Figure 1 shows the dangers that might be experienced by ladies as of now in the science endless supply of a STEM based vocation. Figure 1: A case of The Leaky Pipeline Source: International alliance of college ladies [image online] Available at:  â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â â ifuw.org/imgs/blog/blog_leaky_pipeline.jpg [Accessed 16 April 2011]. Pell (1996) recognizes that a significant part of the determination among people has occurred even before the scholarly world is entered contending that basic stages in the choice towards a scholastic profession incorporate youth, puberty, school years and the activity section period. Pell gives advancement of confidence in early life-course, understudy instructor connection in study halls prompting lower desires among young ladies, less female good examples, and clashes with family obligations, as a portion of the purposes behind the ‘leak’ in the pipeline.â â â Blickenstaff. J (2005) contends then again that ‘no one of every a place of intensity along the pipeline has deliberately chosen to sift ladies through of the STEM stream, however the combined impact of many separate yet related elements brings about the sex awkwardness in STEM that is watched today’. Many accept the ‘leakage’ from the pipeline requires a multi-faceted arrangement, and time is expected to permit modernisations in educating and figuring out how to produce results, at exactly that point will this be clear inside the measurements frequently used to demonstrate such activities have fizzled. It very well may be addressed whether the value of such activities can so rapidly be broke down and closed as disappointments on the off chance that they have not had adequate time to advance. For instance, the expansion of young ladies deciding to contemplate material science may just observe an expansion in numbers once showing rehearses, scholastic importance of the prospectus and practical encouraging groups of people are really adjusted together and are economical. This issue has been additionally tended to by Cronin and Roger (1999) who banter the focal point of different activities meaning to unite ladies and science. They presume that a significant number of these activities are defective as they will in general spotlight on one of three zones: pulling in ladies to science, supporting ladies as of now in science, or changing science to be increasingly comprehensive of ladies and henceforth the other(s) zones are disregarded. A.Phipps (2008) reasons that the ‘important activities intended to address the issue are under-inquired about permitting little open door for instructive professionals, activists, strategy creators and researchers to investigate and gain from the practices and approaches that were created over the past decade’. Outside of the homeroom, numerous activities and associations have been set up to empower, bolster and connect with ladies inside STEM vocations. One of the most notable and long running activities, Women In Science and Engineering (WISE) was established in 1984. The point of WISE, as it is more ordinarily known, is to support the comprehension of science among little youngsters and ladies and accomplish a general effect equipped for advancing STEM based professions as both feasible and animating for ladies. Savvy convey a scope of various alternatives and activities so as to accomplish their innate methodology and straightforwardly work with different associations, where suitable, in an offer to achieve this. They give numerous assets to young ladies, instructors and parents.â These different assets and considerably more can be found on their site wisecampaign.org.uk/. It has been noticed that there is deficient work assessing the effect of WISE strategies since the association st arted. Phipps (2008) proposes that ‘although school visits by WISE had a constructive outcome on young ladies assessments of science this was not converted into long haul change in their profession ambitions’. On the other hand, WISE case that an expansion in female building graduates, from 7% in 1984 to 15% today, can be credited to the achievement of the crusade accepting that the WISE projects characteristic achievements must be estimated utilizing the extents of designing understudies and architects who are female (WISE, 2010). Until now, in any case, there has been no ahead following of members from the WISE standpoint program. This leads others to be progressively basic with Henwood (1996) guaranteeing WISE have ‘inadvertently constrained the manners by which young ladies and ladies could talk about the difficulties they faced’ and with no nitty gritty research assessing whether different activities and strategies by WISE have created the effect, it t ends to be difficult to ascribe the development to WISE without addressing whether these were an aftereffect of different components present at that point. Phipps (2008) echoes this vulnerability expressing ‘it is hard to presume that WISE arrangements have been the definitive or contributory factor in empowering female cooperation in logical careers’. The UK government is focused on curing the present circumstance helping with the dispatch, in 2004,

Bank of the Philippine Islands

