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Psychiatric Disorders/Substance abuse disorders

Substance Abuse

Phenomenology
There are a number of syndromes and disorders associated with the general concept of substance abuse. Some of the most common are:

 * Intoxication. A reversible, substance-specific physiological and behavioral changes due to recent exposure to a psychoactive substance.

 * Addiction. A compulsion to use a drug, usually for its psychic, rather than therapeutic, effects.

 * Tolerance. The decline in potency of a drug experienced with continued use, so that higher doses are needed to achieve the same effect.  This is a receptor-mediated effect, typical of many psychoactive drugs.

 * Physical Dependence. The development of withdrawal symptoms once a drug is stopped.

 * Withdrawal. A physiological state that follows cessation or reduction in the amount of a drug used.  Generally, these effects are the opposite of the drug’s normal effects.

 * Substance Dependence. In the  Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), this is “a maladaptive pattern of substance use with adverse clinical consequences.”

 * Substance Abuse. According to  DSM-IV, this is “a maladaptive pattern of use that causes clinically significant impairment.”   Symptoms of substance abuse have not met the criteria for substance dependence and do not include tolerance and withdrawal (which can, but do not have to be, features of substance dependence).

 * Alcohol intoxication. This refers to the physiological and behavioral response to alcohol use that includes disinhibition, emotional lability, impaired coordination, slurred speech, ataxia, coma, and/or blackouts.

 * Alcohol withdrawal. This is the physiological state that results following cessation of alcohol use; it may be uncomplicated (causing tremulousness, anxiety, and/or increased heart rate) or cause potentially serious complications such as seizures and/or delirium tremens (all of which are discussed further below).

 * Alcoholism. Though not in  DSM-IV (where the term “alcohol dependence” would be used) is remains commonly used by medical clinicians and substance abuse experts.  It can be defined as a repetitive, but inconsistent and sometimes unpredictable loss of control of drinking which produces symptoms of serious dysfunction or disability.

Epidemiology
Use of psychoactive substances is common in society, and is often socially acceptable, or at least tolerated. Historically, psychoactive substances have served a variety of purposes, including medicinal, social, recreational and religious. In the US, 90% of people report some alcohol use, 80% report some caffeine use, 25% report use of tobacco products, and 37% report having used illicit substances (at least once in their lives). Dependence and Abuse are also very common (13.6% in ECA).

Alcohol
Over 10 million Americans are alcoholics; over 8 million are "problem drinkers." Only 3% of alcoholics are on skid row. Alcoholism is reportedly more common in rural areas and in the undereducated. It is more common in males than females, and more common in adults than teens/kids. However, teenage alcoholism studies show that 15% of high school students are reported to have 5 or more drinks per occasion at least once a week, and 31% of high school students were intoxicated 6 or more times in the past year.

Social/economic factors are considerable in that people in low socioeconomic status are less likely to drink, but more likely to misuse if they do. Drinking is associated with unstable work and family circumstances. Additionally, one should not forget the effect of substance abuse on families. Forty three percent of US adults report exposure to alcoholism in their families. Divorced or separated adults are 3 times as likely as married persons to report having been married to an alcoholic or problem drinker. Additionally, the cost to society is of great importance; alcohol-related deaths are the third leading cause of death in the US, after cancer and heart disease. There are 98,000 alcohol-related deaths per year. Furthermore, it is estimated that the medical complications and associated disability from alcohol abuse costs society $86 billion (along with $58 billion in costs from other substances). Alcoholism is also a major cause of other medical illnesses and injuries. Alcohol may be involved in 20-50% of hospital admissions, though these often go unrecognized. It contributes to 18-20% of ER visits, causes 80% of liver cirrhosis, and 33% of suicides are alcohol-related.

Cultural differences are also apparent in that alcoholism rates vary in different countries. Countries with high rates include Russia, France, Scandinavia, Ireland, and Korea. Those with low rates include China, Islamic countries, and Mediterranean countries

Other Substances
The lifetime prevalence of abuse for substances other than alcohol is as follows:
 * Amphetamines: 2%
 * Cannabis: 4%
 * Cocaine 0.2% (1981 data, probably higher now)
 * Hallucinogens: 0.3%
 * Opioids: 0.7%
 * Sedative hypnotics: 1.1%

The reward pathway and addiction
There is considerable research interest in the notion of a common “reward pathway” in the human brain that may be responsible for the pleasurable feelings experienced by humans in response to both natural stimuli (i.e. food, water, sex) and artificial (i.e. drugs). The major structures of this postulated reward pathway include the ventral tegmental area (VTA), the nucleus accumbens, and the prefrontal cortex. The VTA consists of dopamine-containing neurons that project to both the nucleus accumbens and prefrontal cortex. Thus, it is believed that dopamine has a considerable role in addiction, and indeed, a number of illicit drugs cause increased release of dopamine at these synapses. The most recent research indicates that the reward pathway may be important in both obtaining a reward, and in the associated craving. Opioids, cocaine, and nicotine have been shown to potentiate dopamine release in the reward pathway, and alcohol has been shown activate this pathway indirectly through potentiation of neural activity in the globus pallidus (which in turn connects to components of the reward pathway).

Patterns of cigarette smoking provide an interesting perspective on addiction. It is believed that smokers work, consciously or unconsciously, to maintain blood nicotine levels within the “therapeutic window” by a process referred to as nicotine regulation. For example, the smoker can manipulate the dose of nicotine on a puff-by-puff basis (“finger tip control”). Evidence for this comes from studies of low tar, low nicotine cigarettes. Research has convincingly demonstrated that smokers will compensate for low nicotine yields by smoking more effectively—blocking filter holes to prevent ventilation of smoke; smoking more of the cigarette; inhaling more rapidly and deeply; and smoking a larger total number of cigarettes.

The route of delivery also has implications for addictive potential. For example, with cocaine use, smoking the drug causes an increased rate of its delivery to the brain compared to snorting; hence the greater addictive potential of freebase and crack in patients with cocaine dependence. For nicotine, compared to other forms of its administration, cigarettes offer the most efficient delivery and the fastest spike in blood nicotine levels. Likewise, the subjective effects of smoking a cigarette are greater than the subjective effects after nicotine exposure to the nicotine gum or transdermal patch (types of nicotine replacement therapy to be discussed later).

Alcoholism and genetics
While 51% of cases of alcoholism are non-familial, genetics has been well established in alcoholism, particularly among young male alcoholics. Any drinking carries with it a 5-10% risk of becoming alcoholic. For children of alcoholics, having one parent with alcoholism is associated with a 20% risk of alcoholism in the child. With two parents, the risk is 20-50%. Sons of father are at greater risk, at 50%. If the father is a severe alcoholic and criminal, there is a 90% risk in his son. Children of alcoholics are also at risk for other substance use disorders.

Adoption studies and twin studies have shown that alcoholism concordance among identical twins is twice that of fraternal. The Danish Adoption Study (1974), in which adopted sons of alcoholics were raised by non-alcoholic foster parents, showed that these children still had increased risk of alcoholism.

Sons of alcoholics show a number of physiological abnormalities, including abnormal EEG's associated with drinking compared with normal subjects and other abnormal brain wave studies (such as evoked potentials). In addition, there exist abnormal hormonal response patterns in sons of alcoholics.

Some genetic differences may relate to inherited variations in the rate of metabolism. For example, decreased gastric oxidation of alcohol in women causes a higher blood alcohol level (BAL) in woman than in men. There has also been report of an association with a mutation on the D2 dopamine receptor gene on chromosome 11. This likely acts not as "causer," but rather a modifier.

Pathology
Psychoactive effects relate to the direct effect of drug on receptors in the central nervous system. Thus, it is important to understand the pharmacokinetics of a drug: its routes of administration, absorption, metabolism, binding capacity, and excretion. Receptors have been identified for a number of substances—caffeine and cannabis, for example. Others substances act more nonspecifically—alcohol and inhalants, for example, act by dissolving into cell membranes, particularly in the central nervous system.

Pharmacodynamics: the following substances are listed with their receptors:
 * Caffeine: adenosine
 * Cannabis: THC receptor
 * Hallucinogens: serotonin, NMDA
 * Nicotine: nicotinic cholinergic receptors
 * Opioids: opioid receptors
 * Phencyclidine: NMDA
 * Sedatives: chloride channel (GABA receptor)

Alcohol
Alcohol is generally thought to act by dissolving into cell membranes, specifically in the central nervous system. There is also some evidence that alcohol may potentiate the effects at neural synapses with GABAA receptors, similar to drugs such as benzodiazepines. Compared to benzodiazepines and other similar sedative drugs, however, alcohol use requires higher blood concentrations to achieve a comparable level of intoxication. Blood alcohol levels represent the concentration of alcohol in the blood and are typically measured in acutely intoxicated patients presenting for medical care (such as in emergency departments). The rate of increase in BAL is inversely related to the rate of gastric emptying; hence the reason for not drinking on an empty stomach. About 90% of patients with a BAL greater than 0.15% will show gross intoxication (with symptoms involving speech and gait), loss of consciousness can occur at 0.30%, and respiratory depression may be seen at about 0.45% (potentially resulting in death). Other acute effects of alcohol at the cellular level include ADH antagonism (the “happy hour diuresis”), potentiation of gastric acid secretion (increasing the risk for gastritis), increased peripheral vasodilation and flushing (a centrally-mediated effect), and increased levels of HDL, triglycerides, and uric acid.

Alcohol metabolism follows zero-order kinetics, meaning that a constant amount of the substance is metabolized per unit of time. The steps involved in hepatic alcohol metabolism are as follows:

Ethanol  acetaldehyde  acetate

The enzymes involved in this reaction are alcohol dehydrogenase (1st step) and acetaldehyde dehydrogenase (2nd step). As noted above, in women the rate of activity of alcohol dehydrogenase is lower, thus causing increased BAL levels. Alcohol metabolism can also be modified by hepatic microsomal enzymes that use NADPH. Acutely, alcohol use can inhibit hepatic p450 enzymes, thus transiently increasing the levels of concurrently taken drugs such as diazepam. With chronic use, however, alcohol can induce hepatic p450 enzymes, thus causing an increase in its own metabolism along with other drugs eliminated by this route. This may provide one cellular-based mechanism of tolerance that occurs with long-term users.

