To demonstrate your familiarity with artists and the influences in their lives, create a 2-part presentation on selected artists.Part I: Historical ArtistStep 1Select one artist from the following chart. Historical ArtistsAuguste Rodin – sculptureDaguerre – photographyEdgar Degas – painterGeorgia O’Keefe – painterMary Cassatt – painterPablo Picasso – painter, sculpture, collageAuguste Renoir – painterClaude Monet – painterVincent van Gogh – painterLeonardo da Vinci – painterMichelangelo Buonarroti – painter, sculptureRaphael (Raffaello Sanzio da Urbino) – painterAlfred Stieglitz – photographyJohannes Vermeer – painterMarcel Duchamp – multimediaPaul Cezanne – painterRichard Serra – sculptorRembrandt van Rijn – painterThomas Cole – painterThomas Eakins – photographer, painterEdvard Munch – painterPaul Klee – painterGustav Klimt – painterHenri Moore – sculptorPart II: Contemporary ArtistStep 1Select a contemporary artist from ART21: https://art21.org/artists/Parts I & IIStep 2Items to include (whenever available) for each part of your artist biography presentation:1 slide: Introduction to artistFull nameBirth date and date of deathPlace of birth and deathCountry of origin1-2 slides: Influences of family and friendsFamily Life: where did he/she live, mother, father, brothers or sisters?Who influenced their art making? Family or friends?Did they have other artists as friends? Who were they?1-2 slides: Environmental and external influencesWhat contextual elements influenced their art making? i.e. war, religious conflict, patron, economics, cultural, environmental, personal beliefs and social issues 5-6 slides: Select 5 works of art created by your chosen artist. For each piece,Describe the style, movement and time periodWhat medium or media was used to create their art?Explain its purpose and meaning. Was there a patron? If so, who? Is there symbolism and/or iconography? Why was it created?Where is the art piece located today? 1-2 slides: Interesting facts you find. Have fun with this:Music the artist may have listened toBooks they may have read, orCreate your own art piece or pieces using your artist as an influence1-2 slides: Cite your resourcesNote: For help in reducing the file size of your presentation, review the free PowerPoint tutorial.FormatPowerPoint PresentationAPA StyleLength: 20-30 slides, 10-15 for each part
HUMN 1210 WGU Leonardo Da Vinci Historical and Contemporary Artist Presentation
1.Include an APA title block with your name, class title, date, and the assignment number.Include a table of contents and a reference section. Number your pages in the footer along with the date. Include a header starting on page 2 with the Course and assignment number.Write the problem number and the problem title as a level one heading (Example ‐ A.1.1: Chapter 2, Problem 2.1, Check the Completed Questionnaires) and then provide yourresponse.Use level two headings with short titles for multi part questions (Example ‐ A1.1.a, Short Title, A1.1.b, Short Title II, etc.)Use appropriate level headings for key elements of your discussion such as Research Questions, Hypotheses, Descriptive Statistics, Assumptions & Conditions, Interpretation, Results, and others. Your goal is to make your analysis easy to follow and logical.Ensure that all tables and graphs are legible and include a figure number.Carefully review your document prior to submission for formatting, flow, and readability. Keep in mind that running the statistical tests is only the first half of the challenge; you must be able to clearly communicate your findings to the reader!. Cut and paste your outputs directly into your document and refer to them in your interpretation.At least 3 references for each assignmentsAssignment 6A6.1: Chapter 9, Problem 9.1, Scatterplots to Check the Assumption of Linearity. Write a short narrative of your process and interpretation of your findings. , Cut and paste the Scatterplots with Regression Lines from Output 9.1a and 9.1b directly into your document and refer to them in your interpretation.A6.2: Chapter 9, Problem 9.2, Bivariate Pearson and Spearman Correlations. Write a short narrative of your process, an interpretation of your findings, and write your results. Cut and paste the Descriptive Statistics, Correlations, and Nonparametric Correlations tables directly into your document and refer to them in your interpretation.A6.3: Chapter 9, Problem 9.3, Correlation Matrix for Several Variables. Write a short narrative of your process, an interpretation of your findings, and write your results to include tables. Cut and paste the Descriptive Statistics and Correlations tables directly into your document and refer to them in your interpretation.A6.4: Chapter 9, Problem 9.4, Bivariate or Simple Linear Regression. Write a short narrative of your process, an interpretation of your findings, and write your results. Cut and paste the Model Summary, Variables Entered/Removed, ANOVA, and Coefficients tables directly into your document and refer to them in your interpretation.A6.5: Chapter 9, Problem 9.5, Multiple Regression. Write a short narrative of your process, an interpretation of your findings, and write your results to include tables. Cut and paste the Descriptive Statistics, Correlations, Variables Entered/Removed, Model