Mesotherapy Strategies and Techniques

Mesotherapy Strategies and Techniques MESOTHERAPY INTRODUCTION Mesotherapy is an art of injecting small quantities of various medicinal preparations such as vitamins, minerals and other conventional drugs directly into the mesoderm to treat pathological conditions locally. It involves the administration of intradermal or subcutaneous injections of compounds to treat a variety of medical conditions and avoiding systemic adverse effects due to drugs. It appears to be a novel technique to administer medicines local to the pathology while the skin serves as a natural time- release system. BACKGROUND OF MESOTHERAPY The term mesotherapy (derived from Greek mesos. â€Å"Middle† and therapeia to treat medically) denotes injection of substances into middle layer of skin ( mesoderm) for medical purposes. Historical aspects[1] Mesotherapy was originally used to treat painful conditions using local procaine injections. Michael Pistor who coined the term mesotherapy is considered the father of mesotherapy. In his original article,he described treating deafness, tinnitus, vertigo and headaches using local injections of procaine. Earlier to this in 1884, Koller an ophthalmologist used local cocaine to relieve pain. In 1925 Lerich used intradermal injections in the intercostal spaces. In 1937 Aron studied the use of intradermal injections to have an analgesic effect. Albert Lemaire, a Belgian physician used procaine injections to treat trigeminal neuralgia. In 1952, Michel Pistor a French physician popularized mesotherapy to treat various conditions in dermatology,sports,traumatology and vascular disease chiefly as a pain-relieving therapy. He defined mesotherapyas a techniquethat was used to treat mesoderm,(primary germ layer that develops into connective tissue, muscle and the circulatory system). In 1953, Dr .Mario Lebel invented a 3mm length needle that could be used precisely for injection of substances into the dermis. In 1964, the French society of Mesotherapy was founded by Michel Pistor and use of mesotherapy was extended to treat cosmetic conditions. The American influence was evident after Dr. Lionel Bissoon popularized the technique in North America. Despite the fact that mesotherapy is gaining popularity in aesthetic medicine especially for localized cellulite reduction, it continues to be a controversial topic and therefore requires cautious approach. The safety and efficacy of these mesotherapy remain ambiguous to patients and physicians alike. [2] Applied basic science [1, 3] The concept that led to discovery of mesotherapy is quite interesting. Pistor saw recovery of chronic hearing loss while treating a patient with procaineinjections for an asthma attack. Subsequent intradermal injections of this product into the mastoid region proved this effect to be true. However the depth of injection was considered important. This led the researchers to the fact that at a depth of 1.5 to 2mm the local activity of the product would last longer due to a persistent reservoir with weak local diffusion in the dermis whereas products injected into dermis would dissipate to greater distances.A product when injected intradermally acts in two ways. Firstly, by stimulating dermal receptors in situ and secondly, over long distances by reaching other organs via circulation. A concept of meso-interface exists which is the surface of contact established between the injected products and the tissue injected. The more the multiple punctures are made and the more fragmented produc ts are delivered in small quantities, the greater the meso-interface and proportionately greater numbers of dermal receptors get activated.Pistor has always described this technique as follows. â€Å"A little volume, a few times and in the right place†. The idea was that by placing these products in the dermis, the skin acts as a reservoir for drugs to diffuse slowly via microcirculation to activate dermal receptors. A general mechanism of action (based on the target site, dermis) and a specific mechanism of action (based on the ingredients used) has been proposed to explain the concept of mesotherapy. The dermis is considered to be common denominator for circulatory, neurological and immunological functions; and the general mode of action is believed to occur by correction of these altered functions. Individual drugs or agents target the specific indication of mesotherapy. EQUIPMENTS The various equipments used in mesotherapy are Mesogun (Fig 1) Mircromesotherapy device Needleless Mesotherapy Mesogun Mesogun is a syringe infusion pump that is capable of injecting the desired substance at a required amount, speed and depth using the injector and needle. Syringes varying from 2cc-10cc and needle lengthsvarying in size from 4mm to 13mm can be used based on the indication, and desired depth of injection. A device known as guide is used to keep the needle at a constant depth. Once the parameters are chosen, the product can be injected by one of the following modes. Continuous – Min 3cc/min Max 10cc/min. Mircrodose – Max0.1cc/trigger. Standard dose – Max 0.3cc/trigger. Mesoperfusion – Max 0.3cc/trigger. Nappage – 0.1cc/trigger. Advantages of Mesogun Good comfort level for patient and physician Procedure is faster and relatively painless Accurate delivery system Versatality – Ability to perform various modes such as nappage, continuous, mesoperfusion in dosimetry. Syringes used in Mesogun: Generally 1ml, 5ml, 10ml and 20ml syringes with luer lock system is used based on the indication. MesoNeedles (Fig2 a): Mesoneedles or â€Å"Lebel needles† are commonly used in mesotherapy.The John Screw needles have an adjustable length.The recommended parameters for needles are based on the site of injection: Face and neck – 4mm 30G mesoneedles Fat and cellulite – 6mm 30G mesoneedles,  ½ inch 30G needles. Multi-injectors and plates (Fig2 b): These accessories help to cover larger areas in a short time facilitating faster and easier procedure for the injector. There are sterile circular and linear multi-injectors with needles ready to be used for any body part. Micromesotherapy Device Micromesotherapy is an evolution of conventional mesotherapy. Usually mesotherapy uses needles to deliver drugs in deep dermal layer. Here a reverse cone shaped device has ultrafine needle 32Gx2mm by which drugs are injected into the superficial layer of dermis therebyminimizing incidence of bruising, pain and scarring. Needle-Less Mesotherapy or No Needle Mesotherapy This is a needle free device that pushes mesotherapy products painlessly through the skin using electrical waves known as isophoresis. The main features of needle less mesotherapy are: Less painful and less traumatic Uses ultrasound/electroporation technology. Probably around 20% efficiency compared to traditional mesotherapy as there is no neocollagenesis or neo angiogenesis reactions that occur with needle micro injury. This may be an option if mesotherapy is not allowed in the country. It has been discussed in details in Chapter 12. MESO SOLUTIONS (Fig6[VG1] The basic requirements of meso products is that it should be approved and skin-compatible.Systemic administration (intravenous, intramuscular, subcutaneous or intradermal) should be safe and known pharmacological actions to be effective. The ingredients used in mesotherapy products should be water soluble, isotonic and non-allergenic. The mesoproducts vary with the indications chosen for treatment. [4] [ Figure 3]Products used for mesotherapy involves combination of products some of which are main ingredients known as principals as they have high grade of evidence in the treatment of each indications and complementary agents that have been approved for treatment of each indications. For a mixture to be effective it should contain 2 – 3 principals for any given indication. Therefore the ingredients in mesosolutions are broadly classified into main categories: Principal (P) / Major Complementary (C) / Minor. The main targets for mesotherapy are skin, hair, fat and cellulite. (Table 11.1). Table 11.1 Principal and Complementary ingredients in meso solutions in various indications INDICATION PRINCIPAL/MAJOR COMPLEMENTARY/MINOR SKIN REJUVENATION Mesolift Hyaluronic Acid5 DMAE Organic silicum Fibronectin + Vegetal Proteins Vitamin C Glycolic Acid Xadenal Vitamin A Growth Factors Stem Cells Mesoglow Hyaluronic Acid Siloag Vitamin C Xadenal Taurine Meso lightening Kojic Acid Azalaic Acid Vitamin C Glutathione Tretinoin Glycolic Acid Striae or stretch marks Stretch Marks Organic silicum Centella Asiatica Vegetal Proteins + Fibronectin DMAE Vitamin C Idebenone Hair Loss Androgenetic Alopecia Minoxidil Finasteride Dutasteride Dexenol Biotin Amino acids Peptides Zinc Azelaic Acid Stem Cells Telogen effluvium Biotin Dexapanthenol Pyridoxine Multi Vitamins Trace Elements Cellulite and Fat Meso Cellulite Caffeine Carnitine Aminophylline DMAE Rutin Artichoke Yohimbine Procaine Vitamin C Fat deposits Body Sculpting, localized fat, Cellulite PPC Deoxy cholate L – Carnitine Aminophylline Pentoxifylline DMAE -Dimethylaminoethanol ; PPC Phosphatidylcholine TECHNIQUES FOR MESOTHERAPY INJECTIONS The mesoproducts can be injected into the skin by various injection techniques to reach desired depth.The commonly used techniques and the desired depth reached are summarized in Table 11.2and Illustration 11.1 Table 11.2: Techniques and depth in mesotherapy injections Technique Depth Intraepidermal 1mm Papular 2mm Nappage 2-4mm Point by point 4mm Mesoperfusion > 4mm The salient features of various techniques are outlined below: Intra-epidermal This is one of the most superficial of the techniques described by Perrin. Depth: 1mm within the epidermis Painless, no bleeding Simple and large surface covered Ideal for patients with low pain threshold Ideal for facial rejuvenation, mesoglow Papular Depth:2mm dermoepidermal junction Painful Useful in mesobotox Ideal treatment of wrinkles Nappage(French for ‘covering’) Also known as picotage is the classic injection technique in mesotherapy. (Illustration 11.2) It is the most widely used technique in aesthetic dermatology. The syringe is held obliquely and the physician applies constant pressure on the plunger flicks the wrist to infuse