A young woman who is four months pregnant has recently discovered that she has tuberculosis. The doctor informs her that she must take a drug that will cure her disease, but that the drug will also have the effect of aborting the fetus. There is no other available drug that will cure her disease, and if she does not take the drug immediately she will die.
According to natural law, may the young woman take the drug?
Considering the fact that the life of the infant is connected to the life of the mother it can be stated that such a procedure is definitely justified by natural law. What you have to understand is that if the mother refuses treatment not only will she die but the infant will die as well. If she does take the treatment then it is only the infant that will die. While it is understandable that the death of the infant can be considered a severe consequence of the treatment it still falls under the 4 conditions of the principle of the double effect since it encompasses the means-end condition as well as the proportionality condition.
The case example does not indicate that it is the abortion that would save the mother but rather it is the treatment for tuberculosis that will save her. The death of the infant is an unintended yet unavoidable consequence of the action. It must also be noted that a worse act would be to attempt to give birth to the infant despite having a condition that would gradually worsen as time goes on (Smith, 2007).
There is no specific guarantee that the mother will have the strength to complete the full 9 months needed to ensure that the infant can be born properly. A more likely result would be that within the next few months the mother will die along with an almost fully formed infant which can be considered an act of undue suffering and foolishness since the mother would in effect make the death of the infant that much worse considering the number of months it was already alive and could already be considered a fully formed person (Stuchlik, 2011). It is based on this that the act of taking the treatment would be the most viable option at the moment.
Hydrocephalic Fetus Scenario
Summary
In the process of attempting to deliver a fetus, a physician discovers that the fetus is hydrocephalic. The fetuss large cranium makes a normal vaginal delivery impossible; both the woman and fetus would die in the attempt. Neither the mother nor the fetus would survive a cesarean section, so the only way to save the mothers life is to crush the skull of the fetus (craniotomy), thus rendering a vaginal delivery of the stillborn fetus possible.
Would craniotomy be justified by natural law?
One of the inherent problems with this particular case is the fact that it does not indicate whether the mother is involved in the decision making process within the case study. First and foremost, while it is true that the case does fulfill some of the aspects related to the principle of double effect such as the right-intention condition, the problem is that it also happens to violate the means to an end condition wherein the life of the mother has to be saved at the expense of the life of the infant (Wenkel, 2007).
This in effect classifies the action as a violation of the principle of double effect since the means by which a good outcome arises should not come as a direct result of the bad effect (MAGILL, 2011). This is distinctly different than the previous case since the death of the infant does not come as an unintended consequence of the treatment but an intended consequence in order to save the life of the mother.
The fact also remains that the choice of whether or not to kill a baby in order to save the life of the mother should be a decision left to the mother and not to the doctor. Not only that, the basis of the case argument does not specifically elaborate as to precisely why the cesarean section would not work. It is based on this that this particular case cannot be considered applicable under natural law nor would it apply under the principle of double effect.
Reference List
Magill, G. (2011). Threat of imminent death in pregnancy: a role for double-effect reasoning. Theological Studies, 72(4), 848-876.
Smith, I. A. (2007). A New Defense of Quinns Principle of Double Effect. Journal Of Social Philosophy, 38(2), 349-364.
Stuchlik, J. (2012). A Critique of Scanlon on Double Effect. Journal Of Moral Philosophy, 9(2), 178-199.
Wenkel, D. H. (2006). Separation of Conjoined Twins and the Principle of Double Effect. Christian Bioethics: Non-Ecumenical Studies In Medical Morality, 12(3), 291-300.
A Surgeons Life is a medical case history from An Anthropologist on Mars book written by neurologist Oliver Sacks. The story presents a fiftyish, soberly dressed in a black suit surgeon suffering from Tourette syndrome. At the beginning of the history, the author describes the disease of disinhibition : it may occur in every culture and every age, characterizing by numerous vocal or physical tics and cases of grimacing, of barking and twitching, of unconscious cursing, or even blaspheming (Sacks 1). It is necessary for people who suffer Tourette syndrome to be taught how to handle the often disease symptoms such as anger, embarrassment, and stress, states Olive (8).
However, the mental disorder may sometimes paradoxically influence a person by revealing his latent powers, developments, and advantages that might never be discovered or even be imagined. For instance, some scientists consider that Mozart and Samuel Johnson could have had Tourettes syndrome, that Dostoyevsky and van Gogh had temporal lobe epilepsy. Thus, Mr.Bennet is an excellent surgeon and driver, at the same time he is denting and battering the refrigerator door. He will go far if he does not go too far, wrote his schoolteacher (Sacks 28).
If I needed a surgery one day and had good responses from his patients, perhaps, I would go to Dr. Bennett because he regularly performs surgery. In spite of his condition manifesting itself in spontaneous involuntary movements and behavior, Dr. Bennett has graduated from medical school, made a family, and knew how to fly a plane (Paul 2). Probably, it was hard work with his illness that helped him to become a perfect doctor. Regardless, we should not perceive him with prejudice or disapproval, as all men are created equal.
Works Cited
Olive, M. Foster. Tourette Syndrome. New York, NY: Chelsea House, 2010. Print.
Paul, Annie Murphy. Oliver Sackss New Case Study: Himself. The Washington Post 17 May 2015. Web.
Sacks, Oliver. An Anthropologist on Mars. Sydney: Picador, 1995. Print.
Sacks, Oliver. On the Move: A Life. New York: Knopf, 2010. Print.
It is widely promoted that one must wash their hands after visiting the restroom. It is also necessary to dry ones hands after washing them, because wet surface serves as the nurturing environment for bacteria. To make the hand drying process faster warm air and jet air hand dryers were placed in the restrooms all around the world.
They are believed to be more efficient than paper towel dispensers, because using hand dryers one does not have to touch anything in the room. Many contemporary researchers note that the warm air coming from the hand dryers is far from being sterile and may serve as the perfect environment for airborne bacteria.
Research question
The effectiveness of hand dryers over paper towels in reference to the maintenance of sanitary conditions
Hypothesis
Towel dispensers may be old-fashioned, but they are much safer in relation to airborne bacteria spreading.
Prediction
Hand dryers tend to collect bacteria and then stream them on peoples hands with the flow of warm hair.
Source
PubMed Heath website.
Data
The research involved warm air and jet air hand dryers along with paper towels. Contaminated gloves covered in lactobacilli bacteria solution were dried with each of the devices. Afterwards, other participants used the dryers, and the number of bacteria on their hands afterwards was measured in close proximity of the dryers and one meter away.
The results of the research measured that the count of bacteria spread by the jet air dryers (70.7 colony forming units) was four and a half times higher than the one of warm air dryer (15.7) and twenty seven times higher than that of paper towels (2.6) (Air dryers blown away by paper towels in germ tests par. 24).
The results measured one meter away of the dryers were similar and showed 89.7 colony forming units for jet air dryer, 18.7 for warm air dryer and 2.2 for paper towels (Air dryers blown away by paper towels in germ tests par. 25). The research also showed that the distribution of bacteria does not hit only hands, but the whole upper body, and bacteria can be still in the air fifteen minutes later the drying procedures (Restroom Hand Dryers Spread More Germs than Paper Towels, Study Finds par. 5).
Person-contamination experiment involved black paint instead of the bacteria and the users wore white suits, to detect which areas of the users bodies were hit the most. Paper towel dispensers did not produce any paint spots, while jet air dryer users suits counted 144.1 spots and those of warm air dryer users 65.8 spots (Air dryers blown away by paper towels in germ tests par. 29).
Conclusion
The research was conducted in November this year, it is relatively new, but the hypotheses existed for at least a year. The data collected during the research is reliable and sufficient to present strong proofs of the theory. One limitation this research has it that the contaminated hands were placed under the dryers without washing, which assumes that a person would use the dryer right after using the toilet but skipping the hand washing procedure.
