Race o racism Research Paper Example | Topics and Well Written Essays - 750 words

Race o racism - Research Paper Example The marathon race will feature numerous other activities apart from running. These include an avenue to interact among the participants and share ideas. It will also be a family affair where the children will be educated on the importance of stopping racism. The proceeds from the marathon will help the affected racism victims around the world through the organizations planning. This agency has numerous branches all over America and all over the world. The main theme of the marathon is creating awareness on racism. Through the marathon, people will also appreciate the importance of alleviating racism since it has numerous impacts to a society. To highlight on the impacts, racism cause disintegration in a society. The disunity of the society affects numerous other activities of the society especially the developmental projects. Societies cannot develop well since the members do not appreciate each other’s role and position based on racism. It is in this respect that the society lags behind in terms of development. Through having joint public initiatives like this marathon, everyone in the society understand the importance of forgetting the racial differences and working together as one people. This marathon, therefore, is necessary to attend for individuals who seek to debunk the racism problem in the society. In many instances, an individual can be faced with a situation involving racial prejudice. This can be at the workplace, school or even at the church. When the individual is judged base on their race, they get psychological torture. They might feel that they have no place in the society and in some cases commit suicide. The case of racial segregation also develops hatred among different people of the society. The individuals start judging others on ethnic lines. From that perspective, the hatred is likely to develop into conflict. The conflict can further escalate to unprecedented levels. Affect this means that not only will the individuals involved but the whole community as a whole. Through the marathon, you will get to understand how to evade such situations. This would be an available activity for individuals who do not want to participate in the race. Racism also causes uncertainty among the members of a society. Everyone lives not sure of the other persons intention towards them they might feel that any action an individual does is directed to them. The state on uncertainty is not appropriate for the social health of the society (Jackson et al 15). The members do not interact freely and in a mutual interest way. It is in line with this that the race is purposed to bring together members from different races. Participants will get the chance to overcome their racial differences and compete in the marathon. The interaction among these members is a vital step to achieve a racism free country. Through the marathon, the participants will get the chance to prove their competency outside the realm of racism. For the participants who do not wish to participate in the race, various activities are also available to suit their needs on understanding racism. There would be centers where talks are held about racism. Similarly, there would be discussions on racism and its effects. The participants in these discussions are also expected to give some of the possible solutions to racism. The International Agency against Racism hopes that, through this marathon, everyone will have a

The Great Awakening and Age of Enlightenment Essay Example for Free

The Great Awakening and Age of Enlightenment Essay The eighteenth century was a period of change for American colonists. They encountered new ways of life with the revival of religion and the introduction to science. The yearning for knowledge encouraged the colonists to partake in religious activities and explore the scientific world around them. The Great Awakening was a movement created by the Protestants and its purpose was to reestablish religious faith. The Age of Enlightenment was a movement concerning intellectuals all around the world. It was the culmination of old traditions and the beginning of new ideas and approaches. These two major movements significantly affected the growth of colonial America because it inspired people to work as a unified group and gain independence. The Great Awakening took place during the 1700s in colonial America and soon reached to European nations such as England, Scotland and Germany. The movement expressed how being truly religious required a person to trust the heart instead of the head and to depend on biblical beliefs more than human logic. Preaching was vital and had a great impact on the people who were listening. For instance, Jonathan Edwards tried to reform the Pilgrims and turn them back to their Calvinist roots and make them fear God once again. His emotional sermons talked about how all of mankind had sinfulness and hatefulness in their souls. Those who agreed to the message Edwards was sending were called the New Lights and those who opposed it were called the Old Lights. The conflict between them later resulted in the development of future universities and represented a small step towards the unity of all the colonies. The Age of Enlightenment started in Europe around the time of the Great Awakening. The goal was to develop knowledge based on logic and free- thinking. Scientific views and natural philosophy were replacements of religion and were the resources for understanding nature and human fate. There were advancements in mathematics with Sir Isaac Newton, who created physics. In addition, technology was a major achievement with an example of Ben Franklin and his invention of the lightning rod. Due to these successes, people of colonial America grew in their mental rather than their physical state. They were more aware of things around them, which was beneficial  because it created a sense of independence that they didnt have before. In conclusion, the Great Awakening and the Age of Enlightenment were two important movements of the eighteenth century. The movements inspired the American colonists to bond and become less dependent on others who usually take charge. The revival of religions brought people practicing the same belief together, which helped them unite and the Enlightenment period marked the basis on the journey to discover individual liberty. So as it is shown, both would certainly help colonial America grow into one independent nation.

