Sunday, January 26, 2020

Schizophrenia: Risk Factors, Cognition and Structure

Schizophrenia: Risk Factors, Cognition and Structure John Rogers Schizophrenia: a review of risk factors, cognitive deficits, structural and function abnormalities. Introduction Occurring in about 1% of the world’s population, schizophrenia is a disorder of abnormal cognition encompassing oddities in perception, thinking, attention, learning, inhibition, memory, manner relating to and others (Cunningham Peters, 2014). Traditionally, schizophrenia has been broken down into several subtypes depending on the symptomology expressed (e.g. paranoid, disorganized, schizoaffective, catatonic). The symptomology of the disease is subdivided into both positive and negative classifications, as well as cognitive deficits. Positive symptoms implicated in the disease include delusion, hallucination, disorganized speech or clang associations, whereas negative symptoms include emotional flattening, asociality, anhedonia or avolition (Butcher, 2010).      This essay has four main aims. Firstly, while a definitive cause of schizophrenia still eludes us, an abundance of research has identified a wide array of biological and psychosocial risk factors and these aetiological factors will be outlined. Secondly, cognitive deficits associated with the disorder will be outlined. This section will highlight the widespread variety of cognitive deficits presented in patients and discuss some of the batteries of cognitive tests developed in assessing the extent of these shortfalls. Subsequently the structural abnormalities associated with the disease will be briefly revised, along with some of the confines of structural studies. Additionally the essay aims explore whether schizophrenia is a progressive disorder or solely a disorder of neurodevelopment based on structural analysis. Prior to concluding, the essay will review some findings from fMRI studies investigating the functional connectivity within the schizophrenic brain and how they relate to both the positive and negative symptoms presented in the illness. Furthermore, the limitations of fMRI studies, born out of a lack of precision of hemodynamic response measurements will be highlighted by analysing the results of an experiment examining activation during a working memory task. Aetiology The aetiology of schizophrenia is complex and cannot be reduced down to a single causal factor. This is evident when we consider the subtypes and indeed individual cases of the illness deviate massively in their presentation, responsiveness to treatment and illness trajectory (Moore, Kelleher Corvin, 2011). An abundance of research into the cause of the disorder suggests that a combination of predispositional physiological factors and a multitude of environmental risk factors result in brain pathways developing abnormally. Schizophrenia is a polygenic disease and thus cannot be explained by one mutated gene. Eyles, Feldon Meyer (2012) have identified 40 genes implicated in the development of the disease, signifying that it is a cocktail within a certain genotype that confers susceptibility to the illness. A study by Tinari et al. (2004) found that the genotype for higher risk in the illness only resulted in schizophrenia when an individual grew up in a dysfunctional vs. heathy family, suggesting that while biology provides the tinder, environment produces the spark. The dopamine hypothesis has stood out as the more proficient biological theory to date in investigating the causes of schizophrenia. While originally thought to be a functional excess of dopamine, research has indicated that it is actually increased receptor density and sensitivity, (particularly super-sensitivity at the D2 receptors; Wong et al. 1986) that may contribute to susceptibility of the disease (Butcher, 2010). Other successful biologically based studies into the aetiology of schizophrenia include the glutamate hypothesis, hormone studies and twin hereditary studies (see Cunningham Peters for review, 2014). Although the aforementioned studies and approaches are useful in understanding the illness, they all share a common limitation; they each ignore the environmental and developmental factors that may contribute more to the onset of the illness than genetics (Bagby Juhasz, 2013). Cannabis use has been closely related to the onset of schizophrenia, with young males who use being at significantly greater risk of developing the illness (Zammit et al., 2002). Moreover, 75% of individuals presenting with first-episode psychosis use the drug regularly (Archie et al., 2007) although some believe the correlation with high usage rates is due to self-medication (D’souza et al., 2005). Other well documented psychosocial risk factors include urban living, immigration, childhood experiences of trauma or neglect and immunological factors (for review see Cunningham and Peters, 2014) Cognitive deficits About 60-80% of schizophrenic patients display cognitive deficits (Lewis, 2004) across a multitude of domains including; attention, memory, processing speed, social cognition, reasoning and verbal learning (Keefe Harvey, 2012; Green et al. 2004). A study by Keefe et al., (2005) found that 98% of patients perform more poorly on cognitive tests than would be predicted by their parent’s education level. Additionally, a collection of studies have shown that cognitive impairment can reach two standard deviations below a healthy control mean (for review see Keefe Harvey, 2012). The MATRICS (measurement and treatment research in cognition in schizophrenia; Green et al., 2004) project has developed a battery of ten tests (MATRICS Consensus Cognitive battery; MCCB) in order to access cognitive functioning across these domains (see fig. 1) Fig 1. Shows the severity and profile of cognitive impairment in patients using the MCCB (Keefe et al. 2011a) This spread of cognitive deficits manifest itself across numerous domains from social to financial and occupational. For example, poor attention or attentive vigilance may result in an individual being unable to follow instructions or concentrate on a task in an occupational setting, or follow individual or group conversations in a social setting. Furthermore, schizophrenic individuals experience deficits in social cognition that create further difficulty within these settings such as theory-of-mind task performance (Tan et al., 2005) and perception of negative emotions, fear and facial affect in others (Penn et al, 1997). Research suggests that some of the cognitive deficits implicated in schizophrenia may develop prior to the onset of the disorder. A study by Jones Rodgers (1994) identified 30 individuals with schizophrenia from a random sample of 5000 individuals born in 1946. All subjects had been tested for non-verbal, verbal and reading abilities, arithmetic, and vocabulary, at ages 8, 11 and 15. Their progressively low scores in relation to heathy peers indicated a risk factor for the disease. These results should be approached with caution as a dysfunctional home environment may also affect both the academic ability in children as well as contribute to the onset of the illness. Nevertheless, other research has found similar results suggesting the cognitive deficit in a young person is a significant