Pulsed Radio Frequency Energy as Physical Therapy

Pulsed Radio Frequency Energy as Physical Therapy CHAPTER V DISCUSSION Many adults with vascular disease and/or diabetes suffer with chronic leg or foot ulcers, leading to loss of functional ability, poor quality of life and long term ill-health. Studies on patients with chronic leg ulcers have reported the average duration of these ulcers is around 12-13 months, around 60-70% of patients have recurring ulcers, 24% of patients are hospitalized because of the ulcers and most people suffer from the condition for an average of 15 or more years. Care for chronic wounds is reported to cost 2-3% of total health care spending in developed countries and these costs are set to rise with ageing populations. Treatment in the U.S. costs over 3 billion $US and the loss of over 2 million workdays a year. Similarly, Harding quotes a cost of  £400 million each year in the U.K. In Australia, wound dressings are the second most frequent procedure in General Practitioner practice and chronic wound care accounts for 22-50% of community nursing time in the UK and Australi a (Edwards et al.,2013). In addition to direct health care costs, chronic wounds are associated with hidden burdens on the community resulting from loss of mobility, decreased functional ability, social isolation and loss of participation in the workforce and society (Price and Krasner, 2012). The use of pulsed radio-frequency electromagnetic field (PEMF), also termed pulsed radiofrequency energy (PRFE) therapy has shown notable success in healing of chronic wounds. PEMF is a non-ionising energy at the shortwave radiofrequency band of the electromagnetic spectrum, commonly at a frequency of 27.12MHz. Since the introduction of PEMF  Ã‚  Ã‚   in the 1950s, clinical studies on healing of chronic wounds and surgical recovery, as well orthopaedic studies have documented PEMF as a successful clinical therapy. PEMF therapy is none invasive and is delivered through the wound dressing, and to date has shown no unwanted side effects. With positive reports in the literature documenting PEMF as an effective therapy, its wider adoption as an adjunct therapy seems warranted (Rawe,2012). The measurement of wound dimension is an important component of successful wound management. Monitoring changes in wound area allows assessment of treatment efficacy and early detection of stasis or deterioration. The photographic method is an accurate alternative to digital planimetry system (Visitrak TM ) for measuring wound area. The photographic method is a more appropriate technique for clean and uncontaminated wounds, as contact with the wound bed is avoided (Chang et al.,2011). This study investigated the efficacy of pulsed radio frequency energy as physical therapy modality in the treatment of chronic lower limb ulcers through reducing wound surface area (WSA) and wound volume. The findings of this study indicated significant decrease in WSA after treatment in both groups A and B (P

Mental Health Court Essay

Mental health courts are a resource given to prisoners who would normally be put in prison if they had not decided to join this special program. Mental health court is a court run program by the district attorney’s office in some counties. This program is based off of traditional court room structure but is also paired with community services. Mental health courts solve a lot of different problems within our criminal justice system. The first problem it solves is the systematic problem that we have with putting seriously mentally ill offenders in prison instead of putting them in a mental hospital or going through a mental health court program to help them deal with their illness. This gives the offenders the ability to learn how to handle their illness and stay on track to getting their life back together (Thompson, M., Osher, F., & Tomasini-Joshi, D. ,2008). People who work in the mental health court systems take the time out of their day to really take a critical look at th e issues that offenders with mental illnesses face in the criminal justice system. They help craft new ways to deal with these offenders for example with some people you need a more hands on approach in their treatment program and a soft guiding hand, but with other individuals you need to have a firmer no nonsense approach to make them realize that this is not a game but rather an opportunity to get their life back together. The mental health court really gives offenders the ability to work on major mental illnesses while working on taking care of legal issues. This is a very important step in the criminal justice system, because many individuals only committed these crimes due to the fact that they were off their medication at the time the crime occurred (Thompson, M., Osher, F., & Tomasini-Joshi, D. 2008). Mental health courts are very similar to a drug court that you would see. Mental health courts are more of a relaxed dynamic compared to your traditional court room setting. Mental health courts typically meet once a week on a specific day and at a specific ti me. Before the mental health court the case worker, probation officer, judge, and many other people apart of the mental health court process meet to discuss each individual before they see them that day. They spend this time making decisions on what to do with certain individuals who aren’t complying with the terms and also how to keep encouraging everyone who is