Evidence Based Practice Essay

This question reminded me about the famous and probably one of the most important inventors in the world, Thomas Edison. When he was trying to create his filament for his light bulb, it took him more than a thousand tries to do so. Likewise in a hospital, all the procedures and treatments that nurses do while on the job has been practiced and experimented on so the patient can receive first-class quality care from the nurses. Evidence-based nursing is a process founded on the collection, interpretation, and integration of valid, important, and applicable research. An example of this can be when a new technique or procedure has been discovered to help cure new diseases. After extensive amounts of research, the technique will be experimented on. They will perform the new technique on patients to see if the patients feel better, and like the procedure done to them. Evidence-based practice will help you explore the process of making solid clinical decisions that you must make in the hospital. New problems will arise daily, and with evidence-based practice, you are able to solve those problems in a systematic way. I believe that to do evidence-based practice needs to be done with a group or a team. Efficiency and accuracy is needed when doing evidence-based practice because in the end, the patients are the ones that need to be satisfied with the care that they are receiving. An example of the evidence based practice is as a chemo nurse, patients admitted for chemotherapy are offered pre-treatment assessment and physical and emotional support. Also, we provide a low-stress setting that helps patients and families to receive fully absorb the information and educate themselves about their disease and its treatments. As an effect to evidence-based nursing, we can now be more confident about the procedures that we do on our patients, because they have been thoroughly checked over.