risk factor (Caspi et al., 2003; Erlenmeyer-Kimling et al. 2000). Although the impact of antipsychotic medications on neurocogniton provides minimal benefits to patients (Keefe Harvey, 2012), recent research has shown that patients who receive psychosocial support preform significantly better on several cognitive tasks than those who do not, suggesting that such interventions may be beneficial to those suffering with the disorder (Dalagdi et al., 2014). Structural abnormalities An abundance of research has aimed at identifying the structural deficits within schizophrenia. The most well documented deficits associated with the disorder are compromised white matter integrity (Kubicki et al., 2007) in addition to, a reduced grey matter volume across a range of neuroanatomical areas including the anterior cingulate, frontal and temporal lobes, hippocampus/amygdala and the thalamus (Shepard et al. 2002). Moreover, dorsolateral prefrontal cells have a simple dendritic organisation, indicating fewer synapses than a heathy individual (Kolb Whishaw, 2009) What remains a source of debate within the literature of the brain structure of schizophrenia is whether the disorder is progressive throughout the life-span or is strictly a neurodevelopmental disorder. While the lion’s share of the sMRI research posits that the illness progressively affects both grey and white matter (for meta-analysis see Olabi et al., 2011), others have suggested that the ‘progressive’ structural abnormalities observed could more be a consequence of numerous confounding variables (e.g. low physical activity, smoking, stress, alcohol, cannabis, anti-psychotic medication ; Zipursky, Reilly Murray, 2012). Furthermore, Zipursky et al. (2012) argue there is an absence of evidence of any toxic effect of psychosis on brain tissue. Zhang et al., (2014) used diffusion tensor imaging and a cross-sectional design in order to investigate whether schizophrenia produces progressive brain abnormalities. They found that schizophrenic patients showed lower fractional anisotropy (diffusion in the cells) values in the corpus callosum and corona radiate, and that these values were negatively correlated with the age of the patient. These researchers used a cross-sectional design and a majority of drug-naà ¯ve participants in an attempt to control for any medication effects, however, in doing this they open their results to scrutiny by drawing inferences about differences in two different brains. There are several limitations in structural studies in schizophrenia. Firstly, it’s very difficult to measure the effect of anti-psychotics on the brain without a control group of drug naà ¯ve patients. Given the debilitating nature of the illness, it’s difficult to find older patients that have not been medicated for long periods of time. Furthermore, if these patients are severely psychotic, it may prove impossible to test them, meaning some samples aren’t a true representation of the population. Secondly, there are causal problems in the structural studies. Consider, for example, an experiment using sMRI undertaken by Fornito et al., (2012). Their results showed schizophrenic patients have altered interregional connectivity and hypoactivation in the prefrontal cortex. What remains unclear is whether schizophrenic patients have these altered patterns of activation are a cause or are a consequence of the disorder. Functional abnormalities Schizophrenia is believed to be a disorder arising from disturbances in brain connectivity (Fornito et al., 2012) and that these disruptions prevent functionality in cognitive domains which often require communication between several distinct regions (Konrad Winterer, 2008). An analysis of resting functional connectivity of the disorder by Venkataraman et al. (2012) posits that patients display two distinct patterns when compared with healthy controls and that these patterns are correlated with the symptomology expressed. Abnormally increased connectivity between the medial parietal and frontal lobes was correlated with the presentation of positive symptoms, whereas decreased connectivity between medial parietal and temporal regions, and the temporal cortex, bilaterally corresponded with the presentation of negative symptoms (Venkataraman et al. 2012). Functional studies in schizophrenia typically use fMRI, which measures hemodynamic response related to changes in neural activity. While their usefulness in neuropsychology cannot be overstated, they are not without their limitations due to their precision. Consider for example the following experiment by Royer et al. (2009). This study found that even though schizophrenic individuals did not perform as well as the healthy groups in the working memory task (n-back), patients that did do well showed hyper-activation in the prefrontal and parietal lobes when compared to the control. Furthermore, fMRI showed increased activity in the superior frontal sulcus (self-awareness) and the posterior parietal cortex (planning of movement, attentional maintenance, response preparation/monitoring; Royer et al. (2009)) during successful trails. Here we run into a problem due to the lack of precision in the fMRI. While we can now observe frontal-parietal over-activation, we cannot distinguish whether this suggests either or both; (i) a compensatory mechanism allowing patients to perform well despite impaired cognitive functioning or, (ii) over-activation in the parietal areas corresponds to the BA 40 area (short term memory), suggesting improved effort (Royer et al., 2009). Conclusion Ultimately, schizophrenia is one of the most horrific examples of what can happen when the brain goes wrong. The disorder has a huge social and financial burden on sufferers, family members and healthcare systems. While there is no single cause of the disease, at least that we know of, research has shown the disorder to have a wide variety of risk factors in both biological and psychosocial domains. Schizophrenia presents itself in a wide variety of moderately to severely debilitating cognitive deficits although very recent research has shown that psychosocial interventions may at least curve the extent of these shortfalls (Dalagdi et al., 2014), at least in individuals whose positive or negative symptoms are not too extreme. Structurally, schizophrenia can be observed as disorder of compromised white matter integrity (Kubicki et al., 2007), reduced grey matter within the frontal and temporal lobes, hippocampus/amygdala and the thalamus (Shepard et al., 2002) and simple dendritic organisation within the dorsolateral prefrontal cells. The jury is out on whether schizophrenia is a progressive or neurodevelopmental disorder and this is primarily due to the difficulty in controlling for variables such as the effects of anti-psychotic medications, stress, and long term institutionalisation may have on brain structure. The positive or negative symptoms expressed in schizophrenia are related to the functional abnormalities in connectivity between the various brain regions (Venkataraman et al., 2012). While fMRI studies can provide us with valuable clues as to which brain regions are implicated in specific processes, there are issues with precision when comparing blood flow to activation is precise areas.