The research is important because airborne bacteria present serious danger in the contemporary world, so all possible ways of spreading them need to be detected and addressed. The conclusion of this research points out one of such ways. Its reduction is possible and easy. Findings of the research show that paper towel dispensers are much safer than hand dryers in relation to spreading airborne bacteria as the number of colony forming units on distributed by paper towel dispensers was significantly smaller than that of the dryers.
Works Cited
Air dryers blown away by paper towels in germ tests. PubMed Health. 2014.
Restroom Hand Dryers Spread More Germs Than Paper Towels, Study Finds. Drugs. 2014.
Kinesiology, as the science of human movement, incorporates all-inclusive health subjects, which uses the moderate art of muscle monitoring (biofeedback) to access information about a persons wellbeing. Definitely, it ascertains the features that impede the bodys normal internal energies and access the life of improving prospective within a person (Getchell and Mikesky 56). Moreover, individuals perform various exercises to help control their movements.
According to Dounskaia (204), such exercises target to increase flexibility, increase endurance, increase strength, exercise prescription and specificity, as well as Motor teaching and motor learning. The control of human movement is a broad concept under kinesiology; it touches on physiology of exercise, neural basis of movement, psychology of movement, and biomechanics.
According to MedicinePlus, the process by which nerves, bones, and muscles coordinates to create slight, precise movements constitutes fine motor control. In the field of sports, the study of control of human movement is essential in providing students and scholars on the confines of human performance (Dounskaia 207). The coordination of the brain in organizing human movements is also a fundamental concept in sport science.
Exercise to Increase Flexibility
Flexibility is determined with the level of muscle stiffness or elasticity, which is referred to as pliability by the therapists. Certainly, inclusive fitness schemes should be integrated into flexibility exercises since this is relevant in developing and upholding the range of motion (ROM). These exercises help in stretching the major muscle groups. Therefore, an individual ought to perform them at least two days a week.
Indeed, there are relevant parameters for stretching protocols, which include intensity of stretching force, duration of stretch, as well as the frequency of stretch (Leonard 109). Notably, these parameters are used in prescription to increase flexibility. The best stretching ought to encompass suitable static, as well as dynamic practices. Some of the techniques involve slow elongation of muscle and holding it in stretched state for some time and dynamic techniques, which is slow, cyclical elongating, holding, and shortening of a muscle (Leonard 144).
Despite the existence of static and dynamic categories of muscle stretching, other types of muscle stretching are also in existence. , such as Proprioceptive Neuromuscular Facilitation (PNF), which involves the altering activation in a compressed muscle with reflexive protraction of the muscle. In addition, there is ballistic that involves repeated prancing movements, wherein tendon are swiftly elongated and instantly slackened.
Flexibility, as a key concept under control of human movement, has various advantages, some of which include an increase range of motion, improvements in joint function, enhancing muscle performance, preventing muscle injury, especially during eccentric exercise, and preventing other soft tissue injury as well as decreasing post-exercise soreness.
However, persistent stretching can increase a muscles resting length and decrease the amount of passive force that it develops at certain points in the range of motion of joints that the muscle crosses (Sternad 45).
Exercise to Increase Endurance
These workout instructions identify principles for three factors, namely, duration, frequency, and intensity. Specifically, the elements bring about a total workout impetus referred to as training volume. Besides, therapists give some specific prescription parameters, which are approved by the American College of Sports Medicine to ensure enhancement of endurance (Dounskaia 204).
For that reason, an individual should have them in consideration to be certain of the full achievement of this activity. The components of the activity include frequency of training, intensity of training, duration of training, as well as the mode of activity involved. First, frequency of training of an individual who aims at increasing endurance should range between three to five days a week. In addition, the trainee has a duty to ensure the intensity of his/her training is per the prescription of the therapist.
Explicitly, the maximum oxygen uptake reserve (VO2R) of between 50% and 85% is recommended. In retrospect, therapists regulate the workout potency by launching a work out heart rate at 65% to 90% of maximum heart rate (HRmax) or 50% to 85% of HRmax reserve (HRR) (Dounskaia 203). On the other hand, therapists recommend unfit individuals to have lower intensity exercise, which ranges between 55% to 64% of HRmax and 40% to 49% of HRR (Winter 84).
Besides, an individual has to consider the duration of training. Indeed, the period should range between twenty to sixty minutes of uninterrupted or recurrent activity contingent on its strength. In the process of exercise, however, some factors seek ardent consideration. For instance, an individual ought to perform lower-intensity exercise for at least thirty minutes per day while more intense for at least twenty minutes daily.
Likewise, less fit persons may well mount up workout bouts all through the day on condition that each bout continues for over ten minutes. Consequently, persons are highly likely to achieve overall fitness with workout spells of sensible strength and lengthier periods. Definitely, moderate magnitude workout is harmless and linked with healthier observance than more intense schemes.
As a final point, the mode of activities involves large muscle groups as well as rhythmical and aerobic. Some of the events include jogging, skating, cycling-bicycling, walking-hiking, and skiing. A prescribed schedule of stepwise increments in frequency, duration, and intensity gradually leads to a maintenance level of fitness, which is required in the field of sports (Sternad 53). Nonetheless, there is a special group such as those with hypertension. To these individuals, standard prevention parameters can apply.
That is to say, such individuals should ensure that they take in consideration both the primary and tertiary prevention strategies. In other words, primary prevention strategy involves the reduction of the rise in blood pressure that occurs over time in people at risk due to endurance exercise. Whereas the tertiary prevention is the type where endurance exercise produces ten millimeters reductions on average in systolic and diastolic blood pressure to people with mild essential hypertension, (140-180/90-105).
Definitely, endurance workout lowers blood glucose levels, and can as well increase insulin sensitivity for approximately three days (Dounskaia 206). At the same time, the exercises have to go hand in hand with a proper diet, thus touching on the nutrition field.
Importantly, endurance training has various benefits, including maintaining and improving cardiovascular functions, maximal VO2, cardiac output, and arteriovenous oxygen difference, as well as reducing the risk factors associated with coronary artery disease, diabetes mellitus, hypertension, obesity, hyperlipidemia, and constipation (Dounskaia 205).
Besides, it improves health status and increases life expectancy of individuals who consider it worth implementing. It boosts health of bones and decreases osteoporosis risks, particularly in postmenopausal female. The exercise also enhances postural stability and minimizes falling risks as well as related cracks and injuries. Finally, it preserves cognitive function, alleviate symptoms of depression, and improve concepts of personal control and self-efficacy.
Exercise to Increase Strength
This activity is vital for ensuring that the magnitude and value of workout for expanding and sustaining cardiorespiratory and muscular aptness, and adjustability in healthy adults is attainable with ease. Consequently, there are certain prescription parameters in place that an individual ought to consider for the successful exercise. In addition, there is intensity of training, which requires the involvement of both the therapists and the trainee.
In other words, the therapists apply the theory of a repetition maximum (RM) to recommend the load that an individual is capable of lifting (Winter 50). In line with the training, several specialists endorse the aspect of between eight and twelve repetitions per set, though a lower repetition series with a weightier load for instance, between six and eight repetitions can even augment muscles power and resilience. Besides, there is the duration of training; one should at least have one set of exercise, which is between eight and ten. Finally, there is the mode of training; in this case, the ACSM recommends no specific mode of exercise (Goodheart and Frost 451).
Conclusion
Movements and interactions of joints help in improving quality of life through by promoting physical activities, preventing and managing injuries and chronic diseases, and general enhancement of health and performance.
Human movement is an imperative topic in the field of sports, as the course entails physical fitness. From another perspective, the study of sports offers insight into the perimeters of human performance. Exercise, physical and health education, elite sport, and nutrition are some of the crucial topics that have to touch on control of human movement.
Works Cited
Dounskaia, Natalia. Control of Human Limb Movements: The Leading Joint Hypothesis and Its Practical Applications. Exercise Sports Science Reviews 38.4 (2010): 201-208. Print.
