Creating a Pamphlet for College Students on Pregnancy Coursework

Making a Pamphlet for College Students on Pregnancy - Coursework Example The fundamental segments that are required for a sound pre-natal period are the womans mental and physical wellbeing. The progressions that the womans body experiences during this period will require standard mental and physical pre-natal registration by an expert social insurance supplier, just as a fitting activity program (Fetal Development). Physical wellbeing is indispensable, and appropriate pre-birth sustenance is fundamental for sound fetal turn of events (Civitas). The lady should counsel proficient data to guarantee she is getting the sufficient admission amounts of folic corrosive, iron, protein, liquids, and calcium (Civitas). Moreover, there might be nourishments that should be decreased and substances, for example, liquor and tobacco, which should be wiped out. All in all, dangerous sexual conduct that occasionally describes a school way of life may bring about an undesirable pregnancy. The couple ought to be genuinely prepared and the lady ought to be truly arranged. The pre-natal period ought to incorporate appropriate nourishment, satisfactory exercise, and absolute forbearance from substances that can influence the solid improvement of the

Gouverneur K. Warren - Civil War - Major General - Union Army

Gouverneur K. Warren - Civil War - Major General - Union Army Gouverneur K. Warren - Early Life Career: Conceived at Cold Spring, NY on January 8, 1830, Gouverneur K. Warren was named for a nearby Congressman and industrialist.â Raised locally, his more youthful sister, Emily, later wedded Washington Roebling and assumed a key job in the structure of the Brooklyn Bridge.â A solid understudy, Warren acquired admission to West Point in 1846.â Traveling a short separation down the Hudson River, he kept on showing his scholarly aptitudes as a cadet.â Graduating second in the Class of 1850, Warren got a commission as a brevet second lieutenant in the Corps of Topographical Engineers.â In this job, he voyaged west and supported in ventures along the Mississippi River just as helped plan courses for railways. Filling in as a designer on Brigadier General William Harneys staff in 1855, Warren previously experienced battle at the Battle of Ash Hollow during the First Sioux War.â In the wake of the contention, he kept on reviewing the grounds west of the Mississippi with the objective of deciding a course for the cross-country railroad.â Ranging through the Nebraska Territory, which included pieces of cutting edge Nebraska, North Dakota, South Dakota, Wyoming, and Montana, Warren made the principal point by point maps of the locale as wellâ as broadly overviewed the Minnesota River Valley.â Gouverneur K. Warren -  The Civil War Begins: A first lieutenant, Warren had returned east by 1861 and filled a post at West Point educating mathematics.â With the start of the Civil War in April, he left the foundation and started supporting in raising a neighborhood regiment of volunteers.â Successful, Warren was named lieutenant colonel of the fifth New York Infantry on May 14.â Ordered to Fortress Monroe, the regiment partook in Major General Benjamin Butlers rout at the Battle of Big Bethel on June 10.â Sent to Baltimore in late July, theâ regiment helped in developing strongholds on Federal Hill.â In September, following the advancement of the fifth New Yorks administrator, Colonel Abram Duryã ©e, to brigadier general, Warren accepted order of the regiment with the position of colonel. Coming back to the Peninsula in the spring of 1862, Warren progressed with Major General George B. McClellans Army of the Potomac and participated in the Siege of Yorktown.â During this time, he often helped the armys boss geological designer, Brigadier General Andrew A. Humphreys, by leading surveillance missions and drafting maps.â As the crusade advanced, Warren accepted commandâ of a detachment in Brigadier General George Sykes division of V Corps.â On June 27, he continued an injury in the leg during the Battle of Gaines Mill, yet stayed in command.â As the Seven Days Battles advanced he againâ saw activity at the Battle of Malvern Hill where his men supported in repulsing Confederate assaults.â Gouverneur K. Warren -  Ascent to Command:â With the disappointment of the Peninsula Campaign, Warrens detachment returned north and saw activity at the Second Battle of Manassas in late August.â In the battling, his men were driven back by an enormous attack from Major General James Longstreets corps.â Recovering, Warren and his order were available the next month at the Battle of Antietam however stayed for possible later use during the fighting.