a drop of the solutioninto the dermis(Fig 4). The injections are 2-2.5mm deep and 1cm apart. This technique can also be used for injections using a mesogun. (Fig 5) Depth 2-4mm Less pain and less bleeding Ideal for rejuvenation and scalp treatments Point by Point(Fig 6) Depth 4mm Perpendicular injection Ideal for fat reduction Mesoperfusion Depth > 4 mm Mesosolution is injected slowly over a priod of 10 minutes Not commonly used in dermatology PRACTICAL ASPECTS OF MESOTHERAPY Indications and contraindications for mesotherapy are listed in box 11.1 and box11.2. Box 11.1 Indications for mesotherapy Box 11.2 : Contraindications for mesotherapy Related to patient Unrealistic expectations Body mass index greater than 30 Pregnancy / Lactation H/O strokes, recent cancer. H/o multiple meds for heart disease H/o allergy to ingredients e.g. Soy proteins, lignocaine. Autoimmune disorders Epilepsy Insulin dependent diabetes Related to product Aminophylline – Known hypersensitivity to drug, active peptic ulcer, Pentoxiphylline, aminophylline- recent cerebral retinal bleed L. carnitine – history of seizure disorder Phosphatidyl choline relative contraindications with antiphospholipid antibody syndrome Caffeine – arrhythmias, anxiety, insomnia hypotension Mannitol – pulmonary edema, renal disease. Patient selection Selecting the patient with a valid indication for mesotherapy is the key to success. Care should be taken to avoid patients with active skin diseases, too elderly and patients with history of sensitive skin. For androgenetic alopecia better results are seen in patient with Grades 1 – 3. Counseling and preparing the patient A proper counseling is essential before starting mesotherapy. Patients with body dysmorphic disorders and those with unrealistic expectations should not be treated. Alternate procedures should be discussed sufficiently as mesotherapy is still in the controversial stage. A written informed consentis mandatory in the present medical scenario. A good before and after clinical photograph is needed to evaluate results following the procedure. Procedural aspects The area to be treated is marked and thoroughly cleaned with an antiseptic solution. For anesthesia, a local anesthetic cream may be applied or ice-anesthesia can be used to numb the treatment area. Patients are preferably injected in a lying down position. The required quantity of ingredients is drawn into the syringe using an 18Gx11/2needle. The injection is given either manually or using a device to deliver by the papular, nappage or point by point technique. A gentle massage is given after the treatments. Fresh normal saline and a mositurising cream can be applied to the treated area and massaged gently. [9]. The procedure takes about 20 – 30 minutes depending on the indication and area to be treated. There is no downtime after the procedure and the patient will be able to return to normal activities immediately. Good results are seen with mesotherapy done for skin rejuvenation, cellulite and double chin. [Fig 7, 8, 9] Post procedure care and counseling for follow up There may be mild pain, pinpoint bleeding, itching, burning or erythema after the injection which will subside spontaneously. Bruising and hematoma can appear occasionally and can be managed symptomatically. Mild swelling at site of injection may require anti-inflammatory agents for few days. The patients need to be counseled on the following aspects: Avoid sun exposure and smoking for next 48 hours Loose fitting clothes to be worn especially after lipolytic injections. The area to be treated is generally massaged after 72 hours and continued daily till disappearance of nodules if any. Follow up: Generally treatments are given once every 1-2weeks for 6 sessions, then once a month for 5months. Maintenance sessions are to be done once or twice a year. This protocol may be altered depending on the indication, patient’s lifestyle, financial position and response to previous treatments. Complications Though there are few evidence based studies on the efficacy of mesotherapy, there are documented reports on various complications. [10-17] The complications can be classified as local and systemic complications. (Box 11. 3) Box 11.3: Complications Local Bruising Burning or itching Pain, Tenderness, swelling Urticaria [10] Skin necrosis, Ulcers [11] Abscess [12] Hyper pigmentation Atypical mycobacterial infection [13] Rare – granulomatous panniculitis [14,15], koebnerisation, granuloma annulare, Oleoma [16] Systemic Anaphylaxis Nausea Vasovagal shock Hepatic toxicity Nerve demyelination Allergy to specific ingredients Thyrotoxicosis Ischaemic colitis [17] Management of Complications: Bruising:  It is a common but preventable complication. Always advice patient to stop aspirin or NSAIDs at least 2 weeks prior to the day of procedure. While injecting be slow and gentle. It is advisable to avoid mesotherapy during menstruation. Burning/Itching:  Burning can be overcome by adding lignocaine to the products if compatible. A mesomask applied immediately following procedure can also minimize burning and itching as it has a soothing