Some wilderness enthusiasts will tell you that this is because a clean, natural landscape is the only place in our modern world that is capable of connecting us to something larger than ourselves.  Surrounded by concrete and skyscrapers, we forget what trees and flowers look like when they’re not surrounded by mulch. Eating fast food and prepackaged meals, our bodies have forgotten what it is like to take sustenance from the pure, un-preserved forms of food found in the wild.

If you find yourself feeling continually bored, lethargic, stifled, moody, or stressed out, mother nature may be able to help you. There is a new school of thought about the benefit of outdoor exposure, and it seems it may be even more helpful than we at first thought.

Wilderness therapy is the moniker given to the many forms of controlled outdoor exposure. There does not have to be an underlying therapeutic objective, although some programs are designed that way. Simply being in a wilderness setting as part of a group is often enough.

In 1999, psychologists Frederickson and Anderson took two groups of twelve female participants on either a six-day backpacking trip through the Grand Canyon or a seven-day canoe trip through the Minnesota wilderness. Some of the women were from high-stress corporate settings and some were full-time homemakers; all were struggling with stress or depression in various forms.

During the course of the trip, the participants all became visibly more relaxed. Many cited the purity of the outdoor environment as a large part of the cause. They felt that the solitude they were able to enjoy in the wilderness gave them time to ponder some of life’s more difficult questions, and added to their spirituality. As one woman said, “I express my spirituality when I am deeply in tune with the forces of nature and feel a certain interconnectedness with all other living things- that is when I am experiencing my spirituality to the fullest.”

Many studies echo the findings of this one. Wilderness experiences can reduce depression through relieving stress and stimulate the body physically, which can also energize the mind. All of the participants felt that they were able to abandon the perplexing social rules and restrictions they were obliged to follow in their daily lives for a feeling of acceptance and freedom seldom felt anywhere else.

You may question the lasting effects of such a trip, but in a follow-up interview conducted 30 days after the initial experience, 92% of participants still felt a reduced level of stress from the time before the trip. Many of the women also stated that, when they did feel stressed or depressed, they were able to use the uplifting feelings they had on their trip as a meditation tool to help them feel better again.

Types of wilderness therapy are many and varied. There are trips that are designed specifically for men and deal with some of the issues that commonly cause stress and depression in men, as well as general trips for men and women that simply rely on outdoor exposure to be the healing balm. Many small, independent companies offer these types of programs in all regions of the country, and provide a more personalized experience. You can find these companies in your area by doing an internet search for wilderness therapy, or by visiting www.wildernesstherapy.org, a non-profit website that offers people helpful and accurate information on agencies that offer wilderness therapy programs.

Larger companies such as Outward Bound use wilderness therapy to help adolescents cope with difficulties in their lives or behavior problems by using the natural landscape as a teaching and learning tool. Perhaps the largest-scale organization,  National Outdoor Leadership School (NOLS) has classes ranging from 10 days to several months, where intense outdoor survival skills are taught in an effort to heal the earth and humanity as one.

There is no question that NOLS students learn the hardest and longest-lasting lessons about the wilderness. Students learn to practice Leave No Trace, an environmentally-friendly practice that means whatever you pack in, you must pack out, including trash and feces (don’t worry, there are special bags and containers for this purpose!) They also learn how to live off of nature, navigate the wilderness, and study the flora and fauna of the environment. Many former NOLS students learn a rewarding way of life that they adopt as a permanent part of their lives, and most leave NOLS with such a deep love and respect for the wilderness that they return year after year.

Even if you are not looking for such an intense or time-consuming experience, there is no population on earth that cannot benefit from some form of wilderness exposure. It has not only been clinically proven to help reduce stress, depression, anxiety, and a variety of social disorders, but it also has enumerable positive physical effects, increases overall life-satisfaction, and can help your corporation achieve goals and increase productivity in a fun and team-building way. Co-workers who undergo a wilderness experience together emerge feeling part of a cohesive team, valued for their individuality and experience.

If you undertake a wilderness experience, you may get wet, dirty, have to do your business under a tree, and at times be bone-weary, but you will feel a sense of personal satisfaction and achievement that no modern diversion can offer. No matter how uncomfortable you may be at times, when it is all over you will fervently wish to return to the woods.

As the veteran of thousands of hours spent in the wilderness, I can say with authority that firsthand knowledge of the ageless healing beauty of nature really can enhance your everyday life.  Simply being aware that there is something larger out there is enough to give life more meaning, for you will have seen firsthand how we are all a part of one whole, striving for common goals. It helps us realize that the decisions we agonize over are really not life-or-death. Knowledge of the wilderness puts things into a grand perspective and affects an attitude change whose effects are omnipresent. Outdoor exposure is the healing panacea that we modern humans have been searching for, and it has been firmly beneath our feet since the dawn of time.

Works Cited

Fletcher, T. B., & Hinkle, J. S. (2002). Adventure based counseling: An innovation in counseling. Journal of Counseling and Development, 80(3), 1-15.

Frederickson, L. M., & Anderson, D. H. (1999). A qualitative exploration of the wilderness experience as a source of spiritual inspiration.  Journal of Environmental Psychology, 19, 21-39.

Glass, J. S., & Myers, J. E. (2001). Combining the old and the new to help adolescents: Individual psychology and adventure-based counseling. Journal of Mental Health Counseling, 23(2), 1-9.

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The most know and commonly used is dark soy sauce. Dark soy is used throughout Asia and is a bit richer and thicker than the lighter varieties. It tends to have a chocolate brown color, and a pungent, rather than overly salty, flavor. This sauce is the most traditional of them all, but in some cases the sauce is altered slightly. Nowadays, Dark sauce is added an American usual, molasses. This gives a slightly altered flavor and texture with a dark, deep brown color. This variety is mainly used as a table top seasoning, but is also used in cooking. It has a richer flavour than light soy sauce, but is less salty (Wikipedia).

Two other types of dark soy sauce that stem from the original is Mushroom soy sauce, and Tamari sauce. Mushroom soy sauce is a dark soy sauce from China which adds straw mushroom essence to the sauce’s brew. It has a deep, rich flavor and can be used in place of other types of soy sauce in most recipes. Mushroom soy sauce is used generally, but not limited to, a table condiment. The other type of dark soy sauce is Tamari. In 1254, a Zen monk called Kakushin, brought back Miso (soybean paste) from China, and while teaching locals how to make Miso, accidentally found a liquid residue in the bottom of the container. This is how the thick soy sauce called Tamari, was found (Japanese Food & Restaurant Guide). This is a deeply colored Japanese soy sauce which has a rich texture and intense flavor. It can be used anywhere regular soy sauce is called for, and is especially good to use as a table condiment and dipping sauce. Both of these other dark soy sauces can complement dishes the same as the original dark soy, but in most cases, better. The unique blends of the two gives soy-lovers a little more excitement to their meals, proving and bypassing their expectations allowing their irresistible essence to emerge as its own. Another dark soy sauce includes Saishikomi, a soy sauce that is fermented twice which gives it a much thicker consistency.