Saturday, January 18, 2020

Human Evolution Essay

Human evolution is the evolutionary process leading up to the appearance of modern humans. While it began with the last common ancestor of all life, the topic usually covers only the evolutionary history of primates, in particular the genus Homo, and the emergence of Homo sapiens as a distinct species of hominids (or â€Å"great apes†). The study of human evolution involves many scientific disciplines, including physical anthropology, primatology, archaeology, linguistics, evolutionary psychology, embryology and genetics.[1] Genetic studies show that primates diverged from other mammals about 85 million years ago in the Late Cretaceous period, and the earliest fossils appear in the Paleocene, around 55 million years ago.[2] The family Hominidae diverged from the Hylobatidae (Gibbon) family 15-20 million years ago, and around 14 million years ago, the Ponginae (orangutans), diverged from the Hominidae family.[3] Bipedalism is the basic adaption of the Hominin line, and the earl iest bipedal Hominin is considered to be either Sahelanthropus or Orrorin, with Ardipithecus, a full bipedal, coming somewhat later. The gorilla and chimpanzee diverged around the same time, about 4-6 million years ago, and either Sahelanthropus or Orrorin may be our last shared ancestor with them. The early bipedals eventually evolved into the australopithecines and later the genus Homo.Human evolution is the evolutionary process leading up to the appearance of modern humans. While it began with the last common ancestor of all life, the topic usually covers only the evolutionary history of primates, in particular the genus Homo, and the emergence of Homo sapiens as a distinct species of hominids (or â€Å"great apes†). The study of human evolution involves many scientific disciplines, including physical anthropology, primatology, archaeology, linguistics, evolutionary psychology, embryology and genetics.[1] Genetic studies show that primates diverged from other mammals about 85 million years ago in the Late Cretaceous period, and the earliest fossils appear in the Paleocene, around 55 million years ago.[2] The family Hominidae diverged from the Hylobatidae (Gibbon) family 15-20 million years ago, and around 14 million years ago, the Ponginae (orangutans), diverged from the Hominidae family.[3] Bipedalism is the basic adaption of the Hominin line, and the earliest bipedal Hominin is considered to be either Sahelanthropus or Orrorin, with Ardipithecus, a full bipedal, coming somewhat later. The gorilla and chimpanzee diverged around the same time, about 4-6 million years ago, and either Sahelanthropus or Orrorin may be our last shared ancestor with them. The early bipedals eventually evolved into the australopithecines and later the genus Homo.Human evolution is the evolutionary process leading up to the appearance of modern humans. While it began with the last common ancestor of all life, the topic usually covers only the evolutionary history of primates, in particular the genus Homo, and the emergence of Homo sapiens as a distinct species of hominids (or â€Å"great apes†). The study of human evolution involves many scientific disciplines, including physical anthropology, primatology, archaeology, linguistics, evolutionary psychology, embryology and genetics.[1] Genetic studies show that primates diverged from other mammals about 85 million years ago in the Late Cretaceous period, and the earliest fossils appear in the Paleocene, around 55 million years ago.[2] The family Hominidae diverged from the Hylobatidae (Gibbon) family 15-20 million years ago, and around 14 million years ago, the Ponginae (orangutans), diverged from the Hominidae family.[3] Bipedalism is the basic adaption of the Hominin line, and the earliest bipedal Hominin is considered to be either Sahelanthropus or Orrorin, with Ardipithecus, a full bipedal, coming somewhat later. The gorilla and chimpanzee diverged around the same time, about 4-6 million years ago, and either Sahelanthropus or Orrorin may be our last shared ancestor with them. The early bipedals eventually evolved into the australopithecines and later the genus Homo.Human evolution is the evolutionary process leading up to the appearance of modern humans. While it began with the last common ancestor of all life, the topic usually covers only the evolutionary history of primates, in particular the genus Homo, and the emergence of Homo sapiens as a distinct species of hominids (or â€Å"great apes†). Th e study of human evolution involves many scientific disciplines, including physical anthropology, primatology, archaeology, linguistics, evolutionary psychology, embryology and genetics.[1] Genetic studies show that primates diverged from other mammals about 85 million years ago in the Late Cretaceous period, and the earliest fossils appear in the Paleocene, around 55 million years ago.[2] The family Hominidae diverged from the Hylobatidae (Gibbon) family 15-20 million years ago, and around 14 million years ago, the Ponginae (orangutans), diverged from the Hominidae family.[3] Bipedalism is the basic adaption of the Hominin line, and the earliest bipedal Hominin is considered to be either Sahelanthropus or Orrorin, with Ardipithecus, a full bipedal, coming somewhat later. The gorilla and chimpanzee diverged around the same time, about 4-6 million years ago, and either Sahelanthropus or Orrorin may be our last shared ancestor with them. The early bipedals eventually evolved into the australopithecines and later the genus Homo.Human evolution is the evolutionary process leading up to the appearance of modern humans. While it began with the last common ancestor of all life, the topic usually covers only the evolutionary history of primates, in particular the genus Homo, and the emergence of Homo sapiens as a distinct species of hominids (or â€Å"great apes†). The study of human evolution involves many scientific disciplines, including physical anthropology, primatology, archaeology, linguistics, evolutionary psychology, embryology and genetics.