BANK OF THE PHILIPPINE ISLANDS Bank of the Philippine Islands (BPI) is that nation's second-biggest bank, trailing just Metropolitan Bank ; Trust. It is additionally the Philippines' most seasoned bank and one of the most established of every Asian bank. BPI offers a full scope of business and retail money related administrations, including corporate fund administrations, resource the board, and financier and other budgetary counseling services.BPI's retail arrange incorporates in excess of 700 branches all through the Philippines, just as branches in New York, Hong Kong, and Tokyo. The bank additionally works a system of in excess of 1,200 robotized teller machines and in excess of 8,500 retailer-based retail location machines. In 1999, BPI spearheaded internet banking in the Philippines with the dispatch of online bank BPI Direct in 1999.In expansion to its financial items and administrations, BPI has additionally built up a solid non-life coverage activity, essentially under auxil iary BPI/MS Insurance Corporation. Recorded on the Philippines Stock Exchange, BPI has for quite some time been greater part constrained by Philippines combination Ayala Corporation. * pioneer in electronic banking, having presented a large portion of the firsts in the business, for example, * robotized teller machines (ATMs), * a retail location charge framework * booth banking * telephone banking web banking * versatile banking * possessed by the Ayala Corporation Business Evolution * post World War II time, BPI advanced from a simply business bank to a completely broadened general bank * achieved mostly through mergers and acquisitions in the eighties when it assimilated a venture house, a stockbrokerage organization, a renting organization, a reserve funds bank, and a retail account organization * Since the late 1990s †culminated three bank mergers * 1996 †converged with City Trust Banking Corporation 2000 * fulfilled the greatest merger then in the financial business when it converged with the previous Far East Bank ; Trust Company (FEBTC) * formalized its obtaining of three significant insurance agencies in the life, non-life and reinsurance fields * 2005 †procured and converged with Prudential Bank MERGERS April 2007 †Bank of the Philippine Islands (Europe) Plc * October 2008 †BPI, Ayala Corporation and Globe Telecom consented to a Memorandum of Arrangement to shape the country’s first portable microfinance bank * 2009 †went into a key bancassurance association with The Philippine American Life Insurance Company (Philamlife) to shape BPI-Philam Life Assurance Corp Principal Subsidiaries * BPI Family Savings Bank, Inc. * BPI Capital Corporation * BPI Leasing Corporation * BPI Direct Savings Bank * BPI International Finance Limited, Hong Kong BPI Express Remittance Corporation * Bank of the Philippine Island (Europe) Plc, * Ayala Plans, Inc. * BPI/MS1 Insurance Corporation Reasons Of merger * Jaime Augusto Zobel de Aya la, BPI’s Chairman, said the buy would encourage â€Å"enhance† the tasks of BPI with expanded or enlarged system. * New motivating force bundle by BSP as for mergers and acquisitions * BPI has been keeping watch for some great acquisitions so as to support its situation as a rising provincial monetary powerhouse. The merger apparently offers a decent key fit to BPI in entering the appealing client fragment of Prudential made for the most part out of center market business people. * With the merger, BPI will harden its situation as the country’s second biggest manage an account with joined resources totaling P456. 09 billion. * BPI hopes to pick up at any rate 200,000 new records with the obtaining. BPI and FAR EAST BANK TRUST COMPANY MERGER The larger part investors of the Bank of Philippine Islands (BPI) and Far East Bank and Trust Co. FEBTC) endorsed the merger of the two banks, making the consolidated element the tenth biggest money related organization in t he area with over $3. 5 billion in capital. The merger launch BPI/FEBTC as the nation's biggest bank, representing 14 percent of the whole financial industry's all out assets with combinedâ assets of P372. 4 billion. The combined organization will likewise have the biggest branch system of 680. BPI president Xavier Loinaz, in a meeting, said they expect the mix of the two banks to be solidified before the finish of March this year. We imagine that by end of March this year, they (merger process) would be falling into place,† Loinaz stated, when gotten some information about the merger timetable. FEBTC president Octavio Espiritu guaranteed FEBTC representatives that they will work out approaches to sift out outstanding issues with respect to the merger especially the conceivable gigantic dislodging of FEBTC staff. While they are finishing the combination, both Loinaz and Espiritu said the presentation of their individual banks in 1999 was generally â€Å"flat†. â€Å"W e haven't seen any development for the year, practically a similar level as last year.Loans are level for 1999,† Loinaz stated, including that BPI's bottomline was likewise â€Å"flat†. Something very similar with FEBTC, Espiritu said the bank's salary was down because of advances provisioning adding up to about P2 billion for the year. This year, Loinaz said they are as yet trusting that the economy will pivot. â€Å"Last year was very frustrating. We indicated a slight drop in (bottomline) the past year,† he included. Loinaz said they don't expect â€Å"too much† from the main year of merger of BPI and FEBTC.But, he educated the investor that for 2000, the professional forma anticipated income per share for the blended bank would be 5. 37 percent, 6. 31 percent in 2001 and 6. 79 percent in 2001. In view of BPI's end cost on Oct. 20, 1999, the day that the merger understanding was marked and declared, the trade proportion spoke to an inferred estimation o f P82. 50 for each FEBTC share or a suggested premium of 18 percent to FEBTC's end cost on that day. As per Loinaz, they anticipate working with DBS Bank which presently claims around 20 percent of the blended bank. DBS Bank is the second biggest bank in the locale.