Another type of Soy sauce is Light soy sauce. Originated and most commonly found in Japan, light soy sauce has a thinner consistency and a saltier flavor than the darker varieties. It is preferred when a darker sauce will ruin the appearance of a dish, or when a lighter flavor is sought, especially when serving seafood. Light soy accents, but doesn’t alter the color of the product. When used in Seafood, which is usually lighter in color already, a light sauce will show the true appearance in the way the finished product should be with the added flavor of soy. Not to be confused with white soy sauce, which is light in color, White soy sauce uses larger ratio of wheat : soybeans and requires more salt water than others. Used for cooking white fish, vegetables and soup base for noodles. Mainly made and consumed in Nagoya (Japanese Food & Restaurant Guide). There is always ‘something else’ which contributes to outstanding flavor or deliciousness. In soy sauce, the “something else” comes from various Amino acids which make up a harmony and a fine balance of natural ingredients. Soy sauce contains the essence of peach, apple, pineapple, rose and hyacinths to make a unique symphony of aromas to bring out the natural taste of the ingredients (Japanese Food & Restaurant Guide).

Soy sauce, no matter what type, or distinction, is a delectable treat that Asian history has birthed, and allowed to make its place in the world of all things culinary. Its amazing blend of flavors has tantalized many people for many years and will continue to do so for more to come. Soy sauce is one ingredient that will not only increase the desire to devour sushi, steamed rice, or even soups; but this remarkable “liquid happiness” will accent those dull, bland, and learned flavors and create a burst of zest that no person can deny distinction or sensibility.

Works Cited

CuisineNet. Dine Core, Inc. www.cuisinenet.com

Japanese Food & Restaurant Guide. Japan Web Publishing.

Wikipedia, The Free Encyclopedia. GNU Documentation License. en.wikipedia.org/wiki/Soy_sauce

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Obsessive Compulsive Disorder OCD is characterized by the presence of obsessions and/or compulsions that can be extremely time consuming and/or disrupt a person’s normal routine. According to the literature, ‘time consuming’ means that a person engages in the obsession, or compulsion, for at least 1 hour a day (Geffken, Storch, Gedford, Adkins, Goodman, 2004). Common obsessions in OCD include fear of contamination, chronic doubting, somatic (body) worries, need for symmetry or to make thinks match, and aggressive and sexual thoughts. Some of the more common compulsions include checking, hand washing, touching and tapping (Geffken, et al., 2004). The goal of these behaviors? To alleviate the anxiety caused by the unwanted, intrusive thoughts that occur over and over.

As said above, not all persons afflicted with OCD are hand washers. The majority of people with OCD are obsessed with contamination and engage in compulsive acts of cleaning, usually hand washing. However, up to 25% of OCD sufferers fall in the category of pure obsession. This is where cognitive, not behavioral, rituals predominate. People who fall into this 25% category experience repetitive and intrusive thoughts, usually of a sexual or aggressive nature. As one might guess, this last group is particularly hard to diagnose because of (the client’s) tendency towards secrecy, and because there are no observable compulsions taking place (Spengler, Jacobi, 1998).

One of the delineating factors in a diagnosis of OCD is that the person with the disorder KNOWS that their thoughts or actions are unreasonable, but they feel incapable of stopping them. In most cases, they experience their thoughts as senseless, have poorly developed schemata, and avoid disclosing to others (Spengler, Jacobi, 1998).

OCD usually begins early in life and is a chronic condition that can lead to social and occupational impairment. Onset of the disease occurs most commonly in the adolescent and college years, with men exhibiting signs earlier (17.5 years old) than women (20.5 years old). OCD does not discriminate as there are no differences in rates related to race, marital status, intelligence or educational level.

Although OCD is a debilitating disorder with a lifetime prevalence rate of 25% in adults (Geffken, et al, 2004), many diagnosed with OCD do not receive appropriate care. One of the reasons given for this failure to treat is the incorrect assumption that OCD is a rare disorder. In fact, OCD is recognized as the fourth most common mental disorder following, in order of occurrence, substance abuse, phobias, and major depression (Spengler, Jacobi, 1998). Perhaps part of the reason for this “confusion” is that several disorders manifest ideational processes that are much like the obsessional thinking in OCD. People with Generalized Anxiety Disorder (GAD) and posttraumatic stress disorder (PTSD) also have cognitive processes that are intrusive, repetitive, and exaggerated. The difference lies in how clients view their obsessions. With those that have PTSD or GAD, the intrusive, repetitive exaggerated thoughts are seen as related to one’s self-view of life circumstances. With OCD they are not. (Spengler, Jacobi, 1998). The most common co-morbid condition with OCD is depression – nearly two-thirds of OCD sufferers have lifetime histories of depression. Substance abuse is also common with OCD (24.1%) and up to half of all OCD patients have a personality disorder. (Spengler, Jacobi, 1998).

Clearly, assessment of clients should include ruling out and treating all related disorders.

Obsessive Compulsive Disorder in the Brain

OCD has a genetic and biological component that has been documented in the research. In one comprehensive study of twenty three outpatients with OCD and 27 healthy comparison subjects, MRIs revealed significant differences in the brains of these two groups of people (Szesko, MacMillan, McMeniman, Chen, et. al, 2004). The regions of interest in the study included the frontal lobe sub regions, the caudate nucleus, the putamen and the globus pallidus. The finding in the study included a positive correlation between the globus pallidus and anterior cingulated gyrus volumes in the healthy volunteers, but not in the patients with OCD. This indicates that there is a defect in the connectivity of the frontal-sub cortical circuitry in OCD brains and may play a role in the the pathophysiology of the disease (Szesko, et. al, 2004). In addition to this study, there has been evidence produced to confirm that abnormalities in the basal ganglia are linked to OCD.

Yet why is it necessary to discuss the physiology of OCD? Because the presence of abnormalities in the brain can lead to treatment that is not only technical but pharmacological. Much like the diabetic or the person with high blood pressure, it may be that those with OCD need only take a drug to counteract the problems in their brains. Given this, we are left with questions as to how to treat this disabling disease.

Treatment Options

Given the brain etiology of OCD, it may seem surprising to find out that, in many cases, it has been documented that cognitive behavioral therapy (CBT) is more effective than psychotropic drugs when it comes to long term results. Because of its success, space will be given here to outline the CBT treatment of choice: Exposure and response prevention.