Summary, ANOVA, and Coefficients tables directly into your document and refer to them in your interpretation.A6.6, Application Problem ‐ Correlation and Regression. Using the “college student data.sav” file, do the following problems. Write a short narrative of your process, an interpretation of your findings, and write your results to include tables. Cut and paste your outputs directly into your document and refer to them in your interpretation.Write a research question and a null hypothesis exploring the relationship between student’s height and parent’s height. Conduct a correlation analysis to test the relationship including a scatterplot. Include Descriptive Statistics, Correlations, and Nonparametric Correlations tables and refer to them in your interpretation. Prior to running the analysis, discuss how the data meets the assumptions and conditions for the tests you are going to conduct. Support your assertion with the appropriate descriptive statistics.Write a research questions and a null hypothesis exploring the relationship between student gender, parent’s height, and student’s height to see if student’s height can be predicted. Before beginning thetest, recode gender (1 = male, 2 = female) to “Male” (1 = male, 0 = not male).Explain why recoding gender “Male” was necessary to run this test. Conduct a regression analysis to test the relationship. Include Descriptive Statistics, Correlations, Variables Entered/Removed, Model Summary, ANOVA, and Coefficients tables and refer to them in your interpretation. Prior to running the analysis, discuss how the data meets the assumptions and conditions for the tests you are going to conduct. Support your assertion with the appropriate descriptive statistics.
Faulkner University Scatterplots to Check the Assumption of Linearity Project
Please write a summary for the following paper:Social InequalityI learned a lot about inequality and the systems in society that contribute to the ever growing phenomenon of inequality. The weekly readings provided explanations of how inequality occurs in society and how it affects us. However, I found the weekly discussions and video blogs by my classmates to be more interesting. My classmates provided real-life examples of their experiences with inequality, which I found to be an effective way to understand how different people face different forms of inequality. Thank you to my instructors and my classmates for making this course an ideal learning opportunity and an eye-opener.Immigration, Class, Wealth, and Poverty are some of the factors that create inequality in the US. The readings provided a detailed explanation of how these factors enhance the gap between the rich and the poor as well as discriminate against individuals from certain ethnic backgrounds, religion and social classes.Americans and other majority communities in other nations may view immigration as an element that threatens national identity. As a result, immigrants, in some cases, may face discrimination from the native inhabitants or the majority communities in a nation. In the US, there are both legal and illegal immigrants. While they may both experience similar challenges, illegal immigrants may face more severe challenges. The article by HopkinsLinks to an external site. explains that Americans develop anti-immigrant policies based on the fear of a culture loss. Language, in particular, is the main concern for Americans. However, the consequences of their actions are that immigrants, especially those who are here legally my face discrimination, which lowers the quality of their life. Immigrants may also affect the employability of Americans. The article by Lopez explains how industries used Mexican immigrants to replace African American workers. Employers in the US have a more positive perception of Mexican immigrants in comparison to African American Immigrants. Therefore, immigration is a concern for society due to the inequality it creates.Class, wealth and poverty all have an influence on achievement. Reardon explains that a family’s socioeconomic status characteristics play a role in the creation of inequality. The income gap between high and low-income families has widened, and so has the achievement gap between the children from these families. Reardon finds that the achievement gap is larger for children born in 2001 than those born 25 years ago. The growth of the income achievement gap also means that future generations may have an even larger inequality gap. The podcast by ChanaLinks to an external site.also shows how class and wealth creates inequality for future generations. Children from wealthy schools are generally expected to become successful professionals or individuals who have power or influence in society. Children from schools in the lower class are mainly expected to remain in their social class, especially if they lack the exposure to opportunities. Exposing children from lower social classes to opportunities through cultural exchange programs or trips to universities or companies is an ideal way to enhance their chances or progressing to the next higher social class. Less educated parents are also less likely to realize the importance of investing in their children, which leads to the widening of the inequality gap.