The PANDAS Hypothesis and Causes of OCD

The PANDAS Hypothesis and Causes of OCD OCD Causes Print The PANDAS Hypothesis and Causes of OCD By Naveed Saleh, MD, MS twitter linkedin Naveed Saleh, MD, MS, is a medical writer and editor covering new treatments and trending health news. Learn about our editorial policy Naveed Saleh, MD, MS Medically reviewed by Medically reviewed by Daniel B. Block, MD on November 26, 2019 twitter linkedin Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Daniel B. Block, MD on November 26, 2019 Getty Images More in OCD Causes Symptoms and Diagnosis Treatment Types Living With OCD Related Conditions It may sound improbable that strep throat can be a cause of obsessive-compulsive disorder. However, for the first time, large-scale research coming out of Denmark seems to support this causal relationship. Background Bacteria are responsible for between 5 and 10 percent of sore throats. The most common bacterial agent responsible for sore throat is group A beta-hemolytic streptococci (GAS or “strep”). In 1998, researchers at the National Institute of Mental Health (NIHM) observed that some children abruptly develop obsessive-compulsive disorder, tics, and other neuropsychiatric symptoms after being infected with GAS and other types of bacteria and viruses. These symptoms are rapid onset, and peak in intensity within 24 to 48 hours. Usually, OCD begins more gradually. Furthermore, the initial presentation of OCD can be hidden for months by a child secondary to anxiety or embarrassment about irrational worries and behaviors. In the beginning, the NIMH chose to focus its initial research efforts on the association between streptococcal infection and sore throat. They came up with a working hypothesis titled Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections or PANDAS. The PANDAS hypothesis describes how infection with GABS potentially causes OCD through an autoimmune process. The PANDAS hypothesis is controversial, and for years, there was limited support for it because all the studies examining the relationship between streptococcal infection, OCD, and tics involved only small numbers of participants. However, in a May 2017 issue of JAMA Psychiatry, Orlovska and co-authors detail a large study examining the link between GASâ€"as well as other types of infectionâ€"and OCD and tics. They looked at the records of more than one million Danish children spanning 17 years.         PANDAS Diagnosis There is no laboratory test that diagnoses PANDAS. Instead, a diagnosis of PANDAS is based on a detailed history and physical examination. Here are the five criteria used to diagnose PANDAS: Presence of either OCD, tic disorder, or both.The explosion in the onset of OCD, tics, or both that occurs abruptly and can wax and wane following subsequent streptococcal infections. Subsequent exacerbations similarly present with dramatic symptoms.Onset between 3 years and 11 years (the beginning of puberty). (This criterion is arbitrary, and adolescents can rarely be diagnosed with PANDAS.)Association with the sudden onset of symptoms suggestive of other neuropsychiatric illness, including concentration difficulties, general anxiety, bed-wetting, irritability, and developmental regression.A temporal association with a streptococcal infection needs to be established by either throat culture or blood tests (i.e., elevated anti-GAS antibody titers). Sydenham chorea, which also results in rapid, involuntary movements resembling tics, must also be ruled out to diagnose PANDAS. Like PANDAS, Sydenham chorea and, more generally, rheumatic fever have autoimmune underpinnings and occur secondary to  streptococcal infection. OCD in Children Differs From Adults How Does PANDAS Occur? Genetics, development, and immunity contribute to the development of PANDAS: First, certain children seem susceptible to PANDAS, and these children may share genetic similarities with those who experience rheumatic fever and Sydenham chorea.Second, PANDAS is developmental in nature because it usually affects children who have not yet experienced puberty, with the peak age being 6 or 7.Third, as with Syndenham chorea, those with PANDAS are hypothesized to develop antibodies that attack nerve cells in the brain. Streptococcal bacteria are a hardy and primeval organism that can mimic the cellular appearance of various body tissues to evade the body’s immune system.   When GABS mimic the appearance of brain cells, antibodies to brain tissue are thought to form. These antibodies end up attacking the basal ganglia, and instead of causing Sydenham chorea, result in OCD, tics, and so forth. PANS Diagnosis Because it is often hard to pinpoint an exact temporal relationship between strep infection and OCD or tics, in 2010, clinicians and researchers expanded the classification of PANDAS so that it falls under the umbrella of Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). Instead of explicitly tying diagnosis to only streptococcal infection, PANS is more generally described by the abrupt onset of OCD and can be associated with nonstreptococcal infection, too, including influenza and varicella (chicken pox). Specifically, here are the diagnostic criteria for PANS: The abrupt and dramatic onset of OCDConcurrent presence of two