Exposure is an essential practice in CBT for OCD. Simply put, it can be described as having individuals face their fear. Through repeated trials of exposure to a feared stimuli, individuals with OCD have a decreased experience of anxiety (Geffken, et. al, 2004). Response prevention, which is also called ritual prevention, involves having a client refrain from engaging in repetitive, consuming compulsions. Numerous studies have shown that response prevention can help eventually eliminate compulsive rituals (Geffken, et. al, 2004). It is also important to keep in mind that both exposure and response prevention are forms of behavior therapy and as such result in changed cognitions.

Certain guidelines and steps are necessary when employing exposure and response prevention techniques. It is best that this type of therapy be conducted at the location of the symptoms (i.e. in vivo). This is particularly important with regard to exposure, or facing fear, because the goal is to enable the client to interact in the actual places that have previously been sources of trouble – usually places that they have come to avoid. If you are going to use this therapy, it is necessary for the client to understand what the treatment is intended to do and to believe that the treatment is likely to be helpful for them (Geffken, et. al, 2004). This is particularly true due to the nature of anxiety.

After educating the client, situational assessment begins. Questions to ask may go something like, “What ritual physical of behavioral activities or mental rituals does me client do to decrease his or her anxiety, discomfort, distress, or feelings of disgust?” Or you might ask, “What situations and thoughts does my patient try to avoid.” (Geffken, et. al, 2004). Once these are determined, the next step is to establish a hierarchy of your client’s feared situations and how difficult it may be for him/her to approach those situations. Ranking is an important part of the therapy at this point. Anxiety provoking situations can be ranked according to their “subjective units of distress” (SUDS) rating. Usually distress is expressed on a scale of 0 to 100 with 100 representing the most-feared activity and 0 representing a non-feared, neutral activity. Each feared situation on the hierarchy should be assigned a value between 0 and 100 (Geffken, et. al, 2004). Following the establishing of a hierarchy, goals are formulated jointly between client and therapist. Goals should be related to situations at the less-feared end of the hierarchy, such as easier exposures, coupled with partial response-prevention exercises. In addition, the goals should be stated very specifically, written down, and progress checked at each session.

When the symptoms of OCD include thoughts of aggression or sexual acting out, CBT often involves imaginal exposure rather than actual re-enactment. In this way, clients are encouraged to vividly picture the events they fear to enhance the reality of the exposure (Geffken, et. al, 2004).

Given that OCD has a biological and “brain effected” component, it would make sense that psychotropic medication is indicated in treatment. The best medications for OCD are the selective serotonin reuptake inhibitors because they reduce anxiety while allowing individual to experience some anxious arousal. This experience of anxious arousal is necessary to support the effectiveness of CBT. Medications like benzodiazepines prevent individuals from reaching a heightened level of anxious arousal, which can reduce the effectivenss of CBT because heightened arousal is a necessary component of the intervention. Also of note is the fact that OCD occurs very frequently with other disorders, such as depression. When this is the case, pharmacological management of the co-morbid disorder is necessary

What Really Works?

There is extensive agreement that exposure and response prevention is the treatment of choice for OCD. Data suggest that between 50% and 100% of OCD clients respond positively and most maintain changes long after treatment (Spengler, Jacobi, 1998). In some controlled studies of CBT with adults who have OCD, success rates of up to 83% were reported (Geffken, et. al, 2004). In still other studies there was data to suggest that “…CBT may be associated with slightly greater improvement (Geffken, et. al, 2004).”

This doesn’t mean that psychotropic drugs are ineffective in treatment. Researchers in one study found that 53.6% of participants (who received both CBT and setraline) showed complete recovery, that 39.3% of participants became nearly asymptomatic with just CBT, and that 21,4% of the group became asymptomatic when treated with setraline alone (Anonymous, 2004). In addition, because comorbidity is the rule rather than the exception in most OCD clients, psychotropic drugs may be necessary to get a client to a state in which he/she can engage actively in obsession and ritual reduction. Interestingly enough, exposure and response prevention have been shown to produce neurophysiological changes similar to those observed with anti-compulsive medications.

Where To Go From Here

Obsessive-compulsive disorder creates particular challenges for mental health counselors, due to the secretive nature of OCD, the unfounded belief that it is a rare disorder and the reluctance clinicians may have to intentionally increase their clients’ anxiety. Effective treatment of this disorder requires diligence and accurate observation. Attention should be paid in at least three context areas. Counselors must first identify and dispel myths and misconceptions related to OCD, as a way of building a knowledge base. Second, assessment methods for OCD must be learned. And finally, counselors must remain abreast of what is currently known about the treatment of OCD (Spengler, Jacobi, 1998).

In closing, here are three quick screening questions that can be used during an office visit to screen for OCD. Employing them may help to capture some of those silent sufferers.
1) “Do you have repetitive thoughts that make you anxious and that you cannot get rid of regardless of how hard you try?”
2) “Do you keep things extremely clean and tidy or wash your hands frequently?”
3) “Do you check things to excess?” (Zepf, 2004). Perhaps, if we were to take a minute for this simple screening, those suffering from OCD will receive the treatment they need.

References

Anonymous (2004). Combination therapy best for obsessive disorders. AORN Journal, 80, 1156-1157.

Geffken, G.R, Storch, E.A., Gelford, K.M., Adkins, J.W., Goodman, W. K. (2004). Cognitive-behavioral therapy for obsessive-compulsive disorder: review of treatment techniques. Psychosocial Nursing and Mental Health Services, 42, 44-56.

Spengler, P. M., Jacobi, D. M. (1998). Assessment and treatment of obsessive-compulsive disorder in college age students and adults. Journal of Mental Health Counseling, 20, 95-112.

Szeszko, P.R., MacMillan, S., McMeniman, M., Chen, S., et. Al. (2004). Brain structural abnormalities in psychotropic drug-naïve pediatric patients with obsessive-compulsive disorder. The American Journal of Psychiatry, 161, 1049-1057.

Zepf, B. (2004). Management strategies for obsessive-compulsive disorder. American Family Physician, 70, 1379-1381.

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Even with this standardization, it remains difficult for the uninformed consumer to decipher the differences between different organic and non-organic labels. Therefore, it is important to discuss the regulations and standards for food products that are labeled organic, as well as the main actors in the labeling process. The regulations and standards can be broken down into three subgroups: production and handling standards; labeling standards; and accreditation and certification standards. A brief overview of the active parties in the organic labeling process will be followed by an analysis of the aforementioned standards.