â Promoted to brigadier general on September 26, he kept on driving his unit and came back to battle in December during the Union thrashing at the Battle of Fredericksburg.â With the climb of Major General Joseph Hooker to order of the Army of the Potomac inâ early 1863, Warren got a task as the armys boss land engineer.â This before long observed him advance to become theâ armys boss architect. In May, Warren saw activity at the Battle of Chancellorsvilleâ and thoughâ it brought about a stunningâ victory for General Robert E. Lees Army of Northern Virginia, he was praised for his exhibition in the campaign.â As Lee started moving north to attack Pennsylvania, Warren prompted Hooker on the best courses for blocking the enemy.â When Major General George G. Meade succeeded Hooker on June 28, he proceeded toâ help direct the armys movements.â As the two armed forces conflicted at the Battle of Gettysburgâ on July 2, Warren perceived the significance of the statures at Little Round Top which was arranged off the Union left.â Racing Union powers to the slope, his endeavors just forestalled Confederateâ troops from seizing theâ heights and turning Meades flank.â In the battling, Colonel Joshua L. Chamberlains twentieth Maine broadly held the line against the attackers.  In acknowledgment for his activities at Gettysburg, Warren got an advancement to signif icant general on August 8. Gouverneur K. Warren - Corps Commander: With this advancement, Warren accepted order of II Corps as Major General Winfield S. Hancock had been severely injured at Gettysburg.â In October, he drove the corps to triumph over Lieutenant General A.P. Slope at the Battle of Bristoe Station and demonstrated expertise and discretionâ a month later during the Mine Run Campaign.  In the spring of 1864, Hancock came back to deployment ready and the Army of the Potomac redesigned under direction of Lieutenant General Ulysses S. Award and Meade.  As a piece of this, Warren got order of V Corps on March 23.  With the start of the Overland Campaign in May, his men saw broad taking on during the Conflicts of the Wilderness and Spotsylvania Court House.  As Grant pushed south, Warren and the armys mounted force officer, Major General Philip Sheridan, repeatedlyâ clashed as the last felt that the V Corps pioneer was excessively wary.  â â â As the militaries drew nearer to Richmond, Warrens corps again observed activity at Cold Harbor before moving further south to enter the Siege of Petersburg.  In a push to compel the circumstance, Grant and Meade started expanding Union lines south and west.  Moving as a major aspect of these activities, Warren prevailed upon a triumph Hill at the Battle of Globe Tavern in August.  A month later, he made another progress in the battling around Peebles Farm.  During this time, Warrens relationship with Sheridan remained strained.â In February 1865, he saw considerable activity at the Battle of Hatchers Run.â Following the Confederate thrashing at the Battle of Fort Stedman in late March 1865, Grant educated Sheridan to strike Confederate powers at the key junction of Five Forks.  In spite of the fact that Sheridan mentioned Major General Horatio G. Wrights VI Corps bolster the activity, Grant rather relegated V Corps as it was better situated.  Aware of Sheridans issues with Warren, the Union head allowed the previous to calm him if the circumstance justified.  Attacking on April 1, Sheridan adequately crushed foe powers drove by Major General George Pickett at the Battle of Five Forks.  In the battling, he accepted that V Corps moved too gradually and that Warren was out of position.  Immediately after the fight, Sheridan assuaged Warren and supplanted him with Major General Charles Griffin.  Gouverneur K. Warren - Later Career: Quickly sent to lead the Department of Mississippi, an angry Warren surrendered his bonus as a significant general of volunteers on May 27 and returned to his position of major of designers in the customary armed force.  Serving in the Corps of Engineers for the following seventeen years, he worked along the Mississippi River and helped in the development of railways.  During this time, Warrenâ repeatedly mentioned a court of investigation into his activities at Five Forks with an end goal to clear his notoriety.  These were rejected until Grant went out.  Finally, in 1879, President Rutherford B. Hayes requested a court gathered.  After broad hearings and declaration, the court presumed that Sheridans activities had been unjustified.  Allocated to Newport, RI, Warren kicked the bucket there on August 8, 1882, a quarter of a year prior to the courts discoveries were officially distributed.  Only fifty-two, the reason for death was recorded as intense liver disappointment identified with diabetes.  As per his desires, he was covered locally in Island Cemetery with no military distinctions and wearing regular citizen garments.  Chosen Sources: Common War Trust: Gouverneur K. WarrenCivil War: Gouverneur K. WarrenNNDB: Gouverneur K. Warren