additional neuropsychiatric symptoms similar to those seen in PANDASSymptoms which can’t be better explained by another neurological or motor disorder, such as Sydenham chorea, lupus, or Tourette disorder Notably, by formulating the PANS diagnosis, these clinicians and researchers hope to facilitate the diagnosis and treatment of abrupt-onset OCD. The relationship between PANDAS and PANS is analogous to the relationship between melanoma and cancer. In other words, just like melanoma is a subset of cancer, PANDAS is a subset of PANS. Of note, a diagnosis of PANS is also based on a detailed history and physical exam. Early vs Late-Onset OCD New Research Orlovska and colleagues examined Danish patient records spanning 17 (1996 to 2013) years and representing 1,067,743 children (defined as fewer than 18 years old). This study is by far the highest-powered analysis of the PANDAS hypothesis to date, and results support fundamental elements of this hypothesis. Here is a more specific breakdown of the patient records: 519,821 girls547,922 boys638,265 children received a streptococcal test349,982 had at least one positive streptococcal test The researchers found that children with a positive strep test result were more likely to exhibit mental disordersâ€"in particular, OCD and ticâ€"compared with those children without a strep test. More specifically, children with a positive strep test had an 18 percent higher risk of developing any mental disorder, a 51 percent higher risk of developing OCD, and a 35 percent higher risk of developing tic disorders. The researchers also found that children who had a nonstreptococcal throat infection (i.e., negative streptococcal test) also were at increased risk for mental disorders, OCD, and tic disorders. However, the magnitude of this risk was lower than that for streptococcal infection. The researchers found that, as defined by PANDAS criteria, children between age 3 and 11 had the greatest increased risk of OCD and tic disorders. According to the researchers, the results of the study support the PANDAS hypothesis to some extent. With regards to nonstreptococcal infection, they write the following: Our findings that the risk of mental disorders is only slightly less elevated after a nonstreptococcal throat infection than after a streptococcal infection suggest that other, possibly viral, infectious agents are also linked with the development of OCD and tic disorders. This finding might instead support the recently proposed concept of pediatric acute-onset neuropsychiatric syndrome … Pediatric acute-onset neuropsychiatric syndrome offers an alternative to PANDAS with wider diagnostic criteria; it is primarily thought to be a postinfectious condition but without restriction to streptococcal infections. PANDAS Treatment and Prevention As described in Fegin and Cherry’s Textbook of Pediatric Diseases: This proposed disorder [PANDAS] is currently a hypothesis, and it remains a controversial topic. Several authors believe in this disorder as a separate entity and recommend treatment and prophylaxis. Others argue that it is only a hypothesis and that further evidence with double-blind studies is needed before recommending treatment and prevention for children given a diagnosis of PANDAS. In other words, some experts view PANDAS (and PANS) as conjecture. Others, however, consider PANDAS diagnosis and will treat it accordingly. Recommendations Of note, the NIMH does recommend certain treatment options for those who are thought to have the condition: Children with PANDAS-related obsessive-compulsive symptoms will benefit from cognitive behavioral therapy (CBT) and/or anti-obsessional medications. Studies show that the best results are produced from the combination of CBT and an SSRI medication (such as fluoxetine, fluvoxamine, sertraline, or paroxetine). Children with PANDAS appear to be unusually sensitive to the side-effects of SSRIs and other medications, so it is important to “START LOW AND GO SLOW!!” when using these medications. By starting children on low dosages of psychotropic medications, the number and severity of negative side effects are minimized. If a child ends up experiencing negative side effects while on medication, the dosage should be decreased immediately. Of note, psychotropic medications should not be stopped abruptly because doing so could be dangerous. Antibiotics The NIMH stresses that if the strep infection is still present, the best treatment for PANDAS is antibiotics, including amoxicillin, penicillin, azithromycin, and cephalosporins. With positive throat cultures, a single course of antibiotics should be sufficient. Other measures include replacing toothbrushes and testing family members for strep to limit the risk of re-infection. Based on a small number of case reports, some clinicians treat patients who demonstrate symptoms of PANDAS with antibiotics even when streptococcal tests are negative. This practice requires further investigation. Immune-based therapies, including plasma exchange (i.e., plasmapheresis) and intravenous immunoglobulin, have also shown been used to effectively treat symptoms related to PANDAS. Steroids Steroids have also been used to treat PANDAS. However, the results of steroid treatment are mixed, with only some reports