effect. Pain/Tenderness: Procedural pain can be minimized by using adequate topical anaesthesia. Immediate post treatment pain can be alleviated by cold compresses with ice. Other methods that help to minimize pain are by pinching the skin for point by point injections or by stretching it when giving a nappage. Change needles after every few pricks to reduce the pain caused by blunt injecting needles Urticaria:  Urticaria can be avoided by a careful history to avoid products that would provoke an allergic reaction. E.g. phosphatidyl choline in individuals with history of allergy to soy proteins. Skin necrosis:  Skin necrosis occurs usually with phosphatidyl choline when the injections are given superficially Ulcers:  Ulcers can due to infection or irritant nature of the drugs. Irritant induced ulcers can be prevented by minimizing the number of drugs used in the cocktail to 4 or 5. Infective ulcers can be avoided by disinfecting the treatment area thoroughly and by wearing sterile gloves and using sterile equipment and materials. Hyper pigmentation:  This can be avoided by advising the patient photo protection for 48 hours after the procedure and by addition of topical skin lightening agents in patients with a history of post inflammatory hyper pigmentation. COMBINING MESOTHERAPY WITH OTHER TECHNIQUES Mesotherapy can be combined with other techniques to enhance results.Soon after injection of mesotherapy products, ultrasound, radiofrequency or electroporation may be applied to help in better diffusion of the injected products. The techniques are discussed in chapter 12. Mesomasks can be applied immediately after the injections to minimize bleeding points and to overcome the discomfort that follows injections.It is a 150 g of powder to be mixed with water to form a paste which is applied for 15minutes as a mask over gauze. This allows all products to penetrate deeper in the skin to give a better effect. These masks contain a mixture of calcium sulfate, talc and orange oil. Other procedures such as chemical peels, fillers and neurotoxins can be carried out between the mesotherapy sessions. In countries where mesotherapy is not practiced, mesotherapy products can be used following cosmetic skin needling. By using a dermaroller in the area to be treated, it is possible to create micro perforations that will be used as channels to deliver a product deeply into the skin. CLINICAL STUDIES Mesotherapy has been in history for a long time and there are proponents who have been successfully using it in practice for the benefits of their patients. However there are few indexed studies about the safety and efficacy of mesotherapy but many about its complications, hence it only natural to distrust proponents in relation to this technique Hence adequate controlled studies are needed to establish the value of mesotherapy in aesthetic dermatology. [18] Mesotherapy for skin rejuvenation, treatment of local fat deposits, body sculpting have been assigned Evidence Level C, whereas cellulite treatment has been assigned Evidence Level D [18]. Few recent studies have shown promising results for mesotherapy in various aesthetic indications. A study by Larruba et al showed good results with hyaluronic acid mesotherapy on photoaging and assessed by ultrasound techniques. [5] A study by Savoia etal showed promising [VG1] An excellent compilation with evidence for few of them are given in these two articles from IJDVL Sarkar R, Garg VK, Mysore V. Position paper on mesotherapy. Indian J Dermatol Venereol Leprol 2011;77:232-7 Konda D, Thappa DM. Mesotherapy: What is new?. Indian J Dermatol Venereol Leprol 2013;79:127-34 Another review of various indication s of mesotherapy is in this article by Dr. premlatha 3.Latha P. and Vandana K.R. / International Journal of Advanced Pharmaceutics / 1 (1), 2011, 19-29 ( full text available of all three) The meso solutions can be tabulated in the format below Indication Product Mechanism of action ( should include original intention versus intention in mesotherapy e.g. aminophylline was originally used for brochodilation. In mesotherapy it is used for vasodilatation etc Evidence grade ( wherever available)

Buckley / Ericsson :: essays research papers

Buckley / Ericsson   Ã‚  Ã‚  Ã‚  Ã‚  In their essays both Buckley and Ericsson analyze the different ways we use lies to help and hurt our self in our every day lives, and how this effects American culture. Ericsson shows the way lies can , as she puts it, â€Å" lubricate the daily machinery of living†(128). Buckley, on the other hand uses examples of lies as a way to deny himself; and do exactly the opposite of Ericsson. But they both show how we as Americans use lies these ways and others so much that most of us may not realize it.   