different cultural beliefs about death

different cultural beliefs about death Person, Culture and Medicine Alexandra Lamb â€Å"Human Behaviour is essentially the same across groups and populations.† Biological death is inevitable. For all humans, death is the exclamation point marking the end of a life, the end of a journey; however it is approached and for however long. This is the universal biological condition for all humans. According to Benjamin Franklin, â€Å"†¦Everything appears to promise that it will last. But in this world nothing can be said to be certain except death and taxes.† (Curran 1975) It is in how we live our lives that we see the breadth of human cultural and psychological variation (Seeman, 2010), leading us to discover a great diversity of meanings regarding death and dying, spanning across all groups and populations (Charmaz, 1997). â€Å"Cross cultural [variation embodies] not just different opinions or beliefs, but different ways of everyday living and different systems.† (Jecker Carrese Pearlman, 1995, p. 6) At the most basic level we are all â€Å"built† the same. Death is a complicated process that is the result of the breakdown of the body’s systems. We all live, until the chaos in our body, caused by either natural causes or a forced external factor, is too much for all the intricate systems to work together as a coherent whole (Badham, 1996). Despite the advancement of technology and medical progress, there is no stopping everyone eventually facing death. Whilst biologically we are all essentially the same, from a cultural and psychological perspective, we all behave very differently. This can be seen by considering the bond between a parent and a child, which is said to be the most significant, powerful and enduring human relationship (Parkes Laungani Young, 2003,). Thus, the death of a child is acknowledged as the worst possible event, one that gives the deepest emotional impact. In this tragic event, we can see marked behavioural differences across and within cultures and so it is a good example to use to examine the differences in human behaviour in the face of death. Nations, as well as individuals, all live with very distinctive ideas and beliefs around how to deal with death (Charmaz, 1997). Most cultures are similar in that they attribute unique significance to a child’s death. Biologically many aspects of a parent-child relationship are pre-programmed from conception however, each of these characteristics are developed within a specific family, social and cultural context (Parkes Laungani Young, 2003,). These wider influences are what greatly shape the meaning and experience of the relationship for both parent and child and thus influence the meaning of death. This makes the emotional impact of parental bereavement unique. For example, in Western Societies, parents are expected to grieve in private and return to normal activities soon after the child’s death, where as in Egypt, a mother may be withdrawn and mute up to seven years after the child’s death and this is considered normal. A Balinese mother would be considere d normal if she remained cheerful and calm after her child’s death, as her culture believes that emotional upset makes one vulnerable to illness (Parkes Laungani Young, 2003,). â€Å"Grieving and death rituals vary across cultures and are often heavily influenced by religion† (Lobar Youngblut Brooten 2006, p. 45). For example whilst the traditional burial is common around the world, the rituals that are associated with it vary. In areas influenced by Islamic and Jewish faiths, the corpse is washed and dressed in a shroud and placed in a simple wooden coffin (in areas where coffins are used). In China, where Confucian beliefs dominate, thick wooden coffins packed with clothing and shrouds are used to delay decay and in Christian-dominated regions, bodies are dressed in normal clothing and placed in a coffin made of either chipboard, wood or metal. (Canning Szmigin 2010) The combination of both structural (cultural) and individual factors that impacts the experience of death is dynamic. (Howarth, 2007) Not every member of a particular ethnic group will share the same beliefs and values and other aspects such as social status, economic position, gender, sexuality, age will also have an impact on experiences and beliefs which when combined give meaning to the experiences of death and dying (Howarth, 2007). For example, the prevalence of child mortality also influences the experience of death. In developed countries, where changes to nutrition and sanitation and the evolution of medicine have made childhood mortality rare, a death of a child is more likely to be perceived as tragic. Whereas in developing countries, where the death of a child occurs much more often and thus is considered inevitable, mourning may only last a few days (Parkes Laungani Young, 2003,). Each person has their own beliefs about death, which are generated through experiences at a social, cultural and individual level. Universally, there is a level of respect shown for the dead and there are different â€Å"accepted† practices depending on the age, gender, social status and cause of death of the individual. (Bradbury, 1999) However, all of the beliefs around death are determined by the way the individual lives, which is why there is such diversity with regards to the biological condition that is an inevitable human fact. Just in this discussion of how different people across different groups and populations approach death and dying, a lack of conformity with the statement â€Å"Human Behaviour is essentially the same across groups and populations,† has been shown. Parallels can be drawn between people, but vast differences can also be highlighted. (Seeman, 2010) We begin and we end in much the same way, but the way we live our lives is remarkably different . Much can be learned about the breadth of human variation by examining the way we approach death and dying: â€Å"Our ways of dying are our ways of living. Or should I say our ways of living are our ways of dying?† -Toloki the Professional Mourner (Seeman, 2010, p. 1) References Badham, P. Ballard, P. (1996) Facing Death- An Interdisciplinary Approach. Cardiff, University of Wales Press. Bradbury, M. (1999) Representations of Death- A Social Psychological Perspective. New York, Routledge. Canning, L. Szmigin, I. 2010, ‘Death and disposal: The universal, environmental dilemma,’ Journal of Marketing Management, vol. 26, viewed 28 August 2014, (electronic Scopus). Charmaz, K. Howarth, G. Kellehear, A. 1997, The Unknown Country: Death in Australia, Britain and the USA. Great Britain, Macmillan Press Ltd. Curran, C. 1975, ‘Death and Dying’, Journal of Religion and Health, vol. 14, viewed 28 August 2014, (electronic Scopus). Howarth, G. 2007, Death and Dying- A Sociological Introduction. Cambridge, Polity Press. Jecker, N. Carrese, J. Pearlman, R. 1995, ‘Caring for Patients in Cross-Cultural Settings’, The Hastings Center Report, vol. 25, p.6, viewed 28 August 2014, (electronic Scopus). Lobar, S. Youngblut, J. Brooten, D. 2006, ‘Cross-cultural beliefs, ceremonies, and rituals surrounding death of a loved one,’ Peadiatric Nursin, vol. 32, p. 44, viewed 28 August 2014, (electronic Scopus). Parkes, C. Laungani, P. Young, W. 2003, Death and Bereavement Across Cultures. Routledge. Seeman, E. (2010) Death in the New World- Cross Cultural Encounters. Philadelphia, University of Pennsylvania Press.

