Music in the 1920’s and 1930’s

What were some of the most popular musical styles from the 1920’s and 1930’s?

The most popular musical styles in 1920 and 1930 were Jazz and Blues. The 64-bar show tune, the romantic ballad and the tenor sax dominated the East Side Style, (Mordden 16). Another style that was used was Scat singing.

Who were some of the blues and/or Jazz musicians?

At the beginning of 1920, Jazz music had started progressing and was fueled by the prohibition of alcohol to some extent. In Chicago, jazz scene developed very fast as a result of immigration of jazzmen (Naumann and Aoseley 87).  Some of the jazz musicians included, Paul Whiteman who recorded a subgenre known as Whispering. Other jazz musicians included Duke Ellington and Louis Armstrong. Blues music was also played during the period by musicians such as Mamie Smith who recorded Crazy Blues.

What were the most songs about?

Jazz had its roots in work songs, blues, field holler, and spirituals. Some were gospel and other songs were about love.

What was the difference between white music and black music?

The main difference between white music and black music was the instruments used to play the music (Randle 67). Many Africans and Hispanic Americans had fewer instruments, teachers, and opportunities as opposed to the white musicians.

 

Works Cited

Mordden, Ethan. Make belief: the Broadway musical in the 1920s. Oxford University Press, 1997.

Naumann, Emil, and F. A. Gore Ouseley. The history of music. Cambridge University Press, 2013.

Randle, William. “Black Entertainers on Radio, 1920-1930.” The Black Perspective in Music, vol. 5, no. 1, 1977, p. 67., doi:10.2307/1214359.

 

 

Works Cited

Davis, Nancy J., and Robert V. Robinson. Sociological Perspectives. Pearson Custom Pub., 2009.

Jarvis, Peter. Globalisation, lifelong learning and the learning society: sociological perspectives. Routledge, 2008.

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The Efficacy and Tolerability of Non-Drug Therapy Versus Drug Therapy in the Treatment of Generalised Anxiety Disorder (GAD).

5.0. The Results

Generalized Anxiety Disorder undergoes primary care to cure the psychological and Somatic symptoms in efforts to try lower the side effects profile. The recommended Gad treatment can either be conducted by the use of Psychological therapy or application of the antidepressants[1].

5.1. Non-Pharmacological Therapy for GAD

According to the study conducted by the University of Massachusetts, Suffolk University, Boston University and Boston VA Healthcare System International Review Boards, there were no adverse effects reported the entire duration of the study.  A total of 31 participants took part in the study and assigned to (ABT, n=15) Treatment or (n=16) Waitlist[2]. Furthermore, the results from the ACS scale scores illustrated an excellent internal consistency with a total of 0.94. Clients treated with the acceptance-based behavioural therapy reported fewer difficulties in emotion regulation and fear of emotional responses, as well as greater tolerance of uncertainty and perceived control over anxiety than those on the waitlist control condition[3].

Figure 1

 

Figure 2

The Figure 2, above demonstrates the two weeks test-retest reliability(R=0.78) of the internal consistency[4].

Furthermore, study shows that there has been an evolution in the psychological treatment for GAD from the general understanding of the anxiety to the medications to the concepts of pathological worry. However, GAD treatment has empirically supported the use of the more comprehensive anxiety-reduction strategies such as applied relaxation strategy (AR). Research is considerate of the use of the AR as compared to other anxiety –reduction strategies. The data depicts AR as an appropriate treatment for GAD’s worry, severity, depression and general psychology[5].

In demonstrating the data a sample (N=65) involved 43 women and 22 men in the initial Diagnosis of GAD, all the participants were Francophone. In the study, 38.5 years was (SD=12.0) was the participants’ mean age with 15.3 average years of education (SD=3.4).  Moreover, the research included an ethnic composition of the sample with 2% Asian, 2% Hispanic, 5% Middle Eastern and 91% White/European. Besides, 26.6% constituted unemployed sample, student sample was 10.9%, and 62.5 % sample population was employed[6].

 

Figure 3

Another study carried out by Leichsenring et al, indicated that Cognitive Behavioural Therapy is an efficacious treatment for generalized anxiety disorder[7]. The results suggested CBT and short term psychodynamic psychotherapy are beneficial for the patient with GAD. This includes a research that was carried out for a 30 weekly sessions using the primary measure of the Hamilton scale. Furthermore, a research conducted by Evans and the colleagues found that despite CBT’s effectiveness in the treatment of GAD gave a percentage of the patients struggle with residual symptoms. Therefore, it is suggested that Mindfulness-based cognitive therapy be used to help people GAD[8].

Furthermore, there are the secondary conditions included the panic with or without agoraphobia n=27[9].

Figure 4

The study found that there are significant improvements regarding the symptoms of anxiety and depression in both cognitive Behavioural Therapy (CBT) and Short-term Psychodynamic Psychotherapy (STPP)[10].  Following a six month’s follow-up, these effects become stable. However, the treatment of the anxiety and worry was superior with the use of the CBT. The research found that STPP and CBT achieved significant short-term improvements in anxiety and depressions for patients with GAD. This model projected usefulness by reporting the high effects of stress and worry, which become stable and showed improvement within the one year follow-up period.

5.2. Pharmacological Treatment of GAD

5.1.1. SSRIs

5.1.1.1 Citalopram

Citalopram is one of the Selective Serotonin Re-uptake Inhibitors (SSRIs) used to treat anxiety disorders. The study selected 34 participants with more than 60 years of age and with DSM-IV anxiety disorder. They were assigned a Hamilton Anxiety Rating Scale o17 or higher[11]. The responses were determined to the score by use of (1) as (Vey much improved), and (20 indicated (Much improvement). Therefore, the responses along with the side effects got compared to use of the Citalopram and Placebo on a chi-square test and linear modelling[12].

Figure 5

5.1.1.2 Escitalopram

Adults often face the Generalized Anxiety Disorder (GAD). However, there has been insufficient data top facilitate safe treatment.   A study conducted had 177 participants with age exceeding 60 years with a randomised GAD diagnosis. They received either Escitalopram or placebo for two weeks 10-20 MG/D of Escitalopram (n=85) and Placebo (n=92)[13]. This evidence Shows the patient disposition for the14-week study period for all groups. A total of 98 patients (14%) withdrew from the study during the 12-week, double-blind period (Table 2), and withdrawal rate ranged from 10.8% to 18.7%[14]

Figure 6

5.1.1.3 Paroxetine

  The study assessed the efficacy of the fixed doses of Paroxetine to treat generalised anxiety disorder. The Sheehan Disability Scale measured this disorder. In 8 weeks, the reductions in the total score on the Hamilton anxiety scale indicated greater higher levels for paroxetine[15].  Another research indicated that more patients withdrew prematurely due to adverse events from the paroxetine group than the escitalopram group (22.6% vs. 6.6%; p=0.02, Fisher exact test)[16]. No adverse event was reported as a reason for discontinuation from escitalopram treatment by more than one patient; for paroxetine, headache, insomnia, and nausea each led to the discontinuation of two or more patients. The incidence of-treatment emergent adverse events overall was 88.7% for paroxetine and 77.0% for escitalopram[17]. Of note, sexual adverse events (ejaculation disorder, anorgasmia, and decreased libido), constipation, and insomnia were more frequent in paroxetine-treated patients than in escitalopram-treated patients. Conversely, diarrhea and upper respiratory tract infection were more likely to be reported by escitalopram- than paroxetine treated patients[18].

Figure 7

5.1.1.4 Sertraline

The study evaluated Sertraline’s efficacy and tolerability in the treatment of anxiety disorder. The sample population of adult outpatients with DSM-IV and generalised anxiety disorder was performed using Hamilton’s Anxiety Rating scale with a total score of 18 or more. 50-150 mg/day of sertraline got randomly assigned to patients for 12 weeks[19].

Figure 8

5.2. SNRIs

5.2.1 Duloxetine

A flexible-dose study was conducted to evaluate the efficacy and safety of Duloxetine 30-120mg once in daily in the treatment of GAD in older patients. The study was a double-blind survey conducted to patients with at least 65 years of age. The procedure performed was either for duloxetine (N=151) or Placebo (N=140)[20].  In an internet study conducted by Two-part piecewise growth models were fitted for the treatment group only and included follow-up data at 6 months. On PSWQ there was a significant negative slope during the follow-up phase, b ¼ _0.1, 95% CI [_0.17, _0.03], indicating that participants continued to improve during the follow up phase[21].

 

Figure 9

5.1.3. Vortioxetine

Table 1: Vortioxetine safety measures (Bidzan, L., et, al., 2012)

Term Placebo

(n=150)

  Vortioxetine 5mg

 

( n=150)

 
  Events Subjects %  

Events

Subjects
Gastrointestinal disorders 106  

55(36.7)

137  

74 (49.3)

Nervous system disorders 10  

9(6.0)

19 18(12.0)
Headache 14 4(2.7) 10 9(6.0)

 

5.1.4. Pregabalin

The GAD diagnosis by use of Pregabalin in patients was evaluated. Patients were placed to eight weeks of flexible –dose treatment with PGB (300=600mg/day), Placebo or (VXR) 72-255 mg/day)[22].

Figure 10

PGB was a safe and effective treatment of GAD, with a significantly earlier onset of anxiolytic activity than VXR [23].On the other hand, Non-pharmaceutical methods demonstrated advanced levels in coping strategies due to heightened emotional intensity and adverse reactions to emotions[24].

6.0 Discussion

In the analysis, all the randomised, placebo-controlled and double-blind trials indicated that SSRIs and SSNRIs in patients with GA demonstrated efficacy for all individual agents put on trial[25].  Evidence indicated that drug treatment reported an increased level of treatment over the non-drug therapies.

6.1 Non-pharmaceutical

Specifically, the research illustrated that patients that underwent BBT showed reduced difficulties in emotional responses and regulation. At the same time, they depicted an increase in tolerance of uncertainty and perceived control over anxiety[26]. Most of the non-pharmaceutical theoretical models also suggested a certain level of reliability for the treatment of the GAD components. However, the finds illustrated the importance of therapy based on a specific model to give a clear picture of the categorical impacts of a particular treatment model. Cognitive Behavioural Therapies focus on heightening the emphasis on individual’s tolerance and uncertainty.  The non-drug GAD treatment includes Relaxation, hypnotherapy, Rogerian nondirective and supportive therapy[27]. Furthermore, non-drug therapies Cognitive Behaviour Therapy, and relaxation methods serve as the primary methods used in the treatment anxiety disorders during the randomised controlled trials. The research study proves that CBT is shown useful in the treatment of all DSM-IV categories of Anxiety disorders in all the Randomized Control Trials and other types of meta-analyses.

6.1.2 Cognitive Behavioural Therapy (CBT) for GAD

Nondrug therapies are used in the assessment for various cases of phobias and obsessions. Cognitive behavioural therapy aims at enhancing emotional responses and at the same time obtains extinction to emotional[28]. Furthermore, the emphasis on the acceptance-based and mindfulness procedures, the participants indicated a greater control on a variety of anxiety –related emotion and events following treatments[29]. The findings are in support with the fact that a declined distress level goes along with the mindfulness and acceptance based interventions. There is a bigger role played by mindfulness in influencing an experience. BBT is therefore likely to alter the patient’s expectations about their abilities to take control of certain situations in their lives[30]. Such as situation is likely to influence the perceived control measurement, therapists engage with the clients abut are less likely to have an overall influence over each other’s live. In this phase, clients are only encouraged to take part in actions that are more likely to fall under their control.