Ã‚  Ã‚  Ã‚  Ã‚  Ericsson’s essay was obviously about The Ways We Lie, mostly about the way we lie to other people to make their or your own life easier. Buckley’s essay is not so obviously about lying, but if you read deeper into the text you can see how Buckley makes his life harder by lying to himself. When Ericsson is describing the white lie; she use the example of a friend telling another friend she looks good when the truth is she doesn’t. This is exactly how we use lies to lubricate daily living, we avoid confrontation. â€Å" The liar deciding what is best for the lied to† (Ericsson 121). When Buckley describes the amount of discomfort he endured from the heat on the train, he imagines what would happen to the conductor in an age of more violence. â€Å"The passengers would seize the conductor and strap him down on a seat over the radiator to share the fate of his patrons† (64). He has strong feelings toward the conductor, because someth ing has not already been done. When the conductor approaches Buckley; he has intensions of making the conductor aware of the problem, but the simple stare of his neighbor drives him to ignore the plain facts. Even though Buckley notices, â€Å"the car was flecked with the white shirts of the passengers†; he uses the stare as a way to dilute the truth into believing that his idea of turning the heat down would not be the consensus of the rest of the car (64).   Ã‚  Ã‚  Ã‚  Ã‚  The way lies have become a part of are daily life as Americans, and the way this has effected our culture is what both Ericsson and Buckley express in their essays. I think Buckley clearly stated his essay’s purpose when he said, â€Å" what has happened to the American people.

Differential Calculus: Maximum and Minimum Problem and Solution

An oil refinery is located on the north bank of a straight river that is 2 km wide. A pipeline is to be constructed from the refinery to storage tanks located on the south bank of the river 6 km east of the refinery. The cost of laying pipe is $200,000 per km over land to a point P on the north bank and $400,000 per km under the river to the tanks. To minimize the cost of the pipeline, how far from the refinery should P be located? (Round your answer to two decimal places. ) 1 year ago Report Abuse Colorado†¦ Best Answer – Chosen by VotersThis is a min-max calculus problem, where we want to minimize the cost function: We need a drawing of the situation: see https://docs. google. com/drawings/d/1PvkU†¦ where R is the refinery, O will be the x-axis origin, P is the point on the north bank, and x= distance from O to the storage tanks. [Note, we could have put R at the origin, but the algebra is a little simpler this way] The cost C(x) of the pipeline as a function of x is: C(x) = distance along north shore * pipeline cost over land + distance under the river * pipeline cost under land The distance along the north shore is 6-xThe distance (by Pythagorean theorem) under the water is sqrt( 2^2 + x^2) So, C(x) = (6-x)*200000 + sqrt(4 + x^2) * 400000 [You should graph this] To find the value of x where C(x) is minimized, we set dC/dx = 0, [Reminder – use the chain rule to differentiate the second term] Differentiating and simplifying, we get dC/dx = C'(x) = -200000 + 400000x/ sqrt(4+x^2) = 0 400000x / sqrt(4+x^2) = 200000 400000x/200000 = sqrt(4+x^2) Squaring both sides, we get 4x^2= 4 + x^2 x = sqrt(4/3) = 1. 15 So the distance from the refinery to point P is 6-x = 4. 85 km

MIS

MIS Executive SummaryManagement Information Systems (MIS) is one of the key instruments for an organizations survival as it plays a critical role in the banking industry as it does in all other industries. It provides the management with the necessary information in a prompt and accurate manner that can assist them in making decisions, future planning and all other business functions. MIS will enhance the business' overall productivity and support the organizations overall goals.Introduction" When Management Information System (MIS) was young, the holy grail at the heart of our discipline was" how do we [create and] develop information systems that deliver value to the users, on time, and under budget?" thirty years later this questions is still at the core of our craft. Is MIS a failed discipline? Have we gone on for almost three decades without making progress?"1(Briggs, Robert O., Nunamaker, Jay Sprague, Ralph, 2000:5-10)In the beginning of twentieth century, revolution began in know ledge and information then accelerated gradually thereafter(2).Society for the Management of Information Systems ...It became now the foundation for many new services and products where in 1974 applications pushed the limits of human ability. As information system, research advanced so did user expectations. And the question raised is how individuals, organization can adjust in order to leverage the delivery of information technology.(3)The infrastructure of the information technology (IT) affords the base for an organization to construct its information system needed to complete the work and provide the employee with all the necessary information. However, management decisions regarding IT are very critical because it affects employees' productivity and performance and therefore, it may affect the organization's overall success. (4)"[Across all industries] nevertheless, developing countries are increasingly deploying IT to solve their development problems. Lending by the World Bank for[ information technology] (IT) has been growing at...