Main Actors

The United States Department of Agriculture, formed in 1862 by President Lincoln, is at the forefront of nutrition, conservation, agricultural protection and other related issues. Of the seven USDA mission areas, organic regulations and standards are actively handled by the Marketing and Regulatory Programs (MRP) section through which the Agricultural Marketing Service (AMS) and the Animal and Plant Health Inspection Service (APHIS) are run. The National Organic Program (NOP), a division within the USDA and more specifically the AMS works with the National Organic Standards Board (NOSB) to develop organic labeling standards. The NOSB is a fifteen member panel representing a diverse group including, “farmer and grower; handler and processor; retailer; consumer and public interest; environmentalist; scientist; and certifying agent.”[3] While it is these organizing bodies that develop the standards for organic labeling and regulate the market for organic food products, it is ultimately the growing consciousness of consumers that has catalyzed the growth in organic sales.

Production and Handling Standards

When a food product is a candidate to be labeled organic, several factors are taken into consideration and strict national standards are enforced. These standards are applied to the “methods, practices, and substances used in producing and handling crops, livestock, and processed agricultural products.”[4] For crop production, the methods and practices prohibited include the use of sewage sludge, genetic engineering, most conventional pesticides, and ionizing radiation, among others. The substances that are permitted and prohibited are listed on the National List of Allowed Synthetic and Prohibited Non-Synthetic Substances, this list includes fertilizers and other substances to sustain crops. Fertilizers are important to crops because they add the nutrients back into the soil that were lost during harvesting – fertilizers can be organic or inorganic. Organic fertilizers are made up of the partially decomposed waste products of animals and plants and must be further decomposed before it can be used on crops.

Due to this waiting period, most farmers use inorganic fertilizers made of nitrogen, phosphorus, calcium or potassium (all produced in an industrial process).[5] If prohibited substances have been used on the crop land, at least three years must pass before organic crops can be grown on that soil. It is through the use of organic fertilizers, tillage and cultivation practices, and crop rotation that soil fertility for organically labeled products is assured.[6]

Livestock standards apply not only to the meat taken from animals, but also to the products derived from these animals, such as milk, eggs, butter, and other animal products. Livestock standards are a fairly complex set of rules that include the time periods throughout which the producers must feed the livestock 100 percent organic feed products. Organically raised animals must be 100 percent hormone and antibiotic free, however, it is the responsibility of producers to provide adequate health care when animal get sick. Treated animals may not be used organically. Another requirement for organic livestock is the exposure and access to the outdoors rather than confinement.[7] The handling standards for organic products are very simple – commingling of organic and non-organic products is strictly prohibited.[8]

Labeling Standards

Labeling standards have led to the formation of four labeling categories for organic products. The first category is that of one hundred percent organic products; it is only these products that can be labeled “100% Organic.” The second category of organic labeling is that of products containing at least ninety-five percent organic ingredients; these products are most commonly labeled “organic.” These two categories are the only ones that are permitted to display the USDA Organic Seal (*see attached sheet for a picture of this seal).[9] The third category of “organicness” includes those products that are made with at least seventy percent organic ingredients; these products can claim to be “made with organic ingredients.” The final labeling category is comprised of the products made with less than seventy percent organic ingredients; these products may only use the term organic to specifically list the organic

ingredients on the back or side of the label.[10] The National Organic Program enforces these standards and imposes a ten thousand dollar fine on blatant violations of these standards. Due to the incredibly large volume of products and the strict standards that need to be followed for organic labeling, the USDA accredits producers and handlers of organic products.

Accreditation and Certification Standards

In order for a handler or producer of organic products to be accredited by the USDA, it must go through an application process in which they must prove that they abide by all of the aforementioned standards for production and handling of organic products. The applicants that pass the application process are then able to become certifying agents. These accredited certifying agents are located all across the nation and even internationally, including: New Zealand, the United Kingdom, Spain, Canada, Israel, and Denmark.[11] Producers and handlers that only sell less than five thousand dollars of organic products annually do not have to be certified in order to display one of the categories of labels, however, the may never use the USDA Organic Seal. While all of these standards are of great importance, the “effectiveness” of this organic labeling system must be analyzed.

“Effectiveness” of the Organic Labeling Program

There are several standards by which I will measure the “effectiveness” of the organic labeling program in the United States, including: the quantity of labeling standards, the quantity of organic food product sales, and the level of consumer consciousness through Organic organizations. While it may seem like a false measurement of effectiveness, it is my belief that the increasing quantity of organic labeling standards is an important tool by which to measure the quality of the program. The more standards that are developed means that more standards will ultimately be enforced, thus increasing the quality of the labeling process. Consumers today have unprecedented levels of consciousness on organic food products due to the increasing number of “organic” grocery stores, markets, and restaurants. Also contributing to this consciousness is the formation of organic organizations such as the Organic Consumers Association (OCA) and the International Federation of Organic Agriculture Movements (IFOAM).

As mentioned in the opening paragraph, sales of organic food products has been increasing by a steady twenty percent each year since 1998 – a fact that by itself is an adequate attestation to the success of the organic labeling program. While the importance of recognizing the mounting popularity and trendiness of the organic lifestyle, it is also important to mention that the majority of consumers chose to not make the consumption of organic foods a part of their fast-paced lives. I, however, remain optimistic and believe that any change in the direction of healthier lifestyles, effecting both humans and the earth, is a positive change. It is through the quantity of labeling standards, the quantity of organic food product sales, and the level of consumer consciousness that the successes of the organic labeling program in the United States can be noticed and applauded.

Bibliography

Belk, Colleen and Virginia Borden. 2004. Biology Science for Life. Pearson Education, INC: New Jersey. pp 408-409.

“Background Information”. October 2002. The National Organic Program. http://www.ams.usda.gov/nop/FactSheets/Backgrounder.html

Jeantheau, Mark. “You Don’t Have to be Crazy to Eat Food That’s Certifiable”. 20 July 2004. Grinning Planet. http://www.grinningplanet.com/2004/07-20/food-labels-article.htm

“Organic Food Standards and Labels: The Facts”. April 2002. The National Organic Program. http://www.ams.usda.gov/nop/Consumers/brochure.html

“Organic Production and Handling Standards”. October 2002. The National Organic Program. http://www.ams.usda.gov/nop/FactSheets/ProdHandE.html

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In an effort to understand and look at ways to combat the nursing shortage in Hawaii, we will be asking ourselves the following questions. Why is there a nursing shortage in Hawaii? What has the shortage done to existing nurses? How has Hawaii nursing schools contributed to the nursing shortage in Hawaii? What does a nursing shortage mean for Hawaii? And finally, what actions should we be taking to alleviate the nursing shortage in Hawaii?

Let’s first look at what are contributing factors to the nursing shortage in Hawaii. “In 2000, Hawaii experienced a shortage of 1,041 registered nurses. It is expected to grow to 1,518 registered nurses by the end of 2005 and to 2,267 registered nurses by the end of 2010. Furthermore, nearly 80% of Hawaii’s current registered nurse workforce is expected to retire by 2026.” (State of Hawaii Employee Outlook) Thus, as demand increases dramatically, supply will remain relatively stagnant.