UCD Types of Discrimination Discussion
Thematic Connections: Sweat, How it Feels to be Colored Me, Seeing the World Through One Eye
Directions: In an essay of personal narrative, I would like you to write about a situation that has in some important way transformed your view of the world and your place in it. This essay asks you to consider, perhaps, a profound moment of change in the way you perceive the world. This could cover a broad range of situations and many students choose to write about both positive and negative experiences. The tone of the essay is completely up to you.
I have given you a sample of an essay from one of my favorite authors Zora Neale Hurston. Hailey Miller’s story is also an example, as is my own. Consider each of these essays as an acceptable response to this assignment, as effective samples; but by no means is this the only way to respond successfully. Feel free to write humorously, more seriously or whatever mood seems appropriate to the story you are telling. Don’t forget that, in essence, this is exactly what you are doing—telling a story!
You may choose to talk about a personal experience that has taught you something important about yourself, about others, or even about your perceptions of the world in general. It doesn’t really matter whether your experience was small or large, since it turns out this is usually only a matter of perspective.
What have been your most meaningful moments? What scenes from your life have made a lasting impression? Try to focus on one situation, as trying to discuss many experiences may prove too demanding. Some of my students say they haven’t had any profound transformational experiences. If you’re one of them, just aim for an experience that left you with a lasting piece of wisdom, even if it seems less than profound. One of the best essays I’ve ever read began with these lines: “My dad kept a pork chop in his pocket at all times. No one knew why. My family is just weird like that.” By the end of the essay I could barely breathe I was laughing so hard.
I find that very often the most amazing insights can be found when we pay attention to seemingly “inconsequential” matters. If your experience moved you in some way, it is likely to do so for your readers as well.
Guidelines: Your essay should be 4-6 pages in length. Don’t get caught up in counting words or pages though. It should be MLA formatted as well.
San Diego Mesa College Struggles of Life & Situations Change Essay
History of Islam in China Essay
The history of Islam in China mostly dates back to the period of Mohammad (Pbuh). During this era, China was regarded as the most developed nation worldwide. It is believed that the existence of Islam in China can even be traced earlier than this, during the period of Uthman ibn Affan which is taken as the third Calihp. The introduction of Islam in China occurred after the Islam triumphed over Byzantine, Persian and Romans. Then Uthman ibn Affan commissioned a delegation to China in 29 AH (650 C.E) which was eighteen years later after the death of Phuh. Some people link the initiation of Islam in China to the Arab merchants. The Arabs traders, who had visited China on their Silk Route, had taken this opportunity to spread Islam to the Chinese who they interacted with as they traded. The rate of spread of Islam in China by then was very minimal, since the spread of Islam did not have any organized effort. Despite lack of considerable documentation about the history of Arab history, the brief Chinese history depicted above and the evidence contained in the Ancient Record of Tang Dynasty described this event as the birth of Islam in China. In appreciation of the Islamic religion in China, the Chinese emperor referred as Yung Wei ordered the building the of first China’s mosque formerly known as Magnificent Canton mosque, which is currently named the Memorial Mosque. This mosque still stands even to date after having existed for fourteen centuries (Ban par.2-5). The presence of this mosque facilitated the establishment of the first Muslim settlement in this port city. The settlement was greatly boosted when Umayyads and Abbasids sent six delegations to China that was greatly appreciated by the Chinese. Since the Muslims and in particular the Arabs were very civilized both technologically and economically through trade, those Muslims who migrated to China greatly boosted the economic growth of China. They were renowned to dominate the imports/exports trades during the period of the Sung Dynasty which occurred between 960 to 1279 CE. This was also boosted intensively by the presence of a Muslim as the director General of shipping. It was under the Ming Dynasty which existed in 1368 to 1644 CE that Muslims became fully integrated in China. This period is often referred as the golden age of Islam in China as Chinese Muslims flourished greatly during this period. This period was also marked by large number of intermarriages between Muslims who had migrated to China and the Han Society. An interesting phenomenon of these intermarriages