Cocaine
Cocaine acts in the brain by inhibiting catecholamine reuptake, thus increasing the availability of DA and NE in the synaptic cleft. As described above, the potentiation of DA activity in regions of the brain such as the nucleus accumbens may be responsible for cocaine’s addictive properties as well as its euphoriant effects. Dopaminergic activity is thought to also underlie the hallucinations (often tactile) sometimes seen during cocaine intoxication. Additionally, increased NE activity in the brain may cause symptoms of psychomotor agitation, including stereotypic or repetitive behaviors such as pacing, nail-biting, and scratching. This may be related to the binding of cocaine in areas such as the caudate nucleus. In addition, cocaine has peripheral effects on the body, augmenting sympathetic nervous system activity and causing tachycardia, pupillary dilation, and hypertension. Cocaine-mediated vasoconstriction can also produce angina, and in rarer instances, sudden cardiac death. Note that the effects of other substances on the body, particularly amphetamines, can mimic cocaine intoxication. Amphetamines enhance the release of NE and DA from the axon terminal, thus working similar to cocaine by increasing their availability in the synaptic cleft.

Nicotine
Receptors: Nicotine in tobacco exerts its actions on physiology and behavior by binding to nicotinic acetylcholine receptors (nAChRs), ion-gated channels that are normally responsive to endogenous acetylcholine. These receptors are found in the central nervous system and in the periphery (ANS, neuromuscular junction), and they are all involved in the physiological responses to tobacco. Each class of receptors generally contains different subunits, and experiments using gene knockout mice have indicated that certain subunits are specifically implicated in nicotine dependence. In time, this information may help to understand individual differences in response to nicotine and therefore nicotine dependence (e.g., those smokers with more or less of the specific nicotinic receptors), and it might help in tailoring new pharmacologic treatments which specifically target these receptors (e.g., by blocking or antagonizing their function, making nicotine less reinforcing).

It is also important to understand the dynamics of receptor function in relation to smoking and blood/brain nicotine levels. Neuroreceptors can become more sensitive for various reasons and they can also proliferate, both of which can be referred to as upregulation. Typically, one observes upregulation of receptors as a compensatory response to low levels of a neurotransmitter. Downregulation refers to the opposite, reduced sensitivity or fewer receptors, which in turn serves to compensate for excess levels of a neurotransmitter.

In the case of nicotinic receptors, the story is a little more complicated, and can be explained as follows: upon smoking a cigarette, a small pulse of nicotine activates nAChRs that directly or indirectly induce dopamine release, thus providing a pleasurable effect. With continued use, nicotine builds up to a slow steady-state concentration that causes significant nAChR desensitization and, over time, inactivation. There is evidence that nicotinic receptor turnover decreases following inactivation, leading to an increased number of nAChRs. In between cigarettes, during sleep, or under conditions of abstinence while attempting to stop smoking, nicotine levels drop and a portion of the inactive nAChRs recover to a responsive state. Because of the increased number of nAChRs that have now become responsive, some cholinergic systems become hyperexcitable to acetylcholine, contributing to the drive for the next cigarette. Thus, smokers may medicate themselves with nicotine to regulate the number of functional nAChRs. Note that this is still only a theoretical model, but it explains the powerful reinforcement experienced when smoking after a period of abstinence, even overnight. Understanding receptor function can also explain the rapid development of tolerance to nicotine’s effects, which would drive continued smoking.

Effects on the body: The effects of nicotine on the body are widespread. In the CNS, nicotine causes direct activation of ACh receptors, which when activated in regions such as the hippocampus can improve short-term memory and cognition/attention. Additionally, via activation of ACh receptors, nicotine can potentiate the release of dopamine (promoting its addictive properties, as described above), NE (promoting stimulation and arousal), and endogenous opioids (promoting stress-reducing and analgesic effects). There is also evidence that a component of tobacco (not nicotine) may inhibit the enzyme monoamine oxidase (MAO), which normally breaks down neurotransmitters such as dopamine, serotonin, and norepinephrine. Peripheral effects of nicotine are considerable and include increased heart rate, increased blood pressure, vasoconstriction, increased metabolic rate and lipolysis, skeletal muscle relaxation, and increased ACTH release and adrenal steroid production. Nicotine is rapidly cleared from the brain, and has a short half-life in the blood (with p450 liver metabolism to cotinine, the active metabolite), both which are factors that could partially account for the need for constant dosing.

Diagnosis
Classes of psychoactive substances recognized in DSM-IV include alcohol, amphetamines and related drugs, caffeine, cannabis, cocaine, hallucinogens, inhalants, nicotine, opioids, phencyclidine and related drugs, and sedatives. Polysubstance abuse occurs in which three or more categories of drug are abused (not including nicotine). Other drugs of abuse can include steroids, nitrates, and anticholinergics, to name a few. The criteria for diagnosis are as follows:

Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) Definitions
DSM-IV defined Substance Dependence is a maladaptive pattern of substance use. Criteria for diagnosis include three of following over a 1 year period:
 * Tolerance
 * Withdrawal
 * Use in larger amounts than intended
 * Persistent desire or unsuccessful attempts to cut down
 * Time spent in activities necessary to get substance, taking substance or recovering from its effects.
 * Social, occupational or recreational activities given up as a result of the substance
 * Continued substance use despite knowledge of having a problem

Note that these patients don't need to have physical dependence. The definition of substance dependence is basically equivalent to "addiction," which is not used in DSM.

DSM-IV Substance Abuse is a maladaptive pattern of substance use leading to impairment. Criteria include one or more of following over 12 months:

 * recurrent substance use resulting in a failure to fulfill role obligations (work, school, home)
 * hazardous use (driving while intoxicated)
 * related legal problems
 * continued use despite persistent problems relating to the substance

It is important in the case of substance abuse to rule out substance dependence (which takes precedence).

DSM-IV Substance Intoxication is a reversible substance-specific syndrome due to recent exposure to a substance. Maladaptive behaviors or psychological changes can develop due to the substance and are not due to another medical/mental condition.

DSM-IV Substance Withdrawal is a substance-specific syndrome due to cessation or reduction in substance use that has been heavy and prolonged. Withdrawal causes distress/impairment, and is not due to another medical/mental condition.

Alcohol
Aside from classification according to DSM-IV criteria, other schemas of substance use/abuse exist as well. One such schema includes alcohol patterns. The so-called "alpha" pattern is one of continual excessive use when under stress, with no dependence and no loss of control. The "beta" pattern is one of heavy social drinking with physical complications, such as cirrhosis, but no dependence. The "delta" pattern is that of heavy daily drinking, but no loss of control. This is the more common type in Europe, for example in France. The "epsilon" pattern is defined as binge drinking, and the "gamma" pattern is that of physical dependence with loss of control. This is a more common type in the US.

Diagnostic tools for detecting alcoholism include administering the CAGE Questionnaire, and collecting other relevant historical data.

 * The CAGE Questionnaire:
 * Have you ever felt the need to Cut down on your drinking?
 * Have you ever felt Annoyed by criticisms of your drinking?
 * Have you ever had Guilty feelings about your drinking?
 * Have you ever taken a morning Eye opener?

Some historical “red flags” might include (1) a pattern of unexplained job changes; (2) vague, defensive or evasive responses to alcohol-related questions; (3) DUI convictions; or (4) multiple unexplained traffic accidents. In addition, patients with alcoholism may have a history of impulsive behavior, fighting, or falls and scrapes, blackouts, binge drinking, or delirium tremens (DT’s). A history of drinking to relax or sleep is significant, as is a history of family chaos and instability. Relevant physical data to collect include the obvious stigmata of alcohol or drug use. For alcohol use, this may include spider angiomas, ruddy nose and face, peripheral neuropathies, liver disease, or cerebellar dysfunction. Additionally, patients may experience symptoms of gastric irritation related to acute or chronic alcohol use. For other drugs, this may be cutaneous abscesses and track marks (in IV drug abusers), or nasal lesions (cocaine).

Relevant laboratory data to collect for diagnostic purposes in alcoholism include a complete blood count and liver enzymes. Lab abnormalities may relate to malnutrition and organ damage, and may be expressed as leukopenia, macrocytic anemia, target cells (liver damage), thrombocytopenia, and bone marrow suppression. CAMP (cyclic adenosine monophosphate) levels in white blood cells of alcoholics are three times normal. Liver enzymes are abnormal in chronic alcoholism. Substance use can be easily detected via toxicology screens, in which urinary metabolites of several drugs are measured. It is important to observe directly the sample collection process. In addition, it is important to note the risk of false positives. One needs to confirm findings with a second test on the same sample using different analytic method (for example, poppy seed ingestion can cause false positive screens for opiates). Informed consent is crucial in toxicity screens.

Differential
"Normal use" is the main component in the differential of substance abuse. However, this brings up the question of what is normal. Perhaps the most important differential is between those patients who are addicted to drugs, and those who are merely physically dependent. The difference lies in the definition of addiction. For example, a patient with chronic pain, who is using regular opioids to alleviate pain, is probably physically dependent on the opioids, in the sense that the patient is probably tolerant to opioids, and would likely go into withdrawal if the opioids were suddenly stopped. However, such a patient does not necessarily show the compulsive behaviors associated with addiction. Furthermore, if the patient is taking the opioids for their analgesic, rather than euphoriant effects, then one cannot really say that the patient is addicted to antidepressants. Other differentials to consider in a patient with suspected substance abuse includes delirium along with other Axis I psychiatric conditions (which are often comorbid).

Alcohol
Withdrawal. Though generally uncomplicated, alcohol withdrawal can progress to delirium tremens (DTs), 10% of which are fatal. It is important to understand the differences between uncomplicated withdrawal and delirium tremens. Also, note that the hallucinations found in both of the above conditions are typically visual or tactile in nature, which may be distinguished from the auditory hallucinations of a distinct entity termed alcohol hallucinosis (described later).