Getchell, Bud, and Alan Mikesky. Physical Fitness: A Way of Life. 6th ed. Boston: CPG Publications, 2007. Print.
Goodheart, George, and Robert Frost. Applied Kinesiology, Revised Edition a Training Manual and Reference Book of Basic Principles and Practices. Berkeley, Calif.: North Atlantic, 2014. Print.
Leonard, Charles. The Neuroscience of Human Movement. St. Louis: Mosby, 1998. Print.
Sternad, Dagmar. Progress in Motor Control: A Multidisciplinary Perspective. New York: Springer, 2009. Print.
Winter, David. Biomechanics and Motor Control of Human Movement. 4th ed. New York: Wiley, 2009. Print.
Eating problems among women have been associated with a feminine obsession with thinness. However, Thompson, in the article, A Way Outa No Way: Eating Problems among African-American, Latina, and White Women, challenges this assumption. This analytical treatise attempts to explicitly expound on Thompsons suggestions on the causes of eating problems. Besides, the treatise reviews the role of the media in supporting attitudes and behaviors related to eating disorders.
Causes of eating problems
Thompsons findings reveal that most of the eating problems among her sample population are associated with different traumas such as sexual abuse, racism, poverty, acculturation, physical and emotional abuse, and heterosexism among others. In her findings, Thomson reveals that victims of sexual abuse may resort to binge or excessive dieting to deal with the psychological effects of any form of sexual abuse. Almost 61% of the respondents stated that binging was their coping mechanism for dealing with psychological consequences as a result of a series of sexual abuse.
Another issue identified by Thompson as a major cause of eating problem among women is poverty. Thomson discusses poverty as a trauma which her respondents had to deal with through binging. For instance, Yolanda started binging to cope up with the challenges of raising small children within a budget $539 in a month. For such women, binging offers them solace. Through compulsive eating, the victim develops an involuntary pattern of coping with daily financial problems.
Also, Thompson identifies racism and class injuries as a cause of eating disorders among women she interviewed. For instance, the past experiences of Joselyn in the hand of a racist family motivated her to reduce her food intake to the point of starvation to survive the pressure of losing weight. Joselyn had to meet the social standards set by her father to survive in the white neighborhood where every woman is thin.
Thompsons position
In summary, Thompsons position on the causes of eating disorders among women is the need to survive. Specifically, Thompson identifies different traumas affecting women and the need to cope with them through developing unpredictable eating habits. Even when thinness culture inspires eating disorders, Thompson notes that bulimia, anorexia, and binging are largely associated with the need to cope with different traumas.
How media influences eating disorder attitudes and behaviors
The media is a very significant factor influencing the development of eating disorders in younger women. For instance, in the video, Dying to be thin, a slim body is presented as a powerful figurative form, a ground on which the central hierarchies function, and a metaphysical commitment to a culture that is strengthened through the visible body. For instance, the ladies in black dresses in the video are thin and continue to maintain this state through a series of exercises.
The focus on the smallness of womens bodies has significantly increased in the media creation of a womans figure. For instance, in the film, Kill us softly, the media have created an obsession with thinness. The image of the model in a white dress is presented as an ideal feminine body. This obsession has resulted in poor eating habits since no woman wants to be fat. The models in the film are not only slim but also thin. As a result, most women would love to compare themselves to models.
The media also alludes that slim figured women get decent clothes to wear than those who are overweight. To fit in the thinness culture, young women are under pressure and may end up developing eating disorders.
Helen is a 67-year-old white female. She has a history of arthritis, hypertension, and right sided CVA with left hemiparesis. The hemiparesis has affected her dominant hand; hence, she cannot write. In addition, her non-paralyzed side is weakened. Her religious affiliation is based on a commune that practices New Age religious beliefs. The commune adheres to vegetarian diet, beliefs in prayer and crystals to heal body imbalances. The diagnoses confirmed pneumonia, dehydration, upper tract infections (UTI) and pressure ulcer. The Emergency Room (ER) nurse termed the pressure ulcer as huge. Based on the diagnosis the planned medical treatment was surgical management of the coccygeal ulcer. On the other hand, there was the issue of religious beliefs. For example, the accompanying caretaker, Anna had objected the placement of an indwelling catheter. She argued that Helen could achieve balance without tubes. Thus, the following paper presents the possible holistic intervention based on PICO.
Intervention
I used the internet to search for databases that contain information on life sciences and the holistic care. I identified two databases the EMBASE and Medline. I settled on Medline because it has medical, dental and nursing journals. I then searched for Medline and found that it could be accessed through ProQuest, Web Knowledge, EBSCO, and PubMed. The sites required membership subscription in order to gain access except PubMed. Thus, I chose PubMed. To access the article in PubMed search site, I refined the search to full free articles. I then used keywords pressure ulcers and holistic care. This provided me with many articles. I read the abstracts for the various articles and opted for the article, Managing Pressures Ulcers in a Resource Constrained Situation: A Holistic Approach. According to Dam, Datta, Mohanty and Badndhopadhyay (2011), the article employs a holistic care delivery process that is centered on evidence-based practice and patients attributes.
I logged into PubMed home page. In the search site, I entered my search words evidence-based care and searched. I customized the search for text availability to free full text. In the species category, I customized it into humans. Further, in the journal category, I refined the search to search words management of pressure ulcers. I skimmed over the articles, and I settled on the article Pressure ulcers: Current understanding and newer modalities of treatment. The article outlines an evidence-based care for people with pressure ulcers (Bhattacharya & Mishra, 2015).
Outcome
The holistic care is a form of healing, which is based on the philosophy of healing environments (Zamanzadeh, Jasemi, Valizadeh, Keogh & Teleghani, 2015). As such, the care decision for patients is centered on healing the body, mind, spirit and the emotions. The basis of the healing is the integration of the evidence-based practices with the mind and spiritual healing. The first article provided care delivery for the patient based on a reflection that was centered on individual decisions making process, cultural consideration, and medical principles. The care provision as outlined is based on the healing hospital paradigm, which entails the reflection of the beliefs, values and philosophies of the person being treated (Zborowsky & Hellmich, 2011).
The relevant care outcome for Helen will be a healing process that takes care of body, mind and spirituality. The concept plays a critical role in healing the body, mind and spirit. In this case, it will be based on provision of meaning, purpose and connection to Helens culture. However, the health professionals should explain to Helens caregiver the need for the integration of the medical process and spiritual concept and the dangers of extreme beliefs that may alter the treatment process.
References
Bhattacharya, S., & Mishra, R. (2015). Pressure ulcers: Current understanding and newer modalities of treatment. Indian Journal of Plastic Surgery, 48(1), 1-16.
Dam, A., Datta, N., Mohanty, U., & Badndhopadhyay, C. (2011). Managing pressure ulcers in a resource constrained situation: A holistic approach. Indian Journal of Palliative Care, 17(3), 255-259.
Zamanzadeh, V., Jasemi, M., Valizadeh, L., Keogh, B., & Teleghani, H. (2015). Effective factors in providing holistic care: A qualitative study. Indian Journal of Palliative Care, 21(2), 214-224.
Zborowsky, T., & Hellmich, L. (2011). Impact of place on people and process: The integration of research on the built environment in the planning and design of critical care areas. Critical Care Nursing Quarterly, 34(4), 268-281.
Psychiatric diagnoses have been riddled with controversies for a long time with proponents and critics giving different views on the issue. The proponents hold that psychiatric diagnoses are normally near accurate, and thus the practice should not be dismissed based on misdiagnosis claims.
On the other side, critics argue that psychiatric diagnosis is a sham and its professionals are in it for money. Most psychiatric patients will side with the critics by arguing that every time they visit a different psychiatrist they get disparate diagnoses. For instance, a patient might be diagnosed with schizophrenia at one point and be diagnosed with major depression in another setup. These inconsistencies in psychiatric diagnoses have prompted worldwide debate on the soundness of psychiatry as a professional practice.
