Clausewitz in the 21st Century

Clausewitz lived in a period where fights were battled in sections and lines, with warriors utilizing black powder rifles and strong fired gun; when states were the selective entertainers in war; when innovative change happened over decades, if not hundreds of years. What significance could his work along these lines have for the key issues of the 21st century? Presentation Clausewitz was not a cookbook essayist. He was not searching for rigid principles for directing war, which he eschews.Indeed, Clausewitzian hypotheses expounded at various timeframes are in close combination with the pervasive political, key, and military setting, which is totally consonant with Clausewitz’s unique origination of his own work: ‘Theory ought to be study, not precept [†¦] It is a logical examination prompting a nearby colleague with the subject; applied to encounter †for our situation, to military history †it prompts exhaustive commonality with it.The closer it goes to th at objective, the more it continues from the target type of a science to an abstract type of an ability, the more compelling it will demonstrate in regions where the idea of the case concedes no mediator however ability. ’ ‘Theory is intended to teach the psyche of things to come authority, or, all the more precisely, to direct him in his self-instruction, not to go with him to the combat zone. ’ If ‘the ridiculous contrast among hypothesis and practice’ is to be finished, at that point the correspondence among hypothesis and practice infers the correspondence between the military administrator and military thinker.Therefore, ‘self-education’ is significant and helpful to the military mastermind as well. He should not be limited by a solitary hypothesis of war however with the way to build up his own thoughts (target information on war), fuelled by his ability (emotional limit and application). The marvels of war are more various than an y other time in recent memory: from psychological warfare to between state war, from data war to riots in rustic zones, from air strikes to intifada. Free systems of restricted wars have supplanted the desire for an atomic end of the world that portrayed the Cold War.The contrasts and logical inconsistencies between the different ends and relating examinations with respect to a key circumstance are nevertheless an impression of the assortment of military clashes and the decent variety of points of view from which these contentions are watched. These viewpoints rely upon time, culture, and political setting. This wonder has been dissected through the idea of vital culture, that is ‘a particular and enduring allowance of faith based expectations, qualities and propensities with respect to the danger and utilization of power, which have their foundations in such major impacts as the topographical setting, history and political culture’.States (e. g. Americans, Europeans, C hinese, Iranians, Indians and so on ) will in general have alternate points of view on vital issues, and the purpose behind these divergences presumably goes past the guard of transient interests. The amazingly heterogeneous circumstance of the marvels of war is investigated from totally different focal points of various key societies, and subsequently makes states’ speculations of war hard to evaluate. In addition, it is hard to approve the teachings that mirror these various speculations by the utilization of instances of operational achievement or failure.Therefore, the requirement for a hypothesis of-speculations of war stays legitimate. An overall hypothesis of war will consider the impact of the cooperation between the mastermind and his object and can shape the system required to dissect the vital discussion. Clausewitz in this way keeps on staying applicable to break down vital issues of the 21st century as he had built up a hypothesis about the hypothesis of war. Exp loration ApproachClausewitz perceived that Napoleon had overextended himself and the hypothetical centrality that a reliable, single military methodology could have diverse recorded results. In his own acknowledgment †apparent in his note of 1827 †that any hypothesis of war needed to oblige two kinds of war: war to oust the foe; and war that is the premise of exchange with him. Four essential differences are stressed between the early and later Clausewitz since they stay integral to contemporary discussions about his work: (1) The power of military power versus the supremacy of governmental issues. 2) Existential fighting, or rather fighting identified with one’s own character, which drew in Clausewitz most emphatically in his initial years, as against the instrumental perspective on war that wins in his later work. (3) The quest for military accomplishment through boundless savagery exemplifying ‘the guideline of destruction’, versus the power of const rained war and the constraint of brutality in war, which lingered progressively enormous in Clausewitz’s later years. (4) The power of protection as the more grounded type of war, versus the guarantee of conclusive outcomes that was typified in the seizure of hostile initiative.It isn't the aim or motivation behind this paper to sum up Clausewitz’s works, given its extension, or to challenge the attestations of explicit enemy of Clausewitz essayists, for example, Martin van Crevald, John Keegan or even Alvin and Heidi Toffler. The paper will rather feature the appearing to be unbounded-ness of war (or furnished clash) and viciousness in the twenty-first century, and propose a procedure of regulation of war and savagery. This will relate later Clausewitz’s ideas of war and legislative issues to our present reality. At the start, I will give an examination of Clausewitz’s idea of the idea of war.Additionally, given the exploration question’s suggesti on that Clausewitz ought to be marooned because of his absence of respect for ‘non-state actors’ and that his works were in a period of moderate ‘technological change’, I will likewise exhibit that Clausewitz was very much aware of the impact of non-state entertainers and their capacity to take up arms; and his considerations has proceeded with pertinence presently of fast innovative changes. The Nature of War For Clausewitz, war was compared to a chameleon, taking into consideration changes to its appearance, however recommending that its fundamental nature remains unchanged.The character of war has positively changed or transformed since his time. His faultfinders contend that a few changes can adjust war’s very nature, and the idea of war today is fundamentally not quite the same as the idea of war at that point, the period of Napoleon. As it were, the progressions are more key than can just be accounted by moving qualities. The latest English int erpretation of the content, by Michael Howard and Peter Parat, renders its initial sentence along these lines: ‘War is in excess of a genuine chameleon that somewhat adjusts its attributes to the given case. As an absolute wonder its prevailing inclinations consistently make war an astounding trinity. Plainly, a chameleon stays a chameleon whatever shading it embraces for the present. The critical two words in the interpretation are ‘more than’, which infer that the conditions of war can make war change more than its attributes: War at the end of the day isn't care for a chameleon. In any case, this interpretation didn't catch the subtlety of Clausewitz’s unique: ‘Der Krieg ist likewise nicht nu rein wahres Chamaleon, weil er in jedem konkreten Fall seine Natur etwas andert, sondern er ist auch seinem Gesamterscheinungen nach, in Beziehung auf bite the dust in ihm herrschenden Tendenzen, eine wunderliche Dreifaltigkeit’.The suggestion here is t hat war may in fact be a chameleon, in that it changes its temperament somewhat in every individual case (its ‘character’), however not its inclination by and large, which is comprised of the ‘trinity’ (tended to later). The interpretation along these lines peruses: ‘War isn't just a genuine chameleon, since it changes its temperament somewhat in each solid case, yet it likewise, in it is by and large appearance, according to its innate inclinations, a wondrous trinity’. The Primacy of Policy and the ‘Trinity’ War is an instrument of strategy. ’ It ‘is just a continuation of political intercourse, with the expansion of other means’. Clausewtiz’s axiom on the connection among war and strategy was presently being excused not on the grounds that war had no utility but since it is being pursued for reasons that are not political or strategy driven. Pundits contend that Clausewitz no longer have a spot in the current vital and security contemplates discusses, where war was not, at this point the region of military yet additionally of non-state actors.The question was whether methodology, customarily characterized, keeps on being the most ideal perspective on was, revealingly, not, at this point even called war, however furnished clash. Clausewitz comprehended a network as having its own political and social personality, regardless of whether it needed statehood. Such an understanding is consonant with Clausewitz’s own enthusiasm for wars before 1648, where he explicitly connected the shortcomings of states to ‘exceptional appearances in the specialty of war’.In his survey of the historical backdrop of war, he depicted ‘the semibarbarous Tartars, the republics of times long past, the primitive masters and exchanging urban communities of the Middle Ages, eighteenth-century rulers and the rulers and people groups of the nineteenth-century’ as ‘all lead ing war in their own specific manner, utilizing various techniques and seeking after various aims’. Regardless of this inconstancy, Clausewitz focuses on that war is every one of these cases stays a continuation of their arrangement by different methods. In doing as such, be that as it may, he smothers the contrast between the arrangements of states and the aims of different networks which wage war.Therefore, it bodes well to enhance the supremacy of strategy as a general classification with the alliance of belligerents to a warring network. In the event that the networks are states, we can talk about legislative issues in the advanced sense; in the event that they are e

What Principles of Time and Stress Management are Violated by Chet Assignment - 1

What Principles of Time and Stress Management are Violated by Chet - Assignment Example Chet is progressively centered around how viable he was during that day overlooking that a compelling director ought to have results for what he has done during the day. In fact he is a chief who has contemplated his work propensities, an exceptionally significant advance to decide his qualities and shortcomings yet his work propensities study is for the most part dependent on time the executives and not the outcomes. As a director, he ought to be increasingly worried about performing top-level administration capacities which will incorporate long haul choices arranging and representative different obligations to center and first line the board. The structure of the executives in Chet’s organization has a significant task to carry out in his inadequacies, there doesn’t appear to be a characterized center level and administrative branch this is seen when the pressmen report straightforwardly to him as opposed to answering to a foreman Carl Jung in his attribute hypothesis arranges individuals into type An and type B according to their capacity to deal with pressure. Type A characters when in an administrative post tend to not believe their subordinates to deal with anything so they do everything themselves. This prompts them being focused on the grounds that they have a lot of work to deal with at the same time. Chet, for this situation, is a sort A character. The second part of his character is that he foresees pressure and doesn't have a system to deal with them he rather faces them head-on. This expands his degree of stress and contrarily influences his capacity to make the sound judgment on what’s significant and what’s critical. Chet should, for this situation, embrace type B character. This character when in an administration present concurring on Carl Jung is one who is acceptable at assigning obligations to his subordinates, he concentrates just on significant parts of the establishment leaving the rest to be arranged by center or first line the board. He should attempt however much as could reasonably be expected to assign the unimportant obligations to different workers.