Seizures. Seizures are common with high levels of alcohol use, independent of withdrawal.

Alcoholic Hallucinosis. Hallucinations can occur after drinking cessation in patients with alcohol dependence. These occur in a clear sensorium, and are not part of DTs. They are usually auditory hallucinations with persecutory content, and they can become chronic. Wernicke's encephalopathy: An acute neurological syndrome associated with long term alcohol abuse, the condition consists of delirium and the following triad of symptoms: ataxia, nystagmus and opthalmoplegia. It is thought to result from the thiamine deficiency that can result from chronic alcoholism. The treatment is, of course, to give thiamine (typically, it is given with folate).

Dementia. Dementia is common in patients with alcoholism. Most classic is the Korsakoff's Dementia (sometimes called Korsakoff's Psychosis, but that is a misnomer). This is characterized by an extremely poor short term memory--much worse than with Alzheimer's. Often associated with the memory losses are confabulations, though this is nonspecific to any dementia. More common is a more "run of the mill" type of dementia; usual called simply alcohol dementia, or dementia due to alcohol dependence. There remains some debate as to whether the dementia associated with alcoholism is due to a neurotoxic effect of alcohol itself, or to accessory problems (e.g., malnutrition, vitamin deficiencies).

The dementia associated with alcoholism is most likely irreversible. In the case of Korsakoff’s, the thiamine and folate are usually given, which do generally improve the Wernicke’s syndrome, but the memory disorder generally remains.

Fetal Alcohol Syndrome. FAS is due to heavy alcohol use during pregnancy. There is a high incidence in alcoholic mothers. Seventeen percent of births to alcoholic mothers are stillborn or die shortly after birth. Twenty percent have some defects, and 32% show fetal alcohol syndrome. Of those children with fetal alcohol syndrome, less than 6% are able to function normally in schools, and most never hold a job. (see is link for FAS

Withdrawal from other drugs
Unlike alcohol withdrawal, the course of withdrawal is generally not life-threatening in most of the other drugs of abuse described above. However, withdrawal in these instances may be very uncomfortable for the patient. Nicotine, for example, causes symptoms of irritability, headache, anxiety, increased heart rate, cravings, and (most concerning for many) weight gain. Women tend to gain more weight than men do during withdrawal. Most symptoms send to subside within two weeks on average, with considerable variability, but cravings and appetite increases may persist for much longer periods of time. Cocaine withdrawal also produces a number of symptoms, including hypersomnolence, fatigue, depression, intense cravings, and in some cases, suicidality. Note that the course of benzodiazepine withdrawal can mimic that of alcohol withdrawal (including seizures, DTs, or death), as both substances utilize biochemical mechanisms of action. Thus, benzodiazepine detoxification is approached with the same vigilance as in patients withdrawing from alcohol.

Psychiatric Comorbidities
ECA data suggested that 53% of those with a substance disorder had a comorbid mental disorder. Some of these mental disorders include antisocial personality disorder (11x higher than the general public), anxiety disorders (panic disorder, generalized anxiety disorder, and phobias), and depression. Most often, depression is secondary to alcoholism. It generally improves with abstinence, though some dysphoria may remain. Depression affects 13% of female alcoholics. Alcoholism is also more common in patients with schizophrenia and bipolar disorder. Attention Deficit Disorder may predispose to alcoholism, but this is a controversial topic.

Course
General principles dictate that alcoholism is often worse if familial. There are probably high incidences of (unreported) spontaneous remission. This complicates evaluation of different treatments. Drug abuse patterns are influenced by social and cultural factors and, compared with alcohol abuse, fluctuate over time.

Alcoholism typically has an exacerbating and remitting course, with periods of relative or complete abstinence. 2-3% of alcohol dependents become abstinent per year. Onset of alcoholism rarely begins after 45. Thirty percent of college problem drinkers are alcohol dependent 20 years later. The first hospitalization for alcohol tends to occur earlier in men (age 30 to 40). Abuse of cocaine and stimulants has a rapidly progressing course: from use to abuse and dependence. This is particularly true when the drugs are administered by the more potent routes (injection, inhaled). Oral and intranasal routes of ingestion show slower progression. Cannabis use rarely progresses to abuse and dependence if used alone. Hallucinogens very rarely progress to dependence. Opioid dependence represents a lifelong, chronic pattern. Abuse of sedative hypnotics can remit, either spontaneously or with treatment.


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Automobile Repair/Research

When in trouble remain calm. Go and buy the book (assuming that one is available, and you do not already own it) and use your resources fully. Ask mechanically inclined friends for pointers and only sometimes for help. If that is not possible try the library. They usually have auto repair manuals for many different makes and models. If you have struck out at the library you could try an internet search engine: blogs,forums and owner's clubs - be specific in terms of make, model, year of manufacture, engine size and type, even trim. Chances are somebody has the same or similar car and may have gone through similar problems or can help if you post questions. Lastly, when you finally find out what is wrong and you have to go and purchase parts, do shop around (online parts distributors, brokers and of course your local scrap yards) it is worth it. However some jobs are best left to the certified mechanic, especially if your vehicle is still under warranty. Be sure to keep all of your receipts, many new and used parts have very good warranties!!! Okay, good luck and I hope this information helps.

license: Creative Commons - Attribution Share-Alike - https://creativecommons.org/licenses/by-sa/4.0/

title: Automobile Repair/Research


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Geometry/Appendix A

This is an incomplete list of formulas used in geometry.

Polygon

 * Sum the lengths of the sides.

Circle

 * $$\pi d\ = 2\pi r\,$$
 * $$d\,$$ is the diameter
 * $$r\,$$ is the radius

Triangles

 * Law of Sines: $$\frac{a}{sin(A)}=\frac{b}{sin(B)}=\frac{c}{sin(C)}$$
 * $$a, b, c\,$$ are sides, $$A, B, C\,$$ are the angles corresponding to $$a, b, c\,$$ respectively.
 * Law of Cosines: $$c^2 = a^2 + b^2 - 2ab\cos(C),$$
 * $$a, b, c\,$$ are sides, $$A, B, C\,$$ are the angles corresponding to $$a, b, c\,$$ respectively.

Right Triangles

 * Pythagorean Theorem: $$c^2=a^2+b^2$$
 * $$a, b, c\,$$ are sides where c is greater than other two.

Triangles

 * $$A=\frac{bh}{2}\,$$
 * $$b\,$$ = base, $$h\,$$ = height (perpendicular to base), $$A\,$$ = area
 * Heron's Formula: $$A=\sqrt{s(s-a)(s-b)(s-c)}\,$$
 * $$a, b, c\,$$ are sides, and $$s = \frac{a+b+c}{2} \,$$, $$A\,$$ = area

Equilateral Triangles

 * $$\frac{\sqrt{3}a^2}{4}\,$$
 * $$a\,$$ is a side

Squares

 * $$s^2\,$$
 * $$s\,$$ is the length of the square's side

Rectangles

 * $$ab\,$$
 * $$a\,$$ and $$b\,$$ are the sides of the rectangle

Parallelograms

 * $$bh\,$$
 * $$b\,$$ is the base, $$h\,$$ is the height

Trapezoids

 * $$\frac{(b_1+b_2)h}{2}\,$$
 * $$b_1,b_2\,$$ are the two bases, $$h\,$$ is the height

Circles

 * $$\pi r^2\,$$
 * $$r\,$$ is the radius

Surface Areas

 * Cube:   6×($$s^2$$)
 * $$s\,$$ is the length of a side.
 * Rectangular Prism: 2×(($$l,$$ × $$w\,$$) + ($$l\,$$ × $$h\,$$) + ($$w\,$$ × $$h\,$$))
 * $$l\,$$, $$w\,$$, and $$h\,$$ are the length, width, and height of the prism
 * Sphere:  4×π×($$r\,$$2)
 * $$r\,$$ is the radius of the sphere
 * Cylinder: 2×π×$$r\,$$×($$h\,$$ + $$r\,$$)
 * $$r\,$$ is the radius of the circular base, and $$h\,$$ is the height
 * Pyramid: $$A = A_b + \frac{ps}{2}$$
 * $$A$$ = Surface area, $$A_b$$ = Area of the Base, $$p$$ = Perimeter of the base, $$s$$ = slant height.
 * The surface area of a regular pyramid can also be determined based only on the number of sides($$n$$), the radius($$r$$) or side length($$l$$), and the height($$h$$)
 * If $$r$$ is known, $$l$$ is defined as $$l = \sqrt{(rcos(\frac{360}{n})-r)^2 + (rsin(\frac{360}{n}))^2} = \sqrt{2}r\sqrt{1-cos(\frac{360}{n})}$$
 * or if $$l$$ is known, $$r$$ is defined as $$r = \frac{l}{\sqrt{2}\sqrt{1-cos(\frac{360}{n})}}$$
 * The slant height $$h_1$$ is given by $$\sqrt{r^2+h^2+\frac{l^2}{4}}$$
 * The total surface area of the pyramid is given by $$n\frac{l}{2}[h_1 + h_0]$$

 * Cone: π×r×(r + √(r2 + h2))
 * $$r\,$$ is the radius of the circular base, and $$h\,$$ is the height.

Volume

 * Cube $$s^3 = s \cdot s \cdot s$$
 * s = length of a side
 * Rectangular Prism $$l \cdot w \cdot h$$
 * l = length, w = width, h = height
 * Cylinder(Circular Prism)$$\pi r^2 \cdot h$$
 * r = radius of circular face, h = distance between faces
 * Any prism that has a constant cross sectional area along the height:
 * $$A \cdot h$$
 * A = area of the base, h = height
 * Sphere: $$\frac{4}{3} \pi r^3$$
 * r = radius of sphere
 * Ellipsoid: $$\frac{4}{3} \pi abc$$
 * a, b, c = semi-axes of ellipsoid
 * Pyramid: $$\frac{1}{3} A h$$
 * A = area of base, h = height from base to apex
 * Cone (circular-based pyramid):$$\frac{1}{3} \pi r^2 h$$
 * r = radius of circle at base, h = distance from base to tip

title: Geometry/Appendix A


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Erlang Programming

Erlang is a general purpose, concurrency-oriented functional programming language suited for fault-tolerant, distributed, soft real-time systems. It features strong dynamic typing, lightweight concurrency, eager evaluation and prolog like pattern matching. Erlang was developed in the 1980s at the Ericsson Computer Science Laboratory to address a then-unfulfilled need for telecommunications programming: a high-level, expressive language suitable for rapid development that offered the error recovery, concurrency, distribution and performance features required by telecommunications equipment.