The critics side seems to be drawing significant support from different quarters as people question the accuracy of psychiatric evaluation. Psychiatry became a medical field in the mid 18th century even though the Greeks had been practicing it from as early as the 3rd century. However, despite the practice being in existence for many centuries, it has been dogged with controversies especially on the way diagnoses are carried out.
As opposed to other medical diagnoses, which rely on set laboratory procedures, psychiatry depends on subjective information without proper procedures to determine a case using data derived from scientific experiments. Nevertheless, critics should not overlook the view that some psychiatric patients have been treated successfully using the allegedly abstract diagnosis methods. However, the successful cases might be isolated cases of chance as opposed to accuracy.
This paper will explore the critics stand that psychiatric diagnoses are inaccurate, and thus they cannot be relied in the treatment of mental disorders. This stand is befitting due to the many inherent flaws in psychiatric diagnosis. Diagnosis in psychiatry does not have the same level of rigor and consistency as diagnosis in any other form of medicine.
Psychiatry misdiagnosis
When patients visit doctors regardless of the underlying sickness, they expect to get professional help based on facts derived from established scientific procedures. Unfortunately, when psychiatric patients visit their doctors, they are not sure of what to expect as the practice relies on subjective information given by the patient.
Ironically, people rely on their brains to make decisions or describe situations, but mentally unsound people are expected give information about their sickness from the very dysfunctional faculties. This aspect discredits the entire practice and it inevitably leads to misdiagnosis. Bhatia rues that there is no doubt that among the medical professions, psychiatry is the most scientifically primitive (3).
This primitivism hinges on the apparent lack of structures and scientific experiments to assist in psychiatric evaluation. Cases of psychiatric misdiagnosis are very common in the contemporary society, which further casts doubt over the credibility of the practice. In one interesting case, a woman killed herself only for investigations to reveal that she had been (mis)diagnosed with all known psychiatric disorders within a record period of twelve months.
The medical history does not have records of an individual suffering from all known mental disorders, and thus this case underscores the primitivism in the field of psychiatry. One might argue that the case was an isolated incidence and it should not be used as a reference point for all psychiatric cases. However, this case was not isolated as in 2010, a study found that about 20 percent or 900,000 of the 4.5 million children identified as having ADHD had been probably misdiagnosed (Henion and Elder par. 1).
This realization means that psychiatric diagnoses are more of guesswork than a professional procedure. Therefore, critics have a valid point when dismissing psychiatric evaluation as a sham procedure that adds little value in the field of medicine.
The psychiatrys incapability to come up with a standard procedure of determining cases with high degrees of confidence forms the basis of its dismissal as a pseudoscience field. Therefore, the majority of patients cannot define their disorder with surety because at best they can only say my doctor said this and that.
Therefore, mental disorder patients cannot understand the technicalities that are used when giving a diagnosis, and thus they have to rely on the trust that their doctor is at least qualified to make sound judgments. Unfortunately, patients are given different diagnoses, and given that they are mentally unstable, they take these labels to define their personalities. For instance, a patient suffering from severe depression might be misdiagnosed with schizophrenia.
Given that this person cannot make sound judgments, s/he ends up with the schizophrenic label yet s/he simply suffered from a different case of severe depression. The concern of labeling individuals wrongly boils down to the primary purpose of diagnosis. Conventionally, diagnosis seeks to improve patient care outcomes by determining the course of action that should be taken towards recovery.
Essentially, if people have same diagnosis results they should logically be suffering from the same condition, and thus they should undergo set intervention procedures. In addition, diagnosis helps in determining whether a patient will deteriorate or recover, which determines the appropriate course of action.
Unfortunately, psychiatric diagnoses do not lead to any of the above outcomes. In the worst-case scenario, a patient may die in the hands of psychiatrists due to misdiagnosis, which deteriorates an otherwise manageable condition. Hence, the credibility of psychiatric diagnosis falls short, and thus it becomes difficult for its proponents to prove critics wrong by giving tangible evidence on the practices usefulness in the field of medicine.
In a bid to narrow down the allegations leveled against psychiatric diagnosis, this section will focus on the numerous issues surrounding the bipolar disorder misdiagnosis. Currently, psychiatrists cannot agree on what symptoms one should possess in a bid to be classified under those suffering from bipolar disorder. Regrettably, anyone with some mood disorders is highly likely to be categorized as a bipolar disorder victim.
As noted earlier, information from mentally unstable people cannot be relied solely in a diagnosis, and thus in a bid to cover the inconsistencies that patients might give, psychiatrists make assumptions of what might have happened. For instance, an individual might be having mood disorders, but without the necessary collaborating evidence to show the presence of maniac episodes.
Therefore, a psychiatrist will easily conclude that the maniac episode lacks because the patient cannot remember it or they will somehow occur with time. The DSM can be overly restrictive, requiring a full symptomatic picture of mania with a duration of four days, while many experts believe that the average duration of the hypomanic state is 1 to 3days& in bipolar II, it can be difficult to elicit a past history of hypomanic episodes from the patients (Tanvir and Rajput 58).
Therefore, psychiatrists end up giving treatment based on assumptions, which might be wrong. Some patients develop maniac episodes after taking bipolar disorder prescriptions as directed by their doctors. Human health and well-being cannot be subjected to such guesswork especially in the 21st century where technology can be employed to improve patient care outcomes.
The proponents of psychiatric diagnosis will claim that the misdiagnoses are not as important for ultimately almost all mentally unstable individuals get almost a similar concoction of medication after all. This line of thinking may sound appealing, but its repercussions are far reaching. As mentioned earlier, labeling mentally unstable individuals wrongly elicits lifelong outcomes.
Individuals may start to think about themselves based on the verdict given from the guesswork that defines the psychiatric evaluation process. This aspect affects peoples future lives, and thus they might live miserable lives due to a misdiagnosis that could have been prevented if psychiatrists admitted that the practice has numerous loopholes.
Instead of wasting time and resources defending the conspicuous untrustworthiness that underlines the practice, psychiatrists should face the issue and stipulate guidelines on how to approach the issue professionally. Other individuals might not even be suffering from mental disorders, but they may fake symptoms in a bid to get some entitlements. Therefore, they will create perfect history to reflect the presence of the disorder in their families, and thus psychiatrists will easily believe the fabrications.
Unknowingly to the fake patients, after such information is entered in their medical charts, it becomes part of their lives whether true or false and the reverberations are serious. For instance, if someone faked bipolar disorder symptoms and s/he suffers from schizophrenia later in life, doctors will simply look at the past records, note a history of bipolar disorder, and offer prescription right away.
Therefore, the individual will end up being treated for the wrong disorder, due to some inherent errors bedeviling the psychiatry practice. Such loopholes should not exist in the medical field, which might determine life or death of an individual.
The highly publicized modern diagnostic processes like DSM-V are also dogged with numerous shortcomings. For instance, DSM-V largely relies on a series of mutually exclusive questions requiring yes or no answers. In addition, the allegedly new diagnostic methods still rely on the mentally unstable patients to offer reliable information concerning their past for effective treatment.
As aforementioned, this aspect was the bane of the earlier diagnostic methods, but regrettably, the new methods are falling in the same trap. Even if the patients had the capacity of understanding their past in details, the jargon used in psychiatry evaluation might be very technical for a non-professional to understand. On the other side, individuals might understand the course of action of the different psychiatric disorders.
Therefore, they may end up giving the wrong information so that they do not get certain prescriptions or lose some entitlements. In addition, some will falsify information in a bid to avoid the stigmatizations that accompany some cases like schizophrenia. The anosognosia issue is a threat to the current dysfunctional psychiatric diagnosis procedures.
