The PANDAS Hypothesis and Causes of OCD

The PANDAS Hypothesis and Causes of OCD OCD Causes Print The PANDAS Hypothesis and Causes of OCD By Naveed Saleh, MD, MS twitter linkedin Naveed Saleh, MD, MS, is a medical writer and editor covering new treatments and trending health news. Learn about our editorial policy Naveed Saleh, MD, MS Medically reviewed by Medically reviewed by Daniel B. Block, MD on November 26, 2019 twitter linkedin Daniel B. Block, MD, is an award-winning, board-certified psychiatrist who operates a private practice in Pennsylvania. Learn about our Medical Review Board Daniel B. Block, MD on November 26, 2019 Getty Images More in OCD Causes Symptoms and Diagnosis Treatment Types Living With OCD Related Conditions It may sound improbable that strep throat can be a cause of obsessive-compulsive disorder. However, for the first time, large-scale research coming out of Denmark seems to support this causal relationship. Background Bacteria are responsible for between 5 and 10 percent of sore throats. The most common bacterial agent responsible for sore throat is group A beta-hemolytic streptococci (GAS or “strep”). In 1998, researchers at the National Institute of Mental Health (NIHM) observed that some children abruptly develop obsessive-compulsive disorder, tics, and other neuropsychiatric symptoms after being infected with GAS and other types of bacteria and viruses. These symptoms are rapid onset, and peak in intensity within 24 to 48 hours. Usually, OCD begins more gradually. Furthermore, the initial presentation of OCD can be hidden for months by a child secondary to anxiety or embarrassment about irrational worries and behaviors. In the beginning, the NIMH chose to focus its initial research efforts on the association between streptococcal infection and sore throat. They came up with a working hypothesis titled Pediatric Autoimmune Neuropsychiatric Disorders Associated With Streptococcal Infections or PANDAS. The PANDAS hypothesis describes how infection with GABS potentially causes OCD through an autoimmune process. The PANDAS hypothesis is controversial, and for years, there was limited support for it because all the studies examining the relationship between streptococcal infection, OCD, and tics involved only small numbers of participants. However, in a May 2017 issue of JAMA Psychiatry, Orlovska and co-authors detail a large study examining the link between GASâ€"as well as other types of infectionâ€"and OCD and tics. They looked at the records of more than one million Danish children spanning 17 years.         PANDAS Diagnosis There is no laboratory test that diagnoses PANDAS. Instead, a diagnosis of PANDAS is based on a detailed history and physical examination. Here are the five criteria used to diagnose PANDAS: Presence of either OCD, tic disorder, or both.The explosion in the onset of OCD, tics, or both that occurs abruptly and can wax and wane following subsequent streptococcal infections. Subsequent exacerbations similarly present with dramatic symptoms.Onset between 3 years and 11 years (the beginning of puberty). (This criterion is arbitrary, and adolescents can rarely be diagnosed with PANDAS.)Association with the sudden onset of symptoms suggestive of other neuropsychiatric illness, including concentration difficulties, general anxiety, bed-wetting, irritability, and developmental regression.A temporal association with a streptococcal infection needs to be established by either throat culture or blood tests (i.e., elevated anti-GAS antibody titers). Sydenham chorea, which also results in rapid, involuntary movements resembling tics, must also be ruled out to diagnose PANDAS. Like PANDAS, Sydenham chorea and, more generally, rheumatic fever have autoimmune underpinnings and occur secondary to  streptococcal infection. OCD in Children Differs From Adults How Does PANDAS Occur? Genetics, development, and immunity contribute to the development of PANDAS: First, certain children seem susceptible to PANDAS, and these children may share genetic similarities with those who experience rheumatic fever and Sydenham chorea.Second, PANDAS is developmental in nature because it usually affects children who have not yet experienced puberty, with the peak age being 6 or 7.Third, as with Syndenham chorea, those with PANDAS are hypothesized to develop antibodies that attack nerve cells in the brain. Streptococcal bacteria are a hardy and primeval organism that can mimic the cellular appearance of various body tissues to evade the body’s immune system.   