What has the shortage done to existing nurses? Well consider this, “because hospitals operate 24 hours a day, seven days a week, nurses have to put up with all sorts of demands.” (Dela Cruz) Hospital census coupled with higher patient acuity is ever increasing and nurses are reporting less time to take care of patients, less satisfaction with working conditions, monetary compensation, and overall job satisfaction. Side affects of the nursing shortage include constant strains on schedules, mandatory overtime, increasing workloads, high turnover, loss of compassion and inattentiveness while on the job. The Joint Commission on Accreditation of Healthcare Organizations (JACO) reported that, “24 percent of patient errors resulting in critical injuries and or death were related directly to inadequate staffing.”

Who’s to blame? It is not a matter of whom to blame; rather what have we, as a society, been doing to contribute to the nursing shortage. The American Association of Colleges of Nursing (2002) reported a 2.1 percent drop in entry-level nursing student enrollments. In Hawaii, an average of 400 nurses retire annually, but only about 280-300 nurses graduate each year. If graduation rates do not increase dramatically, there will not be enough new graduated to replace retiring nurses and meet new demands. “In 2003, Hawaii nursing schools turned away nearly 300 qualified nursing applicants because they did not have enough faculty positions to meet the student demand.” (Hawaii’s Health in the Balance)

A shortage of qualified registered nurses threatens the health and welfare of Hawaii’s citizens. Without enough registered nurses, some healthcare providers (i.e. hospitals, nursing homes and home care agencies) have started to limit or discontinue services. In some cases, providers continue to provide services but with fewer staff members, potentially affecting patient safety. Ponder about that for a second, how does that make you feel?

There is clear evidence that reducing the nurse-to-patient ratios lead to safe workplaces, less stress and high overall satisfaction. So what are we doing to combat the nursing shortage in Hawaii? With the nursing shortage plaguing Hawaii, The University of Hawaii – Manoa (UHM) felt the need to establish a way to alleviate the nursing shortage. Therefore, they launched a program in 2002 that offers a fast-track nursing program that took less than half the time it takes to complete the traditional three-year Bachelor of Science nursing program. The UHM program joined two other accelerated programs already available in Hawaii. The goals of course to train, educate and graduate a higher number of nurses in the years to come. Additionally, in an effort to analyze data trends, develop a plan for implementing recruitment and retention strategies and research practices and quality outcomes in nursing, the Hawaii State Center for Nursing, affiliated with the UH School of Nursing and Dental Hygiene, was established by the Legislature in 2003. (Sawada)

Increasing supply or decreasing demand can resolve the nursing shortage. While some observes suggest that demand may be tempered by possible changes in health care financial, there is no evidence that this would be significant enough to resolve the shortage. “Investments made today will not only benefit Hawaii over the next 20 years but begin to develop a proactive culture that will sustain a qualifies nursing workforce needs well into the future. (Hawaii’s Health in the Balance) What can you do to help?

References

American Nurses Association. (2001). Analysis of American nurses association staffing survey. Nursing World Staffing

Bureau of Labor statistics. (2002). U.S. Department of Labor. Bureau of Labor Statistics

Dela Cruz, L. (2002). Not enough caring. ­Hawaii Business Magazine. Retrieved July 26, 2005 from EBSCOHost Database, University of Phoenix Library.

Sawada, K. (2003). New UH Center addresses nursing shortage. Pacific Business News. University of Hawaii Nursing Shortage

State of Hawaii employment Outlook for Industries and Occupations, 2000-2010, State of Hawaii, Department of Labor and Industrial relations, Research and Statistics Office.

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Purpose

This study investigates whether a relationship exists between nonverbal cues and positive social interaction among two ADHD-diagnosed adolescent boys, one medicated and one non-medicated, in a small-group setting. Two boys, both 12 years in age, and in 7^th grade at a rural Illinois middle school, serve as the subjects of this study. Both boys have been clinically diagnosed with ADHD. One boy is clinically recognized as medicated, as he takes prescription Adderall, and the other is regarded as non-medicated, as his parents insist on solely homeopathic treatments.

The baseline measure for this study was collected over the course of two small- group social work meetings. The groups were held during the school day. The two boys and their fellow group members were pulled from their usual classrooms and placed in a separate room within the school for the 46-minute sessions. Direct behavioral observation was utilized during baseline measurement to gauge the current level of the boys’ active, positive participation in group proceedings. Instances of positive contribution to group discussion were noted with tick marks beside the boys name on a sheet of paper. Participation during the baseline measurements was limited, with the medicated boy offering minimal input, and the non-medicated boy offering no input whatsoever.

Research Question

Through the course of this study, it is likely that a relationship between nonverbal cues and positive group behavior in these boys will be recognized. It is probable that relative to the frequency of empathic nonverbal cues implemented by the social worker, the incidences of positive behavior within the group setting will increase among both the medicated and non-medicated, ADHD-diagnosed adolescent boys. For the purposes of this study the research question is, “Will utilization of nonverbal cues by a group leader impact positive behavior in ADHD-diagnosed adolescent boys?” The hypothesized outcome of this study is that there is a direct relationship between the frequency of nonverbal cues implemented by the social worker, and output of positive behavior displayed by both the medicated and non-medicated adolescent boy in the small group setting.

Relevance to Social Work

This study is pertinent to social work. Diagnoses of ADHD among school children have increased dramatically over the last ten years, which has raised questions among social workers and members of related social service and mental health fields as to the validity of these diagnoses, as well as the intervention methods, which rely heavily on the use of psychotropic prescription drugs. Social workers, particularly school social workers, must be aware of alternative methods of managing ADHD symptoms in children, as well as the simple need for understanding strategic interventions that can be utilized to control problem behavior in the classroom. This study intends to investigate one strategy (the use of nonverbal cues) intended to incite positive behavior among medicated and non-medicated ADHD adolescent boys, both belonging to groups relevant to the social worker.

Definitions of Variables in the Study

The independent variable in this study is the nonverbal cue, or wordless communication, implemented by the social worker, utilizing body language as a means of expression. For the purpose of this study, the nonverbal cue is defined as any of the following: head nodding, eye contact, head tilting, smiling, leaning in, head shaking, eyebrow furrowing, hand gestures, and winking.

The dependent variable in this study is positive behavior in the small-group setting. For the purpose of this study, positive behavior is defined by any of the following: hand raising, active participation in discussion, empathic expression, offering of advice, and refraining from side conversation.

These variables were measured using direct behavioral observation. For each instance of a nonverbal cue directed toward one of the boys by the social worker, a tick mark was recorded by the social worker. For each instance of positive behavior during group time, a tick mark was recorded by the social worker.