The Second Coming Vs. Things Fall Apart Essay Example For Students

The Second Coming Vs. Things Fall Apart Essay The bookThings Fall Apart , by Chinua Achebe , is fundamentally the same as thepoem , The Second Coming by William Butler Yeats. Acomparison of The Second Coming to Things Fall Apartwill show many comparing angles between both ofthese scholarly artful culminations. Seeing the line Things fall apartin the sonnet , Achebe makes an extraordinary affiliation. Atthis point in time he says to himself, I should name my bookThings Fall Apart , It will show the primary thought of the book. One of the many agreeing ideas between the two is thedaunted misgiving of both the sonnet and the book. InThings Fall Apart it appears at whatever point the principle character,Okonkwo, gains trust things happen to self-destruct . Thecontents of The Second Coming recounted a clamorous worldand a base that couldn't hold due to its own innerconflicts. In Addition to the equal inclination both thebook and the sonnet give, the two of them uncover an extraordinary move fromand old period to another time. The Second Coming uncovers anapocolypse. Yeats shows this change by depicting theconversions our reality, as a worldwide network, madethroughout history . Key lines that allude to these progressions intime are Turning and Turning in the extending gyre the falconcannot hear the falconer. These lines allude to the constantadjustments we need to make and furthermore the way that wecannot return in time . Chinua Achebe additionally uncovers amajor move by depicting Umuofa as it was initially. We will compose a custom exposition on The Second Coming Vs. Things Fall Apart explicitly for you for just $16.38 $13.9/page Request now In depicting Umuofa as it was initially he makes it easierto notice the significant changes all through the story . Another matching thought in the two pieces is the penance ofsomething to maintain a strategic distance from changes that tag along . Okonkwoends his life if all else fails . In doing this he feels that hesaves his respect and legacy . He additionally executes himself to dodgethe agony and enduring that Christianity brought to his way of life . The Second Coming cautions us of an apocolypse . Theapocolypse is the finish of progress in our reality . Whatmakes the sonnet so interchangeable to the book is that in eithercase it is beyond the realm of imagination to expect to prevent the progressions from happening . A fourth concurring thought in The Second Coming andThings Fall Apart is the loss of control of a higher powerover a lower power . In Things Fall Apart Okonkwo attempts toteach Nwoye the old methods of their kin . He additionally attempts tomake his child not at all like Okonkwos father . Nwoye needed tobe his own man . He didnt need to need to satisfy theexpectations of his dad , Okonkwo . Nwoye takes on theways of Christianity in anticipation of a superior life . Okonkwo feelsdishonored by Nwoyes turn towards Christianity. Okonkwo now looks his child as he did his dad . Nwoyesmove to Christianity shows the loss of Okonkwos powerover his life . In The Second Coming the loss of control issymbolized by the line the bird of prey doesn't hear the falconer. Where the hawk is the image of the lesser force andthe falconer the image of the higher force . The line saysthat after time passes and changes happen powerschange . The last intelligent thought between the sonnet and thebook is the regard towards an unrivaled power . The superiorforce isn't generally an item that one can feel or hold in hisor her hand yet it could be as straightforward as a thought. Thesuperior power in The Second Coming was not theapocolypse however it was time . Time can't be delayed orturned back so whatever is done may never be changed . .u057a337fe5603be62bc2d8839b554803 , .u057a337fe5603be62bc2d8839b554803 .postImageUrl , .u057a337fe5603be62bc2d8839b554803 .focused content territory { min-tallness: 80px; position: relative; } .u057a337fe5603be62bc2d8839b554803 , .u057a337fe5603be62bc2d8839b554803:hover , .u057a337fe5603be62bc2d8839b554803:visited , .u057a337fe5603be62bc2d8839b554803:active { border:0!important; } .u057a337fe5603be62bc2d8839b554803 .clearfix:after { content: ; show: table; clear: both; } .u057a337fe5603be62bc2d8839b554803 { show: square; change: foundation shading 250ms; webkit-progress: foundation shading 250ms; width: 100%; haziness: 1; progress: obscurity 250ms; webkit-progress: darkness 250ms; foundation shading: #95A5A6; } .u057a337fe5603be62bc2d8839b554803:active , .u057a337fe5603be62bc2d8839b554803:hover { mistiness: 1; change: murkiness 250ms; webkit-progress: murkiness 250ms; foundation shading: #2C3E50; } .u057a337fe5603be62bc2d8839b554803 .focused content zone { width: 100%; position: rel ative; } .u057a337fe5603be62bc2d8839b554803 .ctaText { fringe base: 0 strong #fff; shading: #2980B9; text dimension: 16px; textual style weight: striking; edge: 0; cushioning: 0; content enrichment: underline; } .u057a337fe5603be62bc2d8839b554803 .postTitle { shading: #FFFFFF; text dimension: 16px; textual style weight: 600; edge: 0; cushioning: 0; width: 100%; } .u057a337fe5603be62bc2d8839b554803 .ctaButton { foundation shading: #7F8C8D!important; shading: #2980B9; outskirt: none; fringe range: 3px; box-shadow: none; text dimension: 14px; textual style weight: intense; line-stature: 26px; moz-outskirt span: 3px; content adjust: focus; content embellishment: none; content shadow: none; width: 80px; min-tallness: 80px; foundation: url(https://artscolumbia.org/wp-content/modules/intelly-related-posts/resources/pictures/basic arrow.png)no-rehash; position: outright; right: 0; top: 0; } .u057a337fe5603be62bc2d8839b554803:hover .ctaButton { foundation shading: #34495E!important; } .u057a 337fe5603be62bc2d8839b554803 .focused content { show: table; stature: 80px; cushioning left: 18px; top: 0; } .u057a337fe5603be62bc2d8839b554803-content { show: table-cell; edge: 0; cushioning: 0; cushioning right: 108px; position: relative; vertical-adjust: center; width: 100%; } .u057a337fe5603be62bc2d8839b554803:after { content: ; show: square; clear: both; } READ: The contender EssayTime doesn't permit the world to plan for The SecondComing , So all expectation is lost . The Superior power in ThingsFall Apart is the spread of Christianity . Christianity createsChaos in Umuofia . It makes all the individuals that were faithful totheir predecessors disregard where they were from . Theculture of the individuals in Umuofia was gradually put to extinctionby the spread of Christianity . Our reality changes from dayto day . All that we do now thinks about how the futurewill be . On the off chance that there is one idea one gains from comparingthese two fine abstract works . It is to not harp on mistakesin the past however to make them up by doing admirably later on . Chinua Achebe and William Butler Yeats make this ideaunderstandable to us by utilizing it in their masterpieces. Okonkwo new the finish of his way of life was coming so he triesto do whatever he can to stop it . After years ofhopelessness he at long last observes an exit plan through death . InThe Second Coming it is highly unlikely to prevent theapocolypse from happening . So the world becomeshelpless and succumbs to The Second Coming . Thestories that both the book and the sonnet told were of lifesend . Book Reports

Church and State Assignment Example | Topics and Well Written Essays - 250 words

Church and State - Assignment Example The wordings utilized by Jefferson in encircling the statement of autonomy uncovered the picture of somebody who in spite of the fact that knew about the directs of religion and God, was hesitant to grasp it (Hamburger 13). The laws of nature depend on the human comprehension of the world. They are not really incited by any strict affiliations however, on the off chance that they are, it is an oblivious tendency towards strict convictions. The laws of nature identify with a portion of the arrangements of religion. It is confounded that the likeness between the announcements of the establishing fathers and the goals of Christianity suggest that they were deliberately applied in adoration to God. A distrustful perspective on such decrees cast slanders on the utilization (Hamburger 120). It is reasonable thinking that in the event that it were a reality that the establishing fathers advocated Christianity, at that point its application could be clear in the Declaration of Independence. Normal rights are natural. Fundamentally, nature directs the best human activities. Frequently, the normal laws have similitudes with the precepts of Christianity (Hamburger 45). Within the sight of such a comparability, people might be confounded to accept that they buy in to the

Global Trade Essay Example | Topics and Well Written Essays - 250 words