When GABS mimic the appearance of brain cells, antibodies to brain tissue are thought to form. These antibodies end up attacking the basal ganglia, and instead of causing Sydenham chorea, result in OCD, tics, and so forth. PANS Diagnosis Because it is often hard to pinpoint an exact temporal relationship between strep infection and OCD or tics, in 2010, clinicians and researchers expanded the classification of PANDAS so that it falls under the umbrella of Pediatric Acute-onset Neuropsychiatric Syndrome (PANS). Instead of explicitly tying diagnosis to only streptococcal infection, PANS is more generally described by the abrupt onset of OCD and can be associated with nonstreptococcal infection, too, including influenza and varicella (chicken pox). Specifically, here are the diagnostic criteria for PANS: The abrupt and dramatic onset of OCDConcurrent presence of two additional neuropsychiatric symptoms similar to those seen in PANDASSymptoms which can’t be better explained by another neurological or motor disorder, such as Sydenham chorea, lupus, or Tourette disorder Notably, by formulating the PANS diagnosis, these clinicians and researchers hope to facilitate the diagnosis and treatment of abrupt-onset OCD. The relationship between PANDAS and PANS is analogous to the relationship between melanoma and cancer. In other words, just like melanoma is a subset of cancer, PANDAS is a subset of PANS. Of note, a diagnosis of PANS is also based on a detailed history and physical exam. Early vs Late-Onset OCD New Research Orlovska and colleagues examined Danish patient records spanning 17 (1996 to 2013) years and representing 1,067,743 children (defined as fewer than 18 years old). This study is by far the highest-powered analysis of the PANDAS hypothesis to date, and results support fundamental elements of this hypothesis. Here is a more specific breakdown of the patient records: 519,821 girls547,922 boys638,265 children received a streptococcal test349,982 had at least one positive streptococcal test The researchers found that children with a positive strep test result were more likely to exhibit mental disordersâ€"in particular, OCD and ticâ€"compared with those children without a strep test. More specifically, children with a positive strep test had an 18 percent higher risk of developing any mental disorder, a 51 percent higher risk of developing OCD, and a 35 percent higher risk of developing tic disorders. The researchers also found that children who had a nonstreptococcal throat infection (i.e., negative streptococcal test) also were at increased risk for mental disorders, OCD, and tic disorders. However, the magnitude of this risk was lower than that for streptococcal infection. The researchers found that, as defined by PANDAS criteria, children between age 3 and 11 had the greatest increased risk of OCD and tic disorders. According to the researchers, the results of the study support the PANDAS hypothesis to some extent. With regards to nonstreptococcal infection, they write the following: Our findings that the risk of mental disorders is only slightly less elevated after a nonstreptococcal throat infection than after a streptococcal infection suggest that other, possibly viral, infectious agents are also linked with the development of OCD and tic disorders. This finding might instead support the recently proposed concept of pediatric acute-onset neuropsychiatric syndrome … Pediatric acute-onset neuropsychiatric syndrome offers an alternative to PANDAS with wider diagnostic criteria; it is primarily thought to be a postinfectious condition but without restriction to streptococcal infections. PANDAS Treatment and Prevention As described in Fegin and Cherry’s Textbook of Pediatric Diseases: This proposed disorder [PANDAS] is currently a hypothesis, and it remains a controversial topic. Several authors believe in this disorder as a separate entity and recommend treatment and prophylaxis. Others argue that it is only a hypothesis and that further evidence with double-blind studies is needed before recommending treatment and prevention for children given a diagnosis of PANDAS. In other words, some experts view PANDAS (and PANS) as conjecture. Others, however, consider PANDAS diagnosis and will treat it accordingly. Recommendations Of note, the NIMH does recommend certain treatment options for those who are thought to have the condition: Children with PANDAS-related obsessive-compulsive symptoms will benefit from cognitive behavioral therapy (CBT) and/or anti-obsessional medications. Studies show that the best results are produced from the