Summary

Through direct behavioral observation, this study will measure the frequency of positive behavior displayed by one medicated and one non-medicated ADHD 7^th grade boy in a small group setting, as a function of the frequency of nonverbal cues initiated by the social worker.

II. Relevant Literature

“ADHD” (Attention Deficit Hyperactivity Disorder) refers to one of a cluster of related neurobiological behavioral disorders, characterized by chronic, inappropriate levels of impulsivity, general inattention and often, hyperactivity (CHADD, 2001c.). ADHD is a brain-based condition resulting from differences in neurochemical and structural aspects of the central nervous system (Rief, 2005).

Approximately 15 million American children and adults, regardless of socioeconomic or intellectual status, suffer from ADHD. In fact, virtually every human being exhibits symptoms of ADHD, to a certain degree, at some time in his/her life. However, individuals suffering from ADHD display these traits to a developmentally maladaptive degree, as compared with others of their age (Rief, 2005).

ADHD is a “developmental disorder of self-control,” whose characteristic impulsivity, increased activity, and reduced attention span interfere with one’s ability to self-regulate in and out of the classroom (Barkley 2001b.). It is often incorrectly identified as a learning disorder, as behavioral symptoms associated with ADHD create “inconsistencies in performance, output, and production,” which are particularly damaging in the classroom (Rief, 2005). The most common neurobehavioral disorder of early childhood, ADHD is also highly prevalent in middle-childhood, making it one of the most common chronic health conditions affecting school-aged children (American Academy of Pediatrics, 2000). At one time, medical consensus seemed to suggest that ADHD was a disorder restricted to childhood, although it is now apparent that only about 33% of ADHD-sufferers “grow out” of the condition, while the other 67% continue struggling with it throughout adulthood (Hallowell & Ratey, 1994). For all suffering from ADHD, symptoms are pervasive and developmentally inappropriate, causing difficulty in daily life (Goldstein, 1999).

ADHD, although prevalent across age-groups, socioeconomic statuses, and intellectual levels, is most common during early childhood and school-age years. Therefore, addressing behavior modification in the classroom is an essential tool for educators and other school personnel. Among the many approaches to ADHD intervention, one tactic with only limited research literature is the use of nonverbal cues in the classroom or other group setting.

Because ADHD is accepted as a disorder of self-control, it is logical to presume that redirection and intensive, consistent reinforcement of social norms and cues would likely be helpful in regulating self-control in ADHD patients, particularly in the classroom or other group setting (Johnston, 1991). Using nonverbal cues to reinforce such norms would be helpful, as they would mirror of broader social situations, in which such cues are often subtle, silent, and frequent. Also, maintaining active nonverbal contact with an ADHD student would engage the student in the lesson or discussion by providing increased direct visual stimulation, and creating a sense that the student is essential to the lesson at hand. This combination of a sense of involvement and increased visual stimulation would, theoretically, blunt the symptoms of ADHD, creating a more conducive learning environment for the student. It should also be noted that the student is being actively watched during the class or other group setting, which may also influence his/her behavior during this time. Whether affecting the student through intimidation of being watched, or engagement in conversation through obvious nonverbal attention from the instructor, nonverbal cues present a logical, subtle theoretical method of obtaining attention and participation from the ADHD student.

III. Methodology

Introduction

This study examines whether positive behavior in ADHD-diagnosed adolescent boys will be affected by nonverbal cues. This SSD will help provide data reflecting the efficiency of a behavior intervention on target (positive) behavior. A consistent measurement approach is utilized throughout the report. These measurements are based on direct observations by the researcher. Data was recorded during two baseline sessions, four follow-up sessions, and two new baseline sessions. This study investigates whether simple nonverbal cues will increase the positive participation of two ADHD-diagnosed adolescent boys in a social work group setting.

Type of Study

This is an exploratory, quantitative study. It intends to search for a relationship between an intervention and a target behavior, and is measured with numerical data (which will be interpreted statistically later in the report).

Study Design

This study uses single subject, A-B-A methodology. This design is most appropriate for the study because it allows for repeated measurements, which reduce false conclusions, and a total of four baseline measurements (two initial, and two follow-up). Adequate baseline measurements provide a solid control against which to measure repeated observational data., resulting in as accurate inferences as possible.

Intervention

In a middle school setting, students with academic, emotional, or other identified social or developmental problems are referred to social work groups for support and social skill development. The two boys in this study participate in a group co-led by the researcher. Within these groups, there are often students displaying difficulty participating appropriately in group discussion. In particular, students diagnosed with ADHD present difficulty focusing on group tasks, and offering relevant input when appropriate. This study examines whether the social researcher’s use of seven specific nonverbal cues (nodding, smiling, eye contact, hand gestures, head shaking, head tilting, and smiling) increase prevalence of positive student participation (as indicated by hand raising, relevant input, sharing stories when called upon, refraining from side conversation) in the group setting. The researcher actively utilized each of these nonverbal cues within the four non-baseline measurements, and document the number of times the students observed exhibit positive participation during that group meeting. Data was compared against two initial baseline measurements, in which no nonverbal cues were used, and again in two “new” baseline measurements at the conclusion of the study.

Population and Sample

The participants in this study are two 7^th grade boys, both 12 years of age. One of the boys is medicated for his ADHD, and one is not. The boys were chosen through convenience sampling, as the researcher is time-limited at the middle school group sessions, and both boys met the criteria of being ADHD-diagnosed, and being involved in social work groups co-led by the researcher. The school is set in a rural town approximately 75 miles west of Chicago, IL. The majority of the students in the school are Caucasian, and socio-economically lower-middle class. Both boys involved in this study are white males, also belonging to the lower-middle class. They come from intact nuclear families, living in single-family homes.

Investigative Techniques

Direct behavioral observation was the primary technique used in collecting data for this study. This was the most appropriate technique for this study, largely because it allowed for a relaxed setting with minimally-disruptive research methods. Students were able to act naturally and openly, while the researcher was able to directly observe the situation where problem behavior was frequently noted.

Instrumentation

To record data, the researcher simply initiated the aforementioned seven nonverbal cues, and recorded instances of positive participation by the two boys during group time. No standardized instrument was used in data collection. The use of direct behavioral observation in this study was not adversely affected by the lack of a standardized instrument, as the researcher herself observed all the data, and did not require any feedback or further written recordings from any outside source. Frequency of positive group behavior was recorded via tick marks on a sheet of paper, over a total of eight weeks. For statistical purposes, the researcher will identify each student’s total tick marks per day as his “positive behavioral score.”

Collecting Data

Direct behavioral observations were recorded during social work group time. The group met for 46 minutes, each Monday morning, from September 19^th, 2005, to November 14^th, 2005. Observations were recorded each meeting for a total of eight meetings (see Appendix A).