The interaction for the subscale scores focuses at Depression, anger, anxiety and Positive Affect. Patients in the treatment conditions face great decrease in the amount of fear of emotions as well as difficulties in emotional controls. Furthermore, additional variance occurs in CBT that proves effectiveness over AR method. The results indicated similarities in the 12 and 24 months follow-ups. Moreover, CBT once more proved superiority over WL in providing change to depressive and general anxiety symptoms[31]. Furthermore, AR method also proved superiority over the WL on at least one outcome of overall severity in the assessment for ADIS-iv patients. However, the long outcomes of CBT and AR conditions indicated little differences in the groups used in the sample. This is to show that when the data from the two groups were compared, the results proved that participants had achieved significant progress in the follow-up phase. Therefore, the tests appeared that the CBT formula used to tests the patients had a substantial impact on the patient’s treatment by decreasing their worry after the procedure was terminated. A significant factor is that the CBT process helps the patients to begin changing their beliefs and behaviours and the change process is likely to progress even at in the post-treatment phase[32]. Clients can take control of their own actions.  On the hand, the AR was less likely to continue with positive outcomes in two years after the treatment process is conducted.

The non-drug GAD therapy for CBT is a more considerable change by making the clinical improvement from the pre-treatment to post-treatment[33]. The comparisons between CBT and AR adequately meets the needs of the individuals with GAD and promote the use of the behavioural approach to solve issues of anxiety disorders.

Shortcomings in the articles

Significantly, the articles on non-medical approaches to treat GAD disorders are not limited to flaws, for instance, there is the likelihood that CBT was favoured in its treatment of patients compared to other non-drug treatments. However, the treatment methodology vastly depends on the specific therapist’s ability to carry out the treatment process. The study relatively failed to assess the therapist’s competencies, therefore, posing as an alternative limitation to the study as their integrities often reflect their abilities to work[34]. Finally, the study’s weakness revealed in the way it used the self-recruited samples.

6.3 Drug Treatment for GAD

6.3.1 Citalopram

Citalopram is one of the best treatments applied in the early stages of patient treatment following GAD symptoms. The data in figure 5 shows that Citalopram is efficacious in the management of the acute anxiety disorders in the older aged people. Over the 8 weeks’ observation, the participants reflected an advanced level of improvement. In the current study, there was significant toleration of Citalopram as compared to the side effects posed by Placebo[35]. The UKU side Effects rating scale found that citalopram reduced the overall number of side effects. Similarly, the drug has achieved the treatment to the late-life depression under the comorbid anxiety.

Furthermore, the study related with some limitations. First, the study featured a small sample; the results are likely to later with an increase in the number of participants. Besides, the effectiveness of the drug may differ in accordance to the gender, for example, GAD treatment cannot be generalised for both men and women groups unless the sample considers the selection of the same sample size. Finally, the study shows that Citalopram is only sufficient to the elderly patients as opposed to the young[36].

6.3.2 Escitalopram
The study shows that Escitalopram was tolerated and was safe to use. Patients placed on the Escitalopram had higher improvement rates compared to placebo in all the defined efficacy aspects. Escitalopram has benefits on both the psychological and somatic symptoms of GAD. The drug led to the overall improvement of the patient’s condition and that it the reason it is globally recognised. The comparison between the Escitalopram and Placebo indicated that those put on the Escitalopram dosage had higher ratings in the quality of their life. During the treatment period, there was a considerable reduction in the GAD symptoms and became consistent with the efficacy of 10 mg/day dosage[37]. During the trials, the 10mg/day dosage of escitalopram in the depression trials addressed the comorbid GAD. On the other hand, Escitalopram was well tolerated by the GAD patients more than the placebo[38]. It is because the drug has continuously reflected progress in various depression trial studies. Escitalopram’s tolerability is significantly higher than other GAD treatments since it serves appropriately in it evaluated with warranted safety and efficacy. The Escitalopram’s dosage was relatively superior to the Placebo on a 10 and 20 mg.  Escitalopram dosage was efficacious in the mid-term treatment of the generalised anxiety disorder. Moreover, the drug has a few safety risks as compared to other therapeutic procedures and antidepressants.

6.3.3Paroxetine

The study provided proof that paroxetine doses were significantly useful in the treatment of GAD. The process follows an eight-week placebo-controlled survey under the fixed dosage of 20 and 40gm/day. Previous research has also demonstrated increased effectiveness in the drug’s ability to alleviate the GAD symptoms in patients and similarly regarded with superiority over the placebo dosage. With the use of the Hamilton scale, clear signs described a higher level of improvement in the paroxetine sample during the early period of study such as the fourth week. According to the results, the drug indicated as much as 50% of the reduction in the severity rates of GAD symptoms[39]. As a result, the cut is clinically significant since the critical symptoms in the early stages of treatment declined during the onset of the 8th week. Furthermore, the paroxetine patients that completed the study were indistinguishable from the healthy population as the response rates had escalated to 80%. The drug was validated by measurements that scored it as user-friendly across the treatment groups to indicate that the patients demonstrated a heightened level of improvement.

In a review of the results, Paroxetine was well tolerated and also had a lower dropout rate of 11% for the treatment groups. It is a sign to show that higher dosage of the paroxetine would be more useful in individual cases. The drug has thus established as an appropriate treatment for depression along with other anxiety disorders frequently associated with the generalised anxiety. The drugs’ versatile nature allows it to manage any drug that would, in any case, come along with the ability to manage chronic suffering and impairments that usually pose a medical challenge.

6.3.4 Sertraline

In the study, Sertraline indicated a symptom reduction following a short-term treatment procedure. It resulted in the improvement of both improvements in the quality of work productivity as well as life[40]. It regards the generalised anxiety disorder with an impairment which received similar treatment for the social anxiety and panic. Furthermore, treatments with sertraline reported good toleration by the patients. Also, Sertraline demonstrated a greater level of efficacy in comparison to the Placebo on the psychic and somatic anxiety issues.  Figure 8 demonstrated the patient’s response to the drug diagnosis whereby the treatment with Sertraline became tolerated with the symptoms similar adverse and severe events. The study properly demonstrates well effective responses to elderly patients. However, the study was limited to the use of the small sample sizes insufficient to demonstrate the entire population in the nation.

6.4 SNRIs

6.4.1 Duloxetine

This study used the randomised, multicenter, double-blind and placebo-controlled to evaluate the tolerability and efficacy in older GAD patients. The results illustrated that the patient’s use of the duloxetine 30-120 mg reduced anxiety symptoms faster than the sample placed on the placebo. Furthermore, the patients put on Duloxetine were more likely to give superior patient improvements as compared to placebo-treated. The patients got improvement during their experiences in the acute therapies[41]. The success of the study is that Duloxetine treatment was likely to initiate higher completion rate and lower discontinuation rates. Up to 60.3% of duloxetine-treated patients demonstrated more improvement in the cognition and depressive symptoms as compared to Placebo[42]. Placebo had more levels of nausea, diarrhoea, dry mouth and constipation as it corresponds to the placebo.

Another major significance in this study demonstrated high efficacious in the improvement of the diseases severity, functioning and enjoyment of life for adult patients with GAD. The safety and tolerability of duloxetine treatment were consistent with the treatment of the GAD. Patients that received duloxetine experienced a higher improvement in their anxiety symptoms as compared to placebo[43]. It is because there were no serious adverse events that occurred in the duloxetine groups. Duloxetine experienced a 31.1% of discontinuation as compared to 16.2% of placebo-treated patients[44]. Other signs experienced included dizziness, but also experienced improvement in the overall symptom of severity than those who received placebo. Duloxetine-treated patients faced a reduction in the symptom level with anxious mood, tension, muscular pain, respiratory symptoms and anxiety behaviours compared with placebo-treated patients. 87% of the patients with GAD improve following their complaints on depression, sleep disturbances, physical illnesses and pain[45].   Moreover, the finding indicated that duloxetine helped attain a reduction in the somatic symptoms associated with GAD since it significantly assisted to break the cycle between worry and physical complaints. The Sheem Disability Scale illustrated that duloxetine-treated patients had more significant improvements when compared to placebo-treated patients.  Duloxetine 60 mg and 120mg were well tolerated hence the low discontinuation rates tom adverse events which did not give a significant variation between the two groups[46]. However, the treatment exceeding two weeks indicated an increase in the duloxetine adverse events as compared to the placebo-treated patients.

Notably, nausea was the only adverse effect that contributed to the particular rates of study discontinuation.  However, most of the patients that experienced nausea could tolerate it leading only to 2.7% of the interruption. After discontinuation, the most recognised symptom was dizziness[47].

To sum up, the finding of the study should be considerate of the limitations such as short-term treatment of 9 weeks was used to generalise the results of the study. Also, efficacy, safety and tolerability of the drug could not be executed through a direct comparison one type of medication.

4.4.2Vortioxetine

Vortioxetine improves the patients’ outcomes in the total score.  Besides, Vortioxetine is considerably important over the placebo when used in an eight weeks anxiety sub-score.  All patients with severe GAD have a more substantial benefit from the treatment with vortioxetine than placebo. The trial failed to illustrate a failure in the experiments as the inverse probability of the patients to respond. For instance, there was a significant difference indicated in the mean change for the baseline scores of the Vortioxetine vs placebo.  Primary analysis stated the benefits of Vortioxetine against Placebo

4.4.3 Pregabalin

The investigation was conducted to study the treatment duration to demonstrate the tremendous significance for pregabalin efficiency as compared to placebo.  Some of the side effects of the drug include tiredness, dry mouth, vomiting, bloating, headache and dizziness.

4.4.4 To evaluate the efficacy and tolerability of non-drug therapy versus drug therapy in the treatment of Generalised anxiety disorder (GAD)

The Generalized anxiety disorder (GAD) a standard therapy in the clinical setting. For purposes of an appropriate remedy for the diseases, the study utilised various approaches to come up with pharmacological treatment for GAD.  The specific factors use included the response rates to acute therapy, prediction of response and treatment tolerability. On the basis of the recent study, the pharmacological treatment recommended for the treatment of the generalised anxiety disorder.

The GAD disorder is based on various categories of somatic and psychic anxiety symptoms that include the irritability, fatigue, restlessness, and disturbed sleep[48]. The findings of the randomised placebo-controlled trials indicate that less than 60% of the patients responded to placebo and 75% to SSRI[49]. The tolerability structure meant that medication is an essential consideration in the long-term treatment. The only adverse effects SSRIs and SNRIs included a headache, nausea and nervousness.  Alternatively, some of the problems as SSRIs and SNRIs in the long-term treatment include sexual dysfunction, discontinuation, and persistent disturbance sleep.

The most disturbing part to use the pharmacological treatment is that one cannot predict the patients that will respond well or have a limited response to treatment[50]. GAD is a chronic disorder that requires naturalistic recovery. It calls for the longitudinal fluidity of the diagnosis especially the use of the antidepressants that help to reduce the risk of recurring symptoms. The value of the long-term involvement of the antidepressants based on the factor that there is the possibility of these symptoms to reoccur. The study has recommended six consecutive months for the treatment. Most of the double-blind treatment for placebo goes up to 18 months after the first response.

The sampling account between the drug and non-drug treatment yields the specific estimation of the increased use of the antidepressants among the youths and the older adults.  In this case, age plays a vital role in ensuring that the observed disorders display a high rate of observable symptoms. Active treatment by use of the antidepressants is importantly associated with high levels of somatic symptoms during and after the severity symptoms appear[51]. Despite the differences in the antidepressants used to treat patients, they are considered bests in the analysis of the anxiety disorders. Findings determine the relationship in the studies with continuous outcomes with

Discontinuation symptoms

  The discontinuation symptoms involve stopping treatment with many psychotropic drugs such as the SSRIs and SNRIs. Discontinuation symptoms occur on antidepressant withdrawal during the period when more patients. The influence of more extended treatment compounds results in a more prolonged duration of dosage as well as higher treatment that influence dropout by severity. For instance, the study proves that after an eight weeks study 20mg/d paroxetine or placebo, there were reports of anxiety, nausea, or dizziness[52].

