Posted: 25 Jul 2010 11:27 AM PDT

After a bout with a sore throat, nine-year old Jason started to cling to his parents and obsess over noises outside his bedroom window. He was sure that there were robbers outside that would break through and harm him and his family. Jason said he knew his fears weren't "real," but still refused to sleep in his own room unless his parents helped him perform an elaborate ritual - checking under the bed, in the closet and other places to make sure he was safe. The symptoms started suddenly and then subsided gradually over the ensuing weeks. Jason seemed to be over the problem, but he developed the same symptoms again several months later, following a bout of the flu.

Eight year old Jessica thought monsters would emerge from the bathroom pipes to take her away from her parents. She resisted taking baths and complained about going to school. Abruptly, she began to twirl and pull at her hair, and display facial tics, so much so that her teachers recommended a psychologist. These behaviors emerged suddenly after a course of strep throat.

Given these symptoms, many parents would consider counseling for their children. Such obsessions and/or compulsions are observed in about 1% of children of elementary school age and often bring kids into the counselor's office. However, in some cases, physicians determine that the symptoms stem from an unlikely source - the aftermath of an untreated strep throat infection. Doctors are tipped off by how suddenly the behaviors came about, and by how closely they show up in connection with a strep infection. These children may be suffering from a little-known disorder called PANDAS or Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococci.

Dr. Susan Swedo is the National Institute of Mental Health physician and researcher who is credited with the discovery of PANDAS. She says, "These children explode with symptoms before they come into the physician's office. Typically, the OCD symptoms and movement disorder symptoms don't come by themselves." In addition to obsessions, compulsions and tics, children affected by this autoimmune disorder also display attachment fears, deficits of attention and a host of other behavioral symptoms, including irritability and excessive mood swings.

Dr. Swedo, who is also Chief of the Pediatrics and Developmental Neuropsychiatry Branch noted, "We get reports of children who had no problems separating from parents who now need to follow them everywhere they go. For example, one 11 year old boy begged to sleep with his parents because he feared something might happen to him."

What is PANDAS?

The course of PANDAS is often confusing since there is little warning or predictability to the behaviors. No one knows the prevalence of PANDAS but for families affected by it, the disorder can become all consuming. What separates PANDAS from non-strep related psychiatric symptoms is the sudden and abrupt emergence of the symptoms. Without warning or prior history of psychiatric illness, children become fearful, obsessed with danger, develop compulsions or other movement disorders. A typical pattern is for a pre-pubertal child to experience strep throat and then within several days of the occurrence of the bacterial illness, the child changes dramatically. Normally happy, sunny children often develop worries, obsessions and/or extreme mood swings. They may refuse to leave the room where a parent is. Children who previously had no problems going to bed will throw tantrums to get a parent to stay in the room or will repeatedly crawl into bed with parents.

The behavioral symptoms usually persist for several days to weeks. The tics or OCD then seem to go away, and the children often enjoy a few weeks or several months without problems. However, for reasons described below, these children remain vulnerable to relapses.

How Does Strep Lead to Psychiatric Symptoms?

The discovery of PANDAS came through observing the reactions of patients. Initially, Swedo's team noticed a group of patients who were ill with infections and then suddenly developed dramatic psychiatric symptoms. At first, they were not sure streptococcus was the culprit but research soon isolated the strep antibodies as an important focus of interest.

PANDAS is controversial in medical circles with some physicians questioning whether such extreme psychiatric symptoms can be triggered by strep antibodies. However, according to Dr. Swedo, there is little doubt that the body's efforts to fight the strep bacteria set off a chain of events leading to PANDAS symptoms. "The science is clear now," Swedo asserts. "We not only have a direct relationship between the anti-strep antibodies and the anti-neuronal antibodies, but also have demonstrated that the antibodies interact with receptors in the brain that could produce the symptoms observed."

Normally when the strep bacteria enter the body, they defend themselves by mimicking healthy cells and elude detection by the immune system. Using the stealth strategy, the strep bacteria create an infection. In response, the body naturally creates antibodies - cellular components designed to find the bacteria, bind with them and direct the immune system to destroy the bacteria. When this happens as designed, the antibodies find the strep bacteria and the immune system wins the battle.

However, antibodies are not terribly discriminating and sometimes cannot tell a streptococcus bacterium apart from a healthy cell. In some children, these antibodies pass into the brain and look for something to connect with. In PANDAS, the strep antibodies are unable to discriminate between strep and healthy brain cells. However, the union of strep antibody and neural tissue is not a match made in heaven. Recent research, reported last fall by University of Oklahoma researcher, Madeleine Cunningham, suggests that the antibodies connect with parts of the brain which regulate repetitive behaviors and movement, such as compulsions and tics. According to Dr. Swedo, such autoimmune actions may have the direct result of producing obsessions, compulsions and tics; and in addition, they might indirectly offset the critical balance of brain chemistry which regulates mood and emotion.