of benefit and other reports of worsening tics. Furthermore, steroids should be used only for a short period of time because they can be dangerous when used long-term. Finally, patients with PANDAS who receive steroids can experience a rebound effect which results in PANDAS symptoms that are even worse than when the steroids were started. For these reasons, steroids are usually not recommended for treatment in children who have PANDAS. Of note, sometimes a brief treatment with steroids can help clinicians gauge which patients will be responsive to plasma exchange and intravenous immunoglobulin. On a related note, the preceding treatment guidance primarily applies to PANDAS not PANS, because PANS is a newer diagnosis with no tested treatments. Nevertheless, if PANS appears to be triggered by an infectious agent, treatment of the infection may attenuate the symptoms of OCD and other neuropsychiatric symptoms. Additionally, treatments that work for PANDAS, such as immune-based therapies, as well as preventive strategies, may also be useful when treating symptoms related to PANS. In two small clinical trials, prophylactic treatment with antibioticsâ€"or treatment before the occurrence of streptococcal throat infection and PANDAS symptomsâ€"proved effective in preventing strep infections and reducing recurrences of PANDAS symptoms. Specifically, some children who previously experienced PANDAS-related symptoms several months a year experienced far fewer exacerbations once given prophylactic antibiotics. These children were treated with either penicillin or azithromycin. Analogously, treatment with prophylactic antibiotics has proven useful with other streptococcal sequelae that have autoimmune origins, such as rheumatic fever and Sydenham chorea thus providing further support for this intervention. Could Childhood OCD be an Autoimmune Disorder?

Guide to Your MBA Recommendation Letters

Go ahead, ask him for a letter! [Image source: The Office} Letters of recommendation, those sneaky devils. Despite being a critical component of the application, a lot of prospective MBAs pay little mind to obtaining their letters of recommendation. As a b-school hopeful, you might be more concerned with taking the GMAT or crafting the perfect application essay. Totally understandable, but I’m here to tell you that your letters of recommendation deserve a bit more attention than you might be giving them. While you have some measure of control over your performance on the GMAT or GRE, and you have total control over your application essays, when it comes to your recommendation letters, you’re putting your trust in someone else’s ability to vouch for you. But don’t be scared. In this post, I’ll discuss how to choose good recommenders, and how to set yourself up for the best recommendation letters, on your behalf, to the b-schools of your dreams. Choose a supervisor as one of your recommenders It’s no surprise that business schools tend to want at least one recommendation from a direct supervisor at your current position, so that they can learn about you in a professional context. Ideally, it’s someone who has worked with you for a few years and can speak to your work, your character, and your development over time on the job. If for whatever reason you don’t believe your direct supervisor will be your best advocate, consider reaching out to someone else who has overseen your work in your current job, or someone who oversaw your work in a different, recent professional context. Recommenders will often be asked questions about your strengths and weaknesses, especially compared to others working in your position. What matters here is having someone who has seen you from above and can vouch that you are responsible, teachable, and working to grow. While a current direct supervisor is the obvious logical choice, keep in mind that he or she is not the only logical choice for someone to answer these questions about you. Choose someone who can speak specifically about you Since team projects abound in b-school, it’s likely your recommender will also be faced with questions about how you work in teams, how you have demonstrated leadership potential, and how you have taken independent initiative and gone above and beyond. Think about people you’ve worked with who can answer these types of questions about you in a specific, meaningful way. Most applicants to MBA programs are hardworking, ambitious, self-motivated people. In that respect, you’re just like everyone else applying. And yet you’re nothing like everyone else applying. What makes you unique to a committee are the stories and details recommenders are able to share about you. While it’s great to have your recommenders spend the letters talking about how hard-working, ambitious, and self-motivated you are, remind them to provide specific examples to back up their endorsements of your character and accomplishments. â€Å"Important† people aren’t necessarily good recommenders Opting for recommenders based on the weight of their titles or their connections to a school is often not the best strategy. Getting a recommendation from the CEO of your company or from an acquaintance who is strongly connected to your dream school can seriously backfire. No matter how â€Å"important† these