The recommended guidelines for SSRI pharmacological treatment of GAD to give a balance on the efficacy and tolerability, an alternative medication intervention to withdraw from these drugs include switching drugs and combining medication with psychological treatment. Sometimes, mental intervention becomes essential for some patients especially the young ones. Cognitive behavioural therapy repeatedly became identified as the most critical psychological treatment due to its superior control of the patient’s management. Cognitive behaviour therapy is an effective treatment of GAD problem[53]. The study has found that CBT takes more time that of medication. However, no single treatment is based suited for every patient.

Conclusion

Primary and secondary caregivers often encounter generalised Anxiety disorder (GAD). The patients face recurrent and abrupt panic attacks. Such conditions can have an impact on the patient’s quality of life and in the process disrupt their day to day activities[54].  These conditions require essential considerations. Typically, there are physical symptoms associated with GAD such as chronic headaches, restlessness, sleep disturbance, irritability and muscle tension.  Various scales are used to establish a diagnosis of the severity of the disease.

Efficacy side effects and lengths of drug and non-drug treatment

Drugs vary in the psychotherapies and psychotropic for the treatment of the patient with GAD.  Randomized double-blind in placebo-controlled trials provide the correct evidence for the efficacy of some SSRIs, SNRIs, and other drugs. There are the long-term and short-term treatments which have the adverse effects when given to patients for long periods exceeding 12 months. The exact type of treatment is determined by factors such as the patient’s preference for the approach as well as the presence of the comorbid depression or the history of the same. Doctors guide patients to understand that the healing process is not immediate, sometimes, these symptoms are seen to worsen in the first stages of treatment and gets better with time. GAD patients have a definite room for improvement with the use of the more efficacious and acceptable pharmacological approaches to manage the disorder.

Basically, study shows that medication and psychotherapies are effective in the treatment of the suspected anxiety disorder[55].  The non-drug therapy is an important foundation in treating the Anxiety disorder. Sometimes, patient education is a relevant step to manage the patient’s behaviour. Most of the non-drug symptoms are recommended to lower the anxiety related symptoms. Usually, specialists advise their patients to avoid using things that trigger the symptoms. Although non-drug treatment is considered tolerable and efficacious, the symptoms are more likely to recur in future hence the need to come up with treatment. There is an identified dose-response relations linked to tolerance and side effects. These are the adverse effects evaluated in the use of drug prescribed interventions.

More often psychotherapy and relaxation Therapies have various approaches like CBT. CBT applied to such methods like relaxation, exposure, breathing, and cognitive restructuring[56].   For effectiveness, GAD patients undergo weekly therapies with at least eight weeks.  Cognitive Behaviour Therapies are useful in the GAD treatment. It helps to assists the cognitive patterns primarily by the introduction of thinking strategies that enable patients to relax. The patient’s particular anxieties got connected to his or her needs. These therapeutically approaches have minimal adverse effects; however, they are still linked to the mild increase in the anxiety[57].

Besides, mindfulness is another psychotherapy process that helps to support the CBT as well as other therapies[58]. These processes are necessary in the stress reduction and also reduce the anxiety symptoms. Despite the effectiveness in the care, there are rebound symptoms that occur with psychotherapy more than it does in the medications

The data based on the UK treatments. The table 1 above describes the procedures using placebo for responses along with Vortioxetine[59]. Furthermore, all comparisons made along with placebo in the long run, depicted active treatments by specific drugs. Furthermore, all the results show that alternative drugs became favoured over the Placebo. The mixed treatments meta-analysis encouraged the use of the drug treatment for the generalized anxiety disorder in UK. The analysis placed duloxetine, pregnable, escitalopram with the quickest responses, remissions and withdrawals following adverse events[60]. Evidence shows that low rate of GAD treatment is uncalled for, this because the various non pharmacological and drug have proved efficacy. The drugs have a well-designed ability to intervene the clinical issue especially the use of SSRI’s and SNRI’s[61]. The development of the drugs is generally a preferable methodology that will help suppress the number of young and aged patients.  Drug and dosage have to be specified to each patient and help meet their health needs.  The well-being therapy along other proven methods can turn into improved medical treatment desirable for each specific medical GAD issue.

Moreover, the efficacy and tolerability of medications for GAD and other psychiatric disorder have been continuously instrumental to provide evidence that support the clinical decision making. The short-term and long-term studies have proved efficacy is revealed in various drug interventions for up to 26 weeks. More scales have proved   measurement dimensions aggregated to reduce the symptoms. The multiple drugs used in the clinical trials maintained a lower withdrawal rate that helped to pose a balance between efficacy and tolerability[62]. These interventions are worthy have added little adverse effects. It was consistent with the various trials that have been carried out in the previous studies. In some cases some factors influenced the outcome of the investigation; such factors include the sample size, dosages and design. The Clinical bottom line should be structured in a manner that all the patients suspected of the mental disorders are assessed to serve the first goals of therapy which involves the identification of the primary patterns that seem irrational and replace them with the rational ones. Most clinicians have not been able to choose whether to use the drug dosage or not. In such a scenario, it is advisable that CBT or any other non-drug therapy is utilized. This is because the strategy is free form dependency risks and impairment .However, a study conducted on the patients with an age higher than 60 years illustrated that they required the use of the sertraline. The patient’s ability to use and cope with the side effects should sometimes serve as the basis to guide decisions on drug therapy.

Preliminary, research has found that the use of drugs will moderate the psychological disorders[63]. Besides, there is the need to consolidate the psychotherapy with the help of memory experiences which leverage the patient’s ability to disrupt the inconsistencies in the memories. Continuous outcomes standardised the possible pair of treatments with the probability to shows a relative intervention without uncertainty. The pharmacological management proved the drugs by the improvement[64]. The study shows that a given number of patients showed the possibilities to worry about their dependency levels on medication. As a result, there has been pharmacological effectiveness with satisfactory.

 

 

 

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  9. Kaspera S, Giancarl H, Michael N, Ameringen V, Petraliad A, Mandelb F, Baldinettie, F and Borwin B, Efficacy of pregabalin and venlafaxine-XR in generalized anxiety disorder: results of a double-blind placebo-controlled 8-week trial.
  10. Bose A, Korotzer A, Gommoll C, and Li D .Randomized Placebo-Controlled Trial Of Escitalopram And Venlafaxine Xr In The Treatment Of Generalized Anxiety Disorder. Journal of Depression and anxiety 2008; 25:854-861.
  11. Davidson J, Bose A, Korotzer A, and Zheng H. Double-blind, placebo controlled, flexible-dose study. Depression and Anxiety 19:234-240, 2004.
  12. Baldwin D, Karina A, Huusom T, and Melham E. Escitalopram and paroxetine in the treatment of generalized anxiety disorder Randomized, placebo-controlled, double-blind study. British Journal of psychiatry, 2005, 189; 264-272.
  13. Bielski R, Bose A, and Chang C. A Double-Blind Comparison of Escitalopram and Paroxetine in the Long-Term Treatment of Generalized Anxiety Disorder. Annals of Clinical Psychiatry, 2005; 17(2):65–69.
  14. Cvjetkovic-Bosnjak M, Soldatovic-Stajic B, Babovic S, Boskovic1 K, and Jovicevic M. Pregabalin versus sertraline in generalized anxiety disorder. An open label study, European Review for medical and pharmacological Science, 2015; 19:2120-2124.
  15. Koponen H, Allgulander C, Erickson J, Dunayevich E, Pritchett Y, Detke M, Ball S, and Russel M. Efficacy of Duloxetine for the treatment of Generalized anxiety disorder: implications for primary care physicians, 2007 Pdf.
  16. Rynn M, Russel J, Erickson J, Detke M, Ball S, Dinkel J, Rickels K, and Raskin J. Efficacy and Safety of Duloxetine in the Treatment of Generalized Anxiety Disorder: A Flexible-dose, Progressive titration, Placebo-controlled Trial, PDF.
  17. Crits- Christoph P, Newman M, Rickels K, Gallop R, Gibbons M, Hamilton J, Ring-Kurtz S and Pastva A. Combined medication and cognitive therapy for generalized anxiety disorder. Journal of anxiety disorders, 2004 25; 1087-1094.
  18. Guarna, J. Comparing ACT and CBT. ACBS pdf.
  19. Davidson J, Bose A, Korotzer A, AND Zheng H. Escitalopram in The Treatment of Generalized Anxiety Disorder: Double-Blind, Placebo Controlled, Flexible-Dose Study. Journal of Depression and anxiety, 2004; 19: 134-240.
  20. Roemer E, Orsillo S, and Salters-Pedneault. Efficacy of an Acceptance-Based Behavior Therapy for Generalized Anxiety Disorder: Evaluation in a Randomized Controlled Therapy. Consult Clin Psychol, 2008; 76(6): 1083–1089.
  21. Lenze J, Rollman B, Shear K, Dew M, Pollock B, Ciliberti C, Constantino, Snyder S, Shi P, Spitznagel and Butters M. Escitalopram for Older Adults with Generalized Anxiety Disorder A Randomized Controlled Trial. American Medical Association, 2009; 3001(3).
  22. Dahlin M, Anderson G, Magnusson K, Johansson T, Sjogren J, Hakansson A, Pettersson M, Kadowaki A, Cuijpers P, and Carlbrign P. Internet-delivered acceptance-based behaviour therapy for generalized anxiety disorder: A randomized controlled. Behaviour Research and Therapy, 2016; 77; 86-95.
  23. Evans, S. Ferrando S, Marianne F, Stowell C, Smart C, and Haglin D. Mindfulness-based cognitive therapy for generalized anxiety disorder. Journal of Anxiety Disorders, 2008; 716-721.
  24. Rickels K, Pollack M, Douglas E, Lydiard B, Zimbroff D, Bieslki R, Tobias K, Brock J, Zornberg G, and Pande A. Pregabalin for Treatment of Generalized Anxiety Disorder A 4-Week, Multicenter, Double-blind, Placebo-Controlled Trial of Pregabalin and Alprazolam. Arch Gen Psychiatry, 2005; 62:1022-1030.
  25. Petralia A, Mandel F, Baldinetti F, and Bandelow B. Efficacy of pregabalin and venlafaxine-XR in generalized anxiety disorder: results of a double-blind, placebo-controlled 8-week trial. Int Clin Psychopharmacol, 2009, 24:87–96,
  26. Kasper S, Schweizer and Iglesias-Garcia C. E, 1018-Long-term efficacy and safety study of pregabalin in subjects with generalised anxiety disorder (GAD). European Psychiatry ·, 2013.
  27. Pande A, Crockatt J, Feltner D, Janney C, Smith W, Weisler R, Londborg, P, Bielski R, Zimbroff D, Davidson J, and Liu-Dumaw M. Pregabalin in Generalized Anxiety Disorder: A Placebo-Controlled Trial. Am J Psychiatry, 2003; 160:533–540.
  28. Montgomery S, Zornberg G, Kasper S, and Pande AC. Efficacy and safety of pregabalin in the treatment of generalized anxiety disorder: a 6week, multicenter, randomized, doubleblind, placebo-controlled comparison of pregabalin and venlafaxine. Journal of Clinic Psychiatry.67(5):77182, 2006.
  29. Mokheber N, Azarpazhooh R, Khajehdaluee M, Valayati A and Hopwood M. Randomized, single-blind, trial of sertraline and buspirone for treatment of elderly patients with generalized anxiety disorder. Psychiatry and Clinical Neurosciences, 2010; 64: 128–133.
  30. Allgulander C, Dahl A, Austin C, Morris P, Sogaard J, Fayyad R, Kutcher S, Clary C, Efficacy of Sertraline in a 12-Week Trial for Generalized Anxiety Disorder. Am J Psychiatry; 2004, 161:1642–1649.
  31. Leichsenring F, Salzer S, Jaege U, Kächele H, Kreische R, Leweke F, Rüger U, Winkelbach C, and Leibing E. Short-Term Psychodynamic Psychotherapy and Cognitive-Behavioral Therapy in Generalized Anxiety Disorder: A Randomized, Controlled Trial. Am J Psychiatry, 2009; 166:875–881.
  32. Brenes G, Danhauer S, Lyles MHogan P, Miller M. Telephone-Delivered Cognitive Behavioral Therapy and Telephone-Delivered Nondirective Supportive Therapy for Rural Older Adults with Generalized Anxiety Disorder A Randomized Clinical Trial. JAMA Psychiatry, October 2015, 72(10).
  33. Mewton L, Wong N, and Andrews G. The effectiveness of internet cognitive behavioural therapy for generalized anxiety disorder in clinical practice. Depression and Anxiety; 2012; 29:843–849.
  34. Rothschild A, Mahableshwarkar A, Jacobsen P, Yan Minhjin and Sheehan D. Vortioxetine (Lu AA21004) 5 mg in generalized anxiety disorder: Results of an 8-week randomized, double-blind, placebo-controlled clinical trial in the United States. European Neuropsycho-pharmacology; 2012; 22, 858–866.
  35. Mahableshwarkar A, Jacobsen P, Serenko M, and Chen Y. A randomized, double-blind, fixed-dose study comparing the efficacy and tolerability of vortioxetine 2.5 and 10 mg in acute treatment of adults with generalized anxiety disorder. Human Psychopharmacol Clinical Expert 2014; 29: 64–72.