Comparison and Contrast Essay Topics Examples

Comparison and Contrast Essay Topics ExamplesDue to the fact that almost every student in the world is required to take comparison and contrast essay topics samples on their college or university applications, the topics that are normally used as comparison and contrast essays are now becoming more commonplace. Therefore, when you are looking for subject material for your essays, it is very important to understand the various types of topics that you can use as the basis for your essay.The first topic is the 'student.' This is a broad category that can include anyone that will be taking a class with you; it could also include any student that will be taking an exam with you. The main purpose of this topic is to make sure that the student that you are talking about will be able to grasp what you are trying to get across to them.Another aspect of subject matter that can be used to make a comparison and contrast essay is the diversity of the individuals in the group. If you are going to write about a group of students that all come from a similar high school and all attend the same college then you will need to have a reason why each person in the group is different from each other. Therefore, if you are going to write about the college students then you will want to mention something about the colleges that the group comes from, and the similarities between the students in that group.As a comparison and contrast essay topics examples, the most common type of subject matter that people take advantage of is ethnicity. The difference between ethnicity and culture is that ethnicity refers to a group of people that share the same cultural background. The culture is simply a set of practices and beliefs that are believed to be valid and accepted in society. However, ethnicity refers to a cultural background that is different from the others.The other comparison and contrast essay topics examples that are frequently used are religion and belief. Since religion has becom e such a big part ofeveryones life that is why it is often a good topic to use in comparison and contrast essays. The fact that religion is so pervasive throughout society is why it is a very good comparison and contrast essay topic that can be used to drive a point home to your reader.Finally, the next comparison and contrast essay topics examples that are commonly used are gender. Gender refers to the way that individuals treat one another. This is often more obvious when it comes to relationships where females are considered to be more nurturing than males, and males are considered to be more aggressive.Because these two categories are often referred to as 'differences' there is a tendency for many writers to assume that they will need to use both the 'subject'point' categories when writing a comparison and contrast essay topics. Therefore, many students often ignore this and stick to the 'point' category when they should be using the 'subject' category.When writing your essay, y ou must be aware of the differences that can be listed as 'differences' and the similarities that can be listed as 'similarities.' Understanding how these two different categories relate to one another will help you more accurately create your comparison and contrast essay topics.

Psychology, The Scientific Study Of The Mind - 1476 Words

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Americas Family Planning Programs - 1534 Words

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Cell Phone Evolution Good and Bad - 1252 Words

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Assessment Of The Cardiac System Of Patientâ€Myassignmenthelp.Com

Question: Discuss About The Assessment Of The Cardiac System Of Patient? Answer: Introducation The patient in the present case study analysis is Mr Paul Peters who had been admitted to the cardiac unit with the NSTEMI (Non-ST segment elevation myocardial infarction). From the assessment of his current condition, it is noted that he is in unstable condition and the ECG shows abnormality in heart rhythm. The correct vital statistics are T36.5, HR 88, RR 18, BP 110/70, while the oxygen saturation is 96%. His age is 50 and weighs 88 kgs. He is a factory worker and a regular smoker, with a sedentary lifestyle. His level is education is low. The present section would detail the assessments to be taken for the patient. Assessment of the cardiac system of the patient would be most crucial since the patient has abnormal heart rhythm and he is in unstable condition. The cardiac examination would follow the stages of inspection, palpation and auscultation. The Business would need to be positioned in the supine position and torso and neck would be exposed completely. The general inspection would include his status of comfort, an abnormal movement like head bobbing. The hands are to be inspected for skin turgor and temperature. It is imperative that a nurse is as objective as possible while collecting patient data. Reporting the findings is very much essential, and the charting of the results in a clear manner is also needed (Donahue 2011). The second assessment would be a central nervous system that would involve the assessment of the motor and the sensory responses of the patient. The purpose would be the determination of impairment of nervous system. The examination to be conducted is Mental Status Examination. This would involve the assessment of consciousness using the Glasgow Coma Scale. A Mini Mental State (MMSE) examination would be pivotal. Muscle strength is to be examined through the MRC (Medical Research Council) scale. The patient is to be assessed for muscle tone and rigidity. Any abnormal movement, such as seizures and fasciculations are to be assessed along with the above mentioned assessments (Watkins, Whisman and Booker 2016). The consecutive assessments would be of the abdomen, respiratory system and the renal system. Abdomen assessment would involve inspection, auscultation, palpation and percussion of the abdomen. The inspection would include an examination of the shape of the abdomen, abdominal masses, skin abnormalities, and abdomen wall movement with respiration. Auscultation would detect altered bowel sounds, vascular bruits or rubs. Atherosclerosis is the common cause of alteration of arterial blood flow. Palpation refers to the abdomen examination for crepitus of the abdominal wall, for any abdominal masses or abdominal tenderness (Lewis et al. 2016) . Assessment of the renal system, that is, kidneys and bladder are commonly performed in combination with an abdominal assessment. Auscultation is performed before percussion and palpation because these activities can lead to vague abdominal vascular sounds and enhanced bowel sounds. Assessment elements would include frequent urination, difficulty in urination and hematuria. A urine specimen is to be checked for infection, and odour and colour. The bladder is to be palpated for any signs of distention of the bladder. Assessment of the respiratory system would mainly focus on the evaluation of respiratory distress. Major evidence of distress are a cough and audible wheezing. Body temperature and respiratory rate are to be checked regularly (Considine and Currey 2015). Since the patient is a regular smoker and drinker, his social background is also to be assessed before outlining the care plan. The regular nutritional diet of the patient is to be assessed. It is important to know whether the patient had suffered loss or increase in weight in the recent past. The Patient Centered Assessment Method (PCAM) can be the appropriate tool for assessing the complexity of the patient through examination of the health determinants. The tool assesses the lifestyle behaviour of the patient, the mental well being and the health literacy. The social environment is also to be assessed. The members of the family who can provide in depth information about the patient is to be ascertained. Intellectual function, depression and mental impairment are to be accurately highlighted. The rationale is that thee behavioural and mental stare of the patient plays a key role in achieving ultimate patient outcomes after the administration of medical interventions (Forbes and Wat t 2015). The prioritization of nursing needs enlists the main areas of focus to be cardiac monitoring, nutritional needs and patient education. Since the patient has abnormal heart rhythm, this would be the centre of nursing care for the patient. Cardiac monitoring refers to the continual monitoring of the patients heart condition with the help of probes placed on the skin of the patients body. The method would be noninvasive and painless. While such monitoring is done, the nurse would play a crucial role in preparing the patient and ensuring that the test is being done accurately. The monitor is to be observed correctly, and accurate results are to be reported. It has been found that the patient is obese, weighing 88 kgs. A review of the dietary intake of the patient is needed. This would include calorie intake, eating habits and type of food consumed. This step would provide the chance of focusing on the importance of balanced diet as per the body needs. An eating plan is to be formulated that would be based upon the patient specifications. A diet would include food items from all basic groups and help in maintaining optimal body functioning. A suitable environment is to be created that would foster the positive eating habit of the patient. Activity level of the patient would also be assessed simultaneously. The patient would be required to carry out physical activity in some form to maintain appropriate body weight (Butcher et al. 2013). The last nursing care aspect would be patient education. It is important that the patient is encouraged to quit smoking and drinking. The nurse to refer the patient to a counsellor who would aid in encouraging the patient to quit these two habits. The role of the nurse in this regard would be to provide emotional support and educate the patient about the adverse impact of alcohol and tobacco on healthcare. Since the literacy level of the patient is low, it is advisable that the nurse communicates in a language that is understandable to laymen. The communication between the two needs to be clear and transparent (Morton et al. 2017). References Butcher, H.K., Bulechek, G.M., Dochterman, J.M.M. and Wagner, C., 2013.Nursing Interventions Classification (NIC)-E-Book. Elsevier Health Sciences. p. 178-180. Considine, J. and Currey, J., 2015. Ensuring a proactive, evidence?based, patient safety approach to patient assessment.Journal of clinical nursing,24(1-2), pp.300-307. Donahue, M.P., 2011. Nursing, the finest art: An illustrated history. Mosby. pp. 258-259. Forbes, H. and Watt, E., 2015.Jarvis's Physical Examination and Health Assessment. Elsevier Health Sciences. p. 327. Lewis, S.L., Bucher, L., Heitkemper, M.M., Harding, M.M., Kwong, J. and Roberts, D., 2016.Medical-Surgical Nursing-E-Book: Assessment and Management of Clinical Problems, Single Volume. Elsevier Health Sciences. Morton, P.G., Fontaine, D., Hudak, C.M. and Gallo, B.M., 2017.Critical care nursing: a holistic approach. Lippincott Williams Wilkins. pp. 25-27. Watkins, T., Whisman, L. and Booker, P., 2016. Nursing assessment of continuous vital sign surveillance to improve patient safety on the medical/surgical unit.Journal of clinical nursing,25(1-2), pp.278-281.