Although its roots are in telecommunications, Erlang's unique features and extensive library make it suitable as a general-purpose programming language and well-suited to programming projects such as network servers, control systems and web development.

The Erlang language, together with an extensive library of applications and modules, a virtual machine and operating system, and a set of design principles establishing standard behaviors, comprise Erlang/OTP (OTP stands for Open Telecommunications Platform). Erlang/OTP is distributed as free software (under the Apache Public License) as well as a commercially supported version from Ericsson. Both distributions run on Microsoft Windows, VxWorks by Wind River, and many varieties of Unix.

Introduction

 * /History/
 * /Overview/
 * /Getting Started/
 * Quick Tips

Basic Erlang

 * /Terms/
 * /Pattern Matching/
 * /Expressions/
 * /Functions/
 * Guards
 * /Modules/
 * /Errors/
 * /Operators/
 * Processes and Messages
 * /Timeouts/
 * /Macros/
 * /Techniques of Recursion/
 * /List Comprehensions/
 * Comments
 * /Variables/

Basic OTP

 * Kernel and Stdlib
 * Distribution
 * Behaviors
 * Design Principles
 * Network Programming
 * Testing
 * Documentation

How To Do It Example

Intermediate Erlang

 * Records
 * Additional Types
 * Function Objects
 * Bitsyntax

Object Programming with Erlang

 * Example1

Popular Modules

 * Using lists
 * Using regular expressions

Software Engineering

 * Debugging and Tracing
 * Performance and Optimization
 * Unit Testing with eunit

Advanced OTP

 * Database Programming
 * Using ets
 * Using mnesia
 * Using External Databases

Thinking in Parallel

 * Autonomous Agents
 * Parallel Programming with linda

Advanced Erlang

 * Making Parsers with yecc
 * Evaluation
 * Parse Transformation

Appendixes

 * Creating Web Applications with yaws
 * The document database CouchDB

 * Using Erlang with Emacs
 * Erlang Resources

title: Erlang Programming


text:
Erlang Programming/Erlang Resources

 * Open Source Erlang - Official site
 * Documentation - Comprehensive documentation and user's guide for Erlang/OTP R11B
 * Erldocs - Erlang documentation alternative with filter/search function and better interface
 * trap_exit - Forum and wiki about Erlang
 * Jungerl - Collection of free Erlang software

Large Projects Built with Erlang

 * CouchDB - Document oriented database
 * ejabberd - A large volume Jabber/XMPP IM server.
 * Wings 3D - A 3D modeller (Wikibook manual: Wings 3D)
 * wxErlang - A GUI API
 * Yaws - A web server (Wikibook manual: Yaws)
 * Disco - An implementation of the Map-Reduce framework
 * Zotonic - The Erlang Web Framewoork & CMS

Erlang related projects

 * Erlide - An erlang IDE plugging for Eclipse

title: Erlang Programming/Erlang Resources


text:
Talk:Arabic/whereQuestions

Untitled
Is the word "taal" which means "come" in english an impolite word to say. Like "Roh" i know that this word is not so polite to say.

title: Talk:Arabic/whereQuestions


text:
Erlang Programming/Getting Started

Getting Erlang
Erlang/OTP is available as free software from Open Source Erlang Downloads. Once you have downloaded the Erlang/OTP distribution, you will need to compile it (if on a Unix platform) and install it.

Installing Erlang
In addition to the brief instructions below, you may wish to consult the Installation Guide.

Unix
Unpack the source distribution. Decide where you want Erlang and its libraries installed. For our example, we will assume you want it in. Create this directory, as well as a build directory for building the Erlang sources.

mkdir /usr/local/erlang/otp_r11b

From within the top-level directory, type. This will configure, build and install the Erlang/OTP distribution.

Add the distribution's  directory to your path. You may wish to set this in your shell initialization file.

Microsoft Windows
The distribution is a self-installing  file. Invoke it (for example, by double-clicking on its icon) and answer the prompts.

The Erlang Shell
Erlang comes with a shell which is used interactively when controlling the Erlang environment and developing programs. On Unix, invoke the shell by typing  on the command line. On Windows, type  on the command line, or double-click the Erlang shortcut icon.

This starts the Erlang system and provides a shell for input and evaluation of Erlang.

Eshell V5.4.13 (abort with ^G) 1>

Your First Erlang Code
At the shell prompt, type  followed by a dot. You can follow that up with some arithmetic. Or answer the question "What is six times 9?" in base-13 notation:

1> "hello, world!". "hello, world!" 2> 1 + 2. 3 3> 13#6 * 13#9. 54

When you are ready to exit, you can stop the Erlang system using the  built-in function:

4> halt.

title: Erlang Programming/Getting Started


text:
Haskell/Testing

Quickcheck
Consider the following function:

How would we effectively test this function in Haskell? We'll use refactoring and QuickCheck.

Keeping things pure
The getList function is hard to test because  does IO out in the world, so there's no internal way to verify things. The other statements in our  block are all wrapped up with the IO.

Let's untangle our function so we can at least test the referentially transparent parts with QuickCheck. We can take advantage of lazy IO firstly, to avoid all the unpleasant low-level IO handling.

So the first step is to factor out the IO part of the function into a thin "skin" layer:

Testing with QuickCheck
Now, we can test the 'guts' of the algorithm, the take5 function, in isolation. Let's use QuickCheck. First we need an Arbitrary instance for the Char type — that takes care of generating random Chars for us to test with. Restrict it to a range of nice chars just for simplicity:

Let's fire up GHCi and try some generic properties (it's nice that we can use the QuickCheck testing framework directly from the Haskell REPL). An easy one first, a [Char] is equal to itself:

OK, passed 100 tests.
 * A> quickCheck ((\s -> s == s) :: [Char] -> Bool)

What just happened? QuickCheck generated 100 random [Char] values, and applied our property, checking the result was True for all cases. QuickCheck generated the test sets for us!

A more interesting property now: reversing twice returns the identity:

OK, passed 100 tests.
 * A> quickCheck ((\s -> (reverse.reverse) s == s) :: [Char] -> Bool)

Great!

Testing take5
The first step to testing with QuickCheck is to work out some properties that are true of the function, for all inputs. That is, we need to find invariants.

A simple invariant might be: $$\forall s.\; \mathit{length} (\mathit{take}5\; s) = 5$$

So let's write that as a QuickCheck property:

Which we can then run in QuickCheck as: Falsifiable, after 0 tests: ""
 * A> quickCheck (\s -> length (take5 s) == 5)

Ah! QuickCheck caught us out. If the input string contains less than 5 filterable characters, the resulting string will be no more than 5 characters long. So let's weaken the property a bit: $$\forall s.\; \mathit{length} (\mathit{take}5\; s) \le 5$$

That is, take5 returns a string of at most 5 characters long. Let's test this: OK, passed 100 tests.
 * A> quickCheck (\s -> length (take5 s) <= 5)

Good!

Another property
Another thing to check would be that the correct characters are returned. That is, for all returned characters, those characters are members of the set ['a','b','c','d','e'].

We can specify that as: $$\forall s. \forall e. (e \in take5\; s) \Rightarrow (e \in \{a, b, c, d, e\}) $$

And in QuickCheck: OK, passed 100 tests.
 * A> quickCheck (\s -> all (`elem` ['a'..'e']) (take5 s))

Excellent. So we can have some confidence that the function neither returns strings that are too long nor includes invalid characters.

Coverage
One issue with the default QuickCheck configuration, when testing [Char]: the standard 100 tests isn't enough for our situation. In fact, QuickCheck never generates a String greater than 5 characters long when using the supplied Arbitrary instance for Char! We can confirm this:

OK, passed 100 tests.
 * A> quickCheck (\s -> length (take5 s) < 5)

QuickCheck wastes its time generating different Chars, when what we really need is longer strings. One solution to this is to modify QuickCheck's default configuration to test deeper:

This instructs the system to find at least 10000 test cases before concluding that all is well. Let's check that it is generating longer strings:

Falsifiable, after 125 tests: ";:iD^*NNi~Y\\RegMob\DEL@krsx/=dcf7kub|EQi\DELD*"
 * A> deepCheck (\s -> length (take5 s) < 5)

We can check the test data QuickCheck is generating using the 'verboseCheck' hook. Here, testing on integers lists:

0: [] 1: [0] 2: [] 3: [] 4: [] 5: [1,2,1,1] 6: [2] 7: [-2,4,-4,0,0] Falsifiable, after 7 tests: [-2,4,-4,0,0]
 * A> verboseCheck (\s -> length s < 5)

More information on QuickCheck

 * http://haskell.org/haskellwiki/Introduction_to_QuickCheck
 * http://haskell.org/haskellwiki/QuickCheck_as_a_test_set_generator

HUnit
Sometimes it is easier to give an example for a test than to define one from a general rule. HUnit provides a unit testing framework which helps you to do just this. You could also abuse QuickCheck by providing a general rule which just so happens to fit your example; but it's probably less work in that case to just use HUnit.

 * TODO: give an example of HUnit test, and a small tour of it

More details for working with HUnit can be found in its user's guide.

title: Haskell/Testing


text:
Horticulture/Polygonum perfoliatum

Mile-a-minute weed (Polygonum perfoliatum), also known as Devil's tail tearthumb, Asiatic tearthumb, or Devil Shield, is an herbaceous, annual, trailing vine in the buckwheat family.