According to Martyr et al., anosognosia is the deficit of self-awareness, a condition in which a person who suffers certain disability seems unaware of the existence of his or her disability (94). Therefore, it becomes insurmountable for a patient to describe his/her condition, yet s/he is not aware its existence.
Rebuttal
Notwithstanding the smear campaign against psychiatric diagnosis, the process has been critical in dealing with mental disorder patients. Therefore, critics cannot dismiss the entire practice as a sham fuelled by philistinism, without appreciating the achievements realized in psychiatry courtesy of the involved procedures. Al-Huthail (53) maintains that without psychiatric diagnosis, victims of mental disorders would be living pathetically.
Patient care has improved with time, and with the current DSM-V diagnostic tool, the levels of accuracy are improving. Al-Huthail (35) holds that psychiatry, just like any other medical field, is evolving and despite the inherent challenges in the practice, it cannot be dismissed as a sham.
According to a study conducted by Al-Huthail in 2008, the accuracy of diagnosing these disorders was the highest in this study, confirming that the detection of these disorders is poor, but once detected by the treating teams, the likelihood of accurate diagnosis is high (37). Therefore, if the field could surmount the challenge of detecting the disorders, then psychiatric diagnosis will compare with other medical diagnoses.
In addition, Al-Huthail (36) holds that research is underway on how neurobiologists can use technology to improve diagnosis outcomes for psychiatric patients. This advancement will allow specialists to pinpoint the nature of mental disorder that an individual suffers just as laboratory tests can determine the presence of the malaria-causing pathogen in a patients blood.
However, Al-Huthail and his fellow proponents of psychiatric diagnosis fail to address the loophole of using subjective information to make reliable diagnosis (Martyr et al. 98). The claim that psychiatric diagnosis has helped many people with mental disorder is a platitude that adds no value to such position because this medical field is supposed to aid the sick.
In addition, Al-Huthail claims that the field of psychiatric diagnosis is undergoing an evolution, but he forgets that the practice has been around from the 3rd century, and thus human beings cannot be used continually as guinea pigs for a practice that has failed to advance. In addition, Al-Huthail admits that accuracy in psychiatric diagnosis can only be achieved after recognizing the presence of a condition first.
Therefore, this form of accuracy is dependent on other factors, which cannot be established using psychiatric diagnosis. Therefore, the proponents of psychiatric diagnosis like Al-Huthail do not have a valid point, and thus the practice should be scrapped from the field of medicine.
Conclusion
Psychiatric diagnosis is the most archaic system of all known medical procedures in the 21st century. Psychiatrists depend on information given by psychiatric patients to make a diagnosis, and thus the results cannot be reliable. Cases of misdiagnosis in this medical field are common in the contemporary society, and this situation has prompted critics to propose the scrapping of the profession as it adds little or no value to the field of medicine.
Sadly, a mentally unstable patient can be diagnosed with a myriad of disorders in a span of one year, which casts doubt over the reliability of psychiatric diagnosis. In addition, most disorders are classified as bipolar due to the lack of enough evidence to put them under any other category.
However, this trend is dangerous as it may have far-reaching repercussions as individuals might live with stigmatization that comes with some disorders like schizophrenia. From the discussion given in this paper, diagnosis in psychiatry does not have the same level of rigor and consistency as diagnosis in any other form of medicine, and thus Rosenhan and Slater are right as their studies support this assertion.
Works Cited
Al-Huthail, Ayer. Accuracy of Referring Psychiatric Diagnosis. International Journal of Health Sciences 2.1 (2008): 35-38. Print.
Bhatia, Manjeet. Over Diagnosis, Overshadowing, and Overtreatment in Psychiatry. Delhi Psychiatry Journal 15.1 (2012): 3-4. Print.
Martyr, Anthony, Linda Clare, Sharon Nelis, Judith Roberts, Julia Robinson, Ilona Roth, Ivana
Markova, Robert Woods, Christopher Whitaker, and Robin Morris. Dissociation between implicit and explicit manifestations of awareness in early stage dementia: Evidence from the emotional Stroop effect for dementia-related words. International Journal of Geriatric Psychiatry 26.1 (2011): 9299. Print.
Tanvir, Singh, and Muhammad Rajput. Misdiagnosis of bipolar disorder. Psychiatry 1.1 (2006): 57-63. Print.
Chickpea is leguminous crop, which offers a good nutrition to people across the world. It is common in Afro-Asian countries where there is a favorable tropical and sub-tropical climate. Moreover, Afro-Asian countries have fertile soils that provide robust nutrients to chickpea. Chickpea ranks second after soybean as the common leguminous crop that people grow and consume across the world. Therefore, its study is significant because chickpea has nutritional and economic importance in the world.
Scientific Name
Fabaceae and Faboideae are family and subfamily names of chickpea respectively. The generic name of chickpea is Cicer, while the specific name is arietinum. Therefore, the scientific name of chickpea is Cicer arietinum.
Brief Overview: Economic Importance; Where grown; Uses
Chickpea has great economic importance because it ranks second after soybean as the common leguminous crop that farmers grow and people consume across the world. Since chickpea is one of the major legumes that people consumed around the world, it generates a lot of income to farmers who are mainly in Afro-Asian countries. Countries such as India, Pakistan, Australia, Turkey, and Burma are major producers of chickpea because they have favorable climate and fertile soils.
According to Sharma, Yadav, Singh, and Kumar, chickpea has important nutrition because it has quality proteins and sufficient carbohydrates (805). Hence, due to nutritional significance, chickpea provides nutrition to both humans and livestock. For instance, Indians use chickpea in making Indian cuisines such as hummus, salads, and stew. Moreover, farmers use some of chickpea in making animal feed for their livestock.
Focus Areas of this Report
To enhance understanding of chickpea, the report focuses on pathology, nutrition, biotechnology, secondary metabolites, ecology, domestication, and breeding and genetic resources as aspects of chickpea.
Pathology
Fungal Infections
Chickpea is susceptible to a number of fungal infections. For example, ascochyta blight is a dominant fungal infection caused by Ascochyta rabiei. In countries such as Western Australia and India, farmers have experienced reduced yields in crop production due to ascochyta blight infections on their crops. According to the Department of Agriculture and Food, the susceptibility of chickpea to ascochyta blight infection varies depending on the crops variety and the level of fungicide protection applied (par. 4).
An infected plant has black spots, brown margins, and gray centers on the stems and leaves. Thereafter, the stems break causing the plant to wilt and eventually die. Usually, the stem damage is the major cause poor yields experienced by chickpea farmers in most countries. Infections usually take place when seed batches that have the fungus, or small pieces of trash infested with the disease causing fungi are transferred to a an area initially free from the infection. Evidently, low level of seed infection can cause a significant outbreak of the disease in a chickpea plantation, and affect the overall crop production.
Bacterial Infection
Chickpea farmers have continually experienced declining yields in the overall productivity of the plant. The declining productivity is attributable to bacterial infections that affect the crops. One of the notable bacteria that infest chickpea is Pseudomonas syringae that causes bacterial blight. When infected the stems look appear soaked and later turn into olive green. The stems eventually develop purple brown spots and break. Moreover, the leaves become brown or black and take the shape of a fan.
They later turn yellow and build up brown papery spots on their lesions. Usually, an infection takes place on flowers and in sepals. The infection kills the flower buds before they open, and thus prevents pollination and reduces crop yield in chickpea (Crop Gene Bank par. 4). Infestation occurs when fresh uninfected plants mix with diseased plants and trash. This is because the bacterium can survive in the diseased plant for several months. Insects also may spread the infections to new plants during pollination.
Pests
Chickpea has a number of insect pests. Among many pests, pod borer (Helicoverpa armigera), is the dominant one. The pest causes serious crop damage in countries like Australia, Mediterranean, and Asia. Yadav, Naveen, Redden, Chen, and Sharma, state that, pod borers can cause a loss of over 25-40% on chickpea farms, a figure that amounts to $325 million per year (2).