Worldwide Trade - Essay Example th reference to the watchman, the administrations will be in a situation to pass global limitations that secures household businesses (The Guardian, pp. 1-3). Moreover, the legislatures will advance national security. It will be a methods for actualizing an international strategy focusing on foe states. As per Reimer, by interceding in exchange, the administrations are attempting to hold fast to the vital exchange approach (Reimer, pp. 1-50). By empowering household work, governments may raise their taxes to impact exchange. Also, they may utilize the key arrangements to alleviate impacts of large enterprises. It will help developing organizations locally. Governments may raise burdens on products that exchange with adversary nation to execute their international strategies (Reimer, pp. 1-50). Exchanging the past for the most part abided in exchange governmental issues. These days worldwide exchange has progressed and exchange laws have supplanted exchange legislative issues. Furthermore, exchange has changed slowly till these days nations exchange with a body called World Trade Organization managing the exercises. As indicated by Pauwelny, exchanging framework has created from power based to rules based exchange (Pauwelyn, pp. 1-20) Neediness is an issue that influences current worldwide exchanging. The significant reason for neediness is auxiliary changes by the World Bank. Also, the advances to underdeveloped nation are another issue in exchange. The credits sabotage improvements and diminish exchange

Treatment-Resistant Depression Symptoms, Diagnosis, Treatment

Treatment-Resistant Depression Symptoms, Diagnosis, Treatment Depression Types Print An Overview of Treatment-Resistant Depression Antidepressants dont always work By Amy Morin, LCSW facebook twitter instagram Amy Morin, LCSW, is a psychotherapist, author of the bestselling book 13 Things Mentally Strong People Dont Do, and a highly sought-after speaker. Learn about our editorial policy Amy Morin, LCSW Medically reviewed by Medically reviewed by Steven Gans, MD on March 12, 2019 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on January 30, 2020 Depression Overview Types Symptoms Causes & Risk Factors Diagnosis Treatment Coping ADA & Your Rights Depression in Kids Westend61 / Getty Images In This Article Table of Contents Expand Prevalence Symptoms Causes Diagnosis Treatment Coping View All Depression is usually managed with medication, therapy, or a combination of the two, and usually, symptoms resolve with treatment. But sometimes, symptoms don’t get better with typical treatment. Although definitions may vary, when two or more medications fail to provide expected relief, the disorder may be considered “treatment-resistant depression.” Treatment-resistant depression can be complex. Depression symptoms, such as sleep issues and appetite problems, may continue despite patient compliance with treatment. At other times, the symptoms resolve briefly but come back. Its important to remember that even if depression does not respond to the first couple of treatments, that doesnt mean it cannot be treated. But it  may require a different approach to treatment. You should work with your doctor to monitor your symptoms and response to treatment so that you can find an option that works for you. Prevalence Studies have found that 30% to 40% of people only experience a partial remission of depressive symptoms after taking antidepressants.?? Approximately 10% to 15% of people dont respond to antidepressant treatments at all. Consequences for people with treatment-resistant depression can be significant. It’s associated with poor social functioning, medical comorbidity, and increased mortality. Untreated depression is also a common cause of disability, so it’s important to continue trying to find strategies that can bring relief. People with untreated depression have a lifetime suicide risk of 2% to 15%. Symptoms Symptoms of treatment-resistant depression can include: A lack of response to medication or psychotherapy treatmentNot enough of a response to standard depression treatmentsBrief improvements followed by a return of depressive symptoms Because standard treatments do not work well or at all, people may begin to experience profound hopelessness. Symptoms can drag on for months without feeling any relief or improvement in mood.   Symptoms of Clinical Depression Causes Doctors and researchers are not entirely sure what causes treatment-resistant depression. Some theories include: Genetics: Researchers believe that inherited characteristics may play a role in how peoples bodies respond to different antidepressants. While some genes have been associated with treatment-resistant depression, further research is needed to identify genetic biomarkers.??  