Suprascapular Neuropathy in Overhead Athletes

Suprascapular Neuropathy in Overhead Athletes SUPRASCAPULAR NEUROPATHY IN OVERHEAD ATHLETES: A SYSTEMATIC REVIEW ON AETIOLOGY AND TREATMENT OPTIONS Surya.P, Pankhania. R, Funk.L ABSTRACT Suprascapular neuropathy is often overlooked as a cause for shoulder pain in overhead athletes. However, with recent advancements in the understanding of the condition as well as its treatment methods, suprascapular neuropathy is now diagnosed more frequently. Consistent overhead activities, rotator cuff tear and direct compression of the nerve, by space occupying lesion are important etiologies for suprascapular neuropathy. While MRI is widely used to identify space-occupying lesions and rotator cuff injury; Electromyography (EMG) and Nerve Conduction Velocity (NCV) remains gold standards for confirming injury to the nerve. Conservative physical therapy, nerve blocks and arthroscopic and open surgical interventions are the main treatment plans for suprascapular neuropathy. 1. INTRODUCTION AND BACKGROUND The posterosuperior aspect of shoulder receives its sensory innervation from the suprascapular nerve. The suprascapular nerve also provides motor innervation to supraspinatus and infraspinatus muscles. Compression or traction of nerve and rotator cuff diseases are found to be associated with suprascapular nerve damage and neuropathy. Clinical symptoms of the condition include pain in the posterior shoulder, feeble forward flexion, and weak external rotation. It is also noteworthy that the multiple presentations for suprascapular nerve neuropathy vary greatly in different patients and thus diagnosis of the condition is often challenging. This kind of nerve damage is a less common reason for shoulder pain and dysfunction in the general population, however is widely observed in athletes who play overhead sports such as volleyball, tennis, badminton, and baseball. Such sports expose the athletes hands to overhead, abducted and externally rotated positions for prolonged periods of time. ( Cummins Schneider, 2008). Observational studies have identified that players involved in overhead sports are at higher risk of injuries related to overuse of the shoulder such as rotator cuff tendinopathy and tearing of glenoid labrum (Pillai et al. 2011). On the other hand, shoulder pain due to suprascapular neuropathy is observed in only 1-2% of cases and therefore, the condition is often overlooked during diagnosis for shoulder pain (Boykin et al. 2010). Among the overhead sports athletes, incidences of suprascapular neuropathy are maximum in volleyball players. Around 33% of volleyball players suffer from this condition at some instance in their career (Boykin et al. 2010). Traditionally, suprascapular neuropathy has always been regarded as a diagnosis of exclusion. However, now with further understanding of the etiology and advanced diagnostic options, the condition is being recognised by physicians from an earlier onset. 2. AETIOLOGY FOR SUPRASCAPULAR NEUROPATHY Rotator cuff tear is considered as a prime cause for suprascapular neuropathy. Studies show that suprascapular neuropathy can also develop secondary to traction and microtrauma, especially in overhead athletes, particularly due to tightening of the spinoglenoid ligament during the overhead throwing position. The risk for the development of suprascapular neuropathy also increases in patients with ossification of the transverse scapular ligament or spinoglenoid ligament. Other causes such as; compression of the nerve at spinoglenoid notch due to the presence of a bone tumor, cyst due to labral, soft tissue or capsular injury tissue can also lead to the condition. Suprascapular neuropathy is also rarely seen following brachial neuritis, glenohumeral dislocation, fracture of the shoulder girdle, and penetrating or iatrogenic injury to the nerve (Lewis et al. 2012). All these etiological factors for suprascapular neuropathy are discussed in detail in the following section. 2.1 Rotator Cuff Injury: Anatomically, the suprascapular nerve branches from the upper trunk of the brachial plexus. From there, it travels posterior to the clavicle, passes below the transverse scapular ligament and then enters the suprascapular notch. The motor branches innervate the supraspinatus, and the nerve continues past the spinoglenoid notch and innervates the infraspinatus. Injury due to traction or compression of the nerve at any point in this path can lead to suprascapular neuropathy. Retracted superior or posterior rotator cuff tear is the most common cause for suprascapular nerve traction injury. Tension on the suprascapular nerve lying at a suprascapular notch or spinoglenoid notch increases with the retraction of supraspinatus and infraspinatus tendons. Studies on cadavers by Gosk et al (2007) showed that as the retraction of supraspinatus tendon increases, it reduces the angle between the suprascapular nerve and its first motor branch, which leads to an increase in tension and thus causes t raction injury. Gosk et al. (2007) also found that massive rotator cuff tear was the main reason for suprascapular neuropathy in eight different overhead players. On the other hand, studies by Lajtai et al. (2009) found that rotator cuff tear and muscle atrophy were responsible for only 8% of suprascapular neuropathy cases. Expanding the knowledge on