The pests lay their eggs on the young pods and flowers of chickpea, while the larvae feed on the young leaves; hence, destroy seedlings of the plant. Moreover, the larvae of pod borers attack chickpea by boring holes on flower buds, pods, and maturing seeds. Therefore, the overall productivity of chickpea is affected.
Effect on Production or Yield
Fungi, bacteria, and pests have detrimental effects on chickpea plants. Across the world, farmers incur huge losses every year because of the damages caused by the fungi, bacteria, and pests. In the Australian, Indian, and Mediterranean regions, fungal diseases such as ascochyta blight adversely affect the productivity of the plant. Department of Agriculture and Food, pests and diseases cause significant reduction in chickpea yields in many countries around the Mediterranean region (par. 1).
On the other hand, bacterial infections are also destructive as farmers who plant chickpea incur great losses. For example, during winter, farmers in southern France, South Africa, and New Zealand, experience serious infections of bacterial blight, which has a negative impact on the yield and productivity of chickpea. Furthermore, pests such as pod borers destroy chickpeas. Therefore, fungi, bacteria, and pests, affect the yield of chickpea and reduce their overall productivity in many countries around the world.
Ways of Management
In the management of fungal and bacterial diseases of chickpea, infected crops should be isolated from the new plants because isolation reduces the introduction of the disease on the uninfected seeds. Moreover, farmers can also employ extensive crop rotation so that they can minimize the spread of infections within a single paddock. In addition, farmers can use fungicides and bactericides at the initial stages of the crop to reduce the risk associated with early infections.
To control pests, farmers can employ a number of strategies that are available. According to Acharjee and Sarmah, these strategies include rotational planting, spacing, time of sowing, inter cropping, fertilizer application, strip-cropping, wide hybridization, and germ-plasma screening (par. 4). Farmers can use these strategies to reduce the effects of fungal and bacterial diseases and in the control of pests.
Nutrition
Human Nutrition
Chickpea is an important leguminous crop because it provides nutrition to significant number of people in different parts of the world. Like other legumes, chickpea provides important nutrition to humans. Sharma, Sanjeev, Yadav, Singh, and Kumar state that chickpea provides quality proteins and good starch, which form part of human nutrition (808). Given chickpea is among the dominant legumes, it helps in meeting the protein and starch needs that humans require in their nutrition.
According to Jukanti, Gaur, Gowda, and Chibbar, in the semi-arid tropics, chickpea is an important component of the diets of those individuals who cannot afford animal proteins or those who are vegetarian by choice (11). Thus, chickpea offers cheap and quality proteins to the poor and vegetarians. Additionally, the starch provides carbohydrates and roughages that form a vital component of human nutrition.
Importance Worldwide
Across the world, chickpea is an important leguminous crop not only in terms of nutrition, but also economically. Countries in the Middle East, North Africa, southern Europe, Australia, and Asia rely on chickpea as a source of food and commercial product. Jukanti, Gaur, Gowda, and Chibbar report that, during 2006 and 2009, the global chickpea production area was about 11.3 million hectares, with a production of 9.6 million metric tons and an average yield of 849 kg per hectare (11).
Out of this production, India alone produces about 66% of the worlds production. Thus, India is the major exporter of chickpea in the world. Farmers in India and other countries that grow chickpea earn money when they export their produce to different importers in various countries. Therefore, due to its nutritional and economic importance, Food and Agricultural Organization regards chickpea as the second dominant legume after soybean, which is grown and consumed across the world.
Nutrients that It Provides
Chickpea provide important nutrients such as proteins, carbohydrates, vitamins, and minerals. Chickpea has quality proteins that can supplement essential amino acids such as isoleucine, leucine, and tryptophan. Sharma, Yadav, Singh, and Kumar state that the protein content of chickpea is about 18-31% depending on the variety of chickpea (805). While kabuli variety of chickpea has the highest content of protein, desi variety of chickpea has the lowest content of protein. In addition to proteins, chickpea has carbohydrates in the form of fats, starch, and fibers.
The fats that are present in chickpea are unsaturated and have low levels of cholesterol, and thus good for human consumption (Sharma, Sanjeev, Yadav, Singh, and Kumar 806). Moreover, starch and fibers provide energy and roughages respectively. Riboflavin, thiamin, pyridoxine, and niacin are some of the vitamins that are present in chickpea. The presence of these vitamins makes chickpea a nutritious crop. Chickpea also has minerals such as iron, copper, zinc, and magnesium, which are essential in the human body.
Biotech Approaches
To improve nutritional value of chickpea, biotechnologists have employed a number of approaches. Hybridization is one of the methods that biotechnologists have used in breeding of chickpea to improve its productivity and nutritional value. In hybridization approach, biotechnologists employ single, triple, and multiple crosses when improving genome of chickpea. The combination of the crosses through backcross enables biotechnologists to insert new traits into native breeds or other hybrids.
In addition to hybridization approach, genomics-assisted breeding is an underway approach that aims at enhancing the traits of chickpea. Gaur, Jukanti, and Varshney state that application of genomic tools in breeding of chickpea has enhanced its productivity and nutritional value (212). Thus, genomic-assisted breeding is a breeding approach that has a great potential of improving nutritional value, since it entails the incorporation of other genes into chickpea.
Biotechnology
Biotechnology Methods
Biotechnologists have devised numerous ways of ensuring that chickpea has increased resistance to pests and diseases. Helicoverpa armigera (pod borer) is a common pest that severely affects chickpea, and thus reduces yields significantly. To prevent the pest, biotechnologists have developed genetically modified chickpea that is resistant to the pod borer. According to Acharjee and Sarmah, biotechnologists have managed to insert a gene of Bacillus thuringesis (Bt gene), which confers insecticidal property to chickpea, and thus enables it to resist the attack of pod borers (5709).
Moreover, biotechnologists have developed chickpea that is resistant to fungal blight. The use of hybridization is another way of improving yields and productivity of chickpea. Conventional breeding approaches have given over 350 improved cultivars, which have contributed to improved productivity, reduced fluctuations in yield, and enhanced adoption of chickpea to new niches (Gaur, Jukanti, and Varshney 200). This means that hybridization by crossing the native and the hybrid varieties have enhanced traits of chickpea.
Importance of Biotechnology
Application of biotechnology in the development of chickpea hybrids that are resistant to pests and diseases has reduced the cost of using pesticides, fungicides, and bactericides. Consequently, resistance of chickpea to pests and diseases leads to increased yields. Gaur, Jukanti, and Varshney assert that the development of hybrids that have enhanced productivity of chickpea because biotechnology improves the traits of the wild chickpea (208). The wild varieties of chickpea are not only susceptible to pests and diseases, but they are also unproductive. Thus, the use of biotechnology is important because it increases the resistance of chickpea to pests and diseases, and improves yields.
The article Chronicle of Health Creation by Weeks dwells upon the concept of interprofessional teams in the national pain strategy. It is stated that pain management requires an integrative approach that presupposes the collaboration of different healthcare professionals (Weeks par. 6). It is also stressed that the use of interprofessional teams is becoming more common, but there are still various gaps in this area that can be removed with the help of effective on-job training and formal education.
The article is relevant to the field of integrative care and the use of interprofessional teams as it unveils some peculiarities of this approach in pain management. It is necessary to note that the use of interprofessional teams has been discussed quite extensively in news and scholarly articles. For instance, researchers and practitioners share their knowledge on the effectiveness of this approach in particular spheres. Pain management is also the area where the integrative approach has become widely discussed. Researchers note that the quality of services provided is increasing when interprofessional teams are in the play, and the personnels confidence plays a significant role in this process. It is stressed that this approach is effective in chronic care as well, and it is associated with the effective collaboration of professionals and provision of high-quality healthcare services. Professionals working in interprofessional teams share knowledge and experience. Practitioners also apply different perspectives and insights to address particular issues. Obviously, any health problem has many features and causes, which makes it important to look at it from different angles. In simple terms, professionals employ different skills and methods that turn out to be beneficial for the patients health and wellbeing. Moreover, researchers note that the use of interprofessional teams leads to the lower level of the personnels burnout as well as a high level of care.
