Monday, September 16, 2019
Acupuncture as a nonconventional chronic neck pain treatment Essay
Acupuncture as a nonconventional chronic neck pain treatment Introduction Abstract à à à à à à à à à à à Chronic neck pain is an ailment that is characterized by pain in the neck that lasts for a period of more than three months. It is usually different from common medical conditions of neck pains that last for only days. In most occasions, chronic neck pain is an ailment that may even take years without success in its treatment, particularly in the mainstream medical practices. Research assert that chronic neck pain is usually associated with a number of disorders, as well as diseases that can involve any of the tissues around the neck. The study was carried out to fully analyze the effectiveness of acupuncture in the reduction of chronic neck pain, and also to examine whether the possible effects attributed to the therapy are long lasting. The data used in this study was collected through specified procedures to ensure credibility of the results in regard to the use of acupuncture in health care to provide a remedy for chronic neck pain in both short and long term basis. Using a well-structured methodology to guide the research patients were carefully analyzed in regard to the various methods of acupuncture to determine the respective effectiveness of each method. Further, a thorough analysis of the data collected is subsequently discussed showcasing the viability of the medical alternative. Lastly, recommendations for further research of acupuncture as an ideal treatment for individuals with chronic pain of the neck is well provided in this paper. See more: Social process essay à à à à à à à à à à à Research indicate that acupuncture as a recognized nonconventional alternative for chronic neck pain that is increasingly becoming popular across the world. Acupuncture therapy is among world widely known health care procedures that is used to treat over 30 health conditions and diseases, with a major emphasize of relieving pain to different ailments. One of the main uses of acupuncture is to relieve pain, hence it is one of effective remedies for chronic neck pains. Research has for a long time hinted on the benefits of acupuncture for relief of chronic neck pain, as well as other body pains such as chronic shoulder pain, migraines and osteoarthritis among others(Blossfeldt 2004, p. 146). Researchers have provided data from over 30 high quality studies involving more than 18,000 patients with different chronic pains. As a nonconventional remedy for different pains, acupuncture is commonly used in different methods, providing flexibility i n its treatment procedures, as well as a provider of choice for patients who opt to use acupuncture as a remedy for chronic neck pain(Salter et al, 2004, p 10). à à à à à à à à à à à Further, researchers assert that although acupuncture is increasingly being used for various conditions including chronic neck pain treatment, the evidence of its effectiveness remains inconclusive. This indicates that there is a need for a further well designed research. With the use of a variety of methods or options on the use of acupuncture to relieve pain, there is also a need to establish the key features required for the design, as well as implementation of larger scale trial on acupuncture for neck pain. Acupuncture is believed to decrease pain by enhancing the release of the chemicals responsible for blocking pain, commonly referred to as endorphins(Liang et al, 2010, p. 8). Most of the acu-points are usually found near the nerves. In this regard, when stimulated, the nerves cause a dull ache, a feeling of fullness in the patientââ¬â¢s muscle. The stimulated muscle then sends a message to central nervous system subsequently cau sing a release of endorphins. These are crucial elements in the human body that are automatically released to modify the nerve impulses, hence reducing or nullifying the effect of pain to the patient.The endorphins together with other neurotransmitters subsequently block the message of pain from being taken up to the brain, hence a relief to the patient(Blossfeldt 2004, p. 146). Acupuncture may be used as a reliable treatment for chronic neck,and therefore, should be included as a part of an extensive and comprehensive pain management programs for relieving pain in patients. à à à à à à à à à à à The scope of this paper is to ascertain the effectiveness of acupuncture in the treatment of chronic neck pain. The paper seeks to understand the role played by the various methods of acupuncture that are used to relieve pain for patients ailing from neck pains. Shallow, Sham and randomized acupuncture therapies are well explained in regard to their role in relieving pain. à à à à à à à à à à à Lastly, the main purpose of this study is to establish the use of acupuncture in individuals with chronic pain of the neck. The paper focuses to establish the effectiveness of three acupuncture therapies used as alternative medical conventions to relieve pain. Additionally, the study proposes to explain both the short term and long term effects of acupuncture therapies in the treatment of chronic neck pain. To establish the viability of acupuncture therapies in the treatment of chronic neck pain. To understand how sham, shallow and randomized acupuncture therapies are utilized in the treatment of chronic neck pain. To provide a conclusive evidence of the success of acupuncture as an ideal method of relieving pain. To establish the effects of the three acupuncture therapies in the treatment of individuals with chronic pain of the neck. To offer recommendation of the viability of acupuncture as a treatment option that can be used by people with chronic neck pains. Basic approach to acupuncture as a nonconventional chronic neck pain treatment à à à à à à à à à à à The use of acupuncture as an alternative chronic neck pain treatment is based on the medical understanding of the specific elements responsible for alienating pain or sending messages of pain to the brain. The study of acupuncture is based on the thought that decrease or alienation of pain can be enhanced by releasing the chemicals responsible for blocking pain, referred to as endorphins. Most of the acu-points are usually found near the nerves(Liang et al, 2012, p. 8). The approach of this study is based on the understanding