Description
It has a reddish stem that is armed with downward pointing hooks or barbs which are also present on the underside of the leaf blades. The light green colored leaves are shaped like an equilateral (equal-sided) triangle and alternate along the narrow, delicate stems. Distinctive circular, cup-shaped leafy structures, called ocreas, surround the stem at intervals. Flower buds, and later flowers and fruits, emerge from within the ocreas. Flowers are small, white and generally inconspicuous. The fruits are attractive, metallic blue and segmented, each segment containing a single glossy, black or reddish-black seed.

Ecology
Mile-a-minute weed generally colonizes open and disturbed areas, along the edges of woods, wetlands, stream banks, and roadsides, and uncultivated open fields, resulting from both natural and human causes. Natural areas such as stream banks, parks, open space, road shoulders, forest edges and fence lines are all typical areas to find mile-a-minute. It also occurs in environments that are extremely wet with poor soil structure. Available light and soil moisture are both integral to the successful colonization of this species. It will tolerate shade for a part of the day, but needs a good percentage, 63-100% of the available light. The ability of mile-a-minute to attach to other plants with its recurved barbs and climb over the plants to reach an area of high light intensity is a key to its survival. It can survive in areas with relatively low soil moisture, but demonstrates a preference for high soil moisture.

The first records of mile-a-minute in North America are from Portland, Oregon (1890) and Beltsville, Maryland (1937). Both of these sites were eliminated or did not establish permanent populations of the species. However, the introduction of mile-a-minute somewhere between the late 1930s and 1946 to a nursery site in Stewartstown, York County, Pennsylvania did produce a successful population of this plant. It is speculated that the seed was spread with Rhododendron stock. The owner of the nursery was interested in the plant and allowed it to reproduce; unfortunately, subsequent efforts to eradicate it were not successful. The distribution of mile-a-minute has radiated from the York County site into neighboring states. 55 years after its introduction, the range for this plant in the United States had extended as far as 300 miles in several directions from the York County, Pennsylvania site.

Mile-a-minute weed is primarily a self-pollinating plant (supported by its inconspicuous, closed flowers and lack of a detectable scent), with occasional outcrossing. Fruits and viable seeds are produced without assistance from pollinators. Vegetative propagation from roots has not been successful for this plant. It is a very tender annual, withering with a slight frost, and reproduces successfully until the first frost. Mile-a-minute is a prolific seeder, producing many seeds on a single plant over a long season, from June until October in Virginia, and a slightly shorter season in more northern geographic areas.

Birds are probably the primary long-distance dispersal agents of mile-a-minute weed. Transport of seeds short distances by native ant species has been observed. This activity is probably encouraged by the presence of a tiny white food body (elaiosome) on the tip of the seed that may be attractive to the ants. These seed-carrying ants may play an important role in the survival and germination of the seeds of mile-a-minute weed. Local bird populations are important for dispersal under utility lines, bird feeders, fence lines and other perching locations. Other animals observed eating mile-a-minute weed fruits are chipmunks, squirrel and deer.

Water is also an important mode of dispersal for mile-a-minute weed. Its fruits can remain buoyant for 7-9 days, an important advantage for dispersing seed long distances in stream and river environments. The long vines frequently hang over waterways, allowing fruits that detach to be carried away in the water current. During storm events the potential spread of this plant is greatly increased throughout watersheds.

Uses
In traditional Chinese medicine, mile-a-minute weed is known as gangbangui (杠板归), and is valued for its diuretic, anti-inflammatory, and other effects.

It may also be eaten as a sour-flavored leaf vegetable, although its relatively high content of oxalic acid means that it should be eaten in moderation, and avoided by people with kidney disorders, gout, or rheumatoid arthritis.

title: Horticulture/Polygonum perfoliatum


text: User talk:211.203.144.103

title: User talk:211.203.144.103


text:
Talk:Horticulture/Polygonum perfoliatum

Transwiki notes
Copied from Mile-a-minute weed 09:08, 21 September 2006 (UTC) using this version

title: Talk:Horticulture/Polygonum perfoliatum


text:
French/Lessons/Slavery under Napoleon

L'esclavage sous Napoléon
Tiré de www.wikipedia.org.

Napoléon est aussi celui qui rétablit l'esclavage, aboli par la République en 1794. En mai 1802, après la signature d'un traité avec le Royaume-Uni restituant la Martinique à la France, « l'esclavage ainsi que la Traite des Noirs et leur importation dans les dites colonies auront lieu conformément aux lois et règlements antérieurs à 1789 ».

Début juin, il fait arrêter et déporter Toussaint Louverture, qui avait pris la tête de la révolte des esclaves noirs de Saint-Domingue onze ans plus tôt, et qui, s'appuyant sur les idéaux de la Révolution et confiant dans les hommes censés les représenter, avait rallié l'île à la France. Il devait mourir un an plus tard au Fort de Joux, dans le Doubs. Quant aux armées napoléoniennes, elles provoquent bien des massacres lors de la deuxième révolte des esclaves de Saint-Domingue, avant que ceux-ci en sortent victorieux et créent la première République Noire indépendante en janvier 1804.

La Guadeloupe se révolte aussi en 1802 mais la rébellion conduite par Louis Delgrès échoue et se termine par le suicide collectif des insurgés. De retour de l'île d'Elbe, Napoléon décrète une abolition immédiate de l'esclavage. Sa décision est confirmée par le traité de Paris le 20 novembre 1815. Néanmoins, à la Restauration, celle-ci reste lettre morte.

Questions de compréhension
Répondez en français: 1. Napoléon était-il pour ou contre l'esclavage ?

2. En quelle année le traité avec le Royaume-Uni est-il signé ? Quelles en sont les conséquences ?

3. Qui est Toussaint Louverture ? Que fait-il ? Sur quels idéaux s'appuie-t-il ?

4. Que se passe-t-il en janvier 1804 ?

5. Comment la rébellion en Guadeloupe se termine-t-elle ?

'Quant à' and 'lors de'
Quant aux armées napoléoniennes, elles provoquent bien des massacres lors de la deuxième révolte. The expression quant à means 'as for' and, of course, the à contracts as normal to form quant au, quant à la, and quant aux. Practice Write five sentences with quant à in them. Use the expression in the text or the examples given as models. It is important to use sentences as models to prevent the tendency to translate word-for-word. For example, Napoléon est pour l'esclavage ; Abraham Lincoln, quant à lui, trouve cette idée abominable. The expression lors de means 'during' and once again, we have lors du, lors de la and lors des.

Ceux-ci
[...] avant que ceux-ci en sortent victorieux Ceux-ci (and of course, celui-ci, celle-ci and celles-ci) refer to (an) object(s) or person(s) that have just been mentioned. By using ceux-ci, we can avoid mentioning the name again. Therefore: Nos armées ont battu les armées anglaises, mais les armées anglaises étaient quand même fortes becomes Nos armées ont battu les armées anglaises, mais celles-ci étaient quand même fortes. In this phrase, the en refers to the clause la deuxième révolte. This is because the implied sentence is: “[...] avant que ceux-ci sortent de la deuxième révolte.” Since it is a clause introduced by de, we can replace it with en. Practice Write five sentences with en that are used in the way described above: that is, that REPLACE a clause introduced by de. For example, Elle a réussi son examen, elle en est fière (elle est fière de sa réussite). Here are some verbs followed by de: sortir de descendre de avoir peur de avoir honte de avoir besoin de prier de être content de être heureux de s'excuser de féliciter de manquer de se souvenir de parler de se méfier de revenir de être fier de

Activités écrites
1. ''Vous êtes esclave à l'époque napoléonienne. Rédigez un court extrait de votre journal intime, dans lequel vous parlerez de votre vie quotidienne. Vous pouvez également parler des rébellions mentionnées dans le texte.'' You are a slave at the time of Napoleon. Write a short extract of your personal diary in which you speak of your daily life. You can also speak about the rebellions mentioned in the text.

2. ''Vous devez présenter un discours sur l'esclavage sur Napoléon à un club de jeunes. Rédigez ce discours en vous appuyant sur le texte.'' You have to present a speech on slavery under Napoleon to a youth club. Drawing on the text, write this speech.

title: French/Lessons/Slavery under Napoleon


text:
Reaktor/Modules/Event V.C. Min

Comments

 * The G/gate input on this module is not a gate at all. Were it an actual gate you would expect any update at the In port on a voice for which gate is "1" to trigger an update at the output. Instead it functions more like a trigger, but stranger still, it works like trigger inputs on audio modules as it triggers on a rising edge (going from 0 to 1 or presumably any other positive value). This is unlike every other event "trigger" input (except Event V.C. Max), which of course trigger on any event, or any positive event, but in any case do not require sending a 0 followed by a 1.

 * This module also does not work properly at initialization time, perhaps a side effect of the bizarre behavior of the G input.

title: Reaktor/Modules/Event V.C. Min


text:
Reaktor/Modules/Event V.C. Max

Comments

 * The G/gate input on this module is not a gate at all. Were it an actual gate you would expect any update at the In port on a voice for which gate is "1" to trigger an update at the output. Instead it functions more like a trigger, but stranger still, it works like trigger inputs on audio modules as it triggers on a rising edge (going from 0 to 1 or presumably any other positive value). This is unlike every other event "trigger" input (except Event V.C. Min), which of course trigger on any event, or any positive event, but in any case do not require sending a 0 followed by a 1.

 * This module also does not work properly at initialization time, perhaps a side effect of the bizarre behavior of the G input.

title: Reaktor/Modules/Event V.C. Max


text:
Muggles' Guide to Harry Potter/Major Events/NEWT exams

Overview
The NEWTs (Nastily Exhausting Wizarding Tests) are final exams taken by 7th year students at Hogwarts. Not all students are able to proceed to take NEWTs in all subjects; teachers will accept for further study only those students who have done well enough in their OWLs to convince the teachers that they will benefit from more advanced study. Magical education that is designed to lead to NEWT testing is, of course, referred to as "NEWT-level courses", and magic normally taught at that level is referred to as "NEWT-level magic."

The NEWT exams typically determine the career of the students, so passing these exams is critical, as is made obvious when Percy passes his NEWTs and enters the Ministry of Magic.