 


 

End Notes

[1] Cvjetkovic-Bosnjak M, Soldatovic-Stajic B, Babovic S, Boskovic1 K, and Jovicevic M. Pregabalin versus sertraline in generalized anxiety disorder. An open label study, European Review for medical and pharmacological Science, 19:2120-2124, 2015.

 

[2] Trenor, M, Erisman, S, Salters-Pedneault, K, Roemer, L and Orsillo, S. An acceptance-based behavioral therapy for GAD: Effects on outcomes from three theoretical models. Depression Anxiety, 28(2): 127–136; 2011.

[3] Rickels K, Zaninelli R, McCafferty J, Bellew, K Iyengar M, and Sheehan D. Paroxetine Treatment of Generalized Anxiety Disorder: A Double-Blind, Placebo-Controlled Study. Journal Psychiatry, 2003; 160:749–75.

 

[4] Trenor, M, Erisman, S, Salters-Pedneault, K, Roemer, L and Orsillo, S. An acceptance-based behavioral therapy for GAD: Effects on outcomes from three theoretical models. Depression Anxiety, 28(2): 127–136; 2011.

[5] Dugas J, Brillon P, Savard P, Turcotte J, Gaudet A, Ladouceur R, Leblanc R, and Gervais N. Concordia UniversityA Randomized Clinical Trial of Cognitive-Behavioral Therapy and Applied Relaxation for Adults with Generalized Anxiety Disorder. Behavioral Therapy, 41(1): 46–58; 2010.

[6] Dugas J, Brillon P, Savard P, Turcotte J, Gaudet A, Ladouceur R, Leblanc R, and Gervais N. Concordia UniversityA Randomized Clinical Trial of Cognitive-Behavioral Therapy and Applied Relaxation for Adults with Generalized Anxiety Disorder. Behavioral Therapy, 41(1): 46–58; 2010

[7] Leichsenring F, Salzer S, Jaege U, Kächele H, Kreische R, Leweke F, Rüger U, Winkelbach C, and Leibing E. Short-Term Psychodynamic Psychotherapy and Cognitive-Behavioral Therapy in Generalized Anxiety Disorder: A Randomized, Controlled Trial. Am J Psychiatry, 2009; 166:875–881.

[8] Evans S, Fernando, Findler M, Stowell C, Smart C, and Haglin, D. Mindfulness-based cognitive therapy for generalized anxiety disorder. Journal of Anxiety Disorder, 2008; 716-721.

 

[9] Rickels K, Zaninelli R, McCafferty J, Bellew, K Iyengar M, and Sheehan D. Paroxetine Treatment of Generalized Anxiety Disorder: A Double-Blind, Placebo-Controlled Study. Journal Psychiatry, 2003; 160:749–75.

[10] Leichsenring F, Salzer S, Jaege U, Kächele H, Kreische R, Leweke F, Rüger U, Winkelbach C, and Leibing E. Short-Term Psychodynamic Psychotherapy and Cognitive-Behavioral Therapy in Generalized Anxiety Disorder: A Randomized, Controlled Trial. Am J Psychiatry; 166:875–881, 2009.

[11] Lenze E, Mulsant B,  and Shear K. Dew M, Miller M, Pollock, B, Houck P, Tracey B,  and Reynolds C. Efficacy and Tolerability of Citalopram in the Treatment of Late-Life Anxiety Disorders: Results From an 8-Week Randomized, Placebo-Controlled Trial. Am J Psychiatry 162:146–150; 2005.

[12] Lenze E, Mulsant B,  and Shear K. Dew M, Miller M, Pollock, B, Houck P, Tracey B,  and Reynolds C. Efficacy and Tolerability of Citalopram in the Treatment of Late-Life Anxiety Disorders: Results From an 8-Week Randomized, Placebo-Controlled Trial. Am J Psychiatry 162:146–150; 2005

[13] Lenze E, Mulsant B,  and Shear K. Dew M, Miller M, Pollock, B, Houck P, Tracey B,  and Reynolds C. Efficacy and Tolerability of Citalopram in the Treatment of Late-Life Anxiety Disorders: Results From an 8-Week Randomized, Placebo-Controlled Trial. Am J Psychiatry 162:146–150; 2005.

[14] Baldwin D, Karina A, Huusom T, and Melham E. Escitalopram and paroxetine in the treatment of generalized anxiety disorder Randomized, placebo-controlled, double-blind study. British Journal of psychiatry, 2005, 189; 264-272.

 

[15] Rickels K, Zaninelli R, McCafferty J, Bellew, K Iyengar M, and Sheehan D. Paroxetine Treatment of Generalized Anxiety Disorder: A Double-Blind, Placebo-Controlled Study. Journal Psychiatry, 2003; 160:749–75.

[16]Bielski R, Bose A, and Chang C. A Double-Blind Comparison of Escitalopram and Paroxetine in the Long-Term Treatment of Generalized Anxiety Disorder. Annals of Clinical Psychiatry, 2005; 17(2):65–69.

 

[17] Bielski R, Bose A, and Chang C. A Double-Blind Comparison of Escitalopram and Paroxetine in the Long-Term Treatment of Generalized Anxiety Disorder. Annals of Clinical Psychiatry, 2005; 17(2):65–69.

 

[18] Bielski R, Bose A, and Chang C. A Double-Blind Comparison of Escitalopram and Paroxetine in the Long-Term Treatment of Generalized Anxiety Disorder. Annals of Clinical Psychiatry, 2005; 17(2):65–69.

 

[19] Cvjetkovic-Bosnjak M, Soldatovic-Stajic B, Babovic S, Boskovic1 K, and Jovicevic M. Pregabalin versus sertraline in generalized anxiety disorder. An open label study, European Review for medical and pharmacological Science, 2015; 19:2120-2124.

[20] Alaka K, Montejo A, Noble W, and Lily, E. Efficacy and safety of duloxetine in the treatment of older adult patients with generalized anxiety disorder: A randomized… International Journal of Geriatric Psychiatry, 2014; 29: 978–986.

[21]Dahlin M, Anderson  G, Magnusson  K, Johansson T, Sjogren J, Hakansson A, Pettersson M, Kadowaki A, Cuijpers P,  and  Carlbrign P.  Internet-delivered acceptance-based behaviour therapy for generalized anxiety disorder: A randomized controlled. Behaviour Research and Therapy, 2016; 77; 86-95.

[22] Kaspera S, Giancarl H,  Michael N, Ameringen V, Petraliad A, Mandelb F,  Baldinettie, F and Borwin B,. Efficacy of pregabalin and venlafaxine-XR in generalized anxiety disorder: resu Alaka K, Montejo A, Noble W, and Lily, E. Efficacy and safety of duloxetine in the treatment of older adult patients with generalized anxiety disorder: A randomized… International Journal of Geriatric Psychiatry, 29: 978–986; 2014. lts of a double-blind placebo-controlled 8-week trial

[23] Petralia A, Mandel F, Baldinetti F, and Bandelow B. Efficacy of pregabalin and venlafaxine-XR in generalized anxiety disorder: results of a double-blind, placebo-controlled 8-week trial. Int Clin Psychopharmacol, 2009, 24:87–96.

[24] Montgomery S, Zornberg G, Kasper S, and Pande AC. Efficacy and safety of pregabalin in the treatment of generalized anxiety disorder: a 6week, multicenter, randomized, doubleblind, placebo-controlled comparison of pregabalin and venlafaxine. Journal of Clinic Psychiatry.67(5):77182, 2006.

[25] Alaka K, Montejo A, Noble W, and Lily, E. Efficacy and safety of duloxetine in the treatment of older adult patients with generalised anxiety disorder: A randomised… International Journal of Geriatric Psychiatry, 2014; 29: 978–986.

[26] Trenor, M, Erisman, S, Salters-Pedneault, K, Roemer, L and Orsillo, S. An acceptance-based behavioral therapy for GAD: Effects on outcomes from three theoretical models. Depression Anxiety, 2011; 28(2): 127–136.

[27] Leichsenring F, Salzer S, Jaege U, Kächele H, Kreische R, Leweke F, Rüger U, Winkelbach C, and Leibing E. Short-Term Psychodynamic Psychotherapy and Cognitive-Behavioral Therapy in Generalized Anxiety Disorder: A Randomized, Controlled Trial. Am J Psychiatry, 2009; 166:875–881.

[28] Leichsenring F, Salzer S, Jaege U, Kächele H, Kreische R, Leweke F, Rüger U, Winkelbach C, and Leibing E. Short-Term Psychodynamic Psychotherapy and Cognitive-Behavioral Therapy in Generalized Anxiety Disorder: A Randomized, Controlled Trial. Am J Psychiatry, 2009; 166:875–881.

[29] Evans S, Fernando, Findler M, Stowell C, Smart C, and Haglin, D. Mindfulness-based cognitive therapy for generalized anxiety disorder. Journal of Anxiety Disorder, 2008; 716-721.

 

[30] Dugas J, Brillon P, Savard P, Turcotte J, Gaudet A, Ladouceur R, Leblanc  R, and  Gervais N.  A Randomized Clinical Trial of Cognitive-Behavioral Therapy and Applied Relaxation for Adults with Generalized Anxiety Disorder. Behavioural Therapy, 2010; 41(1): 46–58.

[31] Evans S, Fernando, Findler M, Stowell C, Smart C, and Haglin, D. Mindfulness-based cognitive therapy for generalized anxiety disorder. Journal of Anxiety Disorder, 2008; 716-721.

[32] Roemer E, Orsillo S, and Salters-Pedneault. Efficacy of an Acceptance-Based Behavior Therapy for Generalized Anxiety Disorder: Evaluation in a Randomized Controlled Therapy. Consult Clin Psychol, 2008; 76(6): 1083–1089

[34]Dugas J, Brillon P, Savard P, Turcotte J, Gaudet A, Ladouceur R, Leblanc R, and Gervais N. Concordia UniversityA Randomized Clinical Trial of Cognitive-Behavioral Therapy and Applied Relaxation for Adults with Generalized Anxiety Disorder. Behavioral Therapy, 2010; 41(1): 46–58.