was noted by the manner in which the Muslim names changed. Many Muslims who married Han women opted to take on the names of their wives, while others opted to adapt the surnames of Mai, Mu and Mo. Get your 100% original paper on any topic done in as little as 3 hours Learn More Those who adapted these names were mostly those Muslims who had names such as Mustafa, Muhammad and Masoud. Those Muslims that could not identify Chinese names that matched their surnames opted to take the Chinese character that mostly resembled their names. For instance Ha for Hassan, Sai for Said, Hu, for Hussain among others. Apart from the great transformation of the Chinese Muslim names, the Muslim custom of dressing and foods ware also greatly affected. The Muslims dietary and mode of dressing was strictly observed and not compromised. As time elapsed, the Muslims who had migrated to China started speaking the Hans vernacular and were also conversant in reading the Chinese language. This completely transformed the Muslims to look like the other Chinese. The only difference that existed between the Muslims and other Chinese was the unique way that the Chinese Muslims dressed. The challenging aspect that was prevalent among the Muslims is that despite their great economical progression, they maintained a humble lifestyle. Muslims were regarded as being fair, self disciplined and law-abiding. This ensured a smooth coexistence of Muslims and non- Muslims Chinese. As time passed and more Muslims migrated to China, Muslims built more Schools, mosques and madrasas that were very popular such that they attracted students as far as in India and Russia. It is noted that in 1790’s the city of Bukhara had as many as 30,000 Islam students. The city was often referred as the birthplace of Imam Bukhari who was a renowned compiler of hadith. The place later came to be referred as the Pillar of Islam (Rahman 5). The great propagation of Muslim in China changed with the rise of the Ch’ing Dynasty that lasted from1644 to 1911. The Ch’ing king was a Manchu, but not Han. Since Manchu were the smallest faction of the Chinese, they employed the strategy of divide and rule to split the Tibetans, Hans, Muslims and Mongolians. In fact they were responsible for inciting the anti-Muslim sentiment in the entire China. They employed the Han soldiers to repress those areas in China that were dominated by Muslims. Islamic religion had continued to spread widely during the reign of Yuan and Ming dynasty. During these eras, Muslims who migrated to China were known to be offered senior positions in the Chinese administration, before the coming of Manchu dynasty which greatly suppressed Islam. The fall of Manchu Dynasty in 1911 resulted to the establishment of the republic of China that was being headed by Sun Yat Sen who declared that the state belonged equally to Muslims (Hui), Han Manchu, Meng and the Tibetan people. He enacted very strategic policies that greatly promoted favorable relations among these groups. We will write a custom Essay on History of Islam in China specifically for you! Get your first paper with 15% OFF Learn More Since the establishment of the republic of China in 1949, there have existed many upheavals that had culminated in cultural revolutions. This has resulted to great suffering of the Muslims together with other Chinese population. The Chinese government liberalized its policies toward Islam and Muslim during the 11th central committee. In addition, the declaration of freedom of worship in China in 1978 has greatly assisted the Muslims in China in expressing their convictions fearlessly. Before then, very few pilgrims were allowed to visit Mecca, but with introduction of this policy in china, the Chinese government started to relax its strict Muslim policies that regulated closely Muslim conducts. Nowadays there are many Muslims that visit Mecca yearly. The current China’s leadership seems to be experiencing a modest revival. This is because religious leaders are reporting more Muslim worshipers than before the occurrence of the Cultural Revolution. Similarly, there has been noted great increase of interest in religion among the young generation (Gernet 7). There has been a great spread of Islam in China lately. In 1998, it was noted that there was over 23,000 mosques in China and more than 3,749 of these mosque be located in the province of Xinjiang. This illustrates how the Islam religion has greatly propagated in China. China has been noted to have an amplified upsurge in Islamic religion. This has resulted to formation of many nationwide Islamic associations which are used to coordinate the inter-ethnics activities amongst the Chinese Muslims. This has enhanced the accessibility of the Islamic literature and also promoted the translation of Qur’an into eight different Chinese languages to facilitate the spread of Islam in China. In addition, these associations have also enabled translation of Qur’an into Uygur and other Turkic languages which has also boosted the spreading of the Islam religion (Gernet 11). The