doing a great job in the program. Mental health court is defiantly more of an encouraging environment for offenders than a traditional court room setting. You have a lot of people who truly want to rehabilitate these offenders and give all their effort to do so. Mental health court is a program that is voluntary. Offenders must opt-in to mental health court to receive the treatment that he/she wants to receive. Some places give the offender the ability to observe the mental health court process while they decide if they want to participate. Although many apply for mental health court not all are accepted into this pr ogram. In order to be accepted into mental health court you have to have had an evaluation with a psychiatrist and have been diagnosed with a mental illness. Every court varies and because of the extensive amount of disorders in the DSM which as of this year is now 800 pages long not every disorder is accepted as the right diagnosis for mental health court. While I am talking about this section I am going to use York County as an example for what is expected of someone in mental health court and what diagnostic criteria you have to meet. To be accepted into the York County mental health court you must meet the diagnostic criteria which means you must be diagnosed with a major Axis I diagnosis, which includes disorders like Bipolar Disorders, Major Depressive Disorders, and Schizophrenia. PTSD is usually only excepted when you are a veteran and then you would not go into the mental health court but into the veteran’s court that they offer. Other disorders besides these can sometimes be acceptable but they have to come with substantial evidence that it impaired their judgment. At York County an exclusion from the mental health court would be if you had any previous charges they are not resolved in other states. Not every charge is allowed to enter into mental health court some examples of that are murder, any sexual charge, any violent offense (example aggravated assault), and anyone who is classified as a violent offender. Although these crimes are excluded under the conditions under certain circumstances they might allow one of these charges to enter into mental health court. Along with a list of certain circumstances to get into mental health court York County also provides a list of prohibited medications in the treatment court so people are aware of the rules before entering. The mental health court at York County has three phases for the offenders and has listed what is expected of them and what the possible sanctions if they do not follow what is required of them (York county mental health court manual, May, 2005). I stated earlier how most mental health court programs are for a yearlong and can change depending on what happens with the offender and the treatment courts position. From being able to have the opportunity to work and observe the mental health court process I learned a lot. York Counties mental health court is not like most according to the research that I found. The treatment court there is mandatory for everyone to attend for 18 months which is why there are the three phases of this program. I think that 18 months is a great reasonable time for someone to complete this program and truly get everything they need out of it. Before you enter York Counties program besides the mental diagnosis you also need to plead guilty to all the charges that have been brought up on you. It is very important for the offender before entering the program to recognize what they did was wrong and that they need to own up to what they have done. The offender has to sign many papers including the contractual agreement saying that they are committing to program for the designated 18 months and they will comply with the entire requirements or face the sanctions that are listed in the manual. Towards the end of completion offender visits become less at York County and then if they are cleared they do not have to come back till graduation day. York County took graduation very seriously because it gave the offenders a sense of accomplishment and sometimes for some of them it was the only time in their lives that they had finally finished something. I was lucky enough while interning there that I was able to go through the end part of the mental health court journey with some people and see them graduate. Overall I feel like York County likes to give an approach of a soft but firm stand point in the treatment court. Everyone who worked there was dedicated to helping the offenders live a mentally better life and stay on track after they graduate (York county mental health court manual, May, 2005). The plea structure of mental health court is very different than the typical plea agreements you see in a regular court system. When you are accepted into mental health court the prosecuting attorney will then proceed to freeze the charges that you are currently charged with. If you have been charged with a felony typically if you complete the mental health court and do everything you were supposed to do the felony will be reduced into a misdemeanor. If you have been charged with a misdemeanor they the charges against you after successful completion will then be dropped from your record (The Proliferation of Mental Health Courts). Mental health courts like I had stated earlier do not typically take violent offenders or certain charges and this is why mental health court is sometimes