[35] Lenze E, Mulsant B,  and Shear K. Dew M, Miller M, Pollock, B, Houck P, Tracey B,  and Reynolds C. Efficacy and Tolerability of Citalopram in the Treatment of Late-Life Anxiety Disorders: Results From an 8-Week Randomized, Placebo-Controlled Trial. Am J Psychiatry 2005; 162:146–150.

[36] Lenze E, Mulsant B,  and Shear K. Dew M, Miller M, Pollock, B, Houck P, Tracey B,  and Reynolds C. Efficacy and Tolerability of Citalopram in the Treatment of Late-Life Anxiety Disorders: Results From an 8-Week Randomized, Placebo-Controlled Trial. Am J Psychiatry 2005; 162:146–150.

[37] Bielski R, Bose A, and Chang C. A Double-Blind Comparison of Escitalopram and Paroxetine in the Long-Term Treatment of Generalized Anxiety Disorder. Annals of Clinical Psychiatry, 2005; 17(2):65–69.

[38] Lenze J, Rollman B, Shear K, Dew M, Pollock B, Ciliberti C, Constantino, Snyder S, Shi P, Spitznagel and Butters M. Escitalopram for Older Adults With Generalized Anxiety Disorder A Randomized Controlled Trial. American Medical Association, 2009; 3001(3).

[40] Cvjetkovic-Bosnjak M, Soldatovic-Stajic B, Babovic S, Boskovic1 K, and Jovicevic M. Pregabalin versus sertraline in generalized anxiety disorder. An open label study, European Review for medical and pharmacological Science, 2015; 19:2120-2124.

[41] Koponen H, Allgulander C, Erickson J, Dunayevich E, Pritchett Y, Detke M, Ball S, and Russel M. Efficacy of Duloxetine for the treatment of Generalized anxiety disorder: implications for primary care physicians, 2007 Pdf.

[42] Alaka K, Montejo A, Noble W, and Lily, E. Efficacy and safety of duloxetine in the treatment of older adult patients with generalized anxiety disorder: A randomized… International Journal of Geriatric Psychiatry, 2014; 29: 978–986.

[43] Rynn M, Russel J, Erickson J, Detke M, Ball S, Dinkel J, Rickels K, and Raskin J. Efficacy and Safety of Duloxetine in the Treatment of Generalized Anxiety Disorder: A Flexible-dose, Progressive titration, Placebo-controlled Trial, PDF

[44] Alaka K, Montejo A, Noble W, and Lily, E. Efficacy and safety of duloxetine in the treatment of older adult patients with generalized anxiety disorder: A randomized… International Journal of Geriatric Psychiatry, 2014; 29: 978–986.

[45] Evans S, Fernando, Findler M, Stowell C, Smart C, and Haglin, D. Mindfulness-based cognitive therapy for generalized anxiety disorder. Journal of Anxiety Disorder, 2008; 716-721.

[46] Crits- Christoph P, Newman M, Rickels K, Gallop R, Gibbons M, Hamilton J, Ring-Kurtz S and Pastva A. Combined medication and cognitive therapy for generalized anxiety disorder. Journal of anxiety disorders, 2004 25; 1087-1094

[47] Pande A, Crockatt J, Feltner D, Janney C, Smith W , Weisler R, Londborg,  P, Bielski R, Zimbroff D, Davidson J, and Liu-Dumaw M. Pregabalin in Generalized Anxiety Disorder: A Placebo-Controlled Trial. Am J Psychiatry, 2003; 160:533–540.

[48] . Rothschild A, Mahableshwarkar A, Jacobsen P, Yan Minhjin and Sheehan D. Vortioxetine (Lu AA21004) 5 mg in generalized anxiety disorder: Results of an 8-week randomized, double-blind, placebo-controlled clinical trial in the United States. European Neuropsycho-pharmacology; 2012; 22, 858–866.

[49] Alaka K, Montejo A, Noble W, and Lily, E. Efficacy and safety of duloxetine in the treatment of older adult patients with generalized anxiety disorder: A randomized… International Journal of Geriatric Psychiatry, 2014; 29: 978–986.

[50] . Rothschild A, Mahableshwarkar A, Jacobsen P, Yan Minhjin and Sheehan D. Vortioxetine (Lu AA21004) 5 mg in generalized anxiety disorder: Results of an 8-week randomized, double-blind, placebo-controlled clinical trial in the United States. European Neuropsycho-pharmacology; 2012; 22, 858–866.

[51] Rynn M, Russel J, Erickson J, Detke M, Ball S, Dinkel J, Rickels K, and Raskin J. Efficacy and Safety of Duloxetine in the Treatment of Generalized Anxiety Disorder: A Flexible-dose, Progressive titration, Placebo-controlled Trial, PDF.

[52] Davidson J, Bose A, Korotzer A, and Zheng H. Double-blind, placebo controlled, flexible-dose study. Depression and Anxiety 19:234-240, 2004.

[53] Dahlin M, Anderson G, Magnusson K, Johansson T, Sjogren J, Hakansson A, Pettersson M, Kadowaki A, Cuijpers P, and Carlbrign P.  Internet-delivered acceptance-based behaviour therapy for generalized anxiety disorder: A randomized controlled. Behaviour Research and Therapy, 2016; 77; 86-95.

[54] Bielski R, Bose A, and Chang C. A Double-Blind Comparison of Escitalopram and Paroxetine in the Long-Term Treatment of Generalized Anxiety Disorder. Annals of Clinical Psychiatry, 2005; 17(2):65–69.

[55] Leichsenring F, Salzer S, Jaege U, Kächele H, Kreische R, Leweke F, Rüger U, Winkelbach C, and Leibing E. Short-Term Psychodynamic Psychotherapy and Cognitive-Behavioral Therapy in Generalized Anxiety Disorder: A Randomized, Controlled Trial. Am J Psychiatry, 2009;166:875–881.

[56] Evans, S. Ferrando S, Marianne F, Stowell C, Smart C, and Haglin D. Mindfulness-based cognitive therapy for generalized anxiety disorder. Journal of Anxiety Disorders, 2008; 716-721.

[57] Mewton L, Wong N, and Andrews G. The effectiveness of internet cognitive behavioural therapy for generalized anxiety disorder in clinical practice. Depression and Anxiety; 2012; 29:843–849.

[58] Brenes G, Danhauer S,  Lyles MHogan P,Miller M. Telephone-Delivered Cognitive Behavioral Therapy and Telephone-Delivered Nondirective Supportive Therapy For Rural Older Adults with Generalized Anxiety Disorder A Randomized Clinical Trial. JAMA Psychiatry, October 2015, 72(10).

[59] Rothschild A, Mahableshwarkar A, Jacobsen P, Yan Minhjin and Sheehan D. Vortioxetine (Lu AA21004) 5 mg in generalized anxiety disorder: Results of an 8-week randomized, double-blind, placebo-controlled clinical trial in the United States. European Neuropsycho-pharmacology; 2012; 22, 858–866.

[60] Davidson J, Bose A, Korotzer A, and Zheng H. Double-blind, placebo controlled, flexible-dose study. Depression and Anxiety 19:234-240, 2004.

[61] Lenze E, Mulsant B,  and Shear K. Dew M, Miller M, Pollock, B, Houck P, Tracey B,  and Reynolds C. Efficacy and Tolerability of Citalopram in the Treatment of Late-Life Anxiety Disorders: Results From an 8-Week Randomized, Placebo-Controlled Trial. Am J Psychiatr, 2005;162:146–150.

[62] Davidson J, Bose A, Korotzer A, and Zheng H. Double-blind, placebo controlled, flexible-dose study. Depression and Anxiety 19:234-240, 2004.

[63] Brenes G, Danhauer S, Lyles MHogan P, Miller M. Telephone-Delivered Cognitive Behavioral Therapy and Telephone-Delivered Nondirective Supportive Therapy for Rural Older Adults with Generalized Anxiety Disorder A Randomized Clinical Trial. JAMA Psychiatry, October 2015, 72(10).

s[64] Lenze J, Rollman B, Shear K, Dew M, Pollock B, Ciliberti C, Constantino, Snyder S, Shi P, Spitznagel and Butters M. Escitalopram for Older Adults With Generalized Anxiety Disorder A Randomized Controlled Trial. American Medical Association, 2009; 3001(3).

 

Analysis of Different Generations to Create an Engagement Policy in Italy- Compare South and North of Italy

Introduction

Managers in various businesses continue to grapple with generational difference among their workforce. Challenges and problems often arise in communication styles and the diverse mindset of employees in different generations. In organizations, the friction between the young and the old generation may be aggravated by the advancement of technology and working patterns that mix employees of different ages in dynamic teams (Ozcelik, 2015).

The aging generation of Baby boomers is considered to be more competitive and perceive an ideology that workers should pay their dues as soon as they arise. Generation X is considered to be skeptical and independent-minded. Generation Y or the millennial is more focused on teamwork, feedbacks and are friendlier to technology (Bristow, 2015). Organizations face a huge challenge when attempting to effectively address the diverse values, perceptions, and expectations of these diverse generations. Managers are required to be careful not to get involved in the blanket stereotypes and also ensure that the old workers are not disadvantaged or increase their risk retention problems and legal battles.

As the business opportunities and management styles in the Eurozone continue growing, the Greenfield investment data revealed that Italy has been one of the blocs where commerce and employment have reached a black spot (Bigoni et al., 2016). Although Italy’s attractiveness to foreign investment has been on the rise, in the past five decades, the businesses in the south still lag behind compared to most of its peers. The North-South problem in Italy has caused a huge difference. The northern region is relatively wealthy and attracts a third of all the Foreign Greenfield Investment since 2009.

Management styles and engagement policies between different generations

The politics of generations in management in modern-day Italy has been very complicated. According to Bull (2017),  the company executives of Nestle Sisto in Perugia made an appalling proposal of that employees would be required to make 25% cut on their salary so that their children can be guaranteed a work opportunity in the organization. While this course of action was totally condemned, research shows that majority of the employees really supported that idea (Biggs, 2018). This incidence shows a sore relationship between the different generations that exist in Italy and the challenges they experience. The act of blaming the baby boomers as the course of management challenges and social problems for their selfishness has become common (Yi, Ribbens & Cheng, 2015). The crash between generations is also credited with being the cause of nepotism, corruption, and cementation of political hegemony that has continually benefitted only the older generations.

First generation (babyboomers)

Baby boomer is a descriptive term that is used to refer to a group of people who were born between the mid-1940s and mid-1960s. Also known as the silent generation, it comprises of a significant fraction of the global population especially the developed countries. In Italy, this is the generation that is blamed for all the problems that the country undergoes. Despite being born at a time when there were numerous opportunities in terms of employment, education, and business, this old-age consumes about 15% of the country’s GDP and 57% of social spending. This is the generation that is considered to have had the poorest management styles that have caused miseries to Italy. Most of them still hold onto offices and are adamant to allow the younger generation to exercise their leadership abilities. This disparity happens despite having a high unemployment rate of the younger generations (Wiedmer, 2015).

Generation X

They comprise of a group of people who were born between the early 1970s and late 1980s. Generation X management style is aimed at removing the fossilized gerontocracy that has impoverished the country along political lines. This generation has blamed the baby boomers for much of the problems that the younger generations in Italy encounter. These engagement policies seek to create a harmonious working relationship between the south and the north and ensure equitable distribution of resources between the young and the old.  The poor management styles of the baby boomers and massive integration failures have led to youth unemployment. The rebuttal of the situation by the generation X who felt stifled by the older generation of leaders who drove the public debt and unemployment rates to crippling levels to keep the jobs for themselves.

Generation Y

This group is also called the millennial and comprise of those people who were born in the late 1990s and early 2000s. They form the majority of the unemployed youth and most of them still live with their parents. Therefore, generation Y in Italy cannot be guaranteed the same quality of life like that of the baby boomers or their grandparents. This situation led to the creation of social groups whose expressions were made through the media.