Event Details
Fairly often in the books, something is mentioned as being NEWT-class or NEWT-level magic. Examples of this are Harry's ability to conjure a corporeal Patronus, and Hermione's ability to perform the Protean Charm. NEWT-class spells are complicated enough that the average wizard does not expect to have to perform them for real until his NEWT exams, and thus Harry's ability, in his third year at Hogwarts, and Hermione's ability early in her fifth (and, with the Polyjuice Potion, even second) year, to perform magic that is not generally tested until seventh year, is exceptional.

In the same way, the courses one takes in sixth and seventh year classes, after one has achieved a sufficiently high OWL grade, are called NEWT-level courses. Professor McGonagall teaches advanced Transfiguration, for instance, to sixth and seventh year students who have achieved at least an E in their Transfiguration OWL, and we see Neville wondering whether he can somehow parley his Transfiguration A into NEWT-level study in McGonagall's class.

The only person we hear of receiving their NEWT grades is Percy Weasley, and while we do hear that he had received his "top-grade NEWTs", we are not close enough to him to know what exams he is sitting or when. Professor Dumbledore does mention at one point that he is aware that Dawlish had received top grades in his NEWTs.

Passing Grades

 * O - Outstanding
 * E - Exceeds Expectations
 * A - Acceptable

Failing Grades

 * P - Poor
 * D - Dreadful
 * T - Troll

Notable Consequences
Presumably, it is because of Percy's top-grade NEWTs that he is able to gain employment with the Ministry. Harry is told that in order to become an Auror, he must manage to achieve at least five Exceeds Expectations grades in his NEWTs.

Analysis
Similarly to the OWL exams, which are the analog of the Muggle GCSE or O-Level exams, the NEWT exams are analogous to the Muggle A-level exams, which are generally required for proceeding to university. There is no mention of a Wizarding university, but the top jobs require NEWTs as a prologue to the further education that is required before starting work proper. We are told that there will be three years of study after graduation from Hogwarts before Harry will be able to start work as an Auror.

While there must be a lot of stress in the lead-up to the NEWT exams, we don't actually get to see this, as Harry does not attend Hogwarts in his seventh year.

We can see that the OWL exams are probably named after the O-levels that were standard in Muggle education, until they were replaced by GCSEs; we can guess that the author is of an age to have taken O-levels and probably A-levels as a high school student. The reason for the name NEWT is uncertain, but we can guess that, having selected one animal with Wizarding associations for the fifth-year tests, another animal with magical associations should be selected as the acronym for the seventh-year tests. It is, perhaps, unlikely that any Government body would have the necessary sense of humour to name an exam with the words "nastily exhausting", so we can speculate that the official name, while retaining the NEWT acronym, may be something less droll. If so, we never hear the official name.

It is likely that the NEWT exams are taken in the two weeks of summer term following the OWL exams. We have seen that OWLs take two weeks, during which time the Great Hall will be full of fifth-year students writing their exams; presumably, the NEWT exams fill the Great Hall for the following two weeks. Given that no more than one seventh of the school population will be taking OWLs at any given time, and that significantly less that one seventh will be taking NEWTs, it is possible that theory sections of OWLs and NEWTs are taken at the same time, though care must clearly be taken to avoid collisions between the practical exams.

Greater Picture
Because Harry, Hermione, and Ron do not attend Hogwarts in their seventh year, we do not actually experience NEWT exams. We could possibly have seen Fred and George taking these exams, but they elected to leave school dramatically in the middle of their seventh year. (In an interview following the publication of the seventh book, the author has said that Hermione returned to school to complete her seventh year, and presumably sat her NEWT exams at that time, but no mention of this is made in the books.)

Despite Harry's being told that he must have at least five Exceeds Expectations NEWT results to become an Auror, the author has implied that he entered the Aurors in the year that would have followed his seventh year at school. As he neither attended Hogwarts that year, nor sat NEWTs, we must assume that the Aurors accepted his year of unsupervised work (remaining hidden from Voldemort, finding and destroying four or five Horcruxes, assisting in the Battle of Hogwarts, and finally decisively defeating Voldemort) as being equivalent to the necessary studies and exams.


text:
Inorganic Chemistry/Group 1 metals

Group 1A - ALKALI METALS
These consist of: Li  Lithium [He] 2s1 Na  Sodium [Ne] 3s1 K   Potassium [Ar] 4s1 Rb  Rubidium [Kr] 5s1 Cs  Cesium [Xe] 6s1 Fr  Francium [Ra] 7s1

Fr is radioactive (half-life 21 min.) hence very little is known about it

Physical Properties
1) Silvery white soft solid, can be cut with a knife except Li 2) Highly malleable and ductile 3) Silver lustre is due to the presence of highly mobile electrons of the metallic lattice 4) Large size in their respective periods; size increases down the group 5) IE (ionisation enthalpy) decreases down the group 6) They show +1 oxidation state 7) Reducing character increases from Na to Cs, however Li is strongest reducing of them all 8) They have very low melting points due to weak metallic bonds 9) Density increases from Li to Cs (except K being lighter than Na) 10) Ionic character increases from Li to Cs 11) They are good conductors of heat and electricity

Chemical Properties
1. Reaction with oxygen: Alkali metals tarnish in air due to formation of oxide or hydroxide on their surface. When heated in excess of air Li forms normal oxide, Na forms peroxide and others form superoxide K can form all the three types of oxides (also it forms KO3 and K2O3) 4Li + O2 → 2Li2O 2Na + O2 → Na2O2 K + O2 → KO2

2. Reaction with water: 2Na + 2H2O → 2NaOH + H2

3. Reaction with liquid ammonia: 2Na + 2NH3 → 2NaNH2 + H2

Group 1B - TRANSITION METALS
These consist of: Cu Copper Ag Silver AU Gold

title: Inorganic Chemistry/Group 1 metals


text:
User:Randomfloop

Hi there. --Randomfloop 11:32, 21 September 2006 (UTC)

title: User:Randomfloop


text:
World Stamp Catalogue/Latvia/1995

Europa issue, national epic
LVA-1995-12

European safe driving week
LVA-1995-13

United Nations, 50th anniversary
LVA-1995-14

Via Baltica highway project
LVA-1995-15

See also corresponding stamps for Estonia and Lithuania

European nature conservation year
LVA-1995-16

Christmas
LVA-1995-19

Cardinal Vaivods
LVA-1995-21

Traditional costumes

 * see stamps of 1993

Karlis Ulmanis appeal
LVA-1995-22

800th anniversary of Riga
LVA-1995-23

1995

title: World Stamp Catalogue/Latvia/1995


text:
User:Benjamin Mako Hill

I have more webpages than I can reasonably count and my current policy to to try to not aggrevate this problem so I'm going to be brief.

I have many webpages where I talk a lot about myself, my projects, and other things that I do. If you are interested in this, you can read any of the pages linked below:

 * My Homepage
 * Copyrighteous (My Blog)
 * My Up-To-Date Contact Information

Please don't hesitate to get a hold of me by editing my talk page or by emailing me at mako@atdot.cc or any of the methods mentioned in the pages above.

title: User:Benjamin Mako Hill


text:
User:Benjamin Mako Hill/myskin.css

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text:
Adventist Youth Honors Answer Book/Recreation/Physical Fitness (General Conference)

1. List ten benefits of being physically fit.

 * 1) You will have more energy
 * 2) Effective weight control
 * 3) Less likely to suffer from constipation
 * 4) Improved brain function and concentration
 * 5) Less depression
 * 6) Better self-image & self-confidence
 * 7) Better sleep
 * 8) Greater bone strength
 * 9) Fewer 'aches and pains' and other physical complaints
 * 10) Improved ability to handle stress
 * 11) More leisure opportunities available to you
 * 12) Easier pregnancy and childbirth

a. Exercise
Exercise, especially aerobic exercise, improves the function of the heart and lungs. It also improves the oxygen-carrying capacity of the blood. These are all important for avoiding heart disease and clogged arteries (which can cause early death). Exercise also consumes calories, which helps control weight. When exercise and diet are in balance, the calories taken in equal the calories expended, and weight is maintained.

Exercise also alters the chemical balance in your body, producing mood-lifting endorphins which make a person feel happier.

Our bodies were designed for regular activity, but sadly, people in modern times are mostly sedentary. Exercise is a great way to restore the body's natural need for activity, making it function the way it was intended to by our Creator.

b. Proper eating
A good diet improves your physical, emotional, mental, and spiritual well-being. If you take in more calories each day than you expend, you will gain weight. This is true whether you are under-weight, over-weight, or at a healthy weight. Conversely, if you take in fewer calories than you expend, you will lose weight, and again, this is true regardless of how much you currently weigh.

Proper eating means that your vitamin and mineral intake is sufficient to prevent disease, that your caloric intake is equal to your caloric needs, and that the types of food you eat are well balanced. It means that the amount of carbohydrates, proteins, and fat in your diet is also balanced.

If your diet is not well-balanced, your health will suffer. For instance, if your diet does not provide you with enough calcium, your body will "steal" calcium from your bones (calcium is needed in order for your muscles to function) e.g milk, cheese, oranges, kiwi, tangerine, bread, eggs etc.. This will weaken your bones which will make them more fragile and susceptible to fractures. If your diet does not provide you with sufficient vitamins, you will get a disease - indeed, that is the very definition of vitamin. Any nutrient whose lack causes a disease is a vitamin. It is also possible to take too many vitamins and get vitamin poisoning. So it is important that your vitamin intake is also balanced.

If your diet contains too much fat, it will build up under your skin and in your arteries. This is bad for your heart, as it constricts the passage through which the heart must pump your blood. In other words, it makes your heart have to work harder to achieve the same results.

c. Emotional stability
Emotional stability helps us to positively deal with stress in our lives. Exercise and diet both play an important part in emotional stability. Too much (or too little) food can contribute to irritability. Regular exercise is a great outlet for stress, and sticking with a regular exercise program tends to help people stick with other things as well, enabling them to solve difficult problems at work or in school.