Effects of Divorce on Children

Effects of Divorce on Children Introduction Divorce is the act of dissolving or terminating a marriage between two people before the death of one partner thus rendering the marriage null and void. Divorce frees one of legal responsibilities and duties that he/she was previously bound to by the union of marriage. It also frees one of marriage with another person. Divorce in the society happens for different reasons depending on the individual cases.Advertising We will write a custom essay sample on Effects of Divorce on Children specifically for you for only $16.05 $11/page Learn More Different authorities that have a legal authority to allow the dissolution of the marriage (Isle, 2012, Para. 4) carry out the process. These authorities might be religious, government arms, or traditional settings depending on the laws of marriage to which the partners subscribed. As the paper reveals, regardless of the reason behind any divorce case, the children of the divorced parents feel a remarkable ef fect. Effects of divorce on children The effects that children have after a divorce may be psychological, social, and or emotional because each divorce case tends to be unique in its own way though divorces can be grouped into different broad categories: at fault divorce, no fault divorce, summary divorce, uncontested divorce, collaborative divorce, and mediated divorce. Specific reasons that might come under the above broad groups may include unfaithfulness in marriage, lack of commitment in marriage by one or both partners, irreconcilable differences, abusive marriage, distance, and a partner developing interest in getting married to a different person (Amato, 2003, p. 605). At the end of the day, divorce has its own effects towards the divorcing couples and the people around them especially their families and children. When a divorce happens to a couple who have children, it stops being an issue concerning two people only. It becomes an issue concerning them and their children be cause, in society, children’s interest and wellbeing are paramount and hence a responsibility of any person with a legal age. When a divorce happens between a married couple with children, the interest of the children have to be secured as provided for by the law so that they do not end up suffering as a consequence of the divorce.Advertising Looking for essay on social sciences? Let's see if we can help you! Get your first paper with 15% OFF Learn More Though the wellbeing of children seem secured, in case of a divorce, children tend to be affected in different ways both negatively and positively because it always has psychological effects on them. The extent of the impact of a break up on a kid will at times relate with the age of the kids at the time of the separation. For instance, though a toddler may not comprehend the issues going on then, they tend to sense it within their parents, â€Å"as their parents’ energy levels and mood tend to shift† (Douglas, 2005, p.49). This leads to the infants’ reaction in different ways based on their instincts that may be observed. There might be a change in the sleeping patterns of the baby as well as their eating habits. The baby might become so fussy with lots of mood swings, which were unusual to the baby before. Regression can also be viewed in the baby with the baby unlearning the skills it had acquired before. Either the baby may become slow in gaining weight, cutting the gained weight, or stagnating. The baby may also be slow in development (Douglas, 2005, p.50). For the best welfare of the child, the parents should try as much as possible to maintain the previous routine between them and the child so as not to upset the balance in the child’s life. Divorce happening to parents with pre-school children tends to affect the children in such a way that they will always feel it as if it their mistake led to their parents’ moving apart. This leads to t heir feeling insecure by always wanting to be around an adult and not wanting to be left alone. They have the fear that they might be abandoned. They develop a friendly nature. They also tend to become angered by small things, which can be attributed to mood swings. In some instances, kids who had stopped wetting beds will start again (Temke, 2006, p. 2). All these are psychological, and are often due to their searching for the answer as to why daddy no longer lives with mummy. A divorce occurring when a child is an adolescent or a teen usually leaves him/her with lots of mental torture. The teenagers in this case feel embarrassed at the prospect of belonging to a broken family because societal norms advocate for a complete continuous family. This makes them frustrated and angry thus making them resort to