[1] Genetic studies show that primates diverged from other mammals about 85 million years ago in the Late Cretaceous period, and the earliest fossils appear in the Paleocene, around 55 million years ago.[2] The family Hominidae diverged from the Hylobatidae (Gibbon) family 15-20 million years ago, and around 14 million years ago, the Ponginae (orangutans), diverged from the Hominidae family.[3] Bipedalism is the basic adaption of the Hominin line, and the earliest bipedal Hominin is considered to be either Sahelanthropus or Orrorin, with Ardipithecus, a full bipedal, coming somewhat later. The gorilla and chimpanzee diverged around the same time, about 4-6 million years ago, and either Sahelanthropus or Orrorin may be our last shared ancestor with them. The early bipedals eventually evolved into the australopithecines and later the genus Homo.Human evolution is the evolutionary process leading up to the appearance of modern humans. While it began with the last common ancestor of all life, the topic usually covers only the evolutionary history of primates, in particular the genus Homo, and the emergence of Homo sapiens as a distinct species of hominids (or â€Å"great apes†). The study of human evolution involves many scientific disciplines, including physical anthropology, primatology, archaeology, linguistics, evolutionary psychology, embryology and genetics.[1] Gen etic studies show that primates diverged from other mammals about 85 million years ago in the Late Cretaceous period, and the earliest fossils appear in the Paleocene, around 55 million years ago.[2] The family Hominidae diverged from the Hylobatidae (Gibbon) family 15-20 million years ago, and around 14 million years ago, the Ponginae (orangutans), diverged from the Hominidae family.[3] Bipedalism is the basic adaption of the Hominin line, and the earliest bipedal Hominin is considered to be either Sahelanthropus or Orrorin, with Ardipithecus, a full bipedal, coming somewhat later. The gorilla and chimpanzee diverged around the same time, about 4-6 million years ago, and either Sahelanthropus or Orrorin may be our last shared ancestor with them. The early bipedals eventually evolved into the australopithecines and later the genus Homo. Human evolution is the evolutionary process leading up to the appearance of modern humans. While it began with the last common ancestor of all life, the topic usually covers only the evolutionary history of primates, in particular the genus Homo, and the emergence of Homo sapiens as a distinct species of hominids (or â€Å"great apes†). The study of human evolution involves many scientific disciplines, including physical anthropology, primatology, archaeology, linguistics, evolutionary psychology, embryology and genetics.[1] Genetic studies show that primates diverged from other mammals about 85 million years ago in the Late Cretaceous period, and the earliest fossils appear in the Paleocene, around 55 million years ago.[2] The family Hominidae diverged from the Hylobatidae (Gibbon) family 15-20 million years ago, and around 14 million years ago, the Ponginae (orangutans), diverged from the Hominidae family.[3] Bipedalism is the basic adaption of the Hominin line, and the earl iest bipedal Hominin is considered to be either Sahelanthropus or Orrorin, with Ardipithecus, a full bipedal, coming somewhat later. The gorilla and chimpanzee diverged around the same time, about 4-6 million years ago, and either Sahelanthropus or Orrorin may be our last shared ancestor with them. The early bipedals eventually evolved into the australopithecines and later the genus Homo.Human evolution is the evolutionary process leading up to the appearance of modern humans. While it began with the last common ancestor of all life, the topic usually covers only the evolutionary history of primates, in particular the genus Homo, and the emergence of Homo sapiens as a distinct species of hominids (or â€Å"great apes†). The study of human evolutio n involves many scientific disciplines, including physical anthropology, primatology, archaeology, linguistics, evolutionary psychology, embryology and genetics.[1] Genetic studies show that primates diverged from other mammals about 85 million years ago in the Late Cretaceous period, and the earliest fossils appear in the Paleocene, around 55 million years ago.[2] The family Hominidae diverged from the Hylobatidae (Gibbon) family 15-20 million years ago, and around 14 million years ago, the Ponginae (orangutans), diverged from the Hominidae family.[3] Bipedalism is the basic adaption of the Hominin line, and the earliest bipedal Hominin is considered to be either Sahelanthropus or Orrorin, with Ardipithecus, a full bipedal, coming somewhat later. The gorilla and chimpanzee diverged around the same time, about 4-6 million years ago, and either Sahelanthropus or Orrorin may be our last shared ancestor with them. The early bipedals eventually evolved into th e australopithecines and later the genus Homo.Human evolution is the evolutionary process leading up to the appearance of modern humans. While it began with the last common ancestor of all life, the topic usually covers only the evolutionary history of primates, in particular the genus Homo, and the emergence of Homo sapiens as a distinct species of hominids (or â€Å"great apes†). The study of human evolution involves many scientific disciplines, including physical anthropology, primatology, archaeology, linguistics, evolutionary psychology, embryology and genetics.