longer than the actual time they would have served for just the crime. The treatment time in mental health court is usually around a yea r although it can be extended for a period of two years. The court has the right to extend the treatment of the offender if they deem it to be something that is absolutely necessary for them to do in order for the offender to have the opportunity to fully get what they need out of the program. Like I had stated earlier they are required to attend mental health court often and one of the reasons for this is so the judge can monitor them along with the other court personal. Along with attending mental health court they are required to attend all other programs and meet with their probation officer on a consistent basis in order to be in compliance with terms of the treatment court. Overall if they attend what they are supposed to over time the amount of attending the treatment court will lessen towards the end of their treatment. The amount of time that the offender spends in treatment court should not go over the maximum time they would have spent in prison or on probation for their crime (Thompson, M., Osher, F., & Tomasini-Joshi, D. 2008). Mental health courts often reach out to other resources in the community to give the offenders the ability to continue on their path to recovery after the treatment court ends. They provide resources like counseling services after, group meetings to keep them on track, and job placement to keep them an active and productive member of society. All of these resources give the offenders the ability to keep on track an d give a smoother transition back into the community. I think that this is almost if not more important than the treatment court itself. So many times we see that these offenders end up recidivating because they are put back in the same situations that they were in before without any resources to keep them on track. Community resources are a really good thing that the courts do and hopefully continue to do in the future with these courts (The Proliferation of Mental Health Courts). The short term goals of mental health court would be to help offenders get into treatment for their mental illness and reduce the amount of people that we currently have incarcerated. Usually each mental health court has its own set of goals specifically designed for them but they usually fall into basically the same thing. Some of the long term goals for mental health courts is to increase the public safety by hopefully reducing the crime and recidivism rate with the offenders, to encourage treatment amo ng the mental ill community within the criminal justice system, lessening the cost on the community by using the corrections institutions, and overall improving the quality of life for the population of mentally ill people in the criminal justice system (Mental health courts a primer for policy makers and practitioners, 2008). Mental health courts have many benefits to the community and the criminal justice system. Overall in most areas they have been decently successful. Down at York County District Attorney’s Office with my experience in mental health court many people completed the program, but sometimes it really depended on the drive the own individual had to really change their life and turn it around. They contribute to the cases moving faster through the criminal justice system, help the communication between the criminal justice community and mental health communities, and help the offenders with true mental illnesses learn how to deal with them. Mental health courts have had good support from the community and funding which makes this program possible. I do believe that these courts are a great asset to the criminal justice system and help the community with mental illness. So many of the state hospitals in Pennsylvania have closed it has created a large amount of the prison population with mental illnesses not receiving the proper treatment for their disorders. I believe that mental health courts are a great way to reduce the prison population and give people who truly need those resources the opportunity to get them. Each and every county is working hard to serve the offenders the best they can in this court. The idea of treatment court has room for a tremendous amount of gro wth and I only see it becoming an even better system in the future of our criminal justice system. In conclusion from the research that I conducted I found that mental health courts that took a softer approach on their offenders and led them the right way with a gentle hand were more successful. Building relationships with the offenders during this process is just as important as them following through with the proper treatments. Holding them accountable and guiding them are two of the most important components from what I observed. Like I had stated earlier mental health courts have a bright future in our criminal system and seem to do more good for society than harm. References Mental health courts a primer for policy makers and practitioners. (2008). The Proliferation of Mental Health Courts. Center for Court Innovation. N.p., n.d. Web. 1 Sept. 2013 Thompson, M., Osher, F., & Tomasini-Joshi, D. (2008).Improving responses to people with mental illnesses: The essential elements of a mental health court. What have we learned from evaluations of mental health courts?. (N.d.). York county mental health court manual . (May, 2005).