activities that would give them solace.Advertising We will write a custom essay sample on Effects of Divorce on Children specifically for you for only $16.05 $11/page Learn More Some might indulge in drugs while others might indulge actively in sports as a way of ventilating their frustrations to release some pent up energies. Teens tend to be affected a lot because they understand the reasons for their parents’ divorce. This is worse off because they are so helpless to stop the divorce thus ending up frustrated. Divorce comes with divisions in the family. At times, they are forced to lay blame on one party whom they believe is the cause of the divorce (Elizabeth, 2006, p. 19). This leads to their division as to which side they should take. At the same time, it also comes with new responsibilities for teenagers who might be forced to cope with the different changes happening in their lives on their own on issues like sexual feelings. The teenagers might also grow up to dislike the institution of marriage by growing doubts on whether they will ever want to get married or whether they could stay in a marriage. A good example of a divorce victim is the musician Enrique Iglesias who feels that there is no point of getting married because, at some point, the marriage might break up. Enrique’s dad had so many marriages, which kept on breaking up. This informed his decision not to get married. In general, divorce might have lifelong effects to children when it happens as they witness it. Children who grow up in a divorced marriage tend to develop manipulative behaviors. This case happens when there is competition between the two parents when one wants the children to see him/her as being better than the other. They will therefore shower their kids with favors as a way of winning them over. The moment the kids come to discover what their parents are up to, they will start making demands besides playing the parents against each other. At the back of their minds, they have the knowledge that one parent will definitely give them what the other has refused to give. This might go on into their adult lives thus giving them undesirable characters. Children growing up in a divorced family might not have a lot of respect for the institution of marriage. They would easily walk out of a marriage in the future with the belief that, after all, their parents’ marriage did not work. The psychological impact that always afflicts children when they have to attend court sessions to hear out the differences between their parents can be great (Chase, 2010, p.211). This leads to lose of self-esteem in children because they will always be embarrassed by the courtroom drama and the prospect of the news becoming public among their peers.Advertising Looking for essay on social sciences? Let's see if we can help you! Get your first paper with 15% OFF Learn More In many cases, children wish that they were not there to face the situation thus preferring to move away from the area they are staying to a new place where people do not know about their skeletons in the closet. The children would also ask that they change schools and their complete social setting just to run away from what has happened to their parents. Some children would always wish that their parents got back together. They would do everything in their power to push or convince their parents to come back together. Conclusion In conclusion, divorce affects children in the family psychologically and in a negative way. It is in very few instances that one would find a child who was not negatively affected even though it was the only thing that would guarantee them peace and survival. There is always that thought in the children that things should have worked out differently. Therefore, to save the children on the effects of divorce, there is the need for parents to cultivate some good relations by nurturing everything that strengthens their love bond besides involving their children in matters that convince them positively that marriage is the best institution that every person ought to join when time comes. Reference List Amato, P. (2003). People’s Reasons for divorcing. Journal of Family issues, 24(5), 602- 626. Chase, K. (2010). Dicken and the Rise of Divorce: The Failed Marriage Plot and the Novel Tradition. Victorian Institute Journal, 38(1), 211-214. Douglas, L. (2005). The Binuclear Family Boom. Library Journal, 130(14), 49-50. Elizabeth, M. (2006). No Good Divorce. Christian Century, 123(3), 18-23. Isle, I. (2012). Legal Separation Grounds for Divorce: The Legal Process. Retrieved from divorceaid.co.uk/legal/process.htm Temke, M. (2006). The Effect of Divorce On Children, Family Consumer Resources. Hampshire: University of Hampshire Cooperative Extension.