Among the most noticeable features in the electronic technology, there are three key characteristics that make the media particularly intriguing. These characteristics include the way they have overcome the limits of physical space, allow people to remain anonymous and connect the youth with a particular culture. The media was able to unify the dispersed people across Italy and beyond thus creating a virtual gathering space despite being geographically fragmented (Wiedmer, 2015). According to Sedra and Smith (2016), there is a high correlation between the second generation of Italians with frequent and serious crimes. The findings suggest that the self –reported deviant behaviors among the Italian second generation is highly correlated with generational conflict, weak family bonds, the perception of stigma and relatively higher influence of the information age.

A decade ago, making 1,000 euros was a huge nightmare to many overqualified young people in Italy with the unemployment rate reaching as high as 47%. In December 2005, a group underemployed youths in their thirties joined together to form a club that was known as the thousand-euro generation’. This group later spawned novel and movie in regards to the predicament of the overqualified Italians living in poverty or earning under less than 1,000 per month. Since the advent of the thousand euro generation, unemployment among the youths has increased and the wage rates by approximate 40% before the thousand euro generation were formed. The current generation of the workforce between the ages of 25 and 34 years has an unemployment rate of comprised of 50%. However, the state-sponsored initiatives such as internships and apprenticeships bore fruits as it was able to provide the youths with the much-needed job experience to undertake the high paying jobs.

Strategies for Achieving Engagement Policies

The government has been encouraging the managers of different organizations to undertake training on social issues in order to adapt to the changing work environments and also actively engage the different generations rather than trying to change the staff (Cascio, 2018). Organizations often facilitate mentorship programs to all employees as a way of encouraging cross-generational interaction. The younger employees are encouraged to learn experience and wisdom from the older generation.

The offering of different working options presented by advancement in telecommunication and the privilege of working offsite aims at focusing on the product other than the process of doing the job (Harvey & Allard, 2015). This change can give the employees some degree of flexibility on how they want to work and stay in the organization regardless of where one likes to spend time working. People management skills are essential when dealing with different generations in business. However, lack of human resource institutions that can manage people puts the organization at a severe disadvantage especially in a market where top talents may be required. Therefore, managing generations in Italy is likely to improve effectiveness, performance, and profitability in the organization. Modern workforce mirrors a global marketplace and organizations must focus on creating a diverse workforce do minimize disparity in organizational growth.

The North-South Divide and Generational Gap in Italy

This divide between the north and south is not new; it has existed since 1861 when the unification process led by the northern kingdom of Piedmont was initiated. In agriculture, industrialization and transport development, the policy makers in the north have been making sound decisions in regards to investment and business growth. The North had very fertile plains that offered ample cultivable land using the modern methods such as fertilizers, mechanized tools, and irrigation schemes. The baby boomer generation facilitated the developments and improvements made the firms more productive and efficient. In addition, the north had diverse and profitable agricultural activities such as cultivation of grapes, dates, cone alongside dairy farming. The farms were also run by capitalist tenant farmers who employed the landless farm laborers on contracts, a tradition that later became a norm.

The decision and adoption of policies that allowed mechanization of farming practices led to the acceleration of the commerce and industrialization in total contrast with southern Italy. The south comprised of the mountainous poor farmlands that were characterized by hot dry climate making it unsuitable for any form of agriculture. The coastal plains were also infested with malaria reducing the amount of land that was suitable for agriculture. In addition, the poor landholding policies compounded the underdevelopment problem in the south because the system of latifundia encouraged noble owning of estates. This left the population with very little interest in land as they also rejected the new farming methods resulting in more than 70% of the population living in poverty. Unification of the two regions did not yield any investment or industrialization opportunity to the south and until now it has remained behind most of the European markets (González, 2011).

However, there are many other factors that have impacted on the stability of the country such as the weakening of the Italian Parliamentary government, opposing groups and the advent of the nationalist politics. The baby boomers and the generation X have been very active in maintaining cultural and political differences between the North and the South leading to development diversity. Cultural and political differences contributed to the existence of the divide and disparities in development policies between the two parts. Dialectic variation created political, religious and cultural barriers which turned to be development obstacles, especially for the south.  The northern lingua bore a close resemblance to that of Italians while the southern dialects borrow a lot from Sicily. This great disparity in the Italian Peninsula completely undermined the fundamental goals of the Liberals to unite Italy. Although Italy has constitutionally been considered as a unified state, in reality, it exists as two divided nations which hence diminish the political efficiency of a united country. The regional disparity in Italy has hampered the growth and development of the country on many fronts. This divide is a widely known management problem but despite this awareness, the issues do not appear to become easier to solve.

Methodology

When conducting this research, the researcher will team will collect all the necessary information from print and digital sources for methodological analysis of peer-reviewed and publications from January 2000 to the most recent up to March 2018. The main search strategy will be based on the headings of Italy’s business growth, management styles and generational policy as the key subject and other words relating to the subject. The ultimate search citation will include the north-south divide, unification of Italy, disparity between the north and south as well as other topics of interest.

Figure 1: An Analytical framework for analyzing for management styles of different generations in Italy

The search journals and articles were only restricted to those written in English and those that involved discussion of the national subject. Through the use of the available peer-reviewed studies and articles, the researcher will conduct a supplementary search on the online catalogue to establish whether the systematic review will effectively address the information gap (McGowan, et al., 2016). The search will then be extended to national archives of Italian government institutions such as the parliament to identify the social, political, generational and management issues raised about the divide.  The websites included those relating to proceedings of the Italian parliament, different government ministries and departments, and statistics from the European Union. The search was then completed with a digital databank with a manual search on the citations from different authors of peer-reviewed articles on matters of principle.

Selection of the study

Using the outlined inclusion and exclusion criteria, the reviewer assessed the abstract and titles of the sources for relevance based on the summarized table below. The identified articles and journals were saved for further reviews and future references. Each article was then analyzed for eligibility criteria. Any disagreement arising from the inclusion and exclusion parameters was forwarded to a neutral reviewer for further assessment of its credibility. Some search and selection criteria were further modified for additional evaluation of the adverse effects so as to take care of the non-comparative studies such as case reports and case studies.

Study characteristics Inclusion criteria Exclusion criteria
Population used Adult at least the age of 18 Non- European
Intervention Involving the historical development of north-south disparity in Italy Any unrelated topic
Comparator None None
Outcome –          Business growth No relevant outcome
Timing duration No timing None
Setting Italy or the European Union None
Study design Random selection of data samples

Secondary data analysis

Observed studies, including non-comparative and non-randomized comparative studies

None
Publications Published from 2000 to up to date

Peer-reviewed publication

Strictly published in English

Non-English publications

Published 2000 or later

Table 1: Summarized inclusion and rejection criteria

Quality assessment of the research materials

By introducing the quality criteria for each material obtained, the researcher was able to abstract the article summary to evaluate the quality score for each source. The most appropriate data was eventually selected based on their effectiveness in providing information about Italy. The main quality criteria included; adequacy in concealment of personal identities, comprehensive follow-ups, group comparability, acknowledgment of other’s contribution and legitimacy of the results.

Research questions

  1. What are the merits of the management styles adopted by businesses in Italy in uniting the different generations?
  2. What are the most appropriate methods for creating an engagement policy between various generations in Italy?

The significance of the study

According to McGowan (2016), in order to understand the history Italy, this research study will undertake a systematic review of the different generations in the creation of engagement policy in Italy that seeks to create a level playing ground between the north and the south. Detailed analysis of this topic will provide the researcher with merits and demerits of the policies that have been put in place historically to ensure that the two regions grow simultaneously.

Search methods

The researcher will conduct a systematic review of the available literature based on a random assessment using the data obtained from secondary sources such as books, newspapers, journals, business reports, and online sources.

Criteria for selection of materials

The researcher will include a random collection of materials relating to the historical and social development of Italy. The studies will be restricted to those that talk about Italy since 1896 with the assumption that this period was when the north and south problems began. Most recent materials that provide information of recent development in the region will also be considered to provide a different view of current development in terms of policy to the country.

Data collection and analysis

After completing the assessment of the materials obtained, the viability of completeness and quantitative synthesis will be determined by exploring the volume of the literature, theoretical uniformity and extensiveness of the data reported. Once the analysis is found to complete, the researcher will employ content analysis to develop quantitative output from the data.

Hypothesis

  1. There are no merits of the management styles adopted by businesses in Italy in uniting the different generations.
  2. There are no appropriate methods for creating an engagement policy between various generations in Italy.

Scope

The scope of this research will deal with data collected about the country Italy between the years 2001 to present. The subject matter in which the researcher limited himself/herself was on managing generational differences in business between the two regions of Italy.

Timetable

ACTIVITY WEEK

1

WEEK 2 WEEK 3 WEEK 4 WEEK 5 WEEK 6 WEEK 7
Formulation of proposal’s statement of the problem.              
Development of Research Objectives and research questions.              
Compilation of the literature on research topic and conceptual framework.              
Determination of research methodology and formulation of the questionnaire.              
Conduction of Pilot study.              
Collection of data and Data analysis.              
Summary, drawing of conclusion and drawing and submission of the project to the department.              

References

Biggs, S. (2018). Adapting to an aging society: The need for cultural change. Policy Quarterly, 10(3).

Bigoni, M., Bortolotti, S., Casari, M., Gambetta, D., & Pancotto, F. (2016). Amoral familism, social capital, or trust? The behavioral foundations of the Italian North-South divide. The Economic Journal, 126(594), 1318-1341.

Bristow, J. (2015). Baby boomers and generational conflict. Springer.

Bull, A. (2017). Speaking out and Silencing: Culture, society and politics in Italy in the 1970s. Routledge.

Cascio, W. (2018). Managing human resources. McGraw-Hill Education.

González, S. (2011). The North/South divide in Italy and England: Discursive construction of regional inequality. European Urban and Regional Studies, 18(1), 62-76.

Harvey, C. P., & Allard, M. (2015). Understanding and managing diversity: Readings, cases, and exercises. Pearson.

McGowan, J., Sampson, M., Salzwedel, D. M., Cogo, E., Foerster, V., & Lefebvre, C. (2016). PRESS peer review of electronic search strategies: 2015 guideline statement. Journal of clinical epidemiology, 75, 40-46.

Ozcelik, G. (2015). Engagement and retention of the millennial generation in the workplace through internal branding. International Journal of Business and Management, 10(3), 99.

Sedra, A.S. and Smith, K.C., (2016). A second-generation current conveyor and its applications. IEEE Transactions on circuit theory17(1), pp.132-134.

Wiedmer, T. (2015). Generations do differ: Best practices in leading traditionalists, boomers, and generations X, Y, and Z. Delta Kappa Gamma Bulletin82(1), 51.

Yi, X., Ribbens, B., Fu, L., & Cheng, W. (2015). Variation in career and workplace attitudes by generation, gender, and culture differences in career perceptions in the United States and China. Employee Relations, 37(1), 66-82.

 

Music Teaching Folio

Australia Music Teaching Folio

Australian Music is mostly facilitated by diversity rising from several influences, styles, and genres. The Australian music class is when organized into various categories that are to include the various primary sources such as the literacy through singing, teaching pentatonic, through a showing of films to children, tips on leading a singing session and the exploration of grammar through music. In teaching music, one can use the Jolly Music or the EYFS learning goals. According to the Australian educator Zoltan Kodaly, literacy through singing encourages learning of a variety of subjects such as mathematics (Burnard, & Murphy, 2017). Also, a pentatonic scale. Example of a pentatonic scale is the interactive whiteboard. The interactive whiteboard not only allows one to know which song is singing but also it allows an individual to master how such songs are pronounced and hence they easily master the song.

Another primary source is to make the use of soundtracks. Soundtracks focus on the use of music mostly in children movies to convey particular messages and feelings. Singing also requires specific sitting postures for one to express their voices and not to appear as straining firmly (Martin, 2017). One should better be standing with their shoulders wide apart.