Vatican Council Ii

Concilium Oecumenicum Vaticanum Secundum (The Vatican Council II) The Second Vatican Council was formally opened by Pope John XXIII on 11 October 1962 and closed under Pope Paul VI on 8 December 1965. Its aim was â€Å"†¦ to throw open the windows of the Catholic Church so that we can see out and the people can see in. † – Pope John XXIII. T The main topics discussed were the Church itself, ecumenism and other religions, relation to the modern world and the liturgy of mass. The Catholic Church recognised the increasing rift between people and their relationship with God and the Church, and created four constitutions which addressed the issue.Dei Verbum (Dogmatic Constitution on Divine Revelation), Lumen Gentium (Dogmatic Constitution on the Church), Gaudium et Spes (Pastoral Constitution on the Church in the Modern World), Sacrosanctum Concilium (Constitution on the Sacred Liturgy). These documents are responses to the external issues and internal issues that impac ted the Church, and are further discussed later. The 1960’s was a huge counter-cultural movement which challenged the traditional codes of behaviour linked to sexuality and interpersonal relationships.With the sexual revolution brought the normalisation of pre-marital sex, the contraception and the pill, homosexuality and later; the legalisation of abortion. There was a rapid evolution of a youth subculture which encouraged experimentation and change, and religious values were disregarded and replaced with hedonistic attitudes. This impacted the Church because the one of the fundamental teachings of the Church is that sexual intercourse is only to express married love and for the procreation of children.The Church opposed abortion and contraception as it goes against their teachings and this caused an uproar from the feminists. Their argument was that they should have â€Å"free choice because it’s my body†. The Church until this time was also a male dominant bo dy, and women began to fight for the right to become a priest and for female altar servers. The advancement of technology also impacted the Church as prior to TV and travelling technology, society had a narrow view of the world, and mainly stuck to their own local community.The Church had played a huge role in their life because of this. But when TV became more popular, people began to spend more time watching TV and learning about things more relevant to their lives, and it became another â€Å"voice† they listened to. With the rise of technology, the â€Å"voice† of the Church became less significant. These were the major social changes which impacted the Church and some changes were made to counter the issues. During this time the Church was also facing internal issues as well as being confronted with social changes.Mass attendance was falling due to a lot of social changes. This included the sexual revolution, the role of women in society and decreased respect for the church as an authority figure. â€Å"The sexual revolution was a development in the modern world which saw the significant loss of power by the values of a morality rooted in the Christian tradition and the rise of permissive societies of attitudes that were accepting of greater sexual freedom and experimentation that spread all over the world. † (Extract from Wikipedia).Falling mass attendance may also have been due to people not being able to understand the mass, as it was in Latin or maybe feeling that the Church was too hierarchal in the way that the laity weren’t allowed to contribute during mass. Another issue was that religious numbers were also falling as many of the religious and priests had left Europe on missions. There was also tension between Protestant Churches and the Catholic Church, as the Church’s main goal was to convert as many people to Catholicism as possible.The role and structure of the Church was also under speculation as many though t the Church needed an â€Å"update† to society, and others believed that the old traditions should not be changed at all, and this caused some conflict within the Church. In order to deal with these internal and external issues, the Vatican Council II created four documents which responded to these matters. The first dogmatic constitution was Dei Verbum which was about Divine Revelation.Divine Revelation can be defined as God’s activity in making himself and his purposes known to mankind through Christ, the prophets and the apostles. Pre Vatican II, the Church taught that only priests could read and interpret scripture. But Council stated â€Å"Easy access to Sacred Scripture should be provided for all the Christian faithful. But since the word of God should be accessible at all times, the Church by her authority and with maternal concern sees to it that suitable and correct translations are made into different languages, especially from the original texts of the sac red ooks. †(Dei Verbum p. 22). This basically meant that anyone could read the bible, but the magisterium alone has been trusted with guiding and teaching the meaning of the scripture with the help of the Holy Spirit. The aim of this change was so that â€Å"Through the reading and study of the sacred books â€Å"the word of God may spread rapidly and be glorified† (Thessalonians. 