that, when stimulated, the nerves cause a dull ache, a feeling of fullness in the patientââ¬â¢s muscle. The stimulated muscle then sends a message to central nervous system subsequently causing a release of endorphins. These are crucial elements in the human body that are automatically released to modify the nerve impulses hence reducing or nullifying the effect of pain to the patient(Willich et al, 2006, p. 98). T he endorphins, as well as other neurotransmitters, subsequently block the message of pain from being taken up to the brain, hence a relief to the patient. The findings of this study will pin point out how the alienation of pain is conversely connected to the various elements thought to treat people suffering from chronic neck pains. Basic Background information à à à à à à à à à à à Acupuncture used in the modern day alternative treatment for pain is a branch of a traditional Chinese medicine practice. It is a practice that has historically been tired, and equally tested as a health care practice that has in practice for thousands of years, particularly in China and South East Asia. For centuries, acupuncture has been gradually developed, tested and researched, as well as refined over many centuries giving out a complex, and rather detailed understanding of the energetic balance of the human body. The first known record of Chinese Medicine was a book, the classic of Internal Medicine of Yellow Emperor, which dates back to between the 1st century BC and the 1st century AD(Sun et al, 2009, p. 850). It is essential to acknowledge that all the styles of acupuncture found in the modern day health care practices trace their roots to this particular text. à à à à à à à à à à à Without the help of the modern day scientific equipment, scholars from the Ancient China discovered many aspects of biomedical science, like the effect of emotional stress on an individualââ¬â¢s immune system. The traditional acupuncturists were not less scientific or sophisticated that it is the case with the western clinicians with their understanding of the functioning of the body, although the contemporary acupunctural practices depict that of the culture and historic origin of the Chinese medicine. The traditional Chinese medicine has vividly remained in the shadow of the western medicine, until a certain period between 1934 and 1935, where the without drugs sick and wounded faced death. It was the intervention of traditional Chinese medicine, which generally used acupuncture and other several traditional treatment methods(Witt 2004, p. 99). From this point, the traditional and western medicines started to be practicing side to sid e in China. In the contemporary, the practice has gained popularity across different region of the world. More people with chronic pains, where it is primarily being used to treat such case, as it with the alienation chronic neck pain. Methods Population à à à à à à à à à à à The research data collected in this study focused on patients suffering from chronic neck pain. The individuals used in the research fell within the age of 21 and 55 years old. Although there are many patients who report about neck pain ailments in different health care facilities across the United States, patients with the age of 21 and 55 years old were ideal for a research. This is due to the fact that they are easier to track their progress of healing over a longer period of time. Elderly patients over the age of 55 years are not best placed in this research considering the various attributes in the healing processes of such people, which is proven to be relatively lower. Most of the data about individuals with chronic pain of the necks was randomly collected in health care facilities in the State of California, United States. The majority of these patients was diagnosed with chronic neck pain and were put under a special focus while t hree acupuncture methods of therapies were performed(Witt 2004, p. 99). The study generally involved a thorough investigation of 191 patients in Californiaââ¬â¢s health care. It is important to acknowledge that the various patients were deliberately initiated to acupuncture treatment as their decision to try the alternative medical practice after allegedly failed treatments in the mainstream medical procedures. à à à à à à à à à à à There were certainly no limitation on the sex of the patients, hence the research involved both male and female patients. Additionally, there were no specified number of male or females in the study, as patients, as treatment and progress of treatment of patients was randomly taken. Further, it was assumed that both male and female patients presented similar responses to the different acupuncture therapies performed in the study(Sun et al, 2009, p. 850). The research was also not limited by either ethnicity or race, although believed to have different characteristics in regard to various medical procedures. Variable and Delimitations à à à à à à à à à à à The dependent variables in this study included the neck pain as an ailment caused by various aspects such as physical injury and disease or condition among others. The rates of cases involving chronic neck pains during the period of this study was generally unprecedented as the causes of such ailments greatly varied. Chronic neck pain among the patients varied in regard to the specific causes, which in this case included degenerative disc disease, neck injury, neck strain, herniated disc as well as pinched neck(Sun et al, 2009, p. 850). The first step in the treatment procedure involved a thorough diagnosis of common neck infections that caused the chronic pain. à à à à à à à à à à à The key delimitations were based on neck pain due to common infection like virus infection of the neck and lymph nope swelling, as well as other infections such as tuberculosis of the neck, meningitis, and infection of spine bones around the neck.The different patients involved in this study had chronic neck pains attributed to extremely different causes, which included physical injuries, some rare infections, and virus infections among others(Witt 2004, p. 99). The patients with this problem are generally taken through the three acupuncture therapies, regardless of the cause of their condition(Hush 2004, p. 1533). The fact that all patients are uniformly taken into similar medical procedures without being categorized in relation