[1] Genetic studies show that primates diverged from other mammals about 85 million years ago in the Late Cretaceous period, and the earliest fossils appear in the Paleocene, around 55 million years ago.[2] The family Hominidae diverged from the Hylobatidae (Gibbon) family 15-20 million years ago, and around 14 million years ago, the Ponginae (orangutans), diverged from the Hominidae family.[3] Bipedalism is the b asic adaption of the Hominin line, and the earliest bipedal Hominin is considered to be either Sahelanthropus or Orrorin, with Ardipithecus, a full bipedal, coming somewhat later. The gorilla and chimpanzee diverged around the same time, about 4-6 million years ago, and either Sahelanthropus or Orrorin may be our last shared ancestor with them. The early bipedals eventually evolved into the australopithecines and later the genus Homo.Human evolution is the evolutionary process leading up to the appearance of modern humans. While it began with the last common ancestor of all life, the topic usually covers only the evolutionary history of primates, in particular the genus Homo, and the emergence of Homo sapiens as a distinct species of hominids (or â€Å"great apes†). The study of human evolution involves many scientific disciplines, including physical anthropology, primatology, archaeology, linguistics, evolutionary psychology, embryology and genetics.[1] Genetic studies show that primates diverged from other mammals about 85 million years ago in the Late Cretaceous period, and the earliest fossils appear in the Paleocene, around 55 million years ago.[2] The family Hominidae diverged from the Hylobatidae (Gibbon) family 15-20 million years ago, and around 14 million years ago, the Ponginae (orangutans), diverged from the Hominidae family.[3] Bipedalism is the basic adaption of the Hominin line, and the earliest bipedal Hominin is considered to be either Sahelanthropus or Orrorin, with Ardipithecus, a full bipedal, coming somewhat later. The gorilla and chimpanzee diverged around the same time, about 4-6 million years ago, and either Sahelanthropus or Orrorin may be our last shared ancestor with them. The early bipedals eventually evolved into the australopithecines and later the genus Homo.Human evolution is the evolutionary process leading up to the appearance of modern humans. While it began with the last common ancestor of all life, the topic usually covers only the evolutionary history of primates, in particular the genus Homo, and the emergence of Homo sapiens as a distinct species of hominids (or â€Å"great apes†). The study of human evolution involves many scientific disciplines, including physical anthropology, primatology, archaeology, linguistics, evolutionary psychology, embryology and genetics.[1] Genetic studies show that primates diverged from other mammals about 85 million years ago in the Late Cretaceous period, and the earliest fossils appear in the Paleocene, around 55 million years ago.[2] The family Hominidae diverged from the Hylobatidae (Gibbon) family 15-20 million years ago, and around 14 million years ago, the Ponginae (orangutans), diverged from the Hominidae family.[3] Bipedalism is the ba sic adaption of the Hominin line, and the earliest bipedal Hominin is considered to be either Sahelanthropus or Orrorin, with Ardipithecus, a full bipedal, coming somewhat later. The gorilla and chimpanzee diverged around the same time, about 4-6 million years ago, and either Sahelanthropus or Orrorin may be our last shared ancestor with them. The early bipedals eventually evolved into the australopithecines and later the genus Homo.Human evolution is the evolutionary process leading up to the appearance of modern humans. While it began with the last common ancestor of all life, the topic usually covers only the evolutionary history of primates, in particular the genus Homo, and the emergence of Homo sapiens as a distinct species of hominids (or â€Å"great apes†). The study of human evolution involves many scientific disciplines, including physical anthropology, primatology, archaeology, linguistics, evolutionary psychology, embryology and genetics.[1] Genetic studies show that primates diverged from other mammals about 85 million years ago in the Late Cretaceous period, and the earliest fossils appear in the Paleocene, around 55 million years ago.[2] The family Hominidae diverged from the Hylobatidae (Gibbon) family 15-20 million years ago, and around 14 million years ago, the Ponginae (orangutans), diverged from the Hominidae family.[3] Bipedalism is the basic adaption of the Hominin line, and the earliest bipedal Hominin is considered to be either Sahelanthropus or Orrorin, with Ardipithecus, a full bipedal, coming somewhat later. The gorilla and chimpanzee diverged around the same time, about 4-6 million years ago, and either Sahelanthropus or Orrorin may be our last shared ancestor with them. The early bipedals eventually evolved into the australopithecines and later the genus Homo.Human evolution is the evolutionary process leading up to the appearance of modern humans. While it began with the last common ancestor of all life, the topic usually covers only the evolutionary history of primates, in particular the genus Homo, and the emergence of Homo sapiens as a distinct species of hominids (or â€Å"great apes†). The study of human evolution involves many scientific disciplines, including physical anthropology, primatology, archaeology, linguistics, evolutionary psychology, embry ology and genetics.[1] Genetic studies show that primates diverged from other mammals about 85 million years ago in the Late Cretaceous period, and the earliest fossils appear in the Paleocene, around 55 million years ago.