3:1) and the treasure of revelation, entrusted to the Church, may more and more fill the hearts of men. This change was adopted because the bible was written for everyone and therefore everyone has the chance to learn all about God’s Revelation and his gifts to all people. The second dogmatic constitution is Lumen Gentium which redefined the structure and role of the Church. The church recognises Christ as the head of the body, and as the image of the invisible God, and that all members must be formed in his likeness until Christ is formed in them. It also became more focused on divers ity and pluralism, rather than being a private circle of religious.It said that â€Å"In virtue of this catholicity each part contributes its own gifts to other parts and to the whole Church, so that the whole and each of the parts are strengthened by the common sharing of all things and by the common effort to attain fullness in unity,† (Lumen Gentium p. 13), explaining that the Church is not just about bishops, priests and the pope, but also all the faithful. Priests were described as â€Å"its support and mouthpiece, called to the service of the People of God,† (Willis, M. Lumen Gentium Summary, p. 3), which clarified their vocation as not just preaching the word of God, but also being there to guide and support the community. A dogmatic constitution on the Church was also formed about sacred liturgy. This document revealed the changes made to mass. One of the external issues during the 60’s was falling mass attendance. The youth were rebelling and trying new things and their attitude towards the Church had changed. Before Sacrosanctum Concilium, there were several differences between the traditional mass, and the mass we know today. God who â€Å"wills that all men be saved and come to the knowledge of the truth† (Timothy 2:4).Probably the biggest change was that the language of the mass changed from Latin to vernacular. This meant that the laity could now completely understand what was going on at mass. To promote participation, the people were encourages to take part by means of readings, responses, hymns and giving out communion. The communion rail was withdrawn, and the priest now has his back to the tabernacle to face the people. The document also allowed altar girls. These changes were made so that the Church was more appealing to people, so that they felt more welcome and interested in the Church again.The last dogmatic constitution made was Gaudium et Spes. This document deals with the relevance of the Church and its pla ce it society. It also talks about interaction with other faiths. The Council expresses a desire to engage in conversation with the entire human family so that the Church can cooperate in solving contemporary problems. It addresses this Constitution to Catholics, to all Christians, and to the whole of humanity. The Council sets out to establish a working relationship with the world, claiming â€Å"Christ, to be sure, gave His Church no proper mission in the political, economic or social order.The purpose which He set before her is a religious one. But out of this religious mission itself come a function, a light and an energy which can serve to structure and consolidate the human community according to the divine law. † (Gaudium et Spes p. 11). The Church is desired to assist the whole of humanity to overcome all strife and conflict between nations, and this sense of unity comes from one of its fundamental beliefs that the Church is one with the Holy Spirit. One way this was shown Pope John XXIII invited other Christians outside of the Catholic Church to send observers to the Council.Acceptances came from both the Protestant denominations and Eastern Orthodox churches. The goal of conforming people to Catholicism was no more, instead the Church now preaches Ecumenism. While helping the world and receiving many benefits from it, the Church has a single intention: that God's kingdom may come, and that the salvation of the whole human race may come to pass. â€Å"The Council wished to ponder the many problems and possibilities of the modern world â€Å"in the light of the gospel and of human experience†. Michael Paul Gallagher SJ, Reaching out to the world: Gaudium et Spes). In its final form, Gaudium et Spes encourages a â€Å"new humanism† marked by a greater sense of our responsibility for history. God, so to speak, gives the world into our hands. We are dramatically free and called, with the help of grace, to transform this planet throug h loving service. These responses strengthened the mission of the Church for a contemporary society. The Church acknowledged that there was growing secularism in society, and that growing numbers of people are abandoning religion in practice. Church does not only communicate divine life to men but in some way casts the reflected light of that life over the entire earth, most of all by its healing and elevating impact on the dignity of the person, by the way in which it strengthens the seams of human society and imbues the everyday activity of men with a deeper meaning and importance†, (Gaudium et Spes, p. 40) summarises the mission of the Church in contemporary society; to bring salvation. It was Pope John XXIII who realised that the Church had â€Å"†¦ o throw open the windows of the Catholic Church so that we can see out and the people can see in,† (Pope John XXIII), so that they can understand and come to terms with the always changing society, to reform itself to the needs of the people. Through the four dogmatic constitutions of the Second Vatican Council, the Church was able to renew their relationship with the world, renovate new ways to communicate with the whole of humanity, and achieve its goal of making Church more engaging and relevant to a contemporary society.The Second Vatican