the topic, different studies also showed that the tension between rotator cuff, supraspinatus and infraspinatus tendons has a profound impact on the condition of the suprascapular nerve. Observations of cadaver showed that the tension on the neurovascular pedicle increases significantly once the lateral advancement of a retracted rotator cuff tear exceeds 3 cm (Greiner et al. 2003). Other studies suggest that if the rotator cuff extension increases by 3 cm, it lay significant tension on the motor branches of the suprascapular nerve. Also, the tension on the medial portion of the suprascapular nerve starts to increase only by 1 cm extension of the rotator cuff. Increased tension is one of the important reasons for traction injury to the nerve (Larissa et al. 2014). It has also been reported that following surgical repair of rotator cuff tear, the tendons can be advanced up to 3.5 cm without any significant risk to the health of suprascapular nerve. Various reports suggest that surgical repair of rotator cuff tear can help in either partially or completely resolving suprascapular neuropathy. Nerve recovery by reinnervation has been found in patients of suprascapular neuropathy following partial or complete arthroscopic rotator cuff repair (Petra et al. 2013). 2.2 Nerve injury: Sports Specific Etiology: Sports physiotherapists have proposed various etiological mechanisms for suprascapular neuropathy which includes repeated traction, microtrauma, ischaemia of the nerve and compression of the nerve by soft tissue, tumor or cyst. However, the majority of the healthcare professionals consider that nerve injury due to repetitive trauma is the main reason for the development of suprascapular neuropathy. Two main sites for suprascapular nerve injury are: the suprascapular notch and the spinoglenoid notch. The symptoms alongside clinical presentation for suprascapular neuropathy thus depend on the location of nerve injury. Injury of suprascapular nerve at the spinoglenoid notch has been found to cause isolated atrophy and weakness of the infraspinatus muscle. This condition is also known as infraspinatus syndrome. A systematic literature review by Lee et al. (2007) found that suprascapular neuropathy due to infraspinatus syndrome is common in overhead game athletes, particularly volleyball players. (https://www.shoulderdoc.co.uk/article/1250) One important reason for traction injury in volleyball players is the huge amount of motion occurring at the shoulder during throwing action. The role of the scapula in allowing throwing motion as well as other overhead sports activity is now well-researched. It has been observed that the movement of the scapula during the protraction and retraction of hands leads to significant trauma of suprascapular nerve at both the suprascapular and spinoglenoid notches. This phenomenon is known as the sling effect. The sling effect proposes that certain positioning of upper limb during overhead activity exposes the suprascapular nerve at the suprascapular notch to a significant amount of sheer stress and thus injury. Sling effect also suggests that the suprascapular nerve is exposed to high risk of traction injury when it bends around the spine of the scapula at the spinoglenoid notch (Arash et al. 2015). Chronic overuse of shoulder, as well as functional instability, may cause the suprascapular nerve to angle sharply at the spinoglenoid notch, as an adaptive response. This condition is known as SICK scapula which is an abbreviation to Scapular protraction, Inferior border prominence, Coracoid tightness, and Kinesis abnormalities of the scapula (Burkhart et al. 2003). While imaging for the shoulder injuries of volleyball players, Crema Murakami (2016) found that SICK scapula significantly contributes to increased tension on the suprascapular nerve and thus causes traumatic injury. https://www.shoulderdoc.co.uk/article/930 http://www.scielo.br The spinoglenoid ligament lays into the posterior glenohumeral capsule. Observations suggest that the ligament gets stretched and rigid with the abduction and internal rotation of the ipsilateral upper limb across the body. Such action leads to the traction of suprascapular nerve at the spinoglenoid notch (Crema Murakani, 2016). Sandow Ilic (1998) provided another proposal for traumatic injury to the suprascapular nerve. According to them, when the upper limb is abducted and externally rotated, the medial border of the spinatus tendon present at the spinoglenoid notch compresses the suprascapular nerve. Repeated upper limb action thus causes trauma to the nerve and injures it. Plancher Petterson (2016), recently supported this mechanism of nerve injury in their research paper. The injury to the posterior part of the suprascapular nerve is thought to occur due to multiple, abrupt, peculiar stretching of infraspinatus tendon during the deceleration phase of the floater serve (the most common type of overhead volleyball serve). Ferretti observed such injury in volleyball players while Arash et al. (2016) observed this in various overhead sports players as well as labourers. 