[2] The family Hominidae diverged from the Hylobatidae (Gibbon) family 15-20 million years ago, and around 14 million years ago, the Ponginae (orangutans), diverged from the Hominidae family.[3] Bipedalism is the basic adaption of the Hominin line, and the earliest bipedal Hominin is considered to be either Sahelanthropus or Orrorin, with Ardipithecus, a full bipedal, coming somewhat later. The gorilla and chimpanzee diverged around the same time, about 4-6 million years ago, and either Sahelanthropus or Orrorin may be our last shared ancestor with them. The early bipedals eventually evolved into the australopithecines and later the genus Homo.Human evolution is the evolutionary process leading up to the appearance of modern humans. While it began with the last common ancestor of all life, the topic usually covers only the evolutionary history of primates, in particular the genus Homo, and the emergence of Homo sapiens as a distinct species of hominids (or â€Å"great apes†). The study of human evolution involves many scientific disciplines, including physical anthropology, primatology, archaeology, linguistics, evolutionary psychology, embryology and genetics.[1] Gen etic studies show that primates diverged from other mammals about 85 million years ago in the Late Cretaceous period, and the earliest fossils appear in the Paleocene, around 55 million years ago.[2] The family Hominidae diverged from the Hylobatidae (Gibbon) family 15-20 million years ago, and around 14 million years ago, the Ponginae (orangutans), diverged from the Hominidae family.[3] Bipedalism is the basic adaption of the Hominin line, and the earliest bipedal Hominin is considered to be either Sahelanthropus or Orrorin, with Ardipithecus, a full bipedal, coming somewhat later. The gorilla and chimpanzee diverged around the same time, about 4-6 million years ago, and either Sahelanthropus or Orrorin may be our last shared ancestor with them. The early bipedals eventually evolved into the australopithecines and later the genus Homo.Human evolution is the evolutionary process leading up to the appearance of modern humans. While it began with the last common ancestor of all life, the topic usually covers only the evolutionary history of primates, in particular the genus Homo, and the emergence of Homo sapiens as a distinct species of hominids (or â€Å"great apes†). The study of human evolution involves many scientific disciplines, including physical anthropology, primatology, archaeology, linguistics, evolutionary psychology, embryology and genetics.[1] Genetic studies show that primates diverged from other mammals about 85 million years ago in the Late Cretaceous period, and the earliest fossils appear in the Paleocene, around 55 million years ago.[2] The family Hominidae diverged from the Hylobatidae (Gibbon) family 15-20 million years ago, and around 14 million years ago, the Ponginae (orangutans), diverged from the Hominidae family.[3] Bipedalism is the basic adaption of the Hominin line, and the earliest bipedal Hominin is considered to be either Sahelanthropus or Orrorin, with Ardipithecus, a full bipedal, coming somewhat later. The gorilla and chimpanzee diverged around the same time, about 4-6 million years ago, and either Sahelanthropus or Orrorin may be our last shared ancestor with them. The early bipedals eventually evolved into the australopithecines and later the genus Homo.Human evolution is the evolutionary process leading up to the appearance of modern humans. While it began with the last common ancestor of all life, the topic usually covers only the evolutionary history of primates, in particular the genus Homo, and the emergence of Homo sapiens as a distinct species of hominids (or â€Å"great apes†). The study of human evolution involves many scientific disciplines, including physical anthropology, primatology, archaeology, linguistics, evolutionary psychology, embryology and genetics.[1] Genetic studies show that primates diverged from other mammals about 85 million years ago in the Late Cretaceous period, and the earliest fossils appear in the Paleocene, around 55 million years ago.[2] The family Hominidae diverged from the Hylobatidae (Gibbon) family 15-20 million years ago, and around 14 million years ago, the Ponginae (orangutans), diverged from the Hominidae family.[3] Bipedalism is the ba sic adaption of the Hominin line, and the earliest bipedal Hominin is considered to be either Sahelanthropus or Orrorin, with Ardipithecus, a full bipedal, coming somewhat later. The gorilla and chimpanzee diverged around the same time, about 4-6 million years ago, and either Sahelanthropus or Orrorin may be our last shared ancestor with them. The early bipedals eventually evolved into the australopithecines and later the genus Homo. Human evolution is the evolutionary process leading up to the appearance of modern humans. While it began with the last common ancestor of all life, the topic usually covers only the evolutionary history of primates, in particular the genus Homo, and the emergence of Homo sapiens as a distinct species of hominids (or â€Å"great apes†). The study of human evolution involves many scientific disciplines, including physical anthropology, primatology, archaeology, linguistics, evolutionary psychology, embryology and genetics.[1] Genetic studies show that primates diverged from other mammals about 85 million years ago in the Late Cretaceous period, and the earliest fossils appear in the Paleocene, around 55 million years ago.[2] The family Hominidae diverged from the Hylobatidae (Gibbon) family 15-20 million years ago, and around 14 million years ago, the Ponginae (orangutans), diverged from the Hominidae family.