to their specific cause of chronic neck pain remain as the greatest delimitating attribute of this research. Search Criteria à à à à à à à à à à à The key terms I commonly used while searching for the relevant articles included: chronic neck pain, cervical pain types of acupuncture, alternative medicine, sham acupuncture, Shallow acupuncture and randomized acupuncture. Short statements were also useful in searching for relevant information about the use of acupuncture in the treatment of chronic pain. These statements included: Alternative treatment of chronic pain, use of acupuncture in the treatment of chronic neck pain, and the acupuncture methods used in the treatment of chronic neck pain(Witt 2004, p. 99). I thoroughly searched in various databases for article that provided information for patients suffering from chronic neck pains, specifically those individuals between the age of 21 and 55 years old. I further categorized the data collected to form two groups of patients of the age bracket of 21 and 34 years and those between 35 and 55 years old. The creation of these two grou ps was essential as taking a wider range of people of ages 21 to 55 years old would present relatively a higher deviation in the healing processes of the patients, as those above the age of 35 years present a much longer period of healing as compared to the youthful 21 to 34 years group. I also focused my research on the following: MasterFile Premier, ALT Healthwatch, US National Library of Medicine, BioMed central. Chronic Neck Pain à à à à à à à à à à à Chronic neck pain is an ailment that is characterized by pain in the neck that lasts for an unusually long period of time, commonly over a period of three months. Although different from the common medical conditions of neck pains that last for only days, chronic neck pain is typically an ailment that takes even years without success in its treatment in the mainstream medical practices. Chronic neck pain is usually associated with a number of disorders, as well as diseases that can involve any of the tissues around the neck(Witt 2004, p. 99). For instance, the common causes of this condition are strains of the neck, injury of the neck like a herniated disc, pinched disc, or whiplash, and degenerative disc disease. In addition, chronic neck pain is also linked to common infection like virus infection of the neck and lymph nope swelling, as well as other infections such as tuberculosis of the neck, meningitis, and infection of spine bones ar ound the neck. Some patients also had chronic neck pains caused by extremely different causes, which include physical injuries, some rare infections, and virus infections among others. Further, chronic neck pain is also caused by certain infections like virus infection of the neck and lymph nope swelling, as well as other infections such as tuberculosis of the neck, meningitis, and infection of spine bones around the neck. Risk Factors à à à à à à à à à à à Chronic neck pain is generally caused by numerous factors ranging from physical injury to certain infections around the neck body tissues. Since neck pain affects the muscles around the body areas of the neck, it becomes painful to move the neck as it is usually painful. The risk factors for pain usually include injury from involvement in motor vehicle accidents, horse rising, contact sports and bull riding among others(De Loose, 2008, p. 475). In order to avoid or to prevent neck pains for the patients, it is always essential to consider staying away from activities may twist the neck and subsequently aggravate the already painful section of the neck(Witt 2004, p. 99). In addition, it is also advisable to have activities that will enhance neck strengthening exercise, as well as neck bracing. Types of acupuncture used in the treatment of chronic neck pain Optimized acupuncture therapy à à à à à à à à à à à Optimized acupuncture therapy in the treatment of chronic neck pain involves the utilization of traditional acupuncture, which is usually followed by intradermal needle therapy, commonly referred to as INT(Hush 2004, p. 1533). The use of OAT usually consists of the use of nine acupuncture points typically selected for an optimized acupuncture therapy group on the advice and consensus of the national expert committee of the OAT procedures. In this case, four points are subsequently located by physician intending to perform the OAT. The points selected are usually the cervical positive reactions planes found in the top and bottom of the cervical planes as well as horizontally away from the corresponding cervical vertebra(Witt 2004, p. 99). This type of acupuncture practice is highly sensitive and usually need to be performed by an individual with more than five of practice experiences. Sham acupuncture therapy à à à à à à à à à à à Sham acupuncture therapy involves the use of skin penetrating shallow needles on the specified sham groupsââ¬â¢ tender points.The tender points that are used in this method of acupuncture therapy are categorized as the key areas recommended for the acupuncture, which are the Ah Shee, also referred to as ââ¬Å"oh yes pointâ⬠. The points are crucial in this therapy and have to be used throughout the treatment procedure. Typically, the location of sham points is commonly defined by 25mm lateral extending to the standard location used for the OAT group.They include: the sham point of Dazhui (GV14) 25mm, which is 25 mm vertically below the usual standard GV14, sham points of (S115) Jianzhongshu and Huatuojiaji, which is 25 mm lateral to standard S115 (Liang et al, 8).After the sham acupuncture, individuals undergoing the process or patients are treated through the use of point pressing (De Loose, 2008, p. 475). Shallow acupuncture therapy Shallow acupuncture group undergoes similar procedures as the other OAT groups. à à à à à à à à à à à However, the physicians are required to insert the needles in a vertical manner in order to reach the subcutaneous level at a specified depth of not more than 3 mm (Salter et al, 2004). Needle manipulation or any other sensation is prohibited in this particular group. Ultimately, after the shallow acupuncture, the patients are additionally treated by INT through the use of a similar method as in the other OAT groups. Physiotherapy versus acupuncture à à à à à à à à à à à Zhuang (2012) compares the use of acupuncture and