2.3 Other etiologies: Nerve compression: According to Raddic Wallace (2016) direct compression of suprascapular nerve passing through spinoglenoid notch can occur due to ganglionic cysts arising from the glenohumeral joint. Such cysts are formed by synovial fluid leakage due to injury to the posterior glenoid labrum. Incidences of suprascapular nerve compression due to a bone tumor or the surrounding soft tissues are very rare but not absent. Nerve ischaemia: In very rare conditions, microemboli formed after any trauma gets trapped in the suprascapular artery and then migrate to the vasa nervorum thus hindering the blood and fluid supply to the suprascapular nerve. This leads to nerve ischemia and then neuropathy (Shin et al. 2016). 3. PRESENTATION DIAGNOSIS OF SUPRASCAPULAR NEUROPATHY The peculiar clinical presentations of suprascapular neuropathy are as follows: Shoulder pain which worsens on cross body abduction or internal rotation of ipsilateral muscle. Atrophy of supraspinatus or/and infraspinatus muscle, observable on physical examination. The weakness of ipsilateral shoulder abduction observed during manual muscle testing. The weakness of external rotation of shoulder observed during manual muscle testing. Pain elicited by pressure application over the suprascapular and spinoglenoid notch. The tenderness between the clavicle and the spine of the scapula or deep and posterior to the acromioclavicular joint (Podgorski et al. 2014). Radiological examination using X-rays is the first step for diagnosis if suprascapular neuropathy is suspected. It is important to have a radiological view of a suprascapular notch and spinoglenoid notch along with a standard view of the shoulder area. However, no remarkable changes can be observed in the radiological images unless is a prominent trauma responsible for the condition. MRI of the shoulder helps in identifying muscle oedema, muscle atrophy, and ganglionic cyst, if present. These factors are responsible for suprascapular neuropathy due to direct compression. Three Tesla (3-T) MRI scan is another tool used in the diagnosis of suprascapular neuropathy as it helps to identify any nerve abnormality or any denervation changes in muscles. Ultrasound is also appliable for the diagnosis of cysts and other muscle abnormalities as it is an inexpensive and relatively accurate diagnostic tool (Ahlawat et al. 2015). Electrodiagnostic studies are gaining increasing popularity as an important diagnostic tool for suprascapular neuropathy. Positive sharp waves and fibrillation potentials indicated by electromyography can suggest denervation while polyphasic motor unit action potentials suggest motor innervation abnormalities. Larisa et al (2014) suggest that electromyography (EMG) and nerve conduction velocity (NCV) tests are the gold standards for the detection of suprascapular nerve injury. EMG and NCV are suggested in the following conditions: Consistent pain on the back upper side of the shoulder and no confirm diagnosis is found. Atrophy as well as the weakness of supraspinatus and infraspinatus tendons in the absence of rotator cuff injury. MRI observations show muscle edema. Massive rotator cuff tendons with retraction and traction on the nerve. There are published and examined normative values for electrodiagnostic studies. According to which, the normal distal motor latencies to the supraspinatus muscles during stimulation at the Erb point are 2.7 msec  ± 0.5 and to the infraspinatus muscles, 3.3 msec  ± 0.5. Side-to-side differences greater than 0.4 msec suggest focal entrapment of the SSN or another neural injury (Larisa et al. 2014). In some cases, where outcomes of these electrodiagnostic studies are negative or not specific; fluoroscopically guided local anesthetic injection is used. This injection is administered to the region of suprascapular nerve and related pain relief is evaluated. This method is very effective in confirming the involvement of suprascapular nerve injury in shoulder pain (Debbie et al. 2014). 4. TREATMENT MODALITIES FOR SUPRASCAPULAR NEUROPATHY Treatment for suprascapular neuropathy is selected on the basis of different factors like etiology of nerve damage, the severity of nerve damage, duration of pain and weakness in shoulder, degree of functional disability and patients choice. The three main types of treatment options are conservative physical therapy, nerve blocks and surgical repair. 4.1 Physical therapy: If the suprascapular neuropathy is caused due to rotator cuff tear or labral tear with paralabral cyst, the treatment selection is done with regards to the pathology. However, in the case of isolated nerve injury, the conservative treatment plan including activity modification, analgesic drugs, and conservative physical therapy is initiated. The patient is asked to avoid or stop overhead activity as soon as he/she is diagnosed with suprascapular neuropathy. Following which, a physical therapy program is initiated which focuses on the movement of shoulder and muscle strengthening. The therapy also includes scapular stabilisation (Trojian, 2015). Different studies on patients with isolated suprascapular neuropathy suggest that non operative treatment for 6 months to 1 year provides good to excellent outcomes in the majority of the patients while surgical intervention following physical therapy is required by only 20% patients (Lee et al. 2007). Boykin et al (2010) suggest that such non-operative treatments in the case of suprascapular neuropathy due to compression by mass or a cyst do not provide satisfactory results. It has been found that 53% of patients with suprascapular neuropathy due to spinoglenoid cyst get significant pain control and symptomatic relief with non-operative methods while 96% of such patients experienced positive outcomes with surgical treatment. 