Essay of Ancient China

Ancient China In ancient Chinese cosmology, the universe was created not by divinities but self-generated from the interplay of nature's basic duality: the active, light, dry, warm, positive, masculine yang and the passive, dark, cold, moist, negative yin. All things, animate and inanimate, and all circumstances were a combination of these fundamentals. The ultimate principle of the universe was the tao, â€Å"the way,† and it determined the proper proportions of yin and yang in everything. Anything that altered the natural relation of yin to yang was considered bad, and right living consisted of carefully following the tao.If one observed the tao by moderation, equanimity, and morality, as taught in the Tao-te Ching, by Lao-tzu (sixth century B. C. ), one would be impervious to disease and resistant to the ravages of aging; disregard of the tao led to illness, which was not so much a punishment for sin as the inevitable result of acting contrary to natural laws. However, illn ess also could be caused by forces beyond one's control: â€Å"Wind is the cause of a hundred diseases,† and atmospheric conditions could upset the harmonious inner balance of the yang and yin.One had to be alert to this possibility and combat its effects as well as modify internal imbalances of the vital forces. Longevity and health were the rewards. Chinese medicine, in league with Taoism, was focused on the prevention of illness; for, as the legendary Huang Ti, father of Chinese medicine, observed, â€Å"the superior physician helps before the early budding of disease. † Although Taoist hygiene called for temperance and simplicity in most things, sexual mores were governed by the yin-yang aspect of Chinese philosophy.Ejaculation in intercourse led to diminution of a man's yang, which, of course, upset the inner balance of his nature. On the other hand, one was strengthened by absorption of the yin released by the orgasm of one's female partner—unless she was over thirty, the point where female essence lost its efficacy. The tao was important in Confucianism also, as the path of virtuous conduct, and for centuries the precepts of Confucius (K'ung Fu-tzu, 550-479 B. C. ) set the most prevalent standards of behavior. In early Chinese philosophy, there was a tendency to accept and combine aspects of all religions and to make way for new ideas.Nevertheless, the ancient Chinese were profoundly conservative once an institution, custom, philosophy, mode of dress, or even a furniture style was firmly established, and it remained relatively unchanged over centuries. As Confucius said: â€Å"Gather in the same places where our fathers before us have gathered; perform the same ceremonies which they before us have performed; play the same music which they before us have played; pay respect to those whom they honored; love those who were dear to them. † Although ancient China's development was relatively isolated, there was early contact with India and Tibet.Buddhism came to China from India, and medical concepts and practices were an important part of its teachings. The gymnastic and breathing exercises in Chinese medical methodology also came from India and were closely related to the principles of Yoga and to aspects of Ayurvedic medicine. There were also contacts with Southeast Asia, Persia, and the Arabic world. In the second century B. C. , the Chinese ambassador Chang Chien spent more than a decade in Mesopotamia, Syria, and Egypt, bringing back information on drugs, viticulture, and other subjects.Over the centuries, knowledge of humoral medicine and of numerous new medicaments filtered into China. The introduction of the wisdom of the Mediterranean world was greatly facilitated in the fifth century by the expulsion and wide dispersion from Constantinople of the heretical Nestorian Christians. The mother of Kublai Khan (1216-94), founder of the Mongol dynasty, was a Nestorian and asked the Pope to send European d octors to China. Early Medical Writings Classical Chinese medicine was based primarily on works ascribed to three legendary emperors. The most ancient was Fu Hsi (c. 2900 B. C. , who was said to have originated the pa kua, a symbol composed of yang lines and yin lines combined in eight (pa) separate trigrams (kua) which could represent all yin-yang conditions. This system is followed even today in the I Ching (Book of Changes), though as a game or superstition in the West. Shen Nung, the Red Emperor (Hung Ti), compiled the first medical herbal, the Pen-tsao (c. 2800 B. C. ), in which he reported the effects of 365 drugs, all of them personally tested. One legend explains that a magic drug made his abdominal skin transparent, so he could observe the action of the many plants he evaluated.Another story tells that he cut open his abdomen and stitched in a window. Shen Nung is also said to have drawn up the first charts on acupuncture, a medical procedure presumably even older than the legendary emperors. The fame of Yu Hsiung (c. 2600 B. C. ), the Yellow Emperor (Huang Ti), rests on his great medical compendium, the Nei Ching (Canon of Medicine). Transmitted orally for many centuries, this seminal work was possibly committed to writing by the third century B. C. Its present form dates from the eighth century A. D. when the last extensive revision was done by Wang Ping. The major portion of the Nei Ching, the Sun-Wen (Simple Questions), records the discourse of the Yellow Emperor with Ch'i Po, his prime minister, on virtually all phases of health and illness, including prevention and treatment. The section called Ling-Hsu (Spiritual Nucleus), deals entirely with acupuncture. Yu Hsiung also was said to be responsible for another great compendium, The Discourses of the Yellow Emperor and the Plain Girl, which thoroughly covered the subject of sex from the Taoist point of view.Among other notable sources for ancient medical lore, one might mention the Shih Ching (Boo k of Odes), which perhaps predates Homer's epics, and the Lun-yu, discourses of Confucius probably written down shortly after his death, which affected patterns of behavior for many generations. During the long Chou dynasty (c. 1050-255 B. C. ), a lengthy compilation of medical works, Institutions of Chou, was completed and became the criterion for subsequent dynasties on the duties and organization of physicians. In the Han dynasty (206 B. C. -A. D. 20), there was a noted clinical author named Tsang Kung, who pioneered in the description of many diseases, including cancer of the stomach, aneurysm, and rheumatism. Chang Chung-ching, the Chinese Hippocrates, in the third century A. D. , wrote the classic treatise Typhoid and Other Fevers. Ko Hung, a famed alchemist and a careful observer, wrote treatises describing beriberi (a vitamin B deficiency), hepatitis, and plague, and gave one of the earliest reports on smallpox: â€Å"As the New Year approached there was a seasonal affectio n in which pustules appeared on the face and spread rapidly all over the body.They looked like burns covered with white starch and reformed as soon as they were broken. The majority died if not treated. After recovery purplish black scars remained. † Sun Szu-miao (A. D. 581-682) wrote Ch'ien Chin Yao Fang (A Thousand Golden Remedies), which summarized in thirty volumes much of the known medical learning, and he headed a committee which produced a fifty-volume collection on pathology. An extensive codification of forensic medicine, Hsi Yuan Lu, was done in the Sung dynasty and became the prime source for knowledge of medical jurisprudence.Anatomy and Physiology Ideas of anatomy in ancient China were reached by reasoning and. by assumption rather than dissection or direct observation. Since the doctrines of Confucius forbade violation of the body, it was not until the eighteenth century, long after Vesalius, that the Chinese began systematic, direct anatomical studies. Even as l ate as the nineteenth century, in the Viceroy's Hospital Medical School, anatomy was taught by diagrams and artificial models rather than dissection.Physiological functions were constructed into a humoral system much like Greek concepts of the sixth century B. C. and Galenic views of the second century A. D. , except that there were five instead of four essential humors. (The number five had mystical value for the Chinese and was used for most classifications: five elements, five tastes, five qualities, five kinds of drugs, five treatments, five solid organs, five seasons, five emotions, five colors, etc. ) The medical compendium Nei Ching stated that each emotion had its seat in a particular organ.Happiness dwelt in the heart, thought in the spleen, sorrow in the lungs, and the liver housed anger as well as the soul. Ideas in the Nei Ching concerning movement of the blood (â€Å"All the blood is under control of the heart. † â€Å"The blood current flows continuously in a c ircle and never stops. â€Å") have been thought to approach an understanding of its circulation antedating Harvey by thousands of years; however, some body vessels were believed to convey air, and there is little evidence that commentators perceived the blood-carrying vessels as a contained system. DiagnosisThe Chinese methods of diagnosis included questioning, feeling the pulse, observing the voice and body, and in some circumstances touching the affected parts. In almost all times and cultures physicians have used a similar approach, for all healers have sought to know as much as possible about a patient in order to understand his or her illness and advise treatment. However, in some respects ancient physicians saw each patient more completely as a reflection of his surroundings (indeed, the entire universe) than does the doctor of today. The Chinese doctor wanted to learn ow the patient had violated the tao, and to do this he took into account the patient's rank; changes in his or her social status, household, economic position, sense of well-being, or appetite; the weather; and the dreams of the patient and his or her family. Perhaps the most important diagnostic technique of the ancient Chinese was examination of the pulse. The physician felt the right wrist and then the left. He compared the beats with his own, noting precise time as well as day and season since each hour affected the nature of the pulsations.Each pulse had three distinct divisions, each associated with a specific organ, and each division had a separate quality, of which there were dozens of varieties. Moreover, each division or zone of the pulse had a superficial and deep projection. Thus literally hundreds of possible characteristics were obtainable. In one treatise, Muo-Ching, ten volumes were necessary to cover all the intricacies of the pulse. A patient had only to extend his or her arm through drawn bed curtains for the physician to determine the symptoms, diagnosis, prognosis, a nd proper treatment by intensive palpation of the pulse.Whenever possible the examiner also felt the skin of the ill person. However, it was considered bad form for a man to intimately examine a woman, so special ceramic, ivory, and wooden dolls were pointed to by the invalid to indicate where discomfort was felt. Treatment According to the Nei Ching, there were five methods of treatment: cure the spirit, nourish the body, give medications, treat the whole body, and use acupuncture and moxibustion. The physician had to put the patient back on the right path, the tao.Assuming that specific mental states caused changes in specific organs, the healer linked certain objectionable behavioral and constitutional factors with illness and attempted to have the patient rectify these. For instance, dissolute and licentious ideas led to diseases of the lungs, but acting out such thoughts brought on heart trouble. A doctor had to determine the cause of disharmony in the body and act accordingly. Exercises were developed to keep the body fit and to restore well-being. Hua T'o, the great surgeon, worked out an ingenious system of physical therapy by advising mimicry of the natural movements of animals.Massage—kneading, tapping, pinching, and chafing—was also a regular method of treatment, as were the application of plasters and evacuation of the intestinal tract by cathartics. In nourishing a patient's body, the physician resorted to complex combinations of foods according to their potential amounts of yang and yin. Foods also had to fit the seasons, and each of the five tastes had benefits for a particular element of the body: sour for the bones, pungent for the tendons, salty for the blood, bitter for respiration, and sweet for muscle.Medications The Chinese pharmacopoeia was always rich, from the time of the Pen-tsao, the first medical herbal, to the later dynasties when two thousand items and sixteen thousand prescriptions made up the armamentarium. Drugs w ere considered more likely to be good if they tasted bad. As one would expect, they were classified into five categories: herbs, trees, insects, stones, and grains. The therapeutic minerals and metals included compounds of mercury (calomel was employed for venereal diseases), arsenic, and magnetic stones.Animal-derived remedies, in addition to â€Å"dragon teeth† (powdered fossilized bones), included virtually anything obtainable from living creatures: whole parts, segments of organs, urine, dung. Two plant substances especially associated with China may be singled out. One is ephedra (ma huang), the â€Å"horsetail† plant described by the Red Emperor, which was used for thousands of years as a stimulant, as a remedy for respiratory -diseases, to induce fevers and perspiration, and to depress coughs.Ephedra entered the Greek pharmacopoeia and eventually was disseminated throughout most of the world. It only became a factor in Western medicine in the late nineteenth cen tury after Japanese investigators isolated and purified the active principle, ephedrine, and established its pharmacologic action. A second medicinal herb, always highly popular among the Chinese, is ginseng (â€Å"man-shaped root†). To the Chinese, preparations containing ginseng were almost miraculous in delaying old age, restoring sexual powers, stimulating the debilitated, and sedating the overwrought.In addition it improved diabetes and stabilized blood pressure. In recent years this root has been under scrutiny by Western pharmacologists attempting to evaluate its true benefits. Multitudes in Asia, and even some Westerners, are so convinced of its effectiveness that high-grade wild roots have brought fabulous prices (even reaching thousands of dollars apiece). Although many items in the Chinese materia medica have either faded into bscurity or been labeled fanciful, others subsequently have been found to possess sound pharmacologic bases: seaweed, which contains iodine, was used in treating enlargement of the thyroid; the willow plant, containing salicylic acid, was a remedy for rheumatism; the Siberian wort has antispasmodics for menstrual discomfort; and mulberry flowers contain rutin, a treatment for elevated blood pressure. Whether opium was used as a drug before quite late in Chinese history is still in dispute. Acupuncture and