Compounding the problem is the durability of strep antibodies. They can remain on the prowl for a hook up weeks after the strep is gone. Subsequent infections or even colds can stimulate the immune system to produce more of the same kind of antibodies which the triggered the original symptoms. PANDAS children can then abruptly re-experience the same symptoms after a symptom-free span of time. Dr. Swedo explained, "We see a saw-toothed pattern of symptoms, extreme outbursts of behaviors for a brief period in response to the infections and then the child may be relatively symptom-free for a period of time."

What can parents do?

The primary advice for parents is to treat strep throats promptly. This means a visit to the primary care provider at the first signs of strep throat. Symptoms of strep throat include:

Severe and sudden sore throat without coughing, sneezing, or other cold symptoms,
pain or difficulty with swallowing,
high fever,
swollen lymph nodes in the neck,
white or yellow spots or coating on the throat and tonsils,
bright red throat or dark red spots on the roof of the mouth at the back near the throat and/or swollen tonsils, although this symptom may also be caused by a viral infection.
Vomiting without diarrhea, headache and other nonspecific signs of illness can also signal a strep infection.

Some children dislike having a throat culture done and will deny that they are in pain, rather than risk getting "the swab." However, for reasons other than PANDAS (e.g., rheumatic fever), it is important to investigate and treat these symptoms promptly. For some children, the sudden PANDAS behavioral changes are the tipoff that an otherwise unclear symptom picture is really strep throat. Thus, any sudden changes in behavior should involve a trip to the pediatrician to rule out a biological trigger.

While it is tempting to keep children who are vulnerable to post-strep behavioral symptoms on antibiotics, this is not the preferred course. The antibodies themselves are not altered by antibiotic medication and so, antibiotics cannot shorten the course of obsessions, compulsions or tics. For severe cases, parents and physicians might consider using immunoglobulin treatment (IVIG) or plasmapheresis. IVIG administration produces a vigorous immune response that appears to counteract the PANDAS symptoms. Plasmapheresis cleans the strep antibodies (and others) from the blood via plasma exchange. These interventions are considered experimental and are not without side-effects. In addition, they are expensive and insurance companies often won't pay for this "off-label" use of the treatments. However, for extremely symptomatic children, the procedure may offer relief.

Psychological counseling can also be helpful as means of helping both parents and child understand the condition. Since there are no traumas to uncover, cognitively based counseling which focuses on helping children better understand and reframe their obsessions and fears is most helpful.

Parents might also consider calling a regional medical school or facility to find out if any PANDAS research studies are underway. For example, Children's Hospital in Pittsburgh currently has an open study (http://www.chp.edu/CHP/PANDAS) and can provide up to date information on treatment.

The National Institute of Health provides up to date information on PANDAS and a helpful Q & A on this website: http://intramural.nimh.nih.gov/pdn/web.htm.

.........

Warren Throckmorton, PhD is Associate Professor of Psychology and Fellow for Psychology and Public Policy at the Center for Vision and Values at Grove City College (PA). His personal blog is at www.wthrockmorton.com.

Originally published in March 2009 Christian Post

Five Filters featured article: Headshot - Propaganda, State Religion and the Attack On the Gaza Peace Flotilla. Available tools: PDF Newspaper, Full Text RSS, Term Extraction.

Crime & Place

Posted: 25 Jul 2010 02:56 PM PDT

Mastan Mirza tried every trick in the book to undo his past. After his 18-month incarceration during the Emergency, which debilitated the once notorious smuggler, he surrendered in the presence of revolutionary leader Jayaprakash Narain. Subsequently he performed Haj, wrapped himself in a cloak of piety and got a more respectable name, Haji Mastan. But despite this, and despite his other famed sobriquets like friend of the poor, Mumbai's Robin Hood and kind-hearted Muslim patriarch, Haji Mastan could never wash away the infamy that accompanied his meteoric rise. That infamy hounds him even in death.

Mastan's adopted son Sunder Shekhar will soon approach the Bombay high court to mitigate some of this notoriety by trying to stall the release of Once Upon A Time in Mumbai—a film which reportedly paints Mastan as an underworld don. Nagpada, an area near which Mastan began in Mumbai, must undoubtedly figure in the movie—as it does in a recent academic work which revisits city localities that bred smugglers, dons and criminals. Abdul Shaban's Mumbai: Political Economy Of Crime And Space provides a ready reckoner—and a perspective—to understand why some minority-concentrated corners in the city became what scholars refer to as "delinquency areas or hot spots of crime". Shaban, who teaches Developmental Studies at the Tata Institute of Social Sciences (TISS), especially dissects the psychology of Nagpada, the area which produced the maximum number of dons and their underlings.