THE FALL OF CONSTANTINOPLE Essays - EastWest Schism,

THE FALL OF CONSTANTINOPLE THE FALL OF CONSTANTINOPLE On Tuesday, May 29 1453 the last bastion on Christianity in the East, Constantinople, fell to the Ottoman Turks led by Sultan Mehmet ( also called Mahomet ). This ended the 1100 year reign of the Byzantium Empire and gave the Ottomans a new capital. One of the most famous churches in history, the Church of Holy Wisdom ( also known as the Hagia Sophia ) was converted into a Mosque. The Turks used a revolutionary weapon in the siege - the cannon. Though the cannon had been in Europe for over a century, this was one of the first times they were used effectively. The Turkish army would not have been able to capture Constantinople had they not had the great cannon with them, had the Byzantinians not been so isolated from the West and had the Turkish soldiers not been so devoted. The cannon was essential in the capture of Constantinople. The walls of the city were massive, and had repulsed invaders since 330 A.D. It would have taken the Turks a lot longer to breech the walls if they did not have the great cannon, and aid from the West would have arrived. The cannon had a long range, and it was used to block access to Constantinople by sea. The very presence of the cannon was very demoralizing for the defenders of the city, "Once more the bells of the churches rang to sound the alarm, but the noise was drowned out by the roar from the great cannon," " the reverberations could be heard for a hundred stadia after it fired."Imagine standing on a wall having cannon balls weighing 12 hundredweight booming towards you. The isolation from the West, the preoccupation of the Western powers with other issues and the clash of the Eastern and Western variations of Christianity helped lead to the fall of Constantinople. The people of Byzantine Empire had some disdain for Western Christianity, and did not want to form a union of churches with the West. The pope (Pius II) was not anxious to send reinforcements until he felt that a true union of the churches had been achieved. Most of the other European powers had their own problems to deal with, and while they wanted to help the citizens of Constantinople they were either to far away (Russia, which became a major Christian center after the fall of Constantinople) or had their own problems to deal with.(there was a revolt in Rome in January 1453) The absolute devotion of the Turkish soldiers to their Sultan and to their God helped Mehmet capture the city. The troops of the sultan were fiercely loyal, especially the fearsome Janissaries,( Christian youths taken from captured villages, and trained for seven years. They were fanatical Muslims and fiercely loyal to the Sultan.) The soldiers believed that God would have a special place in Paradise for those who died attacking the city. "They shall conquer Qostantiniya." "Glory be to the Prince and to the army that achieve it."The sultan offered a fantastic prize to the first man inside the city, this, added to the belief that the soldiers had, that those to fall in battle would rise to Paradise, and the men they killed would be their servants there, had each man whipped into a fanatical fervor, willing to rush the walls, ignoring the Christian missiles. This allowed the Turks to capture the city very quickly, before the West would decided to send aid. As you can see, the three main factors that led the Turks to capture Constantinople were, the devotion of their troops, the isolation of the City ( both physically and spiritually ) and their innovative use of the cannon, a new weapon. This shows us that new weapons have a great power to change the world ( Airplanes, Tanks and Nuclear Missiles all have ) and that fanaticism is a grave danger that society as a whole must try to stop. If men are willing to die to establish fundamentalist states and theocracies how are we to stop them?

Free Essays on Escher

Maurits Cornelius Escher was born on June 17th, 1898 in Leeuwarden, Netherlands. His father was a civil engineer. Escher’s great skill for art and drawing was realized at an early age. This led his father to decide to send him to study at the School of Architecture and Decorative Arts in Haarlem. But, when he was 21 years old, Escher gave up architecture to study in the field of graphic arts. Escher spent most of his life travelling in Europe looking for inspiration for his works. In 1921 he got married and stayed in Rome. This is when his works of art began to show landscapes with impossible perspectives. In the 1930s, Fascism in Italy made life impossible for Escher and his family, so they moved to Switzerland. In 1936, Escher visited the Alhambra in Granada. The Moorish tiling he came across was amazing too him. Escher read and understood Pà ³lya’s paper on the 17 planes of symmetry, even though he didn't understand all of the ideas in the paper. Between 1936 and 19 42 Escher concentrated on colored drawings using all of the different symmetry types. He invented a highly mathematical system of study using a process which he invented himself. In 1941, Escher went home to the Netherlands. His popularity began to grow, and in the 1950s, articles on his work were written. His drawings of symmetry began to be displayed in science museums more than art galleries. In his later years several books were published about him. One of these books described his works of art as he neared death. â€Å"When Escher's view of the world turned inward he produced his best known puzzling prints, which, art aside, were truly intellectually playful, yet he was not. His life turned inward, he cut himself off and he had few friends. ... He died after a protracted illness...† Escher died on March 27th, 1972, in the Netherlands.... Free Essays on Escher Free Essays on Escher Maurits Cornelius Escher was born on June 17th, 1898 in Leeuwarden, Netherlands. His father was a civil engineer. Escher’s great skill for art and drawing was realized at an early age. This led his father to decide to send him to study at the School of Architecture and Decorative Arts in Haarlem. But, when he was 21 years old, Escher gave up architecture to study in the field of graphic arts. Escher spent most of his life travelling in Europe looking for inspiration for his works. In 1921 he got married and stayed in Rome. This is when his works of art began to show landscapes with impossible perspectives. In the 1930s, Fascism in Italy made life impossible for Escher and his family, so they moved to Switzerland. In 1936, Escher visited the Alhambra in Granada. The Moorish tiling he came across was amazing too him. Escher read and understood Pà ³lya’s paper on the 17 planes of symmetry, even though he didn't understand all of the ideas in the paper. Between 1936 and 19 42 Escher concentrated on colored drawings using all of the different symmetry types. He invented a highly mathematical system of study using a process which he invented himself. In 1941, Escher went home to the Netherlands. His popularity began to grow, and in the 1950s, articles on his work were written. His drawings of symmetry began to be displayed in science museums more than art galleries. In his later years several books were published about him. One of these books described his works of art as he neared death. â€Å"When Escher's view of the world turned inward he produced his best known puzzling prints, which, art aside, were truly intellectually playful, yet he was not. His life turned inward, he cut himself off and he had few friends. ... He died after a protracted illness...† Escher died on March 27th, 1972, in the Netherlands....