Misdiagnosis: Poor response to standard depression treatments can also occur when people have been incorrectly diagnosed with depression. While they may have symptoms of major depressive disorder, they may actually have a different condition such as bipolar disorder.Metabolic abnormalities: Some research has suggested that metabolic disorders may cause nutritional deficiencies that can play a role in treatment-resistant depression. One study found, for example, that folate (vitamin B9) deficiency was more common in people with depression resistant to treatment.?? Further research in this area is needed to determine the exact impact of metabolic conditions. Diagnosis If you have been treated for depression but your symptoms have not improved, you should talk to your doctor. Treatment-resistant depression is not an official diagnosis included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), nor is it consistently defined. Some experts suggest that it is defined as having tried two different antidepressants without relief, while others suggest that it can take as many as four different treatments before depression should be identified as resistant. In any case, you should always talk to your doctor about your symptoms and concerns. If you have not experienced any relief, only minimal relief, or a complete return of symptoms, you may need a different type of antidepressant. Your doctor may: Review the treatments that you have tried so farConsider the type of response you have shown to treatmentsAssess your current physical health and consider underlying medical conditionsConsider a diagnosis of other psychiatric disordersEvaluate other medications and supplements you are currently taking If your doctor believes that you have treatment-resistant depression, they may recommend a different dosage, medication, or treatment approach. Your doctor may also refer you to a psychiatrist for additional treatment advice and options. Treatment While estimates vary, it is believed that anywhere 30% to 50% of patients with depression may not respond to a particular antidepressant medication. Before a physician or psychiatrist will consider a medication a treatment failure, they will consider the following questions: How long was the medication administered? Most antidepressants take four to six weeks to reach their full effect. Before declaring a treatment is not working, providers will want to ensure that the medication has been taken long enough to be effective.How closely did the patient adhere to the prescription? A prescription is usually only considered to be “adhered to” if it is taken according to the prescription at least 80% of the time. A few missed doses could greatly impact the ability of a medication to be effective. So before determining if a medication is a failure, a doctor will want to know if a patient has been compliant. Sometimes, doctors do pill counts or take other steps to monitor a patient’s medication.Is the medication at a therapeutic dose? Sometimes medications are started at a low dose to minimize risk or side effects. As it’s tolerated, the dosage may be increased slowly. A physician will want to ensure the dosage is at a therapeutic level before determining whether the treatment is a failure. The Best Online Help Resources for Depression Medications If a psychiatrist determines that your current medication is a failure, there are some other treatment options that affect brain chemistry in a different way. Those options include: Prescribing a different antidepressant. Just because one antidepressant doesn’t work doesn’t mean there aren’t any medication options. Sometimes physicians switch a patient to a different medication within the same class such as from Prozac (fluoxetine) to Zoloft (sertraline), or from one class to a different oneâ€"for example, from Celexa (citalopram) to Wellbutrin (bupropion) to see if a different medication has the desired effect.Changing to another type of antidepressant. Sometimes it’s helpful to switch from one class of antidepressant to another. Changing from a selective serotonin reuptake inhibitor (SSRI) to a monoamine oxidase inhibitor (MAOI), for example, may be helpful because they affect chemicals in the brain differently.Adding an additional type of medication. If antidepressants aren’t working, your doctor may add a different type of medication (known as augmentation). Some antipsychotics, anticonvulsants, or antianxiety drugs, for example, may be used in con junction with an antidepressant. Abilify (aripiprazole), Seroquel (quetiapine), and Zyprexa (olanzapine) are just a few examples of medications that may be used in conjunction with an antidepressant. How to Know Which Antidepressant Is Right for You Talk Therapy If you arent already attending therapy, a referral may be made to a mental health professional who offers it. While there are many different types of psychotherapy that have been found to be beneficial in depression, cognitive behavioral therapy (CBT) has been found to be especially effective for treatment-resistant depression. Patients attending CBT may learn a variety of skills to manage their symptoms and improve their