3. Define the following exercises
Isometric exercise is a form of physical exercise in which the muscles flex and hold a stationary position. No movement of a load takes place, and the exercises require little in the way of equipment. An example of an isometric exercise is placing the palms of the hands against each other and pushing. Isometric exercises are primarily used in physiotherapy and injury rehabilitation because the intensity can be rapidly and precisely adjusted, which makes them very safe. They are now rarely used outside this context. Isotonic exercise is a form of strength training in which each effort is performed against a specific opposing force. Exercises are isotonic if a body part is moving against the force. Exercises are isometric if a body part is holding still against the force. Resistance exercise is used to develop the strength and size of skeletal muscles. Properly performed, resistance training can provide significant functional benefits and improvement in overall health and well-being, though it does very little for the cardiovascular system. The classic example is weight lifting. Isokinetic exercise is similar to isotonic exercise, except that motion is resisted through an entire circuit. In weight lifting, resistance is present only when lifting - gravity lowers the weights. In isotonic training, the downward motion is also resisted. Anaerobic exercise requires very little oxygen uptake. An example would be sprinting, as a sprinter can run the 100 yard dash while holding his breath. Short bursts of exercise fall into this category.
 * a. Isometric:
 * b. Isotonic:
 * c. Isokinetic:
 * d. Anaerobic:

Aerobic exercise is the most beneficial of all the types listed here, as it requires the body to use large amounts of oxygen over an extended period of time. This improves cardiovascular health. Examples include jogging, swimming, skating, and many other activities.
 * e. Aerobic:

4. Know the meaning of the principles involved in the following exercise program

 * a. Warm up: There are two purposes for warming up before exercising. The first is that it stretches and warms the muscles, decreasing the likelihood of an injury.  The second is that it gradually increases the heart rate in preparation for the workout.  Warming up can be as easy as doing leg stretches for a few minutes.  Slowly warming up can help people do even more aerobic exercise than if they had not warmed up at all.
 * b. Aerobic exercises: This is the main part of an exercise program, and the part from which most of the benefits of exercise are derived. Any exercise that increases oxygen intake and increases the heart rate past the target rate and is performed for at least 20 minutes can be considered aerobic.
 * c. Cool down: The cool down phase should last for about five minutes after the aerobic phase. It allows the heart to gradually slow down.  If you were jogging, walk around for five minutes.  If you were swimming, walk around in the shallow end of the pool.  If you were bicycling, get off the bike and walk it around for five minutes.  Most heart attacks that happen in conjunction with an exercise program occur after the aerobic phase.  Allowing the heart to gradually slow protects it and lessens the chance of an incident.
 * d. Calisthenics: This portion of the program should last ten minutes.  It builds up muscle strength which decreases the chance of injury during future aerobic activities.

5. Know how to determine your heart rate at rest and after exercise.
First you'll need to find your pulse. You can do this by placing a finger on your wrist just below the thumb joint, or by placing your hand over your heart. If you have just exercised, you can often hear your heart beat, and feel it as well. If you cannot, then you'll need to take your pulse the same way as when you are at rest. The only problem with determining your heart rate after exercise is that what you really want to do is determine what it was when you were exercising, and when you stop exercising, the heart slows. It takes a few seconds to find your pulse, and then at least 15 seconds to measure it, and in that time, the heart can slow significantly. Therefore, you should add 10% to whatever number you measure.

If you have a stethoscope, you can hear your heart even when you are rested. You can also find your pulse by placing a finger on the neck below the jaw, but this is not recommended as placing pressure there can alter your heart rate.

Once you find your pulse, count the heartbeats over a 15 second interval. Then multiply by four. You can also count the heartbeats over a 20 second period and multiply by 3, or over a 30 second period and multiply by 2. Do not use a period shorter than 15 seconds though, as any errors are also multiplied, and it is better to multiply them by a small number than by a large one. For instance, if you count 7 pulses over 6 seconds when you should have counted 8, you will miscalculate your heart rate by 10 beats.

Men
Use the following formula for men:

$$rate = (205 - \frac{age}{2}) \times 80%$$

In words, you subtract half your age from 205 and then multiply by 80%. Let's run through this for an 18 year-old man.

First take half of 18 which is 9. Subtracting that from 205 gives us 196. Multiplying 196 by 80 and dividing by one hundred (to get 80%) gives us 156.8 which we can round to 157.

Women
Use the following formula for women:

$$rate = (220 - age) \times 80%$$

In words, you subtract your age from 220 and then multiply by 80%. Let's run through this for an 18 year-old woman.

First subtract 18 from 220 which gives us 202. Multiplying 202 by 80 and dividing by one hundred (to get 80%) gives us 161.6 which we can round to 162.

==7. Using the four steps given in requirement 4, do a regular exercise program at least four times a week for three months. For each exercise period, maintain the minimum heart rate determined in requirement 6 for a period of at least 20 minutes. Keep a chart of the following==
 * a. Type of warm-up exercises performed:
 * b. Type of aerobic exercises performed:
 * c. How long aerobic exercises were performed:
 * d. Type of calisthenics performed:

If you are over the age of 35, you should have a medical examination (including a stress test) before starting any exercise program.

The warm-up should last for two or three minutes, and should be something easy like stretches.

Choose an exercise that you enjoy, as this will make it a lot easier to stick with it. Any activity that raises your heart rate above the rate determined in requirement 6 for at least 20 minutes will do. Suggestions include cross-country skiing, swimming, running, and jogging. You can also skate or ride a bicycle, but be careful that you are exercising the whole time and not just "coasting". It is also possible to get your heart rate up by walking, but you will have to walk vigorously, and it may take a little while to get your heart rate up to the minimum. Don't start counting the 20 minutes until the heart rate reaches the target.


text: Adventist Youth Honors Answer Book/Recreation/Physical Fitness (South Pacific Division)


text:
Windows Vista/Introduction

Windows Vista, a version of the Microsoft Windows operating system, was released to manufacturing in 2006. It is the successor of Windows XP but is extremely different than any prior version of Windows. Vista’s hardware requirements and reputation for annoying security prompts prevented the OS from succeeding in the market. Its successor, Windows 7, was released in 2009. Windows 7 was almost exactly the same as Windows Vista. Microsoft attempted to distance itself from the marketing failure that Windows Vista had become by changing the branding. Windows 7 saw wide adoption.

Major changes in Windows Vista

 * Translucent window borders and Flip 3D (these features were removed in Windows 8)
 * Rewritten OS installer system (that is still in use)
 * BitLocker was introduced, providing strong encryption of internal hard drives only
 * Protection against spyware was added as Windows Defender (full antivirus would not be included until Windows 8)
 * Completely overhauled security model, including the introduction of User Account Control
 * Overhauled inbox games, all of which are 3D-accelerated
 * Significant improvements to system search
 * A redesigned Start menu
 * Windows Sidebar and sidebar gadgets

Other notable changes

 * A new error message that appears when users attempt to rename a folder to an invalid name. (In previous versions of Windows, attempts to rename files or folders to reserved MS-DOS device names, such as CON, were silently reverted.)
 * Windows Vista does not permit the user to change the system clock to an invalid time due to rules.

title: Windows Vista/Introduction


text:
Cookbook:Demerara Sugar

Demerara is a large-grained, yellowish brown sugar with slightly sticky crystals and a relatively low molasses content - hence its paler color and milder flavor. Said to be a more natural product (fewer or no chemicals used in its manufacture) than brown sugar, it's a popular product for tea and coffee in England, Australia and Canada, but not very well known in the U.S. It makes an excellent table sugar and can be used for decorating cookies or as the caramelizing sugar on creme brulee.

title: Cookbook:Demerara Sugar


text:
Cookbook:Gem Squash

Gem squash is a small, round summer squash with a dark green skin and yellow flesh. The skin can be quite thick or thin enough to eat, depending on when the squash was harvested.

title: Cookbook:Gem Squash


text:
Cookbook:Heart of Palm

Heart of palm, also called palm heart, palmito, or swamp cabbage, is a vegetable harvested from the inner core and growing bud of certain palm trees (notably the coconut (Cocos nucifera), Palmito Juçara (Euterpe edulis), Açaí palm (Euterpe oleracea), sabal (Sabal spp.) and pejibaye (Bactris gasipaes) palms). It is costly because harvesting kills the tree. It is eaten raw, usually in salads, and has a mild, slightly sweet nutty flavor and a pleasant texture. In appearance it is off-white and usually sold as round stalks about an inch in diameter and 4-5 inches long, in jars or cans with salt water.

title: Cookbook:Heart of Palm


text:
Psychiatric Disorders/Personality disorders

The personality disorders are not disorders in the same sense as the other psychiatric disorders, and to reflect this, the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) lists them under a separate axis, Axis II. For this reason, they are sometimes referred to as “Axis II Disorders.” Rather than discrete disorders in the sense of major depression or schizophrenia, they are more patterns of maladaptive behaviors. They are disorders, however, in the sense that they do represent somewhat consistent clusters of symptoms, have a predictable course, and predictable responses to treatment. In addition, the disruptions they can cause in a person’s social and/or occupational functioning legitimizes their status as true disorders.

Working Definitions

 * Personality Trait. A stable, recurring pattern of human behavior.

 * Personality Type. A constellation of personality traits recognizable as a frequent and familiar combination – e.g. the compulsive personality, characterized by preoccupations with work, detail, order, time, money, and cleanliness.

 * Personality Disorder. A constellation of personality traits, which are inflexible and maladaptive. These traits lead to difficulties in work or interpersonal relations, and can cause subjective distress.

 * Neurosis. An unfashionable term for a non-psychotic mental disorder that causes the patient unpleasant feelings (including anxiety, depression, pathological shame or guilt).  Many disorders formerly called neuroses are now incorporated into more major mood disorders, such as generalized anxiety disorder, dysthymia, adjustment disorder, obsessive-compulsive disorder, etc.

Speculations on Etiology
Personality is formed through an interaction of genetic and developmental influences. Severe personality disorders generally imply a mood disorder, mild neurological abnormality (such as attention deficit disorder or learning disability), or a family history of alcoholism or personality disorder, plus some kind of early loss, trauma, or abuse. If the developmental history is apparently benign, the likelihood of an affective or organic factor is even greater.