Other than the primary sources, there are also secondary sources which promote the leaning of music. They include getting students excited about the piece of literature. Excitement results from using things such as exciting songs and or even use of idols such movie idols and musicians that the audience likes. Encouraging participation during the study is also important. Students are more likely to remain active, and to grasps information more quickly (McMahon, 2017). Other than encouraging participation, the teacher should also allow the remaining individuals to study the materials covering the history of Australia. The instructor should also listen and give preference to the Australian folk and music from a variety of social-cultural and historical contexts. The students may also participate and remain active in the environment beyond the classroom.

Instrumentation

Piccolo

Flute 1

Flute 2

Oboe ½

Bassoon ½ et cetera.

Other important factors to consider is taking a deeper dive into the program related to the piece of literature under study. Playing with sounds as sounds track is also important since it reinforces understanding (Lebler, 2015). Tonal variation and style variation is also used in depicting several themes and mood within the piece of literature. It also helps indulge the audience into the piece of literature and hence promoting their understanding.

Guitar

For one to understand tab, basic guitar knowledge is a must. The guitar’s neck is a protruding extension of the body. Frets are metal stuff that is found alongside the neck of the guitar and run parallel to each other and at a perpendicular angle to those strings from the topmost end to the bottom end of the neck. In most cases guitar can have 22 to about 24 frets, this depends on the type of music played and the type of the guitar. Earlier mentioned is the strings that align or run the distance of the neck. Usually, a guitar contains six strings, but special styles like folk guitars contain twelve strings while others like metal guitars use seven strings.

Guitarists play notes by putting their fingers in the fret positions, which is the gap between across the tab -sheet page. Tab –sheet is a leaf of paper whereby a tablature is recorded. The six lines represent the six strings in a guitar. Also, those lines are labelled with numbers showing which the fret to press down (Shannona et al., 2016). Guitar tablature also has a unique notation for the chords. These are denoted as lead sheet. Lead sheet functionality depends on a short music hand, to show a song through a solo jotted melody together with symbols. Chord charts is another form of chording in tablature. Difference between lead sheets and chord charts is that the latter makes use of some standard notation in music to depict the way the long chord can be played.

Guitar tablature is available in both guitar tutorial volumes and tablature guitar websites, but the most utilized is the guitar tutorial volumes. A bigger percentage of the websites permits the users to upload tablature in their websites, the reason behind it is since the tablature utilizes the line and the numbers structure to give an overall presentation of music to be played on the guitar neck. It is written with ease on a computers word processor program which explains why it can be uploaded with ease. In most scenarios with the websites, learners (musicians) edit and create guitar tabs and other guitarists permitted to rate them based on importance and accuracy. The first step to creating a tab by users is, listening to the recorded work, followed by decreasing the musical tab by analysing the key plus the chord structure of the planning. With most current songs having a common chord structure, it becomes easy to determine the chord structures. For instance, blues and rock most of them use chord progression of I, IV, V.

References

Burnard, P., & Murphy, R. (2017). Teaching music creatively. Taylor & Francis.

Lebler, D. (2015). The BoPMAT: Bachelor of Music Popular Music Program. In Assessment in Music Education: from Policy to Practice (pp. 221-235). Springer, Cham.

Martin, C. B. (2017). master of music composition folio.

McMahon, K. R. (2017). Portfolio Careers in the Music Industry. Australian Musicians Interviewed: Career Investigation Report. GRIN Verlag.

Shannona, A. G., Galeazzi, M., & Krawczyk-Bernotas, Z. (2016). GRADUATE FOLIO PRESENTATIONS IN THE CREATIVE & PERFORMING ARTS. INTERNATIONAL JOURNAL OF RESEARCH IN EDUCATION METHODOLOGY7(3), 1158-1175.

Research Proposal: How Israel government can increase its national green building practices by drawing lessons from Germany

Problem Statement

            Green building practice refers to the practice of making structures and utilizing a process that does minimal damage to the surrounding ecosystem. In so doing, the contractors ensure that the process they engage in lay more emphasis on conservation of natural resources like water, energy, and land as a means of preserving one’s health and wellbeing (Henderson, 2012). In Germany, serious efforts have been instituted over the past twenty years by the various architectural companies to develop ecological-friendly buildings that help in preserving the culture as well as the ecology of the country. For instance, German architectural firms such as Stuttgart’s Behnisch Architekten, Munich’s Allmann Sattler Wappner, Berlin’s Sauerbruch & Hutton, Hamburg’s Hadi Teherani, and Schneider + Schumacher have developed the eco-friendly building to the admiration of the locals as well as the international community (Porter & Linde, 2014). Furthermore, many artists from Germany have continuously been advocating for the adoption of green buildings in other major cities of the world.

            Green building strategies have however not been prominently utilized among Israel’s notable populations. The most recognizable effort in Israel to adopt and use green buildings was in 2011 when the Israeli administration through the Ministry of Environment Protection and Standard Institute contemplated instituting notable changes in the existing policies to ensure that green building practices got encouraged. The government then tasked the ministry with the creation of accurate standards aimed at adopting green building practices in the country as argued by Shaviv & Pushkar (2014). The new rules got regarded as useful and comprised of principles that could be updated by architectures in their fields of operation to improving the green building practices in the Middle-East state. Though there exist some standards meant to encourage green buildings in Israel, the rate of adoption of these practices has been slow compared to Germany. The 2005 standard (IS-5281) did not achieve much in encouraging the practices as the administration did not put not put much effort towards seeing it succeed (Shaviv & Pushkar, 2014). The lack of support by the Israeli government towards green building practices can be said to have led to a political problem in the efforts aimed at making Israel green. Unlike Israel, German architectures which have a bias towards eco-friendly buildings get support from the government in the form of funds and legislation. According to Shrestha & Technische Universität Berlin (2016), Germany’s federal and local governments provide funds for the construction of environmental-friendly buildings and offer support in terms of personnel to mark the location as well as determine the sustainability of the constructed roads and railways.

            Fuel combustion in Israel accounts for about 76% of greenhouse gas emissions where 56% originate from energy and electricity production while 20% represent vehicle emissions according to Kottmeier (2016). Carbon dioxide is the central source of greenhouse gas accounting for about 87% followed by methane which is emitted during various agricultural and industrial activities in the country. There is, therefore, a strong indication that human activities cause global warming. Political goodwill and support can be utilized in formulating and implementing laws that can encourage the adoption of the green building practices. The Israeli government can thus learn from the actions of the Germany government when it comes to supporting green building practices. A review of past studies on the subject revealed that most of them do not base their research on Germany, which is the green leader in Europe and by extension the world. This is the essence of this research which will seek to find out how the Israeli government can learn from green building strategies encouraged in Germany.

State of Knowledge

            As it stands, not many individuals in Israel have full knowledge on how green building practices can impact their lives. The Israeli government is partly to blame for this inadequacy of expertise among the Israelites. Despite the previous regimes putting in place standards to encourage green buildings, the current system has not done much to ensure the practice continues. One of the ways in which this can be done is through proper enforcement of the existing standards and also sending a section of its people to other countries that have done well in green building (like Germany) to learn from them. The research will thus help in exploring ways in which the Israeli political agencies can enhance the implementation of green practices in the country by drawing lessons from Germany. As a first world country, Germany has put in place various policies and standards that promote green building practices.  The study is essential in linking political influence and the causes of greenhouse gases and how green building can help in solving the problems related to environmental degradation (Tal, 2013). Reports from developed countries show that politics play an essential role in ensuring that laws get enacted. The research will explore how parliament through the request of the Israeli government can pass laws that set standards meant to ensure that green building practices get implemented in the country (Helmut & Lutz, 2008).

Research Question

How are the current ‘Green Building’ policies in Israel, or lack thereof, affecting its national implementation?

Method

            A qualitative research methodology will be used for the research. Questionnaires will be used to collect primary data regarding the role of the Israeli government in enhancing green building practices. Also, the questionnaire will include questions to do with the lessons Israel can learn from Germany concerning green building practices. The naturalistic design will be used in the studying of the global situations on green building practices with specific reference to Germany. The method will be non-controlled and non-manipulative to be open to other factors as recommended by Franklin (2012). Collected data will then be analyzed and interpreted. The findings will be presented in tables, line graphs, pie charts and bar graphs. Conclusions and recommendations will then be drawn from the analyzed, interpreted and presented data. The study will use and apply the tenets of the environmental political theory. According to Brown (2016), the theory makes sentient attempts to consider the environmental concerns and how global actors have managed to address them. The theory argues that most governments have attempted to lay down strategies aimed at eliminating hazards to the environment, but not all have succeeded in doing so. The approach will be applicable in the case of Israeli government trying to adopt green building strategies.

Data Source

            The researcher will make use of both primary and secondary data. Primary data will be conducted using questionnaire filled online by respondents. Secondary sources will include data from the Ministry of Environment of the two countries. Also, the report presented by different organizations on green building practices will be analyzed to assess whether there are additional factors that can be utilized or emulated from Germany to help in increasing green building practices in Israel. Also, the researcher will make use of different political science databases to get information on green building practices.

References

Brown, M.B. (2016). “Three approaches to environmental political theory.” Contemporary Political Theory, 15(3), e21–e28

Franklin, M. (2012). Understanding research: coping with the quantitative-qualitative         divide. London/New York. Routledge.

Henderson, H. (2012). Becoming a green building professional. Hoboken, N.J: Wiley.

Helmut, W. & Lutz, M. (2008). “German Climate Change Policy: a success story with some flaws.” The Journal of Environment and Development. 17: 356–378.

Kottmeier, C. et al., (2016). “New perspectives on interdisciplinary earth science at the Dead

Sea: The DESERVE project.” Science of the Total Environment, 544: 1045–1058.             https://doi.org/10.1016/j.scitotenv.2015.12.003

Porter, M.E., & Lide, V. (2014). “Green and competitive: ending the stalemate.” In Wubben, E. M. The dynamics of the eco-efficient economy: environmental regulation and competitive advantage (4th Ed.). Cheltenham, United Kingdom: Edward Elgar Publishing.

Tal, A., Leon-Zchout, S., Greenspan, I., Oshry, L., & Akov, S. (2013). “Israel’s environmental movement: strategic challenges.” Environmental Politics, 22 (5), 779–791.

Shaviv, E. & Pushkar, S. (2014). “Green Building Standards -visualization of the building as layers according to lifetime expectancy.” Energy Procedia, 57, 1696-1705

Shrestha, S., & Technische Universität Berlin. (2016). Comparison of energy efficient and green buildings: Technological and policy aspects with case studies from Europe, the USA, India and Nepal. Berli: Technische Uni Berlin.

 

THE US ELECTION OF 1968

Political campaigns significantly rely on the historical and contemporary events. The presidential candidates constructed their campaigns using several emerging issues at the time. In 1967, the Democratic senator Eugene McCarthy questioned President Johnson on his Vietnam War policies.[1] This moment was significant in the upcoming 1968 election. For instance, the Vietnam War and the consequent antiwar movement shaped the political campaign adverts. Richard M. Nixon, who was the Republican candidate, constructed his campaign to promise that he will ensure the conclusion of the Vietnam War, the restoration of law and order, and the re-establishment of the traditional American ideals. Nixon’s campaign used the unrest caused by the Vietnam War and the civil rights movement to promise an end to the riots and a return to stability in the country.

1968 was a tumultuous year in American history. There was a significant lack of advancement in the Vietnam War. Within five years, American troops in Vietnam had increased from 16,000 to over 500,000.[2] The death toll of the American forces steadily increased hence resulting in rising unpopularity of the war. The “living-room war” received nightly coverage throughout the country thus igniting an antiwar movement. On March 31, President Johnson announced that he would not seek reelection. Additionally, the slow progress of civil rights implementation caused unrest among the African Americans.[3] There was an increase in sporadic violence and crime in various cities. On April 4, the assassination of Martin Luther King Jr. after just four days triggered riots in over 100 cities in the country.