physiotherapy in the treatment of chronic neck pain in a research that took place in China. The research involved screening of a total of 310 patients. The patients were then randomly split into two equal groups, where one group was treated using acupuncture method, while the other group received treatment through physiotherapy. The outcome of the treatment of the two procedures revealed that patients treated under acupuncture procedures had better results in relieving neck pain, particularly after a period of three months.It is essential to acknowledge that physiotherapy is an alternative medical practice that can be used in the treatment of chronic neck pain. While acupuncture therapies generally used sterilizes needles that are usually inserted in the area around the neck depending on the type of acupuncture used, physiotherapy does not involve the use of needles. Physiotherapy utilizes several types of manipulation as well as exercise to relieve pain. The common illustration of the use of physiotherapy is the stretch, strengthen and straighten up exercise movements of the neck. Adverse event and acupuncture à à à à à à à à à à à White (2001) researched about the adverse events following a use of acupuncture to treat patients with chronic neck pain. In his survey, which included a prospective survey of 32,000 consultations with physiotherapists and doctors, the researcher, Adrian White aimed at ascertaining the incidence of adverse events that are related to acupuncture treatment, as practiced by British doctors during that time. The research utilized data that were collected for the June of 1998 to February of 2000, from a total of 78 acupuncturists. Altogether the resulting significant events were 43, subsequently giving only a rate of only 14 patients of the 10,000 patients included in the data. The results of this study showed that only 0.14 percent of the patients who used acupuncture in the treatment of chronic pain experience adverse events. All the adverse events were reported to have had cleared within the period of one week after the therapy. Similar dimi nishing events were characterized at a longer period, except foronly one incident that lasted for several weeks. The result derived from the data of acupuncture treatment did not report any serious adverse events. The rates can only be classified as minimal considering that it was only 14 adverse effects out of the total 10,000 patients who were analyzed with the data provided. Generally, these event rates do not give significant risk per individual patient. Physician views on acupuncture à à à à à à à à à à à The article by Chen, L. et al., (2010), offers exclusive views on acupuncture given by various physicians. The research by Chen among other authors who contributed to the article, there study targets collecting information that addresses the role of acupuncture in the management of pain in regard to opinions of physicians who manage such conditions. The research was conducted between 2007 and 2008 using a nationwide e-mail to 1083 physicians who were in active acupuncture practice in the United States. Chan et al., (2010) found that the overwhelmingly majority of the responders of the survey had a positive attitude and favorable experience of the use of acupuncture as an alternative modality in the management of chronic pain. The results of the survey subsequently indicate that acupuncture is considered effective by physicians in the management of chronic neck pain. Discussion à à à à à à à à à à à Chronic neck pain commonly occur as a result of a number of disorders, and diseases that in involve any of the tissues around the neck (Witt 2004, p. 99). The risk factors of this condition have also been linked tothe strains of the neck, injury of the neck such as the herniated disc, pinched disc, or whiplash, and degenerative disc disease. Additionally, chronic neck pain is also associated with to common infection like virus infection of the neck and lymph nope swelling, as well as other infections such as tuberculosis of the neck, meningitis, and infection of spine bones around the neck. Further, chronic neck pain is also found to be caused other different causes, which include physical injuries, some rare infections, and virus infections among others. Moreover, chronic neck pain is also caused by certain infections like virus infection of the neck and lymph nope swelling, as well as other infections such as tuberculosis of the neck, me ningitis, and infection of spine bones around the neck. Despite the different causes of the chronic neck pain, the use of acupuncture has subsequently been showcased as an ideal alternative medical procedure towards the treatment of this condition. The research shows that the three types of acupuncture are equally ideal in providing effective treatment for neck pain. à à à à à à à à à à à Although I extensively performed research on a wide range of databases, there are some articles that may have been missed out. Since I was individually conducting this research alone, it is possible that the large number of crucial articles were subsequently overlooked. In addition, there are many external factors that could have influenced the entire result of the use of acupuncture as an ideal treatment for chronic neck pain. The majority of studies slightly differs in a number of issues such as data collected, population, or any of combinations of these factors. White (2001) preciselyresearched about the adverse events following a use of acupuncture to treat patients with chronic neck pain, with an extreme number of respondents. Chen, L. et al., (2010), had a relatively smaller number of responders, and also had collection of data to be collected only through email in his research on the effectiveness of acupuncture in the management of chronic pain in the neck. These are some of the factors that were out of the scope of the research, hence determining the effectiveness of acupuncture was difficult, since the aspect of effectiveness could easily be isolated from some external factors. à à à à à à à à à à à The analysis of the specific information provided by the studies of the literature review of this research paper indicate that either of the three methods of acupuncture can effectively treat the chronic neck pain. The procedural practice of sham, shallow and optimized acupuncture, though different, they present similar