Moxibustion These modalities have been an integral part of Chinese medical therapy for thousands of years.The Yellow Emperor is said to have invented them, but they may well have existed long before his time. The aim of these treatments was to drain off excess yang or yin and thus establish a proper balance, but external energy also could be introduced into the body. In acupuncture the skin is pierced by long needles to varying prescribed depths. Needles are inserted into any of 365 points along the twelve meridians that traverse the body and transmit an active life force called ch'i. Each of these points is related to a particular organ.For instance, puncture of a certain spot on the ear lobe might be the proper way to treat an abdominal ailment. Virtually every illness, weakness, and symptom is thought to be amenable to correction by acupuncture. Acupuncture spread to Korea and Japan by the end of the tenth century A. D. , to Europe about the seventeenth century, and recent years have seen a wider interest in this Chinese medical practice in the West. Individual paramedical healers and even some medical practitioners have been swamped with requests for acupuncture, especially for problems apparently little benefited by conventional practices.The eventual acceptability of this practice in standard Western medicine remains to be seen. Moxibustion is as old as acupuncture, and the same meridians and points govern placement of the moxa. However, in this treatment a powdered plant substance, usually mugwort, is fashioned into a small mound on the patient's skin and burned, usually raising a blister. Dentistry The treatment of tooth disorders was confined mainly to applying or ingesting drugs—pomegranate, aconite, ginseng, garlic, rhubarb, and arsenic, as well as animal products such as dung and urine.The Nei Ching classified nine types of toothaches, which included some obviously due to infections and tooth decay. Like the Mesopotamians and Egyptians, the ancient Chinese believed that worms were often responsible for dental problems. Toothpicks and tooth whiteners were used, and loose teeth were stabilized with bamboo splints. Gold was sometimes used to cover teeth, but the purpose was decorative rather than protective. Surgery Although surgery was not one of the five methods of treatment listed in the Nei Ching, the knife was known and used.Hua T'o, one of the few names mentioned in connection with surgery, treated an arm wound of the famous general Kuan Yu by cutting his flesh and scraping the bone. Physicians knew how to deal with wounds, and at least two classics we re devoted entirely to their treatment. The proper attitude toward pain was to bear it without a sign of emotion, and much was made of the insouciance of the general treated by Hua T'o; he played chess while the surgeon operated. Nevertheless, apparently some kind of anesthesia was often used.Wine and drugs like hyoscyamus were probably mainstays, but the use of opium and Indian hemp is still in question. Eunuchs and Footbinding Another surgical procedure, though hardly therapeutic, was the frequent castration of certain males seeking advancement at court. Though originally a severe punishment, the total removal of penis and testicles came to be a pledge of absolute allegiance to the monarch, since it released the eunuch from conflict with Confucian admonitions of first loyalty to family and the obligation of siring a son for posterity.Footbinding is also of medical interest, for it caused the development of artificially clubbed feet. Over a period of one thousand years, every young girl of proper family willingly permitted herself to be crippled by her mother and aunts to achieve the tiny foot of ideal feminine beauty. Her toes were gradually folded under the sole, and by increasingly tight bandaging her heelbone and forefoot were brought closer together. Without Golden Lotuses, as the best-shaped bound feet were called, a girl was unmarriageable, nor was the life of a courtesan open to her, for tiny feet were a woman's most desirable feature.For a man, a bound-foot wife had profound sexual significance, but she was also a status symbol inasmuch as her helplessness indicated that he was wealthy enough to support a woman, or women, in idleness. There was also an advantage to him in her restricted mobility, for it kept her home and made illicit amorous adventures difficult. Although China's Manchu conquerors forbade the practice in the nineteenth century, it was not until the early twentieth that footbinding was completely abandoned. Diseases Some epidemic dise ases were understood well enough to allow the development of protective measures.In the eleventh century, inoculation against smallpox was effected by putting scabs from smallpox pustules into the nostrils, a method which may have come from India. Wearing the clothing of someone who had the disease was another means of prevention. The relationship of cowpox (as a protective) to smallpox may have been perceived, since ingesting powdered fleas from infected cows was also recommended to stave off smallpox. But other devastating pestilences were neither understood nor held in check. During the Han dynasty an epidemic of what appears to have been typhoid fever killed two-thirds of the population of one region.Precise descriptions of leprosy in the Nei Ching and later works attest to the diagnostic accuracy of the early Chinese healers, but their explanation of the disease's causes and their treatment follow preconceived notions of the time. â€Å"The wind and chills lodge in the blood v essels and cannot be got rid of. This is called li-feng. For the treatment prick the swollen parts with a sharp needle to let the foul air out. † Fourteenth-century writings referred to chaulmoogra oil, a pressing from seeds of an East Indian tree, as a specific for leprosy, and this oil remained the principal antileprous drug even in the West until recent decades.An illness that may have been tuberculosis was recognized as contagious: â€Å"Generally the disease gives rise to high fever, sweating, asthenia, unlocalized pains making all positions difficult and slowly bringing about consumption and death, after which the disease is transmitted to the relations until the whole family has been wiped out. † Venereal diseases, although not well differentiated, received a variety of therapies, including the use of metallic substances for internal medication.In the Secret Therapy for the Treatment of Venereal Disease, the seventeenth-century physician Chun Szi-sung reported us ing arsenic, which, until the development of penicillin, was the modern medication for venereal disease, in the form of Salvarsan and derivatives synthesized by Paul Ehrlich. There seem always to have been places in China where the sick poor could go for medical care. With the advance of Buddhism in the Han and T'ang dynasties, in-patient hospitals staffed by physician-priests became common.However, in the ninth century, when anti-Buddhists were in control, hospitals as well as 4,600 temples were destroyed or emptied. Nevertheless, by the twelfth century hospitals had again become so numerous that virtually every district had at least one tax-supported institution. The upper classes preferred to be treated and cared for in their homes, thus leaving public hospitals to the poor and lower classes. The Practitioners In the Institutions of Chou, compiled hundreds of years before Christ, the hierarchy of physicians in the kingdom was delineated.The five categories were: chief physician ( who collected drugs, examined other physicians, and assigned them); food physicians (who prescribed six kinds of food and drink); physicians for simple diseases (such as headaches, colds, minor wounds); ulcer physicians (who may have been the surgeons); and physicians for animals (evidently veterinarians). Physicians were also rated according to their results, and as early as the Chou and T'ang dynasties each doctor had to report both successes and failures—to control his movement up or down in the ranks.In the seventh century A. D. examinations were required for one to qualify as a physician, some four centuries earlier than the first licensing system in the West. Medical knowledge was thought of as a secret power that belonged to each practitioner. Whereas in other societies, both advanced and primitive, closely knit guilds might control the spread of medical lore, the Chinese physician kept his secrets to himself—passing them on only to sons or, sometimes, specially selected qualifiers.In early times, a physician gave his services out of philanthropy, for since the original healers were rulers, sages, nobles, and, perhaps, priests, economic and social incentives were absent. Later, direct fees or salaries were instituted, and the court and certain prosperous households kept physicians on retainer. Formal schools may have existed as early as the tenth century, and in the eleventh century an organization for medical education was set up under imperial auspices. Under the Ming dynasty in the fourteenth century, the school system became fixed. It changed little over the next centuries, xcept for a gradual decline, and by 1800 there was only one medical school left in Peking. Teachers were held strictly accountable for the performance of their students, and fines were imposed if the professor failed to enforce attendance or if his pupils did poorly on exams. The examination system was complex: a pyramidal structure provided a process of elimination which continued until those with the highest scores emerged. The top students could be heart doctors, the next level were assistant examiners, and lower scores could mean limited assignment in teaching.Specialization may have occurred early. While physicians and apothecaries were separate for a long time, they were both regarded as healers. In the Chou dynasty there were nine specialties, and they grew to thirteen by the Mongol period, early in the fourteenth century. The subdivisions became even more complex, with doctors for the great blood vessels, small vessels, fevers, smallpox, eyes, skin, bones, larynx, and mouth and teeth. There were also gynecologists, pediatricians, and pulsologists for internal diseases, external medicine, the nose and throat, and for children's illnesses.Some healers specialized in moxibustion, acupuncture, or massage. Even the experts in incantation and dietetics were considered medical specialists and were often held in higher regard than other doctor s; surgeons were generally of low rank. Furthermore, each of the practitioners in each category had assistants and students—all of whom had to qualify by examination. Obstetrics was in the hands of midwives for many centuries; it is not known when the first women doctors were in practice. One female physician is mentioned by name in documents from the Han dynasty (206 B.C. -A. D. 220), but women may have been doctors at an earlier date. By the fourteenth century women were officially recognized as physicians. Throughout the Ming dynasty (1368-1644), the practicing medical theorists could be divided into six main philosophic schools. The Yin-yang group focused on insufficiencies of one of these forces. The Wen-pou doctors attributed illnesses to a preponderance of yang and frequently prescribed ginseng and aconite. The Radical group used drastic medication.The Conservatives relied entirely on the authorities of the past, reedited the classic works, and made no deviations from strict authoritarianism. The Eclectic physicians, as their name implies, used a variety of principles from the other sects. The sixth school based all therapy on bringing the five elements and six vapors into harmony. Spread of Chinese Medicine to Korea, Japan, And Tibet Ancient Chinese medicine was well-developed long before the beginning of the Christian era, and its influence appears to have spread into adjacent Korea by the sixth century A.D. At that time, after a severe epidemic had ravaged Japan, Korean doctors who were invited to counsel Japanese physicians introduced them to Chinese medical classics and commentaries. By the seventh century, Japanese scholars and doctors were going directly to China for their information and experience. In the eighth century, a Chinese Buddhist monk named Chien Chen came to Japan and achieved a prominent position in the imperial court at Nara, where, given the Japanese name Kanjin, he taught, practiced medicine, and translated Chinese materia medica.Late in that century, Chinese medicine was well-established in Japan, and a medical school based on its methodology was founded by the Japanese physician Wake Hiroya. Early in the next century (806–10), the Emperor Heijo vainly attempted to combat foreign influence and restore traditional Japanese medical practice, but the methods of Chinese healing were too firmly entrenched. In the tenth century, acupuncture reached Japan, followed by moxibusti on (the word moxa is Japanese), and the full complement of Chinese medicine was accepted in Japan.With medical training closely based on Chinese systems, the Japanese exacted exceptionally intensive and prolonged study before permitting entrance into the profession by governmental examination. As in ancient China, high social standing was a requirement for admission to medical school, but separate instruction by assigned teachers was apparently also arranged to accommodate the more lowly. The authority of Chinese medicine, no t to mention Chinese culture and philosophy, moved east as well as west by the seventh and eighth centuries.However, Arabic and Indian missionaries of Islam and Buddhism made influence a two-way exchange as they traveled to China seeking converts. Since their missions necessitated the translation of Sanskrit and Arabic writings into Chinese and vice versa, medical knowledge inevitably was passed back and forth. Consequently, the crossroads areas of Southeast Asia and Tibet developed a medical system combining aspects of Chinese, Indian, and Arabic practice. Arabic influence, which stemmed in part from Greek teachings, was evident in the doctrine of four humors (phlegm, blood, bile, and wind), whereas Indian deas were seen in the Yogic placement of the soul in the core of the spinal column and reliance on breathing exercises. Traveling Buddhist priests, who were quite successful in spreading their faith, for a long time also practiced medicine. During this early period, the two wives (one Chinese) of a Tibetan king converted him to Buddhism, and thereafter scholars were invited to bring Chinese writings into Tibet, which resulted in collections in Tibetan called Kanjur and Tanjur, the latter containing medical information.In the thirteenth century, the Mongol conqueror Kublai Khan wanted this body of knowledge available again in Chinese but was unable to carry through the translation. Nevertheless, his grandson in the next century arranged for scholars from Tibet, Mongolia, and Central Asia to accomplish the task. Ironically, while the Mongols were in control they allied themselves with non-Chinese such as Uighars, Jews, Christians, and Moslems, and they preferred Arabic medicine to Chinese. Essay