Data Analysis Plan

Statistics will likely be interpreted as descriptive/univariate. There was only one variable being tested and controlled for (univariate), and the major aspect being measured was frequency of a target behavior. Also to be measured is whether there is a central tendency of both boys toward a similar behavioral result.

Human Subjects Protection

The researcher gained permission from the school social worker to conduct this study with the boys during group time. During all data recording, pseudonyms were assigned to the boys to ensure confidentiality. During a conference, the school social worker and the researcher concluded that subtle nonverbal cues, and candid behavioral observation were neither physically nor emotionally risky for human subjects.

Ethics

The power differential between the researcher and subjects was existent, though not monumental. The subjects were aware of the researcher’s status as a student intern, and frequently acknowledged the researcher as being “young.” They clearly felt a connection and significant level of comfort with the researcher, though they were aware of her role as a staff member. Also, the students were informed before the study began that the researcher “may act a little differently” during group time, but it was just because she was trying to understand people’s feelings better.

Bias

The major differences between the researcher and the subjects of this study were educational level, gender, and developmental level. The subjects are both early adolescent, 7^th grade males, while the researcher is a 24-year old female graduate student. Both the subjects and the researcher have significantly varied outlooks on life, friendships, and the world in general, which may affect the way they interacted, communicated, and understood one another.

IV. Findings

Introduction

This study investigated the hypothesis that use of nonverbal cues by a social work group co-leader (the researcher in this study) would increase output of positive behavior in ADHD-diagnosed adolescent boys. Within a small group of eight seventh-grade boys, aged eleven to twelve years, two ADHD-diagnosed boys were singled out for this study.

One of the boys was medicated, taking a daily regimen of prescription Aderrall, while the other boy was non-medicated. The researcher interacted with these two boys exclusively through nonverbal interaction for four consecutive group meetings, and recorded instances of positive participation by each boy as the behavior occurred.

Results

The independent variable in this study was the use of nonverbal cues as reinforcement by the researcher. The dependent variable in this study was the output of positive behavior by the boys during group meetings. The researcher utilized an equal number of nonverbal cues in communicating with each boy throughout the course of the group meetings. No nonverbal cues were explicitly used during the four baseline measurements.

Over the course of the eight week study, the instances of positive behavior displayed by each of the boys increased at a rate paralleling the use of nonverbal cues. The medicated boy offered slightly more positive participation than the non-medicated boy overall, but proportionally, both boys increased their positive behavior noticeably from their baseline levels (see Appendix B).

Instances of positive behavior, as well as incidences of nonverbal cue use, were recorded via tick marks by the researcher. These recordings, derived from direct behavioral observation, clearly signify an increase in positive behavior output as a function of nonverbal communication from the researcher.

Summary

As graphically visualized, each boy’s behavior increase from the baseline was steady and noticeable. Over a period of two weeks, positive behavior in each of the boy’s cases had nearly doubled from the initial baseline measurements. Also, although the recorded positive behavior fell slightly for each boy during the follow-up baseline measurements, it remained considerably higher than in the initial baseline measurements. This suggests that the effects of nonverbal cues were long-lasting, and may have built a rapport between the students and the researcher that enhanced behavior quality, even when the researcher ceased using nonverbal communication as methodically.

V. Discussion

This study attempted to explore the potential relationship between nonverbal cues and positive behavioral output in two ADHD-diagnosed adolescent boys. In doing so, the study covertly attempted to examine discreet, effective behavior management of ADHD symptoms.

Conclusions

Analysis of data collected revealed that the initial hypothesis was correct: the results indicated a clear, positive relationship between the researcher’s use of nonverbal cues and positive behavior output. As hypothesized, use of nonverbal cues by the researcher incited increased positive participation in group discussion on behalf of the two ADHD-diagnosed adolescent males. Within the first non-baseline measurement, the subjects’ recorded positive behavior increased slightly. Over the next two meetings, it peaked, and leveled off for the remaining meetings. The final two “new” baseline measurements revealed a slight drop in positive participation (relative to the measurements taken during the intervention process) which may be attributed to the halt in nonverbal cue usage during this time. However, the final baseline data demonstrated notably higher instances of positive behavior output than was recorded during the first baseline measurements. This trend not only suggests that the researcher’s use of nonverbal communication during the intervention phase impacted the participants’ behavior, but also indicates that these behavioral influences were lasting. Although further research is necessary to determine causality, the data suggest that an intervention utilizing nonverbal cues yielded an increase in positive group behavior in the ADHD-diagnosed seventh-grade boys in this study.

Limitations

An obvious limitation of this study was the medication status of the participants. One boy was medicated, and one non-medicated, which may have affected their processing of and responses to the nonverbal cues. Another limitation was the consistency of the participants; on three occasions, one or both of the boys arrived to group more than five minutes late, which offered less time for the nonverbal communication to unfold naturally. Finally, the time constraints involved in the study allowed for limited data collection. This study was part of a requirement, due midway through a sixteen-week graduate research course. The restricted number of group meetings allowed for few measurements, whereas the most reliable results would be gathered from several more meetings and measurements, taken over a longer period of time.

Implications

The data collected in this study suggests a speculative relationship between nonverbal cues and positive behavioral output. Because the subjects of this study were two ADHD-diagnosed adolescent boys, any implications therein cannot be generalized to a larger population. However, the information gathered from the data could be beneficial to social workers dealing with ADHD-diagnosed adolescents. The study outlined a clear behavioral intervention, which proved successful with a small sample of the target population (ADHD-diagnosed youth). Through further studies, these implications may be cemented, or expounded upon, and used in the development of innovative new interventions for adolescents (and perhaps other populations) diagnosed with ADHD. Information gleaned from this study may provide a stepping-stone for social workers, educators, researchers, and theorists in their approaches to understanding, accommodating, providing treatment for, and controlling symptoms of students diagnosed with ADHD.

VI. Cited Literature

Barkley, R. A. (2001b). Genetics of childhood disorders: XVII. ADHD, Part I: The executive functions and ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 1064-1068.

Children and Adults with Attention Deficit Disorders (CHADD). (2001). The disorder named AD/HD – CHADD fact sheet #1. Retrieved October 15, 2005, from http://www.chadd.org.

Goldstein, S. (1999). The facts about AD/HD: An overview of attention-deficit hyperactivity disorder. CHADD 1999 Conference Book. Landover, MD: CHADD.

Hallowell, E.M. Ratey, J. (1994). Driven to distraction : Recognizing and coping with Attention Deficit Disorder from childhood through adulthood. New York, NY: Touchstone.

Johnston, R.B. (1991). Attention deficits, learning disabilities, and Ritalin: A practical guide (2^nd ed.). San Diego, CA: Singular Publishing Group, Inc.