The assassination of Robert F. Kennedy occurred in June after he won the California Primary. The assassinations influenced the perception of the population.[4] Many Americans believed that the social fabric of the country was in shambles. Markedly, Vice President Hubert Humphrey became the Democratic nominee even though he had not won any primaries. Factionalism threatened the unity of the Democratic Party. Consequently, the Democratic convention in Chicago was chaotic due to the aggressive altercations between the police and antiwar protestors.

The Republicans nominated Nixon who branded himself as the voice of the “silent majority” of law-abiding citizens.[5] The campaign targeted the middle-class white Americans who supported the status quo rather than the radical movements that occurred at the time. He claimed to speak for them in the middle of the social upheaval due to the war. Nixon pledged to restore the country’s stability to what it used to be during the rule of Eisenhower. The slogan for his campaign was “vote like your whole world depended on it.” The statement gave the illusion that the country is in deep crisis that only Nixon can salvage. The contemporary issues, especially the Vietnam War and the civil rights movement played a pivotal role in molding the structure of the campaign advertisements.[6]

Eugene Jones, a filmmaker, was the creator of Nixon’s campaign advertisement. The adverts entailed the use of montages of still photographs and jarring music.[7] The campaign team portrayed an image that showed that the country is out of control. The pictures illustrated an increase in crime rates and violence all over the country. The campaign clearly associated the Democratic administration to these challenges. Since Humphrey was part of the government, the adverts directly linked him to the problems. Notably, an advert contained purposefully orchestrated images of a smiling Humphrey next to photographs of the war in Vietnam and the turbulent Democratic convention. The Nixon campaign adverts aimed at insinuating that Humphrey was either the root of these problems or was indifferent towards them.

Jones used the upheavals that resulted from the existence of the Vietnam War and the increase in the involvement of American troops.[8] Consequently, the controversial nature of some of the adverts determined the understanding of the events by various sections of the public. For instance, the majority of the white population responded positively to the idea of restoring law and order and American values. The surge of violence due to riots during the civil rights movement made more Americans embrace the notion of stability.[9] Additionally, the rising death toll of the American troops in the Vietnam War decreased the popularity of the Johnson administration that Humphrey was the vice president.[10] The carefully structured campaigns emphasized the notion that Nixon would provide the much-needed change that Humphrey and the current government had failed to deliver.

Political campaigns play a major role in how the society assesses contemporary events. Political candidates analyze the perceptions of the public towards the events to determine the direction that their campaign advertisements will take. There is interdependence between the public’s understanding of an issue and the political campaigns. For instance, the unpopularity of the Vietnam War was already increasing even before the campaign intensified. However, the broadcasting of Nixon campaign adverts made a larger section of the population blame the challenges on Humphrey since he was part of the ruling administration.

 

Bibliography

Hall, Jacquelyn. “The Long Civil Rights Movement and the Political Uses of the Past.” Journal of American History, 91(4), 1233 (2005):  http://dx.doi.org/10.2307/3660172

Latham, Michael. “Redirecting the revolution? The USA and the failure of nation-building in South Vietnam.” Third World Quarterly, 27(1), 27-41 (2006): http://dx.doi.org/10.1080/01436590500368743

“The election of 1968.” Khan Academy, 2018. Web. 5 Apr. 2018.

“The Living Room Candidate – Commercials – 1968 – Vietnam.” Livingroomcandidate.org, 2016. Web. 5 Apr. 2018.

            [1] “The election of 1968.” Khan Academy, 2018. Web. 5 Apr. 2018.

            [2] “The Living Room Candidate – Commercials – 1968 – Vietnam.” Livingroomcandidate.org, 2016. Web. 5 Apr. 2018.

            [3] Hall, Jacquelyn. “The Long Civil Rights Movement and the Political Uses of the Past.” Journal Of American History, 91(4), 1233 (2005):  http://dx.doi.org/10.2307/3660172

            [4] “The Living Room Candidate – Commercials – 1968 – Vietnam.” Livingroomcandidate.org, 2016. Web. 5 Apr. 2018.

            [5] “The election of 1968.” Khan Academy, 2018. Web. 5 Apr. 2018.

 

            [6] Latham, Michael. “Redirecting the revolution? The USA and the failure of nation-building in South Vietnam.” Third World Quarterly, 27(1), 27-41 (2006): http://dx.doi.org/10.1080/01436590500368743

            [7] “The Living Room Candidate – Commercials – 1968 – Vietnam.” Livingroomcandidate.org, 2016. Web. 5 Apr. 2018.

            [8] Latham, Michael. “Redirecting the revolution? The USA and the failure of nation-building in South Vietnam.” Third World Quarterly, 27(1), 27-41 (2006): http://dx.doi.org/10.1080/01436590500368743

 

            [9] Hall, Jacquelyn. “The Long Civil Rights Movement and the Political Uses of the Past.” Journal Of American History, 91(4), 1233 (2005):  http://dx.doi.org/10.2307/3660172

            [10] “The election of 1968.” Khan Academy, 2018. Web. 5 Apr. 2018.

 

THE IMPACTS OF BREXIT IN THE UK’S GLOBAL ECONOMY COMPETITIVENESS

 

THE IMPACTS OF BREXIT IN THE UK’S GLOBAL ECONOMY COMPETITIVENESS

 

The United Kingdom has been hailed as a haven for starting business and different investment ventures, but this stands to be significantly affected by the current vote to exit the European Union with the move severing the free trade ties between the UK and EU’s economies. As a trading bloc, the EU has helped translate benefits through access to high-quality goods and services at lower expenses. Reduced cost of products, services and labor movement has seen increased sales and profits. Increase trade has in response spearheaded higher productivity, better incomes, and living standards (Finck, 2017). The Brexit has significantly aggravated the economic well-being of the United Kingdom. Increased instability is predicted to negatively impact on the consumption, foreign trade and even reduction in investments. The exit from the Single Market is anticipated to put strains on the economy due to increased costs of business and movement of labor. The British pound fell to the lowest level in three decades after the exit vote with inflation expected to rise consequently.

With the UK exporting almost half of the total global exports it is supposed to sustain losses worth billions of euros if a new trade agreement with EU is not in place when they leave the single market. As a result, the country’s competitiveness in the EU and global markets is anticipated to take a plunge with increased operational tariffs translating to low profits. The move also digs into the country’s GDP with implications taking a share between 1.5 to 3.9% while 8.8% lowers the exports. The rate of unemployment is, besides expected to rise with estimates recording an increase to 6.5% attributed to the recession (PATHMARAJAH, 2016). The numbers of immigrants considering jobs outside the UK has dramatically increased and could compromise the nation’s labor competitiveness, with huge gaps expected to add stress in demand for skilled workers and suppliers. This will profoundly lower the productivity of its systems.

Besides, half of UK’s foreign investments come from the rest of the European Union with trade relations after Brexit expected to decrease investments’ prospects in the UK significantly. Analysts predict a 22% decrease in the foreign direct investments (FDI) following the exit with lower trade owing to greater obstructions to trade. Besides losses in the United Kingdom, the rest of European Union members will also feel the pinch with estimated combined losses amounting to between 12 and 28 billion euros. Countries deeply hit by the Brexit trade the most with the UK, such as Ireland, Netherlands, and Belgium (Ponzano, 2016). After the Brexit, the UK is set to miss out on trade deals and future market integration within the EU as well as any future reductions in intra-EU trade costs which have been declining at a rate of 40% faster compared to OECD (Organization for Economic Cooperation and Development) countries.

The Brexit will enable the UK to control and prohibit the free flow of immigrants from the EU, disregards the EU guidelines when taxing and even do away with EU membership fees and budgetary contributions (KOCH, 2017). However, choosing to remain in the Single Market would require the UK to make payments to the EU as does Norway, a member of European Economic Area. Furthermore, the European Union needs members in the Single Market allow free flow of labor even if they are not members of European Union’s Customs Union like Norway and Switzerland. Though the UK could adopt Norway’s trade relations, significant changes in the market would not strengthen its competitiveness as an outside member. This is the ‘soft Brexit’ hypothesis, and most trade relations would be maintained with no dire implications on the cost of doing business. In the ‘hard Brexit’ analogy trade would be governed by World Trade Organization guidelines and would impose higher trade costs (Chalmers, 2017). It would, however, save on much of its present financial obligations to the EU, being outside the EEA. Included are public finance components excluding those made to higher learning institutions, firms and non-governmental bodies, sponsored by the agricultural grants in the EU’s Common Agricultural Policy.

Income drops by 1.28% based on the present and predicted dynamics in non-tariff barriers in the former while the losses rise to 2.61% in the latter. The exit of the United Kingdom puts it in a position where it can liberalize its import policies with protagonists asserting the abolition of all tariffs on imports into the UK would reflect on the low pricing of imported goods (de Witte, 2017). This, however, remains to be seen with the relatively low political motivation for such policy changes. Nevertheless, trade can be robust by increasing competition but cuts down on supernormal profits while fostering efficiency. Such market operations promote innovation and even the quality of good and services offered. Also, if the UK joined another market, such as the EFTA (European Free Trade Association), the trading outcomes would fall by a quarter by trading with countries in the European economies. Besides, joining EFTA would bring down the UK’s incomes by points ranging from 6.3 and 9.5%. This undermines its economic credibility taking into account that UK’s GDP skyrocketed between 8.6 and 10.6 % when in the European Union.

With no obligations to its largest trading partner, the United Kingdom could pursue trade relations with other countries such as the United States, China, India or even other emerging economies. These trade partnership, however, do not come close to offset the United Kingdom’s plummeting competitiveness (Fugazzi, 2015). This owed to the fact that almost half of the UK’s trade transactions are with member countries within the EU. With an overall GDP fall estimated at between 26 to 55 billion euros, stable and more formidable trade partnership could take years for a turnaround.

The economic repercussions of the UK parting ways with its largest trading partner can only be assessed by analyzing the policies that the country puts into action to counter the financial imbalance already at play. Reduced trading capabilities will be synonymous with the exit as the European bloc was the preferred destination for most of its exports. The workforce relations will also affect how goods and services are delivered with the United Kingdom taking a strongly defiant stand on imposing stronger border controls against EU citizens, a fact not well received in the Single Market (HAQUE, 2017). How the nation prefers to trade will also determine the kind of investment and partnership developed besides the motivations underlying the associations.

 

 

 

 

 

 

 

 

 

 

 

References

Chalmers, D. (2017). LSE Law Brexit Special #4: Trade after Brexit. SSRN Electronic Journal.

Dallago, B. (2016). The future of European integration and Brexit: Is Brexit only Brexit?. Acta Oeconomica, 66(s1), pp.111-136.

de Witte, F. (2017). LSE Law Brexit Special #1: Negotiating Brexit. SSRN Electronic Journal.

Eliot, G. (2016). The mill on the Floss. New York: Open Road Integrated Media.

Finck, M. (2017). LSE Law Brexit Special #3: Brexit and the European Institutions. SSRN Electronic Journal.

Fugazzi, S. (2015). Brexit?. [S.l.]: ABC Economics.

HAQUE, F. (2017). BREXIT. [S.l.]: ERLY STAGE STUDIOS LTD.

KOCH, I. (2017). What’s in a vote? Brexit beyond culture wars. American Ethnologist, 44(2), pp.225-230.

PATHMARAJAH, S. (2016). BREXIT. [S.l.]: NEW GENERATION PUBLISHING.

Ponzano, P. (2016). Borderless Debate: After Brexit, What Will Happen? After Brexit, What Should the European Union Do?. The Federalist Debate, 29(3).