functioning. The goals of CBT often involve reframing negative thoughts, problem-solving, increasing social interaction, and increasing activity level. CBT may also help reduce sleep problems. Some other types of therapy that may also be helpful include interpersonal therapy, dialectical behavioral therapy, and group psychotherapy. Other Treatment Options When medication and therapy aren’t reducing depression, your doctor may decide to turn to other treatment options. Here are some additional procedures that may be effective for treatment-resistant depression: Electroconvulsive therapy (ECT): Perhaps the most effective treatment for resistant depression is ECT. ECT is a procedure that is usually administered under general anesthesia. Electric currents are passed through the brain triggering a brief seizure. It seems to cause changes in brain chemistry that can reduce depression (and reverse symptoms of other mental illnesses). Although it is generally considered safe, it can have side effects such as some short-term memory loss as well as some physical side effects. ECT is often initially administered two to three times per week for a total of six to 12 sessions.Vagus nerve stimulation (VNS):  VNS is a surgical procedure that involves implanting a  pacemaker-like device in the body. It is attached to a stimulating wire that is threaded along the vagus nerve, which is thought to influence an area of the brain that regulates mood. Once implanted, the device delivers regular impulses to the brain via the vagus nerve. It can take several month s for the effects to be felt.Repetitive transcranial magnetic stimulation (rTMS): rTMS involves using a magnet to stimulate certain areas of the brain. It has been used since 1985 and is being increasingly utilized, but there isn’t a lot of data available on the long-term success rate.Ketamine: A type of anesthetic agent administered intravenously, ketamine has been found to be a potentially rapidly effective agent that can result in an improvement of depressive symptoms. Issues remain around how to sustain its effect long term.Spravato (esketamine) nasal spray: The newest FDA approved option for treatment-resistant depression is a fast-acting nasal spray called esketamine. It is one of the two molecules that make up ketamine. Like ketamine, it needs to be administered under close observation of a doctor.   Coping Dealing with treatment-resistant depression can be difficult for a number of reasons. Not only are you coping with persistent symptoms of depression, but you are also struggling with the difficulty in treating your condition. Some of the things you can do that can help: Follow your treatment plan. Even if it feels like you arent experiencing improvements, its important to take your medication as prescribed and attend recommended therapy sessions. Both therapy and antidepressants take time to work.Find ways to manage your stress. Unhappiness and stress that stems from areas of your life such as relationships, work, school, and finances can also contribute to feelings of depression. Stress management techniques such as meditation, journaling, progressive muscle relaxation, and yoga may provide some benefits and relief.Avoid drugs and alcohol. Substance use can not only worsen symptoms of depression; it can also cause interactions with your antidepressant medications. Always talk to your doctor about any substances, other medications, or even natural supplements that you are taking.Practice good self-care. While it can be difficult to do when you are feeling depressed, caring for yourself by eating healthy, sleeping enough, and exercising regularly may help you better manage your symptoms. A Word From Verywell If you or a loved one is experiencing depression and medication isn’t working, don’t give up. Talk to your physician or psychiatrist about other treatment options. It may take several attempts to find something that works well for you, but it’s important to keep trying so that you can experience relief from your symptoms. 8 Tips for Coping With Depression

A Perfect Score on the New PSAT is a...1520