Innovative Nursing Care Delivery Model Assignment

Innovative Nursing Care Delivery Model - Assignment Example The innovative nursing care delivery models were developed to reduce inefficiencies in healthcare institutions and ultimately the healthcare sector and to ensure better patient outcomes. This paper will discuss the abode models. The transitional care model provides comprehensive planning and care coordination in hospital settings and a follow-up after discharge from hospital. This model was developed specifically for high-risk elders. People in this age group do not get effective healthcare attention, therefore, this model responds to this problem by offering the elderly effective healthcare service delivery. An interdisciplinary team in the University of Pennsylvania developed and tested this model aimed at improving post-discharge outcomes and prevents unnecessary re-infection (Kimball & Joynt, 2007, p. 395). Transitional care includes a number of services and settings that are specifically designed to promote safe movement of patients between different levels of healthcare attention and settings. It was developed to address the needs of adult patients with chronic illnesses and complex therapeutic regimens that need special attention (Naylor & Keating, 2008, p. 58). There are core aspects of the transitional care model that include a comprehensive analysis of individual health preferences and goals, inclusion of evidence-based planning in the care, extensive care that begins at admission and extends past the discharge time and also coordinated services during the care process among other features (Naylor & Sochalski, 2010, p. 2). The primary care team model is a model that integrates a registered nurse care manager, a registered nurse and a clinical assistant. The model was developed to increase the value of the experience nurse in patient care because of the nursing shortage in the U.S. An example of the application of this model was implemented at Seton Family of Hospitals located in Austin, Texas. The patient care team has the

Nutrition and Health in Developing Countries - Iron Deficiency Research Proposal

Nutrition and Health in Developing Countries - Iron Deficiency - Research Proposal Example Crucial studies have reported how a person’s body regulates iron absorption together with metabolism in response to changing iron status by ‘upregulation’ and ‘downregulation’ of key intestinal and hepatic proteins. The effective control of iron deficiency in population can be controlled by iron fortification of foods, target iron supplement, or both. In spite of the technical challenges limiting the number of bioavailable iron compounds, available for use in the fortification of food, studies show that iron fortification can be an effective strategy against nutritional iron deficiency. Iron deficiency is the most common nutritional deficiency and a leading cause of anaemia in many countries. The terms anaemia, Iron deficiency, and iron deficiency anaemia are usually interchangeably used but they all fall under the same context. A severe iron deficiency with anaemia can affect the functioning of several body organs with devastating results. Iron deficiency is a concern because it can delay infant motor function (normal activity and movement) or the normal thinking and processing skills (mental function).Additionally, iron deficiency anaemia during pregnancy can increase the risk for small or early (preterm) babies, who are more likely to develop health problems or die in the first year of their lives than infants born full term and are small. Iron deficiency also causes fatigue which impairs the ability to do physical work in adults. In teens, it may also affect memory or other mental functions. 1) Iron Deficiency from Increased Iron Needs: Because of their rapid growth, infants and toddlers consume more iron than older children. More often, their normal diet offers them not enough iron. Pregnant women also have higher iron intake and needs. In this regard, health care providers often recommend iron supplements. Bleeding also causes the loose of iron, thus extra iron is needed to replace what has been lost. Increased blood loss can occur with heavy menstrual periods, frequent blood donation, as well as with stomach and intestinal conditions.  