The article in question touches upon the topic of education and training that is relevant to the integrative approach (Weeks par. 13). It has been acknowledged that this method should become an integral part of the medical curriculum. For example, many researchers concentrate on interprofessional education in nursing homes and stress that it positively affects the delivery of care. It is clear that on-job training and formal education should include the integrative approach as practitioners should be equipped with skills to effectively collaborate in interprofessional teams. It has been found that the method may be implemented inefficiently, which results in the personnels dissatisfaction with the approach and the provision of low-quality care. Therefore, medical schools and every healthcare facility should make sure that they provide the necessary training to future, new practitioners and experienced healthcare professionals. The use of interprofessional teams should become a part of hospitals organizational culture.
In conclusion, it is possible to note that the article in question unveils some peculiarities of the use of interprofessional teams in pain management. It is relevant to the field as it draws practitioners and researchers attention to the problem. The method is still underdeveloped and lacks formal or standardized practices. Healthcare professionals still lack important skills that could allow them to provide care in a more efficient way. The formation process, the choice of professionals, communication, and collaboration are still areas to research and improve. At that, the discussion of the issue will inevitably translate into the development of specific methods and tools that will be applicable in various settings.
Works Cited
Weeks, John. Chronicle of Health Creation: Are Integrative Health and Medicine Part of the National Pain Strategy? The Huffington Post, 2016. Web.
The HCC Partners in Life is an aggregated medical service provider that dispenses curative, preventive, and palliative care to diagnose and treat patients (Nichols, 2008). In the recent past, the HCC Security Operations Center has perceived of malware and policy transgressions within its Intrusion Detection System (IDS). Ever since the lead HCC database administrator opened an email attachment, her computer system has divulged technical snags. These glitches have elucidated the need to review potential breach, prompting HCC to engage due forensic investigation services from our XYZ Incorporation. This paper projects the blueprint procedures that we, at XYZ Inc., have lined up to explore the HCC network, its database server, plus other workstations. After that, a court prosecution will follow, where I, in the capacity of the Lead Forensic Investigator, will represent the forensic team.
Body
What is Our Plan to Process the Potential Crime/ Incident Scene?
My response strategy constitutes of an Enterprise Incident Response and the famous FOR508 1 (Marshall, 2008). Below is a summary of our program with a recommendation from Marshalls Digital Forensics.
Response program
Preparation. Outline the tools to counter the intrusion effectively. The tools for use here include data capture of traffic, packets, network recording, audit logs, and audit trails.
Identification. Spot and distinguish all the compromised systems and workstations, in this case, the database administrators computer system and the database server.
Containment. Fathom the exact steps in which the breaches ensued and establish the encroached details.
Recovery. File a threat intelligence, which HCC will use in the face of a future security adversary.
How will we identify the potential digital evidence?
The XYZ Inc. team has devised the following stratagem to pinpoint the pertinent evidence, with a tribute to Caseys Foundations of Digital Forensics.
Cyber crime investigation. We shall scrutinize timeline and MFT anomalies, deleted files, registry keys, NTFS timestamps, ShimCaches, and Sleuthkit toolsets. Research will also include scanning of physical entities such as thumb drives, cell phones, CDs, external hard drives, routers, and PDAs among others.
Data collection. The predominant data collection method lies in appropriate data capture from email servers, backup media, network shares, cellular devices, and the computer setups. Equally important is scrutiny of fax machines, scanners, printers, digital cameras, and answering machines.
How will we prepare for the search?
The preparation stage entails the considerations that the team should take into account beforehand such as organizing a Chain of Custody and threat intelligence. This chain is crucial in demonstrating the bearings of all HCC units of evidence, from the time of collection to the time of testifying in the court (Casey, 2011). A sufficient preparation comprises of fraud detection, operational time length, discerning malicious engineers, as well as documenting legal evidence (Marshall, 2008).
What steps will we take to seize digital evidence?
With reference to Barret and Kipper (2010), we aim to collect and obtain live evidence by executing the steps below.
Photograph HCCs database servers, workstations, and the running computer screens.
Secure live data including RAM image, logged on users, and the network connection state.
Disengage the power connection within the entire HCC working space.
Map out and mark all the cords.
Tally the model and serial numbers of the hardware devices.
Disengage the devices from their cords.
Search the HPA and subsequently image the hard drives.
Wrap up all evidence entities into evidence bags.
What documentation processes will we follow to help support any potential legal proceedings?
Marshall explains that documentation of forensic findings embodies data preservation and presentation (2008). We will appoint the aid of dedicated hardware and software accessories such as write blockers and Helix hardware imagers to register evidence, following guidance from Pandya (2013). We shall further detail into affidavits, the Chain of Custody and file the substantiated evidence of a breach, the data collection, and preservation methods.
How will my team follow proper storage on evidence means?
Marshall (2008) asserts that appropriate evidence repository epitomizes tabulation of items within the Chain of Custody. At XYZ Inc., we go all out to contend to this chain by tagging and labeling of the proof fundamentals (Nelson, Philips & Stuart, 2010). Tagging and labeling aids in easier and faster recognition of the testimonial items later. My response team will tag the item description, date, location, brand name, police case number, and serial numbers of the assembled hardware devices.
How Will My Team Approach and Process the Database Administrators Computer?
The HCC database administrator remarked that she had observed technical anomalies within her computer workstation, following the opening of an email attachment she received from the Human Resources. The attachment to the email contained some vital information on the company benefits. According to Nelson, Philips and Stuart (2010), such malware encroachment is critical to a company as it poses financial and regulatory risks for the firm. Apparently, malware technicians have perked up their expertise and so have we, at XYZ Inc. With adherence to Pandya (2013), my team and I have drafted the following approaches to process probable malware.
Assessing malware risks. Here, we will gauge the attack vectors susceptible to breach such as firewall, the Microsoft Baseline Security Analyzer (MBSA), and antivirus software on the computer in question.
Physical security. We shall employ this defense plan to prevent theft, human error, and tampering of records. The critical elements involved are network access points, personnel security, server computers, plus the administrators computer.
Logical security. Here, we assess software safeguards across the HCC workforce to establish which other persons, apart from the administrator, has admission to the particular workstation. We shall look at user IDs, password entries, rights of use, and authentication.
Reactive and proactive procedures. We shall use reactive methodologies to unravel the attack program utilized to compromise the administrators system, with particular attention to the email attachment. Furthermore, we shall also employ proactive policies to avert the host-based attack from endangering the entire HCC network.
What steps will we use to image her drive?
Barret and Kipper (2010) quote that hard drive imaging and cloning has a rule of thumb- to, at no time, reshape the original media. We will perform forensic imaging an assortment of various storage media such as her hard drive, floppy disks, zip drives, and CDs. We will administer a bit stream imaging by way of generating an exact bit-for-bit replica of the original subject media on the drives. We shall also implement the MD5 algorithm standard to test data integrity, MD5 hash values, and digital signature applications. We shall begin by documenting the Chain of Custody, followed by noting the type, model, brand, and the drives serial number. Next, we photograph the drive and authenticate the date and time details of the drive, before finally certifying the exactness of the information gathered (Pandya, 2013).
What areas on her system will we analyze for potential evidence of infection?
We see fit to examine the physical components of the administrators computer system, concerning the CPU, chips, boards, monitor, printer, and storage media (Barret and Kipper, 2010). Further, we shall pore over the RAM, internal hard drive, backups, and caches, CDs, DVDs, and digital cameras. In addition to this, we have a mind to evaluate varied software tools such as data storage techniques, application packages and the systems operating system as a whole. The reason for this is that we firmly believe that data infringements exist in a dual form. Pandya explains a double form as the state where the physical dimension of evidence is a product of software application creation (2013).