Shaban's study frequently mentions the area which stretches from Temkar Street to Maulana Azad Road in Nagpada. "The area produced gangsters like Karim Lala, Dawood Ibrahim, Yusuf Patel, Chhota Shakeel, Alamzeb, Ameerzada, Ahmed Kashmiri and Asif Baatla while the adjoining Agripada houses Dagdi Chawl, Arun Gawli's den," says 38-year-old Shaban, who spent weeks roaming the streets conversing with locals. In this crime hotspot, three generations live in single, tiny rooms where privacy is a privilege. Outside the tenements, in narrow lanes and bylanes, drug dealers, pimps and prostitutes prowl as cops look away.

"Before the Mumbai police started cracking down on organised crime post the 1993 serial blasts, people in the delinquency areas trusted the dadas or bhais (goons) more than the cops," explains Shaban who hails from Gonda (UP) and has studied at various institutions, including AMU, JNU and IIT-Powai before he landed at TISS.

During the British era, Nagpada, Pydhonie and Dongri became enclaves of Muslim merchants and over the years turned into Muslim ghettos as migrants began to settle there. Their numerical strength in these areas provided the Muslims with a certain psychological comfort, writes the scholar. He maps the ghetto's psychology: in the absence of trust in the police, the community depends on criminals, and some even harbour them and look upon them as role models. Criminalisation, Shaban says, is a byproduct of ghettoisation and a feeling that institutions of the State like the police are a community's enemy, which leads inhabitants of the ghetto to hold hardened criminals in high esteem.

Shaban maintains that Shekhar's protest against Once Upon A Time In Mumbai is misplaced and unwarranted. "A son is bound to find any negative depiction of his parents malicious," he says. "But even if Haji Mastan might never have fired a shot at anyone, he presided over a culture which incubated notorious criminals." Indeed, Mastan—who was a coolie at the Bombay Docks before he endeared himself to corrupt officers, bypassed laws, and smuggled gold, silver and electronic goods—was very friendly with dons like Karim Lala and Varadarajan Mudaliar, on account of which the rich and powerful hobnobbed with him.

A senior Urdu journalist, who would regularly meet Mastan, concurs. "Does Shekhar want the world to call Haji Mastan a saint?" he asks.

"Don't forget that Mastan had friends across the social spectrum, from film stars to politicians to the underworld. Karim Lala was one of these, and among those who benefited from Lala's tutelage was Dawood Ibrahim." Many also recall Mastan's benevolence, his help to the poor who queued up every morning outside Baitul Surur, his palatial bungalow on plush Warden Road. But, they say, that does not negate the criminality he practised, encouraged and condoned.

Shaban compares the landscape of Nagpada, on which Mastan banked a lot after he launched his outfit Dalit-Muslim Suraksha Mahasangh, with that of Five Oaks in Ohio (USA). In the 1970s and 1980s, he writes, Five Oaks (with a heavy concentration of African-Americans) was infested with crime where pimps and prostitutes, drug dealers and local goons abounded.

Then in 1990s Five Oaks was redesigned, street layouts were altered and mini-neighbourhoods created which led to a sharp drop in crime in the area.

Almost a similar plan for Mohammed Ali Road and adjoining Nagpada, dreamed up by Dawoodi Bohra entrepreneurs, is in the pipeline. Perhaps the image of the city's crime hot spots too could change in future.

Five Filters featured article: Headshot - Propaganda, State Religion and the Attack On the Gaza Peace Flotilla. Available tools: PDF Newspaper, Full Text RSS, Term Extraction.

Experts discuss the government's growing intelligence network: Is it too big?

Posted: 24 Jul 2010 09:00 PM PDT

There are corporations as large and complex as our intelligence system that are very well managed. The problem is not size, but clear lines of authority, which are spectacularly missing in the intelligence community.

The 9/11 Commission's central recommendation was the creation of a Directorate of National Intelligence with wide authority over the entire community, including those elements in the Department of Defense and including budget authority.

The Senate pretty much agreed, but the House balked, as the Post story pointed out. The result was the creation of a directorate that simply added another layer of complexity to an already too complex system.

If the DNI had the authority of an efficient corporation's chief executive, intelligence gathering would be more efficient, shared better, and the budget and number of personnel could be reduced by 25 percent.

Former U.S. congressman Mickey Edwards is vice president of the Aspen Institute.

While it may sometimes seem as though organizations take on a life of their own -- spawning spinoffs, manufacturing redundancies, building layers and walls that are permeable when they shouldn't be and impermeable when flow is required, all of it a spawn of HAL, the malevolent computer -- the truth is somewhat more pedestrian: When that happens, management's focus is too narrow.

