Effects of Munchausen Syndrome by Proxy | Literature Review

Effects of Munchausen Syndrome by Proxy | Literature Review What are some of the factors associated with mothers inflicting consistent harm on their children? Munchausen by proxy. A review of the literature. Introduction The literature on Mynchausens syndrome by proxy is considerable and growing at a rapid rate. Many professionals are sure that the condition exists and there appears to be an equally certain number in the non-professional sector who argue vociferously that such professionals are misguided. The purpose of this review is to determine the evidence base for the condition (Sackett, 1996). and to try to present a rational assessment of the very emotive arguments in this area. Literature review The first article that we shall consider is the book by Feldman (et al 1994) which appeared a decade ago, but is useful as it was considered by many to be the â€Å"gold standard† on the topic in its time. The book itself is written as a series of case narratives followed by a discussion on each. This is clearly instructive, but the most important seminal feature of the book is the fact that it was the first to draw a clear distinction between factitious illness and malingering. It describes the authors’ perception that factitious disorders lie along a spectrum from the benign use of illness on one extreme to the syndrome of Mynchausens syndrome by proxy at the other. It is fair to comment that, inevitably, thinking has progressed since this book was published and the basic amalgamation of factitious illness with malingering no longer finds a resonance with mainstream practice today. Malingering is defined here as â€Å"conscious manipulation for external gain such as compensation† while factitious disorder is defined as â€Å"an unconscious motivation to gain attention or control†. More modern opinion believes that many people who seek compensation after trauma are genuine, as can be their symptoms, whether they are purely physical or psychological. The more modern appreciation of the problem would consider that malingering is a conscious manipulation – and therefore not an illness, whereas the factitious disorders generally are essentially unconsciously motivated and therefore more akin to a hysterical conversion disorder and therefore a true illness. The next book to consider is a more recent publication which takes the same presentation – discussion format, as the last. This book (Gregory 2004) is remarkable as it is written by a survivor of the abuse from Mynchausens syndrome by proxy and, in our opinion, should be read by every worker in the field. It presents a remarkably perceptive insight into the mechanisms of the disorder together with a remarkable analysis of the actual resultant coping mechanisms employed by the proxy child who progressively gains both insight and resilience as she gets older and approaches adulthood. It is equally important for the consideration that the author develops for her younger siblings as she becomes aware of them being damaged in the same way. From the healthcare professional’s point of view, there are a number of truly insightful comments including: But the memories that hang heaviest are the easiest to recall. They hold in their creases the ability to change ones life, organically, forever. Even when you shake them out, theyve left permanent wrinkles in the fabric of your soul. Such books as these two are clearly inspirational and edifying, but they do not contribute to the evidence base directly. For that we must turn to the peer reviewed literature. Professors Craft and Hall (2004) have published an excellent review of the pertinent issues which looks, with a degree of concern, at the media presentation of the issues. They suggest that the presentation of Mynchausens syndrome by proxy in the media tends to both glamorise and demonise the condition in a way that is very unhelpful to the healthcare professionals working in the area. They cite tabloid phrases such as â€Å"Meadows discredited theory of Munchausen syndrome by proxy† as being truly hostile to the overriding needs of the victims. The paper itself sets out the evolution of the condition from Caffey’s 1942 paper, where the condition was described but not named, through the papers by Money and Werlwas (1976) to the present day assessment of the condition. The authors specifically consider the issues of Mynchausens syndrome by proxy in relation to severe child abuse and apparent cot death, and provide what should perhaps be considered a most authoritative resume on the issue. In terms of specific psychopathology we can turn to papers such as the one by Eminson D (et al 2000) who suggest that the perpetrators have an increased incidence of personality disorder or, more rarely a psychotic illness. Firstman R (et al 1998) point to the fact that women who suffer from the condition tend to have reported a number of â€Å"fantasies, obsessions and anxieties† regarding their babies which typically focus on their perceived inability to care adequately for them. Golden M (et al. 2003) adds the observation that many of these fantasies include the worry that the mother may actually harm the child together with the observation that there is an associated increase in the incidence of Post natal depression in these cases. References Caffey 1942,  quoted in Royal College of Paediatrics and Child Health.  Fabricated or induced illness by carers.  London: RCPCH, 2002. Craft AW and D M B Hall 2004 Munchausen syndrome by proxy and sudden infant death BMJ, May 2004; 328: 1309 1312 ; Eminson DM, Postlethwaite RJ. 2000  Munchausen syndrome by proxy abuse: a practical approach.  Oxford: Butterworth Heinemann, 2000. Feldman MD, Ford C, Reinhold T 1994  Patient or Pretender: Inside the Strange World of Factitious Disorders  London: Wiley, ISBN 0-471-58080-5 Firstman R, Talan J. 1998  The death of innocents.  New York: Bantam, 1998. Golden MH, Samuels MP, Southall DP. 2003  How to distinguish between neglect and deprivational abuse.  Arch Dis Child 2003;88: 105-7. Gregory J 2004  Sickened: The True Story of a Lost Childhood  London: Century books ISBN 1 844 13442 3 Money and Werlwas (1976)  Quoted in Fisher G, Mitchell I.  Is Munchausen syndrome by proxy really a syndrome?  Arch Dis Child 1995;72: 530-4. Sackett, (1996).  Doing the Right Thing Right: Is Evidence-Based Medicine the Answer?  Ann Intern Med, Jul 1996; 127: 91 94. 7.12.05 PDG Word count 1,083  