of Ancient China Ancient China In ancient Chinese cosmology, the universe was created not by divinities but self-generated from the interplay of nature's basic duality: the active, light, dry, warm, positive, masculine yang and the passive, dark, cold, moist, negative yin. All things, animate and inanimate, and all circumstances were a combination of these fundamentals. The ultimate principle of the universe was the tao, â€Å"the way,† and it determined the proper proportions of yin and yang in everything. Anything that altered the natural relation of yin to yang was considered bad, and right living consisted of carefully following the tao.If one observed the tao by moderation, equanimity, and morality, as taught in the Tao-te Ching, by Lao-tzu (sixth century B. C. ), one would be impervious to disease and resistant to the ravages of aging; disregard of the tao led to illness, which was not so much a punishment for sin as the inevitable result of acting contrary to natural laws. However, illn ess also could be caused by forces beyond one's control: â€Å"Wind is the cause of a hundred diseases,† and atmospheric conditions could upset the harmonious inner balance of the yang and yin.One had to be alert to this possibility and combat its effects as well as modify internal imbalances of the vital forces. Longevity and health were the rewards. Chinese medicine, in league with Taoism, was focused on the prevention of illness; for, as the legendary Huang Ti, father of Chinese medicine, observed, â€Å"the superior physician helps before the early budding of disease. † Although Taoist hygiene called for temperance and simplicity in most things, sexual mores were governed by the yin-yang aspect of Chinese philosophy.Ejaculation in intercourse led to diminution of a man's yang, which, of course, upset the inner balance of his nature. On the other hand, one was strengthened by absorption of the yin released by the orgasm of one's female partner—unless she was over thirty, the point where female essence lost its efficacy. The tao was important in Confucianism also, as the path of virtuous conduct, and for centuries the precepts of Confucius (K'ung Fu-tzu, 550-479 B. C. ) set the most prevalent standards of behavior. In early Chinese philosophy, there was a tendency to accept and combine aspects of all religions and to make way for new ideas.Nevertheless, the ancient Chinese were profoundly conservative once an institution, custom, philosophy, mode of dress, or even a furniture style was firmly established, and it remained relatively unchanged over centuries. As Confucius said: â€Å"Gather in the same places where our fathers before us have gathered; perform the same ceremonies which they before us have performed; play the same music which they before us have played; pay respect to those whom they honored; love those who were dear to them. † Although ancient China's development was relatively isolated, there was early contact with India and Tibet.Buddhism came to China from India, and medical concepts and practices were an important part of its teachings. The gymnastic and breathing exercises in Chinese medical methodology also came from India and were closely related to the principles of Yoga and to aspects of Ayurvedic medicine. There were also contacts with Southeast Asia, Persia, and the Arabic world. In the second century B. C. , the Chinese ambassador Chang Chien spent more than a decade in Mesopotamia, Syria, and Egypt, bringing back information on drugs, viticulture, and other subjects.Over the centuries, knowledge of humoral medicine and of numerous new medicaments filtered into China. The introduction of the wisdom of the Mediterranean world was greatly facilitated in the fifth century by the expulsion and wide dispersion from Constantinople of the heretical Nestorian Christians. The mother of Kublai Khan (1216-94), founder of the Mongol dynasty, was a Nestorian and asked the Pope to send European d octors to China. Early Medical Writings Classical Chinese medicine was based primarily on works ascribed to three legendary emperors. The most ancient was Fu Hsi (c. 2900 B. C. , who was said to have originated the pa kua, a symbol composed of yang lines and yin lines combined in eight (pa) separate trigrams (kua) which could represent all yin-yang conditions. This system is followed even today in the I Ching (Book of Changes), though as a game or superstition in the West. Shen Nung, the Red Emperor (Hung Ti), compiled the first medical herbal, the Pen-tsao (c. 2800 B. C. ), in which he reported the effects of 365 drugs, all of them personally tested. One legend explains that a magic drug made his abdominal skin transparent, so he could observe the action of the many plants he evaluated.Another story tells that he cut open his abdomen and stitched in a window. Shen Nung is also said to have drawn up the first charts on acupuncture, a medical procedure presumably even older than the legendary emperors. The fame of Yu Hsiung (c. 2600 B. C. ), the Yellow Emperor (Huang Ti), rests on his great medical compendium, the Nei Ching (Canon of Medicine). Transmitted orally for many centuries, this seminal work was possibly committed to writing by the third century B. C. Its present form dates from the eighth century A. D. when the last extensive revision was done by Wang Ping. The major portion of the Nei Ching, the Sun-Wen (Simple Questions), records the discourse of the Yellow Emperor with Ch'i Po, his prime minister, on virtually all phases of health and illness, including prevention and treatment. The section called Ling-Hsu (Spiritual Nucleus), deals entirely with acupuncture. Yu Hsiung also was said to be responsible for another great compendium, The Discourses of the Yellow Emperor and the Plain Girl, which thoroughly covered the subject of sex from the Taoist point of view.Among other notable sources for ancient medical lore, one might mention the Shih Ching (Boo k of Odes), which perhaps predates Homer's epics, and the Lun-yu, discourses of Confucius probably written down shortly after his death, which affected patterns of behavior for many generations. During the long Chou dynasty (c. 1050-255 B. C. ), a lengthy compilation of medical works, Institutions of Chou, was completed and became the criterion for subsequent dynasties on the duties and organization of physicians. In the Han dynasty (206 B. C. -A. D. 20), there was a noted clinical author named Tsang Kung, who pioneered in the description of many diseases, including cancer of the stomach, aneurysm, and rheumatism. Chang Chung-ching, the Chinese Hippocrates, in the third century A. D. , wrote the classic treatise Typhoid and Other Fevers. Ko Hung, a famed alchemist and a careful observer, wrote treatises describing beriberi (a vitamin B deficiency), hepatitis, and plague, and gave one of the earliest reports on smallpox: â€Å"As the New Year approached there was a seasonal affectio n in which pustules appeared on the face and spread rapidly all over the body.They looked like burns covered with white starch and reformed as soon as they were broken. The majority died if not treated. After recovery purplish black scars remained. † Sun Szu-miao (A. D. 581-682) wrote Ch'ien Chin Yao Fang (A Thousand Golden Remedies), which summarized in thirty volumes much of the known medical learning, and he headed a committee which produced a fifty-volume collection on pathology. An extensive codification of forensic medicine, Hsi Yuan Lu, was done in the Sung dynasty and became the prime source for knowledge of medical jurisprudence.Anatomy and Physiology Ideas of anatomy in ancient China were reached by reasoning and. by assumption rather than dissection or direct observation. Since the doctrines of Confucius forbade violation of the body, it was not until the eighteenth century, long after Vesalius, that the Chinese began systematic, direct anatomical studies. Even as l ate as the nineteenth century, in the Viceroy's Hospital Medical School, anatomy was taught by diagrams and artificial models rather than dissection.Physiological functions were constructed into a humoral system much like Greek concepts of the sixth century B. C. and Galenic views of the second century A. D. , except that there were five instead of four essential humors. (The number five had mystical value for the Chinese and was used for most classifications: five elements, five tastes, five qualities, five kinds of drugs, five treatments, five solid organs, five seasons, five emotions, five colors, etc. ) The medical compendium Nei Ching stated that each emotion had its seat in a particular organ.Happiness dwelt in the heart, thought in the spleen, sorrow in the lungs, and the liver housed anger as well as the soul. Ideas in the Nei Ching concerning movement of the blood (â€Å"All the blood is under control of the heart. † â€Å"The blood current flows continuously in a c ircle and never stops. â€Å") have been thought to approach an understanding of its circulation antedating Harvey by thousands of years; however, some body vessels were believed to convey air, and there is little evidence that commentators perceived the blood-carrying vessels as a contained system. DiagnosisThe Chinese methods of diagnosis included questioning, feeling the pulse, observing the voice and body, and in some circumstances touching the affected parts. In almost all times and cultures physicians have used a similar approach, for all healers have sought to know as much as possible about a patient in order to understand his or her illness and advise treatment. However, in some respects ancient physicians saw each patient more completely as a reflection of his surroundings (indeed, the entire universe) than does the doctor of today. The Chinese doctor wanted to learn ow the patient had violated the tao, and to do this he took into account the patient's rank; changes in his or her social status, household, economic position, sense of well-being, or appetite; the weather; and the dreams of the patient and his or her family. Perhaps the most important diagnostic technique of the ancient Chinese was examination of the pulse. The physician felt the right wrist and then the left. He compared the beats with his own, noting precise time as well as day and season since each hour affected the nature of the pulsations.Each pulse had three distinct divisions, each associated with a specific organ, and each division had a separate quality, of which there were dozens of varieties. Moreover, each division or zone of the pulse had a superficial and deep projection. Thus literally hundreds of possible characteristics were obtainable. In one treatise, Muo-Ching, ten volumes were necessary to cover all the intricacies of the pulse. A patient had only to extend his or her arm through drawn bed curtains for the physician to determine the symptoms, diagnosis, prognosis, a nd proper treatment by intensive palpation of the pulse.Whenever possible the examiner also felt the skin of the ill person. However, it was considered bad form for a man to intimately examine a woman, so special ceramic, ivory, and wooden dolls were pointed to by the invalid to indicate where discomfort was felt. Treatment According to the Nei Ching, there were five methods of treatment: cure the spirit, nourish the body, give medications, treat the whole body, and use acupuncture and moxibustion. The physician had to put the patient back on the right path, the tao.Assuming that specific mental states caused changes in specific organs, the healer linked certain objectionable behavioral and constitutional factors with illness and attempted to have the patient rectify these. For instance, dissolute and licentious ideas led to diseases of the lungs, but acting out such thoughts brought on heart trouble. A doctor had to determine the cause of disharmony in the body and act accordingly. Exercises were developed to keep the body fit and to restore well-being. Hua T'o, the great surgeon, worked out an ingenious system of physical therapy by advising mimicry of the natural movements of animals.Massage—kneading, tapping, pinching, and chafing—was also a regular method of treatment, as were the application of plasters and evacuation of the intestinal tract by cathartics. In nourishing a patient's body, the physician resorted to complex combinations of foods according to their potential amounts of yang and yin. Foods also had to fit the seasons, and each of the five tastes had benefits for a particular element of the body: sour for the bones, pungent for the tendons, salty for the blood, bitter for respiration, and sweet for muscle.Medications The Chinese pharmacopoeia was always rich, from the time of the Pen-tsao, the first medical herbal, to the later dynasties when two thousand items and sixteen thousand prescriptions made up the armamentarium. Drugs w ere considered more likely to be good if they tasted bad. As one would expect, they were classified into five categories: herbs, trees, insects, stones, and grains. The therapeutic minerals and metals included compounds of mercury (calomel was employed for venereal diseases), arsenic, and magnetic stones.Animal-derived remedies, in addition to â€Å"dragon teeth† (powdered fossilized bones), included virtually anything obtainable from living creatures: whole parts, segments of organs, urine, dung. Two plant substances especially associated with China may be singled out. One is ephedra (ma huang), the â€Å"horsetail† plant described by the Red Emperor, which was used for thousands of years as a stimulant, as a remedy for respiratory -diseases, to induce fevers and perspiration, and to depress coughs.Ephedra entered the Greek pharmacopoeia and eventually was disseminated throughout most of the world. It only became a factor in Western medicine in the late nineteenth cen tury after Japanese investigators isolated and purified the active principle, ephedrine, and established its pharmacologic action. A second medicinal herb, always highly popular among the Chinese, is ginseng (â€Å"man-shaped root†). To the Chinese, preparations containing ginseng were almost miraculous in delaying old age, restoring sexual powers, stimulating the debilitated, and sedating the overwrought.In addition it improved diabetes and stabilized blood pressure. In recent years this root has been under scrutiny by Western pharmacologists attempting to evaluate its true benefits. Multitudes in Asia, and even some Westerners, are so convinced of its effectiveness that high-grade wild roots have brought fabulous prices (even reaching thousands of dollars apiece). Although many items in the Chinese materia medica have either faded into bscurity or been labeled fanciful, others subsequently have been found to possess sound pharmacologic bases: seaweed, which contains iodine, was used in treating enlargement of the thyroid; the willow plant, containing salicylic acid, was a remedy for rheumatism; the Siberian wort has antispasmodics for menstrual discomfort; and mulberry flowers contain rutin, a treatment for elevated blood pressure. Whether opium was used as a drug before quite late in Chinese history is still in dispute. Acupuncture and