[3] Bipedalism is the basic adaption of the Hominin line, and the earl iest bipedal Hominin is considered to be either Sahelanthropus or Orrorin, with Ardipithecus, a full bipedal, coming somewhat later. The gorilla and chimpanzee diverged around the same time, about 4-6 million years ago, and either Sahelanthropus or Orrorin may be our last shared ancestor with them. The early bipedals eventually evolved into the australopithecines and later the genus Homo.Human evolution is the evolutionary process leading up to the appearance of modern humans. While it began with the last common ancestor of all life, the topic usually covers only the evolutionary history of primates, in particular the genus Homo, and the emergence of Homo sapiens as a distinct species of hominids (or â€Å"great apes†). The study of human evolution involves many scientific disciplines, including physical anthropology, primatology, archaeology, linguistics, evolutionary psychology, embryology and genetics.[1] Genetic studies show that primates diverged from other mammals about 85 million years ago in the Late Cretaceous period, and the earliest fossils appear in the Paleocene, around 55 million years ago.[2] The family Hominidae diverged from the Hylobatidae (Gibbon) family 15-20 million years ago, and around 14 million years ago, the Ponginae (orangutans), diverged from the Hominidae family.[3] Bipedalism is the basic adaption of the Hominin line, and the earliest bipedal Hominin is considered to be either Sahelanthropus or Orrorin, with Ardipithecus, a full bipedal, coming somewhat later. The gorilla and chimpanzee diverged around the same time, about 4-6 million years ago, and either Sahelanthropus or Orrorin may be our last shared ancestor with them. The early bipedals eventually evolved into the australopithecines and later the genus Homo.

Friday, January 10, 2020

Apa Snippets and Style Writing Pointers to Help Tcl Nursing

APA Snippets and Style Writing Pointers to Help TCL Nursing Students Write Excellent Papers Datatel Number Technical College of the Lowcountry Course Number Abstract All papers should have an abstract. An abstract is a brief, comprehensive summary of the contents of the paper, including the purpose and major findings. The abstract should be well organized, concise and specific. The abstract should be one paragraph of no more than 120 words on a page by itself. Other features of an abstract include double-spacing, one inch margins without indentation, and Times Roman or Courier 12 font.APA Snippets and Style Writing Pointers to Help TCL Nursing Students Write Excellent Papers The aim of this article is to discuss the varieties of pain assessments, and to determine under which circumstances each assessment is most appropriate. Pain is rated differently by each patient, and is subjective to many factors in the patient's life, including but not limited to culture and past experiences wit h pain. Since pain may have an effect on all aspects of a patient's life, healthcare providers must strive to most properly identify the amount of pain in order to properly control it.Symptoms such as â€Å"crying, elected temperature, facial grimacing, groaning, moaning, guarding of the affected area, loss of sleep, nausea, vomiting, restlessness, rise in blood pressure, rise in respiratory rate, and tachycardia† are typical indicators that a patient is in pain; but how much pain? Healthcare providers, namely nurses, use a system of scales and work with the patient to rate their pain. Nurses must be aware of the different pain rating scales available in order to most accurately assess a patient's pain level.A nurse must not only be able to determine which pain scale is most appropriate for the patient to identify and express his or her pain level, but also be able to carefully interpret and evaluate the scores. For example, the pain scale that is appropriate for a fully func tioning adult will differ from one that is appropriate for a child and differ from one that is appropriate for a patient affected by dementia, etc. A variety of unidimensional scales quantify the intensity of the pain and are more simple; while multidimensional scales do so plus identify the pain quality, uration, and any relieving factors, and are more complex. If time permits, a nurse may choose to use a combination of pain assessments in order to be as thorough as possible. Nurses can implement the use of a variety of pain assessments reviewed in this article into their patient's shift assessment. A nurse may choose to use a more complex, thorough multidimensional scale upon his or her patient's admission assessment, and then use a more simple, quick unidimensional scale upon his or her patient's regularly scheduled shift assessments.Regardless of the type of scale being used, a nurse must always use â€Å"effective and sensitive communication with the patient to assist in expre ssions of pain. † Nurses must listen to their patient and accurately document their patient's subjective descriptions of the pain. Also, nurses should allow their patients ample amount of time to respond to their questions, which should also be open-ended questions. After the doctor has reviewed the pain assessment and ordered meds, the â€Å"effects of analgesia should be monitored closely and recorded in nursing notes to maintain continuity of patient care. In conclusion, nurses should assess the patient's abilities, then choose and tailor the pain assessment to the patient's needs. Assessments are of immeasurable importance as they have a direct effect on the patient's quality of life. The more extensive of knowledge a nurse has of the plethora of pain assessments to choose from, the more he or she can also select the most appropriate pain scale per the patient, which in turn will have the greatest impact on the patient's progress. Resources In the text, cite resources use d to prepare the paper.Cite references in