Did you score a 1520 on the October 2015 PSAT? If so, then congrats--you got a perfect score.The College Board had indicated that the new PSAT would be scored out of 1600 points, but it has recently reversed course and decided to make 1520 the highest score. It has also tinkered with the scores and percentiles by scaling them both upward, most likely in an effort to make the SAT a less intimidating test and to compete with the ACT, the College Board's rival exam. This is welcome news for those of you who are considering taking the new SAT! It used to be that the PSAT was scored out of 1600 points, and the SAT was scored out of 1600 points. Made sense. Later, the PSAT had 2400 points, and the SAT was out of 2400 points too. Also made sense. To get a sense of what SAT percentiles used to look like on both the 1600 and 2400-point scoring scales, check out this table. Now, however, the PSAT is out of 1520 and the SAT is out of 1600. Here is a sample PSAT score report so you can get an id ea.You should also examine the new SAT / new ACT / old SAT concordance tables recently published by the College Board, which better explain the relationship between the scoring scales of each exam, including the old 1600-point SAT that geezers like me took decades ago, meaning that you can directly compare your scores to those of your parents.Scoring the new PSAT and the new SAT on two different scales doesn't make much sense to me from a SAT score prediction standpoint, especially for high-scoring students, but hey, that's just how it is--the decision has already been made. Read the college board's explanation here.For decades now, the SAT and ACT have been fighting a battle royale. Lately, the ACT has been winning--becoming the more popular exam--because the SAT has had a (well-earned) reputation as the tougher test. Unfortunately, this "thinning of the ranks" has had the effect of making the smaller pool of SAT test-takers even more competitive, driving down percentiles even furt her, which explains the appeal of the ACT, which has more test-takers and is less competitive, thus providing an easier avenue to a high-percentile score.The good news is the the College Board has apparently realized this, and has thus decided to raise SAT scores and SAT percentiles across the board. Why? Because curving SAT scores upward by 5-10% allows SAT percentiles to become more directly comparable to those on the ACT.So what does this mean for you? First of all, to state the obvious, if you're a high-scoring student, then it means that your PSAT score might be a bit lower than your SAT score would be, since the PSAT is capped at a 1520. It also means that the percentiles will be higher than usual. A score of 1170 on the PSAT (typically around 75%) is 87% on this year's test, for example. And a score of 1360 (typically around 94%) is 99/98% on this year's PSAT.How did this happen? On purpose, of course, and by using some fancy wording. As usual when dealing with a large compan y, you have to read the fine print. The College Board is no longer giving you an actual percentile of test takers, because it is aware that the SAT is a harder test than the ACT, and as a result, the pool of SAT test-takers becomes more competitive every year. So the Board is giving you something called a "Nationally Representative Sample Percentile" instead, which to me just sounds like a fancy way to raise everyone's percentile scores so high school students won't be afraid of the new SAT. It's actually a great business idea on the College Board's part to "adjust" SAT percentiles to make them comparable to those on the ACT, since SAT percentiles have been lagging behind their ACT counterparts for more than a decade now. (I have able to personally verify this through my own private tutoring practice by comparing the SAT and ACT percentiles of students who take both exams.)The College Board is now giving students two percentiles--a "Nationally Representative Sample Percentile," and a "User Percentile," both of which are very lawyerly in their descriptions, and both of which serve as creative ways to inflate SAT scores.Please note: as far as I can tell, the SAT is putting a much stronger emphasis on the "Nationally Representative Sample Percentile" than on "The User Percentile -- Nation." For example, the PDF versions of PSAT score reports do not mention the user percentile whatsoever, although the detailed online score reports do. The user percentile is normally a few percentage points below the NRSP, depending on where you scored.Here is what is currently written on the College Board website, word for word, so you can see for yourself (emphasis mine):"The Nationally Representative Sample percentile shows how your score compares to the scores of all U.S. students in a particular grade, including those who dont typically take the test. The User Percentile Nation shows how your score compares to the scores of only some U.S. students in a particular grade, a gro up limited to students who typically take the test."Translation: "we're bumping up your SAT scores and percentiles, in order to reflect the reality that only higher-scoring students tend to choose the SAT. New SAT percentiles will be directly comparable to ACT percentiles, so please don't be afraid of our test."Also, don't forget that you can log onto your College Board account to check your PSAT scores and review every question on the October 2015 PSAT.