people are, if they don’t know you well, they will write you a generic letter that won’t do you justice on your application. Here’s an example to put this in context: let’s say I worked in operations at Facebook for a few years, and had a certain famous COO mentor me during my time there. If I were applying to business school, I’d want her to write as someone who knows me and my work (and she just so happens to be Sheryl Sandberg), rather than to write about me as Sheryl Sandberg (who just so happens to know me). Prioritize recommenders based on the strength of your relationship first and their objective influence second. Someone who knows you well will be able to state your case better than someone â€Å"important† who barely knows you, and has no stake in your future. Choose recommenders who can offer different perspectives Think of your letters as fraternal twins rather than identical twins, sharing similarities but not the same. Two recommenders who know you in the same context and who value the same characteristics about you are likely to tell the same stories about you. And when an admissions officer has only a short period of time to review your materials, you want to be using every precious second of their attention to give them as complete a picture as possible. Your second letter could come from a supervisor from another job, or it could be someone you worked with at the same job. It could come from a peer, from someone whom you’ve managed, or even from a satisfied client. Your second letter could also just as well come from someone outside your professional life. As long as it’s someone who knows you well enough to evaluate and write compellingly about your professional potential, you’re in good shape. Have an in-depth conversation with your recommenders If you’ve chosen well, your recommenders will be excited to write on your behalf and will want to do the best job possible. After you’ve courted your team, schedule a conversation with each recommender to talk in greater depth about your goals—for your MBA, for your career, and ultimately, for the letter itself. Different schools have different formats for recommendations. Some schools ask recommenders to rate you on a scale, some ask them to answer a few questions about how you acted in different situations on the job, and others ask for a letter explaining why they believe you’re a fit at the institution. Your recommenders might already be familiar with these formats and with applying for a MBA as a whole, but if not, this conversation is a good time to outline what they should expect as recommenders, and what types of things to write about you. Especially if you’re coming from a job where it’s less conventional for an employee to go off and get a MBA, it is critical that you give your supervisor a sense of how to approach this kind of letter. While I have no idea what my boss ultimately wrote about me for my letter of recommendation, I doubt he spent it talking about my abilities as a researcher and my proficiency in Chinese—excellent skills for a job in a China-oriented think tank, but not so relevant to the admissions committee. Help your recommenders help you. Give them all the information they need to help you shine on paper. Be honest and open with them about your reasons for wanting to get a MBA, what you want to do after school, and how you believe this degree will help you get there. Emphasize the importance of their being specific in talking about you and in taking stock of your accomplishments. Have them read drafts of your essays. Have them read this blog post! Do whatever you can to give them the very best shot in pitching your candidacy to the committee—just don’t write the actual letter for them. Show Gratitude Nobody has to help you with this process, but your recommenders kindly joined your (MB)A-team and offered their time, energy, and words to help make your dream come true. Send a note or do something thoughtful for your recommenders to thank them for their help and support. And when you get your good news, count them in for the victory party. Looking for more help with your applications to business school? Check out these other blog posts written by our business school admissions consultants in Boston and New York:Does success on the GMAT predict success in MBA classes, MBA programs:You Got In! Now What?, andAn MBA is Only as Good as Your Plans For It.If you'd like more hands-on support, feel free to reach out to Cambridge Coaching! Our business school admissions coaches will be happy to help. ;

Teen Suicide Essay - 1679 Words