The Ivory Coast Essay Example for Free

The Ivory Coast Essay Giving money for a positive cause is always a good thing especially when they create favorable long term effects. There are numerous countries suffering for several different reasons all around the world, one of these countries being The Ivory Coast. The Ivory Coast is failing in different aspects because of certain social, economic and political issues. One of the biggest problems to date is the poor education system. We plan to repair the countries damaged education system by rebuilding schools and supplying people with the necessary resources needed to pursue a decent education. With help from the World Bank, Oprah Winfrey and any others willing to contribute to our cause, we are confident that the Ivory Coast can be put on a steady path to success. The Ivory Coast is located on the South coast of West Africa. Surrounding countries include Guinea, Liberia, Burkina Faso and Ghana. The country is about 322,463 sq. Kilometers. Today, there are over 20 million people living in the Ivory Coast. There are about 39 people per sq. Kilometer. There is a pretty even number of males to females, 51% males, to 49 % females. The life expectancy age is approximately 59 years old. People of the Ivory Coast practice many different religions. These religions include traditional beliefs practiced and developed in certain varying villages, Christianity, Roman Catholicism and Islam. The current president is Alassane Ouattara. The official language of the Ivory Coast is French, but there are multiple languages spoken in the country including Dioula, Baloule, Dan, Anyin and Cebaara Senufo. The capital of the country is Yamoussoukro and Abidjan serves as the administrative center. The flag of the country is composed of three bold, vertical strips all different colors. The orange color on the flag represents the rich and generous land, it also is a symbol for the blood of young people who fought for emancipation. The white strip represents peace, and the green exemplifies hope for a better future. Common Cuisine consists of a dish called aloko, a popular snack that is served with fried banana, onions and chilies. Popular music includes Zoblazo, Zouglou and Coupà ©- Dà ©calà ©. When traveling to the Ivory Coast, All visitors require a passport and a visa is necessary, except for nationals of USA and ECOWAS countries. It is hard to determine when existence first began in the Ivory Coast due to the fact that human remains have not been well preserved. But with discovery of old weapon fragments and tools, life of the Ivory Coast seems to have begun during the upper Patheolithic period (15,000 to 10,000 BC). Research indicates that the early inhabitants of the Ivory Coast seem to be scattered, leaving historians to come to the conclusions that the ancestors of present Ivory Coast Inhabitants were displaced. The earliest recorded history of the Ivory Coast is found within the trade caravan condu cted by North African traders from early Roman times. A caravan of salt, slaves, gold etc. was conducted across the Sahara. After independence from France in 1960, the Ivory Coast economic success story was built on cocoa, and other agricultural products including coffee, cotton and fruits. But many laborers, who originally came from neighboring countries, and their descendants, increasingly felt marginalized. This contributes to a rebellion in 2002 which split Ivory Coast in two. The Ivory Coast is currently suffering due to ongoing social and economic issues. The major economic issue today in Ivory Coast is the rebuilding of Ivory Coast infrastructure, main roads, cocoa farm and reducing their deficit which is about us$2.3 million. As the political impasse persists in divided Ivory Coast, the West Africa country, which was once the region’s economic powerhouse, faces further decline. Residents and analysis are very worried about the quickly dissolving economic situation there. After the political crisis a lot of banks were shot down, cocoa farms which is one of the major resources in Ivory Coast were destroyed, shortage of cooking gas, roads were damage and the price of food raised. Socially, the health of the country is extremely poor. Malaria, a virus caused by parasites infects a high percentage of the country and is a leading cause of death in children and is the second highest cause of morbidity and mortality in the Ivory Coast. Symptoms of malaria include fever, body aches, nausea, vomiting, fatigue and sweating. Unfortunately, Malaria is not the only deadly disease which affects many in the Ivory Coast. The AIDS epidemic is preoccupying; over 3.9% of the adult population is HIV-positive. Around 500,000 persons are living with HIV. HIV/AIDS is the highest cause of morbidity and mortality in Cote dIvoire. Aside from diseases, Water pollution is an environmental problem in the Ivory Coast. Due to chemical waste from agricultural, industrial, and mining sources: about 92% of the countrys city dwellers and 72% of the rural population have safe water. Water pollution is a massive problem in the Ivory Coast that is causing struggle and delaying the process to achieve peace. Sadly, there are other issues in the Ivory Coast aside from health concerns. Poor education has not always been a problem, but the topic has become increasingly significant in recent years. Most people do not continue school after the primary level. There are multiple factors that contribute to such a low number of educated individuals. One of the main reasons that education is at such a decline now, is because of the current political crisis. The 2010 presidential election between incumbent Laurent Gbagbo and opposition member Alassane Ouattara resulted in a political standoff and violent conflict after Gbagbo refused to honor the results that declared Ouattara the winner. Two elections were held. The initial election did not yield a winner and a second electoral round was held on November 28, 2010. The polling results were released on December 2, 2010 and declared Ouattara the new president of Cà ´te d’Ivoire after he received 54.1% of the vote. The political stalemate turned violent and caused the decline of state security, threatened regional stability, and resulted in gross human rights violations and violence against civilians. The UN reported in March 2011 that over 1000 people were killed in clashes, and the UN High Commissioner for Refugees stated that over 500,000 Ivorians were forcibly displaced, and 94,000 Ivorians fled to neighboring Liberia out of fear of violence. The country seemed to be divided. Forces loyal to Gbagbo and Ouattara were accused of gross human rights against civilians which could amount to crimes against humanity including enforced disappearances, sexual violence, and extrajudicial killings. After months of defying the outcome of the presidential election, Laurent Gbagbo was arrested by Ouattara forces on 11 April 2011 following an attack o n his residence in Abidjan. Alassane Ouattara immediately called for the establishment of a truth and reconciliation commission. Cà ´te d’Ivoire now faces many challenges as a result of the far reaching effects of the crisis, including the restoration of peace and security, the prevention of further human rights abuses, and the delivery of humanitarian aid. Alassane Ouattara’s government must now foster peace and reconciliation in Cà ´te d’Ivoire and insure that those responsible for gross human rights violations are held accountable. After the 2010 presidential crisis there were nearly 800,000 children out of school due to the crisis and some are still waiting to get back to learning. â€Å"We arrived at school at 7:30 a.m. as we always do on a school day. At exactly 8:30 we could hear shooting coming from the direction of a neighbouring village,† recalls Pafait Guei, a 14-year-old boy who attended primary school in the western area of Ivory Coast. Instead of being in school, youn g children are seen selling goods on road sides in attempt to earn very little money to support themselves and their family. In a venture to try and help the Ivory Coast education system we have devised a plan that will ultimately rebuild the Ivory Coast education system. Our plan is to obtain a minimum of $10,000,000 dollars from the world bank and Oprah Winfrey to help at least 100,000 children by distributing school bags filled with supplies such as textbooks, pens, pencils, eraser, pencil sharpener to support families in need. We also want to re-open/re-build many schools that were affected by the crisis. Even the ones that have re-opened have a shortage in desks, chairs, and supplies. We plan on hiring more teachers. Most of the schools have 1 teacher per 50 students. We will use all of the money to help the government pay for the teacher’s salaries and hopefully the country will move in the right direction and will be able to afford and continue our efforts once the money finishes. We feel as though Oprah would be a good choice as a financial contributor because of her stand on education, especially after building the school in South Africa, she was quoted saying: â€Å"I think the reason not just Africa but the world is in the state that it is because of a lack of leadership on all levels of government and particularly in regard to schools and schooling for poor children. The best way to effect change long term is to give children exposure and opportunity and nurture them to understand their own power and possibility.† We hope that she would be willing to aid us with a significant amount of funds to move the Ivory Coast forward in the right direction. There are many commendable reasons to donate money to the Ivory Coast. Donating money to the Ivory Coast would only result in positive effects. Only about half of the population is illiterate and many children are not enrolled in school (between the ages 6-10). By donating money to the Ivory Coast, we will be able to begin to change the statistics by creating more education opportunities. We also will make educational resources more accessible to everyone. Those who have some form of education can have the opportunity to extend their education, and those who have no or very little education would have the chance to receive one. Having better education opportunities would not only benefit those going to school, but it would also create jobs. There is usually about one teacher to every fifty children, but with the money we receive, we plan to hire more teachers. Less children in the classrooms means that the children could receive better and more direct attention. This can ensure that the material being taught is actually getting across to each student, and it will become easier to give one on one attention to those who need i t if there are more teachers available to help. Not to mention the fact that the employment rate will increase providing more individuals with a source of income. If anyone were to decide to donate or contribute money to the Ivory Coast you would be a part of our plan to help to build a stronger economy. One of the many reasons Africa is suffering as a whole is because of the lack of necessary resources needed to obtain a good paying job. If we do not invest in education, the education system will continue to fail. Majority of people in The Ivory Coast do not continue schooling after primary school because they do not have the funds for college and feel that it more important to get a job barely making ends meats. But if we can provide money for schooling and education, this can create a better future not just for the Ivory Coast but for Africa as well. If people were to have the credentials needed to land a decent job, this could slowly start to increase income in households. Donations could also help begin to restore order in the Ivory Coast. Because people were displaced, had to flee, or were forced out of their homes, many people of all ag es could not continue to go to school. If we can focus in on trying to get people of the Ivory Coast back in school, this can be a stepping stone to help the country prosper. In the 1980’s education was named one of the country’s main priorities and the plan has proven successful . Education received about one-third of the national budget. Because education was so greatly emphasized, The Ivory Coast education rate changed dramatically. An overall 43% literacy rate increase, 53% for men, and 31% for woman. Nearly 15% of the country was enrolled in some sort of educational institution. If we attempt this once again, we are confident that we can get the same, if not better results than we had in the 1980’s. The fact that a similar plan was put into effect and carried out with positive results gives us more motivation to believe that our approach will be effective. Education is extremely significant when trying to make a country prosper. If we try to make education our main focus, the things that are important become relevant again and the Ivory Coast can continue to flourish positively. Giving the children a chance at a better education can ensure a better future for the country’s entirety. The flight from JFK airlines to Abidjan through Air France i s approximately $1513. You would be staying in one of the best hotels in the Ivory Coast, The Ibis Abidjan Plateau (located in Abidjan), which is $1137 for 7 days 6 nights; it includes breakfast and a car rental. While in the Ivory Coast, there are many interesting places and landmarks to visit. The Basilica Notre Dame de la Paix, also known as Basilica of Our Lady of Peace of Yammousoukro is one of the greatest prides of the Ivory Coast. It is considered as the tallest and largest church in the whole world. The basilica is specifically located at Yammousoukro, Ivory Coast. Its construction started in 1985 and was finished four years later. It cost $300 million to complete the basilica. The Taà ¯ National Park is a national park in Cà ´te dIvoire containing one of the last areas of primary rainforest in West Africa. It was inscribed as a World Heritage Site in 1982 due to the breadth of its flora and fauna. There are a few of the animals found on the Taà ¯ National Park that are on the red list of threatened species such as the pygmy hippopotamus, leopards, and chimpanzees. The rainforest is located in Abidjan. There is also a beach called Bassam, it is about 45 minutes away from Abidjan city, so its possible to do a day trip from the city. This country has the potential to become prosperous and peaceful. All it needs is good leadership and unity within the country. Ivory Coast has good natural resources and it has been proven to have the capacity to do well economically. Hopefully now with the new president the country will continue in the good direction and he will focus on the major issues facing this country such as political stability, addressing the health issues, and most importantly, not forget the importance of an education, and all the benefits it will bring to the country as a whole if at least the literacy rate of the country goes up. Bibliography unicef.org http://www.unicef.org/infobycountry/cotedivoire_59009.html http://www.unicef.org/infobycountry/cotedivoire_57879.html wikipedia.org http://en.wikipedia.org/wiki/Oprah_Winfrey_Leadership_Academy_for_Girls http://en.wikipedia.org/wiki/Ivory_coast responsibilitytoprotect.org http://www.responsibilitytoprotect.org/index.php/crises/crisis-in-ivory-coast ttp://www.voanews.com http://www.geopolitical-info.com http://traveltips.usatoday.com/famous-places-ivory-coast-58979.html http://www.virtualtourist.com/travel/Africa/Cote_DIvoire/Things_To_Do-Cote_DIvoire-TG-C-1.html http://www.netglobers.com/africa/cote-d-ivoire-main-health-risks-for-cote-d-ivoire.html

Racism in Toni Morrisons Song of Solmon Essay -- Song of Solmon Essay

Racism in Toni Morrison's Song of Solmon Milkman is born on the day that Mr. Smith kills himself trying to fly; Milkman as a child wanted to fly until he found out that people could not. When he found, "that only birds and airplanes could fly&emdash;he lost all interest in himself" (9). The novel Song of Solomon is about an African American man nicknamed Milkman. This novel, by Nobel Prize winner Toni Morrison was first published in 1977, shows a great deal of the African American culture, and the discrimination within their culture at the time Song of Solomon takes place. In part one, the setting is in a North Carolina town in the 30's and 40's. Â   Part one introduces readers to not only Milkman, but also to his family and friends. His father holds power in the African American community because he has his own business and is ambitious. Milkman's mother is a center figure in the community simply because her father was the doctor. Milkman has a mysterious unmarried Aunt, with a single daughter and granddaughter. He also has a friend, Guitar who is a member of a group of seven African American men dedicated to keeping the 'ratio' between blacks and whites the same. Throughout the novel, Milkman gradually learns about his families past as well as forgotten pieces of his own childhood. Â   In part two, Milkman goes south to his father's hometown. He is looking for a fortune that his father and aunt had found long before. When he does not find the fortune he begins trying to find where it went. This takes him to where his great grandfather and mother originated. Milkman eventually is led to the town where he is a direct descendant of the town's legend, Solomon. It is in this town that Milkman finds himself and becomes his own m... ... lied for it, killed for it," (247). For her revenge, after all of the Butlers died Circe says "I want to see it all go, make sure it does go, and that nobody fixes it up. I brought the dogs in to make sure" (247). She allows everything they loved to be destroyed. Â   Morrison shows readers a side of American History rarely seen. She shows the deepness of prejudice and how many different ways it has effected people. While she does this she also tells a story of soul searching, Milkman tries to find himself among many people who are confused and ate up by hate and prejudice. In the end, he is able to find who he is and where he stands on all of the issues that are going on around him. When he gets this understanding Milkman retrieves, and achieves his childhood dream of flying. Works Cited Morrison, Toni. Song of Solomon. New York, Penguin Books USA Inc., 1987