Moxibustion These modalities have been an integral part of Chinese medical therapy for thousands of years.The Yellow Emperor is said to have invented them, but they may well have existed long before his time. The aim of these treatments was to drain off excess yang or yin and thus establish a proper balance, but external energy also could be introduced into the body. In acupuncture the skin is pierced by long needles to varying prescribed depths. Needles are inserted into any of 365 points along the twelve meridians that traverse the body and transmit an active life force called ch'i. Each of these points is related to a particular organ.For instance, puncture of a certain spot on the ear lobe might be the proper way to treat an abdominal ailment. Virtually every illness, weakness, and symptom is thought to be amenable to correction by acupuncture. Acupuncture spread to Korea and Japan by the end of the tenth century A. D. , to Europe about the seventeenth century, and recent years have seen a wider interest in this Chinese medical practice in the West. Individual paramedical healers and even some medical practitioners have been swamped with requests for acupuncture, especially for problems apparently little benefited by conventional practices.The eventual acceptability of this practice in standard Western medicine remains to be seen. Moxibustion is as old as acupuncture, and the same meridians and points govern placement of the moxa. However, in this treatment a powdered plant substance, usually mugwort, is fashioned into a small mound on the patient's skin and burned, usually raising a blister. Dentistry The treatment of tooth disorders was confined mainly to applying or ingesting drugs—pomegranate, aconite, ginseng, garlic, rhubarb, and arsenic, as well as animal products such as dung and urine.The Nei Ching classified nine types of toothaches, which included some obviously due to infections and tooth decay. Like the Mesopotamians and Egyptians, the ancient Chinese believed that worms were often responsible for dental problems. Toothpicks and tooth whiteners were used, and loose teeth were stabilized with bamboo splints. Gold was sometimes used to cover teeth, but the purpose was decorative rather than protective. Surgery Although surgery was not one of the five methods of treatment listed in the Nei Ching, the knife was known and used.Hua T'o, one of the few names mentioned in connection with surgery, treated an arm wound of the famous general Kuan Yu by cutting his flesh and scraping the bone. Physicians knew how to deal with wounds, and at least two classics we re devoted entirely to their treatment. The proper attitude toward pain was to bear it without a sign of emotion, and much was made of the insouciance of the general treated by Hua T'o; he played chess while the surgeon operated. Nevertheless, apparently some kind of anesthesia was often used.Wine and drugs like hyoscyamus were probably mainstays, but the use of opium and Indian hemp is still in question. Eunuchs and Footbinding Another surgical procedure, though hardly therapeutic, was the frequent castration of certain males seeking advancement at court. Though originally a severe punishment, the total removal of penis and testicles came to be a pledge of absolute allegiance to the monarch, since it released the eunuch from conflict with Confucian admonitions of first loyalty to family and the obligation of siring a son for posterity.Footbinding is also of medical interest, for it caused the development of artificially clubbed feet. Over a period of one thousand years, every young girl of proper family willingly permitted herself to be crippled by her mother and aunts to achieve the tiny foot of ideal feminine beauty. Her toes were gradually folded under the sole, and by increasingly tight bandaging her heelbone and forefoot were brought closer together. Without Golden Lotuses, as the best-shaped bound feet were called, a girl was unmarriageable, nor was the life of a courtesan open to her, for tiny feet were a woman's most desirable feature.For a man, a bound-foot wife had profound sexual significance, but she was also a status symbol inasmuch as her helplessness indicated that he was wealthy enough to support a woman, or women, in idleness. There was also an advantage to him in her restricted mobility, for it kept her home and made illicit amorous adventures difficult. Although China's Manchu conquerors forbade the practice in the nineteenth century, it was not until the early twentieth that footbinding was completely abandoned. Diseases Some epidemic dise ases were understood well enough to allow the development of protective measures.In the eleventh century, inoculation against smallpox was effected by putting scabs from smallpox pustules into the nostrils, a method which may have come from India. Wearing the clothing of someone who had the disease was another means of prevention. The relationship of cowpox (as a protective) to smallpox may have been perceived, since ingesting powdered fleas from infected cows was also recommended to stave off smallpox. But other devastating pestilences were neither understood nor held in check. During the Han dynasty an epidemic of what appears to have been typhoid fever killed two-thirds of the population of one region.Precise descriptions of leprosy in the Nei Ching and later works attest to the diagnostic accuracy of the early Chinese healers, but their explanation of the disease's causes and their treatment follow preconceived notions of the time. â€Å"The wind and chills lodge in the blood v essels and cannot be got rid of. This is called li-feng. For the treatment prick the swollen parts with a sharp needle to let the foul air out. † Fourteenth-century writings referred to chaulmoogra oil, a pressing from seeds of an East Indian tree, as a specific for leprosy, and this oil remained the principal antileprous drug even in the West until recent decades.An illness that may have been tuberculosis was recognized as contagious: â€Å"Generally the disease gives rise to high fever, sweating, asthenia, unlocalized pains making all positions difficult and slowly bringing about consumption and death, after which the disease is transmitted to the relations until the whole family has been wiped out. † Venereal diseases, although not well differentiated, received a variety of therapies, including the use of metallic substances for internal medication.In the Secret Therapy for the Treatment of Venereal Disease, the seventeenth-century physician Chun Szi-sung reported us ing arsenic, which, until the development of penicillin, was the modern medication for venereal disease, in the form of Salvarsan and derivatives synthesized by Paul Ehrlich. There seem always to have been places in China where the sick poor could go for medical care. With the advance of Buddhism in the Han and T'ang dynasties, in-patient hospitals staffed by physician-priests became common.However, in the ninth century, when anti-Buddhists were in control, hospitals as well as 4,600 temples were destroyed or emptied. Nevertheless, by the twelfth century hospitals had again become so numerous that virtually every district had at least one tax-supported institution. The upper classes preferred to be treated and cared for in their homes, thus leaving public hospitals to the poor and lower classes. The Practitioners In the Institutions of Chou, compiled hundreds of years before Christ, the hierarchy of physicians in the kingdom was delineated.The five categories were: chief physician ( who collected drugs, examined other physicians, and assigned them); food physicians (who prescribed six kinds of food and drink); physicians for simple diseases (such as headaches, colds, minor wounds); ulcer physicians (who may have been the surgeons); and physicians for animals (evidently veterinarians). Physicians were also rated according to their results, and as early as the Chou and T'ang dynasties each doctor had to report both successes and failures—to control his movement up or down in the ranks.In the seventh century A. D. examinations were required for one to qualify as a physician, some four centuries earlier than the first licensing system in the West. Medical knowledge was thought of as a secret power that belonged to each practitioner. Whereas in other societies, both advanced and primitive, closely knit guilds might control the spread of medical lore, the Chinese physician kept his secrets to himself—passing them on only to sons or, sometimes, specially selected qualifiers.In early times, a physician gave his services out of philanthropy, for since the original healers were rulers, sages, nobles, and, perhaps, priests, economic and social incentives were absent. Later, direct fees or salaries were instituted, and the court and certain prosperous households kept physicians on retainer. Formal schools may have existed as early as the tenth century, and in the eleventh century an organization for medical education was set up under imperial auspices. Under the Ming dynasty in the fourteenth century, the school system became fixed. It changed little over the next centuries, xcept for a gradual decline, and by 1800 there was only one medical school left in Peking. Teachers were held strictly accountable for the performance of their students, and fines were imposed if the professor failed to enforce attendance or if his pupils did poorly on exams. The examination system was complex: a pyramidal structure provided a process of elimination which continued until those with the highest scores emerged. The top students could be heart doctors, the next level were assistant examiners, and lower scores could mean limited assignment in teaching.Specialization may have occurred early. While physicians and apothecaries were separate for a long time, they were both regarded as healers. In the Chou dynasty there were nine specialties, and they grew to thirteen by the Mongol period, early in the fourteenth century. The subdivisions became even more complex, with doctors for the great blood vessels, small vessels, fevers, smallpox, eyes, skin, bones, larynx, and mouth and teeth. There were also gynecologists, pediatricians, and pulsologists for internal diseases, external medicine, the nose and throat, and for children's illnesses.Some healers specialized in moxibustion, acupuncture, or massage. Even the experts in incantation and dietetics were considered medical specialists and were often held in higher regard than other doctor s; surgeons were generally of low rank. Furthermore, each of the practitioners in each category had assistants and students—all of whom had to qualify by examination. Obstetrics was in the hands of midwives for many centuries; it is not known when the first women doctors were in practice. One female physician is mentioned by name in documents from the Han dynasty (206 B.C. -A. D. 220), but women may have been doctors at an earlier date. By the fourteenth century women were officially recognized as physicians. Throughout the Ming dynasty (1368-1644), the practicing medical theorists could be divided into six main philosophic schools. The Yin-yang group focused on insufficiencies of one of these forces. The Wen-pou doctors attributed illnesses to a preponderance of yang and frequently prescribed ginseng and aconite. The Radical group used drastic medication.The Conservatives relied entirely on the authorities of the past, reedited the classic works, and made no deviations from strict authoritarianism. The Eclectic physicians, as their name implies, used a variety of principles from the other sects. The sixth school based all therapy on bringing the five elements and six vapors into harmony. Spread of Chinese Medicine to Korea, Japan, And Tibet Ancient Chinese medicine was well-developed long before the beginning of the Christian era, and its influence appears to have spread into adjacent Korea by the sixth century A.D. At that time, after a severe epidemic had ravaged Japan, Korean doctors who were invited to counsel Japanese physicians introduced them to Chinese medical classics and commentaries. By the seventh century, Japanese scholars and doctors were going directly to China for their information and experience. In the eighth century, a Chinese Buddhist monk named Chien Chen came to Japan and achieved a prominent position in the imperial court at Nara, where, given the Japanese name Kanjin, he taught, practiced medicine, and translated Chinese materia medica.Late in that century, Chinese medicine was well-established in Japan, and a medical school based on its methodology was founded by the Japanese physician Wake Hiroya. Early in the next century (806–10), the Emperor Heijo vainly attempted to combat foreign influence and restore traditional Japanese medical practice, but the methods of Chinese healing were too firmly entrenched. In the tenth century, acupuncture reached Japan, followed by moxibusti on (the word moxa is Japanese), and the full complement of Chinese medicine was accepted in Japan.With medical training closely based on Chinese systems, the Japanese exacted exceptionally intensive and prolonged study before permitting entrance into the profession by governmental examination. As in ancient China, high social standing was a requirement for admission to medical school, but separate instruction by assigned teachers was apparently also arranged to accommodate the more lowly. The authority of Chinese medicine, no t to mention Chinese culture and philosophy, moved east as well as west by the seventh and eighth centuries.However, Arabic and Indian missionaries of Islam and Buddhism made influence a two-way exchange as they traveled to China seeking converts. Since their missions necessitated the translation of Sanskrit and Arabic writings into Chinese and vice versa, medical knowledge inevitably was passed back and forth. Consequently, the crossroads areas of Southeast Asia and Tibet developed a medical system combining aspects of Chinese, Indian, and Arabic practice. Arabic influence, which stemmed in part from Greek teachings, was evident in the doctrine of four humors (phlegm, blood, bile, and wind), whereas Indian deas were seen in the Yogic placement of the soul in the core of the spinal column and reliance on breathing exercises. Traveling Buddhist priests, who were quite successful in spreading their faith, for a long time also practiced medicine. During this early period, the two wives (one Chinese) of a Tibetan king converted him to Buddhism, and thereafter scholars were invited to bring Chinese writings into Tibet, which resulted in collections in Tibetan called Kanjur and Tanjur, the latter containing medical information.In the thirteenth century, the Mongol conqueror Kublai Khan wanted this body of knowledge available again in Chinese but was unable to carry through the translation. Nevertheless, his grandson in the next century arranged for scholars from Tibet, Mongolia, and Central Asia to accomplish the task. Ironically, while the Mongols were in control they allied themselves with non-Chinese such as Uighars, Jews, Christians, and Moslems, and they preferred Arabic medicine to Chinese.