Chinese community has shown a considerable tolerance of the Islamic religion. This is evident by how non Muslim Chinese had embraced the restrictions of breeding of pigs in areas that are highly Muslims dominated. The breeding pigs are generally forbidden since it contradicts the Islamic faith. In addition, the Muslims in China have been given separate cemeteries. Muslims couples who are getting married are often privileged to have their marriages consecrated by an Imam. Moreover, Muslim workers in China are given free holidays during major Muslim religious festivals such as during Eidul-Adha, Eidul-Fitri and Mawlid festivals. Similarly, the Chinese Muslims have been awarded an almost unrestricted allowance to visit Mecca. The number of Muslims who attend pilgrimage annually in Mecca has tremendously increased nowadays. In the year 2010, more than 13,100 pilgrims from China visited Mecca. During this season they dominantly leased flights that departed from China’s major cities such as Beijing, Lanzhou, Urumqi Kunming and Yinchuan (Ban par.15). Not sure if you can write a paper on History of Islam in China by yourself? We can help you for only $16.05 $11/page Learn More Through the past 1,400 years ,the Chinese Muslims mainly from the 10 ethnic minority factions such as Kazakh, Tajik, Uzbek, Hui, Uyghur, Bonan, Dongxiang, Salar, Kyrgyz and Tatar maintained their Islamic faith and culture which has promoted the formation of Asia’s largest Muslim population. The Muslims in China account for less than 2% of the total population of China, which represents 21 million Muslims. Most Muslims live in the north-west part of China’s provinces such as Gansu, Ningxia and Xinjiang. Currently many Muslims have moved to other parts of China such as Shanghai, Yunnan, Beijing, Henan and Guangdong. It has been noted that despite the diverse ancestral and cultural orientations of the 10 ethnic groups, they all observe similar cultures involving the diet, dress codes and teaching. Women wear head scarves while men are known to wear white caps. Although, Muslims accounts for only 2% of the total Chinese population, the Chinese Muslim population had continued to grow tremendously. The growth have been facilitated by the movement of the north-west Muslims to the south and east regions. There settlements in these regions have necessitated the building of mosque in these areas which has greatly boosted the growth of Muslims in China (Ban par.6). Although the China’s Muslims are known to be very law abiding citizens, they have are also renowned to be very vibrant in Chinese politics. The Muslims in China have always expressed firmly all issues that affected them directly without shying away. They continued holding and practicing their faith even in very trying moments. Their steadfast element greatly helped them in their fight for removal of those policies that in the past had greatly discriminated Muslims by restricting them participate adequately in Muslim activities such as visits to Mecca. This has resulted to the Chinese government implementing appropriate policies that have really enhanced the proliferation of Islamic religion in China to become the second largest religion in China. Works Cited Ban, Chow.”Muslims in China keep their faith.” The star Online. January 13, 2011. Web. Gernet, Jacques. A History of Chinese Civilization. London: Cambridge University Press. 1996 print. Rahman, Yusuf .History of Islam in China and Distribution of Islamic Faith in China. New York: Prentice Hall. 2007 print
UMGC The Cost Associated with Mandatory Vaccination Argumentative Essay
online homework help UMGC The Cost Associated with Mandatory Vaccination Argumentative Essay.
Group AssignmentThis is 2 and half page assignment.Culturally, the United States places great value on individual liberties, arguably more than any other nation on earth. This creates a natural tension between what may be beneficial for the general population and what may infringe on individual rights. Working within a group designated by your professor, develop a consensus statement supporting Mandatory VaccinationDefine the societal benefit or burden and whether current practice is insufficient, about right, or overbearing. Remember this is not about individual opinions, all perspectives must be supported by appropriate scholarly research and consider opposing viewpoints.Since this is a group assignment, here is how it is distributed1.One person is working on Coronavirus vaccine development.2.Another person is working on Mandatory vaccination success story/perception.3.Another person is working on importance of mandatory vaccines and herd immunity4.Mine is cost associated with mandatory vaccination.This task is to work on cost associated with mandatory vaccination to support what other team members are working on. This will be a 2 and half page assignment.
UMGC The Cost Associated with Mandatory Vaccination Argumentative Essay
JOUR 2310 Feature Story
JOUR 2310 Feature Story.
I’m working on a creative writing question and need guidance to help me learn.