Other items
Casey offers that deployment and management are crucial in mitigating malicious attacks (2011). In this case, we will validate, monitor, and report on the optimum antivirus software, Window Defenders, user education, log files, and the MBSA. The objective behind this is to confirm that the followed procedures to authenticate the firewall, gateway, and the MBSA, are efficient and thorough, explains Barret and Kipper (2010).
How Will My Team Approach and Process the Potential Breach in the Database Server?
The tipoff from the HCC Snort IDS has alerted probability of infections in the firms database. Security failures that lead to interference of personal medical records and data in HCC are synonymous with legal, financial, regulatory, and reputation risks for the entire enterprise (Nichols, 2008). These risks advance prospects of danger in detriment to the associated patients, as mischievous characters could steal their identities (Nichols, 2008). In an imperious move, my team and I have formulated a number of recovery processes using various approaches and tools. Referring to Pandya (2013), we intend to apply cleaning applications including the Malicious Software Removal Tool, Sysinternals tools, along with manual procedures as follows.
Detach the affected server from the rest of the network.
Modify all account and system passwords, paying exceptional attention to financially oriented structures, in addition to those that host commercial information.
Distinguish processes and drivers that lack icons, company names, or descriptions.
Investigate peculiar URLS, DLLs or services, and bare TCP/IP.
Deactivate malevolent drivers, processes, files, and auto starts.
Reboot the system.
Ultimately, update and renew the impaired database files and reserves.
What steps will we use to image the database server?
In reverence of the HCC servers inconsistencies, an e-investigation server imaging is paramount. My team and I have arranged to employ the same steps as those applied to mirror the administrators drive, with guidance from Barret and Kipper (2010). These encompass logging the Chain of Custody, the drives serial number. Next, we take pictures of the internal hard drives and authenticate the date and time details, before finally certifying the accuracy of the information accumulated (Barret & Kipper, 2010). We also contemplate on the usage of special software imaging tools such as the EnCase, SHA, and MD5 hash functions, in combination with just standards to clone the HCC server.
Dislodge the internal hard drives from the server one-at-a-time.
Note the model, type, brand, position, and the drives serial numbers in a catalog, before taking a picture of them.
Attach each hard drive to a rapid computer forensic imaging equipment to generate bit-by-bit forensic duplicates.
Tabulate these data in digital forensic image folders enclosing drive checksum values, SHA1, and MD5 hash values.
Contrast the images against the initial hash values, in the event, correcting errors, partitions, encryption, as well as file systems.
Record the servers clock and internal calendar, before reinstalling the drives.
Which areas of the server system will we analyze for potential evidence of infection?
Based on references from Pandya (2013), my team and I propose to comb through familiar places to fish out possible infection. These familiar areas highlight the hidden, deleted, or temporary files, in combination with spools, RAM, internal hard drives, the RAM, backups, and caches. We intend to scan memory buffers, network storage, ISP records, steganography, printouts, notes, and swap spaces (Pandya 2013). Over and above, we shall also pore over external media equipment such as iPods, digital cameras, CDs, and DVDs.
Other items
In addition to the chartered scheme for identifying the security infringement, we have also resolved to scan and monitor the entire HCC network. Drawing instructions from Barret and Kipper (2010), my team will use Nmap, IP traf, TCP dump, plus Wireshark scanners to probe and filter packets. We also intend to review the proposed antivirus software to give an optimum value. These procedures will aid in surveying the traffic trends within the network and eventually, disclose the perpetrators.
How Will I Prepare My Forensic Team to Support Any Expert Testimony Court Requirements?
One of the duty objectives of a certified forensic expert is serving as an expert witness in a court of law (Marshall, 2008). My thought processes are to acquaint my forensic crew of their expected roles in a federal court and due compliance with Civil Procedure and Rules of Evidence (Nichols, 2008). By virtue of their job specification, the forensic investigators are expert witnesses, permissible to project opinions on sensitive issues. I will dispense professional training courses to equip the team with witness knowledge including the responsibility to help the jury comprehend the facts and factual conclusions (Marshall, 2008). In addition, I will notify them on the added benefits to proffer opinion testimonies, calculated facts, as well as inadmissible evidence.
What are the steps I will take in the documentation phases of the investigation?
I plan to emulate the research documentation procedures outlined above to serve as an auxiliary tool in preparing my witness experts. Data preservation and presentation are essential constituents in mastering how to support expert testimony. Crime investigators are subject to learning the representation of affidavit writing and bearing witness to those facts and declarations present (Nelson, Philips & Stuart, 2010).
How will I prepare my team for a court testimony?
In fulfillment of the directives prescribed by the U.S. Supreme Court, forensic investigators must submit and testify on the tabled evidence (Marshall, 2008). I have integrated the NIJ online training course to equip my team with professionalism as itemized below. Moreover, the course assists to prepare for the pretrial discovery process to endure challenging opposing attorneys (Casey, 2011).
Oath-taking. The process of taking the oath when summoned to bear witness necessitates the witness to stand upright and give your word to the clerk. It requires the expert witness to declare, I do in a clear and concise manner.
Be knowledgeable. Acknowledge jurisdictional laws, the forensic subject matter, and the Rules of Evidence, courtesy of the Federal state.
Cultivate organization skills. Have well-organized reports enabling fast and easy reference.
Be alert. Practice intelligibility, promptness, and credibility in responding to queries from attorneys. Recognize prejudicial motions that ban testifying on evidence.
Be levelheaded. Conduct yourself in a controlled manner and avoid laughing or sneering. Act reasonably by way of desisting from making utterances only until you get to the witness stand.
Tell the truth. Most importantly, be genuine and speak the truth concerning the facts and evidence.
Maintain emotional stability. Balance your temper even when asked extremely discourteous questions.
What are the ethical responsibilities that I conform to and require of my teams performance?
The digital forensic field comprises of compounded Code of Ethics, as illustrated below; that uphold integrity and virtue of the discipline (Nelson, Philips & Stuart, 2010). In my capacity as the Lead Forensic Investigator, I duly comply with these ethical requirements and assure of the same from my response team.
Exercise steadfastness, integrity, and diligence in discharging of duties.
Remain objective in examining and presenting forensic records and statistics.
Conduct reputable and validated assessments by way of decent morals and ethical standards.
Give truthful testimonies and evidence withal, facing any court, board or other proceedings.
Cleave to all legal orders and stipulations anticipated by the courts.
Avoid any events or courses of action that would bring about a conflict of interest, at any point in the survey process.
Exercise practice of sincere and conscientious research within the scope of the contract.
Conclusion
The HCC Partners in Life, a healthcare company, has freshly endorsed us, the XYZ Inc., to unearth interference of their medical records. We have forwarded a proposal with which to detect and test the hypothetical evidence that will suffice as permissible evidence in a court of law.
References
Barret, D., & Kipper, G. (2010). Virtualization and forensics: A digital forensic investigators guide to virtual environments. Amsterdam: Syngress/ Elsevier.
Casey, E. (2011). Foundations of digital forensics. In Digital evidence and computer crime: Forensic science, computers, and the Internet. (3rd ed.). (pp 3-34). London, England: Academic Press.
Marshall, A. M. (2008). Digital forensics: Digital evidence in criminal investigation. Chichester, UK: Wiley- Blackwell.
Nelson, B., Philips, A., & Stuart, C. (2010). Guide to computer forensics and investigations. Boston, MA: Course Technology Cengage Learning.
Nichols, C. L. (2008). Medical identity theft. Chicago, Ill: AHIMA.
Pandya, P. (2013). Chapter 14, Local Area Network Security. In Vacca, J. R. (Ed.), Computer and information security handbook. Boston, MA: Morgan Kaufmann Publishers.