combination of CBT and an SSRI medication (such as fluoxetine, fluvoxamine, sertraline, or paroxetine). Children with PANDAS appear to be unusually sensitive to the side-effects of SSRIs and other medications, so it is important to “START LOW AND GO SLOW!!” when using these medications. By starting children on low dosages of psychotropic medications, the number and severity of negative side effects are minimized. If a child ends up experiencing negative side effects while on medication, the dosage should be decreased immediately. Of note, psychotropic medications should not be stopped abruptly because doing so could be dangerous. Antibiotics The NIMH stresses that if the strep infection is still present, the best treatment for PANDAS is antibiotics, including amoxicillin, penicillin, azithromycin, and cephalosporins. With positive throat cultures, a single course of antibiotics should be sufficient. Other measures include replacing toothbrushes and testing family members for strep to limit the risk of re-infection. Based on a small number of case reports, some clinicians treat patients who demonstrate symptoms of PANDAS with antibiotics even when streptococcal tests are negative. This practice requires further investigation. Immune-based therapies, including plasma exchange (i.e., plasmapheresis) and intravenous immunoglobulin, have also shown been used to effectively treat symptoms related to PANDAS. Steroids Steroids have also been used to treat PANDAS. However, the results of steroid treatment are mixed, with only some reports of benefit and other reports of worsening tics. Furthermore, steroids should be used only for a short period of time because they can be dangerous when used long-term. Finally, patients with PANDAS who receive steroids can experience a rebound effect which results in PANDAS symptoms that are even worse than when the steroids were started. For these reasons, steroids are usually not recommended for treatment in children who have PANDAS. Of note, sometimes a brief treatment with steroids can help clinicians gauge which patients will be responsive to plasma exchange and intravenous immunoglobulin. On a related note, the preceding treatment guidance primarily applies to PANDAS not PANS, because PANS is a newer diagnosis with no tested treatments. Nevertheless, if PANS appears to be triggered by an infectious agent, treatment of the infection may attenuate the symptoms of OCD and other neuropsychiatric symptoms. Additionally, treatments that work for PANDAS, such as immune-based therapies, as well as preventive strategies, may also be useful when treating symptoms related to PANS. In two small clinical trials, prophylactic treatment with antibioticsâ€"or treatment before the occurrence of streptococcal throat infection and PANDAS symptomsâ€"proved effective in preventing strep infections and reducing recurrences of PANDAS symptoms. Specifically, some children who previously experienced PANDAS-related symptoms several months a year experienced far fewer exacerbations once given prophylactic antibiotics. These children were treated with either penicillin or azithromycin. Analogously, treatment with prophylactic antibiotics has proven useful with other streptococcal sequelae that have autoimmune origins, such as rheumatic fever and Sydenham chorea thus providing further support for this intervention. Could Childhood OCD be an Autoimmune Disorder?

TSA Screening System Draws Criticism

Are the airlines getting a free ride on the taxpayers dime thanks to the Transportation Safety Administrations (TSA) new high-tech and high dollar system to detect fake boarding passes?In these days of print-at-home boarding passes and programs like Photoshop, the number of people illegally boarding planes and flying for free by using fake boarding passes and IDs has increased significantly. To the airlines, this is fraud that results in lost income. To honest, paying passengers, its an insult that results in higher ticket prices. To the TSA, its a gaping hole is security that could result in another terrorist attack.To the rescue comes the TSAs high-tech and high-cost CAT/BPSS -- Credential Authentication Technology and Boarding Pass Scanning System - now being tested at George Bush Intercontinental in Houston, Luis Muà ±oz Marà ­n International in San Juan, and Washington, D.C. Dulles International at an initial combined cost of $3.2 million.In testimony before the House Committe e on Homeland Security, Stephen M. Lord, director of homeland security and justice issues at the Government Accountability