way of performing the acupuncture therapy, equally offering effective treatment for chronic neck pain. Liang et al, (2012) asserts that the three types of acupuncture to be based on the thought that decrease or alienation of pain can be enhanced by releasing the chemicals responsible for blocking pain. Issues of age in the study have been considered as the research only focused on individuals between 21 years old and 55 years, as they are likely to have a faster period of healing as compared to adult elderly groups of more than 55 years old. Generally, the use of acupuncture is illustrated as effective as it has previously been used to treat patients with chronic neck pain. à à à à à à à à à à à The loopholes evident in the research include the possibility of a prior knowledge in determining the differences that may emerge upon consideration for gender in the treatment program. In the entire study, there is no single explanation of the ratio of females against the males in finding out the effectiveness of acupuncture treatment procedures. The study focused on a general perspective of patients with chronic neck pain regardless of their respective sex or gender. The knowledge of the differences that exist between males and females could have some effects on the understanding the use of acupuncture. In addition, the paper did not focus on the causes of the various neck pain, which could also compromise the results of the study, considering that such plans are typically attributed to a wide variety of causes. à à à à à à à à à à à Topics that can be considered for further research are establishing the element of gender in determining the effectiveness of acupuncture while treating chronic neck problem. The various studies illustrated in the research paper did not point out the importance of understanding differences in the healing process of male and female patients with chronic neck pain. I suggest a study be conducted with a major emphasis on the aspect of gender differences between patients in order to determine the effectiveness of acupuncture treatment for neck pain in male and female patients. If this study is conducted, it will be possible to compare the effectiveness of acupuncture treatment between male and female patients within the same health condition of chronic neck pain. References Blossfeldt, P. (2004). Acupuncture for Chronic neck pain: a cohort study in an NHS pain Clinic.22(3): 146-151. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/15551941Chen, L., Houghton, M., Seefeld, L., Malarick, C. & Mao. Jianren. (2010). A Survey of SelectedPhysician Views on Acupuncture in Pain Management. 11(4), 530-534 Salter, G.C, Roman, M., Bland, M. J & MacPherson, H. (2006). Acupuncture for chronic pain: apilot for randomized controlled trial. 7(1): 3-14 . Retrieved fromhttp://www.biomedcentral.com/1471-2474/7/99 Liang, Z. H., Di, Z., Jiang, S., Xu, S. J., Zhu, X. P., Fu, W,. & Lu, A. P. (2012). The optimizedacupuncture treatment for neck pain caused by cervical spondylosis: a study protocol of amulticenter randomized controlled trial. 13(1): 2-18 . Retrieved fromhttp://www.ncbi.nlm.nih.gov/pubmed/22776567 American Academy of Orthopaedic Surgeons. (2013). neck pain. Retrieved from http://orthoinfo.aaos.org/topic.cfm?topic=a00231Chen, L., Houghton, M., Seefeld, L., Malarick, C., & Mao, J. (2010). a survey of selected physician views on acupuncture in pain management. Pain Medicine, 11(4), 530-534. Retrieved from SPORTDiscus. De Loose, V., Burnotte, F., Cagnie, B., Stevens, V., & Van Tiggelen, D. (2008). Prevalence and risk factors of neck pain in military office workers. Military Medicine, 173(5), 474-479. Retrieved from Academic Search Premier. Hush, J. M., Michaleff, Z., Maher, C. G., & Refshauge, K. (2009). Individual, physical and psychological risk factors for neck pain in Australian office workers: a 1-year longitudinal study. European Spine Journal, 18(10), 1532-1540. Retrieved from Academic Search Premier. Irnich, D., Behrens, N., Gleditsch, J. M., Stà ¶r, W., Schreiber, M. A., Schà ¶ps, P., & â⬠¦ Beyer, A. (2002). Immediate effects of dry needling and acupuncture at distant points in chronic neck pain: results of a randomized, double-blind, sham-controlled crossover trial. Pain (03043959), 99(1/2), 83. Retrieved from Academic Search Premier. Ji-Eun, P., Myeong Soo, L., Jun-Yong, C., Bo-Young, K., & Sun-Mi, C. (2010). Adverse Events Associated with Acupuncture: A Prospective Survey. Journal Of Alternative & Complementary Medicine, 16(9), 959-963. Retrieved by Academic Search Premier. National Center for Complementary and Alternative Medicine. (2012). Acupuncture: an introduction. Retrieved from http://nccam.nih.gov/health/acupuncture/introduction.htmNational Institutes of Health. (2013). neck pain. Retreived from http://www.nlm.nih.gov/medlineplus/ency/article/003025.htmRobertshawe, P. (2008). acupuncture and physiotherapy for neck tension. Journal Of The Australian Traditional-Medicine Society, 14(3), 187. Retrieved from Academic Search Premier. Sun, M., Hsieh, C., Cheng, Y., Hung, H., Li, T., Yen, S., & Huang, I. (2010). The therapeutic effects of acupuncture on patients or individuals with chronic neck myofascial pain syndrome:: a single-blind randomized controlled trial. American Journal Of Chinese Medicine, 38(5), 849-859. Retrieved from Academic Search Premier. Vas, J., Perea-Milla, E., Mà ©ndez, C., Navarro, C., Leà ³n Rubio, J., Brioso, M., & Obrero, I. (2006). Efficacy and safety of acupuncture for chronic uncomplicated neck pain: A randomised controlled study. Pain (03043959), 126(1-3), 245-255. Retrieved from Academic Search Premier. White, A. (2001). Adverse events following acupuncture: prospective survey of 32,000 consultations with doctors and physiotherapists. 10(1), 3-14 Retrieved from BMJ Research Articles Willich, S. N., Reinhold, T., Selim, D., Jena, S., Brinkhaus, B., & Witt, C. M. (2006). Cost-effectiveness of acupuncture treatment in patients or individuals with chronic neck pain.Pain (03043959), 125(1/2), 107-113. Retrieved from Academic Search Premier Witt, C. M., Jena, S., Brinkhaus, B., Liecker, B., Wegscheider, K., & Willich, S. N. (2006). Acupuncture for patients or individuals with chronic neck pain. Pain (03043959), 125(1/2), 98-106. Retrived from Academic Search Premier. Source document
Sunday, September 15, 2019
Why Our Life Is Being Dominated by Technology?
ââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬â- Our life is being dominated by technology. This is a good trend. Modern technology has solved many problems that people face and play an important role in the development of many countries. Modern technology has solved many problems that people face and play an important role in the development of many countries. Modern technologies create many kinds of products ââ¬â computers, cloning technology, and video games etc. Technology today has made life better and quicker.In our modern society, people can't see themselves without computers, cell phones, voice mailâ⬠¦ etcâ⬠¦ As we look at technologies, questions are risen. The Technological progress make our society more convenient and safe. Making impossible things possible are similar features of the change which previous people have experienced by social change, like shifting from a hunting societ y to an agricultural society and establishing a commercial society due to the invention of new tools.To consider these advantages and change of society, modern technology, which we use today, might be not only a new tool but also the tool, which makes a dramatic change in history. However, the contribution of modern technology to society should not be eliminated and should be distributed evenly. Some positive aspects of technology * It makes our work easier. * We can use it for entertainment. * It saves our time. * It provides information about new things. * It develops the country. ââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âConclusion At last I would like thank my teacher subash sir for giving this kind of project work. I would also thank to my parents for helping me to do this project work. This kind of project work will increase our mind. ââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬â Remarks * Excellent ( ) * Very good ( ) * Good ( ) * Bad ( ) Why Our Life Is Being Dominated by Technology? ââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬â- Our life is being dominated by technology. This is a good trend. Modern technology has solved many problems that people face and play an important role in the development of many countries. Modern technology has solved many problems that people face and play an important role in the development of many countries. Modern technologies create many kinds of products ââ¬â computers, cloning technology, and video games etc. Technology today has made life better and quicker.In our modern society, people can't see themselves without computers, cell phones, voice mailâ⬠¦ etcâ⬠¦ As we look at technologies, questions are risen. The Technological progress make our society more convenient and safe. Making impossible things possible are similar features of the change which previous people have experienced by social change, like shifting from a hunting societ y to an agricultural society and establishing a commercial society due to the invention of new tools.To consider these advantages and change of society, modern technology, which we use today, might be not only a new tool but also the tool, which makes a dramatic change in history. However, the contribution of modern technology to society should not be eliminated and should be distributed evenly. Some positive aspects of technology * It makes our work easier. * We can use it for entertainment. * It saves our time. * It provides information about new things. * It develops the country. ââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âConclusion At last I would like thank my teacher subash sir for giving this kind of project work. I would also thank to my parents for helping me to do this project work. This kind of project work will increase our mind. ââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬âââ¬â Remarks * Excellent ( ) * Very good ( ) * Good ( ) * Bad ( )
Saturday, September 14, 2019
Concept of Dynamics in Music
Imagine you are listening to Edward Sharpe and the Magnetic Zeros close their concert with 0m Nashi Me, and the whole band stops right in the middle of the song. Or you are watching The Avett Brothers open up their concert with Paranoia In B Flat Major, and by the end of the song, they are playing nearly twice the volume they started out at, and the crowd grew right alongside them. Music has the ability to produce feelings and energy that few things are capable of reproducing.There are any different elements that bring life to these feelings, but dynamics are something that possess the power to change the mood of a song, and the person listening to It. Simply put, dynamics are ââ¬Å"variation and gradation in the volume of musical sound. â⬠(Merriam-Webster) They are what make it possible for a song to be barely audible at the beginning, and crescendo into a powerful and moving composition. They can also change suddenly and drastically, for example a, sforzando.Sudden changes I n dynamics can be notated by adding the word subito (Italian for suddenly) s a prefix or suffix to the new dynamic notation. Accented notes , which are notes to emphasize or play louder compared to surrounding notes, can be called sforzando, sforzato, forzando or forzato (abbreviated sfz or fz). There are two Italian words that are used to show gradual changes in volume, which are the opposite of accented notes. Crescendo, abbreviated cresc. , translates as ââ¬Å"gradually becoming louderâ⬠, and diminuendo, abbreviated dim.. means ââ¬Å"gradually becoming softerâ⬠.The alternate decrescendo, abbreviated to decresc. also means ââ¬Å"gradually becoming softerâ⬠. In addition to all of the volume Indications have mentioned, the execution of a given piece, for example the stylistic choices of staccato or legato are part of dynamics also. (Dynamics, music) When written in musical notation, for example in a band or orchestra piece, they are what allow for the whole band to be given very specific instructions on what the composer intended for an individual part to sound likeâ⬠making dynamics Just another word in the beautiful language that music is.Although dynamics seem to be what makes music possible, music actually existed before the Introduction of different dynamic levels. The harpsichordâ⬠which Is ââ¬Å"a keyboard instrument, precursor of the piano, in which the strings are plucked by leather or quill points connected with the keysâ⬠, (Merriam-Webster) could play only ââ¬Å"terracedâ⬠dynamics, which are either loud or soft, but not In between. (Dynamics, music)To get around this dilemma, composters would use the trick of layering chords together to create a contrast In sounds, without a single note having to be louder