4.2 Surgical Treatment: In case the conservative physical therapy for isolated suprascapular neuropathy fails, the patient is switched to surgical intervention. Furthermore, surgical intervention is immediately offered if suprascapular neuropathy is concomitant to rotator cuff tear or labrum tears with paralabral cysts. However, literature review suggests that there are debates about the application of surgical intervention for correcting nerve decompression in case of concomitant pathology. Many researchers recommend only for the correction of the isolated rotator cuff or labral repair and avoid surgery for nerve decompression (Boykin et al. 2010). Nerve damage at the suprascapular notch is usually treated with the release of the transverse ligament by an open or arthroscopic technique. Fewer complications have been observed with the open technique. Patients are reported to have adequate pain management as well as improved muscle strength with the open technique. However, muscle atrophy cannot be reversed in all the cases using this technique. Improvement of supraspinatus muscle strength is observed among 90% of patients treated by open technique while no significant improvement of infraspinatus muscle is seen (Kim et al. 2005). While there are no specific indications for arthroscopic suprascapular nerve decompression, it has been found to be similarly effective in resolving pain. However, extensive data is not available to show the effectiveness of the technique in treating muscle atrophy and weakness (Boykin et al. 2010). Nerve damage at spinoglenoid notch is usually secondary to nerve compression by the space-occupying lesion. Surgical management of such lesions often requires open or arthroscopic approach and resection of the lesion. It is noteworthy that patients with suprascapular neuropathy at spinoglenoid notch show poor results with physical therapy alone and thus are suggested to have surgical intervention immediately. Cyst recurrence rates are very low with both the methods (Petra et al. 2013). Literature review suggests that ultrasound-guided paralabral cyst aspiration is a good alternative to surgical intervention for suprascapular neuropathy due to compression at spinoglenoid notch. While the majority of patients reported excellent pain relief with the technique, recurrence rates for cyst are found to be between 75 100% (Moen et al. 2012). 4.3 Nerve Block: Nerve blocks are non-surgical treatment options for suprascapular neuropathy. Nerve blocks are usually administered to manage shoulder pain in preoperative setups as well as in the case of painful shoulder conditions like adhesive capsulitis. Diagnostic usage and specificity of nerve blocks are widely debated, but the blocks are used to achieve rapid symptomatic relief so that the patient can properly participate in the rehabilitation physical therapy. Nerve blocks consist of an injection of an anaesthetic mixed with corticosteroid administered to the suprascapular notch (Blum et al. 2013). Newer techniques like radiofrequency ablation of suprascapular nerve or palliative treatment for pain due to suprascapular neuropathy are still under consistent research phase and are not yet widely applied. 5. CONCLUSION The incidences of suprascapular neuropathy can be more easily recognised now due to increased understanding of the condition and improved diagnostic methods. Overhead athletes presenting with vague posterosuperior shoulder pain, muscle atrophy, weakness of supraspinatus and infraspinatus tendons must be investigated for suprascapular neuropathy. The condition must also be investigated in all the athletes with rotator cuff tear, due to the high incidence. MRI and EMG are the most reliable diagnostic techniques to identify suprascapular neuropathy and rotator cuff health. Recently, fluoroscopically guided injections to the suprascapular notch are also gaining popularity as a diagnostic method for the condition. While conservative physical methods can be applied to treat the isolated suprascapular neuropathy, open or arthroscopic surgical corrections are compulsory to treat suprascapular neuropathy due to rotator cuff tear and cystic compression. REFERENCES:Ahlawat S, Wadhwa V, Belzberg AJ, Batra K, Chhabra A. (2015) Spectrum of suprascapular nerve lesions: normal and abnormal neuromuscular imaging appearances on 3-T MR neurography. AJR Am J Roentgenol. 