Office, reported that the estimated 20-year life cycle cost of the CAT/BPSS system is approximately $130 million based on a nationwide deployment of 4,000 units.What CAT/BPSS DoesCosting $100,000 each, and with multiple systems to eventually be installed by the TSA at all U.S. airports serving commercial flights, the CAT/BPSS system automatically compares the passengers ID to an extensive set of security features. Most modern forms of state-issued identification include encoded data, such as barcodes, holograms, magnetic stripes, embedded electrical circuits, and computer-readable text.CAT/BPPS also validates the authenticity of the passengers boarding pass at the first TSA security checkpoint using bar code readers and encryption techniques. The system is compatible with any barcode and can be used with paper boarding passes printed on a home computer, boarding passes printed by the airlines, or a paperless boarding passes that are sent to passengers mobile devices.br/>The system temporarily captures and displays the photograph from the passengers ID for viewing only by TSA agents to help them compare the photo to the person carrying the ID.Finally, CAT/BPPS compares the encoded data on the passengers ID to data on the boarding pass. If they match, they fly.Encountering the CAT/BPSS SystemAccording to the TSA, actually using the CAT/BPSS system will work like this: At the first TSA checkpoint, passengers will hand their ID to the TSA Travel Document Checker (TDC). The TDC will scan the passengers ID, while the passenger scans his or her boarding pass using a built-in scanner. TSA says that testing has shown the CAT/BPSS process takes no longer than the current process in which the TDC visually compares the passengers ID to the boarding pass.In response to concerns about the CAT/BPSS system and personal privacy, the TSA assures that the CA T/BPSS system automatically and permanently deletes all information it has gathered from the ID and the boarding pass. TSA further states that the picture on the passengers ID can be viewed only by TSA agents.Also See: TSA Defends Boarding Gate Drink ChecksIn announcing the development of the CAT/BPSS system, TSA administrator John S. Pistole stated in a press release, This technology will help facilitate risk-based security, while making the process more effective and efficient.What the Critics SayCritics of the CAT/BPSS argue that if the TSA is effective at its primary job - screening for Weapons, Incendiaries, and Explosives - another computer system dedicated only to verifying passenger identity is an unnecessary waste of money. After all, they point out, once passengers have passed the TSA scanning checkpoints, they are allowed to board planes without showing their IDs.Also See: Congressman Takes On Rogue TSA Airport ScreenersWhen the LA Times on June 30, 2011, reported the sto ry of a Nigerian airline stowaway who succeeded in flying from New York to Los Angeles by presenting an expired boarding pass in another persons name and was found to be in possession of at last 10 similar boarding passes, the TSA issued the following statement:Every passenger that passes through security checkpoints is subject to many layers of security including thorough physical screening at the checkpoint. TSAs review of this matter indicates that the passenger went through screening. It is important to note that this passenger was subject to the same physical screening at the checkpoint as other passengers.While the stowaway succeeded in stealing from the airline by flying free on a clearly fraudulent boarding pass, no evidence was ever found relating the incident to terrorism.In other words, say critics, the CAT/BPSS is another expensive taxpayer-funded solution to something that, if TSA is doing its job properly, should not be a problem in the first place.

Drink Business Plan - 7631 Words

[pic] Student Names McGill ID BRILLANT, Aà ¯sha 260194236 CHENG, Chin-Yun 260014110 JOLIN LESSARD, Audrey 260180785 LEBLANC, Genevià ¨ve 260188501 MURCIA, Nicolas 260177704 NGUYEN, Jean-Louis 260078995 TIAN, Yu 260177360 Course Information Marketing Management I MCGR 352, Section 005 Professor: Constantina Kavadas Marketing Plan Part 1: Market and Consumer Profile Date of submission: Wednesday, March 29th, 2006 [pic] The following marketing plan forms the basis for the introduction of an innovative new product by the Coca-Cola Company. The analysis allows us to outline the best strategies to follow for the achievement of the company’s strategic goals. â€Å"Bubble Buzz† will be marketed†¦show more