â€Å"Suicide of any kind is an act in which a person takes his or her own life. FACT: Suicide is a prevalent cause of death among America’s youth today.Each and every day almost 1000 teenagers think about suicide and about 0.018% of them will be successful in committing it.† It is an ongoing problem that is often described as uncalled for immature and unnecessary. But having a deeper understanding and better knowledge are some key factors for preventing teenage suicide. This â€Å"problem† most likely start because of a state of depression, and it can be either a medical concern, or just because of a saddened point in a person’s life. Point is, suicide among adolescents is not uncommon, and it can be preventable with the proper approach and†¦show more content†¦Point is, suicide among adolescents is not uncommon, and it can be preventable with the proper approach and understanding. Suicide doesn’t just happen out of the blue, many events and warning signs lead up to the act. The medical condition of depression and suicide usually goes hand in hand. They usual experience strong feelings of stress, self-doubt, and confusion. They can also be troubled by the pressure to succeed, financial uncertainty and other fears while growing up. But according to experts, more than eighty percent of the time they are extremely depressed, and their minds are focused on the terrible emotional pain that they are currently going through.(Colman 75). In their depression, Most often dwell on what they feel is their unlucky and helpless point in life, repeatedly leading them to believe that their situation is hopeless and that the world would be better off without them. â€Å"FACT: Few suicides happen without some kind of warning. Most teenagers who have attempted or committed suicide will leave several hints and warning signs along the way. Some teens will leave hints or say things to others suitably letting them know what they are thinking about and how they are feeling. A common statement they usually make â€Å"The world will be better off without me, nobody would care anyways† or the heavy conversation about death and what it is like. Some even give away personal belongings. Others begin by saying goodbye.Show MoreRelatedAn Essay on Teen Suicide798 Words   |  4 PagesTeen suicide My essay is on teen suicide there are a lot of suicides that happen in the U.S they are caused from being bullied also it can caused by being depressed. There is also a high increase of suicides for people who take antidepressants. All this information is true based on the sites below. 1) http://www.findingdulcinea.com/news/health/September-October-08/Teen-Suicide-Rate-Worries-Mental-Health-Experts.html 2) http://articles.latimes.com/2013/oct/20/nation/la-na-nn-funeral-illinois-teen-suicide-bullying-20131020Read MoreTeen Suicide Essay605 Words   |  3 PagesDaneshia Alberty Campbell EnglishIII-7 11 February, 2011 Teen Suicide Essay Teen suicide is one of the fastest killers for young teenagers. Every year thousands of teens die in the United States. There are many different reasons of why young teens commit suicide. Family issues, low self-esteem, and bullying are three of the many leading factors towards suicide for teens. Problems at home can cause a teenager to take their lives. Abuse in the home of the teenager can most often establish aRead MoreTeen Suicide Essay881 Words   |  4 PagesTeen Suicide Suicide is a growing problem in American culture. Sadly, teens are affected the most. 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As social media become s more intertwined in young people s lives there has been an increase in teen suicide from cyber bullying. Often times young teens don t know the dangers and consequences social media can cause and makesRead MoreTeen Suicide Essay1080 Words   |  5 PagesTeen Suicide â€Å"Suicide is the third leading cause of death for young people between eleven and eighteen years of age† (â€Å"Introduction to Teen Suicide†). According to Merriam-Webster’s Collegiate Dictionary: suicide is the act or an instance of taking ones own life voluntarily and intentionally. Meaning that when someone takes their life they are fully aware of their decisions. These decisions are clouded by the rational part of the brain not maturing until the age of twenty five. Looking at thisRead MoreTeen Suicide Essay1224 Words   |  5 Pages The rates of suicides in teens have been rising more and more over the past few years; with an increase of over 300% in adolescents since the 1950s. (Miller 2009) Teens are basically crying out for our helps, but it seems that we are ignoring them. But why? Do we not care? Or do we even know what signs to be looking for? ANd average of 1,800 young people take their own lives and almost 85,000 are hospitalized for attempts (CDC, 2008). With the statistics being this high we need to take some actionRead MoreTeen Suicide Essay866 Words   |  4 PagesNydria Daniel Leslie Campos Enc1101 31 October 2017 Emotional Suicide amongst Teens Suicide has become an extremely important social issue in our society. Did you know that suicide rate is the 10th leading cause of death in the United States according to the A.F.S.P (American Foundation for Suicide Prevention)? Teen suicide rates continue to increase every year according to statistics. Today, teens are having mental struggles that can affect their everyday lifestyle and they can’t seem to find anyoneRead MoreTeen Suicide Essay1320 Words   |  6 PagesEnglish Language Arts 09 November 2017 Teen/Adult Suicides Suicides in the United States have increased in the last year has increased by 9%. The Problems With Suicide/ Percent of Deaths With Suicide In 1980 nearly 27,000 people took their own lives, making suicide the 10th most common cause of death. 57 percent of the cases of suicide in the United States involved firearms. In 2015 Suicide had been marked the second leading cause of death from ages 10-24. Suicide has been a major health problem in the