Electoral Systems :: essays research papers fc

From my limited studies of comparative government I have come to the conclusion that a plurality type of electoral process where winner takes all is a superior compared to proportional representation for several key reasons. Proportional representation is based on having an election based on census instead of consensus. In other words, ask the masses which party they feel will do the best job on a ticket where there may be several political parties running which intern will select its own leader from a list based on an individual's faithfulness to the party. The pros of proportional representation includes increase voter turnout based on the premise that every vote counts for a particular party, so you may not get all of the representation as in the plurality, but you may get some representation, so it gives more choices to the voter. Proportional representation would increase the amount of women in office because they make up 50 percent of the population, and this form of election would decrease the amount of negative campaigning, because the competition shift from all or nothing to all or something (http://www.britannica.com/bcom/eb/article/6/0,5716,63126+1+61565,00.html). An example of this would be if a politician gets 51% of the vote, this would garner 100% of the representation. There is no reason for a political party with less then 45% of the vote to make an effort as a party. Why spend the money?   Ã‚  Ã‚  Ã‚  Ã‚  Plurality on the other hand is a vote of consensus rather then census in other words, the party with the most votes will be elected. It's easy to understand by voters, allows quick decisions and it is less costly to run. The only significant drawbacks include low voter turnout and the party that has the less amount of voters usually gets removed, so the winner takes all. The drawback to this is there may not be significant representation among the masses, but at least there is a constraint in the number of parties (http://www.ask.com/main/metaanswer.asp?metaEngine=directhit&origin.html). Plurality is ideal for us Americans who are accustomed to a simple yuppie lifestyle with the most complicated decision in our daily existence is what will eat for dinner.

Disability in Sports

Sports for persons with disabilities are described using the disability element and not using the sporting/athlete element as is usually common in traditional sports. For example, in a sporting activity like volleyball there may be more than one team for the same gender and age category due to the different divisions created to cater for the varied degrees of disabilities. Even so, this does not mean that sports for persons with disabilities are inferior to those practiced by their counterparts without disabilities.In fact, the core tasks of organization, management, officiating, competing, and development of the sports for persons with disability are more or less similar to those carried out in their colleagues without disabilities. They are all run by international bodies that do similar tasks of identifying, nurturing, funding, and developing talent just as in the case with traditional sports. For example, the management of the game of Tennis for persons with disabilities sport is carried out by the International Tennis Federation.Persons with disabilities are accorded equal opportunities to compete at the international level during major global sporting meetings. For instance, the â€Å"Paralympics Game, Special Olympics World Games, and the Deaflympics Games† (p. 136) are the three major global sporting events that brings together competitors from all parts of the world. Again, sports for persons with disabilities are organized into summer and winter to allow for proper preparation as well as not to coincide with other global events.Basically, the underlying idea on sports for persons with disabilities, particularly the global tournaments is to explore the various abilities and reward them. The Paralympics Games are generally meant for professional athletes with one or multiple disabilities to compete. Disabilities here can be taken to include cerebral palsy, amputation, visual impairment, and dwarfs among other types of disabilities. On the other h and, Special Olympics form a relatively smaller outing for persons with disabilities.This event covers a wide range of disabilities that touches on cognitive and developmental with the main aim being not to compete for winning wards but to just to take part in the event. Generally, the rules applied here are more or less similar to those applied in traditional sports with minor modifications made to cater for specific disabilities. Deaflympics Games are more or less similar to the Paralympics only that they specifically deal with Deaf athletes.Perhaps another very important aspect of disability sports is the coaching part of it. Given their physically challenged nature, persons with disability may find it very hard committing themselves to sports. In this regard coaches working with persons with disabilities should be highly qualified and most importantly motivated individuals capable of providing both sport-specific training as well as psychological mindset to the athletes.Unfortun ately, this is not always the case with many athletes – some do not have access to coaching facilities while others access ill-prepared coaches who end up not helping them. Essentially, coaches should be professionally trained people, probably retired disability sports athletes who can understand and diagnose varied remedies for disability sports athletes. Ideally, they should be very listening so as to notice any change in attitudes among their trainees and make the necessary adjustments in training.They should also liaise with the necessary medical practitioners to have the disabilities checked to avoid cases of strain or even under training. Most importantly, they should complement disability sports-specific training styles with other traditional coaching methods such as use of video tapes for comparative purposes. Due to the bulging number of athletes with disabilities venturing into sports, there has been notable increase in demand for disability sports medicine and trea tment.Essentially, the overall fitness of athletes with disabilities is greatly determined by the nature of training they undertake as well as the medicine or treatment they undergo. Moreover, some of the disabilities demands require careful medical checkups to diagnose any potential health lapses, to prevent future infection and injury, as well as to give overall body care. Such medication should be closely linked to normal training particularly to the affected body parts.Athletes with disabilities require a great deal of equipments to perform to their optimum. Apart from the normal sports equipments utilized in traditional sports, disability sports require complex and expensive activity-specific equipments without which the activity cannot take place. Amputees taking part in wheelchair basketball may be hindered greatly due to the poor nature of their wheelchairs. Perhaps, this is one of the few areas that bring out the huge difference between traditional and disability sports.Wit h the proliferation of technological innovations, disability sports has been greatly enhanced as new, reliable, and efficient activity-specific equipments are now available. Organizing disability sports involves more or less the usual procedures involved in traditional sport. Basically, the tenets of event management are employed in making disability sports events a success. The whole process is done under the stewardship of the democratically elected management boards, depending on the type of sport being held as well as whether the event is being held at a national or even international level.It involves the forming of planning and organizing committees that are charged with the responsibilities of focusing on critical issues such as booking and preparation of fields to suit the various disability sports activities. Again, the committees’ makes accommodation and transport arrangements, preparation of sport facilities such as fields, courts etc, and coordinates security team s particularly in this era of global terrorism, and works closely with the media people.