content†¦Today, while the soft drink industry’s value has increased in 2004, the volume sales of carbonated soft drinks has declined due to a large proportion of consumers who are opting for the trend towards healthier alternatives in the functional drink segment (energy drinks, smoothies, milk juice drinks, sports drinks) as well as bottled juices and water (ref.5). Companies have been actively engaged in new product developments in order to counter the growing concerns about negative health impacts of high-fructose drinks, but also to increase the demand in a market where product offerings are quickly maturing (ref.4). New flavor introductions and health-conscious form ulations have been launched in an attempt to offset the decline in carbonated soft drink sales (ref.6). The functional market is expected to show sustained growth and consumer interest in the future years as consumption shifts to trendier, healthier and more sophisticated products (ref.7). Profitability future growth potential: In 1993, Concentrate Producers earned 29% pretax profits on their sales, while bottlers earned 9% profits on their sales, for a total industry profitability of 14%. While the functional drinks sector only accounts for 3.7% of the total soft drinks sales in 2004 (Appendix B), estimates are forecasting a growth of 7.3% in sales and 11.0% in volume consumption by 2009 (ref.4). SWOT ANALYSIS (Strengths and weaknesses, opportunities and threats)Show MoreRelatedBusiness Plan for a New Energy Drink Company1053 Words   |  5 PagesOutline 1. Table of Contents 2. Introduction 3. Executive Summary: Write this last. It’s just a page or two of highlights. 4. Company Description: Legal establishment, history, start-up plans, etc. 5. Product: Describe what you’re selling. 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Themes †of Mice and Men Free Essays

Of Mice and Men, a novella written by John Steinbeck, is a tragedy incorporating a hero with a tragic flaw, a climax, and a tragic resolution. The title of the novella, â€Å"Of Mice and Men†, is the first clue to Steinbeck’s specific cultural issues. The title is a line taken from a poem called, â€Å"To a Mouse†, by Robert Burns. We will write a custom essay sample on Themes – of Mice and Men or any similar topic only for you Order Now This poem talks about man’s enslavement to forces of both elemental and human nature which cannot be controlled, destroying hopes and dreams. This stems into the theme of the loss of the American Dream. Along with alienation, the American Dream is a major theme explored throughout the course of the novel. Of Mice and Men is a story about the nature of human dreams and aspirations and the forces that work against them. Humans give meaning to their lives by creating dreams. George and Lennie’s dream — to own a little farm of their own — is so central to Of Mice and Men that it appears in some form in five of the six chapters. The telling of the story, which George has done so often, becomes a ritual between the two men: George provides the narrative, and Lennie, who has difficulty remembering even simple instructions, finishes George’s sentences. To George, this dream of having their own place means independence, security, being their own boss, and, most importantly, being â€Å"somebody. † To Lennie, the dream is like the soft animals he pets: It means security, the responsibility of tending to the rabbits, and a sanctuary where he won’t have to be afraid. This theme not only applies to George and Lennie, but also to Candy and Crooks. To Candy, who sees the farm as a place where he can assert a responsibility he didn’t take when he let Carlson kill his dog, it offers security for old age and a home where he will fit in. For Crooks, the little farm will be a place where he can have self-respect, acceptance, and security. Having and sharing the dream, however, are not enough to bring it to life. Each man must make a sacrifice or battle some other force that seeks to steal the dream away. Some of these obstacles are external – the threat from Curley’s wife, Curley’s violence, and the societal prejudices that plague each man; others are internal – Lennie’s strength and his need to touch soft things. For George, the greatest threat to the dream is Lennie himself; ironically, it is Lennie who also makes the dream worthwhile. In addition to dreams, humans crave contact with others to give life meaning. Alienation is present throughout this novel. On the most obvious level, we see this isolation when the ranch hands go into town on Saturday night to ease their