204 (3), 589-601. Arash A., Michael J., and Felix H. (2015) Suprascapular Nerve Release: General Principles. In: Elite Techniques in Shoulder Arthroscopy. Switzerland: Springer International Publishing, 271-281. Blum A, Lecocq S, Louis M, Wassel J, Moisei A, Teixeira P. (2013) The nerves around the shoulder. Eur J Radiol., 82(1),2-16. Boykin RE, Friedman DJ, Higgins LD, Warner JJ. (2010) Suprascapular neuropathy. J Bone Joint Surg Am., 92(13), 2348-64. Burkhart SS, Morgan CD, Kibler WB. (2003) The disabled throwing shoulder: spectrum of pathology Part III: The SICK scapula, scapular dyskinesis, the kinetic chain, and rehabilitation. Arthroscopy, 19(6), 641-61. Crema M., and Murakami A. (2016) Imaging of volleyball injuries. In: Imaging in Sports-Specific Musculoskeletal Injuries. Switzerland: Springer International Publishing, 663-695. Cummins CA, Schneider DS. (2008) Peripheral nerve injuries in baseball players. Neurol Clin., 26(1), 195-215. Debbie L., Angel M., William E., Susan V., and Ambrose J. (2014) Optimization and Standardization of Technique for Fluoroscopically Guided Suprascapular Nerve Blocks. American Journal of Roentgenology, 202(3), 576-584, 2014. Gosk J, Urban M, Rutowski R. (2007) Entrapment of the suprascapular nerve: anatomy, etiology, diagnosis, treatment. Ortop Traumatol Rehabil, 9(1), 68-74. Greiner K., Golser M, Wambacher F, Kralinger G, and Sperner T. (2003) The course of the suprascapular nerve in the supraspinatus fossa and its vulnerability in muscle advancement. Journal of Shoulder and Elbow Surgery, 12(3), 256-259. Kim D, Murovic JA, Tiel R, and Kline D. (2005) Management and outcomes of 42 surgical suprascapular nerve injuries and entrapments. Neurosurgery, 57(1), 120-127, 2005. Lajtai G, Pfirrmann CW, Aitzetmà ¼ller G, Pirkl C, Gerber C, and Jost B. (2009) The shoulders of professional beach volleyball players: high prevalence of infraspinatus muscle atrophy. The American Journal of Sports Medicine, 37(7), 1375-1383. Larisa J., Elena J., Marisa J., and Jeffrey A. (2014) Evaluation, Treatment, and Outcomes of Suprascapular Neuropathy: A 5-Year Review. PM R, 6(9), 774-80. Lee BC, Yegappan M, Thiagarajan P. (2007) Suprascapular nerve neuropathy secondary to spinoglenoid notch ganglion cyst: case reports and review of literature. Ann Acad Med Singapore, 36(12),1032-5. Lewis L., Michael T., Paul Y., and Jon J. (2012) Suprascapular Nerve: Is It Important in Cuff Pathology? Advances in Orthopedics, Article ID 516985. Moen TC, Babatunde OM, Hsu SH, Ahmad CS, Levine WN. (2012) Suprascapular neuropathy: what does the literature show? J Shoulder Elbow Surg., 21(6), 835-46. Petra M, Gaspar S, Sven L, Peter H, and Mathias W. (2013) Results of Arthroscopic Partial Repair of Large Retracted Rotator Cuff Tears. Arthroscopy-The Journal of Arthroscopic and Related Surgery, 29(8), 1275-1282, 2013. Pillai G, Baynes JR, Gladstone J, Flatow EL. (2011) Greater strength increase with cyst decompression and SLAP repair than SLAP repair alone. Clin Orthop Relat Res., 469(4), 1056-60. Plancher K., and Petterson S. (2016) Distal Suprascapular Nerve Compression: Spinoglenoid Ligament Release. In: Elite Techniques in Shoulder Arthroscopy. Switzerland: Springer International Publishing, 283-302. Podgorski M, Miroslaw T, Marcin S, Piotr G, Ludomir S, and Michal P. (2014) New parameters describing morphological variations in the suprascapular notch region as potential predictors of suprascapular nerve entrapment. Bmc Musculoskeletal Disorders, 15. Raddic R Wallace A. (2016) Arthroscopic release and labral repair for bifocal compression of the suprascapular nerve. Shoulder Elbow, 8(1), 32-36. Trojian T. (2015, October 13) Suprascapular Neuropathy. Retrieved from: http://emedicine.medscape.com/article/92672-overview

Poems By Robert Frost And Leon :: essays research papers

Have you ever wondered what makes two places the same, but in two totally different areas? Throughout the poems â€Å"Stopping by the Woods on a Snowy Evening† by Robert Frost, and â€Å"The Bus† by Leonard Cohen, there are many similarities that take place. These similarities are the life in cities and towns, the escape into nature, and the consequences of such escapes. Throughout this essay these similarities will be explained in detail.In all cities and towns people always have obligations and responsibilities to perform. One example of this is when Robert Frost says â€Å"I have promises to keep†(pg 127). This quote proves that he has an obligation to the city and to the people at home.The Bus has it’s own similarities in the life in cities and towns. While reading the poem Leonard Cohen makes the reader feel that the bigger the city, the less homy it is. The is proven when Cohan states â€Å"Lets run away from the big city...† (pg 144). This qu ote shows that Cohan is trying to â€Å"run away† from his obligations and responsibilities.The similarities in cities and towns from â€Å"Stopping by the Woods on a Snowy Night† and â€Å"The Bus† are in both poems the character is effect by there obligations to the world. In â€Å"Stopping by the Woods on a Snowy Night† Frost’s character is honouring his responsibilities and obligations by leaving the wood to go home to his family. In â€Å"The Bus† the character wants run away from them.In both poems the author escapes into nature. At on point in â€Å"Stopping by the Woods on a Snowy Night† Frost’s character notices the beauty of the forest around him: â€Å"The woods are lovely, dark, and deep† (pg 127). This shows that the character has a deep feelings for the nature around him.Leonard Cohen also escapes into nature in his poem. When his character is riding the bus home he says to the bus driver â€Å"Lets find o urselves a tiny american fishing village, in unknown Florida† (pg144). With this quote he expresses that he is picturing a beautiful place out in the middle of no-where. A place the is beautiful and relaxing to him.In both poems the escape into nature is obvious. In â€Å"Stopping by the Woods on a Snowy Night† Frost is showing us how beautiful mother nature really is. Meanwhile in â€Å"The Bus† Cohan was dreaming of how beautiful and relaxing his tiny fishing village would be.