Rief, S. F. (2005). How to reach and teach children with ADD/ADHD : Practical techniques, strategies, and interventions. San Francisco, CA: Jossey-Bass.

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Anorexia Nervosa

Anorexia nervosa is basically self-starvation. These people are usually considered walking skeletons. Anorexia nervosa is characterized by severe weight loss and an unreasonable fear of being fat. They are stubborn, struggling, and appearance-obsessed individuals and don’t know when to stop dieting. Eating is scary but even scarier if the choice of food is made by someone else. Anorexics avoid and delay meals as long as possible. They actually think that one bite of food can make them gain weight. Many exercise and eat fruits and vegetables that are low in calories. The individual maintains a body weight that is about 15% below normal for age, height, and body type. Anyone can develop an eating disorder. There are some myths about only white high class women having eating disorders. Anorexia can develop at almost any age and at any time of life and children as young as seven and adults well into their senior years have been documented. A high percentages of people suffering from ano!rexia have a history of abuse, neglect, or other traumatic experiences.

Many turn to anorexia because it helps them cope with their difficulties and be able to concentrate on losing weight. In able to lose weight it takes s time, energy, and planning and this distracts them from their pain. Losing weight makes the individual feel special and powerful. No matter how many pounds they lose it’s never enough and being fat is the worst thing in the world to people suffering from anorexia. As soon as they meet their weight loss goals new ones are set. Research shows approximately 10% of anorexics are male, and anorexia is a response to a complex mix of cultural, social, familial, psychological, and biological influences unique to each person. Some experts say that anorexia usually develops in adolescence, but the majority of sufferers are adults. The first step in recovering anorexia is simply to choose life. Some studies show that “5-20 percent of people with anorexia die from complications from the disorder . It is possible to recover from anorexia, but it’s not easy It is important to get help as soon as possible.

Bulimia Nervosa

Bulimia nervosa is characterized as by episodes of binging and purging through vomiting, using laxatives, and compulsive exercising. People with bulimia nervosa eat large amounts of food then, then purge to remove it from their body, either by vomiting or the abuse of laxatives or diuretics. The urge to binge may be planned or just come suddenly. Binges can happen once a week or, as the condition worsens, several times daily. Bulimia is a more dangerous eating disorder because it has long lasting damage to the body. Bulimics almost always maintain a normal body weight and are extremely secretive about their disorder; family and friends may not even know of her problem until she is in the advanced stage of the disorder.

Many reasons why people develop bulimia are because low self- esteems, childhood conflicts, a feeling of helplessness, and a fear of becoming fat. Most people with bulimia tend to be uncomfortable with close, intimate relationships and that bulimia becomes their best friend and they believe that it’s the only one thing that they can count. Bulimia is definitely worth fighting against and the recovery process needs to begin as soon as possible before the behavior ends in death.

Binge Eating Disorder

The Binge Eating Disorder(BED) is sometimes refereed to compulsive overeating, emotional overeating, and food addiction. These people eat whether their hungry or not, they just don’t know when to stop. Compulsive eating and BED are the most common eating disorders, and BED is found in about 2% of the general population. However, experts estimate that as many as sixty to seventy million people suffer from some sort of eating disorder. “ The large increase in childhood obesity in the past decade is ominous”(Smith, 2004). “65% of Americans are over weight” (Strand, 2004). Binge eaters usually have very expensive grocery bills and stash food in their lockers, closets, cars, and go to food for comfort if anything badhappens. Some possible signs of (BED) are eating throughout the day even if their not hungry, bingeing for no apparent reason, feeling guilty after overeating, spending a lot of time thinking about food, spending a lot of money on food, and eating stressed or ups!et. They look at food as comfort and a reward to themselves.. BED often leads to other forms of eating disorders and start to purge after eating or not eat at all. According to Campbell (2002), light may be a deterrent to binge eating and people are more apt to give in to food cravings in dimly lit surroundings because they feel uninhibited. This disorder isn’t as serious as anorexia and bulimia but it leads to obesity, which brings serious health problems.

Conclusion

Eating disorders are serious and should be helped immediately to prevent serious damage to the body or death. A new discovery that was recently studied is, “Night Eating Syndrome, it’s a disorder in which individuals regularly wake one to three times a night to eat, consuming more than half their daily calories during these episodes” (Campbell ,2002). “Orthorexia is an unhealthy fixation with healthy eating and it has several serious diagnoses , like anorexia, it often involves severe weight loss but orthorexks are obsessed with food quality , rather than quantity and strive for personal purity in their eating habits(Strand, 2004). There are different types of treatment and therapy and a wide variety of approaches for different people to look at. Recovery is long and painful and has many stages to go through but it’s worth it in the end. Young patients usually progress more quickly and have a higher success rate than those who have suffered for many years. No one can put a! time frame on recovery. There are professional therapist that can help with support, listening and talking to them about what’s best. They could have a nutritional counselor that also offers support and educates the patient with their body’s nutritional need and has a food plan that will be accepted by the patient and the nutritionist. It has been proven that treatment is more successful when the patient enters with willingness. Family and Friends musty be supportive during recovery because recovery is long and painful and filled with ups and downs for the patient. They should never nag the patient about food or their weight. They should also have a therapist and a nutritionist working with them. In general, people must be very be careful to what they say to anyone that is going through an eating disorder because their self esteem is veryfragile. Even though society favors the outer appearance of someone’s body, the true beauty becomes from within. The best way to lose we!
ight is to eat healthy and to exercise.

Results

I’ve learned a lot by writing this research paper and I enjoyed it. I expected these results because eating disorders are serious and I knew the signs of them because I recently have had someone I know diagnosed with anorexia. I was surprised to know about orthorexia and the NightEating Syndrome. These actually surprised me because they both are also very serious that can lead to unhealthy eating habits. I didn’t know that eating disorders are often coping mechanisms that help people deal with different issues, such as: painful events, low self-esteem, anger, negativity, anxiety about the future, loneliness, lack of control in their life and self-hatred. For many eating and dieting serves as a form of escape from emotional problems. People with eating disorders are perfectionists because they can’t handle stress, have a distorted body shape, and are constantly thinking about food, their weight , and their body shape. Even though society favors the outer appearance of some!one and a thin figure is usually what is seen. Skinny models are usually portrayed as being happy and successful. Magazines are a big problem because on the front page are tall, skinny, and beautiful role models but also, the captions all over the front page are talking about how to have firmer thighs, flatter stomach and tinier waist. Thin bodies are used to sell products and life-styles, implying that the right body can bring happiness and a perfect life. This is why many feel that theyhave to be skinny in order to be happy and successful. Many think being thin is, in and many young girls have many pressures on them to look good and to try to be perfect.

Also see:
NEDIC National Eating Disorder Information Centre

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