Council was the most significant event for the Catholic Church in the 20th century. It had four aims; to impart an ever increasing vigour to the Christian life of the faithful, to adapt more closely to the need of our age those institutions which are subject to change, to foster whatever can promote union among all who believe in Christ and to strengthen whatever can help to call all mankind into the Church’s fold.The four dogmatic constituents; Sacrosanctum Concilium, Gaudium et Spes, Dei Verbum and Lumen Gentium, addressed internal and external issues that impacted the Church, and endeavoured to answer them. Such issues included the sexual revolu tion of the 60’s, the feminist movement, the reformation of the protestant church, and falling mass attendance. The responses strived to improve these circumstances and help to bring people closer to God. The allowance of female altar servers, the changes to liturgy in order to make it more engaging to people and the preaching of ecumenism helped restore elationships between the Church and the faithful, and the Church and other religions. There are still unresolved issues and debates involving the Church, such as contraception and abortion and the request for female priests, and if the Church was to call another Council, these would be the issues discussed. Overall, the Second Vatican Council was successful in making a difference and re-establishing its role in the world today. REFERENCES Pope Paul VI; Dogmatic Constitution on Divine Revelation – Dei Verbum. (n. d. ).Retrieved April  13, 2013, from http://www. vatican. va/archive/hist_councils/ii_vatican_council/docu ments/vat-ii_const_19651118_dei-verbum_en. html Gaudium et spes | Catholic Social Services Australia. (n. d. ). Retrieved April  15, 2013, from http://catholicsocialservices. org. au/Catholic_Social_Teaching/Gaudium_et_spes Pastoral Constitution on the Church in the Modern Word-Gaudium et Spes. (n. d. ). Retrieved April  12, 2013, from http://www. vatican. va/archive/hist_councils/ii_vatican_council/documents/vat-ii_cons_19651207_gaudium-et-spes_en. htmlSexual revolution in 1960s United States – Wikipedia, the free encyclopaedia. (n. d. ). Retrieved  April  13 2013, from http://en. wikipedia. org/wiki/Sexual_revolution_in_1960s_United_States Dale A. Robbins; From the book, â€Å"What People Ask About The Church, What is the mission of the church? (n. d. ). Retrieved  April  13 2013 from http://www. victorious. org/churchbook/chur04. htm Michael Paul Gallagher S; Reaching out to the world: Gaudium et spes | Catholicireland. net. (n. d. ). Retrieved  April  12 2013 from, http://www. catholicireland. net/reaching-out-to-the-world-gaudium-et-spes/

Character Analysis Of Eveline - 1123 Words

James Joyce’s Eveline is a story of a woman dealing with the decision to stay at home with her father and the children she cares for while enduring abuse, or going out across the sea with her boyfriend Frank, who wishes to make Eveline his wife. Although Eveline s father had caused her strife through his abusiveness, she reflects on a time when she was younger and her mother was still alive and he was not that way. Eveline wonders what what they would say about her in the stores if she were to go with Frank. Leading me to believe that she cares what other people’s opinions are of her. Throughout much of the story Eveline sits by a windowsill pondering her decision and reflecting on her childhood. Did she want to live as her mother did†¦show more content†¦Eveline reveals that they had been happier at that time, even that â€Å"her father was not that bad then†(Joyce) insinuating that her father developed his abusive nature after her siblings had left and her mother had passed. Eveline cares about the things that people say about her: â€Å"what would they say of her in the stores when they found out she had run away with a fellow?†(Joyce) clearly the thoughts of others has an effect on her decision of whether to leave home or not. What one would assume is her boss, Miss Gavin, is someone who had an edge on her, especially whenever there were people listening.†(Joyce) The lack of respect does not just come from the people at the stores, but it comes at home from her father as well: â€Å"She is caught in a death trap, doomed by by paralysis of will born of timidity and a mistaken sense of obligation.†(Walzl 225) this brings to light that Eveline is indeed trapped by her father’s manipulative methods of keeping her in his home. Her being concerned about what her father may think of her if she is to leave with Frank must also be weighing heavily on Eveline’s mind. Eveline’s father has not been exactly supportive nor has ever instilled much faith in Eveline. In fact, he makes her give him her wages, â€Å"he said she used to squander the money, that she had no head†(Joyce) Eveline’s father did not think highly of her at all. That begs the question of why would she stay and put up with such demeaning actions? Why would Eveline putShow MoreRelatedEssay about Character Analysis of James Joyce Eveline1432 Words   |  6 PagesNick Tomlinson English 122 Ms. Purvis An Analysis of a Promise The short story written by James Joyce â€Å"Eveline† is about a young lady who lives her life in a promise. The promise is to her mother, who had passed away, that no matter how bad the family became, she would always keep it together. At a significant point in Eveline’s life, she was given the opportunity to leave the family and start a family of her own. 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