Conflict Management Styles Essay

Conflict usually occurs when individuals within a group or organization has differences in opinions. When individuals are in a disagreement about something like policies and procedures or even the overall direction of which an organization or company is heading it can become very frustrating. As we all know conflict the process of conflict usually begins when an individual or party has perceived the other part and it has showed a negative impact or will affect something that another party cares about. According to the readings in Chapter 15 the early approach of conflict saw that all conflict was labeled to be bad. Conflict then had a negative vibe and was used often to be linked with such terms as violence, destruction, or irrationality as reinforcement to its negative association. There are several types of conflict from the integrationist point of view that includes functional and dysfunctional conflict. Functional conflict usually arises during when the goals of a group are supported and the performance rises. On the other hand dysfunctional conflict is conflicts that hinder the performance of the group as a whole. The conflict process consists of five stages that include potential opposition, incompatibility, cognition and personalization, intentions, behaviors, and outcomes. In my workplace the most common form of conflict management is potential opposition and incompatibility. I have worked for Viking Range Corporation for 10 years now and I enjoy my work there. My Supervisor is always open for communication but this is one of the most vital parts that bring about conflict in my organization. Most of the times communication plays a huge role in the effectiveness of the company. Communication is the biggest problem that we have as a whole throughout the facility because there always seem to be conflict that arises between departments on part outages, and department personnel. Conflict is something we can’t avoid whether at home or at the workplace. Conflict will be present in just about every human interaction that we come across and this can make the strategies that we use for conflict management very important. According to (Conflict Management Home-versus-work) â€Å"Conflict management strategies vitally increase the performance and effectiveness of an individual and in turn the effectiveness of the organization as a whole. † I am an individual that can’t handle or try to avoid conflict. I have been a part of a lot of confrontations and I try to avoid them at all costs. â€Å"In the same article Rahim and Bonama’s (1979) categorization of the styles of settling interpersonal conflict is based on two facades, first when a person considers himself and his own concerns and the second when a person considers others and the concerns of others. Their styles for handling conflict include an integrating style in which a person considers his style and the styles of others. Secondly would be the avoiding style in which the individual has no concerns for their self as well as others. Thirdly would be obliging in which the individual posses a concern for others but not himself. The next one is the dominating style in which the individual has high concerns for himself for low concerns for others. Lastly we have the compromising style in which the individual possess some consideration for himself and some for others. I can relate more to the dominating style because in my organization every department is usually out for themselves meaning they like to maintain a high standard by any means. However, one thing that I have learned that is being a part of the business world there will always be some form of conflict and differences of opinions will arise so it is best to handle the situation immediately. By acknowledging that there is conflict present and communication has come to a standstill we can decrease the problems that unsolved conflict can bring about in any organization. One way that we deal with conflict in our organization is by acknowledging the goals of each department as well as the employees. The Supervisor over our department does not handle conflict well and he tries to avoid any altercations at all costs. With me being next in line he will usually push things of this nature off for me to handle. I often deal with the situations by bringing the employees into the office to see what the problem is in forms of communication and what caused the problem to begin with. I have tried to encourage my Supervisor to deal with situations in the future before they occur and he has taken steps on his own to deal with situations where he sense conflict. He can actually sense when there is a lack of communication and conflict is about to arise so he stops it before it starts by bringing both individuals into the office to try and get to the root of the problem before something major happens. This same occurrence can happen between male and female management personnel that can’t seem to see eye to eye and have issues that lead to conflict. According to (Conflict Management Modes and Leadership Styles) â€Å"most individual characteristics have an impact on the instruments analyzed, for example: younger managers are more task-oriented, while older managers are typically relationship- oriented and avoid conflicts, women are more collaborative and avoid conflicts less and men tend to use the accommodating mode more than women. â€Å"Rather surprisingly, according to our survey, women appear to be more competitive than men. The compromising style of conflict matches my personal preference tremendously, because I can relate to this style in my organization on a day to day basis. Being in my field of work there will always be a competition between the male and female employees as well as male and female management personnel. I look at this as something that will be unavoidable because there will always be a power struggle between the genders. So I try to look at things from a bigger perspective and consider both parties involved because there will always be differences in opinions.

EDU 636 DB4 Essay Example | Topics and Well Written Essays - 500 words

EDU 636 DB4 - Essay Example Books are not enough anymore due to advances in technology (Brooks, 1949, p.8). This report would discuss some appropriate instructional media for each level of Bloom’s cognitive domain. The first level is knowledge which is often used to recall information or data. The instructional media appropriate for this level are graphics, charts, photographs, and charts. Using symbols can be very helpful in assisting learner’s to recall valuable information. For example, pre-school children can effectively match a word with a certain object or symbol. The suggested media would not take the place of the teacher but only act as an aid or additional resource for learner. The second level of the cognitive domain is comprehension which involves interpretation of information such as following instructions, rewriting information or explaining in one’s own words material that has been read. Audio media such as podcast or student presentation can help learners realize this cogniti ve domain. If a student can make a power point presentation of a report in class that is very informative, then comprehension is achieved.

Home land security and terrorism Essay Example | Topics and Well Written Essays - 500 words

Home land security and terrorism - Essay Example Either they belong to Muslim communities or non Muslim; they become the target of violent spreading factors (Eric Croddy, James J. Wirtz, 2005, p 458). In such a worse condition there are few countries which are severely affected i.e. Pakistan Afghanistan and Srilanka. But the super power of this world is not yet largely affected by the roots of terrorism. Securing the borders is one of the biggest challenges that US government is facing these days. To avoid the risk of terrorism the government utilizes a number of technologies such as â€Å"virtual fence† of sensors; cameras, motion detectors, and other equipments (United States, Dept. of Defense, Newton N. Minow). Undocumented immigrants are also forbidden by the government so that the invasion of terrorists is controlled within a state. But this does not make the whole system a fool proof system but it still leaves doubts because of which the government tries to enhance its system. Bush administration bequeathed a border security program to Obama team in which undocumented immigrants were cited as a cause of terrorism. Therefore Secure Border Initiative (SBI) plan was made by Obama administration’s new team. It is a comprehensive plan to control the illegal flow of immigrations. It includes increased staffing to strengthen interior enforcement. A great investment was also made in detecting technology and infrastructure. A vital module of the SBI strategy is SBI- net program. In March 2010 DHS designed another surveillance policy in which a new security technology would be installed. It includes mobile surveillance, thermal imaging devices, ultra-light detection, backscatter units, mobile radios, cameras and laptop computers for pursuit vehicles, and remote video surveillance system enhancements. By applying all these parameters it is expected that US can be successful in maintaining security

Information Security Program Survey Essay Example | Topics and Well Written Essays - 1000 words

Information Security Program Survey - Essay Example Since the NASA needs to manage highly sensitive data, information, strategic plans, and space programs, the organization pays particular attention to its information security program. This paper will analyze NASA’s information security program focusing on aspects like strategic fit, breadth and coverage, program deficiencies or implementation issues, and stated costs and benefits. NASA Information Security Program The NASA IT Security (ITS) Division operations under the control the Chief Information Officer to manage security projects and thereby to mitigate vulnerabilities, improve obstacles to cross-center collaboration, and to provide cost effective IT security services for supporting the agency’s systems and e-Gov initiatives. The ITS Division works to ensure that IT security across the organization meets integrity and confidentiality to enhance disaster recovery and continuity of operations. â€Å"The ITS Division develops and maintains an information security pro gram that ensures consistent security policy, indentifies and implements risk-based security controls, and tracks security metrics to gauge compliance and effectiveness† (IT Security Division). This Division also performs periodical audits and reviews to make certain that security policies and procedures meet accepted standards. It is clear that NASA extensively relies on information systems and networks to manage its activities such as scientific discovery, aeronautics research, and space exploration. Since many of these information systems and networks are interconnected using internet, they are more likely to be threatened by cyber attacks from different sources. While analyzing the strategic fit of the NASA’s information security program, it seems that the program cannot well support the organization’s goals and objectives due to several security pitfalls. Although the organization has achieved significant advancements in information security program manageme nt and security control implementation, it is still vulnerable to cyber attacks. According to the GAO report, NASA has not always implemented proper control measures to ensure the confidentiality and integrity of its systems and networks that support the organization’s mission directorates. As a result, the organization often fails to sufficiently prevent, restrict, and detect unauthorized access to its systems and networks (GAO). The major pitfall of the NASA’s information security program is that it has not been consistent in identifying and authenticating users and limiting user access to its key systems and networks. The organization cannot effectively encrypt its network services and data and often fails to protect its network boundaries. It is alarming to note that the organization has even failed to protect its information technology resources physically. In addition, shortcomings in the auditing and monitoring of computer-related events also contributed to the organization’s information security inefficiency. The organization also faces challenges in effectively segregating incompatible duties and managing system configurations. The key reason for those inefficiencies in NASA’s information security program is that the organization is yet to implement some key activities to make certain that control measure are appropriately developed and functioning efficiently. The organization does not give specific focus to complete assessment of information secur