loneliness with alcohol and women. Similarly, Lennie goes into Crook’s room to find someone with whom to talk, and later Curley’s wife comes for the same reason. Crooks says, â€Å"A guy goes nuts if he ain’t got nobody. Don’t make no difference who the guy is, long’s he’s with you. † Even Slim mentions, â€Å"I seen the guys that go around on the ranches alone. That ain’t no good. They don’t have no fun. After a long time they get mean. † George’s taking care of Lennie and the dream of the farm are attempts to break the pattern of loneliness that is part of the human condition. Similarly, Lennie’s desire to pet soft things comes from his need to feel safe and secure, to touch something that gives him that feeling of not being alone in the world. For Lennie, the dream of the farm parallels that security. George and Lennie, however, similarly to the American Dream, are not the only characters who struggle against loneliness. Although present in all the characters to some degree, the theme of loneliness is most notably present in Candy, Crooks, and Curley’s wife. They all fight against their isolation in whatever way they can. Until its death, Candy’s dog stopped Candy from being alone in the world. After its death, Candy struggles against loneliness by sharing in George and Lennie’s dream. Curley’s wife is also lonely; she is the only female on the ranch, and her husband has forbidden anyone to talk with her. She combats her loneliness by flirting with the people on the ranch. Crooks is isolated because of his skin colour. As the only black man on the ranch, he is not allowed into the bunkhouse with the others, and he does not associate with them. Of Mice and Men is a novella that tries to explain what it means to be human. Man is a very small part of a very large universe; in the greater scheme of things, individuals come and go and leave very little, lasting marks. Yet deep inside all people is a longing for a place in nature — the desire for the land, roots, and a place to call â€Å"home. † Steinbeck explores the themes of the America Dream and alienation to portray the uncertainty of success. How to cite Themes – of Mice and Men, Essay examples

War Is Peace Essay Research Paper WAR free essay sample

War Is Peace Essay, Research Paper WAR IS PEACE leads people to believe that war is a good thing when in world it is merely good for the authorities that they should believe this. Ironically, it is about true, at lest in 1984. Because the provinces are at war, they are locked in ageless dead end. The war neer endangers any of the province # 8217 ; s of import land and it prevents the equal distribution of goods by devouring them. Overproduction and equal distribution of goods would let true socialism, which the party was neer interested in from the beginning. The Party realizes that throughout history a society divides itself into high, in-between, and low categories. The high category is maintained by maintaining the center and low categories in changeless plodding and everyone is kept content by agencies of doublethink and newspeak. The lone peace war creates is reserved for the authorities. We will write a custom essay sample on War Is Peace Essay Research Paper WAR or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page I think that War is Peace is wholly true. Let us utilize, as an illustration, the Great Depression in America ; this was an atrocious clip in our history, there was utmost poorness, unbelievable I nflation, and unprecedented loss of guiltless lives. No 1 truly knows how long the Great Depression would hold lasted if it weren T for World War II. It is about as if War gives society something to make when it gets bored. War helps the economic system by coercing War Machines to be manufactured, hence bettering stocks and net-worthy of companies, and War provides for War Bonds. I think that War is Peace is wholly false. In War immature work forces and adult females die contending for their state, now where does Peace come-in in that last statement? It does non affect itself in that last statement. Peace means non at war. If one were to travel back and expression at every War of all time fought, one wouldn T of all time happen a Peaceful War. This is where I draw a decision ; in my ain sentiment I do believe that War is Peace, I look at this fact. Again, travel back to World War II ; in the 1920s there was enormous prosperity, in the 1930s there was a Great Depression, in the 1940s there was War, and in the 1950s there was enormous prosperity one time once more. I believe that War brings Peace.