or ofter.The Renaissance composer Giovanni Gabrieli was one of the first composers to Indicate dynamics In music notation, and since him, It Is hard to find a song that doesnt have variations in volume writt en in. (Dynamics, music) But, music is often left open to some interpretation by the performers or director, and dynamics are no exception to this rule. Dynamic indications are relative, not absolute. Mp does not indicate an exact level of volume; it just indicates that the part marked as such t Of3 snou10 De a llttle louder tnan p ana a llttle quleter tnan mT.Ine ty to aec10e wnat would be appropriate or best contribute to the sound as a whole group is part of what makes music great. Counting Crows has a very wise song called Big Yellow Taxi that describes perfectly the idea of appreciating things more after the absence of them. The song says, ââ¬Å"Don't it always seem to go, that you don't know what you've got til its gone. â⬠(Big Yellow Taxi) I think this song applies to music Just as it applies to the seasons during the year.When you're listening to a song that is very quiet, and radually or suddenly grows loud, that makes a much larger impact on the emotion of the song than if it had Just started at the louder volume. Or, if you are listening to a song that has unexpected loud notes, that instantly makes it more interesting to listen to. This applies to the seasons, especially in Minnesota, that you think you appreciate summer weather, but after a long winter, you realize how much you had missed it and welcome it much more. Contrast and diversity are what make things beautiful in all things.Whether its music, weather, people, religion, or any other xample. There is much to be learned from diversity of appearance, beliefs, experience, sound, or qualities. Early on, composers realized the power of dynamics and many uses of them in compositions have become iconic in a sense. An example is when John Cage took a chance and composed a song in 1952 that instructed the musician to go to their instrument and be silent for 4 minutes and 33 seconds. (4â⬠² 33â⬠²)The idea was that in the absence of what the audience was expecting, they would hear all t he environmental noise around them, and appreciate everyday sounds as music.Another example of an iconic use of dynamics is in Beethoven's 5th symphony, which was written between 1804 and 1808. (Symphony No. 5 (Beethoven)). The song starts out really intense with the 4 note fgure that everybody seems to knowââ¬â regardless of their music taste. It remains intense for about a minute only to back off, then build, alternating between loud and soft and finally end with an impressive crescendo. This constant variation makes it very interesting and emotional. Another iconic example is when Count Basie and his Orchestra performed All of Me in 1965.It starts with a mooth piano and percussion line, then about a minute into the piece, almost startlingly sudden, the horns Join and instantly add life and excitement to the song. (Basie, Count) These musical geniuses, though they composed during very different stages of the development of music, all appreciated the effect dynamics could have on music. Music as definitely evolved over the years, as has the use of dynamics. There is a wide variety of musicians and bands that make dynamics a key element to their music.
Friday, September 13, 2019
Ethical Issues Essay Example | Topics and Well Written Essays - 250 words - 3
Ethical Issues - Essay Example Computers and information systems have become part of human lives and, as a result, have created an opportunity for abuse and misuse hence raising the issue of ethics (Haag & Cummings, 2013). There is an ethical issue relating to the privacy of personal information and increasing concern about storage and access to personal details (Haag & Cummings, 2013). The risk of losing individual privacy affects information system because some people are unwilling to transact online for fear of exposing personal details to unintended persons. On the other organizations are incurring a lot of expenses to protect clients details from unauthorized users. Although organizations cannot fully prevent unauthorized access clients information, they can limit the accessibility by installing security details such as data encryption and use of passwords (Haag & Cummings, 2013). In conclusion, the use of information technology and systems has both positive and negative implications in the society. Although it has improved interactions of persons across the globe, it has caused ethical issues such as loss of privacy through unauthorized access to personal details. Organizations should improve protection of personal information. However, organizations should provide their clients with training on what information they should share and how to protect their privacy against unintended
Thursday, September 12, 2019
Supreme court decisions and discussions on the exclusionary rule Research Paper
Supreme court decisions and discussions on the exclusionary rule - Research Paper Example The exclusionary rule was initiated from the Weeks v. United States 232 U.S. 383, 34 S. Ct. 341, 58 L. Ed. 652 (1914) case where a Federal agent had carried out a search without warrant in order to collect proof of gambling in Freemont Weeksââ¬â¢ residence. The evidence proved Weeks guilty but since the search was illegal or warrantless, conviction of the accused was repealed. Weeks was found guilty of fraudulent mail related activities and his house was thoroughly searched and documents seized by the Federal and local officials. Before this case the validity of evidence was judged by its truthfulness. There were two major reasons given for this law. First, it involved the deterrence rationale which specified that ââ¬Ëthe rule was necessary to deter law enforcement personnel from violating the Fourth Amendment or to ââ¬Å"police the policeâ⬠ââ¬â¢ (Hensely and Snook, 2006, p.160). The second reason concerned due process argument or the fairness rationale. This included that the federal government cannot attain convictions with the help of lawless actions. Thus any evidence collected unconstitutionally would not hold for a case even if the accused is found guilty on the basis of that evidence. The rule was formed through this case and was subject to controversies since then. The controversies found existence in Warren, Burger and Rehnquist courts. In fact Lee Epstein and Thomas Walk observe ââ¬Å"the exclusionary rule provides yet another example of Warren Courtââ¬â¢s revolutionary treatment of the rights of the criminally accusedâ⬠(Hensely and Snook, 