Even Sigmund Freud participated Essay

Today the medical sphere may offer us good examples of how the existing diversification of approaches and methods towards the treatment of people is related to the fundamental shifts in our perception of the old problem of finding the connection between the human body and the mind. In fact, on one hand medicine as such is on the most fundamental level an inherently conservative filed of knowledge and practice because what is at stake for a doctor is often the very human life, the value of which overthrows any possible dubious methods of treatment that may lead to the lack of positive results, or even to negative ones. On the other hand, as we are constantly learning new things about such an intricate structure as the human body is, it becomes clear that phenomena that had been thought understandable in reality have a much more complicated nature, which requires elaboration of existing scientific approaches, or even demands refusal from some of the traditional medical postulates. To grasp challenges that arise from such shifts in our understanding of mind-body connection we may consider perhaps too extreme examples – numerous schools of the so-called New Age medicine which under the pretence of the break-through knowledge all too often advance simply untenable and absurd claims based on mere speculations (Reisser, Reisser, and Weldon, 1988, pp. 147-52), and the overly sceptical defenders of the traditional Western medicine who may tend to be too inflexible in their admission of the validity of alternative approaches to medical treatment of people. More specifically, the matter of the influence of human psychological processes on what has traditionally been considered purely physiological disorders is one of the most inflaming causes of disagreements between the mentioned approaches. This tension that in one form or another is ongoing between representatives of different medical camps to a large degree defines the modern discourse of approaches to the medical treatment (Miller, 2003, pp. 185-187). In this regard, it would be interesting to closely investigate the existing literature that represents the current state of affairs in the perception of the connection between the mind and the body. As a suitable object of our analysis may serve the book written by Doctor of Medicine John E. Sarno, a Professor of Clinical Rehabilitation Medicine at the New York University School of Medicine, and attending physician at the Howard A. Rusk Institute of Rehabilitation Medicine at the New York University Medical Center. His best-selling work â€Å"The Mindbody Prescription: Healing the Body, Healing the Pain† belongs to the list of the most popular books that highlight academic and practical achievements in the field of psychosomatic medicine, a school of medicine which is based on the principle of unity of the mind and the body, and which aims to examine the mechanisms of the interdependency between emotions and bodily functions and to promote psychological methods of medical care (Levenson, 2004, pp. 3-66). The combination of the academic approaches of the author to the support of his material and the popularity of the book among lay people to whom it is largely addressed suggests that on the example of this work we may judge the level of penetration of what could unanimously be perceived alternative medicine not long time ago into the modern medical discourse. With all this in mind, let us examine the volume of John E. Sarno in the context of its connection as of a textbook of applied psychosomatic medicine with the modern medical paradigms. For this purpose, we will briefly outline the history of psychosomatic medicine, then will try to link it with the book of Sarno, and in the main body of the paper will provide the book report with relevant comments on the book`s contents. Background on psychosomatic medicine The origins of the psychosomatic medicine can be found in the teachings of early Western philosophers and physicians who acknowledged that emotions played an important role for the human health (Cacioppo, 1989, p. 589). Still, the Western medicine has traditionally been more inclined towards the study of the significance of bodily functions (Loudon, 1997, p. 238). However, by the middle of the nineteenth century the level of attention to the involvement of emotions in diseases development grew as the observational evidence was accumulating that had suggested that some disorders were not always accompanied by organic affections (U. S. National Library of Medicine, 2005). For example, only since the seventeenth and the eighteenth centuries such a neurosis as hysteria began to be linked with emotional factors and the nervous system in general. Even Sigmund Freud participated in the study of symptoms of hysteria, and one of his conclusions was that they are based on memories linked to mental traumas which under certain conditions may intrude in the processes of somatic innervation. In this way, a possible mechanism for the interaction between mind and body was offered that was reminiscent of mechanisms that Sarno would be describing in his book. The German psychoanalysts Georg Groddeck even went as far as claiming that psychological mechanisms engendering hysteria can be applied to all somatic diseases which from this point of view are the bodily manifestations of unconscious psychological processes. In the 1930s psychoanalyst Franz Alexander attempted to find a compromise between the Freudian theory, such views as those of Groddeck, and existing knowledge of physiology. He was against excessively psychological interpretations that ignored the automatic mechanisms in the body that to a large degree directed emotional expressions. The theoretical basis developed by Alexander contributed in the United States to the invigorated extensive research of psychosomatic mechanisms, and psychosomatic medicine as a separate field of study was formed in 1939 when the medical journal dedicated to this branch of medicine was published. After that time, psychosomatic medicine was only gaining momentum. For example, World War II spurred the interest to it due to numerous manifestations of psychosomatic symptoms in soldiers. Eventually, by the 1950s interest to psychosomatic medicine and its scientific background grew so much that its concepts entered the popular culture as media started to publish numerous articles and thus popularized psychosomatic theories (U. S. National Library of Medicine, 2005). Now, fast forward to today, and we can witness that many of the postulates of psychosomatic medicine are already among the undisputed popular opinions of many people, and for instance the maxim that in order to stay healthy a person should avoid excessive stresses and disturbing emotional states is among the most frequently heard ones in both media sources and in our everyday interaction. However, after the surge of academic interest to it half a century ago, psychosomatic medicine, in contrast to its successful penetration into the public perception, somewhat lost momentum within scientific circles in the second half of the twentieth century (Kennedy, 2004, p. 400). So, it is in such circumstances that the book of John E. Sarno â€Å"The Mindbody Prescription: Healing the Body, Healing the Pain† saw the light of the day. The book of John E. Sarno in the larger social and historical context â€Å"The Mindbody Prescription: Healing the Body, Healing the Pain† builds upon themes from Sarno’s previous book â€Å"Healing Back Pain: The Mind-Body Connection† that advanced the idea that the cause of back pain, headache, slipped discs, and other chronic forms of pain is actually rooted in our psychology (Sarno, 1991). In â€Å"The Mindbody Prescription† Sarno adds new knowledge about the psychology of emotionally stimulated physical manifestations, and elucidates how such emotions as anger, anxiety, guilt, and other negative mental states can cause mental stimulation of negative physical symptoms. Thus, in both of those books the author touches upon very urgent topics for the modern American society in which an increasing number of people are plagued by back, neck, or limb pain. In fact, this is a serious economic problem as well, as industries in which large percentage of people are working at computers bear significant health insurance burden due to a variety of similar disorders causing pain, like fibromyalgia or repetitive stress injury (Sarno, 2005). More generally, pain as such in its different forms is a crippling problem for many individuals in both their professional and private lives (Margoles, 1998, pp. 9-32). So, â€Å"The Mindbody Prescription† addresses precisely this disturbing epidemic as it analyses clinical data to find the main cause of the pain disorders, and elaborates methods to treat those disorders. Importantly, in doing so the author tries to fill the gap existing in the traditional methods of chronic pain treatment that are apparently unable to stop this pain epidemic. From the very beginning of the main body of the volume it becomes clear for a reader that the author adopts a holistic approach to his subject. More specifically, Sarno opens the first chapter of the book with construction of various typical and stressful scenarios that in one form or another take place in lives of many of us and contribute to chronic physical pain that people experience. What is untypical, though, is that Sarno from the very beginning of the book begins to draw our attention to what could be considered as a minor element of those scenarios, but what in reality, according to the author, underlies the different manifestation of the pain disorders. This significant element is the factor of unconscious anger or outright rage that Sarno envisions as inevitably accompanying all of the scenarios that he delves in, like our troubles with private life, or within family, or career-related frustration, and many other different â€Å"or† that Sarno repeats in succession to bring home to us his case of unconscious mechanisms that generate anger in so many people. Now, this initial attention to the emotional side of our life is in a good agreement with our above observations about the widely acknowledged role that our mind plays in our health, and the author as if resumes that the existence of the definite connection between our emotional experiences and our bodily health is factual. But, judging from the way he begins his work, what we can expect from Sarno is the elaboration on the exact mechanisms that keep the mind-body connection running, especially as the author immediately claims that the disorders that he is about to discuss â€Å". . . are neither illnesses nor diseases, but rather symptomatic states induced by the brain to serve a psychological purpose† (Sarno, 1998, p. 3). After all, while general public does not always bother to verify its