Instructions:Please interview a person who has an interesting job/hobby. This can be a local business owner, UNT staff member, etc. You can ask them questions about their life, their job, the process of getting the job, what they enjoy/not enjoy about it, among others. Please take thorough notes. Use at least TWO other sources to flesh out your story. This means your story must contain a total of three sources. This can include one research source.Note: This person cannot be a friend, family member or classmate. Why? You can’t be completely objective. Plus, you need to get used to talking with new people.Once you have your notes, please write a feature story using an alternative lead of your choice. Check out some feature story examples. in this week’s module.Some pointers:You may interview your subject via phone or online apps such as Skype, Zoom or FaceTime. Pay attention to their mannerisms and things in their environment. For example: how does the person talk? do they use their hands? What’s the room look like? Does the person use voice inflection or facial expressions?Please get their permission before recording them. Take notes, too. The story should be focused on the person’s job/hobby. The questions should focus around this particular aspect of the person’s life.You are free to interview the person’s friends or family if you feel that doing so will give you additional relevant material. You can quote them in your story.You will need to use material from other sources such as newspapers to add to your story. For example, if my subject Tom was a coin collector and he spoke about discovering a rare coin, I might use an online resource to add more information on that particular coin to show readers how rare it is. I might also interview a coin broker to find out what it was worth.The story should have at least two good direct quotes.Be sure to add a nut graf to the story. Remember, this is the paragraph that comes below the alternate lead and sums up the newsworthiness of the story. Since your subject is unlikely to be a celebrity/newsworthy (prove me wrong!), your nut graf could be something very simple. Using the previous example of the coin collector, my nut graf could simply say something like this—Tom has been collecting coins since the time he was a teenager, and he has a large collection of coins that he displays at local exhibitions.Before you start writing, please be sure to look at the examples of feature stories that I posted on Canvas. Requirements:Length: 750-words (roughly 3 pages of double-spaced text)Format: Double-spaced, indent paragraphs, 1-inch margins and Times New Roman 12-point font.Pay careful attention to grammar, spelling, punctuation, sentence structure and AP Style.Upload as yourlastname_feature.
JOUR 2310 Feature Story
University of Texas Rio Grande Exercise for Stress and Anxiety Discussion Response
University of Texas Rio Grande Exercise for Stress and Anxiety Discussion Response.
Peer review is an important process in graduate education where we offer constructive criticism of the work of our peers. For this discussion, post a draft of your Evidence-Based Presentation. It does not need to be a video and can be the visual presentation only. After you have posted your initial posting (your rough draft) by the third day of the module, respond substantively to at least two peers with suggestions for improvement by the end of the module.Please post an initial posting with at least two references using correct APA STYLE (this will be expected for all if not of your work in the program). After you have posted your initial posting by the third day of the module, respond substantively to at least two peers by the end of the module (this will be the basic discussion format for the course please use APA style in you response reference or references).PLEASE PEER THE THE PRESENTATION ONE AND TWO WITH TWO CITATION EAC PLUS REFERENCES AT THE BOTTOM. DUE BY 07/01/2020 BY NOON.THANKS1) FIRST VISUAL PRESENTATION Anxiety Disorder Anxiety disorders include disorders that share features of excessive fear and anxiety and related behavioral disturbances. Fear is the emotional response to real or perceived imminent threat, whereas anxiety is anticipation of future threat. Obviously, these two states overlap, but they also differ, with fear more often associated with surges of autonomic arousal necessary for fight or flight, thoughts of immediate danger, and escape behaviors, and anxiety more often associated with muscle tension and vigilance in preparation for future danger and cautious or avoidant behaviors. Sometimes the level of fear or anxiety is reduced by pervasive avoidance behaviors. Panic attacks feature prominently within the anxiety disorders as a particular type of fear response. Panic attacks are not limited to anxiety disorders but rather can be seen in other mental disorders as well (APA, 2013). Anxiety disorders are the most prevalent psychiatric disorders and are associated with a high burden of illness.1-3 with a 12-month prevalence of 10.3%, specific (isolated) phobias are the most common anxiety disorders, although persons suffering from isolated