The Use of Gamification to Improve the Internal Communication

The Use of Gamification to Improve the Internal Communication The Use of Gamification to Improve the Internal Communication between Nationals and Expatriates in the Private Sector Companies of Dubai Introduction The improvement of internal communication between representatives of different cultures is a challenging task to address by managers. In Dubai, the percentage of expatriates working in the private companies is extremely high (Srimannarayana Santosh, 2011). The development of strategies that allow expatriates and nationals to communicate and work as teams at projects is a priority for managers in these organizations.Advertising We will write a custom proposal sample on The Use of Gamification to Improve the Internal Communication specifically for you for only $16.05 $11/page Learn More As a result, managers analyze available methods and choose new effective approaches to engage employees in the teamwork and promote cooperation. Gamification in this area is one of the newest and most promising strategies to moti vate employees and create conditions for their interaction and effective collaboration. Gamification is effectively used in spheres of training, rewarding, and marketing (Roth, Schneckenberg, Tsai, 2015). From this perspective, referring to gamification as an effectively working approach, it is also possible to expect positive results in the field of internal communication. In companies located in the United Arab Emirates (UAE), the popularity of gamification increases actively, and in Dubai, there are agencies that train managers to apply principles of gamification to all areas, including teamwork, communication, promotion, rewarding, training, and performance management (Thottathil, 2013). This prospectus discusses the key concepts used in the study with the focus on the development of the gamification concept, concentrates on the nature of the problem in the private sector companies of Dubai, and explains the selected methodology. Key Concepts Internal communication is discussed in the academic literature as the process of sharing the information and ideas in the company (Linke Zerfass, 2011). In this research, the focus is on the internal communication between representatives of the diverse workforce: nationals and expatriates. Rana (2013) states that in companies with the diverse workforce, the communication plays the critical role, and it is necessary to improve collaboration. Linke and Zerfass (2011) propose to influence the employees’ motivation to improve the internal communication. In spite of the fact that gamification is not discussed as a tool to improve the internal communication directly, Roth et al. (2015) accentuate the advantages of gamification for the organizational culture and performance. These aspects are important to speak about the effective exchange of knowledge in the organization. Therefore, it is possible to expect that improvement of communication between diverse employees as a result of applying the gamification principl e.Advertising Looking for proposal on communications media? Let's see if we can help you! Get your first paper with 15% OFF Learn More Problem Statement The problem is in the fact that Internal Communication specialists in Dubai private sector companies recognize advantages of gamification because the organization can use this principle in training or marketing, but they hesitate to refer to it when it is necessary to improve internal communication between nationals and expatriates. Gamification can be useful to promote the teamwork, conduct assessments, and provide feedbacks, but it is not applied to the field of internal communication actively, why? Thus, the research questions to be answered in this study are the following ones: Does gamification lead to improving the communication between nationals and expatriates in Dubai private sector companies? Is the use of gamification related to positive changes in the teamwork, assessments, and feedback provisio n in Dubai private sector companies? This study aims to use two operational definitions for concepts of internal communication and gamification. In this study, internal communication is defined as a process of sharing the information in the organization. Gamification means the use of game elements in the business context not related to the game (Roth et al., 2015). Methodology The mixed method approach is selected for the study. The quantitative information will be collected with the help of the survey, and the qualitative data will be collected as a case study. Variables The independent variable in the research is the use of gamification. The dependent variable is the internal communication measured in relation to positive or negative changes. The purpose of the research is to study whether there is a relationship between gamification and any changes in the internal communication. For answering the second research question, the focus is on measuring the presence of positive change s in internal communication and other aspects of the employees’ interaction. Sampling The study will focus on examining gamification in one company representing the private sector of Dubai where it is used not only in management but also in internal communications. The sample for the survey will include nationals and expatriates that will be selected with the help of a stratified random sampling (Chambliss Schutt, 2013). It is expected that the sample will represent males and females from the 18-45-year-old age group. This approach to sampling allows examining attitudes to the gamification of both nationals and expatriates. For the case study, the sample will include Internal Communication specialists working in the company.Advertising We will write a custom proposal sample on The Use of Gamification to Improve the Internal Communication specifically for you for only $16.05 $11/page Learn More Methods The quantitative cross-sectional survey is chose n to assess the extent to which the use of gamification in the area of internal communication