parentheses at the end of the sentence, but before the period (Burckhalter, 2009). Give the author's last name, a comma, and year of publication. When citing the same resource several times in the same paragraph, it is necessary to cite the author every time but the year only once (Burckhalter). Cite a page number only for quotes. For works by two authors, name both every time and use an ampersand (Merwin & Sapp, 2008). For works with three to five authors, name all in the first citation (Bible, Simmons, & Beasley, 2009). In later citations, cite only the first author's name and the term et al. nd the year. For works of six or more authors, cite only the first author's surname followed by et al. and year in the text, but identify all the authors in the reference list (Slyh et. al, 2007). When a group or organization is the author, cite the group's name followed by the year (TCL Nursing Faculty, 2008). References Cite all resources used in th e text. For the reference list, center the word â€Å"References† at the top of the last page. Double space the entries and indent all lines, except the first line of each entry, five to seven spaces. Alphabetize the list by the authors’ surnames.Include only the initials and last name of authors, not full names or professional initials. Examples of citations are in the sample reference list with this paper. Note the examples of punctuation and capitalization. Journal citations capitalize only the first word of the article title. All major words in the title of the journal are capitalized. The name of the journal and the journal volume are italicized, but the issue and page numbers are not italicized. For books, the reference citation begins with the author or authors, followed by the date of publication. Only the first word of a book title is capitalized.Book titles are italicized. The publisher’s location is cited by city and state, a colon, and the name of th e publisher. Electronic citations use the same guidelines indicated above. Do not place a period at the end of an electronic address. Email sent from one to another should be cited as personal communication and is not included in the reference list. Information from classroom lectures are also personal communication (S. Beasley, April 14, 2009). Conclusion A paper should have a conclusion which restates the purpose of the paper, states the major points, and gives recommendations for practice and/or research.This paper has presented suggestions for helping TCL nursing students write excellent papers. A student may also consider using this document as a foundation for a paper. The margins are set correctly. References American Psychological Association. (2009). Publication manual of the American Psychological Association (6th ed. ). Washington, DC: Author. Author, C. K. (2007, September 30). Title of a journal article. Imprint, 21, 35-40. Retrieved from Academic Search Premier databas e. Benton Foundation. (1998, July 7). Barriers to closing the gap. In Losing ground bit by bit: Low-income communities in the information age (chap. ). Retrieved from HYPERLINK â€Å"http://www. Benton. org/Library/Low-Income/two. html† http://www. Benton. org/Library/Low-Income/two. html Bible, C. M. , Simmons, A. W. , & Beasley, S. G. (2009). Summer events at TCL. Journal of Nursing Education, 46(8), 89-96. Burckhalter, T. S. (February 2009). Beaufort’s best nursing students. Nurse Educator, 53, 46-65. McPheron, S. (2009). Mapping families. Imprint, 23(4), 14-27. Merwin, D. M. & Sapp, M. P. (2008). Where to find happiness. Journal of Divine Meditation, 38(5), 35-42. Simmons, A. (2007). Frustrations in nursing education.In M. Sapp (Ed. ), Success for nursing students (pp. 13-29). Beaufort, SC: Technical College of the Lowcountry. Slyh, K. P, Merwin, D. M. , Sapp, M. L. , Bible, C. W. , Slachta, P. A. , & Simmons, A. W. (2007). What nursing students want. Journal of Am erican Community Colleges, 26(3), 32-46. Nursing Faculty. Technical College of the Lowcountry nursing student handbook (2008). Beaufort, SC: Author. Thomas, C. L. (Ed. ). (2008). Taber's cyclopedic medical dictionary (21st ed. ). Philadelphia: F. A. Davis. APA SNIPPETS AND STYLE WRITING PAGE * MERGEFORMAT 7 PAGE

Thursday, January 2, 2020

Light Of The Attacks On The Charlie Hebdo Headquarters

In light of the attacks on the Charlie Hebdo Headquarters in early 2015, the topic of free speech seemed to regalvanize. This conversation will only pick up more momentum and fully convicted sentiments with the rise of social movements like the Black Lives Matter and Social Justice Warrior movements. Edward Morrisey writes his article, The Coming Demise of Free Speech in America, to share information regarding the first amendment, respective court cases, and the results of an implementation of a hypothetical ‘hate speech’ law. The substance and its presentation of the article is highly readable and flows easily to cover multiple topics while still giving each a fair share of dialogue. The web of topics covered is centered around that of ‘hate speech’. Questions regarding that, its relationship with the first amendment, and current events are addressed. I found that the polls and analysis of supreme court cases to be particularly insightful to the topic. The author also provided opinions and statements of opposing views to be addressed, and conceded his own position early on in the article. Doing so, the article was very capable of communicating critical details to the reader. The author’s conveyance of the subject really resonated with me personally as I believe that the idea of the first amendment goes far beyond its reach as a keystone to the constitution; it is an inalienable right. Going through the benefits and consequences of free speech I find simple. As for the