phobias rarely seek treatment. Panic disorder with or without agoraphobia (PDA) is the next most common type with a prevalence of 6.0%, followed by social anxiety disorder (SAD, also called social phobia; 2.7%) and generalized anxiety disorder (GAD; 2.2%). Women are 1.5 to two times more likely than men to receive a diagnosis of anxiety disorder ( Bandelow, Michaelis, & Wedekind, 2017). Generalized Anxiety Disorder Generalized Anxiety Disorder (GAD) is a common mental disorder marked by persistent anxiety and worries, which are excessive and difficult to control, as well as multiple psychological and physical symptoms. GAD often has a chronic course with a lifetime prevalence rate for DSM-IV criteria estimated at approximately 6 % . Persons suffering from GAD present significant impairments in work, social and family functioning, and health-related quality of life. There is also increasing evidence regarding the economic burden of GAD in terms of lost work productivity and medical costs due to high utilization of medical services. GAD is highly associated with comorbid psychiatric disorders, with major depressive disorder being the most frequent, and comorbid physical illness (Roberg et al., 2015). Diagnostic CriteriaAccording to APA (2013), diagnostic criteria for GAD include the following:Excessive anxiety and worry, occurring more days than not for at least 6 months, about a number of events or activities such as work or school performance.The individual finds it difficult to control the worry.The anxiety and worry are associated with three or more of the following six symptoms with at least some symptoms having been present for more days than not for the past 6 months; restlessness or feeling keyed up or on edge, being easily fatigued, difficulty concentrating or mind going blank, irritability, muscle tension, and sleep disturbance.The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.The disturbance is not attributable to the physiological effects of a substance such as a drug of abuse, a medication or another medical condition such as hyperthyroidism.The disturbance is not better explained by another mental disorder (e.g., anxiety or worry about having panic attacks in panic disorder, negative evaluation in social anxiety disorder [social phobia], contamination or other obsessions in obsessive-compulsive disorder, separation from attachment figures in separation anxiety disorder, reminders of traumatic events in posttraumatic stress disorder, gaining weight in anorexia nervosa, physical complaints in somatic symptom disorder, perceived appearance flaws in body dysmorphic disorder, having a serious illness in illness anxiety disorder, or the content of delusional beliefs in schizophrenia or delusional disorder). Treatment Options Medication or psychotherapy is a reasonable initial treatment option for GAD. Some studies suggest that combining medication and psychotherapy may be more effective for patients with moderate to severe symptoms. Compassionate listening and education are an important foundation in the treatment of anxiety disorders. The establishment of a therapeutic alliance between the patient and physician is important to allay fears of interventions and to progress toward treatment. Common lifestyle recommendations that may reduce anxiety-related symptoms include identifying and removing possible triggers (e.g., caffeine, stimulants, nicotine, dietary triggers, stress), and improving sleep quality/quantity and physical activity. Physical activity is a cost-effective approach in the treatment of GAD and PD.16,17 Exercising at 60% to 90% of maximal heart rate for 20 minutes three times weekly has been shown to decrease anxiety16; yoga is also effective ( Locke, Kirst, & Shultz, 2015). Medication A number of medications are available for treating anxiety, selective serotonin reuptake inhibitors (SSRIs) are generally considered first-line therapy for GAD. Second line of treatment includes tricyclic antidepressants (TCAs) such as Amitriptyline, Imipramine (Tofranil), Nortriptyline (Pamelor). Antiepileptics such as Pregabalin (Lyrica), and antipsychotics such as quetiapine (seroquel) are considered second line of treatment. For third line of treatment, Monoamine oxidase inhibitors especially Isocarboxazid (Marplan), Phenelzine (Nardil), and Tranylcypromine (Parnate) can be used. Lastly for augmentation treatment, Benzodiazepines especially Alprazolam (Xanax), Clonazepam (Klonopin), Diazepam (Valium), and Lorazepam (Ativan) can be used. Medications should be titrated slowly to decrease the initial activation. Because of the typical delay in onset of action, medications should not be considered ineffective until they are titrated to the high end of the dose range and continued for at least four weeks. Once symptoms have improved, medications should be used for 12 months before tapering to limit relapse. Some patients will require longer treatment. Benzodiazepines are effective in reducing anxiety, but there is a dose-response relationship associated with tolerance, sedation, confusion, and increased mortality. When used in combination with antidepressants, benzodiazepines may speed recovery from anxiety-related symptoms but do not improve longer-term outcomes. The higher risk of dependence and adverse outcomes complicates the use of benzodiazepines. National Institute for Health and Care Excellence (NICE) guidelines recommend only short-term use during crises. Benzodiazepines with an intermediate to long onset of action such as clonazepam (Klonopin) may have less potential for abuse and less risk of rebound ( Locke, Kirst, & Shultz, 2015). Risk and Prognostic Risk FactorsAccording to APA (2013), this can be categorized as:(i)Temperamental where by behavioral inhibition, negative affectivity (neuroticism), and harm avoidance has been associated with generalized anxiety disorder.