contributes to the productive interaction between nationals and expatriates. Advantages of the cross-sectional survey are in possibilities to receive questions to answers quickly and at low costs. Disadvantages include the impossibility to check the influence of external factors on answers (Reagan, 2006). This limitation is addressed with the help of using the case study approach to gain the qualitative data on the gamification strategy in the company. The advantages of the case study are in possibilities to focus on the experience of the concrete company basing on interviews and the review of documents (Berger, 2014). Weaknesses of the case study approach are addressed while combining it with the quantitative method. Instruments To conduct the survey, it is necessary to use the questionnaire structured with the help of the Likert scale indicating the extent to which employees discuss the g amification strategy in the internal communication as positive. The use of the questionnaire based on the Likert scale is supported by the necessity of adapting the qualitative answers to measuring them with the help of quantitative tools (Chambliss Schutt, 2013). To guarantee the high level of reliability, the questionnaire on gamification will be retrieved from the existing literature. Questionnaires will be sent to participants via e-mail. For the case study, instruments include the structured interview questions to communicate with the Internal Communication specialists. The other data on the use of gamification will be collected referring to the corporate documentation. Conclusion The study on the problem of using gamification to improve the internal communication of nationals and expatriates in the private sector of Dubai will utilize the mixed methods in order to explore the problem in detail and determine possible relationships. The focus is on using the questionnaire and a case study approach. The proposed study will allow concluding about the effectiveness of using gamification in the sphere of internal communications and provide the results of the quantitative and qualitative assessments to support the conclusions. References Berger, A. A. (2014). Media and communication research methods: An introduction to qualitative and quantitative approaches. New York, NY: Sage Publications.Advertising Looking for proposal on communications media? Let's see if we can help you! Get your first paper with 15% OFF Learn More Chambliss, D. F., Schutt, R. K. (2013). Making sense of the social world: Methods of investigation. New York, NY: Sage Publications. Linke, A., Zerfass, A. (2011). Internal communication and innovation culture: developing a change framework. Journal of Communication Management, 15(4), 332-348. Rana, R. (2013). Effective communication in a diverse workplace. International Journal of Enhanced Research in Management and Computer Applications, 2(2), 1-5. Reagan, J. (2006). Applied research methods for mass communicators. New York, NY: Marquette Books. Roth, S., Schneckenberg, D., Tsai, C. W. (2015). The Ludic drive as innovation driver: Introduction to the gamification of innovation. Creativity and Innovation Management, 24(2), 300-306. Srimannarayana, M., Santosh, K. M. (2011). A study of human resource issues in Dubai. International Journal of Economics and Management Science, 1(1), 55-66. Thottathil, M. (2013, December 2). Gamification set to increase corporate growth in 2014. Th e Arabian Gazette. Retrieved from https://arabiangazette.com/

Punctuation Errors When Posing a Question

Punctuation Errors When Posing a Question Punctuation Errors When Posing a Question Punctuation Errors When Posing a Question By Mark Nichol When writers pose a question, or call attention to one, they sometimes impose unnecessary punctuation in the framing sentence. Here are a few examples of extraneous punctuation in such sentences. 1. â€Å"To pass a necessity test usually means a negative response to the question: ‘Can the same result be obtained by other means?’† A colon is correctly used only when it follows a complete thought; it serves as a traffic sign noting that what follows is a definition, expansion, or explanation. The question in question is none of these it’s just a question, and to precede it with a colon (or a comma) implies that it’s the only existing question. Delete colons in such constructions: â€Å"To pass a necessity test usually means a negative response to the question ‘Can the same result be obtained by other means?’† (And because the quotation is not attributed no one is credited with a â€Å"Smith said† type of attribution the comma that normally follows such a phrase is not necessary before the quotation here.) 2. â€Å"There remains the question: where, if at all, should we draw the line?† This sentence suffers from the same problem as the previous one. The question is not styled to suggest that it was actually uttered or can be uttered, although that is possible; it’s an unspoken expression of a problem to solve and can therefore be incorporated directly into the framing sentence: â€Å"There remains the question of where, if at all, we should draw the line.† 3. â€Å"The question was how to translate and standardize these successful processes across a company that had several new divisions, a diverse global spread, and disparate technical platforms?† This sentence is correctly rendered in terms of the incorporation recommended for the previous example, but one problem remains no question is literally posed in the sentence, the syntax of which is declarative so interrogative punctuation is not appropriate: â€Å"The challenge was to translate and standardize these successful processes across a company that had several new divisions, a diverse global spread, and disparate technical platforms.† Want to improve your English in five minutes a day? Get a subscription and start receiving our writing tips and exercises daily! Keep learning! Browse the Punctuation category, check our popular posts, or choose a related post below:5 Uses of InfinitivesAwoken or Awakened?15 Names and Descriptions of Effects