Healthcare Finance Assignment Example | Topics and Well Written Essays - 250 words - 1

Healthcare Finance - Assignment Example This saves time and resources dedicated to budgeting (Shim, Siegel & Shim, 2012). Top-down approach also minimizes unnecessary spending by the various departments and helps streamline an organization’s accounting processes. This further helps an organization to stay financially firm while avoiding cost overruns. This is unlike the bottom up approach where departments make their own budgets and pass them to the upper executives. The major risk that comes with this approach is the possibility of experiencing cost overruns, which can be financially damaging (Shim, Siegel & Shim, 2012). By leaving the responsibility of budgeting to the upper management, chances of costs overruns are greatly reduced. A top-down approach can also be used to help departments know what is expected of them. Each department is allocated a budget according to the expectations of the organization on that department. This is ideal in a situation where an organization wants to reduce on its

The Joke by Milan Kundera and how it relates with history of European, Essay

The Joke by Milan Kundera and how it relates with history of European, the Czech society, socialism, totalitarianism and any oth - Essay Example Consequently, the thesis statement of this paper is that the author criticises the communist ideology in Czechoslovakia. Analysis The idea of communism when it was introduced in many of the Eastern Europe countries was to create optimism on the people that they will be equal in acquiring and enjoying social and economic benefits (McKay, 2007). Ideally, the ideology was targeting the equal distribution of the resources in the society to enable people to grow equally on social benefits. This political idea has been castigated by the author as an opium system. Indeed, the author illustrates how one of the characters in the fiction novel wrote in a postcard critiquing the notion of optimism in a society. "Optimism is the opium of the people! A healthy atmosphere stinks of stupidity! Long live Trotsky!" (Kundera 18). This observation of the author through the use of the character in the fiction novel, illustrates how the writer thought of the communist ideology in the republic of Czechosl ovakia during those days. Inasmuch the idea of communism in the country was to draw equality in the lives of the population, the system according to the writer, was pegged on optimism to the people that social and economic benefits will be distributed equally for their own good. ... Consequently, the statement from the novel depicts how the writer blames the communist ideology in Czechoslovakia in beholding them from participating in innovative and creative activities to improve their lives. Another aspect that has been demonstrated in the fiction novel by the writer in critiquing the communist idea is the imprisonment of the mind. This implied the effect of the political system that was practiced in the country in preventing the population in questioning the rationale of the government actions. Thus, the writer demonstrates how the communist ideology in his country had blinded the minds of the population in holding the government accountable in carrying out the state’s affairs. Indeed, the writer illustrates how one of the characters described another character in the fiction novel as unable to go beyond the government rhetoric in questioning its action. In addition, the writer demonstrates how the population is politically constrained in understanding t he ills of the government actions due to the legal system that was introduced by the communist ideology. "She was constitutionally unable to look behind anything; she could only see the thing itself" (Kundera, 143). In contrast, the communist idea in the history of European society was agitated to end the capitalism ills in imprisoning the population. Indeed, it was argued that the capitalism ideology had imprisoned the minds of the population due to its embracement of materialism in the society (McKay, 2007). However, the fiction novel demonstrates how the communist idea failed in liberating the population in questioning the actions of their own government. Indeed, the author demonstrates how one of the character

Research paper Essay Example | Topics and Well Written Essays - 750 words - 3

Research paper - Essay Example As such, relationship building, intimacy, and the cost benefit theory of a relationship will be analyzed through the lens of how these aspects are presented within the film in question. These three have been selected due to the fact that this analyst believes they are the strongest determinants of the plot and action that takes place within the film in question. Firstly, with regards to relationship building, the text refers to this is a multipart process result in the strengthening of the relationship or can ultimately result in its undoing. As with so many films that are concentric upon relationship and the means by which individuals fall in and out of love, â€Å"Hitch† follows a somewhat predictable line in that it presents the case of two individuals who initiate, experiment, intensify, integrate and bond throughout the course of the film. Naturally, this process is not painless or carried out in one seamless action. Rather the inverse of these is also represented to the fact that during the latter half of the film, the couple experiences a degree of differentiation, circumscribing, stagnation, avoidance, and termination. Naturally, as is the case with many films, the ability of the filmmakers to encapsulate all of these actions and emotions within a brief one hour and 20 minutes is necessarily limited. However, each of these determinants is presented in a verifiable way so that it can be ascertained that this process is indeed taking place; howbeit in fast-forward. Similarly, although intimacy is oftentimes misunderstood to merely equate to a type of physical intimacy, involving sexual relations, this is not only what was presented within the movie in question. For instance, the scene regarding Ellis Island creates a moment of intense spiritual and psychological intimacy that sees both characters share from their past and bond rapidly over these realities. Although the film has previously been described within this analysis as something of each rig ht Hollywood production, this depth in helping to describe and elaborate upon human emotion is useful and relevant with regards to seeking to understand this film within the context of sociological and interpersonal development. This alternative definition of C is a welcome refreshment from the one-sided definition of intimacy is oftentimes presented to the viewer. Although it is true that neither physical nor emotional intimacy can be categorized as having a more powerful effect, seeking to exhibit both within a film is more effective means of presenting the level of closeness that would necessarily exist between characters that share such a bond. Similarly, as it is realized that there is tension between the two characters and a series of conflicts arise, it can be noted that the female character, played by Eva Mendes, begins to engage in what can be termed as a cost-benefit analysis of the relationship (Hitch 2005). Ultimately, as a result of the seeming deception that she has wi tnessed throughout the course of her relationship, she becomes highly self doubtful with regards to whether there remains any future between the two. However, as time goes on, it is clearly seen that a level of regret is exhibited on the part of both characters and they ultimately seek to reconcile these differences new the conclusion of the film.

HTM101 Research Paper Example | Topics and Well Written Essays - 2000 words

HTM101 - Research Paper Example The American accommodation industry regularly acknowledges Marriott Hotels as a leading player because of practicing grand business ethics. In addition to being an event and accommodation company, Marriott Hotels oversees the high-quality visitor loyalty initiative called Marriott Rewards and The Ritz-Carlton Rewards initiatives that collectively exceed 45 million members globally (Kuang, 2012). Before 1957, founder J. Willard Marriott, along with his spouse Alice, ran a simple root beer store in Washington D.C. that gradually grew a drive-in diner called Hot Shoppes in 1927 (Marriott Jr. and Brown, 2013). Between 1957 and 1985, Marriott created Marriott Hotels as a means of venturing into the accommodation and hospitality sector fully. This business move was historical for the company since it marked the bold application of the owner’s interest in worldwide enterprise. Before his demise in 1985, Marriott transformed the American, Mexican, and European hospitality sectors with the foundation of the pioneering and biggest motor hotel (Marriott Jr. and Brown, 2013). The takeover of Marriott Hotels by Marriott’s son, J. W. Junior, saw the inclusion of numerous new brands into the organization’s operations and partnerships as a creative model (Marriott Jr. and Brown, 2013). This model was the first of its kind since it aimed at extending stays for business visitors or guests in all Marriott Hotels. In 1993, J. W. Junior formally founds a new organization, Marriott International Inc. that takes over operational and managerial roles for all Marriott Hotels and its brands (Marriott Jr. and Brown, 2013). By 2014, Marriott International had acquired more than five accommodation companies across the world, including The Ritz-Carlton Hotel Company and Renaissance Hotel Group. During the same period, Marriott International launched historic brands in European, Asian, and African markets like Bulgari Hotels & Resorts in Italy, AC Hotels

Assignment Example | Topics and Well Written Essays - 500 words - 132

Assignment Example Erb explains that Kilpatrick had been arrested thrice on different charges during his tenure as mayor. Kilpatrick’s corruption involved other people including his chief of staff and his father (Erb p1). Kilpatrick’s conduct was unethical because it involved behavior that did not match the expectations of his status and position. As a mayor, he was supposed to be a steward of public funds upholding accountability and responsibility but he spent public funds recklessly. The people of Detroit had entrusted him with the task of looking after their welfare but he did not live up to his mandate because he worsened Detroit’s economic crisis. The conduct was also unethical because Kilpatrick repeated crimes for which he was previously convicted thus showing lack of remorse. It was unethical for Kilpatrick to have used racialism as his excuse when he should have been taking responsibility of his mistakes. It is all the more unethical for him to have been spending public funds in the name of living up to his image as a hip-hop mayor when in the actual sense it appears like he was doing it selfishly (Erb p3). Kilpatrick was taken to court, several times, and tried for charges that were filed against him. Some of the charges included using public funds to pay expensive dinners, pay college expenses for relatives and leasing a Lincoln Navigator. In a 2007 lawsuit, Kilpatrick tried and convicted of having an illicit affair with his chief of staff, Christine Beatty and was found guilty. He was indicted for eight criminal charges and he agreed to serve one hundred and twenty days in jail and pay one million dollars as restitution to Detroit. In addition, the sentence directed that Kilpatrick give up his law license and that he should not seek public office for a period of five years (Erb p7). After this trial, a judge ordered Kilpatrick back to court for charges that he was hiding some of his assets in order not to make restitution. Kilpatrick faced

Nicholas Romanov Essay Example for Free

Nicholas Romanov Essay Nicholas II was the last of the Romanov dynasty rule as the Czar of Russia. His rule began on 1st of November and finished on the 15th of 1917. During the time of Nicholas’s reign Russia saw him go from the great and powerful â€Å"little father† to a much more dishonorable and weak â€Å"bloody Nicholas†. Nicholas II was unsuccessful and the reason behind all of Russia’s many downfalls such as WW1 and the Russo-Japanese war. Bloody Sunday, The October Manifesto and the Russo-Japanese war were all events that support how unsuccessful he was as Czar and prove that he was the worst ruler of his time. The Russ-Japanese was the beginning of the on going failure of Czar Nicholas II. The war began over both Japan and Russia wanting control over Manchuria, Russia was defeated and shaken. The Czars people began lose their faith as it started the many strikes and demonstrations in St. Petersburg. Starting a war was Nicholas’s plan to divert the attention from the national problems of Russia, however created the original division between the Czar and his people. The war was fought in the far eastern reaches of Russia and most of the population lived in Moscow and St. Petersburg, so talk of the war created little enthusiasm for people to fell about the war, which Nicholas was hoping for. Bloody Sunday was an event that brought attitudes and opinions of hate towards Nicholas II and branded him with the new nickname â€Å"bloody Nicholas† which also creates a sense of how the working class felt about their Czar. Bloody Sunday was the massacre of innocent peasants holding a peaceful petition led by father Gapon, outside the winter palace and through the streets of Russia. Peasants marched unarmed and carrying religious symbols on flags hoping that their Czar would show compassion and help his people like a Czar should. This was not the case. The Imperial Guard fired 3 shots before shooting into the crowd killing over 200 people and injuring many more. Bloody Sunday provides clear evidence of Czar Nicholas failure and how unsuccessful he was at addressing the problems of Russia. The October Manifesto was a result of the horrible occurrences of Bloody Sunday in 1905. The October Manifesto was issued by Nicholas II to serve as a response to the Russian Revolution in 1905, but in fact, created an even bigger problem for the Czar to solve. The idea was to create a Duma and grant public liberties such as freedom of speech, assembly and religion. The plan was to bring back the bond between the Czar and his peasants but backfired and led to failure. The duma was unsuccessful as the Czar still had full control and was unwilling to share, which created an even bigger uproar among peasants as it was beneficial for the wealthier individuals of Russia more so than the working class. Nicholas II was now dealing with two gigantic holes in society that couldn’t be fixed, proving how unsuccessful he was as a ruler. In conclusion, Nicholas II was a highly unsuccessful ruler for the three major events of his reign bringing him failure and eventually leading him to his abdication. Bloody Sunday, the October Manifesto and Russo-Japanese are all stages of the Romanov Dynasty that prove Czar Nicholas was ineffective and distorted ruler, who was unsuccessful in solving the problems of Russia, which led to the downfall of the country and the end of an empire.