views, practitioners of classical pathophysiology would surely expect solid support of any claim related to the emotional aspects of diseases and illnesses and to the connection between pain problems and stress. At the same time, having chosen the non-technical style of presentation Sarno procured the easiness of reading for common people whose pain-related problems are the actual target of the book. The structure and the contents of the book â€Å"The Mindbody Prescription† consists of three parts preceded by an extended preface and an introduction that deals with a historical perspective of the book`s theme. The preface and the introduction of the book summarize theories and experience of Sarno with treatment of back pain and other types of musculoskeletal disturbances. Naturally, already in the opening parts of the work the emotional foundation of the pain is emphasized. In the end of the book we can find a thorough appendix, which provides supportive citations for conclusions of Sarno, and a bibliography which refers to articles that cover physical and psychoanalytic issues related to chronic pain and its treatment. In the first part of the book Sarno reflects upon concepts underlying mind-body medicine, and exemplifies influences that physical stress and such psychological states as feeling of guilt, anxiety, depression, or personality disorders have on the range of symptoms manifested in patients. Sarno categorizes the range of painful symptoms that may arise due to psychological processes as belonging to what he terms Tension Myositis Syndrome (TMS), which is a painful condition that develops in the back, shoulders, neck, or buttocks, and may equally arise in other parts of the body, and which throughout the whole book would be the main object of study for the author. But before shifting to investigation of concrete instances of TMS-related maladies, in order to justify his principal claim that chronic pain symptoms are in reality a kind of a defense mechanism used by our brain to distract our attention from our unconscious emotions of anger, Sarno copiously refers to the prominent figures whom we have discussed – Sigmund Freud, Franz Alexander, and some other defenders of the theory of psychoanalysis like Stanley Coen and Heinz Kohut. I believe that this approach is beneficial as it helps readers appreciate the historical inheritance that underlies basic conceptions of the psychosomatic medicine, and thus provides a firmer footing for beliefs held by many people who have had successful experiences with psychosomatic approaches to treatment of illnesses. Aside from the references to important figures in the history of psychosomatic medicine, the first part of the book also elaborates a distinct and well-structured explanation of the concepts constituting the basic principles of mind-body interaction. In the process of such explanation the author mentions such fields of study and such medical and psychological notions as neurophysiology of psychogenic disturbances, problems of psychosomatic origin, and reactions of conversion (which is one of the types of interaction between the mind and the body when unconscious elements of human psyche intrude into somatic processes) (Sarno, 1998, pp. 173-174). Sarno also mentions the findings of Candace Pert, a neuroscientist who found opiate receptors in the human brain, and who greatly contributed to the growth of our knowledge of links between biochemical processes in the brain and physiological phenomena. In this way, Sarno anchors the theme of his book in the history of psychosomatic medicine, and, even though he is mentioning some radical concepts that may be critically perceived by adherents of traditional pathophysiology, the style of Sarongs presentation is lucid and definitely absorbing. All in all, the first part of the book serves as a bridge between the general discussion of the psychological mechanisms of emotional influence on physical disorders and more detailed investigation of psychoneurophysiology that underlies psychogenic processes. In the second part of the book Sarno closely examines his clinical experience with emotionally caused physical disorders, and is primarily concerned with various manifestations of TMS and with the possibility to extend his theory of the mechanisms of TMS emergence to other diseases and illnesses. In fact, many of the clinical problems that he examines have already been known to have a connection to stress, which either produces them, or aggravates their effects. However, what makes the work of Sarno special is his approach to explanation of these disease states from the point of view of unconscious working of repressed anger and rage. To prove his case, Sarno has combined physical medicine with psychoanalytic theory in order to give what he believes is a proper account for TMS, which, according to his practice, is the main cause of musculoskeletal and back pain. For Sarno, the origin of painful manifestations of TMS lies in repressed emotions. And the pain in various parts of body as such is theorized by the author as being caused by a diminution of blood flow to the corresponding tissues. This process of blood flow reduction is mediated via the autonomic system as a stressful reaction of brain to repressed emotions. We may chart the TMS pathophysiology in the following way: The formation of unconscious repressed emotions (anger/rage); ? Abnormal patterns of autonomic system`s activity; ? Decrease of the level of local blood circulation; ? Development of mild oxygen deprivation; ? The resulting pain in muscles and other possible symptoms (for example pain in tendons, tingling, numbness, weakness). Having established such a mechanism of the emergence of pain, Sarno surmises that this approach from the TMS formation theory can as well be applied not only for the fixed number of cases of muscle and back pain, but to a wider range of physical disturbances. In this light, Sarno earlier pointed out that in a 1975 survey it had been found that â€Å"88 per cent of patients with TMS had histories of up to five common mindbody disorders† (Sarno, 1998, p. 29). And, indeed, Sarno manages to extend his theory of the emergence of pain disorders to migraine, to such various conditions as carpal tunnel syndrome, fibromyalgia, colitis, peptic ulcer, post-polio syndrome, infections, skin disorders, and even to more unusual instances like the chronic pain that accompanies Lyme disease, which is caused by bacteria transmitted through ticks. The author also mentions disorders in which emotions might be involved, among which are atherosclerosis, hypertension, one of the most common heart problems termed mitral valve prolapse, and even cancer. Of course, with such a broad scope of concern at hand Sarno has to offer an adequate methodology for unambiguous diagnosing of emotionally induced pain. For this purpose, his requirement is that the TMS diagnosis can be ascribed to a patient only if traditional physical exam failed to uncover existing abnormalities. However, according to the author, even in the presence of an abnormality TMS still can be working in a patient and exasperate the pain to the higher level than the found abnormality itself would be capable of. In the third part of the book Sarno discusses approaches that may effectively treat TMS and related physical disturbances. From what we have observed before it should already become clear that Sarno essentially assigns to the pain the function of a defense reaction that aims to divert our consciousness from the need to face repressed anger or other unbearable forms of emotional strain. On ground of this, as the only possible way of treatment of the real cause of TMS symptoms Sarno postulates the examination of the physical origins of repressed negative emotions as the way for the deliverance from pain. Generally speaking, a person has to find ways to single out those harmful emotions and roots of the unconscious anger that are undermining his or her psychological well-being. And what also makes the theory of Sarno special is that, according to him, the mere acknowledgement of certain emotional concerns, and not of any bodily abnormalities, as the ground of the deteriorated physical state is in many cases already a sufficient condition for healing. One may not even have to remove the psychological problem itself in order to procure a visible clinical improvement. This contrasts with some of the New Age schools of psychotherapy that also associate unconscious repressed emotions with various maladies, but which require that before the healing can take place such unconscious `problem spots` must be dissolved, like is proposed, for instance, by the so-called primal therapy, a school of psychotherapy elaborated by psychologist Arthur Janov (Janov, 1999). For Sarno, the identification of a problem is the main task for people suffering from emotionally induced physical disorders, and such identification can normally be implemented by means of an insightful self-examination, perhaps with the help of such techniques as meditation or self-affirmation (a method of compensation for the lowered self-esteem in one area by consideration of one`s proficiency in other areas (Sarno, 1998, p. 22; Nezu and Nezu, 2004, pp. 182-188). In this regard, from the point of view of Sarno it is also very important that a patient should have no doubts about the correctness of the TMS diagnosis, and that he or she fully realizes the exclusively psychosomatic origin of pain. To bolster this indispensable perception in patients, after the mentioned thorough physical examination needed for the elimination of possibility of the presence of real physical problems, Sarno accentuates the need to educate people and to assure them that the influence of repressed emotions is a sufficient condition for the reduction of the flow of blood to the affected areas of the body which leads to the pain and other troublesome symptoms, which nevertheless should not be viewed by people as those inflicting permanent damage to the body. Even if some structural abnormalities related to ordinary changes due to physical activity or aging are found, the patient should have a clear understanding of their nature. Basically, what is demanded from a patient is in no way the denial of the presence of the pain but rather the acceptance of its genuine origin. To help maintain such an attitude to chronic pain, Sarno recommends to patients who know that they have no physiological abnormalities to suspend physical therapy and to return to normal physical activity. In addition to that, patients should on the daily basis remind themselves the following points: I only have a mild oxygen deprivation and not structural abnormalities; my condition stems from repressed negative emotions and is not physically harmful; TMS exists to divert my attention from emotions; there is nothing to be afraid of for me; the