Managing an organization's structure to ensure that it functions properly is no less a managerial imperative than the ability to imagine a sleeker hood ornament or stickier tape. Creativity is great fun but real managing requires a lot of i-dotting and t-crossing. In building an organization, sometimes an axe is as important a tool as glue.

A Reagan-era ambassador and arms control director, Ken Adelman is co-founder and vice president of Movers and Shakespeares, which offers executive training and leadership development.

It's not primarily the size of the sprawling intelligence network that makes it flawed, though that's surely a problem; anything that big can't work all that well. But two other factors lead to expectation-inflation and the resulting feeling that the intelligence community doesn't yield results, i.e. to warn us of future threats.

First, many threats simply aren't predictable. There's a distinction between a mystery and a secret. Mysteries are inherently uncertain, not factual at all, often because they're uncertain to the actors themselves.

During the Reagan administration, we looked to the intelligence community to tell us what Mikhail Gorbachev would do and, more generally, what he had in mind. Well, that turned out to be less a secret than a mystery. Gorbachev himself didn't know what he'd do -- that depended on so many factors (themselves mostly mysteries). And what he had in mind one minute differed from that which sprang into his fertile mind the next.

Five Filters featured article: Headshot - Propaganda, State Religion and the Attack On the Gaza Peace Flotilla. Available tools: PDF Newspaper, Full Text RSS, Term Extraction.

2. The psychology of spending

Posted: 23 Jul 2010 04:56 PM PDT

IN a perfect world, we would avoid too much debt and would never have to deal with the desperation of being unable to meet our debt obligations. But this isn't a perfect world and, unfortunately, these distressing situations are the norm for many people.

According to the Credit Counselling and Debt Management Agency (AKPK), as at June 30, close to 126,292 people had sought AKPK's free debt counselling services and, of that total, 45,336 had taken advantage of the agency's Debt Management Programme (DMP).

Almost 38% of the DMP cases involve individuals whose annual salaries are below RM24,000, while another 32% earn salaries of between RM24,000 and RM36,000 a year.

The top reasons for default or difficulty in servicing the debts are high medical costs (26% of the cases), poor financial planning (25%) and lack of self-control when using personal credit cards (15%).

When the DMP cases are broken down by regions, Kuala Lumpur has by far the highest number of cases, with 56%. Johor Baru is second, but that's under 13%.

Maybe people in Kuala Lumpur are not earning enough to enjoy their urban lifestyle, or the cost of living is a lot higher than those of other states. Or, simply, Kuala Lumpur has so many choices and fun attractions to spend our money on. One can only assume.

Our urban lifestyle needs and wants can be based on personal reasons and often are due to external factors and influences such as family, friends and advertising. Given the nature of these factors and influences, we often find it difficult to differentiate between the needs and wants that are created for us and those that we genuinely require. This has an impact on our spending decisions.

Regardless of gender, we all have some compulsion to spend. Studies show that people with self-esteem issues engage in more impulse spending, thus buying things they don't really need. When "convenience" becomes an integral part of our urban lifestyle, almost like a "need" for us, we will spend money to enjoy convenience. We are willing to pay more for services like eating out, shopping at supermarkets or in-home maid services. The list goes on.

Studies also show that most people are much less likely to buy, or less willing to spend as much, when paying with cash as opposed to credit cards. This is because of the ease that card payment offers.

Also, using debit cards may not necessarily be wise if the person quickly depletes the savings account to which the debit card is linked.

And having the convenience of credit cards to pay for our needs and wants can compound our spending problems when our credit card limits are higher than our monthly salary.

Another problem is the lack of financial knowledge among the general population. Many do not fully realise the compounding effect of interest charges when credit card debts are not fully settled.

Unless we seek professional financial planning advice or attend financial education talks and briefings, such as the initiatives provided by AKPK, we may be forever stuck in the "debt trap."

More importantly, if overspending is psychologically influenced, then we need to analyse the root causes of the overspending problem. How did you get too deeply into debt? Why did you keep charging items you couldn't afford? Why did you feel the urge to use those little plastic cards for things that weren't necessary, even when you began to struggle to make the payments? What causes your compulsive spending?

Spend time to find answers to these questions, and seek professional financial coaching or counselling, if necessary.

Have the determination to solve these problems and you will increase your chances of achieving debt-free status.

·The writer is a personal financial coach and also founder and CEO of Abacus for Money

Five Filters featured article: Headshot - Propaganda, State Religion and the Attack On the Gaza Peace Flotilla. Available tools: PDF Newspaper, Full Text RSS, Term Extraction.

Psychology

Sunday, July 25, 2010

“Christian Living Resources, Bible Study Tools, Jesus Christ” plus 3 more

“Christian Living Resources, Bible Study Tools, Jesus Christ” plus 3 more

No comments:

Post a Comment

Popular Posts