Logic, Imagination and Deduction Essays -- Logic Imagination Deductio

Logic, Imagination and Deduction "Quit your day dreaming" "Mr. Gies, are you still with us?" "Hello!" These are some of the common inquisitions I heard while trying my best to pay attention during elementary school classes. It seems that I had some issues with staying on task. Perhaps it was a problem that I would outgrow, or at least be able to control, but as the years went on by I found that time did not change me. What a break! It turns out that using my imagination has helped me numerous times in solving networking issues, writing code, troubleshooting electronic devices, and designing complex systems. So are critical thinking, logic and deduction, and problem solving learned skills? Or are they simply tied to ones ability to imagine. Although genetics may play a role in the degree to which an individual can imagine; I believe imagination can be a skill that is developed and is directly proportional to ones ability to use logic and deduction when solving complicated problems. So who does all this imagining anyway? Bronowski, in his essay, "The Reach of Imagination", states, "To imagine is the characteristic act, not of the poet’s mind, or the painter’s, or the scientist’s, but of the mind of man" (Bronowski 461). It seems that this act of imagining is for all mankind. You’ve probably heard the phrase "right brained people". These are the artsy, imaginative, creative types that seem to dominate media venues such as TV and radio, and because of this visibility it would be easy to assume that’s where all the creative people hang out. I think that assumption is way off track. Plenty of highly imaginative technical experts are discovering great solutions to all kind of problems. Architects designing buildings to... ...ion is controlled by conditioning and experiences. Life and its experiences have far more to do with ones ability to imagine then the physical makeup of your genes. I do, however, believe that problem-solving correlates directly to one’s ability to imagine. As I write the conclusion to this essay I find my self imagining a multitude of other things. I imagine how the essay will look printed, did I get the point across, and will it be received well. A quick reflection back in time and I hear a voice from the past saying "Mr. Zimmerman, are you with us?", "Mr. Zimmerman, stay on task", and only now can I safely say, "No. I think I’m just going to think for awhile". Imagine that. Works Cited Katherine Anne Ackley, Perspectives on Contemporary Issues Bronowski Jacob, The Reach of Imagination Hoffmann Roald, The Chemist Ridley Matt, The Year of the Genome

Living with Asthma :: Medical Medicine Respiratory Essays

Living with Asthma missing works cited The weather in Boston is just beginning to feel cooler as Maeve Vaillancourt, a Northeastern University sophomore rushes to her first class of the day. Although she is already behind schedule, she huddles in a corner to take a dose of her Abuterol inhaler, then finishes her ten-minute walk and slips into class late. â€Å"I hate taking my inhaler in public, because it is embarrassing, but after quick walks like that, I need to or else I feel as if I can’t breathe,† said Vaillancourt. Vaillancourt has been suffering from asthma since she was diagnosed at the age of 9. She is one of 18.2 million adults age 18 years and older with this illness according to the Agency for Healthcare Research and Quality. Over seven million children ages 0-17 have asthma. Asthma is a chronic disease of the respiratory system that leads to inflammation of the bronchial tubes, resulting in difficulty carrying air to the lungs. Asthma greatly affects an individual’s breathing, and can place severe restrictions on daily life. During asthma attacks, which may be triggered by weather, allergens, exercise, the individuals’ ability to breathe becomes difficult. As a young, active college student, Vaillancourt’s battle with asthma plays a role in her day-to-day life, beyond just her walks to class. â€Å"I don’t think of inhalers as medicine. I bring it out everywhere; itis like a wallet, or cash,† said Vaillancourt, who suffers from mild asthma. â€Å"If I don’t bring it out, I panic and actually make my asthma worse.† Like most who suffer mild asthma, Vaillancourt is prescribed two inhalers. One is a preventative inhaler, Advair; and the other is her emergency inhaler, Albuterol. Advair is used to prevent an attack from occurring. It contains the steroid, fluticasone, which prevents inflammation that leads to asthma attacks; and salmeterol, which is abronchodilator, to relax muscles to improve breathing.Albuterol is also a bronchodilator, used to treat bronchospasms as they are occurring. Vaillancourt takes Advair, her preventative inhaler, and once in the morning and once before she goes to bed, as well as before exercising. Although she knows it is important Vaillancourt said she â€Å"often has trouble remembering and keeping up with taking the inhaler.† Vaillancourt has noticed that since she has been living in Boston and consistently walking, especially in cool weather, she is more likely to remember her inhalers since she is more likely to need them.