Personality traits that are maladaptive in adulthood may have been more adaptive in childhood. In some cases, it is possible to see how troublesome personality traits were reinforced by the family environment. However, it may happen that initially adaptive behaviors become counterproductive in adulthood, particularly if the environment has changed. Appreciation of the Role of Early Trauma in Severe Personality Disorders

Several studies show increased prevalence of childhood abuse, incest, or neglect, early loss, or family alcoholism in hospitalized patients with severe personality disorders.

Chronic post-traumatic stress disorder may produce symptoms that aggravate the personality disorder. Developmental histories of patients with severe personality disorder must attend to potential trauma, abuse, and neglect. Specific therapeutic attention to traumatic events may be crucial to success of treatment.

Making a Personality Diagnosis
Making a diagnosis of a personality disorder can be difficult. It generally requires observing an individual over time, and the reliability of cross sectional diagnosis of a personality disorder is poor. Under sufficient stress, most individuals have the capacity to “regress” to a less mature state. For example, a patient diagnosed with a serious mental illness, can begin to have difficulties coping with this new stress, and can appear at that time like a person with a personality disorder.

In addition to longitudinal evaluations, the reliability of a diagnosis is enhanced by interviewing collateral sources such as family members.

Taking a full history is important as well. It is tempting to rely on certain key behaviors (for example, wrist cutting) as if they were pathognomonic for a disorder, however this is rarely the case. Of greatest importance is a full and accurate social and development history, in order to demonstrate the individual’s behaviors over time and in different situations.

Personality tests, such as the Minnesota Multiphasic Personality Inventory complement the clinical interview and are a useful preventive against a clinician’s biases and blind spots. They are not in themselves diagnostic.

For the acute management of a patient with a suspected personality disorder, an assessment of current strengths and weaknesses is often more pertinent than precise categorical diagnosis.

Approaches to Describing Personality

 * Categorical. In this approach, specific personality disorders are defined by diagnostic criteria in a manner similar to other mental.  The advantages of such an approach are that this approach is consistent with the approach used by psychiatrists (in DSM-IV) to describe all other mental disorders.  This approach is useful in research, as it presents a consistent approach to case identification, and thus is convenient for the types of empirical research that require large, homogeneous groups of patients (for example, treatment studies). There are disadvantages to approach, however.  A categorical approach must draw a potentially arbitrary line between the normal and pathological:  either people have the disorder or they do not.  Furthermore, though groups of patients may be superficially linked by common symptoms, they may in fact have heterogeneous pathologies, in which case the diagnoses attached may not have predictive value.   Finally, the use of these disorders in too superficial a manner can invite “labeling” and stigmatization of the individual.

 * Dimensional. In the dimensional approach, personalities are seen on a continuum from “normal” to ‘deviant.”  Generally, personality is divided into specific traits, which are then scaled.  In this approach, a disorder is defined in terms of a statistical deviance from the normal range of behaviors.  This approach may be more valid than a categorical approach, as it avoids seemingly arbitrary all-or-none decision.  Furthermore, it has the capacity to permit a greater appreciation of individual differences.  Disadvantages lie in the implementation of a dimensional approach.  Defining normal behavior requires a normative sample; collecting a true normative sample that represents the actual range of adaptive behaviors can be illusory.  Furthermore, the dimensional ratings obtained are based on standardized tests, which vulnerable to biases in design.

 * Prototypical. Patients’ personalities are compared with typical examples of well-recognized personality types, such as the compulsive, the hysterical, the antisocial, etc.   The advantage of such an approach is that this approach models the way the way that clinicians think about disorders (comparing an individual to idealized forms of health and disease).  It also facilitates recognition of certain patterns.  Disadvantages to this approach include is vulnerable to bias, the subjectivity of the approach which makes inter-rater reliability difficult.   This in turn makes research on the disorders difficult.

 * Structured Assessments Of Adaptive Strengths And Preferred Defense Mechanisms. This approach avoids defining a disorder altogether, and simply describes a persons personality in terms of t psychological strengths and weaknesses.  The appraisal is done in a structured, albeit qualitative manner.  This approach is useful as a complement to other forms of diagnosis, and can be helpful in planning a patient’s management and treatment.  However, a person’s strengths and weaknesses may fluctuate with time, and may be less stable than the personality traits assessed by other approaches.  Furthermore, strength and weakness assessments may depend greatly on the clinician’s interviewing skill

The DSM-IV Personality Disorders
The personality disorders are divided into three clusters, organized alphabetically: Types A, B and C.  Type A is called the “Odd Cluster”, Type B the Dramatic Cluster, and Type C the Anxious Cluster.

A. The Odd Cluster

 * Paranoid Personality. This is defined by the person’s high level of suspiciousness.  Persons with disorder are mistrustful of everyone.  This distrust does not reach the level of a delusion, however. More on this disorder

 * Schizoid personality. This disorder is defined by the individual’s lacks of intimate relationships, and their tendency to be frightened by closeness.  They seem to be virtually incapable of personal warmth, and are anxious when others try to be close (due to the fear of the intimacy of socialization). More on this disorder

 * Schizotypal personality. This disorder is defined by the presence of odd and eccentric ideas.  These ideas seem outside the norm, may influence daily behavior, but are not psychotic. More on this disorder

B. The Dramatic Cluster

 * Antisocial personality. This disorder is defined by the individuals disregard for rules, laws and social conventions.  Sometimes referred as “psychopaths” they are dishonest, and unconcerned about the effect of their behavior on others. More on this disorder.

 * Narcissistic personality. Persons with this disorder are grandiose, needing constant attention.  They have a lack of empathy for others, and an exaggerated sense of self-importance. They tend to act as if they are superior to unique from others. More on this disorder

 * Borderline personality. These individuals are emotionally intense and unstable, with impulsive behavior, self-destructiveness, an inner emptiness and an intolerance of being alone.M ore on this disorder

 * Histrionic personality. Individuals with this disorder are dramatic, with attention-seeking behavior.  They often present as a caricature of femininity or masculinity. More on this disorder

C. The Anxious Cluster

 * Avoidant personality. Persons with this disorder avoid social situations because of fears of rejection, criticism, or disappointment.  They tend to avoid occupational or social challenges and are seen as “underachievers.” . More on this disorder

 * Dependent personality. Persons with this disorder cling to a stronger person, sometimes submissively.  They rely on that person for help and advice, and are anxious when faced with the need for an independent decision. More on this disorder

 * Obsessive-compulsive personality. Persons with this disorder (sometimes called OCPD) have a preoccupation with orderliness, perfectionism, and mental and interpersonal control, at the expense of flexibility.  They may be described as being preoccupied with work or duty, not enjoying life, and being rigid and inflexible.   This disorder is different from Obsessive-Compulsive disorder (OCD), an Axis I diagnosis in that OCPD people do not have clear rituals or intrusive thoughts, and rarely see their habits as being alien to themselves (or “ego dystonic” which is common in OCD, but not OCPD). More on this disorder

How Personality Disorders Present

 * In Medical Settings. Personality disordered patients are often very challenging for doctors. They are more likely to have interpersonal problems in the doctor-patient relationship. They may be more prone to being noncompliant with their medical care.   They can have particular difficulty in coping with any restrictions on their normal function:  hospitalization, disability or medical regimens (e.g. dietary restrictions) can be particularly trying for these patients. Professionals may find that these patients bring out the worse in them, and unprofessional behaviors are more likely with such patients.

 * In The Family. Patients with personality disorders are more likely to have marital conflicts (including violent conflicts), and problems with child rearing.  The risk of divorce is high in this group of patients.
 * Within The Individual. Patients with personality disorders can experience multiple losses resulting from their behaviors:  divorce, job losses are all common.  Their difficulties in the medical setting can result in poorer outcomes from medical conditions.   Specific personality disorders can have very particular difficulties when they are not able to live according to their usual style (for example, when a dependent person is removed from the object of their dependency).

Comorbidity
Personality disorders are often of high risk for various disorders. They have high rates of Axis I psychiatric disorders, particularly mood disorders, anxiety disorders and substance abuse. They may have higher rates of medical illnesses as well, for the reasons described above.

Some specific concerns:

 * Antisocial, borderline, and histrionic personalities are vulnerable to alcohol and drug abuse.
 * Borderline personalities are vulnerable to brief reactive psychosis and to major depression.
 * Schizotypal and schizoid personalities are vulnerable to schizophrenia.
 * Dependent personalities are vulnerable to agoraphobia.
 * Compulsive personalities are vulnerable to obsessive-compulsive disorder.


text:
User talk:محمد شمیل قریشی

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User talk:Labonn

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User talk:Chunfai

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User talk:Pandabearbaby~enwikibooks

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Your account will be renamed
Hello,

The developer team at Wikimedia is making some changes to how accounts work, as part of our on-going efforts to provide new and better tools for our users like cross-wiki notifications. These changes will mean you have the same account name everywhere. This will let us give you new features that will help you edit and discuss better, and allow more flexible user permissions for tools. One of the side-effects of this is that user accounts will now have to be unique across all 900 Wikimedia wikis. See the announcement for more information.

Unfortunately, your account clashes with another account also called Pandabearbaby. To make sure that both of you can use all Wikimedia projects in future, we have reserved the name Pandabearbaby~enwikibooks that only you will have. If you like it, you don't have to do anything. If you do not like it, you can pick out a different name.

Your account will still work as before, and you will be credited for all your edits made so far, but you will have to use the new account name when you log in.

Sorry for the inconvenience.

Yours, Keegan Peterzell Community Liaison, Wikimedia Foundation 23:35, 17 March 2015 (UTC)

Renamed
 This account has been renamed as part of single-user login finalisation. If you own this account you can |log in using your previous username and password for more information. If you do not like this account's new name, you can choose your own using this form after logging in: . -- Keegan (WMF) (talk) 05:21, 19 April 2015 (UTC)

title: User talk:Pandabearbaby~enwikibooks


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User talk:Khanindrak

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title: User talk:Khanindrak