2006, p.160). In fact in the Wolf v Colorado case the Vinson Court declined to apply this law because most of the states had not adopted the rule and there were other options to ensure sustenance of the Fourth Amendment. In the Warren Court the case of Mapp v Ohio (1961) enforced the exclusionary rule (Hensely and Snook, 2006, p.161). On the other hand individuals cannot receive Fourth Amend ment protection unless they are not able to demonstrate the reasons behind their expectation of privacy regarding the place where searches and seized are happened. According to the Supreme Court of US individuals can have a rational expectation of privacy respect to their own bodies, homes, business offices and others personal properties. Individuals can also enjoy a reliable expectation of privacy in terms of their automobiles. Generally people do not possess reasonable expectation of things like ââ¬Å"vehicle location and paint, garbage left at roadside for collection, public place, bank records and the things left open at public placeâ⬠(LII, 2010). Miranda warnings come into question with respect to the Fifth Amendment where the suspect when retained for any interrogation should be given a warning before questioning. This warning refers to the right of a criminal suspect to remain silent during interrogation and the warning must be given to him with respect to the use of a ny statement against the person which may be termed as self-incrimination during the trial. this rule can protect the suspect against any ââ¬Å"psychological ploysââ¬
Wednesday, September 11, 2019
Research Proposal Thesis, Major Points, and Plan Essay
Research Proposal Thesis, Major Points, and Plan - Essay Example Firstly, the police force is responsible for handling crimes in the specific areas under their jurisdiction. This area covers at least a number of municipalities. The police are on the ground and are sometimes engaged in violent encounters involving a minor. They have a duty to protect public from these criminals. Lawyers on the other hand have an in-depth knowledge about the laws of the country. They have the ability to analyze various situations, from different points of view and hence can provide insightful information about the rights and obligations of the minors in the country in respect to violent crimes. Lastly, the human rights organization has the mandate to ensuring that the people of this country are accorded the best treatment deserved. They hold that every person has a right to life. Additionally, they ensure that the culprit (minors or adults) receive a fair trial. For a comprehensive and in-depth of the study, the study would cover several sections that are deemed crucial in gathering persuasive information. The major sections are outlined in the research plan below. The research objectives would be to answer a number of questions identified for this particular research study. The questions formulated aims at gathering information that address the objectives of the study. The questions are designed in a way that they address how the independent variables influence the dependent variables of the topic under study. The questions include: The research would be carried out by collection of primary data from the identified respondents. This activity will make use of personal interviews involving the selected respondents in the sample. The secondary data would be collected through review of literature. These materials are available in the library. The analysis of the collected data would make use of both qualitative and quantitative
Tuesday, September 10, 2019
Supercomputing Exaflop Target Assignment Example | Topics and Well Written Essays - 1000 words
Supercomputing Exaflop Target - Assignment Example Data delivery and correction of errors might reduce the speed of the application despite the superb programming. The GPUs has allows enormous calculations of numbers in parallel as they constitute more cores as compared to the CPUs and current is applied to various data-intensive calculations. The GPUs was originally for tasks that are of graphics such as rendering every pixel in an image. This is because the graphics problem resembles the supercomputing problems (Geller, 16). In the modern world of supercomputing, the GPUs relies on the CPUs for other tasks despite being able to provide the highest calculation power. The speed is not a matter of throwing more cores in the given mix given that it is not easy to avail all the power used in the processing. The data ought to be managed for their proper intake and managing of the outcome. For the data to move appropriately between the CPUs and GPUs and attainment of better performance, the problem has to fit in the GPUs itself. Before th e benefit is attained the speed of the moving data and that of computing are so mismatched and therefore the GPU has to undertake a number of computations (Geller, 16). The Asian researchers are well positioned to the GPUs more parallel supercomputing that is massive. It is believed that economics that favors such innovations may be brought about by Chinaââ¬â¢s isolation from the western influences. This is because of the vendors from the US who holds different perceptions. Whereas the potential bang for the buck is in Asia, if an application works effectively on this kind of accelerator technology, it might turn out to be very cost effective. Chinaââ¬â¢s recent entry into HPC may be of help in this regard. In contrast, it is argued that programmers in more experienced nations may have to undergo re-education (Geller, 16). Historically Hybrid architectures have had an upper hand over the parallelism. They have used less energy than comparable CPU-only systems. The new Top500 l ist showed that the architectural battle over energy efficiency is on. The U.S.ââ¬â¢s CPU-based IBM Blue Gene/Q Prototype supercomputer is the most energy-efficient system with the efficiency of 1,680 Mflops/watt. The K Computer consumes enough energy to power nearly 10,000 homes and costs $10 million a year to operate. These costs would significantly increase in an exaflop world. Major changes in the hardware will require major changes in the algorithms and software. Supercomputing is already widely used in fields as diverse as weather modeling, financial predictions, animation, fluid dynamics, and data searches. Each of these fields embodies several applications. While exaflop computers will spawn now-unimagined uses, any current increases in speed as we race toward that goal will greatly benefit many existing applications (Geller, 16).
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