Concept of suicide

Concept of suicide 1.0 Concept of Suicide 1.1 Background Sir Thomas Browned originates the word suicide in 1642 in his Religio Medici. It was derived from SUI (of oneself) and CAEDES (murder).since then, this word has caused much controversy and evoked many professionals to continuous research and debate upon its definition in various ways from every aspects: medical, social, psychological, administrative, legal, spiritual and religious purposes.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Suicide is no longer uncommon in the society and every day, there are people from many walks of life living under the same roof without us knowing what problems they are plagued with. Back centuries, suicide was a taboo subject to be discussed and yet, many are engaged in such behavior although it is believed that most suicide cases are unreported. To some, suicidal actions are glorified especially to cults and religion purposes. As time progresses, the mentality of the society changes along with time and the stigma of suicide is slowly undergoing much debate and understanding. Now, suicide is regarded more of a tragedy instead of ritual because part of the reason is that the society undergoes globalization and no longer practices scarification. Even if there is a minority of tribes who endorses scarification, the groups are negligible throughout the globe. Also, suicide in this era more often is done due to personal reasons; be it mentality, spiritual etc. In 1763, the first attempt was done scientifically by Merian to understand the rationale behind suicide. It is believed that suicide was not perceived as a sin or a crime. Instead, suicide has been regarded as a disease of mankind. After the death of Jean Jacques Rousseau in 1822, which had sequentially and graphically described circumstances of his death, Farlet manages to conduct a first in-depth examination on suicide. This enables better understanding on suicide with broader perspective. A famous psychiatrist, Dr R. Gaupp, says that amongst people committing suicide they possess unique and bizarre personality traits. For the past 50 years, it is concluded by series of researches that suicide begins from the state of mind, coupled with external factors, resulting in suicide. Herein, we will look in depths of suicide amongst Malaysian school students. 1.2 Definition A suicide idea is when one thought of ending ones own life. One thing leads to another, suicide ideas often leads to suicidal attempt and suicidal behaviour. Suicidal behaviours are thoughts or tendencies that started off a person and put them at risk for committing suicide. Simply said, suicide is an intentional or voluntary determination to end ones life, as defined by the World Health Organization (WHO). A suicidal person often closed ones options in life, and looks at another darker side of negativity. To them, dying is a pre-requisite for the end of all sufferings. A famous sociologist, Emile Durkheim whom not only proposes the theory of functionalism but also studied on Suicide, states that: the term suicide is applied to all cases of death resulting directly or indirectly from a positive or negative act of the victim himself, which he knows will produce this result (1982, p. 110 [excerpt from Suicide]). 1.3 Description Suicide is not an uncommon issue these days and it is widely discussed in institutions although it is still condemned by the society. Much about discussing facts and truths behind this dark sentiment of life, there are common myths about suicide which we need to eradicate in order to comprehend the problem better we are able to curb this issue. When we listened to people whom talks about suicide, we assumed that these people would not do it since they are open to discussion. To include, people who are open to discussion should not be overlooked because they might also consider the options of suicide since the minds of a person is incomprehensible. In addition, the society views the troubled ones as people whom cannot be saved and are unwilling to seek help. Since they intend to commit suicide, nothing can stop him. These misconstrued assumptions are proven wrong because they are lost and sometimes hope for care and understanding. Indeed, these are individuals whom should not be segre gated. Another notion that should be avoided is that people believed that suicide indicates lack of faith in religion. This is incorrect because there are certain religions which encourage suicide in the name of faith. Thoughts and attempts of suicide as well as committing suicide are major concerns throughout the world and it is still a growing concern amongst the society. Very much obvious, most suicidal case involves adolescents and young teens. The teenage years are one of the most difficult stages in life, as identified by psychologists. Although teenagers are thought to enjoy life without worries of financial stability and mid-life crisis, suicide seems way an inconsiderable option to them since they ought to have no problems at this phase of life besides studying. But many changes in the mind which takes place during puberty can change their identity and their vulnerable self if they may have to cope with a broad range of personal and social obstacles. Since young people are so fragile, they may experience difficulty in dealing with stress. Children prior to puberty had hardly been bothered by suicidal behavior, probably due to their inability to envisage or execute a suicide plan. When puberty hits adolescence, risky psychiatric factors, such as depression and drug abuse become imminent and play a part in contributing to the causes of frequency in suicidal behaviour. Some children especially girls, view the transition from primary to middle school stressful. In addition, as one gets older parental supervision decreases, so teenagers are more likely to engage in unhealthy behavior without their parents consents. Suicide is divided into several commonly used terms to identify its symptoms and causes. Here are the descriptions provided by the World Health Organization (WHO) regarding suicidal terms that needed to be taken into account:- Suicide: a planned act of killing oneself intentionally. The act can be performed by the person with or without the full knowledge or expectation of any fatal outcome. Suicidal attempt: A medical intervention is required in this case, after the person whom intended to end his or her life committed a life-threatening act with a conscious intent. Suicidal gesture: A series of self-threatening behaviour on display, which may be detrimental or non- detrimental. Suicidal idea: The power of mind to thought or set up the process to end ones own life. Suicidal risk: The tendency of ending ones life depends on this characteristic, depending on its presence or absence. Suicidal pact: Two or more people in agreement to die concurrently by committing the act of suicide. Suicidal cluster: People who gather in groups to commit suicide together, usually for a common objective. Suicidal counters: To prevent suicide, this set of factors operates within the individual, family or society. 1.4 Facts and Figures With many reasons believed to be the causes for suicide, facts and figures of statistics below are generally shown to highlight suicide from methods of ending life in different ethnic groups (inference is drawn from analysis of data from suicidal cases from the University Malaya Medical Centre mortuary ) to why it is committed : It is estimated that 450 million people suffered from mental of behavioral disorder. Every year, close to 1 million people committed suicide and 1 in 4 families have at least a member with mental disorder. There are 25 million schizophrenic patients and 50 million who suffer from epilepsy, which About 40 million or 80% are assumed to live in developing countries Most of them lived for 33% of the years with disability are due to neuropsychiatric disorders (depression, alcohol-use disorders, schizophrenia and bipolar disorder). From 2000-2004, University Malaya Medical Centre found suicides of 164 male (65%) and 87 female (35%) victims with their ages ranging from 15 to 80 years. The age group with the highest total of cases between 21 to 30 (83 of 251; 33.1%) The highest rate of suicide was among Chinese (ethnic groups) with a total of 120 cases (120 of 251; 47.8%) by using the common method; jumping from height (41%). Whereas, Indians commonly commit suicide by hanging themselves (49 of 87) and poisoning (20 of 37; 54.1%); and Muslims had shown the lowest cases of suicide (18 of 251; 7.2%). 1.5 Types of suicide Collective tendencies have an existence of their own; they are forces as real as cosmic forces, though of another sort; they, likewise, affect the individual from without (Thompson, 1982, p. 109 [excerpt from Suicide]) To separate true suicides from accidental deaths, Durkheim proposed this definition of suicide: the term suicide is applied to all cases of death resulting directly or indirectly from a positive or negative act of the victim himself, which he knows will produce this result (1982, p. 110 [excerpt from Suicide]). Then, Durkheim proposes four types of suicide: 1) Egoistic suicide Minimal social integration allows outcasts and segregation of individuals who are not considered fit to be bounded to specific social groups. These individuals are left with little social support or guidance. Thus, tendency to commit suicide increases. For example, students especially girls in schools wanted to belong in groups or so-called cliques. Most of the times, the ones whom are shunned off are the ones to be laughed at and criticized. 2) Altruistic suicide The opposite of egoistic suicide. This type of suicide results from too much of integration. Self-sacrifice is the prominent trait and members of the group were so integrated that they lost their individuality and ever so willing to sacrifice for the groups interest. For example, black metal groups in school do underground sacrificial methods at times in their act of worshipping. 3) Anomic suicide (of moral regulation)   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  When means were unable to fulfill needs, an imbalance of means and needs arise. i. Acute economic anomie Traditional institutions such as religion and government failed to practise moral restraints on a capitalist society. Hence, the ruling of private individuals to determine ones fate in life. This type of suicide does not apply in Malaysia because it is a democratic country where everyone has the equal rights to flourish in their own ability. ii. Chronic economic anomie Social regulation gradually diminishes after a revolution or urbanization. As a result, traditional social rules deteriorated. Wealth and property was not enough to make individuals happy, as was demonstrated by higher suicide rates among the wealthy than the poor. For instance, richer students gain easier access to drugs because of their high allowance making it affordable for them. Later on, usage of drug substances will lead to suicide (will be discussed later in this topic). This also explains why students in urban schools are more prone to suicide instead of rural area students. iii. Acute domestic anomie   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  The inability of an individual to adapt to sudden changes in life results in this suicide. For instance, a student who could not cope the loss of his or her family members might consider suicide as an option to end the suffering. iv. Chronic domestic anomie The way marriage is seen in different regulations and needs for each gender. Bachelors tended to commit suicide at higher rates than married men because of a lack of regulation and established goals and expectations. On the other hand, bachelorettes are lower risk to commit suicide because without marriage, they are not confined to boundaries set by the household. This is not an issue for students in Malaysian schools unless if young girls are married off during schooling. Such cases are rare in Malaysia unless in rural areas like in Sabah or Sarawak. 4) Fatalistic suicide This type of suicide did not receive much attention because it is a rare phenomenon of the real world. People who are over regulated and receive unrewarding lives like the slaves or childless married women might consider suicide. Their future is relies on others to determine. Cases do happened like prostitution or human trafficking, but this type of suicide does not relate much to the field of education. 1.6 Warning signs Rarely, suicide spurs a moment of intense decision, says Dr Suarn Singh, Head of Psychiatry, Ministry of Health Malaysia. More often, there are many clues to look out for to identify school students at risk of mental and social distress and signs leading to the actual attempt, such as: A change in behavior- speech or actions such as constantly saying that I cant go on or I want to end it all. Attitudes or appearance takes a toll on health and individual becomes recluse and not care of how they look usually by not grooming. Behaving recklessly by not taking safety measures, e.g.: crossing the road without looking. Giving away prized possessions and valuable items. Individual may be accompanied with unpredicatable mood swings like crying, self-mutilation and impulsiveness. Identify the distress and dramatic change that affects the students performance in school (e.g.: attendance and behavior) Lack of interest in school, overall decline in performance, misconduct in class, unexplainable absence or truancy. Abuse of substance, smoking or drug (including cannabis). Violent behaviour which sometimes involves the police. 1.7 Risk Factors and Risk Situations When accessing suicide patterns amongst students, all parties including school staffs, families and friends should be aware of the victims behaviour. Repetitive self mutilation should also be taken into note because distraught teenagers tend to repeat their acts. Particular suicide behaviour under circumstances is interdependent with the environment and genetic factors. Various states or neighbouring countries that features factors of cultural, political and economic differences may play a role in risking the youths decisions of suicide. On the other hand, risk situations are hurtful or injurious events which are experienced by the victims. These occurrences may wound the victims personal dignity and self-image. Example, a suicidal student may encounter with peer pressure in school, bullying, disappointment and failure in academic or high expectations from parents during examination. Suicide has become an intense debate, yet, it still remains as an ambiguous subject to fully grasp. A normal person will never understand to what extent these youth will do just to end their lives. Researches were done and found that major risk factors are linked to young people who are plagued with these causes that might have been the reasons leading them to suicide. The major risk factors to include are: Cultural and sociodemographic factors Family pattern and negative life events during childhood Cognitive style and personality Anxiety disorders Substance abuse Eating disorders Psychotic disorders Current negative life events as triggers of suicidal behavior Cultural and sociodemographic factors Different countries are linked to different cultures and demographic structures. In the third world countries, low socioeconomic status, lack of education system and unemployment are risk factors for suicide. Although Malaysia is a developed country and cannot be compared to third world neighbours, suicide still happens rampantly in urban areas, which is developed and suicide rates are expected to be lower instead of a drastic statistics to show. When urbanization enforces competitions, psychological impact of torture may lead to self-conflict between oneself and the society. One is expected to perform to the standards of societys customary demands. Likewise, in Malaysian schools, students are very academic inclined. This is a powerful risk factor for students to be depressed and may resort to self-destruction. Also, students and adolescents whom lack of self-identity and cultural roots may opt for this choice of suicide under stressful environment. That said, Each individual young p ersons growth is intertwined with collective cultural tradition, as stated by World Health Organization (WHO). Since Malaysia is a multiracial country, there are more than one race that plays a greater attribution of gender nonconformity and identity issues. Imagine an Indian girl being placed at a Chinese school with the majority of Chinese, she is hardly accepted into the culture of the majority. When a student begins to fear a serious acceptance problem, they will lack of support in order to experience an optimum growth during that phase of life. Family pattern and negative life events during childhood Personal loss and conflict, associated with parents or romantic attachments are one of the commonest reasons for suicide amongst students. Physical or sexual abuse, family feud played a part in suicide contemplation as well. Usually, suicidal youth will leave a note or tracks that they are about to suicide. Like the diary, short notes of apologies, so on and so forth. More often, suicidal students want to escape the pressure from demands of the environment or from psychological aspects that the truth is a painful unbearable fact to handle. Broken families and traumatic experiences e.g. rape, mental torture, etc. leave a scar for life in the child especially when the child is unable to manage with the aftermaths of trauma. There are evidences that suggest suicidal students often come from destructive families with more than one factor risks. The effects are cumulative and these problems are usually not known because suicides are more likely to refrain from seeking help from others. He re are a few negative aspects to take note of a dysfunctional family that often characterizes cases of suicidal students: Family with the history of suicide. Alcohol and substance abuse member in the family. Abusive family (physically, mentally or sexually). Divorce and separation of family Very high or very low demands of standards from the parents. Lack of attention and care from family members. Cognitive style and personality It is arguable between the relationship of a certain suicidal trait and an array of cognitive style and personality that risk suicides amongst young people. It is generally equivocal and ambivalent because suicidal patterns vary amongst different individuals. The following traits are observed in a suicidal youth, particularly students during adolescence: Instability in mood. Aggressive and needs anger management. Anti-social High impulsiveness Inability to grasp realities and rigid mentality, often in their own world of illusion. Great feeling of worthlessness and despair. Anxiety and inferiority. Provocative behaviour towards others including family and classmates. Ambivalent relationships with the society (family, friends, people). Suicidal behaviour is overrated amongst school children and adolescents with the following psychiatric disorders: Anxiety disorders and Depression It is known from studies that have proven the connection between anxiety disorder and suicide. Whilst traits of anxiety appear to be independent of depression, its effect always leads to psychosomatic symptoms if not treated. Unlike depression, anxiety disorder is prominent to detect and victim will always shows signs of worries and unhappiness with themselves.   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Discussion about depression should be taken seriously. Depression is often beyond recognition. Students may seem fairly disappointed or angry at minor disturbances and may never considered suicide. But if the symptoms of depression last for more than a week or so without improvement, help is needed. The signs of depression noticed amongst students or youth include: Utter degree of sadness Gradual withdrawal from everything. Student becomes recluse and isolated. School performance dropped with no apparent reasons. Loss of interest in activities that student used to enjoy. Feelings of worthlessness, hopelessness, helplessness Lack of motivation. Differences in sleeping habits and fatigue. Change in appetite and eating patterns. Self-neglect and self-hatred. Physical complaints, sad thoughts or death. Anger management needed for reckless attitude and temper. Substance abuse. Restlessness and agitation with one self or others. School students with depression symptoms oftentimes present anti social behavior and both are precursor to suicide. It is noticed that depressed female student will be more silent and withdrawn from others, whereas on their male counterpart, students of that gender becomes aggressive and disrupted and seek a great deal of attention. Prior to that, students can kill themselves too without having to be depressed and they can also be in a state of depression without killing themselves. Substance abuse   Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Ã‚  Students who abused alcohol and drugs are often linked to suicide. Teenagers are oftentimes found to have committed the act of suicide after consuming the substances. Sometimes, students used these substances to ease their stress and depression. In another case, youth whom have never thought of suicide may have done so after taken alcohol because alcohol suppresses rationale thinking. Simply, their actions are based on an impulsive act which leads them to ending their lives even so they might never have contemplated suicide when they are sober. Eating disorders Eating disorders happen mostly to the female genders whom are dissatisfied with their own bodies. In the eye of the society, thin slender girls are objects of desire. The media often portrays catwalk models, who are skinny and scrawny. In schools, fat students are always being sneered and jeered as well as being outcast. Anorexic and bulimic girls are susceptible towards depression and suicide risk for anorexics are as much as 20 times more than youth in general. Psychotic disorders Albeit, we hardly heard of Malaysian students suffering from severe psychiatric disorders like the schizophrenia or manic-depressive disorder, those affected are still in jeopardy with suicide risks. But most psychotic youths started off with other risk factors, such as excessive smoking and substance abuse. Current negative life events as triggers of suicidal behavior As aforementioned due to inherited genetic factors, destructive families and negative aspects in life, students of this age find themselves susceptible towards suicide because when current negative life events happen in concurrent with their condition they find it difficult to cope furthermore. This susceptibility makes it difficult to cope with negative life events adequately, and that said, stressful life events precede suicide. They reminds of the student of sense of hopelessness and despair. 2.0 How Schools can Prevent Suicide Usually, suicidal students hardly attempt suicides within the school compound. But when the outbreak of a students suicide takes place, even off schools territory, the news will shock others, causing extreme emotional distress amongst students, staff, and parents whilst school activities will come to halt for weeks before it is resumed. Hence, schools play an important role for preventing suicides. Many young students whom are affected by mood disorders or substance abuse later on contemplate suicide. Whilst the other emotional setbacks linked to suicide includes conduct disorders, aggression, split personality disorder, and intense feeling degree of hopelessness (Berman, Jobes, and Silverman, 2006). Here, the schools responsibility and roles to play are summarized by the National Association of School Psychologists (NASP) (Poland and Lieberman, 2003): 2.1 Detection/ Awareness School administration and staff personnel should take note of students behaviour for signs of suicide. Interaction on a regular basis is encouraged amongst the school and students. School counselor must play his or her responsibility in helping problematic students before any occurrence of suicide. 2.2 Parent notification When awareness is created, any changes in attitudes or suspicious acts arise the school should update the parents or guardian of students. Face to face discussion is recommended to come about ways of preventing the student from suicide, which includes close supervision or referral to professionals. Also, a record of victims parent and victim should be kept confidential. 2.3 Support for students at risk of suicide The school, psychologists and counselors, should monitor and support suicidal students. Counseling and follow-up services shall be recommended. 2.4 School-Based Suicide Prevention Programs Schools should train teachers and staffs to help recognize students at risk of suicide. This can be done through training and appropriate mechanisms necessary. These mechanisms include a series of programs specially designed to counteract suicidal risks. Schools must heed these vital steps to control suicide among their students: Ø School-based suicide prevention program and school-based mental health services Health screening, mental health survey and educational activities are carried out at school level to help students recognize and seek help when needed. Programs like health promotion program and risk prevention can be effective if made comprehensive to students. Ø Suicide prevention gate keeping program People who have regular interaction and contact with students in school are teachers. They need to know how to recognize students behavioural patterns and warning signs. Also, teachers need to be actively involved in dialogue to explore the risk of suicide amongst students and to ensure that the victim must receive proper guidance and treatment when it is necessary. Records must be kept up to date and problematic students must be scrutinized. Ø School crisis preparation and response plan This prepares the school in the case of emergency, from natural disaster to violence within the school. The school crisis preparation plan should include procedures of preventing self-destructive students as well as students in the midst of contemplation. Also, guidance must be taken into account as a reference for teachers and staffs to respond such cases when such tragedy arises. Ø Postvention Such term is used to measure preventions to be implemented after a tragedy takes place. The purpose of this program is to lessen the risk of those witnesses to be affected directly after the incident. Suicide or unexpected death of another student can result in a traumatized individual. This program includes grief counseling for students and school party. Postvention helps to identify other students whom may be at risk after a trauma, and to support students. Sometimes, school works with the media to ensure such coverage of news does not lead to additional risks of suicide. 3.0Suggestions: A guide for Teachers and School Staffs It takes time for a student to attempt suicide. Rarely, suicide occurs out of sudden with no warning. Most cases, teachers and members of the society who observe the victim on a daily basis is able to distinguish a behaviour of norm and suicidal. The following are three (3) steps of prevention: before, during and after a suicide: 3.1 General prevention: before any suicidal incident Early recognition helps save lives. Experts advised that it is not a wise approach to teach about suicide explicitly. Rather, they recommend tackling this problem by replacing issues of suicide with a positive mental health approach. a) Mental health of schoolteachers and other school staff Teachers are the role model in any causes. A positive teacher is able to change the outlook of a persons perspective in a brighter light. Hence, strengthening the mental health of a teacher only can he or she guides the students into the correct path in life. b) Students self-esteem Positive self-esteem is vital to protect students against suicide. One with topnotch of esteem will cope better with stress even how difficult ones situation may be. To nurture positivity amongst the students, a few rules should not be taken lightly. Firstly, students must never been pressured constantly to fare better than other students. They must always look on the brighter side of life experiences in order to forge a positive identity. Every student should be cherished as who they are and be accepted for what they are. In addition, the school should work on introducing life skills by having experts giving talks and later on assimilate a positive workshop as part of the curriculum. Most importantly, the programme is able to send out messages of knowledge to peers on how to be supportive and seek help if necessary. Plus, the school should revise and review the education system to enhance the development of every student holistically. c) Emotional expression Students should learn on how to express their emotions appropriates and to take charge of how they feel seriously. When things gone awry, they should confide in parents, teachers, adults, doctor, friends or even religious advisors. d) Bullying and violence at school Issues on bullying have been a serious matter for ages since bullying make suicide seemed more pleasant to students to escape from humiliation and personal dignity. Because the victim could not determine what others had done to him/her, the victim had only his own life to control. Thus, specific skills should be taught in schools to prevent bullying and violence. This way, only the school can provide a sanctuary for safety and intolerance of the negative aspects. e) Information about care services In Malaysia, Befrienders are not unfamiliar to the society these days. Students should be aware about the availability of these services and by making it accessible to the young people, so that they can utilize the help lines in the case of crisis and psychiatric emergency. To include, there are over 240 Health Centres nationwide in Malaysia that have psychiatric units and also counseling unit for help. The latest news up to date, Prof Hu