Essay on Procter Gamble Rely Tampons Case Study

Abstract The purpose of this research paper is that to present the difficulties Procter amp; Gamble faced in the early 1980 ¡Ã‚ ¦s due to a correlation between the company ¡Ã‚ ¦s Rely tampon and the disease Toxic Shock Syndrome (TSS). Also, how the company handled the findings before and after new laws were passed by Congress giving the Food and Drug Administration (FDA) the authority to regulate medical devices, which included tampons. Thereafter, I will analyze the ethical issues relevant to this case within a SWOT analysis. Introduction Corporate Social Responsibility (CSR) is about how companies manage their business processes to produce a positive impact on society. Companies introduce new products in markets, usually after testing†¦show more content†¦Throughout Procter amp; Gamble ¡Ã‚ ¦s history and development, the company has grown to be divided into five business segments: healthcare, beauty care, baby and family care, snacks and beverages and fabric and home care. The company ¡Ã‚ ¦s headquarters are located in Cincinnati, Ohio and employs around 110,000 people in nearly 80 countries and markets over 300 products worldwide with a net income of $5.66 billion. Company Background Procter amp; Gamble ¡Ã‚ ¦s major competitors begun marketing tampons as early as the 1930 ¡Ã‚ ¦s. In 1972 a ban to advertise sanitary products on television was lifted. Seeing this and the preference of women to use tampons, thus becoming a highly competitive market, Pamp;G decides to enter this market in the early 1970 ¡Ã‚ ¦s. Enters the Rely tampon. By 1980, this tampon had acquired 20% of the market. In January 1980, twelve (12) cases of TSS were reported to the federal Centers for Disease Control (CDC). TSS begins suddenly, its symptoms are vomiting, high fever, rapid drop in blood pressure, diarrhea, headache, sore throat and muscle aches. After 24 hours a rash appears which is sunburn like. On days 3 and 4 of the disease, broken blood vessels appear in the skin, along with confusion, fatigue and weakness and weak and rapid pulse. The disease can cause kidney dysfunction, liver failure, can be deadly and needs immediate treatment (Klein, 2004). TSS was firstShow MoreRelate dProcter Gamble Rely Tampons Case Study2383 Words   |  10 Pagespaper is that to present the difficulties Procter Gamble faced in the early 1980 ¡Ã‚ ¦s due to a correlation between the company ¡Ã‚ ¦s Rely tampon and the disease Toxic Shock Syndrome (TSS). Also, how the company handled the findings before and after new laws were passed by Congress giving the Food and Drug Administration (FDA) the authority to regulate medical devices, which included tampons. Thereafter, I will analyze the ethical issues relevant to this case within a SWOT analysis. 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