Opportunities Analysis for Citigroup Project Essay

Opportunities Analysis for Citigroup Project - Essay Example Citigroup is being recognized as the largest company in the world as per Forbes in 2008. It also has a customer base of over 200 million. The business of the company is divided into three in order to enable specialized services for the customers. The three groups are Global consumer, Global wealth management, and Institutional clients group. "Citi is organized into three major business groups - Global Consumer, Institutional Clients Group, and Global Wealth Management." (How Citi is organized, 2007). Here the company plans to implement a project in which they focus on undertaking an up gradation in their computer systems. The new project is aimed at providing improved and speedy services for the customers. The company is very keen on providing services to the customers strictly on the basis of their needs. Inconvenience for their customers is something that the company cannot afford to happen. The company has thus come up with the idea that, for speeding up the process the systems in the company has to be improved and upgraded. This report looks into the various areas regarding the implementation of this project. The relevance of focusing extremely on customer needs is being discussed on the basis of Citigroup. It is explained in the report about the link between the goals and objectives of the company and the new project proposal. As the company is highly focused on the customer needs the new system will enable them to deliver even better quality results. In this section of the report, an analysis of the new project proposal is being done.Environmental scan of Citi group: Like any other business Citigroup too is influenced by the changes in the environment in which it operates. The major environmental factors that affect the company are political, economic and social conditions. Among all these, the economic condition is the factor that has the most influence. Any changes in the economic factors affect the company directly and indirectly. The interest rate dif ference made by the central bank on the basis of the economy makes the company revise its own interest rates. Similarly, political instability will adversely affect the better functioning of the company in the country. The changes in the attitude of the society towards the company also have an impact on the functioning. The strategies of the competitors of the company are one of the major external factors that affect the company. Citigroup faces very high competition from the other leading banks and financial companies. "Citigroup competitors are primarily in the Money Center Banks industry. Citigroup also competes in the Online Banking, Private Banking, and Asset Management sectors."(Citigroup competitors, 2008). The major competitors of Citigroup are Bank of America, Deutsche Bank, and JPMorgan Chase. These are some of the leading banks in the world along with Citigroup.Customer needs and expectations: The customers in this particular sector are very choosy. One of the reasons for this is that there are a number of service providers in this sector. Since there are a number of companies operating in the sector the customers are left with a sufficient number of products to choose from. The company already has a very large customer base in the market. The major expectation and desire of the customers are fast and better services from the banks.

Write about two sociological variables race and animal abuse Essay

Write about two sociological variables race and animal abuse - Essay Example Hypothesis 1. The ethnicity or race of an individual may or may not have an effect on their propensity to abuse or not abuse animals. To prove or disprove this initial hypothesis, it would be necessary to select an equal group of individuals from every possible racial background. For example, 25 men and 25 women between the ages of twenty and forty would be selected from each racial background. These groups would include Caucasian, African American, Latino and Asian. These groups would all be blind to what the study was about. The groups would be kept separate by race and monitored in a facility for one week. Each individual would be placed with a dog. Each individual would be monitored for the duration of the week. The dogs would also be monitored. At the end of the week, the following would be determined: The behavior of the dog as compared to the behavior at the beginning of the week; the number of times each person fed, watered, petted or spent time with the dog (walking the dog etc); and of course any abuse or neglect would be determined. The possible problems with this study would be age variation in the individuals as a possible factor, whether or not each person was a "dog" person or not, whether or not the person avoided displaying abusive behavior due to feeling "watched" or observed. Possible challenges for this particular method of study might include the fact that there are several variables within the study such as both women and men. The question of whether or not males are more likely to abuse animals as opposed to females could be posed. Another variable to consider is whether the individuals in the study had been abused as children as this may play in to their tendency to be abusive as adults. Also, the fact that this study is not being conducted on a large scale may be a challenging factor. However, the relatively small size of the groups should keep costs low and should therefore be within reach. Finally, religious background could be a variable not foreseen or considered. If an individual is of Hindu faith, they will revere animals as much as human life and therefore possibly be that much less susceptible to abusive behavior towards animals. A solution to this variable dilemma may be to only select individuals of non religion. If individuals have no religious beliefs, this may even out the subjects that are being studied, that much more. Other religions, such as Santeria customarily perform animal sacrifice and therefore may view animals in a less than ethical way. Hypothesis 2. The occurrence of domestic violence and animal abuse may be correlated. If domestic abuse is more prominent in a particular race, then animal abuse must also be. "Shelter women were more likely to report that their partners had threatened to hurt their pets" (Ascione, Weber, Wood, 1997). In order to conduct a study to explore this hypothesis, one would have to narrow down the study to either domestic abusers or victims of domestic abuse" In recent years the link between animal cruelty and family violence has captured the attention of sociologists, psychologists, criminologists, and lawmakers" (Faver, Strand, 2003). The best way to go about this study would be to work within roughly 4 women's shelters. These shelters would need to be a good distance apart from one another in order to broaden the demographics of the study. Once gaining permission from the shelter and its residence, one would need to