physical pain is not dangerous; I will not allow pain to trouble and intimidated me; I will change the object of my concern from pain to emotional experiences; it is my conscious part that will have control, and not my subconscious mind; I have to think about psychological aspects of my life, and not so much about physical. When such a set of attitudes towards the role of one`s unconscious emotional experiences and towards one`s own body is obtained, Sarno believes that the brain that aims to contain the repressed emotions will no longer be able to fool us by drawing our attention to body. To illustrate how psychological relief may have a radica l influence on the chronic pain, the author offers examples of some practical cases. In one of such cases a patient knew about the most probable origin of her back pain but still did not have an improvement, and even had increased level of pain. According to Sarno, the worsening of the pain was brought about by the last efforts of the brain to keep hidden emotions unconscious, but when the feelings finally burst into the patient`s consciousness the pain, as if miraculously, went away. Sarno documents the account of this patient: â€Å". . . in an instant, I started to cry. . . Out of control tears, anger, rage, desperate tears. And I heard myself saying things like, Please take care of me, I don’t ever want to have to come out from under the covers, I’m so afraid, please take care of me, don’t hurt me, I want to cut my wrists, please let me die, I have to run away, I feel sick-and on and on, I couldn’t stop . . . And as I cried, and as I voiced these feelings, it was, literally, as if there was a channel, a pipeline, from my back and out through my eyes. I felt the pain almost pour out as I cried . . . I knew . . . that what I was feeling at that moment was what I felt as a child, when no one would or could take care of me . . . the feelings were there and they poured over me and out of me† (Sarno, 1998, p. 13). However, as in order to get rid of pain we have to use our insight to understand its foundation, one may wonder that if the real cause of the pain is the repressed anger, how helpful psychotherapy may be in the healing of TMS symptoms? The author says: â€Å"The therapists to whom I refer patients are trained to help them explore the unconscious and become aware of feelings that are buried there . . . When we become aware of these feelings . . . the physical symptoms . . . go away† (Sarno, 1998, p. 161). Still, according to Sarno, the need for psychotherapy should not arise too often. The author reports numerous cases when people did away with pain simply after having read the book and having followed suggestions contained there. In fact, Sarno claims that the percentage of those who report the improvement of their condition is as high as 90-95 percent, and that many of his patients had been living with physical disorders and pain for a large part of their lives and could not be treated by the traditional medical approaches. General critical observations Even though the belief that emotions and stressful circumstances are related to physical conditions of people is today generally accepted, the extent to which Sarno emphasizes the role of psychological factors will nevertheless surely seem too extreme for many clinicians. Indeed, formally speaking, the author of â€Å"The Mindbody Prescription† gives some reasons to relate him to those practitioners who denounce the traditional medical approaches as outdated ones, as he says that â€Å". . . poor medical advice . . . keep[s] your attention riveted on your body, which is your brain’s intention† (Sarno, 1998, p. 147), or that â€Å"Modern medical science studies the details of maladies but rejects unconscious emotional processes as the cause†¦ † (Sarno, 1998, p. 117). On the other hand, the effort of the author to extend the validity of his TMS theory to a range of disorders which in combination are shared by significant fractions of Western societies` populations may also seem to be too ambitious and at the same time not sufficiently verified according to strict scientific standards (Wilson, 1991). In this light, while Sarno rightfully remarks that â€Å". . . proper management [of TMS and related disorders] would alleviate much suffering and reduce the enormous cost of medical care that now burdens modern society† (Sarno, 1998, p. 126), he perhaps should also pay more attention to the fact that the majority of physicians still have doubts about the ability of psychological processes to cause chronic pain in the first place, and are more ready to agree that emotions may only aggravate physiological problems, but still in most cases should not be considered as their primary causes. In his turn, Sarno disputes that such processes as osteoarthritic changes and herniated vertebral discs are always the immediate sources of the pain and suggests that very often they may just be coincidentally present close to affected areas that due to emotional causes are deprived of oxygen. Such views further distantiate him from the conventional approaches to treatment of these disturbances. Moreover, Sarno insists that traditional medicine has no valid methods of TMS treatment because â€Å"If you thwart that purpose by taking away the symptoms without dealing with its cause, the brain will simply find a substitute symptom† (Sarno, 1998, p. 39). In any case, despite the unconventional elements of his methods of treatment, Sarno has numerous adherents who attest to the practical applicability and effectiveness of the theory of connection between psychological processes and manifestations of TMS. Therefore, I believe that even if Sarno is not able to provide a completely reliable from the academic point of view account of the mind-body connection, he may be practically exploring the mechanisms of the human body that the fundamental science is only beginning to test experimentally (Brush, 2005, p. 259). For example, consider the recent finding related to the famous placebo effect in which it was again confirmed that such a purely psychological factor as our expectations has not only psychological but as well physical effects on health. But in this particular research a new variety of the placebo effect was found, actually a kind of an anti-placebo effect, as it turned out that â€Å". . . once Alzheimer’s disease robs someone of the ability to expect that a proven painkiller will help them, it doesn’t work nearly as well. . . † (Neergaard, 2005). This fact testifies to the power of our psychology to intervene in the what might seem as purely physiological realm of our bodily functioning, and the data is being gathered to prove that at least such a psychological factor as the placebo effect â€Å". . . actually is physical, and that expecting benefit can trigger the same neurological pathways of healing as real medication does† (Neergaard, 2005). Now, this conclusion is in a perfect agreement with the principles underlying the theory of TMS origin advanced by Sarno. However, quite ironically, the specialists involved in the mentioned research were quick to point out that positive expectations â€Å"aren’t a substitute for real medicine† (Neergaard, 2005), which contradicts the reliance of Sarno on psychology as not only the cause of many physical disorders but at the same time as the only means of their healing. But I suppose that if Sarno produces an impression of being too confident in the self-sufficiency of his conclusions it could only mean that due to his extensive observational experience he may just be a little bit ahead of the vanguard of the mainstream medical science. And, after all, if we want to find what unites Sarno with the conservative part of the medical establishment it is his traditional recommendation for his patients to resume full activities of daily life, including physical exercises. Critical observations about Sarno`s view of migraine as an equivalent of TMS While Sarno devotes a large portion of his book to back pain, among other painful physical disturbances related to mechanisms that lead to TMS he mentions migraine, which is a very common condition that causes headaches, and physiological mechanisms of which are currently quite poorly understood (Cochran, 2004, p. 156). Sarno confesses his personal experience with migraine as he had had this condition for quite a long time before he was introduced to medical research which suggested that â€Å"migraine headache was the result of repressed anger† (Sarno, 1998, p. 111). As he was already amassing evidence in support of the significant influence of psychological factors on many widespread medical problems, he was inclined to test that idea. After trying to find out what anger that he could be repressing was causing his migraine, Sarno allegedly got rid of migraine headaches for the rest of his life. However, he himself acknowledged that some symptoms of migraine still continue to happen to him, which brings us to a question whether the method of the author of the book can be applied without reserve to all the types of chronic pains that seem to have no accompanying physical abnormalities. Indeed, it may be that our lack of understanding of the causes of migraine simply leaves us ignorant of possible physiological mechanisms that underlie it, and even though approaches borrowed from TMS treatment may often be effective for removal of painful symptoms, purely psychological vision of the migraine origins may hide from us its genuine cause. Besides, it may be somewhat alarming that the definition of migraine that Sarno advances is different from the one offered for example by the National Migraine Association. Sarno says that migraine is supposed to arise from â€Å". . . sudden constriction of a single blood vessel within the substance of the brain† (Sarno, 1999, p. 111), while on the website of the National Migraine Association it is stated that: â€Å"Migraine is disease, a headache is only a symptom. Migraine pain is caused by vasodilation in the cranial blood vessels (expansion of the blood vessels), while headache pain is caused by vasoconstriction (narrowing of the blood vessels). During a migraine, inflammation of the tissue surrounding the brain, i. e. , neurogenic inflammation, exacerbates the pain† (Coleman and Burchfield, 2006). Therefore, at least in the case of migraines it seems warranted to say that physiological mechanisms may be working to produce migraine independently from psychological processes, and that without knowing the exact causes and possible consequences of migraine-related tissue inflammation it is perhaps risky to adopt a strategy of assuring oneself that the pain is not physically harmful. The National Migraine Association again confirms this worry by pointing out that â€Å"The Migraine disease is a serious health and disability problem that affects approximately 11 to 18 million Americans .