(ii) Environmental where by childhood adversities and parental overprotection have been associated with generalized anxiety disorder, no environmental factors have been identified as specific to generalized anxiety disorder or necessary or sufficient for making the diagnosis.(iii) Genetic and physiological where by one-third of the risk of experiencing generalized anxiety disorder is genetic, and these genetic factors overlap with the risk of neuroticism and are shared with other anxiety and mood disorders, particularly major depressive disorder. ReferencesAmerican Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders DSM-5 (5th ed.). Washington, DC: American Psychiatric Publishing.Bandelow, B., Michaelis, S., & Wedekind, D. (2017). Treatment of anxiety disorders. Dialogues in clinical neuroscience, 19(2), 93–107.Locke, A.B., Kirst, N., & Shultz, C.G. (2015). Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults. American Family Physician, 91(9), 617-624.Roberge, P., Normand-Lauzière, F., Raymond, I. et al. (2015). Generalized anxiety disorder in primary care: mental health services use and treatment adequacy. BMC Family Practice, 16, 146. Doi: https://doi.org/10.1186/s12875-015-0358-y2) SECOND VISUAL PRESENTATIONAnxiety Disorder Due to Another Medical Condition 293.84 specify (F06.4)“Diagnostic CriteriaPanic attacks or anxiety is predominant in the clinical picture.There is evidence from the history, physical examination, or laboratory findings that the disturbance is the direct pathophysiological consequence of another medical condition.The disturbance is not better explained by another mental disorder.The disturbance does not occur exclusively during the course of a delirium.The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.Coding note: Include the name of the other medical condition within the name of the mental disorder” (DSM-5 2019. Pgs. 230-231.)The DSM-5 (2017) goes on to report that, It is important to note that this particular anxiety disorder is related to another medical condition where it is judged that the best explanation for anxiety is due to the physiological effects of another medical condition. This diagnosis must be made from the clinicians’ judgment based on history, physical exam, and or other laboratory findings. The clinician must determine that symptoms are not better accounted for by another mental disorder such as an adjustment disorder with anxiety in which the stressor is the medical condition. It seems obvious but the clinician must also establish the presence of another medical condition and that anxiety symptoms can be etiologically related to that medical condition. Associated symptoms include chronic conditions of an endocrine disease, cardiovascular disorders, respiratory illness, metabolic disturbances, and neurologic illnesses. The development and course of an anxiety disorder due to another medical condition arrives from the underlying medical illness.There’s also extensive research that adding physical activity to the treatment of anxiety and other medical conditions that are associated with anxiety. Pedersen & Saltin (2015), discuss 26 different chronic diseases that have anxiety overlying symptoms and the benefits of physical activity for each of these diseases. Understandably we have been trained to write a prescription, but writing a prescription for exercise is not out of the question due to the abundance of research.In a meta-analysis, Stubbs et. al., (2017) shows that exercise should be considered an evidence-based option for treatment of anxiety symptoms and other stress related disorders. It is also quite prevalent in the treatment of chronic diseases such as respiratory issues and cardiovascular problems.Diagnostic and statistical manual of mental disorders: DSM-5. (2017). Arlington, VA: American Psychiatric Association.Pedersen, B. K., & Saltin, B. (2015). Exercise as medicine – evidence for prescribing exercise as therapy in 26 different chronic diseases. Scandinavian Journal of Medicine & Science in Sports, 25, 1-72. doi:10.1111/sms.12581Stubbs, B., Vancampfort, D., Rosenbaum, S., Firth, J., Cosco, T., Veronese, N., Schuch, F. B. (2017). An examination of the anxiolytic effects of exercise for people with anxiety and stress-related disorders: A meta-analysis. Psychiatry Research, 249, 102-108. doi:10.1016/j.psychres.2016.12.020
University of Texas Rio Grande Exercise for Stress and Anxiety Discussion Response